Reducing inequalities in preconception health and care is critical to improving the health and life chances of current and future generations. A hybrid workshop was held at the 2023 UK Preconception Early and Mid-Career Researchers (EMCR) Network conference to co-develop recommendations on ways to address inequalities in preconception health and care. The workshop engaged multi-disciplinary professionals across diverse career stages and people with lived experience (total n = 69). Interactive discussions explored barriers to achieving optimal preconception health, driving influences of inequalities and recommendations. The Socio-Ecological Model framed the identified themes, with recommendations structured at interpersonal (e.g. community engagement), institutional (e.g. integration of preconception care within existing services) and environmental/societal levels (e.g. education in schools). The co-developed recommendations provide a framework for addressing inequalities in preconception health, emphasising the importance of a whole-systems approach. Further research and evidence-based interventions are now needed to advance the advocacy and implementation of our recommendations.

The aim of this study was to explore the associations between diet quality, socio-demographic measures, smoking, and weight status in a large, cross-sectional cohort of adults living in Yorkshire and Humber, UK. Data from 43, 023 participants aged over 16 years in the Yorkshire Health Survey, 2nd wave (2013–2015) were collected on diet quality, socio-demographic measures, smoking, and weight status. Diet quality was assessed using a brief, validated tool. Associations between these variables were assessed using multiple regression methods. Split-sample cross-validation was utilised to establish model portability. Observed patterns in the sample showed that the greatest substantive differences in diet quality were between females and males (3.94 points; P < 0.001) and non-smokers vs smokers (4.24 points; P < 0.001), with higher diet quality scores observed in females and non-smokers. Deprivation, employment status, age, and weight status categories were also associated with diet quality. Greater diet quality scores were observed in those with lower levels of deprivation, those engaged in sedentary occupations, older people, and those in a healthy weight category. Cross-validation procedures revealed that the model exhibited good transferability properties. Inequalities in patterns of diet quality in the cohort were consistent with those indicated by the findings of other observational studies. The findings indicate population subgroups that are at higher risk of dietary-related ill health due to poor quality diet and provide evidence for the design of targeted national policy and interventions to prevent dietary-related ill health in these groups. The findings support further research exploring inequalities in diet quality in the population.

The role of housing in providing a welfare asset has been widely explored. With the growth in home ownership between 1979 and 2008 and erosion of the welfare state, housing wealth has become part of the welfare mix in the UK. Here, we present analysis of housing outcomes, as measured in the UK Household Longitudinal Survey (UKHLS), among people who identify as lesbian, gay, or bisexual in Great Britain. This shows that lesbian, gay, and bisexual (LGB) people have poorer housing outcomes than heterosexual counterparts: they are less likely to be homeowners; more likely to be private renters; and more likely to be social renters. With growing intergenerational inequalities in access to home ownership, we argue that, as openly LGB (and broader trans and queer) people being on average younger than the rest of the population, this could lead to LGB people, as a group, being excluded from asset-based welfare in the future as they age.

The aim of the study was to analyze gender differences in life expectancy free of depressive symptoms among the adult population in Chile between 2003 and 2016. The Sullivan method was used to estimate the total and marginal life expectancy, based on prevalence data from the National Health Survey (2003, 2010 and 2016), and abridged life tables for the Chilean population. There was a compression of morbidity among middle-aged men during the first period and among younger and older women during the last one. Men at all ages could expect to live a higher proportion of their lives without depressive symptoms during the whole period. The gender gap in the proportion of life expectancy free of depressive symptoms reached 10 percent points or more, considering almost all ages and periods. Unemployment and lower education increased the probability of depressive symptoms, and these effects were more marked among women. Public policies should have a gender-sensitive approach to address the gap in depression and the disadvantage experienced by women in life expectancy free of depressive symptoms, considering those dimensions that intersect with gender, such as access to education, employment or income.

In Latin America, Colombia stands out for its more significant and persistent rural–urban educational performance gaps. This paper studies the evolution of this under-performance of Colombian rural areas by conducting a long-term descriptive analysis of a new dataset. The results suggest that the role of the national government is a source of these educational inequalities because rural education was introduced late and deficiently. That is, the national government delayed the provision of education to rural areas. Moreover, even when implemented, these rural educational initiatives proved deficient due to their lack of funds, lower quality, curricula detached from the rural context and a design that amplified regional disparities, thus producing and maintaining significant and persistent rural–urban gaps in education.

How can we better situate resource inequities between schools in the longer history of racial oppression and discrimination in the United States? This article provides both a historiographical panorama of the field on a range of topics related to school finance and a roadmap of archival and research paths. It seeks to sketch out the contours of a burgeoning field to show that historians of school finance have the potential to make racial dispossession a central tenet of their analyses. First, I lay out a longer timeline for the periodization of school finance history than most of the previous scholarship has adopted to recast school funding inequality within the racialized context of land and capital dispossession. Second, I situate school finance more explicitly in US political history, showing how the study of school funding policies can illuminate major historiographical debates such as the history of tax revolts, federalism, local governance, and the development of US capitalism. Finally, I chart some of the directions historians can follow to study a wider array of school finance policies beyond the surface of state school funding formulae to make the role of policymakers at all levels of education policy more visible, and to further ground school finance developments in their racial contexts.

Whole-genome sequencing (WGS) information has played a crucial role in the SARS-CoV-2 (COVID-19) pandemic by providing evidence about variants to inform public health policy. The purpose of this study was to assess the representativeness of sequenced cases compared with all COVID-19 cases in England, between March 2020 and August 2021, by demographic and socio-economic characteristics, to evaluate the representativeness and utility of these data in epidemiological analyses. To achieve this, polymerase chain reaction (PCR)-confirmed COVID-19 cases were extracted from the national laboratory system and linked with WGS data. During the study period, over 10% of COVID-19 cases in England had WGS data available for epidemiological analysis. With sequencing capacity increasing throughout the period, sequencing representativeness compared to all reported COVID-19 cases increased over time, allowing for valuable epidemiological analyses using demographic and socio-economic characteristics, particularly during periods with emerging novel SARS-CoV-2 variants. This study demonstrates the comprehensiveness of England’s sequencing throughout the COVID-19 pandemic, rapidly detecting variants of concern, and enabling representative epidemiological analyses to inform policy.

An ageing population increases pressure on health and social care, welfare payments and pensions in public funded systems. There is no simple measure linking population health to economic disadvantage or the resulting tax burden. We imagine a situation in which local areas are responsible for financing their own public services. We hypothesize a local tax is levied to cover healthcare costs, welfare benefits for those who are sick, and pensions. We partition the costs based on years spent in ill health, disability and pensionable years over the life course using the average costs per person per year for each. We argue that area differences in tax rates provide a summary measure of inequality since a higher tax burden would fall on areas least able to afford it. We show that a one year improvement in healthy life expectancy would add 4.5 months to life expectancy (LE) and 3.4 months to working lives whilst reducing taxes by around 0.5%. We cast doubt on the target to increase health expectancy by five years by 2035; however, were it to be achieved it would add 23 months to LE, 17 months to work expectancy and reduce taxes by 2.4%.