PubMed · 10063694
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D Guris, P Strebel, M Wharton. 1998. Pertussis.. https://pubmed.ncbi.nlm.nih.gov/10063694/
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In the Netherlands, the influenza epidemic of the 2004/'05 season started late. The background value of 3 cases of an influenza-like illness per 10,000 inhabitants per week was exceeded from week 1 until week 14 of 2005. The magnitude of the epidemic was the largest of the last 5 years, namely 104 per 10,000 inhabitants. As usual, the epidemic was caused mainly by influenza-A viruses of subtype H3N2 and to a lesser degree by A/H1N1 and B viruses. The H3N2-virus isolates belonged to the newly emerged variant A/California/7/04, which deviated slightly from the vaccine strain used for the 2004/'05 season. The influenza-B and H1N1 viruses matched the corresponding vaccine viruses well. For the 2005/'06 season, the World Health Organization has recommended the following vaccine composition: A/California/7/04 (H3N2), A/New Caledonia/20/99 (HiNI), and B/Shanghai/361/02.
Whether or not the scale of a society's income inequality is a determinant of population health is still regarded as a controversial issue. We decided to review the evidence and see if we could find a consistent interpretation of both the positive and negative findings. We identified 168 analyses in 155 papers reporting research findings on the association between income distribution and population health, and classified them according to how far their findings supported the hypothesis that greater income differences are associated with lower standards of population health. Analyses in which all adjusted associations between greater income equality and higher standards of population health were statistically significant and positive were classified as "wholly supportive"; if none were significant and positive they were classified as "unsupportive"; and if some but not all were significant and supportive they were classified as "partially supportive". Of those classified as either wholly supportive or unsupportive, a large majority (70 per cent) suggest that health is less good in societies where income differences are bigger. There were substantial differences in the proportion of supportive findings according to whether inequality was measured in large or small areas. We suggest that the studies of income inequality are more supportive in large areas because in that context income inequality serves as a measure of the scale of social stratification, or how hierarchical a society is. We suggest three explanations for the unsupportive findings reported by a minority of studies. First, many studies measured inequality in areas too small to reflect the scale of social class differences in a society; second, a number of studies controlled for factors which, rather than being genuine confounders, are likely either to mediate between class and health or to be other reflections of the scale of social stratification; and third, the international relationship was temporarily lost (in all but the youngest age groups) during the decade from the mid-1980s when income differences were widening particularly rapidly in a number of countries. We finish by discussing possible objections to our interpretation of the findings.