Rethinking counterfeit medical supply chains: A critical review of the current literature.

The medical device and pharmaceutical industries include a range of drugs, machines, instruments, and apparatuses used to prevent, diagnose, treat disease and illness, or aid in rehabilitation for patients, and are expected to grow substantially in the coming years. However, they are often targets of criminal organizations who manufacture and profit from fraudulent products, infiltrating the market with counterfeit medical supply chains. In this paper, we discuss and analyze the extent and nature of this problem and make suggestions for mitigation and prevention of this worldwide challenge. Ultimately, we argue that a holistic approach is essential to addressing this problem, including the creation and dissemination of reliable and good quality data, developing healthcare systems to be more robust, establishing/enhancing intra- and international cooperation around this issue, and employing effective technological solutions, such as digital tracing.

High economic inequality is linked to greater moralization.

Throughout the 21st century, economic inequality is predicted to increase as we face new challenges, from changes in the technological landscape to the growing climate crisis. It is crucial we understand how these changes in inequality may affect how people think and behave. We propose that economic inequality threatens the social fabric of society, in turn increasing moralization-that is, the greater tendency to employ or emphasize morality in everyday life-as an attempt to restore order and control. Using longitudinal data from X, formerly known as Twitter, our first study demonstrates that high economic inequality is associated with greater use of moral language online (e.g. the use of words such as "disgust", "hurt", and "respect'). Study 2 then examined data from 41 regions around the world, generally showing that higher inequality has a small association with harsher moral judgments of people's everyday actions. Together these findings demonstrate that economic inequality is linked to the tendency to see the world through a moral lens.

Analyzing the dynamic effect of energy endowment-demand distortion on sustainable development: Insights from China's regional disparity.

The distribution of China's energy resources is concentrated in the central and western regions, whereas the energy demand is predominantly centered in the eastern regions. Under the ambitious "carbon neutrality" goal, how to effectively quantify and respond to the impact of this energy "endowment-demand" distortion (EEDD) on economy and environment has become a key issue. We introduce an EEDD index that quantifies the distortion characteristics of China's energy endowment and demand. Based on the EEDD index, a panel vector auto regression-generalized method of moments (PVAR-GMM) model is adopted to assess the interactive effects between regional EEDD and sustainable development variables. The obtained results indicate that the energy endowment-demand distortions are progressively worsening across most provinces. Interestingly, we discover that the EEDD has significant beneficial effects on regional sustainable development. Moreover, the EEDD is found to be significantly influenced by the sustainability-related variables. These impacts between EEDD and sustainable development variables demonstrate significant regional heterogeneity. This study provides crucial empirical evidence for advancing the comprehensive and sustainable development of regional energy, environment, and economy.

Unequal by malice, protesters by outrage: Agent perceptions drive moralization of, and collective action against, inequality.

Economic inequality does not encounter strong protests even though individuals are generally against it. One potential explanation of this paradox is that individuals do not perceive inequality as caused by intentional agents, which, in line with the Theory of Dyadic Morality (Schein & Gray, 2018), should prevent its assessment as immoral and consequently dampen moral outrage and collective action. Across three studies, we test and confirm this hypothesis. In Studies 1 (N = 395) and 2 (N = 337), the more participants believed that inequality is human driven and caused by intentional agents, the more they moralized inequality, felt outraged and wanted to engage in collective action. This was confirmed in Study 3 (N = 243) through an experimental design. Thus, our research shows that agent perception is crucial in the moralization of economic inequality and, more broadly, that morality can be a powerful motivator and effectively mobilize people to action.

Beliefs about social mobility in young American children.

Although actual experiences of upward social mobility are historically low, many adolescents and adults express a belief in social mobility (e.g., that social status can change). Although a belief in upward mobility (e.g., that status can improve) can be helpful for economically disadvantaged adolescents and adults, a belief in upward social mobility in adults is also associated with greater acceptance of societal inequality. While this belief might have similar benefits or consequences in children, no previous work has examined whether children are even capable of reasoning about social mobility. This is surprising, given that elementary-aged children exhibit sophisticated reasoning about both social status, as well as about the fixedness or malleability of properties and group membership. Across an economically advantaged group of 5- to 12-year-old American children (N = 151, Mage = 8.91, 63% racial majority, 25% racially marginalized; Mhousehold income = $133,064), we found evidence that children can reason about social mobility for their own families and for others. Similar to research in adults, children believe that others are more likely to experience upward than downward mobility. However, in contrast to adult's typical beliefs-but in line with economic realities-between 7- and 9-years-old, children become less likely to expect upward mobility for economically disadvantaged, versus advantaged, families. In sum, children are capable of reasoning about social mobility in nuanced ways; future work should explore the implications of these beliefs. RESEARCH HIGHLIGHTS: Despite harsh economic realities, a belief in upward social mobility and the American Dream is alive and well. Between 7 and 9 years of age, economically advantaged, American children begin to expect economically disadvantaged families to experience less upward mobility than economically advantaged families. Children's beliefs about social mobility better accord with reality than adults' do.

Demographic and economic inequality of antenatal care coverage in 4 African countries with a high maternal mortality rate.

BACKGROUND: Maternal deaths are concentrated in low and middle-income countries, and Africa accounts for over 50% of the deaths. Women from socioeconomically disadvantaged households have higher morbidity and mortality rates and lower access to maternal health services. Understanding and addressing these inequalities is crucial for achieving the Sustainable Development Goals and improving maternal health outcomes. This study examines the demographic and economic disparities in the utilization of antenatal care (ANC) in four countries with high maternal mortality rates in Africa, namely Nigeria, Chad, Liberia, and Sierra Leone. METHOD: The study utilised data from Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) from Nigeria, Chad, Liberia, and Sierra Leone. The data was obtained from the Health Equity Assessment Toolkit (HEAT) database. The study examined ANC service utilisation inequality in four dimensions such as economic status, education, place of residence, and subnational region across different subgroups by using four summary measures (Difference (D), Absolute Concentration Index (ACI), Population Attributable Risk (PAR), and Population Attributable Factor (PAF)). RESULT: A varying level of inequality in ANC coverage across multiple survey years was observed in Nigeria, Chad, Liberia, and Sierra Leone. Different regions and countries exhibit varying levels of inequality. Disparities were prominent based on educational attainment and place of residence. Higher level of inequality was generally observed among individuals with higher education and those residing in urban areas. Inequality in ANC coverage was also observed by economic status, subnational region, and other factors in Nigeria, Chad, Liberia, and Sierra Leone. ANC coverage is generally higher among the richest quintile subgroup, indicating inequality. Nigeria and Chad show the highest levels of inequality in ANC coverage across multiple measures. Sierra Leone displays some variation with higher coverage among the poorest quintile subgroup. CONCLUSION AND RECOMMENDATION: Inequalities in ANC coverage exist across age groups and survey years in Nigeria, Chad, Liberia, and Sierra Leone. Disparities are prominent based on education, residence, and economic status. Efforts should focus on improving access for vulnerable groups, enhancing education and awareness, strengthening healthcare infrastructure, and addressing economic disparities.

Why do people always want more? Perceived economic inequality leads people to be greedy by enhancing relative deprivation.

Greedy phenomena have dramatically increased in societies. However, despite the universality of greedy behaviour, empirical research on the causes of greed is scarce. In this context, we propose that perceived economic inequality may be an important factor influencing greed. Study 1 provided primary evidence of a positive relationship between perceived economic inequality and greed, based on data from a large-scale social survey (CFPS 2018, N = 14,317). Employing well-established questionnaires, Study 2A (N = 200) and Study 2B (N = 399) revealed that perceived economic inequality positively predicts greed, with relative deprivation playing a mediating role. Study 3A (N = 200) and Study 3B (N = 200) manipulated perceived economic inequality to provide causal evidence of its effects on greed and to replicate the mediating effect of relative deprivation. Finally, Study 4 (N = 372), using a blockage manipulation design, showed that the effect of perceived economic inequality on greed significantly decreases when relative deprivation is suppressed. In summary, the results of these six studies consistently suggest that perceived economic inequality positively affects greed and that this effect is mediated by relative deprivation.

Economic Inequality Reduces Preferences for Competent Leaders.

It is well-documented that economic inequality can harm political stability and social cohesion. In six experiments (total N = 1,907) conducted in China and the United Kingdom, we tested our primary hypothesis that high (vs. low) economic inequality leads to voters' reduced preferences for competent political leaders. Across studies, this prediction was consistently supported by experimental evidence, regardless of the voter's social status. We also found that high (vs. low) economic inequality indirectly diminished preferences for competent political leaders through heightened perceptions that politicians were less inclined to care about the populace in a highly (vs. lowly) unequal societal context. In essence, our findings underscore the idea that economic inequality curtails voters' preferences for competent political leaders by amplifying their concerns about politicians' indifference to the populace. It also stresses the need for policies and practices to address economic inequality and maintain the vitality of democracy.

Subjective economic inequality evokes interpersonal objectification.

Interpersonal objectification, treating people as tools and neglecting their essential humanness, is a pervasive and enduring phenomenon. Across five studies (N = 1183), we examined whether subjective economic inequality increases objectification through a calculative mindset. Study 1 revealed that the perceptions of economic inequality at the national level and in daily life were positively associated with objectification. Studies 2 and 3 demonstrated a causal relationship between subjective economic inequality and objectification in a fictitious organization and society, respectively. Moreover, the effect was mediated by a calculative mindset (Studies 3-4). In addition, lowering a calculative mindset weakened the effect of subjective inequality on objectification (Study 4). Finally, increased objectification due to subjective inequality further decreased prosociality and enhanced exploitative intentions (Study 5). Taken together, our findings suggest that subjective economic inequality increases objectification, which further causes adverse interpersonal interactions.

Investigating How High Perceived Economic Inequality Exacerbates Intergroup Competition, Zero-Sum Beliefs, and Perceived Intergroup Prejudice.

Rising economic inequality is associated with more prejudice. Little empirical data, however, investigate how inequality affects individuals' psychological processing and, in turn, exacerbates perceptions of prejudice in people's geographic area. We hypothesized that higher perceived economic inequality triggers beliefs that unequal economies are zero-sum and leads to beliefs that people are in competition for limited resources, which may ultimately exacerbate perceived prejudice. Through nine experiments (Studies 1-5 in the manuscript and three additional studies in the Supplement), we provide evidence that higher perceived inequality increases perceived prejudice against a wide range of outgroups. Furthermore, zero-sum beliefs and perceived competition serially mediate this relationship (Studies 2 and 3). In Study 4, we investigate nuance in this hypothesized model by testing whether higher perceived economic inequality exacerbates perceived racial/ethnic prejudice among a large, diverse sample and find a similar pattern of results. Finally (Study 5), we demonstrate that assuaging competition beliefs mitigates perceived prejudice.

Unexpected PM2.5-related emissions and accompanying environmental-economic inequalities driven by "clean" tertiary industry in China.

The tertiary industry, led by service sectors, usually have "clean" production processes and thus is ignored by current PM2.5 pollution mitigation strategies in China. Actually, the tertiary industry heavily relies on the supplies from its upstream industries, resulting in pollutant emissions and economic benefits transferring among different regions. With the application of the multiregional input-output (MRIO) model, our study explores the emission contribution from the tertiary industry's consumption activities in China and analyses the accompanying emission-economy relationship. We find that the production process of tertiary industry (with the sector Transportation excluded) contributes only ∼1 % of China's PM2.5-related emissions in 2017. However, its consumption-based emission contributions could increase to 11 %-17 %, among which >95 % are indirectly contributed. More than 40 % of tertiary industry consumption-based emissions, accompanied by 25 % of the consumption-based value added, are transferred via interprovincial trade. The proportion of transferred emissions even exceeds 50 % for the top 10 importers. The spatial pattern of value-added flows is nearly opposite to that of emission flows. Our results also reveal that among the 30 provinces and 870 interprovincial trading pairs, 6 provinces are experiencing environmental-economic win, 7 provinces are experiencing environmental-economic loss, and in detail 326 trading pairs are experiencing environmental-economic win or loss. To reduce the unexpected emissions and inequalities embodied in seemingly "clean" industries, consumption activities should be considered and strengthened in China's new-stage environmental policies.

Measuring Subjective Inequality: Development and Validation of the Perceived Economic Inequality Scale (PEIS).

The main goal of the present research is to develop and validate the Perceived Economic Inequality Scale (PEIS), an instrument measuring individuals' perceptions of economic inequality at the national level. The study was conducted on a representative sample of the Italian population (N = 1,446, 51% women). The factorial structure of the scale was assessed through cross-validated exploratory-confirmatory factor analyses. To inspect the PEIS psychometric properties, item and correlation analyses were performed. The results showed that the PEIS is a valid and reliable unidimensional measure of perceived economic inequality at the national level. Further support of the PEIS construct validity was provided by the correlation of the scale score with the perceived wage gap and ideological beliefs like the economic system justification, social dominance orientation, meritocratic beliefs, and participants' political orientation. Crucially, multigroup confirmatory factor analysis supported configural, metric, and scalar invariances of the scale across socio-demographic groups. The PEIS allows researchers to assess the subjective component of economic inequality by also serving as a useful tool for unpacking the psychological correlates of perceived inequality.

Measuring Subjective Inequality: Development and Validation of the Perceived Economic Inequality Scale (PEIS)

The main goal of the present research is to develop and validate the Perceived Economic Inequality Scale (PEIS), an instrument measuring individuals’ perceptions of economic inequality at the national level. The study was conducted on a representative sample of the Italian population (N = 1,446, 51% women). The factorial structure of the scale was assessed through cross-validated exploratory-confirmatory factor analyses. To inspect the PEIS psychometric properties, item and correlation analyses were performed. The results showed that the PEIS is a valid and reliable unidimensional measure of perceived economic inequality at the national level. Further support of the PEIS construct validity was provided by the correlation of the scale score with the perceived wage gap and ideological beliefs like the economic system justification, social dominance orientation, meritocratic beliefs, and participants’ political orientation. Crucially, multigroup confirmatory factor analysis supported configural, metric, and scalar invariances of the scale across socio-demographic groups. The PEIS allows researchers to assess the subjective component of economic inequality by also serving as a useful tool for unpacking the psychological correlates of perceived inequality. (AU)

Individual values predict desiring more economic inequality: The moderator role of social mobility.

Attitudes towards economic inequality are crucial to uphold structural economic inequality in democratic societies. Previous research has shown that socioeconomic status, political ideology, and the objective level of economic inequality associated with individuals' attitudes towards economic inequality. However, some have suggested that people are aware of the individual and social features that are more functional according to the level of economic inequality. Therefore, individual predispositions such as cultural values could also predict these attitudes. In the current research, we expand previous results testing whether cultural variables at the individual level predict attitudes towards economic inequality. After analysing survey data including samples from 52 countries (N = 89,565), we found that self-enhancement values predict positively, and self-transcendence negatively, attitudes towards economic inequality as the ideal economic inequality measures. This result remained significant even after controlling by socioeconomic status, political ideology, and objective economic inequality. However, this effect is only true in high and middle social mobility countries, but not in countries with low social mobility. The present research highlights how cultural values and country social mobility are crucial factors to addressing attitudes towards economic inequality.

Longitudinal Changes in Chinese Prosociality.

This article presents three studies using data from the World Values Survey, 128 published studies, and China Family Panel Studies to comprehensively examine the longitudinal dynamics of Chinese prosociality, encompassing prosocial attitudes, tendencies, and behaviors, with the overarching goal of shedding light on the evolving nature of prosociality in the Chinese context. These studies reveal a consistent pattern, illustrating a decline followed by a resurgence in all three aspects, with a nadir around 2014. In addition, the study investigates the intricate relationship between economic inequality, prosocial behavior, and prosocial attitudes. The findings suggest that while economic inequality significantly relates to prosocial behavior, it does not entirely explain its fluctuations. Prosocial attitudes partially mediate the connection between economic inequality and prosocial behavior. These insights suggest that addressing inequality could contribute to a more conducive social environment for societal-level prosociality. However, further research is imperative to explore additional determinants of prosociality shifts.

Subjective economic inequality is associated with lower well-being through more upward comparison and lower trust.

Individuals often misconstrue the actual degree of economic inequality, which might account for the ambiguity in the literature about the role that inequality plays in well-being. Instead of focusing on objective inequality, we propose a subjective inequality approach by investigating the long-term association between subjective economic inequality and well-being (N = 613). We found that subjective inequality predicted lower life satisfaction and higher depression one year later, which were accounted for by more upward socioeconomic comparison and lower trust. Furthermore, the negative association between subjective inequality and well-being remained constant, regardless of individuals' objective socioeconomic status (SES), subjective SES, and mindset of SES. The long-term association between subjective inequality and well-being remained robust after controlling for prior levels of well-being and multiple covariates. Our findings revealed that subjective inequality is detrimental to well-being and opens a new window into psychological research on economic inequality.

Why do we never have enough time? Economic inequality fuels the perception of time poverty by aggravating status anxiety.

People in many societies report that they do not have enough time. What makes people feel so rushed? We propose that economic inequality leads to perceived time poverty by increasing status anxiety. Five studies examined this line of reasoning. Study 1 (N = 230) found a positive correlation between economic inequality and perceived time poverty. Study 2 (N = 194) manipulated economic inequality to test the causal link between economic inequality and perceived time poverty. The results showed that people perceived more time poverty in the high (vs. low) economic inequality condition. Study 3 (N = 381) supported the mediating role of status anxiety in the relationship between economic inequality and perceived time poverty using a questionnaire survey. Study 4 (pre-registered; N = 283) manipulated economic inequality in an ecological valid way and yielded further support for the hypotheses. In pre-registered Study 5 (N = 233), a blockage manipulation design was employed to test the mediating effect of status anxiety as a function of economic inequality, which provided causal evidence for the proposed mediator. Our findings suggest that economic inequality serves as a structural societal factor that fuels people's perception of time poverty.

How does economic inequality shape conspiracy theories? Empirical evidence from China.

Conspiracy theories tend to be prevalent, particularly in societies with high economic inequality. However, few studies have examined the relationship between economic inequality and belief in conspiracy theories. We propose that economic inequality leads people to believe conspiracy theories about economically advantaged groups (i.e., upwards conspiracy theories) and that moral evaluations of those groups mediate this relationship. Study 1 (N = 300) found support for these ideas in a survey among Chinese residents. Study 2 (N = 160) manipulated participants' perceptions of economic inequality in a virtual society. The manipulation shaped moral evaluations of economically advantaged groups, and conspiracy beliefs, in the predicted manner. In Study 3 (N = 191) and Study 4 (N = 210), we experimentally manipulated participants' perceptions of economic inequality in real Chinese society and replicated the results of Study 2. In addition, in Study 4, we find that economic inequality predicts belief in conspiracy theories about economically disadvantaged groups (i.e., downward conspiracy theories), which was mediated by anomie. We conclude that perceived economic inequality predicts conspiracy theories about economically advantaged groups and that moral evaluations account for this effect. Also, upward and downward conspiracy theory beliefs are associated with different psychological processes.

Effect of economic inequality on generosity: A social norm perspective.

Economic inequality has been found to reduce individuals' generosity in western contexts. However, whether this effect is cross-culturally consistent and its internal mechanism remain unclear, as well as how to mitigate this impact. Hence, we explored whether and why economic inequality may erode generosity in a sample of Chinese adults from the social norm perspective and introduced the equal allocation norm to mitigate this effect. Four online studies were conducted: two were correlational (Study 1: n = 300; Study 2: n = 568) and two were experimental (Study 3: n = 289; Study 4: n = 500). Results showed that economic inequality predicted less generosity in the dictator game, and perceived unequal allocation norm accounted for this effect. Moreover, introducing the equal allocation norm could buffer this negative effect. Findings suggest economic inequality impairs generosity, and making the equal allocation norm more salient may guide people to act more generously.

Concerns About Inequality in Health, Education and Income Jointly Predict Collective Actions

Introduction: Income inequality is often tolerated and justified, but when it brings about disparities in other domains of life (e.g., health or education), it may be seen with different eyes. In this research, we aimed to explore concerns regarding economic inequality in health, education, and income, and its relationship to supporting collective actions to reduce inequality. Method: We used survey data (N = 20,204, 18 countries) from the Latinobarometer 2020. We conducted descriptive analyses, latent class analyses, and analyses of multilevel linear regression to test our hypothesis. Results: We found that people were more concerned about health access and education opportunities than income inequality. We also identified two classes of people: one class concerned about education and health and the other unconcerned about inequality in any domain. In addition, results showed that all concerns and class membership predicted greater support of collective actions to reduce inequality. Conclusions: These preliminary findings suggest that concerns about education and health disparities may serve to increase awareness of overall inequality and mobilise the public.

Introducción: La desigualdad de ingresos a menudo se tolera y justifica, pero cuando esta conlleva desigualdades en otros ámbitos de la vida (e.g., salud o educación), puede que se vea con ojos diferentes. En este artículo tratamos de explorar la preocupación por la desigualdad económica en salud, educación e ingresos, así como su relación con el apoyo a acciones colectivas para reducir la desigualdad. Método: Usamos datos secundarios (N = 20 204, 18 países) del Latinobarómetro 2020. Llevamos a cabo análisis descriptivos, análisis de clases latentes y análisis de regresión multinivel. Resultados: Encontramos que la gente estaba más preocupada por el acceso a la salud y las oportunidades en educación que por la desigualdad en el ingreso. También identificamos dos perfiles de personas: unas preocupadas por la educación y la salud, y otras poco preocupadas por la desigualdad en ninguno de los ámbitos. Además, los resultados mostraron que todas las preocupaciones y los distintos perfiles predecían un mayor apoyo a las acciones colectivas para reducir la desigualdad. Conclusiones: Estos hallazgos preliminares sugieren que la preocupación por las desigualdades en salud y educación podrían servir para aumentar la conciencia sobre la desigualdad general y movilizar al público.