The relationship of area-level sociodemographic characteristics, household composition and individual-level socioeconomic status on walking behavior among adults.

PubMed

Hearst, Mary O; Sirard, John R; Forsyth, Ann; Parker, Emily D; Klein, Elizabeth G; Green, Christine G; Lytle, Leslie A

2013-04-01

Understanding the contextual factors associated with why adults walk is important for those interested in increasing walking as a mode of transportation and leisure. This paper investigates the relationships between neighborhood-level sociodemographic context, individual level sociodemographic characteristics and walking for leisure and transport. Data from two community-based studies of adults (n=550) were used to determine the association between the area-sociodemographic environment (ASDE), calculated from U.S. Census variables, and individual-level SES as potential correlates of walking behavior. Descriptive statistics, mean comparisons and Pearson's correlations coefficients were used to assess bivariate relationships. Generalized estimating equations were used to model the relationship between ASDE, as quartiles, and walking behavior. Adjusted models suggest adults engage in more minutes of walking for transportation and less walking for leisure in the most disadvantaged compared to the least disadvantaged neighborhoods but adding individual level demographics and SES eliminated the significant results. However, when models were stratified for free or reduced cost lunch, of those with children who qualified for free or reduced lunch, those who lived in the wealthiest neighborhoods engaged in 10.7 minutes less of total walking per day compared to those living in the most challenged neighborhoods (p<0.001). Strategies to increase walking for transportation or leisure need to take account of individual level socioeconomic factors in addition to area-level measures.

Socio-economic benefits from protected areas in southeastern Australia.

PubMed

Heagney, E C; Kovac, M; Fountain, J; Conner, N

2015-12-01

International case studies of protected area performance increasingly report that conservation and socio-economic outcomes are interdependent. Effective conservation requires support and cooperation from local governments and communities, which in turn requires that protected areas contribute to the economic well-being of the communities in which they are sited. Despite increasing recognition of their importance, robust studies that document the socio-economic impacts of protected areas are rare, especially in the developed world context. We proposed 3 potential pathways through which protected areas might benefit local communities in the developed world: the improved local housing value, local business stimulus, and increased local funding pathways. We examined these pathways by undertaking a statistical longitudinal analysis of 110 regional and rural communities covering an area of approximately 600,000 km(2) in southeastern Australia. We compared trends in 10 socio-economic indicators describing employment, income, housing, business development and local government revenue from 2000 to 2010. New protected areas acquisitions led to an increased number of new dwelling approvals and associated developer contributions, increased local business numbers, and increased local government revenue from user-pays services and grants. Longer-term effects of established protected areas included increased local council revenue from a variety of sources. Our findings provide support for each of our 3 proposed benefit pathways and contribute new insights into the cycling of benefits from protected areas through the economy over time. The business and legislative models in our study are typical of those operating in many other developed countries; thus, the benefit pathways reported in our study are likely to be generalizable. By identifying and communicating socio-economic benefits from terrestrial protected areas in a developed world context, our findings represent an important

How do area-level socioeconomic status and gender norms affect partner violence against women? Evidence from Tanzania.

PubMed

Vyas, Seema; Heise, Lori

2016-11-01

To explore how area-level socioeconomic status and gender-related norms influence partner violence against women in Tanzania. We analysed data from the 2010 Tanzania Demographic and Health Survey and used multilevel logistic regression to estimate individual and community-level effects on women's risk of current partner violence. Prevalence of current partner violence was 36.1 %; however, variation in prevalence exists across communities. Twenty-nine percent of the variation in the logodds of partner violence is due to community-level influences. When adjusting for individual-level characteristics, this variation falls to 10 % and falls further to 8 % when adjusting for additional community-level factors. Higher levels of women's acceptance towards wife beating, male unemployment, and years of schooling among men were associated with higher risk of partner violence; however, higher levels of women in paid work were associated with lower risk. Area-level poverty and inequitable gender norms were associated with higher risk of partner violence. Empowerment strategies along with addressing social attitudes are likely to achieve reductions in rates of partner violence against women in Tanzania and in other similar low-income country settings.

Estimating an area-level socioeconomic status index and its association with colonoscopy screening adherence.

PubMed

Wheeler, David C; Czarnota, Jenna; Jones, Resa M

2017-01-01

Socioeconomic status (SES) is often considered a risk factor for health outcomes. SES is typically measured using individual variables of educational attainment, income, housing, and employment variables or a composite of these variables. Approaches to building the composite variable include using equal weights for each variable or estimating the weights with principal components analysis or factor analysis. However, these methods do not consider the relationship between the outcome and the SES variables when constructing the index. In this project, we used weighted quantile sum (WQS) regression to estimate an area-level SES index and its effect in a model of colonoscopy screening adherence in the Minnesota-Wisconsin Metropolitan Statistical Area. We considered several specifications of the SES index including using different spatial scales (e.g., census block group-level, tract-level) for the SES variables. We found a significant positive association (odds ratio = 1.17, 95% CI: 1.15-1.19) between the SES index and colonoscopy adherence in the best fitting model. The model with the best goodness-of-fit included a multi-scale SES index with 10 variables at the block group-level and one at the tract-level, with home ownership, race, and income among the most important variables. Contrary to previous index construction, our results were not consistent with an assumption of equal importance of variables in the SES index when explaining colonoscopy screening adherence. Our approach is applicable in any study where an SES index is considered as a variable in a regression model and the weights for the SES variables are not known in advance.

Area-socioeconomic disparities in mental health service use among children involved in the child welfare system.

PubMed

Kim, Minseop; Garcia, Antonio R; Yang, Shuyan; Jung, Nahri

2018-06-01

Relying on data from a nationally representative sample of youth involved in the child welfare system (CWS) in 1999-2000 (the National Survey of Child and Adolescent Well-Being, Cohort 1) and 2008-2009 (Cohort 2), this study implemented a diverse set of disparity indicators to estimate area-socioeconomic disparities in mental health (MH) services use and changes in area-socioeconomic disparities between the two cohorts. Our study found that there are area-socioeconomic disparities in MH service use, indicating that the rates of MH service use among youth referred to the CWS differ by area-socioeconomic positions defined by county-level poverty rates. We also found that area-socioeconomic disparities increased over time. However, the magnitude of the increase varied widely across disparity measures, suggesting that there are different conclusions about the trend and magnitude of area-socioeconomic disparities, depending upon which disparity measures are implemented. A greater understanding of the methodological differences among disparity measures is warranted, which will in turn impact how interventions are designed to reduce socioeconomic disparities among children in the CWS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Are area-level and individual-level socioeconomic factors associated with self-rated health in adult urban citizens? Evidence from Slovak and Dutch cities.

PubMed

Behanova, Martina; Reijneveld, Sijmen A; Nagyova, Iveta; Katreniakova, Zuzana; van Ameijden, Erik J C; Dijkshoorn, Henriëtte; van Dijk, Jitse P

2017-05-01

Evidence shows that living in disadvantaged areas is associated with poor health. This may be due to the socioeconomic (SE) characteristics of both these residents and the areas where they live. Evidence regarding this on Central European (CE) countries is scarce. Our aim was to assess whether the prevalence of poor self-rated health (SRH) was higher in deprived urban areas, whether this can be explained by individual SE status (SES) and whether this differed between Slovakia and the Netherlands per age group. We examined the association of urban-level data and individual-level SE factors from different urban areas in different countries (Slovakia, the Netherlands) using comparable urban health indicators and area indicators. We also obtained unique data from the EU-FP7 EURO-URHIS 2 project. Multilevel logistic regression showed that poor SRH was associated with area deprivation in both countries. Regarding age by country, poor SRH occurred more frequently in the more deprived areas for the younger age group (≤64) in the Netherlands but for the older age group (≥65 years) in Slovakia. Moreover, Slovak citizens reported poor SRH significantly more often than Dutch residents. Individual SES was significantly associated with poor SRH in both age groups and both countries for most area-level SE measures. Individual SES is associated with SRH more strongly than area deprivation. Therefore, it is important to account for relative deprivation at an individual level when considering health-enhancing activities. Moreover, the effect of urban-area deprivation seems to differ between CE and WE countries. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996-2007.

PubMed

Nolasco, Andreu; Quesada, José Antonio; Moncho, Joaquín; Melchor, Inmaculada; Pereyra-Zamora, Pamela; Tamayo-Fonseca, Nayara; Martínez-Beneito, Miguel Angel; Zurriaga, Oscar

2014-04-01

While research continues into indicators such as preventable and amenable mortality in order to evaluate quality, access, and equity in the healthcare, it is also necessary to continue identifying the areas of greatest risk owing to these causes of death in urban areas of large cities, where a large part of the population is concentrated, in order to carry out specific actions and reduce inequalities in mortality. This study describes inequalities in amenable mortality in relation to socioeconomic status in small urban areas, and analyses their evolution over the course of the periods 1996-99, 2000-2003 and 2004-2007 in three major cities in the Spanish Mediterranean coast (Alicante, Castellón, and Valencia). All deaths attributed to amenable causes were analysed among non-institutionalised residents in the three cities studied over the course of the study periods. Census tracts for the cities were grouped into 3 socioeconomic status levels, from higher to lower levels of deprivation, using 5 indicators obtained from the 2001 Spanish Population Census. For each city, the relative risks of death were estimated between socioeconomic status levels using Poisson's Regression models, adjusted for age and study period, and distinguishing between genders. Amenable mortality contributes significantly to general mortality (around 10%, higher among men), having decreased over time in the three cities studied for men and women. In the three cities studied, with a high degree of consistency, it has been seen that the risks of mortality are greater in areas of higher deprivation, and that these excesses have not significantly modified over time. Although amenable mortality decreases over the time period studied, the socioeconomic inequalities observed are maintained in the three cities. Areas have been identified that display excesses in amenable mortality, potentially attributable to differences in the healthcare system, associated with areas of greater deprivation. Action

Association of area socioeconomic status with lung function in children.

PubMed

Wu, Yi-Fan; Wu, Cho-Kai; Chen, Duan-Rung; Chie, Wei-Chu; Lee, Yungling Leo

2012-12-01

The study investigates the association between area-level socioeconomic status (SES) and children's lung function. Participants were 3994 seventh grade students from the Taiwan Children Health Study living in 14 communities in Taiwan and were recruited in 2007. Area-level SES predictors were population size, occupation type, income and education level. Hierarchical linear models (HLM) were used to examine the effects of area-level SES on lung function, after accounting for area air pollution and individual SES (parental education and family income). Areas with high income were independently associated with lower child lung function. The coefficients for log transformation of area tax per person in HLM were -47.8 (95% confidence interval (CI): -80.9, -14.8) in FEV(1), -43.8 (95% CI: -75.2, -12.5) in FVC, -93.4 (95% CI: -179.3, -7.5) in FEF(25-75) and -203.2 (95% CI: -349.1, -57.2) in PEF. All SES predictors influenced in the same direction and affected males more. The interaction of area tax per person with parental educational level was significant on PEF, suggesting significant association of greater parental education with lower lung function in children. High area SES was inversely associated with lung function in Taiwanese children. Copyright © 2012 Elsevier Inc. All rights reserved.

A multilevel analysis of socioeconomic (small area) differences in household food purchasing behaviour.

PubMed

Turrell, G; Blakely, T; Patterson, C; Oldenburg, B

2004-03-01

To examine the association between area and individual level socioeconomic status (SES) and food purchasing behaviour. The sample comprised 1000 households and 50 small areas. Data were collected by face to face interview (66.4% response rate). SES was measured using a composite area index of disadvantage (mean 1026.8, SD = 95.2) and household income. Purchasing behaviour was scored as continuous indices ranging from 0 to 100 for three food types: fruits (mean 50.5, SD = 17.8), vegetables (61.8, 15.2), and grocery items (51.4, 17.6), with higher scores indicating purchasing patterns more consistent with dietary guideline recommendations. Brisbane, Australia, 2000. Persons responsible for their household's food purchasing. Controlling for age, gender, and household income, a two standard deviation increase on the area SES measure was associated with a 2.01 unit increase on the fruit purchasing index (95% CI -0.49 to 4.50). The corresponding associations for vegetables and grocery foods were 0.60 (-1.36 to 2.56) and 0.94 (-1.35 to 3.23). Before controlling for household income, significant area level differences were found for each food, suggesting that clustering of household income within areas (a composition effect) accounted for the purchasing variability between them. Living in a socioeconomically advantaged area was associated with a tendency to purchase healthier food, however, the association was small in magnitude and the 95% CI for area SES included the null. Although urban areas in Brisbane are differentiated on the basis of their socioeconomic characteristics, it seems unlikely that where you live shapes your procurement of food over and above your personal characteristics.

[Nutritional status of school children from different socioeconomic levels].

PubMed

Amigo, H; Bustos, P; Radrigán, M E; Ureta, E

1995-09-01

The aim of this work was to compare the nutritional status of children from low and high socioeconomic levels. Weight, height, mid arm circumference and tricipital skinfold thickness were measured in 1,842 children of low and 2,770 of high socioeconomic status. Mean weight, height, and mid arm muscular circumference were higher in children of high socioeconomic status. Also, growth failure and overweight had a higher frequency among children of low socioeconomic status. Mean weight, height and mid arm circumference were higher in males of both groups. Among children of low socioeconomic status, height/age ratios were lower in men and weight/height ratios were higher in women. These differences were not observed in children of high socioeconomic level. We conclude that adverse environmental conditions, lower physical activity and indigenous ancestors may alter the nutritional status of children of low socioeconomic levels.

Variations in area-level disadvantage of Australian registered fitness trainers usual training locations.

PubMed

Bennie, Jason A; Thornton, Lukar E; van Uffelen, Jannique G Z; Banting, Lauren K; Biddle, Stuart J H

2016-07-11

Leisure-time physical activity and strength training participation levels are low and socioeconomically distributed. Fitness trainers (e.g. gym/group instructors) may have a role in increasing these participation levels. However, it is not known whether the training location and characteristics of Australian fitness trainers vary between areas that differ in socioeconomic status. In 2014, a sample of 1,189 Australian trainers completed an online survey with questions about personal and fitness industry-related characteristics (e.g. qualifications, setting, and experience) and postcode of their usual training location. The Australian Bureau of Statistics 'Index of Relative Socioeconomic Disadvantage' (IRSD) was matched to training location and used to assess where fitness professionals trained and whether their experience, qualification level and delivery methods differed by area-level disadvantage. Linear regression analysis was used to examine the relationship between IRSD score and selected characteristics adjusting for covariates (e.g. sex, age). Overall, 47 % of respondents worked in areas within the three least-disadvantaged deciles. In contrast, only 14.8 % worked in the three most-disadvantaged deciles. In adjusted regression models, fitness industry qualification was positively associated with a higher IRSD score (i.e. working in the least-disadvantaged areas) (Cert III: ref; Cert IV β:13.44 [95 % CI 3.86-23.02]; Diploma β:15.77 [95 % CI: 2.17-29.37]; Undergraduate β:23.14 [95 % CI: 9.41-36.86]). Fewer Australian fitness trainers work in areas with high levels of socioeconomic disadvantaged areas than in areas with low levels of disadvantage. A higher level of fitness industry qualifications was associated with working in areas with lower levels of disadvantage. Future research should explore the effectiveness of providing incentives that encourage more fitness trainers and those with higher qualifications to work in more socioeconomically

Influence of municipal- and individual-level socioeconomic conditions on mortality in Japan.

PubMed

Honjo, Kaori; Iso, Hiroyasu; Fukuda, Yoshiharu; Nishi, Nobuo; Nakaya, Tomoki; Fujino, Yoshihisa; Tanabe, Naohito; Suzuki, Sadao; Subramanian, S V; Tamakoshi, Akiko

2014-01-01

The health effect of area socioeconomic conditions has been evident especially in Western countries; however, limited research has focused on the effect of municipal-level socioeconomic conditions, especially in Asia. Multilevel research using data from the Japan Collaborative Cohort Study, a large cohort study followed from 1990 to 2006, was conducted to examine individual as well as municipal socioeconomic conditions on risk of death, adjusting for each other. We included 24,460 men and 32,649 women aged 40 to 65 years at baseline in 35 municipalities as our study population. Primary predictors were municipal socioeconomic conditions (proportion of college graduates, per capita income, unemployment rate, and proportion of households receiving public assistance) and individual socioeconomic conditions (education level and occupation). Among men, the multilevel logistic estimate (standard errors) of proportion of college graduates and unemployment rate for mortality from cardiovascular disease were -0.399 (0.094) and -0.343 (0.122), respectively. Among women, the multilevel logistic estimate (standard errors) of proportion of college graduates and per capita annual income for mortality from injuries were -0.386 (0.171) and -1.069 (0.407). Individual education level and occupation were associated with all-cause mortality, in particular, mortality from cardiovascular disease or injuries. Interactions between individual education level and indicators of municipal socioeconomic conditions were observed for mortality from cancer and cardiovascular disease among men and mortality from injuries among women. Municipal and individual socioeconomic conditions were independently and interactively associated with premature death; this suggests that reducing social inequalities in health demands a focus on municipal conditions in addition to those of individuals.

Trends in socioeconomic inequalities in amenable mortality in urban areas of Spanish cities, 1996–2007

PubMed Central

2014-01-01

Background While research continues into indicators such as preventable and amenable mortality in order to evaluate quality, access, and equity in the healthcare, it is also necessary to continue identifying the areas of greatest risk owing to these causes of death in urban areas of large cities, where a large part of the population is concentrated, in order to carry out specific actions and reduce inequalities in mortality. This study describes inequalities in amenable mortality in relation to socioeconomic status in small urban areas, and analyses their evolution over the course of the periods 1996–99, 2000–2003 and 2004–2007 in three major cities in the Spanish Mediterranean coast (Alicante, Castellón, and Valencia). Methods All deaths attributed to amenable causes were analysed among non-institutionalised residents in the three cities studied over the course of the study periods. Census tracts for the cities were grouped into 3 socioeconomic status levels, from higher to lower levels of deprivation, using 5 indicators obtained from the 2001 Spanish Population Census. For each city, the relative risks of death were estimated between socioeconomic status levels using Poisson’s Regression models, adjusted for age and study period, and distinguishing between genders. Results Amenable mortality contributes significantly to general mortality (around 10%, higher among men), having decreased over time in the three cities studied for men and women. In the three cities studied, with a high degree of consistency, it has been seen that the risks of mortality are greater in areas of higher deprivation, and that these excesses have not significantly modified over time. Conclusions Although amenable mortality decreases over the time period studied, the socioeconomic inequalities observed are maintained in the three cities. Areas have been identified that display excesses in amenable mortality, potentially attributable to differences in the healthcare system

Area-Level Socioeconomic Factors Are Associated With Noncompletion of Pediatric Preventive Services.

PubMed

Jones, Margaret N; Brown, Courtney M; Widener, Michael J; Sucharew, Heidi J; Beck, Andrew F

2016-07-01

We examined 4872 infants born consecutively, 2011-2012, and seen at 3 primary care centers to determine whether area-based socioeconomic measures were associated with noncompletion of common preventive services within the first 15 months. Addresses were geocoded and linked to census tract poverty, adult educational attainment, and household vehicle ownership rates. The quartile of patients in the highest poverty (adjusted odds ratio [aOR] 1.25; 95% confidence interval [CI] 1.01-1.54) and lowest vehicle ownership tracts (aOR 1.32; 95% CI 1.07-1.63) had significantly increased odds of service noncompletion. There were significant spatial clusters of low completion in Cincinnati's urban core. These findings have implications for preventive service delivery. © The Author(s) 2016.

An Alignment/Transfer Experiment with Low Socioeconomic Level Students.

ERIC Educational Resources Information Center

Elia, June Isaacs

1994-01-01

This study examined the amount of variance explained by alignment of testing to instruction among low socioeconomic level fourth graders, proposing two instructional alignment hypotheses. Results indicated that alignment had an unusually high effect. Low performing low socioeconomic level students achieved high success levels when conditions of…

Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project.

PubMed

Gullón, Pedro; Bilal, Usama; Cebrecos, Alba; Badland, Hannah M; Galán, Iñaki; Franco, Manuel

2017-06-06

Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics. All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts. Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on. Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas.

Analysing risk factors for poorer breast cancer outcomes in residents of lower socioeconomic areas of Australia.

PubMed

Roder, David; Zorbas, Helen M; Kollias, James; Pyke, Chris M; Walters, David; Campbell, Ian D; Taylor, Corey; Webster, Fleur

2014-05-01

are likely to vary with the country and health system characteristics. What does this paper add? The present study found that in Australia, women from lower socioeconomic areas do not have more advanced cancers at diagnosis, nor, in general, other cancer features that would predispose them to poorer outcomes. The standout differences were that they tended more to live in areas that were more remote from specialist metropolitan centres and were more likely to be treated in regional settings where prior research has indicated poorer outcomes. The reasons for these poorer outcomes are not known but may include lower levels of surgical specialisation, less access to specialised adjunctive services, and less involvement with multidisciplinary teams. Women from lower socioeconomic areas also appeared more likely to attend lower case load surgeons. Little difference was evident in the type of clinical care received, although women from lower socioeconomic areas were less likely to be asymptomatic referrals from other clinical settings (excluding BreastScreen). What are the implications for practitioners? Results suggest that poorer outcomes in women from lower socioeconomic areas in Australia may have less to do with the characteristics of their breast cancers or treatment modalities and more to do with health system features, such as access to specialist centres. This study highlights the importance of demographic and health system features as potentially key factors in service outcomes. Health system research should be strengthened in Australia to augment biomedical and clinical research, with a view to best meeting service needs of all sectors of the population.

Environmental and socioeconomic factors contributing to elevated blood lead levels in children from an industrial area of Upper Silesia.

PubMed

Pelc, Wojciech; Pawlas, Natalia; Dobrakowski, Michał; Kasperczyk, Sławomir

2016-10-01

The present study concentrated on a cross-sectional analysis of recent exposure to lead (Pb) and the socioeconomic factors behind increased Pb exposure in Polish children. Lead is one of the most widespread toxic heavy metals in the industrial region of Upper Silesia (Poland). Elevated blood Pb levels in children continue to be a matter of serious concern. The present study involved 4882 children from the Upper Silesia region, aged from 3 yr to 18 yr, over the calendar years 1999 to 2013. The concentration of Pb in blood was determined in each child. The children's parents were asked to answer survey questions about the child's environmental exposure to Pb as well as the socioeconomic condition of the family. Factors that correspond with increased exposure to Pb included: lower level of education of parents, unemployment, parents' occupational Pb exposure, poor socioeconomic status of the family, smoking at home, living on the ground floor of buildings, consumption of locally grown vegetables and fruits, longer outdoor playing periods in a polluted environment, and male gender. Environmental exposure to Pb is the most important factor behind chronic poisoning of children in Upper Silesia. The most important socioeconomic factor associated with concentrations of Pb in children's blood is a lower level of education of a child's mother and father. Environ Toxicol Chem 2016;35:2597-2603. © 2016 SETAC. © 2016 SETAC.

Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.

PubMed

Carroll, Robert; Knipe, Duleeka; Moran, Paul; Gunnell, David

2017-12-01

Socioeconomic deprivation is associated with increased rates of self-harm but its association with levels of clinical care has not previously been explored. The aim of the current study was to investigate socioeconomic differences in the clinical management of people who self-harm. Cross-sectional analysis of 3607 people presenting to a large inner-city hospital following self-harm. People living in the least deprived quintile were more likely to receive a psychosocial assessment (most vs. least deprived: 63.51 vs. 70.14%). This effect persisted in our fully adjusted model (OR 1.45, CI 1.15-1.82, p = 0.002). Mediation analysis suggested this association was in large part explained by higher rates of self-discharge in people presenting from areas of higher deprivation. Compared to those from more deprived areas, people from less deprived areas are more likely to receive a psychosocial assessment when presenting to hospital following self-harm. The occurrence of higher rates of self-discharge from emergency departments among those from more deprived areas may explain the association.

Environmental Resources of Selected Areas of Hawaii: Socioeconomics (DRAFT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saulsbury, J.W.; Sorensen, B.M.; Schexnayder, S.M.

1994-06-01

This report has been prepared to make available and archive the background information on socioeconomic resources collected during the preparation of the Environmental Impact Statement (EIS) for Phases 3 and 4 of the Hawaii Geothermal Project (HGP) as defined by the state of Hawaii in its April 1989 proposal to Congress. The U.S. Department of Energy (DOE) published a notice in the Federal Register on May 17, 1994 (Fed. Regis. 5925638), withdrawing its Notice of Intent (Fed Regis. 57:5433), of February 14, 1992, to prepare the HGPEIS. Since the state of Hawaii is no longer pursuing or planning to pursuemore » the HGP, DOE considers the project to be terminated. This document provides background information on socioeconomic resources in Hawaii County, with particular emphasis on the Puna District (Fig. 1). Information is being made available for use by others in conducting future socioeconomic impact assessments in this area. This report describes existing socioeconomic resources in the areas studied (i.e., the affected environment) and does not represent an assessment of environmental impacts. The socioeconomic resources described are primarily those that would be affected by employment and population growth associated with any future large-scale development. These resource categories are (1) population, (2) housing, (3) land use, (4) economic structure (primarily employment and income), (5) infrastructure and public services (education, ground transportation, police and fire protection, water, wastewater, solid waste disposal, electricity, and emergency planning), (6) local government revenues and expenditures, and (7) tourism and recreation.« less

Gut Microbiota Differences in Children From Distinct Socioeconomic Levels Living in the Same Urban Area in Brazil.

PubMed

Mello, Carolina S; Carmo-Rodrigues, Mirian S; Filho, Humberto B A; Melli, Lígia C F L; Tahan, Soraia; Pignatari, Antônio C C; de Morais, Mauro B

2016-11-01

To compare gut microbiota in impoverished children versus children of high socioeconomic status living in the same urban area in Brazil. A cross-sectional study was conducted to evaluate 100 children living in a slum and 30 children from a private school, ages between 5 and 11 years old, in Sao Paulo State, Brazil. To characterize the groups, data based on socioeconomic status, sanitation, and housing conditions were collected. Anthropometric measurements and neonatal data were obtained from both groups. Gut microbiota were quantified in fecal samples by real-time polymerase chain reaction. The children in the private school group had higher rates of cesarean delivery and premature birth than the children in the slum group. Staphylococcus aureus (90% vs 48.0%) and Clostridium difficile (100% vs 43.0%) were more commonly found in the children from the private school than in the impoverished children (P < 0.0001). C perfringens was most frequently identified in the group of children from the slum (92.0% vs 80%; P = 0.064). Higher counts of total eubacteria, Firmicutes and Bacteroidetes phyla organisms, Escherichia coli, Lactobacillus spp., and Methanobrevibacter smithii were found in the children living in poverty, whereas higher counts of Salmonella spp., C difficile, and C perfringens were observed in the children living in satisfactory housing conditions (P < 0.05). Important differences were observed between the gut microbiota of children living under distinct socioeconomic and environmental conditions within the same city. Our findings suggest that children of high socioeconomic status have less favorable gut microbiota than do children who live in poverty.

Prediction of community mental health service utilization by individual and ecological level socio-economic factors.

PubMed

Donisi, Valeria; Tedeschi, Federico; Percudani, Mauro; Fiorillo, Andrea; Confalonieri, Linda; De Rosa, Corrado; Salazzari, Damiano; Tansella, Michele; Thornicroft, Graham; Amaddeo, Francesco

2013-10-30

Individuals with a more deprived socioeconomic status (SES) are more likely to have higher rates of psychiatric morbidity and use of psychiatric services. Such service use is also influenced by socioeconomic factors at the ecological level. The aim of this article is to investigate the influence of these variables on service utilization. All patients in contact with three Italian community psychiatric services (CPS) were included. Community and hospital contacts over 6 months were investigated. Socio-economic characteristics were described using a SES Index and two new Resources Accessibility Indexes. Low SES was found to be associated with more community service contacts. When other individual and ecological variables were controlled for, SES was negatively associated only with the number of home visits, which was about half the rate in deprived areas. An association between service utilization and the resources of the catchment area was also detected. The economic crisis in Europe is increasing inequality of access, so paying attention to SES characteristics at both the individual and the ecological levels is likely to become increasingly important in understanding patterns of psychiatric service utilization and planning care accordingly. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Municipal health expectancy in Japan: decreased healthy longevity of older people in socioeconomically disadvantaged areas.

PubMed

Fukuda, Yoshiharu; Nakamura, Keiko; Takano, Takehito

2005-06-14

Little is known about small-area variation in healthy longevity of older people and its socioeconomic correlates. This study aimed to estimate health expectancy at 65 years (HE65) at the municipal level in Japan, and to examine its relation to area socio-demographic conditions. HE65 of municipalities (N = 3361) across Japan was estimated by a linear regression formula with life expectancy at 65 years and the prevalence of those certificated as needing nursing care. The relation between HE65 and area socio-demographic indicators was examined using correlation coefficients. The estimated HE65 (years) ranged from 13.13 to 17.39 for men and from 14.84 to 20.53 for women. HE65 was significantly positively correlated with the proportion of elderly and per capita income, and negatively correlated with the percentage of households of a single elderly person, divorce rate, and unemployment rate. These relations were stronger in large municipalities (with a population of more than 100,000) than in small and medium-size municipalities. A decrease in healthy longevity of older people was associated with a higher percentage of households of a single elderly person and divorce rate, and lower socioeconomic conditions. This study suggests that older people in urban areas are susceptible to socio-demographic factors, and a social support network for older people living in socioeconomically disadvantaged conditions should be encouraged.

Socioeconomic area disparities in tobacco retail outlet density: a Western Australian analysis.

PubMed

Wood, Lisa J; Pereira, Gavin; Middleton, Nick; Foster, Sarah

2013-05-20

To examine the association between tobacco outlet density and area socioeconomic status (SES) in Western Australia. Ecological cross-sectional study investigating the relationship between the area SES of, and the density of tobacco retail outlets in, WA suburbs and towns for the Perth metropolitan area, and at the regional and state level. SES was determined using the 2006 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and classified into quartiles (very low, low, high and very high); tobacco outlet data were sourced from the WA Department of Health register of retailers licensed to sell tobacco at May 2011. Tobacco outlet density rate (per 10 000 residents). In WA overall, suburbs and towns with a very low IRSAD had more than four times the number of tobacco outlets compared with those with a very high IRSAD (P> < 0.001). This trend was similar when analyses were restricted to the Perth metropolitan area and to regional areas. Suburbs and towns in regional WA with a very low IRSAD had more than five times the number of tobacco outlets than those with a very high IRSAD (P> < 0.001). This study provides the first Australian evidence of a strong relationship between area SES and tobacco outlet density. Findings are consistent with a number of United States studies that report higher tobacco outlet densities in lower SES or minority neighbourhoods. The results underscore the importance of policy approaches to limit the number of tobacco retail licences granted, and to reduce the geographic density of outlets in more disadvantaged suburbs and towns.

Does exposure to the food environment differ by socioeconomic position? Comparing area-based and person-centred metrics in the Fenland Study, UK.

PubMed

Maguire, Eva R; Burgoine, Thomas; Penney, Tarra L; Forouhi, Nita G; Monsivais, Pablo

2017-09-06

Retail food environments (foodscapes) are a recognised determinant of eating behaviours and may contribute to inequalities in diet. However, findings from studies measuring socioeconomic inequality in the foodscape have been mixed, which may be due to methodological differences. The aim of this cross-sectional study was to compare exposure to the foodscape by socioeconomic position using different measures, to test whether the presence, direction or amplitude of differences was sensitive to the choice of foodscape metric or socioeconomic indicator. A sample of 10,429 adults aged 30-64 years with valid home address data were obtained from the Fenland Study, UK. Of this sample, 7270 participants also had valid work location data. The sample was linked to data on food outlets obtained from local government records. Foodscape metrics included count, density and proximity of takeaway outlets and supermarkets, and the percentage of takeaway outlets relative to all food outlets. Exposure metrics were area-based (lower super output areas), and person-centred (proximity to nearest; Euclidean and Network buffers at 800 m, 1 km, and 1 mile). Person-centred buffers were constructed using home and work locations. Socioeconomic status was measured at the area-level (2010 Index of Multiple Deprivation) and the individual-level (highest educational attainment; equivalised household income). Participants were classified into socioeconomic groups and average exposures estimated. Results were analysed using the statistical and percent differences between the highest and lowest socioeconomic groups. In area-based measures, the most deprived areas contained higher takeaway outlet densities (p < 0.001). However, in person-centred metrics lower socioeconomic status was associated with lower exposure to takeaway outlets and supermarkets (all home-based exposures p < 0.001) and socioeconomic differences were greatest at the smallest buffer sizes. Socioeconomic differences in

Individual- and Area-level Unemployment Influence Smoking Cessation Among African Americans Participating in a Randomized Clinical Trial

PubMed Central

Kendzor, Darla E.; Reitzel, Lorraine R.; Mazas, Carlos A.; Cofta-Woerpel, Ludmila M.; Cao, Yumei; Ji, Lingyun; Costello, Tracy J.; Vidrine, Jennifer Irvin; Businelle, Michael S.; Li, Yisheng; Castro, Yessenia; Ahluwalia, Jasjit S.; Cinciripini, Paul M.; Wetter, David W.

2012-01-01

African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative

Are some areas more equal than others? Socioeconomic inequality in potentially avoidable emergency hospital admissions within English local authority areas.

PubMed

Sheringham, Jessica; Asaria, Miqdad; Barratt, Helen; Raine, Rosalind; Cookson, Richard

2017-04-01

Objectives Reducing health inequalities is an explicit goal of England's health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000). We measured absolute inequality gradients nationally and within each administrative area using neighbourhood-level linear models of the relationship between national deprivation and age-sex-adjusted emergency admission rates. We assessed local equity performance by comparing local inequality against national inequality to identify areas significantly more or less equal than expected; evaluated stability over time; and identified where equity performance was steadily improving or worsening. We then examined associations between change in socioeconomic inequalities and change in within-area deprivation (gentrification). Finally, we used administrative area-level random and fixed effects models to examine the contribution of primary care to inequalities in admissions. Results Data on 316 administrative areas were included in the analysis. Local inequalities were fairly stable between consecutive years, but 32 areas (10%) showed steadily improving or worsening equity. In the 21 improving areas, the gap between most and least deprived fell by 3.9 admissions per 1000 (six times the fall nationally) between 2004/5 and 2011/12, while in the 11 areas worsening, the gap widened by 2.4. There was no indication that measured improvements in local equity were an artefact of gentrification or that changes in primary care supply or quality contributed to changes in

Are some areas more equal than others? Socioeconomic inequality in potentially avoidable emergency hospital admissions within English local authority areas

PubMed Central

Asaria, Miqdad; Barratt, Helen; Raine, Rosalind; Cookson, Richard

2016-01-01

Objectives Reducing health inequalities is an explicit goal of England’s health system. Our aim was to compare the performance of English local administrative areas in reducing socioeconomic inequality in emergency hospital admissions for ambulatory care sensitive chronic conditions. Methods We used local authority area as a stable proxy for health and long-term care administrative geography between 2004/5 and 2011/12. We linked inpatient hospital activity, deprivation, primary care, and population data to small area neighbourhoods (typical population 1500) within administrative areas (typical population 250,000). We measured absolute inequality gradients nationally and within each administrative area using neighbourhood-level linear models of the relationship between national deprivation and age–sex-adjusted emergency admission rates. We assessed local equity performance by comparing local inequality against national inequality to identify areas significantly more or less equal than expected; evaluated stability over time; and identified where equity performance was steadily improving or worsening. We then examined associations between change in socioeconomic inequalities and change in within-area deprivation (gentrification). Finally, we used administrative area-level random and fixed effects models to examine the contribution of primary care to inequalities in admissions. Results Data on 316 administrative areas were included in the analysis. Local inequalities were fairly stable between consecutive years, but 32 areas (10%) showed steadily improving or worsening equity. In the 21 improving areas, the gap between most and least deprived fell by 3.9 admissions per 1000 (six times the fall nationally) between 2004/5 and 2011/12, while in the 11 areas worsening, the gap widened by 2.4. There was no indication that measured improvements in local equity were an artefact of gentrification or that changes in primary care supply or quality contributed to changes in

Trends in socioeconomic inequalities in preventable mortality in urban areas of 33 Spanish cities, 1996-2007 (MEDEA project).

PubMed

Nolasco, Andreu; Moncho, Joaquin; Quesada, Jose Antonio; Melchor, Inmaculada; Pereyra-Zamora, Pamela; Tamayo-Fonseca, Nayara; Martínez-Beneito, Miguel Angel; Zurriaga, Oscar; Ballesta, Mónica; Daponte, Antonio; Gandarillas, Ana; Domínguez-Berjón, M Felicitas; Marí-Dell'Olmo, Marc; Gotsens, Mercè; Izco, Natividad; Moreno, M Concepción; Sáez, Marc; Martos, Carmen; Sánchez-Villegas, Pablo; Borrell, Carme

2015-04-01

Preventable mortality is a good indicator of possible problems to be investigated in the primary prevention chain, making it also a useful tool with which to evaluate health policies particularly public health policies. This study describes inequalities in preventable avoidable mortality in relation to socioeconomic status in small urban areas of thirty three Spanish cities, and analyses their evolution over the course of the periods 1996-2001 and 2002-2007. We analysed census tracts and all deaths occurring in the population residing in these cities from 1996 to 2007 were taken into account. The causes included in the study were lung cancer, cirrhosis, AIDS/HIV, motor vehicle traffic accidents injuries, suicide and homicide. The census tracts were classified into three groups, according their socioeconomic level. To analyse inequalities in mortality risks between the highest and lowest socioeconomic levels and over different periods, for each city and separating by sex, Poisson regression were used. Preventable avoidable mortality made a significant contribution to general mortality (around 7.5%, higher among men), having decreased over time in men (12.7 in 1996-2001 and 10.9 in 2002-2007), though not so clearly among women (3.3% in 1996-2001 and 2.9% in 2002-2007). It has been observed in men that the risks of death are higher in areas of greater deprivation, and that these excesses have not modified over time. The result in women is different and differences in mortality risks by socioeconomic level could not be established in many cities. Preventable mortality decreased between the 1996-2001 and 2002-2007 periods, more markedly in men than in women. There were socioeconomic inequalities in mortality in most cities analysed, associating a higher risk of death with higher levels of deprivation. Inequalities have remained over the two periods analysed. This study makes it possible to identify those areas where excess preventable mortality was associated with more

Association of cutaneous melanoma incidence with area-based socioeconomic indicators-United States, 2004-2006.

PubMed

Singh, Simple D; Ajani, Umed A; Johnson, Christopher J; Roland, Katherine B; Eide, Melody; Jemal, Ahmedin; Negoita, Serban; Bayakly, Rana A; Ekwueme, Donatus U

2011-11-01

Socioeconomic status (SES) has been associated with melanoma incidence and outcomes. Examination of the relationship between melanoma and SES at the national level in the United States is limited. Expanding knowledge of this association is needed to improve early detection and eliminate disparities. We sought to provide a detailed description of cutaneous melanoma incidence and stage of disease in relationship to area-based socioeconomic measures including poverty level, education, income, and unemployment in the United States. Invasive cutaneous melanoma data reported by 44 population-based central cancer registries for 2004 to 2006 were merged with county-level SES estimates from the US Census Bureau. Age-adjusted incidence rates were calculated by gender, race/ethnicity, poverty, education, income, unemployment, and metro/urban/rural status using software. Poisson multilevel mixed models were fitted, and incidence density ratios were calculated by stage for area-based SES measures, controlling for age, gender, and state random effects. Counties with lower poverty, higher education, higher income, and lower unemployment had higher age-adjusted melanoma incidence rates for both early and late stage. In multivariate models, SES effects persisted for early-stage but not late-stage melanoma incidence. Individual-level measures of SES were unavailable, and estimates were based on county-level SES measures. Our findings show that melanoma incidence in the United States is associated with aggregate county-level measures of high SES. Analyses using finer-level SES measures, such as individual or census tract level, are needed to provide more precise estimates of these associations. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Association between cardiovascular disease and socioeconomic level in Portugal.

PubMed

Ribeiro, Sónia; Furtado, Cláudia; Pereira, João

2013-11-01

Cardiovascular disease is the leading cause of morbidity, mortality and disability in Portugal. Socioeconomic level is known to influence health status but there is scant evidence on socioeconomic inequalities in cardiovascular disease in Portugal. To analyze the distribution of cardiovascular disease in the Portuguese population according to socioeconomic status. We conducted a cross-sectional study using data from the fourth National Health Survey on a representative sample of the Portuguese population. Socioeconomic inequalities in cardiovascular disease, risk factors and number of medical visits were analyzed using odds ratios according to socioeconomic status (household equivalent income) in the adult population (35-74 years). Comparisons focused on the top and bottom 50% and 10% of household income distribution. Of the 21 807 individuals included, 53.3% were female, and mean age was 54 ± 11 years. Cardiovascular disease, stroke, ischemic heart disease, hypertension, diabetes, obesity and physical inactivity were associated with lower socioeconomic status, while smoking was associated with higher status; number of medical visits and psychological distress showed no association. When present, inequality was greater at the extremes of income distribution. The results reveal an association between morbidity, lifestyle and socioeconomic status. They also suggest that besides improved access to effective medical intervention, there is a need for a comprehensive strategy for health promotion and disease prevention that takes account of individual, cultural and socioeconomic characteristics. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Drivers and socioeconomic impacts of tourism participation in protected areas.

PubMed

Liu, Wei; Vogt, Christine A; Luo, Junyan; He, Guangming; Frank, Kenneth A; Liu, Jianguo

2012-01-01

Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems

Drivers and Socioeconomic Impacts of Tourism Participation in Protected Areas

PubMed Central

Liu, Wei; Vogt, Christine A.; Luo, Junyan; He, Guangming; Frank, Kenneth A.; Liu, Jianguo

2012-01-01

Nature-based tourism has the potential to enhance global biodiversity conservation by providing alternative livelihood strategies for local people, which may alleviate poverty in and around protected areas. Despite the popularity of the concept of nature-based tourism as an integrated conservation and development tool, empirical research on its actual socioeconomic benefits, on the distributional pattern of these benefits, and on its direct driving factors is lacking, because relevant long-term data are rarely available. In a multi-year study in Wolong Nature Reserve, China, we followed a representative sample of 220 local households from 1999 to 2007 to investigate the diverse benefits that these households received from recent development of nature-based tourism in the area. Within eight years, the number of households directly participating in tourism activities increased from nine to sixty. In addition, about two-thirds of the other households received indirect financial benefits from tourism. We constructed an empirical household economic model to identify the factors that led to household-level participation in tourism. The results reveal the effects of local households' livelihood assets (i.e., financial, human, natural, physical, and social capitals) on the likelihood to participate directly in tourism. In general, households with greater financial (e.g., income), physical (e.g., access to key tourism sites), human (e.g., education), and social (e.g., kinship with local government officials) capitals and less natural capital (e.g., cropland) were more likely to participate in tourism activities. We found that residents in households participating in tourism tended to perceive more non-financial benefits in addition to more negative environmental impacts of tourism compared with households not participating in tourism. These findings suggest that socioeconomic impact analysis and change monitoring should be included in nature-based tourism management systems

Spatial Distribution of Socioeconomic Characteristics in Rural’s Java: A Case from Three Different Rural Areas in Central Java

NASA Astrophysics Data System (ADS)

Rudiarto, I.; Handayani, W.; Wijaya, H. B.; Insani, T. D.

2018-02-01

The intention of this paper is to combine the socio economic development into spatial aspect with the fact that the divided sub study areas are differed in its socio-economic characteristic. The research was conducted in three different rural areas, i.e.; coastal area in Sayung sub district - Demak Regency, plain area in Delanggu sub district - Klaten Regency, and mountain area in Kledung sub district - Temanggung regency. Spatial interpolation technique has been applied in order to identify the spatial distribution of socioeconomic data. The results show that socioeconomic characteristic in plain area and coastal area is more varied and regularly distributed as compared to the mountain area. Educated people are less found in the plain area while in coastal and mountain area the condition is better. Coastal area is identified as the prone area to the disaster issues and therefore socioeconomically vulnerable. The result of this research is very important to the development policies that need to undertake regarding to socioeconomic development in each associated location.

Does alcohol outlet density differ by area-level disadvantage in metropolitan Perth?

PubMed

Foster, Sarah; Hooper, Paula; Knuiman, Matthew; Trapp, Georgina; Wood, Lisa

2017-09-01

Research suggests that there are area-level disparities in alcohol outlets, with greater density in disadvantaged areas. In part, this might be explained by the inequitable distribution of retail, attracted by lower rents to disadvantaged neighbourhoods. This ecological study examines the distribution of liquor licences in Perth, Australia, and whether discrepancies in the distribution of retail land-uses could account for a socio-economic gradient. Area disadvantage was determined for each Statistical Area 1 (SA1) using the Australian Bureau of Statistics Index of Relative Socio-economic Disadvantage, and licence locations were mapped in GIS. Negative binomial loglinear models examined whether licence densities within SA1s differed by area disadvantage, controlling for demographics and spatial correlation. Models included an offset term, so the estimated effects of area-level disadvantage were on licences per km 2 , or licences per retail destination. In the area-based analyses, for every unit increase in disadvantage decile (i.e. a reduction in relative disadvantage), general licences reduced by 15% (P = 0.000) and liquor stores reduced by 7% (P = 0.004). These gradients were not apparent when licences were examined as a function of retail; however, for every unit increase in disadvantage decile, the density of on-premise licences per retail destination increased by 14% (P = 0.000). The direction of the socio-economic gradient for general licences and liquor stores in Perth is concerning, as all licences selling packaged alcohol were more abundant in disadvantaged areas. However, the over-representation of packaged liquor in disadvantaged areas may relate to the increased provision of retail. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Demographic and socio-economic determinants of post-neonatal deaths in a special project area of rural northern India.

PubMed

Kabir, Zubair

2003-07-01

The demographic and socio-economic determinants of post-neonatal deaths (n = 475) in a special project area of rural northern India (Ballabgarh) were ascertained from 1991 to 1999 using the electronic database system of the project area for data extraction, and were compared with the eligible living children of the same age using a matched population-based case-control study design. Similar determinants were also ascertained in neonatal deaths (n = 212) using the same study design. After controlling for the potential confounders using conditional logistic regression analyses, lower caste (a proxy measure for low socio-economic conditions in rural India) was found to be significantly associated with higher post-neonatal deaths (OR = 2.21). Higher maternal age (>30 years) and fathers' lower educational levels were significantly associated with higher neonatal deaths, in addition to higher post-neonatal deaths in the same area.

Individual- and area-level unemployment influence smoking cessation among African Americans participating in a randomized clinical trial.

PubMed

Kendzor, Darla E; Reitzel, Lorraine R; Mazas, Carlos A; Cofta-Woerpel, Ludmila M; Cao, Yumei; Ji, Lingyun; Costello, Tracy J; Vidrine, Jennifer Irvin; Businelle, Michael S; Li, Yisheng; Castro, Yessenia; Ahluwalia, Jasjit S; Cinciripini, Paul M; Wetter, David W

2012-05-01

African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative

Supermarket access, transport mode and BMI: the potential for urban design and planning policy across socio-economic areas.

PubMed

Murphy, Maureen; Koohsari, Mohammad Javad; Badland, Hannah; Giles-Corti, Billie

2017-12-01

To investigate dietary intake, BMI and supermarket access at varying geographic scales and transport modes across areas of socio-economic disadvantage, and to evaluate the implementation of an urban planning policy that provides guidance on spatial access to supermarkets. Cross-sectional study used generalised estimating equations to investigate associations between supermarket density and proximity, vegetable and fruit intake and BMI at five geographic scales representing distances people travel to purchase food by varying transport modes. A stratified analysis by area-level disadvantage was conducted to detect optimal distances to supermarkets across socio-economic areas. Spatial distribution of supermarket and transport access was analysed using a geographic information system. Melbourne, Australia. Adults (n 3128) from twelve local government areas (LGA) across Melbourne. Supermarket access was protective of BMI for participants in high disadvantaged areas within 800 m (P=0·040) and 1000 m (P=0·032) road network buffers around the household but not for participants in less disadvantaged areas. In urban growth area LGA, only 26 % of dwellings were within 1 km of a supermarket, far less than 80-90 % of dwellings suggested in the local urban planning policy. Low public transport access compounded disadvantage. Rapid urbanisation is a global health challenge linked to increases in dietary risk factors and BMI. Our findings highlight the importance of identifying the most appropriate geographic scale to inform urban planning policy for optimal health outcomes across socio-economic strata. Urban planning policy implementation in disadvantaged areas within cities has potential for reducing health inequities.

Relationships between phenylalanine levels, intelligence and socioeconomic status of patients with phenylketonuria.

PubMed

Castro, Isabel Pimenta Spínola; Borges, Juliana Martins; Chagas, Heloísa Alves; Tibúrcio, Jacqueline; Starling, Ana Lúcia Pimenta; Aguiar, Marcos José Burle de

2012-07-01

To assess intelligence and its relationship with blood phenylalanine concentrations and socioeconomic status in patients with phenylketonuria after 6 to 12 years of treatment. Sixty-three children were classified according to phenylalanine levels and socioeconomic status and assessed using the Wechsler Intelligence Scale for Children. The Statistical Package for the Social Sciences (SPSS) was used to analyze phenylalanine; ANOVA was used to analyze intelligence quotients (IQ) and phenylalanine levels; and ordinal logistic regression was used to analyze the likelihood of higher IQ. The overall IQ scores of 90.5% of the children were within a range from borderline intellectual deficiency to very high intelligence; for verbal IQ this proportion was 96.8% and 92.1% had performance IQ scores within this band. The categories from low to upper-medium socioeconomic status contained 98.4% of patients' families. The likelihood of having medium to high IQ was 4.29 times greater for children with good phenylalanine control and 4.03 greater for those from higher socioeconomic strata. Treatment prevented mental retardation in 90.5% of the patients. Control of phenylalanine levels and higher socioeconomic status were associated with higher IQ scores.

Assessing the Impact of Socioeconomic Variables on Small Area Variations in Suicide Outcomes in England

PubMed Central

Congdon, Peter

2012-01-01

Ecological studies of suicide and self-harm have established the importance of area variables (e.g., deprivation, social fragmentation) in explaining variations in suicide risk. However, there are likely to be unobserved influences on risk, typically spatially clustered, which can be modeled as random effects. Regression impacts may be biased if no account is taken of spatially structured influences on risk. Furthermore a default assumption of linear effects of area variables may also misstate or understate their impact. This paper considers variations in suicide outcomes for small areas across England, and investigates the impact on them of area socio-economic variables, while also investigating potential nonlinearity in their impact and allowing for spatially clustered unobserved factors. The outcomes are self-harm hospitalisations and suicide mortality over 6,781 Middle Level Super Output Areas. PMID:23271304

Assessing the impact of socioeconomic variables on small area variations in suicide outcomes in England.

PubMed

Congdon, Peter

2012-12-27

Ecological studies of suicide and self-harm have established the importance of area variables (e.g., deprivation, social fragmentation) in explaining variations in suicide risk. However, there are likely to be unobserved influences on risk, typically spatially clustered, which can be modeled as random effects. Regression impacts may be biased if no account is taken of spatially structured influences on risk. Furthermore a default assumption of linear effects of area variables may also misstate or understate their impact. This paper considers variations in suicide outcomes for small areas across England, and investigates the impact on them of area socio-economic variables, while also investigating potential nonlinearity in their impact and allowing for spatially clustered unobserved factors. The outcomes are self-harm hospitalisations and suicide mortality over 6,781 Middle Level Super Output Areas.

[Individual social factors and their association with environmental socioeconomic factors--a descriptive small-area analysis in the city of Dortmund].

PubMed

Neuner, B; Berger, K

2010-11-01

Apart from individual resources and individual risk factors, environmental socioeconomic factors are determinants of individual health and illness. The aim of this investigation was to evaluate the association of small-area environmental socioeconomic parameters (proportion of 14-year-old and younger population, proportion of married citizens, proportion of unemployed, and the number of private cars per inhabitant) with individual socioeconomic parameters (education, income, unemployment, social class and the country of origin) in Dortmund, a major city in Germany. After splitting the small-area environmental socioeconomic parameters of 62 statistical administration units into quintiles, differences in the distribution of individual social parameters were evaluated using adjusted tests for trend. Overall, 1,312 study participants (mean age 53.6 years, 52.9% women) were included. Independently of age and gender, individual social parameters were unequally distributed across areas with different small-area environmental socioeconomic parameters. A place of birth abroad and social class were significantly associated with all small-area environmental socioeconomic parameters. If the impact of environmental socioeconomic parameters on individual health or illness is determined, the unequal small-area distribution of individual social parameters should be considered. © Georg Thieme Verlag KG Stuttgart · New York.

Socio-economic and ecological impacts of global protected area expansion plans

PubMed Central

Visconti, Piero; Bakkenes, Michel; Smith, Robert J.; Joppa, Lucas; Sykes, Rachel E.

2015-01-01

Several global strategies for protected area (PA) expansion have been proposed to achieve the Convention on Biological Diversity's Aichi target 11 as a means to stem biodiversity loss, as required by the Aichi target 12. However, habitat loss outside PAs will continue to affect habitats and species, and PAs may displace human activities into areas that might be even more important for species persistence. Here we measure the expected contribution of PA expansion strategies to Aichi target 12 by estimating the extent of suitable habitat available for all terrestrial mammals, with and without additional protection (the latter giving the counterfactual outcome), under different socio-economic scenarios and consequent land-use change to 2020. We found that expanding PAs to achieve representation targets for ecoregions under a Business-as-usual socio-economic scenario will result in a worse prognosis than doing nothing for more than 50% of the world's terrestrial mammals. By contrast, targeting protection towards threatened species can increase the suitable habitat available to over 60% of terrestrial mammals. Even in the absence of additional protection, an alternative socio-economic scenario, adopting progressive changes in human consumption, leads to positive outcomes for mammals globally and to the largest improvements for wide-ranging species. PMID:26460136

Socio-economic and ecological impacts of global protected area expansion plans.

PubMed

Visconti, Piero; Bakkenes, Michel; Smith, Robert J; Joppa, Lucas; Sykes, Rachel E

2015-11-05

Several global strategies for protected area (PA) expansion have been proposed to achieve the Convention on Biological Diversity's Aichi target 11 as a means to stem biodiversity loss, as required by the Aichi target 12. However, habitat loss outside PAs will continue to affect habitats and species, and PAs may displace human activities into areas that might be even more important for species persistence. Here we measure the expected contribution of PA expansion strategies to Aichi target 12 by estimating the extent of suitable habitat available for all terrestrial mammals, with and without additional protection (the latter giving the counterfactual outcome), under different socio-economic scenarios and consequent land-use change to 2020. We found that expanding PAs to achieve representation targets for ecoregions under a Business-as-usual socio-economic scenario will result in a worse prognosis than doing nothing for more than 50% of the world's terrestrial mammals. By contrast, targeting protection towards threatened species can increase the suitable habitat available to over 60% of terrestrial mammals. Even in the absence of additional protection, an alternative socio-economic scenario, adopting progressive changes in human consumption, leads to positive outcomes for mammals globally and to the largest improvements for wide-ranging species. © 2015 The Author(s).

[Evaluation of the socioeconomic status in epidemiological surveys: hypotheses of research in the Brianza area MONICA project].

PubMed

Cesana, G C; Ferrario, M; De Vito, G; Sega, R; Grieco, A

1995-01-01

Socio-economic status (SES) has been reported as a causative factor of increasing health inequalities in industrialized countries. The phenomenon has been particularly investigated for job related diseases, including cardiovascular disease and risk. The group of occupational medicine specialists in the world wide MONItoring program of CARdiovascular disease (WHO-MONICA Project) is now producing a number of hypotheses about the application of internationally defined criteria and tools for SES evaluation in the Italian area of the Project, Area Brianza. After a short review of some main conceptual and methodological problems, a proposal is presented of an SES index, derived from the pooled data of two population surveys carried out in this area. From a randomized sample of 3200 residents, 25-64 years old, stratified by sex and age decade, 1731 subjects, 594 females and 1137 males, employed at the time of the screening were extracted. Four variables were considered: age, education, occupational level and job-strain (according to the Karasek-Theorell model) by which each subject was classified in three levels--high, medium, low--of education and occupation, whose combination was used to obtain as many levels of socio-economic status. This a method of building an SES index is based on a sequence of approximations following two essential criteria: limitation of the variables to be surveyed, through standardized procedures; ability to identify the "low" SES category, presumably more at risk for disease.

Linking sea level rise and socioeconomic indicators under the Shared Socioeconomic Pathways

NASA Astrophysics Data System (ADS)

Nauels, Alexander; Rogelj, Joeri; Schleussner, Carl-Friedrich; Meinshausen, Malte; Mengel, Matthias

2017-11-01

In order to assess future sea level rise and its societal impacts, we need to study climate change pathways combined with different scenarios of socioeconomic development. Here, we present sea level rise (SLR) projections for the Shared Socioeconomic Pathway (SSP) storylines and different year-2100 radiative forcing targets (FTs). Future SLR is estimated with a comprehensive SLR emulator that accounts for Antarctic rapid discharge from hydrofracturing and ice cliff instability. Across all baseline scenario realizations (no dedicated climate mitigation), we find 2100 median SLR relative to 1986-2005 of 89 cm (likely range: 57-130 cm) for SSP1, 105 cm (73-150 cm) for SSP2, 105 cm (75-147 cm) for SSP3, 93 cm (63-133 cm) for SSP4, and 132 cm (95-189 cm) for SSP5. The 2100 sea level responses for combined SSP-FT scenarios are dominated by the mitigation targets and yield median estimates of 52 cm (34-75 cm) for FT 2.6 Wm-2, 62 cm (40-96 cm) for FT 3.4 Wm-2, 75 cm (47-113 cm) for FT 4.5 Wm-2, and 91 cm (61-132 cm) for FT 6.0 Wm-2. Average 2081-2100 annual SLR rates are 5 mm yr-1 and 19 mm yr-1 for FT 2.6 Wm-2 and the baseline scenarios, respectively. Our model setup allows linking scenario-specific emission and socioeconomic indicators to projected SLR. We find that 2100 median SSP SLR projections could be limited to around 50 cm if 2050 cumulative CO2 emissions since pre-industrial stay below 850 GtC, with a global coal phase-out nearly completed by that time. For SSP mitigation scenarios, a 2050 carbon price of 100 US2005 tCO2 -1 would correspond to a median 2100 SLR of around 65 cm. Our results confirm that rapid and early emission reductions are essential for limiting 2100 SLR.

Neighborhood socioeconomic context and cognitive decline among older Mexican Americans: results from the Sacramento Area Latino Study on Aging.

PubMed

Zeki Al Hazzouri, Adina; Haan, Mary N; Osypuk, Theresa; Abdou, Cleopatra; Hinton, Ladson; Aiello, Allison E

2011-08-15

In 1 previous study, it was shown that neighborhood socioeconomic disadvantage is associated with cognitive decline among Latinos. No studies have explored whether and to what extent individual-level socioeconomic factors account for the relation between neighborhood disadvantage and cognitive decline. The purpose of the present study was to assess the influence of neighborhood socioeconomic position (SEP) on cognitive decline and examine how individual-level SEP factors (educational level, annual income, and occupation) influenced neighborhood associations over the course of 10 years. Participants (n = 1,789) were community-dwelling older Mexican Americans from the Sacramento Area Latino Study on Aging. Neighborhood SEP was derived by linking the participant's individual data to the 2000 decennial census. The authors assessed cognitive function with the Modified Mini-Mental State Examination. Analyses used 3-level hierarchical linear mixed models of time within individuals within neighborhoods. After adjustment for individual-level sociodemographic characteristics, higher neighborhood SEP was significantly associated with cognitive function (β = -0.033; P < 0.05) and rates of decline (β = -0.0009; P < 0.10). After adjustment for individual educational level, neighborhood SEP remained associated with baseline cognition but not with rates of decline. Differences in individual educational levels explained most of the intra- and interneighborhood variance. These results suggest that the effect of neighborhood SEP on cognitive decline among Latinos is primarily accounted for by education.

[Physical activity levels among Colombian adults: inequalities by gender and socioeconomic status].

PubMed

González, Silvia; Lozano, Óscar; Ramírez, Andrea; Grijalba, Carlos

2014-01-01

Worldwide studies show inequalities in physical activity levels related to socio-demographic characteristics. In Colombia, among the countries in Latin America with the highest inequality, the evidence related to inequalities in physical activity is limited. It is imperative to identify disparities in physical activity in the country, to guide the design of public policies aimed at promoting physical activity. 1) To estimate the prevalence and associated factors of meeting physical activity recommendations; 2) to assess inequalities by gender and socioeconomic status in meeting physical activity recommendations, and 3) to assess the trends in physical activity prevalence within a five-year period. A secondary analysis of data from the 2010 National Nutrition Survey was conducted. The sample included 27,243 adults. The International Physical Activity Questionnaire was used to measure leisure time and transport domains. Socioeconomic status was measured by the Sisben level. Compared to men, women were less likely to meet physical activity recommendations in all domains. Compared to adults from high socioeconomic-status households, low socioeconomic-status adults had a lower prevalence of meeting physical activity recommendations during leisure time and the highest prevalence of using a bicycle for transport. The factors associated with meeting physical activity recommendations differed by gender and physical activity domain. Household and individual variables explained 13.6% of the inequalities observed by gender, and 23.2% of the inequalities by socioeconomic status. In a five-year period, the prevalence of physical activity in leisure time decreased, while the physical activity of walking for transport increased and biking for transport did not change. Future interventions to increase physical activity levels in Colombia must consider inequalities by gender and socioeconomic status. Of special concern is the low prevalence of meeting physical activity

Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis

PubMed Central

2012-01-01

Background A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge. PMID:23176397

Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan.

PubMed

Fukuda, Yoshiharu; Nakamura, Keiko; Takano, Takehito

2007-03-01

To formulate an index representing area deprivation and elucidate the relation between the index and mortality in Japan. Ecological study for prefectures (N=47) and municipalities (N=3366) across Japan. Based on socioeconomic indicators of seven domains of deprivation (i.e. unemployment, overcrowding, low social class and poverty, low education, no home ownership, low income and vulnerable group), an index was formulated using the z-scoring method. The relation between the index and mortality was examined by correlation analysis, hierarchical Poisson regression and comparison of standardized mortality ratio according to the index. The deprivation index ranged from -7.48 to 10.98 for prefectures and from -16.97 to 13.82 for municipalities. The index was significantly positively correlated with prefectural mortality, especially in the population aged under 74 years: r=0.65 for men and r=0.41 for women. At the municipal level, hierarchical Poisson regression showed a significant positive coefficient of the index to mortality for both men and women, and excess mortality in the most deprived fifth compared to the least deprived fifth was 26.4% in men and 11.8% in women. We formulated a deprivation index, which was substantially related to mortality at the prefectural and municipal levels. This study highlights the higher risk of dying among populations in socially disadvantaged areas and encourages the use of indices representing area socioeconomic conditions for further studies of area effects on health.

Unequal socioeconomic distribution of the primary care workforce: whole-population small area longitudinal study

PubMed Central

Cookson, Richard; Fleetcroft, Robert; Ali, Shehzad

2016-01-01

Objective To measure changes in socioeconomic inequality in the distribution of family physicians (general practitioners (GPs)) relative to need in England from 2004/2005 to 2013/2014. Design Whole-population small area longitudinal data linkage study. Setting England from 2004/2005 to 2013/2014. Participants 32 482 lower layer super output areas (neighbourhoods of 1500 people on average). Main outcome measures Slope index of inequality (SII) between the most and least deprived small areas in annual full-time equivalent GPs (FTE GPs) per 100 000 need adjusted population. Results In 2004/2005, inequality in primary care supply as measured by the SII in FTE GPs was 4.2 (95% CI 3.1 to 5.3) GPs per 100 000. By 2013/2014, this SII had fallen to −0.7 (95% CI −2.5 to 1.1) GPs per 100 000. The number of FTE GPs per 100 000 serving the most deprived fifth of small areas increased over this period from 54.0 to 60.5, while increasing from 57.2 to 59.9 in the least deprived fifth, so that by the end of the study period there were more GPs per 100 000 need adjusted population in the most deprived areas than in the least deprived. The increase in GP supply in the most deprived fifth of neighbourhoods was larger in areas that received targeted investment for establishing new practices under the ‘Equitable Access to Primary Medical Care’. Conclusions There was a substantial reduction in socioeconomic inequality in family physician supply associated with national policy. This policy may not have completely eliminated socioeconomic inequality in family physician supply since existing need adjustment formulae do not fully capture the additional burden of multimorbidity in deprived neighbourhoods. The small area approach introduced in this study can be used routinely to monitor socioeconomic inequality of access to primary care and to indicate workforce shortages in particular neighbourhoods. http://creativecommons.org/licenses/by/4.0 PMID:26787245

Association between individual-level and community-level socio-economic status and blood pressure among Inuit in Greenland.

PubMed

Riva, Mylène; Larsen, Christina Viskum Lytken; Bjerregaard, Peter

2016-01-01

Despite abundant evidence that socio-economic status (SES) is a fundamental determinant of health, there is a dearth of research examining association between SES, measured at the individual and community levels, and cardiovascular risk factors and morbidity among indigenous populations. To examine the influence of individual-level and community-level SES on systolic and diastolic blood pressure among Greenlandic Inuit. Multilevel analysis of cross-sectional data from the Inuit Health in Transition - Greenland Survey, to which 3,108 Greenlandic Inuit aged 18 years and older participated. Blood pressure is measured using an automatic device, according to standardized protocol. Individual SES is measured by education. Community socio-economic conditions are measured using combined information on average disposable household income and settlement type. Education was not significantly associated with blood pressure. There was an inverse U-shape association between community socio-economic conditions and blood pressure with significantly lower SBP and DBP among participants living in remote traditional villages characterized by lower average disposable household income and in affluent more urbanized towns. Sex-stratified analyses demonstrate the salience of community conditions for men. The association observed between blood pressure and community-level socio-economic conditions suggests that public health and social policies, programmes and interventions aiming to improve living conditions might improve cardiovascular health in Greenland. Studies are required to further examine social gradients in cardiovascular risk factors and morbidity among indigenous populations using different measures of SES.

Socioeconomic disadvantage and the purchase of takeaway food: a multilevel analysis.

PubMed

Turrell, Gavin; Giskes, Katrina

2008-07-01

This study examined relationships between individual-level socioeconomic position, area-level disadvantage, characteristics of the takeaway food environment, and the purchase of takeaway food. 'Takeaway' is conceptualised as foods or meals that are prepared and purchased outside of the home, and ready for immediate consumption either at the place of purchase or elsewhere. The analytic sample comprised 1001 households and 50 small areas in Brisbane, Australia. Takeaway food was purchased more regularly by high-income householders and those with higher levels of education. Residents of advantaged areas purchased takeaway food more regularly, although area differences attenuated to the null after adjustment for individual-level compositional factors. Number of takeaway shops in the local food environment, and road distance to the closest takeaway shop, were largely unrelated to the purchase of takeaway food. We conclude that there is little evidence that takeaway food purchasing in Brisbane is influenced by area-level socioeconomic disadvantage or features of the takeaway food environment. Rather, it seems that what matters most in terms of influencing the decision or capacity of Brisbane residents to purchase takeaway food are the socioeconomic characteristics of individuals and their households. The findings of this and previous analyses of the Brisbane Food Study data suggest that policy and health promotion aimed at improving the diets of residents and reducing dietary inequalities between socioeconomic groups should focus on people more so than places.

Unequal socioeconomic distribution of the primary care workforce: whole-population small area longitudinal study.

PubMed

Asaria, Miqdad; Cookson, Richard; Fleetcroft, Robert; Ali, Shehzad

2016-01-19

To measure changes in socioeconomic inequality in the distribution of family physicians (general practitioners (GPs)) relative to need in England from 2004/2005 to 2013/2014. Whole-population small area longitudinal data linkage study. England from 2004/2005 to 2013/2014. 32,482 lower layer super output areas (neighbourhoods of 1500 people on average). Slope index of inequality (SII) between the most and least deprived small areas in annual full-time equivalent GPs (FTE GPs) per 100,000 need adjusted population. In 2004/2005, inequality in primary care supply as measured by the SII in FTE GPs was 4.2 (95% CI 3.1 to 5.3) GPs per 100,000. By 2013/2014, this SII had fallen to -0.7 (95% CI -2.5 to 1.1) GPs per 100,000. The number of FTE GPs per 100,000 serving the most deprived fifth of small areas increased over this period from 54.0 to 60.5, while increasing from 57.2 to 59.9 in the least deprived fifth, so that by the end of the study period there were more GPs per 100,000 need adjusted population in the most deprived areas than in the least deprived. The increase in GP supply in the most deprived fifth of neighbourhoods was larger in areas that received targeted investment for establishing new practices under the 'Equitable Access to Primary Medical Care'. There was a substantial reduction in socioeconomic inequality in family physician supply associated with national policy. This policy may not have completely eliminated socioeconomic inequality in family physician supply since existing need adjustment formulae do not fully capture the additional burden of multimorbidity in deprived neighbourhoods. The small area approach introduced in this study can be used routinely to monitor socioeconomic inequality of access to primary care and to indicate workforce shortages in particular neighbourhoods. http://creativecommons.org/licenses/by/4.0. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Individual and School-Level Socioeconomic Gradients in Physical Activity in Australian School children

ERIC Educational Resources Information Center

Lewis, Lucy; Maher, Carol; Katzmarzyk, Peter; Olds, Timothy

2016-01-01

Background: We attempted to determine whether there was a socioeconomic gradient in 9- to 11-year-old Australian children's moderate-to-vigorous physical activity (MVPA), and whether school facilities or policies supporting physical activity were associated with school-level socioeconomic status (SES) and MVPA. Methods: Children (N = 528) from 26…

The Purdue Elementary Problem-Solving Inventory (PEPSI), Grade Level, and Socioeconomic Status: A Preliminary Study.

ERIC Educational Resources Information Center

Cox, David W.

1985-01-01

The effects of grade level and socioeconomic status upon Purdue Elementary Problem-Solving Inventory (PEPSI) scores were investigated with 123 elementary students. It was concluded that the PEPSI is usable with most grade two through grade six pupils at both lower and middle socioeconomic levels, and has potential utility in teaching…

Geographic variation in colorectal cancer survival and the role of small-area socioeconomic deprivation: a multilevel survival analysis of the NIH-AARP Diet and Health Study Cohort.

PubMed

Lian, Min; Schootman, Mario; Doubeni, Chyke A; Park, Yikyung; Major, Jacqueline M; Stone, Rosalie A Torres; Laiyemo, Adeyinka O; Hollenbeck, Albert R; Graubard, Barry I; Schatzkin, Arthur

2011-10-01

Adverse socioeconomic conditions, at both the individual and the neighborhood level, increase the risk of colorectal cancer (CRC) death, but little is known regarding whether CRC survival varies geographically and the extent to which area-level socioeconomic deprivation affects this geographic variation. Using data from the National Institutes of Health (NIH)-AARP Diet and Health Study, the authors examined geographic variation and the role of area-level socioeconomic deprivation in CRC survival. CRC cases (n = 7,024), identified during 1995-2003, were followed for their CRC-specific vital status through 2005 and overall vital status through 2006. Bayesian multilevel survival models showed that there was significant geographic variation in overall (variance = 0.2, 95% confidence interval (CI): 0.1, 0.2) and CRC-specific (variance = 0.3, 95% CI: 0.1, 0.4) risk of death. More socioeconomically deprived neighborhoods had a higher overall risk of death (most deprived quartile vs. least deprived: hazard ratio = 1.2, 95% CI: 1.1, 1.4) and a higher CRC-specific risk of death (most deprived quartile vs. least deprived: hazard ratio = 1.2, 95% CI: 1.1, 1.5). However, neighborhood socioeconomic deprivation did not account for the geographic variation in overall and CRC-specific risks of death. In future studies, investigators should evaluate other neighborhood characteristics to help explain geographic heterogeneity in CRC survival. Such research could facilitate interventions for reducing geographic disparity in CRC survival.

Socioeconomic Determinants of Urban Poverty Area Workers' Labor Force Participation and Income.

ERIC Educational Resources Information Center

Pinkerton, James R.

This study examined how the socioeconomic characteristics of male workers from poverty areas in Saint Louis, Missouri, San Antonio, Texas, and Chicago, Illinois, affect their incomes, hours of employment, unemployment, and labor force participation. The research was based on statistical analysis, using an interaction model, of data from the 1970…

Relationships between Family Levels of Socioeconomic Status and Distribution of Breast Cancer Risk Factors

PubMed Central

Mohaghegh, Pegah; Yavari, Parvin; Akbari, Mohammad Esmaeil; Abadi, Alireza; Ahmadi, Farzaneh; Shormeij, Zeinab

2015-01-01

Background Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. Methods This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. Results The mean age of the patients was 48.30 (SD=11.41). According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer (p value<0.001). Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant (p value> 0.001). In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant (p value> 0.007). Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant (p value=0.05 and p value=0.02, respectively). Conclusion The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective

Relationships between Family Levels of Socioeconomic Status and Distribution of Breast Cancer Risk Factors.

PubMed

Mohaghegh, Pegah; Yavari, Parvin; Akbari, Mohammad Esmaeil; Abadi, Alireza; Ahmadi, Farzaneh; Shormeij, Zeinab

2015-01-01

Not only the expand development of knowledge for reducing risk factors, but also the improvement in early diagnosis and treatment of cancer, and socioeconomic inequalities could affect cancer incidence, diagnosis stage, and mortality. The aim of this study was investigation the relationships between family levels of socioeconomic status and distribution of breast cancer risk factors. This descriptive cross-sectional study has conducted on 526 patients who were suffering from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from March 2008 to December 2013. A reliable and valid questionnaire about family levels of socioeconomic status has filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS19. The mean age of the patients was 48.30 (SD=11.41). According to the results of this study, there was a significant relationship between family socioeconomic status and patient's age at diagnosis of breast cancer (p value<0.001). Also, the relationships between socioeconomic status and number of pregnancies, and duration of breast feeding were significant (p value> 0.001). In the multiple logistic regressions, the relationship between excellent socioeconomic status and number of abortions was significant (p value> 0.007). Furthermore, the relationships between moderate and good socioeconomic statuses and smoking were significant (p value=0.05 and p value=0.02, respectively). The results have indicated that among those patients having better socioeconomic status, age at cancer diagnosis, number of pregnancies and duration of breast feeding was lower, and then number of abortions was more than the others. According to the results of this study, it was really important to focus on family socioeconomic status as a critical and effective variable on breast cancer risk factors

Associations between area-level unemployment, body mass index, and risk factors for cardiovascular disease in an urban area.

PubMed

Naimi, Ashley Isaac; Paquet, Catherine; Gauvin, Lise; Daniel, Mark

2009-12-01

Cardiovascular Disease (CVD) has been linked to "neighbourhood" socioeconomic status (nSES), often operationalized as a composite index of aggregate income, occupation and education within predefined administrative boundaries. The role of specific, non-composite socioeconomic markers has not been clearly explained. It is also unclear whether the relationship between nSES and CVD varies according to sex. We sought to determine whether area-level unemployment (ALU) was associated with CVD risk, and whether this association differed by sex. 342 individuals from the Montreal Neighbourhood Survey of Lifestyle and Health provided self-reported behavioural and socioeconomic information. A nurse collected biochemical and anthropometric data. ALU, a weighted average of the proportion of persons 15-years and older available for but without work, was measured using a Geographic Information System for a 250 m buffer centred on individual residence. Generalized Estimating Equations were used to estimate the associations between ALU, body mass index (BMI) and a cumulative score for total cardiometabolic risk (TCR). After confounder adjustments, the mean 4(th) minus 1(st) quartile difference in BMI was 3.19 kg/m(2) (95% CI: 2.39, 3.99), while the prevalence ratio for the 4(th) relative to 1(st) quartile for TCR was 2.20 (95 % CI: 1.53, 3.17). Sex interacted with ALU; women relative to men had greater mean 3.97 kg/m(2) (95% CI: 2.08, 5.85) BMI and greater mean TCR 1.51 (95% CI: 0.78, 2.90), contrasted at mean ALU. Area-level unemployment is associated with greater CVD risk, and this association is stronger for women.

Learning Strategies in Different Socioeconomic Levels. Final Report, June 27, 1968 - September 1, 1970.

ERIC Educational Resources Information Center

Shapiro, Martin M.; And Others

Learning behavior of young children of contrasting socioeconomic backgrounds is examined in this study, which poses the question: what are the necessary or sufficient environmental conditions for the establishment of identifiable patterns of behavior? Socioeconomic level (SEL), the principal independent variable, was defined in terms of parental…

Association of Childhood Blood Lead Levels With Cognitive Function and Socioeconomic Status at Age 38 Years and With IQ Change and Socioeconomic Mobility Between Childhood and Adulthood.

PubMed

Reuben, Aaron; Caspi, Avshalom; Belsky, Daniel W; Broadbent, Jonathan; Harrington, Honalee; Sugden, Karen; Houts, Renate M; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E

2017-03-28

Many children in the United States and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain. To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife. A prospective cohort study based on a population-representative 1972-1973 birth cohort from New Zealand; the Dunedin Multidisciplinary Health and Development Study observed participants to age 38 years (until December 2012). Childhood lead exposure ascertained as blood lead levels measured at age 11 years. High blood lead levels were observed among children from all socioeconomic status levels in this cohort. The IQ (primary outcome) and indexes of Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed (secondary outcomes) were assessed at age 38 years using the Wechsler Adult Intelligence Scale-IV (WAIS-IV; IQ range, 40-160). Socioeconomic status (primary outcome) was assessed at age 38 years using the New Zealand Socioeconomic Index-2006 (NZSEI-06; range, 10 [lowest]-90 [highest]). Of 1037 original participants, 1007 were alive at age 38 years, of whom 565 (56%) had been lead tested at age 11 years (54% male; 93% white). Mean (SD) blood lead level at age 11 years was 10.99 (4.63) µg/dL. Among blood-tested participants included at age 38 years, mean WAIS-IV score was 101.16 (14.82) and mean NZSEI-06 score was 49.75 (17.12). After adjusting for maternal IQ, childhood IQ, and childhood socioeconomic status, each 5-µg/dL higher level of blood lead in childhood was associated with a 1.61-point lower score (95% CI, -2.48 to -0.74) in adult IQ, a 2.07-point lower score (95% CI, -3.14 to -1.01) in perceptual reasoning, and a 1.26-point lower score (95% CI, -2.38 to -0.14) in working memory. Associations of childhood blood lead level with deficits in

Sea level rise under the Shared Socioeconomic Pathways (SSPs)

NASA Astrophysics Data System (ADS)

Schleussner, C. F.; Nauels, A.; Rogelj, J.; Mengel, M.; Meinshausen, M.

2017-12-01

In order to assess future sea level rise and its impacts, we need to study climate change pathways combined with different scenarios of socioeconomic development. Here, we present Sea Level Rise (SLR) projections for the Shared Socioeconomic Pathway (SSP) storylines and different year-2100 radiative Forcing Targets (FTs). Future SLR is estimated with a comprehensive SLR emulator that accounts for latest research on additional Antarctic rapid discharge dynamics from hydrofracturing and ice cliff instability. Across all baseline scenario realizations (no dedicated climate mitigation), we find 2100 median SLR relative to 1986-2005 of 102 cm (likely range: 77 to 135 cm) for SSP1, 118 cm (90 to 151 cm) for SSP2, 118 cm (91 to 149 cm) for SSP3, 107 cm (81 to 137 cm) for SSP4, and 144 cm (112 to 184 cm) for SSP5. The 2100 sea level responses for combined SSP-FT scenarios is dominated by the mitigation targets and yield median estimates of 68 cm (56 to 87 cm) for FT 2.6 Wm-2, 76 cm (61 to 107 cm) for FT 3.4 Wm-2, 90 cm (68 to 120 cm) for FT 4.5 Wm-2, and 105 cm (79 to 136 cm) for FT 6.0 Wm-2. Average 2081-2100 annual rates of SLR are 6 mm/yr and 19 mm/yr for the FT 2.6 Wm-2 and the baseline scenarios, respectively. Our model setup allows linking scenario-specific emission and socioeconomic indicators to projected SLR. For limiting median 2100 SSP SLR projections to below 80 cm, we find that 2050 cumulative CO2 emissions since pre-industrial should not exceed around 860 GtC, with the global coal phase-out nearly completed. For SSP mitigation scenarios, the median 2050 carbon price of 90 US$2005 tCO2-1 would correspond to a median 2100 SLR of around 80 cm. Our results confirm that rapid and early emission reductions are essential for limiting 2100 SLR.

Regional Inequalities in Lung Cancer Mortality in Belgium at the Beginning of the 21st Century: The Contribution of Individual and Area-Level Socioeconomic Status and Industrial Exposure.

PubMed

Hagedoorn, Paulien; Vandenheede, Hadewijch; Willaert, Didier; Vanthomme, Katrien; Gadeyne, Sylvie

2016-01-01

Being a highly industrialized country with one of the highest male lung cancer mortality rates in Europe, Belgium is an interesting study area for lung cancer research. This study investigates geographical patterns in lung cancer mortality in Belgium. More specifically it probes into the contribution of individual as well as area-level characteristics to (sub-district patterns in) lung cancer mortality. Data from the 2001 census linked to register data from 2001-2011 are used, selecting all Belgian inhabitants aged 65+ at time of the census. Individual characteristics include education, housing status and home ownership. Urbanicity, unemployment rate, the percentage employed in mining and the percentage employed in other high-risk industries are included as sub-district characteristics. Regional variation in lung cancer mortality at sub-district level is estimated using directly age-standardized mortality rates. The association between lung cancer mortality and individual and area characteristics, and their impact on the variation of sub-district level is estimated using multilevel Poisson models. Significant sub-district variations in lung cancer mortality are observed. Individual characteristics explain a small share of this variation, while a large share is explained by sub-district characteristics. Individuals with a low socioeconomic status experience a higher lung cancer mortality risk. Among women, an association with lung cancer mortality is found for the sub-district characteristics urbanicity and unemployment rate, while for men lung cancer mortality was associated with the percentage employed in mining. Not just individual characteristics, but also area characteristics are thus important determinants of (regional differences in) lung cancer mortality.

Integrated conservation and development: evaluating a community-based marine protected area project for equality of socioeconomic impacts.

PubMed

Gurney, Georgina G; Pressey, Robert L; Cinner, Joshua E; Pollnac, Richard; Campbell, Stuart J

2015-11-05

Despite the prevalence of protected areas, evidence of their impacts on people is weak and remains hotly contested in conservation policy. A key question in this debate is whether socioeconomic impacts vary according to social subgroup. Given that social inequity can create conflict and impede poverty reduction, understanding how protected areas differentially affect people is critical to designing them to achieve social and biological goals. Understanding heterogeneous responses to protected areas can improve targeting of management activities and help elucidate the pathways through which impacts of protected areas occur. Here, we assessed whether the socioeconomic impacts of marine protected areas (MPAs)-designed to achieve goals for both conservation and poverty alleviation-differed according to age, gender or religion in associated villages in North Sulawesi, Indonesia. Using data from pre-, mid- and post-implementation of the MPAs for control and project villages, we found little empirical evidence that impacts on five key socioeconomic indicators related to poverty differed according to social subgroup. We found suggestive empirical evidence that the effect of the MPAs on environmental knowledge differed by age and religion; over the medium and long terms, younger people and Muslims showed greater improvements compared with older people and Christians, respectively. © 2015 The Author(s).

Integrated conservation and development: evaluating a community-based marine protected area project for equality of socioeconomic impacts

PubMed Central

Gurney, Georgina G.; Pressey, Robert L.; Cinner, Joshua E.; Pollnac, Richard; Campbell, Stuart J.

2015-01-01

Despite the prevalence of protected areas, evidence of their impacts on people is weak and remains hotly contested in conservation policy. A key question in this debate is whether socioeconomic impacts vary according to social subgroup. Given that social inequity can create conflict and impede poverty reduction, understanding how protected areas differentially affect people is critical to designing them to achieve social and biological goals. Understanding heterogeneous responses to protected areas can improve targeting of management activities and help elucidate the pathways through which impacts of protected areas occur. Here, we assessed whether the socioeconomic impacts of marine protected areas (MPAs)—designed to achieve goals for both conservation and poverty alleviation—differed according to age, gender or religion in associated villages in North Sulawesi, Indonesia. Using data from pre-, mid- and post-implementation of the MPAs for control and project villages, we found little empirical evidence that impacts on five key socioeconomic indicators related to poverty differed according to social subgroup. We found suggestive empirical evidence that the effect of the MPAs on environmental knowledge differed by age and religion; over the medium and long terms, younger people and Muslims showed greater improvements compared with older people and Christians, respectively. PMID:26460130

Cross-sectional study of area-level disadvantage and glycaemic-related risk in community health service users in the Southern.IML Research (SIMLR) cohort.

PubMed

Cross, Roger; Bonney, Andrew; Mayne, Darren J; Weston, Kathryn M

2017-09-19

Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia. Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence. Glycaemic risk categories were defined as HbA1c 5.0-5.99% (lowest risk), 6.0-7.49% (intermediate risk) and ≥7.5% (highest risk). Logistic regression models were fit with glycaemic risk category as the outcome variable and IRSD as the study variable, adjusting for age and sex. Results Data from 29064 individuals were analysed. Higher disadvantage was associated with belonging to a higher glycaemic risk category in the fully adjusted model (most disadvantaged vs least disadvantaged quintile; odds ratio 1.74, 95% confidence interval 1.58, 1.93; P<0.001). Conclusion In this geocoded clinical dataset, area-level socioeconomic disadvantage was a significant correlate of increased glycaemic-related risk. Geocoded clinical data can inform more targeted use of health service resources, with the potential for improved health care equity and cost-effectiveness. What is known about the topic? The rapid increase in the prevalence of Type 2 diabetes (T2D), both globally and nationally within Australia, is a major concern for the community and public health agencies. Individual socioeconomic disadvantage is a known risk factor for abnormal glucose metabolism (AGM), including T2D. Although small-area-level socioeconomic disadvantage is a known correlate of AGM in Australia, less is known of the association of area-level disadvantage and glycaemic-related risk in individuals with AGM. What does this

Experiences of cancer caregiving in socioeconomically deprived areas of Attica, Greece.

PubMed

Germeni, Evi; Sarris, Markos

2015-07-01

The shift of the majority of cancer care from inpatient to outpatient settings has given rise to a number of issues that have not yet been adequately addressed. This is especially true in countries undergoing rapid and profound socioeconomic changes that have substantially affected the health care sector. We conducted 12 in-depth interviews with family cancer caregivers residing in socioeconomically deprived areas of Attica, Greece. Using an inductive thematic approach, we identified three major themes: (a) the truth within boundaries, focusing on the flow of information in the triad doctor-caregiver-patient; (b) the evil called "cancer," reflecting caregivers' perceptions of the illness; and (c) being left "high and dry," reflecting participant experiences of home-based care. Against a background of financial crisis, this study underlines the need for safeguarding the rights of chronically ill patients and ensuring that informal cancer care, apart from a cost-effective solution, will also be an efficient one. © The Author(s) 2014.

Patterns and socioeconomic influences of tobacco exposure in tobacco cultivating rural areas of Yunnan Province, China

PubMed Central

2012-01-01

Background This study describes the patterns and socioeconomic influences of tobacco use among adults in tobacco-cultivating regions of rural southwest China. Methods A cross-sectional survey was conducted in 8681 adults aged ≥18 years in rural areas of Yunnan Province, China from 2010 to 2011. A standardized questionnaire was administered to obtain data about participants’ demographic characteristics, individual socioeconomic status, ethnicity, self-reported smoking habits, and exposure to secondhand smoke (SHS). The socioeconomic predictors of current smoking, nicotine addiction, and SHS exposure were analyzed using multivariate logistic regression. Results The prevalence rates of tobacco use were much higher in men compared with women (current smoking 68.5% vs. 1.3%; and nicotine dependence 85.2% vs. 72.7%). However, the rate of SHS exposure was higher in women compared with men (76.6% vs. 70.5%). Tobacco farmers had higher prevalence rates of current smoking, nicotine dependence, and SHS exposure compared with participants not engaged in tobacco farming (P<0.01). Most tobacco users (84.5%) reported initiating smoking during adolescence. A total of 81.1% of smokers smoked in public places, and 77.6% smoked in workplaces. Individuals belonging to an ethnic minority had a lower probability of SHS exposure and nicotine dependence. Individual educational level was found to be inversely associated with the prevalence of current smoking, exposure to SHS, and nicotine dependence. Higher annual household income was associated with a greater risk of nicotine dependence. Conclusions This study suggests that tobacco control efforts in rural southwest China must be tailored to address tobacco-cultivating status and socioeconomic factors. PMID:23035644

Socioeconomic Disadvantage Is Associated with a Higher Incidence of Aneurysmal Subarachnoid Hemorrhage.

PubMed

Nichols, Linda; Stirling, Christine; Otahal, Petr; Stankovich, Jim; Gall, Seana

2018-03-01

Aneurysmal subarachnoid hemorrhage (aSAH) incidence is not well studied. Varied definitions of "subarachnoid hemorrhage" have led to a lack of clarity regarding aSAH incidence. The impact of area-level socioeconomic disadvantage and geographical location on the incidence of aSAH also remains unclear. Using a population-based statewide study, we examined the incidence of aSAH in relation to socioeconomic disadvantage and geographical location. A retrospective cohort study of nontraumatic subarachnoid hemorrhages from 2010 to 2014 was undertaken. Researchers manually collected data from multiple overlapping sources including statewide administrative databases, individual digital medical records, and death registers. Age-standardized rates (ASRs) per 100,000 person years were calculated using the 2001 Australian population. Differences in incidence rate ratios were calculated by age, sex, area-level socioeconomic status, and geographical location using Poisson regression. The cohort of 237 cases (mean age, 61.0 years) with a female predominance of 166 (70.04%) included 159 confirmed aSAH, 52 community-based deaths, and 26 probable cases. The ASR for aSAH was 9.99 (95% confidence interval [CI], 8.69-11.29). A significant association between area-level socioeconomic disadvantage and incidence was observed, with the rate of aSAH in disadvantaged geographical areas being 1.40 times higher than that in advantaged areas (95% CI, 1.11-1.82; P = .012). This study uses a comprehensive search of multiple data sources to define a new baseline of aSAH within an Australian population. This study presents a higher incidence rate of aSAH with socioeconomic variations. As a key risk factor that may explain this paradox, addressing socioeconomic inequalities is important for effective prevention and management interventions. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Association of childhood blood-lead levels with cognitive function and socioeconomic status at age 38 years and with IQ change and socioeconomic mobility between childhood and adulthood

PubMed Central

Reuben, Aaron; Caspi, Avshalom; Belsky, Daniel W.; Broadbent, Jonathan; Harrington, Honalee; Sugden, Karen; Houts, Renate M.; Ramrakha, Sandhya; Poulton, Richie; Moffitt, Terrie E.

2017-01-01

Importance Many children in the US and around the world are exposed to lead, a developmental neurotoxin. The long-term cognitive and socioeconomic consequences of lead exposure are uncertain. Objective To test the hypothesis that childhood lead exposure is associated with cognitive function and socioeconomic status in adulthood and with changes in IQ and socioeconomic mobility between childhood and midlife. Design, Setting, and Participants Prospective cohort study based on a population-representative 1972–73 birth cohort from New Zealand, the Dunedin Multidisciplinary Health and Development Study, followed to age 38 years (December, 2012). Exposure Childhood lead exposure ascertained as blood-lead levels measured at 11 years. High blood-lead levels were observed among children from all socioeconomic status levels in this cohort. Main Outcomes and Measures The IQ (primary outcome) and indexes of Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed (secondary outcomes) were assessed at 38 years using the Wechsler Adult Intelligence Scale–IV (WAIS-IV; IQ range 40–160). Socioeconomic status (primary outcome) was assessed at 38 years using the New Zealand Socioeconomic Index-2006, (NZSEI-06; range 10=lowest-90=highest). Results Of 1037 original participants, 1007 were alive at 38 years, of whom 565 (56%) had been lead tested at 11 years (54% male; 93% white). Mean blood-lead level at 11 years was 10.99μg/dL (SD=4.63). Among blood-tested participants included at 38 years, mean WAIS-IV score was 101.16 (SD=14.82) and mean NZSEI-06 score was 49.75 (SD=17.12). After adjusting for maternal IQ, childhood IQ, and childhood socioeconomic status, each 5μg/dL higher level of blood-lead in childhood was associated with a 1.61-point lower score (95%CI:−2.48, −0.74) in adult IQ, a 2.07-point lower score (95%CI: −3.14, −1.01) in Perceptual Reasoning, and a 1.26-point lower score (95%CI: −2.38, −0.14) in Working Memory. Lead

The household-based socio-economic deprivation index in Setiu Wetlands, Malaysia

NASA Astrophysics Data System (ADS)

Zakaria, Syerrina; May, Chin Sin; Rahman, Nuzlinda Abdul

2017-08-01

Deprivation index usually used in public health study. At the same time, deprivation index can also use to measure the level of deprivation in an area or a village. These indices are also referred as the index of inequalities or disadvantage. Even though, there are many indices that have been built before. But it is believed to be less appropriate to use the existing indices to be applied in other countries or areas which had different socio-economic conditions and different geographical characteristics. The objective of this study is to construct the index based on the socio-economic factors in Setiu Wetlands (Jajaran Merang, Jajaran Setiu and Jajaran Kuala Besut) in Terengganu Malaysia which is defined as weighted household-based socioeconomic deprivation index. This study has employed the variables based on income level, education level and employment rate obtained from questionnaire which are acquired from 64 villages included 1024 respondents. The factor analysis is used to extract the latent variables or observed variables into smaller amount of components or factors. By using factor analysis, one factor is extracted from 3 latent variables. This factor known as socioeconomic deprivation index. Based on the result, the areas with a lower index values until high index values were identified.

The retail availability of tobacco in Tasmania: evidence for a socio-economic and geographical gradient.

PubMed

Melody, Shannon M; Martin-Gall, Veronica; Harding, Ben; Veitch, Mark Gk

2018-03-19

To describe the retail availability of tobacco and to examine the association between tobacco outlet density and area-level remoteness and socio-economic status classification in Tasmania. Ecological cross-sectional study; analysis of tobacco retail outlet data collected by the Department of Health and Human Services (Tasmania) according to area-level (Statistical Areas Level 2) remoteness (defined by the Remoteness Structure of the Australian Statistical Geographical Standard) and socio-economic status (defined by the 2011 Australian Bureau of Statistics Index of Relative Socioeconomic Advantage and Disadvantage). Tobacco retail outlet density per 1000 residents. On 31 December 2016, there were 1.54 tobacco retail outlets per 1000 persons. The density of outlets was 79% greater in suburbs or towns in outer regional, remote and very remote Tasmania than in inner regional Tasmania (rate ratio [RR], 1.79; 95% confidence Interval [CI], 1.29-2.50; P < 0.001). Suburbs or towns in Tasmania with the greatest socio-economic disadvantage had more than twice the number of tobacco outlets per 1000 people as areas of least disadvantage (RR, 2.30; 95% CI, 1.32-4.21; P = 0.014). A disproportionate concentration of tobacco retail outlets in regional and remote Tasmania and in areas of lowest socio-economic status is evident. Our findings are consistent with those of analyses in New South Wales and Western Australia. Progressive tobacco retail restrictions have been proposed as the next frontier in tobacco control. However, the intended and unintended consequences of such policies need to be investigated, particularly for socio-economically deprived and rural areas.

An ecological study of the relationship between socioeconomic isolation and mental health in the most deprived areas in Auckland, New Zealand.

PubMed

Pearson, Amber L; Griffin, Edward; Davies, Anna; Kingham, Simon

2013-01-01

International debate posits that when groups feel deprived relative to reference groups in society, there may be psychosocial impacts. Deprivation varies geographically and deprived areas may be proximal to advantaged areas. In theory, this leads to chronic stress and poor mental health. This research explored whether socioeconomically isolated deprived areas experience increased levels of anxiety/mental disorder treatment, compared to other deprived areas. We developed a spatial isolation measure to characterise deprived areas surrounded by advantaged areas in Auckland, New Zealand. We found that isolated areas were characterised by fewer Māori and Pacific people, high density and shorter travel time to General Practitioners. We found significantly higher rates of anxiety/mood disorder treatment in highly isolated versus non-isolated areas and a statistically significant relationship with anxiety/mood disorders for each isolation level, both before and after confounder adjustment. This evidence suggests that mental health within small areas may be sensitive to the neighbourhood interactions, through social comparison or discrimination which lead to psychosocial stress. Copyright © 2012 Elsevier Ltd. All rights reserved.

General practitioners in German metropolitan areas - distribution patterns and their relationship with area level measures of the socioeconomic status.

PubMed

Bauer, Jan; Brueggmann, Doerthe; Ohlendorf, Daniela; Groneberg, David A

2016-11-25

Geographical variation of the general practitioner (GP) workforce is known between rural and urban areas. However, data about the variation between and within urban areas are lacking. We analyzed distribution patterns of GP full time equivalents (FTE) in German cities with a population size of more than 500,000. We correlated their distribution with area measures of social deprivation in order to analyze preferences within neighborhood characteristics. For this purpose, we developed two area measures of deprivation: Geodemographic Index (GDI) and Cultureeconomic Index (CEI). In total n = 9034.75 FTE were included in n = 14 cities with n = 171 districts. FTE were distributed equally on inter-city level (mean: 6.49; range: 5.12-7.20; SD: 0.51). However, on intra-city level, GP distribution was skewed (mean: 6.54; range: 1.80-43.98; SD: 3.62). Distribution patterns of FTE per 10^4 residents were significantly correlated with GDI (r = -0.49; p < 0.001) and CEI (r = -0.22; p = 0.005). Therefore, location choices of GPs were mainly positively correlated with 1) central location (r = -0.50; p < 0.001), 2) small household size of population (r = -0.50; p < 0.001) and 3) population density (r = 0.35; p < 0.001). Intra-city distribution of GPs was skewed, which could affect the equality of access for the urban population. Furthermore, health services planners should be aware of GP location preferences. This could be helpful to better understand and plan delivery of health services. Within this process the presented Geodemographic Index (GDI) could be of use.

Socioeconomic variation in the burden of chronic conditions and health care provision--analyzing administrative individual level data from the Basque Country, Spain.

PubMed

Orueta, Juan F; García-Álvarez, Arturo; Alonso-Morán, Edurne; Vallejo-Torres, Laura; Nuño-Solinis, Roberto

2013-09-22

Chronic diseases are posing an increasing challenge to society, with the associated burden falling disproportionally on more deprived individuals and geographical areas. Although the existence of a socioeconomic health gradient is one of the main concerns of health policy across the world, health information systems commonly do not have reliable data to detect and monitor health inequalities and inequities. The objectives of this study were to measure the level of socioeconomic-related inequality in prevalence of chronic diseases and to investigate the extent and direction of inequities in health care provision. A dataset linking clinical and administrative information of the entire population living in the Basque Country, Spain (over 2 million individuals) was used to measure the prevalence of 52 chronic conditions and to quantify individual health care costs. We used a concentration-index approach to measure the extent and direction of inequality with respect to the deprivation of the area of residence of each individual. Most chronic diseases were found to be disproportionally concentrated among individuals living in more deprived areas, but the extent of the imbalance varies by type of disease and sex. Most of the variation in health care utilization was explained by morbidity burden. However, even after accounting for differences in morbidity, pro-poor horizontal inequity was present in specialized outpatient care, emergency department, prescription, and primary health care costs and this fact was more apparent in females than males; inpatient costs exhibited an equitable distribution in both sexes. Analyses of comprehensive administrative clinical information at the individual level allow the socioeconomic gradient in chronic diseases and health care provision to be measured to a level of detail not possible using other sources. This frequently updated source of information can be exploited to monitor trends and evaluate the impact of policy reforms.

Wildland-Urban Interface Fires and Socioeconomic Conditions: A Case Study of a Northwestern Patagonia City

NASA Astrophysics Data System (ADS)

de Torres Curth, Monica; Biscayart, Carolina; Ghermandi, Luciana; Pfister, Gabriela

2012-04-01

In many regions of the world, fires are primarily of anthropogenic origin. In northwestern Patagonia, the number of fires is not correlated with meteorological variables, but is concentrated in urban areas. This study was conducted in the wildland-urban interface (WUI) area of San Carlos de Bariloche (Patagonia, Argentina), within the Nahuel Huapi National Park. WUI fires are particularly problematic because, besides people and goods, they represent a danger to protected areas. We studied the relationship between fire records and socioeconomic indicators within the WUI of San Carlos de Bariloche. We conducted a Multiple Correspondence Factorial Analysis and an Ascendant Hierarchical Classification of the city neighborhoods. The results show that the neighborhoods in Bariloche can be divided into three classes: High Socioeconomic Fire Risk neighborhoods, including neighborhoods with the highest fire rates, where people have low instruction level, high levels of unsatisfied basic needs and high unemployment levels; Low Socioeconomic Fire Risk neighborhoods, that groups neighborhoods which present the opposite characterization, and Moderate Socioeconomic Fire Risk neighborhoods, which are more heterogeneous. Once neighborhoods were classified, a Socioeconomic Fire Risk map was generated, supplementing the existing WUI Fire Danger map. Our results emphasize the relevance of socioeconomic variables to fire policies.

Assessment of Macro-Level Socioeconomic Factors That Impact Waterborne Diseases: The Case of Jordan.

PubMed

Polimeni, John M; Almalki, Ahmad; Iorgulescu, Raluca I; Albu, Lucian-Liviu; Parker, Wendy M; Chandrasekara, Ray

2016-11-25

The Hashemite Kingdom of Jordan is an example of a country that suffers from high water scarcity. Additionally, due to the economic drivers in the country, such as phosphate and potash extraction and pharmaceutical production, the little fresh water that remains is generally polluted. The infrastructure, often antiquated in urban areas and non-existent in rural areas, also contributes to poor water conditions and to the spread of waterborne diseases. This paper examines the socioeconomic factors that contribute to diarrhea and hepatitis A on a macro level in Jordan and discusses the public-policies that government officials could use to abate those problems. Ordinary least squares time series models are used to understand the macro-level variables that impact the incidence of these diseases in Jordan. Public health expenditure has a significant impact on reducing their incidence. Furthermore, investment in sanitation facilities in rural regions is likely to reduce the number of cases of hepatitis A. Perhaps the most surprising outcome is that importation of goods and services likely results in a decrease in cases of hepatitis A. However, income has little impact on the incidence of diarrhea and hepatitis A.

Assessment of Macro-Level Socioeconomic Factors That Impact Waterborne Diseases: The Case of Jordan

PubMed Central

Polimeni, John M.; Almalki, Ahmad; Iorgulescu, Raluca I.; Albu, Lucian-Liviu; Parker, Wendy M.; Chandrasekara, Ray

2016-01-01

The Hashemite Kingdom of Jordan is an example of a country that suffers from high water scarcity. Additionally, due to the economic drivers in the country, such as phosphate and potash extraction and pharmaceutical production, the little fresh water that remains is generally polluted. The infrastructure, often antiquated in urban areas and non-existent in rural areas, also contributes to poor water conditions and to the spread of waterborne diseases. This paper examines the socioeconomic factors that contribute to diarrhea and hepatitis A on a macro level in Jordan and discusses the public-policies that government officials could use to abate those problems. Ordinary least squares time series models are used to understand the macro-level variables that impact the incidence of these diseases in Jordan. Public health expenditure has a significant impact on reducing their incidence. Furthermore, investment in sanitation facilities in rural regions is likely to reduce the number of cases of hepatitis A. Perhaps the most surprising outcome is that importation of goods and services likely results in a decrease in cases of hepatitis A. However, income has little impact on the incidence of diarrhea and hepatitis A. PMID:27898017

Impact of Dental Fluorosis, Socioeconomic Status and Self-Perception in Adolescents Exposed to a High Level of Fluoride in Water.

PubMed

Molina-Frechero, Nelly; Nevarez-Rascón, Martina; Nevarez-Rascón, Alfredo; González-González, Rogelio; Irigoyen-Camacho, María Esther; Sánchez-Pérez, Leonor; López-Verdin, Sandra; Bologna-Molina, Ronell

2017-01-12

Objective : To identify adolescents' self-perception of dental fluorosis from two areas with different socioeconomic levels. Methods : A cross-sectional, descriptive study was conducted with 15-year-old youths by applying a questionnaire designed and validated to assess self-perceptions of dental fluorosis in two areas with different socioeconomic statuses (SESs). Fluorosis was clinically evaluated by applying the Thylstrup and Fejerkov (TF) index on the upper front teeth. Results : A total of 308 adolescents were included in the study. The medium-SES population, which was exposed to 2.5 ppm of fluoride in water, and the low-SES population, which was exposed to 5.1 ppm, presented the following levels of dental fluorosis: TF 2-3 (50%), TF 4-5 (45.6%) and TF 6-7 (4.4%) for medium SES and TF 2-3 (12.3%), TF 4-5 (67.1%) and TF 67 (20.6%) for low SES. A significant association was found between self-perception and dental fluorosis in those with medium and low SESs ( p < 0.05). The multiple regression model found differences between TF levels and self-perception, with a 6-7 TF level for concerns about color (OR = 1.6), smile (OR = 1.2) and appearance (OR = 3.36). Conclusions : Self-perceptions of dental fluorosis affect adolescents such that adolescents with a medium SES have more negative perceptions than those with a low SES. Such perceptions increase as the TF index increases.

Impact of Dental Fluorosis, Socioeconomic Status and Self-Perception in Adolescents Exposed to a High Level of Fluoride in Water

PubMed Central

Molina-Frechero, Nelly; Nevarez-Rascón, Martina; Nevarez-Rascón, Alfredo; González-González, Rogelio; Irigoyen-Camacho, María Esther; Sánchez-Pérez, Leonor; López-Verdin, Sandra; Bologna-Molina, Ronell

2017-01-01

Objective: To identify adolescents’ self-perception of dental fluorosis from two areas with different socioeconomic levels. Methods: A cross-sectional, descriptive study was conducted with 15-year-old youths by applying a questionnaire designed and validated to assess self-perceptions of dental fluorosis in two areas with different socioeconomic statuses (SESs). Fluorosis was clinically evaluated by applying the Thylstrup and Fejerkov (TF) index on the upper front teeth. Results: A total of 308 adolescents were included in the study. The medium-SES population, which was exposed to 2.5 ppm of fluoride in water, and the low-SES population, which was exposed to 5.1 ppm, presented the following levels of dental fluorosis: TF 2–3 (50%), TF 4–5 (45.6%) and TF 6–7 (4.4%) for medium SES and TF 2–3 (12.3%), TF 4–5 (67.1%) and TF 67 (20.6%) for low SES. A significant association was found between self-perception and dental fluorosis in those with medium and low SESs (p < 0.05). The multiple regression model found differences between TF levels and self-perception, with a 6–7 TF level for concerns about color (OR = 1.6), smile (OR = 1.2) and appearance (OR = 3.36). Conclusions: Self-perceptions of dental fluorosis affect adolescents such that adolescents with a medium SES have more negative perceptions than those with a low SES. Such perceptions increase as the TF index increases. PMID:28085102

Individual and community level socioeconomic inequalities in contraceptive use in 10 Newly Independent States: a multilevel cross-sectional analysis

PubMed Central

2012-01-01

Introduction Little is known regarding the association between socioeconomic factors and contraceptive use in the Newly Independent States (NIS), countries that have experienced profound changes in reproductive health services during the transition from socialism to a market economy. Methods Using 2005–2006 data from Demographic Health Surveys (Armenia, Azerbaijan, and Moldova) and Multiple Indicator Cluster Surveys (Belarus, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine, and Uzbekistan), we examined associations between individual and community socioeconomic status with current modern contraceptive use (MCU) among N = 55,204 women aged 15–49 married or in a union. Individual socioeconomic status was measured using quintiles of wealth index and education level (higher than secondary school, secondary school or less). Community socioeconomic status was measured as the percentage of households in the poorest quintile of the nationals household wealth index (0%, 0–25%, or greater than 25%). We used multilevel logistic regression to estimate associations adjusted for age, number of children, urban/rural, and socioeconomic variables. Results MCU varied by country from 14% (in Azerbaijan) to 62% (in Belarus). Overall, women living in the poorest communities were less likely than those in the richest to use modern contraceptives (adjusted odds ratio (aOR) = 0.82, 95% Confidence Interval = 0.76, 0.89). Similarly, there was an increasing odds of MCU with increasing individual-level wealth. Women with a lower level of education also had lower odds of MCU than those with a higher level of education (aOR = .75, 95%CI = 0.71, 0.79). In country-specific analyses, community-level socioeconomic inequalities were apparent in 4 of 10 countries; in contrast, inequalities by individual-level wealth were apparent in 7 countries and by education in 8 countries. All countries in which community-level socioeconomic status was associated with MCU were in

The Level of Shyness among Talented Students in Light of Socio-Economic Level of the Family in Riyadh

ERIC Educational Resources Information Center

Asi, Khaled Yousef

2016-01-01

The present study aimed to identify the level of shyness among talented students in the city of Riyadh, Saudi Arabia, and detect differences according to the variable of socio-economic level of the family. The sample consisted of (101) students, who randomly chosen from centers of talented students in Riyadh, Saudi Arabia. Shyness scale utilized…

Socioeconomic variation in the burden of chronic conditions and health care provision – analyzing administrative individual level data from the Basque Country, Spain

PubMed Central

2013-01-01

Background Chronic diseases are posing an increasing challenge to society, with the associated burden falling disproportionally on more deprived individuals and geographical areas. Although the existence of a socioeconomic health gradient is one of the main concerns of health policy across the world, health information systems commonly do not have reliable data to detect and monitor health inequalities and inequities. The objectives of this study were to measure the level of socioeconomic-related inequality in prevalence of chronic diseases and to investigate the extent and direction of inequities in health care provision. Methods A dataset linking clinical and administrative information of the entire population living in the Basque Country, Spain (over 2 million individuals) was used to measure the prevalence of 52 chronic conditions and to quantify individual health care costs. We used a concentration-index approach to measure the extent and direction of inequality with respect to the deprivation of the area of residence of each individual. Results Most chronic diseases were found to be disproportionally concentrated among individuals living in more deprived areas, but the extent of the imbalance varies by type of disease and sex. Most of the variation in health care utilization was explained by morbidity burden. However, even after accounting for differences in morbidity, pro-poor horizontal inequity was present in specialized outpatient care, emergency department, prescription, and primary health care costs and this fact was more apparent in females than males; inpatient costs exhibited an equitable distribution in both sexes. Conclusions Analyses of comprehensive administrative clinical information at the individual level allow the socioeconomic gradient in chronic diseases and health care provision to be measured to a level of detail not possible using other sources. This frequently updated source of information can be exploited to monitor trends and evaluate

[Intersection between gender and socioeconomic status in medical sciences career choice].

PubMed

Gallardo-Hernández, Georgina; Ortiz-Hernández, Luis; Compeán-Dardón, Sandra; Verde-Flota, Elizabeth; Delgado-Sáncnchez, Guadalupe; Tamez-González, Silivia

2006-01-01

Analyze the relationship between gender identity and socioeconomic level associated with career choice among undergraduate students selecting the area of health sciences. Our sample was comprised of first year medical nutrition, dentistry and nursing students (n=637) admitted to the Universidad Autonoma Metropolitana - Xochimilco. A self administered questionnaire was used. The dependent variable was career choice. Independent variables included socioeconomic status, gender norms in student's homes, and gender stereotype internalization. More female nursing students came from low socioeconomic strata, while medical students had a higher socioeconomic status. Among males, more nursing and medical students belonged to a higher socioeconomicstrata. Nutrition and dentistry students belonged to a medium strata. In comparison with males from high socioeconomic strata more male participants reported that household chores were divided among men and women. For women, as the socioeconomic level increased, the participation of men and women also increased. In the indicators of internalization of gender stereotypes, nursing students had the highest rates in the submission scale, but the lowest for masculinity and machismo. As the socioeconomic strata increased, the characteristics of masculinity and machismo also increased. The present results seem to indicate that among women of low socioeconomic strata more traditional gender stereotypes prevail which lead them to seek career choices considered femenine. Among men, there is a clear relationship between career choice, socioeconomic level and internalization of gender stereotypes.

Socio-Economic Factors, Food Habits and Phosphorus Levels in Patients on Hemodialysis.

PubMed

Santoro, Domenico; Ingegnieri, Maria Teresa; Vita, Giuseppe; Lucisano, Silvia; Zuppardo, Carmelo; Canale, Valeria; Savica, Vincenzo; Buemi, Michele

2015-07-01

Hyperphosphoremia is one of the most important risk factors for morbidity and mortality for chronic kidney disease (CKD) patients, and also, for the general population. Excessive dietary intake of phosphate (P) is one of the key factors. In particular, P in its inorganic form, which is contained in food additives, is more readily absorbed. Unfortunately, these food additives are mostly present in convenience so called "fast foods" (pre-cooked), soft drinks, which represent the typical food consumed by our hemodialysis (HD) population, composed by elderly people, mostly low-socio economic class, who often live alone. We performed an observational retrospective multicenter study to find any association between social, cultural and economic situation, as well as food habits, and P levels in a cohort of patients on HD. Secondarily; we also examined the association between the fast food consumption and increased P levels, as well as patient compliance for P binding products. To explore the association between socio-economic factors and serum P levels, we enrolled 100 patients on periodic HD treatment from three different units. Information on social, cultural, economic, diet habits, therapy for hyperphosphoremia and hematological and clinical parameters had been collected through specific questionnaires, administered by a physician. Results showed serum P level was reduced in patients who live alone compared to patients in family (P = 0.04), in self-sufficient (P = 0.05) and in patients belonging to middle-upper class, versus low-class (P = 0.003). Fast foods intake correlates with increase in P serum levels (P = 0.002), whilst the same correlation was not found for cheese intake. Our data show that socio-economic status and food habits are useful predictors of P serum levels. In conclusion, dietary counseling of patients on HD is mandatory. Interventions that consider the socio-economic situation allow delivering important messages on foods with the least amount of P

The 'everyday work' of living with multimorbidity in socioeconomically deprived areas of Scotland.

PubMed

O'Brien, Rosaleen; Wyke, Sally; Watt, Graham G C M; Guthrie, Bruce; Mercer, Stewart W

2014-01-01

Multimorbidity is common in patients living in areas of high socioeconomic deprivation and is associated with poor quality of life, but the reasons behind this are not clear. Exploring the 'everyday life work' of patients may reveal important barriers to self-management and wellbeing. To investigate the relationship between the management of multimorbidity and 'everyday life work' in patients living in areas of high socioeconomic deprivation in Scotland, as part of a programme of work on multimorbidity and deprivation. Qualitative study: individual semi-structured interviews of 14 patients (8 women and 6 men) living in deprived areas with multimorbidity, exploring how they manage. Analysis was continuous and iterative. We report the findings in relation to everyday life work. The in-depth analysis revealed four key themes: (i) the symbolic significance of everyday life work to evidence the work of being 'normal'; (ii) the usefulness of everyday life work in managing symptoms; (iii) the impact that mental health problems had on everyday life work; and (iv) issues around accepting help for everyday life tasks. Overall, most struggled with the amount of work required to establish a sense of normalcy in their everyday lives, especially in those with mental-physical multimorbidity. Everyday life work is an important component of self-management in patients with multimorbidity in deprived areas, and is commonly impaired, especially in those with mental health problems. Interventions to improve self-management support for patients living with multimorbidity may benefit from an understanding of the role of everyday life work. Journal of Comorbidity 2014;4:1-10.

Socioeconomic inequalities in mortality in 16 European cities.

PubMed

Borrell, Carme; Marí-Dell'olmo, Marc; Palència, Laia; Gotsens, Mercè; Burström, B O; Domínguez-Berjón, Felicitas; Rodríguez-Sanz, Maica; Dzúrová, Dagmar; Gandarillas, Ana; Hoffmann, Rasmus; Kovacs, Katalin; Marinacci, Chiara; Martikainen, Pekka; Pikhart, Hynek; Corman, Diana; Rosicova, Katarina; Saez, Marc; Santana, Paula; Tarkiainen, Lasse; Puigpinós, Rosa; Morrison, Joana; Pasarín, M Isabel; Díez, Èlia

2014-05-01

To explore inequalities in total mortality between small areas of 16 European cities for men and women, as well as to analyse the relationship between these geographical inequalities and their socioeconomic indicators. A cross-sectional ecological design was used to analyse small areas in 16 European cities (26,229,104 inhabitants). Most cities had mortality data for a period between 2000 and 2008 and population size data for the same period. Socioeconomic indicators included an index of socioeconomic deprivation, unemployment, and educational level. We estimated standardised mortality ratios and controlled for their variability using Bayesian models. We estimated relative risk of mortality and excess number of deaths according to socioeconomic indicators. We observed a consistent pattern of inequality in mortality in almost all cities, with mortality increasing in parallel with socioeconomic deprivation. Socioeconomic inequalities in mortality were more pronounced for men than women, and relative inequalities were greater in Eastern and Northern European cities, and lower in some Western (men) and Southern (women) European cities. The pattern of excess number of deaths was slightly different, with greater inequality in some Western and Northern European cities and also in Budapest, and lower among women in Madrid and Barcelona. In this study, we report a consistent pattern of socioeconomic inequalities in mortality in 16 European cities. Future studies should further explore specific causes of death, in order to determine whether the general pattern observed is consistent for each cause of death.

Evaluating area-based socioeconomic status indicators for monitoring disparities within health care systems: results from a primary care network.

PubMed

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-04-01

To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. © Health Research and Educational Trust.

Country- and individual-level socioeconomic determinants of depression: multilevel cross-national comparison.

PubMed

Rai, Dheeraj; Zitko, Pedro; Jones, Kelvyn; Lynch, John; Araya, Ricardo

2013-03-01

The prevalence and correlates of depression vary across countries. Contextual factors such as country-level income or income inequalities have been hypothesised to contribute to these differences. To investigate associations of depression with socioeconomic factors at the country level (income inequality, gross national income) and individual (education, employment, assets and spending) level, and to investigate their relative contribution in explaining the cross-national variation in the prevalence of depression. Multilevel study using interview data of 187 496 individuals from 53 countries participating in the World Health Organization World Health Surveys. Depression prevalence varied between 0.4 and 15.7% across countries. Individual-level factors were responsible for 86.5% of this variance but there was also reasonable variation at the country level (13.5%), which appeared to increase with decreasing economic development of countries. Gross national income or country-level income inequality had no association with depression. At the individual level, fewer material assets, lower education, female gender, economic inactivity and being divorced or widowed were associated with increased odds of depression. Greater household spending, unlike material assets, was associated with increasing odds of depression (adjusted analysis). The variance of depression prevalence attributable to country-level factors seemed to increase with decreasing economic development of countries. However, country-level income inequality or gross national income explained little of this variation, and individual-level factors appeared more important than contextual factors as determinants of depression. The divergent relationship of assets and spending with depression emphasise that different socioeconomic measures are not interchangeable in their associations with depression.

Spatial analysis of leprosy incidence and associated socioeconomic factors.

PubMed

Cury, Maria Rita de Cassia Oliveira; Paschoal, Vania Del'Arco; Nardi, Susilene Maria Tonelli; Chierotti, Ana Patrícia; Rodrigues Júnior, Antonio Luiz; Chiaravalloti-Neto, Francisco

2012-02-01

To identify clusters of the major occurrences of leprosy and their associated socioeconomic and demographic factors. Cases of leprosy that occurred between 1998 and 2007 in São José do Rio Preto (southeastern Brazil) were geocodified and the incidence rates were calculated by census tract. A socioeconomic classification score was obtained using principal component analysis of socioeconomic variables. Thematic maps to visualize the spatial distribution of the incidence of leprosy with respect to socioeconomic levels and demographic density were constructed using geostatistics. While the incidence rate for the entire city was 10.4 cases per 100,000 inhabitants annually between 1998 and 2007, the incidence rates of individual census tracts were heterogeneous, with values that ranged from 0 to 26.9 cases per 100,000 inhabitants per year. Areas with a high leprosy incidence were associated with lower socioeconomic levels. There were identified clusters of leprosy cases, however there was no association between disease incidence and demographic density. There was a disparity between the places where the majority of ill people lived and the location of healthcare services. The spatial analysis techniques utilized identified the poorer neighborhoods of the city as the areas with the highest risk for the disease. These data show that health departments must prioritize politico-administrative policies to minimize the effects of social inequality and improve the standards of living, hygiene, and education of the population in order to reduce the incidence of leprosy.

Socioeconomic and urban-rural differentials in exposure to air pollution and mortality burden in England.

PubMed

Milojevic, Ai; Niedzwiedz, Claire L; Pearce, Jamie; Milner, James; MacKenzie, Ian A; Doherty, Ruth M; Wilkinson, Paul

2017-10-06

Socioeconomically disadvantaged populations often have higher exposures to particulate air pollution, which can be expected to contribute to differentials in life expectancy. We examined socioeconomic differentials in exposure and air pollution-related mortality relating to larger scale (5 km resolution) variations in background concentrations of selected pollutants across England. Ozone and particulate matter (sub-divided into PM 10 , PM 2.5 , PM 2.5-10 , primary, nitrate and sulphate PM 2.5 ) were simulated at 5 km horizontal resolution using an atmospheric chemistry transport model (EMEP4UK). Annual mean concentrations of these pollutants were assigned to all 1,202,578 residential postcodes in England, which were classified by urban-rural status and socioeconomic deprivation based on the income and employment domains of the 2010 English Index of Multiple Deprivation for the Lower-level Super Output Area of residence. We used life table methods to estimate PM 2.5 -attributable life years (LYs) lost in both relative and absolute terms. Concentrations of the most particulate fractions, but not of nitrate PM 2.5 or ozone, were modestly higher in areas of greater socioeconomic deprivation. Relationships between pollution level and socioeconomic deprivation were non-linear and varied by urban-rural status. The pattern of PM 2.5 concentrations made only a small contribution to the steep socioeconomic gradient in LYs lost due to PM 2.5 per 10 3 population, which primarily was driven by the steep socioeconomic gradient in underlying mortality rates. In rural areas, the absolute burden of air pollution-related LYs lost was lowest in the most deprived deciles. Air pollution shows modest socioeconomic patterning at 5 km resolution in England, but absolute attributable mortality burdens are strongly related to area-level deprivation because of underlying mortality rates. Measures that cause a general reduction in background concentrations of air pollution may modestly

Profiling of Alzheimer's disease patients in Puerto Rico: A comparison of two distinct socioeconomic areas.

PubMed

Camacho-Mercado, Clara L; Figueroa, Raúl; Acosta, Heriberto; Arnold, Steven E; Vega, Irving E

2016-01-01

The Latino/Hispanic community in the United States is at higher risk of developing Alzheimer's disease than other ethnic groups. Specifically, Caribbean Hispanics showed a more severe Alzheimer's disease symptomatology than any other ethnic group. In a previous study, we demonstrated that the mortality rate associated with Alzheimer's disease in Puerto Rico is higher than that reported in the United States. Moreover, the mortality rate associated with Alzheimer's disease was higher among Puerto Rican living in Puerto Rico than those in the mainland United States. There is also a differential geographical distribution of mortality rate associated with Alzheimer's disease in Puerto Rico, which may be associated with differential socioeconomic status and/or access to healthcare. However, there is no information regarding the clinical profile of Alzheimer's disease patients in Puerto Rico. Here, we present the results of a retrospective study directed to profile Alzheimer's disease patients clustered into two groups based on areas previously determined with low (Metro Region) and high (Northwest-Central Region) mortality rate associated with Alzheimer's disease in Puerto Rico. Significant difference in the age-at-diagnosis and years of education was found among patients within the two studied regions. Despite these differences, both regions showed comparable levels of initial and last Mini Mental State Examination scores and rate of cognitive decline. Significant difference was also observed in the occurance of co-morbidities associated with Alzheimer's disease. The differential profile of Alzheimer's disease patients correlated with differences in socioeconomic status between these two regions, suggesting that covariant associated with social status may contribute to increased risk of developing Alzheimer's disease. Further studies should be conducted to determine the role of socioeconomic factors and healthy living practices as risk factors for Alzheimer's disease.

Obesity and Association with Area of Residence, Gender and Socio-Economic Factors in Algerian and Tunisian Adults

PubMed Central

Atek, Madjid; Traissac, Pierre; El Ati, Jalila; Laid, Youcef; Aounallah-Skhiri, Hajer; Eymard-Duvernay, Sabrina; Mézimèche, Nadia; Bougatef, Souha; Béji, Chiraz; Boutekdjiret, Leila; Martin-Prével, Yves; Lebcir, Hassiba; Gartner, Agnès; Kolsteren, Patrick; Delpeuch, Francis; Romdhane, Habiba Ben; Maire, Bernard

2013-01-01

Introduction The epidemiological transition has resulted in a major increase in the prevalence of obesity in North Africa. This study investigated differences in obesity and its association with area of residence, gender and socio-economic position among adults in Algeria and Tunisia, two countries with socio-economic and socio-cultural similarities. Methods Cross-sectional studies used stratified, three-level, clustered samples of 35–70 year old adults in Algeria, (women n = 2741, men n = 2004) and Tunisia (women n = 2964, men n = 2379). Thinness was defined as Body Mass Index (BMI) = weight/height <18.5 kg/m2, obesity as BMI ≥30, and abdominal obesity as waist circumference/height ≥0.6. Associations with area of residence, gender, age, education, profession and household welfare were assessed. Results Prevalence of thinness was very low except among men in Algeria (7.3% C.I.[5.9–8.7]). Prevalence of obesity among women was high in Algeria (30.1% C.I.[27.8–32.4]) and Tunisia (37.0% C.I.[34.4–39.6]). It was less so among men (9.1% C.I.[7.1–11.0] and 13.3% C.I.[11.2–15.4]).The results were similar for abdominal obesity. In both countries women were much more obesity-prone than men: the women versus men obesity Odds-Ratio was 4.3 C.I.[3.4–5.5] in Algeria and 3.8 C.I.[3.1–4.7] in Tunisia. Obesity was more prevalent in urban versus rural areas in Tunisia, but not in Algeria (e.g. for women, urban versus rural Odds-Ratio was 2.4 C.I.[1.9–3.1] in Tunisia and only 1.2 C.I.[1.0–5.5] in Algeria). Obesity increased with household welfare, but more markedly in Tunisia, especially among women. Nevertheless, in both countries, even in the lowest quintile of welfare, a fifth of the women were obese. Conclusion The prevention of obesity, especially in women, is a public health issue in both countries, but there were differences in the patterning of obesity according to area of residence and socio-economic position. These specificities

Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults.

PubMed

Giskes, Katrina; Turrell, Gavin; Bentley, Rebecca; Kavanagh, Anne

2011-06-01

To examine associations between individual-, household- and neighbourhood-level socioeconomic position (SEP) and harmful alcohol consumption. Adults aged 18-76 residing in 50 neighbourhoods in Melbourne completed a postal questionnaire (n= 2349, 58.7% response rate). Alcohol-related behaviours were classified by risk of short- and long-term harm. Individual-, household- and neighbourhood-level SEP were ascertained by education, household income and proportion of low-income households, respectively. The association were examined by multi-level logistic regression. Participants lower education or household income were less likely to consume alcohol frequently compared to their more-advantaged counterparts. Lower-educated men were more likely to be at risk of short-term harm [OR 1.75 (1.23 - 2.48)]. Low-income women were less likely to be at risk of short-term harm [OR 0.44 (0.23 - 0.81)]. Neighbourhood disadvantage was not associated with alcohol consumption. Men and women from socioeconomically advantaged backgrounds were more frequent consumers of alcohol, whereas their disadvantaged counterparts drank less frequently but in greater quantities on each drinking occasion. Socioeconomic disadvantage at the individual and household levels may be an important determinant of alcohol consumption among Australian adults. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Socioeconomic inequalities and determinants of oral hygiene status among Urban Indian adolescents.

PubMed

Mathur, Manu Raj; Tsakos, Georgios; Parmar, Priyanka; Millett, Christopher J; Watt, Richard G

2016-06-01

To assess the socioeconomic inequalities in oral hygiene and to explore the role of various socioeconomic and psychosocial factors as determinants of these inequalities among adolescents residing in Delhi National Capital Territory. A cross-sectional study was conducted among 1386 adolescents aged 12-15 years from three different socioeconomic groups according to their area of residence (middle-class areas, resettlement colonies and urban slum colonies). Level of oral hygiene was examined clinically using the Simplified Oral Hygiene Index (OHI-S), and an interviewer-administered questionnaire was used to measure key socio-demographic variables and psychosocial and health-related behaviours. Logistic regression analysis tested the association between area of residence and poor oral hygiene. Poor oral hygiene was observed in 50.2% of the adolescents. There was a socioeconomic gradient in poor oral hygiene, with higher prevalence observed at each level of deprivation. These differences were only partly explained, and the differences between adolescent groups remained statistically significant after adjusting for various demographic variables, standard of living, social capital, social support and health-affecting behaviours (OR: 1.96, 95% CI: 1.30-2.76; and OR: 2.50, 95% CI: 1.60-3.92 for adolescents from resettlement colonies and urban slums, respectively, than middle-class adolescents). Area of residence emerged as a strong socioeconomic predictor of prevalence of poor oral hygiene among Indian adolescents. Various material, psychosocial and behavioural factors did not fully explain the observed inequalities in poor oral hygiene among different adolescent groups. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Socioeconomic and state-level differences in prenatal diagnosis and live birth prevalence of Down's syndrome in the United States.

PubMed

Khoshnood, B; Pryde, P; Blondel, B; Lee, K S

2003-12-01

Previous studies have shown socioeconomic disparities in the use of prenatal diagnosis in several countries, including France and the United States. Few studies however, have examined the impact of socioeconomic differences in prenatal testing on disparities in the live birth prevalence of congenital anomalies. In this article, we first review and further discuss some of the results of our previously published work that assesses: i) socioeconomic differences in the use of amniocentesis in the United States using data from national birth cohorts; and ii) impact of socioeconomic differences in prenatal diagnosis on the live birth prevalence of Down's syndrome (trisomy 21). We then present the results of a study that explores the potential effects of public policies regarding abortion on state-level differences in the live birth prevalence of Down's syndrome. We used birth data from the National Center for Health Statistics for the years 1989 to 1991 as well as data from the National Abortion and Reproductive Rights Action League (NARAL) state-by-state review of abortion rights. The main individual-level socioeconomic variables in the analyses were maternal ethnicity and education; the analyses of the interaction effects between maternal age and ethnicity are presented here. Interaction effects were assessed using logistic regression models with likelihood ratio tests. We used hierarchical logistic regression models for analyses of state-level effects while controlling for individual-level socioeconomic factors. We found substantial age-specific socioeconomic differences in the use of amniocentesis and in the rates of age-related increase in the live birth prevalence of Down's syndrome. In particular, African Americans and Mexican Americans were found to have lower odds of amniocentesis use and higher odds of Down's syndrome at birth. In addition, after controlling for maternal age, socioeconomic factors and prenatal care, we found that states which allowed public

Moving forward socio-economically focused models of deforestation.

PubMed

Dezécache, Camille; Salles, Jean-Michel; Vieilledent, Ghislain; Hérault, Bruno

2017-09-01

Whilst high-resolution spatial variables contribute to a good fit of spatially explicit deforestation models, socio-economic processes are often beyond the scope of these models. Such a low level of interest in the socio-economic dimension of deforestation limits the relevancy of these models for decision-making and may be the cause of their failure to accurately predict observed deforestation trends in the medium term. This study aims to propose a flexible methodology for taking into account multiple drivers of deforestation in tropical forested areas, where the intensity of deforestation is explicitly predicted based on socio-economic variables. By coupling a model of deforestation location based on spatial environmental variables with several sub-models of deforestation intensity based on socio-economic variables, we were able to create a map of predicted deforestation over the period 2001-2014 in French Guiana. This map was compared to a reference map for accuracy assessment, not only at the pixel scale but also over cells ranging from 1 to approximately 600 sq. km. Highly significant relationships were explicitly established between deforestation intensity and several socio-economic variables: population growth, the amount of agricultural subsidies, gold and wood production. Such a precise characterization of socio-economic processes allows to avoid overestimation biases in high deforestation areas, suggesting a better integration of socio-economic processes in the models. Whilst considering deforestation as a purely geographical process contributes to the creation of conservative models unable to effectively assess changes in the socio-economic and political contexts influencing deforestation trends, this explicit characterization of the socio-economic dimension of deforestation is critical for the creation of deforestation scenarios in REDD+ projects. © 2017 John Wiley & Sons Ltd.

Impact of County-Level Socioeconomic Status on Oropharyngeal Cancer Survival in the United States.

PubMed

Megwalu, Uchechukwu C

2017-04-01

Objective To evaluate the impact of county-level socioeconomic status on survival in patients with oropharyngeal cancer in the United States. Study Design Retrospective cohort study via a large population-based cancer database. Methods Data were extracted from the SEER 18 database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute. The study cohort included 18,791 patients diagnosed with oropharyngeal squamous cell carcinoma between 2004 and 2012. Results Patients residing in counties with a low socioeconomic status index had worse overall survival (56.5% vs 63.0%, P < .001) and disease-specific survival (62.7% vs 70.3%, P < .001) than patients residing in counties with a high socioeconomic status index. On multivariable analysis, residing in a county with a low socioeconomic status index was associated with worse overall survival (hazard ratio, 1.21; 95% CI, 1.14-1.29; P < .001) and disease-specific survival (hazard ratio, 1.21; 95% CI, 1.12-1.30; P < .001), after adjusting for race, age, sex, marital status, year of diagnosis, site, American Joint Committee on Cancer stage group, presence of distant metastasis, presence of unresectable tumor, histologic grade, surgical resection of primary site, treatment with neck dissection, and radiation therapy. Conclusion Residing in a county with a low socioeconomic status index is associated with worse survival. Further research is needed to elucidate the mechanism by which socioeconomic status affects survival in oropharyngeal cancer.

Coastal vulnerability assessment with the use of environmental and socio-economic indicators

NASA Astrophysics Data System (ADS)

Alexandrakis, George; Petrakis, Stelios; Vousdoukas, Mixalis; Ghionis, George; Hatziyanni, Eleni; Kampanis, Nikolaos

2014-05-01

Climate change has significant repercussions on the natural environment, triggering obvious changes in the natural processes that have a severe socio-economic impact on the coastal zone; where a great number of human activities are concentrated. So far, the estimation of coastal vulnerability was based primarily on the natural processes and less on socio-economic variables, which would assist in the identification of vulnerable areas. The present investigation proposes a methodology to examine the vulnerability of a highly touristic area in the Island of Crete to an expected sea level rise of up to ~40 cm by the year 2100, according to the A1B scenario of IPCC 2007. The methodology includes the combination of socio-economic indicators into a GIS-based coastal vulnerability index for wave-induced erosion. This approach includes three sub-indices that contribute equally to the overall index. The sub-indices refer to coastal forcing, socio-economic and coastal characteristics. All variables are ranked on a 1-5 scale with 5 indicating higher vulnerability. The socio-economic sub-index includes, as indicators, the population of the study area, cultural heritage sites, transport networks, land use and protection measures. The coastal forcing sub-index includes the frequency of extreme events, while the Coastal Vulnerability Index includes the geological variables (coastal geomorphology, historical coastline changes, and regional coastal slope) and the variables representing the marine processes (relative sea level rise, mean significant wave height, and tidal range). The main difficulty for the estimation of the index lies in assessing and ranking the socio-economic indicators. The whole approach was tested and validated through field and desktop studies, using as a case study the Elouda bay, Crete Isl., an area of high cultural and economic value, which combines monuments from ancient and medieval times, with a very high touristic development since the 1970s.

Evaluating Area-Based Socioeconomic Status Indicators for Monitoring Disparities within Health Care Systems: Results from a Primary Care Network

PubMed Central

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-01-01

Objective To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. Data Sources/Study Setting 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Study Design Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Data Collection Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. Principal Findings ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Conclusions Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. PMID:25219917

Socioeconomic status and survival among older adults with dementia and depression.

PubMed

Chen, Ruoling; Hu, Zhi; Wei, Li; Wilson, Kenneth

2014-06-01

People from lower socioeconomic groups have a higher risk of mortality. The impact of low socioeconomic status on survival among older adults with dementia and depression remains unclear. To investigate the association between socioeconomic status and mortality in people with dementia and late-life depression in China. Using Geriatric Mental Status - Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) we interviewed 2978 people aged ⩾60 years in Anhui, China. We characterised baseline socioeconomic status and risk factors and diagnosed 223 people with dementia and 128 with depression. All-cause mortality was followed up over 5.6 years. Individuals with dementia living in rural areas had a three times greater risk of mortality (multivariate adjusted hazard ratio (HR) = 2.96, 95% CI 1.45-6.04) than those in urban areas, and for those with depression the HR was 4.15 (95% CI 1.59-10.83). There were similar mortality rates when comparing people with dementia with low v. high levels of education, occupation and income, but individuals with depression with low v. high levels had non-significant increases in mortality of 11%, 50% and 55% respectively Older adults with dementia and depression living in rural China had a significantly higher risk of mortality than urban counterparts. Interventions should be implemented in rural areas to tackle survival inequality in dementia and depression. Royal College of Psychiatrists.

Does school social capital modify socioeconomic inequality in mental health? A multi-level analysis in Danish schools.

PubMed

Nielsen, Line; Koushede, Vibeke; Vinther-Larsen, Mathilde; Bendtsen, Pernille; Ersbøll, Annette Kjær; Due, Pernille; Holstein, Bjørn E

2015-09-01

It seems that social capital in the neighbourhood has the potential to reduce socioeconomic differences in mental health among adolescents. Whether school social capital is a buffer in the association between socioeconomic position and mental health among adolescents remains uncertain. The aim of this study is therefore to examine if the association between socioeconomic position and emotional symptoms among adolescents is modified by school social capital. The Health Behaviour in School-aged Children Methodology Development Study 2012 provided data on 3549 adolescents aged 11-15 in two municipalities in Denmark. Trust in the school class was used as an indicator of school social capital. Prevalence of daily emotional symptoms in each socioeconomic group measured by parents' occupational class was calculated for each of the three categories of school classes: school classes with high trust, moderate trust and low trust. Multilevel logistic regression analyses with parents' occupational class as the independent variable and daily emotional symptoms as the dependent variable were conducted stratified by level of trust in the school class. The prevalence of emotional symptoms was higher among students in school classes with low trust (12.9%) compared to school classes with high trust (7.2%) (p < 0.01). In school classes with low level of trust, the odds ratio for daily emotional symptoms was 1.89 (95% CI 1.25-2.86) in the low socioeconomic group compared to the high socioeconomic group. In school classes characterised by high and moderate trust, there were no statistically significant differences in emotional symptoms between high and low socioeconomic groups. Although further studies are needed, this cross-sectional study suggests that school social capital may reduce mental health problems and diminish socioeconomic inequality in mental health among adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

Area deprivation, individual socioeconomic position and smoking among women in South Korea.

PubMed

Park, Eun-Ja; Kim, Ho; Kawachi, Ichiro; Kim, Il-Ho; Cho, Sung-Il

2010-10-01

The objective of this study was to examine how area deprivation and individual socioeconomic position affect smoking among women using national survey data. Smoking and individual sociodemographic characteristics were gathered from the Third Korea National Health and Nutrition Examination Survey, 2005. The Carstairs index was derived for each area using the 2005 census data. The data were analysed using multilevel logistic regression models. After adjusting for age and marital status, low education and manual jobs were significantly associated with a higher likelihood of smoking. In addition, the effect of manual jobs on smoking was modified by area deprivation. When individual occupation and area deprivation were examined together, results indicated that women with manual occupation had much greater odds of smoking when they lived in the least-deprived areas (OR, 4.03; CI, 2.00 to 8.14) than did women with manual job who lived in the middle- or most-deprived areas (OR, 2.19; CI, 1.15 to 4.16), compared to the reference group (housewives in the middle- or most-deprived areas). The results of the present study show that among Korean women, manual work is associated with smoking, and the association is strongest among those living in the least-deprived areas. This interaction between manual work and area deprivation resulted in a higher smoking prevalence among women in affluent urban areas.

Conflating Time and Energy: Views From Older Adults in Lower Socioeconomic Status Areas on Physical Activity.

PubMed

Devereux-Fitzgerald, Angela; Powell, Rachael; French, David P

2018-05-24

Perceptions of time and energy and their role in physical activity engagement were examined in older adults living in lower socioeconomic status areas. Semistructured interviews were conducted with 19 participants aged 67-94 years. A thematic framework analysis identified four themes: Time is Energy (older adults conflate time and energy in relation to physical activity), Reduced Day (engaging in activities outside a certain time frame is deemed unacceptable), Being Given Enough Time (need for time to socialize and go at own pace), and Seasonal Impact (seasonal differences affecting access). Enjoyment appears to mitigate the perceived energy drain and increase the capacity for physical activities for many. Conflation of time and energy may explain observed discrepancies between older adults' actual and perceived available time. Having locally based physical activities means less time/energy is required to attend, leaving more resources for physical activity itself. A limited availability of resources in lower socioeconomic status areas is therefore problematic.

Language and Disadvantage: A Comparison of the Language Abilities of Adolescents from Two Different Socioeconomic Areas

ERIC Educational Resources Information Center

Spencer, Sarah; Clegg, Judy; Stackhouse, Joy

2012-01-01

Background: It is recognized that children from areas associated with socioeconomic disadvantage are at an increased risk of delayed language development. However, so far research has focused mainly on young children and there has been little investigation into language development in adolescence. Aims: To investigate the language abilities of…

Profiling of Alzheimer’s disease patients in Puerto Rico: A comparison of two distinct socioeconomic areas

PubMed Central

Camacho-Mercado, Clara L; Figueroa, Raúl; Acosta, Heriberto; Arnold, Steven E; Vega, Irving E

2016-01-01

Objective: The Latino/Hispanic community in the United States is at higher risk of developing Alzheimer’s disease than other ethnic groups. Specifically, Caribbean Hispanics showed a more severe Alzheimer’s disease symptomatology than any other ethnic group. In a previous study, we demonstrated that the mortality rate associated with Alzheimer’s disease in Puerto Rico is higher than that reported in the United States. Moreover, the mortality rate associated with Alzheimer’s disease was higher among Puerto Rican living in Puerto Rico than those in the mainland United States. There is also a differential geographical distribution of mortality rate associated with Alzheimer’s disease in Puerto Rico, which may be associated with differential socioeconomic status and/or access to healthcare. However, there is no information regarding the clinical profile of Alzheimer’s disease patients in Puerto Rico. Methods: Here, we present the results of a retrospective study directed to profile Alzheimer’s disease patients clustered into two groups based on areas previously determined with low (Metro Region) and high (Northwest-Central Region) mortality rate associated with Alzheimer’s disease in Puerto Rico. Results: Significant difference in the age-at-diagnosis and years of education was found among patients within the two studied regions. Despite these differences, both regions showed comparable levels of initial and last Mini Mental State Examination scores and rate of cognitive decline. Significant difference was also observed in the occurance of co-morbidities associated with Alzheimer’s disease. Conclusions: The differential profile of Alzheimer’s disease patients correlated with differences in socioeconomic status between these two regions, suggesting that covariant associated with social status may contribute to increased risk of developing Alzheimer’s disease. Further studies should be conducted to determine the role of socioeconomic factors and

Area deprivation, individual socioeconomic status and low vision in the EPIC-Norfolk Eye Study.

PubMed

Yip, Jennifer L Y; Luben, Robert; Hayat, Shabina; Khawaja, Anthony P; Broadway, David C; Wareham, Nick; Khaw, K T; Foster, Paul J

2014-03-01

Poor vision is associated with lower socioeconomic status, but less is known about its relationship to area deprivation. The European Prospective Investigation into Cancer and Nutrition study Norfolk Eye Study was a cross-sectional study of 8563 participants with completed eye examinations. Logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) was measured using standard protocols and low vision (LV) was defined as Snellen equivalent (VA) ≤6/12 in the better eye. Uncorrected refractive error (URE) was defined as improvement of VA by 2 logarithm of the minimum angle of resolution lines with pinhole. The lowest 5% of index of multiple deprivation rank was used to define the most deprived areas. The index of multiple deprivation is a composite measure using routine data from seven domains of deprivation to identify the most disadvantaged areas in England. Logistic regression was used to examine univariable and multivariable associations with LV. Ninety-six participants with missing data were excluded, leaving 8467 for analysis (98.9%). The mean age of the study group was 68.7 years (SD=8.1, range=48-92), with 55.1% women. LV was present in 263 participants (3.1%, 95% CI 2.7 to 3.5%). LV was associated with deprivation after adjusting for age, sex, education, social class and cataract surgery (OR=1.7, 95% CI 1.1 to 2.6, p=0.03), but this effect was mitigated by additionally adjusting for URE (OR=1.5, 95% CI 1.0 to 2.4, p=0.09). People with LV are more likely to live in the most deprived areas; this association was independent of socioeconomic status and partly mediated by URE. Targeting URE in deprived areas may reduce health inequalities associated with LV.

Promoting Low Socio-Economic Participation in Higher Education: A Comparison of Area-Based and Individual Measures

ERIC Educational Resources Information Center

Dockery, Alfred M.; Seymour, Richard; Koshy, Paul

2016-01-01

As with other countries, Australia has been grappling with the identification, measurement and impact of disadvantage in higher education. In particular, the measurement of socio-economic status (SES) has been of central concern. The immediate solution in Australia has been the introduction of an "area" measure in which students' SES is…

Few geographic and socioeconomic variations exist in primary total shoulder arthroplasty: a multi-level study of Australian registry data.

PubMed

Brennan-Olsen, Sharon L; Page, Richard S; Lane, Stephen E; Lorimer, Michelle; Buchbinder, Rachelle; Osborne, Richard H; Pasco, Julie A; Wluka, Anita E; Sanders, Kerrie M; Ebeling, Peter R; Graves, Stephen E

2016-07-16

Associations between socioeconomic position (SEP) and the uptake of primary total shoulder arthroplasty (TSA) is not well understood in the Australian population, thus potentially limiting equitable allocation of healthcare resources. We used the Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR) to examine whether geographic or socioeconomic variations exist in TSA performed for a diagnosis of osteoarthritis 2007-11 for all Australians aged ≥40 years. Primary anatomical and reverse TSA data were extracted from the AOA NJRR which captures >99 % of all TSA nationally. Residential addresses were cross-referenced to Australian Bureau of Statistics 2011 Census data to identify SEP measured at the area-level (categorised into deciles), and geographic location defined as Australian State/Territory of residence. We used a Poisson distribution for the number of TSA over the study period, and modelled the effects of age, SEP and geographic location using multilevel modelling. During 2007-11, we observed 6,123 TSA (62.2 % female). For both sexes, TSA showed a proportional increase with advancing age. TSA did not vary by SEP or geographic location, with the exception of greater TSA among men in New South Wales. Using a national registry approach we provide the first reliable picture of TSA at a national level. The uptake of TSA was equitable across SEP; however, there was some variation between the States/Territories. With an aging population, it is imperative that monitoring of major surgical procedures continues, and be focused toward determining whether TSA uptake correlates with need across different social and area-based groups.

Socioeconomic Segregation in Large Cities in France and the United States.

PubMed

Quillian, Lincoln; Lagrange, Hugues

2016-08-01

Past cross-national comparisons of socioeconomic segregation have been undercut by lack of comparability in measures, data, and concepts. Using IRIS data from the French Census of 2008 and the French Ministry of Finance as well as tract data from the American Community Survey (2006-2010) and the U.S. Department of Housing and Urban Development Picture of Subsidized Households, and constructing measures to be as similar as possible, we compare socioeconomic segregation in metropolitan areas with a population of more than 1 million in France and the United States. We find much higher socioeconomic segregation in large metropolitan areas in the United States than in France. We also find (1) a strong pattern of low-income neighborhoods in central cities and high-income neighborhoods in suburbs in the United States, but varying patterns across metropolitan areas in France; (2) that high-income persons are the most segregated group in both countries; (3) that the shares of neighborhood income differences that can be explained by neighborhood racial/ethnic composition are similar in France and the United States; and (4) that government-assisted housing is disproportionately located in the poorest neighborhoods in the United States but is spread across many neighborhood income levels in France. We conclude that differences in government provision of housing assistance and levels of income inequality are likely important contributing factors to the Franco-U.S. difference in socioeconomic segregation.

The ‘everyday work’ of living with multimorbidity in socioeconomically deprived areas of Scotland

PubMed Central

O’Brien, Rosaleen; Wyke, Sally; Watt, Graham G.C.M.; Guthrie, Bruce; Mercer, Stewart W.

2014-01-01

Background Multimorbidity is common in patients living in areas of high socioeconomic deprivation and is associated with poor quality of life, but the reasons behind this are not clear. Exploring the ‘everyday life work’ of patients may reveal important barriers to self-management and wellbeing. Objective To investigate the relationship between the management of multimorbidity and ‘everyday life work’ in patients living in areas of high socioeconomic deprivation in Scotland, as part of a programme of work on multimorbidity and deprivation. Design Qualitative study: individual semi-structured interviews of 14 patients (8 women and 6 men) living in deprived areas with multimorbidity, exploring how they manage. Analysis was continuous and iterative. We report the findings in relation to everyday life work. Results The in-depth analysis revealed four key themes: (i) the symbolic significance of everyday life work to evidence the work of being ‘normal’; (ii) the usefulness of everyday life work in managing symptoms; (iii) the impact that mental health problems had on everyday life work; and (iv) issues around accepting help for everyday life tasks. Overall, most struggled with the amount of work required to establish a sense of normalcy in their everyday lives, especially in those with mental–physical multimorbidity. Conclusions Everyday life work is an important component of self-management in patients with multimorbidity in deprived areas, and is commonly impaired, especially in those with mental health problems. Interventions to improve self-management support for patients living with multimorbidity may benefit from an understanding of the role of everyday life work. Journal of Comorbidity 2014;4:1–10 PMID:29090148

Predicting Third Grade Reading Achievement for Mexican-American Students from Lower Socioeconomic Levels.

ERIC Educational Resources Information Center

Stevens, Frances Ann Bennett

The purpose of this study was to determine if measures of first grade readiness, scholastic aptitude, and reading achievement were significant predictors of third grade reading achievement for Mexican-American students from two lower socioeconomic levels. The sample included 94 third grade students for whom the following measurements had been…

Socioeconomic inequality in childhood obesity and its determinants: a Blinder-Oaxaca decomposition.

PubMed

Kelishadi, Roya; Qorbani, Mostafa; Heshmat, Ramin; Djalalinia, Shirin; Sheidaei, Ali; Safiri, Saeid; Hajizadeh, Nastaran; Motlagh, Mohammad Esmaeil; Ardalan, Gelayol; Asayesh, Hamid; Mansourian, Morteza

Childhood obesity has become a priority health concern worldwide. Socioeconomic status is one of its main determinants. This study aimed to assess the socioeconomic inequality of obesity in children and adolescents at national and provincial levels in Iran. This multicenter cross-sectional study was conducted in 2011-2012, as part of a national school-based surveillance program performed in 40,000 students, aged 6-18-years, from urban and rural areas of 30 provinces of Iran. Using principle component analysis, the socioeconomic status of participants was categorized to quintiles. Socioeconomic status inequality in excess weight was estimated by calculating the prevalence of excess weight (i.e., overweight, generalized obesity, and abdominal obesity) across the socioeconomic status quintiles, the concentration index, and slope index of inequality. The determinants of this inequality were determined by the Oaxaca Blinder decomposition. Overall, 36,529 students completed the study (response rate: 91.32%); 50.79% of whom were boys and 74.23% were urban inhabitants. The mean (standard deviation) age was 12.14 (3.36) years. The prevalence of overweight, generalized obesity, and abdominal obesity was 11.51%, 8.35%, and 17.87%, respectively. The SII for overweight, obesity and abdominal obesity was -0.1, -0.1 and -0.15, respectively. Concentration index for overweight, generalized obesity, and abdominal obesity was positive, which indicate inequality in favor of low socioeconomic status groups. Area of residence, family history of obesity, and age were the most contributing factors to the inequality of obesity prevalence observed between the highest and lowest socioeconomic status groups. This study provides considerable information on the high prevalence of excess weight in families with higher socioeconomic status at national and provincial levels. These findings can be used for international comparisons and for healthcare policies, improving their programming by

Individual and School-Level Socioeconomic Gradients in Physical Activity in Australian Schoolchildren.

PubMed

Lewis, Lucy; Maher, Carol; Katzmarzyk, Peter; Olds, Timothy

2016-02-01

We attempted to determine whether there was a socioeconomic gradient in 9- to 11-year-old Australian children's moderate-to-vigorous physical activity (MVPA), and whether school facilities or policies supporting physical activity were associated with school-level socioeconomic status (SES) and MVPA. Children (N = 528) from 26 randomly selected schools participated in the International Study of Childhood Obesity, Lifestyle and the Environment. School-level SES was determined by the Index of Community Socio-Educational Advantage. MVPA was determined from 7-day, 24-hour accelerometry. School facilities (21 items) were evaluated with an objective school ground audit. School policies related to physical activity were collected (18 items) in a school administrator survey. Relationships among SES, MVPA, school facilities, and policies were examined using bivariate regression, correlation analyses, and analysis of variance. There was a clear SES gradient in daily and in-school MVPA. School facilities or physical activity policies were not associated with SES or in-school MVPA, with the exception of presence of a sports field which was associated with lower SES schools (p = .02) and lower in-school MVPA (p = .001). School-built, policy, and resource environments are similar across different SES-level schools. Therefore, some other mechanism must be underlying the SES gradients seen in MVPA participation in Australian children. © 2016, American School Health Association.

Maternal age, education level and migration: socioeconomic determinants for smoking during pregnancy in a field study from Turkey.

PubMed

Ergin, Isil; Hassoy, Hur; Tanik, Feride A; Aslan, Gokce

2010-06-09

Smoking during pregnancy has been associated with socioeconomic determinants and it is recognized as the most important preventable risk factor for an unsuccessful pregnancy outcome. Turkey has national data on the prevalance of smoking during pregnancy; however there is no data on the characteristics of the high-risk population. This is a field study that aims to identify socioeconomic determinants for smoking during pregnancy as well as differentiating the daily and occasional smokers. Cross sectional study was conducted among women with 0-5 year old children living in the area served by Primary Health Care Center (PHCC) in Burhaniye, Turkey. Face-to-face interviews were conducted by the researchers during January-March 2008 at the home of the participants with 83.7% response rate (n = 256). The relation of "smoking during pregnacy" and "daily smoking during pregnancy" with the independent variables was determined with chi2 tests. Women's age, educational level, number of previous births, place of origin, migration, partner's educational level, poverty, perceived income, social class were evaluated. Statistical significance was achieved when the p value was less than 0.05. The variables in relation with the dependent variables in the chi2 tests were included in the forward-stepwise logistic analysis. Prevalance of smoking during pregnancy was 22.7%. The majority (74.1%) were daily smokers. Young mothers (< 20), low educated women and migrants were at increased risk for smoking during pregnancy. Low education and being a migrant were risk factors for daily consumption (p < 0.05). Systematic attention should be paid to socioeconomic determinants in smoking for pregnant women, especially in countries like Turkey with high rates of infant and mother mortality and substantial health inequalities. Young mothers (< 20), low educated women and migrants are important groups to focus on.

Maternal age, education level and migration: Socioeconomic determinants for smoking during pregnancy in a field study from Turkey

PubMed Central

2010-01-01

Background Smoking during pregnancy has been associated with socioeconomic determinants and it is recognized as the most important preventable risk factor for an unsuccessful pregnancy outcome. Turkey has national data on the prevalance of smoking during pregnancy; however there is no data on the characteristics of the high-risk population. This is a field study that aims to identify socioeconomic determinants for smoking during pregnancy as well as differentiating the daily and occasional smokers. Method Cross sectional study was conducted among women with 0-5 year old children living in the area served by Primary Health Care Center (PHCC) in Burhaniye, Turkey. Face-to-face interviews were conducted by the researchers during January-March 2008 at the home of the participants with 83.7% response rate (n = 256). The relation of "smoking during pregnacy" and "daily smoking during pregnancy" with the independent variables was determined with χ2 tests. Women's age, educational level, number of previous births, place of origin, migration, partner's educational level, poverty, perceived income, social class were evaluated. Statistical significance was achieved when the p value was less than 0.05. The variables in relation with the dependent variables in the χ2 tests were included in the forward-stepwise logistic analysis. Results Prevalance of smoking during pregnancy was 22.7%. The majority (74.1%) were daily smokers. Young mothers (< 20), low educated women and migrants were at increased risk for smoking during pregnancy. Low education and being a migrant were risk factors for daily consumption (p < 0.05). Conclusions Systematic attention should be paid to socioeconomic determinants in smoking for pregnant women, especially in countries like Turkey with high rates of infant and mother mortality and substantial health inequalities. Young mothers (< 20), low educated women and migrants are important groups to focus on. PMID:20534133

Area-based socioeconomic status, type 2 diabetes and cardiovascular mortality in Scotland

PubMed Central

Jackson, CA; Jones, NRV; Walker, JJ; Fischbacher, CM; Colhoun, HM; Leese, GP; Lindsay, RS; McKnight, JA; Morris, AD; Petrie, JR; Sattar, N; Wild, SH

2014-01-01

Aims To explore the relationships between type 2 diabetes mellitus, area-based socioeconomic status (SES) and cardiovascular disease mortality in Scotland. Methods We used an area-based measure of SES, Scottish national diabetes register data linked to mortality records, and general population cause-specific mortality data to investigate the relationships between SES, type 2 diabetes and ischaemic heart disease (IHD) and cerebrovascular disease (CbVD) mortality, for 2001-2007. We used negative binomial regression to obtain age-adjusted relative risks (RRs) of mortality (by sex), comparing people with type 2 diabetes to the non-diabetic population. Results Among 216,652 people aged 40 years or older with type 2 diabetes (980,687 person-years), there were 10,554 IHD deaths and 4,378 CbVD deaths. Age-standardised mortality increased with increasing deprivation, and was higher among men. IHD mortality RRs were highest among the least deprived quintile and lowest in the most deprived quintile (Men, least deprived: RR 1.94 95% CI 1.61, 2.33; most deprived: RR 1.46 95% CI 1.23, 1.74) and were higher in women than men (Women, least deprived: RR 2.84 95% CI 2.12, 3.80; most deprived: RR 2.04 95% CI 1.55, 2.69). A similar, weaker, pattern was observed for cerebrovascular mortality. Conclusions Absolute risk of cardiovascular mortality is higher in people with diabetes than the non-diabetic population, and increases with increasing deprivation. The relative impact of diabetes on cardiovascular mortality differs by SES and further efforts to reduce cardiovascular risk both in deprived groups and people with diabetes are required. Prevention of diabetes may reduce socioeconomic health inequalities. PMID:22893029

A novel approach for measuring residential socioeconomic factors associated with cardiovascular and metabolic health

EPA Science Inventory

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used hierarchical clu...

Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam.

PubMed

Lim, Travis; Zelaya, Carla; Latkin, Carl; Quan, Vu Minh; Frangakis, Constantine; Ha, Tran Viet; Minh, Nguyen Le; Go, Vivian

2013-11-13

HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. There was little urban-rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (p<0.05). For individuals, higher education was significantly associated with lower stigma (HIV and drug related) reported by both PWID and community members. Part-time employed PWID reported more experiences and perceptions of drug-related stigma, while conversely unemployed community

Tuberculosis inequalities and socio-economic deprivation in Portugal.

PubMed

Apolinário, D; Ribeiro, A I; Krainski, E; Sousa, P; Abranches, M; Duarte, R

2017-07-01

To analyse the geographical distribution of tuberculosis (TB) in Portugal and estimate the association between TB and socio-economic deprivation. An ecological study at the municipality level using TB notifications for 2010-2014 was conducted. Spatial Bayesian models were used to calculate smoothed standardised notification rates, identify high- and low-risk areas and estimate the association between TB notification and the European Deprivation Index (EDI) for Portugal and its component variables. Standardised notification rates ranged from 4.41 to 76.44 notifications per 100 000 population. Forty-one high-risk and 156 low-risk municipalities were identified. There was no statistically significant association between TB notification rate and the EDI, but some of its variables, such as the proportion of manual workers and the percentage unemployed, were significantly and directly associated with TB notification, whereas the variable 'proportion of residents with low education level' showed an inverse relationship. Wide inequalities in TB notification rates were observed, and some areas continued to exhibit high TB notification rates. We found significant associations between TB and some socio-economic factors of the EDI.

A novel approach to measuring residential socioeconomic factors associated with cardiovascular and metabolic health

EPA Science Inventory

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used a novel applica...

The illegal cigarette market in a socioeconomically deprived inner-city area: the case of the South Bronx.

PubMed

Kurti, Marin K; von Lampe, Klaus; Thompkins, Douglas E

2013-03-01

To determine the scope of the cigarette black market in a socioeconomically deprived inner-city area in the US, taking the South Bronx in New York City as a case study. The South Bronx Litter Pack Survey collected discarded cigarette packs (n=497) along 30 randomised census tracts to quantify the prevalence of counterfeit, legal and out-of-state tax stamps. It was found that 76.2% of cigarette packs collected avoided the combined New York City and State tax. More specifically, 57.9% were untaxed (counterfeit or bearing no tax stamp), for 15.8% taxes were paid outside of New York City (including other states and New York State only). Only 19.4% of tax stamps collected indicated that New York City and New York State taxes were paid. 4.4% of the cigarette packs could not be analysed because the tax stamps were not discernible. The finding that the majority of cigarettes did not have a tax stamp or bore a counterfeit tax stamp suggests that these cigarettes were being bootlegged, most likely from Native American Reservations. The present study highlights the importance of examining the illegal cigarette market in socioeconomically deprived regions of the US, where tax avoidance and black market activities appear to far exceed levels found elsewhere in the country including Chicago and New York City at large.

Impact of medical student origins on the likelihood of ultimately practicing in areas of low vs high socio-economic status.

PubMed

Puddey, Ian B; Playford, Denese E; Mercer, Annette

2017-01-05

Medical schools are in general over-represented by students from high socio-economic status backgrounds. The University of Western Australia Medical School has been progressively widening the participation of students from a broader spectrum of the community both through expanded selection criteria and quota-based approaches for students of rural, indigenous and other socio-educationally disadvantaged backgrounds. We proposed that medical students entering medical school from such backgrounds would ultimately be more likely to practice in areas of increased socio-economic disadvantage. The current practice address of 2829 medical students who commenced practice from 1980 to 2011 was ascertained from the Australian Health Practitioner Regulation Agency (AHPRA) Database. Logistic regression was utilised to determine the predictors of the likelihood of the current practice address being in the lower 8 socio-economic deciles versus the top 2 socio-economic deciles. Those who were categorised in the lower 8 socio-economic deciles at entry to medical school had increased odds of a current practice address in the lower 8 socio-economic deciles 5 or more years after graduation (OR 2.05, 95% CI 1.72, 2.45, P < 0.001). Other positive univariate predictors included age at medical degree completion (for those 25 years or older vs those 24 years or younger OR 1.53, 95% CI 1.27, 1.84, P < 0.001), being female (OR 1.26, 95% CI 1.07, 1.48, P = 0.005) and having a general practice versus specialist qualification (OR 4.16, 95% CI 3.33, 5.19, P < 0.001). Negative predictors included having attended an independent school vs a government school (OR 0.77, 95% CI 0.64, 0.92, P < 0.001) or being originally from overseas vs being born in Oceania (OR 0.80, 95% CI 0.67, 0.96, P = 0.017). After adjustment for potential confounders in multivariate logistic regression, those in the lower 8 socio-economic deciles at entry to medical school still had increased odds of

Socioeconomic studies of high-level nuclear waste disposal.

PubMed Central

White, G F; Bronzini, M S; Colglazier, E W; Dohrenwend, B; Erikson, K; Hansen, R; Kneese, A V; Moore, R; Page, E B; Rappaport, R A

1994-01-01

The socioeconomic investigations of possible impacts of the proposed repository for high-level nuclear waste at Yucca Mountain, Nevada, have been unprecedented in several respects. They bear on the public decision that sooner or later will be made as to where and how to dispose permanently of the waste presently at military weapons installations and that continues to accumulate at nuclear power stations. No final decision has yet been made. There is no clear precedent from other countries. The organization of state and federal studies is unique. The state studies involve more disciplines than any previous efforts. They have been carried out in parallel to federal studies and have pioneered in defining some problems and appropriate research methods. A recent annotated bibliography provides interested scientists with a compact guide to the 178 published reports, as well as to relevant journal articles and related documents. PMID:7971963

Learning to (Dis)Engage? The Socialising Experiences of Young People Living in Areas of Socio-Economic Disadvantage

ERIC Educational Resources Information Center

Mason, Carolynne; Cremin, Hilary; Warwick, Paul; Harrison, Tom

2011-01-01

Young people are increasingly required to demonstrate civic engagement in their communities and help deliver the aspirations of localism and Big Society. Using an ecological systems approach this paper explores the experiences of different groups of young people living in areas of socio-economic disadvantage. Using volunteering as an example of…

Socioeconomic research in agroforestry: progress, prospects, priorities

Treesearch

D. Evan Mercer; R.P. Miller

1998-01-01

Fourteen years after the birth of the journal Agroforestry Systems, biophysical studies continue to dominate agroforestry research while other important areas have not received the attention they deserve. This paper reviews the progress in one of these under-researched areas, socioeconomics. A quantitative and qualitative analysis of published socioeconomic research...

Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States.

PubMed

Henry, Kevin A; Swiecki-Sikora, Allison L; Stroup, Antoinette M; Warner, Echo L; Kepka, Deanna

2017-07-14

This study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.). Data from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately. In 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of  HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32)  than Hispanic boys in  low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas. Higher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with

Association of dental caries with socioeconomic status in relation to different water fluoridation levels.

PubMed

Cho, Hyun-Jae; Lee, Heung-Soo; Paik, Dai-Il; Bae, Kwang-Hak

2014-12-01

The aim of this study was to assess the prevalence of dental caries in 11-year-old children, related to water fluoridation and family affluence scale (FAS), as an indicator of socioeconomic status (SES) in Korea. A total of eight areas were selected for study: four areas with fluoridated piped water (WF areas) and four areas with nonfluoridated piped water (non-WF areas). Non-WF areas had a similar economic level and population size compared with the WF areas. A total of 1446 elementary school students, 11 years of age, were included. They were examined, and questionnaires completed by their parents were analyzed. In the questionnaire, information about gender, FAS as an indicator of SES, occasions of daily cariogenic snack intake, occasions of daily cariogenic beverage intake, drinking of piped water, cooking with piped water, and usage of oral hygiene supplemental measures were surveyed. The bivariate association between the characteristics of the subjects and the number of decayed, filled, and missing permanent teeth (DMFT score) was analyzed through an independent samples t-test. The difference in the mean DMFT score between different FAS groups was analyzed by DMFT ratio, after adjusting for gender, oral health behaviors, and usage of piped water variables. The DMFT ratio was calculated from a Poisson regression model, because the DMFT score was not normally distributed. There was no significant association between FAS and the mean DMFT score in both areas, by bivariate analysis. After adjusting for each group of confounders, a significant association (95% CI: 1.032-1.513) was found between the FAS and mean DMFT scores in non-WF areas; however, no significant difference was observed in the WF areas (95% CI: 0.766-1.382). This study supported that water fluoridation could not only lead to a lower prevalence of dental caries, but also help to reduce the effect of SES inequalities on oral health. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Ethnic-group socioeconomic status as an indicator of community-level disadvantage: A study of overweight/obesity in Asian American adolescents.

PubMed

Cook, Won Kim; Tseng, Winston; Tam, Christina; John, Iyanrick; Lui, Camillia

2017-07-01

Asian American children and adolescents are an under-investigated subpopulation in obesity research. Informed by a wide socioeconomic diversity among Asian American ethnic groups, this study explored ethnic-group socioeconomic status (SES) as an indicator of community-level disadvantage that may influence overweight/obesity in Asian American adolescents. We hypothesized that ethnic-group SES was inversely associated with overweight/obesity in Asian American adolescents. Multiple logistic regression models were fitted using a sample of 1525 Asian American adolescents ages 12-17 from pooled 2007-2012 California Health Interview Survey (CHIS) data. Age, gender, nativity, individual-level SES (income and education), and two lifestyle variables (fast food consumption and physical activity) were controlled for. We found that adolescents in high- or middle-level SES ethnic groups were far less likely to be overweight/obese than those in low-SES ethnic groups. Further, these relationships were more pronounced for foreign-born adolescents but not significant for U.S.-born adolescents. Ethnic-group SES may be a meaningful indicator of community-level socioeconomic disparities that influence the health of Asian Americans and, potentially, other populations with high proportions of immigrants of diverse socioeconomic and ethnic backgrounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

Socio-economic factors affecting the conservation of natural woodlands in Central Riyadh Area – Saudi Arabia

PubMed Central

Al-Subaiee, Faisal Sultan

2015-01-01

This study aimed to identify some socioeconomic factors affecting local people in central Riyadh area for the utilization of wood and other energy sources in cooking and heating in order to develop some recommendations for conserving woodlands. The study results revealed that gas is the most common energy source used for cooking with a mean usage level of 2.79 (SD = 0.58). On the other hand, wood ranked first for heating with the highest mean, usage level of 1.90 (SD = 1.06). However, electricity and gas as sources of energy for heating ranked second and third with mean usage level of 1.81 and 0.80 respectively. The study revealed that local people with the university education were significantly making higher use of electricity for both cooking and heating and those with no formal education ranked the highest on wood use for both cooking and heating. In addition, those living in traditional houses significantly used more wood for cooking than those living in villas and apartments. Also, local people with high income levels significantly were using more electricity for heating than others. The study recommended conducting extension and environmental awareness raising programs to enhance local residents’ adoption of wood substitutes, promoting employment opportunities for unemployed locals, and subsidizing prices of alternative energy sources. PMID:27081355

Integration of data from censuses and remote sensing to measure the socio-economic and environmental evolution in urban areas: case of the city of Sherbrooke (1981-2006)

NASA Astrophysics Data System (ADS)

Dari, Ouassini

The urban environment is complex, heterogeneous and temporally changeable. Man is the main actor in the transformation of urban areas where he interacts with intensity. Spatial differentiation is a result of human occupation in the urban environment. This occupation may vary according to land use, population density, social and economic characteristics and environment. This leads us to say that the socio-economic and environmental indicators change according to the various locations in the urban area and through time. Our goal is to measure the socio-economic and environmental changes in the urban area of the city of Sherbrooke using remote sensing data synchronized with the censuses and that we will then integrate into the geographic information system (GIS). We have used data from the 1981 and 2006 censuses, 1983 aerial photos, 2007 orthophotos and 1983 MSS and 2006 Ikons satellite images to measure the socio-economic and environmental changes in the city of Sherbrooke. We have used spatial analysis tools to integrate image data with census data. The methods uses such as global indices, principal component analysis combined with the variation between the two dates have yielded interesting results. The first factor in principal component analysis with orthogonal rotation (Varimax) justified a substantial percentage of the variance in global indices. The use of dissemination areas resulted in detailed information on the change in the city. From the perspective of spatial distribution, we noted a major difference between the central areas and the peripheral areas in 1981 and 2006. From the perspective of evolution between 1981 and 2006, we observed that are positive and negative changes at various levels took place. We also observed the evolution of ethnicity in the Sherbrooke city and Lennoxville municipality. The study showed that the French population is prevalent in the old city of Sherbrooke as the English population is prevalent in Lennoxville. The European

The Potential of Solar as Alternative Energy Source for Socio-Economic Wellbeing in Rural Areas, Malaysia

NASA Astrophysics Data System (ADS)

Alam, Rashidah Zainal; Siwar, Chamhuri; Ludin, Norasikin Ahmad

Malaysia's energy sector is highly dependent on fossil fuels as a primary energy source. Economic growth and socio-economic wellbeing also rely on the utilization of energy in daily life routine. Nevertheless, the increasing cost for electricity and declining fossil fuels resources causes various negative impacts to the people and environment especially in rural areas. This prompted Malaysia to shift towards alternative energy sources such as solar energy to ensure social, economic and environmental benefits. The solar energy is one of the potential renewable energy sources in tropical countries particularly in Malaysia. The paper attempts to analyze the benefits and advantages related to energy efficiency of solar for sustainable energy use and socio economic wellbeing in rural areas, Malaysia. The paper uses secondary sources of data such as policies, regulations and research reports from relevant ministries and agencies to attain the objectives. As a signatory country to the UN Convention on Climate Change and the Kyoto Protocol, Malaysia has taken initiatives for decreasing energy dependence on oil to reduce greenhouse gas emissions (GHG) for sustainable development. The paper shows solar energy becomes one of the promising alternative energy sources to alleviate energy poverty in Malaysia for rural areas. Finally, solar energy has increased socio-economic wellbeing and develops green potential and toward achieving energy efficiency in energy sector of Malaysia by preserving environment as well as reducing carbon emission.

A spatial model of socioeconomic and environmental determinants of dengue fever in Cali, Colombia.

PubMed

Delmelle, Eric; Hagenlocher, Michael; Kienberger, Stefan; Casas, Irene

2016-12-01

Dengue fever has gradually re-emerged across the global South, particularly affecting urban areas of the tropics and sub-tropics. The dynamics of dengue fever transmission are sensitive to changes in environmental conditions, as well as local demographic and socioeconomic factors. In 2010, the municipality of Cali, Colombia, experienced one of its worst outbreaks, however the outbreak was not spatially homogeneous across the city. In this paper, we evaluate the role of socioeconomic and environmental factors associated with this outbreak at the neighborhood level, using a Geographically Weighted Regression model. Key socioeconomic factors include population density and socioeconomic stratum, whereas environmental factors are proximity to both tire shops and plant nurseries and the presence of a sewage system (R 2 =0.64). The strength of the association between these factors and the incidence of dengue fever is spatially heterogeneous at the neighborhood level. The findings provide evidence to support public health strategies in allocating resources locally, which will enable a better detection of high risk areas, a reduction of the risk of infection and to strengthen the resilience of the population. Published by Elsevier B.V.

Relationship between physical activity level and psychosocial and socioeconomic factors and issues in children and adolescents with asthma: a scoping review.

PubMed

Westergren, Thomas; Berntsen, Sveinung; Ludvigsen, Mette Spliid; Aagaard, Hanne; Hall, Elisabeth O C; Ommundsen, Yngvar; Uhrenfeldt, Lisbeth; Fegran, Liv

2017-08-01

Asthma is a heterogeneous chronic airway disease which may reduce capability for physical activity. In healthy peers, physical activity is influenced by psychosocial and socioeconomic factors. Knowledge about the role of these factors has not been mapped in children and adolescents with asthma. The main objective of this scoping review was to identify psychosocial and socioeconomic factors associated with physical activity level in children and adolescents with asthma in the literature. The specific objectives were to map the instruments used to measure these factors, report on the construction and validation of these instruments, map psychosocial and socioeconomic issues related to physical activity level reported in qualitative studies, and identify gaps in knowledge about the relationship between psychosocial and socioeconomic factors and physical activity level in children and adolescents with asthma. Children and adolescents with asthma aged six to 18 years. Psychosocial and socioeconomic factors related to physical activity level and participation. All physical activity contexts. Quantitative and qualitative primary studies in English, with no date limit. The databases searched included nine major databases for health and sports science, and five databases for unpublished studies. After screening and identification of studies, the reference lists of all identified reports were searched, and forward citation searches were conducted using four databases. The following data were extracted: (a) relevant study characteristics and assessment of physical activity level, (b) instruments used to assess psychosocial and socioeconomic factors, (c) association between physical activity level and these factors, (d) construction and validation of instruments, and (e) psychosocial and socioeconomic issues related to physical activity participation. Twenty-one quantitative and 13 qualitative studies were included. In cross-sectional studies, enjoyment, physical self

Racial residential segregation, socioeconomic disparities, and the White-Black survival gap.

PubMed

Popescu, Ioana; Duffy, Erin; Mendelsohn, Joshua; Escarce, José J

2018-01-01

To evaluate the association between racial residential segregation, a prominent manifestation of systemic racism, and the White-Black survival gap in a contemporary cohort of adults, and to assess the extent to which socioeconomic inequality explains this association. This was a cross sectional study of White and Black men and women aged 35-75 living in 102 large US Core Based Statistical Areas. The main outcome was the White-Black survival gap. We used 2009-2013 CDC mortality data for Black and White men and women to calculate age-, sex- and race adjusted White and Black mortality rates. We measured segregation using the Dissimilarity index, obtained from the Manhattan Institute. We used the 2009-2013 American Community Survey to define indicators of socioeconomic inequality. We estimated the CBSA-level White-Black gap in probability of survival using sequential linear regression models accounting for the CBSA dissimilarity index and race-specific socioeconomic indicators. Black men and women had a 14% and 9% lower probability of survival from age 35 to 75 than their white counterparts. Residential segregation was strongly associated with the survival gap, and this relationship was partly, but not fully, explained by socioeconomic inequality. At the lowest observed level of segregation, and with the Black socioeconomic status (SES) assumed to be at the White SES level scenario, the survival gap is essentially eliminated. White-Black differences in survival remain wide notwithstanding public health efforts to improve life expectancy and initiatives to reduce health disparities. Eliminating racial residential segregation and bringing Black socioeconomic status (SES) to White SES levels would eliminate the White-Black survival gap.

District-level variations in childhood immunizations in India: The role of socio-economic factors and health infrastructure.

PubMed

Rammohan, Anu; Awofeso, Niyi

2015-11-01

Routine childhood immunizations against measles and DPT are part of the World Health Organization's (WHO) Expanded Program on Immunization (EPI) set up in 1974, with the aim of reducing childhood morbidity and mortality. Despite this, immunization rates are sub-optimal in developing countries such as India, with wide heterogeneity observed across districts and socio-economic characteristics. The aim of this paper is to examine district-level variations in the propensity to vaccinate a child in India for measles and DPT3, and analyse the extent to which these immunizations are given age-inappropriately, either prematurely or delayed. The present study uses data from the Indian District Level Household Survey (DLHS-3) collected in 2008, and the final sample contains detailed information on 42157 children aged between 12 and 60 months, across 549 Indian districts for whom we have complete information on immunization history. Our empirical study analyses: (i) the district-level average immunization rates for measles and DPT3, and (ii) the extent to which these immunizations have been given age-appropriately. A key contribution of this paper is that we link the household-level data at the district level to data on availability and proximity to health infrastructure and district-level socio-economic factors. Our results show that after controlling for an array of socio-economic characteristics, across all our models, the district's income per capita is a strong predictor of better immunization outcomes for children. Mother's education level at the district-level has a statistically significant and positive influence on immunization outcomes across all our models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam

PubMed Central

Lim, Travis; Zelaya, Carla; Latkin, Carl; Quan, Vu Minh; Frangakis, Constantine; Ha, Tran Viet; Minh, Nguyen Le; Go, Vivian

2013-01-01

Introduction HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. Methods A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. Results There was little urban–rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (p<0.05). For individuals, higher education was significantly associated with lower stigma (HIV and drug related) reported by both PWID and community members. Part-time employed PWID reported more experiences and perceptions of drug-related stigma, while

Socioeconomic position and education in patients with coeliac disease.

PubMed

Olén, Ola; Bihagen, Erik; Rasmussen, Finn; Ludvigsson, Jonas F

2012-06-01

Socioeconomic position and education are strongly associated with several chronic diseases, but their relation to coeliac disease is unclear. We examined educational level and socioeconomic position in patients with coeliac disease. We identified 29,096 patients with coeliac disease through biopsy reports (defined as Marsh 3: villous atrophy) from all Swedish pathology departments (n=28). Age- and sex-matched controls were randomly sampled from the Swedish Total Population Register (n=145,090). Data on level of education and socioeconomic position were obtained from the Swedish Education Register and the Occupational Register. We calculated odds ratios for the risk of having coeliac disease based on socioeconomic position according to the European Socioeconomic Classification (9 levels) and education. Compared to individuals with high socioeconomic position (level 1 of 9) coeliac disease was less common in the lowest socioeconomic stratum (routine occupations=level 9 of 9: adjusted odds ratio=0.89; 95% confidence interval=0.84-0.94) but not less common in individuals with moderately low socioeconomic position: (level 7/9: adjusted odds ratio=0.96; 95% confidence interval=0.91-1.02; and level 8/9: adjusted odds ratio=0.99; 95% confidence interval=0.93-1.05). Coeliac disease was not associated with educational level. In conclusion, diagnosed coeliac disease was slightly less common in individuals with low socioeconomic position but not associated with educational level. Coeliac disease may be unrecognised in individuals of low socioeconomic position. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Differences in adults' health and health behaviour between 16 European urban areas and the associations with socio-economic status and physical and social environment.

PubMed

de Gelder, Rianne; Koster, Emmy M; van Buren, Laurens P; van Ameijden, Erik J C; Harrison, Annie; Birt, Christopher A; Verma, Arpana

2017-05-01

With a growing proportion of the European population living in urban areas (UAs), exploring health in urban areas becomes increasingly important. The objective of this study is to assess the magnitude of differences in health and health behaviour between adults living in urban areas (UAs) across Europe. We also explored whether and to what extent such differences can be explained by socio-economic status (SES) and physical or social environment. Data were obtained from a cross-sectional questionnaire survey, performed between as part of the European Urban Health Indicator System Part 2 (EURO-URHIS 2) project. Using multi-level logistic regression analysis, UA differences in psychological distress, self-assessed health, overweight and obesity, daily smoking, binge drinking and physical exercise were assessed. Median Odds Ratios (MORs) were calculated to estimate the extent to which the observed variance is attributable to UA, individual-level SES (measured by perceived financial strains, education level and employment status) and/or characteristics of physical and social environment. The dataset included 14 022 respondents in 16 UAs within 9 countries. After correction for age and gender, all MORs, except that for daily smoking, indicated statistically significant UA health differences. SES indicators (partly) explained UA differences in psychological distress, decreasing the MOR from 1.43 [95% credible interval (Cr.I.) 1.27-1.67, baseline model], to 1.25 (95% Cr.I. 1.14-1.40, SES model): a reduction of 42%. Accounting for the quality of green areas reduced the MOR for psychological distress by an additional 40%, to 1.15 (95% Cr.I. 1.05-1.28). Our study showed large differences in health and health behaviour between European UAs. Reducing socio-economic disadvantage and improving the quality of the neighbourhood's green spaces may reduce UA differences in psychological distress. © The Author 2016. Published by Oxford University Press on behalf of the European

A Whole Class Teaching Approach to Improve the Vocabulary Skills of Adolescents Attending Mainstream Secondary School, in Areas of Socioeconomic Disadvantage

ERIC Educational Resources Information Center

Murphy, Aoife; Franklin, Sue; Breen, Annemarie; Hanlon, Molly; McNamara, Aoife; Bogue, Aine; James, Emily

2017-01-01

Young people from areas of socioeconomic disadvantage (SED) are more likely to present with language difficulties, particularly vocabulary difficulties. Studies have shown the effectiveness of vocabulary interventions for children with language impairment but not for adolescents from areas of SED. This article aims to establish the effectiveness…

Assessing the Relationship between Socioeconomic Conditions and Urban Environmental Quality in Accra, Ghana

PubMed Central

Fobil, Julius; May, Juergen; Kraemer, Alexander

2010-01-01

The influence of socioeconomic status (SES) on health inequalities is widely known, but there is still poor understanding of the precise relationship between area-based socioeconomic conditions and neighborhood environmental quality. This study aimed to investigate the socioeconomic conditions which predict urban neighbourhood environmental quality. The results showed wide variation in levels of association between the socioeconomic variables and environmental conditions, with strong evidence of a real difference in environmental quality across the five socioeconomic classes with respect to total waste generation (p < 0.001), waste collection rate (p < 0.001), sewer disposal rate (p < 0.001), non-sewer disposal (p < 0.003), the proportion of households using public toilets (p = 0.005). Socioeconomic conditions are therefore important drivers of change in environmental quality and urban environmental interventions aimed at infectious disease prevention and control if they should be effective could benefit from simultaneous implementation with other social interventions. PMID:20195437

The late-stage diagnosis of colorectal cancer: demographic and socioeconomic factors.

PubMed Central

Mandelblatt, J; Andrews, H; Kao, R; Wallace, R; Kerner, J

1996-01-01

OBJECTIVES: This study described factors related to colorectal cancer stage at diagnosis. METHODS: Logistic regression analyses were used on data from the New York State Tumor Registry and US Census area-level social class indicators. RESULTS: After the effects of other predictors were controlled for, the odds of late-stage cancer increased as age decreased; women and African Americans were significantly more likely to have late stage than men and Whites; and individuals living in areas of low socioeconomic status (SES) were significantly more likely to be diagnosed at late stage than those living in higher SES areas. Stratified analyses showed that living in a low SES area was the most important determinant of stage for all age, race, gender and source-of-care groups. CONCLUSIONS: While all populations would benefit from the systematic use of screening socioeconomically disadvantaged groups may also benefit from targeted screening. PMID:9003140

Contextual socioeconomic factors associated with childhood mortality in Nigeria: a multilevel analysis.

PubMed

Adekanmbi, Victor T; Kandala, Ngianga-Bakwin; Stranges, Saverio; Uthman, Olalekan A

2015-11-01

Childhood mortality is a well-known public health issue, particularly in the low and middle income countries. The overarching aim of this study was to examine whether neighbourhood socioeconomic disadvantage is associated with childhood mortality beyond individual-level measures of socioeconomic status in Nigeria. Multilevel logistic regression models were applied to data on 31 482 under-five children whether alive or dead (level 1) nested within 896 neighbourhoods (level 2) from the 37 states in Nigeria (level 3) using the most recent 2013 Nigeria Demographic and Health Survey (DHS). More than 1 of every 10 children studied had died before reaching the age of 5 years (130/1000 live births). The following factors independently increased the odds of childhood mortality: male sex, mother's age at 15-24 years, uneducated mother or low maternal education attainment, decreasing household wealth index at individual level (level 1), residing in rural area and neighbourhoods with high poverty rate at level 2. There were significant neighbourhoods and states clustering in childhood mortality in Nigeria. The study provides evidence that individual-level and neighbourhood-level socioeconomic conditions are important correlates of childhood mortality in Nigeria. The findings of this study also highlight the need to implement public health prevention strategies at the individual level, as well as at the area/neighbourhood level. These strategies include the establishment of an effective publicly funded healthcare system, as well as health education and poverty alleviation programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data.

PubMed

Katikireddi, Srinivasa Vittal; Whitley, Elise; Lewsey, Jim; Gray, Linsay; Leyland, Alastair H

2017-06-01

Alcohol-related mortality and morbidity are high in socioeconomically disadvantaged populations compared with individuals from advantaged areas. It is unclear if this increased harm reflects differences in alcohol consumption between these socioeconomic groups, reverse causation (ie, downward social selection for high-risk drinkers), or a greater risk of harm in individuals of low socioeconomic status compared with those of higher status after similar consumption. We aimed to investigate whether the harmful effects of alcohol differ by socioeconomic status, accounting for alcohol consumption and other health-related factors. The Scottish Health Surveys are record-linked cross-sectional surveys representative of the adult population of Scotland. We obtained baseline demographics and data for alcohol consumption (units per week and binge drinking) from Scottish Health Surveys done in 1995, 1998, 2003, 2008, 2009, 2010, 2011, and 2012. We matched these data to records for deaths, admissions, and prescriptions. The primary outcome was alcohol-attributable admission or death. The relation between alcohol-attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income, and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors (including smoking and body-mass index [BMI]) mediating social patterning was explored in separate regression models. Reverse causation was tested by comparing change in area deprivation over time. 50 236 participants (21 777 men and 28 459 women) were included in the analytical sample, with 429 986 person-years of follow-up. Low socioeconomic status was associated consistently with strikingly raised alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, BMI, and smoking. Evidence was noted of effect modification; for example, relative to light drinkers living in

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings.

PubMed

Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

2013-06-10

Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban-rural status. Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991-2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings

PubMed Central

2013-01-01

Background Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban–rural status. Methods Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Results Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991–2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Conclusions Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse

Variation with socioeconomic status of indoor radon levels in Great Britain: The less affluent have less radon.

PubMed

Kendall, Gerald M; Miles, Jon C H; Rees, David; Wakeford, Richard; Bunch, Kathryn J; Vincent, Tim J; Little, Mark P

2016-11-01

We demonstrate a strong correlation between domestic radon levels and socio-economic status (SES) in Great Britain, so that radon levels in homes of people with lower SES are, on average, only about two thirds of those of the more affluent. This trend is apparent using small area measures of SES and also using individual social classes. The reasons for these differences are not known with certainty, but may be connected with greater underpressure in warmer and better-sealed dwellings. There is also a variation of indoor radon levels with the design of the house (detached, terraced, etc.). In part this is probably an effect of SES, but it appears to have other causes as well. Data from other countries are also reviewed, and broadly similar effects seen in the United States for SES, and in other European countries for detached vs other types of housing. Because of correlations with smoking, this tendency for the lower SES groups to experience lower radon levels may underlie the negative association between radon levels and lung cancer rates in a well-known ecological study based on US Counties. Those conducting epidemiological studies of radon should be alert for this effect and control adequately for SES. Copyright © 2016 Elsevier Ltd. All rights reserved.

A socio-economic hypothesis for lower birth sex ratios at racial, national and global levels.

PubMed

Grech, Victor

2018-01-01

The sex ratio at birth may be depressed by a variety of events or conditions due to an excess of male foetal losses. Evidence is accumulating that observed differences in this ratio between races, nations and even at regional global level, may be due to socio-economic stress. This review summarises findings pertaining to Blacks in the United States, and to a global United Nations dataset, as well as to other smaller studies. Extant evidence reinforces the theory that chronic socio-economic stress may be the reason for a lower birth sex ratio at racial, national and global levels. While innate periconceptual and gestational (e.g. hormonal) racial differences have been cited as possible causes for these M/T differences, this may be a mechanism/pathway and not the actual cause for lower M/T. Stress may, however, act by using hormonal pathways to effect the observed M/T disparities. Copyright © 2017. Published by Elsevier B.V.

The coastal area of Togo: A space vulnerable to sea level rise hotly disputed

NASA Astrophysics Data System (ADS)

Adjoussi, P. D.

2015-12-01

Abstract Erosion caused in the coastal area of Togo especially in the cell to the east of the harbor of Lomé some reorganization of space and a reallocation of tasks functions of the importance of existing issues. This reorganization is an important race against time between the various stakeholders which paradoxically make this area a very dynamic environment. In spite of the disaster situation in the area, it is changing. This mutation has been observed for a decade in many ways. Fishing is a traditional activity disappears causing the emergence of new activities such as the extraction of gravel, the gardening, the informal trade of any kind, installing hotels, etc.. At the socio-economic transformation is associated with a beach in state of deficit causing the decline of the coastline that reaches approximately 500 m over a few kilometers according to the old marks missing. The decline of the coastline is by undermining the beach by the waves at high tide. These issues are reshaping the land use map that passes a distribution of fishing villages on the coast in 1980 to a suburban area exposed to sea level rise corollary to anticipated climate change. Keywords: Space, Reorganization, Vulnerability, Stakeholders, Sea Level, Fishing

Associations between socioeconomic status and cardiovascular risk factors in an urban population in China.

PubMed

Yu, Z; Nissinen, A; Vartiainen, E; Song, G; Guo, Z; Zheng, G; Tuomilehto, J; Tian, H

2000-01-01

In developed countries socioeconomic status has been proven to be an important factor in the progression of cardiovascular disease. The present article reports the results of a cross-sectional assessment to investigate the association between socioeconomic status and cardiovascular risk factors in a Chinese urban population. In 1996, a behavioural risk factor survey was carried out in Tianjin, the third largest city in China. A sample of 4000 people aged 15-69 years, stratified by sex and 10-year age groups, was drawn randomly from urban areas of the city. The present study covers respondents aged 25-69 years (1615 men and 1592 women). Four socioeconomic indicators (education, occupation, income, and marital status), blood pressure, body mass index, and cigarette smoking were determined in the survey. Educational level seemed to be the most important measure of the four socioeconomic indicators in relation to the cardiovascular risk factors in the study population. People with lower socioeconomic status had higher levels of cardiovascular risk factors. The association between socioeconomic status and cardiovascular risk factors was more consistent among women than men. Our findings do not seem to differ from those observed in developed countries.

Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010.

PubMed

Almasian Kia, Abdollah; Rezapour, Aziz; Khosravi, Ardeshir; Afzali Abarghouei, Vajiheh

2017-01-01

The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010

PubMed Central

2017-01-01

Objectives The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children’s sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition. PMID:28605886

The Association between Socioeconomic Status and Obesity in Peruvian Women

PubMed Central

Poterico, J.A.; Stanojevic, S.; Ruiz, P.; Bernabe-Ortiz, A.; Miranda, J. J.

2012-01-01

Historically in developing countries, the prevalence of obesity has been greater in more advantaged socioeconomic groups. However, in recent years the association between socioeconomic status (SES) and obesity has changed and varies depending on the country’s development stage. This study examines the relationship between SES and obesity using two indicators of SES: education or possession assets. Using the cross-sectional 2008 National Demographic and Family Health Survey of Peru (ENDES 2008) we investigated this relationship in women aged 15 to 49 years living in rural and urban settings. Descriptive, linear and logistic regressions analyses were conducted accounting for the multi-staged nature of the sampling design. The overall prevalence of obesity in this study was 14.1% (95%CI: 13.3–14.8); 8.4% (95%CI: 7.5–9.3) in rural areas and 16.2% (95%CI: 15.2–17-2) in urban areas. Wealthier women were more likely to be obese, and this association was stronger in rural areas. Conversely, more educated women were less likely to be obese, especially in urban areas. The distribution of obesity in Peruvian women is strongly related to socioeconomic position, and differs whether measured as possession assets or by level of education. These findings could have important implications for policy development in Peru. PMID:21959344

Subjective wellbeing, suicide and socioeconomic factors: an ecological analysis in Hong Kong.

PubMed

Hsu, C-Y; Chang, S-S; Yip, P S F

2018-04-10

There has recently been an increased interest in mental health indicators for the monitoring of population wellbeing, which is among the targets of Sustainable Development Goals adopted by the United Nations. Levels of subjective wellbeing and suicide rates have been proposed as indicators of population mental health, but prior research is limited. Data on individual happiness and life satisfaction were sourced from a population-based survey in Hong Kong (2011). Suicide data were extracted from Coroner's Court files (2005-2013). Area characteristic variables included local poverty rate and four factors derived from a factor analysis of 21 variables extracted from the 2011 census. The associations between mean happiness and life satisfaction scores and suicide rates were assessed using Pearson correlation coefficient at two area levels: 18 districts and 30 quantiles of large street blocks (LSBs; n = 1620). LSB is a small area unit with a higher level of within-unit homogeneity compared with districts. Partial correlations were used to control for area characteristics. Happiness and life satisfaction demonstrated weak inverse associations with suicide rate at the district level (r = -0.32 and -0.36, respectively) but very strong associations at the LSB quantile level (r = -0.83 and -0.84, respectively). There were generally very weak or weak negative correlations across sex/age groups at the district level but generally moderate to strong correlations at the LSB quantile level. The associations were markedly attenuated or became null after controlling for area characteristics. Subjective wellbeing is strongly associated with suicide at a small area level; socioeconomic factors can largely explain this association. Socioeconomic factors could play an important role in determining the wellbeing of the population, and this could inform policies aimed at enhancing population wellbeing.

Dietary patterns of children and socioeconomical, behavioral and maternal determinants

PubMed Central

Villa, Julia Khéde Dourado; Santos, Thanise Sabrina Souza; Ribeiro, Andréia Queiroz; Silva, Angélica Ribeiro e; da Rocha Sant'Ana, Luciana Ferreira; Pessoa, Milene Cristine

2015-01-01

Abstract Objective: To identify dietary patterns of children and to verify their association with socio-economical, behavioral and maternal determinants. Methods: A cross-sectional study with a random sample of 328 children aged 8 and 9 years. Dietary intake was assessed by food records in three nonconsecutive days and measured in grams of food groups and nutrients. Factor analysis and subsequent orthogonal rotation (varimax) were used to determine dietary patterns. Ordinal logistic regression was used to assess associations between dietary patterns and the studied determinants. Results: Five dietary patterns were observed: “Traditional,” “Sweetened beverages and snacks,” “Monotonous,” “Healthy” and “Egg-dairy.” A higher maternal level of education was directly associated with “Sweetened beverages and snacks” and “Egg-dairy' standards. Low income children who were submitted to greater food restriction by parents/guardians followed the more “Traditional” standard, represented by the consumption of rice, beans, vegetables, cooked roots and tubers and red meat. The “Monotonous” pattern, represented by a high consumption of milk and chocolate powder, was most followed by children from the middle class. Children living in rural areas consumed more foods from the “Egg-dairy” pattern, when compared to those from the urban area. Conclusions: Dietary patterns of children were associated with family socioeconomic status, maternal level of education, practice of food restriction by parents/guardians and location of residence in urban or rural area. Better socioeconomic conditions contributed to a more nutritionally inadequate dietary pattern. PMID:26163945

The influence of area-level education on body mass index, waist circumference and obesity according to gender.

PubMed

Boing, Antonio Fernando; Subramanian, S V

2015-09-01

The aim of this study was to analyze the association between area-level education and body mass index (BMI), waist circumference (WC) and obesity controlling for individual demographic and socioeconomic characteristics. A cross-sectional population-based study was carried out with 1720 adults aged 20-59 in southern Brazil. We used multilevel modeling techniques to test whether area-level education was associated with BMI, WC and obesity regardless of individual-level characteristics. We observed a significant between-groups variance for both BMI and WC. Among women, area-level education explained 27.6 and 30.0% of the between-groups variance of BMI and WC, respectively. In the fully adjusted model, the WC was 4.67 cm higher (p < 0.05) and the BMI was 1.12 kg/m(2) higher (p < 0.05) in the women residents of low education neighborhoods compared to the residents of high education areas. In the same group, the chance of central obesity and general obesity was, respectively, 2.05 (IC95% 1.19-3.52) and 1.85 (IC95% 1.04-3.29) times higher. The findings suggest that neighborhood characteristics play an important role in the distribution of obesity and must be addressed by policy makers.

Incorporation of Socio-Economic Features' Ranking in Multicriteria Analysis Based on Ecosystem Services for Marine Protected Area Planning

PubMed Central

Portman, Michelle E.; Shabtay-Yanai, Ateret; Zanzuri, Asaf

2016-01-01

Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA) has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical) attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity. PMID:27183224

Incorporation of Socio-Economic Features' Ranking in Multicriteria Analysis Based on Ecosystem Services for Marine Protected Area Planning.

PubMed

Portman, Michelle E; Shabtay-Yanai, Ateret; Zanzuri, Asaf

2016-01-01

Developed decades ago for spatial choice problems related to zoning in the urban planning field, multicriteria analysis (MCA) has more recently been applied to environmental conflicts and presented in several documented cases for the creation of protected area management plans. Its application is considered here for the development of zoning as part of a proposed marine protected area management plan. The case study incorporates specially-explicit conservation features while considering stakeholder preferences, expert opinion and characteristics of data quality. It involves the weighting of criteria using a modified analytical hierarchy process. Experts ranked physical attributes which include socio-economically valued physical features. The parameters used for the ranking of (physical) attributes important for socio-economic reasons are derived from the field of ecosystem services assessment. Inclusion of these feature values results in protection that emphasizes those areas closest to shore, most likely because of accessibility and familiarity parameters and because of data biases. Therefore, other spatial conservation prioritization methods should be considered to supplement the MCA and efforts should be made to improve data about ecosystem service values farther from shore. Otherwise, the MCA method allows incorporation of expert and stakeholder preferences and ecosystem services values while maintaining the advantages of simplicity and clarity.

County-Level Climate Uncertainty for Risk Assessments: Volume 21 Appendix T - Forecast Sea Ice Area Fraction.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Backus, George A.; Lowry, Thomas Stephen; Jones, Shannon M.

2017-06-01

This report uses the CMIP5 series of climate model simulations to produce country- level uncertainty distributions for use in socioeconomic risk assessments of climate change impacts. It provides appropriate probability distributions, by month, for 169 countries and autonomous-areas on temperature, precipitation, maximum temperature, maximum wind speed, humidity, runoff, soil moisture and evaporation for the historical period (1976-2005), and for decadal time periods to 2100. It also provides historical and future distributions for the Arctic region on ice concentration, ice thickness, age of ice, and ice ridging in 15-degree longitude arc segments from the Arctic Circle to 80 degrees latitude, plusmore » two polar semicircular regions from 80 to 90 degrees latitude. The uncertainty is meant to describe the lack of knowledge rather than imprecision in the physical simulation because the emphasis is on unfalsified risk and its use to determine potential socioeconomic impacts. The full report is contained in 27 volumes.« less

Tipping Points towards Regional Forest or Urban Transition in Stressed Rural Areas: An Agent-based Modelling Application of Socio-Economic Shifts in Rural Vermont US

NASA Astrophysics Data System (ADS)

Tsai, Y.; Turnbull, S.; Zia, A.

2015-12-01

In rural areas where farming competes with urban development and environmental amenities, urban and forest transitions occur simultaneously at different locales with different rates due to the underlying socio-economic shifts. Here we develop an interactive land use transition agent-based model (ILUTABM) in which farmers' land use decisions are made contingent on expansion and location choices of urban businesses and urban residences, as well as farmers' perceived ecosystem services produced by their land holdings. The ILUTABM simulates heterogeneity in land use decisions at parcel levels by differentiating decision making processes for agricultural and urban landowners. Landowners are simulated to make land-use transition decisions as bounded rational agents that maximize their partial expected utility functions under different underlying socio-economic conditions given the category of a landowner and the spatial characteristics of the landowner's landholdings. The ILUTABM is parameterized by spatial data sets such as National Land Cover Database (NLCD), zoning, parcels, property prices, US census, farmers surveys, building/facility characteristics, soil, slope and elevation. We then apply the ILUTABM to the rural Vermont landscape, located in the Northeast Arm District of Lake Champlain and the downstream sub-watersheds of Missisquoi River, to generate phase transitions of rural land towards urban land near peri-urban areas and towards forest land near financially stressed farmlands during 2001-2051. Possible tipping point trajectories of rural land towards regional forest or urban transition are simulated under three socio-economic scenarios: business as usual (ILUTABM calibrated to 2011 NLCD), increased incentives for conservation easements, and increased incentives for attracting urban residences and businesses.

Socioeconomic Risk Moderates the Link between Household Chaos and Maternal Executive Function

PubMed Central

Deater-Deckard, Kirby; Chen, Nan; Wang, Zhe; Bell, Martha Ann

2012-01-01

We examined the link between household chaos (i.e., noise, clutter, disarray, lack of routines) and maternal executive function (i.e., effortful regulation of attention and memory), and whether it varied as a function of socioeconomic risk (i.e., single parenthood, lower mother and father educational attainment, housing situation, and father unemployment). We hypothesized that: 1) higher levels of household chaos would be linked with poorer maternal executive function, even when controlling for other measures of cognitive functioning (e.g., verbal ability), and 2) this link would be strongest in the most socioeconomically distressed or lowest-socioeconomic status households. The diverse sample included 153 mothers from urban and rural areas who completed a questionnaire and a battery of cognitive executive function tasks and a verbal ability task in the laboratory. Results were mixed for hypothesis 1, and consistent with hypothesis 2. Two-thirds of the variance overlapped between household chaos and maternal executive function, but only in families with high levels of socioeconomic risk. This pattern was not found for chaos and maternal verbal ability, suggesting that the potentially deleterious effects of household chaos may be specific to maternal executive function. The findings implicate household chaos as a powerful statistical predictor of maternal executive function in socioeconomically distressed contexts. PMID:22563703

Socioeconomic Status, Higher-Level Mathematics Courses, Absenteeism, and Student Mobility as Indicators of Work Readiness

ERIC Educational Resources Information Center

Folds, Lea D.; Tanner, C. Kenneth

2014-01-01

The purpose of this study was to analyze the relations among socioeconomic status, highest-level mathematics course, absenteeism, student mobility and measures of work readiness of high school seniors in Georgia. Study participants were 476 high school seniors in one Georgia county. The full regression model explained 27.5% of the variance in…

A multi-scale framework to link remotely sensed metrics with socioeconomic data

NASA Astrophysics Data System (ADS)

Watmough, Gary; Svenning, Jens-Christian; Palm, Cheryl; Sullivan, Clare; Danylo, Olha; McCallum, Ian

2017-04-01

There is increasing interest in the use of remotely sensed satellite data for estimating human poverty as it can bridge data gaps that prevent fine scale monitoring of development goals across large areas. The ways in which metrics derived from satellite imagery are linked with socioeconomic data are crucial for accurate estimation of poverty. Yet, to date, approaches in the literature linking satellite metrics with socioeconomic data are poorly characterized. Typically, approaches use a GIS approach such as circular buffer zones around a village or household or an administrative boundary such as a district or census enumeration area. These polygons are then used to extract environmental data from satellite imagery and related to the socioeconomic data in statistical analyses. The use of a single polygon to link environment and socioeconomic data is inappropriate in coupled human-natural systems as processes operate over multiple scales. Human interactions with the environment occur at multiple levels from individual (household) access to agricultural plots adjacent to homes, to communal access to common pool resources (CPR) such as forests at the village level. Here, we present a multi-scale framework that explicitly considers how people use the landscape. The framework is presented along with a case study example in Kenya. The multi-scale approach could enhance the modelling of human-environment interactions which will have important consequences for monitoring the sustainable development goals for human livelihoods and biodiversity conservation.

Robust small area estimation of poverty indicators using M-quantile approach (Case study: Sub-district level in Bogor district)

NASA Astrophysics Data System (ADS)

Girinoto, Sadik, Kusman; Indahwati

2017-03-01

The National Socio-Economic Survey samples are designed to produce estimates of parameters of planned domains (provinces and districts). The estimation of unplanned domains (sub-districts and villages) has its limitation to obtain reliable direct estimates. One of the possible solutions to overcome this problem is employing small area estimation techniques. The popular choice of small area estimation is based on linear mixed models. However, such models need strong distributional assumptions and do not easy allow for outlier-robust estimation. As an alternative approach for this purpose, M-quantile regression approach to small area estimation based on modeling specific M-quantile coefficients of conditional distribution of study variable given auxiliary covariates. It obtained outlier-robust estimation from influence function of M-estimator type and also no need strong distributional assumptions. In this paper, the aim of study is to estimate the poverty indicator at sub-district level in Bogor District-West Java using M-quantile models for small area estimation. Using data taken from National Socioeconomic Survey and Villages Potential Statistics, the results provide a detailed description of pattern of incidence and intensity of poverty within Bogor district. We also compare the results with direct estimates. The results showed the framework may be preferable when direct estimate having no incidence of poverty at all in the small area.

All-cause and cause-specific mortality among US youth: socioeconomic and rural-urban disparities and international patterns.

PubMed

Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad; Kogan, Michael D

2013-06-01

We analyzed international patterns and socioeconomic and rural-urban disparities in all-cause mortality and mortality from homicide, suicide, unintentional injuries, and HIV/AIDS among US youth aged 15-24 years. A county-level socioeconomic deprivation index and rural-urban continuum measure were linked to the 1999-2007 US mortality data. Mortality rates were calculated for each socioeconomic and rural-urban group. Poisson regression was used to derive adjusted relative risks of youth mortality by deprivation level and rural-urban residence. The USA has the highest youth homicide rate and 6th highest overall youth mortality rate in the industrialized world. Substantial socioeconomic and rural-urban gradients in youth mortality were observed within the USA. Compared to their most affluent counterparts, youth in the most deprived group had 1.9 times higher all-cause mortality, 8.0 times higher homicide mortality, 1.5 times higher unintentional-injury mortality, and 8.8 times higher HIV/AIDS mortality. Youth in rural areas had significantly higher mortality rates than their urban counterparts regardless of deprivation levels, with suicide and unintentional-injury mortality risks being 1.8 and 2.3 times larger in rural than in urban areas. However, youth in the most urbanized areas had at least 5.6 times higher risks of homicide and HIV/AIDS mortality than their rural counterparts. Disparities in mortality differed by race and sex. Socioeconomic deprivation and rural-urban continuum were independently related to disparities in youth mortality among all sex and racial/ethnic groups, although the impact of deprivation was considerably greater. The USA ranks poorly in all-cause mortality, youth homicide, and unintentional-injury mortality rates when compared with other industrialized countries.

Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas.

PubMed

Agustina, Rina; Sari, Tirta P; Satroamidjojo, Soemilah; Bovee-Oudenhoven, Ingeborg M J; Feskens, Edith J M; Kok, Frans J

2013-10-19

Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. A cross-sectional study was conducted among 274 randomly selected children aged 12-59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child's defecation pattern. Food-hygiene practices including mother's and child's hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child's bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged < 2 years (adjusted OR 4.55, 95% CI = 1.08-19.1). Overall poor mother's food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea.

Can money buy green? Demographic and socioeconomic predictors of lawn-care expenditures and lawn greenness in urban residential areas

Treesearch

Weiqi Zhou; Austin Troy; J. Morgan Grove; Jennifer C. Jenkins

2009-01-01

It is increasingly important to understand how household characteristics influence lawn characteristics, as lawns play an important ecological role in human-dominated landscapes. This article investigates household and neighborhood socioeconomic characteristics as predictors of residential lawn-care expenditures and lawn greenness. The study area is the Gwynns Falls...

A Randomized Controlled Trial Evaluation of an After-School Prosocial Behavior Program in an Area of Socioeconomic Disadvantage

ERIC Educational Resources Information Center

O'Hare, Liam; Biggart, Andy; Kerr, Karen; Connolly, Paul

2015-01-01

A randomized controlled trial was used to evaluate the effects of a prosocial behavior after-school program called Mate-Tricks for 9- and 10-year-old children and their parents living in an area of significant socioeconomic disadvantage. The children were randomly assigned to an intervention (n = 220) or a control group (n = 198). Children were…

Psychomotor development, environmental stimulation, and socioeconomic level of preschoolers in Temuco, Chile.

PubMed

Doussoulin Sanhueza, Arlette

2006-01-01

This research was designed to describe the psychomotor development, environmental stimulation, and the socioeconomic condition of preschool children attending three educational institutions in the city of Temuco, Chile. The sample included 81 boys and girls whose age ranged from three to four years. The Test de Desarrollo Psicomotor (The Psychomotor Development Test), or TEPSI, was used to assess psychomotor development; the Home Observation Measurement of the Environment (HOME) Scale was used to evaluate environmental stimulation; and the Socioeconomic Standardization Model was used to categorize children's socioeconomic status. The highest statistical correlation was observed between psychomotor development and environmental stimulation when comparing all three parameters across the sample. Environmental stimulation may be the most relevant parameter in the study of psychomotor development of children. Socioeconomic status alone does not seem to be strongly related to children's psychomotor development in the Temuco region of Chile.

Street connectivity and obesity in Glasgow, Scotland: impact of age, sex and socioeconomic position.

PubMed

Ball, Kylie; Lamb, Karen; Travaglini, Noemi; Ellaway, Anne

2012-11-01

This study investigated associations of street connectivity with body mass index (BMI), and whether these associations varied by sex, age and socioeconomic position, amongst adults in Glasgow, Scotland. Data on socio-demographic variables, height and weight were collected from 1062 participants in the Greater Glasgow Health and Well-being Study, and linked with neighbourhood-level census and geo-referenced data on area level deprivation and street connectivity. Results of multilevel models showed that, after adjustment for individual level covariates, street connectivity was not significantly associated with either BMI or BMI category; nor were there any significant interactions between age, sex or socioeconomic position and street connectivity. Copyright © 2012 Elsevier Ltd. All rights reserved.

Geographic and socioeconomic variation in the onset of decline of coronary heart disease mortality in white women.

PubMed Central

Wing, S; Barnett, E; Casper, M; Tyroler, H A

1992-01-01

BACKGROUND. Regional, metropolitan, and socioeconomic factors related to the onset of decline of coronary heart disease (CHD) mortality among White women are reported. Such studies are important for planning population-level interventions. METHODS. Mortality data for 1962 to 1978 were used, to estimate the year of onset of decline. Ecological analyses of socioeconomic data from the US census were used to emphasize structural and organizational aspects of changes in disease, rather than as a substitute for an individual-level design. RESULTS. Onset of decline of CHD mortality among White women was estimated to have occurred by 1962 in 53% of 507 state economic areas (SEAs), ranging from 79% in the Northeast to 39% in the South. Metropolitan areas experienced earlier onset of decline than did nonmetropolitan areas. Average income, education, and occupational levels were highest in early onset areas and declined across onset categories. CONCLUSIONS. The results provide additional evidence for previously observed geographic and social patterns of CHD decline. Emphasis on structural economic factors determining the shape of the CHD epidemic curve does not detract from the medical importance of risk factors, but underscores the importance of community development to public health improvements. The results are consistent with the idea that the course of the CHD epidemic in the United States has been strongly influenced by socioeconomic development. PMID:1739148

"Geography of suicide in Hong Kong: spatial patterning, and socioeconomic correlates and inequalities".

PubMed

Hsu, Chia-Yueh; Chang, Shu-Sen; Lee, Esther S T; Yip, Paul S F

2015-04-01

Past urban research on Western nations tends to show high suicide rates in inner city and socioeconomically deprived areas. However, little is known about geographic variations in suicide in non-Western cities. We used Bayesian hierarchical models to estimate smoothed standardised mortality ratios (2005-2010) for suicide in people aged 10 years or above in each geographic unit in Hong Kong at two levels, i.e. large street block (n = 1639; median population = 1860) and small tertiary planning unit group (n = 204; median population = 14,850). We further analysed their associations with a range of area socioeconomic characteristics and a deprivation index. The "city centre" of Hong Kong, a generally non-deprived area, showed mostly below average suicide rates. However, there were high rates concentrating in some socioeconomically deprived, densely populated areas, including some inner city areas, across the city. Males had greater geographic variations in rates than females, except the elderly group. The use of smaller geographic units revealed finer detailed suicide distribution than the use of larger units, and showed that suicide rates were associated with indicators of socioeconomic deprivation (population with non-professional jobs and low median household income), and social fragmentation (proportions of unmarried adults and divorced/separated adults), but not with Gini coefficient. Sex/age groups had different associations with suicide rates. Areas in the most deprived quintile had a suicide rate more than two times higher than the least deprived. The association between suicide and deprivation was stronger in males than females and more marked in the younger populations compared to the elderly. The spatial distribution of suicide in Hong Kong showed distinct patterning and a stronger association with income compared to findings from Western countries. Suicide prevention strategies should consider tackling the marked socioeconomic gradient in suicide and high

Investigating maternal risk factors as potential targets of intervention to reduce socioeconomic inequality in small for gestational age: a population-based study.

PubMed

Hayward, Irene; Malcoe, Lorraine Halinka; Cleathero, Lesley A; Janssen, Patricia A; Lanphear, Bruce P; Hayes, Michael V; Mattman, Andre; Pampalon, Robert; Venners, Scott A

2012-06-13

The major aim of this study was to investigate whether maternal risk factors associated with socioeconomic status and small for gestational age (SGA) might be viable targets of interventions to reduce differential risk of SGA by socioeconomic status (socioeconomic SGA inequality) in the metropolitan area of Vancouver, Canada. This study included 59,039 live, singleton births in the Vancouver Census Metropolitan Area (Vancouver) from January 1, 2006 to September 17, 2009. To identify an indicator of socioeconomic SGA inequality, we used hierarchical logistic regression to model SGA by area-level variables from the Canadian census. We then modelled SGA by area-level average income plus established maternal risk factors for SGA and calculated population attributable SGA risk percentages (PAR%) for each variable. Associations of maternal risk factors for SGA with average income were investigated to identify those that might contribute to SGA inequality. Finally, we estimated crude reductions in the percentage and absolute differences in SGA risks between highest and lowest average income quintiles that would result if interventions on maternal risk factors successfully equalized them across income levels or eliminated them altogether. Average income produced the most linear and statistically significant indicator of socioeconomic SGA inequality with 8.9% prevalence of SGA in the lowest income quintile compared to 5.6% in the highest. The adjusted PAR% of SGA for variables were: bottom four quintiles of height (51%), first birth (32%), bottom four quintiles of average income (14%), oligohydramnios (7%), underweight or hypertension, (6% each), smoking (3%) and placental disorder (1%). Shorter height, underweight and smoking during pregnancy had higher prevalence in lower income groups. Crude models assuming equalization of risk factors across income levels or elimination altogether indicated little potential change in relative socioeconomic SGA inequality and reduction

Area-level poverty and preterm birth risk: A population-based multilevel analysis

PubMed Central

DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

2008-01-01

Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB < 35 weeks occurred in 24,490 pregnancies (3.9%). The rate of PTB < 35 weeks was 2.8% in counties within the lowest quartile of poverty and increased through the 4th quartile (4.9%), p < 0.0001. High county-level poverty was significantly associated with PTB risk. PTB risk (< 35 weeks) was increased for women who resided in counties within the highest quartile of poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (< 32 weeks), adjOR 1.27 (95% CI 1.06, 1.52). Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

Area-level poverty and preterm birth risk: a population-based multilevel analysis.

PubMed

DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

2008-09-15

Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Population-based study utilizing Missouri's birth certificate database (1989-1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. PTB < 35 weeks occurred in 24,490 pregnancies (3.9%). The rate of PTB < 35 weeks was 2.8% in counties within the lowest quartile of poverty and increased through the 4th quartile (4.9%), p < 0.0001. High county-level poverty was significantly associated with PTB risk. PTB risk (< 35 weeks) was increased for women who resided in counties within the highest quartile of poverty, adjusted odds ratio (adj OR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (< 32 weeks), adj OR 1.27 (95% CI 1.06, 1.52). Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

Neighborhood socioeconomic status and barriers to peritoneal dialysis: a mixed methods study.

PubMed

Prakash, Suma; Perzynski, Adam T; Austin, Peter C; Wu, C Fangyun; Lawless, Mary Ellen; Paterson, J Michael; Quinn, Rob R; Sehgal, Ashwini R; Oliver, Matthew James

2013-10-01

The objective of this study was to evaluate the association between neighborhood socioeconomic status and barriers to peritoneal dialysis eligibility and choice. This study was a mixed methods parallel design study using quantitative and qualitative data from a prospective clinical database of ESRD patients. The eligibility and choice cohorts were assembled from consecutive incident chronic dialysis patients entering one of five renal programs in the province of Ontario, Canada, between January 1, 2004 and December 31, 2010. Socioeconomic status was measured as median household income and percentage of residents with at least a high school education using Statistics Canada dissemination area-level data. Multivariable models described the relationship between socioeconomic status and likelihood of peritoneal dialysis eligibility and choice. Barriers to peritoneal dialysis eligibility and choice were classified into qualitative categories using the thematic constant comparative approach. The peritoneal dialysis eligibility and choice cohorts had 1314 and 857 patients, respectively; 65% of patients were deemed eligible for peritoneal dialysis, and 46% of eligible patients chose peritoneal dialysis. Socioeconomic status was not a significant predictor of peritoneal dialysis eligibility or choice in this study. Qualitative analyses identified 16 barriers to peritoneal dialysis choice. Patients in lower- versus higher-income Statistics Canada dissemination areas cited built environment or space barriers to peritoneal dialysis (4.6% versus 2.7%) and family or social support barriers (8.3% versus 3.5%) more frequently. Peritoneal dialysis eligibility and choice were not associated with socioeconomic status. However, socioeconomic status may influence specific barriers to peritoneal dialysis choice. Additional studies to determine the effect of targeting interventions to specific barriers to peritoneal dialysis choice in low socioeconomic status patients on peritoneal

Widening socioeconomic inequalities in Australian suicide, despite recent declines in suicide rates.

PubMed

Too, Lay San; Law, Phillip C F; Spittal, Matthew J; Page, Andrew; Milner, Allison

2018-04-30

This study aims to investigate trends in socioeconomic inequalities of suicide from 1979 to 2013 for Australian males and females aged 15-34 years and 35-64 years. Data on suicides and population were obtained from national registries. An area-based measure of socioeconomic status (SES) was used, and categorized into low, middle, and high SES areas. Suicide rates for each SES groups were estimated using a negative binomial regression model, adjusted for confounders. Socioeconomic inequalities in suicide were assessed using absolute and relative risk of low-to-high SES areas. Secular changes in socioeconomic inequalities were assessed using trend tests for relative risk. For young males, there was an increase in socioeconomic inequality driven by a significant decrease in suicide rates in high SES areas. For older males, inequality in suicide increased by 29%, which was related to a marked increase in suicide rates in low SES areas. Inequalities in both young and older female suicides also increased. These increases occurred when corresponding suicide rates in high SES areas decreased. Recent widening socioeconomic inequalities in Australian suicide have been primarily associated with declines in suicide rates in high SES areas. However, an increasing inequality in older male suicide is linked with low SES. Efforts targeting people from poor areas, especially older males, should be considered when developing suicide prevention strategy.

Association of food-hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas

PubMed Central

2013-01-01

Background Information on the part that poor food-hygiene practices play a role in the development of diarrhea in low socioeconomic urban communities is lacking. This study was therefore aimed at assessing the contribution of food-hygiene practice to the prevalence of diarrhea among Indonesian children. Methods A cross-sectional study was conducted among 274 randomly selected children aged 12–59 months in selected low socioeconomic urban areas of East Jakarta. The prevalence of diarrhea was assessed from 7-day records on frequency and consistency of the child’s defecation pattern. Food-hygiene practices including mother’s and child’s hand washing, food preparation, cleanliness of utensils, water source and safe drinking water, habits of buying cooked food, child’s bottle feeding hygiene, and housing and environmental condition were collected through home visit interviews and observations by fieldworkers. Thirty-six practices were scored and classified into poor (median and below) and better (above median) food-hygiene practices. Nutritional status of children, defined anthropometrically, was measured through height and weight. Results Among the individual food-hygiene practices, children living in a house with less dirty sewage had a significantly lower diarrhea prevalence compared to those who did not [adjusted odds ratio (OR) 0.16, 95% confidence interval (CI) = 0.03-0.73]. The overall food-hygiene practice score was not significantly associated with diarrhea in the total group, but it was in children aged < 2 years (adjusted OR 4.55, 95% CI = 1.08-19.1). Conclusions Overall poor mother’s food-hygiene practices did not contribute to the occurrence of diarrhea in Indonesian children. However, among children < 2 years from low socioeconomic urban areas they were associated with more diarrhea. PMID:24138899

Temporal Variation and Association of Aflatoxin B1 Albumin-Adduct Levels with Socio-Economic and Food Consumption Factors in HIV Positive Adults

PubMed Central

Jolly, Pauline E.; Akinyemiju, Tomi F.; Jha, Megha; Aban, Inmaculada; Gonzalez-Falero, Andrea; Joseph, Dnika

2015-01-01

The association between aflatoxin exposure and alteration in immune responses observed in humans suggest that aflatoxin could suppress the immune system and work synergistically with HIV to increase disease severity and progression to AIDS. No longitudinal study has been conducted to assess exposure to aflatoxin (AF) among HIV positive individuals. We examined temporal variation in AFB1 albumin adducts (AF-ALB) in HIV positive Ghanaians, and assessed the association with socioeconomic and food consumption factors. We collected socioeconomic and food consumption data for 307 HIV positive antiretroviral naive adults and examined AF-ALB levels at recruitment (baseline) and at six (follow-up 1) and 12 (follow-up 2) months post-recruitment, by age, gender, socioeconomic status (SES) and food consumption patterns. Generalized linear models were used to examine the influence of socioeconomic and food consumption factors on changes in AF-ALB levels over the study period, adjusting for other covariates. AF-ALB levels (pg/mg albumin) were lower at baseline (mean AF-ALB: 14.9, SD: 15.9), higher at six months (mean AF-ALB: 23.3, SD: 26.6), and lower at 12 months (mean AF-ALB: 15.3, SD: 15.4). Participants with the lowest SES had the highest AF-ALB levels at baseline and follow up-2 compared with those with higher SES. Participants who bought less than 20% of their food and who stored maize for less than two months had lower AF-ALB levels. In the adjusted models, there was a statistically significant association between follow up time and season (dry or rainy season) on AF-ALB levels over time (p = 0.04). Asymptomatic HIV-positive Ghanaians had high plasma AF-ALB levels that varied according to season, socioeconomic status, and food consumption patterns. Steps need to be taken to ensure the safety and security of the food supply for the population, but in particular for the most vulnerable groups such as HIV positive people. PMID:26633502

COUNTRY-LEVEL SOCIOECONOMIC INDICATORS ASSOCIATED WITH SURVIVAL PROBABILITY OF BECOMING A CENTENARIAN AMONG OLDER EUROPEAN ADULTS: GENDER INEQUALITY, MALE LABOUR FORCE PARTICIPATION AND PROPORTIONS OF WOMEN IN PARLIAMENTS.

PubMed

Kim, Jong In; Kim, Gukbin

2017-03-01

This study confirms an association between survival probability of becoming a centenarian (SPBC) for those aged 65 to 69 and country-level socioeconomic indicators in Europe: the gender inequality index (GII), male labour force participation (MLP) rates and proportions of seats held by women in national parliaments (PWP). The analysis was based on SPBC data from 34 countries obtained from the United Nations (UN). Country-level socioeconomic indicator data were obtained from the UN and World Bank databases. The associations between socioeconomic indicators and SPBC were assessed using correlation coefficients and multivariate regression models. The findings show significant correlations between the SPBC for women and men aged 65 to 69 and country-level socioeconomic indicators: GII (r=-0.674, p=0.001), MLP (r=0.514, p=0.002) and PWP (r=0.498, p=0.003). The SPBC predictors for women and men were lower GIIs and higher MLP and PWP (R 2=0.508, p=0.001). Country-level socioeconomic indicators appear to have an important effect on the probability of becoming a centenarian in European adults aged 65 to 69. Country-level gender equality policies in European counties may decrease the risk of unhealthy old age and increase longevity in elders through greater national gender equality; disparities in GII and other country-level socioeconomic indicators impact longevity probability. National longevity strategies should target country-level gender inequality.

Elementary Students' Self-Efficacy Beliefs in Science: Role of Grade Level, Gender, and Socio-Economic Status

ERIC Educational Resources Information Center

Karaarslan, Guliz; Sungur, Semra

2011-01-01

This study examined grade level and gender difference with respect to elementary students' science and technology self-efficacy. Additionally, relationship between socio-economic status (SES) and self-efficacy was examined. A total of 145 elementary students participated in the study. Self efficacy towards Science and Technology Scale was used to…

Socioeconomic risk moderates the link between household chaos and maternal executive function.

PubMed

Deater-Deckard, Kirby; Chen, Nan; Wang, Zhe; Bell, Martha Ann

2012-06-01

We examined the link between household chaos (i.e., noise, clutter, disarray, lack of routines) and maternal executive function (i.e., effortful regulation of attention and memory), and whether it varied as a function of socioeconomic risk (i.e., single parenthood, lower mother and father educational attainment, housing situation, and father unemployment). We hypothesized that: 1) higher levels of household chaos would be linked with poorer maternal executive function, even when controlling for other measures of cognitive functioning (e.g., verbal ability), and 2) this link would be strongest in the most socioeconomically distressed or lowest-socioeconomic status households. The diverse sample included 153 mothers from urban and rural areas who completed a questionnaire and a battery of cognitive executive function tasks and a verbal ability task in the laboratory. Results were mixed for Hypothesis 1, and consistent with Hypothesis 2. Two-thirds of the variance overlapped between household chaos and maternal executive function, but only in families with high levels of socioeconomic risk. This pattern was not found for chaos and maternal verbal ability, suggesting that the potentially deleterious effects of household chaos may be specific to maternal executive function. The findings implicate household chaos as a powerful statistical predictor of maternal executive function in socioeconomically distressed contexts. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Cigarette availability and price in low and high socioeconomic areas.

PubMed

Dalglish, Emma; McLaughlin, Deirdre; Dobson, Annette; Gartner, Coral

2013-08-01

To determine whether tobacco retailer density and cigarette prices differ between low and high socioeconomic status suburbs in South-East Queensland. A survey of retail outlets selling cigarettes was conducted in selected suburbs over a two-day period. The suburbs were identified by geographical cluster sampling based on their Index of Relative Socio-economic Advantage and Disadvantage score and size of retail complex within the suburb. All retail outlets within the suburb were visited and the retail prices for the highest ranking Australian brands were recorded at each outlet. A significant relationship was found between Index of Relative Socioeconomic Advantage and Disadvantage score (in deciles) and the number of tobacco retail outlets (r=0.93, p=0.003), with the most disadvantaged suburbs having a greater number of tobacco retailers. Results also demonstrate that cigarettes were sold in a broader range of outlets in suburbs of low SES. The average price of the packs studied was significantly lower in the most disadvantaged suburbs compared to the most advantaged. While cigarettes were still generally cheaper in the most disadvantaged suburbs, the difference was no longer statistically significant when the average price of cigarette packs was compared according to outlet type (supermarket, newsagent, etc). In South-East Queensland, cigarettes are more widely available in the most disadvantaged suburbs and at lower prices than in the most advantaged suburbs. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Socio-economic disparities in health system responsiveness in India.

PubMed

Malhotra, Chetna; Do, Young Kyung

2013-03-01

To assess the magnitude of socio-economic disparities in health system responsiveness in India after correcting for potential reporting heterogeneity by socio-economic characteristics (education and wealth). Data from Wave 1 of the Study on Global Ageing and Adult Health (2007-2008) involving six Indian states were used. Seven health system responsiveness domains were considered for a respondent's last visit to an outpatient service in 12 months: prompt attention, dignity, clarity of information, autonomy, confidentiality, choice and quality of basic amenities. Hierarchical ordered probit models (correcting for reporting heterogeneity through anchoring vignettes) were used to assess the association of socio-economic characteristics with the seven responsiveness domains, controlling for age, gender and area of residence. Stratified analysis was also conducted among users of public and private health facilities. Our statistical models accounting for reporting heterogeneity revealed socio-economic disparities in all health system responsiveness domains. Estimates suggested that individuals from the lowest wealth group, for example, were less likely than individuals from the highest wealth group to report 'very good' on the dignity domain by 8% points (10% vs 18%). Stratified analysis showed that such disparities existed among users of both public and private health facilities. Socio-economic disparities exist in health system responsiveness in India, irrespective of the type of health facility used. Policy efforts to monitor and improve these disparities are required at the health system level.

Ethnic and Socioeconomic Comparisons of Fitness, Activity Levels, and Barriers to Exercise in High School Females

ERIC Educational Resources Information Center

Fahlman, Mariane M.; Hall, Heather L.; Lock, Robyn

2006-01-01

The purpose of this study was to determine if high school females differed in individual measures of health-related physical fitness, barriers to exercise, or activity level based on ethnicity or socioeconomic status. A cross-sectional sample consisting of African American (28%), Hispanic (23%), and white (49%) female high school students, 46%…

Fish consumption and socio-economic factors among residents of Arkhangelsk city and the rural Nenets autonomous area.

PubMed

Petrenya, Natalia; Dobrodeeva, Liliya; Brustad, Magritt; Bichkaeva, Fatima; Menshikova, Elena; Lutfalieva, Gulnara; Poletaeva, Anna; Repina, Veronika; Cooper, Marie; Odland, Jon Øyvind

2011-02-01

The urban Russian and the rural Indigenous populations in the Russian European North have different lifestyles, living conditions and food supplies. The objective of this study was to investigate and compare fish consumption in relation to the socio-economic characteristics of 2 communities in Arkhangelsk County. A cross-sectional study. In total, 166 adults (83.1% women) from Arkhangelsk city and 134 adults (80.6% women) from the village of Nelmin-Nos (of which 88.9% are Indigenous people, Nenets), in the Nenets Autonomous Area (NAO), attended a health screening. The screening included a physical examination, blood sampling and a questionnaire. The populations studied had different socio-economic characteristics. In the rural NAO group, education levels were lower, the number of full-time employees was less, the percentage of persons with low monthly income was higher and the number of children per household was higher when compared to the Arkhangelsk group. The median total fish intake was 48.8 g/day for Arkhangelsk city and 27.1 g/day for Nelmin-Nos (p=0.009). Locally caught whitefish constituted a major part of the total fish consumption in Nelmin-Nos, while lean marine fish species were rarely eaten. Cod and cod-family fish species were often consumed by residents of Arkhangelsk city (p < 0.001). Fish consumption was positively related to monthly income. The frequency of fishing in the respondents from the Nelmin-Nos group predicted their fish consumption. Monthly income had a significant influence on fish intake in both study populations from Northern Russia. Fishing seems to be an important factor for predicting fish consumption in the residents of the rural NAO.

Blood lead levels in pregnant women of high and low socioeconomic status in Mexico City.

PubMed Central

Farias, P; Borja-Aburto, V H; Rios, C; Hertz-Picciotto, I; Rojas-Lopez, M; Chavez-Ayala, R

1996-01-01

This study examined the determinants of blood lead (BPb) in 513 pregnant women in Mexico City: 311 from public hospital prenatal clinics, representing primarily women of low socioeconomic status (SES), and 202 from private hospitals, primarily women of high SES. Overall, BPb levels ranged from 1.38 to 29 micrograms/dl, with geometric means of 6.7 and 11.12 micrograms/dl for women from private and public hospitals, respectively. The crude geometric means difference obtained by t-test was 4.42 (p < 0.001). BPb was measured from January 1994 to August 1995 and showed higher levels during fall and winter and lower levels during spring and summer. The main BPb determinants were the use of lead-glazed ceramics in women from public hospitals and season of the year in women from private hospitals. Consumption of tortillas (corn bread rich in calcium) decreased BPb levels in the lower SES group, but the relationship was not statistically significant (p > 0.05). Consumption of milk products significantly (p < 0.05) reduced BPb levels in the higher SES group. In 112 women whose diets were deficient in calcium, taking calcium supplements lowered their blood lead levels about 7 micrograms/dl. A predictive model fitted to these data, using the strongest predictors plus gestational age, showed a difference of 14 micrograms/dl between the best and worst scenarios in women from public hospitals. Avoiding use of lead-glazed ceramics, consuming diets rich in calcium, and, if needed, taking calcium supplements, would be expected to result in substantial lowering of BPb, especially in pregnant women of low socioeconomic status. Images Figure 1. Figure 2. PMID:8930548

Surveillance of mother-to-child HIV transmission: socioeconomic and health care coverage indicators.

PubMed

Barcellos, Christovam; Acosta, Lisiane Morelia Weide; Lisboa, Eugenio; Bastos, Francisco Inácio

2009-12-01

To identify clustering areas of infants exposed to HIV during pregnancy and their association with indicators of primary care coverage and socioeconomic condition. Ecological study where the unit of analysis was primary care coverage areas in the city of Porto Alegre, Southern Brazil, in 2003. Geographical Information System and spatial analysis tools were used to describe indicators of primary care coverage areas and socioeconomic condition, and estimate the prevalence of liveborn infants exposed to HIV during pregnancy and delivery. Data was obtained from Brazilian national databases. The association between different indicators was assessed using Spearman's nonparametric test. There was found an association between HIV infection and high birth rates (r=0.22, p<0.01) and lack of prenatal care (r=0.15, p<0.05). The highest HIV infection rates were seen in areas with poor socioeconomic conditions and difficult access to health services (r=0.28, p<0.01). The association found between higher rate of prenatal care among HIV-infected women and adequate immunization coverage (r=0.35, p<0.01) indicates that early detection of HIV infection is effective in those areas with better primary care services. Urban poverty is a strong determinant of mother-to-child HIV transmission but this trend can be fought with health surveillance at the primary care level.

How Does the Choice of A-level Subjects Vary with Students' Socio-Economic Status in English State Schools?

ERIC Educational Resources Information Center

Dilnot, Catherine

2016-01-01

The reasons why students from lower socio-economic groups are under-represented at high status universities are not yet entirely understood, but evidence suggests that part of the gap may be a consequence of differential choice of A-levels by social background. The Russell Group of universities has since 2011 published guidance on A-level subject…

Hospital admissions for severe mental illness in England: changes in equity of utilisation at the small area level between 2006 and 2010.

PubMed

White, Jonathan; Gutacker, Nils; Jacobs, Rowena; Mason, Anne

2014-11-01

Severe Mental Illness (SMI) encompasses a range of chronic conditions including schizophrenia, bipolar disorder and psychoses. Patients with SMI often require inpatient psychiatric care. Despite equity being a key objective in the English National Health Service (NHS) and in many other health care systems worldwide, little is known about the socio-economic equity of hospital care utilisation for patients with SMI and how it has changed over time. This analysis seeks to address that gap in the evidence base. We exploit a five-year (2006-2010) panel dataset of admission rates at small area level (n=162,410). The choice of control variables was informed by a systematic literature search. To assess changes in socio-economic equity of utilisation, OLS-based standardisation was first used to conduct analysis of discrete deprivation groups. Geographical inequity was then illustrated by plotting standardised and crude admission rates at local purchaser level. Lastly, formal statistical tests for changes in socio-economic equity of utilisation were applied to a continuous measure of deprivation using pooled negative binomial regression analysis, adjusting for a range of risk factors. Our results suggest that one additional percentage point of area income deprivation is associated with a 1.5% (p<0.001) increase in admissions for SMI after controlling for population size, age, sex, prevalence of SMI in the local population, as well as other need and supply factors. This finding is robust to sensitivity analyses, suggesting that a pro-poor inequality in utilisation exists for SMI-related inpatient services. One possible explanation is that the supply or quality of primary, community or social care for people with mental health problems is suboptimal in deprived areas. Although there is some evidence that inequity has reduced over time, the changes are small and not always robust to sensitivity analyses. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights

Neighborhood Socioeconomic Status and Barriers to Peritoneal Dialysis: A Mixed Methods Study

PubMed Central

Perzynski, Adam T.; Austin, Peter C.; Wu, C. Fangyun; Lawless, Mary Ellen; Paterson, J. Michael; Quinn, Rob R.; Sehgal, Ashwini R.; Oliver, Matthew James

2013-01-01

Summary Background and objectives The objective of this study was to evaluate the association between neighborhood socioeconomic status and barriers to peritoneal dialysis eligibility and choice. Design, setting, participants, & measurements This study was a mixed methods parallel design study using quantitative and qualitative data from a prospective clinical database of ESRD patients. The eligibility and choice cohorts were assembled from consecutive incident chronic dialysis patients entering one of five renal programs in the province of Ontario, Canada, between January 1, 2004 and December 31, 2010. Socioeconomic status was measured as median household income and percentage of residents with at least a high school education using Statistics Canada dissemination area-level data. Multivariable models described the relationship between socioeconomic status and likelihood of peritoneal dialysis eligibility and choice. Barriers to peritoneal dialysis eligibility and choice were classified into qualitative categories using the thematic constant comparative approach. Results The peritoneal dialysis eligibility and choice cohorts had 1314 and 857 patients, respectively; 65% of patients were deemed eligible for peritoneal dialysis, and 46% of eligible patients chose peritoneal dialysis. Socioeconomic status was not a significant predictor of peritoneal dialysis eligibility or choice in this study. Qualitative analyses identified 16 barriers to peritoneal dialysis choice. Patients in lower- versus higher-income Statistics Canada dissemination areas cited built environment or space barriers to peritoneal dialysis (4.6% versus 2.7%) and family or social support barriers (8.3% versus 3.5%) more frequently. Conclusions Peritoneal dialysis eligibility and choice were not associated with socioeconomic status. However, socioeconomic status may influence specific barriers to peritoneal dialysis choice. Additional studies to determine the effect of targeting interventions to

Assessment of neighbourhood-level socioeconomic status as a modifier of air pollution-asthma associations among children in Atlanta.

PubMed

O'Lenick, Cassandra R; Winquist, Andrea; Mulholland, James A; Friberg, Mariel D; Chang, Howard H; Kramer, Michael R; Darrow, Lyndsey A; Sarnat, Stefanie Ebelt

2017-02-01

A broad literature base provides evidence of association between air pollution and paediatric asthma. Socioeconomic status (SES) may modify these associations; however, previous studies have found inconsistent evidence regarding the role of SES. Effect modification of air pollution-paediatric asthma morbidity by multiple indicators of neighbourhood SES was examined in Atlanta, Georgia. Emergency department (ED) visit data were obtained for 5-18 years old with a diagnosis of asthma in 20-county Atlanta during 2002-2008. Daily ZIP Code Tabulation Area (ZCTA)-level concentrations of ozone, nitrogen dioxide, fine particulate matter and elemental carbon were estimated using ambient monitoring data and emissions-based chemical transport model simulations. Pollutant-asthma associations were estimated using a case-crossover approach, controlling for temporal trends and meteorology. Effect modification by ZCTA-level (neighbourhood) SES was examined via stratification. We observed stronger air pollution-paediatric asthma associations in 'deprivation areas' (eg, ≥20% of the ZCTA population living in poverty) compared with 'non-deprivation areas'. When stratifying analyses by quartiles of neighbourhood SES, ORs indicated stronger associations in the highest and lowest SES quartiles and weaker associations among the middle quartiles. Our results suggest that neighbourhood-level SES is a factor contributing vulnerability to air pollution-related paediatric asthma morbidity in Atlanta. Children living in low SES environments appear to be especially vulnerable given positive ORs and high underlying asthma ED rates. Inconsistent findings of effect modification among previous studies may be partially explained by choice of SES stratification criteria, and the use of multiplicative models combined with differing baseline risk across SES populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

PubMed Central

van Zon, Sander K. R.; Bültmann, Ute; Mendes de Leon, Carlos F.; Reijneveld, Sijmen A.

2015-01-01

Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. Methods The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Results Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Conclusions Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of

Prediction of high-risk areas for visceral leishmaniasis using socioeconomic indicators and remote sensing data

PubMed Central

2014-01-01

Spatial heterogeneity in the incidence of visceral leishmaniasis (VL) is an important aspect to be considered in planning control actions for the disease. The objective of this study was to predict areas at high risk for visceral leishmaniasis (VL) based on socioeconomic indicators and remote sensing data. We applied classification and regression trees to develop and validate prediction models. Performance of the models was assessed by means of sensitivity, specificity and area under the ROC curve. The model developed was able to discriminate 15 subsets of census tracts (CT) with different probabilities of containing CT with high risk of VL occurrence. The model presented, respectively, in the validation and learning samples, sensitivity of 79% and 52%, specificity of 75% and 66%, and area under the ROC curve of 83% and 66%. Considering the complex network of factors involved in the occurrence of VL in urban areas, the results of this study showed that the development of a predictive model for VL might be feasible and useful for guiding interventions against the disease, but it is still a challenge as demonstrated by the unsatisfactory predictive performance of the model developed. PMID:24885128

Dietary Patterns in European and Brazilian Adolescents: Comparisons and Associations with Socioeconomic Factors

PubMed Central

Slater, Betzabeth; Santaliestra-Pasías, Alba Maria; Mouratidou, Theodora; Huybrechts, Inge; Widhalm, Kurt; Manios, Yannis; Valtueña, Jara; Le Donne, Cinzia; Marcos, Ascensión; Molnar, Dénes; Castillo, Manuel J.; De Henauw, Stefaan; Moreno, Luis A.

2018-01-01

Associations between dietary patterns (DP) and socioeconomic factors have been little explored in adolescents. The aim of this study was to identify DP in European and Brazilian adolescents and to investigate their associations with a range of socioeconomic indicators. Adolescents from the HELENA-study and the Household Budget Survey were analyzed. Factor analysis was used to obtain DP. Linear regression was used to examine the association between DP and SES. In Europeans, the Western DP was associated with low education of the mother, high socioeconomic status (boys), older age (boys), and living in cities of the Northern Europe; in Brazilians, the Western DP was associated with high secondary education of the mother, high socioeconomic status and living in Southern areas of the country. The Traditional European DP, in both genders, was associated with high secondary education of the mother and inversely associated with a high socioeconomic status; the Traditional Brazilian DP, was associated with university level education of the mother and older age (boys). The association between DP and socioeconomic factors is relevant for the understanding of food-related practices and highlight the importance of performing a complete assessment of the socioeconomic influence in adolescent’s DP from developed and developing countries. PMID:29315272

Not urbanization level but socioeconomic, physical and social neighbourhood characteristics are associated with presence and severity of depressive and anxiety disorders.

PubMed

Generaal, Ellen; Timmermans, Erik J; Dekkers, Jasper E C; Smit, Johannes H; Penninx, Brenda W J H

2018-03-15

Which neighbourhood factors most consistently impact on depression and anxiety remains unclear. This study examines whether objectively obtained socioeconomic, physical and social aspects of the neighbourhood in which persons live are associated with the presence and severity of depressive and anxiety disorders. Cross-sectional data are from the Netherlands Study of Depression and Anxiety including participants (n = 2980) with and without depressive and anxiety disorders in the past year (based on DSM-based psychiatric interviews). We also determined symptom severity of depression (Inventory of Depression Symptomatology), anxiety (Beck Anxiety Inventory) and fear (Fear Questionnaire). Neighbourhood characteristics comprised socioeconomic factors (socioeconomic status, home value, number of social security beneficiaries and percentage of immigrants), physical factors (air pollution, traffic noise and availability of green space and water) and social factors (social cohesion and safety). Multilevel regression analyses were performed with the municipality as the second level while adjusting for individual sociodemographic variables and household income. Not urbanization grade, but rather neighbourhood socioecononomic factors (low socioeconomic status, more social security beneficiaries and more immigrants), physical factors (high levels of traffic noise) and social factors (lower social cohesion and less safety) were associated with the presence of depressive and anxiety disorders. Most of these neighbourhood characteristics were also associated with increased depressive and anxiety symptoms severity. These findings suggest that it is not population density in the neighbourhood, but rather the quality of socioeconomic, physical and social neighbourhood characteristics that is associated with the presence and severity of affective disorders.

Time perspective and socioeconomic status: a link to socioeconomic disparities in health?

PubMed

Guthrie, Lori C; Butler, Stephen C; Ward, Michael M

2009-06-01

Time perspective is a measure of the degree to which one's thinking is motivated by considerations of the future, present, or past. Time perspective has been proposed as a potential mediator of socioeconomic disparities in health because it has been associated with health behaviors and is presumed to vary with socioeconomic status. In this cross-sectional community-based survey of respondents recruited from hair salons and barber shops in a suburb of Washington DC, we examined the association between time perspective and both education level and occupation. We asked participants (N=525) to complete a questionnaire that included three subscales (future, present-fatalistic, and present-hedonistic) of the Zimbardo Time Perspective Inventory. Participants with more formal education and those with professional occupations had higher scores on the future time perspective subscale, and lower scores on the present-fatalistic subscale, than participants with less formal education or a non-professional occupation. Present-fatalistic scores were also higher among participants whose parents had less formal education. Present-hedonistic scores were not associated with either education level or professional occupation. Time perspective scores were not independently associated with the likelihood of obesity, smoking, or exercise. In this community sample, future time perspective was associated with current socioeconomic status, and past-fatalistic time perspective was associated with both current and childhood socioeconomic status.

Association of Allergic Rhinitis in Female University Students with Socio-economic Factors and Markers of Estrogens Levels.

PubMed

Wronka, I; Kliś, K; Jarzebak, K

2016-01-01

The aim of this study is to investigate the association of allergic rhinitis in female university students with socio-economic factors and sex-hormone markers, including age at menarche, menstrual disorders, and selected anthropometrics indexes. The research was conducted among 640 female university students, aged 19-25 years. The measurements of body height, body mass, waist and hip circumference were taken. Each person completed a questionnaire. The occurrence of allergy was determined on the basis of answers to the questions whether the allergy and its allergens were defined on the basis of medical workup. We found that a significantly larger number of cases of allergic rhinitis were recorded in the university students coming from families of high socio-economic level than those from lower level. Allergic rhinitis also was more frequent in the students who spent their childhood in cities than in those who lived in the countryside. The prevalence of allergic rhinitis was inversely correlated to the number of siblings. There were no differences in the prevalence of allergic rhinitis in relation to the birth order. The estrogen level seemed unassociated with rhinitis. However, there were slightly more allergic among females with an earlier age of menarche.

Socioeconomic status and exposure to outdoor NO2 and benzene in the Asturias INMA birth cohort, Spain.

PubMed

Fernández-Somoano, Ana; Tardon, Adonina

2014-01-01

It is commonly assumed that low socioeconomic levels are associated with greater exposure to pollution, but this is not necessarily valid. Our goal was to examine how individual socioeconomic characteristics are associated with exposure levels in a Spanish region included in the INfancia y Medio Ambiente (INMA) cohort. The study population comprised 430 pregnant women from the Asturias INMA cohort. Air pollution exposure was estimated using land-use regression techniques. Information about the participants' lifestyle and socioeconomic variables was collected through questionnaires. In multivariate analysis, the levels of NO2 and benzene assigned to each woman were considered as dependent variables. Other variables included in the models were residential zone, age, education, parity, smoking, season, working status during pregnancy and social class. The average NO2 level was 23.60 (SD=6.50) μg/m(3). For benzene, the mean value was 2.31 (SD=1.32) μg/m(3). We found no association of any pollutant with education. We observed an association between social class and benzene levels. Social classes I and II had the highest levels. The analysed socioeconomic and lifestyle variables accounted for little variability in air pollution in the models; this variability was explained mainly by residential zone (adjusted R(2): 0.27 for NO2; 0.09 for benzene). Education and social class were not clearly associated with pollution. Administrations should monitor the environment of residential areas regardless of the socioeconomic level, and they should increase the distances between housing and polluting sources to prevent settlements at distances that are harmful to health.

Analysis of area level and unit level models for small area estimation in forest inventories assisted with LiDAR auxiliary information.

PubMed

Mauro, Francisco; Monleon, Vicente J; Temesgen, Hailemariam; Ford, Kevin R

2017-01-01

Forest inventories require estimates and measures of uncertainty for subpopulations such as management units. These units often times hold a small sample size, so they should be regarded as small areas. When auxiliary information is available, different small area estimation methods have been proposed to obtain reliable estimates for small areas. Unit level empirical best linear unbiased predictors (EBLUP) based on plot or grid unit level models have been studied more thoroughly than area level EBLUPs, where the modelling occurs at the management unit scale. Area level EBLUPs do not require a precise plot positioning and allow the use of variable radius plots, thus reducing fieldwork costs. However, their performance has not been examined thoroughly. We compared unit level and area level EBLUPs, using LiDAR auxiliary information collected for inventorying 98,104 ha coastal coniferous forest. Unit level models were consistently more accurate than area level EBLUPs, and area level EBLUPs were consistently more accurate than field estimates except for large management units that held a large sample. For stand density, volume, basal area, quadratic mean diameter, mean height and Lorey's height, root mean squared errors (rmses) of estimates obtained using area level EBLUPs were, on average, 1.43, 2.83, 2.09, 1.40, 1.32 and 1.64 times larger than those based on unit level estimates, respectively. Similarly, direct field estimates had rmses that were, on average, 1.37, 1.45, 1.17, 1.17, 1.26, and 1.38 times larger than rmses of area level EBLUPs. Therefore, area level models can lead to substantial gains in accuracy compared to direct estimates, and unit level models lead to very important gains in accuracy compared to area level models, potentially justifying the additional costs of obtaining accurate field plot coordinates.

Analysis of area level and unit level models for small area estimation in forest inventories assisted with LiDAR auxiliary information

PubMed Central

Monleon, Vicente J.; Temesgen, Hailemariam; Ford, Kevin R.

2017-01-01

Forest inventories require estimates and measures of uncertainty for subpopulations such as management units. These units often times hold a small sample size, so they should be regarded as small areas. When auxiliary information is available, different small area estimation methods have been proposed to obtain reliable estimates for small areas. Unit level empirical best linear unbiased predictors (EBLUP) based on plot or grid unit level models have been studied more thoroughly than area level EBLUPs, where the modelling occurs at the management unit scale. Area level EBLUPs do not require a precise plot positioning and allow the use of variable radius plots, thus reducing fieldwork costs. However, their performance has not been examined thoroughly. We compared unit level and area level EBLUPs, using LiDAR auxiliary information collected for inventorying 98,104 ha coastal coniferous forest. Unit level models were consistently more accurate than area level EBLUPs, and area level EBLUPs were consistently more accurate than field estimates except for large management units that held a large sample. For stand density, volume, basal area, quadratic mean diameter, mean height and Lorey’s height, root mean squared errors (rmses) of estimates obtained using area level EBLUPs were, on average, 1.43, 2.83, 2.09, 1.40, 1.32 and 1.64 times larger than those based on unit level estimates, respectively. Similarly, direct field estimates had rmses that were, on average, 1.37, 1.45, 1.17, 1.17, 1.26, and 1.38 times larger than rmses of area level EBLUPs. Therefore, area level models can lead to substantial gains in accuracy compared to direct estimates, and unit level models lead to very important gains in accuracy compared to area level models, potentially justifying the additional costs of obtaining accurate field plot coordinates. PMID:29216290

Socioeconomic Status Accounts for Rapidly Increasing Geographic Variation in the Incidence of Poor Fetal Growth

PubMed Central

Ball, Stephen J.; Jacoby, Peter; Zubrick, Stephen R.

2013-01-01

Fetal growth is an important risk factor for infant morbidity and mortality. In turn, socioeconomic status is a key predictor of fetal growth; however, other sociodemographic factors and environmental effects may also be important. This study modelled geographic variation in poor fetal growth after accounting for socioeconomic status, with a fixed effect for socioeconomic status and a combination of spatially-correlated and spatially-uncorrelated random effects. The dataset comprised 88,246 liveborn singletons, aggregated within suburbs in Perth, Western Australia. Low socioeconomic status was strongly associated with an increased risk of poor fetal growth. An increase in geographic variation of poor fetal growth from 1999–2001 (interquartile odds ratio among suburbs = 1.20) to 2004–2006 (interquartile odds ratio = 1.40) indicated a widening risk disparity by socioeconomic status. Low levels of residual spatial patterns strengthen the case for targeting policies and practices in areas of low socioeconomic status for improved outcomes. This study indicates an alarming increase in geographic inequalities in poor fetal growth in Perth which warrants further research into the specific aspects of socioeconomic status that act as risk factors. PMID:23799513

A Connected Generation? Digital Inequalities in Elementary and High School Students According to Age and Socioeconomic Level

ERIC Educational Resources Information Center

Collin, Simon; Karsenti, Thierry; Ndimubandi, Alexis; Saffari, Hamid

2016-01-01

The objective of this article was to better understand the relationship between students' age and socioeconomic level, and its influence on students' digital uses. We conducted a quantitative study of 401 elementary and high school students in Quebec. Four independent variables were initially selected: two related to age (actual age and education…

Conceptualizing Health Consequences of Hurricane Katrina From the Perspective of Socioeconomic Status Decline

PubMed Central

Joseph, Nataria T.; Matthews, Karen A.; Myers, Hector F.

2014-01-01

Objective The long-term health impact of acute unemployment and socioeconomic resource deficit has not been shown to be unique from the effects of stable socioeconomic status (SES) and serious life circumstances, such as trauma. This study examined associations between these acute socioeconomic declines and health of hurricane survivors, independent of prehurricane SES and hurricane trauma. Method Participants were 215 African American adults (60% female, mean age = 39 years) living in the Greater New Orleans area at the time of Hurricane Katrina and survey 4 years later. The survey included prehurricane SES measures (i.e., education and neighborhood poverty level); acute unemployment and deficits in access to SES resources following Hurricane Katrina; and posthurricane health events (i.e., cardiometabolic events, chronic pain, posttraumatic stress disorder [PTSD], and major depressive disorder [MDD]). Results Acute unemployment was associated with odds of experiencing a cardiometabolic event (odds ratio [OR] = 5.65, p < .05), MDD (OR = 2.76, p < .05) and chronic pain (OR = 2.76, p < .05), whereas acute socioeconomic resource deficit was associated with odds of chronic pain (OR = 1.93, p < .001) and MDD (OR = 1.19, p < .05). Associations were independent of prehurricane SES, hurricane trauma, potentially chronic SES resource deficits, and current unemployment. Conclusions This study shows that acute socioeconomic decline following a natural disaster can create long-term health disparities beyond those created by prehurricane SES level and traumatic hurricane experiences. Findings suggest that early intervention postdisaster to reduce pervasive socioeconomic disruption may reduce the long-term health impact of disasters. PMID:23527519

Conceptualizing health consequences of Hurricane Katrina from the perspective of socioeconomic status decline.

PubMed

Joseph, Nataria T; Matthews, Karen A; Myers, Hector F

2014-02-01

The long-term health impact of acute unemployment and socioeconomic resource deficit has not been shown to be unique from the effects of stable socioeconomic status (SES) and serious life circumstances, such as trauma. This study examined associations between these acute socioeconomic declines and health of hurricane survivors, independent of prehurricane SES and hurricane trauma. Participants were 215 African American adults (60% female, mean age = 39 years) living in the Greater New Orleans area at the time of Hurricane Katrina and survey 4 years later. The survey included prehurricane SES measures (i.e., education and neighborhood poverty level); acute unemployment and deficits in access to SES resources following Hurricane Katrina; and posthurricane health events (i.e., cardiometabolic events, chronic pain, posttraumatic stress disorder [PTSD], and major depressive disorder [MDD]). Acute unemployment was associated with odds of experiencing a cardiometabolic event (odds ratio [OR] = 5.65, p < .05), MDD (OR = 2.76, p < .05) and chronic pain (OR = 2.76, p < .05), whereas acute socioeconomic resource deficit was associated with odds of chronic pain (OR = 1.93, p < .001) and MDD (OR = 1.19, p < .05). Associations were independent of prehurricane SES, hurricane trauma, potentially chronic SES resource deficits, and current unemployment. This study shows that acute socioeconomic decline following a natural disaster can create long-term health disparities beyond those created by prehurricane SES level and traumatic hurricane experiences. Findings suggest that early intervention postdisaster to reduce pervasive socioeconomic disruption may reduce the long-term health impact of disasters. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Impact of socioeconomic status on municipal solid waste generation rate.

PubMed

Khan, D; Kumar, A; Samadder, S R

2016-03-01

The solid waste generation rate was expected to vary in different socioeconomic groups due to many environmental and social factors. This paper reports the assessment of solid waste generation based on different socioeconomic parameters like education, occupation, income of the family, number of family members etc. A questionnaire survey was conducted in the study area to identify the different socioeconomic groups that may affect the solid waste generation rate and composition. The average waste generated in the municipality is 0.41 kg/capita/day in which the maximum waste was found to be generated by lower middle socioeconomic group (LMSEG) with average waste generation of 0.46 kg/capita/day. Waste characterization indicated that there was no much difference in the composition of wastes among different socioeconomic groups except ash residue and plastic. Ash residue is found to increase as we move lower down the socioeconomic groups with maximum (31%) in lower socioeconomic group (LSEG). The study area is a coal based city hence application of coal and wood as fuel for cooking in the lower socioeconomic group is the reason for high amount of ash content. Plastic waste is maximum (15%) in higher socioeconomic group (HSEG) and minimum (1%) in LSEG. Food waste is a major component of generated waste in almost every socioeconomic group with maximum (38%) in case of HSEG and minimum (28%) in LSEG. This study provides new insights on the role of various socioeconomic parameters on generation of household wastes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Socioeconomic inequality in hypertension in Iran.

PubMed

Fateh, Mansooreh; Emamian, Mohammad Hassan; Asgari, Fereshteh; Alami, Ali; Fotouhi, Akbar

2014-09-01

Hypertension covers a large portion of burden of diseases, especially in the developing countries. The unequal distribution of hypertension in the population may affect 'health for all' goal. This study aimed to investigate the socioeconomic inequality of hypertension in Iran and to identify its influencing factors. We used data from Iran's surveillance system for risk factors of noncommunicable diseases which was conducted on 89 400 individuals aged 15-64 years in 2005. To determine the socioeconomic status of participants, a new variable was created using a principal component analysis. We examined hypertension at different levels of this new variable and calculated slop index of inequality (SII) and concentration index (C) for hypertension. We then applied Oaxaca-Blinder decomposition analysis to determine the causes of inequality. The SII and C for hypertension were -32.3 and -0.170, respectively. The concentration indices varied widely between different provinces in Iran and was lower (more unequal) in women than in men. There was significant socioeconomic inequality in hypertension. The results of decomposition indicated that 40.5% of the low-socioeconomic group (n = 18190) and 16.4% of the high-socioeconomic group (n = 16335) had hypertension. Age, education level, sex and residency location were the main associated factors of the difference among groups. According to our results, there was an inequality in hypertension in Iran, so that individuals with low socioeconomic status had a higher prevalence of hypertension. Age was the most contributed factor in this inequality and women in low-socioeconomic group were the most vulnerable people for hypertension.

Socioeconomic deprivation impact on meat intake and mortality: NIH-AARP Diet and Health Study.

PubMed

Major, Jacqueline M; Cross, Amanda J; Doubeni, Chyke A; Park, Yikyung; Lian, Min; Hollenbeck, Albert R; Schatzkin, Arthur; Graubard, Barry I; Sinha, Rashmi

2011-12-01

Previous studies have not examined potential interactions between meat intake and characteristics of the local environment on the risk of mortality. This study examined the impact of area socioeconomic deprivation on the association between meat intake and all-cause and cause-specific mortality after accounting for individual-level risk factors. In the prospective NIH-AARP Diet and Health Study, we analyzed data from adults, ages 50-71 years at baseline (1995-1996). Individual-level dietary intake and health risk information were linked to the demographic and socioeconomic context of participants' local environment based on census tract data. Deaths (n = 33,831) were identified through December 2005. Multilevel Cox models were used to estimate hazard ratios and 95% confidence intervals for quintiles of area deprivation scores. Associations of red and processed meats with mortality were consistent across deprivation quintiles. Men residing in least-deprived neighborhoods had a stronger protective effect for white meat consumption. No differences by deprivation index were observed for women. Red and processed meat intake increases mortality risk regardless of level of deprivation within a given neighborhood suggesting biological mechanisms rather than neighborhood contextual factors may underlie these meat-mortality associations. The effect of white meat intake on cancer mortality was modified by area deprivation among men.

Pattern of Hepatitis A Incidence According to Area Characteristics Using National Health Insurance Data

PubMed Central

Seo, Joo Youn; Seo, Jae Hee; Kim, Myoung Hee; Ki, Moran; Park, Hee Suk

2012-01-01

Objectives Over the past several years, the incidence of hepatitis A infection has been increasing rapidly in the young-adult population in Korea. We examined the effects of area-level socioeconomic status and environmental hygiene on the incidence of hepatitis A. Methods This study is based on the registered national population of Korea and the national health insurance data from 2004 to 2008. A total of 73 459 individuals were confirmed to have had hepatitis A. The standardized incidences of hepatitis A in 232 districts adjusted for sex and age of people were calculated for each year, and the rate ratios of the incidence rates were estimated according to area-level socioeconomic status and environmental hygiene using multiple Poisson regression models. Results The incidence rates of hepatitis A infection were 15.6 (per 100 000) in 2004, 19.0 (per 100 000) in 2005, 27.2 (per 100 000) in 2006, 25.1 (per 100 000) in 2007, and 61.7 (per 100 000) in 2008. The analysis of the area-level effects showed that residential areas of the less deprived than other regions, areas with higher levels of education, and heavily populated areas were significantly associated with increased risk. Conclusions There is a very strong possibility that both area-level socioeconomic status and environmental hygiene play a role in increasing the risk of hepatitis A infection in Korea. Therefore, to reduce hepatitis A infection, we need a nationwide strategy that considers these area-level characteristics. PMID:22712043

Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review.

PubMed

Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

2016-05-17

The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. A realist review. MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which will require dedicated primary care resources. Published by the BMJ Publishing Group Limited. For

Has the economic crisis widened the intraurban socioeconomic inequalities in mortality? The case of Barcelona, Spain.

PubMed

Maynou, Laia; Saez, Marc; Lopez-Casasnovas, Guillem

2016-02-01

There is considerable evidence demonstrating socioeconomic inequalities in mortality, some of which focuses on intraurban inequalities. However, all the studies assume that the spatial variation of inequalities is stable over the time. We challenge this assumption and propose two hypotheses: (i) have spatial variations in socioeconomic inequalities in mortality at an intraurban level changed over time? and (ii) as a result of the economic crisis, has the gap between such disparities widened? In this paper, our objective is to assess the effect of the economic recession on the spatio-temporal variation of socioeconomic inequalities in mortality in Barcelona (Catalonia, Spain). We used a spatio-temporal ecological design to analyse mortality inequalities at small area level in Barcelona. Mortality data and socioeconomic indicators correspond to the years 2005 and 2008-2011. We specified spatio-temporal ecological mixed regressions for both men and women using two indicators, neighbourhood and year. We allowed the coefficients of the socioeconomic variables to differ according to the levels and explicitly took into account spatio-temporal adjustment. For men and women both absolute and, above all, relative risks for mortality have increased since 2009. In relative terms, this means that the risk of dying has increased much more in the most economically deprived neighbourhoods than in the more affluent ones. Although the geographical pattern in relative risks for mortality in neighbourhoods in Barcelona remained very stable between 2005 and 2011, socioeconomic inequalities in mortality at an intraurban level have surged since 2009. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Socioeconomic status, cognition, and hippocampal sclerosis.

PubMed

Baxendale, Sallie; Heaney, Dominic

2011-01-01

Poorer surgical outcomes in patients with low socioeconomic status have previously been reported, but the mechanisms underlying this pattern are unknown. Lower socioeconomic status may be a proxy marker for the limited economic opportunities associated with compromised cognitive function. The aim of this study was to examine the preoperative neuropsychological characteristics of patients with unilateral hippocampal sclerosis (HS) and their relationship to socioeconomic status. Two hundred ninety-two patients with medically intractable temporal lobe epilepsy and unilateral HS completed tests of memory and intellectual function prior to surgery. One hundred thirty-one had right HS (RHS), and 161 had left HS (LHS). The socioeconomic status of each participant was determined via the Index of Multiple Deprivation (IMD) associated with their postcode. The IMD was not associated with age at the time of assessment, age at onset of epilepsy, or duration of active epilepsy. The RHS and LHS groups did not differ on the IMD. The IMD was negatively correlated with all neuropsychological test scores in the LHS group. In the RHS group, the IMD was not significantly correlated with any of the neuropsychological measures. There were no significant correlations in the RHS group. Regression analyses suggested that IMD score explained 3% of variance in the measures of intellect, but 8% of the variance in verbal learning in the LHS group. The IMD explained 1% or less of the variance in neuropsychological scores in the RHS group. Controlling for overall level of intellectual function, the IMD score explained a small but significant proportion of the variance in verbal learning in the LHS group and visual learning for the RHS group. Our findings suggest that patients living in an area with a high IMD enter surgery with greater focal deficits associated with their epilepsy and more widespread cognitive deficits if they have LHS. Further work is needed to establish the direction of the

Does area-based social capital matter for the health of Australians? A multilevel analysis of self-rated health in Tasmania.

PubMed

Kavanagh, Anne M; Turrell, Gavin; Subramanian, S V

2006-06-01

Material circumstances and collective psychosocial processes have been invoked as potential explanations for socioeconomic inequalities in health; and, linking social capital has been proposed as a way of reconciling these apparently opposing explanations. We conducted multilevel logistic regression of self-rated health (fair or poor vs excellent, very good, or good) on 14 495 individuals living within 41 statistical local areas who were respondents to the 1998 Tasmanian Healthy Communities Study. We modelled the effects of area-level socioeconomic disadvantage and social capital (neighbourhood integration, neighbourhood alienation, neighbourhood safety, social trust, trust in public/private institutions, and political participation), and adjusted for the effects of individual characteristics. Area-level socioeconomic disadvantage was associated with poor self-rated health (beta = 0.0937, P < 0.001) an effect that was attenuated, but remained significant, after adjusting for individual characteristics (beta = 0.0419, P < 0.001). Social trust was associated with a reduction in poor self-rated health (beta = -0.0501, p = 0.008) and remained significant when individual characteristics (beta = -0.0398, P = 0.005) were included. Political participation was non-significant in the unadjusted model but became significant when adjusted for individual characteristics (beta = -0.2557, P = 0.045). The effects of social trust and political participation were attenuated and became non-significant when area-level socioeconomic disadvantage was included. Area-based socioeconomic disadvantage is a determinant of self-rated health in Tasmania, but we did not find an independent effect of area-level social capital. These findings suggest that in Tasmania investments in improving the material circumstances in which people live are likely to lead to greater improvements in population health than attempts to increase area-level social capital.

Where Are Socioeconomically Deprived Immigrants Located in Chile? A Spatial Analysis of Census Data Using an Index of Multiple Deprivation from the Last Three Decades (1992-2012).

PubMed

Vasquez, Andrea; Cabieses, Baltica; Tunstall, Helena

2016-01-01

Immigrants in Chile have diverse characteristics and include socioeconomically deprived populations. The location of socioeconomically deprived immigrants is important for the development of public policy intelligence at the local and national levels but their areas of residence have not been mapped in Chile. This study explored the spatial distribution of socioeconomic deprivation among immigrants in Chile, 1992-2012, and compared it to the total population. Areas with socioeconomically deprived populations were identified with a deprivation index which we developed modelled upon the Index of Multiple Deprivation (IMD) for England. Our IMD was based upon the indicators of unemployment, low educational level (primary) and disability from Census data at county level for the three decades 1992, 2002 and 2012, for 332, 339 and 343 counties respectively. We developed two versions of the IMD one based on disadvantage among the total population and another focused upon the circumstances of immigrants only. We generated a spatial representation of the IMD using GIS, for the overall IMD score and for each dimension of the index, separately. We also compared the immigrants´ IMD to the total population´s IMD using Pearson´s correlation test. Results showed that socioeconomically deprived immigrants tended to be concentrated in counties in the northern and central area of Chile, in particular within the Metropolitan Region of Santiago. These were the same counties where there was the greatest concentration of socioeconomic deprivation for the total population during the same time periods. Since 1992 there have been significant change in the location of the socioeconomically deprived populations within the Metropolitan Region of Santiago with the highest IMD scores for both the total population and immigrants becoming increasingly concentrated in the central and eastern counties of the Region. This is the first study analysing the spatial distribution of socioeconomic

Sociocultural Characteristics of Pregnant and Nonpregnant Adolescents of Low Socioeconomic Status: A Comparative Study.

ERIC Educational Resources Information Center

Alvarez, M. de la Luz; And Others

1987-01-01

Compared the sociocultural characteristics of pregnant adolescents (N=129) of low socioeconomic status with a nonpregnant adolescent group (N=100) from the same area of Santiago, Chile. Found several differences between the groups including less schooling, lower level of aspirations, and a tendency to live in "the present" among the…

Impact of heterogeneity and socioeconomic factors on individual behavior in decentralized sharing ecosystems.

PubMed

Gavaldà-Miralles, Arnau; Choffnes, David R; Otto, John S; Sánchez, Mario A; Bustamante, Fabián E; Amaral, Luís A N; Duch, Jordi; Guimerà, Roger

2014-10-28

Tens of millions of individuals around the world use decentralized content distribution systems, a fact of growing social, economic, and technological importance. These sharing systems are poorly understood because, unlike in other technosocial systems, it is difficult to gather large-scale data about user behavior. Here, we investigate user activity patterns and the socioeconomic factors that could explain the behavior. Our analysis reveals that (i) the ecosystem is heterogeneous at several levels: content types are heterogeneous, users specialize in a few content types, and countries are heterogeneous in user profiles; and (ii) there is a strong correlation between socioeconomic indicators of a country and users behavior. Our findings open a research area on the dynamics of decentralized sharing ecosystems and the socioeconomic factors affecting them, and may have implications for the design of algorithms and for policymaking.

Impact of heterogeneity and socioeconomic factors on individual behavior in decentralized sharing ecosystems

PubMed Central

Gavaldà-Miralles, Arnau; Choffnes, David R.; Otto, John S.; Sánchez, Mario A.; Bustamante, Fabián E.; Amaral, Luís A. N.; Duch, Jordi; Guimerà, Roger

2014-01-01

Tens of millions of individuals around the world use decentralized content distribution systems, a fact of growing social, economic, and technological importance. These sharing systems are poorly understood because, unlike in other technosocial systems, it is difficult to gather large-scale data about user behavior. Here, we investigate user activity patterns and the socioeconomic factors that could explain the behavior. Our analysis reveals that (i) the ecosystem is heterogeneous at several levels: content types are heterogeneous, users specialize in a few content types, and countries are heterogeneous in user profiles; and (ii) there is a strong correlation between socioeconomic indicators of a country and users behavior. Our findings open a research area on the dynamics of decentralized sharing ecosystems and the socioeconomic factors affecting them, and may have implications for the design of algorithms and for policymaking. PMID:25288755

Arterial roads and area socioeconomic status are predictors of fast food restaurant density in King County, WA

PubMed Central

Hurvitz, Philip M; Moudon, Anne V; Rehm, Colin D; Streichert, Laura C; Drewnowski, Adam

2009-01-01

Background Fast food restaurants reportedly target specific populations by locating in lower-income and in minority neighborhoods. Physical proximity to fast food restaurants has been associated with higher obesity rates. Objective To examine possible associations, at the census tract level, between area demographics, arterial road density, and fast food restaurant density in King County, WA, USA. Methods Data on median household incomes, property values, and race/ethnicity were obtained from King County and from US Census data. Fast food restaurant addresses were obtained from Public Health-Seattle & King County and were geocoded. Fast food density was expressed per tract unit area and per capita. Arterial road density was a measure of vehicular and pedestrian access. Multivariate logistic regression models containing both socioeconomic status and road density were used in data analyses. Results Over one half (53.1%) of King County census tracts had at least one fast food restaurant. Mean network distance from dwelling units to a fast food restaurant countywide was 1.40 km, and 1.07 km for census tracts containing at least one fast food restaurant. Fast food restaurant density was significantly associated in regression models with low median household income (p < 0.001) and high arterial road density (p < 0.001) but not with percent of residents who were nonwhite. Conclusion No significant association was observed between census tract minority status and fast food density in King County. Although restaurant density was linked to low household incomes, that effect was attenuated by arterial road density. Fast food restaurants in King County are more likely to be located in lower income neighborhoods and higher traffic areas. PMID:19630979

[Eating habits, physical activity and socioeconomic level in university students of Chile].

PubMed

Rodríguez, Fernando; Palma, Ximen; Romo, Angela; Escobar, Daniela; Aragú, Bárbara; Espinoza, Luis; McMillan, Norman; Gálvez, Jorge

2013-01-01

University students are vulnerable to poor nutrition; they don't eat snacks between meals, don't eat breakfast or fast for long hours, prefer fast food and don't exercise. University students is considered the key young adult population group for health promotion and prevention for future generations, so it's crucial identify the current nutritional status and frequency of physical activity. To determine the factors involved in the choice of food and frequency of physical activity in university students. 799 volunteers were evaluated from four universities of the fifth region of Chile. Instrument was applied to determine the level of physical activity and eating habits, KIDMED test to determine adherence to the Mediterranean diet and Adimark instrument to determinate the socioeconomic status of the subjects. Finally, anthropometric evaluation to determinate BMI, fat mass and muscle mass. Physical inactivity is higher in women than in men and that the main reason for not exercising is lack of time and laziness. In both sexes don't read nutrition labels and have a low and average adherence to the Mediterranean diet. The low knowledge of nutrition is the cause of the poor food quality of subjects and there isn't greater motivation to perform physical activity.Socioeconomic status isn't related to eating habits and physical activity. It's necessary to integrate programs regular and permanent healthy lifestyle in all universities. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

[Relevance of the socioeconomic and health context in patient satisfaction].

PubMed

Pérez-Romero, Shirley; Gascón-Cánovas, Juan J; Salmerón-Martínez, Diego; Parra-Hidalgo, Pedro; Monteagudo-Piqueras, Olga

To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services. The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis. The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 €) (OR: 0.49-0.87) and the ratio "primary health care physicians/inhabitants" is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04). The individual factors that determine patient satisfaction are: sex, age, mental health and country of birth. In addition, there are differences in patient satisfaction among the autonomous communities according to socio-economic determinants such as GDP per capita, low-level study rates, unemployment rates or number of inhabitants/doctor's ratio. User satisfaction studies as well as being adjusted for individual variables such as sex, age or health level should also take into account characteristics of the socioeconomic environment of the geographic area where they reside. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Socioeconomic status and exposure to outdoor NO2 and benzene in the Asturias INMA birth cohort, Spain

PubMed Central

Fernández-Somoano, Ana; Tardon, Adonina

2014-01-01

Background It is commonly assumed that low socioeconomic levels are associated with greater exposure to pollution, but this is not necessarily valid. Our goal was to examine how individual socioeconomic characteristics are associated with exposure levels in a Spanish region included in the INfancia y Medio Ambiente (INMA) cohort. Methods The study population comprised 430 pregnant women from the Asturias INMA cohort. Air pollution exposure was estimated using land-use regression techniques. Information about the participants’ lifestyle and socioeconomic variables was collected through questionnaires. In multivariate analysis, the levels of NO2 and benzene assigned to each woman were considered as dependent variables. Other variables included in the models were residential zone, age, education, parity, smoking, season, working status during pregnancy and social class. Results The average NO2 level was 23.60 (SD=6.50) μg/m3. For benzene, the mean value was 2.31 (SD=1.32) μg/m3. We found no association of any pollutant with education. We observed an association between social class and benzene levels. Social classes I and II had the highest levels. The analysed socioeconomic and lifestyle variables accounted for little variability in air pollution in the models; this variability was explained mainly by residential zone (adjusted R2: 0.27 for NO2; 0.09 for benzene). Conclusions Education and social class were not clearly associated with pollution. Administrations should monitor the environment of residential areas regardless of the socioeconomic level, and they should increase the distances between housing and polluting sources to prevent settlements at distances that are harmful to health. PMID:23999377

SOCIOECONOMIC VARIATIONS IN INDUCED ABORTION IN TURKEY.

PubMed

Ankara, Hasan Giray

2017-01-01

This study aimed to identify the levels of, and socioeconomic variations in, income-related inequality in induced abortion among Turkish women. The study included 15,480 ever-married women of reproductive age (15-49) from the 2003 and 2008 waves of the Turkish Demographic and Health Survey. The measured inequalities in abortion levels and their changes over time were decomposed into the percentage contributions of selected socioeconomic factors using ordinary least square analysis and concentration indices were calculated. The inequalities and their first difference (difference in inequalities between 2003 and 2008) were decomposed using the approaches of Wagstaff et al. (2003). Higher socioeconomic characteristics (such as higher levels of wealth and education and better neighbourhood) were found to be associated with higher rates of abortion. Inequality analyses indicated that although deprived women become more familiar with abortion over time, abortion was still more concentrated among affluent women in the 2008 survey. The decomposition analyses suggested that wealth, age, education and level of regional development were the most important contributors to income-related inequality in abortion. Therefore policies that (i) increase the level of wealth and education of deprived women, (ii) develop deprived regions of Turkey, (iii) improve knowledge about family planning and, especially (iv) enhance the accessibility of family planning services for deprived and/or rural women, may be beneficial for reducing socioeconomic variations in abortion in the country.

Health status and air pollution related socioeconomic concerns in urban China.

PubMed

Jiao, Kaishan; Xu, Mengjia; Liu, Meng

2018-02-05

China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.

Serum Retinol Levels in Pregnant Adolescents and Their Relationship with Habitual Food Intake, Infection and Obstetric, Nutritional and Socioeconomic Variables.

PubMed

Spíndola Garcêz, Laís; de Sousa Paz Lima, Geania; de Azevedo Paiva, Adriana; Maria Rebêlo Sampaio da Paz, Suzana; Lázaro Gomes, Erica Ivana; Nunes, Valéria Sutti; Cotta de Faria, Eliana; de Barros-Mazon, Sílvia

2016-10-25

Globally, vitamin A deficiency (VAD) affects about 19.1 million pregnant women. Its occurrence is classically associated with inadequate food intake and may also be associated with socioeconomic factors and the presence of infection. The aim of this study was to determine the factors related to serum retinol levels among pregnant teenagers. The sample consisted of 89 pregnant adolescents, from whom socioeconomic, obstetric, anthropometric, and food consumption data were collected. Serum concentrations of retinol and the supposed presence of infection were determined by high-performance liquid chromatography and C-reactive protein quantification, respectively. The serum retinol concentrations were classified according to the criteria of the World Health Organization. We adopted a 5% significance level for all statistical tests. Serum retinol levels were significantly and positively associated with sanitation ( p = 0.008) and pre-gestational nutritional status ( p = 0.002), and negatively with the trimester ( p = 0.001). The appropriate sanitation conditions and pre-pregnancy body mass index (BMI) were shown to have a protective effect against VAD. Conversely, serum retinol levels were reduced with trimester progression, favoring VAD occurrence.

Socioeconomic disadvantage and changes in health risk behaviours in Australia: 1989-90 to 2001.

PubMed Central

Najman, Jake M.; Toloo, Ghasem; Siskind, Victor

2006-01-01

OBJECTIVE: Lower socioeconomic status (SES) is associated in industrialized countries with unhealthy lifestyle characteristics, such as smoking, physical inactivity and being overweight or obese. This paper examines changes over time in the association between SES and smoking status, physical activity and being overweight or obese in Australia. METHODS: Data were taken from three successive national health surveys in Australia carried out in 1989-90 (n = 54,576), 1995 (n = 53,828) and 2001 (n = 26,863). Participants in these surveys were selected using a national probability sampling strategy, and aggregated data for geographical areas are used to determine the changing association between SES and lifestyle over time. FINDINGS: Overall, men had less healthy lifestyles. In 2001 inverse SES trends for both men and women showed that those living in lower SES areas were more likely to smoke and to be sedentary and obese. There were some important socioeconomic changes over the period 1989-90 to 2001. The least socioeconomically disadvantaged areas had the largest decrease in the percentage of people smoking tobacco (24% decrease for men and 12% for women) and the largest decrease in the percentage of people reporting sedentary activity levels (25% decrease for men and 22% for women). While there has been a general increase in the percentage over time of those who are overweight or obese, there is a modest trend for being overweight to have increased (by about 16% only among females) among those living in areas of higher SES. CONCLUSION: Socioeconomic inequalities have been increasing for several key risk behaviours related to health; this suggests that specific population-based prevention strategies intended to reduce health inequalities are needed. PMID:17242834

The impact of geographic unit of analysis on socioeconomic inequalities in cancer survival and distant summary stage - a population-based study.

PubMed

Tervonen, Hanna E; Morrell, Stephen; Aranda, Sanchia; Roder, David; You, Hui; Niyonsenga, Theo; Walton, Richard; Baker, Deborah; Currow, David

2016-12-13

When using area-level disadvantage measures, size of geographic unit can have major effects on recorded socioeconomic cancer disparities. This study examined the extent of changes in recorded socioeconomic inequalities in cancer survival and distant stage when the measure of socioeconomic disadvantage was based on smaller Census Collection Districts (CDs) instead of Statistical Local Areas (SLAs). Population-based New South Wales Cancer Registry data were used to identify cases diagnosed with primary invasive cancer in 2000-2008 (n=264,236). Logistic regression and competing risk regression modelling were performed to examine socioeconomic differences in odds of distant stage and hazard of cancer death for all sites combined and separately for breast, prostate, colorectal and lung cancers. For all sites collectively, associations between socioeconomic disadvantage and cancer survival and distant stage were stronger when the CD-based socioeconomic disadvantage measure was used compared with the SLA-based measure. The CD-based measure showed a more consistent socioeconomic gradient with a linear upward trend of risk of cancer death/distant stage with increasing socioeconomic disadvantage. Site-specific analyses provided similar findings for the risk of death but less consistent results for the likelihood of distant stage. The use of socioeconomic disadvantage measure based on the smallest available spatial unit should be encouraged in the future. Implications for Public Health: Disadvantage measures based on small spatial units can more accurately identify socioeconomic cancer disparities to inform priority settings in service planning. © 2016 Public Health Association of Australia.

Socioeconomic Inequality in Childhood Obesity.

PubMed

Moradi, Ghobad; Mostafavi, Farideh; Azadi, Namamali; Esmaeilnasab, Nader; Ghaderi, Ebrahim

2017-08-15

The aim of this study was to assess the socioeconomic inequalities in obesity and overweight in children aged 10 to 12 yr old. A cross-sectional study. This study was conducted on 2506 children aged 10 to 12 yr old in the city of Sanandaj, western Iran in 2015. Body mass index (BMI) was calculated. Considering household situation and assets, socioeconomic status (SES) of the subjects was determined using Principal Component Analysis (PCA). Concentration Index was used to measure inequality and Oaxaca decomposition was used to determine the share of different determinants of inequality. The prevalence of overweight was 24.1% (95% CI: 22.4, 25.7). 11.5% (95% CI: 10.0, 12.0) were obese. The concentration index for overweight and obesity, respectively, was 0.10 (95% CI: 0.05, 0.15), and 0.07 (95% CI:0.00, 0.14) which indicated inequality and a higher prevalence of obesity and overweight in higher SES. The results of Oaxaca decomposition suggested that socioeconomic factors accounted for 75.8% of existing inequalities. Residential area and mother education were the most important causes of inequality. To reduce inequalities in childhood obesity, mother education must be promoted and special attention must be paid to residential areas and children gender.

Climate change and socio-economic scenarios, land use modelling implications on water resources in an inner alpine area, Switzerland

NASA Astrophysics Data System (ADS)

Rey, Emmanuel; Schneider, Flurina; Liniger, Hanspeter; Weingartner, Rolf; Herweg, Karl

2014-05-01

The MontanAqua project aims to study the water resources management in the region Sierre-Montana (Valais, Switzerland). Land use is known to have an influence on the water resources (soil moisture dynamic, soil sealing, surface runoff and deep percolation). Thus land use modelling is of importance for the water resources management. An actual land use map was produced using infrared imagery (Niklaus 2012, Fig.1). Land use changes are known to be mainly drived by socio-economic factors as well as climatic factors (Dolman et al. 2003). Potential future Land uses was separatly predicted according to 1-. socio-economic and 2-. climatic/abiotic drivers : 1. 4 socio-economic scenarios were developped with stakeholders (Schneider et al. 2013) between 2010 and 2012. We modeled those socio-economic scenarios into a GIS application using Python programming (ModelBuilder in ArcGIS 10) to get a cartographic transcription of the wishes of the stakeholders for their region in 2050. 2. Uncorrelated climatic and abiotic drivers were used in a BIOMOD2 (Georges et al. 2013) framework. 4 models were used: Maximum Entropy (MAXENT), Multiple Adaptive Regression Splines (MARS), Classification Tree Analysis (CTA) and the Flexible Discriminant Analysis (FDA) to predict grassland, alpine pasture, vineyards and forest in our study region. Climatic scenarios were then introduced into the models to predict potential land use in 2050 driven only by climatic and abiotic factors The comparison of all the outputs demonstrates that the socio-economic drivers will have a more important impact in the region than the climatic drivers (e.g. -70% grassland surface for the worst socio-economic scenario vs. -40% of grassland surface for the worst climatic models). Further analysis also brings out the sensitivity of the grassland/alpine pasture system to the climate change and to socio-economic changes. Future work will be to cross the different land use maps obtained by the two model types and to use

Why does Scotland have a higher suicide rate than England? An area-level investigation of health and social factors.

PubMed

Mok, Pearl L H; Leyland, Alastair H; Kapur, Navneet; Windfuhr, Kirsten; Appleby, Louis; Platt, Stephen; Webb, Roger T

2013-01-01

Up until the mid-late 2000s, the national suicide rate in Scotland was the highest among all the UK countries, but the reasons for this phenomenon are poorly understood. In a multilevel study of suicide risk in Scotland and England during 2001-2006, the authors examined a range of social, cultural and health-related factors at small area level: postcode sector and Health Board in Scotland and ward and Primary Care Organisation in England. Scotland's national suicide rate was 79% higher than in England (rate ratio 1.79, 95% CI 1.62 to 1.98), with younger male and female Scots aged 15-44 years having double the risk compared with their English peers. Overall, 57% of the excess suicide risk in Scotland was explained by a range of area-level measures, including prescriptions for psychotropic drugs, alcohol and drug use, socioeconomic deprivation, social fragmentation, and other health-related indices. The use of psychotropic drugs, acting as a proxy measure for mental ill health, was the variable most strongly associated with the between-country differences in suicide risk. Alcohol misuse also made an important contribution to the differentials. Overall, the contribution of socioeconomic deprivation and social fragmentation was relatively small. Any attempt to reverse the divergent trend in suicide between Scotland and England will require initiatives to prevent and treat mental ill health and to tackle alcohol and drug misuse. Differences in prescribing rates, however, may also be explained by differences in illness behaviour or the availability of psychosocial interventions, and addressing these may also reduce Scotland's excess risk.

Designing marine reserves to reflect local socioeconomic conditions: lessons from long-enduring customary management systems

NASA Astrophysics Data System (ADS)

Cinner, J. E.

2007-12-01

Coral reef conservation strategies such as marine protected areas have met limited success in many developing countries. Some researchers attribute part of these shortcomings to inadequate attention to the social context of conserving marine resources. To gain insights into applying Western conservation theory more successfully in the socioeconomic context of developing countries, this study examines how long-enduring, customary reef closures appear to reflect local socioeconomic conditions in two Papua New Guinean communities. Attributes of the customary management (including size, shape, permanence, and gear restrictions) are examined in relation to prevailing socioeconomic conditions (including resource users’ ability to switch gears, fishing grounds, and occupations). Customary closures in the two communities appear to reflect local socioeconomic circumstances in three ways. First, in situations where people can readily switch between occupations, full closures are acceptable with periodic harvests to benefit from the closure. In comparison, communities with high dependence on the marine resources are more conducive to employing strategies that restrict certain gear types while still allowing others. Second, where there is multiple clan and family spatial ownership of resources, the communities have one closure per clan/family; one large no-take area would have disproportionate affect on those compared to the rest of the community. In contrast, communities that have joint ownership can establish one large closure as long as there are other areas available to harvest. Third, historical and trade relationships with neighboring communities can influence regulations by creating the need for occasional harvests to provide fish for feasts. This study further demonstrates the importance of understanding the socioeconomic context of factors such as community governance and levels of dependence for the conservation of marine resources.

The contribution of area-level walkability to geographic variation in physical activity: a spatial analysis of 95,837 participants from the 45 and Up Study living in Sydney, Australia.

PubMed

Mayne, Darren J; Morgan, Geoffrey G; Jalaludin, Bin B; Bauman, Adrian E

2017-10-03

Individual-level studies support a positive relation between walkable built environments and participation in moderate-intensity walking. However, the utility of this evidence for population-level planning is less clear as it is derived at much finer spatial scales than those used for regional programming. The aims of this study were to: evaluate if individual-level relations between walkability and walking to improve health manifest at population-level spatial scales; assess the specificity of area-level walkability for walking relative to other moderate and vigorous physical activity (MVPA); describe geographic variation in walking and other MVPA; and quantify the contribution of walkability to this variation. Data on sufficient walking, sufficient MVPA, and high MVPA to improve health were analyzed for 95,837 Sydney respondents to the baseline survey of the 45 and Up Study between January 2006 and April 2010. We used conditional autoregressive models to create smoothed MVPA "disease maps" and assess relations between sufficient MVPA to improve health and area-level walkability adjusted for individual-level demographic, socioeconomic, and health factors, and area-level relative socioeconomic disadvantage. Within-cohort prevalence of meeting recommendations for sufficient walking, sufficient MVPA, and high MVPA were 31.7 (95% CI 31.4-32.0), 69.4 (95% CI 69.1-69.7), and 56.1 (95% CI 55.8-56.4) percent. Prevalence of sufficient walking was increased by 1.20 (95% CrI 1.12-1.29) and 1.07 (95% CrI 1.01-1.13) for high and medium-high versus low walkability postal areas, and for sufficient MVPA by 1.05 (95% CrI 1.01-1.08) for high versus low walkability postal areas. Walkability was not related to high MVPA. Postal area walkability explained 65.8 and 47.4 percent of residual geographic variation in sufficient walking and sufficient MVPA not attributable to individual-level factors. Walkability is associated with area-level prevalence and geographic variation in

Licit prescription drug use in a Swedish population according to age, gender and socioeconomic status after adjusting for level of multi-morbidity

PubMed Central

2012-01-01

Background There is a great variability in licit prescription drug use in the population and among patients. Factors other than purely medical ones have proven to be of importance for the prescribing of licit drugs. For example, individuals with a high age, female gender and low socioeconomic status are more likely to use licit prescription drugs. However, these results have not been adjusted for multi-morbidity level. In this study we investigate the odds of using licit prescription drugs among individuals in the population and the rate of licit prescription drug use among patients depending on gender, age and socioeconomic status after adjustment for multi-morbidity level. Methods The study was carried out on the total population aged 20 years or older in Östergötland county with about 400 000 inhabitants in year 2006. The Johns Hopkins ACG Case-mix was used as a proxy for the individual level of multi-morbidity in the population to which we have related the odds ratio for individuals and incidence rate ratio (IRR) for patients of using licit prescription drugs, defined daily doses (DDDs) and total costs of licit prescription drugs after adjusting for age, gender and socioeconomic factors (educational and income level). Results After adjustment for multi-morbidity level male individuals had less than half the odds of using licit prescription drugs (OR 0.41 (95% CI 0.40-0.42)) compared to female individuals. Among the patients, males had higher total costs (IRR 1.14 (95% CI 1.13-1.15)). Individuals above 80 years had nine times the odds of using licit prescription drugs (OR 9.09 (95% CI 8.33-10.00)) despite adjustment for multi-morbidity. Patients in the highest education and income level had the lowest DDDs (IRR 0.78 (95% CI 0.76-0.80), IRR 0.73 (95% CI 0.71-0.74)) after adjustment for multi-morbidity level. Conclusions This paper shows that there is a great variability in licit prescription drug use associated with gender, age and socioeconomic status

Socioeconomic Factors and Vulnerability to Outbreaks of Leptospirosis in Nicaragua

PubMed Central

Bacallao, Jorge; Schneider, Maria Cristina; Najera, Patricia; Aldighieri, Sylvain; Soto, Aida; Marquiño, Wilmer; Sáenz, Carlos; Jiménez, Eduardo; Moreno, Gilberto; Chávez, Octavio; Galan, Deise I.; Espinal, Marcos A.

2014-01-01

Leptospirosis is an epidemic-prone zoonotic disease that occurs worldwide, with more than 500,000 human cases reported annually. It is influenced by environmental and socioeconomic factors that affect the occurrence of outbreaks and the incidence of the disease. Critical areas and potential drivers for leptospirosis outbreaks have been identified in Nicaragua, where several conditions converge and create an appropriate scenario for the development of leptospirosis. The objectives of this study were to explore possible socioeconomic variables related to leptospirosis critical areas and to construct and validate a vulnerability index based on municipal socioeconomic indicators. Municipalities with lower socioeconomic status (greater unsatisfied basic needs for quality of the household and for sanitary services, and higher extreme poverty and illiteracy rates) were identified with the highest leptospirosis rates. The municipalities with highest local vulnerability index should be the priority for intervention. A distinction between risk given by environmental factors and vulnerability to risk given by socioeconomic conditions was shown as important, which also applies to the “causes of outbreaks” and “causes of cases”. PMID:25153463

A systematic review of the effectiveness of individual, community and societal-level interventions at reducing socio-economic inequalities in obesity among adults

PubMed Central

Hillier-Brown, F C; Bambra, C L; Cairns, J-M; Kasim, A; Moore, H J; Summerbell, C D

2014-01-01

Background: Socioeconomic inequalities in obesity are well established in high-income countries. There is a lack of evidence of the types of intervention that are effective in reducing these inequalities among adults. Objectives: To systematically review studies of the effectiveness of individual, community and societal interventions in reducing socio-economic inequalities in obesity among adults. Methods: Nine electronic databases were searched from start date to October 2012 along with website and grey literature searches. The review examined the best available international evidence (both experimental and observational) of interventions at an individual, community and societal level that might reduce inequalities in obesity among adults (aged 18 years or over) in any setting and country. Studies were included if they reported a body fatness-related outcome and if they included a measure of socio-economic status. Data extraction and quality appraisal were conducted using established mechanisms and narrative synthesis was conducted. Results: The ‘best available' international evidence was provided by 20 studies. At the individual level, there was evidence of the effectiveness of primary care delivered tailored weight loss programmes among deprived groups. Community based behavioural weight loss interventions and community diet clubs (including workplace ones) also had some evidence of effectiveness—at least in the short term. Societal level evaluations were few, low quality and inconclusive. Further, there was little evidence of long term effectiveness, and few studies of men or outside the USA. However, there was no evidence to suggest that interventions increase inequalities. Conclusions: The best available international evidence suggests that some individual and community-based interventions may be effective in reducing socio-economic inequalities in obesity among adults in the short term. Further research is required particularly of more complex, multi

The role of hardship in the association between socio-economic position and depression.

PubMed

Butterworth, Peter; Olesen, Sarah C; Leach, Liana S

2012-04-01

It is well established that socio-economic position is associated with depression. The experience of financial hardship, having to go without the essentials of daily living due to limited financial resources, may explain the effect. However, there are few studies examining the link between financial hardship and diagnosable depression at a population level. The current paper addresses this gap and also evaluates the moderating effect of age. Data were from 8841 participants aged 16-85 years in Australia's 2007 National Survey of Mental Health and Wellbeing. The 12-month prevalence of depressive episode was assessed using the Composite International Diagnostic Interview. Measures of socio-economic position included: financial hardship, education, labour-force status, occupational skill, household income, main source of income, and area-level disadvantage. Financial hardship was more strongly associated with depression than other socio-economic variables. Hardship was more strongly associated with current depression than with prior history of depression. The relative effect of hardship was strongest in late adulthood but the absolute effect of hardship was greatest in middle age. The results demonstrate the critical role of financial hardship in the association between socio-economic disadvantage and 12-month depressive episode, and suggest that social and economic policies that address inequalities in living standards may be an appropriate way to reduce the burden attributable to depression.

Density and type of food retailers surrounding Canadian schools: variations across socioeconomic status.

PubMed

Seliske, Laura M; Pickett, William; Boyce, William F; Janssen, Ian

2009-09-01

Lower socioeconomic status (SES) neighbourhoods may have differential access to food retailers, potentially explaining the varying area-level obesity rates. The food retail environment around 188 schools across Canada was examined, including full-service restaurants, fast food restaurants, sub/sandwich retailers, donut/coffee shops, convenience stores, and grocery stores. School addresses were linked to census data to obtain area-level SES measures. Access to food retailers was generally not associated with the neighbourhood SES in the immediate proximity. Within the broader neighbourhood, lower SES neighbourhoods had access to fewer food retailers of all types. This effect was diminished after taking population density into account.

Socioeconomic factors and the risk for sarcoma.

PubMed

Hampras, Shalaka S; Moysich, Kirsten B; Marimuthu, Sathiya P; Ravi, Vinod; Jayaprakash, Vijayvel

2014-11-01

Sarcomas are a heterogeneous group of rare malignancies arising from mesenchymal tissue. Although several occupational exposures have been evaluated in association with sarcoma, little is known about the role of socioeconomic indicators such as education. Socioeconomic status has been found to be associated with risk of development of several types of cancers, primarily lung, gastric, and cervical cancers. We conducted a hospital-based case-control study to evaluate the association of socioeconomic level with the risk for sarcoma. A total of 371 incident cases of sarcoma were matched in terms of age, sex, and year of enrollment in the study with 742 cancer-free controls. Education and income levels were evaluated as the indicators of socioeconomic status. Higher education (college level) was associated with a significantly lower risk for sarcoma [odds ratio (OR)=0.48, 95% confidence interval (CI)=0.29-0.80], even after adjusting for important confounders. After stratifying by sex, significantly lower risk for sarcoma was observed among men who had college level education compared with men with a level of education of eighth grade or lower (OR=0.38, 95% CI=0.19-0.74). A significant association between education and the risk for sarcoma remained after stratifying by income (OR=0.49, 95% CI=0.28-0.86, among the low income group). When analyzed as a composite exposure, individuals with high education and high income status had significantly lower risk for sarcoma compared with those with low income and low education status (OR=0.41, 95% CI=0.23-0.71). Thus, socioeconomic factors may play a significant role in determining the risk for sarcoma and should be explored further to elucidate the underlying factors that may explain these sociodemographic inequalities related to sarcoma.

Quantifying neighbourhood socioeconomic effects in clustering of behaviour-related risk factors: a multilevel analysis.

PubMed

Halonen, Jaana I; Kivimäki, Mika; Pentti, Jaana; Kawachi, Ichiro; Virtanen, Marianna; Martikainen, Pekka; Subramanian, S V; Vahtera, Jussi

2012-01-01

The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates. The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity), and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression. After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI): 1.03-1.24) and 1.75 (95% CI, 1.54-1.98). Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors. Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.

Spatialization of Brazilian pig production: relationship between productive, physical, environmental, and socio-economic variables.

PubMed

da Silva, Isabel C M; Bremm, Bárbara; Teixeira, Jennifer L; Costa, Nathalia S; Barcellos, Júlio O J; Braccini, José; Cesconeto, Robson J; McManus, Concepta

2017-06-01

Brazilian pig production spans over a large territory encompassing regions of different climatic and socio-economic realities. Production, physical, socio-economic, and environmental data were used to characterize pig production in the country. Multivariate analysis evaluated indices including number productivity, production levels, and income from pigs, together with the average area of pig farm and socio-economic variables such as municipal human development index, technical guidance received from agricultural cooperatives and industrial companies, number of family farms, and offtake; and finally, environmental variables: latitude, longitude, annual temperature range, solar radiation index, as well as temperature and humidity index. The Southern region has the largest herd, number of pigs sold/sow, and offtake rate (p < 0.05), followed by the Midwest and Southeast. No significant correlations were seen between production rates and productivity with the socio-economic and environmental variables in the regions of Brazil. Production indexes, productivity, and offtake rate discriminated Northeast and Midwest and Northeast and Southeast regions. The Northern region, with a large area, has few and far-between farms that rear pigs for subsistence. The Northeast region has large herds, but low productivity. Number of slaughtered pigs has been variable over the past three decades, with few states responsible for maintaining high production in Brazil. However, the activity can be effective in any region of the country with technology and technical assistance adapted to regional characteristics.

School Socioeconomic Composition and Adolescent Sexual Initiation in Malawi.

PubMed

Kim, Jinho

2015-09-01

Numerous studies have documented the determinants of sexual behavior among adolescents in less-developed countries, yet relatively little is known about the influence of social contexts such as school and neighborhood. Using two waves of data from a school-based longitudinal survey conducted in Malawi from 2011-13, this study advances our understanding of the relationship between school-level socioeconomic contexts and adolescents' sexual activity. The results from two-level multinomial logistic regression models suggest that high socioeconomic composition of the student body in school decreases the odds of initiation of sexual activity, independent of other important features of schools and individual-level characteristics. This study also finds that the association between school socioeconomic composition and sexual activity is statistically significant among male adolescents but not female adolescents, suggesting that schools' socioeconomic contexts may be more relevant to male adolescents' initiation of sexual activity. © 2015 The Population Council, Inc.

School socioeconomic composition and adolescent sexual initiation in Malawi

PubMed Central

Kim, Jinho

2015-01-01

While numerous studies have documented the determinants of sexual behavior among adolescents in less developed countries, relatively little is known about the influence of social contexts such as school and neighborhood. Using two waves of data from a school-based longitudinal survey conducted in Malawi from 2011 to 2013, this study advances our understanding of the relationship between school-level socioeconomic contexts and adolescents’ sexual activity. The results from two-level multinomial logistic regression models suggest that high socioeconomic composition of the student body in school decreases the odds of initiating sexual activity, independently of other important features of schools as well as individual-level characteristics. This study also finds that the association between school socioeconomic composition and sexual activity is statistically significant only among males, but not females, suggesting that school’s socioeconomic contexts may be more relevant to male adolescents’ initiation of sexual activity. PMID:26347090

Socioeconomic factors relating to diabetes and its management in India.

PubMed

Shrivastava, Usha; Misra, Anoop; Gupta, Rajeev; Viswanathan, Vijay

2016-01-01

Diabetes is an escalating problem in India and has major socioeconomic dimensions. Rapid dietary changes coupled with decreased levels of physical activity have resulted in increases in obesity and diabetes in rural and semi-urban areas, as well as in urban-based people living in resettlement colonies. Increasing risk has also been recorded in those who suffered from poor childhood nutrition and in rural-to-urban migrants. Social inequity manifests in disparities in socioeconomic status (SES), place of residence, education, gender, and level of awareness and affects prevention, care, and management. All these population subsets have major socioeconomic challenges: low levels of awareness regarding diabetes and prevention, inadequate resources, insufficient allotment of healthcare budgets, and lack of medical reimbursement. Unawareness and delays in seeking medical help lead to complications, resulting in many-fold increased costs in diabetes care. These costs plunge individuals and households into a vicious cycle of further economic hardship, inadequate management, and premature mortality, resulting in more economic losses. At the societal level, these are massive losses to national productivity and the exchequer. Overall, there is an immediate need to strengthen the healthcare delivery system to generate awareness and for the prevention, early detection, cost-effective management, and rehabilitation of patients with diabetes, with a focus on people belonging to the lower SES and women (with a particular focus on nutrition before and during pregnancy). Because of an enhanced awareness campaign spearheaded through the National Program on Prevention of Cardiovascular Disease, Cancer, Diabetes and Stroke (NCPCDS) initiated by Government of India, it is likely that the level of awareness and early detection of diabetes may increase. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Neighbourhoods matter too: the association between neighbourhood socioeconomic position, population density and breast, prostate and lung cancer incidence in Denmark between 2004 and 2008.

PubMed

Meijer, Mathias; Bloomfield, Kim; Engholm, Gerda

2013-01-01

Previous studies have shown that cancer incidence is related to a number of individual factors, including socioeconomic status. The aim of this study was to refine the current knowledge about indicators associated with cancer incidence by evaluating the influence of neighbourhood characteristics on breast, prostate and lung cancer incidence in Denmark. All women aged 30-83 years were followed for breast cancer between 2004 and 2008, men between 50 and 83 years were followed for prostate cancer and both sexes between ages 50 and 83 were followed for lung cancer. Registry data obtained from Statistics Denmark included age, sex, availability of breast cancer screening, marital status, education, disposable income and occupational socioeconomic status on the individual level and population density and neighbourhood socioeconomic status (the proportion of unemployed) on the parish level. Frailty modelling with individuals on the first level and parishes on the second level was conducted. A significantly lower HR of breast cancer was found in areas with low population density (HR=0.93; CI 0.88 to 0.99), while neighbourhood unemployment had no effect. Inhabitants of lower unemployment areas had a higher risk of prostate cancer (HR=1.14; CI 1.08 to 1.21) compared with those in higher unemployment areas, whereas population density had no effect. Risk of lung cancer was lower in areas with lowest population density (HR=0.80; CI 0.74 to 0.85) and lowest in areas with lowest unemployment (HR=0.88; CI 0.84 to 0.92). In addition to individual-level factors, characteristics on the neighbourhood level also have an influence on breast, prostate and lung cancer incidence.

A Multilevel Analysis of Neighborhood Socioeconomic Disadvantage and Transactional Sex with Casual Partners Among Young Men Who Have Sex with Men Living in Metro Detroit.

PubMed

Bauermeister, José; Eaton, Lisa; Stephenson, Rob

2016-01-01

The role of structural factors when evaluating the vulnerability of human immunodeficiency virus/sexually transmitted infection (HIV/STI) risks among young gay, bisexual, and other men who have sex with men is an important area of focus for HIV prevention. Using cross-sectional data from young men living in Metro Detroit (N = 319; aged 18-29 years; 50% black, 25% white, 15% Latino, 9% other race/ethnicity; 9% HIV-positive), we examined whether transactional sex with casual partners was associated with neighborhood-level socioeconomic disadvantage and individual-level factors (race/ethnicity and sexual identity, socioeconomic status, HIV/STI diagnoses, and substance use). Youth living in greater socioeconomic disadvantage reported more transactional sex (b = 0.11; SE = 0.04; p ≤ 0.01). This relationship was mitigated once individual-level correlates were entered into the model. Multilevel efforts to counteract socioeconomic deficits through community and individual level strategies may alleviate youth's exposure to transactional sex and reduce their vulnerability to HIV/STI risks.

Effects of individual-level socioeconomic factors on racial disparities in cancer treatment and survival: findings from the National Longitudinal Mortality Study, 1979-2003.

PubMed

Du, Xianglin L; Lin, Charles C; Johnson, Norman J; Altekruse, Sean

2011-07-15

This is the first study to use the linked National Longitudinal Mortality Study and Surveillance, Epidemiology, and End Results (SEER) data to determine the effects of individual-level socioeconomic factors (health insurance, education, income, and poverty status) on racial disparities in receiving treatment and in survival. This study included 13,234 cases diagnosed with the 8 most common types of cancer (female breast, colorectal, prostate, lung and bronchus, uterine cervix, ovarian, melanoma, and urinary bladder) at age ≥ 25 years, identified from the National Longitudinal Mortality Study-SEER data during 1973 to 2003. Kaplan-Meier methods and Cox regression models were used for survival analysis. Three-year all-cause observed survival for cases diagnosed with local-stage cancers of the 8 leading tumors combined was ≥ 82% regardless of race/ethnicity. More favorable survival was associated with higher socioeconomic status. Compared with whites, blacks were less likely to receive first-course cancer-directed surgery, perhaps reflecting a less favorable stage distribution at diagnosis. Hazard ratio (HR) for cancer-specific mortality was significantly higher among blacks compared with whites (HR, 1.2; 95% confidence interval [CI], 1.1-1.3) after adjusting for age, sex, and tumor stage, but not after further controlling for socioeconomic factors and treatment (HR, 1.0; 95% CI, 0.9-1.1). HRs for all-cause mortality among patients with breast cancer and for cancer-specific mortality in patients with prostate cancer were significantly higher for blacks compared with whites after adjusting for socioeconomic factors, treatment, and patient and tumor characteristics. Favorable survival was associated with higher socioeconomic status. Racial disparities in survival persisted after adjusting for individual-level socioeconomic factors and treatment for patients with breast and prostate cancer. Copyright © 2011 American Cancer Society.

Trends in Breast Cancer Stage and Mortality in Michigan (1992–2009) by Race, Socioeconomic Status, and Area Healthcare Resources

PubMed Central

Akinyemiju, Tomi F.; Soliman, Amr S.; Copeland, Glenn; Banerjee, Mousumi; Schwartz, Kendra; Merajver, Sofia D.

2013-01-01

The long-term effect of socioeconomic status (SES) and healthcare resources availability (HCA) on breast cancer stage of presentation and mortality rates among patients in Michigan is unclear. Using data from the Michigan Department of Community Health (MDCH) between 1992 and 2009, we calculated annual proportions of late-stage diagnosis and age-adjusted breast cancer mortality rates by race and zip code in Michigan. SES and HCA were defined at the zip-code level. Joinpoint regression was used to compare the Average Annual Percent Change (AAPC) in the median zip-code level percent late stage diagnosis and mortality rate for blacks and whites and for each level of SES and HCA. Between 1992 and 2009, the proportion of late stage diagnosis increased among white women [AAPC = 1.0 (0.4, 1.6)], but was statistically unchanged among black women [AAPC = −0.5 (−1.9, 0.8)]. The breast cancer mortality rate declined among whites [AAPC = −1.3% (−1.8,−0.8)], but remained statistically unchanged among blacks [AAPC = −0.3% (−0.3, 1.0)]. In all SES and HCA area types, disparities in percent late stage between blacks and whites appeared to narrow over time, while the differences in breast cancer mortality rates between blacks and whites appeared to increase over time. PMID:23637921

Increase in best practice child car restraint use for children aged 2-5 years in low socioeconomic areas after introduction of mandatory child restraint laws.

PubMed

Brown, Julie; Keay, Lisa; Hunter, Kate; Bilston, Lynne E; Simpson, Judy M; Ivers, Rebecca

2013-06-01

To examine changes in child car restraint practices in low socioeconomic areas following the introduction of mandatory child car restraint legislation in New South Wales (NSW), Australia. Data from two cross-sectional studies of child car restraint use at pre-schools, early childhood centres and primary schools before and after the introduction of legislating mandatory age-appropriate car restraint use for children up to the age of seven years was used in this analysis. All included observations were from local government areas with socioeconomic status in the lowest 30% of urban Sydney. Children aged 2-5 years were observed in their vehicles as they arrived at observation sites (107 pre-legislation, 360 post-legislation). Multilevel logistic regression was used to examine changes in observed age-appropriate and correct use of car restraints. Age-appropriate car restraint use was higher post-legislation than pre-legislation. After controlling for child's age, parental income, language spoken at home and adjusting for clustering, the odds of children being appropriately restrained post-legislation were 2.3 times higher than in the pre-legislation sample, and the odds of them being correctly restrained were 1.6 times greater. Results indicate an improvement in car restraint practices among children aged 2-5 in low socioeconomic areas after introduction of child restraint laws. Implications : Despite improvements observed with enhanced legislation, further efforts are required to increase optimal child car restraint use. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Where Are Socioeconomically Deprived Immigrants Located in Chile? A Spatial Analysis of Census Data Using an Index of Multiple Deprivation from the Last Three Decades (1992-2012)

PubMed Central

2016-01-01

Introduction and Purpose of the Study Immigrants in Chile have diverse characteristics and include socioeconomically deprived populations. The location of socioeconomically deprived immigrants is important for the development of public policy intelligence at the local and national levels but their areas of residence have not been mapped in Chile. This study explored the spatial distribution of socioeconomic deprivation among immigrants in Chile, 1992–2012, and compared it to the total population. Material and Methods Areas with socioeconomically deprived populations were identified with a deprivation index which we developed modelled upon the Index of Multiple Deprivation (IMD) for England. Our IMD was based upon the indicators of unemployment, low educational level (primary) and disability from Census data at county level for the three decades 1992, 2002 and 2012, for 332, 339 and 343 counties respectively. We developed two versions of the IMD one based on disadvantage among the total population and another focused upon the circumstances of immigrants only. We generated a spatial representation of the IMD using GIS, for the overall IMD score and for each dimension of the index, separately. We also compared the immigrants´ IMD to the total population´s IMD using Pearson´s correlation test. Results Results showed that socioeconomically deprived immigrants tended to be concentrated in counties in the northern and central area of Chile, in particular within the Metropolitan Region of Santiago. These were the same counties where there was the greatest concentration of socioeconomic deprivation for the total population during the same time periods. Since 1992 there have been significant change in the location of the socioeconomically deprived populations within the Metropolitan Region of Santiago with the highest IMD scores for both the total population and immigrants becoming increasingly concentrated in the central and eastern counties of the Region. Conclusion

Associations between national viral hepatitis policies/programmes and country-level socioeconomic factors: a sub-analysis of data from the 2013 WHO viral hepatitis policy report.

PubMed

Lazarus, Jeffrey V; Sperle, Ida; Safreed-Harmon, Kelly; Gore, Charles; Cebolla, Beatriz; Spina, Alexander

2017-07-26

As more countries worldwide develop national viral hepatitis strategies, it is important to ask whether context-specific factors affect their decision-making. This study aimed to determine whether country-level socioeconomic factors are associated with viral hepatitis programmes and policy responses across WHO Member States (MS). WHO MS focal points completed a questionnaire on national viral hepatitis policies. This secondary analysis of data reported in the 2013 Global Policy Report on the Prevention and Control of Viral Hepatitis in WHO Member States used logistic regression to examine associations between four survey questions and four socioeconomic factors: country income level, Human Development Index (HDI), health expenditure and physician density. This analysis included 119 MS. MS were more likely to have routine viral hepatitis surveillance and to have a national strategy and/or policy/guidelines for preventing infection in healthcare settings if they were in the higher binary categories for income level, HDI, health expenditure and physician density. In multivariable analyses, the only significant finding was a positive association between having routine surveillance and being in the higher binary HDI category (adjusted odds ratio 26; 95% confidence interval 2.0-340). Countries with differing socioeconomic status indicators did not appear to differ greatly regarding the existence of key national policies and programmes. A more nuanced understanding of the multifaceted interactions of socioeconomic factors, health policy, service delivery and health outcomes is needed to support country-level efforts to eliminate viral hepatitis.

How structurally stable are global socioeconomic systems?

PubMed Central

Saavedra, Serguei; Rohr, Rudolf P.; Gilarranz, Luis J.; Bascompte, Jordi

2014-01-01

The stability analysis of socioeconomic systems has been centred on answering whether small perturbations when a system is in a given quantitative state will push the system permanently to a different quantitative state. However, typically the quantitative state of socioeconomic systems is subject to constant change. Therefore, a key stability question that has been under-investigated is how strongly the conditions of a system itself can change before the system moves to a qualitatively different behaviour, i.e. how structurally stable the systems is. Here, we introduce a framework to investigate the structural stability of socioeconomic systems formed by a network of interactions among agents competing for resources. We measure the structural stability of the system as the range of conditions in the distribution and availability of resources compatible with the qualitative behaviour in which all the constituent agents can be self-sustained across time. To illustrate our framework, we study an empirical representation of the global socioeconomic system formed by countries sharing and competing for multinational companies used as proxy for resources. We demonstrate that the structural stability of the system is inversely associated with the level of competition and the level of heterogeneity in the distribution of resources. Importantly, we show that the qualitative behaviour of the observed global socioeconomic system is highly sensitive to changes in the distribution of resources. We believe that this work provides a methodological basis to develop sustainable strategies for socioeconomic systems subject to constantly changing conditions. PMID:25165600

Risk of several cancers is higher in urban areas after adjusting for socioeconomic status. Results from a two-country population-based study of 18 common cancers.

PubMed

Sharp, Linda; Donnelly, David; Hegarty, Avril; Carsin, Anne-Elie; Deady, Sandra; McCluskey, Neil; Gavin, Anna; Comber, Harry

2014-06-01

Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural <1 person per hectare, intermediate 1-15 people per hectare, urban >15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation.

The socioeconomic gradient and chronic illness and associated risk factors in Australia

PubMed Central

Glover, John D; Hetzel, Diana MS; Tennant, Sarah K

2004-01-01

Objective To examine the prevalence of major chronic diseases and their risk factors in different socioeconomic groups in the Australian population, in order to highlight the need for public policy initiatives to reduce socioeconomic inequalities in health. Methods Data were provided by the Australian Bureau of Statistics (ABS) from the 2001 National Health Survey (NHS) for selected chronic diseases and associated risk factors. Conditions selected were those, which form the National Health Priority Area (NHPA) conditions (other than injury, which has not been included in this paper, with its focus on chronic disease); plus other 'serious' chronic conditions, in line with the classification developed by Mathers; and for which sufficient cases were available for analysis by socioeconomic status. Indirectly age-standardised prevalence rates were calculated by broad age group for Australia and for five groups of socioeconomic status; rate ratios were calculated to show variations in prevalence between these groups. Results Significant socioeconomic inequalities were evident for many of the major chronic diseases; the largest was for diabetes mellitus (at ages 25 to 64 years); and for many diseases, there was also a strong, continuous socioeconomic gradient in the rates. Circulatory system diseases (in particular, hypertensive disease) and digestive system diseases also exhibited a strong differential in the 25 to 64 year age group. In the 65 years and over age group, the strongest inequalities were evident for mental and behavioural problems, diabetes (with a continuous socioeconomic gradient in rates) and respiratory system diseases. A number of risk factors for chronic diseases, namely self-reported smoking, alcohol misuse, physical inactivity and excess weight showed a striking association with socioeconomic status, in particular for people who were smokers and those who did not exercise. Conclusion This analysis shows that the prevalence of chronic disease varies

Road traffic crash circumstances and consequences among young unlicensed drivers: a Swedish cohort study on socioeconomic disparities.

PubMed

Hanna, Christina L; Hasselberg, Marie; Laflamme, Lucie; Möller, Jette

2010-01-14

Young car drivers run a higher risk of road traffic crash and injury not only because of their lack of experience but also because of their young age and their greater propensity for adopting unsafe driving practices. Also, low family socioeconomic position increases the risk of crash and of severe crash in particular. Whether this holds true for young unlicensed drivers as well is not known. Increasing attention is being drawn to the prevalence and practice of unlicensed driving among young people as an important contributor to road traffic fatalities. This is a population-based cohort study linking Swedish national register data for a cohort of 1 616 621 individuals born between 1977 and 1991. Crash circumstances for first-time road traffic crash (RTC) were compared considering licensed and unlicensed drivers. The socioeconomic distribution of injury was assessed considering household socioeconomic position, social welfare benefits, and level of urbanicity of the living area. The main outcome measure is relative risk of RTC. RTCs involving unlicensed drivers were over-represented among male drivers, suspected impaired drivers, severe injuries, crashes occurring in higher speed limit areas, and in fair road conditions. Unlicensed drivers from families in a lower socioeconomic position showed increased relative risks for RTC in the range of 1.75 to 3.25. Those living in rural areas had an increased relative risk for a severe RTC of 3.29 (95% CI 2.47 - 4.39) compared to those living in metropolitan areas. At the time of the crash, young unlicensed drivers display more risky driving practices than their licensed counterparts. Just as licensed drivers, unlicensed young people from low socioeconomic positions are over-represented in the most severe injury crashes. Whether the mechanisms lying behind those similarities compare between these groups remains to be determined.

[Comparative study of height and age at menarche according to the socioeconomic level in Venezuela].

PubMed

López Contreras, M; Tovar Escobar, G; Farid Coupal, N; Landaeta Jiménez, M; Méndez Castellano, H

1981-12-01

This is a retrospective study based on growth and development data published in Venezuela by various authors in the period 1936-1978. The data on height for males of the middle and high socioeconomic strata show growth curves which are very similar to the standards for British children. Likewise, the girls of the same socioeconomic condition follow the British standards, but only up to about 10-12 years of age. After that age, the girls studied by the Venezuelan authors, show a pattern of early maturation with a corresponding lower adult height compared with their British counterparts. There were differences in the growth curves according to the socioeconomic strata. These differences were more marked in the girls data. A secular increase for height was discerned, from the published data, in all socioeconomic strata and in both sexes. The data on sexual maturation showed a tendency for progressively early menarche in Venezuelan girls. These changes in growth in height and age of menarche were more notorious and came about at an earlier age in the upper socioeconomic strata. They were less marked, not constant, and came about later in the lower socioeconomic groups. The secular changes in height and sexual maturation apparent from these data, could be explained by an improvement in the environmental conditions, especially nutrition and hygiene of the population, and also be genetic heterosis from European immigration and with improvement in communications.

Effect of lifestyle, education and socioeconomic status on periodontal health

PubMed Central

Gundala, Rupasree; Chava, Vijay K.

2010-01-01

Background: The health model which forms the basis is knowledge, attitude, temporary, and permanent behaviors. Currently, more emphasis has been directed towards the combined influence of lifestyle, education, levels and socioeconomic factors, instead of regular risk factors in dealing with chronic illnesses. The present study is conducted to correlate the periodontal health of people with reference to lifestyle, education level, and socioeconomic status. Materials and Methods: A cross-sectional study was conducted in the Department of Periodontics, Narayana Dental College and Hospital, Nellore. A total of 1350 subjects were examined and 948 patients were randomly selected from out patient department. Information about their lifestyle, education level, and socioeconomic status were recorded using a questionnaire and correlated with the periodontal status. Results: The statistical analysis showed significant decrease in periodontitis when income and education levels increased. Also the prevalence of periodontitis associated with a healthy lifestyle is significantly lower when compared to an unhealthy lifestyle. Conclusions: There is a strong association of lifestyle, education level, and socioeconomic status with periodontal health. PMID:22114373

Racial and Socioeconomic Disparities in Nutrition Behaviors: Targeted Interventions Needed

ERIC Educational Resources Information Center

Fahlman, Mariane M.; McCaughtry, Nate; Martin, Jeffrey; Shen, Bo

2010-01-01

Objective: To compare dietary knowledge, behaviors and self-efficacy of black middle school students of low socioeconomic status with their white counterparts of higher socioeconomic status. Design: Cross-sectional, school-based survey. Setting: Large metropolitan area in the United States. Participants: Middle school students (1,208 of low…

Associations between disability prevalence and local-area characteristics in a general community-living population.

PubMed

Philibert, M D; Pampalon, R; Hamel, D; Daniel, M

2013-10-01

Disability is understood to arise from person-environment interactions. Hence, heterogeneity in local-area characteristics should be associated with local-area variation in disability prevalence. This study evaluated the associations of disability prevalence with local-area socioeconomic status and contextual features. Disability prevalence was obtained from the Canada census of 2001 for the entire province of Québec at the level of dissemination areas (617 individuals on average) based on responses from 20% of the population. Data on local-area characteristics were urban-rural denomination, social and material deprivation, active and collective commuting, residential stability, and housing quality. Associations between local-area characteristics and disability prevalence were assessed using multilevel logistic regressions. Disability was associated with local-area socioeconomic status and contextual characteristics, and heterogeneity in these factors accounted for urban-rural differences in disability prevalence. Associations between contextual features and disability prevalence were confounded by local-area socioeconomic status. Some associations between local-area socioeconomic status and disability prevalence were moderated by contextual characteristics. The importance of this effect modification is greater when expressed in terms of the absolute magnitude of disability than in the relative likelihood of disability. Explanation of rural-urban differences by the contribution of other local-area characteristics is consistent with the conceptualization of urban-rural categories as the reflection of spatially varying ensembles of compositional and contextual factors. Although local-area socioeconomic status explains most variability in disability prevalence, this study shows that contextual characteristics are relevant to analyses of the spatial patterning of disability as they predict spatial variations of disability, sometimes in interaction with socioeconomic

Engagement: an indicator of difference in the perceptions of antenatal care for pregnant women from diverse socioeconomic backgrounds

PubMed Central

Docherty, Angie; Bugge, Carol; Watterson, Andrew

2011-01-01

Abstract Background  Socioeconomically deprived women are at greater risk of adverse pregnancy outcomes. Research tends to focus on access of services. Yet access may not equate with the equity of services for women from different socioeconomic backgrounds. Objectives  To determine whether pregnant women’s perceptions of antenatal provision differed in relation to their socioeconomic deprivation ranking (determined by the Scottish Index of Multiple Deprivation 2006). Design  A longitudinal, qualitative study with comparative antenatal case studies between January 2007 and April 2009. Setting/Participants  Cases were primigravida women from ‘least deprived’ (n = 9) and ‘most deprived’ (n = 12) geographical areas within one local authority in Scotland. Analysis  Data were analysed using case study replication analysis. Results  There was little difference in access to antenatal services between the ‘least’ and ‘most’ deprived groups. Perception of care differed in relation to the level of ‘engagement’ (defined using constructs of: language and personalization of care; power and relationships; and health literacy). Engagement was evidenced in most of the ‘least deprived’ cases and almost none of the ‘most deprived’ cases. Specifically, socioeconomically deprived women described less evidence of personal connection to their own care, effective communication and the opportunity for shared decision making. Conclusion  In women from socioeconomically deprived areas, access may be a less useful indicator than engagement when assessing antenatal service quality. As engagement levels may be one method by which to predict and improve health outcomes, a more equitable antenatal service may need to be developed through the early identification of those women at risk of non‐engagement. PMID:21615639

Does the level of wealth inequality within an area influence the prevalence of depression amongst older people?

PubMed Central

Marshall, Alan; Jivraj, Stephen; Nazroo, James; Tampubolon, Gindo; Vanhoutte, Bram

2016-01-01

This paper considers whether the extent of inequality in house prices within neighbourhoods of England is associated with depressive symptoms in the older population using the English Longitudinal Study of Ageing. We consider two competing hypotheses: first, the wealth inequality hypothesis which proposes that neighbourhood inequality is harmful to health and, second, the mixed neighbourhood hypothesis which suggests that socially mixed neighbourhoods are beneficial for health outcomes. Our results are supportive of the mixed neighbourhood hypothesis, we find a significant association between neighbourhood inequality and depression with lower levels of depression amongst older people in neighbourhoods with greater house price inequality after controlling for individual socio-economic and area correlates of depression. The association between area inequality and depression is strongest for the poorest individuals, but also holds among the most affluent. Our results are in line with research that suggests there are social and health benefits associated with economically mixed communities. PMID:24662528

Identifying areas at risk of low birth weight using spatial epidemiology: A small area surveillance study.

PubMed

Insaf, Tabassum Z; Talbot, Thomas

2016-07-01

To assess the geographic distribution of Low Birth Weight (LBW) in New York State among singleton births using a spatial regression approach in order to identify priority areas for public health actions. LBW was defined as birth weight less than 2500g. Geocoded data from 562,586 birth certificates in New York State (years 2008-2012) were merged with 2010 census data at the tract level. To provide stable estimates and maintain confidentiality, data were aggregated to yield 1268 areas of analysis. LBW prevalence among singleton births was related with area-level behavioral, socioeconomic and demographic characteristics using a Poisson mixed effects spatial error regression model. Observed low birth weight showed statistically significant auto-correlation in our study area (Moran's I 0.16 p value 0.0005). After over-dispersion correction and accounting for fixed effects for selected social determinants, spatial autocorrelation was fully accounted for (Moran's I-0.007 p value 0.241). The proportion of LBW was higher in areas with larger Hispanic or Black populations and high smoking prevalence. Smoothed maps with predicted prevalence were developed to identify areas at high risk of LBW. Spatial patterns of residual variation were analyzed to identify unique risk factors. Neighborhood racial composition contributes to disparities in LBW prevalence beyond differences in behavioral and socioeconomic factors. Small-area analyses of LBW can identify areas for targeted interventions and display unique local patterns that should be accounted for in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Explaining differences in education-related inequalities in health between urban and rural areas in Mongolia.

PubMed

Dorjdagva, Javkhlanbayar; Batbaatar, Enkhjargal; Dorjsuren, Bayarsaikhan; Kauhanen, Jussi

2015-12-22

After the socioeconomic transition in 1990, Mongolia has been experiencing demographic and epidemiologic transitions; however, there is lack of evidence on socioeconomic-related inequality in health across the country. The aim of this paper is to evaluate the education-related inequalities in adult population health in urban and rural areas of Mongolia in 2007/2008. This paper used a nationwide cross-sectional data, the Household Socio-Economic Survey 2007/2008, collected by the National Statistical Office. We employed the Erreygers' concentration index to assess the degree of education-related inequality in adult health in urban and rural areas. Our results suggest that a lower education level was associated with poor self-reported health. The concentration indices of physical limitation and chronic disease were significantly less than zero in both areas. On the other hand, ill-health was concentrated among the less educated groups. The decomposition results show education, economic activity status and income were the main contributors to education-related inequalities in physical limitation and chronic disease removing age-sex related contributions. Improving accessibility and quality of education, especially for the lower socioeconomic groups may reduce socioeconomic-related inequality in health in both rural and urban areas of Mongolia.

Impact of Neighborhood Socioeconomic Conditions on the Risk of Stroke in Japan

PubMed Central

Honjo, Kaori; Iso, Hiroyasu; Nakaya, Tomoki; Hanibuchi, Tomoya; Ikeda, Ai; Inoue, Manami; Sawada, Norie; Tsugane, Shoichiro

2015-01-01

Background Neighborhood deprivation has been shown in many studies to be an influential factor in cardiovascular disease risk. However, no previous studies have examined the effect of neighborhood socioeconomic conditions on the risk of stroke in Asian countries. Methods This study investigated whether neighborhood deprivation was associated with the risk of stroke and stroke death using data from the Japan Public Health Center-based Prospective Study. We calculated the adjusted hazard ratios of stroke mortality (mean follow-up, 16.4 years) and stroke incidence (mean follow-up, 15.4 years) according to the area deprivation index (ADI) among 90 843 Japanese men and women aged 40–69 years. A Cox proportional-hazard regression model using a shared frailty model was applied. Results The adjusted hazard ratios of stroke incidence, in order of increasing deprivation with reference to the least deprived area, were 1.16 (95% CI, 1.04–1.29), 1.12 (95% CI, 1.00–1.26), 1.18 (95% CI, 1.02–1.35), and 1.19 (95% CI, 1.01–1.41), after adjustment for individual socioeconomic conditions. Behavioral and psychosocial factors attenuated the association, but the association remained significant. The associations were explained by adjusting for biological cardiovascular risk factors. No significant association with stroke mortality was identified. Conclusions Our results indicate that the neighborhood deprivation level influences stroke incidence in Japan, suggesting that area socioeconomic conditions could be a potential target for public health intervention to reduce the risk of stroke. PMID:25757802

Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.

PubMed

McDoom, M Maya; Palta, Priya; Vart, Priya; Juraschek, Stephen P; Kucharska-Newton, Anna; Diez Roux, Ana V; Coresh, Josef

2018-06-01

To investigate the association between individual and area-level socioeconomic status and hypertension risk among individuals later in life. We used Cox proportional hazards models to examine the association of socioeconomic status with incident hypertension using race-specific neighborhood socioeconomic status, median household income, and education among 3372 participants (mean age, 61 years) from the Atherosclerosis Risk in Communities Study at Visit 4 (1996-1998). Incident hypertension was defined as self-reported diagnosis or reported use of antihypertensive medications. Over a median follow-up time of 9.4 years, there were 1874 new cases of hypertension (62.1 per 1000 person-years). Overall, being in high as compared with low socioeconomic status categories was associated with a lower risk of developing hypertension in late life, with hazard ratios (95% confidence intervals) of 0.87 (0.77-0.98) for high neighborhood socioeconomic status tertile, 0.79 (0.69-0.90) for high individual income, and 0.75 (0.63-0.89) for college education after adjustment for traditional risk factors. These findings were consistent and robust whenever accounting for competing risks of all-cause mortality. No significant interactions by race and age (dichotomized at age 65) were observed. Among participants free of hypertension in midlife, high neighborhood and individual socioeconomic status are associated with a decreased risk of incident hypertension. Our findings support population-level interventions, such as blood pressure screening at senior centers and faith-based organizations, that are tailored to shift the distribution of blood pressure and reduce hypertension health inequalities among older adults.

Child restraint use in low socio-economic areas of urban Sydney during transition to new legislation.

PubMed

Keay, Lisa; Hunter, Kate; Brown, Julie; Bilston, Lynne E; Simpson, Judy M; Stevenson, Mark; Ivers, Rebecca Q

2013-01-01

Child restraints protect a young child against injury in crashes but best practice child restraint use is low in Australia, particularly among lower socio-economic groups. We investigated factors associated with restraint use to inform the development of education and distribution programmes to support new Australian legislation on child passengers among families in low socio-economic areas of metropolitan Sydney. We interviewed a parent or carer of 1160 children aged 2-5 years enrolled at one of 28 early childhood centres in low socio-economic areas of urban Sydney. Appropriate child restraint use was defined as a forward facing child restraint (FFCR) for 2-3 year olds and a FFCR or booster seat for children aged 4 years or more. Predictors of self-reported appropriate use were explored using logistic regression. Analysis was conducted on one child from each family in the target age range (2-5 years): 586 (51%) were male and the mean age was 3.5 (Standard Deviation 0.8) years. There were 432 (45%) families with annual income below $60,000, 248 (22%) spoke a language other than English at home and 360 (33%) had 3 or more children. Fifty-four percent of carers indicated that their 2-3 year old children travelled in a FFCR. Inappropriate use among children in this age group was more likely when the carer was <36 years (odds ratio (OR) 1.62, 95% confidence interval (CI) 1.08-2.45), in families with ≥3 children (OR 1.64, 95% CI 1.10-2.44) and when the carer believed that a booster seat was just as safe as a FFCR (OR 2.98, 2.05-4.32). Eight-eight percent of carers of 4-5 year olds reported use of a booster seat or FFCR. Non-use was associated with low household income (OR 3.10, 95% CI 1.67-5.75), in families with ≥3 children (OR 2.03, 95% CI 1.09-3.76) and families where a language other than English is spoken at home (OR 2.39, 95% CI 1.10-5.21). Non-English speaking families had less awareness of the new law and poorer knowledge of safety benefits of child

Socioeconomic status in children is associated with hair cortisol levels as a biological measure of chronic stress.

PubMed

Vliegenthart, J; Noppe, G; van Rossum, E F C; Koper, J W; Raat, H; van den Akker, E L T

2016-03-01

Low socioeconomic status (SES) may be associated with a high risk of lifestyle-related diseases such as cardiovascular diseases. There is a strong association between parental SES, stress and indicators of child health and adult health outcome. The exact mechanisms underlying this association have not yet been fully clarified. Low SES may be associated with chronic stress, which may lead to activation of the hypothalamic-pituitary-adrenal (HPA)-axis, resulting in a higher circulating level of the stress hormone cortisol. Therefore, chronic stress may mediate the association between low SES and elevated cortisol levels and its adverse outcomes. We investigated whether SES was associated with a chronic measure of cortisol exposure in a child population. Cortisol and cortisone were measured in scalp hair in 270 children and adolescents, aged 4-18 years, enrolled through school visits. Neighborhood level SES was based on a score developed by the Netherlands Institute for Social Research using postal codes, and this includes neighborhood measures of income education and unemployment. Maternal and paternal education level were used as indicators of family SES. Neighborhood level socioeconomic status score was significantly associated with hair cortisol (β=-0.103, p=0.007, 95%CI [-0.179, -0.028]) and hair cortisone (β=-0.091, p=0.023, 95%CI [-0.167, -0.015]), adjusted for age and sex. Additionally, hair cortisol was significantly correlated with maternal education level and hair cortisone was significantly correlated with paternal education level. The results of our study suggest that the widely shown association between low family SES and adverse child health outcomes may be mediated by chronic stress, given the chronically higher levels of cortisol in children and adolescents in families with low SES. It is especially notable that the association between SES and cortisol was already found in children of young age as this can have major consequences, such as increased

Socioeconomic disparities in indoor air, breath, and blood perchloroethylene level among adult and child residents of buildings with or without a dry cleaner.

PubMed

Storm, Jan E; Mazor, Kimberly A; Shost, Stephen J; Serle, Janet; Aldous, Kenneth M; Blount, Benjamin C

2013-04-01

In many cities, dry cleaners using perchloroethylene are frequently located in multifamily residential buildings and often cause elevated indoor air levels of perchloroethylene throughout the building. To assess individual perchloroethylene exposures associated with co-located dry cleaners, we measured perchloroethylene in residential indoor air, and in blood and breath of adults and children residing in buildings with a dry cleaner as part of the New York City (NYC) Perc Project. We also measured perchloroethylene in indoor air, and in blood and breath of residents of buildings without a dry cleaner for comparison. Here, we evaluate whether an environmental disparity in perchloroethylene exposures is present. Study participants are stratified by residential building type (dry cleaner or reference) and socioeconomic characteristics (race/ethnicity and income); measures of perchloroethylene exposure are examined; and, the influence of stratified variables and other factors on perchloroethylene exposure is assessed using multivariate regression. All measures of perchloroethylene exposure for residents of buildings with a dry cleaner indicated a socioeconomic disparity. Mean indoor air perchloroethylene levels were about five times higher in minority (82.5 ug/m(3)) than in non-minority (16.5 ug/m(3)) households, and about six times higher in low-income (105.5 ug/m(3)) than in high income (17.8 ug/m(3)) households. Mean blood perchloroethylene levels in minority children (0.27 ng/mL) and adults (0.46 ng/mL) were about two and three times higher than in non-minority children (0.12 ng/mL) and adults (0.15 ng/mL), respectively. Mean blood perchloroethylene levels in low income children (0.34 ng/mL) and adults (0.62 ng/mL) were about three and four times higher than in high income children (0.11 ng/mL) and adults (0.14 ng/mL), respectively. A less marked socioeconomic disparity was observed in perchloroethylene breath levels with minority and low income residents having

Unevenly distributed: a systematic review of the health literature about socioeconomic inequalities in adult obesity in the United Kingdom

PubMed Central

2012-01-01

Background There is a growing literature documenting socioeconomic inequalities in obesity risk among adults in the UK, with poorer groups suffering higher risk. Methods In this systematic review, we summarize and appraise the extant peer-reviewed literature about socioeconomic inequalities in adult obesity risk in the UK published between 1980 and 2010. Only studies featuring empirical assessments of relations between socioeconomic indicators and measures of obesity among adults in the UK were included. Results A total of 35 articles met inclusion criteria, and were reviewed here. Conclusion Socioeconomic indicators of low socioeconomic position (SEP), including occupational social class of the head-of-household at birth and during childhood, earlier adulthood occupational social class, contemporaneous occupational social class, educational attainment, and area-level deprivation were generally inversely associated with adult obesity risk in the UK. Measures of SEP were more predictive of obesity among women than among men. We outline important methodological limitations to the literature and recommend avenues for future research. PMID:22230643

Seasonal variations of all-cause and cause-specific mortality by age, gender, and socioeconomic condition in urban and rural areas of Bangladesh.

PubMed

Burkart, Katrin; Khan, Mobarak H; Krämer, Alexander; Breitner, Susanne; Schneider, Alexandra; Endlicher, Wilfried R

2011-08-04

Mortality exhibits seasonal variations, which to a certain extent can be considered as mid-to long-term influences of meteorological conditions. In addition to atmospheric effects, the seasonal pattern of mortality is shaped by non-atmospheric determinants such as environmental conditions or socioeconomic status. Understanding the influence of season and other factors is essential when seeking to implement effective public health measures. The pressures of climate change make an understanding of the interdependencies between season, climate and health especially important. This study investigated daily death counts collected within the Sample Vital Registration System (VSRS) established by the Bangladesh Bureau of Statistics (BBS). The sample was stratified by location (urban vs. rural), gender and socioeconomic status. Furthermore, seasonality was analyzed for all-cause mortality, and several cause-specific mortalities. Daily deviation from average mortality was calculated and seasonal fluctuations were elaborated using non parametric spline smoothing. A seasonality index for each year of life was calculated in order to assess the age-dependency of seasonal effects. We found distinctive seasonal variations of mortality with generally higher levels during the cold season. To some extent, a rudimentary secondary summer maximum could be observed. The degree and shape of seasonality changed with the cause of death as well as with location, gender, and SES and was strongly age-dependent. Urban areas were seen to be facing an increased summer mortality peak, particularly in terms of cardiovascular mortality. Generally, children and the elderly faced stronger seasonal effects than youths and young adults. This study clearly demonstrated the complex and dynamic nature of seasonal impacts on mortality. The modifying effect of spatial and population characteristics were highlighted. While tropical regions have been, and still are, associated with a marked excess of

Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus.

PubMed

Andrade, Carlos Jefferson do Nascimento; Alves, Crésio de Aragão Dantas

2018-01-04

To evaluate the influence of socioeconomic and psychological factors on glycemic control in young children with type 1 diabetes mellitus. This was a cross-sectional study assessing prepubertal children with type 1 diabetes mellitus. The authors analyzed the socioeconomic status using the Brazil Economic Classification Criterion (Critério de Classificação Econômica Brasil [CCEB]) and psychological conditions through the Brazilian version of the Problem Areas in Diabetes, associated with glycemic control, measured by glycated hemoglobin (HbA1c). Descriptive analysis was used. The variables were assessed by bivariate and multivariate robust Poisson regression model, as well as Fisher's exact and Pearson's chi-squared tests to obtain the ratios of gross and adjusted prevalence ratio, with confidence interval being estimated at 95%. A total of 68 children with type 1 diabetes mellitus were included in the study. A negative association between glycemic control (glycated hemoglobin levels), socioeconomic status (Brazil Economic Classification Criterion), and psychological condition (Brazilian version of the Problem Areas in Diabetes) was observed. Among the study participants, 73.5% (n=50) of the children had an unfavorable socioeconomic status; these participants were 1.4 times more likely to present altered glycated hemoglobin values. In relation to individuals with compromised psychological status, 26 (38.2%) had a score above 70, thus being classified with psychological stress; these children were 1.68 times more likely (95% confidence interval: 1.101, 1.301) to have higher glycated hemoglobin levels. The socioeconomic conditions and psychological characteristics of the study participants were negatively associated with glycated hemoglobin results. These data reinforce the importance of the studied variables as predictors of glycemic control. Copyright © 2017. Published by Elsevier Editora Ltda.

Prevalence of antibiotic prescription in southern Italian outpatients: real-world data analysis of socioeconomic and sociodemographic variables at a municipality level.

PubMed

Russo, Veronica; Monetti, Valeria Marina; Guerriero, Francesca; Trama, Ugo; Guida, Antonella; Menditto, Enrica; Orlando, Valentina

2018-01-01

The aim of this study was to analyze the geographic variation in systemic antibiotic prescription at a regional level and to explore the influence of socioeconomic and sociodemographic variables. This study was a retrospective analysis of reimbursement pharmacy records in the outpatient settings of Italy's Campania Region in 2016. Standardized antibiotic prescription rates were calculated at municipality and Local Health Unit (LHU) level. Antibiotic consumption was analyzed as defined daily doses (DDD)/1000 inhabitants per day (DID). Logistic regression was performed to evaluate the association between antibiotic prescription and sociodemographic and socioeconomic determinants at a municipality level. The average antibiotic prevalence rate was 46.8%. At LHU level, the age-adjusted prevalence rates ranged from 41.1% in Benevento to 51.0% in Naples2. Significant differences were found among municipalities, from 15.2% in Omignano (Salerno LHU [Sa-LHU]) to 61.9% in Moschiano (Avellino [Av-LHU]). The geographic distribution also showed significant differences in terms of antibiotic consumption, from 6.7 DID in Omignano to 41.6 in San Marcelino (Caserta [Ce-LHU]). Logistic regression showed that both municipality type and average annual income level were the main determinants of antibiotic prescription. Urban municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to rural municipalities (adjusted odds ratio [OR]: 8.62; 95% confidence interval [CI]: 4.06-18.30, P <0.001). Low average annual income level municipalities were more than eight times as likely to have antibiotic high prevalence rates compared to high average annual income level municipalities (adjusted OR: 8.48; 95% CI: 3.45-20.81, P <0.001). We provide a snapshot of Campania's antibiotic consumption, evidencing the impact of both socioeconomic and sociodemographic factors on the prevalence of antibiotic prescription. The observed intraregional variability

Comparison of physical, public and human assets as determinants of socioeconomic inequalities in contraceptive use in Colombia - moving beyond the household wealth index

PubMed Central

2010-01-01

Background Colombia is a lower-middle income country that faces the challenge of addressing health inequalities. This effort includes the task of developing measures of socioeconomic position (SEP) to describe and analyse disparities in health and health related outcomes. This study explores the use of a multidimensional approach to SEP, in which socioeconomic inequalities in contraceptive use are investigated along multiple dimensions of SEP. We tested the hypothesis that provision of Public capital compensated for low levels of Human capital. Methods This study used the 2005 Colombian Demographic and Health Survey (DHS) dataset. The outcome measures were 'current non-use' and 'never use' of contraception. Inequalities in contraceptive behaviour along four measures of SEP were compared: the Household wealth index (HWI), Physical capital (housing, consumer durables), Public capital (publicly provided services) and Human capital (level of education). Principal component analysis was applied to construct the HWI, Physical capital and Public capital measures. Logistic regression models were used to estimate relative indices of inequality (RII) for each measure of SEP with both outcomes. Results Socio-economic inequalities among rural women tended to be larger than those among urban women, for all measures of SEP and for both outcomes. In models mutually adjusted for Physical, Public and Human capital and age, Physical capital identified stronger gradients in contraceptive behaviour in urban and rural areas (Current use of contraception by Physical capital in urban areas RII 2.37 95% CI (1.99-2.83) and rural areas RII 3.70 (2.57-5.33)). The impact of women's level of education on contraceptive behaviour was relatively weak in households with high Public capital compared to households with low Public capital (Current use of contraception in rural areas, interaction p = < 0.001). Reduced educational inequalities attributable to Public capital were partly explained by

Population density, socioeconomic environment and all-cause mortality: a multilevel survival analysis of 2.7 million individuals in Denmark.

PubMed

Meijer, Mathias; Kejs, Anne Mette; Stock, Christiane; Bloomfield, Kim; Ejstrud, Bo; Schlattmann, Peter

2012-03-01

This study examines the relative effects of population density and area-level SES on all-cause mortality in Denmark. A shared frailty model was fitted with 2.7 million persons aged 30-81 years in 2,121 parishes. Residence in areas with high population density increased all-cause mortality for all age groups. For older age groups, residence in areas with higher proportions of unemployed persons had an additional effect. Area-level factors explained considerably more variation in mortality among the elderly than among younger generations. Overall this study suggests that structural prevention efforts in neighborhoods could help reduce mortality when mediating processes between area-level socioeconomic status, population density and mortality are found. Copyright © 2011 Elsevier Ltd. All rights reserved.

Variation in supermarket exposure to energy-dense snack foods by socio-economic position.

PubMed

Cameron, Adrian J; Thornton, Lukar E; McNaughton, Sarah A; Crawford, David

2013-07-01

The present study aimed to examine the availability of energy-dense,nutrient-poor snack foods (and fruits and vegetables) in supermarkets located insocio-economically advantaged and disadvantaged neighbourhoods. Cross-sectional supermarket audit. Melbourne, Australia. Measures included product shelf space and number of varieties for soft drinks, crisps, chocolate, confectionery and fruits and vegetables, as well as store size. Thirty-five supermarkets (response 83 %) from neighbourhoods in the lowest and highest quintile of socio-economic disadvantage. Shelf space allocated to soft drinks (23?6m v. 17?7m, P50?006), crisps (16?5m v. 13?0m, P50?016), chocolate (12?2m v. 10?1m, P50?022) and confectionery (6?7m v. 5?1m, P50?003) was greater in stores from socioeconomically disadvantaged neighbourhoods. After adjustment for store size (stores in disadvantaged areas being larger), shelf space for confectionery (6?3m v. 5?6m, P50?024) and combined shelf space for all energy-dense foods and drinks (55?0m v. 48?9m, P50?017) remained greater in stores from socio-economically disadvantaged neighbourhoods. The ratio of shelf space allocated to fruits and vegetables to that for energy-dense snack foods also varied by socio-economic disadvantage after adjustment for store size (most disadvantaged v. least disadvantaged: 1?7 v. 2?1, P50?025). Varieties of fruits and vegetables and chocolate bars were more numerous in less disadvantaged areas (P,0?05). Exposure to energy-dense snack foods and soft drinks in supermarketswas greater in socio-economically disadvantaged neighbourhoods. Thismay impact purchasing, consumption and cultural norms related to eatingbehaviours and may therefore work against elimination of the known socioeconomicgradient in obesity levels. Reform of supermarket stocking practicesmay represent an effective means of obesity prevention.

Individual Income, Area Deprivation, and Health: Do Income-Related Health Inequalities Vary by Small Area Deprivation?

PubMed

Siegel, Martin; Mielck, Andreas; Maier, Werner

2015-11-01

This paper aims to explore potential associations between health inequalities related to socioeconomic deprivation at the individual and the small area level. We use German cross-sectional survey data for the years 2002 and 2006, and measure small area deprivation via the German Index of Multiple Deprivation. We test the differences between concentration indices of income-related and small area deprivation related inequalities in obesity, hypertension, and diabetes. Our results suggest that small area deprivation and individual income both yield inequalities in health favoring the better-off, where individual income-related inequalities are significantly more pronounced than those related to small area deprivation. We then apply a semiparametric extension of Wagstaff's corrected concentration index to explore how individual-level health inequalities vary with the degree of regional deprivation. We find that the concentration of obesity, hypertension, and diabetes among lower income groups also exists at the small area level. The degree of deprivation-specific income-related inequalities in the three health outcomes exhibits only little variations across different levels of multiple deprivation for both sexes. Copyright © 2014 John Wiley & Sons, Ltd.

Socioeconomic disparities and chronic respiratory diseases in Thailand: The National Socioeconomics Survey.

PubMed

Luenam, Amornrat; Laohasiriwong, Wongsa; Puttanapong, Nattapong; Saengsuwan, Jiamjit; Phajan, Teerasak

2018-05-10

This study aimed to determine the association between socioeconomic determinants and Chronic Respiratory Diseases (CRDs) in Thailand. The data were used from the National Socioeconomics Survey (NSS), a cross-sectional study conducted by the National Statistical Office (NSO), in 2010 and 2012. The survey used stratified two-stage sampling to select a nationally representative sample to respond to a structured questionnaire. A total of 17,040 and 16,905 individuals in 2010 and 2012, respectively, were included in this analysis. Multiple logistic regressions were used to identify the association between socioeconomic factors while controlling for other covariates. The prevalence of CRDs was 3.81% and 2.79% in 2010 and 2012, respectively. The bivariate analysis indicated that gender, family size, geographic location, fuels used for cooking and smoking were significantly associated with CRDs in 2010, whereas education, family size, occupation, region, geographic location, and smoking were significantly associated with CRDs in 2012. Both in 2010 and 2012, the multiple logistic regression indicated that the odds of having CRDs were significantly higher among those who lived in urban areas, females, those aged ≥41-50 or ≥61 yr old, and smokers when controlling for other covariates. However, fuels used for cooking, wood and gas, are associated with CRDs in 2010.

Geographic Variations of Colorectal and Breast Cancer Late-Stage Diagnosis and the Effects of Neighborhood-Level Factors.

PubMed

Lin, Yan; Wimberly, Michael C

2017-04-01

The purpose of this study was to examine the geographic variations of late-stage diagnosis in colorectal cancer (CRC) and breast cancer as well as to investigate the effects of 3 neighborhood-level factors-socioeconomic deprivation, urban/rural residence, and spatial accessibility to health care-on the late-stage risks. This study used population-based South Dakota cancer registry data from 2001 to 2012. A total of 4,878 CRC cases and 6,418 breast cancer cases were included in the analyses. Two-level logistic regression models were used to analyze the risk of late-stage CRC and breast cancer. For CRC, there was a small geographic variation across census tracts in late-stage diagnosis, and residing in isolated small rural areas was significantly associated with late-stage risk. However, this association became nonsignificant after adjusting for census-tract level socioeconomic deprivation. Socioeconomic deprivation was an independent predictor of CRC late-stage risk, and it explained the elevated risk among American Indians. No relationship was found between spatial accessibility and CRC late-stage risk. For breast cancer, no geographic variation in the late-stage diagnosis was observed across census tracts, and none of the 3 neighborhood-level factors was significantly associated with late-stage risk. Results suggested that socioeconomic deprivation, rather than spatial accessibility, contributed to CRC late-stage risks in South Dakota as a rural state. CRC intervention programs could be developed to target isolated small rural areas, socioeconomically disadvantaged areas, as well as American Indians residing in these areas. © 2016 National Rural Health Association.

Urban slum structure: integrating socioeconomic and land cover data to model slum evolution in Salvador, Brazil.

PubMed

Hacker, Kathryn P; Seto, Karen C; Costa, Federico; Corburn, Jason; Reis, Mitermayer G; Ko, Albert I; Diuk-Wasser, Maria A

2013-10-20

The expansion of urban slums is a key challenge for public and social policy in the 21st century. The heterogeneous and dynamic nature of slum communities limits the use of rigid slum definitions. A systematic and flexible approach to characterize, delineate and model urban slum structure at an operational resolution is essential to plan, deploy, and monitor interventions at the local and national level. We modeled the multi-dimensional structure of urban slums in the city of Salvador, a city of 3 million inhabitants in Brazil, by integrating census-derived socioeconomic variables and remotely-sensed land cover variables. We assessed the correlation between the two sets of variables using canonical correlation analysis, identified land cover proxies for the socioeconomic variables, and produced an integrated map of deprivation in Salvador at 30 m × 30 m resolution. The canonical analysis identified three significant ordination axes that described the structure of Salvador census tracts according to land cover and socioeconomic features. The first canonical axis captured a gradient from crowded, low-income communities with corrugated roof housing to higher-income communities. The second canonical axis discriminated among socioeconomic variables characterizing the most marginalized census tracts, those without access to sanitation or piped water. The third canonical axis accounted for the least amount of variation, but discriminated between high-income areas with white-painted or tiled roofs from lower-income areas. Our approach captures the socioeconomic and land cover heterogeneity within and between slum settlements and identifies the most marginalized communities in a large, complex urban setting. These findings indicate that changes in the canonical scores for slum areas can be used to track their evolution and to monitor the impact of development programs such as slum upgrading.

Urban slum structure: integrating socioeconomic and land cover data to model slum evolution in Salvador, Brazil

PubMed Central

2013-01-01

Background The expansion of urban slums is a key challenge for public and social policy in the 21st century. The heterogeneous and dynamic nature of slum communities limits the use of rigid slum definitions. A systematic and flexible approach to characterize, delineate and model urban slum structure at an operational resolution is essential to plan, deploy, and monitor interventions at the local and national level. Methods We modeled the multi-dimensional structure of urban slums in the city of Salvador, a city of 3 million inhabitants in Brazil, by integrating census-derived socioeconomic variables and remotely-sensed land cover variables. We assessed the correlation between the two sets of variables using canonical correlation analysis, identified land cover proxies for the socioeconomic variables, and produced an integrated map of deprivation in Salvador at 30 m × 30 m resolution. Results The canonical analysis identified three significant ordination axes that described the structure of Salvador census tracts according to land cover and socioeconomic features. The first canonical axis captured a gradient from crowded, low-income communities with corrugated roof housing to higher-income communities. The second canonical axis discriminated among socioeconomic variables characterizing the most marginalized census tracts, those without access to sanitation or piped water. The third canonical axis accounted for the least amount of variation, but discriminated between high-income areas with white-painted or tiled roofs from lower-income areas. Conclusions Our approach captures the socioeconomic and land cover heterogeneity within and between slum settlements and identifies the most marginalized communities in a large, complex urban setting. These findings indicate that changes in the canonical scores for slum areas can be used to track their evolution and to monitor the impact of development programs such as slum upgrading. PMID:24138776

The importance of socioeconomic factors in symptoms of heartburn.

PubMed

Navarro-Rodríguez, F; Chaves, R C M; Dib, R A; Navarro-Rodríguez, T

2011-01-01

Patients' socioeconomic status is rarely assessed during medical consultations. To correlate patients' socioeconomic conditions with symptoms of heartburn. 1184 patients who answered a questionnaire in three cities on the coast of the State of Sä Paulo, Brazil, were evaluated prospectively. Socioeconomic status was assessed using several criteria: number of bathrooms, consumer goods present at home, health conditions at home, comfort (cars and/or home helps), monthly family income and head of household's educational level. 583 patients (49.2%) reported occurrences of heartburn over the 30 days preceding the consultation, with frequencies ranging from five to thirty episodes over this period. Among patients from the city of Guarujá (low socioeconomic condition), 9.7% had never felt heartburn, while 65.7% reported occurrences, reaching statistical significance in relation to patients of medium socioeconomic condition (city of Sä Vicente) (p = 0.012). There was no difference between patients from medium socioeconomic condition and patients from Santos (high socioeconomic condition) (p = 0.997). There was a statistically significant difference in occurrence of heartburn between the patients with high socioeconomic condition and those of low socioeconomic condition (p = 0.002). The least favored socioeconomic status patients, as confirmed according to a variety of socioeconomic factors, presented greater incidence of heartburn than did the most favored social class.

Socioeconomic Status and Functional Brain Development--Associations in Early Infancy

ERIC Educational Resources Information Center

Tomalski, Przemyslaw; Moore, Derek G.; Ribeiro, Helena; Axelsson, Emma L.; Murphy, Elizabeth; Karmiloff-Smith, Annette; Johnson, Mark H.; Kushnerenko, Elena

2013-01-01

Socioeconomic status (SES) impacts on both structural and functional brain development in childhood, but how early its effects can be demonstrated is unknown. In this study we measured resting baseline EEG activity in the gamma frequency range in awake 6-9-month-olds from areas of East London with high socioeconomic deprivation. Between-subject…

Association between socioeconomic status, surgical treatment and mortality in patients with colorectal cancer.

PubMed

Dik, V K; Aarts, M J; Van Grevenstein, W M U; Koopman, M; Van Oijen, M G H; Lemmens, V E; Siersema, P D

2014-08-01

High socioeconomic status is associated with better survival in colorectal cancer (CRC). This study investigated whether socioeconomic status is associated with differences in surgical treatment and mortality in patients with CRC. Patients diagnosed with stage I-III CRC between 2005 and 2010 in the Eindhoven Cancer Registry area in the Netherlands were included. Socioeconomic status was determined at a neighbourhood level by combining the mean household income and the mean value of the housing. Some 4422 patients with colonic cancer and 2314 with rectal cancer were included. Patients with colonic cancer and high socioeconomic status were operated on with laparotomy (70·7 versus 77·6 per cent; P = 0·017), had laparoscopy converted to laparotomy (15·7 versus 29·5 per cent; P = 0·008) and developed anastomotic leakage or abscess (9·6 versus 12·6 per cent; P = 0·049) less frequently than patients with low socioeconomic status. These differences remained significant after adjustment for patient and tumour characteristics. In rectal cancer, patients with high socioeconomic status were more likely to undergo resection (96·3 versus 93·7 per cent; P = 0·083), but this was not significant in multivariable analysis (odds ratio (OR) 1·44, 95 per cent confidence interval 0·84 to 2·46). The difference in 30-day postoperative mortality in patients with colonic cancer and high and low socioeconomic status (3·6 versus 6·8 per cent; P < 0·001) was not significant after adjusting for age, co-morbidities, emergency surgery, and anastomotic leakage or abscess formation (OR 0·90, 0·51 to 1·57). Patients with CRC and high socioeconomic status have more favourable surgical treatment characteristics than patients with low socioeconomic status. The lower 30-day postoperative mortality found in patients with colonic cancer and high socioeconomic status is largely explained by patient and surgical factors. © 2014 BJS Society Ltd. Published by John

Effect of socioeconomic level on knowledge of stroke in the general population: A social inequality gradient.

PubMed

Ramírez-Moreno, J M; Alonso-González, R; Peral Pacheco, D; Millán-Nuñez, M V; Roa-Montero, A; Constantino-Silva, A B; Aguirre-Sánchez, J J

2016-01-01

Socioeconomic status is a factor that influences health-related behaviour in individuals as well as health conditions in entire populations. The objective of the present study was to analyse the sociodemographic factors that may influence knowledge of stroke. Cross-sectional study. A representative sample was selected by double randomisation. Face-to-face interviews were carried out by previously trained medical students using a structured questionnaire with open- and closed-ended questions. Adequate knowledge was previously defined. The Mantel-Haenszel test and adjusted logistic regression analysis were used to assess the association between knowledge of stroke and the study variables. 2411 subjects were interviewed (59.9% women; mean age 49.0 [SD 17.3] years) Seventy-three per cent were residents of urban areas, 24.7% had a university education, and 15.2% had a low level of schooling. Only 2.1% reported earning more than 40 000 euros/year, with 29.9% earning less than 10 000. Nearly 74% reported having an excellent or good state of health. The unemployment rate was 17.0%. Prevalence of "adequate knowledge" was 39.7% (95% CI: 37.7%-41.6%). Trend analysis showed an association between knowledge of stroke and income (z=10.14, P<0.0001); educational level (z=15.95, P<0.0001); state of health (z=7.92, P<0.0001); and employment status (z=8.98, P<0.0001). Educational level, income, employment status, and state of health are independent factors for adequate knowledge of stroke. Public awareness campaigns should present material using simple language and efforts should be directed toward the most disadvantaged social strata in particular. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

A novel approach for measuring residential socioeconomic ...

EPA Pesticide Factsheets

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used hierarchical clustering to aggregate 444 US Census block groups in Durham, Orange, and Wake Counties, NC, USA into six homogeneous clusters of similar characteristics based on 12 demographic factors. We assigned 2254 cardiac catheterization patients to these clusters based on residence at first catheterization. After controlling for individual age, sex, smoking status, and race, there were elevated odds of patients being obese (odds ratio (OR) = 1.92, 95% confidence intervals (CI) = 1.39, 2.67), and having diabetes (OR = 2.19, 95% CI = 1.57, 3.04), congestive heart failure (OR = 1.99, 95% CI = 1.39, 2.83), and hypertension (OR = 2.05, 95% CI = 1.38, 3.11) in a cluster that was urban, impoverished, and unemployed, compared to a cluster that was urban with a low percentage of people that were impoverished or unemployed. Our findings demonstrate the feasibility of applying hierarchical clustering to an assessment of area-level characteristics and that living in impoverished, urban residential clusters may have an adverse impact on health. The study highlights the importance of neighborhood characteristics on health. After controlling for individual-level demographic factors, significant differences in dise

Decomposing socioeconomic inequality in infant mortality in Iran.

PubMed

Hosseinpoor, Ahmad Reza; Van Doorslaer, Eddy; Speybroeck, Niko; Naghavi, Mohsen; Mohammad, Kazem; Majdzadeh, Reza; Delavar, Bahram; Jamshidi, Hamidreza; Vega, Jeanette

2006-10-01

Although measuring socioeconomic inequality in population health indicators like infant mortality is important, more interesting for policy purposes is to try to explain infant mortality inequality. The objective of this paper is to quantify for the first time the determinants' contributions of socioeconomic inequality in infant mortality in Iran. A nationally representative sample of 108 875 live births from October 1990 to September 1999 was selected. The data were taken from the Iranian Demographic and Health Survey (DHS) conducted in 2000. Households' socioeconomic status was measured using principal component analysis. The concentration index of infant mortality was used as our measure of socioeconomic inequality and decomposed into its determining factors. The largest contributions to inequality in infant mortality were owing to household economic status (36.2%) and mother's education (20.9%). Residency in rural/urban areas (13.9%), birth interval (13.0%), and hygienic status of toilet (11.9%) also proved important contributors to the measured inequality. The findings indicate that socioeconomic inequality in infant mortality in Iran is determined not only by health system functions but also by factors beyond the scope of health authorities and care delivery system. This implies that in addition to reducing inequalities in wealth and education, investments in water and sanitation infrastructure and programmes (especially in rural areas) are necessary to realize improvements of inequality in infant mortality across society. These findings can be instrumental for the recent 5 year Economic, Social and Cultural Development Plan of Iran, which identified the reduction of inequalities in social determinants of health.

SOCIOECONOMIC STATUS AND LEARNING PROFICIENCY IN YOUNG CHILDREN.

ERIC Educational Resources Information Center

ROHWER, WILLIAM D., JR.; AND OTHERS

THIS STUDY WAS INITIATED TO DETERMINE WHY CHILDREN OF LOWER SOCIOECONOMIC STATUS, WHO DO INFERIOR WORK ON SCHOOL-RELATED LEARNING TASKS WHEN COMPARED TO UPPER SOCIOECONOMIC STATUS CHILDREN, LEARN AS EFFICIENTLY AS UPPER LEVEL CHILDREN ON PAIRED-ASSOCIATE TASKS. THE SAMPLE CONSISTED OF 120 LOWER STATUS CHILDREN AND 120 UPPER STATUS CHILDREN,…

Trends in socioeconomic inequalities in mortality in small areas of 33 Spanish cities.

PubMed

Marí-Dell'Olmo, Marc; Gotsens, Mercè; Palència, Laia; Rodríguez-Sanz, Maica; Martinez-Beneito, Miguel A; Ballesta, Mónica; Calvo, Montse; Cirera, Lluís; Daponte, Antonio; Domínguez-Berjón, Felicitas; Gandarillas, Ana; Goñi, Natividad Izco; Martos, Carmen; Moreno-Iribas, Conchi; Nolasco, Andreu; Salmerón, Diego; Taracido, Margarita; Borrell, Carme

2016-07-29

In Spain, several ecological studies have analyzed trends in socioeconomic inequalities in mortality from all causes in urban areas over time. However, the results of these studies are quite heterogeneous finding, in general, that inequalities decreased, or remained stable. Therefore, the objectives of this study are: (1) to identify trends in geographical inequalities in all-cause mortality in the census tracts of 33 Spanish cities between the two periods 1996-1998 and 2005-2007; (2) to analyse trends in the relationship between these geographical inequalities and socioeconomic deprivation; and (3) to obtain an overall measure which summarises the relationship found in each one of the cities and to analyse its variation over time. Ecological study of trends with 2 cross-sectional cuts, corresponding to two periods of analysis: 1996-1998 and 2005-2007. Units of analysis were census tracts of the 33 Spanish cities. A deprivation index calculated for each census tracts in all cities was included as a covariate. A Bayesian hierarchical model was used to estimate smoothed Standardized Mortality Ratios (sSMR) by each census tract and period. The geographical distribution of these sSMR was represented using maps of septiles. In addition, two different Bayesian hierarchical models were used to measure the association between all-cause mortality and the deprivation index in each city and period, and by sex: (1) including the association as a fixed effect for each city; (2) including the association as random effects. In both models the data spatial structure can be controlled within each city. The association in each city was measured using relative risks (RR) and their 95 % credible intervals (95 % CI). For most cities and in both sexes, mortality rates decline over time. For women, the mortality and deprivation patterns are similar in the first period, while in the second they are different for most cities. For men, RRs remain stable over time in 29 cities, in 3

Contribution of industrial density and socioeconomic status to the spatial distribution of thyroid cancer risk in Hangzhou, China.

PubMed

Fei, Xufeng; Lou, Zhaohan; Christakos, George; Liu, Qingmin; Ren, Yanjun; Wu, Jiaping

2018-02-01

The thyroid cancer (TC) incidence in China has increased dramatically during the last three decades. Typical in this respect is the case of Hangzhou city (China), where 7147 new TC cases were diagnosed during the period 2008-2012. Hence, the assessment of the TC incidence risk increase due to environmental exposure is an important public health matter. Correlation analysis, Analysis of Variance (ANOVA) and Poisson regression were first used to evaluate the statistical association between TC and key risk factors (industrial density and socioeconomic status). Then, the Bayesian maximum entropy (BME) theory and the integrative disease predictability (IDP) criterion were combined to quantitatively assess both the overall and the spatially distributed strength of the "exposure-disease" association. Overall, higher socioeconomic status was positively correlated with higher TC risk (Pearson correlation coefficient=0.687, P<0.01). Compared to people of low socioeconomic status, people of median and high socioeconomic status showed higher TC risk: the Relative Risk (RR) and associated 95% confidence interval (CI) were found to be, respectively, RR=2.29 with 95% CI=1.99 to 2.63, and RR=3.67 with 95% CI=3.22 to 4.19. The "industrial density-TC incidence" correlation, however, was non-significant. Spatially, the "socioeconomic status-TC" association measured by the corresponding IDP coefficient was significant throughout the study area: the mean IDP value was -0.12 and the spatial IDP values were consistently negative at the township level. It was found that stronger associations were distributed among residents mainly on a stripe of land from northeast to southwest (consisting mainly of sub-district areas). The "industrial density-TC" association measured by its IDP coefficient was spatially non-consistent. Socioeconomic status is an important indicator of TC risk factor in Hangzhou (China) whose effect varies across space. Hence, socioeconomic status shows the highest TC

Public reporting and market area exit decisions by home health agencies.

PubMed

Jung, Kyoungrae; Feldman, Roger

2012-01-01

To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003. We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level. 2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File. WE FOUND A SMALL AND WEAK EFFECT OF PUBLIC REPORTING ON SELECTIVE EXITS: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education. The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program.

An Overview of Methods for Monitoring Social Disparities in Cancer with an Example Using Trends in Lung Cancer Incidence by Area-Socioeconomic Position and Race-Ethnicity, 1992–2004

PubMed Central

Harper, Sam; Lynch, John; Meersman, Stephen C.; Breen, Nancy; Davis, William W.; Reichman, Marsha E.

2008-01-01

The authors provide an overview of methods for summarizing social disparities in health using the example of lung cancer. They apply four measures of relative disparity and three measures of absolute disparity to trends in US lung cancer incidence by area-socioeconomic position and race-ethnicity from 1992 to 2004. Among females, measures of absolute and relative disparity suggested that area-socioeconomic and race-ethnic disparities increased over these 12 years but differed widely with respect to the magnitude of the change. Among males, the authors found substantial disagreement among summary measures of relative disparity with respect to the magnitude and the direction of change in disparities. Among area-socioeconomic groups, the index of disparity increased by 47% and the relative concentration index decreased by 116%, while for race-ethnicity the index of disparity increased by 36% and the Theil index increased by 13%. The choice of a summary measure of disparity may affect the interpretation of changes in health disparities. Important issues to consider are the reference point from which differences are measured, whether to measure disparity on the absolute or relative scale, and whether to weight disparity measures by population size. A suite of indicators is needed to provide a clear picture of health disparity change. PMID:18344513

ASSOCIATION BETWEEN BODY COMPOSITION, SOMATOTYPE AND SOCIOECONOMIC STATUS IN CHILEAN CHILDREN AND ADOLESCENTS AT DIFFERENT SCHOOL LEVELS.

PubMed

Lizana, Pablo A; González, Sofia; Lera, Lydia; Leyton, Bárbara

2018-01-01

This study examined the association between body composition, somatotype and socioeconomic status (SES) in Chilean children and adolescents by sex and school level (grade). The cross-sectional study was conducted on 1168 schoolchildren aged 6-18 years (572 males) from Valparaíso, Chile. Body composition, as assessed by percentage body fat (BF%) and somatotype, was evaluated using Ellis equations and the Heath-Carter method, respectively. The socioeconomic status of respondents was assessed using the ESOMAR survey. Obesity was defined as BF% ≥25 for boys and ≥30 for girls; 'high endomorph' somatotype was defined as a somatotype endomorph component (EC) of at least 5.5. Logistic regression analysis was used to assess the relationship between high adiposity and SES, potential confounding factors and school level. In females, the results indicated that the groups with lower SES had higher EC. At the 1st (youngest) school level (1-4th grades), males exhibited similar trends in their BF% and EC. High adiposity was associated with the female sex (BF%: OR=3.39; 95% CI 2.60, 4.41; high EC: OR=2.31; 95% CI 1.80, 2.98). In addition, low SES increased the risk of high adiposity compared with high SES (BF%: OR=2.25; 95% CI 1.40, 3.61; high EC: OR=2.19; 95% CI 1.37, 3.47). An association was observed between increased adiposity and lower SES, mainly in females, which indicates that females with low SES might be at greater risk of obesity.

Implementation of the Port Hope Area Initiative Biophysical and Socioeconomic Environmental Assessment Follow-up Programs - 13209

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baba, Nina; Friedmann, Karyn; Groulx, Charles

2013-07-01

The Port Hope Initiative (PHAI) involves the cleanup of historic low-level radioactive waste in various locations throughout the communities of Port Hope and Clarington, Ontario, as well as the construction of two engineered aboveground mounds for safe long-term management. The PHAI is comprised of two major projects - the Port Hope Project and the Port Granby Project. An Environmental Assessment (EA) was undertaken for each project and as a result EA Follow-up Programs were developed and are being implemented addressing both biophysical and socioeconomic aspects. This paper provides insight on elements of the EA Follow-up Program development, and its implementation.more » (authors)« less

Socioeconomic disadvantage increasing risk for depression among recently diagnosed HIV patients in an urban area in Brazil: cross-sectional study.

PubMed

Nomoto, Silmara Harumi; Longhi, Renata Marrona Praça; de Barros, Bruna Paes; Croda, Julio; Ziff, Edward Benjamin; Castelon Konkiewitz, Elisabete

2015-01-01

Depression is the most common psychiatric co-morbidity among people living with HIV (PLHIV), with prevalence rates ranging from 25% to 36%. Depression impacts negatively upon adherence and response to combined antiretroviral therapy (CART) and the transmission of HIV infection through increased sexually risky behavior. This cross-sectional study presents data from a reference HIV-outpatient service in Dourados (Brazil) that evaluated the association between depressive symptoms, health-related quality of life, and clinical, socioeconomic, and demographic factors in newly diagnosed HIV/AIDS patients. Using the Beck Depression Inventory (BDI), the prevalence of depressive symptoms was 61% with a predominance of self-deprecating and cognitive-affective factors. Depressive symptoms were associated with lower income (p=0.019) and disadvantaged social class (p=0.005). Poorer quality of life was related to depressive symptoms (p<0.0001), low educational level (p=0.05), and lower income (p=0.03). These data suggest that socioeconomic factors, including level of income and education, are mediating the risk of depression and poor quality of life of PLHIV. Possible explanations for this effect are discussed, including the possible role of stigma.

The Contribution of Biogeographic Ancestry and Socioeconomic Status to Racial/Ethnic Disparities in Type 2 Diabetes: Results from the Boston Area Community Health (BACH) Survey

PubMed Central

Piccolo, Rebecca S.; Pearce, Neil; Araujo, Andre B.; McKinlay, John B.

2014-01-01

Purpose Racial/ethnic disparities in the incidence of type 2 diabetes (T2DM) are well documented and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research is to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors. Methods We analyzed data from the Boston Area Community Health (BACH) Survey, a prospective cohort with approximately equal numbers of Black, Hispanic, and White participants. We used Ancestry Informative Markers to calculate the percentages of West African and Native American ancestry of participants. We used logistic regression with g-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence. Results We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to Black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors. Conclusions It is likely that non-genetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence. PMID:25088753

Perthes' disease of the hip: socioeconomic inequalities and the urban environment.

PubMed

Perry, Daniel C; Bruce, Colin E; Pope, Daniel; Dangerfield, Peter; Platt, Mary Jane; Hall, Andrew J

2012-12-01

Perthes' disease is a puzzling childhood hip disorder for which the aetiology is unknown. It is known to be associated with socioeconomic deprivation. Urban environments have also been implicated as a risk factor, however socioeconomic deprivation often occurs within urban environments and it is unclear if this association is the result of confounding. The objective of the current work was to gain a greater understanding of the influence of the urban/rural environment in Perthes' disease. This was a descriptive observational study using the Scottish Morbidity Record, based in Scotland, UK using data from 2000-2010. A total of 443 patients with a discharge diagnosis of Perthes' disease were included. Socioeconomic deprivation was determined using the Scottish Index of Multiple Deprivation, and exposure to the 'urban environment' was recorded based on the Scottish Urban-Rural Classification. There was a strong association with socioeconomic deprivation, with rates among the most deprived quintile more than twice those of the most affluent (RR 2.1 (95% CI 1.5 to 2.9)). Urban areas had a greater rate of Perthes' disease discharges (RR 1.8 (95% CI 1.1 to 3.2)), though this was a reflection of greater deprivation in urban areas. Stratification for socioeconomic deprivation revealed similar discharge rates in urban and rural environments, suggesting that the aetiological determinants were not independently associated with urban environments. The occurrence of Perthes' disease within urban environments is high, yet this appears to be a reflection of higher socioeconomic deprivation exposure. Disease rates appear equivalent in similarly deprived urban and non-urban areas, suggesting that the determinant is not a consequence of the urban environment.

Child health inequities in developing countries: differences across urban and rural areas.

PubMed

Fotso, Jean-Christophe

2006-07-11

To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific

Prevalence of skin conditions in primary school children in Turkey: differences based on socioeconomic factors.

PubMed

Inanir, Işil; Sahin, M Turhan; Gündüz, Kamer; Dinç, Gönül; Türel, Aylin; Oztürkcan, Serap

2002-01-01

Skin diseases are associated with environmental factors and a public health approach is particularly important. We determined the prevalence of skin conditions and associated socioeconomic factors in primary school children in Turkey. A questionnaire for determining the socioeconomic level and a complete dermatologic examination were performed in 785 children in two primary schools in different socioeconomic areas of suburban and central Manisa, Turkey. The study included 345 (43.9%) girls and 440 (56.1%) boys with a mean age of 9.25 +/- 1.55 (range 6-14 years). Infectious skin diseases were frequently observed: pediculosis capitis in 74 children (9.4%), scabies in 17 (2.2%), viral skin diseases in 30 (3.8%), and fungal infections in 6 (0.7%). The other common conditions were melanocytic nevi (14.4%), keratosis pilaris (12.5%), pityriasis alba (12%), xerosis (11.8%), and atopic dermatitis (6.8%). Pediculosis capitis, acne, and dandruff were more common in girls. The rate of infections, atopic dermatitis, xerosis, and pityriasis alba were significantly higher in the school children with poor socioeconomic conditions. Improvement in socioeconomic conditions along with education may be needed to decrease the prevalence of some of these skin disorders in order to decrease costs related to treatment.

[Lipid profile from low socioeconomic level preschool children. Valencia, Venezuela].

PubMed

Solano, Liseti; Velásquez, Emma; Naddaf, Gloria; Páez, María

2003-01-01

Overweight and obesity are a public health problem worldwide affecting adults and children as well. The aim of this study was to assess overweight, lipid profile and cardiovascular risk ratios in 390 preschool children from low socio-economic level from Valencia, Venezuela. Nutritional anthropometric evaluation measured by body dimensions, and serum determination of cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol and cardiovascular risk factors, were determined. 95% of the children were in relative and critical poverty. 14.3% of undernutrition and 20.8% of overweight was found. Lipid profile was in normal range, with no significant differences by sex, but higher values for HDL-cholesterol and risk ratios were found in children aged 1 to 3.99 years. Even though no differences were found by nutritional status, overweight children had higher values for lipids, except HDL-cholesterol. 6.3% of overweight children had cholesterol > or =170 mg/dL, 16.5% LDL-cholesterol > or =110 mg/dL, 40.5% triglycerides > or =75mg/dL and 100% HDL-cholesterol <45 mg/dL. Overweight and lipid profile alterations were present in an important group of the children, which increase their risk of obesity and chronic non-transmissible diseases. Nutritional and educational intervention should be addressed.

Prevalence of cardiovascular risk factors and socioeconomic level among public-sector workers in Angola.

PubMed

Capingana, Daniel P; Magalhães, Pedro; Silva, Amílcar B T; Gonçalves, Mauer A A; Baldo, Marcelo P; Rodrigues, Sérgio L; Simões, Cristóvão C F; Ferreira, Albano V L; Mill, José G

2013-08-07

Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P < 0.05); hypertriglyceridemia, 10.6% (men 12.6%, women 8.7%, P > 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P < 0.05); diabetes, 5.7% (men 5.5%, women 5.9%, P > 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P < 0.05); sedentary lifestyle, 87.2% (men 83.0%, women 91,0%, P < 0.05); and left ventricular hypertrophy, 20% (men 32.0%, women 9.0%; P < 0.05). At least one risk factor was present in 27.7% of the sample; 15.2% had two risk factors, and 31.4% had three or more risk factors. Among the individuals with low socioeconomic status, 41.0% had three or more risk factors. The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in Angola. The workers in lower socioeconomic

Prevalence of cardiovascular risk factors and socioeconomic level among public-sector workers in Angola

PubMed Central

2013-01-01

Background Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. Methods We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. Results The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P < 0.05); hypertriglyceridemia, 10.6% (men 12.6%, women 8.7%, P > 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P < 0.05); diabetes, 5.7% (men 5.5%, women 5.9%, P > 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P < 0.05); sedentary lifestyle, 87.2% (men 83.0%, women 91,0%, P < 0.05); and left ventricular hypertrophy, 20% (men 32.0%, women 9.0%; P < 0.05). At least one risk factor was present in 27.7% of the sample; 15.2% had two risk factors, and 31.4% had three or more risk factors. Among the individuals with low socioeconomic status, 41.0% had three or more risk factors. Conclusions The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in

Diabetes mortality in Panama and related biological and socioeconomic risk factors.

PubMed

Motta, Jorge A; Ortega-Paz, Luis G; Gordón, Carlos A; Gómez, Beatriz; Castillo, Eva; Herrera Ballesteros, Víctor; Pereira, Manuel

2013-08-01

To estimate mortality from diabetes mellitus (DM) for the period 2001-2011 in the Republic of Panama, by province/indigenous territory, and determine its relationship with biological and socioeconomic risk factors. Cases for the years 2001-2011 with DM listed as the principal cause of death were selected from Panama's National Mortality Registry. Crude and adjusted mortality rates were generated by sex, age, and geographic area. Linear regression analyses were performed to determine the relationship between DM mortality and biological and socioeconomic risk factors. A composite health index (CHI) calculated from biological and socioeconomic risk factors was estimated for each province/indigenous territory in Panama. DM mortality rates did not increase for men or women during 2001-2011. Of the biological risk factors, being overweight had the strongest association with DM mortality. Of the socioeconomic risk factors, earning less than US$ 100 per month had the strongest association with DM mortality. The highest socioeconomic CHI scores were found in a province that is predominantly rural and in areas with indigenous populations. The highest biological CHI scores were found in urban-rural provinces and those with the highest percentage of elderly people. Regional disparities in the association between DM mortality and DM risk factors reaffirm the heterogeneous composition of the Panamanian population and the uneven distribution of biological and social determinant risk factors in the country and point to the need to vary management strategies by geographic area for this important cause of disability and death in Panama.

Associations between the neighbourhood food environment, neighbourhood socioeconomic status, and diet quality: An observational study.

PubMed

McInerney, Maria; Csizmadi, Ilona; Friedenreich, Christine M; Uribe, Francisco Alaniz; Nettel-Aguirre, Alberto; McLaren, Lindsay; Potestio, Melissa; Sandalack, Beverly; McCormack, Gavin R

2016-09-15

The neighbourhood environment may play an important role in diet quality. Most previous research has examined the associations between neighbourhood food environment and diet quality, and neighbourhood socioeconomic status and diet quality separately. This study investigated the independent and joint effects of neighbourhood food environment and neighbourhood socioeconomic status in relation to diet quality in Canadian adults. We undertook a cross-sectional study with n = 446 adults in Calgary, Alberta (Canada). Individual-level data on diet and socio-demographic and health-related characteristics were captured from two self-report internet-based questionnaires, the Canadian Diet History Questionnaire II (C-DHQ II) and the Past Year Physical Activity Questionnaire (PAQ). Neighbourhood environment data were derived from dissemination area level Canadian Census data, and Geographical Information Systems (GIS) databases. Neighbourhood was defined as a 400 m network-based 'walkshed' around each participant's household. Using GIS we objectively-assessed the density, diversity, and presence of specific food destination types within the participant's walkshed. A seven variable socioeconomic deprivation index was derived from Canadian Census variables and estimated for each walkshed. The Canadian adapted Healthy Eating Index (C-HEI), used to assess diet quality was estimated from food intakes reported on C-DHQ II. Multivariable linear regression was used to test for associations between walkshed food environment variables, walkshed socioeconomic status, and diet quality (C-HEI), adjusting for individual level socio-demographic and health-related covariates. Interaction effects between walkshed socioeconomic status and walkshed food environment variables on diet quality (C-HEI) were also tested. After adjustment for covariates, food destination density was positively associated with the C-HEI (β 0.06, 95 % CI 0.01-0.12, p = 0.04) though the magnitude of the

Sex-specific role of education on the associations of socioeconomic status indicators with obesity risk: A population-based study in South Korea

PubMed Central

Chung, Woojin; Lim, Seung-ji; Lee, Sunmi

2018-01-01

Background No study of obesity risk for people in developed countries has conducted a multi-dimensional analysis of the association of socioeconomic status with obesity. In this paper, we investigated if education functions as either a confounder or an effect modifier in the association of another socioeconomic status indicator with obesity. Methods This cross-sectional study analyzed data of an adult population sample (10,905 men and 14,580 women) from the Korea National Health and Nutrition Examination Survey (2010–2014). The study performed multivariate logistic regression analyses for three education levels and four indicators of socioeconomic status (i.e., marital status, residential area, occupation, and income). Results The overall prevalence of obesity was 38.1% in men and 29.1% in women (p < 0.001). In men, while education functioned as an effect modifier in the association between marital status and obesity (p for interaction = 0.006), it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction < 0.001) in the association between residential area and obesity. In contrast, in women, education functioned as a confounder in the association of residential area with obesity (p = 0.010). However, it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction = 0.012) in the association between income and obesity. A prediction showed that unlike in women, education was positively associated with obesity risk for some socioeconomic indicator groups in men; for example, in a rural resident group, a higher level of education increased the probability of being obese by 19.7%. Conclusions The present study suggests the need to examine sex-specific studies regarding the role of education on the association between other socioeconomic status indicators and obesity. This should be considered in planning education policies to reduce the risk of obesity. PMID:29298319

Sex-specific role of education on the associations of socioeconomic status indicators with obesity risk: A population-based study in South Korea.

PubMed

Chung, Woojin; Kim, Jaeyeun; Lim, Seung-Ji; Lee, Sunmi

2018-01-01

No study of obesity risk for people in developed countries has conducted a multi-dimensional analysis of the association of socioeconomic status with obesity. In this paper, we investigated if education functions as either a confounder or an effect modifier in the association of another socioeconomic status indicator with obesity. This cross-sectional study analyzed data of an adult population sample (10,905 men and 14,580 women) from the Korea National Health and Nutrition Examination Survey (2010-2014). The study performed multivariate logistic regression analyses for three education levels and four indicators of socioeconomic status (i.e., marital status, residential area, occupation, and income). The overall prevalence of obesity was 38.1% in men and 29.1% in women (p < 0.001). In men, while education functioned as an effect modifier in the association between marital status and obesity (p for interaction = 0.006), it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction < 0.001) in the association between residential area and obesity. In contrast, in women, education functioned as a confounder in the association of residential area with obesity (p = 0.010). However, it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction = 0.012) in the association between income and obesity. A prediction showed that unlike in women, education was positively associated with obesity risk for some socioeconomic indicator groups in men; for example, in a rural resident group, a higher level of education increased the probability of being obese by 19.7%. The present study suggests the need to examine sex-specific studies regarding the role of education on the association between other socioeconomic status indicators and obesity. This should be considered in planning education policies to reduce the risk of obesity.

Socioeconomic Condition and Anaemia among the Mahishya Population of Southern West Bengal, India.

PubMed

Bharati, Premananda; Ghosh, Rohini; Gupta, Ranjan

2004-03-01

A cross-sectional study was conducted among the Mahishya population of Chakpota village in Southern West Bengal to determine the relationship between socio-economic conditions and certain haematological parameters, haemoglobin level and haemotocrit. Households were divided into high, middle and low socioeconomic groups on the basis of per capita income per year. The demographic data were collected from all the 255 households comprising 404 adult males and 383 adult females (above 20 years of age). Higher values in the parameters were observed among the males in all the three socioeconomic sub-groups. Significant differences in haemoglobin level and haemotocrit of males were observed between the three socioeconomic groups (p= <.01). On the contrary, insignificant differences in haemoglobin level and haemocrit were observed between the three socioeconomic groups among the females. Higher nutritional intake and lower parasitic infections may be responsible for the higher levels of the haematological parameters in the higher socioeconomic groups. Our study reveals that sex discrimination in food sharing seems to be the major cause for the gender difference in haemoglobin status in all the three economic groups. It is apparent from the study that cultural factors play an important role in determining the haemoglobin status at micro-level, even in high-income households.

A cohort study evaluating the implications of biology, weight status and socioeconomic level on global self-esteem competence among female African-American adolescents.

PubMed

Powell-Young, Yolanda M; Zabaleta, Jovanny; Velasco-Gonzalez, Cruz; Sothern, Melinda S

2013-07-01

The link between obesity and self-esteem among minority youth has received minimal empirical evaluation. This study aims to describe the magnitude of risk that body mass index, household income, and transitional age have on global self-esteem levels among African-American adolescents. These analyses were conducted on cross-sectional data obtained from 264 urban-dwelling African-American females between 14 and 18 years of age. Survey data on global self-esteem levels, transitory age, and socioeconomic levels were collected using self-administered questionnaires. Measured height and weight values were used to calculate and categorize weight status according to body mass index. Logistic regression models examined the probability of reporting less than average levels of global self-esteem. Adolescent African-American females residing in low-income households were 10 times more likely to report lower global self-esteem scores than those individuals from more affluent households (95% CI: 1.94, 60.19, p < .001). Neither weight status (95% CI: 0.81, 2.55; p = .26) nor age (95% CI: 0.05, 1.87; p = .82) were significant risk indicators for lower than average levels of global self-esteem among participants in this study. Household income appears to be the greatest predictor of global self-esteem levels. Further research in this area is needed to fully elucidate precursors for psychological health vulnerability and facilitate intervention development.

A Cohort Study Evaluating the Implications of Biology, Weight Status and Socioeconomic Level on Global Self-Esteem Competence Among Female African-American Adolescents

PubMed Central

Powell-Young, Yolanda M.; Zabaleta, Jovanny; Velasco-Gonzalez, Cruz; Sothern, Melinda S.

2014-01-01

The link between obesity and self-esteem among minority youth has received minimal empirical evaluation. This study aims to describe the magnitude of risk that body mass index, household income, and transitional age have on global self-esteem levels among African-American adolescents. These analyses were conducted on cross-sectional data obtained from 264 urban-dwelling African-American females between 14 and 18 years of age. Survey data on global self-esteem levels, transitory age, and socioeconomic levels were collected using self-administered questionnaires. Measured height and weight values were used to calculate and categorize weight status according to body mass index. Logistic regression models examined the probability of reporting less than average levels of global self-esteem. Adolescent African-American females residing in low-income households were 10 times more likely to report lower global self-esteem scores than those individuals from more affluent households (95% CI: 1.94, 60.19, p < .001). Neither weight status (95% CI: 0.81, 2.55; p = .26) nor age (95% CI: 0.05, 1.87; p = .82) were significant risk indicators for lower than average levels of global self-esteem among participants in this study. Household income appears to be the greatest predictor of global self-esteem levels. Further research in this area is needed to fully elucidate precursors for psychological health vulnerability and facilitate intervention development. PMID:24218867

Environmental and socio-economic risk modelling for Chagas disease in Bolivia.

PubMed

Mischler, Paula; Kearney, Michael; McCarroll, Jennifer C; Scholte, Ronaldo G C; Vounatsou, Penelope; Malone, John B

2012-09-01

Accurately defining disease distributions and calculating disease risk is an important step in the control and prevention of diseases. Geographical information systems (GIS) and remote sensing technologies, with maximum entropy (Maxent) ecological niche modelling computer software, were used to create predictive risk maps for Chagas disease in Bolivia. Prevalence rates were calculated from 2007 to 2009 household infection survey data for Bolivia, while environmental data were compiled from the Worldclim database and MODIS satellite imagery. Socio-economic data were obtained from the Bolivian National Institute of Statistics. Disease models identified altitudes at 500-3,500 m above the mean sea level (MSL), low annual precipitation (45-250 mm), and higher diurnal range of temperature (10-19 °C; peak 16 °C) as compatible with the biological requirements of the insect vectors. Socio-economic analyses demonstrated the importance of improved housing materials and water source. Home adobe wall materials and having to fetch drinking water from rivers or wells without pump were found to be highly related to distribution of the disease by the receiver operator characteristic (ROC) area under the curve (AUC) (0.69 AUC, 0.67 AUC and 0.62 AUC, respectively), while areas with hardwood floors demonstrated a direct negative relationship (-0.71 AUC). This study demonstrates that Maxent modelling can be used in disease prevalence and incidence studies to provide governmental agencies with an easily learned, understandable method to define areas as either high, moderate or low risk for the disease. This information may be used in resource planning, targeting and implementation. However, access to high-resolution, sub-municipality socio-economic data (e.g. census tracts) would facilitate elucidation of the relative influence of poverty-related factors on regional disease dynamics.

Cross-national comparisons of socioeconomic differences in the prevalence of leisure-time and occupational physical activity, and active commuting in six Asia-Pacific countries.

PubMed

Bauman, Adrian; Ma, Guansheng; Cuevas, Frances; Omar, Zainal; Waqanivalu, Temo; Phongsavan, Philayrath; Keke, Kieren; Bhushan, Anjana

2011-01-01

This study describes physical activity patterns and their association with socioeconomic factors in six countries in the Asia-Pacific region, and examines whether physical activity associations with socioeconomic status follow similar patterns across the six countries. Population-wide representative surveys of non-communicable disease risk factors and socioeconomic factors conducted in Australia, China, Fiji, Malaysia, Nauru and the Philippines between 2002 and 2006 were used. Survey respondents aged 18-64 years who provided information on their socioeconomic status (age, education, income, area of residence) and physical activity level in three domains (leisure-time, occupation, commuting) were included in the study (Australia N=15,786; China N=142,693; Fiji N=6763; Malaysia N=2572; Nauru N=2085; Philippines N=3307). Leisure-time physical activity increased with age in China, showed inverse associations for Fiji and Nauru men, and there were no age relationships in other countries. Individuals in China, Fiji and Malaysia living in urban areas, with higher educational attainment and affluence were physically active during leisure time but less active at work and during commuting compared to those in rural areas, with lower educational attainment and lower income. There is a link between types of physical activity participation and socioeconomic factors in developing countries. Associations with socioeconomic indicators are likely to reflect economic growth. The findings strongly support the need for a comparable non-communicable risk factors surveillance system in developing countries.

Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis.

PubMed

Birnie, Kate; Cooper, Rachel; Martin, Richard M; Kuh, Diana; Sayer, Avan Aihie; Alvarado, Beatriz E; Bayer, Antony; Christensen, Kaare; Cho, Sung-il; Cooper, Cyrus; Corley, Janie; Craig, Leone; Deary, Ian J; Demakakos, Panayotes; Ebrahim, Shah; Gallacher, John; Gow, Alan J; Gunnell, David; Haas, Steven; Hemmingsson, Tomas; Inskip, Hazel; Jang, Soong-nang; Noronha, Kenya; Osler, Merete; Palloni, Alberto; Rasmussen, Finn; Santos-Eggimann, Brigitte; Spagnoli, Jacques; Starr, John; Steptoe, Andrew; Syddall, Holly; Tynelius, Per; Weir, David; Whalley, Lawrence J; Zunzunegui, Maria Victoria; Ben-Shlomo, Yoav; Hardy, Rebecca

2011-01-26

Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood. Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations. Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.

Childhood Socioeconomic Position and Objectively Measured Physical Capability Levels in Adulthood: A Systematic Review and Meta-Analysis

PubMed Central

Martin, Richard M.; Kuh, Diana; Sayer, Avan Aihie; Alvarado, Beatriz E.; Bayer, Antony; Christensen, Kaare; Cho, Sung-il; Cooper, Cyrus; Corley, Janie; Craig, Leone; Deary, Ian J.; Demakakos, Panayotes; Ebrahim, Shah; Gallacher, John; Gow, Alan J.; Gunnell, David; Haas, Steven; Hemmingsson, Tomas; Inskip, Hazel; Jang, Soong-nang; Noronha, Kenya; Osler, Merete; Palloni, Alberto; Rasmussen, Finn; Santos-Eggimann, Brigitte; Spagnoli, Jacques; Starr, John; Steptoe, Andrew; Syddall, Holly; Tynelius, Per; Weir, David; Whalley, Lawrence J.; Zunzunegui, Maria Victoria; Ben-Shlomo, Yoav; Hardy, Rebecca

2011-01-01

Background Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood. Methods and Findings Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations. Conclusions Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life. PMID:21297868

Use of SERTS (Socio-Economic, health Resources and Technologic Supplies) models to estimate cancer survival at provincial geographical level.

PubMed

Vercelli, Marina; Lillini, Roberto; Capocaccia, Riccardo; Quaglia, Alberto

2012-12-01

The main aim of this work is to compute expected cancer survival for Italian provinces by Socio-Economic and health Resources and Technologic Supplies (SERTS) models, based on demographic, socioeconomic variables and information describing the health care system (SEH). Five-year age-standardised relative survival rates by gender for 11 cancer sites and all cancers combined of patients diagnosed in 1995-1999, were obtained from the Italian Association of Cancer Registries (CRs) database. The SEH variables describe at provincial level macro-economy, demography, labour market, health resources in 1995-2005. A principal components factor analysis was applied to the SEH variables to control their strong mutual correlation. For every considered cancer site, linear regression models were estimated considering the 5-RS% as dependent variable and the principal components factors of the SEH variables as independent variables. The model composition was correlated to the characteristics of take in charge of patients. SEH factors were correlated with the observed survival for all cancer combined and colon-rectum in both sexes, prostate, kidney and non Hodgkin's lymphomas in men, breast, corpus uteri and melanoma in women (R(2) from 40% to 85%). In the provinces without any CR the survival was very similar with that of neighbouring provinces with analogous social, economic and health characteristics. The SERTS models allowed us to interpret the survival outcome of oncologic patients with respect to the role of the socio-economic and health related system characteristics, stressing how the peculiarities of the take in charge at the province level could address the decisions regarding the allocation of resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

Integrating socio-economic and infrastructural dimension to reveal hazard vulnerability of coastal districts

NASA Astrophysics Data System (ADS)

Mazumdar, Jublee; Paul, Saikat

2015-04-01

scores are then mapped for spatial analysis. Utilizing SeVI and InVI, the highly vulnerable districts are demonstrated that are likely to face significant challenges in coping with tropical cyclone and require strategies to address the various aspects of socio-economic and infrastructural vulnerability. Moreover, this model can be incorporated not only for multi-level governance but also to integrate it with the real-time weather forecasts to identify the predictive areas of vulnerability.

Neighbourhood safety and area deprivation modify the associations between parkland and psychological distress in Sydney, Australia

PubMed Central

2013-01-01

Background The aim of this study was to investigate how perceived neighbourhood safety and area deprivation influenced the relationship between parklands and mental health. Methods Information about psychological distress, perceptions of safety, demographic and socio-economic background at the individual level was extracted from New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. Generalized Estimating Equations logistic regression analyses were performed to account for correlation between participants within postcodes, and with controls for socio-demographic characteristics and socio-economic status at the area level. Results In areas where the residents reported perceiving their neighbourhood to be “safe” and controlling for area levels of socio-economic deprivation, there were no statistically significant associations between the proportion of parkland and high or very high psychological distress. In the most disadvantaged neighbourhoods which were perceived as unsafe by residents, those with greater proportions of parkland, over 20%, there was greater psychological distress, this association was statistically significant (20-40% parkland: OR=2.27, 95% CI=1.45-3.55; >40% parkland: OR=2.53, 95% CI=1.53-4.19). Conclusion Our study indicates that perceptions of neighbourhood safety and area deprivation were statistically significant effect modifiers of the association between parkland and psychological distress. PMID:23635303

Neighbourhood safety and area deprivation modify the associations between parkland and psychological distress in Sydney, Australia.

PubMed

Chong, Shanley; Lobb, Elizabeth; Khan, Rabia; Abu-Rayya, Hisham; Byun, Roy; Jalaludin, Bin

2013-05-01

The aim of this study was to investigate how perceived neighbourhood safety and area deprivation influenced the relationship between parklands and mental health. Information about psychological distress, perceptions of safety, demographic and socio-economic background at the individual level was extracted from New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. Generalized Estimating Equations logistic regression analyses were performed to account for correlation between participants within postcodes, and with controls for socio-demographic characteristics and socio-economic status at the area level. In areas where the residents reported perceiving their neighbourhood to be "safe" and controlling for area levels of socio-economic deprivation, there were no statistically significant associations between the proportion of parkland and high or very high psychological distress. In the most disadvantaged neighbourhoods which were perceived as unsafe by residents, those with greater proportions of parkland, over 20%, there was greater psychological distress, this association was statistically significant (20-40% parkland: OR=2.27, 95% CI=1.45-3.55; >40% parkland: OR=2.53, 95% CI=1.53-4.19). Our study indicates that perceptions of neighbourhood safety and area deprivation were statistically significant effect modifiers of the association between parkland and psychological distress.

Assessment of environmental injustice in Korea using synthetic air quality index and multiple indicators of socioeconomic status: A cross-sectional study.

PubMed

Choi, Giehae; Heo, Seulkee; Lee, Jong-Tae

2016-01-01

Despite the existence of the universal right to a healthy environment, the right is being violated in some populations. The objective of the current study is to verify environmental discrimination associated with socioeconomic status in Korea, using synthetic air quality index and multiple indicators of socioeconomic status. The concentrations of NO₂(nitrogen dioxide), CO (carbon monoxide), SO₂(sulfur dioxide), PM10 (particulate matter with an aerodynamic diameter <10 μm), and O₃(ozone) in ambient air were integrated into a synthetic air quality index. Socioeconomic status was measured at individual level (income, education, number of household members, occupation, and National Basic Livelihood status) and area level (neighborhood index). The neighborhood index was calculated in the finest administrative unit (municipality) by performing standardization and integration of municipality-level data of the following: number of families receiving National Basic Livelihood, proportion of people engaged in an elementary occupation, population density, and number of service industries. Each study participant was assigned a neighborhood index value of the municipality in which they reside. Six regression models were generated to analyze the relationship between socioeconomic status and overall air pollution. All models were adjusted with sex, age, and smoking status. Stratification was conducted by residency (urban/rural). Moran's I was calculated to identify spatial clusters, and adjusted regression analysis was conducted to account for spatial autocorrelation. Results showed that people with higher neighborhood index, people living with smaller number of family members, and people with no education lived in municipalities with better overall air quality. The association differed by residency in some cases, and consideration of spatial autocorrelation altered the association. This study gives strength to the idea that environmental discrimination exists in some

Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status?

PubMed Central

Wang, Qing

2017-01-01

The study aims to estimate the relationship between the individual/local socioeconomic status and the health of internal elderly migrants in China. A multilevel logistic model was used to estimate this association. The estimations were undertaken for 11,111 migrants aged over 60 years, using nationally representative data: the 2015 Migrant Dynamics Monitoring Survey (MDMS), which was carried out in China. Odds ratios with 95% confidence intervals were reported. Both the household income per capita and the area-level average wage were positively associated with migrants’ self-reported health; however, public service supply was not significantly related to their health. In addition, given the household income, migrants living in communities with a higher average wage were more likely to report poor health. Migrants’ health benefited from individual socioeconomic status, but not from the local socioeconomic status, which the migrants cannot enjoy. This study highlights the importance of multilevel and non-discriminatory policies between migrants and local residents. PMID:28368314

Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status?

PubMed

Wang, Qing

2017-04-01

The study aims to estimate the relationship between the individual/local socioeconomic status and the health of internal elderly migrants in China. A multilevel logistic model was used to estimate this association. The estimations were undertaken for 11,111 migrants aged over 60 years, using nationally representative data: the 2015 Migrant Dynamics Monitoring Survey (MDMS), which was carried out in China. Odds ratios with 95% confidence intervals were reported. Both the household income per capita and the area-level average wage were positively associated with migrants' self-reported health; however, public service supply was not significantly related to their health. In addition, given the household income, migrants living in communities with a higher average wage were more likely to report poor health. Migrants' health benefited from individual socioeconomic status, but not from the local socioeconomic status, which the migrants cannot enjoy. This study highlights the importance of multilevel and non-discriminatory policies between migrants and local residents.

Institutional and socioeconomic aspects of water supply

NASA Astrophysics Data System (ADS)

Rauchenschwandtner, H.; Pachel, M.

2012-04-01

Institutional and socioeconomic aspects of water supply Within the project CC-WaterS the participating researchers of the Vienna University of Economics and B.A. have been responsible for the analysis of the socioeconomic aspects related to water supply and climate change, the assessment of future water demands in the City of Vienna, as well as an estimation of economic consequences of possible water shortages and possible scope for the introduction of new legal guidelines. The institutional and socioeconomic dimensions of drinking water and sanitation systems are being examined by utilisation of different prognostic scenarios in order to assess future costs of water provisioning and future demands of main water users, thus providing an information basis and recommendations for policy and decision makers in the water sector. These dimensions, for example, include EU legislation - especially the Water Framework Directive -, national legislations and strategies targeted at achieving sustainability in water usage, best practices and different forms of regulating water markets, and an analysis of the implications of demographic change. As a basis this task encompasses research of given institutional, social, and legal-political structures in the area of water supply. In this course we provide an analysis of the structural characteristics of water markets, the role of water prices, the increasing perception of water as an economic good as well as implications thereof, the public awareness in regard to climate change and water resources, as well as related legal aspects and involved actors from regional to international level; and show how water resources and the different systems of water provisioning are affected by (ideological) conflicts on various levels. Furthermore, and in order to provide a solid basis for management recommendations related to climate change and water supply, an analytical risk-assessment framework based on the concepts of new institutional

Association between socioeconomic factors and cancer risk: a population cohort study in Scotland (1991-2006).

PubMed

Sharpe, Katharine H; McMahon, Alex D; Raab, Gillian M; Brewster, David H; Conway, David I

2014-01-01

Lung and upper aero-digestive tract (UADT) cancer risk are associated with low socioeconomic circumstances and routinely measured using area socioeconomic indices. We investigated effect of country of birth, marital status, one area deprivation measure and individual socioeconomic variables (economic activity, education, occupational social class, car ownership, household tenure) on risk associated with lung, UADT and all cancer combined (excluding non melanoma skin cancer). We linked Scottish Longitudinal Study and Scottish Cancer Registry to follow 203,658 cohort members aged 15+ years from 1991-2006. Relative risks (RR) were calculated using Poisson regression models by sex offset for person-years of follow-up. 21,832 first primary tumours (including 3,505 lung, 1,206 UADT) were diagnosed. Regardless of cancer, economically inactivity (versus activity) was associated with increased risk (male: RR 1.14, 95% CI 1.10-1.18; female: RR 1.06, 95% CI 1.02-1.11). For lung cancer, area deprivation remained significant after full adjustment suggesting the area deprivation cannot be fully explained by individual variables. No or non degree qualification (versus degree) was associated with increased lung risk; likewise for UADT risk (females only). Occupational social class associations were most pronounced and elevated for UADT risk. No car access (versus ownership) was associated with increased risk (excluding all cancer risk, males). Renting (versus home ownership) was associated with increased lung cancer risk, UADT cancer risk (males only) and all cancer risk (females only). Regardless of cancer group, elevated risk was associated with no education and living in deprived areas. Different and independent socioeconomic variables are inversely associated with different cancer risks in both sexes; no one socioeconomic variable captures all aspects of socioeconomic circumstances or life course. Association of multiple socioeconomic variables is likely to reflect the

The socioeconomic inequality in traffic-related disability among Chinese adults: the application of concentration index.

PubMed

Chen, He; Du, Wei; Li, Ning; Chen, Gong; Zheng, Xiaoying

2013-06-01

Traffic crashes have become the fifth leading cause of burden of diseases and injuries in China. More importantly, it may further aggravate the degree of health inequality among Chinese population, which is still under-investigated. Based on a nationally representative data, we calculated the concentration index (CI) to measure the socioeconomic inequality in traffic-related disability (TRD), and decomposed CI into potential sources of the inequality. Results show that more than 1.5 million Chinese adults were disabled by traffic crashes and the adults with financial disadvantage bear disproportionately heavier burden of TRD. Besides, strategies of reducing income inequality and protecting the safety of poor road users, are of great importance. Residence appears to counteract the socioeconomic inequality in TRD, however, it does not necessarily come to an optimistic conclusion. In addition to the worrying income gap between rural and urban areas, other possible mechanisms, e.g. the low level of post-crash medical resources in rural area, need further studies. China is one of the developing countries undergoing fast motorization and our findings could provide other countries in similar context with some insights about how to maintain socioeconomic equality in road safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ethnic, socioeconomic and geographical inequalities in road traffic injury rates in the Auckland region.

PubMed

Hosking, Jamie; Ameratunga, Shanthi; Exeter, Daniel; Stewart, Joanna; Bell, Andrew

2013-04-01

To describe ethnic, socioeconomic and geographical differences in road traffic injury (RTI) within Auckland, New Zealand's largest city. We analysed rates of RTI deaths and non-fatal hospital admissions using the New Zealand Mortality Collection and the National Minimum Data Set 2000-08. Poisson regression examined the association of age, gender, prioritised ethnicity and small area deprivation (New Zealand Index of Deprivation) with RTI rates, and RTI rates were mapped for 21 local board areas within the Auckland region. While RTI rates increased with levels of deprivation in all age groups, the gradient was steepest among children (9% increase/decile) and adults aged 25-64 years (11% increase/decile). In all age groups, RTI risk was highest among Māori. Pacific children had an elevated risk of RTI compared with the NZ European/Other group, but Pacific youth (15-24 years) and adults (25-64 years) had a lower risk. While RTI rates were generally higher for those living in rural local board areas, all but one local board in the southern Auckland urban area had among the highest rates. There are substantial ethnic, socioeconomic and geographic inequalities in RTI risk in the Auckland region, with high rates among Māori (all ages), Pacific children, people living in socioeconomically deprived neighbourhoods, the urban south and rural regions. To meet the vision of regional plans, road safety efforts must prioritise vulnerable communities at greatest risk of RTI, and implement and monitor the effectiveness of strategies that specifically include a focus on reducing inequalities in RTI rates. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Socio-Economic Determinants of the Need for Dental Care in Adults.

PubMed

Trohel, Gilda; Bertaud-Gounot, Valérie; Soler, Marion; Chauvin, Pierre; Grimaud, Olivier

2016-01-01

Oral health has improved in France. However, there are still inequalities related to the socio-economic status. The aim of this study was to measure the prevalence of dental care needs in an adult population and to identify the demographic, socio-economic and behavioral variables that may explain variations in this parameter. A cross-sectional analysis of the French SIRS cohort (n = 2,997 adults from the Paris region; 2010 data) was carried out to determine the prevalence of self-reported dental care needs relative to demographic, socio-economic and behavioral variables. A logistic regression model was used to identify the variables that were most strongly associated with the level of need. In 2010, the prevalence of the need for dental care in the SIRS cohort was 35.0% (95% CI [32.3-37.8]). It was lower in people with higher education levels (31.3% [27.9-34.6]), without immigrant background (31.3% [28.0-34.6]) and with comprehensive health insurance (social security + complementary health cover; 32.8% [30.2-35.4]). It decreased as the socio-economic status increased, but without following a strict linear change. It was also lower among individuals who had a dental check-up visit in the previous two years. In multivariate analyses, the socioeconomic variables most strongly associated with the need for dental care were: educational attainment (OR = 1.21 [1.02-1.44]), income level (OR = 1.66 [1.92-2.12]) and national origin (OR = 1.53 [1.26-1.86]). These results confirm that the prevalence of dental care needs is higher among adults with low socio-economic status. Education level, income level and also national origin were more strongly associated with the need for dental care than insurance cover level.

Comparison of knowledge, attitude and practices of betelnut users in two socio-economic areas of Karachi.

PubMed

Khan, Muhammad Shahzeb; Bawany, Faizan Imran; Shah, Syed Raza; Hussain, Mehwish; Arshad, Mohammad Hussham; Nisar, Nighat

2013-10-01

To gain an insight on the knowledge, attitude and practices of those who chew betel nut in two different socioeconomic regions of Karachi. The cross-sectional study was conducted in Saddar and Defence areas of Karachi over a five-week period in March-April 2012. Individual interviews following verbal consent were conducted using a pre-coded questionnaire, which was divided into 3 sections to analyse the knowledge, attitude and practices of the chewers. The data was entered and analysed using SPSS v. 16.0. Pearson's chi-square was used as the primary statistical test. A total of 370 subjects, 185 (50%) from each area, comprised the study. Majority of the chewers in Defence had higher educational qualification and income. Most of the participants in both areas acknowledged that betel nut chewing can potentially result in mouth (n = 274; 74.1%) and throat cancers (n = 267; 72.2%). A large part of the sample (n = 299; 80.8%) conceded that betel nut chewing is a bad habit, and almost half the sample was addicted to it (n = 194; 52.4%). Awareness regarding the detrimental effects of betel nut was satisfactory amongst the subjects, but the population was not willing to quit the habit. We recommend a two-pronged approach, offering widespread educational and awareness campaigns to prevent increased consumption of betel nuts, and professional counselling services for those already addicted.

Impact of socioeconomic status on survival for patients with anal cancer.

PubMed

Lin, Daniel; Gold, Heather T; Schreiber, David; Leichman, Lawrence P; Sherman, Scott E; Becker, Daniel J

2018-04-15

Although outcomes for patients with squamous cell carcinoma of the anus (SCCA) have improved, the gains in benefit may not be shared uniformly among patients of disparate socioeconomic status. In the current study, the authors investigated whether area-based median household income (MHI) is predictive of survival among patients with SCCA. Patients diagnosed with SCCA from 2004 through 2013 in the Surveillance, Epidemiology, and End Results registry were included. Socioeconomic status was defined by census-tract MHI level and divided into quintiles. Multivariable Cox proportional hazards models and logistic regression were used to study predictors of survival and radiotherapy receipt. A total of 9550 cases of SCCA were included. The median age of the patients was 58 years, 63% were female, 85% were white, and 38% were married. In multivariable analyses, patients living in areas with lower MHI were found to have worse overall survival and cancer-specific survival (CSS) compared with those in the highest income areas. Mortality hazard ratios for lowest to highest income were 1.32 (95% confidence interval [95% CI], 1.18-1.49), 1.31 (95% CI, 1.16-1.48), 1.19 (95% CI, 1.06-1.34), and 1.16 (95% CI, 1.03-1.30). The hazard ratios for CSS similarly ranged from 1.34 to 1.22 for lowest to highest income. Older age, black race, male sex, unmarried marital status, an earlier year of diagnosis, higher tumor grade, and later American Joint Committee on Cancer stage of disease also were associated with worse CSS. Income was not found to be associated with the odds of initiating radiotherapy in multivariable analysis (odds ratio of 0.87 for lowest to highest income level; 95% CI, 0.63-1.20). MHI appears to independently predict CSS and overall survival in patients with SCCA. Black race was found to remain a predictor of SCCA survival despite controlling for income. Further study is needed to understand the mechanisms by which socioeconomic inequalities affect cancer care and

Socioeconomic Status and MMPI-2 Interpretation.

ERIC Educational Resources Information Center

Long, Kathleen A.; And Others

1994-01-01

Examined differences in Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scores between persons of differing educational levels and family income in the MMPI-2 normative sample to determine if MMPI-2 scores are differentially accurate in predicting relevant extra-test characteristics of persons of differing socioeconomic levels. MMPI-2…

A socioeconomic profile of vulnerable land to desertification in Italy.

PubMed

Salvati, Luca

2014-01-01

Climate changes, soil vulnerability, loss in biodiversity, and growing human pressure are threatening Mediterranean-type ecosystems which are increasingly considered as a desertification hotspot. In this region, land vulnerability to desertification strongly depends on the interplay between natural and anthropogenic factors. The present study proposes a multivariate exploratory analysis of the relationship between the spatial distribution of land vulnerability to desertification and the socioeconomic contexts found in three geographical divisions of Italy (north, center and south) based on statistical indicators. A total of 111 indicators describing different themes (demography, human settlements, labor market and human capital, rural development, income and wealth) were used to discriminate vulnerable from non-vulnerable areas. The resulting socioeconomic profile of vulnerable areas in northern and southern Italy diverged significantly, the importance of demographic and economic indicators being higher in southern Italy than in northern Italy. On the contrary, human settlement indicators were found more important to discriminate vulnerable and non-vulnerable areas in northern Italy, suggesting a role for peri-urbanization in shaping the future vulnerable areas. An in-depth knowledge of the socioeconomic characteristics of vulnerable land may contribute to scenarios' modeling and the development of more effective policies to combat desertification. © 2013 Elsevier B.V. All rights reserved.

Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950–2014: Over Six Decades of Changing Patterns and Widening Inequalities

PubMed Central

Jemal, Ahmedin

2017-01-01

We analyzed socioeconomic and racial/ethnic disparities in US mortality, incidence, and survival rates from all-cancers combined and major cancers from 1950 to 2014. Census-based deprivation indices were linked to national mortality and cancer data for area-based socioeconomic patterns in mortality, incidence, and survival. The National Longitudinal Mortality Study was used to analyze individual-level socioeconomic and racial/ethnic patterns in mortality. Rates, risk-ratios, least squares, log-linear, and Cox regression were used to examine trends and differentials. Socioeconomic patterns in all-cancer, lung, and colorectal cancer mortality changed dramatically over time. Individuals in more deprived areas or lower education and income groups had higher mortality and incidence rates than their more affluent counterparts, with excess risk being particularly marked for lung, colorectal, cervical, stomach, and liver cancer. Education and income inequalities in mortality from all-cancers, lung, prostate, and cervical cancer increased during 1979–2011. Socioeconomic inequalities in cancer mortality widened as mortality in lower socioeconomic groups/areas declined more slowly. Mortality was higher among Blacks and lower among Asian/Pacific Islanders and Hispanics than Whites. Cancer patient survival was significantly lower in more deprived neighborhoods and among most ethnic-minority groups. Cancer mortality and incidence disparities may reflect inequalities in smoking, obesity, physical inactivity, diet, alcohol use, screening, and treatment. PMID:28408935

Remote sensing appraisal of Lake Chad shrinkage connotes severe impacts on green economics and socio-economics of the catchment area.

PubMed

Onamuti, Olapeju Y; Okogbue, Emmanuel C; Orimoloye, Israel R

2017-11-01

Lake Chad commonly serves as a major hub of fertile economic activities for the border communities and contributes immensely to the national growth of all the countries that form its boundaries. However, incessant and multi-decadal drying via climate change pose greater threats to this transnational water resource, and adverse effects on ecological sustainability and socio-economic status of the catchment area. Therefore, this study assessed the extent of shrinkage of Lake Chad using remote sensing. Landsat imageries of the lake and its surroundings between 1987 and 2005 were retrieved from Global Land Cover Facility website and analysed using Integrated Land and Water Information System version 3.3 (ILWIS 3.3). Supervised classification of area around the lake was performed into various land use/land cover classes, and the shrunk part of its environs was assessed based on the land cover changes. The shrinkage trend within the study period was also analysed. The lake water size reduced from 1339.018 to 130.686 km 2 (4.08-3.39%) in 1987-2005. The supervised classification of the Landsat imageries revealed an increase in portion of the lake covered by bare ground and sandy soil within the reference years (13 490.8-17 503.10 km 2 ) with 4.98% total range of increase. The lake portion intersected with vegetated ground and soil also reduced within the period (11 046.44-10 078.82 km 2 ) with 5.40% (967.62 km 2 ) total decrease. The shrunk part of the lake covered singly with vegetation increased by 2.74% from 1987 to 2005. The shrunk part of the lake reduced to sand and turbid water showed 5.62% total decrease from 1987 to 2005 and a total decrease of 1805.942 km 2 in area. The study disclosed an appalling rate of shrinkage and damaging influences on the hydrologic potential, eco-sustainability and socio-economics of the drainage area as revealed using ILWIS 3.3.

A novel approach to measuring residential socioeconomic ...

EPA Pesticide Factsheets

Individual-level characteristics, including socioeconomic status, have been associated with poor metabolic and cardiovascular health; however, residential area-level characteristics may also independently contribute to health status. In the current study, we used a novel application of hierarchical clustering to aggregate 444 US Census block groups in Durham, Orange, and Wake Counties, NC, USA into six homogenous clusters of similar characteristics based on 12 demographic factors. We assigned 2254 cardiac catheterization patients to these clusters based on residence at first catheterization. After controlling for individual age, sex, smoking status, and race, there were elevated odds of patients being obese (OR = 1.92, 95% CI = 1.39, 2.67), and having diabetes (OR = 2.19, 95% CI = 1.57, 3.04) and hypertension (OR = 2.05, 95% CI = 1.38, 3.11) in a cluster that was urban, impoverished, and unemployed, compared to a cluster that was urban with a low percentage of people that were impoverished or unemployed. Our findings demonstrate the feasibility of applying hierarchical clustering to an assessment of area-level characteristics and that living in impoverished, urban residential clusters may have an adverse impact on health. This abstract does not necessarily reflect U.S. EPA policy. This is an abstract of a presentation to be presented at the International Society for Environmental Epidemiology (ISEE) 2016 Conference. Reactions to this presentation will guid

Hair cortisol levels, perceived stress and body mass index in women and children living in socioeconomically disadvantaged neighborhoods: the READI study.

PubMed

Olstad, Dana Lee; Ball, Kylie; Wright, Craig; Abbott, Gavin; Brown, Erin; Turner, Anne Isabella

2016-01-01

Disadvantaged communities provide adverse psychosocial exposures that have been linked to high levels of stress, and this may provide one explanatory pathway linking socioeconomic disadvantage to obesity. This study used hair cortisol analysis to quantify associations between stress and body mass index (BMI), and between hair cortisol and perceived psychological stress levels, in women and children living in socioeconomically disadvantaged neighborhoods. Participants were a volunteer sample of 70 women from the Resilience for Eating and Activity Despite Inequality study, including 30 maternal-child pairs. Women self-reported body weight, height and perceived psychological stress using the Perceived Stress Scale (PSS), and provided hair samples for themselves and their child. Children's body weight and height were measured. Following extraction, hair cortisol levels were measured using enzyme-linked immunosorbent assay. Multiple linear regression models examined associations between stress and BMI, and between hair cortisol and perceived stress levels in women and children. Women's hair cortisol levels were not associated with their BMI or PSS scores. Women's PSS scores were positively associated with their BMI (p = 0.015). Within maternal-child pairs, mothers and children's hair cortisol levels were strongly positively associated (p = 0.006). Maternal hair cortisol levels and PSS scores were unrelated to their child's zBMI. Children's hair cortisol levels were not associated with their zBMI or with their mother's PSS score. Findings suggest that cortisol-based and perceived psychological measures of stress may be distinct among women and children living in disadvantaged neighborhoods. Perceived psychological measures may be more important predictors of weight-related risk.

Socioeconomic Status Modifies the Seasonal Effect on Blood Pressure

PubMed Central

Cois, Annibale; Ehrlich, Rodney

2015-01-01

Abstract Seasonal variations in blood pressure have been consistently reported. However, uncertainty remains about the size of the seasonal effect in different regions, and about factors that explain the differences observed across and within populations. Using data from a national panel study, we investigated seasonal variations in blood pressure in the South African adult population, and whether these variations differed across socioeconomic strata. We estimated age-specific seasonal effects on blood pressure using a multilevel structural equation model, with repeated measurements nested within subjects. Effect modification by socioeconomic status was assessed by repeating the analyses in the subpopulations defined by levels of education, household income per capita, and type of housing. In men and women, season had a statistically significant effect on blood pressure, with higher levels in winter and lower levels in summer. For systolic blood pressure, the magnitude of the seasonal effect was 4.25/4.21 mmHg (women/men) and was higher in the older age groups. For diastolic blood pressure, the effect size was 4.00/4.01 mmHg, with no evident age trend. Seasonal effects were higher among subjects in the lowest socioeconomic classes than in the highest, with differences between 2.4 and 7.7 mmHg, depending on gender, whether systolic or diastolic blood pressure, and socioeconomic status indicator. In the South African adult population, blood pressure shows seasonal variation modified by age and socioeconomic status. These variations have epidemiological, clinical, and public health implications, including the prospect of population level intervention to reduce elevated risk of cold weather cardiovascular morbidity. PMID:26334893

Neurobiological Pathways Linking Socioeconomic Position and Health

PubMed Central

Gianaros, Peter J.; Manuck, Stephen B.

2010-01-01

Across individuals, risk for poor health varies inversely with socioeconomic position (SEP). The pathways by which SEP affects health have been viewed from many epidemiological perspectives. Central to these perspectives is the notion that socioeconomic health disparities arise from an interplay between nested, recursive, and cumulative environmental, social, familial, psychological, behavioral, and physiological processes that unfold over the life span. Epidemiological perspectives on socioeconomic health disparities, however, have not yet formally integrated emerging findings from neuropharmacological, molecular genetic, and neuroimaging studies demonstrating that indicators of SEP relate to patterns of brain neurotransmission, brain morphology, and brain functionality implicated in the etiology of chronic medical conditions and psychological disorders. Here, we survey these emerging findings and consider how future neurobiological studies in this area can enhance our understanding of the pathways by which different dimensions of SEP become embodied by the brain to influence health throughout life. PMID:20498294

Socioeconomic inequalities in neonatal intensive care admission rates.

PubMed

Jenkins, J; McCall, E; Gardner, E; Casson, K; Dolk, H

2009-11-01

To examine socioeconomic inequalities in neonatal intensive care (NIC) admissions relating to preterm birth, intrauterine growth restriction (IUGR), multiple births and other conditions. Retrospective review of all NIC admissions from 1996 to 2001 throughout a geographically defined region. Area deprivation indices were grouped into quintiles from least (1) to most (5) deprived. Admissions were classified by predefined hierarchical criteria. The rate of admissions was 31.4 per 1000 births. There was a J-shaped relation with socioeconomic group (28.1 NIC admissions per 1000 in quintile 1, 34.0 in quintile 5 and below 28 in the other quintiles). The most deprived areas had a rate 19% above the regional average. The relation with socioeconomic group differed significantly according to primary reason for admission. The rates of admissions with significant prematurity (34% of all admissions) and IUGR as primary reason were highest in quintile 5 (18% and 41% above the regional average, respectively). This contrasted with the rate of admission for multiple birth which was highest in quintile 1 (45% above average). These differences provided the main explanation for the J-shaped overall curve. Measures to alleviate deprivation and to improve the preterm birth and IUGR rates in deprived groups would have the greatest potential to reduce inequality in need for NIC admission. Efforts to achieve targets for reduction in infant mortality need to take account of the different effects of socioeconomic inequalities for different conditions and groups of infants.

Effect of cross-level interaction between individual and neighborhood socioeconomic status on adult mortality rates.

PubMed

Winkleby, Marilyn; Cubbin, Catherine; Ahn, David

2006-12-01

We examined whether the influence of neighborhood-level socioeconomic status (SES) on mortality differed by individual-level SES. We used a population-based, mortality follow-up study of 4476 women and 3721 men, who were predominately non-HIspanic White and aged 25-74 years at baseline, from 82 neighborhoods in 4 California cities. Participants were surveyed between 1979 and 1990, and were followed until December 31, 2002 (1148 deaths; mean follow-up time 17.4 years). Neighborhood SES was defined by 5 census variables and was divided into 3 levels. Individual SES was defined by a composite of educational level and household income and was divided into tertiles. Death rates among women of low SES were highest in high-SES neighborhoods (1907/100000 person-years), lower in moderate-SES neighborhoods (1323), and lowest in low-SES neighborhoods (1128). Similar to women, rates among men of low SES were 1928, 1646, and 1590 in high-, moderate-, and low-SES neighborhoods, respectively. Differences were not explained by individual-level baseline risk factors. The disparities in mortality by neighborhood of residence among women and men of low SES demonstrate that they do not benefit from the higher quality of resources and knowledge generally associated with neighborhoods that have higher SES.

Neighbourhood Socio-Economic Factors in Relation to Student Drug Use and Programs.

ERIC Educational Resources Information Center

Smart, Reginald G.; And Others

1994-01-01

Examines relationships between drug use problems and socioeconomic status of neighborhoods where students in grades 11 and 13 reside. Found largest number of alcohol and drug problems in areas with lowest socioeconomic characteristics, characterized by low-cost substandard housing, social and racial problems, and delinquency. Includes 13…

Individual and Area-Based Socioeconomic Factors Associated With Dementia Incidence in England: Evidence From a 12-Year Follow-up in the English Longitudinal Study of Ageing.

PubMed

Cadar, Dorina; Lassale, Camille; Davies, Hilary; Llewellyn, David J; Batty, G David; Steptoe, Andrew

2018-05-16

Lower educational attainment is associated with a higher risk of dementia. However, less clear is the extent to which other socioeconomic markers contribute to dementia risk. To examine the relationship of education, wealth, and area-based deprivation with the incidence of dementia over the last decade in England and investigate differences between people born in different periods. Data from the English Longitudinal Study of Ageing, a prospective cohort study that is representative of the English population, were used to investigate the associations between markers of socioeconomic status (wealth quintiles and the index of multiple deprivation) and dementia incidence. To investigate outcomes associated with age cohorts, 2 independent groups were derived using a median split (born between 1902-1925 and 1926-1943) . Dementia as determined by physician diagnosis and the Informant Questionnaire on Cognitive Decline in the Elderly. A total of 6220 individuals aged 65 years and older enrolled in the study (median [interquartile range] age at baseline, 73.2 [68.1-78.3] years; 3410 [54.8%] female). Of these, 463 individuals (7.4%) had new cases of dementia ascertained in the 12 years between 2002-2003 and 2014-2015. The hazard of developing dementia was 1.68 times higher (hazard ratio [HR] = 1.68 [95% CI, 1.05-2.86]) for those in the lowest wealth quintile compared with those in the highest quintile, independent of education, index of multiple deprivation, and health indicators. Higher hazards were also observed for those in the second-highest quintile of index of multiple deprivation (HR = 1.62 [95% CI, 1.06-2.46]) compared with those in the lowest (least deprived) quintile. In an English nationally representative sample, the incidence of dementia appeared to be socioeconomically patterned primarily by the level of wealth. This association was somewhat stronger for participants born in later years.

Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany

PubMed Central

Kroll, Lars Eric; Maier, Werner; Bolte, Gabriele

2018-01-01

Objectives To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association. Design Cross-sectional multilevel analysis of survey data. Setting Germany. Participants 3350 men and 3665 women living in 167 municipalities throughout Germany participating in the ‘German Health Interview and Examination Survey for Adults’ (DEGS1 2008–2011) as part of the national health monitoring. Outcome Perceived social support as measured by Oslo-3 Social Support Scale. Results Prevalence of low perceived social support was 11.4% in men and 11.1% in women. Low social support was associated in men and women with sociodemographic characteristics that indicate more disadvantaged living situations. Taking these individual-level characteristics into account, municipal-level deprivation was independently associated with low perceived social support in men (OR for the most deprived quintile: 1.80 (95% CI 1.14 to 2.84)), but not in women (OR 1.22 (95% CI 0.78 to 1.90)). Conclusion The results of our multilevel analysis suggest that there are gender inequalities in the association of municipal-level deprivation with the prevalence of low perceived social support in Germany independent of individual socioeconomic position. Community health interventions aiming at promotion of social support among residents might profit from a further understanding of the observed gender differences. PMID:29654020

Socioeconomic and lifestyle factors associated with chronic conditions among older adults in Ecuador.

PubMed

Guevara, Pilar Egüez; Andrade, Flávia Cristina Drumond

2015-09-01

To explore socioeconomic and lifestyle factors associated with the prevalence of self-reported chronic conditions among older adults in Ecuador. The sample was drawn from the nationally representative observational cross-sectional data of the Health, Well-Being, and Aging survey conducted in Ecuador in 2009. Logistic regression models were used to explore the association between socioeconomic and lifestyle factors and the prevalence of selected chronic conditions. Older women in Ecuador are more likely than men to have been previously diagnosed with diabetes, heart disease, high blood pressure, and arthritis. Results suggest no difference by education or health insurance on number and type of self-reported chronic conditions. However, older adults who resided in the coastal area were more likely to report having diabetes, heart disease, high blood pressure, and stroke than those in the highlands. Living in rural areas was associated with lower odds of having diabetes and high blood pressure. Compared to white older adults, indigenous older adults were less likely to report having high blood pressure, but more likely to report having arthritis. Older age in Ecuador is marked by low educational levels and poverty. Female gender and living in coastal areas were associated with higher risks of self-reported chronic conditions.

Socioeconomic factors explain racial disparities in invasive community-associated methicillin-resistant Staphylococcus aureus disease rates

PubMed Central

See, Isaac; Wesson, Paul; Gualandi, Nicole; Dumyati, Ghinwa; Harrison, Lee H.; Lesher, Lindsey; Nadle, Joelle; Petit, Susan; Reisenauer, Claire; Schaffner, William; Tunali, Amy; Mu, Yi; Ahern, Jennifer

2017-01-01

Introduction Invasive community-associated methicillin-resistant Staphylococcus aureus (MRSA) incidence in the United States is higher among black persons than white persons. We explored the extent to which socioeconomic factors might explain this racial disparity. Methods A retrospective cohort was based on CDC’s Emerging Infections Program surveillance data for invasive community-associated MRSA cases (isolated from a normally sterile site of an outpatient or on hospital admission day ≤3 in a patient without specified major healthcare exposures) from 2009–2011 in 33 counties of 9 states. We used generalized estimating equations to determine census tract-level factors associated with differences in MRSA incidence and inverse odds ratio weighted mediation analysis to determine the proportion of racial disparity mediated by socioeconomic factors. Results Annual invasive community-associated MRSA incidence was 4.59/100,000 among whites and 7.60/100,000 among blacks (rate ratio: 1.66, 95% CI, 1.52–1.80). In the mediation analysis, after accounting for census tract-level measures of federally-designated medically underserved areas, education, income, housing value, and rural status, 91% of the original racial disparity was explained; no significant association of black race with community-associated MRSA remained (rate ratio: 1.05, 95% CI, 0.92–1.20). Conclusions The racial disparity in invasive community-associated MRSA rates was almost entirely mediated by socioeconomic factors. The specific factors that underlie the association between tract-level socioeconomic measures and MRSA incidence, which may include modifiable social (e.g., poverty, crowding) and biological factors (not explored in this analysis), should be elucidated to define strategies for reducing racial disparities in community-associated MRSA rates. PMID:28362911

Socio-economic inequalities in malnutrition among children and adolescents in Colombia: the role of individual-, household- and community-level characteristics.

PubMed

Garcia, Sandra; Sarmiento, Olga L; Forde, Ian; Velasco, Tatiana

2013-09-01

To examine socio-economic inequalities in malnutrition among Colombian children and adolescents, and to assess the contribution of individual-, household- and community-level factors to those inequalities. Cross-sectional data were used from two sources: 2005 Colombian Demographic and Health Survey and 2005 Colombian census. Malnutrition outcomes included stunting and overweight. Multilevel Poisson models were used to estimate the association between individual, household and contextual characteristics and malnutrition. Changes in prevalence ratios of the poorest quintile (v. richest) were compared to assess the contribution of different characteristics to inequalities in malnutrition. Population-based, representative of Colombia. Children and adolescents <18 years of age (n 30 779) from the Colombian Demographic and Health Survey. Children and adolescents living in the poorest households were close to five times more likely to be stunted, while those from the richest households were 1.3–2.8 times more likely than their poorest counterparts to be overweight. Care practices and household characteristics, particularly mother’s education, explained over one-third of socio-economic inequalities in stunting. The proportion explained by access to services was not negligible (between 6% and 14 %). Access to sanitation was significantly associated with a lower prevalence of stunting for all age groups. Between 14% and 32% of socio-economic disparities in overweight were explained by maternal and household characteristics. Mother’s overweight was positively associated with overweight of the child. Socio-economic inequalities in stunting and overweight coexist among children and adolescents in Colombia. Malnutrition inequalities are largely explained by household characteristics, suggesting the need for targeted interventions.

Human altruistic tendencies vary with both the costliness of selfless acts and socioeconomic status.

PubMed

Grueter, Cyril C; Ingram, Jesse A; Lewisson, James W; Bradford, Olivia R; Taba, Melody; Coetzee, Rebecca E; Sherwood, Michelle A

2016-01-01

Altruism toward strangers is considered a defining feature of humans. However, manifestation of this behaviour is contingent on the costliness of the selfless act. The extent of altruistic tendencies also varies cross-culturally, being more common in societies with higher levels of market integration. However, the existence of local variation in selfless behaviour within populations has received relatively little empirical attention. Using a 'lost letter' design, we dropped 300 letters (half of them stamped, half of them unstamped) in 15 residential suburbs of the greater Perth area that differ markedly in socioeconomic status. The number of returned letters was used as evidence of altruistic behaviour. Costliness was assessed by comparing return rates for stamped vs. unstamped letters. We predicted that there is a positive association between suburb socioeconomic status and number of letters returned and that altruistic acts decrease in frequency when costs increase, even minimally. Both predictions were solidly supported and demonstrate that socioeconomic deprivation and elevated performance costs independently impinge on the universality of altruistic behaviour in humans.

Human altruistic tendencies vary with both the costliness of selfless acts and socioeconomic status

PubMed Central

Ingram, Jesse A.; Lewisson, James W.; Bradford, Olivia R.; Taba, Melody; Coetzee, Rebecca E.; Sherwood, Michelle A.

2016-01-01

Altruism toward strangers is considered a defining feature of humans. However, manifestation of this behaviour is contingent on the costliness of the selfless act. The extent of altruistic tendencies also varies cross-culturally, being more common in societies with higher levels of market integration. However, the existence of local variation in selfless behaviour within populations has received relatively little empirical attention. Using a ‘lost letter’ design, we dropped 300 letters (half of them stamped, half of them unstamped) in 15 residential suburbs of the greater Perth area that differ markedly in socioeconomic status. The number of returned letters was used as evidence of altruistic behaviour. Costliness was assessed by comparing return rates for stamped vs. unstamped letters. We predicted that there is a positive association between suburb socioeconomic status and number of letters returned and that altruistic acts decrease in frequency when costs increase, even minimally. Both predictions were solidly supported and demonstrate that socioeconomic deprivation and elevated performance costs independently impinge on the universality of altruistic behaviour in humans. PMID:27812415

Socioeconomic inequalities in health in older women.

PubMed

Rostad, Berit; Deeg, Dorly J H; Schei, Berit

2009-03-01

Socioeconomic status differentials in health are well documented. Less is known about the socioeconomic variation in health in older people, and in older women in particular. The aim of the study was to examine the association between socioeconomic status and health in older women in relation to two indicators of socioeconomic status and three measures of health, and further, to investigate whether socioeconomic differences in health increase or decrease with advancing age. Data from a cross-sectional population based health survey inviting all women ≥70 years were analysed; 6,380 women aged 70-103 years participated. Logistic regression was applied to analyse variation in health by socioeconomic status. Disadvantaged socioeconomic status (i.e. lower educational levels and previous manual or never been in paid work) was significantly associated with poorer health outcomes, whether measured as self-assessed health or depression. Limiting long-standing illness was significantly associated with never been in paid work. The associations were not attenuated by simultaneous adjustments for health behavioural factors, social support, and marital status. Additional adjustments for medical conditions did only alter the significant association between employment status and limiting long-standing illness. The analyses revealed that educational inequalities did not decrease with advancing age, whereas the results for employment varied across age groups. Our findings suggest an enduring relation between socioeconomic status and health in later life. The study adds to the understanding of the consistent associations between poorer health and social disadvantages at older age. We are not aware of any previous study showing the persistence of social inequalities in health upon adjustments for medical conditions.

Association between HIV infection and socio-economic status: evidence from a semirural area of southern Mozambique.

PubMed

Pons-Duran, Clara; González, Raquel; Quintó, Llorenç; Munguambe, Khatia; Tallada, Joan; Naniche, Denise; Sacoor, Charfudin; Sicuri, Elisa

2016-12-01

To analyse the association between socio-economic status (SES) and HIV in Manhiça, a district of Southern Mozambique with one of the highest HIV prevalences in the world. Data were gathered from two cross-sectional surveys performed in 2010 and 2012 among 1511 adults and from the household census of the district's population. Fractional polynomial logit models were used to analyse the association between HIV and SES, controlling for age and sex and taking into account the nonlinearity of covariates. The inequality of the distribution of HIV infection with regard to SES was computed through a concentration index. Fourth and fifth wealth quintiles, the least poor, were associated with a reduced probability of HIV infection compared to the first quintile (OR = 0.595, P-value = 0.009 and OR = 0.474, P-value < 0.001, respectively). Probability of HIV infection peaked at 36 years and then fell, and was always higher for women regardless of age and SES. HIV infection was unequally distributed across the SES strata. Despite the high HIV prevalence across the entire population of Manhiça, the poorest are at greatest risk of being HIV infected. While women have a higher probability of being HIV positive than men, both sexes showed the same infection reduction at higher levels of SES. HIV interventions in the area should particularly focus on the poorest and on women without neglecting anyone else, as the HIV risk is high for everyone. © 2016 John Wiley & Sons Ltd.

Objectively assessed recess physical activity in girls and boys from high and low socioeconomic backgrounds.

PubMed

Baquet, Georges; Ridgers, Nicola D; Blaes, Aurélie; Aucouturier, Julien; Van Praagh, Emmanuel; Berthoin, Serge

2014-02-21

The school environment influences children's opportunities for physical activity participation. The aim of the present study was to assess objectively measured school recess physical activity in children from high and low socioeconomic backgrounds. Four hundred and seven children (6-11 years old) from 4 primary schools located in high socioeconomic status (high-SES) and low socioeconomic status (low-SES) areas participated in the study. Children's physical activity was measured using accelerometry during morning and afternoon recess during a 4-day school week. The percentage of time spent in light, moderate, vigorous, very high and in moderate- to very high-intensity physical activity were calculated using age-dependent cut-points. Sedentary time was defined as 100 counts per minute. Boys were significantly (p < 0.001) more active than girls. No difference in sedentary time between socioeconomic backgrounds was observed. The low-SES group spent significantly more time in light (p < 0.001) and very high (p < 0.05) intensity physical activity compared to the high-SES group. High-SES boys and girls spent significantly more time in moderate (p < 0.001 and p < 0.05, respectively) and vigorous (p < 0.001) physical activity than low-SES boys. Differences were observed in recess physical activity levels according to socioeconomic background and sex. These results indicate that recess interventions should target children in low-SES schools.

Socioeconomic thresholds that affect use of customary fisheries management tools.

PubMed

Cinner, Joshua E; Sutton, Stephen G; Bond, Trevor G

2007-12-01

Customary forms of resource management, such as taboos, have received considerable attention as a potential basis for conservation initiatives in the Indo-Pacific. Yet little is known about how socioeconomic factors influence the ability of communities to use customary management practices and whether socioeconomic transformations within communities will weaken conservation initiatives with a customary foundation. We used a comparative approach to examine how socioeconomic factors may influence whether communities use customary fisheries management in Papua New Guinea. We examined levels of material wealth (modernization), dependence on marine resources, population, and distance to market in 15 coastal communities. We compared these socioeconomic conditions in 5 communities that used a customary method of closing their fishing ground with 10 communities that did not use this type of management. There were apparent threshold levels of dependence on marine resources, modernization, distance to markets (<16.5 km), and population (>600 people) beyond which communities did not use customary fisheries closures. Nevertheless, economic inequality, rather than mean modernization levels seemed to influence the use of closures. Our results suggest that customary management institutions are not resilient to factors such as population growth and economic modernization. If customary management is to be used as a basis for modern conservation initiatives, cross-scale institutional arrangements such as networks and bridging organizations may be required to help filter the impacts of socioeconomic transformations.

[Influence of Mapuche origin and socioeconomic conditions on adult height].

PubMed

Erazo B, Marcia; Amigo C, Hugo; Bustos M, Patricia

2005-04-01

Studies in Chilean adults of low socioeconomic level suggest that their low height is likely to be due to their indigenous background. However this group also has been marginalized from socioeconomic development. To determine the influence of Mapuche ethnic origin and socioeconomic factors on the height of adults. In a cross sectional design, the height of 1,293 adults (528 males and 765 females) of Mapuche and non Mapuche origin were studied in the Araucania Region (Southern Chile) and in the Metropolitan Region (Central Chile). Subjects with Mapuche surnames were considered as pertaining to this ethnic community and those with Spanish surnames were considered as non Mapuche. Linear regression models were done, stratifying by sex, considering ethnic origin, to live in counties of different social vulnerability, and the level of family poverty. Among males, the mean height was 166.6+/-7.3 cm and among females, the figure was 153.6+/-5.9 cm. Mapuche subjects were significantly shorter: -3.2 cm (95% Confidence Interval (CI) -4.0 to -2.3) among females and -4.8 cm (CI -6.0 to -3.6) among males (non adjusted models). This deficit increased to -4.5 and -7.6 cm among females and males, respectively when they lived in poverty and in areas with highest social vulnerability. These differences decreased significantly if Mapuche subjects lived in communities with low social vulnerability and less poverty (-0.59 and -1.14 cm among females and males respectively). The studied population had low height, being lower in Mapuche subjects. The differences decreased among subjects living in counties of less vulnerability and less family poverty.

Psychological distress among adolescents, and its relationship to individual, family and area characteristics in East London.

PubMed

Fagg, James; Curtis, Sarah; Stansfeld, Stephen; Congdon, Peter

2006-08-01

This paper identifies factors associated with variation in psychosocial distress among adolescents in a relatively deprived and ethnically diverse inner city setting in London, UK. The research draws on literature which discusses whether neighbourhood socio-economic conditions are associated with mental health, as well as attributes of individual adolescents and their families. We report an analysis of data from the Research with East London Adolescents: Community Health Survey (RELACHS). The survey collected data on mental health measured by the Strengths and Difficulties Questionnaire (SDQ), and on various aspects of individual and family circumstances. These data were linked with information about social and economic conditions in 'middle layer standard output areas' (MSOA) used for the population Census 2001, having a mean total population of 6767 in the study area. Census statistics including the Indices of Deprivation for 2004 proposed by the Office of the Deputy Prime Minister, were used to describe the socio-economic conditions within these areas. Although the socio-economic disparities among small areas were not typical of those across the whole of the country, there were differences in levels of deprivation and crime, social fragmentation, and ethnic composition. A Bayesian regression analysis using Gibbs sampling in the programme WinBugs investigated whether there was variability in SDQ at both individual and area (MSOA) level, and whether the predictor variables at both levels were significantly associated with SDQ. Individuals from Asian or Black ethnic groups, and those in families with harmonious relationships and no financial stress had significantly lower SDQ scores, i.e. better health. Those who had special educational needs or long standing illness, or were from reconstituted families had significantly worse SDQ scores. About 6% of the variation in SDQ was associated with area differences. However, this area variation was not related to

[Nutritional knowledge and its association with overweight and obesity in Mexican women with low socioeconomic level].

PubMed

Galindo Gómez, Carlos; Juárez Martínez, Liliana; Shamah Levy, Teresa; García Guerra, Armando; Avila Curiel, Abelardo; Quiroz Aguilar, Marco Antonio

2011-12-01

The objective of this study was to identify the association between knowledge about nutrition with the presence of obesity or overweight in women with low income in Mexico City. Data was obtained with the Urban Food and Nutrition Survey 2002 in the Metropolitan Area of Mexico City (ENURBAL 2002), a stratified multistage and clustered design survey. An ordinal logistic regression model was used in order to estimate the probability to present obesity and overweight or obesity, in relation to nutritional knowledge, age, education, employment, socioeconomic status, and total fat consumption. The variables that were related to overweight or obesity: correct or regular nutrition knowledge (OR = 2,00; CI95% = 1,13-3,54) and (OR = 1,54; CI 95%= 1,03-2,30), respectively; age 30 years (OR = 3,00; CI 95% = 1,94-4,64), belonging to a medium- low socioeconomic status (OR = 2,04; CI 95% = 1,33-3,15), and high fat consumption (OR = 1,65; CI 95% = 1,07-2,55). For obesity was age 30 years (OR = 2,42; IC 95% = 1,48-3,94) and high fat consumption (OR = 1,67; IC 95% = 1,05-2,66). Our results helped to identify associated factors in women with obesity and overweight from low income households, mainly those concerning with nutrition knowledge. This emphasizes the importance of improving knowledge about nutrition, in planning the strategy for interventions aimed to prevent overweight and obesity.

Impact of scale of aggregation on associations of cardiovascular hospitalization and socio-economic disadvantage

PubMed Central

2017-01-01

Background There are numerous studies that show an increased incidence of cardiovascular disease with increasing levels of socio-economic disadvantage. Exposures that might influence the relationship include elements of the built environment and social systems that shape lifestyle risk behaviors. In Canberra (the Australian capital city) there has been a particular housing policy to create ‘mixed-tenure’ neighborhoods so that small pockets of disadvantage are surrounded by more affluent residences (known as a ‘salt-and-pepper’ pattern). This may contribute to a scatter of higher incidence rates in very small areas in this population that may be obscured if aggregated data are used. This study explored the effect of changing the scale of the spatial units used in small area disease modelling, aiming to understand the impact of this issue and the implications for local public health surveillance. Methods The residence location of hospitalized individuals were aggregated to two differently scaled area units. First, the Australian Bureau of Statistics Statistical Area 2 (SA2) which is normally used as the basis for deidentification and release of health data. Second, these data were aggregated to a smaller level: the Statistical Area 1 (SA1). Generalized Additive Models with penalized regression splines were used to assess the association of age-sex-standardized rates for cardiovascular disease hospital admissions with disadvantage. Results The relationships observed were different between the two types of spatial units. The SA1 level exposure-response curve for rates against the disadvantage index extended in a linear fashion above the midrange level, while that found at SA2-level suggested a curvilinear form with no evidence that rates increased with higher disadvantage beyond the midrange. Conclusion Our result supports findings of other work that has found disadvantage increases risk of cardiovascular disease. The shape of the curves suggest a difference in

Engineering and socioeconomic impacts of earthquakes: An analysis of electricity lifeline disruptions in the New Madrid area

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shinozuka, M.; Rose, A.; Eguchi, R.T.

1998-12-31

This monograph examines the potential effects of a repeat of the New Madrid earthquake to the metropolitan Memphis area. The authors developed a case study of the impact of such an event to the electric power system, and analyzed how this disruption would affect society. In nine chapters and 189 pages, the book traces the impacts of catastrophic earthquakes through a curtailment of utility lifeline services to its host regional economy and beyond. the monographs` chapters include: Modeling the Memphis economy; seismic performance of electric power systems; spatial analysis techniques for linking physical damage to economic functions; earthquake vulnerability andmore » emergency preparedness among businesses; direct economic impacts; regional economic impacts; socioeconomic and interregional impacts; lifeline risk reduction; and public policy formulation and implementation.« less

Socioeconomic disadvantage as a social determinant of teen childbearing in the U.S.

PubMed

Penman-Aguilar, Ana; Carter, Marion; Snead, M Christine; Kourtis, Athena P

2013-01-01

We reviewed the literature focused on socioeconomic influences on teen childbearing and suggested directions for future research and practice related to this important indicator of teen sexual health. We conducted an electronic search of Medline, ERIC, PsychLit, and Sociological Abstracts databases for articles published from January 1995 to November 2011. Selected articles from peer-reviewed journals included original quantitative analyses addressing socioeconomic influences on first birth among teen women in the U.S. Articles were abstracted for key information, ranked for quality according to the U.S. Preventive Services Task Force guidelines, assessed for bias, and synthesized. We selected articles with a range of observational study designs. Risk for bias varied across studies. All 12 studies that considered socioeconomic factors as influences on teen childbearing (vs. moderators or mediators of other effects) reported at least one statistically significant association relating low socioeconomic status, underemployment, low income, low education levels, neighborhood disadvantage, neighborhood physical disorder, or neighborhood-level income inequality to teen birth. Few reports included any associations contradicting this pattern. This review suggests that unfavorable socioeconomic conditions experienced at the community and family levels contribute to the high teen birth rate in the U.S. Future research into social determinants of sexual health should include multiple levels of measurement whenever possible. Root causes of teen childbearing should be evaluated in various populations and contexts. Interventions that address socioeconomic influences at multiple levels could positively affect large numbers of teens and help eliminate disparities in teen childbearing.

What type of rural? Assessing the variations in life expectancy at birth at small area-level for a small population province using classes of locally defined settlement types.

PubMed

Terashima, Mikiko; Read Guernsey, Judith; Andreou, Pantelis

2014-02-13

Although efforts have been made to articulate rural-urban health inequalities in recent years, results have been inconsistent due to different geographical scales used in these studies. Small-area level investigations of health inequalities will likely show more detailed pictures of health inequalities among diverse rural communities, but they are difficult to conduct, particularly in a small population region. The objectives of this study were: 1) to compare life expectancy at birth for females and males across small-areas classified by locally defined settlement types for a small province in Canada; 2) to assess whether any of the settlement types explains variations in life expectancy over and above the extent of socioeconomic disadvantage and social isolation; and 3) to examine variations in life expectancies within a (larger) area unit used as the basis of health inequality investigations in previous studies. Seven settlement types were determined for the 'community' units based on population per-kilometre-road density and settlement forms. Mean life expectancies at birth for both genders were compared by settlement type, both for the entire province and within the Halifax Regional Municipality--the province's only census designated metropolitan area, but also contains rural settlements. Linear regression analyses were conducted to assess the statistical associations between life expectancy and the settlement types, adjusting for indicators of community-level deprivation. While types of communities considered as 'rural' generally had lower life expectancy for both genders, the effects of living in any settlement type were attenuated once adjusted for socioeconomic deprivation and social isolation. An exception was the village and settlement cluster type, which had additionally negative effects on health for females. There were some variations observed within the Halifax Regional Municipality, suggesting the importance of further investigating a variety of

Cross-national comparison of socioeconomic inequalities in obesity in the United States and Canada.

PubMed

Siddiqi, Arjumand; Brown, Rashida; Nguyen, Quynh C; Loopstra, Rachel; Kawachi, Ichiro

2015-10-31

Prior cross-national studies of socioeconomic inequalities in obesity have only compared summary indices of inequality but not specific, policy-relevant dimensions of inequality: (a) shape of the socioeconomic gradient in obesity, (b) magnitude of differentials in obesity across socioeconomic levels and, (c) level of obesity at any given socioeconomic level. We use unique data on two highly comparable societies - U.S. and Canada - to contrast each of these inequality dimensions. Data came from the 2002/2003 Joint Canada/U.S. Survey of Health. We calculated adjusted prevalence ratios (APRs) for obesity (compared to normal weight) by income quintile and education group separately for both nations and, between Canadians and Americans in the same income or education group. In the U.S., every socioeconomic group except the college educated had significant excess prevalence of obesity. By contrast in Canada, only those with less than high school were worse off, suggesting that the shape of the socioeconomic gradient differs in the two countries. U.S. differentials between socioeconomic levels were also larger than in Canada (e.g., PR quintile 1 compared to quintile 5 was 1.82 in the U.S. [95 % CI: 1.52-2.19] but 1.45 in Canada [95 % CI: 1.10-1.91]). At the lower end of the socioeconomic gradient, obesity was more prevalent in the U.S. than in Canada. Our results suggest there is variation between U.S. and Canada in different dimensions of socioeconomic inequalities in obesity. Future research should examine a broader set of nations and test whether specific policies or environmental exposures can explain these differences.

[Diabetes mellitus within low socioeconomic strata in Mexico City: a relevant problem].

PubMed

Avila-Curiel, Abelardo; Shamah-Levy, Teresa; Galindo-Gómez, Carlos; Cuevas-Nasu, Lucia; Moreno-Macias, Hortensia; Chávez-Villasana, Adolfo

2007-01-01

To evaluate the feeding and nutrition conditions and its relation with diabetes mellitus (DM-2) in adult population (> 30 years) a sample belonging to the low socioeconomic stratum of the Mexico City metropolitan area was studied. They were participants in the Second Feeding and Nutrition Survey in the Mexico City metropolitan area. (ENURBAL-2002). Information collected by the ENURBAL 2002 was used in order to evaluate the relationship between some risk factors and diabetes mellitus in adult population of low economical level. Logistical regression analysis was applied. A complete set of 1279 individuals with ages over 30 years was studied. The 9.9% (IC 95% 7.9, 12.4) had been previously diagnosed as diabetics and 3.9% (IC 95% 2.9, 5.4) were not been diagnosed but their glycemia reached diabetic levels. Total diabetes prevalence observed in this study was 13.8% (IC 95% 11.7, 16.3). People with good score on its knowledge about nutrition, as well as high total fat intake, are significant and positively associated with DM-2 (RM = 2.41, IC 95% 1.09, 5.35 and RM = 2.14 IC 95% 1.24, 3.69, respectively). Diabetes mellitus was highly prevalent among adult (> 30 years population) mainly on the lower socioeconomic stratum of Mexico City. This result is important to promote changes in life style that allow to prevent its appearance by modifying the obesigenic environment and changes in the feeding patterns.

Socioeconomic and ethnic inequalities in exposure to air and noise pollution in London.

PubMed

Tonne, Cathryn; Milà, Carles; Fecht, Daniela; Alvarez, Mar; Gulliver, John; Smith, James; Beevers, Sean; Ross Anderson, H; Kelly, Frank

2018-06-01

Transport-related air and noise pollution, exposures linked to adverse health outcomes, varies within cities potentially resulting in exposure inequalities. Relatively little is known regarding inequalities in personal exposure to air pollution or transport-related noise. Our objectives were to quantify socioeconomic and ethnic inequalities in London in 1) air pollution exposure at residence compared to personal exposure; and 2) transport-related noise at residence from different sources. We used individual-level data from the London Travel Demand Survey (n = 45,079) between 2006 and 2010. We modeled residential (CMAQ-urban) and personal (London Hybrid Exposure Model) particulate matter <2.5 μm and nitrogen dioxide (NO 2 ), road-traffic noise at residence (TRANEX) and identified those within 50 dB noise contours of railways and Heathrow airport. We analyzed relationships between household income, area-level income deprivation and ethnicity with air and noise pollution using quantile and logistic regression. We observed inverse patterns in inequalities in air pollution when estimated at residence versus personal exposure with respect to household income (categorical, 8 groups). Compared to the lowest income group (<£10,000), the highest group (>£75,000) had lower residential NO 2 (-1.3 (95% CI -2.1, -0.6) μg/m 3 in the 95th exposure quantile) but higher personal NO 2 exposure (1.9 (95% CI 1.6, 2.3) μg/m 3 in the 95th quantile), which was driven largely by transport mode and duration. Inequalities in residential exposure to NO 2 with respect to area-level deprivation were larger at lower exposure quantiles (e.g. estimate for NO 2 5.1 (95% CI 4.6, 5.5) at quantile 0.15 versus 1.9 (95% CI 1.1, 2.6) at quantile 0.95), reflecting low-deprivation, high residential NO 2 areas in the city centre. Air pollution exposure at residence consistently overestimated personal exposure; this overestimation varied with age, household income, and area-level income

Neighborhood socioeconomic status is associated with violent reinjury.

PubMed

Chong, Vincent E; Lee, Wayne S; Victorino, Gregory P

2015-11-01

Measures of individual socioeconomic status correlate with recurrent violent injury; however, neighborhood socioeconomic status may also matter. We conducted a review of victims of interpersonal violence treated at our trauma center, hypothesizing that the percent of the population living under the poverty level in their neighborhood is associated with recurrent violent victimization. We identified victims of interpersonal violence, ages 12-24, in our trauma registry from 2005-2010. Recurrent episodes of violent injury were identified through 2012. The percentage of the population living under the poverty level for the patient's zip code of residence was derived from United States census estimates and divided into quartiles. Multivariable logistic regression was conducted to evaluate predictors of violent injury recidivism. Our cohort consisted of 1890 patients. Multivariable logistic regression confirmed the following factors as independent predictors of violent injury recidivism: male sex (odds ratio [OR] = 2 [1.06-3.80]; P = 0.03), black race (OR = 2.1 [1.44-3.06]; P < 0.001), injury due to firearms (OR = 1.67 [1.12-2.50]; P = 0.01), and living in the lowest zip code socioeconomic quartile (OR = 1.59 [1.12-2.25]; P = 0.01). For young patients injured by violence, the socioeconomic position of their neighborhood of residence is independently correlated with their risk of violent reinjury. Low neighborhood socioeconomic status may be associated with a disrupted sense of safety after injury and also may alter a person's likelihood of engaging in behaviors correlated with recurrent violent injury. Programs aimed at reducing violent injury recidivism should address needs at the individual and neighborhood level. Copyright © 2015 Elsevier Inc. All rights reserved.

Socioeconomic-status and mental health in a personality disorder sample: The importance of neighbourhood factors

PubMed Central

Walsh, Zach; Shea, M. Tracie; Yen, Shirley; Ansell, Emily B.; Grilo, Carlos M.; McGlashan, Thomas H.; Stout, Robert L.; Bender, Donna S.; Skodol, Andrew E.; Sanislow, Charles A.; Morey, Lesley C.; Gunderson, John G.

2015-01-01

This cross-sectional study examined the associations between neighbourhood-level socioeconomic-status, and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighbourhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighbourhood-level socio-economic risk and PD symptoms was evident only at higher levels of individual-level socio-economic risk. Our findings identify NSES as a candidate for explaining some of the variability in symptoms and functioning among PD individuals. PMID:22984860