Do the factors associated with female HIV infection vary by socioeconomic status in Cameroon?

PubMed

Mumah, Joyce N; Jackson-Smith, Douglas

2014-07-01

One of the most consistent findings in social epidemiology is an inverse relationship between indicators of SES and most types of illness. However, a growing body of research on HIV in sub-Saharan Africa suggests an intriguing reversal of this pattern, particularly with respect to HIV among women. In Cameroon, specifically, high-SES women have higher rates of HIV infection compared with low-SES women. Using data from the 2004 Cameroon DHS, this study explored the relationships between SES and HIV and tested a multivariate model designed to highlight the distinctive factors associated with increased risk of HIV among women in different SES classes. The results revealed that high-SES women who reported engaging in riskier sexual behaviour had the highest levels of HIV infection. Surprisingly, among this group increased knowledge of HIV, more domestic decision-making authority and access to health care did not reduce vulnerability. Meanwhile, among low-SES women relative gender inequality was significantly related to HIV risk. Specifically, among this group of women, having a partner with higher education was strongly associated with greater HIV risk. The results suggest that different approaches targeting each sub-group are needed to effectively combat the disease.

Social Anxiety, Depression and Self-Esteem in Obese Adolescent Girls with Acanthosis Nigricans

PubMed Central

Pirgon, Özgür; Sandal, Gonca; Gökçen, Cem; Bilgin, Hüseyin; Dündar, Bumin

2015-01-01

Objective: To assess the impact of acanthosis nigricans (AN) on depression symptoms, related quality of life and self-esteem scores in obese adolescent girls. Methods: Fifty-nine obese adolescent girls (mean age: 13.19±1.3 years, age range: 12-17 years, mean body mass index: 29.89±3.30) were enrolled in this study. The obese adolescent girls were divided into two groups based on presence or absence of AN. Non-obese healthy adolescents constituted the control group (30 girls, mean age: 13.5±1.4 years). All subjects were evaluated using the Children’s Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAI-C), and the modified Rosenberg Self-Esteem Scale (SES). Higher scores indicated more severe depression and anxiety, as well as low self-esteem status. Results: The AN and non-AN obese groups showed significantly higher CDI, STAI-C and SES scores than the control group, and the two obese groups demonstrated no significant differences for these scores. The AN obese group with higher total testosterone levels (>50 ng/dL) had higher scores for SES (2.55±1.8 vs. 1.42±1.2; p=0.03) than the AN obese group with low total testosterone levels. SES scores significantly correlated with total testosterone levels (r=0.362; p=0.03) and fasting insulin (r=0.462; p=0.03) in the AN obese group. Conclusion: Higher SES scores (low self-esteem status) were determined in obese adolescents with acanthosis and were related to hyperandrogenism. This study also showed that a high testosterone level may be one of the important indicators of low self-esteem status in obese girls with AN. PMID:25800478

Social anxiety, depression and self-esteem in obese adolescent girls with acanthosis nigricans.

PubMed

Pirgon, Özgür; Sandal, Gonca; Gökçen, Cem; Bilgin, Hüseyin; Dündar, Bumin

2015-03-01

To assess the impact of acanthosis nigricans (AN) on depression symptoms, related quality of life and self-esteem scores in obese adolescent girls. Fifty-nine obese adolescent girls (mean age: 13.19±1.3 years, age range: 12-17 years, mean body mass index: 29.89±3.30) were enrolled in this study. The obese adolescent girls were divided into two groups based on presence or absence of AN. Non-obese healthy adolescents constituted the control group (30 girls, mean age: 13.5±1.4 years). All subjects were evaluated using the Children's Depression Inventory (CDI), the State-Trait Anxiety Inventory for Children (STAI-C), and the modified Rosenberg Self-Esteem Scale (SES). Higher scores indicated more severe depression and anxiety, as well as low self-esteem status. The AN and non-AN obese groups showed significantly higher CDI, STAI-C and SES scores than the control group, and the two obese groups demonstrated no significant differences for these scores. The AN obese group with higher total testosterone levels (>50 ng/dL) had higher scores for SES (2.55±1.8 vs. 1.42±1.2; p=0.03) than the AN obese group with low total testosterone levels. SES scores significantly correlated with total testosterone levels (r=0.362; p=0.03) and fasting insulin (r=0.462; p=0.03) in the AN obese group. Higher SES scores (low self-esteem status) were determined in obese adolescents with acanthosis and were related to hyperandrogenism. This study also showed that a high testosterone level may be one of the important indicators of low self-esteem status in obese girls with AN.

DC-Obesity: A New Model for Estimating Differential Lifetime Costs of Overweight and Obesity by Socioeconomic Status.

PubMed

Sonntag, Diana; Jarczok, Marc N; Ali, Shehzad

2017-09-01

The aim of this study was to quantify the magnitude of lifetime costs of overweight and obesity by socioeconomic status (SES). Differential Costs (DC)-Obesity is a new model that uses time-to-event simulation and the Markov modeling approach to compare lifetime excess costs of overweight and obesity among individuals with low, middle, and high SES. SES was measured by a multidimensional aggregated index based on level of education, occupational class, and income by using longitudinal data of the German Socioeconomic Panel (SOEP). Random-effects meta-analysis was applied to combine estimates of (in)direct costs of overweight and obesity. DC-Obesity brings attention to opposite socioeconomic gradients in lifetime costs due to obesity compared to overweight. Compared to individuals with obesity and high SES, individuals with obesity and low SES had lifetime excess costs that were two times higher (€8,526). In contrast, these costs were 20% higher in groups with overweight and high SES than in groups with overweight and low SES (€2,711). The results of this study indicate that SES may play a pivotal role in designing cost-effective and sustainable interventions to prevent and treat overweight and obesity. DC-Obesity may help public policy planners to make informed decisions about obesity programs targeted at vulnerable SES groups. © 2017 The Obesity Society.

Jumping the gun: the problematic discourse on socioeconomic status and cardiovascular health in India.

PubMed

Subramanian, S V; Corsi, Daniel J; Subramanyam, Malavika A; Smith, George Davey

2013-10-01

There has been an increased focus on non-communicable diseases (NCDs) in India, especially on cardiovascular diseases and associated risk factors. In this essay, we scrutinize the prevailing narrative that cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) are no longer confined to the economically advantaged groups but are an increasing burden among the poor in India. We conducted a comprehensive review of studies reporting the association between socioeconomic status (SES) and CVRF, CVD, and CVD-related mortality in India. With the exception of smoking and low fruit and vegetable intake, the studies clearly suggest that CVRF/CVD is more prevalent among high SES groups in India than among the low SES groups. Although CVD-related mortality rates appear to be higher among the lower SES groups, the proportion of deaths from CVD-related causes was found to be greatest among higher SES groups. The studies on SES and CVRF/CVD also reveal a substantial discrepancy between the data presented and the authors' interpretations and conclusions, along with an unsubstantiated claim that a reversal in the positive SES-CVRF/CVD association has occurred or is occurring in India. We conclude our essay by emphasizing the need to prioritize public health policies that are focused on the health concerns of the majority of the Indian population. Resource allocation in the context of efforts to make health care in India free and universal should reflect the proportional burden of disease on different population groups if it is not to entrench inequity.

Comparison of BMSs with SES for Symptomatic Intracranial Disease of the Middle Cerebral Artery Stenosis

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

Yue Xuanye; Yin Qin; Xi Gangming

2011-02-15

This study was designed to compare the clinical and angiographic outcomes of patients with symptomatic atherosclerotic middle cerebral artery stenosis treated with balloon-mounted stents (BMS) and self-expandable Wingspan system (SES). We reviewed the 69 consecutive stent placement procedures for symptomatic atherosclerotic stenosis ({>=}70) in M1 segment of middle cerebral artery in 67 patients in 3 years. According to the stent types, the patients were classed as BMS and SES groups. The demographic characteristics, conventional risk factors of ischemic stroke, degree of stenosis, periprocedural complications, stent types, and clinical and angiographic outcomes were analyzed. There were 39 patients in the BMSmore » group and 28 patients in the SES group. The demographic characteristics, conventional risk factors, and periprocedural complications were similar but different in residual stenosis after stenting in both groups (5.9% {+-} 9.9% vs. 14.4% {+-} 14.6%; P = 0.01). For the overall cohort, the rate of stroke or death and restenosis was 10.9% (7/66) and 24.5% (14/57), respectively. The frequency of restenosis was higher in the SES group than in the BMS group (log-rank, P = 0.04; crude hazard ratio = 3.03; 95% confidence interval (CI), 1.01-9.15; P = 0.049; and adjusted hazard ratio = 3.61; 95% CI, 1.06-12.27; P = 0.04); however, there was no difference in clinical outcomes (log-rank, P = 0.51; crude hazard ratio = 1.66; 95% CI, 0.36-7.61; P = 0.51; and adjusted hazard ratio = 0.59; 95% CI, 0.04-7.89; P = 0.69). The corrected degree of restenosis was higher in the SES than the BMS group. The prevalence of restenosis was higher in the SES than the BMS group, but the perioperative complications and follow-up clinical outcomes had no significant difference.« less

Which types of televised anti-tobacco campaigns prompt more quitline calls from disadvantaged groups?

PubMed

Durkin, Sarah J; Wakefield, Melanie A; Spittal, Matthew J

2011-12-01

To examine the efficacy of different types of mass media ads in driving lower socio-economic smokers (SES) to utilize quitlines. This study collected all 33 719 calls to the Victorian quitline in Australia over a 2-year period. Negative binomial regressions examined the relationship between weekly levels of exposure to different types of anti-smoking ads and quitline calls, after adjusting for covariates. Interaction terms were added to determine whether relationships differed by SES. In total, smokers were exposed 88.39 times to anti-smoking ads over the 2-year period, as estimated by target audience ratings points. Higher emotion narrative ad exposure had the strongest association with quitline calls, increasing call rates by 13% for every additional ad exposure per week (per 100 points, rate ratio = 1.132, P = 0.001). Substantially, greater increases in calls to quitline from lower SES groups were observed when higher emotion narrative ads were on air compared with when other ad types were on air, and this advantage was not as strong among higher SES groups. Airing higher emotion narrative anti-smoking ads may contribute to reducing, but not eliminating, socio-economic disparities in calls to the quitline through maximizing the responses of the lower SES smokers.

Pathways Linking Childhood SES and Adult Health Behaviors and Psychological Resources in Black and White Men.

PubMed

Boylan, Jennifer Morozink; Cundiff, Jenny M; Jakubowski, Karen P; Pardini, Dustin A; Matthews, Karen A

2018-03-13

Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health. In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources. Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32). Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups. Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.

Comparison of haemodialysis patients and non-haemodialysis patients with respect to clinical characteristics and 3-year clinical outcomes after sirolimus-eluting stent implantation: insights from the Japan multi-centre post-marketing surveillance registry.

PubMed

Otsuka, Yoritaka; Ishiwata, Sugao; Inada, Tsukasa; Kanno, Hiroyuki; Kyo, Eisho; Hayashi, Yasuhiko; Fujita, Hiroshi; Michishita, Ichiro

2011-04-01

Long-term outcomes after sirolimus-eluting stent (SES) implantation in haemodialysis (HD) patients have remained controversial. We investigated the impact of HD on outcomes after SES implantation. We analysed the data on 2050 patients who underwent SES implantation in a multi-centre prospective registry in Japan. Three-year clinical outcomes were compared between the HD group (n = 106) and the non-haemodialysis (NH) group (n = 1944). At the 3-year clinical follow-up, the rates of unadjusted cardiac mortality (HD: 16.3 vs. NH: 2.3%) and target-lesion revascularization (TLR) (HD: 19.4 vs. NH: 6.6%) were significantly higher in the HD group than the NH group (P < 0.001). Although HD group had a numerically higher stent thrombosis rate, the difference in stent thrombosis between the two groups (HD: 2.0 vs. NH: 0.7%) did not reach statistical significance. Using Cox's proportional-hazard models with propensity score adjustment for baseline differences, the HD group had higher risks of TLR [HD: 16.3 vs. NH: 6.1%; hazard ratio, 2.83; 95% confidence interval (CI): 1.62-4.93, P = 0.0003] and cardiac death (HD: 12.3 vs. NH: 2.3%; hazard ratio, 5.51; 95% CI: 2.58-11.78, P < 0.0001). The consistent results of analyses, whether unadjusted or adjusted for other baseline clinical and procedural differences, identify HD as an independent risk factor for cardiac death and TLR. Percutaneous coronary intervention with SES in HD patients has a higher incidence of repeat revascularization and mortality compared with those in NH patients. Haemodialysis appears to be strongly associated with mortality and repeat revascularization even after SES implantation.

The association between socioeconomic status and exposure to mobile telecommunication networks in children and adolescents.

PubMed

Thomas, Silke; Heinrich, Sabine; Kühnlein, Anja; Radon, Katja

2010-01-01

A potential association between socioeconomic status (SES) and self-reported use of mobile phones has been investigated in a few studies. If measured exposure to mobile phone networks differs by SES in children, it has not yet been studied. Interview data of 1,481 children and 1,505 adolescents on participants' mobile phone use, socio-demographic characteristics and potential confounders were taken from the German MobilEe-study. Sociodemographic data was used to stratify participants into three "status groups" (low, middle, high). Using a personal dosimeter, we obtained an exposure profile over 24 h for each of the participants. Exposure levels during waking hours were expressed as mean percentage of the reference level. Children with a low SES were more likely to own a mobile phone (OR 2.1; 95% CI: 1.1-3.9) and also reported to use their mobile phone longer per day (OR 2.4; 95% CI: 1.1-5.4) than children with a high SES. For adolescents, self-reported duration of mobile phone use per day was also higher with a low SES (OR: 3.4; 95% CI: 1.4-8.4) compared with a high SES. No association between SES and measured exposure to mobile telecommunication networks was seen for children or adolescents. Mobile phone use may differ between status groups with higher use among disadvantaged groups. However, this does not result in higher overall exposure to mobile telecommunication networks. Whether short duration of own mobile phone use or the small numbers of participants with a low SES are causal, have to be investigated in further studies. (c) 2009 Wiley-Liss, Inc.

Geographic variability in the association between socioeconomic status and BMI in the USA and Canada.

PubMed

Lebel, Alexandre; Kestens, Yan; Clary, Christelle; Bisset, Sherri; Subramanian, S V

2014-01-01

Reported associations between socioeconomic status (SES) and obesity are inconsistent depending on gender and geographic location. Globally, these inconsistent observations may hide a variation in the contextual effect on individuals' risk of obesity for subgroups of the population. This study explored the regional variability in the association between SES and BMI in the USA and in Canada, and describes the geographical variance patterns by SES category. The 2009-2010 samples of the Behavioral Risk Factor Surveillance System (BRFSS) and the Canadian Community Health Survey (CCHS) were used for this comparison study. Three-level random intercept and differential variance multilevel models were built separately for women and men to assess region-specific BMI by SES category and their variance bounds. Associations between individual SES and BMI differed importantly by gender and countries. At the regional-level, the mean BMI variation was significantly different between SES categories in the USA, but not in Canada. In the USA, whereas the county-specific mean BMI of higher SES individuals remained close to the mean, its variation grown as SES decreased. At the county level, variation of mean BMI around the regional mean was 5 kg/m2 in the high SES group, and reached 8.8 kg/m2 in the low SES group. This study underlines how BMI varies by country, region, gender and SES. Lower socioeconomic groups within some regions show a much higher variation in BMI than in other regions. Above the BMI regional mean, important variation patterns of BMI by SES and place of residence were found in the USA. No such pattern was found in Canada. This study suggests that a change in the mean does not necessarily reflect the change in the variance. Analyzing the variance by SES may be a good way to detect subtle influences of social forces underlying social inequalities.

Attention-training with children from socioeconomically disadvantaged backgrounds in Cape Town.

PubMed

Schrieff-Elson, Leigh E; Ockhuizen, Ju-Reyn H; During, Genevieve; Thomas, Kevin G F

2017-09-01

Attention is a core process underlying competence in higher-order cognitive abilities. Previous research suggests that healthy children from low socioeconomic status (SES) backgrounds perform poorly, relative to those from higher SES backgrounds, on tasks assessing attentional abilities. In this pilot study, we investigated the effects of an attention-training intervention on task performance in low-SES children. We conducted a quasi-controlled trial with stratified randomisation, using a pre-test/ post-test design. Participants were low-SES children aged 7-13 years. Each was assigned to either an intervention group, a play control group, or a test-only control group (n = 5 per group). We implemented a ten-week manualised cognitive rehabilitation program, Pay Attention!, administering standardised tests of attention, working memory, and inhibition before and after the intervention. Between- and within-group analyses and Reliable Change Index statistics evaluated differences in scores from pre- to post-intervention. Analyses detected no notable between-group differences at either pre- or post-intervention testing. However, on tests of selective attention, attentional control, and inhibition, there were significant within-group and positive individual reliable changes exclusive to the intervention-group participants. Given the variability in our findings, more research needs be conducted with a larger sample to determine, with greater rigour, the efficacy of the intervention within samples of healthy children from low-SES backgrounds.

Race/ethnicity, socioeconomic status, and lifetime morbidity burden in the women's health initiative: a cross-sectional analysis.

PubMed

Gold, Rachel; Michael, Yvonne L; Whitlock, Evelyn P; Hubbell, F Allan; Mason, Ellen D; Rodriguez, Beatriz L; Safford, Monika M; Sarto, Gloria E

2006-12-01

We sought to assess the extent to which race/ethnicity and socioeconomic status (SES) are independently and jointly related to lifetime morbidity burden by comparing the impact of SES on lifetime morbidity among women of different racial/ethnic groups: white, black, Hispanic, American Indian/Alaska Native (AIAN), and Asian/Pacific Islander (API). Using baseline data from the Women's Health Initiative (WHI), a national study of 162,000 postmenopausal women, we measured lifetime morbidity burden using a modified version of the Charlson Index, and measured SES with educational attainment and household income. In multivariable simple polytomous logistic regression models, we first assessed the effect of SES on lifetime morbidity burden among women of each racial/ethnic group, then assessed the combined effect of race/ethnicity and SES. Five percent of all women in the study population had high lifetime morbidity burden. Women with high lifetime morbidity were more likely to be AIAN or black; poor; less educated; divorced, separated, or widowed; past or current smokers; obese; uninsured or publicly insured. Lower SES was associated with higher morbidity among most women. The extent to which morbidity was higher among lower SES compared to higher SES women was about the same among Hispanic women and white women, but was substantially greater among black and AIAN women compared with white women. This study demonstrates the importance of considering race/ethnicity and class together in relation to health outcomes.

Middle class and marginal? Socioeconomic status, stigma, and self-regulation at an elite university.

PubMed

Johnson, Sarah E; Richeson, Jennifer A; Finkel, Eli J

2011-05-01

In four studies, the authors investigated the proposal that in the context of an elite university, individuals from relatively lower socioeconomic status (SES) backgrounds possess a stigmatized identity and, as such, experience (a) concerns regarding their academic fit and (b) self-regulatory depletion as a result of managing these concerns. Study 1, a correlational study, revealed the predicted associations between SES, concerns about academic fit, and self-regulatory strength. Results from Studies 2 and 3 suggested that self-presentation involving the academic domain is depleting for lower (but not higher) SES students: After a self-presentation task about academic achievement, lower SES students consumed more candy (Study 2) and exhibited poorer Stroop performance (Study 3) relative to their higher SES peers; in contrast, the groups did not differ after discussing a nonacademic topic (Study 3). Study 4 revealed the potential for eliminating the SES group difference in depletion via a social comparison manipulation. Taken together, these studies support the hypothesis that managing concerns about marginality can have deleterious consequences for self-regulatory resources. (c) 2011 APA, all rights reserved.

Socioeconomic (SES) differences in language are evident in female infants at 7months of age.

PubMed

Betancourt, Laura M; Brodsky, Nancy L; Hurt, Hallam

2015-12-01

Language skills, strongly linked to academic success, are known to differ by socioeconomic status (SES), with lower SES individuals performing less well than higher SES. To examine the effect of SES on infant language at 7months of age and the relationship between maternal vocabulary skills and infant language function. To determine if the relationships between SES and infant language are mediated by maternal vocabulary skills. Longitudinal follow-up of healthy term female African American infants born to mothers in two SES groups: Low SES (income-to-needs≤1, no education beyond high school) and Higher SES (Income-to-Needs >1, at least a high school diploma). 54 infants tested at 7months of age; 54 mothers tested at infant age 7months. Preschool Language Scale-5 (PLS-5), Vocabulary and Matrix Reasoning subtests of the Wechsler Adult Intelligence Scale-IV. Low SES infants (n=29) performed less well than Higher SES (n=25) on PLS-5 Total Language, Auditory Comprehension, and Expressive Communication (p≤0.012). Maternal Vocabulary subtest scores were lower in Low SES than Higher SES (p=0.002), but not related to infant PLS Language scores (p≥0.17). Maternal vocabulary did not mediate the relationship between SES and infant language skills at age 7months. In this single sex and race cohort of healthy, term, female infants, lower SES exerted negative effects on infant language by 7months of age. While maternal vocabulary scores showed no relation with infant language skills at 7months, continued study of the relations between SES, infant outcomes and maternal characteristics is needed to determine how low SES conditions impact early language. These findings underscore the importance of early interventions, as well as policies designed to improve socioeconomic conditions for infants and families. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Dietary intake and nutrition-related knowledge in a sample of Lebanese adolescents of contrasting socioeconomic status.

PubMed

Nabhani-Zeidan, Maya; Naja, Farah; Nasreddine, Lara

2011-06-01

Socioeconomic status (SES) is postulated to be a major predictor of dietary intake and nutrition-related knowledge in adults. To date, very few studies have addressed this effect among adolescents. To explore differences in nutrient intake and nutrition-related knowledge among adolescents of contrasting SES in Lebanon. In a cross-sectional survey, 209 males and females, aged 17 to 19 years, were recruited from a private university with high tuition and a free public university in Beirut. The participants completed a multicomponent, self-administered questionnaire that inquired about demographic characteristics and nutrition-related knowledge. Three nonconsecutive 24-hour dietary recalls were obtained through interviews. Energy-adjusted means of dietary intake and age-adjusted nutrition-related knowledge were compared between groups using a general linear model. Adolescents in the high-SES group consumed more vegetables, meats, and fats and oils (p < .05). Energy and nutrient intake analysis showed that adolescents in the high-SES group consumed significantly higher amounts of calories, protein, fat, vitamin A, vitamin C, and iron (p < .001) and significantly lower amounts of carbohydrates (p < .05). Nutritional knowledge, although high among all participants, was higher in the high-SES group (p < .05). Although both groups showed good nutrition-related knowledge, SES significantly affected dietary intake in a sample of Lebanese adolescents. This warrants consideration of other factors, such as cost and environment, that may modulate eating behavior among adolescents from different socioeconomic strata.

Reading skill-fractional anisotropy relationships in visuospatial tracts diverge depending on socioeconomic status.

PubMed

Gullick, Margaret M; Demir-Lira, Özlem Ece; Booth, James R

2016-07-01

Low socioeconomic status (SES) has been repeatedly linked with decreased academic achievement, including lower reading outcomes. Some lower SES children do show skills and scores commensurate with those of their higher SES peers, but whether their abilities stem from the same systems as high SES children or are based on divergent strategies is unknown. We here investigated a potential interactive relationship between SES and real-word reading skill in the white matter in 42 typically developing children. SES was determined based on parental education; reading skill and age were not significantly related to SES. There was a significant neural interaction: Clusters in the bilateral inferior longitudinal fasciculus (ILF), left superior longitudinal fasciculus, and left corticospinal tract demonstrated interactive skill-SES relationships in fractional anisotropy. Follow-up analyses demonstrated that higher SES children showed a positive relationship between fractional anisotropy, reflecting tract coherence, and reading skill in left hemisphere tract clusters, whereas lower SES children showed a positive relationship in the right hemisphere homologues. Broadly, the ILF has been demonstrated to support orthographic skill on the left and more general visuospatial processing on the right, so high reading achievement in lower SES children may rely on supplementary visuospatial processing more than for higher SES readers. This pattern is consistent with previous work reporting low SES children's environments to include less rich verbal experience, which may lead them to disproportionately draw on visuospatial skills for success. Further, these results indicate that group SES differences may be best described by an adaptive, not a deficit, model. © 2016 John Wiley & Sons Ltd.

Cross-National Comparisons of Time Trends in Overweight Inequality by Socioeconomic Status Among Women Using Repeated Cross-Sectional Surveys From 37 Developing Countries, 1989–2007

PubMed Central

Jones-Smith, Jessica C.; Gordon-Larsen, Penny; Siddiqi, Arjumand; Popkin, Barry M.

2011-01-01

Chronic diseases are now among the leading causes of morbidity and mortality in lower income countries. Although traditionally related to higher individual socioeconomic status (SES) in these contexts, the associations between SES and chronic disease may be actively changing. Furthermore, country-level contextual factors, such as economic development and income inequality, may influence the distribution of chronic disease by SES as well as how this distribution has changed over time. Using overweight status as a health indicator, the authors studied repeated cross-sectional data from women aged 18–49 years in 37 developing countries to assess within-country trends in overweight inequalities by SES between 1989 and 2007 (n = 405,550). Meta-regression was used to examine the associations between gross domestic product and disproportionate increases in overweight prevalence by SES, with additional testing for modification by country-level income inequality. In 27 of 37 countries, higher SES (vs. lower) was associated with higher gains in overweight prevalence; in the remaining 10 countries, lower SES (vs. higher) was associated with higher gains in overweight prevalence. Gross domestic product was positively related to faster increase in overweight prevalence among the lower wealth groups. Among countries with a higher gross domestic product, lower income inequality was associated with faster overweight growth among the poor. PMID:21300855

CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data.

PubMed

Bosch de Basea, Magda; Espinosa, Ana; Gil, Mariona; Figuerola, Jordi; Pardina, Marina; Vilar, José; Cardis, Elisabeth

2018-01-01

Recent publications reported that children in disadvantaged areas undergo more CT scanning than others. The present study is aimed to assess the potential differences in CT imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences vary with different indicators or different time point SES measurements. The associations between CT scanning and SES, and between the CT scan rate per patient and SES were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to determine whether particular SES dimensions were more closely related to the probability of undergoing one or multiple CTs. Comparisons were made with indices based on 2001 and 2011 censuses. We found evidence of socio-economic variation among young people, mainly related to autonomous communities of residence. A slightly higher rate of scans per patient of multiple body parts in the less affluent categories was observed, possibly reflecting a higher rate of accidents and violence in these groups. The number of CT scans per patient was higher both in the most affluent and the most deprived categories and somewhat lower in the intermediate groups. This relation varied with the SES indicator used, with lower CT scans per patients in categories of high unemployment and temporary work, but not depending on categories of unskilled work or illiteracy. The relationship between these indicators and number of CTs in 2011 was different than that seen with the 2001 census, with the number of CTs increasing with higher unemployment. Overall we observed some differences in the SES distribution of scanned patients by Autonomous Community in Spain. There was, however, no major differences in the frequency of CT scans per patient by SES overall, based on the 2001 census. The use of different indicators and of SES data collected at different time points led to different relations between SES and frequency of CT scans, outlining the difficulty of adequately capturing the social and economic dimensions which may affect health and health service utilisation.

CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

PubMed Central

Espinosa, Ana; Gil, Mariona; Figuerola, Jordi; Pardina, Marina; Vilar, José; Cardis, Elisabeth

2018-01-01

Recent publications reported that children in disadvantaged areas undergo more CT scanning than others. The present study is aimed to assess the potential differences in CT imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences vary with different indicators or different time point SES measurements. The associations between CT scanning and SES, and between the CT scan rate per patient and SES were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to determine whether particular SES dimensions were more closely related to the probability of undergoing one or multiple CTs. Comparisons were made with indices based on 2001 and 2011 censuses. We found evidence of socio-economic variation among young people, mainly related to autonomous communities of residence. A slightly higher rate of scans per patient of multiple body parts in the less affluent categories was observed, possibly reflecting a higher rate of accidents and violence in these groups. The number of CT scans per patient was higher both in the most affluent and the most deprived categories and somewhat lower in the intermediate groups. This relation varied with the SES indicator used, with lower CT scans per patients in categories of high unemployment and temporary work, but not depending on categories of unskilled work or illiteracy. The relationship between these indicators and number of CTs in 2011 was different than that seen with the 2001 census, with the number of CTs increasing with higher unemployment. Overall we observed some differences in the SES distribution of scanned patients by Autonomous Community in Spain. There was, however, no major differences in the frequency of CT scans per patient by SES overall, based on the 2001 census. The use of different indicators and of SES data collected at different time points led to different relations between SES and frequency of CT scans, outlining the difficulty of adequately capturing the social and economic dimensions which may affect health and health service utilisation. PMID:29723272

The relative effect of mammographic screening on breast cancer mortality by socioeconomic status

PubMed Central

Ripping, Theodora M.; van der Waal, Danielle; Verbeek, André L.M.; Broeders, Mireille J.M.

2016-01-01

Abstract Breast cancer incidence and mortality are higher in women with a high socioeconomic status (SES). The potential to prevent death from breast cancer is therefore greater in the high SES group. This does, however, require that the effectiveness of screening in the high SES group is equal to or greater than the effectiveness in the low SES group. The aim of this study is to assess the relative effectiveness of mammographic screening on breast cancer mortality by SES. In Nijmegen, the Netherlands, women are invited to participate in biennial mammographic screening since 1975. Postal code is collected at each round and is used to calculate the SES of each woman based on the SES indicator of the Netherlands Institute for Social Research. The Dutch average was used to classify the SES score of each woman as either high or low. We designed a case-control study to investigate the effect of mammographic screening in women aged 50 to 75, 40 to 75, and 50 to 69 years, and calculated the odds ratios (ORs) and 95% confidence intervals (CIs). Among the women invited to the mammographic screening program in Nijmegen, 10% had a high SES. In women aged 50 to 75 years, the breast cancer death rate was 38% lower in screened women than in unscreened women. The ORs for women with high SES (OR 0.82, 95% CI 0.31–2.19) and low SES did not differ significantly (OR 0.61, 95% CI 0.47–0.78). Mammographic screening reduces breast cancer mortality, but we did not observe a significant difference in the relative effectiveness of screening by SES. If the effectiveness of mammographic screening is indeed not dependent on SES status, the absolute number of breast cancer deaths prevented by mammographic screening will be greater in the high SES than low SES group, because women with a high SES have a greater risk of breast cancer death. PMID:27495038

The effectiveness of school-based smoking prevention interventions among low- and high-SES European teenagers.

PubMed

Mercken, L; Moore, L; Crone, M R; De Vries, H; De Bourdeaudhuij, I; Lien, N; Fagiano, F; Vitória, P D; Van Lenthe, F J

2012-06-01

Preventing smoking initiation among adolescents of lower socio-economic groups is crucial for the reduction of socio-economic inequalities in health. The aim of the present study was to examine whether effective smoking prevention interventions in Europe are equally effective among adolescents of low- and high-socio-economic status (SES). As part of the European Union-funded TEENAGE project, three school-based smoking prevention intervention studies in Europe were selected for secondary analyses: (i) a Dutch class competition intervention, (ii) the European Smoking Prevention Framework (ESFA) study and (iii) the A Stop Smoking in Schools Trial (ASSIST) intervention. All three studies differed in effectiveness by SES. The Dutch class competition study only had a significant effect among higher SES adolescents. The results for the ESFA study and ASSIST study were mixed and depended on which SES indicator was used. The conclusion of the study is that stratified analyses provide important insights in differential intervention effects for higher and lower socio-economic groups. Although findings from the different studies were mixed, interventions that use a social network approach in which youngsters are allowed to deliver the intervention themselves may be a successful strategy in targeting adolescents from lower socio-economic groups.

Perceptions on healthy eating, physical activity and lifestyle advice: opportunities for adapting lifestyle interventions to individuals with low socioeconomic status.

PubMed

Bukman, Andrea J; Teuscher, Dorit; Feskens, Edith J M; van Baak, Marleen A; Meershoek, Agnes; Renes, Reint Jan

2014-10-04

Individuals with low socioeconomic status (SES) are generally less well reached through lifestyle interventions than individuals with higher SES. The aim of this study was to identify opportunities for adapting lifestyle interventions in such a way that they are more appealing for individuals with low SES. To this end, the study provides insight into perspectives of groups with different socioeconomic positions regarding their current eating and physical activity behaviour; triggers for lifestyle change; and ways to support lifestyle change. Data were gathered in semi-structured focus group interviews among low SES (four groups) and high SES (five groups) adults. The group size varied between four and nine participants. The main themes discussed were perceptions and experiences of healthy eating, physical activity and lifestyle advice. Interviews were transcribed verbatim and a thematic approach was used to analyse the data. In general, three key topics were identified, namely: current lifestyle is logical for participants given their personal situation; lifestyle change is prompted by feedback from their body; and support for lifestyle change should include individually tailored advice and could profit from involving others. The perceptions of the low SES participants were generally comparable to the perceptions shared by the high SES participants. Some perceptions were, however, especially shared in the low SES groups. Low SES participants indicated that their current eating behaviour was sometimes affected by cost concerns. They seemed to be especially motivated to change their lifestyle when they experienced health complaints, but were rather hesitant to change their lifestyle for preventive purposes. Regarding support for lifestyle change, low SES participants preferred to receive advice in a group rather than on their own. For physical activities, groups should preferably consist of persons of the same age, gender or physical condition. To motivate individuals with low SES to change their lifestyle, it may be useful to (visually) raise their awareness of their current weight or health status. Lifestyle interventions targeting individuals with low SES should take possible cost concerns into account and should harness the supportive effect of (peer) groups.

Relative and combined effects of socioeconomic status and diabetes on mortality: A nationwide cohort study.

PubMed

Kim, Nam Hoon; Kim, Tae Joon; Kim, Nan Hee; Choi, Kyung Mook; Baik, Sei Hyun; Choi, Dong Seop; Park, Yousung; Kim, Sin Gon

2016-07-01

Both low socioeconomic status (SES) and diabetes mellitus (DM) are important risk factors for mortality. However, little is known about their combined effects and relative contribution to the mortality risk.From a nationwide cohort provided by the National Health Insurance Service in Korea, 153,075 subjects who were over 30 years of age from 2003 to 2004 were followed-up until 2010. The SESs of the subjects in the DM and non-DM (NDM) groups were categorized into 3 groups (highest 30% as S1, middle 40% as S2, and lowest 30% as S3) based on the subjects' income levels.During the 7.9-year follow-up, 3933 deaths occurred. When the subjects were stratified into 6 groups by their socioeconomic and diabetes status, a linearly increasing pattern of the hazard ratio (HR) of mortality from the higher SES without diabetes group (NDM-S1, as a reference) to the lower SES with diabetes group (DM-S3; HR, 2.04, 95% confidence interval (CI), 1.80-2.36) was observed (P for trend < 0.001). Notably, subjects with DM in the highest SES group (DM-S1) had a significantly higher mortality risk than did non-DM subjects in the lowest SES group (NDM-S3). This pattern was maintained in cause-specific mortality but was more prominent in cardiovascular disease (CVD) and less prominent in cancer mortality. The association was not affected by gender; however, in individuals <60 years of age, the combined effects of SES and DM on mortality were more prominent (DM-S3; HR, 3.68, 95% CI, 2.95-4.60) than in those ≥60 years of age.Low SES and DM were major determinants of mortality and synergistically increased the risks of all-cause, CVD, and cancer mortality.

Fear, Sadness and Hope: Which Emotions Maximize Impact of Anti-Tobacco Mass Media Advertisements among Lower and Higher SES Groups?

PubMed

Durkin, Sarah; Bayly, Megan; Brennan, Emily; Biener, Lois; Wakefield, Melanie

2018-01-01

Emotive anti-tobacco advertisements can increase quitting. Discrete emotion theories suggest evoking fear may be more effective than sadness; less research has focused on hope. A weekly cross-sectional survey of smokers and recent quitters (N = 7683) measured past-month quit attempts. The main predictor was level of exposure to four different types of anti-tobacco advertisements broadcast in the two months prior to quit attempts: advertisements predominantly evoking fear, sadness, hope, or evoking multiple negative emotions (i.e., fear, guilt, and/or sadness). Greater exposure to fear-evoking advertisements (OR = 2.16, p < .01) increased odds of making a quit attempt and showed similar effectiveness among those in lower and higher SES areas. Greater exposure to advertisements evoking multiple negative emotions increased quit attempts (OR = 1.70, p < .01), but interactions indicated this was driven by those in lower SES, but not higher SES areas. Greater exposure to hope-evoking advertisements enhanced effects of fear-evoking advertisements among those in higher SES, but not lower SES areas. Findings suggest to be maximally effective across the whole population avoid messages evoking sadness and use messages eliciting fear. If the aim is to specifically motivate those living in lower SES areas where smoking rates are higher, multiple negative emotion messages, but not hope-evoking messages, may also be effective.

Oral cancer screening and socioeconomic status.

PubMed

Johnson, Stephanie; McDonald, J Ted; Corsten, Martin

2012-04-01

To determine if awareness of oral cancer screening correlates with socioeconomic status (SES) and to determine if screening for oral cancer correlates with SES. Data were obtained from the 2008 American National Health Interview Survey (NHIS). Our primary measure of SES was education; additional measures for SES included income, race, health insurance, and immigration status. We performed a logistic regression analysis, controlling for important demographic characteristics. Awareness of oral cancer screening increases with higher education levels (< grade 9 OR 0.37 [CI 0.29-0.48], grade 9-12 OR 0.53 [CI 0.44-0.65], high school OR 0.68 [CI 0.59-0.77], higher degree OR 1.13 [CI 0.96-1.34]). Similarly, screening for oral cancer increases with higher education levels (< grade 9 OR 0.31 [CI 0.23-0.42], grade 9-12 OR 0.34 [CI 0.26-0.43], high school OR 0.60 [CI 0.52-0.68], higher degree OR 1.41 [CI 1.18-1.67]). We found that race, income, immigration, and health insurance status were statistically significant correlates with oral cancer awareness and screening. Higher SES individuals are more likely to be aware of and screened for oral cancer. This is problematic because oral cancers are more prevalent in low SES groups. Future awareness and screening campaigns should be directed at vulnerable low SES populations.

SES, Heart Failure, and N-terminal Pro-b-type Natriuretic Peptide: The Atherosclerosis Risk in Communities Study.

PubMed

Vart, Priya; Matsushita, Kunihiro; Rawlings, Andreea M; Selvin, Elizabeth; Crews, Deidra C; Ndumele, Chiadi E; Ballantyne, Christie M; Heiss, Gerardo; Kucharska-Newton, Anna; Szklo, Moyses; Coresh, Josef

2018-02-01

Compared with coronary heart disease and stroke, the association between SES and the risk of heart failure is less well understood. In 12,646 participants of the Atherosclerosis Risk in Communities Study cohort free of heart failure history at baseline (1987-1989), the association of income, educational attainment, and area deprivation index with subsequent heart failure-related hospitalization or death was examined while accounting for cardiovascular disease risk factors and healthcare access. Because SES may affect threshold of identifying heart failure and admitting for heart failure management, secondarily the association between SES and N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels, a marker reflecting cardiac overload, was investigated. Analysis was conducted in 2016. During a median follow-up of 24.3 years, a total of 2,249 participants developed heart failure. In a demographically adjusted model, the lowest-SES group had 2.2- to 2.5-fold higher risk of heart failure compared with the highest SES group for income, education, and area deprivation. With further adjustment for time-varying cardiovascular disease risk factors and healthcare access, these associations were attenuated but remained statistically significant (e.g., hazard ratio=1.92, 95% CI=1.69, 2.19 for the lowest versus highest income), with no racial interaction (p>0.05 for all SES measures). Similarly, compared with high SES, low SES was associated with both higher baseline level of NT-proBNP in a multivariable adjusted model (15% higher, p<0.001) and increase over time (~1% greater per year, p=0.023). SES was associated with clinical heart failure as well as NT-proBNP levels inversely and independently of traditional cardiovascular disease factors and healthcare access. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989-2007.

PubMed

Jones-Smith, Jessica C; Gordon-Larsen, Penny; Siddiqi, Arjumand; Popkin, Barry M

2011-03-15

Chronic diseases are now among the leading causes of morbidity and mortality in lower income countries. Although traditionally related to higher individual socioeconomic status (SES) in these contexts, the associations between SES and chronic disease may be actively changing. Furthermore, country-level contextual factors, such as economic development and income inequality, may influence the distribution of chronic disease by SES as well as how this distribution has changed over time. Using overweight status as a health indicator, the authors studied repeated cross-sectional data from women aged 18-49 years in 37 developing countries to assess within-country trends in overweight inequalities by SES between 1989 and 2007 (n=405,550). Meta-regression was used to examine the associations between gross domestic product and disproportionate increases in overweight prevalence by SES, with additional testing for modification by country-level income inequality. In 27 of 37 countries, higher SES (vs. lower) was associated with higher gains in overweight prevalence; in the remaining 10 countries, lower SES (vs. higher) was associated with higher gains in overweight prevalence. Gross domestic product was positively related to faster increase in overweight prevalence among the lower wealth groups. Among countries with a higher gross domestic product, lower income inequality was associated with faster overweight growth among the poor. © The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

Cost and affordability of healthy food in rural South Australia.

PubMed

Ward, P R; Coveney, J; Verity, F; Carter, P; Schilling, M

2012-01-01

As in many other countries, Australian consumers have recently had to accommodate increases in costs of basic food, and during the financial year 2007-2008 overall food prices rose by nearly 4%. Food costs are mediating factors in food choice, especially for low-income groups, where food security is often tenuous. There are reports that rural populations may have higher levels of food insecurity, although the evidence is often contradictory. To assess cost and affordability of food in rural areas this study used the Healthy Food Basket (HFB) methodology, which has been applied in a number of settings. The HFBs were costed at supermarkets and stores in different locations with different degrees of rurality. Compared with metropolitan areas, healthy food is more expensive in rural areas; costs are even higher in more remote areas. The overall affordability of HFB in rural areas was not significantly different from metro areas. The main difference concerned low socio-economic status (SES) groups, where the proportion of household income spent on the HFB was three times that of higher SES groups. The unaffordability of healthy food, or 'food stress' in low SES groups is a concern, especially when this group carries the greatest burden of diet-related disease. Findings suggest that there is a need to consider both rurality and SES when developing policy responses to decrease the cost and increase the affordability of healthy foods in rural and remote areas.

Cross-cultural differences in the macronutrient intakes of women with anorexia nervosa in Australia and Singapore.

PubMed

Soh, Nerissa Li-Wey; Touyz, Stephen; Dobbins, Timothy; Surgenor, Lois; Clarke, Simon; Kohn, Michael; Lee, Ee Lian; Leow, Vincent; Rieger, Elizabeth; Ung, Ken Eng Khean; Walter, Garry

2008-11-01

To compare the macronutrient intakes of women with and without anorexia nervosa (AN) across cultures. Participants were women with AN (n = 39) and without AN (n = 89) of North European and East Asian backgrounds recruited in Australia and Singapore. Energy and the percentage energy contributed by protein (%protein), fat (%fat) and carbohydrate (%CHO) were assessed from participant's diet histories and analysed in terms of cultural group, acculturation, socio-economic status (SES) and education level. AN status was associated with lower energy and higher %CHO. Greater %protein was associated with greater acculturation to Western culture and lower SES, but not AN. Greater %fat was associated with lower SES and lower acculturation in women with AN, but with higher acculturation in controls. Greater %CHO was also associated with higher SES. The findings may represent Western diets' higher protein and fat contents, 'Western' knowledge of weight-loss diets, and affordability of low fat foods.

Socioeconomic disparities in access to ART treatment and the differential impact of a policy that increased consumer costs.

PubMed

Chambers, G M; Hoang, V P; Illingworth, P J

2013-11-01

What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. Women undertaking fertility treatment in Australia between 2007 and 2010. Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. In this study, SES was based on the average relative socioeconomic advantage and disadvantage of small geographic areas, and therefore may not reflect the SES of an individual. Additionally, the policy impact was limited to the 12 months following its introduction, and may not reflect longer term trends in ART treatment. While financial barriers are an important obstacle to equitable access to ARTs, socioeconomic differences in utilization are likely to persist in countries with supportive public funding, due in part to differences in childbearing patterns and treatment seeking behaviour. Policy makers should be informed of the impact that changes in the level of cost subsidization have on access to ART treatment by different socioeconomic groups. G.M.C. receives grant support to her institution from the Australian Government, Australian Research Council (ARC) Linkage Grant No LP1002165; ARC Linkage Grant Partner Organisations are IVFAustralia, Melbourne IVF and Queensland Fertility Group. V.P.H. is employed as an Economics Research Associate on the same grant. P.J.I. is Medical Director of the IVF Clinic, IVFAustralia and has a financial interest in the parent group, Virtus. N/A.

Socioeconomic status and the development of atrial fibrillation in Hispanics, African Americans and non-Hispanic whites.

PubMed

Shulman, Eric; Kargoli, Faraj; Aagaard, Philip; Hoch, Ethan; Di Biase, Luigi; Fisher, John; Gross, Jay; Kim, Soo; Ferrick, Kevin J; Krumerman, Andrew

2017-09-01

Atrial fibrillation (AF) is the most common arrhythmia and is associated with significant morbidity and mortality. Despite having a higher burden of traditional AF risk factors, African American and Hispanic minorities have a lower incidence of AF when compared to non-Hispanic whites, referred to as the "racial paradox." Lower SES among Hispanics and African Americans may help to explain the lower incidence rates of AF compared to non-Hispanic whites. An electrocardiogram/electronic medical records database in New York State was interrogated for individuals free of AF for development of subsequent AF from 2000 to 2013. SES was assessed per zip code via a composite of 6 measures Z-scored to the New York State average. SES was reclassified into decile groups. Cox regression analysis controlling for all baseline differences was used to estimate the independent predictive ability of SES for AF. We identified 48 631 persons (43% Hispanic, 37% African Americans, and 20% non-Hispanic white; mean age 59 years; mean follow-up of 3.2 years) of which 4556 AF cases occurred. Hispanics and African Americans had lower AF risk than whites in all SES deciles (P < 0.001 by log-rank test). Higher SES was borderline associated with lower AF risk (hazard ratio: 0.990, 95% confidence interval: 0.980-1.001, P = 0.061). P trend analysis was not significant by any race/ethnic group by SES deciles for AF. Our study suggests that non-Hispanic whites were at higher risk for AF compared to nonwhites, and this was independent of SES. © 2017 Wiley Periodicals, Inc.

Social drift of cardiovascular disease risk factors in Africans from the North West Province of South Africa: the PURE study.

PubMed

Pisa, P T; Behanan, R; Vorster, H H; Kruger, A

2012-08-01

This study examined whether the association between socio-economic status (SES) and cardiovascular disease (CVD) risk factors in black South Africans from the North West Province had shifted from the more affluent groups with higher SES to the less affluent, lower SES groups over a period of nine years. Cross-sectional baseline data of 2 010 urban and rural subjects (35 years and older) participating in the Prospective Urban and Rural (PURE) study and collected in 2005 were analysed to examine the relationship of level of education, employment and urban or rural residence with dietary intakes and other CVD risk factors. These relationships were compared to those found nine years earlier in the Transition and Health during the Urbanisation of South Africans (THUSA) study conducted in the same area. The results showed that urban women had higher body mass index (BMI), serum triglyceride and fasting glucose levels compared to rural women and that both urban men and women had higher blood pressures and followed a more Westernised diet. However, rural men and women had higher plasma fibrinogen levels. The more highly educated subjects (which included both urban and rural subjects) were younger than those with no or only primary school education. Few of the risk factors differed significantly between education groups, except that more highly educated men and women had lower BMIs, and women had lower blood pressure and triglyceride levels. These women also followed a more prudent diet than those with only primary school education. Employed men and women had higher BMIs, higher energy intakes but lower plasma fibrinogen levels, and employed women had lower triglyceride levels. No significant differences in total serum cholesterol values were observed. These results suggest a drift of CVD risk factors from groups with higher SES to groups with a lower SES from 1996 to 2005, indicating that interventions to prevent CVD should also be targeted at Africans living in rural areas, those with low educational levels, and the unemployed.

Socioeconomic status is positively associated with measures of adiposity and insulin resistance, but inversely associated with dyslipidaemia in Colombian children.

PubMed

Buitrago-Lopez, Adriana; van den Hooven, Edith H; Rueda-Clausen, Christian F; Serrano, Norma; Ruiz, Alvaro J; Pereira, Mark A; Mueller, Noel T

2015-06-01

Low socioeconomic status (SES) has been associated with higher risk of cardiometabolic diseases in developed societies, but investigation of SES and cardiometabolic risk in children in less economically developed populations is sparse. We aimed to examine associations among SES and cardiometabolic risk factors in Colombian children. We used data from a population-based study of 1282 children aged 6-10 years from Bucaramanga, Colombia. SES was classified according to household wealth, living conditions and access to public utilities. Anthropometric and biochemical parameters were measured at a clinic visit. Cardiometabolic risk factors were analysed continuously using linear regression and as binary outcomes-according to established paediatric cut points-using logistic regression to calculate OR and 95% CIs. Mean age of the children was 8.4 (SD 1.4) and 51.1% of the sample were boys. Odds of overweight/obesity, abdominal obesity and insulin resistance were greater among higher SES. Compared with the lowest SES stratum, children in the highest SES had higher odds of overweight/obesity (OR=3.25, 95% CI 1.89 to 5.57), abdominal obesity (OR=2.74, 95% CI 1.41 to 5.31) and insulin resistance (OR=2.60, 95% CI 1.81 to 3.71). In contrast, children in the highest SES had lower odds of hypertriglyceridaemia (triglycerides ≥90th centile; OR=0.28, 95% CI 0.14 to 0.54) and low (≤10th centile) high-density lipoprotein (HDL) cholesterol (OR=0.35, 95% CI 0.15 to 0.78). In Colombian children, SES is directly associated with obesity and insulin resistance, but inversely associated with dyslipidaemia (hypertriglyceridaemia and low HDL cholesterol). Our findings highlight the need to analyse cardiometabolic risk factors separately in children and to carefully consider a population's level of economic development when studying their social determinants of cardiometabolic disease. 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.

Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England

PubMed Central

Beard, Emma; Brown, Jamie; West, Robert; Angus, Colin; Brennan, Alan; Holmes, John; Kaner, Eileen; Meier, Petra; Michie, Susan

2016-01-01

Background The Alcohol Harm Paradox refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. Thus this study assessed socioeconomic patterning of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age. Method Data were used from the Alcohol Toolkit Study between March and September 2015 on 31,878 adults (16+) living in England. Participants completed the AUDIT which includes alcohol consumption, harm and dependence modules. SES was measured via qualifications, employment, home and car ownership, income and social-grade, plus a composite of these measures. The composite score was coded such that higher scores reflected greater social-disadvantage. Results We observed the Alcohol Harm Paradox for the composite SES measure, with a linear negative relationship between SES and AUDIT-Consumption scores (β = -0.036, p<0.001) and a positive relationship between lower SES and AUDIT-Harm (β = 0.022, p<0.001) and AUDIT-Dependence (β = 0.024, p<0.001) scores. Individual measures of SES displayed different, and non-linear, relationships with AUDIT modules. For example, social-grade and income had a u-shaped relationship with AUDIT-Consumption scores while education had an inverse u-shaped relationship. Almost all measures displayed an exponential relationship with AUDIT-Dependence and AUDIT-Harm scores. We identified moderating effects from age and gender, with AUDIT-Dependence scores increasing more steeply with lower SES in men and both AUDIT-Harm and AUDIT-Dependence scores increasing more steeply with lower SES in younger age groups. Conclusion Different SES measures appear to influence whether the Alcohol Harm Paradox is observed as a linear trend across SES groups or a phenomenon associated particularly with the most disadvantaged. The paradox also appears more concentrated in men and younger age groups. PMID:27682619

Reinforcing effect of glass-fiber mesh on complete dentures in a test model with a simulated oral mucosa.

PubMed

Yu, Sang-Hui; Oh, Seunghan; Cho, Hye-Won; Bae, Ji-Myung

2017-11-01

Studies that evaluated the strength of complete dentures reinforced with glass-fiber mesh or metal mesh on a cast with a simulated oral mucosa are lacking. The purpose of this in vitro study was to compare the mechanical properties of maxillary complete dentures reinforced with glass-fiber mesh with those of metal mesh in a new test model, using a simulated oral mucosa. Complete dentures reinforced with 2 types of glass-fiber mesh, SES mesh (SES) and glass cloth (GC) and metal mesh (metal) were fabricated. Complete dentures without any reinforcement were prepared as a control (n=10). The complete dentures were located on a cast with a simulated oral mucosa, and a load was applied on the posterior artificial teeth bilaterally. The fracture load, elastic modulus, and toughness of a complete denture were measured using a universal testing machine at a crosshead speed of 5 mm/min. The fracture load and elastic modulus were analyzed using 1-way analysis of variance, and the toughness was analyzed with the Kruskal-Wallis test (α=.05). The Tukey multiple range test was used as a post hoc test. The fracture load and toughness of the SES group was significantly higher than that of the metal and control groups (P<.05) but not significantly different from that of the GC group. The elastic modulus of the metal group was significantly higher than that of the control group (P<.05), and no significant differences were observed in the SES and GC groups. Compared with the control group, the fracture load and toughness of the SES and GC groups were higher, while those of the metal group were not significantly different. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Dental services utilization by women of childbearing age by socioeconomic status.

PubMed

Kaylor, Mary B; Polivka, Barbara J; Chaudry, Rosemary; Salsberry, Pamela; Wee, Alvin G

2010-04-01

For women of childbearing age, oral health not only affects their physical and psychological well-being but also that of their children. This study used the 2003-2004 Ohio Family Health Survey (N = 9,819) to examine dental need and utilization by women in Ohio. Predisposing, enabling, and need variables were examined as they effect dental health service utilization by women of childbearing age at different socioeconomic status (SES) levels. The proportion of women in the low SES group self reporting a dental need (18%) was 3 times that of the proportion of women in the higher SES group with a self reported need (6%). Results of bivariate analysis showed that having a dental visit in the past year varied significantly by SES, race, insurance status, provider density, and need. A racial disparity in dental service utilization was noted in the bivariate analysis of the middle SES group. While dental need and type of dental coverage varied by SES, both were significantly associated with utilization of dental services within all 3 SES categories in the logistic regressions. These results suggest that measures need to be implemented to meet the goal of increasing access and utilization of dental health services by low-income populations.

Parental education and living environmental influence on physical development, nutritional habits as well as level of physical activity in Polish children and adolescents.

PubMed

Suliga, Edyta

2010-01-01

The aim of this work was to evaluate the physical development and nutritional status, the nutrition habits as well as level of physical activity of boys and girls in relation to the socio-economic status of their families. The study was conducted on a group of 529 boys and 535 girls aged 7-16 years from Swietokrzyskie Province in Poland. Boys and girls from high SES families had the greatest body height, BMI, upper arm muscle area, as well as upper arm fat tissue area, while the lowest values of these features occurred among those studied coming from families of a low SES. The higher the family SES, the higher habitual frequency of consuming vegetables and fruit as well as fish. The diet of children coming from higher SES families was also linked with a higher total protein content as well as animal protein, all analysed minerals and some vitamins, but there were no significant differences of energetic value in daily food rations as well as fat content. The longer time spent on some sedentary activities was connected with a higher family SES. The girls coming from a high status families also declared a higher level of physical activity, whereas such relationship was not observed among boys. A more rational set of nutritional habits observed among children from a higher SES families can be the basic reason for their higher advancement in development. A shorter time devoted to sedentary activities is assumed to be the main cause of a smaller relative body mass and less obesity among girls and boys from low SES families.

Associations of family and neighborhood socioeconomic characteristics with longitudinal adiposity patterns in a biracial cohort of adolescent girls.

PubMed

Crespi, Catherine M; Wang, May C; Seto, Edmund; Mare, Robert; Gee, Gilbert

2015-01-01

Although many studies have examined the relationship of adiposity with neighborhood socioeconomic context in adults, few studies have investigated this relationship during adolescence. Using 10-year annual measurements of body mass index, expressed as z-scores (BMIz), obtained from 775 black and white participants of the National Heart, Lung, and Blood Institute Growth and Health Study, a prospective cohort study of girls from pre- to postadolescence, we used multilevel modeling to investigate whether family socioeconomic status (SES) and neighborhood socioeconomic characteristics (measured by census-tract median family income) explain variation in BMIz trajectory parameters. Analyses controlled for pubertal maturation. We found that lower SES was associated with higher overall levels of BMIz for both white and black girls. Additionally, lower-SES black girls had a more sustained increase in BMIz during early adolescence and reached a higher peak compared to higher-SES black girls and to white girls. Neighborhood income was associated with BMIz trajectory for black girls only. Unexpectedly, among black girls, living in higher-income neighborhoods was associated with higher overall levels of BMIz, controlling for SES. Our findings suggest that neighborhood socioeconomic characteristics may affect adolescent BMIz trajectories differently in different racial/ethnic groups.

Associations of family and neighborhood socioeconomic characteristics with longitudinal adiposity patterns in a biracial cohort of adolescent girls

PubMed Central

Crespi, Catherine M.; Wang, May C.; Seto, Edmund; Mare, Robert; Gee, Gilbert

2014-01-01

Although many studies have examined the relationship of adiposity with neighborhood socioeconomic context in adults, few studies have investigated this relationship during adolescence. Using 10-year annual measurements of body mass index, expressed as z-scores (BMIz), obtained from 775 Black and White participants of the NHLBI Growth and Health Study, a prospective cohort study of girls from pre- to post-adolescence, we used multilevel modeling to investigate whether family socioeconomic status (SES) and neighborhood socioeconomic characteristics (measured by census tract median family income) explain variation in BMIz trajectory parameters. Analyses controlled for pubertal maturation. We found that lower SES was associated with higher overall levels of BMIz for both White and Black girls. Additionally, lower SES Black girls had a more sustained increase in BMIz during early adolescence and reached a higher peak compared to higher SES Black girls and to White girls. Neighborhood income was associated with BMIz trajectory for Black girls only. Unexpectedly, among Black girls, living in higher income neighborhoods was associated with higher overall levels of BMIz, controlling for SES. Our findings suggest that neighborhood socioeconomic characteristics may affect adolescent BMIz trajectory differently in different racial/ethnic groups. PMID:25879263

Socioeconomic status, physical fitness, self-concept, attitude toward physical education, and academic achievement of children.

PubMed

Aktop, Abdurrahman

2010-04-01

The goal was to analyze the physical fitness, self-concept, attitudes toward physical education, and academic achievement of Turkish elementary school children by socioeconomic status. 198 (101 boys, 97 girls) students from Grades 7 and 8 completed the Children's Attitude Inventory towards Physical Education, the Piers-Harris Children's Self-concept Scale, and Eurofit Physical Fitness Test Battery. Significant differences were found between the groups of Low and High socioeconomic status (SES) in terms of physical fitness and academic achievement. While the Low SES group had higher mean scores on physical fitness, mean academic achievements of the High SES group were higher. Mean differences in height, self-concept, and children's attitudes toward physical education by socioeconomic status were not statistically significant. Particular attention should be paid to physical fitness in children of high socioeconomic status and the academic achievement of children with low socioeconomic status.

"Get off the sofa and go and play": Family and socioeconomic influences on the physical activity of 10–11 year old children

PubMed Central

Brockman, Rowan; Jago, Russell; Fox, Kenneth R; Thompson, Janice L; Cartwright, Kim; Page, Angie S

2009-01-01

Background Physical activity declines as children approach puberty. Research has focussed on psychosocial, environmental, and demographic determinants. This paper explores how family and socioeconomic factors are related to children's physical activity. Methods Seventeen focus groups were conducted with 113, 10–11 year old children from 11 primary schools in Bristol, UK. Focus groups examined: 1) the way parents encourage their children to be physically active; 2) the extent to which physical activity is engaged in as a family; and 3) the types of non-family based physical activities Year 6 children commonly participate in. Results Participants from all socioeconomic (SES) groups reported that parents encouraged them to be physically active. However approaches differed. Children from middle/high SES schools were assisted through actions such as logistical and financial support, co-participation and modelling. Parents of children from low SES schools mainly restricted their input to verbal encouragement and demands. Participation in family-based activities was reported to be higher in children from middle/high SES schools than children from low SES schools. All SES groups reported time to be a limiting factor in family-based activity participation. Cost was reported as a significant barrier by children from low SES schools. Children from middle/high SES schools reported engaging in more sports clubs and organised activities than children from low SES schools, who reported participating in more unstructured activities or 'free play' with friends. Conclusion The family is important for encouraging children to be physically active, but families from different socioeconomic backgrounds support their children in different ways. This research suggests that the design of physical activity interventions, which might include working with families, requires tailoring to groups from different socio-economic backgrounds. PMID:19622143

Effects of glass fiber mesh with different fiber content and structures on the compressive properties of complete dentures.

PubMed

Yu, Sang-Hui; Cho, Hye-Won; Oh, Seunghan; Bae, Ji-Myung

2015-06-01

No study has yet evaluated the strength of complete dentures reinforced with glass fiber meshes with different content and structures. The purpose of this study was to compare the reinforcing effects of glass fiber mesh with different content and structures with that of metal mesh in complete dentures. Two types of glass fiber mesh were used: SES mesh (SES) and glass cloth (GC2, GC3, and GC4). A metal mesh was used for comparison. The complete dentures were made by placing the reinforcement 1 mm away from the tissue surface. A control group was prepared without any reinforcement (n=10). The compressive properties were measured by a universal testing machine at a crosshead speed of 5 mm/min. The results were analyzed with the Kruskal-Wallis test and the Duncan multiple range test (α=.05). The fracture resistance of the SES group was significantly higher than that of the control, GC4, and metal groups (asymptotic P=.004), but not significantly different from the GC2 and GC3 groups. The toughness of the SES and GC3 groups was significantly higher than that of the others (asymptotic P<.001), but not significantly different from that of the GC4 group. SES and GC3, which have different structures but similar volume content, were the most effective in reinforcing complete dentures. The content of the glass fiber mesh seemed more important than the structures. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Smoking cessation patterns by socioeconomic status in Alaska.

PubMed

Pizacani, Barbara; Pickle, Kathryn; Maher, Julie; Rohde, Kristen; Fenaughty, Andrea

2018-06-01

The ongoing disparity in smoking prevalence across levels of socioeconomic status (SES) is a significant concern in the tobacco control field, and surveillance of cessation-related activity is key to understanding progress. Historically, lower SES smokers have had much lower quit ratios but this measure can be insensitive to recent quit-related behavior. It is therefore important to examine recent quit-related behavior to assess progress toward addressing this disparity, especially in states with tobacco control programs that focus on this priority population. We compared recent quit attempts and successes among non-Native lower SES Alaska smokers to those of higher SES using data from the 2012-2013 Alaska Behavioral Risk Factor Surveillance System (BRFSS). We assessed quit ratios, one-year and five-year quit rates, and six-month abstinence between the two groups. Cessation-related measures restricted to those who smoked in the previous one year did not significantly vary by SES. However, five year quit rates were significantly lower for persons of lower SES vs. higher SES (14% vs. 32% respectively, p  < .001). Results were consistent after adjustment for age, sex, and other factors. Results showed that in the previous year, smokers of lower SES in Alaska were trying to quit and succeeding at similar rates as their higher SES counterparts. However, the equivalent pattern of quit success was not reflected in the five-year time frame. Tobacco control programs should monitor cessation trends using both recent and longer-term time frames for this population. More research is needed on reasons for fewer long-term quits among lower SES smokers.

Inequitable walking conditions among older people: examining the interrelationship of neighbourhood socio-economic status and urban form using a comparative case study

PubMed Central

2010-01-01

Background Supportive neighbourhood walking conditions are particularly important for older people as they age and who, as a group, prefer walking as a form of physical activity. Urban form and socio-economic status (SES) can influence neighbourhood walking behaviour. The objectives of this study were: a) to examine how urban form and neighbourhood SES inter-relate to affect the experiences of older people who walk in their neighbourhoods; b) to examine differences among neighbourhood stakeholder key informant perspectives on socio-political processes that shape the walkability of neighbourhood environments. Methods An embedded comparative case study examined differences among four Ottawa neighbourhoods that were purposefully selected to provide contrasts on urban form (inner-urban versus suburban) and SES (higher versus lower). Qualitative data collected from 75 older walkers and 19 neighbourhood key informants, as well as quantitative indicators were compared on the two axes of urban form and SES among the four neighbourhoods. Results and discussion Examining the inter-relationship of neighbourhood SES and urban form characteristics on older people's walking experiences indicated that urban form differences were accentuated positively in higher SES neighbourhoods and negatively in lower SES neighbourhoods. Older people in lower SES neighbourhoods were more affected by traffic hazards and more reliant on public transit compared to their higher SES counterparts. In higher SES neighbourhoods the disadvantages of traffic in the inner-urban neighbourhood and lack of commercial destinations in the suburban neighbourhood were partially offset by other factors including neighbourhood aesthetics. Key informant descriptions of the socio-political process highlighted how lower SES neighbourhoods may face greater challenges in creating walkable places. These differences pertained to the size of neighbourhood associations, relationships with political representatives, accessing information and salient neighbourhood association issues. Findings provide evidence of inequitable walking environments. Conclusion Future research on walking must consider urban form-SES inter-relationships and further examine the equitable distribution of walking conditions as well as the socio-political processes driving these conditions. There is a need for municipal governments to monitor differences in walking conditions among higher and lower SES neighbourhoods, to be receptive to the needs of lower SES neighbourhood and to ensure that policy decisions are taken to address inequitable walking conditions. PMID:21054879

Physical Activity in Public Parks of High and Low Socioeconomic Status in Colombia Using Observational Methods.

PubMed

Camargo, Diana Marina; Ramírez, Paula Camila; Quiroga, Vanesa; Ríos, Paola; Férmino, Rogério César; Sarmiento, Olga L

2018-03-28

Public parks are an important resource for the promotion of physical activity (PA). This is the first study in Colombia and the fourth in Latin America to describe the characteristics of park users and their levels of PA using objective measures. A systematic observation assessed sex, age, and the level of PA of users of 10 parks in an intermediate-size city in Colombia, classified in low (5 parks) and high (5 parks) socioeconomic status (SES). A total of 10 daily observations were conducted, in 5 days of the week during 3 periods: morning, afternoon, and evening. In total, 16,671 observations were completed, recording 46,047 users. A higher number of users per park, per day, were recorded in high SES (1195) versus low SES (647). More men were observed in low-SES than high-SES parks (70.1% vs 54.2%), as well as more children were observed in low-SES than high-SES parks (30.1% vs 15.9%). Older adults in high-SES parks were more frequent (9.5% vs 5.2%). Moderate to vigorous PA was higher in low-SES parks (71.7% vs 63.2%). Low-SES parks need more green spaces, walk/bike trails, and areas for PA. All parks need new programs to increase the number of users and their PA level, considering sex, age group, and period of the week.

Atypical auditory refractory periods in children from lower socio-economic status backgrounds: ERP evidence for a role of selective attention.

PubMed

Stevens, Courtney; Paulsen, David; Yasen, Alia; Neville, Helen

2015-02-01

Previous neuroimaging studies indicate that lower socio-economic status (SES) is associated with reduced effects of selective attention on auditory processing. Here, we investigated whether lower SES is also associated with differences in a stimulus-driven aspect of auditory processing: the neural refractory period, or reduced amplitude response at faster rates of stimulus presentation. Thirty-two children aged 3 to 8 years participated, and were divided into two SES groups based on maternal education. Event-related brain potentials were recorded to probe stimuli presented at interstimulus intervals (ISIs) of 200, 500, or 1000 ms. These probes were superimposed on story narratives when attended and ignored, permitting a simultaneous experimental manipulation of selective attention. Results indicated that group differences in refractory periods differed as a function of attention condition. Children from higher SES backgrounds showed full neural recovery by 500 ms for attended stimuli, but required at least 1000 ms for unattended stimuli. In contrast, children from lower SES backgrounds showed similar refractory effects to attended and unattended stimuli, with full neural recovery by 500 ms. Thus, in higher SES children only, one functional consequence of selective attention is attenuation of the response to unattended stimuli, particularly at rapid ISIs, altering basic properties of the auditory refractory period. Together, these data indicate that differences in selective attention impact basic aspects of auditory processing in children from lower SES backgrounds. Copyright © 2013 Elsevier B.V. All rights reserved.

The impact of work-related physical assaults on mental health among Japanese employees with different socioeconomic status: The Japan Work Stress and Health Cohort Study (JSTRESS).

PubMed

Tsuno, Kanami; Kawakami, Norito

2016-12-01

Work-related physical assaults or violence has severely impacted on the safety of the work environment and employees' mental health. The aim of the present study was to investigate the prevalence of physical assaults, the effect of socioeconomic status (SES) on it and depression associated with it in employees working at large companies. A total of 22,770 Japanese employees responded to a self-administered questionnaire including SES (educational status and occupational status), violence victimization, worksite social support and depression (response rate, 85%). The 12-month prevalence of physical assaults and depression was examined using a single question and the Center for Epidemiologic Studies Depression scale, respectively. The prevalence of physical assaults was 1.8% both in males and females. Although the risk of exposure to physical assaults was 2-3 times higher in the blue-collar group than in the manager group, the association of exposure to physical assaults with depression was stronger in the manager and white-collar worker group (Prevalence ratio [PR]=2.1 in males; 1.8 in females) than in the blue-collar worker group (PR=1.7 in males; 1.5 in females) after adjusting demographic and occupational covariates. A similar pattern was observed for education in males; the association was stronger than in the lower education group (PR=2.1 and 1.8). Low SES is a risk factor of exposure to physical assaults, however, the association of physical assaults with depression was significantly greater among company employees of higher SES than those of lower SES.

The effects of exit from work on health across different socioeconomic groups: A systematic literature review.

PubMed

Schaap, Rosanne; de Wind, Astrid; Coenen, Pieter; Proper, Karin; Boot, Cécile

2018-02-01

Exit from work leads to different effects on health, partially depending on the socioeconomic status (SES) of people in the work exit. Several studies on the effects of exit from work on health across socioeconomic groups have been performed, but results are conflicting. The aim of this review is to systematically review the available evidence regarding the effects of exit from work on health in high and low socioeconomic groups. A systematic literature search was conducted using Pubmed, Embase, Web of Science, CINAHL and PsycINFO. Search terms related to exit from work, health, SES and design (prospective or retrospective). Articles were included if they focused on: exit from work (early/statutory retirement, unemployment or disability pension); health (general, physical or mental health and/or health behaviour); SES (educational, occupational and/or income level); and inclusion of stratified or interaction analyses to determine differences across socioeconomic groups. This search strategy resulted in 22 studies. For general, physical or mental health and health behaviour, 13 studies found more positive effects of exit from work on health among employees with a higher SES compared to employees with a lower SES. These effects were mainly found after early/statutory retirement. In conclusion, the effects of exit from work, or more specific the effects of early/statutory retirement on health are different across socioeconomic groups. However, the findings of this review should be interpreted with caution as the studies used heterogeneous health outcomes and on each health outcome a limited number of studies was included. Yet, the positive effects of exit from work on health are mainly present in higher socioeconomic groups. Therefore, public health policies should focus on improving health of employees with a lower SES, in particular after exit from work to decrease health inequalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Long-term impact of childhood disadvantage on late-life functional decline among older Japanese: Results from the JAGES prospective cohort study.

PubMed

Murayama, Hiroshi; Fujiwara, Takeo; Tani, Yukako; Amemiya, Airi; Matsuyama, Yusuke; Nagamine, Yuiko; Kondo, Katsunori

2017-09-11

Increasing evidence suggests an impact of childhood disadvantage on late-life functional impairment in Western countries. However, the processes by which childhood disadvantage affects functional capacity are influenced by several factors unique to particular societies. We examined the impact of childhood disadvantage on functional decline among older Japanese, using a large-scale prospective cohort study. Data came from surveys conducted in 2010 and 2013 as part of the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study targeting community-dwelling people aged 65 years and over. Childhood disadvantage included subjective childhood socioeconomic status (SES), body height and educational level. The sample was stratified by age at baseline (65-69 y, 70-74 y, 75-79 y, and ≥ 80 y). A total of 11,601 respondents were analyzed. In the 65-69 y group, lower childhood SES was associated with functional decline, but this association was mediated by adult SES. In contrast, childhood SES was independently associated with functional decline in the older cohort. In the 75-79 y group, lower childhood SES was associated with functional decline. However, in the ≥ 80 y group, people with higher childhood SES were more likely to experience functional decline. Shorter height was associated with functional decline in the 70-74 y group. Higher education was related to functional decline in all age groups except the ≥ 80 y group. These findings suggest that childhood disadvantage affects functional decline, but its effect varies by age cohort. The mechanisms underlying the association between childhood disadvantage and functional decline may be influenced by social and historical context. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Socio-cultural differences in Australian primary school children's weight and weight-related behaviours.

PubMed

Hardy, Louise L; King, Lesley; Hector, Debra; Baur, Louise A

2013-08-01

To examine whether there are socio-cultural differences in overweight/obesity and weight-related behaviours of Australian primary school children. Secondary data analysis of the 2010 NSW Schools Physical Activity and Nutrition Survey (n = 4898). Height and weight were measured. Parents of Year K, 2, 4 children and Year 6 students completed a questionnaire on demographics and weight-related behaviours. Cardio-respiratory fitness was assessed by the 20-meter shuttle run test and categorised as adequately fit or unfit. Children were categorised according to the main cultural/ethnic backgrounds (Middle-Eastern, Asian and English-speaking backgrounds) and socio-economic status (SES) tertile. Within ethnic groups, SES was associated with weight-related behaviours, but not consistently, and not with body mass index status. Within ethnic groups, the odds were higher among low SES, compared with high SES to be inactive, unfit and have poorer dietary habits. Weight-related behaviours among each ethnic group also differed by gender. Compared with low SES children from English-speaking backgrounds, ethnic boys were two times as likely to be overweight/obese, and the odds were significantly higher among ethnic children to be inactive, unfit and have poor dietary patterns. The results indicate the need for obesity prevention initiatives to specifically target and reach children from low SES and Asian and Middle-Eastern backgrounds, and the importance of ensuring that such initiatives are culturally appropriate and address relevant issues. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Disparities in survival after Hodgkin lymphoma: a population-based study

PubMed Central

Keegan, Theresa H.M.; Clarke, Christina A.; Chang, Ellen T.; Shema, Sarah J.; Glaser, Sally L.

2009-01-01

Survival after Hodgkin lymphoma (HL) is generally favorable, but may vary by patient demographic characteristics. The authors examined HL survival according to race/ethnicity and neighborhood socioeconomic status (SES), determined from residential census block group at diagnosis. For 12,492 classical HL patients ≥15 years diagnosed in California during 1988-2006 and followed through 2007, we determined risk of overall and HL-specific death using Cox proportional hazards regression; analyses were stratified by age and Ann Arbor stage. Irrespective of disease stage, patients with lower neighborhood SES had worse overall and HL-specific survival than patients with higher SES. Patients with the lowest quintile of neighborhood SES had a 64% (patients aged 15-44 years) and 36% (≥45 years) increased risk of HL-death compared to patients with the highest quintile of SES; SES results were similar for overall survival. Even after adjustment for neighborhood SES, blacks and Hispanics had increased risks of HL-death 74% and 43% (15-44 years) and 40% and 17% (≥45 years), respectively, higher than white patients. The racial/ethnic differences in survival were evident for all stages of disease. These data provide evidence for substantial, and probably remediable, racial/ethnic and neighborhood SES disparities in HL outcomes. PMID:19557531

Green and lean: Is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity.

PubMed

Morgan Hughey, S; Kaczynski, Andrew T; Child, Stephanie; Moore, Justin B; Porter, Dwayne; Hibbert, James

2017-02-01

Parks and park features are important for promoting physical activity and healthy weight, especially for low-income and racial/ethnic minority youth who have disproportionately high obesity rates. This study 1) examined associations between neighborhood park and playground availability and youth obesity, and 2) assessed whether these associations were moderated by youth race/ethnicity and socioeconomic status (SES). In 2013, objectively measured height and weight were collected for all 3rd-5th grade youth (n=13.469) in a southeastern US county to determine body mass index (BMI) percentiles. Enumeration and audits of the county's parks (n=103) were concurrently conducted. Neighborhood park and playground availability were calculated as the number of each facility within or intersecting each youth's Census block group. Multilevel linear regression models were utilized to examine study objectives. For boys, no main effects were detected; however, SES moderated associations such that higher park availability was associated with lower BMI percentile for low-SES youth but higher BMI percentile for high-SES youth. For girls, the number of parks and playgrounds were significantly associated with lower BMI (b=-2.2, b=-1.1, p<0.05, respectively) and race/ethnicity and SES moderated associations between playground availability and BMI percentile. Higher playground availability was associated with lower BMI percentile for White and high-SES girls but higher BMI percentile for African American and low-SES girls. Considerable variation was detected in associations between park and playground availability and youth obesity by SES and race/ethnicity, highlighting the importance of studying the intersection of these characteristics when exploring associations between built environment features and obesity. Copyright © 2016 Elsevier Inc. All rights reserved.

Antismoking television advertising and socioeconomic variations in calls to Quitline.

PubMed

Siahpush, Mohammad; Wakefield, Melanie; Spittal, Matt; Durkin, Sarah

2007-04-01

To assess the socioeconomic variations in call rates to the Quitline (Victoria, Australia) and in the impact of anti-tobacco television advertising on call rates. The outcome measure was the number of calls to the Quitline in Victoria for each week for each socioeconomic group for the period January 2001 to March 2004. Socioeconomic status (SES) was derived from the caller's postcode using the Index of Socioeconomic Disadvantage provided by the Australian Bureau of Statistics. The exposure measure was weekly Target Audience Rating Points (TARPs, a standard measure of television advertising weight) for anti-tobacco advertising broadcast in Victoria over the same period. Negative binomial regression was used to examine the interaction of SES and TARPs in their effect on the number of Quitline calls. SES and call rates were positively associated. Adjusted call rate was 57% (95% CI 45% to 69%) higher in the highest than the lowest SES quintile. SES differences in call rates were stable over time. In the study period, the effect of the presence or increasing levels of antismoking TARPs on call rates did not vary across categories of SES. In the study period, different SES groups had a similar level of responsiveness to antismoking television advertisements, at least as measured by the rate of calls to the Quitline. However, the present media campaigns are not likely to diminish SES differences in call rates, and more needs to be done to encourage disadvantaged groups to call the Quitline.

Antismoking television advertising and socioeconomic variations in calls to Quitline

PubMed Central

Siahpush, Mohammad; Wakefield, Melanie; Spittal, Matt; Durkin, Sarah

2007-01-01

Objective To assess the socioeconomic variations in call rates to the Quitline (Victoria, Australia) and in the impact of anti‐tobacco television advertising on call rates. Design The outcome measure was the number of calls to the Quitline in Victoria for each week for each socioeconomic group for the period January 2001 to March 2004. Socioeconomic status (SES) was derived from the caller's postcode using the Index of Socioeconomic Disadvantage provided by the Australian Bureau of Statistics. The exposure measure was weekly Target Audience Rating Points (TARPs, a standard measure of television advertising weight) for anti‐tobacco advertising broadcast in Victoria over the same period. Negative binomial regression was used to examine the interaction of SES and TARPs in their effect on the number of Quitline calls. Results SES and call rates were positively associated. Adjusted call rate was 57% (95% CI 45% to 69%) higher in the highest than the lowest SES quintile. SES differences in call rates were stable over time. In the study period, the effect of the presence or increasing levels of antismoking TARPs on call rates did not vary across categories of SES. Conclusions In the study period, different SES groups had a similar level of responsiveness to antismoking television advertisements, at least as measured by the rate of calls to the Quitline. However, the present media campaigns are not likely to diminish SES differences in call rates, and more needs to be done to encourage disadvantaged groups to call the Quitline. PMID:17372288

Absolute rather than relative income is a better socioeconomic predictor of chronic obstructive pulmonary disease in Swedish adults.

PubMed

Axelsson Fisk, Sten; Merlo, Juan

2017-05-04

While psychosocial theory claims that socioeconomic status (SES), acting through social comparisons, has an important influence on susceptibility to disease, materialistic theory says that socioeconomic position (SEP) and related access to material resources matter more. However, the relative role of SEP versus SES in chronic obstructive pulmonary disease (COPD) risk has still not been examined. We investigated the association between SES/SEP and COPD risk among 667 094 older adults, aged 55 to 60, residing in Sweden between 2006 and 2011. Absolute income in five groups by population quintiles depicted SEP and relative income expressed as quintile groups within each absolute income group represented SES. We performed sex-stratified logistic regression models to estimate odds ratios and the area under the receiver operator curve (AUC) to compare the discriminatory accuracy of SES and SEP in relation to COPD. Even though both absolute (SEP) and relative income (SES) were associated with COPD risk, only absolute income (SEP) presented a clear gradient, so the poorest had a three-fold higher COPD risk than the richest individuals. While the AUC for a model including only age was 0.54 and 0.55 when including relative income (SES), it increased to 0.65 when accounting for absolute income (SEP). SEP rather than SES demonstrated a consistent association with COPD. Our study supports the materialistic theory. Access to material resources seems more relevant to COPD risk than the consequences of low relative income.

The Combined Effect of Individual and Neighborhood Socioeconomic Status on Cancer Survival Rates

PubMed Central

Lai, Ning-Sheng; Huang, Kuang-Yung; Chien, Sou-Hsin; Chang, Yu-Han; Lian, Wei-Cheng; Hsu, Ta-Wen; Lee, Ching-Chih

2012-01-01

Background This population-based study investigated the relationship between individual and neighborhood socioeconomic status (SES) and mortality rates for major cancers in Taiwan. Methods A population-based follow-up study was conducted with 20,488 cancer patients diagnosed in 2002. Each patient was traced to death or for 5 years. The individual income-related insurance payment amount was used as a proxy measure of individual SES for patients. Neighborhood SES was defined by income, and neighborhoods were grouped as living in advantaged or disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding and risk factors. Results After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence), tumor extent, treatment modalities (operation and adjuvant therapy), and hospital characteristics (ownership and teaching level), colorectal cancer, and head and neck cancer patients under 65 years old with low individual SES in disadvantaged neighborhoods conferred a 1.5 to 2-fold higher risk of mortality, compared with patients with high individual SES in advantaged neighborhoods. A cross-level interaction effect was found in lung cancer and breast cancer. Lung cancer and breast cancer patients less than 65 years old with low SES in advantaged neighborhoods carried the highest risk of mortality. Prostate cancer patients aged 65 and above with low SES in disadvantaged neighborhoods incurred the highest risk of mortality. There was no association between SES and mortality for cervical cancer and pancreatic cancer. Conclusions Our findings indicate that cancer patients with low individual SES have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group. PMID:22957007

Effects of race and socioeconomic status on the relative influence of education and literacy on cognitive functioning.

PubMed

Dotson, Vonetta M; Kitner-Triolo, Melissa H; Evans, Michele K; Zonderman, Alan B

2009-07-01

Previous research has shown that reading ability is a stronger predictor of cognitive functioning than years of education, particularly for African Americans. The current study was designed to determine whether the relative influence of literacy and education on cognitive abilities varies as a function of race or socioeconomic status (SES). We examined the unique influence of education and reading scores on a range of cognitive tests in low- and higher-SES African Americans and Whites. Literacy significantly predicted scores on all but one cognitive measure in both African American groups and low-SES Whites, while education was not significantly associated with any cognitive measure. In contrast, both education and reading scores predicted performance on many cognitive measures in higher-SES Whites. These findings provide further evidence that reading ability better predicts cognitive functioning than years of education and suggest that disadvantages associated with racial minority status and low SES affect the relative influence of literacy and years of education on cognition.

Trends in the Prevalence and Disparity in Cognitive Limitations of Americans 55-69 Years Old.

PubMed

Choi, HwaJung; Schoeni, Robert F; Martin, Linda G; Langa, Kenneth M

2018-04-16

To determine whether the prevalence of cognitive limitation (CL) among Americans ages 55 to 69 years changed between 1998 and 2014, and to assess the trends in socioeconomic disparities in CL among groups defined by race/ethnicity, education, income, and wealth. Logistic regression using 1998-2014 data from the biennial Health and Retirement Study, a nationally representative data set. CL is defined as a score of 0-11 on a 27-point cognitive battery of items focused on memory. Socioeconomic status (SES) measures are classified as quartiles. In models controlling for age, gender, and previous cognitive testing, we find no significant change over time in the overall prevalence of CL, widening disparities in limitation by income and, in some cases, wealth, and improvements among non-Hispanic whites but not other racial/ethnic groups. Among people 55-69, rates of CL are many times higher for groups with lower SES than those with higher SES, and recent trends show little indication that the gaps are narrowing.

An Increasing Socioeconomic Gap in Childhood Overweight and Obesity in China

PubMed Central

James, Sherman A.; Merli, M. Giovanna; Zheng, Hui

2014-01-01

We used a new conceptual framework that integrates tenets from health economics, social epidemiology, and health behavior to analyze the impact of socioeconomic forces on the temporal changes in the socioeconomic status (SES) gap in childhood overweight and obesity in China. In data from the China Health and Nutrition Survey for 1991 to 2006, we found increased prevalence of childhood overweight and obesity across all SES groups, but a greater increase among higher-SES children, especially after 1997, when income inequality dramatically increased. Our findings suggest that for China, the increasing SES gap in purchasing power for obesogenic goods, associated with rising income inequality, played a prominent role in the country’s increasing SES gap in childhood obesity and overweight. PMID:24228657

Age, gender, and socioeconomic gradients in metabolic syndrome: biomarker evidence from a large sample in Taiwan, 2005-2013.

PubMed

Wu, Hania F; Tam, Tony; Jin, Lei; Lao, Xiang Q; Chung, Roger Yat-Nork; Su, Xue F; Zee, Benny

2017-05-01

To examine the age and gender heterogeneities in the association between socioeconomic status (SES) and the risk of metabolic syndrome (MetS) with biomarker data from Taiwan. Subjects included 102,201 men and 112,015 women aged 25 and above, from the 2005-2013 MJ Health Survey in Taiwan. SES was measured by education and family income. MetS was defined by the Adult Treatment Panel III criteria for Asian population. Logistic regression analyses were performed by age and gender groups. (1) Higher education level was associated with significantly lower risk of MetS. (2) Higher income was associated with lower MetS risk among women aged under 65, but no association among men of all ages. (3) SES gradients were generally much stronger among women than among men of the same age group. (4) SES gradients reduced over the life course with the exception that income gradient remains flat among men of all ages. Among Chinese in Taiwan, the gender and age heterogeneities in the SES gradients in MetS are similar to those reported for Western societies. This cross-cultural convergence is broadly consistent with the general hypothesis that social conditions are fundamental causes of diseases and health disparities. Copyright © 2017 Elsevier Inc. All rights reserved.

Socio-Economic Variation in Price Minimizing Behaviors: Findings from the International Tobacco Control (ITC) Four Country Survey

PubMed Central

Licht, Andrea S.; Hyland, Andrew J.; O’Connor, Richard J.; Chaloupka, Frank J.; Borland, Ron; Fong, Geoffrey T.; Nargis, Nigar; Cummings, K. Michael

2011-01-01

This paper examines how socio-economic status (SES) modifies how smokers adjust to changes in the price of tobacco products through utilization of multiple price minimizing techniques. Data come from the International Tobacco Control Policy Evaluation (ITC) Four Country Survey, nationally representative samples of adult smokers and includes respondents from Canada, the United States, the United Kingdom and Australia. Cross-sectional analyses were completed among 8,243 respondents (7,038 current smokers) from the survey wave conducted between October 2006 and February 2007. Analyses examined predictors of purchasing from low/untaxed sources, using discount cigarettes or roll-your-own (RYO) tobacco, purchasing cigarettes in cartons, and engaging in high levels of price and tax avoidance at last purchase. All analyses tested for interactions with SES and were weighted to account for changing and under-represented demographics. Relatively high levels of price and tax avoidance behaviors were present; 8% reported buying from low or untaxed source; 36% used discount or generic brands, 13.5% used RYO tobacco, 29% reported purchasing cartons, and 63% reported using at least one of these high price avoidance behaviors. Respondents categorized as having low SES were approximately 26% less likely to report using low or untaxed sources and 43% less likely to purchase tobacco by the carton. However, respondents with low SES were 85% more likely to report using discount brands/RYO compared to participants with higher SES. Overall, lower SES smokers were 25% more likely to engage in at least one or more tax avoidance behaviors compared to their higher SES counterparts. Price and tax avoidance behaviors are relatively common among smokers of all SES strata, but strategies differed with higher SES groups more likely to report traveling to a low-tax location to avoid paying higher prices, purchase duty free tobacco, and purchase by cartons instead of packs all of which were less commonly reported by low SES smokers. Because of the strategies lower SES respondents are more likely to use, reducing price differentials between discount and premium brands may have a greater impact on them, potentially increasing the likelihood of quitting. PMID:21318026

Socio-economic variation in price minimizing behaviors: findings from the International Tobacco Control (ITC) Four Country Survey.

PubMed

Licht, Andrea S; Hyland, Andrew J; O'Connor, Richard J; Chaloupka, Frank J; Borland, Ron; Fong, Geoffrey T; Nargis, Nigar; Cummings, K Michael

2011-01-01

This paper examines how socio-economic status (SES) modifies how smokers adjust to changes in the price of tobacco products through utilization of multiple price minimizing techniques. Data come from the International Tobacco Control Policy Evaluation (ITC) Four Country Survey, nationally representative samples of adult smokers and includes respondents from Canada, the United States, the United Kingdom and Australia. Cross-sectional analyses were completed among 8,243 respondents (7,038 current smokers) from the survey wave conducted between October 2006 and February 2007. Analyses examined predictors of purchasing from low/untaxed sources, using discount cigarettes or roll-your-own (RYO) tobacco, purchasing cigarettes in cartons, and engaging in high levels of price and tax avoidance at last purchase. All analyses tested for interactions with SES and were weighted to account for changing and under-represented demographics. Relatively high levels of price and tax avoidance behaviors were present; 8% reported buying from low or untaxed source; 36% used discount or generic brands, 13.5% used RYO tobacco, 29% reported purchasing cartons, and 63% reported using at least one of these high price avoidance behaviors. Respondents categorized as having low SES were approximately 26% less likely to report using low or untaxed sources and 43% less likely to purchase tobacco by the carton. However, respondents with low SES were 85% more likely to report using discount brands/RYO compared to participants with higher SES. Overall, lower SES smokers were 25% more likely to engage in at least one or more tax avoidance behaviors compared to their higher SES counterparts. Price and tax avoidance behaviors are relatively common among smokers of all SES strata, but strategies differed with higher SES groups more likely to report traveling to a low-tax location to avoid paying higher prices, purchase duty free tobacco, and purchase by cartons instead of packs all of which were less commonly reported by low SES smokers. Because of the strategies lower SES respondents are more likely to use, reducing price differentials between discount and premium brands may have a greater impact on them, potentially increasing the likelihood of quitting.

Divergent transcriptional profiles in pediatric asthma patients of low and high socioeconomic status.

PubMed

Miller, Gregory E; Chen, Edith; Shalowitz, Madeleine U; Story, Rachel E; Leigh, Adam K K; Ham, Paula; Arevalo, Jesusa M G; Cole, Steve W

2018-06-01

There are marked socioeconomic disparities in pediatric asthma control, but the molecular origins of these disparities are not well understood. To fill this gap, we performed genome-wide expression profiling of monocytes and T-helper cells from pediatric asthma patients of lower and higher socioeconomic status (SES). Ninety-nine children with asthma participated in a cross-sectional assessment. Out of which 87% were atopic, and most had disease of mild (54%) or moderate (29%) severity. Children were from lower-SES (n = 49; household income <$50 000) or higher-SES (n = 50; household income >$140 000) families. Peripheral blood monocytes and T-helper cells were isolated for genome-wide expression profiling of mRNA. Lower-SES children had worse asthma quality of life relative to higher-SES children, by both their own and their parents' reports. Although the groups had similar disease severity and potential confounds were controlled, their transcriptional profiles differed notably. The monocytes of lower-SES children showed transcriptional indications of up-regulated anti-microbial and pro-inflammatory activity. The T-helper cells of lower-SES children also had comparatively reduced expression of genes encoding γ-interferon and tumor necrosis factor-α, cytokines that orchestrate Type 1 responses. They also showed up-regulated activity of transcription factors that polarize cells towards Type 2 responses and promote Th17 cell maturation. Collectively, these patterns implicate pro-inflammatory monocytes and Type 2 cytokine activity as mechanisms contributing to worse asthma control among lower-SES children. © 2018 Wiley Periodicals, Inc.

The role of socioeconomic status and serum fatty acids in the relationship between intake of animal foods and cardiovascular risk factors.

PubMed

Yeh, L L; Kuller, L H; Bunker, C H; Ukoli, F A; Huston, S L; Terrell, D F

1996-07-01

Little is known regarding the relationship of serum fatty acids to cardiovascular risk factors in Nigerian populations. Civil servants with higher socioeconomic status (SES) in Nigeria appear to be in cultural transition toward a more Westernized lifestyle. For this study the food intakes of 397 civil servants were estimated from two 24-h recalls. Fatty acids in serum total lipids were measured in both absolute weight concentration and percentage composition. Daily meat intake was 43.5 g, and fish intake was 70.5 g. The intakes of meat, eggs, and milk were higher in high SES Nigerians than in low SES Nigerians. The concentration of total fatty acids (TFA, the sum of 12 serum fatty acids) was also higher in high SES men and women, as compared with low SES men and women (2064, 2060, 1831, and 1776 mg/L, respectively). There were significant direct associations between meat intake and serum level of arachidonic acid, and between fish intake and serum levels of eicosapentaenoic acid and docosahexaenoic acid. TFA was positively associated with cholesterol, low-density-lipoprotein cholesterol (LDLc), and triglycerides across gender and SES groups after adjustment for body mass index, fasting insulin level, and age. Nigerian women were compared with two groups of American women. We concluded that fatty acids in absolute weight concentration reflected the amount of fat intake. The level of TFA was directly related to cardiovascular risk factors in Nigerians. Follow-up of such populations in cultural transition can facilitate the understanding of the true roles of animal food intake in the early evolution of atherosclerosis.

Long term impact of balloon post-dilatation on neointimal formation: an experimental comparative study between second-generation self-expanding versus balloon-expandable stent technologies.

PubMed

Aboodi, Michael S; Milewski, Krzysztof; Tellez, Armando; Cheng, Yanping; Yi, Geng-Hua; Kaluza, Greg L; Granada, Juan F

2014-02-15

Background: Self-expanding stents (SES) are reemerging as therapeutic alternatives to treat coronary artery disease. It has been proposed that SES can improve clinical outcomes by inducing less injury at implantation and achieving better vessel wall apposition.To date, little data exists comparing the vascular response to both methods of deployment in a controlled experimental setting. Objective: To quantify differences in vascular injury and healing between second-generation SES and balloon-expandable stents (BES) and the effects of balloon post-dilatation in a porcine coronary model. Methods: Seventy-five bare SES (AXXESS or vProtect) and 42 BES (Vision) were implanted in porcine coronaries. A subset of these received balloon post-dilatation(SES 1 D 5 22, BES 1 D 5 20). Follow-up was scheduled at 30 (BES 5 10, BES 1 D 56, SES 5 19, SES 1 D 5 8), 90 (BES 5 6, BES 1 D 5 8, SES 5 19, SES 1 D 5 8), and 180 days (BES 5 6, BES 1 D 5 6, SES 5 15, SES 1 D 5 6). Results: In vivo imaging and histological analysis showed that neointimal formation peaks early (30 days) in BES. Conversely, for SES, the peak occurred later (90 days). However, the neointimal formation achieved in either group equalized at 180 days. For SES, post-dilatation shortened the peak of neointimal formation to 30 days. Conversely, for BES, post-dilatation delayed the peak of neointimal formation to 90 days. At 30 days, histology showed that SES had significantly less injury. However, at 90 days, injury scores tended to be higher for SES. By 180 days, injury scores were comparable between both groups. Conclusions: The mechanism of stent expansion influences the degree of vascular injury and healing. The synergistic use of balloon post dilatation changes the dynamics of healing and may impact the potential beneficial effects inherent to SES technologies.

The effect of livestock production system and concentrate level on carcass traits and meat quality of foals slaughtered at 18 months of age.

PubMed

Lorenzo, J M; Crecente, S; Franco, D; Sarriés, M V; Gómez, M

2014-03-01

This trial was conducted to study the effect of livestock production system (freedom extensive system (FES) v. semi extensive system (SES)) and amount of finishing feed (1.5 v. 3.0 kg of commercial feed) in SES on carcass characteristics, meat quality and nutritional value of meat foal slaughtered at 18 months of age. For this study, a total of 49 foals (21 from FES and 28 from SES) were used. The obtained results showed that SES had a positive influence on carcass characteristic because these foals showed the best values for live weight, carcass weight, dressing percentage, perimeter of leg (PL) and carcass compactness index. On the other hand, finishing feeding also had a significant (P<0.05) effect on PL and lean thickness, as the highest values were obtained in foals finished with 3 kg of commercial fodder. The physico-chemical properties were significantly affected by the livestock production system with the exception of ashes content (P>0.05). Foals finished in SES increased in 408% the intramuscular fat content (0.23 v. 1.17%, for foals reared in FES and SES, respectively). On the other hand, L*-value and a*-value were significantly (P<0.01) affected by livestock production system, as foals from the FES group had a more intense redder color (higher CIE a*-value) and higher lightness (higher CIE L*-value) compared with those from the SES group. Finally, meat nutritional value was significantly affected by livestock production system, as foals from an extensive production system on wood pasture could be considered as healthier in relation to their fatty acid profiles (low n-6/n-3 ratio and high hypocholesterolemic/hypercholesterolemic ratio) as a result of the beneficial grass intake on meat fatty acid profile.

Does socioeconomic status predict course and outcome in patients with psychosis?

PubMed

Samele, C; van Os, J; McKenzie, K; Wright, A; Gilvarry, C; Manley, C; Tattan, T; Murray, R

2001-12-01

We examined the relationship between socioeconomic status (SES) and course and outcome of patients with psychosis. Two hypotheses were examined: a) patients with higher best-ever SES will have better course and outcome than those with lower best-ever SES, and b) patients with greater downward drift in SES will have poorer course and outcome than those with less downward drift. Data were drawn from the baseline and 2-year follow-up assessments of the UK700 Case Management Trial of 708 patients with severe psychosis. The indicators of SES used were occupational status and educational achievement. Drift in SES was defined as change from best-ever occupation to occupation at baseline. For the baseline data highly significant differences were found between best-ever groups and negative symptoms (non-manual vs. unemployed--coef -10.5, p=0.000, 95% CIs 5.1-15.8), functioning (non-manual vs. unemployed--coef -0.6, p=0.000, 95% CIs 0.3 to -0.8) and unmet needs (manual vs. unemployed - coef 0.5, p=0.004, 95% CIs 0.2-0.9). No significant differences between best-ever groups were found for days in hospital, symptoms, perceived quality of life and dissatisfaction with services. Significant differences for clinical and social variables were found between drift and non-drift SES groups. There were no significant findings between educational groups and clinical and social variables. Best-ever occupation, but not educational qualifications, appeared to predict prognosis in patients with severe psychosis. Downward drift in occupational status did not result in poorer illness course and outcome.

Socioeconomic gradients in body mass index (BMI) in US immigrants during the transition to adulthood: examining the roles of parental education and intergenerational educational mobility.

PubMed

Albrecht, Sandra S; Gordon-Larsen, Penny

2014-09-01

Despite comparatively lower socioeconomic status (SES), immigrants tend to have lower body weight and weaker SES gradients relative to US-born individuals. Yet, it is unknown how changes in SES over the life-course relate to body weight in immigrants versus US-born individuals. We used longitudinal data from a nationally representative, diverse sample of 13 701 adolescents followed into adulthood to investigate whether associations between SES mobility categories (educational attainment reported by individuals as adults and by their parents during adolescence) and body mass index (BMI) measured in adulthood varied by immigrant generation. Weighted multivariable linear regression models were adjusted for age, sex, race/ethnicity and immigrant generation. Among first-generation immigrants, although parental education was not associated with adult BMI, an immigrant's own education attainment was inversely associated with BMI (β=-2.6 kg/m(2); SE=0.9, p<0.01). In addition, upward educational mobility was associated with lower adult mean BMI than remaining low SES (β=-2.5 kg/m(2); SE=1.2, p<0.05). In contrast, among US-born respondents, college education in adulthood did not attenuate the negative association between parental education and adult BMI. Although an SES gradient emerged in adulthood for immigrants, remaining low SES from adolescence to adulthood was not associated with loss of health advantage relative to US-born respondents of US-born parents of similar SES. Immigrants were able to translate higher SES in adulthood into a lower adult mean BMI regardless of childhood SES, whereas the consequences of lower childhood SES had a longer reach even among the upwardly mobile US born. 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.

Reproductive health service use and social determinants among the floating population: a quantitative comparative study in Guangzhou City.

PubMed

Liu, Huan; Wang, Qi; Lu, Zuxun; Liu, Junan

2014-10-30

The World Health Assembly has pledged to achieve universal reproductive health (RH) coverage by 2015. Therefore, China has been vigorously promoting the equalisation of basic public health services (i.e. RH services). The floating population (FP) is the largest special group of internal migrants in China and constitutes the current national focus. However, gaps exist in the access of this group to RH services in China. A total of 453 members of the FP and 794 members of the residential population (RP) aged 18 to 50 years from five urban districts in Guangzhou City were recruited to participate in a cross-sectional survey in 2009. Information on demographics and socioeconomic status (SES) were collected from these two groups to evaluate the utilisation of RH knowledge and skills and family planning services (FPS), and to identify social determinants. The proportion of individuals with low SES in the FP (19.2%) was higher than that in the RP (6.3%) (P <0.001). Of the FP, 9.7% to 35.8% had no knowledge of at least one skill, a proportion higher than the counterpart values (6.2% to 27.5%) for the RP (P <0.05). The frequency of FPS use among the FP and RP was low. However, FPS use was higher among the FP than among the RP (3.51 vs. 2.99) (P =0.050). Logistic regression analysis was used to analyse the social determinants that influence FPS use in the FP and RP. The factors that affect FPS utilisation of the RP included SES (OR =4.652, 95% CI =1.751, 12.362), whereas those of the FP excluded SES. The FPS use of the FP in Guangzhou City was higher under equalised public health services. However, a need still exists to help the FP with low SES to improve their RH knowledge and skills through access to public RH services.

Maternal Obesity Is Associated with Alterations in the Gut Microbiome in Toddlers

PubMed Central

Galley, Jeffrey D.; Bailey, Michael; Kamp Dush, Claire; Schoppe-Sullivan, Sarah; Christian, Lisa M.

2014-01-01

Children born to obese mothers are at increased risk for obesity, but the mechanisms behind this association are not fully delineated. A novel possible pathway linking maternal and child weight is the transmission of obesogenic microbes from mother to child. The current study examined whether maternal obesity was associated with differences in the composition of the gut microbiome in children in early life. Fecal samples from children 18–27 months of age (n = 77) were analyzed by pyro-tag 16S sequencing. Significant effects of maternal obesity on the composition of the gut microbiome of offspring were observed among dyads of higher socioeconomic status (SES). In the higher SES group (n = 47), children of obese (BMI≥30) versus non-obese mothers clustered on a principle coordinate analysis (PCoA) and exhibited greater homogeneity in the composition of their gut microbiomes as well as greater alpha diversity as indicated by the Shannon Diversity Index, and measures of richness and evenness. Also in the higher SES group, children born to obese versus non-obese mothers had differences in abundances of Faecalibacterium spp., Eubacterium spp., Oscillibacter spp., and Blautia spp. Prior studies have linked some of these bacterial groups to differences in weight and diet. This study provides novel evidence that maternal obesity is associated with differences in the gut microbiome in children in early life, particularly among those of higher SES. Among obese adults, the relative contribution of genetic versus behavioral factors may differ based on SES. Consequently, the extent to which maternal obesity confers measureable changes to the gut microbiome of offspring may differ based on the etiology of maternal obesity. Continued research is needed to examine this question as well as the relevance of the observed differences in gut microbiome composition for weight trajectory over the life course. PMID:25409177

Maternal obesity is associated with alterations in the gut microbiome in toddlers.

PubMed

Galley, Jeffrey D; Bailey, Michael; Kamp Dush, Claire; Schoppe-Sullivan, Sarah; Christian, Lisa M

2014-01-01

Children born to obese mothers are at increased risk for obesity, but the mechanisms behind this association are not fully delineated. A novel possible pathway linking maternal and child weight is the transmission of obesogenic microbes from mother to child. The current study examined whether maternal obesity was associated with differences in the composition of the gut microbiome in children in early life. Fecal samples from children 18-27 months of age (n = 77) were analyzed by pyro-tag 16S sequencing. Significant effects of maternal obesity on the composition of the gut microbiome of offspring were observed among dyads of higher socioeconomic status (SES). In the higher SES group (n = 47), children of obese (BMI≥30) versus non-obese mothers clustered on a principle coordinate analysis (PCoA) and exhibited greater homogeneity in the composition of their gut microbiomes as well as greater alpha diversity as indicated by the Shannon Diversity Index, and measures of richness and evenness. Also in the higher SES group, children born to obese versus non-obese mothers had differences in abundances of Faecalibacterium spp., Eubacterium spp., Oscillibacter spp., and Blautia spp. Prior studies have linked some of these bacterial groups to differences in weight and diet. This study provides novel evidence that maternal obesity is associated with differences in the gut microbiome in children in early life, particularly among those of higher SES. Among obese adults, the relative contribution of genetic versus behavioral factors may differ based on SES. Consequently, the extent to which maternal obesity confers measureable changes to the gut microbiome of offspring may differ based on the etiology of maternal obesity. Continued research is needed to examine this question as well as the relevance of the observed differences in gut microbiome composition for weight trajectory over the life course.

Vulnerabilities to Temperature Effects on Acute Myocardial Infarction Hospital Admissions in South Korea

PubMed Central

Kwon, Bo Yeon; Lee, Eunil; Lee, Suji; Heo, Seulkee; Jo, Kyunghee; Kim, Jinsun; Park, Man Sik

2015-01-01

Most previous studies have focused on the association between acute myocardial function (AMI) and temperature by gender and age. Recently, however, concern has also arisen about those most susceptible to the effects of temperature according to socioeconomic status (SES). The objective of this study was to determine the effect of heat and cold on hospital admissions for AMI by subpopulations (gender, age, living area, and individual SES) in South Korea. The Korea National Health Insurance (KNHI) database was used to examine the effect of heat and cold on hospital admissions for AMI during 2004–2012. We analyzed the increase in AMI hospital admissions both above and below a threshold temperature using Poisson generalized additive models (GAMs) for hot, cold, and warm weather. The Medicaid group, the lowest SES group, had a significantly higher RR of 1.37 (95% CI: 1.07–1.76) for heat and 1.11 (95% CI: 1.04–1.20) for cold among subgroups, while also showing distinctly higher risk curves than NHI for both hot and cold weather. In additions, females, older age group, and those living in urban areas had higher risks from hot and cold temperatures than males, younger age group, and those living in rural areas. PMID:26580643

The influence of mitigation evidence, ethnicity, and SES on death penalty decisions by European American and Latino venire persons.

PubMed

Espinoza, Russ K E; Willis-Esqueda, Cynthia

2015-04-01

The purpose of the research was to determine whether European American and Latino mock jurors would demonstrate bias in death penalty decision making when mitigation evidence and defendant ethnicity and socioeconomic status (SES) were varied. A total of 561 actual venire persons acted as mock jurors and read a trial transcript that varied a defendant's case information (mitigating circumstances: strong/weak, defendant ethnicity: European American/Latino, and defendant SES: low/high). European American jurors recommended the death penalty significantly more often for the low SES Latino defendant when strength of mitigation evidence was weak. In addition, they also assigned this defendant higher culpability ratings and lower ratings on positive personality trait measures compared with all other conditions. Strong mitigation evidence contributed to lower guilt ratings by European American jurors for the high SES European American defendant. Latino jurors did not differ in their death penalty sentencing across defendant mitigation, ethnicity, or SES conditions. Discussion of in-group favoritism and out-group derogation, as well as suggestions for procedures to diminish juror bias in death penalty cases, is provided. (c) 2015 APA, all rights reserved).

Socioeconomic Status and Age Variations in Health-Related Quality of Life: Results From the National Health Measurement Study

PubMed Central

Cherepanov, Dasha; Palta, Mari; Dunham, Nancy Cross; Feeny, David; Fryback, Dennis G.

2009-01-01

Objectives We examine whether multiple health-related quality of life (HRQoL) measures are stratified by socioeconomic status (SES) and age in the United States. Methods Data are from the 2005/2006 National Health Measurement Study, a telephone survey of a nationally representative sample of U.S. adults. We plot mean HRQoL scores by SES within age groups. Regression analyses test whether education, income, and assets each have independent associations with three “preference-based” HRQoL measures and self-rated health (SRH). We test whether these associations vary by age. Results There are SES disparities in HRQoL and SRH among adults in the United States at all age groups. Income differentials in HRQoL are strong across current adult age cohorts, except the 75–89 age cohort. Education and assets have statistically significant but weaker associations with HRQoL. All three SES measures are associated with SRH (net of each other) at every age group. Those in the lowest income and education groups in the 35–44 age cohort have worse HRQoL and SRH than those in higher SES groups in the 65+ age cohort. Discussion Significant improvements in HRQoL at the population level will only be possible if we improve the HRQoL of people at the lowest end of the socioeconomic distribution. PMID:19307286

Association of socioeconomic status with overall and cause specific mortality in the Republic of Seychelles: results from a cohort study in the African region.

PubMed

Stringhini, Silvia; Rousson, Valentin; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Bovet, Pascal

2014-01-01

Low socioeconomic status (SES) is consistently associated with higher mortality in high income countries. Only few studies have assessed this association in low and middle income countries, mainly because of sparse reliable mortality data. This study explores SES differences in overall and cause-specific mortality in the Seychelles, a rapidly developing small island state in the African region. All deaths have been medically certified over more than two decades. SES and other lifestyle-related risk factors were assessed in a total of 3246 participants from three independent population-based surveys conducted in 1989, 1994 and 2004. Vital status was ascertained using linkage with vital statistics. Occupational position was the indicator of SES used in this study and was assessed with the same questions in the three surveys. During a mean follow-up of 15.0 years (range 0-23 years), 523 participants died (overall mortality rate 10.8 per 1000 person-years). The main causes of death were cardiovascular disease (CVD) (219 deaths) and cancer (142 deaths). Participants in the low SES group had a higher mortality risk for overall (HR = 1.80; 95% CI: 1.24-2.62), CVD (HR = 1.95; 1.04-3.65) and non-cancer/non-CVD (HR = 2.14; 1.10-4.16) mortality compared to participants in the high SES group. Cancer mortality also tended to be patterned by SES (HR = 1.44; 0.76-2.75). Major lifestyle-related risk factors (smoking, heavy drinking, obesity, diabetes, hypertension, hypercholesterolemia) explained a small proportion of the associations between low SES and all-cause, CVD, and non-cancer/non-CVD mortality. In this population-based study assessing social inequalities in mortality in a country of the African region, low SES (as measured by occupational position) was strongly associated with overall, CVD and non-cancer/non-CVD mortality. Our findings support the view that the burden of non-communicable diseases may disproportionally affect people with low SES in low and middle income countries.

Association of Socioeconomic Status with Overall and Cause Specific Mortality in the Republic of Seychelles: Results from a Cohort Study in the African Region

PubMed Central

Stringhini, Silvia; Rousson, Valentin; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Bovet, Pascal

2014-01-01

Background Low socioeconomic status (SES) is consistently associated with higher mortality in high income countries. Only few studies have assessed this association in low and middle income countries, mainly because of sparse reliable mortality data. This study explores SES differences in overall and cause-specific mortality in the Seychelles, a rapidly developing small island state in the African region. Methods All deaths have been medically certified over more than two decades. SES and other lifestyle-related risk factors were assessed in a total of 3246 participants from three independent population-based surveys conducted in 1989, 1994 and 2004. Vital status was ascertained using linkage with vital statistics. Occupational position was the indicator of SES used in this study and was assessed with the same questions in the three surveys. Results During a mean follow-up of 15.0 years (range 0–23 years), 523 participants died (overall mortality rate 10.8 per 1000 person-years). The main causes of death were cardiovascular disease (CVD) (219 deaths) and cancer (142 deaths). Participants in the low SES group had a higher mortality risk for overall (HR = 1.80; 95% CI: 1.24–2.62), CVD (HR = 1.95; 1.04–3.65) and non-cancer/non-CVD (HR = 2.14; 1.10–4.16) mortality compared to participants in the high SES group. Cancer mortality also tended to be patterned by SES (HR = 1.44; 0.76–2.75). Major lifestyle-related risk factors (smoking, heavy drinking, obesity, diabetes, hypertension, hypercholesterolemia) explained a small proportion of the associations between low SES and all-cause, CVD, and non-cancer/non-CVD mortality. Conclusions In this population-based study assessing social inequalities in mortality in a country of the African region, low SES (as measured by occupational position) was strongly associated with overall, CVD and non-cancer/non-CVD mortality. Our findings support the view that the burden of non-communicable diseases may disproportionally affect people with low SES in low and middle income countries. PMID:25057938

The Association of Socioeconomic Status and Dental Caries Experience in Children in Dili, Timor-Leste.

PubMed

Babo Soares, Lucio Frederico; Allen, Penny; Bettiol, Silvana; Crocombe, Leonard

2016-10-01

Timor-Leste is one of the poorest countries in the world. The aim of this article was to investigate the association between socioeconomic status (SES) and dental caries experience in children living in Dili. Four out of 6 Dili subdistricts and 40 schools were randomly selected. Equal numbers of school children from 4 age groups (6-8, 9-11, 12-14, 15-17 years) were invited to participate. Data were gathered via a questionnaire and an oral examination by dental practitioners. In bivariate analysis, decayed, missing, and filled teeth index for deciduous + permanent teeth (dmft) was higher in children from mid- to high-SES than low-SES schools (1.1, 2.2, P = .001). With age, having had a toothache and dental visiting in the past 12 months in the multivariable model, higher dmft was found in children from mid- to high- to low-SES schools ( P < .001). The primary dental caries experience was greater among children from mid- to high- than low-SES schools, which may be explained by high sugar consumption.

Variations in car crash-related hospitalization costs amongst young adults in New South Wales, Australia.

PubMed

Chen, H Y; Jan, S; Boufous, S; Martiniuk, A L C; Ivers, R; Senserrick, T; Norton, R; Muscatello, D

2012-09-01

This study aims to examine factors associated with variation in crash-related hospitalization costs for young adults in New South Wales (NSW), Australia with a particular focus on types of vehicle occupant, rurality of residence and socioeconomic status (SES). Data on patients aged 17-25 years, admitted to public hospitals due to a crash during July 2000-June 2007 were extracted from the NSW Health Admission Collection database. The hospitalization cost of each admission was calculated based on published charges for specific Australian Refined-Diagnosis Related Groups (AR-DRG). Multivariable analyses using generalized estimating equations were used to estimate costs by vehicle occupant type (driver, passenger and other occupants), rurality of residence (urban, regional and rural areas) and SES (low, moderate and high SES areas). During 2000-2007, there were 11,892 crash-related hospitalizations involving young adults, aged 17-25 years, in NSW. These cost the health sector about A$87.6 million or on average, A$7363 per hospitalization (mean length of stay (LOS) 5.3 days). Compared to drivers, passengers had significantly longer LOS (<0.01) as well as higher hospitalization costs (p = 0.04). Regional and rural young adults had significantly longer LOS and higher hospitalization costs compared to urban young adults (p<0.05). Compared with young adults from high SES areas, young adults from moderate SES areas had significantly higher costs (p = 0.02), whilst the higher costs for young adults of low SES areas was borderline significant (p = 0.06), although differences in LOS by SES were not significant. Annually, young adults' crashes in NSW were estimated to cost the health sector at least A$14.6 million between 2001 and 2007. The higher hospitalization costs and LOS for young adults living in regional and rural vs. urban areas, and those living in moderate and low SES vs. high SES areas partly reflects the severity of these crashes and challenges for treatment. Based on these findings, a strong economic argument can be made for targeting prevention strategies to young people living in rural and low SES areas. The area variations in costs also suggest some scope for policy makers to consider potentially more efficient ways of targeting both treatment and preventative programmes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Differential Effects of Perceived Discrimination on the Diurnal Cortisol Rhythm of African Americans and Whites

PubMed Central

Fuller-Rowell, Thomas E.; Doan, Stacey N.; Eccles, Jacquelynne S.

2011-01-01

Summary The current study considered the influence of perceived discrimination on the diurnal cortisol rhythm of 50 African American older adults and a matched comparison groups of 100 Whites (Mage =56.6; 58% female). The role of socioeconomic status (SES) as a moderator of the effects of discrimination on the diurnal decline was also considered for each group. In support of the idea that perceptions of unfair treatment take on a unique meaning for stigmatized minority groups, results suggest that perceived discrimination is associated with a flatter (less healthy) diurnal slope among Whites but a steeper (more healthy) diurnal slope among African Americans. Perceived discrimination was also found to be more strongly associated with a steepening of the diurnal slope among lower SES African Americans than higher SES African Americans. PMID:21689889

Association of socioeconomic status with psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study.

PubMed

Heshmat, Ramin; Qorbani, Mostafa; Ghoreshi, Behnaz; Djalalinia, Shirin; Tabatabaie, Omid Reza; Safiri, Saeid; Noroozi, Mehdi; Motlagh, Mohammad-Esmaeil; Ahadi, Zeinab; Asayesh, Hamid; Kelishadi, Roya

2016-08-16

The aim of the present study was to evaluate the association between socioeconomic status (SES) and psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents, based on nationwide surveillance programme data, 2011-2012. Overall, 14 880 students, aged 6-18 years, were selected using a multistage cluster sampling method from rural and urban areas of 30 provinces in Iran. SES was estimated based on a main summarised component, extracted from principle component analysis of family assets and parents' jobs and education. For statistical analysis, SES was classified as 'low', 'middle' and 'high'. The WHO-Global School Based Student Health Survey (WHO-GSHS) questionnaire was used to assess psychiatric problems and violent behaviours. In total, 13 486 students (participation rate 90.6%) completed the study: 50.8% were boys and 75.6% were urban residents, with a mean age of 12.47±3.36 years. In the multivariate model, the ORs of depression, anxiety, feeling worthless, anger, insomnia, confusion and physical fights were lower in students with high SES compared with those with low SES (p<0.05) but physical fights was lower in the high SES group than in the low SES group (p<0.05). No significant relationship was documented between SES and other variables, including getting worried, history of bullying and being victimised. Children and adolescents with low SES were at higher risk for psychiatric problems and violent behaviours. Mental health policies and public interventional strategies should be considered at the public level, notably for low SES families. 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/

Influence of socioeconomic status on the whole blood transcriptome in African Americans.

PubMed

Gaye, Amadou; Gibbons, Gary H; Barry, Charles; Quarells, Rakale; Davis, Sharon K

2017-01-01

The correlation between low socioeconomic status (SES) and poor health outcome or higher risk of disease has been consistently reported by many epidemiological studies across various race/ancestry groups. However, the biological mechanisms linking low SES to disease and/or disease risk factors are not well understood and remain relatively under-studied. The analysis of the blood transcriptome is a promising window for elucidating how social and environmental factors influence the molecular networks governing health and disease. To further define the mechanistic pathways between social determinants and health, this study examined the impact of SES on the blood transcriptome in a sample of African-Americans. An integrative approach leveraging three complementary methods (Weighted Gene Co-expression Network Analysis, Random Forest and Differential Expression) was adopted to identify the most predictive and robust transcriptome pathways associated with SES. We analyzed the expression of 15079 genes (RNA-seq) from whole blood across 36 samples. The results revealed a cluster of 141 co-expressed genes over-expressed in the low SES group. Three pro-inflammatory pathways (IL-8 Signaling, NF-κB Signaling and Dendritic Cell Maturation) are activated in this module and over-expressed in low SES. Random Forest analysis revealed 55 of the 141 genes that, collectively, predict SES with an area under the curve of 0.85. One third of the 141 genes are significantly over-expressed in the low SES group. Lower SES has consistently been linked to many social and environmental conditions acting as stressors and known to be correlated with vulnerability to chronic illnesses (e.g. asthma, diabetes) associated with a chronic inflammatory state. Our unbiased analysis of the blood transcriptome in African-Americans revealed evidence of a robust molecular signature of increased inflammation associated with low SES. The results provide a plausible link between the social factors and chronic inflammation.

The Relationship Between Socioeconomic Status and CV Risk Factors

PubMed Central

Quispe, Renato; Benziger, Catherine P.; Bazo-Alvarez, Juan Carlos; Howe, Laura D.; Checkley, William; Gilman, Robert H.; Smeeth, Liam; Bernabé-Ortiz, Antonio; Miranda, J. Jaime; Bernabé-Ortiz, Antonio; Casas, Juan P.; Smith, George Davey; Ebrahim, Shah; García, Héctor H.; Gilman, Robert H.; Huicho, Luis; Málaga, Germán; Miranda, J. Jaime; Montori, Víctor M.; Smeeth, Liam; Checkley, William; Diette, Gregory B.; Gilman, Robert H.; Huicho, Luis; León-Velarde, Fabiola; Rivera, María; Wise, Robert A.; Checkley, William; García, Héctor H.; Gilman, Robert H.; Miranda, J. Jaime; Sacksteder, Katherine

2016-01-01

Background Variations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries. Objective This study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites. Methods Baseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels. Results In the overall population, 41.6% reported a monthly family income

The Relationship Between Socioeconomic Status and CV Risk Factors: The CRONICAS Cohort Study of Peruvian Adults.

PubMed

Quispe, Renato; Benziger, Catherine P; Bazo-Alvarez, Juan Carlos; Howe, Laura D; Checkley, William; Gilman, Robert H; Smeeth, Liam; Bernabé-Ortiz, Antonio; Miranda, J Jaime

2016-03-01

Variations in the distribution of cardiovascular disease and risk factors by socioeconomic status (SES) have been described in affluent societies, yet a better understanding of these patterns is needed for most low- and middle-income countries. This study sought to describe the relationship between cardiovascular risk factors and SES using monthly family income, educational attainment, and assets index, in 4 Peruvian sites. Baseline data from an age- and sex-stratified random sample of participants, ages ≥35 years, from 4 Peruvian sites (CRONICAS Cohort Study, 2010) were used. The SES indicators considered were monthly family income (n = 3,220), educational attainment (n = 3,598), and assets index (n = 3,601). Behavioral risk factors included current tobacco use, alcohol drinking, physical activity, daily intake of fruits and vegetables, and no control of salt intake. Cardiometabolic risk factors included obesity, elevated waist circumference, hypertension, insulin resistance, diabetes mellitus, low high-density lipoprotein cholesterol, and high triglyceride levels. In the overall population, 41.6% reported a monthly family income

"Poor man's risk factor": correlation between high sensitivity C-reactive protein and socio-economic class in patients of acute coronary syndrome.

PubMed

Sethi, Rishi; Puri, Aniket; Makhija, Aman; Singhal, A; Ahuja, A; Mukerjee, S; Dwivedi, S K; Narain, V S; Saran, R K; Puri, V K

2008-01-01

Inflammation has been proposed as one of the factors responsible for the development of coronary artery disease (CAD) and high sensitivity C-reactive protein (hs CRP) at present is the strongest marker of inflammation. We did a study to assess the correlation of hs-CRP with socio-economic status (SES) in patients of CAD presenting as acute coronary syndrome (ACS). Baseline hs-CRP of 490 patients of ACS was estimated by turbidimetric immunoassay. Patients were stratified by levels of hs-CRP into low (<1 mg/L); intermediate (1-3 mg/L) or high (>3 mg/L) groups and in tertiles of 0-0.39 mg/L, 0.4-1.1 mg/L and >1.1 mg/L, respectively. Classification of patient into upper (21.4%), middle (45.37 percent) and lower (33.3%) SES was based on Kuppuswami Index which includes education, income and profession. Presence or absence of traditional risk factors for CAD diabetes, hypertension, dyslipidemia and smoking was recorded in each patient. Mean levels of hs-CRP in lower, middle and upper SES were 2.3 +/- 2.1 mg/L, 0.8 +/- 1.7 mg/L and 1.2 +/- 1.5 mg/L, respectively. hs-CRP levels were significantly higher in low SES compared with both upper SES (p = 0.033) and middle SES (p = 0.001). Prevalence of more than one traditional CAD risk factors was seen in 13.5%, 37.5% and 67.67 percent; in patient of lower, middle and upper SES. It was observed that multiple risk factors had a linear correlation with increasing SES. Of the four traditional risk factors of CAD, smoking was the only factor which was significantly higher in lower SES (73%) as compared to middle (51.67 percent;) and upper (39.4%) SES. We found that 62.3%, 20.8% and 26.5% patients of low, middle and upper SES had hs-CRP values in the highest tertile. Median value of the Framingham risk score in low, middle and upper SES as 11, 14 and 18, respectively. We observed that at each category of Framingham risk, low SES had higher hs-CRP. We conclude from our study that patient of lower SES have significantly higher levels of hs-CRP despite the fact that they have lesser traditional risk factors and lower Framingham risk. These findings add credit to our belief that inflammation may be an important link in the pathophysiology of atherosclerosis and its complications especially in patients of low SES who do not have traditional risk factors.

Differential Associations of Socioeconomic Status With Global Brain Volumes and White Matter Lesions in African American and White Adults: the HANDLS SCAN Study.

PubMed

Waldstein, Shari R; Dore, Gregory A; Davatzikos, Christos; Katzel, Leslie I; Gullapalli, Rao; Seliger, Stephen L; Kouo, Theresa; Rosenberger, William F; Erus, Guray; Evans, Michele K; Zonderman, Alan B

2017-04-01

The aim of the study was to examine interactive relations of race and socioeconomic status (SES) to magnetic resonance imaging (MRI)-assessed global brain outcomes with previously demonstrated prognostic significance for stroke, dementia, and mortality. Participants were 147 African Americans (AAs) and whites (ages 33-71 years; 43% AA; 56% female; 26% below poverty) in the Healthy Aging in Neighborhoods of Diversity across the Life Span SCAN substudy. Cranial MRI was conducted using a 3.0 T unit. White matter (WM) lesion volumes and total brain, gray matter, and WM volumes were computed. An SES composite was derived from education and poverty status. Significant interactions of race and SES were observed for WM lesion volume (b = 1.38; η = 0.036; p = .028), total brain (b = 86.72; η = 0.042; p < .001), gray matter (b = 40.16; η = 0.032; p = .003), and WM (b = 46.56; η = 0.050; p < .001). AA participants with low SES exhibited significantly greater WM lesion volumes than white participants with low SES. White participants with higher SES had greater brain volumes than all other groups (albeit within normal range). Low SES was associated with greater WM pathology-a marker for increased stroke risk-in AAs. Higher SES was associated with greater total brain volume-a putative global indicator of brain health and predictor of mortality-in whites. Findings may reflect environmental and interpersonal stressors encountered by AAs and those of lower SES and could relate to disproportionate rates of stroke, dementia, and mortality.

Socioeconomic Status and Smokers’ Number of Smoking Friends: Findings from the International Tobacco Control (ITC) Four Country Survey

PubMed Central

Hitchman, Sara C.; Fong, Geoffrey T.; Zanna, Mark P.; Thrasher, James F.; Chung-Hall, Janet; Siahpush, Mohammad

2014-01-01

Background Smoking rates are higher among low socioeconomic (SES) groups, and there is evidence that inequalities in smoking are widening over time in many countries. Low SES smokers may be more likely to smoke and less likely to quit because smoking is heavily concentrated in their social contexts. This study investigated whether low SES smokers (1) have more smoking friends, and (2) are more likely to gain and less likely to lose smoking friends over time. Correlates of having more smoking friends and gaining or losing smoking friends were also considered. Method Respondents included 6,321 adult current smokers (at recruitment) from Wave 1 (2002) and Wave 2 (2003) of the International Tobacco Control Project (ITC) Four Country Survey, a nationally representative longitudinal cohort survey of smokers in Australia, Canada, UK, and US. Results Low SES smokers reported more smoking friends than moderate and high SES smokers. Low SES smokers were also more likely to gain smoking friends over time compared with high SES smokers. Smokers who were male, younger, and lived with other smokers reported more smoking friends, and were also more likely to gain and less likely to lose smoking friends. Smoking behaviours, such as higher nicotine dependence were related to reporting more smoking friends, but not to losing or gain smoking friends. Conclusions Smoking is highly concentrated in the social networks of lower SES smokers and this concentration may be increasing over time. Cessation interventions should consider how the structure of low SES smokers’ social networks affects quitting. PMID:25156228

Socioeconomic Status and Physical Activity in Chinese Adults: A Report from a Community-Based Survey in Jiaxing, China.

PubMed

Chen, Mingling; Wu, Yikang; Narimatsu, Hiroto; Li, Xueqing; Wang, Chunmei; Luo, Jianyong; Zhao, Genming; Chen, Zhongwen; Xu, Wanghong

2015-01-01

This study examines the associations of socioeconomic status (SES) with intensity of different types of physical activity (PA) in Chinese adults, aimed at outlining and projecting socioeconomic disparities in PA among the population undergoing a rapid nutrition transition. A community-based survey was conducted among 3,567 residents aged 30-65 years old in Jiaxing, China, in 2010. SES and PA were assessed by a structured questionnaire. SES was assessed as socioeconomic index (SEI) score based on self-reported educational attainment, household income and occupation. Metabolic equivalents (METs) were calculated for each subject to quantify the total amount of PA from occupation, exercise, transportation and housework. Intensity of overall PA in this population was 165 MET-hours/week, in which energy expenditure in occupational PA accounted for 82%. Both types and intensity of PA were significantly different by SES: middle SES groups had higher intensity of occupational activities; lower SES subjects engaged in more household work; whereas higher SES subjects were more likely to exercise, more active during commuting and had longer sedentary time. All the three components of SES, education attainment, income and occupation, contributed to socioeconomic disparities in PA in this population. Our results suggest an overall insufficiency and socioeconomic inequalities in PA among Chinese adults in Jiaxing, a typical city experiencing a rapid urbanization in China. There is an urgent need to promote leisure-time activities in this population.

Why don't poor men eat fruit? Socioeconomic differences in motivations for fruit consumption☆

PubMed Central

Pechey, Rachel; Monsivais, Pablo; Ng, Yin-Lam; Marteau, Theresa M.

2015-01-01

Background: Those of lower socioeconomic status (SES) tend to have less healthy diets than those of higher SES. This study aimed to assess whether differences in motivations for particular foods might contribute to socioeconomic differences in consumption. Methods: Participants (n = 732) rated their frequency of consumption and explicit liking of fruit, cake and cheese. They reported eating motivations (e.g., health, hunger, price) and related attributes of the investigated foods (healthiness, expected satiety, value for money). Participants were randomly assigned to an implicit liking task (Single Category Implicit Association Task) for one food category. Analyses were conducted separately for different SES measures (income, education, occupational group). Results: Lower SES and male participants reported eating less fruit, but no SES differences were found for cheese or cake. Analyses therefore focused on fruit. In implicit liking analyses, results (for income and education) reflected patterning in consumption, with lower SES and male participants liking fruit less. In explicit liking analyses, no differences were found by SES. Higher SES participants (all indicators) were more likely to report health and weight control and less likely report price as motivators of food choices. For perceptions of fruit, no SES-based differences were found in healthiness whilst significant interactions (but not main effects) were found (for income and education) for expected satiety and value for money. Neither liking nor perceptions of fruit were found to mediate the relationship between SES and frequency of fruit consumption. Conclusions: There is evidence for social patterning in food motivation, but differences are modified by the choice of implicit or explicit measures. Further work should clarify the extent to which these motivations may be contributing to the social and gender patterning in diet. PMID:25451584

Challenging behaviors in young children: the father's role.

PubMed

Burbach, Ann D; Fox, Robert A; Nicholson, Bonnie C

2004-06-01

In this study, the authors examined the parenting practices, developmental expectations, and stress levels of 136 fathers and the challenging and prosocial behaviors of their 1- to 5-year-old children. In addition, the authors systematically addressed fathers' qualitative concerns about their parenting. The authors divided the participants into 4 groups and controlled for family socioeconomic status (SES) and the focus child's gender. Results showed a significantly higher use of corporal and verbal punishment and parenting stress among lower income fathers. Secondary analyses demonstrated a significant effect of paternal disciplinary practices that emphasized the frequent use of corporal and verbal punishment on child behavior problems, regardless of SES level. On a positive note, fathers from both lower and higher SES groups had reasonable developmental expectations for their boys and girls, and they reported similar frequencies of their children's prosocial behavior. The authors discuss the need for early parent education programs that include fathers and that teach specific strategies to address child behavior problems.

Exploring why Costa Rica outperforms the United States in life expectancy: A tale of two inequality gradients.

PubMed

Rosero-Bixby, Luis; Dow, William H

2016-02-02

Mortality in the United States is 18% higher than in Costa Rica among adult men and 10% higher among middle-aged women, despite the several times higher income and health expenditures of the United States. This comparison simultaneously shows the potential for substantially lowering mortality in other middle-income countries and highlights the United States' poor health performance. The United States' underperformance is strongly linked to its much steeper socioeconomic (SES) gradients in health. Although the highest SES quartile in the United States has better mortality than the highest quartile in Costa Rica, US mortality in its lowest quartile is markedly worse than in Costa Rica's lowest quartile, providing powerful evidence that the US health inequality patterns are not inevitable. High SES-mortality gradients in the United States are apparent in all broad cause-of-death groups, but Costa Rica's overall mortality advantage can be explained largely by two causes of death: lung cancer and heart disease. Lung cancer mortality in the United States is four times higher among men and six times higher among women compared with Costa Rica. Mortality by heart disease is 54% and 12% higher in the United States than in Costa Rica for men and women, respectively. SES gradients for heart disease and diabetes mortality are also much steeper in the United States. These patterns may be partly explained by much steeper SES gradients in the United States compared with Costa Rica for behavioral and medical risk factors such as smoking, obesity, lack of health insurance, and uncontrolled dysglycemia and hypertension.

Exploring why Costa Rica outperforms the United States in life expectancy: A tale of two inequality gradients

PubMed Central

Rosero-Bixby, Luis; Dow, William H.

2016-01-01

Mortality in the United States is 18% higher than in Costa Rica among adult men and 10% higher among middle-aged women, despite the several times higher income and health expenditures of the United States. This comparison simultaneously shows the potential for substantially lowering mortality in other middle-income countries and highlights the United States’ poor health performance. The United States’ underperformance is strongly linked to its much steeper socioeconomic (SES) gradients in health. Although the highest SES quartile in the United States has better mortality than the highest quartile in Costa Rica, US mortality in its lowest quartile is markedly worse than in Costa Rica’s lowest quartile, providing powerful evidence that the US health inequality patterns are not inevitable. High SES-mortality gradients in the United States are apparent in all broad cause-of-death groups, but Costa Rica’s overall mortality advantage can be explained largely by two causes of death: lung cancer and heart disease. Lung cancer mortality in the United States is four times higher among men and six times higher among women compared with Costa Rica. Mortality by heart disease is 54% and 12% higher in the United States than in Costa Rica for men and women, respectively. SES gradients for heart disease and diabetes mortality are also much steeper in the United States. These patterns may be partly explained by much steeper SES gradients in the United States compared with Costa Rica for behavioral and medical risk factors such as smoking, obesity, lack of health insurance, and uncontrolled dysglycemia and hypertension. PMID:26729886

The risk of developing cardiovascular disease in Bangladesh: does diabetes mellitus matter? Which socioeconomic status does it impact? A cross sectional study.

PubMed

Islam, G M Rabiul

2017-01-01

The elevation of blood pressure levels has been recognized as a determinant of the risk for several common cardiovascular diseases. This work explores the evidence of disparities in the form of association between hypertension and diabetes mellitus in different socioeconomic statuses (SESs) at household level. A population sample of 7561 individuals aged ≥35 years from the 2011 Bangladesh Demographic Health Survey (BDHS) was used for this study. Concentration indexes are used to measure the disparities of myocardial infarction and diabetes mellitus with SES. A two-level hierarchical logit model was used to examine the effects of participants and household SES accompanied by other explanatory variables on having hypertension. Then, the analysis is stratified by SES groups to examine how the overall effect of diabetes mellitus on hypertension may vary with SES. Finally, predictive margins are determined to understand the predictive probability of diabetes and SES of having hypertension as a risk factor of developing cardiovascular disease. The descriptive summary measures of SES inequality indicate that prevalence of hypertension and diabetes was higher among high SES. The multivariate analysis covering all samples reveals that there is a strong association between diabetes and hypertension (P < .01). Likewise, after stratifying, it is evident that in high SES, there is a strong association between individuals with diabetes mellitus and hypertension development; they have around four-fold higher chance of being affected by hypertension in comparison to individuals with normal fasting plasma glucose (P < .01). Moreover, there are strong associations between individuals in low and medium SESs having diabetes and having hypertension (P < .01); the likelihood of having hypertension is almost double compared to individuals who have no diabetes. The result of this study also shed light on the chance of an increase in prevalence of hypertension in prediabetes individuals and in medium and high SES groups, although the association is statistically insignificant (P > .05). Finally, the predictive analysis reveals that the predictive margin of having hypertension is high among individuals belonging to the high SES (23%; CI, 20-23) and diabetic patients with high SES (37%; CI, 33-47). Contrary to other developed countries, hypertension in Bangladesh is prevalent among all SES, and the likelihood is high among diabetic patients in the medium and high SES. Hence, urgent preventive measures are needed to control the impending comorbidity of diabetes and developing cardiovascular disease risk. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Inequity in dental care utilization in the Indonesian population with a self-assessed need for dental treatment.

PubMed

Maharani, Diah Ayu

2009-07-01

Dental caries is one of the most prevalent infectious diseases in Indonesia. More than half of all cases are left untreated. This may be due to inequity in the use of dental care that is caused by economic and geographic barriers. Therefore, the objective of this study was to provide evidence of socioeconomic-related inequality and horizontal inequity in dental care utilization among Indonesian adults who reported having had dental problems and to describe the sources of any identified inequality. We used secondary cross-sectional data from the Indonesian National Socio-Economic Survey 2004 and from the Indonesian Medical Council. Respondents included individuals at least 15 years old who reported having had dental care needs within a one-month recall period (N = 20,718). A concentration curve and a concentration index were employed to describe the extent of inequality. A horizontal inequity index was applied to identify inequity. A decomposition method was used to describe the sources of inequality. The concentration curve indicated a slightly pro-rich inequality in dental care utilization. The concentration index showed a significant concentration of dental care utilization among groups with higher socioeconomic status (SES). The horizontal inequity index illustrated higher unmet dental care needs among lower SES groups. Decomposition revealed that higher SES, urban Java Island residency, and insurance coverage were positively associated with the likelihood of dental care utilization. This study concludes that the expansion of health insurance, especially targeted at low SES groups, and a regionally equitable distribution of dentists may reduce economic and geographic barriers to dental care in the future.

Combined effect of individual and neighbourhood socioeconomic status on mortality of rheumatoid arthritis patients under universal health care coverage system.

PubMed

Chen, Cheng-Hsin; Huang, Kuang-Yung; Wang, Jen-Yu; Huang, Hsien-Bin; Chou, Pesus; Lee, Ching-Chih

2015-02-01

The National Health Insurance program in Taiwan is a public insurance system for the entire population of Taiwan initiated since March 1995. However, the association of socioeconomic status (SES) and prognosis of rheumatoid arthritis (RA) patients under this program has not been identified. Using the National Health Insurance Research Database in Taiwan, we aimed to examine the combined effect of individual and neighbourhood SES on the mortality rates of RA patients under a universal health care coverage system. A study population included patients with RA from 2004 to 2008. The primary end point was the 5-year overall mortality rate. Individual SES was categorized into low, moderate and high levels based on the income-related insurance payment amount. Neighbourhood SES was defined by household income and neighbourhoods were grouped as an 'advantaged' area or a 'disadvantaged' area. The Cox proportional hazards regression model was used to compare outcomes between different SES categories. A two-sided P value < 0.05 was considered statistically significant. Medical data of 23900 RA patients from 2004 to 2008 were reviewed. Analysis of the combined effect of individual SES and neighbourhood SES revealed that 5-year mortality rates were worse among RA patients with a low individual SES compared to those with a high SES (P < 0.001). In the Cox proportional hazards regression model, RA patients with low individual SES in disadvantaged neighbourhoods incurred the highest risk of mortality (Hazard ratio = 1.64; 95% confidence interval, 1.26-2.13, P < 0.001). RA patients with a low SES have a higher overall mortality rate than those with a higher SES, even with a universal health care system. It is crucial that more public policy and health care efforts be put into alleviating the health disadvantages, besides providing treatment payment coverage. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The impact of a hybrid social marketing intervention on inequities in access, ownership and use of insecticide-treated nets.

PubMed

Agha, Sohail; Van Rossem, Ronan; Stallworthy, Guy; Kusanthan, Thankian

2007-01-29

An ITN intervention was initiated in three predominantly rural districts of Eastern Province, Zambia, that lacked commercial distribution and communication infrastructures. Social marketing techniques were used for product and message development. Public sector clinics and village-based volunteers promoted and distributed subsidized ITNs priced at 2.5 dollars per net. A study was conducted to assess the effects of the intervention on inequities in knowledge, access, ownership and use of ITNs. A post-test only quasi-experimental study design was used to compare intervention and comparison districts. A total of 2,986 respondents were interviewed. Survey respondents were grouped into four socio-economic (SES) categories: low, medium-low, medium and high. Knowledge, access, ownership and use indicators are compared. Concentration index scores are calculated. Interactions between intervention status and SES help determine how different SES groups benefited from the intervention. Although overall use of nets remained relatively low, post-test data show that knowledge, access, ownership and use of mosquito nets was higher in intervention districts. A decline in SES inequity in access to nets occurred in intervention districts, resulting from a disproportionately greater increase in access among the low SES group. Declines in SES inequities in net ownership and use of nets were associated with the intervention. The largest increases in net ownership and use occurred among medium and high SES categories. Increasing access to nets among the poorest respondents in rural areas may not lead to increases in net use unless the price of nets is no longer a barrier to their purchase.

Socioeconomic patterns of overweight, obesity but not thinness persist from childhood to adolescence in a 6-year longitudinal cohort of Australian schoolchildren from 2007 to 2012.

PubMed

O'Dea, Jennifer A; Chiang, Hueiwen; Peralta, Louisa R

2014-03-04

The prevalence of childhood overweight and obesity increased during the 1980s to the late 1990s. The prevalence of obesity is higher in socially and economically disadvantaged communities in most Westernised countries. The purpose of this study was to examine how the socioeconomic gradient in weight status, namely thinness, overweight and obesity, changes over time in a longitudinal cohort of Australian schoolchildren, from 2007-2012. 939 Australian children in school grades 2-6 from 10 primary schools initially participated in the study in 2007. Height and weight were directly measured by research assistants each year. Obesity/overweight and thinness were defined by using the International Obesity Task Force BMI cut-offs. Chi-square analyses were used to test associations between categorical variables and linear mixed models were used to estimate whether the differences in SES groups were statistically significant over time. Results found both males and females in the low SES group were more likely to be obese (6-7%) than middle (4-5%) and high (2-3%) SES groups and this pattern tended to be similar over the 6 year study period. There appeared to be no particular SES pattern for thinness with all SES groups having 4-5% of participants who were thin. The gender and SES patterns were also similar over 6 years for BMI with low and middle SES participants having significantly greater BMI than their high SES peers. Patterns of obesity and overweight in children from socially and economically disadvantaged communities in regional NSW are identifiable from a young age and the socioeconomic pattern persists into adolescence. Obesity prevention and intervention programs should be designed, implemented and evaluated with the social determinants of health in mind and in collaboration with community members. Community programs should continue to be based on positive rather than negative messages in order to avoid unintended stigma and other potentially harmful outcomes.

Parent-related mechanisms underlying the social gradient of childhood overweight and obesity: a systematic review.

PubMed

Mech, P; Hooley, M; Skouteris, H; Williams, J

2016-09-01

Low socio-economic status (SES) is a significant risk factor for childhood overweight and obesity (COWOB) in high-income countries. Parents to young children buffer and accentuate social and cultural influences, and are central to the development of this disease. An understanding of the parent-related mechanisms that underlie the SES-COWOB relationship is needed to improve the efficacy of prevention and intervention efforts. A systematic review of relevant literature was conducted to investigate the mechanisms by which levels of SES (low, middle and high) are associated to COWOB, by exploring mediation and interaction effects. Six electronic databases were searched yielding 5155 initial records, once duplicates were removed. Studies were included if they investigated COWOB, SES, parent-related factors and the multivariate relationship between these factors. Thirty studies were included. Factors found to be mediating the SES-COWOB relationship or interacting with SES to influence COWOB were categorized according to an ecological systems framework, at child, parent, household and social system level factors. High parent body mass index, ethnicity, child-care attendance, high TV time (mother and child), breastfeeding (early weaning), food intake behaviours and birthweight potentially mediate the relationship between SES and COWOB. Different risk factors for COWOB in different SES groups were found. For low SES families, parental obesity and maternal depressive symptoms were strong risk factors for COWOB, whereas long maternal working hours and a permissive parenting style were risk factors for higher SES families. None of the studies investigated parental psychological attributes such as attitudes, beliefs, self-esteem and so on as potential mechanisms/risk factors. Families from different SES groups have different risk and protective factors for COWOB. Prevention and intervention efforts may have improved efficacy if they are tailored to address specific risk factors within SES. © 2016 John Wiley & Sons Ltd.

Age and Socioeconomic Gradients of Health of Indian Adults: An Assessment of Self-Reported and Biological Measures of Health.

PubMed

Arokiasamy, Perianayagam; Uttamacharya; Kowal, Paul; Chatterji, Somnath

2016-06-01

This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum.

Towards a novel model for studying the nutritional stage dynamics of the Colombian population by age and socioeconomic status

PubMed Central

Sarmiento, Olga L.; Olaya, Camilo; Lemoine, Pablo D.; Valdivia, Juan A.; Zarama, Roberto

2018-01-01

Low-and middle-income countries (LMICs) are experiencing a nutritional transition in which the burden of obesity tends to shift towards the lower-socioeconomic status (SES) group. We propose a system dynamics (SD) model for assessing the nutritional stage dynamics of the Colombian urban population by age and SES projected to 2030. This SD model captures the ageing population according to body mass index (BMI) categories and SES. In this model, the transference rates (TRs) between BMI categories by age and SES are estimated using a heuristic based on data obtained from national surveys. The simulation results show that the Colombian population, particularly those aged 20 to 39 years with a lower SES, is moving towards the overweight and obese categories. The TRs for overweight and obese categories in the lower SES group (the mean TR from not overweight to overweight = 0.0215 (per year) and mean TR from overweight to obese = 0.0098 (per year)) are increasing more rapidly than the those in the middle (the mean TR from not overweight to overweight = 0.0162 (per year) and mean TR from overweight to obese = 0.0065 (per year)) and higher SES groups (the mean TR from not overweight to overweight = 0.0166 and mean TR from overweight to obese = 0.0054 (per year)). Additionally, from 2005 to 2010, individuals aged 20 to 39 years had the highest TRs towards the overweight and obese categories (from 0.026 to 0.036 per year and from 0.0064 to 0.012 per year, respectively). The TRs also indicated that children aged 0 to 14 years are moving from the obese to overweight and from the overweight to not overweight categories. These TRs show that the Colombian population is experiencing an SES-related nutritional transition that is affecting the lower SES population. The proposed model could be implemented to assess the nutritional transitions experienced in other LMICs. PMID:29420563

Economic inequality in nutritional knowledge, attitude and practice of Iranian households: The NUTRI-KAP study.

PubMed

Heshmat, Ramin; Salehi, Forouzan; Qorbani, Mostafa; Rostami, Mahsa; Shafiee, Gita; Ahadi, Zeinab; Khosravi, Shayesteh; Rezvani, Vahab; Sadeghi Ghotbabadi, Farzaneh; Ghaderpanahi, Maryam; Abdollahi, Zahra

2016-01-01

Background: Improper nutritional knowledge is one of the most important causes of nutritional problems, which can affect practice and cause more complications. The aim of this study was to assess the association between nutritional knowledge, attitude and practice (KAP) of Iranian households with socioeconomic status (SES). Methods: The study population was 14,136 households (57 clusters of 8 individuals in each province) who lived in urban and rural regions of 31 provinces of Iran. The sample size of the study was selected using multistage cluster sampling technique. A structured questionnaire and interview with the qualified person in each family was used to collect data. The questionnaire included demographic, SES and nutritional KAP questions. Using principle component analysis, some variables including household assets, occupation and education level of the heads of the families and respondents and the number of family members were used to construct family SES. The SES was categorized as good, moderate and weak. Pearson's Chi-square test was used to analyze categorical variables. Results: The percentage of knowledge about growing up, acquiring energy and being healthy as reasons for eating food was 24.1%, 44.8% and 54.7%, respectively. Only 69.7%, 60.5% and 52.5% of the participants had knowledge of identification of meat and legumes, grain and dairy group, respectively. More than 97% of the participants had a favorable attitude toward importance of nutrition in health. The nutritional knowledge linearly increased with increasing SES. Families with good SES significantly consumed more fruit, vegetable, dairy group, red meat, chicken and poultry, fish and egg while sugar consumption was significantly higher in families with weak SES (p<0.05). Conclusion: SES can influence the rate of nutritional KAP. Some policies should be considered to increase nutritional KAP especially in lower SES group in the society.

Towards a novel model for studying the nutritional stage dynamics of the Colombian population by age and socioeconomic status.

PubMed

Meisel, Jose D; Sarmiento, Olga L; Olaya, Camilo; Lemoine, Pablo D; Valdivia, Juan A; Zarama, Roberto

2018-01-01

Low-and middle-income countries (LMICs) are experiencing a nutritional transition in which the burden of obesity tends to shift towards the lower-socioeconomic status (SES) group. We propose a system dynamics (SD) model for assessing the nutritional stage dynamics of the Colombian urban population by age and SES projected to 2030. This SD model captures the ageing population according to body mass index (BMI) categories and SES. In this model, the transference rates (TRs) between BMI categories by age and SES are estimated using a heuristic based on data obtained from national surveys. The simulation results show that the Colombian population, particularly those aged 20 to 39 years with a lower SES, is moving towards the overweight and obese categories. The TRs for overweight and obese categories in the lower SES group (the mean TR from not overweight to overweight = 0.0215 (per year) and mean TR from overweight to obese = 0.0098 (per year)) are increasing more rapidly than the those in the middle (the mean TR from not overweight to overweight = 0.0162 (per year) and mean TR from overweight to obese = 0.0065 (per year)) and higher SES groups (the mean TR from not overweight to overweight = 0.0166 and mean TR from overweight to obese = 0.0054 (per year)). Additionally, from 2005 to 2010, individuals aged 20 to 39 years had the highest TRs towards the overweight and obese categories (from 0.026 to 0.036 per year and from 0.0064 to 0.012 per year, respectively). The TRs also indicated that children aged 0 to 14 years are moving from the obese to overweight and from the overweight to not overweight categories. These TRs show that the Colombian population is experiencing an SES-related nutritional transition that is affecting the lower SES population. The proposed model could be implemented to assess the nutritional transitions experienced in other LMICs.

Trends in smoking in Canada from 1950 to 2011: progression of the tobacco epidemic according to socioeconomic status and geography.

PubMed

Corsi, Daniel J; Boyle, Michael H; Lear, Scott A; Chow, Clara K; Teo, Koon K; Subramanian, S V

2014-01-01

Smoking has declined in Canada in recent years. However, it is not clear whether differences in current smoking by socioeconomic status have increased, decreased, or remained unchanged in Canada. We examined rates of current smoking by sex, education, and province from 1950 to 2011. Differences in current smoking, initiation, and cessation were summarized using relative and absolute measures. Between 1950 and 2011, the prevalence of current smoking (including daily and non-daily) among adults aged 20 years and older decreased steadily in men from 68.9 % (95 % CI 63.9-73.3) to 18.6 % (14.9-22.1) but in women increased slightly from 38.2 % (32.3-42.2) in 1950 to 39.1 % (36.4-41.2) in 1959 before declining to 15.4 % (11.9-18.9) in 2011. Among men, there was an inverse association between educational attainment and smoking which was consistent from 1950 to 2011. A similar gradient emerged in the mid-1960s in women. Absolute differences in rates of smoking across levels of education increased despite overall declines in smoking across all levels of education. Rates of smoking in women and men were higher in the Atlantic Provinces and Quebec, although in men these differences have declined since the 1990s. In a subset of data from 1999 to 2011, those with lower levels of education had higher levels of smoking initiation and lower levels of cessation. Smoking rates have fallen over time but socioeconomic differences have increased. Smoking prevalence peaked later in lower socioeconomic status (SES) groups, and rates of decline in lower SES groups and certain provinces have been less steep. This suggests that SES gradients emerge rapidly in later stages of the tobacco epidemic and may have increased through greater efficacy of tobacco control policies in reducing smoking among those of higher SES compared to those of lower SES. Tailored approaches may be required to reduce smoking rates in those of lower SES and narrow SES differences.

Examining the relationship between socioeconomic status and the double burden of maternal over and child under-nutrition in Bangladesh.

PubMed

Hauqe, Syed Emdadul; Sakisaka, Kayako; Rahman, Mosiur

2018-04-25

There is little research on the association between socioeconomic status (SES) and the familial co-existence of maternal over and child under-nutrition (MOCU). Most of these studies conducted in the Latin American countries. Therefore, we intended to further this important area of query by exploring the relationship between SES and the dual burden of MOCU in Bangladesh. We used data from the 2014 Bangladesh Demographic Health Survey (BDHS). The analyses were based on the responses of 5687 mother-child pairs. We focused standard of living (hereafter referred to as wealth) as a measure of SES. We determined MOCU if there were an undernourished child and an overweight mother in the same household. Maternal overweight and MOCU prevalence is higher among the wealthier segment whereas prevalence of child under-nutrition is higher among the poorest segment of the households. The relative risk of a household having MOCU increased by the factors of 2.84 (confidence interval (CI) = 1.58-5.12) among households with richest bands of wealth compared to the poorest category. Household from the medium (Relative risk ratio (RRR) = 1.87, 95% CI = 1.07-3.28) and richer SES groups (RRR = 2.56, 95% CI = 1.39-4.69) had increased chance for MOCU as compared to the household from poorest SES group. As opposed to findings from other Latin American countries, the prevalence of MOCU in Bangladesh is higher in the wealthiest households. Findings of our study therefore suggest that overweight prevention programs in wealthier households of Bangladesh need to think out the possibility that their focus households may also include underweight persons.

Associations Between Socioeconomic Factors and Alcohol Outcomes

PubMed Central

Collins, Susan E.

2016-01-01

Socioeconomic status (SES) is one of the many factors influencing a person’s alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. These associations are further complicated by a variety of moderating factors, such as race, ethnicity, and gender. Thus, among individuals with lower SES, members of further marginalized communities, such as racial and ethnic minorities and homeless individuals, experience greater alcohol-related consequences. Future studies are needed to more fully explore the underlying mechanisms of the relationship between SES and alcohol outcomes. This knowledge should be applied toward the development of multilevel interventions that address not only individual-level risks but also economic disparities that have precipitated and maintained a disproportionate level of alcohol-related consequences among more marginalized and vulnerable populations. PMID:27159815

Associations Between Socioeconomic Factors and Alcohol Outcomes.

PubMed

Collins, Susan E

2016-01-01

Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. These associations are further complicated by a variety of moderating factors, such as race, ethnicity, and gender. Thus, among individuals with lower SES, members of further marginalized communities, such as racial and ethnic minorities and homeless individuals, experience greater alcohol-related consequences. Future studies are needed to more fully explore the underlying mechanisms of the relationship between SES and alcohol outcomes. This knowledge should be applied toward the development of multilevel interventions that address not only individual-level risks but also economic disparities that have precipitated and maintained a disproportionate level of alcohol-related consequences among more marginalized and vulnerable populations.

Socioeconomic status and stress in Mexican–American women: a multi-method perspective

PubMed Central

Shivpuri, Smriti; Gonzalez, Patricia; Fortmann, Addie L.; de los Monteros, Karla Espinosa; Roesch, Scott C.; Talavera, Gregory A.; Matthews, Karen A.

2014-01-01

Stress is a hypothesized pathway in socioeconomic status (SES)-physical health associations, but the available empirical data are inconsistent. In part, this may reflect discrepancies in the approach to measuring stress across studies, and differences in the nature of SES-stress associations across demographic groups. We examined associations of SES (education, income) with general and domain-specific chronic stressors, stressful life events, perceived stress, and stressful daily experiences in 318 Mexican–American women (40–65 years old). Women with higher SES reported lower perceived stress and fewer low-control experiences in everyday life (ps < .05), but greater chronic stress (education only, p < .05). Domain-specific analyses showed negative associations of income with chronic housing and financial stress (ps < .05), but positive associations of SES with chronic work and care-giving stress (all ps < .05 except for income and caregiving stress, p < .10). Sensitivity analyses showed that most SES-stress associations were consistent across acculturation levels. Future research should adopt a multi-dimensional assessment approach to better understand links among SES, stress, and physical health, and should consider the sociodemographic context in conceptualizing the role of stress in SES-related health inequalities. PMID:22644814

Social disadvantage and the self-regulatory function of justice beliefs.

PubMed

Laurin, Kristin; Fitzsimons, Gráinne M; Kay, Aaron C

2011-01-01

Five studies support the hypothesis that beliefs in societal fairness offer a self-regulatory benefit for members of socially disadvantaged groups. Specifically, members of disadvantaged groups are more likely than members of advantaged groups to calibrate their pursuit of long-term goals to their beliefs about societal fairness. In Study 1, low socioeconomic status (SES) undergraduate students who believed more strongly in societal fairness showed greater intentions to persist in the face of poor performance on a midterm examination. In Study 2, low SES participants who believed more strongly in fairness reported more willingness to invest time and effort to achieve desirable career outcomes. In Study 3, ethnic minority participants exposed to a manipulation suggesting that fairness conditions in their country were improving reported more willingness to invest resources in pursuit of long-term goals, relative to ethnic minority participants in a control condition. Study 4 replicated Study 3 using an implicit priming procedure, demonstrating that perceptions of the personal relevance of societal fairness mediate these effects. Across these 4 studies, no link between fairness beliefs and self-regulation emerged for members of advantaged (high SES, ethnic majority) groups. Study 5 contributed evidence from the World Values Survey and a representative sample (Inglehart, Basañez, Diez-Medrano, Halman, & Luijkx, 2004). Respondents reported more motivation to work hard to the extent that they believed that rewards were distributed fairly; this effect emerged more strongly for members of lower SES groups than for members of higher SES groups, as indicated by both self-identified social class and ethnicity. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Psychosocial Factors in the Relationship between Socioeconomic Status and Cardiometabolic Risk: the HCHS/SOL Sociocultural Ancillary Study.

PubMed

McCurley, Jessica L; Penedo, Frank; Roesch, Scott C; Isasi, Carmen R; Carnethon, Mercedes; Sotres-Alvarez, Daniela; Schneiderman, Neil; Gonzalez, Patricia; Chirinos, Diana A; Camacho, Alvaro; Teng, Yanping; Gallo, Linda C

2017-08-01

U.S. Hispanics/Latinos display a high prevalence of metabolic syndrome (MetSyn), a group of co-occurring cardiometabolic risk factors (abdominal obesity, impaired fasting glucose, dyslipidemia, elevated blood pressure) associated with higher cardiovascular disease and mortality risk. Low socioeconomic status (SES) is associated with higher risk for MetSyn in Hispanics/Latinos, and psychosocial factors may play a role in this relationship. This cross-sectional study examined psychosocial factors in the association of SES and MetSyn components in 4,996 Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. MetSyn components were measured at the baseline examination. Participants completed interviews to determine psychosocial risks (e.g., depression) and resources (e.g., social support) within 9 months of baseline (< 4 months in 72.6% of participants). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to identify latent constructs and examine associations. Participant mean age was 41.7 years (SE = 0.4) and 62.7% were female. CFA identified single latent factors for SES and psychosocial indicators, and three factors for MetSyn [blood pressure, lipids, metabolic factors]. SEMs showed that lower SES was related to MetSyn factors indirectly through higher psychosocial risk/lower resources (Y-Bχ 2 (df = 420) = 4412.90, p < .05, RMSEA = .042, SRMR = .051). A statistically significant effect consistent with mediation was found from lower SES to higher metabolic risk (glucose/waist circumference) via psychosocial risk/resource variables (Mackinnon's 95% asymmetric CI = -0.13 to -0.02). SES is related to metabolic variables indirectly through psychosocial factors in U.S. Hispanics/Latinos of diverse ancestries.

Socioeconomic status and obesity in adult populations of developing countries: a review.

PubMed Central

Monteiro, Carlos A.; Moura, Erly C.; Conde, Wolney L.; Popkin, Barry M.

2004-01-01

A landmark review of studies published prior to 1989 on socioeconomic status (SES) and obesity supported the view that obesity in the developing world would be essentially a disease of the socioeconomic elite. The present review, on studies conducted in adult populations from developing countries, published between 1989 and 2003, shows a different scenario for the relationship between SES and obesity. Although more studies are necessary to clarify the exact nature of this relationship, particularly among men, three main conclusions emerge from the studies reviewed: 1. Obesity in the developing world can no longer be considered solely a disease of groups with higher SES. 2. The burden of obesity in each developing country tends to shift towards the groups with lower SES as the country's gross national product (GNP) increases. 3. The shift of obesity towards women with low SES apparently occurs at an earlier stage of economic development than it does for men. The crossover to higher rates of obesity among women of low SES is found at a GNP per capita of about US$ 2500, the mid-point value for lower-middle-income economies. The results of this review reinforce the urgent need to: include obesity prevention as a relevant topic on the public health agenda in developing countries; improve the access of all social classes in these countries to reliable information on the determinants and consequences of obesity; and design and implement consistent public actions on the physical, economic, and sociocultural environment that make healthier choices concerning diet and physical activity feasible for all. A significant step in this direction was taken with the approval of the Global Strategy on Diet, Physical Activity and Health by the World Health Assembly in May 2004. PMID:15654409

Dimensions of socioeconomic status and clinical outcome after primary percutaneous coronary intervention.

PubMed

Jakobsen, Lars; Niemann, Troels; Thorsgaard, Niels; Thuesen, Leif; Lassen, Jens F; Jensen, Lisette O; Thayssen, Per; Ravkilde, Jan; Tilsted, Hans H; Mehnert, Frank; Johnsen, Søren P

2012-10-01

The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood. We studied 7385 patients treated with primary percutaneous coronary intervention. Participants were divided into high-SES and low-SES groups according to income, education, and employment status. The primary outcome was major adverse cardiac events (cardiac death, recurrent myocardial infarction, and target vessel revascularization) at maximum follow-up (mean, 3.7 years). Low-SES patients had more adverse baseline risk profiles than high-SES patients. The cumulative risk of major adverse cardiac events after maximum follow-up was higher among low-income patients and unemployed patients compared with their counterparts (income: hazard ratio, 1.68; 95% CI, 1.47-1.92; employment status: hazard ratio, 1.75; 95% CI, 1.46-2.10). After adjustment for patient characteristics, these differences were substantially attenuated (income: hazard ratio, 1.12; 95% CI, 0.93-1.33; employment status: hazard ratio, 1.27; 95% CI, 1.03-1.56). Further adjustment for admission findings, procedure-related data, and medical treatment during follow-up did not significantly affect the associations. With education as the SES indicator, no between-group differences were observed in the risk of the composite end point. Even in a tax-financed healthcare system, low-SES patients treated with primary percutaneous coronary intervention face a worse prognosis than high-SES patients. The poor outcome seems to be largely explained by differences in baseline patient characteristics. Employment status and income (but not education level) were associated with clinical outcomes.

Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: The P18 cohort study

PubMed Central

Halkitis, Perry N.; Siconolfi, Daniel E.; Stults, Christopher B.; Barton, Staci; Bub, Kristen; Kapadia, Farzana

2014-01-01

Objective To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). Methods Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). Results Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. Conclusions Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences. PMID:25456332

The independent and interacting effects of socioeconomic status and dual-language use on brain structure and cognition.

PubMed

Brito, Natalie H; Noble, Kimberly G

2018-06-07

Family socioeconomic status (SES) is strongly associated with children's cognitive development, and past studies have reported socioeconomic disparities in both neurocognitive skills and brain structure across childhood. In other studies, bilingualism has been associated with cognitive advantages and differences in brain structure across the lifespan. The aim of the current study is to concurrently examine the joint and independent associations between family SES and dual-language use with brain structure and cognitive skills during childhood. A subset of data from the Pediatric Imaging, Neurocognition and Genetics (PING) study was analyzed; propensity score matching established an equal sample (N = 562) of monolinguals and dual-language users with similar socio-demographic characteristics (M age = 13.5, Range = 3-20 years). When collapsing across all ages, SES was linked to both brain structure and cognitive skills. When examining differences by age group, brain structure was significantly associated with both income and dual-language use during adolescence, but not earlier in childhood. Additionally, in adolescence, a significant interaction between dual-language use and SES was found, with no difference in cortical surface area (SA) between language groups of higher-SES backgrounds but significantly increased SA for dual-language users from lower-SES families compared to SES-matched monolinguals. These results suggest both independent and interacting associations between SES and dual-language use with brain development. To our knowledge, this is the first study to concurrently examine dual-language use and socioeconomic differences in brain structure during childhood and adolescence. © 2018 John Wiley & Sons Ltd.

Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles.

PubMed

Mayén, Ana-Lucia; Bovet, Pascal; Marti-Soler, Helena; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Marques-Vidal, Pedro; Stringhini, Silvia

2016-01-01

In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce. In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income. Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25-64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year. Three dietary patterns were identified: "snacks and drinks", "fruit and vegetables" and "fish and rice". No significant associations were found between SES and the "snacks and drinks" pattern. Low vs. high SES individuals had lower adherence to the "fruit and vegetables" pattern [prevalence ratio (95% CI) 0.71 (0.60-0.83)] but a higher adherence to the traditional "fish and rice" pattern [1.58 (1.32-1.88)]. Income modified the association between education and the "fish and rice" pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups. Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition.

Life-course socioeconomic status and breast and cervical cancer screening: analysis of the WHO's Study on Global Ageing and Adult Health (SAGE).

PubMed

Akinyemiju, Tomi; Ogunsina, Kemi; Sakhuja, Swati; Ogbhodo, Valentine; Braithwaite, Dejana

2016-11-22

Socioeconomic differences in screening have been well documented in upper-income countries; however, few studies have examined socioeconomic status (SES) over the life-course in relation to cancer screening in lower-income and middle-income countries. Here, we examine individual, parental and life-course SES differences in breast and cervical cancer screening among women in India, China, Mexico, Russia and South Africa. Data from the WHO's Study on Global Ageing and Adult Health (SAGE) 2007-2008 data were used for survey-weighted multivariable regression analysis. We examined the association between individual, parental and life-course SES in relation to breast and cervical cancer screening using education-based and employment-based measures of SES. 22 283 women aged 18-65 years, recruited from China, India, Mexico, Russia and South Africa. Having a college degree (OR 4.18; 95% CI 2.36 to 7.40) increased the odds of breast cancer screening compared with no formal education. Women with higher parental SES were almost 10 times more likely to receive breast cancer screening (OR 9.84; 95% CI 1.75 to 55.5) compared with women with low parental SES. Stable higher life-course (OR 3.07; 95% CI 1.96 to 4.79) increased breast cancer screening by threefold and increased cervical cancer screening by more than fourfold (OR 4.35; 95% CI 2.94 to 6.45); however, declining life-course SES was associated with reduced breast cancer screening (OR 0.26; 95% CI 0.08 to 0.79) compared to low life-course SES. Higher individual, parental and life-course SES was positively associated with breast and cervical cancer screening, although education-based SES measures were stronger predictors of screening compared with employment-based measures. Improving knowledge of the benefits of cancer screening and integrating cancer screening into routine healthcare practice for low SES women are actionable strategies that may significantly improve screening rates in low-income and middle-income countries. 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/.

Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study

PubMed Central

Kato, Asuka; Fujimaki, Yuko; Fujimori, Shin; Isogawa, Akihiro; Onishi, Yukiko; Suzuki, Ryo; Yamauchi, Toshimasa; Ueki, Kohjiro; Kadowaki, Takashi; Hashimoto, Hideki

2017-01-01

Objectives The aim of this study was to test the psychological and behavioural patterns of stigma (self-esteem and social participation) and their relationship to self-stigma, patient activation for engaging in self-care and glycaemic control among patients with type 2 diabetes mellitus (T2DM). Design A cross-sectional study. Setting 2 tertiary-level hospitals and 2 secondary-level hospitals in Japan. Participants A consecutive sample of 209 outpatients with T2DM. Inclusion criteria were as follows: presence of T2DM, age 20–74 years, no diagnosis of dementia and/or psychosis, and no need for urgent medical procedures. Outcome measures Study measures included a self-administered questionnaire to assess the Rosenberg Self-Esteem Scale (SES), the 3 subscales of 36-question Short Form Health Survey (SF-36; Social Function, Role Physical, Role Emotional), Self-Stigma Scale and Patient Activation Measure (PAM-13). Glycated haemoglobin was obtained from same day blood work. In our previous qualitative study, we found that psychological and behavioural patterns of stigma varied according to patients' levels of illness-related self-esteem as well as attitudes towards social participation. For quantitative consistency, we used the SES scale to measure self-esteem and the SF-36 subscales to measure social participation. We then divided participants into 4 groups by exhibited psychological and behavioural patterns: group A (high SES/high SF-36), group B (high SES/low SF-36), group C (low SES/high SF-36) and group D (low SES/low SF-36). Results Using analysis of covariance after controlling for age and sex, there was a significant difference in self-stigma levels between the four groups (F[3203]=15.70, p<0.001). We observed the highest mean self-stigma levels in group D. Group D also had significantly lower PAM-13 scores than those of groups A (p<0.001) and B (p=0.02). Conclusions The psychological and behavioural pattern of group D was found to be associated with higher levels of self-stigma and poorer patient activation for self-care. PMID:28360238

Alcohol consumption and social inequality at the individual and country levels--results from an international study.

PubMed

Grittner, Ulrike; Kuntsche, Sandra; Gmel, Gerhard; Bloomfield, Kim

2013-04-01

International comparisons of social inequalities in alcohol use have not been extensively investigated. The purpose of this study was to examine the relationship of country-level characteristics and individual socio-economic status (SES) on individual alcohol consumption in 33 countries. Data on 101,525 men and women collected by cross-sectional surveys in 33 countries of the GENACIS study were used. Individual SES was measured by highest attained educational level. Alcohol use measures included drinking status and monthly risky single occasion drinking (RSOD). The relationship between individuals' education and drinking indicators was examined by meta-analysis. In a second step the individual level data and country data were combined and tested in multilevel models. As country level indicators we used the Purchasing Power Parity of the gross national income, the Gini coefficient and the Gender Gap Index. For both genders and all countries higher individual SES was positively associated with drinking status. Also higher country level SES was associated with higher proportions of drinkers. Lower SES was associated with RSOD among men. Women of higher SES in low income countries were more often RSO drinkers than women of lower SES. The opposite was true in higher income countries. For the most part, findings regarding SES and drinking in higher income countries were as expected. However, women of higher SES in low and middle income countries appear at higher risk of engaging in RSOD. This finding should be kept in mind when developing new policy and prevention initiatives.

Socioeconomic Distinction, Cultural Tastes, and Cigarette Smoking*

PubMed Central

Pampel, Fred C.

2011-01-01

Objectives The inverse relationship between socioeconomic status (SES) and smoking is typically seen in terms of the greater economic and social resources of advantaged groups, but it may also relate to cultural resources. This study aims to test theories of symbolic distinction by examining relationships between smoking and ostensibly unrelated cultural preferences. Methods Using the 1993 General Social Survey, ordinal logistic regression models, and a three-category dependent variable (never, former, and current smoker), the analysis estimates relationships of musical likes and dislikes with smoking while controlling for SES and social strain. Results Preferences for classical music are associated with lower smoking, while preferences for bluegrass, jazz, and heavy metal music are associated with higher smoking. Conclusions The results suggest that SES groups may use smoking, like other cultural tastes, to distinguish their lifestyles from those of others. PMID:21874073

Socioeconomic Factors and Women's Use of Complementary and Alternative Medicine in Four Racial/Ethnic Groups

PubMed Central

Chao, Maria T.; Wade, Christine M.

2014-01-01

Objective Higher socioeconomic status (SES) is associated with using complementary and alternative medicine (CAM) in national surveys. Less is known about how socioeconomic factors affect CAM use in US subpopulations. We examined whether the relationship between SES and CAM use differs by racial/ethnic groups. Methods Using national survey data, we assessed education and income effects on women's CAM use in four racial/ethnic groups (Whites, Blacks, Mexican Americans, and Chinese Americans), controlling for age, health status, and geographic region. CAM use was defined as using any of 11 domains in the prior year. Results Adjusted effects of SES on CAM use were similar among Mexican American and non-Hispanic White women—education had a distinct gradient effect, with each increasing level of education significantly more likely to use CAM; household income ≥$60,000 was associated with CAM use compared to income <$20,000. For Chinese American women, socioeconomic factors were not associated with CAM use when controlling for confounders. Although income was not associated with CAM use among African American women, college graduates were three times more likely to use CAM than those with less than a high school education, adjusting for confounders. Conclusion SES effects on CAM use are not uniform across racial/ethnic populations. Other factors, such as culture and social networks, may interact with SES to influence CAM use in minority populations. PMID:18447102

Considering sport participation as a source for physical activity among adolescents.

PubMed

Pharr, Jennifer; Lough, Nancy L

2014-07-01

Studies have shown participation in sport is lower among girls than boys, decreases as students matriculate through high school, is lowest among Black and Hispanic girls and has a positive relationship with SES. With sport recognized as a contributor to physical activity and health in adolescents, consideration of diminishing rates of participation appears warranted. The purpose of this study was to identify patterns related to differences in self-reported sport participation between genders, ethnic groups, grades and SES. This study was a cross-sectional, secondary analysis of data collected for a sport interest survey. All students in grades 8-11 attending middle and high schools were provided an opportunity to participate in the survey. Data from 49,832 students were analyzed. Among the participants, Black girls participated more and White girls participated less than expected. Black boys participated more while White and Asian boys participated less than expected. Reported sport participation was high compared with national data when analyzed by gender and ethnic group. Sport participation was higher in low SES schools compared with high SES schools. The importance of sport as a source of physical activity in underserved groups is significant.

The cost of dementia in an unequal country: The case of Chile.

PubMed

Hojman, Daniel A; Duarte, Fabian; Ruiz-Tagle, Jaime; Budnich, Marilu; Delgado, Carolina; Slachevsky, Andrea

2017-01-01

We study the economic cost of dementia in Chile, and its variation according to socioeconomic status (SES). We use primary data from a survey of 330 informal primary caregivers who completed both a RUD-Lite and a socio-demographic questionnaire to evaluate the severity of dementia and caregiver's burden. The costs of dementia are broken into three components: direct medical costs (medical care, drugs, tests); direct social costs (social service, daycare); and indirect costs (mostly associated to informal care). The average monthly cost per patient is estimated at US$ 1,463. Direct medical costs account for 20 per cent, direct social costs for 5 per cent and indirect costs for 75 per cent of the total cost. The mean monthly cost is found to be inversely related to SES, a pattern largely driven by indirect costs. The monthly cost for high SES is US$ 1,083 and US$ 1,588 for low SES. A multivariate regression analysis suggests that severity of dementia and caregiver's burden account for between 49 and 70 per cent of the difference in the indirect cost across SES. However, between one-third and one-half of the variation across SES is not due to gradient in severity of dementia. Direct medical costs increase in higher SES, reflecting differences in purchasing power, while indirect costs are inversely related to SES and more than compensate differences in medical costs. Moreover, in lower SES groups, female caregivers, typically family members who are inactive in the labor market, mostly provide informal care. The average annual cost of dementia in Chile (US$ 17,559) is lower in comparison to high-income countries (US$ 39,595) and the proportion of cost related to informal cost is higher (74 per cent compared to 40 per cent). SES is a key determinant in the cost of dementia. In the absence of universal access to treatment, part of the social cost of dementia potentially preserves or increases income and gender inequality.

The cost of dementia in an unequal country: The case of Chile

PubMed Central

Hojman, Daniel A.; Duarte, Fabian; Ruiz-Tagle, Jaime; Budnich, Marilu; Delgado, Carolina; Slachevsky, Andrea

2017-01-01

We study the economic cost of dementia in Chile, and its variation according to socioeconomic status (SES). We use primary data from a survey of 330 informal primary caregivers who completed both a RUD-Lite and a socio-demographic questionnaire to evaluate the severity of dementia and caregiver’s burden. The costs of dementia are broken into three components: direct medical costs (medical care, drugs, tests); direct social costs (social service, daycare); and indirect costs (mostly associated to informal care). The average monthly cost per patient is estimated at US$ 1,463. Direct medical costs account for 20 per cent, direct social costs for 5 per cent and indirect costs for 75 per cent of the total cost. The mean monthly cost is found to be inversely related to SES, a pattern largely driven by indirect costs. The monthly cost for high SES is US$ 1,083 and US$ 1,588 for low SES. A multivariate regression analysis suggests that severity of dementia and caregiver’s burden account for between 49 and 70 per cent of the difference in the indirect cost across SES. However, between one-third and one-half of the variation across SES is not due to gradient in severity of dementia. Direct medical costs increase in higher SES, reflecting differences in purchasing power, while indirect costs are inversely related to SES and more than compensate differences in medical costs. Moreover, in lower SES groups, female caregivers, typically family members who are inactive in the labor market, mostly provide informal care. The average annual cost of dementia in Chile (US$ 17,559) is lower in comparison to high-income countries (US$ 39,595) and the proportion of cost related to informal cost is higher (74 per cent compared to 40 per cent). SES is a key determinant in the cost of dementia. In the absence of universal access to treatment, part of the social cost of dementia potentially preserves or increases income and gender inequality. PMID:28267795

Relationships among Food Group Intakes, Household Expenditure, and Education Attainment in a General Japanese Population: NIPPON DATA2010

PubMed Central

Nakamura, Mieko; Ojima, Toshiyuki; Kondo, Imako; Ninomiya, Toshiharu; Yoshita, Katsushi; Arai, Yusuke; Ohkubo, Takayoshi; Murakami, Yoshitaka; Takashima, Naoyuki; Kondo, Keiko; Okayama, Akira

2018-01-01

Background A lower socioeconomic status (SES) may be related to the intake of unhealthy food; however, this relationship has not been examined in detail. This study was undertaken to examine relationships among food group intakes and SES in a representative Japanese population. Methods This was a cross-sectional study using the baseline data of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey in Japan. A total of 2,898 participants were included in the baseline survey in 2010. The effects of age (<65 years and ≥65 years), equivalent household expenditure (EHE), and education attainment on food group intakes (gram per 1,000 kcal) were analyzed using a two-way analysis of variance. Results When EHE was lower, cereal intake was higher in men and women. Among men, fish, milk, and alcohol intakes were reduced with lower EHE. Among women, vegetable intake was reduced with lower EHE. In men and women, cereal intake was higher with lower education attainment. In contrast, meat intake was reduced with lower education attainment. Conclusions Lower SES was associated with a higher cereal intake and lower vegetable, fish, meat, and milk intakes in a representative Japanese population. Socioeconomic discrepancies need to be considered in order to promote healthier dietary habits. PMID:29503382

Ethnic disparities in educational and occupational gradients of estimated cardiovascular disease risk: The Healthy Life in an Urban Setting study.

PubMed

Perini, Wilco; Agyemang, Charles; Snijder, Marieke B; Peters, Ron J G; Kunst, Anton E

2018-03-01

European societies are becoming increasingly ethnically diverse. This may have important implications for socio-economic inequalities in health due to the often disadvantaged position of ethnic minority groups in both socio-economic status (SES) and disease, especially cardiovascular disease (CVD). The aim of this study was to determine whether the socio-economic gradient of estimated CVD risk differs between ethnic groups. Using the Healthy Life in an Urban Setting study, we obtained data on SES and CVD risk factors among participants from six ethnic backgrounds residing in Amsterdam. SES was measured using educational level and occupational level. CVD risk was estimated based on the occurrence of CVD risk factors using the Dutch version of the systematic coronary risk evaluation algorithm. Ethnic disparities in socio-economic gradients for estimated CVD risk were determined using the relative index of inequality (RII). Among Dutch-origin men, the RII for estimated CVD risk according to educational level was 6.15% (95% confidence interval [CI] 4.35-7.96%), indicating that those at the bottom of the educational hierarchy had a 6.15% higher estimated CVD risk relative than those at the top. Among Dutch-origin women, the RII was 4.49% (CI 2.45-6.52%). The RII was lower among ethnic minority groups, ranging from 0.83% to 3.13% among men and -0.29% to 5.12% among women, indicating weaker associations among these groups. Results were similar based on occupational level. Ethnic background needs to be considered in associations between SES and disease. The predictive value of SES varies between ethnic groups and may be quite poor for some groups.

Ethnic disparities in educational and occupational gradients of estimated cardiovascular disease risk: The Healthy Life in an Urban Setting study

PubMed Central

Perini, Wilco; Agyemang, Charles; Snijder, Marieke B.; Peters, Ron J.G.; Kunst, Anton E.

2017-01-01

Background: European societies are becoming increasingly ethnically diverse. This may have important implications for socio-economic inequalities in health due to the often disadvantaged position of ethnic minority groups in both socio-economic status (SES) and disease, especially cardiovascular disease (CVD). Objective: The aim of this study was to determine whether the socio-economic gradient of estimated CVD risk differs between ethnic groups. Methods: Using the Healthy Life in an Urban Setting study, we obtained data on SES and CVD risk factors among participants from six ethnic backgrounds residing in Amsterdam. SES was measured using educational level and occupational level. CVD risk was estimated based on the occurrence of CVD risk factors using the Dutch version of the systematic coronary risk evaluation algorithm. Ethnic disparities in socio-economic gradients for estimated CVD risk were determined using the relative index of inequality (RII). Results: Among Dutch-origin men, the RII for estimated CVD risk according to educational level was 6.15% (95% confidence interval [CI] 4.35–7.96%), indicating that those at the bottom of the educational hierarchy had a 6.15% higher estimated CVD risk relative than those at the top. Among Dutch-origin women, the RII was 4.49% (CI 2.45–6.52%). The RII was lower among ethnic minority groups, ranging from 0.83% to 3.13% among men and −0.29% to 5.12% among women, indicating weaker associations among these groups. Results were similar based on occupational level. Conclusions: Ethnic background needs to be considered in associations between SES and disease. The predictive value of SES varies between ethnic groups and may be quite poor for some groups. PMID:28699411

Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age.

PubMed

Brown, Tyson H; Richardson, Liana J; Hargrove, Taylor W; Thomas, Courtney S

2016-06-01

This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses. © American Sociological Association 2016.

Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age

PubMed Central

Brown, Tyson H.; Richardson, Liana J.; Hargrove, Taylor W.; Thomas, Courtney S.

2016-01-01

This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses. PMID:27284076

Socioeconomic status and ethnicity of deceased donor kidney recipients compared to their donors.

PubMed

Adler, J T; Hyder, J A; Elias, N; Nguyen, L L; Markmann, J F; Delmonico, F L; Yeh, H

2015-04-01

Public perception and misperceptions of socioeconomic disparities affect the willingness to donate organs. To improve our understanding of the flow of deceased donor kidneys, we analyzed socioeconomic status (SES) and racial/ethnic gradients between donors and recipients. In a retrospective cohort study, traditional demographic and socioeconomic factors, as well as an SES index, were compared in 56,697 deceased kidney donor and recipient pairs transplanted between 2007 and 2012. Kidneys were more likely to be transplanted in recipients of the same racial/ethnic group as the donor (p < 0.001). Kidneys tended to go to recipients of lower SES index (50.5% of the time, p < 0.001), a relationship that remained after adjusting for other available markers of donor organ quality and SES (p < 0.001). Deceased donor kidneys do not appear to be transplanted from donors of lower SES to recipients of higher SES; this information may be useful in counseling potential donors and their families regarding the distribution of their organ gifts. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Thyroid cancer incidence in New Jersey: time trend, birth cohort and socioeconomic status analysis (1979-2006).

PubMed

Roche, Lisa M; Niu, Xiaoling; Pawlish, Karen S; Henry, Kevin A

2011-01-01

The study's purpose was to investigate thyroid cancer incidence time trends, birth cohort effects, and association with socioeconomic status (SES) in New Jersey (NJ), a high incidence state, using NJ State Cancer Registry data. Thyroid cancer incidence rates in each sex, nearly all age groups, two major histologies and all stages significantly increased between 1979 and 2006. For each sex, age-specific incidence rates began greatly increasing in the 1924 birth cohort and, generally, the highest thyroid cancer incidence rate for each five-year age group occurred in the latest birth cohort and diagnosis period. Thyroid cancer incidence rates were significantly higher in NJ Census tracts with higher SES and in counties with a higher percentage of insured residents. These results support further investigation into the relationship between rising thyroid cancer incidence and increasing population exposure to medical (including diagnostic) radiation, as well as widespread use of more sensitive diagnostic techniques.

The Prevalence of Tooth Wear in the Dutch Adult Population

PubMed Central

Wetselaar, Peter; Vermaire, Jan H.; Visscher, Corine M.; Lobbezoo, Frank; Schuller, Annemarie A.

2016-01-01

This study aimed to assess the prevalence of tooth wear in different age groups of the Dutch adult population and to determine this tooth wear distribution by gender, socioeconomic class, and type of teeth. Results were compared with the outcomes of a previous study in a comparable population. As part of a comprehensive investigation of the oral health of the general Dutch adult population in 2013, tooth wear was assessed among 1,125 subjects in the city of ‘s-Hertogenbosch. The data collected were subjected to stratified analysis by 5 age groups (25-34, 35-44, 45-54, 55-64, and 65-74 years), gender, socioeconomic class, and type of teeth. Tooth wear was assessed using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected was higher in older age groups. Men showed more tooth wear than women, and subjects with low socioeconomic status (low SES) showed on average higher scores than those with high SES. Tooth wear prevalence found in this study was higher in all age groups than in the previous study. The present study found prevalences of 13% for mild tooth wear and 80% for moderate tooth wear, leading to the conclusion that these are common conditions in the Dutch adult population. Severe tooth wear (prevalence 6%) may however be characterized as rare. A tendency was found for there to be more tooth wear in older age groups, in men as compared with women, in persons with lower SES, and in the present survey as compared with the previous one. PMID:27694757

The Prevalence of Tooth Wear in the Dutch Adult Population.

PubMed

Wetselaar, Peter; Vermaire, Jan H; Visscher, Corine M; Lobbezoo, Frank; Schuller, Annemarie A

2016-01-01

This study aimed to assess the prevalence of tooth wear in different age groups of the Dutch adult population and to determine this tooth wear distribution by gender, socioeconomic class, and type of teeth. Results were compared with the outcomes of a previous study in a comparable population. As part of a comprehensive investigation of the oral health of the general Dutch adult population in 2013, tooth wear was assessed among 1,125 subjects in the city of 's-Hertogenbosch. The data collected were subjected to stratified analysis by 5 age groups (25-34, 35-44, 45-54, 55-64, and 65-74 years), gender, socioeconomic class, and type of teeth. Tooth wear was assessed using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected was higher in older age groups. Men showed more tooth wear than women, and subjects with low socioeconomic status (low SES) showed on average higher scores than those with high SES. Tooth wear prevalence found in this study was higher in all age groups than in the previous study. The present study found prevalences of 13% for mild tooth wear and 80% for moderate tooth wear, leading to the conclusion that these are common conditions in the Dutch adult population. Severe tooth wear (prevalence 6%) may however be characterized as rare. A tendency was found for there to be more tooth wear in older age groups, in men as compared with women, in persons with lower SES, and in the present survey as compared with the previous one. © 2016 S. Karger AG, Basel.

Does the social gradient remain in the dietary habits of a health-conscious population? A study of Seventh-Day Adventists in West Malaysia.

PubMed

Tan, Min Min; Chan, Carina K Y; Reidpath, Daniel D

2017-12-01

Socioeconomic status (SES) is a strong predictor of health, and individuals with higher SES generally have better health than those with lower SES. One of the pathways that SES influences health is through health behaviors, such as dietary intake, and a higher SES has been associated with a better diet. The purpose of this study was to determine whether there was a social gradient in dietary habits among the Seventh-Day Adventists, a group of conservative Christians, where healthy eating is part of the doctrinal teaching. Data from a survey of 574 Adventists residing in West Malaysia, aged 18-80 years, were analyzed. Dietary habits were measured using the Nutrition subscale of Health Promoting Lifestyle Profile II. Education and income were significantly associated with dietary habits before and after controlling for demographics. There was a gradient of association; a higher level of education and higher income were associated with better dietary habits. However, only education remained significantly associated with dietary habits when the other two socioeconomic variables were included. Employment was not significantly associated with dietary habits before or after controlling for demographic variables and the other two sociodemographic variables. This study showed that education is the strongest predictor of healthy diet, and a social gradient in dietary habits still exists even among health-conscious population. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Socioeconomic patterns of overweight, obesity but not thinness persist from childhood to adolescence in a 6 -year longitudinal cohort of Australian schoolchildren from 2007 to 2012

PubMed Central

2014-01-01

Background The prevalence of childhood overweight and obesity increased during the 1980s to the late 1990s. The prevalence of obesity is higher in socially and economically disadvantaged communities in most Westernised countries. The purpose of this study was to examine how the socioeconomic gradient in weight status, namely thinness, overweight and obesity, changes over time in a longitudinal cohort of Australian schoolchildren, from 2007–2012. Methods 939 Australian children in school grades 2–6 from 10 primary schools initially participated in the study in 2007. Height and weight were directly measured by research assistants each year. Obesity/overweight and thinness were defined by using the International Obesity Task Force BMI cut-offs. Chi-square analyses were used to test associations between categorical variables and linear mixed models were used to estimate whether the differences in SES groups were statistically significant over time. Results Results found both males and females in the low SES group were more likely to be obese (6-7%) than middle (4-5%) and high (2-3%) SES groups and this pattern tended to be similar over the 6 year study period. There appeared to be no particular SES pattern for thinness with all SES groups having 4-5% of participants who were thin. The gender and SES patterns were also similar over 6 years for BMI with low and middle SES participants having significantly greater BMI than their high SES peers. Conclusions Patterns of obesity and overweight in children from socially and economically disadvantaged communities in regional NSW are identifiable from a young age and the socioeconomic pattern persists into adolescence. Obesity prevention and intervention programs should be designed, implemented and evaluated with the social determinants of health in mind and in collaboration with community members. Community programs should continue to be based on positive rather than negative messages in order to avoid unintended stigma and other potentially harmful outcomes. PMID:24592991

Neighbourhood variation in the price of soda relative to milk and its association with neighbourhood socio-economic status and race.

PubMed

Kern, David M; Auchincloss, Amy H; Ballester, Lance S; Robinson, Lucy F

2016-12-01

Soda consumption is high in the USA, especially among minorities and individuals of lower socio-economic status (SES); this may be due to its affordable price in relation to healthier alternatives. The objective of the present study was to examine geospatial variation in price of milk and soda, and the price of milk relative to soda, by neighbourhood SES and proportion of Hispanic and black individuals. Retailer soda and milk prices (n 2987; Information Resources, Inc. Academic Data Set 2004-2011) were linked to census block group sociodemographic characteristics (American Community Survey 2005-2009). Linear hierarchical regression models were used to adjust for confounders. Large chain supermarkets and superstores (n 1743) in forty-one states and 1694 block groups (USA). For equivalent fluid ounces, price of soda on average was 62 % lower than milk ($US 0·23 v. $US 0·63 per serving) and there was high dispersion in milk price across geographic areas. After adjustment for confounding, neighbourhoods with a higher concentration of black and Hispanic individuals tended to have lower soda prices and higher milk prices (-$US 0·001 and +$US 0·007 in price per serving, respectively, for a one quintile increase in black/Hispanic population), while soda and milk both became less expensive as SES decreased (-$US 0·002 and -$US 0·015 in serving price per one sd decrease in SES index, respectively). Neighbourhoods with a higher concentration of blacks and Hispanics may be at greater risk of higher soda consumption due to more affordable prices, in absolute terms and relative to the price of milk.

Stress at work: Differential experiences of high versus low SES workers.

PubMed

Damaske, Sarah; Zawadzki, Matthew J; Smyth, Joshua M

2016-05-01

This paper asks whether workers with higher socioeconomic status (SES) experience different levels of stress at work than workers with lower SES and, if so, what might explain these differences. We collected innovative assessments of immediate objective and subjective measures of stress at multiple time points across consecutive days from 122 employed men and women. We find that in comparison to higher SES individuals, those with lower SES reported greater happiness at work, less self-reported stress, and less perceived stress; cortisol, a biological marker of stress, was unrelated to SES. Worker's momentary perceptions of the workplace were predicted by SES, with higher SES individuals more commonly reporting feeling unable to meet work demands, fewer work resources, and less positive work appraisals. In turn, perceptions of the workplace had a generally consistent and robust effect on positive mood, subjective stress, and cortisol. Copyright © 2016 Elsevier Ltd. All rights reserved.

Alcohol consumption and social inequality at the individual and country levels—results from an international study

PubMed Central

Kuntsche, Sandra; Gmel, Gerhard; Bloomfield, Kim

2013-01-01

Background: International comparisons of social inequalities in alcohol use have not been extensively investigated. The purpose of this study was to examine the relationship of country-level characteristics and individual socio-economic status (SES) on individual alcohol consumption in 33 countries. Methods: Data on 101 525 men and women collected by cross-sectional surveys in 33 countries of the GENACIS study were used. Individual SES was measured by highest attained educational level. Alcohol use measures included drinking status and monthly risky single occasion drinking (RSOD). The relationship between individuals’ education and drinking indicators was examined by meta-analysis. In a second step the individual level data and country data were combined and tested in multilevel models. As country level indicators we used the Purchasing Power Parity of the gross national income, the Gini coefficient and the Gender Gap Index. Results: For both genders and all countries higher individual SES was positively associated with drinking status. Also higher country level SES was associated with higher proportions of drinkers. Lower SES was associated with RSOD among men. Women of higher SES in low income countries were more often RSO drinkers than women of lower SES. The opposite was true in higher income countries. Conclusion: For the most part, findings regarding SES and drinking in higher income countries were as expected. However, women of higher SES in low and middle income countries appear at higher risk of engaging in RSOD. This finding should be kept in mind when developing new policy and prevention initiatives. PMID:22562712

Socioeconomic status and adolescent e-cigarette use: The mediating role of e-cigarette advertisement exposure.

PubMed

Simon, Patricia; Camenga, Deepa R; Morean, Meghan E; Kong, Grace; Bold, Krysten W; Cavallo, Dana A; Krishnan-Sarin, Suchitra

2018-07-01

Among adolescents, low socioeconomic status (SES) is associated with greater exposure to tobacco cigarette advertising and cigarette use. However, associations among SES, e-cigarette advertising and e-cigarette use are not well understood. This study examined exposure to e-cigarette advertisements as a mediator of the relationship between SES and adolescent e-cigarette use. Adolescents (N = 3473; 51% Female) from 8 high schools in Connecticut completed an anonymous survey in Spring 2015. Mediation analysis was used to examine whether the total number of sources of recent e-cigarette advertising exposure (e.g., TV, radio, billboards, magazines, local stores [gas stations, convenience stores], vape shops, mall kiosks, tobacco shops, social media) mediated the association between SES (measured by the Family Affluence Scale) and past-month frequency of e-cigarette use. We clustered for school and controlled for other tobacco product use, age, sex, race/ethnicity and perceived social norms for e-cigarette use in the model. Our sample recently had seen advertisements via 2.1 (SD = 2.8) advertising channels. Mediation was supported (indirect effect: β = 0.01, SE = 0.00, 95% CI [0.001, 0.010], p = 0.02), such that higher SES was associated with greater recent advertising exposure, which, in turn, was associated with greater frequency of e-cigarette use. Our study suggests that regulations to reduce youth exposure to e-cigarette advertisement may be especially relevant to higher SES youth. Future research should examine these associations longitudinally and evaluate which types of advertisements target different SES groups. Copyright © 2018 Elsevier Inc. All rights reserved.

Effects of education and word reading on cognitive scores in a community-based sample of Spanish elders with diverse socioeconomic status.

PubMed

Contador, Israel; Bermejo-Pareja, Félix; Del Ser, Teodoro; Benito-León, Julián

2015-01-01

The influence of education and oral word-reading ability on cognitive performance was examined in a sample of 1510 nondemented elders differing in socioeconomic status (SES) from three Spanish communities. All individuals were enrolled in the Neurological Disorders in Central Spain, a population-based epidemiological study in central Spain. They completed a detailed demographic survey and a short standardized neuropsychological battery assessing psychomotor speed, attention, language, and memory. The Word Accentuation Test (WAT) was used as measure of oral reading ability. The influence of education and oral reading on cognitive performance was determined by multiple linear regression models, first controlling for demographics (age and sex), and subsequently for the WAT score and education. The contribution of socioeconomic conditions was addressed by stratifying the sample into groups of high and low SES. The WAT showed a significant independent effect on cognitive scores, generally greater than that predicted by demographics. The higher predictive power of oral word reading on cognitive scores compared to education was consistent across the three communities. Although the variance explained by WAT was very similar in areas with diverse SES (low vs. high), WAT scores accounted for slightly more variance in naming and memory tasks in low SES areas. In contrast, the variance explained by WAT was higher for verbal fluency and the Trail-Making Test in areas with high SES. Oral word-reading ability predicts cognitive performance better than years of education across individuals with different SES. The influence of WAT may be modulated by SES and cognitive task properties.

Unhealthy lifestyles do not mediate the relationship between socioeconomic status and incident depressive symptoms; The Health ABC study

PubMed Central

Groffen, Daniëlle A.I.; Koster, Annemarie; Bosma, Hans; van den Akker, Marjan; Kempen, Gertrudis I.J.M.; van Eijk, Jacques Th M.; van Gool, Coen H.; Penninx, Brenda W.J.H.; Harris, Tamara B.; Rubin, Susan M.; Pahor, Marco; Schulz, Richard; Simonsick, Eleanor M.; Perry, Sara E.; Ayonayon, Hilsa N.; Kritchevsky, Stephen B.

2012-01-01

Background The relationship between low socioeconomic status (SES) and depressive symptoms is well described, also in older persons. Although studies have found associations between low SES and unhealthy lifestyle factors and between unhealthy lifestyle factors and depressive symptoms, not much is known about unhealthy lifestyles as a potential explanation of socioeconomic differences in depressive symptoms in older persons. Methods To study the independent pathways between SES (education, income, perceived income, and financial assets), lifestyle factors (smoking, alcohol use, body mass index, and physical activity), and incident depressive symptoms (CES-D 10 and reported use of antidepressant medication), we used 9 years of follow-up data (1997–2007) from 2,694 American black and white participants aged 70–79 from the Health, Aging, and Body Composition (Health ABC) study. At baseline, 12.1% of the study population showed prevalent depressive symptoms, use of antidepressant medication, or treatment of depression in the five years prior to baseline. These persons were excluded from the analyses. Results Over a period of 9 years time, 860 participants (31.9%) developed depressive symptoms. Adjusted hazard ratios for incident depressive symptoms were higher in participants from lower SES groups compared to the highest SES group. The strongest relationships were found for black men. Although unhealthy lifestyle factors were consistently associated with low SES, they were weakly related to incident depressive symptoms. Lifestyle factors did not significantly reduce hazard ratios for depressive symptoms by SES. Conclusion In generally healthy persons aged 70–79 years lifestyle factors do not explain the relationship between SES and depressive symptoms. (250) PMID:23567402

Unhealthy lifestyles do not mediate the relationship between socioeconomic status and incident depressive symptoms: the Health ABC study.

PubMed

Groffen, Daniëlle A I; Koster, Annemarie; Bosma, Hans; van den Akker, Marjan; Kempen, Gertrudis I J M; van Eijk, Jacques Th M; van Gool, Coen H; Penninx, Brenda W J H; Harris, Tamara B; Rubin, Susan M; Pahor, Marco; Schulz, Richard; Simonsick, Eleanor M; Perry, Sara E; Ayonayon, Hilsa N; Kritchevsky, Stephen B

2013-07-01

The relationship between low socioeconomic status (SES) and depressive symptoms is well described, also in older persons. Although studies have found associations between low SES and unhealthy lifestyle factors, and between unhealthy lifestyle factors and depressive symptoms, not much is known about unhealthy lifestyles as a potential explanation of socioeconomic differences in depressive symptoms in older persons. To study the independent pathways between SES (education, income, perceived income, and financial assets), lifestyle factors (smoking, alcohol use, body mass index, and physical activity), and incident depressive symptoms (Center for Epidemiologic Studies-Depression [CES-D 10] and reported use of antidepressant medication), we used 9 years of follow-up data (1997-2007) from 2,694 American black and white participants aged 70-79 years from the Health, Aging, and Body Composition (Health ABC) study. At baseline, 12.1% of the study population showed prevalent depressive symptoms, use of antidepressant medication, or treatment of depression in the 5 years prior to baseline. These persons were excluded from the analyses. Over a period of 9 years time, 860 participants (31.9%) developed depressive symptoms. Adjusted hazard ratios for incident depressive symptoms were higher in participants from lower SES groups compared with the highest SES group. The strongest relationships were found for black men. Although unhealthy lifestyle factors were consistently associated with low SES, they were weakly related to incident depressive symptoms. Lifestyle factors did not significantly reduce hazard ratios for depressive symptoms by SES. In generally healthy persons aged 70-79 years, lifestyle factors do not explain the relationship between SES and depressive symptoms. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Incidence of lung cancer histologic cell-types according to neighborhood factors: A population based study in California

PubMed Central

McKinley, Meg; Gali, Kathleen; Patel, Manali; Clarke, Christina; Wakelee, Heather; Haile, Robert; Gomez, Scarlett Lin; Cheng, Iona

2018-01-01

Background The relationships between neighborhood factors (i.e., neighborhood socioeconomic status (nSES) and ethnic enclave) and histologic subtypes of lung cancer for racial/ethnic groups, particularly Hispanics and Asian American/Pacific Islanders (AAPIs), are poorly understood. Methods We conducted a population-based study of 75,631 Californians diagnosed with lung cancer from 2008 through2012. We report incidence rate ratios (IRRs) for lung cancer histologic cell-types by nSES among racial/ethnic groups (non-Hispanic (NH) Whites, NH Blacks, Hispanics and AAPIs) and according to Hispanic or Asian neighborhood ethnic enclave status among Hispanics and AAPIs, respectively. In addition, we examined incidence jointly by nSES and ethnic enclave. Results Patterns of lung cancer incidence by nSES and ethnic enclave differed across race/ethnicity, sex, and histologic cell-type. For adenocarcinoma, Hispanic males and females, residing in both low nSES and high nSES neighborhoods that were low enclave, had higher incidence rates compared to those residing in low nSES, high enclave neighborhoods; males (IRR, 1.17 [95% CI, 1.04–1.32] and IRR, 1.15 [95% CI, 1.02–1.29], respectively) and females (IRR, 1.29 [95% CI, 1.15–1.44] and IRR, 1.51 [95% CI, 1.36–1.67], respectively). However, AAPI males residing in both low and high SES neighborhoods that were also low enclave had lower adenocarcinoma incidence. Conclusions Neighborhood factors differentially influence the incidence of lung cancer histologic cell-types with heterogeneity in these associations by race/ethnicity and sex. For Hispanic males and females and AAPI males, neighborhood ethnic enclave status is strongly associated with lung adenocarcinoma incidence. PMID:29791458

The Association between Disturbed Eating Behavior and Socioeconomic Status: The Online Korean Adolescent Panel Survey (OnKAPS)

PubMed Central

Lee, Hae-Jeung; Park, Sangshin; Kim, Cho-il; Choi, Doo-won; Lee, Jung Sun; Oh, Sun Min; Cho, Eunyoung; Park, Hye Kyung; Kwon, Kwang-il; Oh, Sang Woo

2013-01-01

Background A limited amount of research, primarily conducted in Western countries, has suggested that higher socioeconomic status (SES) is associated with higher risk of eating disorders (EDs). However, little is known about this association in Asian countries. We examined the association of SES with disturbed eating behavior (DEB) and related factors in Korean adolescents. Subjects A nationwide online panel survey was conducted in a sample of adolescents (n = 6,943, 49.9% girls). DEB was measured with the 26-item Eating Attitudes Test (EAT-26). Participants who scored ≥20 on the EAT-26 were considered to have DEB. Participants’ SES was determined based on self-reported household economic status. Results The prevalence of DEB was 12.7%: 10.5% among boys and 14.8% among girls. Both boys and girls with DEB were more likely to perceive themselves as obese, experience higher levels of stress, and have lower academic achievement. The risk for DEB was significantly higher in boys of higher SES than in those of middle SES (OR = 1.45, 95%CI = 1.05–1.99 for high SES; OR = 5.16, 95%CI: 3.50–7.61 for highest SES). Among girls, higher risk of DEB was associated with the highest and lowest SES (OR = 1.52, 95%CI: 1.13–2.06 for lowest SES; OR = 2.22, 95%CI: 1.34–3.68 for highest SES). Conclusions Despite the lower prevalence of obesity in Korea compared with Western countries, the prevalence of DEB in Korean adolescents was high, especially among girls. Moreover, the association between SES and DEB followed a U-shaped curve for girls and a J-shaped curve for boys. PMID:23472117

Sirolimus eluting stent (Cypher) in patients with diabetes mellitus: results from the German Cypher Stent Registry.

PubMed

Weber, Frank D; Schneider, Henrik; Wiemer, Marcus; Pfannebecker, Thomas; Tebbe, Ulrich; Hamm, Christian W; Senges, Jochen; Schneider, Steffen; Nienaber, Christoph A

2008-02-01

Patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) are at increased risk for adverse outcomes. The use of sirolimus eluting stents (SES) has been shown to improve outcomes in diabetic patients. Since results from randomized trials were derived from selected patients scientific scrutiny under real world conditions is necessary. 1,948 patients with DM and 4,707 patients without DM were included in the German Cypher Registry, a post-marketing survey of use of SES in Germany. In >99% of entry cases a structured clinical follow-up was completed. By angiographic criteria severity of coronary artery disease was higher in diabetic patients compared to non-diabetics. However, procedural success and in-hospital complication rates were comparable between DM- and non-DM-patients. 6 months MACE rate in the DM group was significantly higher than in the non-DM group (16.4% vs. 13.0%) but lower than expected from historical data with the use of bare metal stents (BMS). The results with SES in diabetics are encouraging but DM remains a risk factor for poor outcome of PCI. No statement is justified whether the treatment of diabetics with SES is at least as safe as bypass surgery. This intriguing question has to be answered in a direct randomized head-to-head comparison with state of the art surgery.

Impact of socioeconomic adjustment on physicians' relative cost of care.

PubMed

Timbie, Justin W; Hussey, Peter S; Adams, John L; Ruder, Teague W; Mehrotra, Ateev

2013-05-01

Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES). The importance of SES adjustment has not been explored in cost-profiling applications that measure costs using an episode of care framework. We assessed the relationship between SES and episode costs and the impact of adjusting for SES on physicians' relative cost rankings. We analyzed claims submitted to 3 Massachusetts commercial health plans during calendar years 2004 and 2005. We grouped patients' care into episodes, attributed episodes to individual physicians, and standardized costs for price differences across plans. We accounted for differences in physicians' case mix using indicators for episode type and a patient's severity of illness. A patient's SES was measured using an index of 6 indicators based on the zip code in which the patient lived. We estimated each physician's case mix-adjusted average episode cost and percentile rankings with and without adjustment for SES. Patients in the lowest SES quintile had $80 higher unadjusted episode costs, on average, than patients in the highest quintile. Nearly 70% of the variation in a physician's average episode cost was explained by case mix of their patients, whereas the contribution of SES was negligible. After adjustment for SES, only 1.1% of physicians changed relative cost rankings >2 percentiles. Accounting for patients' SES has little impact on physicians' relative cost rankings within an episode cost framework.

Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: the P18 cohort study.

PubMed

Halkitis, Perry N; Siconolfi, Daniel E; Stults, Christopher B; Barton, Staci; Bub, Kristen; Kapadia, Farzana

2014-12-01

To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to 19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Changes in Socioeconomic Inequality of Low Birth Weight and Macrosomia in Shaanxi Province of Northwest China, 2010–2013

PubMed Central

Pei, Leilei; Kang, Yijun; Zhao, Yaling; Cheng, Yue; Yan, Hong

2016-01-01

Abstract Socioeconomic disparities in birth weights (BWs) are associated with lifelong differences in health and productivity. Understanding socioeconomic disparities in BW is presently of concern to develop public health interventions that promote a good start in life in Northwest China. In the study, our objective is to investigate the socioeconomic disparities in low and high BW from 2010 to 2013 in this region. Those single live births were recruited using a stratified multistage sampling method in Shaanxi province from August to December 2013. Data were collected with a structured questionnaire and a review of birth certificates. Socioeconomic status (SES) was stratified based on the calculated household wealth index. Prevalence differences (PDs) and concentration indices (CIs) were used to depict the SES inequality of low BW (LBW) and macrosomia. Information for 28722 single live births born were obtained in Shaanxi province. From 2010 to 2013, the overall rates of LBW decreased, and the difference in LBW across differing SES groups decreased by 0.7% (boys, 0.4%; girls, 0.8%). From 2010 to 2013, the overall rates of macrosomia increased by 14.3% (boys, 17.5%; girls, 7.8%), whereas the PDs in macrosomia across various SES groups remained unchanged. From 2010 to 2013, concentration indices for SES inequalities in LBW and macrosomia confirmed the results shown by differences in prevalence. Compared with mothers of high SES, those in low SES group were significantly older, less educated, engaged in farming with less availabile healthcare, and engaged in unhealthy lifestyles (eg, exposure to secondhand smoke) during pregnancy, regardless of the baby's sex. From 2010 to 2013, in Shaanxi province, the negative association between socioeconomic status and LBW weakened. Rates of macrosomia were higher in those of high SES, but the SES disparities varied insignificantly over the same time. Our findings may provide valuable insights to direct healthcare policies for pregnant women to reduce inequalities in health, quality of life, and productivity for their children as they age into adulthood. PMID:26844457

Changes in Socioeconomic Inequality of Low Birth Weight and Macrosomia in Shaanxi Province of Northwest China, 2010-2013: A Cross-sectional Study.

PubMed

Pei, Leilei; Kang, Yijun; Zhao, Yaling; Cheng, Yue; Yan, Hong

2016-02-01

Socioeconomic disparities in birth weights (BWs) are associated with lifelong differences in health and productivity. Understanding socioeconomic disparities in BW is presently of concern to develop public health interventions that promote a good start in life in Northwest China. In the study, our objective is to investigate the socioeconomic disparities in low and high BW from 2010 to 2013 in this region.Those single live births were recruited using a stratified multistage sampling method in Shaanxi province from August to December 2013. Data were collected with a structured questionnaire and a review of birth certificates. Socioeconomic status (SES) was stratified based on the calculated household wealth index. Prevalence differences (PDs) and concentration indices (CIs) were used to depict the SES inequality of low BW (LBW) and macrosomia.Information for 28722 single live births born were obtained in Shaanxi province. From 2010 to 2013, the overall rates of LBW decreased, and the difference in LBW across differing SES groups decreased by 0.7% (boys, 0.4%; girls, 0.8%). From 2010 to 2013, the overall rates of macrosomia increased by 14.3% (boys, 17.5%; girls, 7.8%), whereas the PDs in macrosomia across various SES groups remained unchanged. From 2010 to 2013, concentration indices for SES inequalities in LBW and macrosomia confirmed the results shown by differences in prevalence. Compared with mothers of high SES, those in low SES group were significantly older, less educated, engaged in farming with less availabile healthcare, and engaged in unhealthy lifestyles (eg, exposure to secondhand smoke) during pregnancy, regardless of the baby's sex.From 2010 to 2013, in Shaanxi province, the negative association between socioeconomic status and LBW weakened. Rates of macrosomia were higher in those of high SES, but the SES disparities varied insignificantly over the same time. Our findings may provide valuable insights to direct healthcare policies for pregnant women to reduce inequalities in health, quality of life, and productivity for their children as they age into adulthood.

Socioeconomic Status and Patterns of Parent-Adolescent Interactions

ERIC Educational Resources Information Center

Chen, Edith; Berdan, Louise E.

2006-01-01

This study investigated reciprocity in parent-adolescent interactions among 102 families from lower or higher socioeconomic status (SES) backgrounds. Negative behaviors between parents and adolescents were more reciprocal (strongly correlated) in higher SES than lower SES families, and this reciprocity correlated with higher family relationship…

Socioeconomic differences in selected dietary habits among Norwegian 13–14 year-olds: a cross-sectional study

PubMed Central

Skårdal, Madelene; Western, Inger Mari; Ask, Anne M. S.; Øverby, Nina C.

2014-01-01

Background Social inequalities in health are a major and even growing problem in all European countries. Objective The aim of the present study was to describe 1) differences in dietary habits among Norwegian adolescents by gender and socioeconomic status; 2) differences in self-reported knowledge of dietary guidelines among their parents according to socioeconomic status. Design In 2012, a cross-sectional study where students filled in a web-based food frequency questionnaire at school was conducted in nine lower secondary schools in Vest-Agder County, Norway. Socioeconomic status (SES) and knowledge of dietary guidelines were obtained from the parents using a web-based questionnaire. In total, 517 ninth-grade students (mean age 13.9) out of 742 invited students participated in the study, giving a participation rate of 69.7%. The total number of dyads with information on both parents and students was 308 (41.5%). Results The findings indicate that there is a tendency for girls to have a healthier diet than boys, with greater intake of fruits and vegetables (girls intake in median 3.5 units per day and boys 2.9 units per day), and lower intake of soft drinks (girls 0.25 l in median versus boys 0.5 l per week). Students from families with higher SES reported a significant higher intake of vegetables and fish, and lower intake of soft drinks and fast food than those from lower SES. Parents with higher SES reported a significantly better knowledge of dietary guidelines compared to those with lower SES. Conclusions Differences in dietary habits were found between groups of students by gender and SES. Differences were also found in parents’ self-reported knowledge of dietary guidelines. This social patterning should be recognized in public health interventions. PMID:25140123

Socioeconomic Differences in Dietary Patterns in an East African Country: Evidence from the Republic of Seychelles

PubMed Central

Mayén, Ana-Lucia; Bovet, Pascal; Marti-Soler, Helena; Viswanathan, Bharathi; Gedeon, Jude; Paccaud, Fred; Marques-Vidal, Pedro; Stringhini, Silvia

2016-01-01

Background In high income countries, low socioeconomic status (SES) is related to unhealthier dietary patterns, while evidence on the social patterning of diet in low and middle income countries is scarce. Objective In this study, we assess dietary patterns in the general population of a middle income country in the African region, the Republic of Seychelles, and examine their distribution according to educational level and income. Methods Data was drawn from two independent national surveys conducted in the Seychelles among adults aged 25–64 years in 2004 (n = 1236) and 2013 (n = 1240). Dietary patterns were assessed by principal component analysis (PCA). Educational level and income were used as SES indicators. Data from both surveys were combined as no interaction was found between SES and year. Results Three dietary patterns were identified: “snacks and drinks”, “fruit and vegetables” and “fish and rice”. No significant associations were found between SES and the “snacks and drinks” pattern. Low vs. high SES individuals had lower adherence to the “fruit and vegetables” pattern [prevalence ratio (95% CI) 0.71 (0.60–0.83)] but a higher adherence to the traditional “fish and rice” pattern [1.58 (1.32–1.88)]. Income modified the association between education and the “fish and rice” pattern (p = 0.02), whereby low income individuals had a higher adherence to this pattern in both educational groups. Conclusion Low SES individuals have a lower consumption of fruit and vegetables, but a higher consumption of traditional foods like fish and rice. The Seychelles may be at a degenerative diseases stage of the nutrition transition. PMID:27214139

Social capital, social class and tobacco smoking.

PubMed

Lindström, Martin

2008-02-01

In all developed and some developing countries there are socioeconomic status (SES) differences in tobacco smoking. People with a low of education, manual occupation, low income as well as the unemployed are daily smokers to a higher extent than those with high SES. People with low SES also stop smoking to a lesser extent in many developed countries. Several theories have been proposed to account for SES differences in health. Social capital concerns the relationships of trust, participation and reciprocity among individuals, groups and institutions in a society that may enhance health and health-related behaviors. The materialist standpoint concerns material conditions. Studies with ecological, individual and multilevel study design, mostly cross-sectional studies, suggest that both (individual level) social capital and material factors are related to tobacco smoking, although multilevel studies concerning contextual level social capital are few and mostly, at least in adult populations, fail to demonstrate associations. There is also a want of longitudinal studies to investigate the associations between social capital and material conditions, smoking initiation, smoking continuation as well as smoking cessation, since cross-sectional studies analyze only prevalence data. More sophisticated multilevel studies are needed to investigate the association between social capital and material conditions, and tobacco smoking in SES groups in different social contexts.

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

Modeling the Association between Lifecourse Socioeconomic Disadvantage and Systemic Inflammation in Healthy Adults: The Role of Self-Control

PubMed Central

Hostinar, Camelia E.; Ross, Kharah M.; Chen, Edith; Miller, Gregory E.

2015-01-01

Objective We sought to identify pathways connecting lifecourse socioeconomic status (SES) with chronic, low-grade inflammation, focusing on the explanatory roles of self-control, abdominal adiposity, and health practices. Methods Participants were 360 adults aged 15 - 55 who were free of chronic medical conditions. They were roughly equally divided between low and high current SES, with each group further divided between low and high early-life SES. Structural Equation Modeling (SEM) was used to identify direct and indirect pathways linking early-life and current SES with low-grade, chronic inflammation in adulthood, as manifest by serum interleukin-6 and C-reactive protein. Low SES was hypothesized to relate to inflammation by reducing self-control, which in turn was hypothesized to facilitate lifestyle factors that potentiate inflammation (smoking, alcohol use, sedentary behavior, and weight gain). Results Analyses revealed that self-control was pivotal in linking both early-life and current SES to inflammation. Low early-life SES was related to a harsher family climate, and in turn lower adult self-control, over and above the effects of current SES. Controlling for early-life SES, low current SES was associated with perceived stress, and in turn diminished self-control. Results showed that lower self-control primarily operated through higher abdominal adiposity to associate with greater inflammation. Conclusions The findings suggest a mechanistic scenario wherein low SES in early-life or adulthood depletes self-control and in turn fosters adiposity and inflammation. These pathways should be studied longitudinally to elucidate and potentially ameliorate socioeconomic disparities in health. PMID:25110854

Positive Attitude toward Healthy Eating Predicts Higher Diet Quality at All Cost Levels of Supermarkets☆

PubMed Central

Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J.; Drewnowski, Adam

2014-01-01

Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. PMID:23916974

Traffic, Air Pollution, Minority and Socio-Economic Status: Addressing Inequities in Exposure and Risk

PubMed Central

Pratt, Gregory C.; Vadali, Monika L.; Kvale, Dorian L.; Ellickson, Kristie M.

2015-01-01

Higher levels of nearby traffic increase exposure to air pollution and adversely affect health outcomes. Populations with lower socio-economic status (SES) are particularly vulnerable to stressors like air pollution. We investigated cumulative exposures and risks from traffic and from MNRiskS-modeled air pollution in multiple source categories across demographic groups. Exposures and risks, especially from on-road sources, were higher than the mean for minorities and low SES populations and lower than the mean for white and high SES populations. Owning multiple vehicles and driving alone were linked to lower household exposures and risks. Those not owning a vehicle and walking or using transit had higher household exposures and risks. These results confirm for our study location that populations on the lower end of the socio-economic spectrum and minorities are disproportionately exposed to traffic and air pollution and at higher risk for adverse health outcomes. A major source of disparities appears to be the transportation infrastructure. Those outside the urban core had lower risks but drove more, while those living nearer the urban core tended to drive less but had higher exposures and risks from on-road sources. We suggest policy considerations for addressing these inequities. PMID:25996888

Relationship between socioeconomic status and gastrointestinal infections in developed countries: A systematic review and meta-analysis.

PubMed

Adams, Natalie L; Rose, Tanith C; Hawker, Jeremy; Violato, Mara; O'Brien, Sarah J; Barr, Benjamin; Howard, Victoria J K; Whitehead, Margaret; Harris, Ross; Taylor-Robinson, David C

2018-01-01

The association between socioeconomic status (SES) and health is well-documented; however limited evidence on the relationship between SES and gastrointestinal (GI) infections exists, with published studies producing conflicting results. This systematic review aimed to assess the association between SES and GI infection risk, and explore possible sources of heterogeneity in effect estimates reported in the literature. MEDLINE, Scopus, Web of Science and grey literature were searched from 1980 to October 2015 for studies reporting an association between GI infections and SES in a representative population sample from a member-country of the Organisation for Economic Co-operation and Development. Harvest plots and meta-regression were used to investigate potential sources of heterogeneity such as age; level of SES variable; GI infection measurement; and predominant mode of transmission. The protocol was registered on PROSPERO: CRD42015027231. In total, 6021 studies were identified; 102 met the inclusion criteria. Age was identified as the only statistically significant potential effect modifier of the association between SES and GI infection risk. For children, GI infection risk was higher for those of lower SES versus high (RR 1.51, 95% CI;1.26-1.83), but there was no association for adults (RR 0.79, 95% CI;0.58-1.06). In univariate analysis, the increased risk comparing low and high SES groups was significantly higher for pathogens spread by person-to-person transmission, but lower for environmental pathogens, as compared to foodborne pathogens. Disadvantaged children, but not adults, have greater risk of GI infection compared to their more advantaged counterparts. There was high heterogeneity and many studies were of low quality. More high quality studies are needed to investigate the association between SES and GI infection risk, and future research should stratify analyses by age and pathogen type. Gaining further insight into this relationship will help inform policies to reduce inequalities in GI illness in children.

Do physician organizations located in lower socioeconomic status areas score lower on pay-for-performance measures?

PubMed

Chien, Alyna T; Wroblewski, Kristen; Damberg, Cheryl; Williams, Thomas R; Yanagihara, Dolores; Yakunina, Yelena; Casalino, Lawrence P

2012-05-01

Physician organizations (POs)--independent practice associations and medical groups--located in lower socioeconomic status (SES) areas may score poorly in pay-for-performance (P4P) programs. To examine the association between PO location and P4P performance. Cross-sectional study; Integrated Healthcare Association's (IHA's) P4P Program, the largest non-governmental, multi-payer program for POs in the U.S. 160 POs participating in 2009. We measured PO SES using established methods that involved geo-coding 11,718 practice sites within 160 POs to their respective census tracts and weighting tract-specific SES according to the number of primary care physicians at each site. P4P performance was defined by IHA's program and was a composite mainly representing clinical quality, but also including measures of patient experience, information technology and registry use. The area-based PO SES measure ranged from -11 to +11 (mean 0, SD 5), and the IHA P4P performance score ranged from 23 to 86 (mean 69, SD 15). In bivariate analysis, there was a significant positive relationship between PO SES and P4P performance (p < 0.001). In multivariate analysis, a one standard deviation increase in PO SES was associated with a 44% increase (relative risk 1.44, 95%CI, 1.22-1.71) in the likelihood of a PO being ranked in the top two quintiles of performance (p < 0.001). Physician organizations' performance scores in a major P4P program vary by the SES of the areas in which their practice sites are located. P4P programs that do not account for this are likely to pay higher bonuses to POs in higher SES areas, thus increasing the resource gap between these POs and POs in lower SES areas, which may increase disparities in the care they provide.

Socioeconomic Inequalities in the Oral Health of People Aged 15-40 Years in Kurdistan, Iran in 2015: A Cross-sectional Study.

PubMed

Moradi, Ghobad; Moinafshar, Ardavan; Adabi, Hemen; Sharafi, Mona; Mostafavi, Farideh; Bolbanabad, Amjad Mohamadi

2017-09-01

The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

[Health risks in different living circumstances of mothers. Analyses based on a population study].

PubMed

Sperlich, Stefanie

2014-12-01

The objective of this study was to determine the living circumstances ('Lebenslagen') in mothers which are associated with elevated health risks. Data were derived from a cross-sectional population based sample of German women (n = 3129) with underage children. By means of a two-step cluster analysis ten different maternal living circumstances were assessed which proved to be distinct with respect to indicators of socioeconomic position, employment status and family-related factors. Out of the ten living circumstances, one could be attributed to higher socioeconomic status (SES), while five were assigned to a middle SES and four to a lower SES. In line with previous findings, mothers with a high SES predominantly showed the best health while mothers with a low SES tended to be at higher health risk with respect to subjective health, mental health (anxiety and depression), obesity and smoking. However, there were important health differences between the different living circumstances within the middle and lower SES. In addition, varying health risks were found among different living circumstances of single mothers, pointing to the significance of family and job-related living conditions in establishing health risks. With this exploratory analysis strategy small-scale living conditions could be detected which were associated with specific health risks. This approach seemed particularly suitable to provide a more precise definition of target groups for health promotion. The findings encourage a more exrensive application of the concept of living conditions in medical sociology research as well as health monitoring.

Socioeconomic status and stress-induced increases in interleukin-6.

PubMed

Brydon, L; Edwards, S; Mohamed-Ali, V; Steptoe, A

2004-05-01

Coronary artery disease (CAD) is more prevalent in people from a low socioeconomic background, and low socioeconomic status (SES) is associated with an increased exposure to psychological stress. The pro-inflammatory cytokine interleukin-6 (IL-6) plays a central role in CAD development. IL-6 is responsive to psychological stress and could potentially mediate the effect of psychosocial factors on CAD risk. Accordingly, we predicted that people of low SES would have greater and/or more sustained IL-6 responses to acute psychological stress. Based on previous findings, we also predicted that these people would have delayed post-stress cardiovascular recovery. Thirty-eight male civil servants were tested, with participants divided into high and low SES groups according to employment grade. There were no differences between the groups at baseline. However there were significant differences in IL-6 and heart rate responses to stress. Stress induced increases in plasma IL-6 in all participants. However, in the low SES group, IL-6 continued to increase between 75 min and 2h post-stress, whereas IL-6 levels stabilised at 75 min in the high SES group. Heart rate increased to the same extent following stress in both groups, however by 2h post-stress, it had returned to baseline in 75% of the high SES group compared with only 38.1% of the low SES group. These results suggest that low SES people are less able to adapt to stress than their high SES counterparts. Prolonged stress-induced increases in IL-6 in low SES groups represents a novel mechanism potentially linking socioeconomic position and heart disease.

Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study.

PubMed

Kato, Asuka; Fujimaki, Yuko; Fujimori, Shin; Isogawa, Akihiro; Onishi, Yukiko; Suzuki, Ryo; Yamauchi, Toshimasa; Ueki, Kohjiro; Kadowaki, Takashi; Hashimoto, Hideki

2017-03-29

The aim of this study was to test the psychological and behavioural patterns of stigma (self-esteem and social participation) and their relationship to self-stigma, patient activation for engaging in self-care and glycaemic control among patients with type 2 diabetes mellitus (T2DM). A cross-sectional study. 2 tertiary-level hospitals and 2 secondary-level hospitals in Japan. A consecutive sample of 209 outpatients with T2DM. Inclusion criteria were as follows: presence of T2DM, age 20-74 years, no diagnosis of dementia and/or psychosis, and no need for urgent medical procedures. Study measures included a self-administered questionnaire to assess the Rosenberg Self-Esteem Scale (SES), the 3 subscales of 36-question Short Form Health Survey (SF-36; Social Function, Role Physical, Role Emotional), Self-Stigma Scale and Patient Activation Measure (PAM-13). Glycated haemoglobin was obtained from same day blood work. In our previous qualitative study, we found that psychological and behavioural patterns of stigma varied according to patients' levels of illness-related self-esteem as well as attitudes towards social participation. For quantitative consistency, we used the SES scale to measure self-esteem and the SF-36 subscales to measure social participation. We then divided participants into 4 groups by exhibited psychological and behavioural patterns: group A (high SES/high SF-36), group B (high SES/low SF-36), group C (low SES/high SF-36) and group D (low SES/low SF-36). Using analysis of covariance after controlling for age and sex, there was a significant difference in self-stigma levels between the four groups (F[3203]=15.70, p<0.001). We observed the highest mean self-stigma levels in group D. Group D also had significantly lower PAM-13 scores than those of groups A (p<0.001) and B (p=0.02). The psychological and behavioural pattern of group D was found to be associated with higher levels of self-stigma and poorer patient activation for self-care. 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/.

Job Pressure and SES-contingent Buffering: Resource Reinforcement, Substitution, or the Stress of Higher Status?

PubMed

Koltai, Jonathan; Schieman, Scott

2015-06-01

Analyses of the 2008 National Study of the Changing Workforce demonstrate that job pressure is associated with greater anxiety and job dissatisfaction. In this paper we ask, What conditions protect workers? The conventional buffering hypothesis in the Job-Demands Resource (JD-R) model predicts that job resources should attenuate the relationship. We test whether the conventional buffering hypothesis depends on socioeconomic status (SES). Support for conventional buffering is evident only for job dissatisfaction--and that generalizes across SES. When anxiety is assessed, however, we observe an SES contingency: Job resources attenuate the positive association between job pressure and anxiety among workers with lower SES, but exacerbate it among those with higher SES. We discuss the implications of this SES-contingent pattern for theoretical scenarios about "resource reinforcement," "resource substitution," and the "stress of higher status." Future research should consider SES indicators as potential contingencies in the relationship between job conditions and mental health. © American Sociological Association 2015.

"There's a higher power, but He gave us a free will": socioeconomic status and the intersection of agency and fatalism in infertility.

PubMed

Bell, Ann V; Hetterly, Elizabeth

2014-08-01

Existing literature characterizes fatalism as a passive reaction to health in the face of powerlessness and constructs agency as a more activist perspective based in self-efficacy and control. Frequently studied together, researchers extol agency as the appropriate approach to decision-making around health, while discouraging fatalistic outlooks. Despite associating such beliefs with social classes-agency with high socioeconomic status (SES) groups and fatalism with low SES groups-there is little research that compares health beliefs across class groups. By examining the medicalized condition of infertility among women of both high and low SES, this study examines how social class shapes reactions to health and illness. Through 58 in-depth interviews with infertile women in the U.S., we reveal the complexity of fatalism and agency and the reasons behind that complexity. We first examine the commonalities among SES groups and their mutual use of fatalism. We then demonstrate the nuance and continuity between the health beliefs themselves-fatalism can be agentic and agency can be achieved through fatalism. In other words, we disrupt the binary construction of health beliefs, their conflation with social class, and the static application of health beliefs as psychological attributes, ultimately exposing the classist basis of the concepts. Doing so can result in improved patient care and reduced health inequalities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Intersection of Race/Ethnicity and Socioeconomic Status in Mortality After Breast Cancer

PubMed Central

Yang, Juan; John, Esther M.; Kurian, Allison W.; Cheng, Iona; Leung, Rita; Koo, Jocelyn; Monroe, Kristine R.; Henderson, Brian E.; Bernstein, Leslie; Lu, Yani; Kwan, Marilyn L.; Sposto, Richard; Vigen, Cheryl L. P.; Wu, Anna H.; Keegan, Theresa H. M.; Gomez, Scarlett Lin

2015-01-01

We investigated social disparities in breast cancer (BC) mortality, leveraging data from the California Breast Cancer Survivorship Consortium. The associations of race/ethnicity, education, and neighborhood SES (nSES) with all-cause and BC-specific mortality were assessed among 9372 women with BC (diagnosed 1993–2007 in California with follow-up through 2010) from four racial/ ethnic groups [African American, Asian American, Latina, and non-Latina (NL) White] using Cox proportional hazards models. Compared to NL White women with high-education/high-nSES, higher all-cause mortality was observed among NL White women with high-education/ low-nSES [hazard ratio (HR) (95 % confidence interval) 1.24 (1.08–1.43)], and African American women with low-nSES, regardless of education [high education HR 1.24 (1.03–1.49); low-education HR 1.19 (0.99–1.44)]. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54–0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. Similar patterns were seen for BC-specific mortality. Individual- and neighborhood-level measures of SES interact with race/ ethnicity to impact mortality after BC diagnosis. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health. PMID:26072260

Does who you know in the positional hierarchy protect or hurt? Social capital, comparative reference group, and depression in two societies.

PubMed

Song, Lijun

2015-07-01

Does the socioeconomic status (SES) that one's (ego's) network members (alters) occupy indicate social resources or social comparison standards in the dynamics of health across culture? Using nationally representative data simultaneously collected from the United States and urban China, this study examines two competing theories-social capital and comparative reference group-in the two societies and compares their different application across the two societies using two cultural explanations, relational dependence and self-evaluation motive. Social capital theory expects absolute accessed SES and the size of higher accessed socioeconomic positions to protect health, and the size of lower accessed socioeconomic positions to harm health. But comparative reference group theory predicts the opposite. Additionally, the relational dependence explanation anticipates social capital theory to be more applicable to urban China and comparative reference group theory to be more applicable to the United States. The self-evaluation motive explanation expects the same pattern across the two societies in the examination of the size of lower accessed socioeconomic positions but the opposite pattern in the analysis of absolute accessed SES and the size of higher accessed socioeconomic positions. This study focuses on depressive symptoms and measures accessed occupational status. Results are consistent with the self-evaluation motive explanation. They support both social capital theory and comparative reference group theory in the United States but only the latter theory in urban China. Copyright © 2015 Elsevier Ltd. All rights reserved.

Will Hospital Peer Grouping by Patient Socioeconomic Status Fix the Medicare Hospital Readmission Reduction Program or Create New Problems?

PubMed

Fuller, Richard L; Hughes, John S; Goldfield, Norbert I; Averill, Richard F

2018-04-01

In 2016 the U.S. Congress directed the Centers for Medicare & Medicaid Services (CMS) to implement the 21st Century Cures Act to fix a flaw in the Hospital Readmissions Reduction Program (HRRP). One section of the Act is intended to remove bias in calculating penalties for hospitals treating large percentages of low socioeconomic status (SES) patients. A study was conducted to analyze the effect of the introduction of SES hospital peer groups on the number and distribution of the hospitals being penalized. The CMS analysis files for the fiscal year 2017 HRRP final rule and Disproportionate Share Hospital adjustments were used to assign hospital peer groups. The median excess readmission ratios for hospital peer groups were calculated, and the resulting pattern of hospital penalties within peer groups was analyzed. The findings suggest that because CMS assigns individual HRRP penalties on six clinical conditions but proposes to assign hospitals to a single SES peer group based on all admissions, it will ignore substantial differences in the distribution of peer group medians across these conditions. For surgical cases, as expected, hospitals with fewer patients had higher readmission rates, while for medical cases, hospitals with fewer patients had fewer readmissions. These findings may result in distortion of the peer group adjustment intended to correct for SES. Hospital peer groups may create unintended redistributions of penalties through distortion of peer group medians. An observed relationship between lower-volume hospitals and fewer readmissions for medical conditions requires additional research to establish its basis. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Educational differences in alcohol consumption and heavy drinking: An age-period-cohort perspective.

PubMed

Lui, Camillia K; Kerr, William C; Mulia, Nina; Ye, Yu

2018-05-01

Low socioeconomic status (SES) has been associated with lower alcohol consumption, but also with heavier drinking. To explain this contradictory relationship, we examined SES differences in drinking patterns from an age-period-cohort (APC) perspective. Data are from seven waves of the U.S. National Alcohol Surveys from 1979 to 2010. As a proxy for SES, educational attainment was used. Past-year alcohol volume was calculated from frequency (never-to-every day) and usual quantity (1-2, 3-4, or 5-6 drinks). Past-year frequency of heavy episodic drinking was labelled as total days of 5+ drinks. Gender-stratified APC fixed-effects models were conducted controlling for demographics and adjusting for survey design and weights. Significant APC effects by education were found, but the direction varied by alcohol measure. Education and total volume were positively associated across APC. Cross-over effects for age occurred with a positive education-heavy drinking relationship in young adulthood and negative relationship in mid-adulthood. Cohort-by-education effects showed greater heavy drinking among less educated women in 1956-60 cohort and more educated men and women in younger cohorts (post-1976). Higher SES is consistently associated with total volume across age, period, and cohort, but less consistently with heavy drinking. While there are currently significant intervention efforts to reduce heavy drinking in young adulthood, our study suggests the need for age-specific strategies targeting lower-SES groups in mid-adulthood and cohort-specific strategies for lower-SES women in the baby boomer cohort and higher-SES men and women in younger birth cohorts. Copyright © 2018 Elsevier B.V. All rights reserved.

Nutrient Intakes Linked to Better Health Outcomes Are Associated with Higher Diet Costs in the US

PubMed Central

Aggarwal, Anju; Monsivais, Pablo; Drewnowski, Adam

2012-01-01

Purpose Degrees of nutrient intake and food groups have been linked to differential chronic disease risk. However, intakes of specific nutrients may also be associated with differential diet costs and unobserved differences in socioeconomic status (SES). The present study examined degrees of nutrient intake, for every key nutrient in the diet, in relation to diet cost and SES. Methods Socio-demographic data for a stratified random sample of adult respondents in the Seattle Obesity Study were obtained through telephone survey. Dietary intakes were assessed using food frequency questionnaire (FFQ) (n = 1,266). Following standard procedures, nutrient intakes were energy-adjusted using the residual method and converted into quintiles. Diet cost for each respondent was estimated using Seattle supermarket retail prices for 384 FFQ component foods. Results Higher intakes of dietary fiber, vitamins A, C, D, E, and B12, beta carotene, folate, iron, calcium, potassium, and magnesium were associated with higher diet costs. The cost gradient was most pronounced for vitamin C, beta carotene, potassium, and magnesium. Higher intakes of saturated fats, trans fats and added sugars were associated with lower diet costs. Lower cost lower quality diets were more likely to be consumed by lower SES. Conclusion Nutrients commonly associated with a lower risk of chronic disease were associated with higher diet costs. By contrast, nutrients associated with higher disease risk were associated with lower diet costs. The cost variable may help somewhat explain why lower income groups fail to comply with dietary guidelines and have highest rates of diet related chronic disease. PMID:22662168

Prediction of Bayley and Stanford-Binet scores with a group of very low birthweight children.

PubMed

Dezoete, J A; MacArthur, B A; Tuck, B

2003-09-01

To study the prediction of cognitive development with a group of very low birthweight infants (<1500 g) at 18 months and at 4 years of age. Bayley Scales of Infant Development-II Mental Development Indexes (MDI), and Stanford-Binet Intelligence Scale (S-B) Composite Scores were studied in a population of 334 children with birthweights <1500 g. Independent variables measured were gestational age, birthweight, gender and parental socio-economic status (SES). Longer gestation (28 weeks and over) and higher birthweight (1000-1500 g) proved to be advantageous for cognitive ability at both 18 months and 4 years. Other significant advantages were associated with female and higher SES. High correlations were found between MDI and the S-B Composite Score (r = 0.62), and between birthweight and gestation (r = 0.72). When information available at birth was included in forward stepwise regression analyses to predict the S-B Composite at 4 years, the best predictors were MDI at 18 months and SES. With the measures employed and this population, prediction of cognitive development from early childhood to preschool was possible. This may enable reliable identification of those children at risk for delayed cognitive development who require intervention before starting school.

Age, period, and cohort analysis of regular dental care behavior and edentulism: A marginal approach

PubMed Central

2011-01-01

Background To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts. Methods Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software. Results The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (P < 0.05). The interaction of SDC and age (P < 0.0001) was significant. The probabilities of seeking ADC were even higher among subjects with SDC in all grades and aged 45 years or older. Females, older age group, respondents in earlier survey years, not seeking ADC, lower SES group, and not receiving SDC in all grades were associated with higher probability of being edentulous (P < 0.05). Conclusions With the use of GEE, the potential clustering effect of birth cohorts in sequential cross-sectional oral health survey data could be appropriately considered. The success of Danish dental health policy was demonstrated by a continued increase of regular dental visiting habits and tooth retention in adults because school dental care was provided to Danes in their childhood. PMID:21410991

How equitable is social franchising? Case studies of three maternal healthcare franchises in Uganda and India

PubMed Central

Haemmerli, Manon; Santos, Andreia; Penn-Kekana, Loveday; Lange, Isabelle; Matovu, Fred; Benova, Lenka; Wong, Kerry LM

2018-01-01

Abstract Substantial investments have been made in clinical social franchising to improve quality of care of private facilities in low- and middle-income countries but concerns have emerged that the benefits fail to reach poorer groups. We assessed the distribution of franchise utilization and content of care by socio-economic status (SES) in three maternal healthcare social franchises in Uganda and India (Uttar Pradesh and Rajasthan). We surveyed 2179 women who had received antenatal care (ANC) and/or delivery services at franchise clinics (in Uttar Pradesh only ANC services were offered). Women were allocated to national (Uganda) or state (India) SES quintiles. Franchise users were concentrated in the higher SES quintiles in all settings. The percent in the top two quintiles was highest in Uganda (over 98% for both ANC and delivery), followed by Rajasthan (62.8% for ANC, 72.1% for delivery) and Uttar Pradesh (48.5% for ANC). The percent of clients in the lowest two quintiles was zero in Uganda, 7.1 and 3.1% for ANC and delivery, respectively, in Rajasthan and 16.3% in Uttar Pradesh. Differences in SES distribution across the programmes may reflect variation in user fees, the average SES of the national/state populations and the range of services covered. We found little variation in content of care by SES. Key factors limiting the ability of such maternal health social franchises to reach poorer groups may include the lack of suitable facilities in the poorest areas, the inability of the poorest women to afford any private sector fees and competition with free or even incentivized public sector services. Moreover, there are tensions between targeting poorer groups, and franchise objectives of improving quality and business performance and enhancing financial sustainability, meaning that middle income and poorer groups are unlikely to be reached in large numbers in the absence of additional subsidies. PMID:29373681

How equitable is social franchising? Case studies of three maternal healthcare franchises in Uganda and India.

PubMed

Haemmerli, Manon; Santos, Andreia; Penn-Kekana, Loveday; Lange, Isabelle; Matovu, Fred; Benova, Lenka; Wong, Kerry L M; Goodman, Catherine

2018-04-01

Substantial investments have been made in clinical social franchising to improve quality of care of private facilities in low- and middle-income countries but concerns have emerged that the benefits fail to reach poorer groups. We assessed the distribution of franchise utilization and content of care by socio-economic status (SES) in three maternal healthcare social franchises in Uganda and India (Uttar Pradesh and Rajasthan). We surveyed 2179 women who had received antenatal care (ANC) and/or delivery services at franchise clinics (in Uttar Pradesh only ANC services were offered). Women were allocated to national (Uganda) or state (India) SES quintiles. Franchise users were concentrated in the higher SES quintiles in all settings. The percent in the top two quintiles was highest in Uganda (over 98% for both ANC and delivery), followed by Rajasthan (62.8% for ANC, 72.1% for delivery) and Uttar Pradesh (48.5% for ANC). The percent of clients in the lowest two quintiles was zero in Uganda, 7.1 and 3.1% for ANC and delivery, respectively, in Rajasthan and 16.3% in Uttar Pradesh. Differences in SES distribution across the programmes may reflect variation in user fees, the average SES of the national/state populations and the range of services covered. We found little variation in content of care by SES. Key factors limiting the ability of such maternal health social franchises to reach poorer groups may include the lack of suitable facilities in the poorest areas, the inability of the poorest women to afford any private sector fees and competition with free or even incentivized public sector services. Moreover, there are tensions between targeting poorer groups, and franchise objectives of improving quality and business performance and enhancing financial sustainability, meaning that middle income and poorer groups are unlikely to be reached in large numbers in the absence of additional subsidies.

Effects of socioeconomic status and acculturation on accelerometer-measured moderate-to-vigorous physical activity among Mexican American adolescents: findings from NHANES 2003-2004.

PubMed

Lee, Hyo; Cardinal, Bradley J; Loprinzi, Paul D

2012-11-01

Socioeconomic status (SES) and acculturation are potential contributors of adolescent physical activity disparity among ethnic groups in the U.S. However, studies relying on self-report physical activity measures have reported inconsistent findings regarding sociocultural predictors of physical activity. Therefore, the current study examined the main and interactive effects of SES and acculturation on accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA) among Mexican American adolescents. The National Health and Nutrition Examination Survey 2003-2004 was analyzed. Samples of 153 and 169 Mexican American boys and girls, respectively, were analyzed. SES was indicated by poverty-to-income ratio (PIR); and acculturation was measured by 5-item English preference scales and adolescent and parental country of birth. Regression models were tested separately for boys and girls. U.S.-born boys compared with immigrants did more MVPA (β = .48, P < .01). On the contrary, the effect of English preference on MVPA in boys was negative (β = -.05, P < .01) and amplified by higher SES (β = -.02, P < .01). For girls, none of the tested variables were significant. Higher SES was a risk factor for physical inactivity in Mexican American adolescents, by a moderating mechanism. In addition, physical activity promotion efforts need to consider English speaking and immigrant Mexican American adolescent boys as a target population.

Disparities in Maternal Child and Health Outcomes Attributable to Prenatal Tobacco Use.

PubMed

Mohlman, Mary Katherine; Levy, David T

2016-03-01

Previous estimates of smoking-attributable adverse outcomes, such as preterm births (PTBs), low birth weight (LBW) and Sudden Infant Death Syndrome (SIDs) generally do not address disparities by maternal age, racial/ethnic group or socioeconomic status (SES). This study develops estimates of smoking-attributable PTB, LBW and SIDS for the US by age, SES and racial/ethnic groupings. Data on the number of births and the prevalence of PTB, LBW and SIDS were used to develop the number of outcomes by age, race/ethnicity, and SES. The prevalence of prenatal smoking by age, race/ethnic and education and the relative risk of outcomes for smokers were used to calculate smoking-attributable fractions of outcomes. Prenatal smoking among ages 15-24 is above 12 %, with 20-24 year olds representing at least 35 % of PTB, LBW SIDS cases. Women with a high school education or less represented more than 50 % of PTB and LBW births, and 44 % of SIDS cases. While non-Hispanic Whites had the majority of smoking-attributable outcomes, non-Hispanic Blacks represented a disproportionately high percentage of PTBs (18 %), LBW births (22 %), and SIDS cases (13 %). Reducing prenatal smoking has the potential to reduce adverse birth outcomes and costs with long-term implications, especially among the young, non-Hispanic Blacks and those of lower SES. Stricter tobacco control policies, especially higher cigarette taxes, higher minimum purchase ages for tobacco and improved cessation interventions can help reduce disparities and the cost to insurers, especially public costs through Medicaid.

Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status.

PubMed

Hilpert, Martin; Brockmeier, Konrad; Dordel, Sigrid; Koch, Benjamin; Weiß, Verena; Ferrari, Nina; Tokarski, Walter; Graf, Christine

2017-01-01

Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status

PubMed Central

Hilpert, Martin; Brockmeier, Konrad; Dordel, Sigrid; Koch, Benjamin; Weiß, Verena; Ferrari, Nina; Tokarski, Walter; Graf, Christine

2017-01-01

Background Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. Methods Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). Results Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. Conclusion Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups. PMID:28528341

Socioeconomic status and the growth of intelligence from infancy through adolescence.

PubMed

von Stumm, Sophie; Plomin, Robert

2015-01-01

Low socioeconomic status (SES) children perform on average worse on intelligence tests than children from higher SES backgrounds, but the developmental relationship between intelligence and SES has not been adequately investigated. Here, we use latent growth curve (LGC) models to assess associations between SES and individual differences in the intelligence starting point (intercept) and in the rate and direction of change in scores (slope and quadratic term) from infancy through adolescence in 14,853 children from the Twins Early Development Study (TEDS), assessed 9 times on IQ between the ages of 2 and 16 years. SES was significantly associated with intelligence growth factors: higher SES was related both to a higher starting point in infancy and to greater gains in intelligence over time. Specifically, children from low SES families scored on average 6 IQ points lower at age 2 than children from high SES backgrounds; by age 16, this difference had almost tripled. Although these key results did not vary across girls and boys, we observed gender differences in the development of intelligence in early childhood. Overall, SES was shown to be associated with individual differences in intercepts as well as slopes of intelligence. However, this finding does not warrant causal interpretations of the relationship between SES and the development of intelligence.

Socioeconomic status and the growth of intelligence from infancy through adolescence

PubMed Central

von Stumm, Sophie; Plomin, Robert

2015-01-01

Low socioeconomic status (SES) children perform on average worse on intelligence tests than children from higher SES backgrounds, but the developmental relationship between intelligence and SES has not been adequately investigated. Here, we use latent growth curve (LGC) models to assess associations between SES and individual differences in the intelligence starting point (intercept) and in the rate and direction of change in scores (slope and quadratic term) from infancy through adolescence in 14,853 children from the Twins Early Development Study (TEDS), assessed 9 times on IQ between the ages of 2 and 16 years. SES was significantly associated with intelligence growth factors: higher SES was related both to a higher starting point in infancy and to greater gains in intelligence over time. Specifically, children from low SES families scored on average 6 IQ points lower at age 2 than children from high SES backgrounds; by age 16, this difference had almost tripled. Although these key results did not vary across girls and boys, we observed gender differences in the development of intelligence in early childhood. Overall, SES was shown to be associated with individual differences in intercepts as well as slopes of intelligence. However, this finding does not warrant causal interpretations of the relationship between SES and the development of intelligence. PMID:26640306

Review: Increasing Awareness and Education on Health Disparities for Health Care Providers

PubMed Central

Nesbitt, Shawna; Palomarez, Rigo Estevan

2016-01-01

The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient’s cultural background to promote healthy behaviors PMID:27103768

Change the things you can: Emotion regulation is more beneficial for people from lower than from higher socioeconomic status.

PubMed

Troy, Allison S; Ford, Brett Q; McRae, Kateri; Zarolia, Pareezad; Mauss, Iris B

2017-02-01

Emotion regulation is central to psychological health, and several emotion-regulation strategies have been identified as beneficial. However, new theorizing suggests the benefits of emotion regulation should depend on its context. One important contextual moderator might be socioeconomic status (SES), because SES powerfully shapes people's ecology: lower SES affords less control over one's environment and thus, the ability to self-regulate should be particularly important. Accordingly, effectively regulating one's emotions (e.g., using cognitive reappraisal) could be more beneficial in lower (vs. higher) SES contexts. Three studies (N = 429) tested whether SES moderates the link between cognitive reappraisal ability (CRA; measured with surveys and in the laboratory) and depression. Each study and a meta-analysis of the 3 studies revealed that CRA was associated with less depression for lower SES but not higher SES individuals. Thus, CRA may be uniquely beneficial in lower SES contexts. More broadly, the effects of emotion regulation depend upon the ecology within which it is used. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Positive attitude toward healthy eating predicts higher diet quality at all cost levels of supermarkets.

PubMed

Aggarwal, Anju; Monsivais, Pablo; Cook, Andrea J; Drewnowski, Adam

2014-02-01

Shopping at low-cost supermarkets has been associated with higher obesity rates. This study examined whether attitudes toward healthy eating are independently associated with diet quality among shoppers at low-cost, medium-cost, and high-cost supermarkets. Data on socioeconomic status (SES), attitudes toward healthy eating, and supermarket choice were collected using a telephone survey of a representative sample of adult residents of King County, WA. Dietary intake data were based on a food frequency questionnaire. Thirteen supermarket chains were stratified into three categories: low, medium, and high cost, based on a market basket of 100 commonly eaten foods. Diet-quality measures were energy density, mean adequacy ratio, and total servings of fruits and vegetables. The analytical sample consisted of 963 adults. Multivariable regressions with robust standard error examined relations between diet quality, supermarket type, attitudes, and SES. Shopping at higher-cost supermarkets was associated with higher-quality diets. These associations persisted after adjusting for SES, but were eliminated after taking attitudinal measures into account. Supermarket shoppers with positive attitudes toward healthy eating had equally higher-quality diets, even if they shopped at low-, medium-, or high-cost supermarkets, independent of SES and other covariates. These findings imply that shopping at low-cost supermarkets does not prevent consumers from having high-quality diets, as long as they attach importance to good nutrition. Promoting nutrition-education strategies among supermarkets, particularly those catering to low-income groups, can help to improve diet quality. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria.

PubMed

Onwujekwe, Obinna; Onoka, Chima; Uguru, Nkoli; Nnenna, Tasie; Uzochukwu, Benjamin; Eze, Soludo; Kirigia, Joses; Petu, Amos

2010-06-12

It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts.

Obesity and Overweight Among Brazilian Early Adolescents: Variability Across Region, Socioeconomic Status, and Gender.

PubMed

Fradkin, Chris; Valentini, Nadia C; Nobre, Glauber C; Dos Santos, João O L

2018-01-01

As with most emerging nations, Brazil lacks up-to-date data on the prevalence of obesity and overweight among its children. Of particular concern is the lack of data on children in early adolescence, considered by many to be the crucial stage for weight-related healthcare. To assess regional, socioeconomic, and gender differences in the prevalence of obesity and overweight among Brazilian early adolescents. A cross-sectional study was conducted on a racially diverse sample of students aged 10-13 years, from schools in three geographic regions (north, northeast, south) ( N  = 1,738). Data on gender, age, race, socioeconomic status (SES), weight, and height were obtained. Weight class was calculated from age- and gender-adjusted body mass index, based on children's weight and height. Bivariate and multivariable analyses, with post hoc tests, were conducted to estimate differences between groups and were corrected for multiple comparisons. Procedures were approved by institutional review boards at study sites. Analyses revealed a higher prevalence of obesity and/or overweight among: (1) children of higher SES; (2) children in southern Brazil; (3) males; and (4) Black females. The most salient predictor of weight risk among Brazilian early adolescents is higher SES. This finding is consistent with previous findings of an inverse social gradient, in weight risk, among emerging-nation population groups.

PREVALENCE OF EATING DISTURBANCE AND BODY IMAGE DISSATISFACTION IN YOUNG GIRLS: AN EXAMINATION OF THE VARIANCE ACROSS RACIAL AND SOCIOECONOMIC GROUPS.

PubMed

Deleel, Marissa L; Hughes, Tammy L; Miller, Jeffrey A; Hipwell, Alison; Theodore, Lea A

2009-09-01

Eating disorder research has predominantly focused on White adolescent females. More recent research suggests that eating disorders occur in various racial and age groups. The current study examines prevalence and stability of body image dissatisfaction and eating disturbance in 9- and 10-year-old girls and whether there is variability by racial group or socioeconomic status (SES). Five hundred eighty-one girls completed the Children's Eating Attitude Test (ChEAT) and the Body Image Measure (BIM). Results showed that 11% of the sample scored in the Anorexic range at age 9 and about 7% at age 10. When examining body image, 35% of the sample at age 9 and 38% at age 10 selected Ideal Figures that were smaller than their Real Figures on the BIM. There was a significant difference between the racial groups in their reports of eating disturbance, but not body image dissatisfaction. Specifically, the Minority group had higher eating disturbance scores on average at ages 9 and 10 when compared to the White group. SES did not account for eating disturbance or body image dissatisfaction. These results challenge the maxim that eating disturbance and body image dissatisfaction occur primarily in White females from middle and upper SES populations.

Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria.

PubMed

Onwujekwe, Obinna; Hanson, Kara; Uzochukwu, Benjamin

2012-01-01

There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups. The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care. The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme. The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms.

Examining Inequities in Incidence of Catastrophic Health Expenditures on Different Healthcare Services and Health Facilities in Nigeria

PubMed Central

Onwujekwe, Obinna; Hanson, Kara; Uzochukwu, Benjamin

2012-01-01

Objective There is limited evidence about levels of socio-economic and other differences in catastrophic health spending in Nigeria and in many sub-Saharan African countries. The study estimated the level of catastrophic healthcare expenditures for different healthcare services and facilities and their distribution across socioeconomic status (SES) groups. Methods The study took place in four Local Government Areas in southeast Nigeria. Data were collected using interviewer-administered questionnaires administered to 4873 households. Catastrophic health expenditures (CHE) were measured using a threshold of 40% of monthly non-food expenditure. We examined both total monthly health expenditure and disaggregated expenditure by source and type of care. Results The average total household health expenditure per month was 2354 Naira ($19.6). For outpatient services, average monthly expenditure was 1809 Naira ($15.1), whilst for inpatient services it was 610 Naira ($5.1). Higher health expenditures were incurred by urban residents and the better-off SES groups. Overall, 27% of households incurred CHE, higher for poorer socioeconomic groups and for rural residents. Only 1.0% of households had a member that was enrolled in a health insurance scheme. Conclusion The worse-off households (the poorest SES and rural dwellers) experienced the highest burden of health expenditure. There was almost a complete lack of financial risk protection. Health reform mechanisms are needed to ensure universal coverage with financial risk protection mechanisms. PMID:22815828

Does participation in organized sports predict future physical activity for adolescents from diverse economic backgrounds?

PubMed

Walters, Stephanie; Barr-Anderson, Daheia J; Wall, Melanie; Neumark-Sztainer, Dianne

2009-03-01

To examine cross-sectional and longitudinal associations between socioeconomic status (SES), gender, sports participation and moderate-to-vigorous physical activity (MVPA) in adolescents. Project EAT (Eating Among Teens), a population-based longitudinal study followed a socioeconomically and ethnically diverse sample of 1709 adolescents in 1998-1999 (Time 1) and 2003-2004 (Time 2). Mixed model regression analyses were used to examine longitudinal trends in MVPA as a function of SES and previous sports involvement. For both genders, participation in organized sports and weekly hours of MVPA were positively associated with SES. On average, MVPA decreased between high school and young adulthood for both genders. Adolescents who participated in sports during high school showed a steeper decline in weekly hours of MVPA than their non-sports-participating counterparts. SES had a significant moderating effect on the change in MVPA over time for boys who participated in organized sports, with low SES boys showing a steeper decline in MVPA between time periods than higher SES boys. Although on average, a statistically significant difference in MVPA between previous sports participants and nonparticipants remained at Time 2, for all SES groups and both genders, the gap between hours of MVPA was either overcome or significantly narrowed by young adulthood. Increased dependence on organized sports for MVPA may be insufficient to meet the needs of youth following high school, especially for low SES youth. Designing physical activity promotions that reach and address the unique needs of lower SES youth and families is a public health priority.

Stress at Work: Differential Experiences of High versus Low SES Workers

PubMed Central

Damaske, Sarah; Zawadzki, Matthew J.; Smyth, Joshua M.

2016-01-01

This paper asks whether workers with greater socioeconomic status (SES) experience different levels of stress at work than workers with lower SES and, if so, what might explain these differences. We collected innovative assessments of immediate objective and subjective measures of stress at multiple time points across consecutive days from 122 employed men and women. We find that in comparison to higher SES individuals, those with lower SES reported greater happiness at work, less self-reported stress, and less perceived stress; cortisol, a biological marker of stress, was unrelated to SES. Worker's momentary perceptions of the workplace were predicted by SES, with higher SES individuals more commonly reporting feeling unable to meet work demands, fewer work resources, and less positive work appraisals. In turn, perceptions of the workplace had a generally consistent and robust effect on positive mood, subjective stress, and cortisol. PMID:27038320

Independent effects of bilingualism and socioeconomic status on language ability and executive functioning.

PubMed

Calvo, Alejandra; Bialystok, Ellen

2014-03-01

One hundred and seventy-five children who were 6-years old were assigned to one of four groups that differed in socioeconomic status (SES; working class or middle class) and language background (monolingual or bilingual). The children completed tests of nonverbal intelligence, language tests assessing receptive vocabulary and attention based on picture naming, and two tests of executive functioning. All children performed equivalently on the basic intelligence tests, but performance on the language and executive functioning tasks was influenced by both SES and bilingualism. Middle-class children outperformed working-class children on all measures, and bilingual children obtained lower scores than monolingual children on language tests but higher scores than monolingual children on the executive functioning tasks. There were no interactions with either group factors or task factors. Thus, each of SES and bilingualism contribute significantly and independently to children's development irrespective of the child's level on the other factor. Copyright © 2013 Elsevier B.V. All rights reserved.

Proactive tobacco cessation outreach to smokers of low socioeconomic status: a randomized clinical trial.

PubMed

Haas, Jennifer S; Linder, Jeffrey A; Park, Elyse R; Gonzalez, Irina; Rigotti, Nancy A; Klinger, Elissa V; Kontos, Emily Z; Zaslavsky, Alan M; Brawarsky, Phyllis; Marinacci, Lucas X; St Hubert, Stella; Fleegler, Eric W; Williams, David R

2015-02-01

Widening socioeconomic disparities in mortality in the United States are largely explained by slower declines in tobacco use among smokers of low socioeconomic status (SES) than among those of higher SES, which points to the need for targeted tobacco cessation interventions. Documentation of smoking status in electronic health records (EHRs) provides the tools for health systems to proactively offer tobacco treatment to socioeconomically disadvantaged smokers. To evaluate a proactive tobacco cessation strategy that addresses sociocontextual mediators of tobacco use for low-SES smokers. This prospective, randomized clinical trial included low-SES adult smokers who described their race and/or ethnicity as black, Hispanic, or white and received primary care at 1 of 13 practices in the greater Boston area (intervention group, n = 399; control group, n = 308). We analyzed EHRs to identify potentially eligible participants and then used interactive voice response (IVR) techniques to reach out to them. Consenting patients were randomized to either receive usual care from their own health care team or enter an intervention program that included (1) telephone-based motivational counseling, (2) free nicotine replacement therapy (NRT) for 6 weeks, (3) access to community-based referrals to address sociocontextual mediators of tobacco use, and (4) integration of all these components into their normal health care through the EHR system. Self-reported past-7-day tobacco abstinence 9 months after randomization ("quitting"), assessed by automated caller or blinded study staff. The intervention group had a higher quit rate than the usual care group (17.8% vs 8.1%; odds ratio, 2.5; 95% CI, 1.5-4.0; number needed to treat, 10). We examined whether use of intervention components was associated with quitting among individuals in the intervention group: individuals who participated in the telephone counseling were more likely to quit than those who did not (21.2% vs 10.4%; P < .001). There was no difference in quitting by use of NRT. Quitting did not differ by a request for a community referral, but individuals who used their referral were more likely to quit than those who did not (43.6% vs 15.3%; P < .001). Proactive, IVR-facilitated outreach enables engagement with low-SES smokers. Providing counseling, NRT, and access to community-based resources to address sociocontextual mediators among smokers reached in this setting is effective. clinicaltrials.gov Identifier: NCT01156610.

Cluster-randomised trial to evaluate the 'Change for Life' mass media/ social marketing campaign in the UK.

PubMed

Croker, Helen; Lucas, Rebecca; Wardle, Jane

2012-06-06

Social marketing campaigns offer a promising approach to the prevention of childhood obesity. Change4Life (C4L) is a national obesity prevention campaign in England. It included mass media coverage aiming to reframe obesity into a health issue relevant to all and provided the opportunity for parents to complete a brief questionnaire ('How are the Kids') and receive personalised feedback about their children's eating and activity. Print and online C4L resources were available with guidance about healthy eating and physical activity. The study aims were to examine the impact of personalised feedback and print material from the C4L campaign on parents' attitudes and behaviours about their children's eating and activity in a community-based cluster-randomised controlled trial. Parents of 5-11 year old children were recruited from 40 primary schools across England. Schools were randomised to intervention or control ('usual care'). Basic demographic data and brief information about their attitudes to their children's health were collected. Families in intervention schools were mailed the C4L print materials and the 'How are the Kids' questionnaire; those returning the questionnaire were sent personalised feedback and others received generic materials. Outcomes included awareness of C4L, attitudes to the behaviours recommended in C4L, parenting behaviours (monitoring and modelling), and child health behaviours (diet, physical activity and television viewing). Follow-up data were collected from parents by postal questionnaire after six months. Qualitative interviews were carried out with a subset of parents (n = 12). 3,774 families completed baseline questionnaires and follow-up data were obtained from 1,419 families (37.6%). Awareness was high in both groups at baseline (75%), but increased significantly in the intervention group by follow-up (96% vs. 87%). Few parents (5.2% of the intervention group) returned the questionnaire to get personalised feedback. There were few significant group differences in parental attitudes or parenting and child health behaviours at follow-up. Physical activity was rated as less important in the intervention group, but a significant group-by-socioeconomic status (SES) interaction indicated that this effect was confined to higher SES families. Similar interactions were also seen for physical activity monitoring and child television time; with adverse effects in higher SES families and no change in the lower SES families. Effects were little better in families that completed the questionnaire and received personalised feedback. At interview, acceptability of the intervention was modest, although higher in lower SES families. The C4L campaign materials achieved increases in awareness of the campaign, but in this sample had little impact on attitudes or behaviour. Low engagement with the intervention appeared a key issue. Current Controlled Trials ISRCTN00791709.

Individual and Area Level Socioeconomic Status and Its Association with Cognitive Function and Cognitive Impairment (Low MMSE) among Community-Dwelling Elderly in Singapore.

PubMed

Wee, Liang En; Yeo, Wei Xin; Yang, Gui Rong; Hannan, Nazirul; Lim, Kenny; Chua, Christopher; Tan, Mae Yue; Fong, Nikki; Yeap, Amelia; Chen, Lionel; Koh, Gerald Choon-Huat; Shen, Han Ming

2012-01-01

Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood. The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as <24 on the Mini Mental State Examination. Demographic/clinical details were collected via questionnaire. Multilevel linear regression was used to evaluate factors associated with cognitive function, while multilevel logistic regression determined predictors of cognitive impairment. Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = -1.41, SD = 0.58, p < 0.01) and cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98-13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected. Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society.

Prevalence of traditional and novel markers of cardiovascular disease risk in Scottish adolescents: socioeconomic effects.

PubMed

Buchan, Duncan S; Ollis, Stewart; Thomas, Non-Eleri; Simpson, Alan; Young, John D; Cooper, Stephen-Mark; Malina, Robert M; Cockcroft, John R; Baker, Julien S

2012-10-01

Information on the health status and physical activity of Scottish adolescents is limited. This study examines the prevalence of cardiovascular disease (CVD) risk in Scottish adolescents by socioeconomic status (SES). Participants were recruited from two high schools that differed in the SES of the students in attendance. The sample included 73 boys and 34 girls (16.4 ± 0.6 years). Variables included anthropometry, physical activity, physical fitness, blood pressure, diet, and 11 metabolic markers of CVD risk. Significant sex differences (P ≤ 0.01) were noted for stature, waist circumference, waist-hip ratio, physical activity, cardiorespiratory fitness, muscular power, sprint speed, and several CVD risk factors: high-density lipoprotein (HDL), low-density lipoprotein (LDL), interleukin-6 (IL-6), and C-reactive protein (CRP) levels. Boys from a lower SES had significantly higher levels of glucose and plasminogen activator inhibitor-1 (PAI-1) but lower levels of adiponectin compared with boys from a higher SES. Girls from a lower SES had significantly (P ≤ 0.01) higher glucose and PAI-1 levels but lower levels of insulin and adiponectin than girls from a higher SES. High fat diets, low physical activity levels, and elevated CRP and total cholesterol levels were the CVD risk factors most commonly identified as being at-risk levels in this cohort, regardless of sex or SES. SES differences were not consistently apparent, but several CVD risk factors were identified as elevated in this sample of adolescents, regardless of sex or SES.

Parental Socioeconomic Status and the Neural Basis of Arithmetic: Differential Relations to Verbal and Visuo-spatial Representations

PubMed Central

Demir, Özlem Ece; Prado, Jérôme; Booth, James R.

2015-01-01

We examined the relation of parental socioeconomic status (SES) to the neural bases of subtraction in school-age children (9- to 12-year-olds). We independently localized brain regions subserving verbal versus visuo-spatial representations to determine whether the parental SES-related differences in children’s reliance on these neural representations vary as a function of math skill. At higher SES levels, higher skill was associated with greater recruitment of the left temporal cortex, identified by the verbal localizer. At lower SES levels, higher skill was associated with greater recruitment of right parietal cortex, identified by the visuo-spatial localizer. This suggests that depending on parental SES, children engage different neural systems to solve subtraction problems. Furthermore, SES was related to the activation in the left temporal and frontal cortex during the independent verbal localizer task, but it was not related to activation during the independent visuo-spatial localizer task. Differences in activation during the verbal localizer task in turn were related to differences in activation during the subtraction task in right parietal cortex. The relation was stronger at lower SES levels. This result suggests that SES-related differences in the visuo-spatial regions during subtraction might be based in SES-related verbal differences. PMID:25664675

The Educational Electronic Book as a Tool for Supporting Children's Emergent Literacy in Low versus Middle SES Groups

ERIC Educational Resources Information Center

Korat, O.; Shamir, A.

2008-01-01

The effects of an educational electronic book (e-book) on 149 five- to six-year-old kindergarteners' emergent literacy levels were researched in two SES groups: low (LSES) (79 children) vs. middle (MSES) (70 children). In each SES group, children were randomly assigned to four groups. Three groups were assigned to work individually in one of three…

Mass media campaign improves cervical screening across all socio-economic groups.

PubMed

Anderson, Jenny O; Mullins, Robyn M; Siahpush, Mohammad; Spittal, Matthew J; Wakefield, Melanie

2009-10-01

Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data were obtained from the Victorian Cervical Cytology Registry for each Pap test registered during 2005 and categorized into SES quintiles using the Index of Socio-Economic Advantage/Disadvantage. Negative binomial regression was used to determine the impact of the campaign on the weekly number of Pap tests and whether the media campaign had a differential effect by SES, after adjusting for the number of workdays per week, age group and time since previous test. Cervical screening increased 27% during the campaign period and was equally effective in encouraging screening across all SES groups, including low-SES women. Mass media campaigns can prompt increased rates of cervical screening among all women, not just those from more advantaged areas. Combining media with additional strategies targeted at low-SES women may help lessen the underlying differences in screening rates across SES.

Socioeconomic Inequalities in the Oral Health of People Aged 15-40 Years in Kurdistan, Iran in 2015: A Cross-sectional Study

PubMed Central

2017-01-01

Objectives The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents’ education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs. PMID:29020760

Investigation of quality of life in mothers of children withcerebral palsy in Iran: association with socio-economic status,marital satisfaction and fatigue.

PubMed

Khayatzadeh, Mohammad Mahani; Rostami, Hamid Reza; Amirsalari, Susan; Karimloo, Masood

2013-05-01

This study aimed to compare the quality of life (QOL) of Mothers of Children with Cerebral Palsy (MCCPs) with mothers of Typically Developing (TD) children as a Control Group (CG). The association of the mediating variables including socio-economic status (SES), marital satisfaction and fatigue with maternal QOL was also evaluated. The MCCPs group consisted of 120 mothers (mean age: 30.3 ± 5.5 years) of children with CP. The CG included 100 mothers (mean age: 29.9 ± 4.5 years) of TD children. Demographic characteristics of the participants were recorded and the data was collected by World Health Organization Quality of Life-BREF (WHOQOL-BREF), SES Questionnaire, Index of Marital Satisfaction (IMS) and Fatigue Severity Scale-Persian (FSS-P). Data analysis was done by SPSS version 16.0. The QOL and SES were lower, while FSS-P and IMS were higher in MCCPs group than CG (p < 0.001). The SES, IMS and FSS-P associated with all domains of QOL in MCCPs group, while they did just with some domains of QOL in CG (p < 0.05). The lower QOL in MCCPs group is supposed to be mediated by the SES, marital satisfaction and fatigue so, maternal empowerment in terms of these mediators and family-centered approach are recommended. • Improper activity of trapezius muscle motor units can be a reason of the cervicogenic headache. • Increased muscle tension at rest can lead to decrease of its contractile properties. • Rehabilitation of patients is effective when includes first postisometric relaxation procedures and myofascial mobilization of trigger points, then head protraction and retraction exercises according to McKenzie therapy and finally muscles strengthening exercises supplemented with self-control of the correct body posture.

Effects of the belt electrode skeletal muscle electrical stimulation system on lower extremity skeletal muscle activity: Evaluation using positron emission tomography.

PubMed

Numata, Hitoaki; Nakase, Junsuke; Inaki, Anri; Mochizuki, Takafumi; Oshima, Takeshi; Takata, Yasushi; Kinuya, Seigo; Tsuchiya, Hiroyuki

2016-01-01

Lower-extremity muscle weakness in athletes after lower limb trauma or surgery can hinder their return to sports, and the associated muscle atrophy may lead to deterioration in performance after returning to sports. Recently, belt electrode skeletal muscle electrical stimulation (B-SES) which can contract all the lower limb skeletal muscles simultaneously was developed. However, no study has evaluated skeletal muscle activity with B-SES. Since only superficial muscles as well as a limited number of muscles can be investigated using electromyography, we investigated whether positron emission tomography (PET) can evaluate the activity of all the skeletal muscles in the body simultaneously. The purpose of this study was to evaluate the effectiveness of the B-SES system using PET. Twelve healthy males (mean age, 24.3 years) were divided into two groups. The subjects in the control group remained in a sitting position for 10 min, and [(18)F] fluorodeoxyglucose (FDG) was intravenously injected. In the exercise group, subjects exercised using the B-SES system for 20 min daily for three consecutive days as a pre-test exercise. On the measurement day, they exercised for 10 min, received an injection of FDG, and exercised for another 10 min. PET-computed tomography images were obtained in each group 60 min after the FDG injection. Regions of interest were drawn in each lower-extremity muscle. We compared each skeletal muscle metabolism using the standardized uptake value. In the exercise group, FDG accumulation in the gluteus maximus, gluteus medius, gluteus minimus, quadriceps femoris, sartorius, and hamstrings was significantly higher than the muscles in the control (P < 0.05). Exercise with B-SES increased the skeletal muscle activity of the gluteal muscles as well as the most lower-extremity muscles simultaneously. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Dietary patterns of adolescents in Germany--associations with nutrient intake and other health related lifestyle characteristics.

PubMed

Richter, Almut; Heidemann, Christin; Schulze, Matthias B; Roosen, Jutta; Thiele, Silke; Mensink, Gert B M

2012-03-22

The aim of this study was to identify dietary patterns among a representative sample of German adolescents and their associations with energy and nutrient intake, socioeconomic and lifestyle characteristics, and overweight status. In the analysis, data from the German Health Interview and Examination Survey for Children and Adolescents were used. The survey included a comprehensive dietary history interview conducted among 1272 adolescents aged 12 to 17 years. Dietary patterns were determined with principal component analysis (PCA) based on 48 food groups, for boys and girls separately. Three dietary patterns among boys and two among girls were identified. Among boys, high adherence to the 'western' pattern was associated with higher age, lower socioeconomic status (SES), and lower physical activity level (PA). High adherence to the 'healthy' pattern among boys, but not among girls, was associated with higher SES, and higher PA. Among boys, high adherence to the 'traditional' pattern was associated with higher age. Among girls, high adherence to the 'traditional and western' pattern was associated with lower age, lower SES and more hours watching TV per day. The nutrient density of several vitamins and minerals, particularly of B-vitamins and calcium, increased with increasing scores of the 'healthy' pattern among both sexes. Conversely, with increasing scores of the 'western' pattern among boys, most nutrient densities decreased, particularly of fibre, beta-carotene, vitamin D, biotin and calcium. Among girls with higher scores of the 'traditional and western' pattern, nutrient densities of vitamin A, C, E, K and folate decreased. Among boys, high adherence to the 'traditional' pattern was correlated with higher densities of vitamin B12 and vitamin D and lower densities of fibre, magnesium and iron. No significant associations between dietary patterns and overweight were found. Higher scores for dietary patterns characterized by higher consumption of take away food, meat, confectionary and soft drinks ('western' and 'traditional and western') were found particularly among 16- to 17-years old boys and among adolescents with lower SES. These patterns were also associated with higher energy density, higher percent of energy from unsaturated fatty acids and lower percent of energy from carbohydrates as well as lower nutrient densities of several vitamins and minerals. Therefore, nutritional interventions should try to focus more on adolescents with lower SES and boys in general.

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.

Disparities in Maternal Child and Health Outcomes Attributable to Prenatal Tobacco Use

PubMed Central

Mohlman, Mary Katherine; Levy, David T.

2015-01-01

Objectives Previous estimates of smoking-attributable adverse outcomes, such as preterm births (PTBs), low birth weight (LBW) and Sudden Infant Death Syndrome (SIDs) generally do not address disparities by maternal age, racial/ethnic group or socioeconomic status (SES). This study develops estimates of smoking-attributable PTB, LBW and SIDS for the US by age, SES and racial/ethnic groupings. Methods Data on the number of births and the prevalence of PTB, LBW and SIDS were used to develop the number of outcomes by age, race/ethnicity, and SES. The prevalence of prenatal smoking by age, race/ethnic and education and the relative risk of outcomes for smokers were used to calculate smoking-attributable fractions of outcomes. Results Prenatal smoking among ages 15-24 is above 12%, with 20-24 year olds representing at least 35% of PTB, LBW SIDS cases. Women with a high school education or less represented more than 50% of PTB and LBW births, and 44% of SIDS cases. While non-Hispanic Whites had the majority of smoking-attributable outcomes, non-Hispanic Blacks represented a disproportionately high percentage of PTBs (18%), LBW births (22%), and SIDS cases (13%). Conclusions: Reducing prenatal smoking has the potential to reduce adverse birth outcomes and costs with long-term implications, especially among the young, non-Hispanic Blacks and those of lower SES. Stricter tobacco control policies, especially higher cigarette taxes, higher minimum purchase ages for tobacco and improved cessation interventions can help reduce disparities and the cost to insurers, especially public costs through Medicaid. PMID:26645613

Beverage consumption and individual-level associations in South Korea

PubMed Central

2013-01-01

Background Few previous studies investigated consumption distributions of sugar-sweetened beverages (SSBs) over time and individual-level associations in Asia despite the recent interest in SSBs regarding obesity control. This study aimed to provide recent evidence on beverage consumption trends from 2001 to 2009 for overall and subtypes of SSBs and for milk as a comparable healthy beverage in South Korea, as well as associations with individual-level socioeconomic status (SES). Methods The Korean National Health and Nutrition Examination Surveys from 2001 to 2009 were used. Consumption prevalence and average caloric intake by SSB type were examined. Associations of SES with consumption were assessed in a multivariate logistic regression model (consumption prevalence) and in a multivariate two-part regression model (overall caloric intake adjusting for consumption probability). Results SSB consumption prevalence increased to 38%, 69%, 70%, and 50% by 2009 up from 31%, 66%, 63%, and 32% in 2001 among adolescents, young adults, adults, and the elderly, respectively. Miscellaneous SSBs (sports/energy drinks, coffee/tea products, flavored milk, and others) were the most prevalent and their prevalence increased among adults (from 62% to 69%) and the elderly (from 30% to 47%) between 2001 and 2009. Adolescents consumed the most calories from miscellaneous SSBs among all beverage types although its prevalence was lower than regular soda and milk in both 2001 and 2009. Women (top- income group only) and men in higher income groups showed higher odds of consuming total SSBs (OR = 1.18-1.25), soda (OR = 1.18, men only), fruit drinks (OR = 1.18, the top-income only for both genders), and miscellaneous SSBs (OR = 1.1-1.2). Men with higher-education showed higher odds of total SSB consumption (OR = 1.14-1.20), and all subtypes of SSBs (OR = 1.18, 1.29, 1.19 for soda, fruit drinks, and miscellaneous SSBs, respectively for the top-education group only). There were statistically significant but minimal differences in the overall amount of caloric intake from SSBs by individual SES for both genders. Conclusions South Korea is following the global nutrition transition toward greater consumption of SSBs. However, unlike other developed countries, SSB consumption prevalence was higher among high-SES individuals, particularly for fruit drinks and miscellaneous SSBs. Further research is needed to build the international evidence base. PMID:23497024

Intellectual Interest Mediates Gene-by-SES Interaction on Adolescent Academic Achievement

PubMed Central

Tucker-Drob, Elliot M.; Harden, K. Paige

2011-01-01

Recent studies have demonstrated that genetic influences on cognitive ability and academic achievement are larger for children raised in higher socioeconomic status (SES) homes. However, little work has been done to document the psychosocial processes that underlie this gene-by-environment interaction. One process may involve the conversion of intellectual interest into academic achievement. Analyses of data from 777 pairs of 17-year-old twins indicated that gene-by-SES effects on achievement scores can be accounted for by stronger influences of genes for intellectual interest on achievement at higher levels of SES. These findings are consistent with the hypothesis that higher SES affords greater opportunity for children to seek out and benefit from learning experiences that are congruent with their genetically influenced intellectual interests. PMID:22288554

Postnatal Growth Patterns in a Chilean Cohort: The Role of SES and Family Environment

PubMed Central

Kang Sim, D. E.; Cappiello, M.; Castillo, M.; Lozoff, B.; Martinez, S.; Blanco, E.; Gahagan, S.

2012-01-01

Objective. This study examined how family environmental characteristics served as mediators in the relationship between socioeconomic conditions and infant growth in a cohort of Chilean infants. Methods. We studied 999 infants, born between 1991 and 1996, from a longitudinal cohort which began as an iron deficiency anemia preventive trial. SES (Graffar Index), the Life Experiences Survey, and the Home Observation for Measurement of the Environment (HOME) were assessed in infancy. Using path analysis, we assessed the relationships between the social factors, home environment, and infant growth. Results. During the first year, weight and length gain averaged 540 grams/month and 6.5 cm/month, respectively. In the path analysis model for weight gain, higher SES and a better physical environment were positively related to higher maternal warmth, which in turn was associated with higher average weight gain. Higher SES was directly related to higher average length gain. Conclusions. In our cohort, a direct relationship between SES and length gain developed during infancy. Higher SES was indirectly related to infant weight gain through the home environment and maternal warmth. As the fastest growing infants are at risk for later obesity, new strategies are needed to encourage optimal rather than maximal growth. PMID:22666275

The impact of primary healthcare reform on equity of utilization of services in the province of Quebec: a 2003-2010 follow-up.

PubMed

Ouimet, Marie-Jo; Pineault, Raynald; Prud'homme, Alexandre; Provost, Sylvie; Fournier, Michel; Levesque, Jean-Frédéric

2015-11-30

In 2003, the Quebec government made important changes in its primary healthcare (PHC) system. This reform included the creation of new models of PHC, Family Medicine Groups (e.g. multidisciplinary health teams with extended opening hours and enrolment of patients) and Network Clinics (clinics providing access to investigation and specialist services). Considering that equity is one of the guiding principles of the Quebec health system, our objectives are to assess the impact of the PHC reform on equity by examining the association between socio-economic status (SES) and utilization of healthcare services between 2003 and 2010; and to determine how the organizational model of PHC facilities impacts utilization of services according to SES. We held population surveys in 2005 (n = 9206) and 2010 (n = 9180) in the two most populated regions of Quebec province, relating to utilization and experience of care during the preceding two years, as well as organizational surveys of all PHC facilities. We performed multiple logistical regression analyses comparing levels of SES for different utilization variables, controlling for morbidity and perceived health; we repeated the analyses, this time including type of PHC facility (older vs newer models). Compared with the lowest SES, highest SES is associated with less emergency room visits (OR 0.80) and higher likelihood of at least one visit to a PHC facility (OR 2.17), but lower likelihood of frequent visits to PHC (OR 0.69), and higher affiliation to a family doctor (OR 2.04). Differences remained stable between the 2005 and 2010 samples except for likelihood of visit to PHC source which deteriorated for the lowest SES. Greater improvement in affiliation to family doctor was seen for the lowest SES in older models of PHC organizations, but a deterioration was seen for that same group in newer models. Differences favoring the rich in affiliation to family doctor and likelihood of visit to PHC facility likely represent inequities in access to PHC which remained stable or deteriorated after the reform. New models of PHC organizations do not appear to have improved equity. We believe that an equity-focused approach is needed in order to address persisting inequities.

Influence of having a home garden on personal UVR exposure behavior and risk of cutaneous malignant melanoma in Denmark.

PubMed

Idorn, Luise Winkel; Thieden, Elisabeth; Philipsen, Peter Alshede; Wulf, Hans Christian

2013-03-15

There is a need for more knowledge concerning the association of higher socioeconomic status (SES) with cutaneous malignant melanoma (CMM). Having a home garden is associated with a higher SES. We aimed to study the influence of having a home garden on UVR exposure behavior and risk of CMM. Register study: We collected information from Danish national registers about gender, age, type of home and CMM among persons aged 16-75 in 2002-2006. A total of 5,118 CMM cases were identified. Risk of CMM of the trunk was increased by 46% (p < 0.001, 95% confidence interval (CI): 31-63) and risk of CMM of the extremities by 34% (p < 0.001, 95% CI: 20-49) among people with home gardens. Dosimeter study: During a summer season 194 participants living in the Capital area, Denmark, equally distributed in homes with and without a garden, wore personal electronic UVR dosimeters measuring time-stamped UVR doses continuously and filled in sun exposure diaries. While no difference was found in estimated yearly UVR dose between groups, participants with a home garden had more days exposing shoulders or upper body, and upper extremities outdoors than those without a garden (p = 0.026, age adjusted). People with a home garden are at increased risk of CMM of the trunk and extremities-body sites that seems to be exposed to a higher extent among people with home gardens. People with a higher SES are more likely to have a home garden. This may partly explain the well-known association of higher SES with CMM incidence. Copyright © 2012 UICC.

Food consumption of adults in Germany: results of the German National Nutrition Survey II based on diet history interviews.

PubMed

Heuer, Thorsten; Krems, Carolin; Moon, Kilson; Brombach, Christine; Hoffmann, Ingrid

2015-05-28

The second German National Nutrition Survey (NVS II) aimed to evaluate food consumption and other aspects of nutritional behaviour of a representative sample of the German population, using a modular design with three different dietary assessment methods. To assess usual food consumption, 15,371 German speaking subjects 14-80 years of age completed a diet history interview between November 2005 and November 2006. With reference to the guidelines of the German Nutrition Society (DGE), NVS II observed that the German population did not eat enough foods of plant origin, especially vegetables and consumed too much of meat and meat products. While generally similar food consumption is observed in other European countries, consumption of bread, fruit juices/nectars and beer is higher in Germany. On average, men consumed two times more meat and soft drinks as well as six times more beer than women did, whereas the consumption of vegetables, fruit as well as herbal/fruit tea was higher in women. Older participants showed a lower consumption of meat, fruit juice/nectars, soft drinks and spirits as well as a higher consumption of fish, vegetables, fruit, and herbal/fruit tea than adolescents and younger adults did. There are also differences in food consumption with regard to socio-economic status (SES). Persons with higher SES consumed more vegetables, fruit, fish, water, coffee/tea and wine, while persons with lower SES consumed more meat and meat products, soft drinks and beer. In general, the food consumption of women, the elderly and the higher SES group tends to be closer to the official dietary guidelines in Germany.

Skeletal maturity of the hand in an East African group from Sudan.

PubMed

Elamin, Fadil; Abdelazeem, Nihal; Elamin, Ahmed; Saif, Duaa; Liversidge, Helen M

2017-08-01

Studies of skeletal maturity from Africa indicate a delay, reflected in a negative relative skeletal age (RSA). This study aims to evaluate the influence of age, socioeconomic status (SES) and nutritional status on skeletal maturation in a large sample of children from North Sudan. The sample consisted 665 males and 1018 females from 3-25 years from Khartoum. Height, weight, age of menarche and, SES were recorded of patients attending for dental treatment. Skeletal age was assigned from hand-wrist radiographs using the Greulich-Pyle (GP) atlas (1952). RSA (difference between skeletal and chronological ages) was compared in groups divided by age, sex, height-for-age and body-mass-index z scores, and SES. Spearman's correlation and student t-test was used to compare groups. Delayed skeletal age was noted across all age in boys. In girls, a delay was observed between ages 6-10, while advancement occurred between ages 13-18. Maturity was delayed in low height groups (p < .05) and low SES groups. RSA was negatively associated with HAZ in low SES males (R = -0.0.27, p < .001) and low SES females (R = -0.32, p < .001). There were statistically significant skeletal delays in North Sudanese males and most pre-menarche females, low height and low SES groups. Post-menarche females were advanced relative to males and GP references. Low SES impacts were statistically correlated to skeletal delay. © 2017 Wiley Periodicals, Inc.

Socioeconomic Status, Subjective Social Status, and Perceived Stress: Associations with Stress Physiology and Executive Functioning.

PubMed

Ursache, Alexandra; Noble, Kimberly G; Blair, Clancy

2015-01-01

Several studies have investigated associations between socioeconomic status (SES) and indicators of children's physiological and cognitive self-regulation. Although objective measures of family SES may be good proxies for families' experiences of disadvantage, less is known about subjective aspects of families' experiences. We hypothesize that subjective social status (SSS) and perceived stress may be important independent predictors of children's stress physiology and executive functioning (EF). Eighty-two children from diverse SES backgrounds were administered EF measures and provided saliva samples for cortisol assay. Caregivers reported on objective SES, SSS, and perceived stress. Results suggest that SES and SSS are both independently and positively related to EF. In models predicting stress physiology, higher perceived stress was associated with lower baseline cortisol. Moreover, SES and age interacted to predict cortisol levels such that among younger children, lower SES was associated with higher cortisol, whereas among older children, lower SES was associated with lower cortisol. Results highlight the importance of considering both objective and subjective indicators of families' SES and stressful experiences in relation to multiple aspects of children's self-regulation.

The validity of socioeconomic status measures among adolescents based on self-reported information about parents occupations, FAS and perceived SES; implication for health related quality of life studies.

PubMed

Svedberg, P; Nygren, J M; Staland-Nyman, C; Nyholm, M

2016-04-29

Research has shown inconsistencies in results and difficulties in conceptualization of assessment of socioeconomic status (SES) among adolescents. The aim of this study was thus to test the validity of self-reported information on SES in two age-groups (11-13 and 14-16 years old) in an adolescent population and to evaluate its relationship to self-reported health related quality of life (HRQOL). Different measures of SES commonly used in research in relation to HRQOL were tested in this study; parent's occupations status, family material affluence status (FAS) and perceived SES. A cross-sectional study, with a sample of 948 respondents (n = 467, 11-13 years old and n = 481, 14-16 years old) completed questionnaires about SES and HRQOL. The adolescents' completion rates were used, with chi2-test, to investigate differences between gender and age-group. Correlation was used for convergent validity and ANOVA for concurrent validity. We found a low completion rate for both fathers' (41.7 %) and mothers' (37.5 %) occupation status, and a difference in completion rate between gender and age-groups. FAS had the highest completion rate (100 %) compared to parent's occupations status and perceived SES. The convergent validity between the SES-indicators was weak (Spearman correlation coefficient below 0.3), suggesting that the indicators measured different dimensions of SES. Both FAS and perceived SES showed a gradient in mean HRQOL between low and high SES in relation to HRQOL, this was significant only for perceived SES (p < 0.01, both age-groups). This study indicates the need for considering different approaches to measures of SES among adolescences and when evaluating SES in relation to HRQOL. Further research is needed to investigate sustainable ways to measure SES, delineating the relevance of tangible measures of education, occupation and income in relation to the perceived socioeconomic status in comparison with others in immediate social networks and in society at large.

[Socioeconomic differences in physical activity in the middle-aged working population: The role of education, occupation, and income].

PubMed

Hoebel, Jens; Finger, Jonas D; Kuntz, Benjamin; Lampert, Thomas

2016-02-01

Regular physical activity has positive effects on health at all ages. This study aims to investigate how far physical activity and regular sports engagement, as a more specific type of physical activity, are associated with socioeconomic factors in the middle-aged working population. Data were obtained from 21,699 working men and women aged between 30 and 64 years who participated in the 2009 and 2010 population-based national German Health Update (GEDA) surveys conducted by the Robert Koch Institute. Besides a multi-dimensional index of socioeconomic status (SES), three single dimensions of SES (education, occupation, and income) were used to analyse socioeconomic differences in total physical activity and regular sports engagement. While the prevalence of total physical activity increased with lower SES, the proportion of people with regular sports engagement decreased with lower SES. These associations remained after adjusting for age in men and women. After mutual adjustment of the three single socioeconomic dimensions, physical activity was independently associated with lower education and lower occupational status. Regular sports engagement was observed to be independently associated with higher education, higher occupational status, as well as higher income after mutual adjustment. This study demonstrates significant socioeconomic differences in physical and sports activity in the middle-aged working population. Education, occupation, and income show varying independent associations with physical activity behaviour. Such differences need to be considered when identifying target groups for health-enhancing physical activity interventions.

Dietary patterns of early childhood and maternal socioeconomic status in a unique prospective sample from a randomized controlled trial of Prenatal DHA Supplementation.

PubMed

Hidaka, Brandon H; Kerling, Elizabeth H; Thodosoff, Jocelynn M; Sullivan, Debra K; Colombo, John; Carlson, Susan E

2016-11-25

Dietary habits established in early childhood and maternal socioeconomic status (SES) are important, complex, interrelated factors that influence a child's growth and development. The aim of this study was to define the major dietary patterns in a cohort of young US children, construct a maternal SES index, and evaluate their associations. The diets of 190 children from a randomized, controlled trial of prenatal supplementation of docosahexaenoic acid (DHA) were recorded at 6-mo intervals from 2-4.5 years by 24-h dietary recall. Hierarchical cluster analysis of age-adjusted, average daily intake of 24 food and beverage groups was used to categorize diet. Unrotated factor analysis generated an SES score from maternal race, ethnicity, age, education, and neighborhood income. We identified two major dietary patterns: "Prudent" and "Western." The 85 (45%) children with a Prudent diet consumed more whole grains, fruit, yogurt and low-fat milk, green and non-starchy vegetables, and nuts and seeds. Conversely, those with a Western diet had greater intake of red meat, discretionary fat and condiments, sweet beverages, refined grains, French fries and potato chips, eggs, starchy vegetables, processed meats, chicken and seafood, and whole-fat milk. Compared to a Western diet, a Prudent diet was associated with one standard deviation higher maternal SES (95% CI: 0.80 to 1.30). We found two major dietary patterns of young US children and defined a single, continuous axis of maternal SES that differed strongly between groups. This is an important first step to investigate how child diet, SES, and prenatal DHA supplementation interact to influence health outcomes. NCT00266825 . Prospectively registered on December 15, 2005.

The relationship between relative deprivation and self-rated health among Palestinian women in refugee camps in Lebanon.

PubMed

Salti, Nisreen; Abdulrahim, Sawsan

2016-12-01

Relative deprivation (RD) has been advanced as a theory to explain the relationship between income inequality and health in high-income countries. In this study, we tested the theory in a low-income protracted refugee setting in a middle-income country. Using data from the 2010 Socioeconomic Survey of Palestine Refugees in Lebanon, we examined the relationship between RD and health among a representative sample of Palestinian refugee women ( N =1047). Data were gathered utilizing a household questionnaire with information on socio-demographics and an individual-level questionnaire with information on the health of each respondent. We examined self-rated health (SRH) as the main health measure but also checked the sensitivity of our results using self-reported chronic conditions. We used two measures for absolute SES: total household monthly expenditures on non-food goods and services and total household monthly expenditures on non-health goods and services. With refugee camp as a reference group, we measured a household's RD as a household's rank of absolute SES within the reference group, multiplied by the distance between its absolute SES and the average absolute SES of all households ranked above it. We investigated the robustness of the RD-SRH relationship using these two alternative measures of absolute SES. Our findings show that, controlling for absolute SES and other possible confounders, women report significantly poorer health when they live in households with a higher score on our RD measure (because of either lower relative rank or lower relative SES compared to households better off in the reference group which we take to be the refugee camp). While RD is always significant as a determinant of SRH under a variety of specifications, absolute SES is not consistently significant. These findings persist when we use self-reported chronic conditions as our measure of health instead of SRH, suggesting that the relationship between health and RD may be operating through a psychosocial mechanism. Our findings underscore the importance of examining RD under conditions of poverty and in diverse socio-cultural contexts. They also highlight that public health approaches should be concerned with reducing social inequalities in low-income settings in addition to alleviating poverty.

Decisions of black parents about infant bedding and sleep surfaces: a qualitative study.

PubMed

Ajao, Taiwo I; Oden, Rosalind P; Joyner, Brandi L; Moon, Rachel Y

2011-09-01

The goal of this qualitative study was to examine factors influencing decisions by black parents regarding use of soft bedding and sleep surfaces for their infants. We conducted focus groups and individual interviews with black mothers of lower and higher socioeconomic status (SES). Mothers were asked about many infant care practices, including sleep surface and bedding. Eighty-three mothers were interviewed, 73 (47 lower and 26 higher SES) in focus groups and 10 (7 lower and 3 higher SES) in individual interviews. The primary reason for using soft surfaces was infant comfort. Parents perceived that infants were uncomfortable if the surface was not soft. Many parents also interpreted "firm sleep surface" to mean taut; they were comfortable with and believed that they were following recommendations for a firm sleep surface when they placed pillows/blankets on the mattress as long as a sheet was pulled tautly over the pillows/blankets. The primary reasons for using soft bedding (including bumper pads) were comfort, safety, and aesthetics. In addition to using bedding to soften sleep surfaces, bedding was used to prevent infant rollover and falls, particularly for infants sleeping on a bed or sofa. Some parents used soft bedding to create an attractive space for the infant. Many black parents believe that soft bedding will keep their infant safe and comfortable. There is much misunderstanding about the meaning of a "firm" sleep surface. Additional educational messages apparently are needed to change parental perceptions and practices.

Self-reported vaccination in the elderly

PubMed Central

Reyes-Ortiz, Carlos; Borda, Miguel German; Arciniegas, Antonio

2016-01-01

Objectives: To determine the frequency of vaccination in older adults within the city of Bogotá and to estimate the association with sociodemographic and health factors. Methods: This is a secondary data analysis from the SABE-Bogotá Study, a cross-sectional population-based study that included a total of 2,000 persons aged 60 years. Weighted percentages for self-reported vaccination [influenza, pneumococcal, tetanus] were determined. The association between vaccination and covariates was evaluate by logistic regression models. Results: A total of 73.0% of respondents received influenza, 57.8% pneumococcal and 47.6% tetanus vaccine. Factors independently associated with vaccination included: 1- age (65-74 years had higher odds of receiving vaccinations, compared to 60-64 years); 2- socioeconomic status (SES) (higher SES had lower odds of having influenza and pneumococcal vaccines, compared to those with lower SES); 3- health insurance (those with contributive or subsidized health insurance had higher odds (between 3 and 5 times higher) of having vaccinations, compared to those with no insurance); 4- older adults with better functional status (greater Lawton scores) had increased odds for all vaccinations; 5- older adults with higher comorbidity had increased odds for influenza and pneumococcal vaccinations. Conclusion: Vaccination campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination or vulnerable to reach it such as the disabled elder. PMID:27226661

Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

PubMed Central

2010-01-01

Background It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. Methods The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Results Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Conclusion Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts. PMID:20540787

Socioeconomic Disparities in Health Behaviors

PubMed Central

Pampel, Fred C.; Krueger, Patrick M.; Denney, Justin T.

2011-01-01

The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms. PMID:21909182

Socioeconomic status influences the toll paediatric hospitalisations take on families: a qualitative study.

PubMed

Beck, Andrew Finkel; Solan, Lauren G; Brunswick, Stephanie A; Sauers-Ford, Hadley; Simmons, Jeffrey M; Shah, Samir; Gold, Jennifer; Sherman, Susan N

2017-04-01

Stress caused by hospitalisations and transition periods can place patients at a heightened risk for adverse health outcomes. Additionally, hospitalisations and transitions to home may be experienced in different ways by families with different resources and support systems. Such differences may perpetuate postdischarge disparities. We sought to determine, qualitatively, how the hospitalisation and transition experiences differed among families of varying socioeconomic status (SES). Focus groups and individual interviews were held with caregivers of children recently discharged from a children's hospital. Sessions were stratified based on SES, determined by the percentage of individuals living below the federal poverty level in the census tract or neighbourhood in which the family lived. An open-ended, semistructured question guide was developed to assess the family's experience. Responses were systematically compared across two SES strata (tract poverty rate of <15% or ≥15%). A total of 61 caregivers who were 87% female and 46% non-white participated; 56% resided in census tracts with ≥15% of residents living in poverty (ie, low SES). Interrelated logistical (eg, disruption in-home life, ability to adhere to discharge instructions), emotional (eg, overwhelming and exhausting nature of the experience) and financial (eg, cost of transportation and meals, missed work) themes were identified. These themes, which were seen as key to the hospitalisation and transition experiences, were emphasised and described in qualitatively different ways across SES strata. Families of lower SES may experience challenges and stress from hospitalisations and transitions in different ways than those of higher SES. Care delivery models and discharge planning that account for such challenges could facilitate smoother transitions that prevent adverse events and reduce disparities in the postdischarge period. NCT02081846; Pre-results. 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/.

Arsenic in private well water part 3 of 3: Socioeconomic vulnerability to exposure in Maine and New Jersey.

PubMed

Flanagan, Sara V; Spayd, Steven E; Procopio, Nicholas A; Marvinney, Robert G; Smith, Andrew E; Chillrud, Steven N; Braman, Stuart; Zheng, Yan

2016-08-15

Arsenic is a naturally occurring toxic element often concentrated in groundwater at levels unsafe for human consumption. Private well water in the United States is mostly unregulated by federal and state drinking water standards. It is the responsibility of the over 13 million U.S. households regularly depending on private wells for their water to ensure it is safe for drinking. There is a consistent graded association with health outcomes at all levels of socioeconomic status (SES) in the U.S. Differential exposure to environmental risk may be contributing to this persistent SES-health gradient. Environmental justice advocates cite overwhelming evidence that income and other SES measures are consistently inversely correlated with exposure to suboptimal environmental conditions including pollutants, toxins, and their impacts. Here we use private well household surveys from two states to investigate the association between SES and risks for arsenic exposure, examining the potentially cumulative effects of residential location, testing and treatment behavior, and psychological factors influencing behavior. We find that the distribution of natural arsenic hazard in the environment is socioeconomically random. There is no evidence that higher SES households are avoiding areas with arsenic or that lower SES groups are disproportionately residing in areas with arsenic. Instead, disparities in exposure arise from differing rates of protective action, primarily testing well water for arsenic, and secondly treating or avoiding contaminated water. We observe these SES disparities in behavior as well as in the psychological factors that are most favorable to these behaviors. Assessment of risk should not be limited to the spatial occurrence of arsenic alone. It is important that social vulnerability factors are incorporated into risk modeling and identifying priority areas for intervention, which should include strategies that specifically target socioeconomically vulnerable groups as well as all the conditions which cause these disparities in testing and treatment behavior. Copyright © 2016 Elsevier B.V. All rights reserved.

Analysing horizontal equity in enrolment in Disease Management Programmes for coronary heart disease in Germany 2008-2010.

PubMed

Bozorgmehr, Kayvan; San Sebastian, Miguel; Brenner, Hermann; Razum, Oliver; Maier, Werner; Saum, Kai-Uwe; Holleczek, Bernd; Miksch, Antje; Szecsenyi, Joachim

2015-03-10

Disease Management Programmes (DMPs) have been introduced in Germany ten years ago with the aim to improve effectiveness and equity of care, but little is known about the degree to which enrolment in the programme meets the principles of equity in health care. We aimed to analyse horizontal equity in DMP enrolment among patients with coronary heart disease (CHD). Cross-sectional analysis of horizontal inequities in physician-reported enrolment in the DMP for CHD in a large population-based cohort-study in Germany (2008-2010). We calculated horizontal inequity indices (HII) and their 95% confidence intervals [95%CI] for predicted need-standardised DMP enrolment across two measures of socio-economic status (SES) (educational attainment, regional deprivation) stratified by sex. Need-standardised DMP enrolment was predicted in multi-level logistic regression models. Among N = 1,280 individuals aged 55-84 years and diagnosed with CHD, DMP enrolment rates were 22.2% (women) and 35.0% (men). Education-related inequities in need-standardised DMP enrolment favoured groups with lower education, but HII estimates were not significant. Deprivation-related inequities among women significantly favoured groups with higher SES (HII = 0.086 [0.007 ; 0.165]. No such deprivation-related inequities were seen among men (HII = 0.014 [-0.048 ; 0.077]). Deprivation-related inequities across the whole population favoured groups with higher SES (HII estimates not significant). Need-standardised DMP enrolment was fairly equitable across educational levels. Deprivation-related inequities in DMP enrolment favoured women living in less deprived areas relative to those living in areas with higher deprivation. Further research is needed to gain a better understanding of the mechanisms that contribute to deprivation-related horizontal inequities in DMP enrolment among women.

THE IMPACT OF MEASURES OF SOCIOECONOMIC STATUS ON HOSPITAL PROFILING IN NEW YORK CITY

PubMed Central

Blum, Alexander B.; Egorova, Natalia N.; Sosunov, Eugene A.; Gelijns, Annetine C.; DuPree, Erin; Moskowitz, Alan J.; Federman, Alex D.; Ascheim, Deborah D.; Keyhani, Salomeh

2014-01-01

Background Current 30-day readmission models used by the Center for Medicare and Medicaid Services for the purpose of hospital-level comparisons lack measures of socioeconomic status (SES). We examined whether the inclusion of a SES measure in 30-day congestive heart failure (CHF) readmission models changed hospital risk standardized readmission rates (RSRR) in New York City (NYC) hospitals. Methods and Results Using a Centers for Medicare & Medicaid Services (CMS)-like model we estimated 30-day hospital-level RSRR by adjusting for age, gender and comorbid conditions. Next, we examined how hospital RSRRs changed relative to the New York City mean with inclusion of the Agency for Healthcare Research and Quality (AHRQ) validated SES index score. In a secondary analysis, we examined whether inclusion of the AHRQ SES Index score in 30-day readmission models disproportionately impacted the RSRR of minority-serving hospitals. Higher AHRQ SES scores, indicators of higher socioeconomic status, were associated with lower odds, 0.99, of 30-day readmission (p< 0.019). The addition of the AHRQ SES index did not change the model’s C statistic (0.63). After adjustment for the AHRQ SES index, one hospital changed status from “worse than the NYC average” to “no different than the NYC average”. After adjustment for the AHRQ SES index, one NYC minority-serving hospital was re-classified from “worse” to “no different than average”. Conclusions While patients with higher SES were less likely to be admitted, the impact of SES on readmission was very small. In NYC, inclusion of the AHRQ SES score in a CMS based model did not impact hospital-level profiling based on 30-day readmission. PMID:24823956

Supporting the Health of Low Socioeconomic Status Employees: Qualitative Perspectives from Employees and Large Companies.

PubMed

Parrish, Amanda T; Hammerback, Kristen; Hannon, Peggy A; Mason, Caitlin; Wilkie, Michelle N; Harris, Jeffrey R

2018-03-13

The aim of this study was to identify alignments between wellness offerings low socioeconomic status (SES) employees need and those large companies can provide. Focus groups (employees); telephone interviews (large companies). Employees were low-SES, insured through their employers, and employed by large Washington State companies. Focus groups covered perceived barriers to healthy behaviors at work and potential support from companies. Interviews focused on priorities for employee health and challenges reaching low-SES employees. Seventy-seven employees participated in eight focus groups; 12 companies completed interviews. Employees identified facilitators and barriers to healthier work environments; companies expressed care for employees, concerns about employee obesity, and reluctance to discuss SES. Our findings combine low-SES employee and large company perspectives and indicate three ways workplaces could most effectively support low-SES employee health: create healthier workplace food environments; prioritize onsite physical activity facilities; use clearer health communications.

[Socioeconomic Gradients in Dental Care Accessibility in Germany].

PubMed

Leonhardt, Konrad Alexander; Hirsch, Christian

2017-03-17

The aim of this study was to determine whether dental care accessibility in Germany from 2002 to 2009 was linked to socioeconomic status (SES) or household net income (HHN). Analysis was based upon a nation-wide cross-sectional survey of German adults from 18 to 79 years (mean 49.1 years; 55% females) which was conducted by the "Bertelsmann Gesundheitsmonitor" from 2002-2009. Patients in Germany visit the dentist 2.4 times per year independently of the SES. Patients with higher income paid per income group 34 € (95%- KI: 6 €-63 €) more for their denture. People from the middle class had 1.28 (95% CI: 1.02-1.22), and people from the upper class had 1.86 (95%-CI: 1.58-2.18) as much dental coinsurance coverage as people from the lower class. The ability to pay for denture and obtain dental insurance coverage rose with higher SES or HHN. The rise of additional payments for dental services leads to discrepancies in dental health care. © Georg Thieme Verlag KG Stuttgart · New York.

Intergenerational Profiles of Socioeconomic (Dis)advantage and Obesity During the Transition to Adulthood

PubMed Central

Scharoun-Lee, Melissa; Adair, Linda S.; Popkin, Barry M.; Kaufman, Jay S.; Suchindran, Chirayath M.

2012-01-01

Investigations of socioeconomic status (SES) and health during the transition to adulthood in the United States are complicated by the later and more varied transitions in residence, employment, schooling, and social roles compared with previous generations. Parental SES is an important influence during adolescence but cannot sufficiently capture the SES of the independent young adult. Typical, single SES indicators based on income or education likely misclassify the SES of young adults who have not yet completed their education or other training, or who have entered the labor force early with ultimately lower status attainment. We use a latent class analysis (LCA) framework to characterize five intergenerational SES groups, combining multidimensional SES information from two time points—that is, adolescent (parental) and young adult (self) SES data. Associations of these groups with obesity, a high-risk health outcome in young adults, revealed nuanced relationships not seen using traditional intergenerational SES measures. In males, for example, a middle-class upbringing in adolescence and continued material advantage into adulthood was associated with nearly as high obesity as a working poor upbringing and early, detrimental transitions. This intergenerational typology of early SES exposure facilitates understanding of SES and health during young adulthood. PMID:21491185

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.

The effectiveness of a primer to help people understand risk: two randomized trials in distinct populations.

PubMed

Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

2007-02-20

People need basic data interpretation skills to understand health risks and to weigh the harms and benefits of actions meant to reduce those risks. Although many studies document problems with understanding risk information, few assess ways to teach interpretation skills. To see whether a general education primer improves patients' medical data interpretation skills. Two randomized, controlled trials done in populations with high and low socioeconomic status (SES). The high SES trial included persons who attended a public lecture series at Dartmouth Medical School, Hanover, New Hampshire; and the low SES trial included veterans and their families from the waiting areas at the White River Junction Veterans Affairs Medical Center, White River Junction, Vermont. 334 adults in the high SES trial and 221 veterans and their families in the low SES trial were enrolled from October 2004 to August 2005. Completion rates for the primer and control groups in each trial were 95% versus 98% (high SES) and 85% versus 96% (low SES). The intervention in the primer groups was an educational booklet specifically developed to teach people the skills needed to understand risk. The control groups received a general health booklet developed by the U.S. Department of Health and Human Services Agency for Health Care Research and Quality. Score on a medical data interpretation test, a previously validated 100-point scale, in which 75 points or more is considered "passing." Secondary outcomes included 2 other 100-point validated scores (interest and confidence in interpreting medical statistics) and participants' ratings of the booklet's usefulness. In the high SES trial, 74% of participants in the primer group received a "passing grade" on the medical data interpretation test versus 56% in the control group (P = 0.001). Mean scores were 81 and 75, respectively (P = 0.0006). In the low SES trial, 44% versus 26% "passed" (P = 0.010): Mean scores were 69 and 62 in the primer and control groups, respectively (P = 0.008). The primer also significantly increased interest in medical statistics by 6 points in the high SES trial (a 4-point increase vs. a 2-point decrease from baseline) (P = 0.004) and by 8 points in the low SES trial (a 6-point increase vs. a 2-point decrease from baseline) (P = 0.004) compared with the control booklet. The primer, however, did not improve participants' confidence in interpreting medical statistics beyond the control booklet (a 2-point vs. a 4-point increase in the high SES trial [P = 0.36] and a 2-point versus a 6-point increase in the low SES trial [P = 0.166]). The primer was rated highly: 91% of participants in the high SES trial found it "helpful" or "very helpful," as did 95% of participants in the low SES trial. The primarily male low SES sample and the primarily female high SES sample limits generalizability. The authors did not assess whether better data interpretation skills improved decision-making. The primer improved medical data interpretation skills in people with high and low SES. ClinicalTrials.gov registration number: NCT00380432.

Socioeconomic status discrimination and C-reactive protein in African-American and White adults.

PubMed

Van Dyke, Miriam E; Vaccarino, Viola; Dunbar, Sandra B; Pemu, Priscilla; Gibbons, Gary H; Quyyumi, Arshed A; Lewis, Tené T

2017-08-01

We examined the association between socioeconomic status (SES) discrimination and C-reactive protein (CRP) in a biracial cohort of middle-aged adults using an intersectionality framework. Participants were 401 African-American and White adults from a population-based cohort in the Southeastern United States. SES discrimination was self-reported with a modified Experiences of Discrimination Scale, and CRP levels were assayed from blood samples. Linear regression analyses were used to examine the associations among SES discrimination, race, education, and CRP after controlling for age, gender, racial and gender discrimination, financial and general stress, body mass index, smoking, sleep quality, and depressive symptoms. Intersectional effects were tested using race×SES discrimination, education×SES discrimination and race×education×SES discrimination interactions. Adjusting for sociodemographics, racial discrimination, gender discrimination, and all relevant two-way interaction terms, we observed a significant race×education×SES discrimination interaction (p=0.019). In adjusted models stratified by race and education, SES discrimination was associated with elevated CRP among higher educated African-Americans (β=0.29, p=0.018), but not lower educated African-Americans (β=-0.13, p=0.32); or lower educated (β=-0.02, p=0.92) or higher educated (β=-0.01, p=0.90) Whites. Findings support the relevance of SES discrimination as an important discriminatory stressor for CRP specifically among higher educated African-Americans. Copyright © 2017 Elsevier Ltd. All rights reserved.

Young Adult Risk Factors for Cancer: Obesity, Inflammation, and Sociobehavioral Mechanisms.

PubMed

Yang, Yang Claire; Johnson, Moira P; Schorpp, Kristen M; Boen, Courtney E; Harris, Kathleen Mullan

2017-09-01

The paper assesses social disparities in the burdens of metabolic and inflammatory risks for cancer in the U.S. young adult population and examines psychosocial and behavioral mechanisms in such disparities. Using data of 7,889 individuals aged 12-32 years from the National Longitudinal Study of Adolescent to Adult Health from 1994 to 2009, generalized linear models were used to assess the sex, race/ethnicity, and SES differences in the risks of obesity and inflammation, measured by C-reactive protein. Further tests examined the extent to which social isolation, smoking, physical inactivity, alcohol abuse, and illicit drug use explain social differentials in each biomarker outcome. Women, blacks, Hispanics, and socioeconomically disadvantaged groups had higher risks of obesity and elevated C-reactive protein, with the SES gradients being more pronounced in female participants. Health-related behaviors showed large variation across sex, race, and SES strata. After adjusting for these behavioral variables, sex, and race disparities in obesity and excess inflammation in blacks diminished, whereas the adolescent SES disparity in obesity remained. The associations of adolescent and young adult SES disadvantage and inflammation were also explained by behavioral mechanisms. Behavioral factors associated with higher risks of obesity and inflammation differed, with the exception of fast food consumption, a risk factor for both. This study provides new knowledge of social distribution of early life exposures to physiologic precedents to cancer development later in life with implications for prevention and early intervention of modifiable risky behaviors in adolescents and young adults. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

9-month results of polymer-free sirolimus eluting stents in young patients compared to a septuagenarian and octogenarian all-comer population.

PubMed

Kherad, Behrouz; Waliszewski, Matthias; Leschke, Matthias; Kader, Muhammad Ali; Bang, Liew Houng; Ruiz-Poveda, Fernando Lozano; Pieske, Burkert; Krackhardt, Florian

2018-06-01

To evaluate the 9-month safety and efficacy of polymer-free sirolimus eluting drug eluting stents in septuagenarians and octogenarians. An all-comer, worldwide single armed trial (ClinicalTrials.gov Identifier NCT02629575) was conducted to demonstrate the safety and efficacy of an ultra-thin strut, polymer-free sirolimus eluting stent (PF-SES). The primary endpoint was the 9-month target revascularization rate (TLR). Secondary endpoints included the rates of major adverse cardiac events (MACE), stent thrombosis (ST) and bleeding (BARC) in septuagenarians (≥70 years, <80 years), and in octogenarians (≥80 years) to be compared to the younger patient group (<70 years). A total of 1607 patients were treated with PF-SES in the sub-70-year-old age group, 694 in septuagenarians, and 371 in the octogenarian patient group. At 9 months, the MACE rates were 7.2% in octogenarians, 5.3% in septuagenarians, and 3.0% in the younger patient group (P = 0.001). These were mostly driven by all-cause mortality (4.4% vs 1.9% vs 0.6%, P < 0.001) while the TLR rates were only numerically lower in the younger age group (P = 0.080). BARC 1-5 bleeding events were more frequent in the older age group (1.9% vs 2.7% vs 4.6%, P = 0.012) whereas the rates for ST were not different (0.7% vs 0.6% vs 0.6%, P = 0.970). In octogenarians treated with PF-SES, the rates for MACE, overall mortality, and bleeding are higher as compared to the younger age groups. However, the rates for TLR and ST were not significantly different across the investigated age groups. PF-SES are safe and effective in octogenarians. © 2017, Wiley Periodicals, Inc.

The Relationship between Socioeconomic Status, Family Income, and Measures of Muscular and Cardiorespiratory Fitness in Colombian Schoolchildren.

PubMed

Sandercock, Gavin R H; Lobelo, Felipe; Correa-Bautista, Jorge E; Tovar, Gustavo; Cohen, Daniel Dylan; Knies, Gundi; Ramírez-Vélez, Robinson

2017-06-01

To determine the associations between socioeconomic status (SES) and physical fitness in a sample of Colombian youth. Prueba SER is cross-sectional survey of schoolchildren in Bogota, Colombia. Mass, stature, muscular fitness (standing long-jump, handgrip), and cardiorespiratory fitness (20-m shuttle run) were measured in 52?187 schoolchildren 14-16 years of age. Area-level SES was categorized from 1 (very low) to 4 (high) and parent-reported family income was categorized as low, middle, or high. Converting measures into z scores showed stature, muscular, and cardiorespiratory fitness were significantly (z?=?0.3-0.7) below European values. Children in the mid- and high SES groups jumped significantly further than groups with very low SES. Differences were independent of sex but became nonsignificant when adjusted for anthropometric differences. Participants in the mid-SES and high-SES groups had better handgrip scores when adjusted for body dimension. There were, however, no significant between-group differences in cardiorespiratory fitness, which was strongly clustered by school and significantly greater in students from private schools. Area-level SES is associated with measures of muscular fitness in Colombian schoolchildren. These associations were largely explained by the large differences in body dimensions observed between SES groups. When area-level SES is considered, there was no evidence that family income influenced fitness. The clustering of outcomes reaffirms the potential importance of schools and area-level factors in promoting fitness through opportunities for physical activity. Interventions implemented in schools, can improve academic attainment; a factor likely to be important in promoting the social mobility of children from poorer families. Copyright © 2016 Elsevier Inc. All rights reserved.

Cluster-randomised trial to evaluate the ‘Change for Life’ mass media/ social marketing campaign in the UK

PubMed Central

2012-01-01

Background Social marketing campaigns offer a promising approach to the prevention of childhood obesity. Change4Life (C4L) is a national obesity prevention campaign in England. It included mass media coverage aiming to reframe obesity into a health issue relevant to all and provided the opportunity for parents to complete a brief questionnaire (‘How are the Kids’) and receive personalised feedback about their children’s eating and activity. Print and online C4L resources were available with guidance about healthy eating and physical activity. The study aims were to examine the impact of personalised feedback and print material from the C4L campaign on parents’ attitudes and behaviours about their children’s eating and activity in a community-based cluster-randomised controlled trial. Methods Parents of 5–11 year old children were recruited from 40 primary schools across England. Schools were randomised to intervention or control (‘usual care’). Basic demographic data and brief information about their attitudes to their children’s health were collected. Families in intervention schools were mailed the C4L print materials and the ‘How are the Kids’ questionnaire; those returning the questionnaire were sent personalised feedback and others received generic materials. Outcomes included awareness of C4L, attitudes to the behaviours recommended in C4L, parenting behaviours (monitoring and modelling), and child health behaviours (diet, physical activity and television viewing). Follow-up data were collected from parents by postal questionnaire after six months. Qualitative interviews were carried out with a subset of parents (n = 12). Results 3,774 families completed baseline questionnaires and follow-up data were obtained from 1,419 families (37.6%). Awareness was high in both groups at baseline (75%), but increased significantly in the intervention group by follow-up (96% vs. 87%). Few parents (5.2% of the intervention group) returned the questionnaire to get personalised feedback. There were few significant group differences in parental attitudes or parenting and child health behaviours at follow-up. Physical activity was rated as less important in the intervention group, but a significant group-by-socioeconomic status (SES) interaction indicated that this effect was confined to higher SES families. Similar interactions were also seen for physical activity monitoring and child television time; with adverse effects in higher SES families and no change in the lower SES families. Effects were little better in families that completed the questionnaire and received personalised feedback. At interview, acceptability of the intervention was modest, although higher in lower SES families. Conclusions The C4L campaign materials achieved increases in awareness of the campaign, but in this sample had little impact on attitudes or behaviour. Low engagement with the intervention appeared a key issue. Trial registration number Current Controlled Trials ISRCTN00791709. PMID:22672587

Population-based incidence trends of oropharyngeal and oral cavity cancers by sex among the poorest and underprivileged populations

PubMed Central

2014-01-01

Background Oral cancer is an important health issue, with changing incidence in many countries. Oropharyngeal cancer (OPC, in tonsil and oropharygeal areas) is increasing, while oral cavity cancer (OCC, other sites in the mouth) is decreasing. There is the need to identify high risk groups and communities for further study and intervention. The objective of this study was to determine how the incidence of OPC and OCC varied by neighbourhood socioeconomic status (SES) in British Columbia (BC), including the magnitude of any inequalities and temporal trends. Methods ICDO-3 codes were used to identify OPC and OCC cases in the BC Cancer Registry from 1981–2010. Cases were categorized by postal codes into SES quintiles (q1-q5) using VANDIX, which is a census-based, multivariate weighted index based on neighbourhood average household income, housing tenure, educational attainment, employment and family structure. Age-standardized incidence rates were determined for OPC and OCC by sex and SES quintiles and temporal trends were then examined. Results Incidence rates are increasing in both men and women for OPC, and decreasing in men and increasing in women for OCC. This change is not linear or proportionate between different SES quintiles, for there is a sharp and dramatic increase in incidence according to the deprivation status of the neighbourhood. The highest incidence rates in men for both OPC and OCC were observed in the most deprived SES quintile (q5), at 1.7 times and 2.2 times higher, respectively, than men in the least deprived quintile (q1). For OPC, the age-adjusted incidence rates significantly increased in all SES quintiles with the highest increase observed in the most deprived quintile (q5). Likewise, the highest incidence rates for both OPC and OCC in women were observed in the most deprived SES quintile (q5), at 2.1 times and 1.8 times higher, respectively, than women in the least deprived quintile (q1). Conclusion We report on SES disparities in oral cancer, emphasizing the need for community-based interventions that address access to medical care and the distribution of educational and health promotion resources among the most SES deprived communities in British Columbia. PMID:24886308

Surprising SES Gradients in Mortality, Health, and Biomarkers in a Latin American Population of Adults

PubMed Central

Dow, William H.

2009-01-01

Background To determine socioeconomic status (SES) gradients in the different dimensions of health among elderly Costa Ricans. Hypothesis: SES disparities in adult health are minimal in Costa Rican society. Methods Data from the Costa Rican Study on Longevity and Healthy Aging study: 8,000 elderly Costa Ricans to determine mortality in the period 2000–2007 and a subsample of 3,000 to determine prevalence of several health conditions and biomarkers from anthropometry and blood and urine specimens. Results The ultimate health indicator, mortality, as well as the metabolic syndrome, reveals that better educated and wealthier individuals are worse off. In contrast, quality of life–related measures such as functional and cognitive disabilities, physical frailty, and depression all clearly worsen with lower SES. Overall self-reported health (SRH) also shows a strong positive SES gradient. Traditional cardiovascular risk factors such as diabetes and cholesterol are not significantly related to SES, but hypertension and obesity are worse among high-SES individuals. Reflecting mixed SES gradients in behaviors, smoking and lack of exercise are more common among low SES, but high calorie diets are more common among high SES. Conclusions Negative modern behaviors among high-SES groups may be reversing cardiovascular risks across SES groups, hence reversing mortality risks. But negative SES gradients in healthy years of life persist. PMID:19196695

Retail food safety risks for populations of different races, ethnicities, and income levels.

PubMed

Signs, Renata J; Darcey, Valerie L; Carney, Trish A; Evans, Alison A; Quinlan, Jennifer J

2011-10-01

Research has found that populations with low socioeconomic status (SES) and minority populations have greater access to small corner markets and less access to supermarkets than high-SES and Caucasian populations. This represents a significant difference in the farm-to-fork continuum that these populations experience. This research examined whether differential retail access to foods results in different food safety risks at the retail level for consumers with different demographics. U.S. Census Bureau census tracts with high African American, Asian, Hispanic, Caucasian, low-SES, and high-SES populations were identified in Philadelphia, PA. Approximately 60 retail food establishments were sampled in each census tract category from June 2008 to June 2010. Food samples collected at stores included milk, eggs, lunchmeat, sandwiches, and ready-to-eat (RTE) fresh fruit, greens, and herbs, when available. With the exception of milk and eggs, only food that had been handled and/or prepared at the retail level was sampled. Food samples were tested for temperature, aerobic plate count, coliforms, fecal coliforms, Escherichia coli, Staphylococcus aureus, and Listeria monocytogenes. The results indicated that internal egg temperatures were higher in samples from low-SES census tracts than in eggs from Caucasian census tracts, and eggs were more often found unrefrigerated in markets in low-SES and Asian census tracts. Milk samples from markets in Hispanic and low-SES census tracts had higher aerobic plate counts than high-SES census tract samples. Sandwiches from markets in high-SES census tracts had higher coliform counts than sandwiches from markets in all other census tract categories. Markets in Asian census tracts had a higher incidence of fecal coliform contamination on sandwiches than markets in Caucasian census tracts. Fecal coliforms were present in a percentage of RTE greens from markets in all census tracts except African American, with the highest percentages of RTE greens positive for fecal coliforms in low-SES (100%), Asian (71.4%), and Caucasian (45.5%) markets.

Mothers of Young Adults with Intellectual Disability: Multiple Roles, Ethnicity, and Well-Being

PubMed Central

2011-01-01

Background Two opposing perspectives--role strain and role enhancement—were considered as predictive of women’s psychological and physical health. The authors examined the relation between multiple role occupancy (parenting, employment, marriage) and well-being (depression and health) among mothers of young adults with intellectual disability (ID). Method Participants were 226 mothers aged 35-70 years caring for a young adult aged 16-26 years with moderate to severe/profound ID. Mothers were either of Latino ethnicity (n=117) or Anglo (n=109). Mothers’ ethnicity and degree of acculturation and young adults’ adaptive behaviour and behaviour problems were examined as potential moderators. Results Mothers who were employed, married, or both reported better well-being than mothers who were both unemployed and unmarried, especially when their offspring had relatively higher adaptive functioning. This relationship between role occupancy and well-being was fully mediated by socio-economic (SES) factors. Results did not suggest a role enhancement effect, but instead indicated a role shortage effect; unemployed, unmarried mothers experienced markedly poor well-being, while all other mothers experienced comparable well-being. Well-being scores were higher for Anglo than for Latino mothers; this relationship was entirely accounted for by SES. In Latina mothers, the relation between role occupancy and well-being was moderated by degree of acculturation. Conclusions Findings suggest that multiple roles benefit mothers of young adults with ID primarily through their impact on socio-economic resources. For more acculturated Latina mothers, occupying more roles predicted better well-being even after controlling for SES. Latina mothers who were unemployed and unmarried had lower SES, and this group emerged as at particular risk. The latter group may benefit most from respite assistance and other interventions aimed at addressing their physical and mental health. PMID:17100951

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

Mothers of young adults with intellectual disability: multiple roles, ethnicity and well-being.

PubMed

Eisenhower, A; Blacher, J

2006-12-01

Two opposing perspectives--role strain and role enhancement--were considered as predictive of women's psychological and physical health. The authors examined the relation between multiple role occupancy (parenting, employment, marriage) and well-being (depression and health) among mothers of young adults with intellectual disability (ID). Participants were 226 mothers aged 35-70 years old caring for a young adult aged 16-26 years old with moderate to severe/profound ID. Mothers were of either Latino ethnicity (n=117) or Anglo (n=109). Mothers' ethnicity and degree of acculturation and young adults' adaptive behaviour and behaviour problems were examined as potential moderators. Mothers who were employed, married, or both reported better well-being than mothers who were both unemployed and unmarried, especially when their offspring had relatively higher adaptive functioning. This relationship between role occupancy and well-being was fully mediated by socio-economic status (SES) factors. Results did not suggest a role enhancement effect, but instead indicated a role shortage effect; unemployed, unmarried mothers experienced markedly poor well-being, while all other mothers experienced comparable well-being. Well-being scores were higher for Anglo than for Latino mothers; this relationship was entirely accounted for by SES. In Latina mothers, the relation between role occupancy and well-being was moderated by degree of acculturation. Findings suggest that multiple roles benefit mothers of young adults with ID primarily through their impact on socio-economic resources. For more acculturated Latina mothers, occupying more roles predicted better well-being even after controlling for SES. Latina mothers who were unemployed and unmarried had lower SES, and this group emerged as at particular risk. The latter group may benefit most from respite assistance and other interventions aimed at addressing their physical and mental health.

Adherence to airway clearance therapy in pediatric cystic fibrosis: Socioeconomic factors and respiratory outcomes.

PubMed

Oates, Gabriela R; Stepanikova, Irena; Gamble, Stephanie; Gutierrez, Hector H; Harris, William T

2015-12-01

The evidence linking socioeconomic status (SES) and adherence in cystic fibrosis (CF) is inconclusive and focused on medication uptake. We examined associations between SES, adherence to airway clearance therapy (ACT), and CF respiratory outcomes. Socioeconomic, clinical, and adherence data of CF patients (N = 110) at a single CF Center were evaluated in this cross-sectional observational study. SES was operationalized as maternal and paternal education and household income. Adherence to ACT was measured with utilization data from the high-frequency chest wall oscillation (HFCWO) device over 4-6 weeks. Statistical modeling was used to test three hypotheses: (H1) Higher SES is associated with higher ACT adherence; (H2) Higher SES is associated with better respiratory outcomes; and (H3) ACT adherence mediates the relationship between SES and respiratory outcomes. In multinomial logistic regression, maternal college education, annual income >$50,000, and more adults in the household were independently related to better adherence (P < 0.05). Paternal college education, income >$100,000, and lack of exposure to smoking were independently related to higher lung function (P < 0.05). Current adherence to ACT with HFCWO was not associated with lung function over 12 months. SES is associated both with ACT adherence and respiratory outcomes in pediatric CF patients. However, the link between SES and respiratory outcomes in this study was not mediated by adherence to ACT with HFCWO. These data emphasize the importance of socioeconomic resources and household environment for CF health. Family socio-demographic profiles can help identify patients at increased risk for ACT nonadherence. © 2015 Wiley Periodicals, Inc.

[The relations of socioeconomic status to health status, health behaviors in the elderly].

PubMed

Lee, Sok-Goo; Jeon, So-Youn

2005-05-01

To analyze the relationships of socioeconomic status(SES) to health status and health behaviors in the elderly. Data were obtained from self-administered questionnaire of 4,587 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, socioeconomic status, health status (subjective health status, acute disease, admission experience, dental state, chronic disease etc.), activities of daily living (ADL), instrumental activities of daily living (IADL), and mini-mental state examination-Korean (MMSE-K). Binary and multinominal logistic regression analyses were employed to analyze factors affecting on the socioeconomic status of the elderly. With regard to the SES and health status, those with a low SES had poorer subjective health states and lower satisfaction about their physical health. Also, acute disease experiences, admission rates and tooth deciduation rates were higher in those of low SES. In the view of physical and cognitive functions, the ADL, IADL and MMSE-K scores were also lower in those of low SES. However, with regard to health behaviors, lower smoking and alcohol drinking rates were found in the low SES group, and a similar trend was shown with regular physical exercise, eating breakfast, and regular physical health check-up. From these findings, we surmise that those with low SES have a poorer health condition and less money to spend on health, therefore, they can not smoke or drink alcohol, exercise and or have a physical health check-up. This study suggests that socioeconomic status plays an important role in health behaviors and status of the elderly. Low socioeconomic status bring about unhealthy behavior and poor health status in the elderly. Therefore, more specific target oriented(esp. low SES persons) health promotion activities for the elderly are very important to improve not only their health status, but their health inequity also.

Fast-food exposure around schools in urban Adelaide.

PubMed

Coffee, Neil T; Kennedy, Hannah P; Niyonsenga, Theo

2016-12-01

To assess whether exposure to fast-food outlets around schools differed depending on socio-economic status (SES). Binary logistic regression was used to investigate the presence and zero-inflated Poisson regression was used for the count (due to the excess of zeroes) of fast food within 1000 m and 15000 m road network buffers around schools. The low and middle SES tertiles were combined due to a lack of significant variation as the 'disadvantaged' group and compared with the high SES tertile as the 'advantaged' group. School SES was expressed using the 2011 Australian Bureau of Statistics, socio-economic indices for areas, index of relative socio-economic disadvantage. Fast-food data included independent takeaway food outlets and major fast-food chains. Metropolitan Adelaide, South Australia. A total of 459 schools were geocoded to the street address and 1000 m and 1500 m road network distance buffers calculated. There was a 1·6 times greater risk of exposure to fast food within 1000 m (OR=1·634; 95 % 1·017, 2·625) and a 9·5 times greater risk of exposure to a fast food within 1500 m (OR=9·524; 95 % CI 3·497, 25·641) around disadvantaged schools compared with advantaged schools. Disadvantaged schools were exposed to more fast food, with more than twice the number of disadvantaged schools exposed to fast food. The higher exposure to fast food near more disadvantaged schools may reflect lower commercial land cost in low-SES areas, potentially creating more financially desirable investments for fast-food developers.

Childhood socioeconomic position, adult socioeconomic position and social mobility in relation to markers of adiposity in early adulthood: evidence of differential effects by gender in the 1978/79 Ribeirao Preto cohort study.

PubMed

Aitsi-Selmi, A; Batty, G D; Barbieri, M A; Silva, A A M; Cardoso, V C; Goldani, M Z; Marmot, M G; Bettiol, H

2013-03-01

Longitudinal studies drawn from high-income countries demonstrate long-term associations of early childhood socioeconomic deprivation with increased adiposity in adulthood. However, there are very few data from resource-poor countries where there are reasons to anticipate different gradients. Accordingly, we sought to characterise the nature of the socioeconomic status (SES)-adiposity association in Brazil. We use data from the Ribeirao Preto Cohort Study in Brazil in which 9067 newborns were recruited via their mothers in 1978/79 and one-in-three followed up in 2002/04 (23-25years). SES, based on family income (salaries, interest on savings, pensions and so on), was assessed at birth and early adulthood, and three different adiposity measures (body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)) ascertained at follow-up. The association between childhood SES, adult SES and social mobility (defined as four permutations of SES in childhood and adulthood: low-low, low-high, high-low, high-high), and the adiposity measures was examined using linear regression. There was evidence that the association between SES and the three markers of adiposity was modified by gender in both adulthood (P<0.02 for all outcomes) and childhood SES (P<0.02 for WC and WHR). Thus, in an unadjusted model, linear regression analyses showed that higher childhood SES was associated with lower adiposity in women (coefficient (95% confidence intervals) BMI: -1.49 (-2.29,-0.69); WC: -3.85 (-5.73,-1.97); WHR: -0.03 (-0.04,-0.02)). However, in men, higher childhood SES was related to higher adiposity (BMI: 1.03 (0.28,-1.78); WC: 3.15 (1.20, 5.09); WHR: 0.009 (-0.001, 0.019)) although statistical significance was not seen in all analyses. There was a suggestion that adult SES (but not adult health behaviours or birthweight) accounted for these relationships in women only. Upward mobility was associated with protection against greater adiposity in women but not men. In the present study, in men there was some evidence that both higher childhood and adulthood SES was related to a higher adiposity risk, while the reverse gradient was apparent in women.

Coronary heart disease risk factors in men with light and dark skin in Puerto Rico.

PubMed Central

Costas, R; Garcia-Palmieri, M R; Sorlie, P; Hertzmark, E

1981-01-01

The association of skin color with coronary heart disease risk factors was studied in 4,000 urban Puerto Rican men. Skin color on the inner upper arm was classified according to the von Luschan color tiles. Using this grading, men were separated into two groups of light or dark skin color. The dark group had a lower socioeconomic status (SES) based on income, education, and occupation. Dark men had slightly higher mean systolic blood pressures (SBP) and lower mean serum cholesterol levels than the light, but the relative weights and cigarette smoking habits of both groups were similar. After controlling for the differences in SES, skin color showed a small but statistically significant association with SBP. Whether this association with skin color represents genetic or environmental influences on SBP could not be determined from this study. PMID:7235099

Barriers to Accessing Optimal Esophageal Cancer Care for Socioeconomically Disadvantaged Patients.

PubMed

Lineback, Christina M; Mervak, Colin M; Revels, Sha'shonda L; Kemp, Micheal T; Reddy, Rishindra M

2017-02-01

The 5-year survival of patients with low socioeconomic status (SES) and esophageal cancer is significantly lower than that in patients with high SES. It is poorly understood what causes these worse outcomes. We hypothesized that a qualitative approach could elucidate the underlying causes of these differences. Patients with a diagnosis of esophageal cancer were recruited through flyers in regional cancer centers as well as through Facebook advertisements in cancer support groups and newspapers; they participated in a 1-hour semistructured interview or completed an online survey. Patients were stratified into low- and high-SES groups and were surveyed about their health history and access to cancer care. Data were coded into common themes based on participant responses. Eighty patients completed the interviews or surveys, with 38 in the high-SES group and 42 in the low-SES group. There were no clinically significant differences between the groups in comorbidities and cancer staging. Patients with low SES were offered operative treatment at significantly lower rates (19 of 42 [44.7%] versus 29 of 38 [76.3%]; p = 0.0048), had a decreased rate of second opinions (10 of 42 [23.8%] versus 25 of 38 [65.8%]; p = 0.00016), and were more likely to lose their jobs (14 of 42 [33.3%] versus 1 of 38 [2.6%]; p = 0.00044) than their high-SES counterparts. Thematic analysis found that communication difficulties, lack of understanding of treatment, and financial troubles were consistently reported more prominently in the lower-SES groups. Having a facilitator (eg, social worker) improved care by helping patients navigate complex treatments and financial concerns. Financial and communication barriers exist, which may lead to disparities in cancer outcomes for patients with low SES. There is a critical need for medical advocates to assist patients with limited resources. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Healthy subjects volunteering for Phase I studies: influence of curiosity, exploratory tendencies and perceived self-efficacy.

PubMed

Almeida, L; Kashdan, T B; Coelho, R; Albino-Teixeira, A; Soares-da-Silva, P

2008-03-01

To test the hypothesis that trait-curiosity and perceived self-efficacy influence the willingness of healthy subjects to volunteer for participation in Phase I studies. A group of healthy subjects who had never participated in clinical studies ("index group") were invited to participate in a Phase I study. They were assessed with regard to trait curiosity (Curiosity and Exploration Inventory; CEI-T) and perceived self-efficacy (Self-Efficacy Scale; SES) and subjects who accepted the invitation to participate were compared with those who refused and with a group of healthy subjects who had previously participated in clinical studies ("validation group"). A significant positive correlation was found between the willingness to participate and the CEI-T total score (R=0.28; p<0.01), exploratory tendencies (R=0.34; p<0.001), SES total score (R=0.30, p<0.01), initiative and persistence (R=0.29, p<0.01), planning/goal setting (R=0.19, p<0.05) and social self-efficacy (R=0.29; p<0.01). The "index group" subjects who accepted the invitation to participate showed significantly greater CEI-T exploratory tendencies (Z=-3.334, p = 0.001, Mann-Whitney test) and total scores (Z=-2.703, p<0.01) and greater SES total score (Z=-3.131, p<0.01), initiative and persistence (Z=-3.065, p<0.01), planning/goal setting (Z=-2.173, p<0.05) and social self-efficacy (Z=-2.954, p<0.01) than subjects who refused. No differences were found between the subjects in the "index group" who accepted the invitation and subjects in the "validation group". Using a logistic regression model, both CEI-T exploratory tendencies and SES initiative/persistence were significant predictors of participation. Subjects higher in curiosity/exploration and in perceived initiative/persistence are more willing to volunteer for Phase I studies. The impact of these self-selection biases on Phase I study results is unknown but deserves further evaluation.

Socioeconomic status and the utilization of diagnostic imaging in an urban setting

PubMed Central

Demeter, Sandor; Reed, Martin; Lix, Lisa; MacWilliam, Leonard; Leslie, William D.

2005-01-01

Background In publicly funded health care systems, the utilization of health care services should be equitable, irrespective of socioeconomic status (SES). Although the association between SES and health care utilization has been examined in Canada relative to surgical, cardiac and preventive health care services, no published studies have specifically explored the association between SES and diagnostic imaging. Methods We examined over 300 000 diagnostic imaging claims made in the Winnipeg Regional Health Authority between Apr. 1, 2001, and Mar. 31, 2002. Using patient postal codes, we assigned SES on the basis of average household incomes in Canada's 1996 census. Using multiple regression, we examined the association between income quintile, patient age group (≤16, 17–64, ≥ 65 years), patient morbidity level according to the Johns Hopkins University Adjusted Clinical Group method (high, moderate, low), and imaging modality (general radiology, vascular, computed tomography, magnetic resonance, and general and obstetric ultrasound). Results Relative rates (RR) of diagnostic imaging utilization (highest v. lowest income quintile) were significantly increased in pediatric and adult patient groups at all morbidity levels receiving general radiology (highest RR 2.47, 95% confidence interval [CI] 2.07–2.93); pediatric and adult patient groups at high and low morbidity levels and elderly patient groups at low morbidity levels receiving general ultrasound (highest RR 2.26, 95% CI 1.20–4.26); pediatric and adult patient groups at all morbidity levels and elderly patients at high and moderate morbidity levels receiving magnetic resonance imaging (highest RR 2.51, 95% CI 1.78– 3.52); and adult patient groups at all morbidity levels receiving computed tomography (highest RR 1.46, 95% CI 1.35– 1.59). A lower RR of diagnostic imaging utilization in the highest income quintile was found only among patients receiving obstetric ultrasound (RR 0.80, 95% CI 0.73–0.87). No significant associations were found among elderly patients receiving general radiology or computed tomography or adult patients receiving vascular imaging. Interpretation We found a pattern of increased diagnostic imaging utilization in patient groups with a higher SES. Further research is needed to better understand the nature of this finding and how it contributes to health outcomes. PMID:16275968

Experiential "Hot" Knowledge and Its Influence on Low-SES Students' Capacities to Aspire to Higher Education

ERIC Educational Resources Information Center

Smith, Lisa

2011-01-01

The Australian Government has recently signalled its intention to fund programs that assist in "raising" the aspirations of low socio-economic status (SES) students. However, this objective can imply that low-SES students lack adequate aspirations for their future. This implication supports deficit views of low-SES students and elides…

Reading Skill-Fractional Anisotropy Relationships in Visuospatial Tracts Diverge Depending on Socioeconomic Status

ERIC Educational Resources Information Center

Gullick, Margaret M.; Demir-Lira, Özlem Ece; Booth, James R.

2016-01-01

Low socioeconomic status (SES) has been repeatedly linked with decreased academic achievement, including lower reading outcomes. Some lower SES children do show skills and scores commensurate with those of their higher SES peers, but whether their abilities stem from the same systems as high SES children or are based on divergent strategies is…

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.

The global childhood obesity epidemic and the association between socio-economic status and childhood obesity

PubMed Central

Wang, Youfa; Lim, Hyunjung

2015-01-01

This paper describes the current prevalence and time trends of childhood obesity worldwide, and the association between childhood obesity and socio-economic status (SES). Childhood obesity has become a global public health crisis. The prevalence is highest in western and industrialized countries, but still low in some developing countries. The prevalence also varies by age and gender. The WHO Americas and eastern Mediterranean regions had higher prevalence of overweight and obesity (30–40%) than the European (20–30%), south-east Asian, western Pacific, and African regions (10–20% in the latter three). A total of 43 million children (35 million in developing countries) were estimated to be overweight or obese; 92 million were at risk of overweight in 2010. The global overweight and obesity prevalence has increased dramatically since 1990, for example in preschool-age children, from approximately 4% in 1990 to 7% in 2010. If this trend continues, the prevalence may reach 9% or 60 million people in 2020. The obesity–SES association varies by gender, age, and country. In general, SES groups with greater access to energy-dense diets (low-SES in industrialized countries and high-SES in developing countries) are at increased risk of being obese than their counterparts. PMID:22724639

The global childhood obesity epidemic and the association between socio-economic status and childhood obesity.

PubMed

Wang, Youfa; Lim, Hyunjung

2012-06-01

Abstract This paper describes the current prevalence and time trends of childhood obesity worldwide, and the association between childhood obesity and socio-economic status (SES). Childhood obesity has become a global public health crisis. The prevalence is highest in western and industrialized countries, but still low in some developing countries. The prevalence also varies by age and gender. The WHO Americas and eastern Mediterranean regions had higher prevalence of overweight and obesity (30-40%) than the European (20-30%), south-east Asian, western Pacific, and African regions (10-20% in the latter three). A total of 43 million children (35 million in developing countries) were estimated to be overweight or obese; 92 million were at risk of overweight in 2010. The global overweight and obesity prevalence has increased dramatically since 1990, for example in preschool-age children, from approximately 4% in 1990 to 7% in 2010. If this trend continues, the prevalence may reach 9% or 60 million people in 2020. The obesity-SES association varies by gender, age, and country. In general, SES groups with greater access to energy-dense diets (low-SES in industrialized countries and high-SES in developing countries) are at increased risk of being obese than their counterparts.

Between-group differences in nutrition- and health- related psychosocial factors among US adults and their associations with diet, exercise, and weight status

PubMed Central

Wang, Youfa; Chen, Xiaoli

2012-01-01

Background Large disparities exist across ethnic and socioeconomic status (SES) groups regarding obesity and other chronic diseases. Eliminating health disparities is a national priority in the US. Objective To test between-group differences in nutrition- and health-related psychosocial factors (NHRPF) and their associations with US adults’ diet, exercise, and weight status. Design and participants/setting Nationally representative data from the Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey in 1994-96 from 4,356 US adults aged 20-65 years were used. Diet was assessed using 24-hour recalls; NHRPF, by 25 questions; weight status, by self-reported weight and height. Index scores were created to measure NHRPF. Diet quality was assessed using the US Department of Agriculture 2005 Healthy Eating Index (HEI). Statistical analyses Multivariate linear and logistic regression models were conducted to examine the associations. Results Some ethnic differences in NHRPF existed but were small. There were statistically significant (P<0.05) and large ethnic differences in diet (blacks had the worst average HEI; whites, the best, at 47.6 vs. 52.3, respectively). Groups with higher SES had better NHRPF (had better nutrition knowledge and beliefs, made better food choices, and had better awareness of nutrition-related health risks) and HEI. Subjects with high school education had higher NHRPF score (37.2 vs. 35.7) and HEI (54.5 vs. 49.5) than those with less than a high school education. Conclusions Ethnic differences among American adults’ NHRPF were small, but SES differences were greater. More efforts are needed to study the influences of the complex interactions between individual and social environmental factors that affect Americans’ diet and weight status and to explain related ethnic disparities. PMID:22709700

Decisions of Black Parents About Infant Bedding and Sleep Surfaces: A Qualitative Study

PubMed Central

Ajao, Taiwo I.; Oden, Rosalind P.; Joyner, Brandi L.

2011-01-01

OBJECTIVE: The goal of this qualitative study was to examine factors influencing decisions by black parents regarding use of soft bedding and sleep surfaces for their infants. METHODS: We conducted focus groups and individual interviews with black mothers of lower and higher socioeconomic status (SES). Mothers were asked about many infant care practices, including sleep surface and bedding. RESULTS: Eighty-three mothers were interviewed, 73 (47 lower and 26 higher SES) in focus groups and 10 (7 lower and 3 higher SES) in individual interviews. The primary reason for using soft surfaces was infant comfort. Parents perceived that infants were uncomfortable if the surface was not soft. Many parents also interpreted “firm sleep surface” to mean taut; they were comfortable with and believed that they were following recommendations for a firm sleep surface when they placed pillows/blankets on the mattress as long as a sheet was pulled tautly over the pillows/blankets. The primary reasons for using soft bedding (including bumper pads) were comfort, safety, and aesthetics. In addition to using bedding to soften sleep surfaces, bedding was used to prevent infant rollover and falls, particularly for infants sleeping on a bed or sofa. Some parents used soft bedding to create an attractive space for the infant. CONCLUSIONS: Many black parents believe that soft bedding will keep their infant safe and comfortable. There is much misunderstanding about the meaning of a “firm” sleep surface. Additional educational messages apparently are needed to change parental perceptions and practices. PMID:21859921

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.

Price promotions on healthier compared with less healthy foods: a hierarchical regression analysis of the impact on sales and social patterning of responses to promotions in Great Britain.

PubMed

Nakamura, Ryota; Suhrcke, Marc; Jebb, Susan A; Pechey, Rachel; Almiron-Roig, Eva; Marteau, Theresa M

2015-04-01

There is a growing concern, but limited evidence, that price promotions contribute to a poor diet and the social patterning of diet-related disease. We examined the following questions: 1) Are less-healthy foods more likely to be promoted than healthier foods? 2) Are consumers more responsive to promotions on less-healthy products? 3) Are there socioeconomic differences in food purchases in response to price promotions? With the use of hierarchical regression, we analyzed data on purchases of 11,323 products within 135 food and beverage categories from 26,986 households in Great Britain during 2010. Major supermarkets operated the same price promotions in all branches. The number of stores that offered price promotions on each product for each week was used to measure the frequency of price promotions. We assessed the healthiness of each product by using a nutrient profiling (NP) model. A total of 6788 products (60%) were in healthier categories and 4535 products (40%) were in less-healthy categories. There was no significant gap in the frequency of promotion by the healthiness of products neither within nor between categories. However, after we controlled for the reference price, price discount rate, and brand-specific effects, the sales uplift arising from price promotions was larger in less-healthy than in healthier categories; a 1-SD point increase in the category mean NP score, implying the category becomes less healthy, was associated with an additional 7.7-percentage point increase in sales (from 27.3% to 35.0%; P < 0.01). The magnitude of the sales uplift from promotions was larger for higher-socioeconomic status (SES) groups than for lower ones (34.6% for the high-SES group, 28.1% for the middle-SES group, and 23.1% for the low-SES group). Finally, there was no significant SES gap in the absolute volume of purchases of less-healthy foods made on promotion. Attempts to limit promotions on less-healthy foods could improve the population diet but would be unlikely to reduce health inequalities arising from poorer diets in low-socioeconomic groups.

A randomized controlled trial of combined exercise and psycho-education for low-SES women: short- and long-term outcomes in the reduction of stress and depressive symptoms.

PubMed

van der Waerden, Judith E B; Hoefnagels, Cees; Hosman, Clemens M H; Souren, Pierre M; Jansen, Maria W J

2013-08-01

Exercise may have both a preventive and a therapeutic impact on mental health problems. The Exercise without Worries intervention aims to reduce stress and depressive symptoms in low-SES women by means of a group-based program combining physical exercise and psycho-education. Between September 2005 and May 2008, 161 Dutch low-SES women with elevated stress or depressive symptom levels were randomly assigned to the combined exercise/psycho-education intervention (EP), exercise only (E) or a waiting list control condition (WLC). The E condition provided low to moderate intensity stretching, strength, flexibility, and body focused training as well as relaxation, while the EP program integrated the exercise with cognitive-behavioral techniques. Depressive symptoms (CES-D) and perceived stress (PSS) were measured before and immediately after the intervention and at 2, 6 and 12 month follow-up. Multilevel linear mixed-effects models revealed no differential patterns in reduction of CES-D or PSS scores between the EP, E and WLC groups on the short (post-test and 2 month follow-up) or long term (6 and 12 months follow-up). Depressive symptom outcomes were moderated by initial depressive symptom scores: women from the EP and E groups with fewer initial symptoms benefited from participation on the short term. Further, women in the EP and E groups with the lowest educational level reported more stress reduction at post-test than women with higher educational levels. In the overall target population of low-SES women, no indications were found that the Exercise without Worries course reduced depressive symptom and stress levels on the short or long term. The findings do suggest, however, that exercise alone or in combination with psycho-education may be a viable prevention option for certain groups of disadvantaged women. Especially those low-SES women with less severe initial problems or those with low educational attainment should be targeted for future depression prevention practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Family Socioeconomic Status, Cortisol, and Physical Health in Early Childhood: The Role of Advantageous Neighborhood Characteristics.

PubMed

Roubinov, Danielle S; Hagan, Melissa J; Boyce, W Thomas; Adler, Nancy E; Bush, Nicole R

2018-06-01

Children from families with lower socioeconomic status (SES) evidence greater physiological dysregulation and poorer health. Despite recognition of environmental contributors, little is known about the influence of neighborhood characteristics. The present study examined the moderating role of community-level risks and resources on the relation of family SES to children's daily cortisol output and physical health during the kindergarten year. In fall and spring of kindergarten, children's (N = 338) daily total cortisol was measured and parents and teachers rated children's global physical health. Parents reported family SES. Neighborhood characteristics were assessed using the Child Opportunity Index, a population-level tool that evaluates the quality of multiple domains of neighborhood attributes. In fall, children reared in lower SES family environments had higher cortisol when residing in lower quality (lower opportunity) neighborhoods (b = -.097, p < .001), but there was no relation between family SES and children's cortisol in more advantaged (higher opportunity) neighborhoods (b = -.023, p = .36). Lower family SES was prospectively associated with poorer physical health in spring (controlling for fall health) only among children living in lower opportunity neighborhoods (b = -.250, p = .018) and was unrelated to physical health among children residing in higher opportunity neighborhoods (b = .042, p = .70). Higher opportunity neighborhoods may protect against the negative consequences of low family SES on children's stress physiology and physical health. Public health interventions that bolster neighborhood opportunities may benefit young children reared in socioeconomically disadvantaged family environments.

Cognitive Outcomes for Extremely Preterm/Extremely Low Birth Weight Children in Kindergarten

PubMed Central

Orchinik, Leah J.; Taylor, H. Gerry; Espy, Kimberly Andrews; Minich, Nori; Klein, Nancy; Sheffield, Tiffany; Hack, Maureen

2012-01-01

Our objectives were to examine cognitive outcomes for extremely preterm/extremely low birth weight (EPT/ELBW, gestational age <28 weeks and/or birth weight <1000 g) children in kindergarten and the associations of these outcomes with neonatal factors, early childhood neurodevelopmental impairment, and socioeconomic status (SES). The sample comprised a hospital-based 2001-2003 birth cohort of 148 EPT/ELBW children (mean birth weight 818 g; mean gestational age 26 weeks) and a comparison group of 111 term-born normal birth weight (NBW) classmate controls. Controlling for background factors, the EPT/ELBW group had pervasive deficits relative to the NBW group on a comprehensive test battery, with rates of cognitive deficits that were 3 to 6 times higher in the EPT/ELBW group. Deficits on a measure of response inhibition were found in 48% versus 10%, OR (95% CI) = 7.32 (3.32, 16.16), p <.001. Deficits on measures of executive function and motor and perceptual-motor abilities were found even when controlling for acquired verbal knowledge. Neonatal risk factors, early neurodevelopmental impairment, and lower SES were associated with higher rates of deficits within the EPT/ELBW group. The findings document both global and selective cognitive deficits in EPT/ELBW children at school entry and justify efforts at early identification and intervention. PMID:21923973

Failure to thrive and cognitive development in toddlers with infantile anorexia.

PubMed

Chatoor, Irene; Surles, Jaclyn; Ganiban, Jody; Beker, Leila; Paez, Laura McWade; Kerzner, Benny

2004-05-01

The goal of this study was to examine the relative contributions of growth deficiency and psychosocial factors to cognitive development in toddlers with infantile anorexia. Eighty-eight toddlers, ranging in age from 12 to 33 months, were enrolled in this study. Toddlers were evaluated by 2 child psychiatrists and placed into 1 of 3 groups: infantile anorexia, picky eater, and healthy eater. All 3 groups were matched for age, race, gender, and socioeconomic status (SES). Toddlers underwent nutritional evaluations and cognitive assessments with the Bayley Scales of Infant Development. Toddlers and their mothers were also videotaped during feeding and play interactions, which later were rated independently by 2 observers. On average, toddlers with infantile anorexia performed within the normal range of cognitive development. However, the Mental Developmental Index (MDI) scores of the healthy eater group (MDI = 110) were significantly higher than those of the infantile anorexia (MDI = 99) and picky eater (MDI = 96) groups. Within the infantile anorexia group, correlations between MDI scores and the toddlers' percentage of ideal body weight approached statistical significance (r =.32). Across all groups, the toddlers' MDI scores were associated with the quality of mother-child interactions, SES level, and maternal education level. Collectively, these variables explained 22% of the variance in MDI scores. This study demonstrated that psychosocial factors, such as mother-toddler interactions, maternal education level, and SES level, are related to the cognitive development of toddlers with feeding problems and explain more unique variance in MDI scores than nutritional status.

Cause-specific mortality and socioeconomic status in Chakaria, Bangladesh.

PubMed

Hanifi, Syed M A; Mahmood, Shehrin S; Bhuiya, Abbas

2014-01-01

Bangladesh has achieved remarkable gains in health indicators during the last four decades despite low levels of economic development. However, the persistence of inequities remains disturbing. This success was also accompanied by health and demographic transitions, which in turn brings new challenges for a nation that has yet to come to terms with pre-transition health challenges. It is therefore important to understand the causes of death and their relationship with socioeconomic status (SES). The paper aims to assess the causes of death by SES based on surveillance data from a rural area of Bangladesh, in order to understand the situation and inform policy makers and programme leaders. We analysed population-based mortality data collected from the Chakaria Health and Demographic Surveillance System in Bangladesh. The causes of death were determined by using a Bayesian-based programme for interpreting verbal autopsy findings (InterVA-4). The data included 1,391 deaths in 217,167 person-years of observation between 2010 and 2012. The wealth index constructed using household assets was used to assess the SES, and disease burdens were compared among the wealth quintiles. Analysing cause of death (CoD) revealed that non-communicable diseases (NCDs) were the leading causes of deaths (37%), followed by communicable diseases (CDs) (22%), perinatal and neonatal conditions (11%), and injury and accidents (6%); the cause of remaining 24% of deaths could not be determined. Age-specific mortality showed premature birth, respiratory infections, and drowning were the dominant causes of death for childhood mortality (0-14 years), which was inversely associated with SES (p<0.04). For adult and the elderly (15 years and older), NCDs were the leading cause of death (51%), followed by CDs (23%). For adult and the elderly, NCDs concentrated among the population from higher SES groups (p<0.005), and CDs among the lower SES groups (p<0.001). Epidemiologic transition is taking place with a shift from the dominance of CDs to NCDs. SES inequity in mortality still persists--the poor suffer from CDs in all age groups, whereas those better off suffer more from NCDs than CDs. Policy makers thus need to consider the social distribution of diseases before developing any public health action targeted towards reducing mortality and the extent of disease burden in an equitable manner.

Resurrecting the chimera: Progressions in parenting and peer processes.

PubMed

Forgatch, Marion S; Snyder, James J; Patterson, Gerald R; Pauldine, Michael R; Chaw, Yvonne; Elish, Katie; Harris, Jasmine B; Richardson, Eric B

2016-08-01

This report uses 6-year outcomes of the Oregon Divorce Study to examine the processes by which parenting practices affect deviant peer association during two developmental stages: early to middle childhood and late childhood to early adolescence. The participants were 238 newly divorced mothers and their 5- to 8-year-old sons who were randomly assigned to Parent Management Training-Oregon Model (PMTO®) or to a no-treatment control group. Parenting practices, child delinquent behavior, and deviant peer association were repeatedly assessed from baseline to 6 years after baseline using multiple methods and informants. PMTO had a beneficial effect on parenting practices relative to the control group. Two stage models linking changes in parenting generated by PMTO to children's growth in deviant peer association were supported. During the early to middle childhood stage, the relationship of improved parenting practices on deviant peer association was moderated by family socioeconomic status (SES); effective parenting was particularly important in mitigating deviant peer association for lower SES families whose children experience higher densities of deviant peers in schools and neighborhoods. During late childhood and early adolescence, the relationship of improved parenting to youths' growth in deviant peer association was mediated by reductions in the growth of delinquency during childhood; higher levels of early delinquency are likely to promote deviant peer association through processes of selective affiliation and reciprocal deviancy training. The results are discussed in terms of multilevel developmental progressions of diminished parenting, child involvement in deviancy producing processes in peer groups, and increased variety and severity of antisocial behavior, all exacerbated by ecological risks associated with low family SES.

The home electronic media environment and parental safety concerns: relationships with outdoor time after school and over the weekend among 9-11 year old children.

PubMed

Wilkie, Hannah J; Standage, Martyn; Gillison, Fiona B; Cumming, Sean P; Katzmarzyk, Peter T

2018-04-05

Time spent outdoors is associated with higher physical activity levels among children, yet it may be threatened by parental safety concerns and the attraction of indoor sedentary pursuits. The purpose of this study was to explore the relationships between these factors and outdoor time during children's discretionary periods (i.e., after school and over the weekend). Data from 462 children aged 9-11 years old were analysed using generalised linear mixed models. The odds of spending > 1 h outdoors after school, and > 2 h outdoors on a weekend were computed, according to demographic variables, screen-based behaviours, media access, and parental safety concerns. Interactions with sex and socioeconomic status (SES) were explored. Boys, low SES participants, and children who played on their computer for < 2 h on a school day had higher odds of spending > 1 h outside after school than girls, high SES children and those playing on a computer for ≥2 h, respectively. Counterintuitive results were found for access to media devices and crime-related safety concerns as both of these were positively associated with time spent outdoors after school. A significant interaction for traffic-related concerns*sex was found; higher road safety concerns were associated with lower odds of outdoor time after school in boys only. Age was associated with weekend outdoor time, which interacted with sex and SES; older children were more likely to spend > 2 h outside on weekends but this was only significant among girls and high SES participants. Our results suggest that specific groups of children are less likely to spend their free time outside, and it would seem that only prolonged recreational computer use has a negative association with children's outdoor time after school. Further research is needed to explore potential underlying mechanisms, and parental safety concerns in more detail.

The association of interacting neighborhood gene-environment risk with cortisol and blood pressure in African-American adults

PubMed Central

Coulon, Sandra M.; Wilson, Dawn K.; Van Horn, M. L.; Hand, Gregory A.; Kresovich, Stephen

2016-01-01

Background African-American adults are disproportionately affected by stress-related chronic conditions like high blood pressure (BP), and both environmental stress and genetic risk may play a role in its development. Purpose This study tested whether the dual risk of low neighborhood socioeconomic status (SES) and glucocorticoid genetic sensitivity interacted to predict waking cortisol and BP. Methods Cross-sectional waking cortisol and BP were collected from 208 African-American adults who were participating in a follow-up visit as part of the Positive Action for Today’s Health trial. Three single nucleotide polymorphisms were genotyped, salivary cortisol samples were collected, and neighborhood SES was calculated using 2010 Census data. Results The sample was mostly female (65%), with weight classified as overweight or obese (MBMI=32.74, SD=8.88), and a mean age of 55.64 (SD=15.21). The gene-by-neighborhood SES interaction predicted cortisol (B=0.235, p=.001, r2=.036), but not BP. For adults with high genetic risk, waking cortisol was lower with lower SES but higher with higher SES (B=0.87). Lower neighborhood SES was also related to higher systolic BP (B=−0.794, p=.028). Conclusions Findings demonstrated an interaction whereby African-American adults with high genetic sensitivity had high levels of waking cortisol with higher neighborhood SES, and low levels with lower neighborhood SES. This moderation effect is consistent with a differential susceptibility gene-environment pattern, rather than a dual-risk pattern. These findings contribute to a growing body of evidence that demonstrates the importance of investigating complex gene-environment relations in order to better understand stress-related health disparities. PMID:26685668

Poverty, race, and CKD in a racially and socioeconomically diverse urban population.

PubMed

Crews, Deidra C; Charles, Raquel F; Evans, Michele K; Zonderman, Alan B; Powe, Neil R

2010-06-01

Low socioeconomic status (SES) and African American race are both independently associated with end-stage renal disease and progressive chronic kidney disease (CKD). However, despite their frequent co-occurrence, the effect of low SES independent of race has not been well studied in CKD. Cross-sectional study. 2,375 community-dwelling adults aged 30-64 years residing within 12 neighborhoods selected for both socioeconomic and racial diversity in Baltimore City, MD. Low SES (self-reported household income <125% of 2004 Department of Health and Human Services guideline), higher SES (> or =125% of guideline); white and African American race. CKD defined as estimated glomerular filtration rate <60 mL/min/1.73 m(2). Logistic regression used to calculate ORs for relationship between poverty and CKD, stratified by race. Of 2,375 participants, 955 were white (347 low SES and 608 higher SES) and 1,420 were African American (713 low SES and 707 higher SES). 146 (6.2%) participants had CKD. Overall, race was not associated with CKD (OR, 1.05; 95% CI, 0.57-1.96); however, African Americans had a much greater odds of advanced CKD (estimated glomerular filtration rate <30 mL/min/1.73 m(2)). Low SES was independently associated with 59% greater odds of CKD after adjustment for demographics, insurance status, and comorbid disease (OR, 1.59; 95% CI, 1.27-1.99). However, stratified by race, low SES was associated with CKD in African Americans (OR, 1.91; 95% CI, 1.54-2.38), but not whites (OR, 0.95; 95% CI, 0.58-1.55; P for interaction = 0.003). Cross-sectional design; findings may not be generalizable to non-urban populations. Low SES has a profound relationship with CKD in African Americans, but not whites, in an urban population of adults, and its role in the racial disparities seen in CKD is worthy of further investigation. Copyright 2010 National Kidney Foundation, Inc. All rights reserved.

Socioeconomic differentials in the immediate mortality effects of the national Irish smoking ban.

PubMed

Stallings-Smith, Sericea; Goodman, Pat; Kabir, Zubair; Clancy, Luke; Zeka, Ariana

2014-01-01

Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000-2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring that a differentiated analytical approach aided in understanding the complexities in which structural and material factors influence mortality.

Socioeconomic Differentials in the Immediate Mortality Effects of the National Irish Smoking Ban

PubMed Central

Stallings-Smith, Sericea; Goodman, Pat; Kabir, Zubair; Clancy, Luke; Zeka, Ariana

2014-01-01

Background Consistent evidence has demonstrated that smoking ban policies save lives, but impacts on health inequalities are uncertain as few studies have assessed post-ban effects by socioeconomic status (SES) and findings have been inconsistent. The aim of this study was to assess the effects of the national Irish smoking ban on ischemic heart disease (IHD), stroke, and chronic obstructive pulmonary disease (COPD) mortality by discrete and composite SES indicators to determine impacts on inequalities. Methods Census data were used to assign frequencies of structural and material SES indicators to 34 local authorities across Ireland with a 2000–2010 study period. Discrete indicators were jointly analysed through principal component analysis to generate a composite index, with sensitivity analyses conducted by varying the included indicators. Poisson regression with interrupted time-series analysis was conducted to examine monthly age and gender-standardised mortality rates in the Irish population, ages ≥35 years, stratified by tertiles of SES indicators. All models were adjusted for time trend, season, influenza, and smoking prevalence. Results Post-ban mortality reductions by structural SES indicators were concentrated in the most deprived tertile for all causes of death, while reductions by material SES indicators were more equitable across SES tertiles. The composite indices mirrored the results of the discrete indicators, demonstrating that post-ban mortality decreases were either greater or similar in the most deprived when compared to the least deprived for all causes of death. Conclusions Overall findings indicated that the national Irish smoking ban reduced inequalities in smoking-related mortality. Due to the higher rates of smoking-related mortality in the most deprived group, even equitable reductions across SES tertiles resulted in decreases in inequalities. The choice of SES indicator was influential in the measurement of effects, underscoring that a differentiated analytical approach aided in understanding the complexities in which structural and material factors influence mortality. PMID:24887027

The epidemiology of hip fractures across western Victoria, Australia.

PubMed

Holloway, Kara L; Sajjad, Muhammad A; Mohebbi, Mohammadreza; Kotowicz, Mark A; Livingston, Patricia M; Khasraw, Mustafa; Hakkennes, Sharon; Dunning, Trisha L; Brumby, Susan; Page, Richard S; Pedler, Daryl; Sutherland, Alasdair; Venkatesh, Svetha; Brennan-Olsen, Sharon L; Williams, Lana J; Pasco, Julie A

2018-03-01

Hip fractures are associated with considerable morbidity and mortality. Hip fracture incidence varies across different levels of accessibility/remoteness and socioeconomic status (SES). As part of the Ageing, Chronic Disease and Injury Study, we aimed to map the pattern of hip fractures across the western region of the Australian state of Victoria, which contains a range of remoteness levels and SES. Data on hip fractures resulting in hospital admission were extracted from the Victorian Admitted Episodes Dataset (VAED) for men and women aged 40+years during 2010-2013 inclusive. An age-adjusted incidence rate (per 10,000population/year) was calculated for the entire region. Crude incidence rates and length of acute care hospital stay (excluding rehabilitation) were calculated for each Local Government Area (LGA). The impact of aggregated age, accessibility/remoteness index of Australia (ARIA) and SES on hip fracture rates aggregated across LGAs was determined using Poisson regression. For men, the age-standardised rate of hospitalisations for hip fracture across the whole region was 19.2 per 10,000population/year (95%CI 18.0-20.4) and for women, 40.0 (95%CI 38.3-41.7). The highest incidence rates for both sexes occurred in the less accessible LGAs of Yarriambiack and Hindmarsh, as well as the LGA with the lowest SES, Central Goldfields. In both sexes, approximately two thirds of individuals were discharged from acute hospital care within 14days. Increasing age, higher remoteness and lower SES were all associated with higher hip fracture rates. Crude incidence rates varied by location. Given that a high proportion of patients had acute hospital care of ≤14days, and accessibility and SES were associated with hip fracture rates, these results can inform policy and provide a model for other groups to conduct similar research in their local environment. Copyright © 2017 Elsevier Inc. All rights reserved.

Childhood socioeconomic status and lifetime health behaviors: The Young Finns Study.

PubMed

Puolakka, Elina; Pahkala, Katja; Laitinen, Tomi T; Magnussen, Costan G; Hutri-Kähönen, Nina; Männistö, Satu; Pälve, Kristiina S; Tammelin, Tuija; Tossavainen, Päivi; Jokinen, Eero; Smith, Kylie J; Laitinen, Tomi; Elovainio, Marko; Pulkki-Råback, Laura; Viikari, Jorma S A; Raitakari, Olli T; Juonala, Markus

2018-05-01

Differences in health behaviors partly explain the socioeconomic gap in cardiovascular health. We prospectively examined the association between childhood socioeconomic status (SES) and lifestyle factors in adulthood, and the difference of lifestyle factors according to childhood SES in multiple time points from childhood to adulthood. The sample comprised 3453 participants aged 3-18 years at baseline (1980) from the longitudinal Young Finns Study. The participants were followed up for 31 years (N = 1675-1930). SES in childhood was characterized as reported annual family income and classified on an 8-point scale. Diet, smoking, alcohol intake and physical activity were used as adult and life course lifestyle factors. Higher childhood SES predicted a healthier diet in adulthood in terms of lower consumption of meat (β ± SE -3.6 ± 0.99,p < 0.001), higher consumption of fish (1.1 ± 0.5, p = 0.04) and higher diet score (0.14 ± 0.044, p = 0.01). Childhood SES was also directly associated with physical activity index (0.059 ± 0.023, p = 0.009) and inversely with the risk of being a smoker (RR 0.90 95%CI 0.85-0.95, p < 0.001) and the amount of pack years (-0.47 ± 0.18, p = 0.01). Life course level of smoking was significantly higher and physical activity index lower among those below the median childhood SES when compared with those above the median SES. These results show that childhood SES associates with several lifestyle factors 31 years later in adulthood. Therefore, attention could be paid to lifestyle behaviors of children of low SES families to promote cardiovascular health. Copyright © 2017 Elsevier B.V. All rights reserved.

How social-class stereotypes maintain inequality.

PubMed

Durante, Federica; Fiske, Susan T

2017-12-01

Social class stereotypes support inequality through various routes: ambivalent content, early appearance in children, achievement consequences, institutionalization in education, appearance in cross-class social encounters, and prevalence in the most unequal societies. Class-stereotype content is ambivalent, describing lower-SES people both negatively (less competent, less human, more objectified), and sometimes positively, perhaps warmer than upper-SES people. Children acquire the wealth aspects of class stereotypes early, which become more nuanced with development. In school, class stereotypes advantage higher-SES students, and educational contexts institutionalize social-class distinctions. Beyond school, well-intentioned face-to-face encounters ironically draw on stereotypes to reinforce the alleged competence of higher-status people and sometimes the alleged warmth of lower-status people. Countries with more inequality show more of these ambivalent stereotypes of both lower-SES and higher-SES people. At a variety of levels and life stages, social-class stereotypes reinforce inequality, but constructive contact can undermine them; future efforts need to address high-status privilege and to query more heterogeneous samples. Copyright © 2017 Elsevier Ltd. All rights reserved.

Potential Reach of mHealth Versus Traditional Mass Media for Prevention of Chronic Diseases: Evidence From a Nationally Representative Survey in a Middle-Income Country in Africa.

PubMed

Yepes, Maryam; Maurer, Jürgen; Viswanathan, Barathi; Gedeon, Jude; Bovet, Pascal

2016-05-20

Public radio and television announcements have a long tradition in public health education. With the global rise of computer and mobile device ownership, short message service (SMS) and email-based health services (mHealth) are promising new tools for health promotion. Our objectives were to examine 1) self-reported exposure to programs related to noncommunicable diseases (NCDs) on national public television and radio during the 12 months preceding the survey (2013-2014), 2) current ownership of a mobile phone, smartphone, computer, or tablet, and use of the Internet, and 3) willingness of individuals to receive SMS or emails with information on health, with a focus on distribution of these variables across different demographic, socioeconomic status (SES), and NCD risk groups. We obtained data in a population survey of 1240 participants aged 25-64 years conducted in 2013-2014 in the Seychelles, a rapidly developing small island state in the African region. We administered a structured questionnaire and measured NCD risk factors. Univariate and multivariate analyses explored the relationships between outcomes and sociodemographic variables. Of 1240 participants, 1037 (83.62%) reported exposure to NCD-related programs on public television, while a lower proportion of 740 adults (59.67%), reported exposure via public radio (P<.001). Exposure to NCD-related programs on public television was associated with older age (P<.001) and female sex (P<.001), but not with SES, while exposure to NCD-related programs on public radio was associated with older age (P<.001) and lower SES (P<.001). A total of 1156 (93.22%) owned a mobile phone and ownership was positively associated with female sex (P<.001), younger age (P<.001), and higher SES (P<.001). Only 396 adults (31.93%) owned a smartphone and 244 adults (19.67%) used their smartphone to access the Internet. A total of 1048 adults (84.51%) reported willingness to receive health-related SMS, which was positively associated with female sex (P<.001), younger age (P<.001), and higher SES (P<.001). Controlling for SES, exposure to NCD-related programs on public television or radio and willingness to receive health-related SMS were not independently associated with a person's NCD risk. Broadcasting health programs through traditional mass media (national public radio and television) reached the majority of the population under study, including older adults and those in lower socioeconomic groups. With a high penetration of mobile phones and willingness to receive health-related SMS, mHealth presents an opportunity for health programs, especially when targeted SMS messages are intended for younger adults and those in higher socioeconomic groups. By contrast, due to reduced Internet access, email-based programs had a more limited reach for health promotion programs. These findings emphasize the different reach of interventions using SMS or email versus traditional mass media, according to demographic and socioeconomic categories, for health education programs in a developing country.

Ethnic differences in current smoking and former smoking in the Netherlands and the contribution of socioeconomic factors: a cross-sectional analysis of the HELIUS study

PubMed Central

Brathwaite, Rachel; Smeeth, Liam; Addo, Juliet; Kunst, Anton E; Peters, Ron J G; Snijder, Marieke B; Derks, Eske M; Agyemang, Charles

2017-01-01

Objectives Data exploring how much of the ethnic differences in smoking prevalence and former smoking are explained by socioeconomic status (SES) are lacking. We therefore assessed ethnic differences in smoking prevalence and former smoking and the contribution of both educational level and occupational-related SES to the observed ethnic differences in smoking behaviour. Methods Data of 22 929 participants (aged 18–70 years) from the multiethnic cross-sectional Healthy Life in an Urban Setting study in the Netherlands were analysed. Poisson regression models with a robust variance were used to estimate prevalence ratios. Results Compared with the Dutch, after adjustment for age and marital status, smoking prevalence was higher in men of Turkish (prevalence ratio 1.69, 95% CI 1.54 to 1.86), African Surinamese (1.55, 95% CI 1.41 to 1.69) and South-Asian Surinamese origin (1.53, 95% CI 1.40 to 1.68), whereas among women, smoking prevalence was higher in Turkish, similar in African Surinamese but lower in all other ethnic origin groups. All ethnic minority groups, except Ghanaians, had a significantly lower smoking cessation prevalence than the Dutch. Socioeconomic gradients in smoking (higher prevalence among those lower educated and with lower level employment) were observed in all groups except Ghanaian women (a higher prevalence was observed in the higher educated). Ethnic differences in smoking prevalence and former smoking are largely, but not completely, explained by socioeconomic factors. Conclusions Our findings imply that antismoking policies designed to target smoking within the lower socioeconomic groups of ethnic minority populations may substantially reduce ethnic inequalities in smoking particularly among men and that certain groups may benefit from targeted smoking cessation interventions. PMID:28698339

The role of psychosocial factors in socioeconomic differences in physical activity: a population-based study.

PubMed

Lehto, Elviira; Konttinen, Hanna; Jousilahti, Pekka; Haukkala, Ari

2013-08-01

Socioeconomic health inequalities are partly attributed to different physical activity (PA) patterns. Psychosocial factors interacting with PA are suggested to explain the socioeconomic differences in PA to some extent. The aim of the present study was to examine whether PA self-efficacy, PA social support, and general self-control contribute to the socioeconomic status (SES) differences in leisure time physical activity (LTPA) and in total PA. The sample consisted of 25-74-year-old Finnish men (n = 2325) and women (n = 2699), who participated in the cross-sectional FINRISK Study in 2007. Physical activity was measured as total PA (MET-h/week) and as LTPA (inactive/active). A psychosocial factor questionnaire included scales measuring PA self-efficacy, PA social support, and general self-control. SES was defined by household gross income and years of education. Both higher education and income were associated with higher levels of LTPA, whereas total PA was higher among those with lower SES. Subjects with high SES reported higher levels of PA self-efficacy and PA social support, but general self-control correlated only with higher income. PA self-efficacy, PA social support and general self-control had positive associations with both LTPA and total PA. These psychosocial factors partly explained the SES differences in LTPA, but not in total PA. Future intervention studies should examine whether, by influencing PA self-efficacy, PA social support, and general self-control, it is possible to diminish the SES differences in PA.

Socioeconomic inequalities in injuries treated in primary care in Madrid, Spain.

PubMed

Zoni, Ana Clara; Domínguez-Berjón, María Felícitas; Esteban-Vasallo, María D; Velázquez-Buendía, Luis M; Blaya-Nováková, Vendula; Regidor, Enrique

2017-03-01

Socioeconomic inequalities in injury morbidity are an important yet understudied issue in Southern Europe. This study analysed the injuries treated in primary care in the Community of Madrid, Spain, by socioeconomic status (SES), sex and age. This was a cross-sectional study of injuries registered in the primary care electronic medical records of the Madrid Health Service in 2012. Incidence stratified by sex, SES and type of injury were calculated. Poisson regression was performed. A statistically significant upward trend in global injury incidence was observed with decreasing SES in all age groups. By type of injury, the largest differences were observed in injuries by foreign body in men aged 15-44 and in poisonings in girls under 15 years of age. Burns risk also stood out in the group of girls under 15 years of age with the lowest SES. In the group above 74 years of age, wounds, bruises and sprains had the lowest SES differences in both sexes, and the risk of fractures was lower in the most socioeconomically advantaged group. People with lower SES were at a greater risk of injury. The relationship between SES and injury varies by type of injury and age. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Factors associated with oral health habits and use of dental services by adolescents].

PubMed

Davoglio, Rosane Silvia; Aerts, Denise Rangel Ganzo de Castro; Abegg, Claídes; Freddo, Silvia Letícia; Monteiro, Lisiane

2009-03-01

This was a cross-sectional study of 1,170 seventh-grade adolescents from the municipal public school system in Gravataí, Rio Grande do Sul State, Brazil, investigating the association between socio-demographic, psychosocial, and lifestyle factors and oral health habits and use of dental services. Data were analyzed by Cox regression, modified for cross-sectional studies. Females showed higher frequency of brushing, as did adolescents that reported not feeling alone or discriminated. Daily flossing was associated with higher socioeconomic status (SES), use of private dental services, parental understanding, and lack of feeling of loneliness. Frequency of annual dental visits was higher among individuals with higher SES. Preventive dental checkups were more frequent among individuals with higher SES, those who felt understood by their parents, and those who did not habitually eat candy. Oral health habits were associated with family SES and psychosocial factors except for frequency of annual dental visits. As for lifestyle, low candy consumption had a positive impact on reasons for use of dental appointments.

Socioeconomic status and overweight prevalence in polish adolescents: the impact of single factors and a complex index of socioeconomic status in respect to age and sex.

PubMed

Kowalkowska, Joanna; Wadolowska, Lidia; Weronika Wuenstel, Justyna; Słowińska, Małgorzata Anna; Niedźwiedzka, Ewa

2014-07-01

The aim of this study was to analyze the association between overweight prevalence and socioeconomic status (SES) measured by complex SES index and single SES factors in Polish adolescents in respect to age and sex. This cross-sectional study was conducted in 2010-2011. A total of 1,176 adolescents aged 13.0-18.9 years were included. The respondents were students of junior-high and high schools from northern, eastern and central Poland. Quota sampling by sex and age was used. The SES was determined by: place of residence, self-declared economic situation, and parental education level. Respondents with low, average or high SES index (SESI) were identified. The level of overweight was assessed using Polish and international standards. The odds ratio (OR) for overweight prevalence in the oldest girls (aged 17.0-18.9 years) with high SESI was 0.34 (95%CI:0.13-0.92; P < 0.05) by Polish standards and 0.22 (95%CI:0.05-0.95; P < 0.05) by international standards, in comparison to the reference group (low SESI). In total girls who had mothers with higher education level, the OR adjusted for age was 0.44 (95%CI:0.21-0.90; P <0.05) by Polish standards and 0.35 (95%CI:0.15-0.81; P < 0.05) by international standards, in comparison to the reference group (maternal elementary education). The other single SES factors were not significant for overweight prevalence. The relationship between socioeconomic status and prevalence of overweight was related to sex and age. The high socioeconomic status strongly lowered the risk of overweight prevalence in the oldest girls, but not in boys, irrespective of age. Maternal education level lowered risk of overweight prevalence in girls.

Socioeconomic Status and Overweight Prevalence in Polish Adolescents: The Impact of Single Factors and a Complex Index of Socioeconomic Status in Respect to Age and Sex

PubMed Central

KOWALKOWSKA, Joanna; WADOLOWSKA, Lidia; WERONIKA WUENSTEL, Justyna; SŁOWIŃSKA, Małgorzata Anna; NIEDŹWIEDZKA, Ewa

2014-01-01

Abstract Background The aim of this study was to analyze the association between overweight prevalence and socioeconomic status (SES) measured by complex SES index and single SES factors in Polish adolescents in respect to age and sex. Methods This cross-sectional study was conducted in 2010-2011. A total of 1,176 adolescents aged 13.0-18.9 years were included. The respondents were students of junior-high and high schools from northern, eastern and central Poland. Quota sampling by sex and age was used. The SES was determined by: place of residence, self-declared economic situation, and parental education level. Respondents with low, average or high SES index (SESI) were identified. The level of overweight was assessed using Polish and international standards. Results The odds ratio (OR) for overweight prevalence in the oldest girls (aged 17.0-18.9 years) with high SESI was 0.34 (95%CI:0.13-0.92; P < 0.05) by Polish standards and 0.22 (95%CI:0.05-0.95; P < 0.05) by international standards, in comparison to the reference group (low SESI). In total girls who had mothers with higher education level, the OR adjusted for age was 0.44 (95%CI:0.21-0.90; P <0.05) by Polish standards and 0.35 (95%CI:0.15-0.81; P < 0.05) by international standards, in comparison to the reference group (maternal elementary education). The other single SES factors were not significant for overweight prevalence Conclusions The relationship between socioeconomic status and prevalence of overweight was related to sex and age. The high socioeconomic status strongly lowered the risk of overweight prevalence in the oldest girls, but not in boys, irrespective of age. Maternal education level lowered risk of overweight prevalence in girls. PMID:25909059

Socioeconomic Patterning in Changes in Child Exposure to Secondhand Smoke After Implementation of Smoke-Free Legislation in Wales

PubMed Central

2011-01-01

Introduction: Secondhand smoke (SHS) exposure is higher among children from lower socioeconomic status (SES) households. Legislation banning smoking in public places has been linked with reduced SHS exposure in children. However, socioeconomic patterning in responses to legislation has been little explored. Methods: A total of 3,083 children aged 10–11 years, within 75 Welsh primary schools, completed questionnaires either before legislation or 1 year later. Saliva samples were provided by 2,787 of these children for cotinine assay. Regression analyses assessed socioeconomic differences in SHS exposure, and associations of legislation with exposure among children from low, medium, and high SES households. Changes in parental smoking in the home, car-based exposure, and perceived norms were assessed. Results: SHS exposure was highest among children from lower SES households. The likelihood of providing a sample containing an undetectable level of cotinine increased significantly after legislation among children from high [relative risk ratio (RRR) = 1.44, 95% CI = 1.04–2.00] and medium SES households (RRR = 1.66, 95% CI = 1.20–2.30), while exposure among children from lower SES households remained unchanged. Parental smoking in the home, car-based SHS exposure, and perceived smoking prevalence were highest among children from low SES households. Parental smoking in the home and children’s estimates of adult smoking prevalence declined only among children from higher SES households. Conclusions: Post-legislation reductions in SHS exposure were limited to children from higher SES households. Children from lower SES households continue to have high levels of exposure, particularly in homes and cars, and to perceive that smoking is the norm among adults. PMID:21571691

Deprived, but not depraved: Prosocial behavior is an adaptive response to lower socioeconomic status.

PubMed

Robinson, Angela R; Piff, Paul K

2017-01-01

Individuals of lower socioeconomic status (SES) display increased attentiveness to others and greater prosocial behavior compared to individuals of higher SES. We situate these effects within Pepper & Nettle's contextually appropriate response framework of SES. We argue that increased prosocial behavior is a contextually adaptive response for lower-SES individuals that serves to increase control over their more threatening social environments.

Exploring the impact of chronic obstructive pulmonary disease (COPD) on diabetes control in diabetes patients: a prospective observational study in general practice.

PubMed

Luijks, Hilde D; de Grauw, Wim J C; Bor, Jacobus H J; van Weel, Chris; Lagro-Janssen, Antoine L M; Biermans, Marion C J; Schermer, Tjard R

2015-04-23

Little is known about the association between COPD and diabetes control parameters. To explore the association between comorbid COPD and longitudinal glycaemic control (HbA1C) and systolic blood pressure (SBP) in a primary care cohort of diabetes patients. This is a prospective cohort study of type 2 diabetes patients in the Netherlands. In a mixed model analysis, we tested differences in the 5-year longitudinal development of HbA1C and SBP according to COPD comorbidity (present/absent). We corrected for relevant covariates. In subgroup effect analyses, we tested whether potential differences between diabetes patients with/without COPD were modified by age, sex, socio-economic status (SES) and body mass index (BMI). We analysed 610 diabetes patients. A total of 63 patients (10.3%) had comorbid COPD. The presence of COPD was not significantly associated with the longitudinal development of HbA1C (P=0.54) or SBP (P=0.33), but subgroup effect analyses showed significant effect modification by SES (P<0.01) and BMI (P=0.03) on SBP. Diabetes patients without COPD had a flat SBP trend over time, with higher values in patients with a high BMI. For diabetes patients with COPD, SBP gradually increased over time in the middle- and high-SES groups, and it decreased over time in those in the low-SES group. The longitudinal development of HbA1C was not significantly associated with comorbid COPD in diabetes patients. The course of SBP in diabetes patients with COPD is significantly associated with SES (not BMI) in contrast to those without COPD. Comorbid COPD was associated with longitudinal diabetes control parameters, but it has complex interactions with other patient characteristics. Further research is needed.

Socioeconomic inequalities in smoking in The Netherlands before and during the Global Financial Crisis: a repeated cross-sectional study.

PubMed

Benson, Fiona E; Kuipers, Mirte A G; Nierkens, Vera; Bruggink, Jan-Willem; Stronks, Karien; Kunst, Anton E

2015-05-06

The Global Financial Crisis (GFC) increased levels of financial strain, especially in those of low socioeconomic status (SES). Financial strain can affect smoking behaviour. This study examines socioeconomic inequalities in current smoking and smoking cessation in The Netherlands before and during the Global Financial Crisis (GFC). Participants were 66,960 Dutch adults (≥ 18 years) who took part in the annual national Health Survey (2004-2011). Period was dichotomised: 'pre-' and 'during-GFC'. SES measures used were income, education and neighbourhood deprivation. Outcomes were current smoking rates (smokers/total population) and smoking cessation ratios (former smokers/ever smokers). Multilevel logistic regression models controlled for individual characteristics and tested for interaction between period and SES. In both periods, high SES respondents (in all indicators) had lower current smoking levels and higher cessation ratios than those of middle or low SES. Inequalities in current smoking increased significantly in poorly educated adults of 45-64 years of age (Odds Ratio (OR) low educational level compared with high: 2.00[1.79-2.23] compared to pre-GFC 1.67[1.50-1.86], p for interaction = 0.02). Smoking cessation inequalities by income in 18-30 year olds increased with borderline significance during the GFC (OR low income compared to high income: 0.73[0.58-0.91]) compared to pre-GFC (OR: 0.98[0.80-1.20]), p for interaction = 0.051). Overall, socioeconomic inequalities in current smoking and smoking cessation were unchanged during the GFC. However, current smoking inequalities by education, and smoking cessation inequalities by income, increased in specific age groups. Increased financial strain caused by the crisis may disproportionately affect smoking behaviour in some disadvantaged groups.

Educational attainment, gender and health inequalities among older adults in Catalonia (Spain).

PubMed

Solé-Auró, Aïda; Alcañiz, Manuela

2016-08-04

Health expectancies vary worldwide according to socioeconomic status (SES), with health disadvantages being evident among lower SES groups. Using educational attainment as a proxy of SES, we seek to identify trends in SES differentials in health by gender, with a particular focus on individuals with low educational attainment in the adult Catalan population (Spain) aged 55 or older. Using cross-sectional data for 1994 and 2010-2014 drawn from the Catalan Health Survey, we examined three health indicators to document social health inequalities: self-perceived health, functional limitations, and restrictions on activities of daily living (ADL). We applied logistic models for each indicator, controlling for sociodemographic characteristics, health coverage and health behaviours. Among the less-educated, females presented a greater improvement in their self-perceived health over time than did their male counterparts, there being no significant variations among the medium/high educated. Regardless of education, males showed an increase in the prevalence of functional problems (as did the women, but the increase was not statistically significant). Both genders presented a higher prevalence of limitations when performing ADL in the second time period. The gender health gap was reduced slightly both for the low and the medium/high educated, expect in the case of ADL restrictions. Health and functioning differences by education level persisted, but showed significant signs of reduction. Less-educated females constitute the most disadvantaged group in terms of health and personal autonomy, though there are encouraging signs that the gap is closing both in terms of gender and level of education. Health policymakers need to devote particular attention to the aging population with low SES, especially to women. Public programmes promoting greater protection and equity, while fostering preventive and healthy practices, need to target the most underprivileged.

Racial/Ethnic, socioeconomic, and geographic disparities of cervical cancer advanced-stage diagnosis in Texas.

PubMed

Zhan, F Benjamin; Lin, Yan

2014-01-01

Advanced-stage diagnosis is among the primary causes of mortality among cervical cancer patients. With the wide use of Pap smear screening, cervical cancer advanced-stage diagnosis rates have decreased. However, disparities of advanced-stage diagnosis persist among different population groups. A challenging task in cervical cancer disparity reduction is to identify where underserved population groups are. Based on cervical cancer incidence data between 1995 and 2008, this study investigated advanced-stage cervical cancer disparities in Texas from three social domains: Race/ethnicity, socioeconomic status (SES), and geographic location. Effects of individual and contextual factors, including age, tumor grade, race/ethnicity, as well as contextual SES, spatial access to health care, sociocultural factors, percentage of African Americans, and insurance expenditures, on these disparities were examined using multilevel logistic regressions. Significant variations by race/ethnicity and SES were found in cervical cancer advanced-stage diagnosis. We also found a decline in racial/ethnic disparities of advanced cervical cancer diagnosis rate from 1995 to 2008. However, the progress was slower among African Americans than Hispanics. Geographic disparities could be explained by age, race/ethnicity, SES, and the percentage of African Americans in a census tract. Our findings have important implications for developing effective cervical cancer screening and control programs. We identified the location of underserved populations who need the most assistance with cervical cancer screening. Cervical cancer intervention programs should target Hispanics and African Americans, as well as individuals from communities with lower SES in geographic areas where higher advanced-stage diagnosis rates were identified in this study. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Social distribution of internal exposure to environmental pollution in Flemish adolescents.

PubMed

Morrens, Bert; Bruckers, Liesbeth; Hond, Elly Den; Nelen, Vera; Schoeters, Greet; Baeyens, Willy; Van Larebeke, Nicolas; Keune, Hans; Bilau, Maaike; Loots, Ilse

2012-07-01

Environmental justice research suggests that inequalities in the distribution of environmental exposure to chemical pollution systematically disadvantage the lower social strata of society. The effects of these inequalities on the human exposure to pollution are however to a large extend unknown. The purpose of this study is to assess social gradients in human biomonitoring results of a representative sample of Flemish adolescents. We investigate the associations between individual socioeconomic status (SES), measured by parental educational attainments, and internal body concentration of seven chemical compounds in biological samples of 1642 adolescents aged 14-15 in Flanders (Belgium): PCBs, HCB, DDE, lead, cadmium, benzene and PAHs. Social gradients in average and high exposure to these biomarkers were examined with geometric means and odds ratios (with 95% confidence intervals), using multiple regression models, controlling for covariates and confounders. Depending on the (type of) pollutant, adolescents with a lower SES either have higher or lower internal concentrations. Chlorinated compounds (PCBs and pesticides HCB and DDE) are positively associated with SES (higher exposures for higher SES), while heavy metals (lead and cadmium) are negatively associated (higher exposures for lower SES). For metabolites of organic compounds (benzene and PAHs) we find no association with SES. Socially constructed factors, such as dietary and lifestyle habits, play an important role in these relations. Our study suggests that the association between individual SES and the internal body concentration of exposure to environmental pollutants in Flemish adolescents is more complex than can be assumed on the basis of the environmental justice hypothesis. Copyright © 2011 Elsevier GmbH. All rights reserved.

Socioeconomic status, psychological resources, and inflammatory markers: Results from the MIDUS Study

PubMed Central

Elliot, Ari J.; Chapman, Benjamin P.

2016-01-01

Objective To investigate interactions of psychological resources and socioeconomic status in predicting markers of systemic inflammation, as well as potential gender differences and the explanatory role of childhood and adult stress exposures, health behaviors, and negative and positive affect. Method We utilized a sample of adults from the Midlife in the United States Survey (MIDUS) who provided biomarker data (N=1,152). SES was operationalized as a composite of education, income, and occupational prestige, and psychological resources as a latent factor measured with optimism, perceived control, and self-esteem. Linear regression models examined these two factors and their interaction in predicting interleukin-6 (IL-6) and C-reactive protein (CRP) measured on average 2 years later, as well as three-way interactions involving gender and the impact of covariate adjustment. Results Psychological resources interacted with SES in men (for IL-6: p<.001; for CRP: p=.04) but not in women. In men, greater psychological resources were associated with lower concentrations of IL-6 at lower levels of SES, but higher concentrations of both markers at higher levels of SES. The inverse association between resources and IL-6 at low SES was moderately attenuated upon adjustment for negative affect. Conclusion Socioeconomic status might modulate the linkage between psychological resources and systemic inflammation in men. At lower levels of SES, resources may be related to lower inflammation in part through lower negative affect. Associations with higher inflammation at higher SES add to growing evidence suggesting that adaptive psychological characteristics may be associated with markers of poorer physiological function under certain conditions. PMID:27280368

Childhood Socioeconomic Disadvantage and Pre-diabetes and Diabetes in Later Life: A Study of Biopsychosocial Pathways

PubMed Central

Tsenkova, Vera; Pudrovska, Tetyana; Karlamangla, Arun

2014-01-01

Objective We examined the relationship between childhood socioeconomic status (SES) and glucoregulation in later life and used a life-course framework to examine critical periods and underlying pathways. Methods Data came from the MIDUS (Midlife in the U.S.) national study (n=895). Childhood SES indicators retrospectively reported at MIDUS I were used to create a childhood SES disadvantage index. Adult SES disadvantage and potential pathways were measured at MIDUS I and included waist circumference, depressive symptoms, and physical activity. Glucose and HbA1c, measured approximately 9-10 years later at MIDUS II, were used to create the ordinal outcome measure (no diabetes/prediabetes/diabetes). Results Childhood SES disadvantage predicted increased odds of prediabetes and diabetes net of age, gender, race, and smoking (OR=1.11, 95% CI: 1.01-1.22). Childhood SES disadvantage predicted adult SES disadvantage (β=.26, p=.001) and the three key mediators: higher waist circumference (β=.10, p=.002), lower physical activity (β=−.11, p=.001), and marginally higher depressive symptoms (β=.07, p=.072). When childhood and adult SES disadvantage were in the same model, only adult SES predicted glucoregulation (OR=1.07, 95% CI: 1.01-1.13). The SES disadvantage measures were no longer significantly associated with glucoregulation after including waist circumference, physical activity, and depressive symptoms, all of which were significant predictors of glucoregulation. Conclusions The consequences of childhood SES disadvantage are complex and include both critical period and pathway effects. The lack of a direct effect of childhood SES on glucoregulation does not negate the importance of early environment but suggests that early-life socioeconomic factors propel unequal life-course trajectories that ultimately influence health. PMID:25272201

Gender differences in the relationship between socioeconomic status and height loss among the elderly in South Korea: Korean National Health and Nutrition Examination Survey 2008-2010.

PubMed

Kim, Yang-Hyun; Ahn, Kyung-Sik; Cho, Kyung-Hwan; Kang, Chang Ho; Cho, Sung Bum; Han, Kyungdo; Rho, Yong-Kyun; Park, Yong-Gyu

2017-08-01

This study aimed to examine average height loss and the relationship between height loss and socioeconomic status (SES) among the elderly in South Korea.Data were obtained from the Korean National Health and Nutrition Examination Survey 2008-2010. A total of 5265 subjects (2818 men and 2447 women) were included. Height loss was calculated as the difference between the subject's self-reported maximum adult height and their measured current height. The height loss values were divided into quartiles (Q1-Q4) for men and women. SES was determined using a self-reported questionnaire for education level, family income, and occupation.Height loss was associated with SES in all age groups, and mean height loss increased with age. In the relationship between education level and maximum height loss (Q4), men with ≤6, 7-9, or 10-12 years of education had higher odds ratios for the prevalence of height loss (Q4) than men with the highest education level (≥13 years). With regard to the relationship between the income level and height loss (Q4), the subjects with the lowest income had an increased prevalence of maximum height loss (Q4) than the subjects with the highest income (odds ratios = 2.03 in men and 1.94 in women). Maximum height loss (Q4) was more prevalent in men and women with a low SES and less prevalent in men with a high SES than in men with a middle SES.Height loss (Q4) was associated with education level in men and with income level (especially low income) in men and women. Height loss was also associated with a low SES in men and women.

Socioeconomic disparities in outcomes after acute myocardial infarction.

PubMed

Bernheim, Susannah M; Spertus, John A; Reid, Kimberly J; Bradley, Elizabeth H; Desai, Rani A; Peterson, Eric D; Rathore, Saif S; Normand, Sharon-Lise T; Jones, Philip G; Rahimi, Ali; Krumholz, Harlan M

2007-02-01

Patients of low socioeconomic status (SES) have higher mortality after acute myocardial infarction (AMI). Little is known about the underlying mechanisms or the relationship between SES and rehospitalization after AMI. We analyzed data from the PREMIER observational study, which included 2142 patients hospitalized with AMI from 18 US hospitals. Socioeconomic status was measured by self-reported household income and education level. Sequential multivariable modeling assessed the relationship of socioeconomic factors with 1-year all-cause mortality and all-cause rehospitalization after adjustment for demographics, clinical factors, and quality-of-care measures. Both household income and education level were associated with higher risk of mortality (hazard ratio 2.80, 95% CI 1.37-5.72, lowest to highest income group) and rehospitalization after AMI (hazard ratio 1.55, 95% CI 1.17-2.05). Patients with low SES had worse clinical status at admission and received poorer quality of care. In multivariable modeling, the relationship between household income and mortality was attenuated by adjustment for demographic and clinical factors (hazard ratio 1.19, 95% CI 0.54-2.62), with a further small decrement in the hazard ratio after adjustment for quality of care. The relationship between income and rehospitalization was only partly attenuated by demographic and clinical factors (hazard ratio 1.38, 95% CI 1.01-1.89) and was not influenced by adjustment for quality of care. Patients' baseline clinical status largely explained the relationship between SES and mortality, but not rehospitalization, among patients with AMI.

Early life risk exposure and stunting in urban South African 2-year old children.

PubMed

Slemming, W; Kagura, J; Saloojee, H; Richter, L M

2017-06-01

Stunting is a measure of overall nutritional status and is a major public health concern because of its association with child mortality and morbidity and later adult performance. This study examined the effects of pregnancy events, birth characteristics and infant risk exposure on stunting at age 2 years. The study, established in 1990 in Soweto, an urban South African township, included 1098 mother-infant pairs enroled in the Birth to Twenty Plus longitudinal birth cohort study. In total, 22% of children were stunted at age 2 years, with males at greater risk than females [24.8 v. 19.4%, odds ratio (OR)=1.38; 95% confidence interval (CI): 1.03, 1.83]. In unadjusted analysis, male sex, household socio-economic status (SES), overcrowding, maternal age, maternal education, single motherhood, ethnicity, birth weight, gestational age and duration of infant breastfeeding were all significantly associated with stunting. In multivariable analysis, higher birth weight was protective against stunting for both sexes. Higher maternal education was protective for females only (adjusted odds ratio (AOR)=0.35; 95% CI: 0.14, 0.87), whereas wealthier household SES protected males (AOR for richest SES group=0.39; 95% CI: 0.16, 0.92). In this and other similar settings, current stunting prevention efforts focussing on primarily providing targeted proximal interventions, such as food supplements, risk undermining the critical importance of addressing key distal determinants of stunting such as SES and maternal education.

Equity in access to health care among asylum seekers in Germany: evidence from an exploratory population-based cross-sectional study.

PubMed

Bozorgmehr, Kayvan; Schneider, Christine; Joos, Stefanie

2015-11-09

Research on inequities in access to health care among asylum-seekers has focused on disparities between asylum-seekers and resident populations, but little attention has been paid to potential inequities in access to care within the group of asylum-seekers. We aimed to analyse the principles of horizontal equity (i.e., equal access for equal need irrespective of socioeconomic status, SES) and vertical equity (higher allocation of resources to those with higher need) among asylum-seekers in Germany. We performed a secondary exploratory analysis on cross-sectional data obtained from a population-based questionnaire survey among all asylum-seekers (aged 18 or above) registered in three administrative districts in Germany during the three-month study period (N = 1017). Data were collected on health care access (health care utilisation of four types of services and unmet medical need), health care need (approximated by sex, age and self-rated health status), and SES (highest educational attainment and subjective social status, SSS). We calculated odds ratios and 95% confidence intervals (CI) in multiple logistic regression models to analyse associations between SES indicators and access to health care under control of need. We contacted 60.4% (614) of the total asylum-seekers population, of which 25.4% (N = 156) participated in the study. Educational attainment showed no significant effect on health care access in crude models, but was positively associated with utilisation of psychotherapists and hospital admissions in adjusted models. Higher SSS was positively associated with health care utilisation of all types of services. The odds of hospitals admissions for asylum-seekers in the medium and highest SSS category were 3.18 times [1.06, 9.59] and 1.6 times [0.49, 5.23] the odds of those in the lowest SSS category. After controlling for need variables none of the SES indicators were significantly associated with measures of access to care, but a positive association remained, indicating higher utilisation of health care among asylum-seekers with higher SES. Age, sex or general health status were the only significant predictors of health care utilisation in fully adjusted models. The adjusted odds of reporting unmet medical needs among asylum-seekers with "fair/bad/very bad" health status were 2.16 times [0.84, 5.59] the odds of those with "good/very good" health status. Our findings revealed that utilisation of health services among asylum-seekers is associated with higher need (vertical equity met). Horizontal equity was met with respect to educational attainment for most outcomes, but a social gradient in health care utilisation was observed across SSS. Further confirmatory research is needed, especially on potential inequities in unmet medical need and on measurements of SES among asylum-seekers.

Tobacco use, smoking quit rates, and socioeconomic patterning among men and women: a cross-sectional survey in rural Andhra Pradesh, India.

PubMed

Corsi, Daniel J; Subramanian, S V; Lear, Scott A; Teo, Koon K; Boyle, Michael H; Raju, P Krishnam; Joshi, Rohina; Neal, Bruce; Chow, Clara K

2014-10-01

Tobacco use is common in India and a majority of users are in rural areas. We examine tobacco use and smoking quit rates along gender and socioeconomic dimensions in rural Andhra Pradesh. Data come from a cross-sectional survey. Markers of socioeconomic status (SES) were education, occupation, and income. Regression analyses were undertaken to examine determinants of current smoking, smoking quit rates, tobacco use by type (cigarettes, bidis, and chewing), and quantity consumed (number per day, pack-years). The weighted prevalence of current smoking and tobacco chewing was higher in men (50.3%, 95% confidence interval, CI, 48.1-52.6 and 5.0%, 95% CI 4.1-5.9, respectively) compared with women (4.8%, 95% CI 3.9-5.7 and 1.0%, 95% CI 0.6-1.4, respectively) and higher among older age groups. The quit rate was higher in women (45.5%, 95% CI 38.7-52.2) compared to men (18.8%, 95% CI 16.7-20.9). Illiterate individuals were more likely to be current smokers of any type compared to those with secondary/higher education (odds ratio, OR, 3.25, 95% CI 2.54-4.16), although cigarette smoking was higher in men of high SES. Smoking quit rates were positively associated with SES (OR 2.56, 95% CI 1.76-3.71) for secondary/higher education vs. illiterates. Level of consumption increased with SES and those with secondary/higher education smoked an additional 1.93 (95% CI 1.08-2.77) cigarettes or bidis per day and had an additional 1.87 (95% CI 0.57-3.17) pack-years vs. illiterates. The social gradients in cigarette smoking and level of consumption contrasted those for indigenous forms of tobacco (bidi smoking and chewing). International prevention and cessation initiatives designed at modifying Western-style cigarette usage will need to be tailored to the social context of rural Andhra Pradesh to effectively influence the use of cigarettes and equally harmful indigenous forms of tobacco. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

Do socio-economic factors influence supermarket content and shoppers' purchases?

PubMed

Vinkeles Melchers, Natalie V S; Gomez, Maria; Colagiuri, Ruth

2009-12-01

Obesity is at crisis proportions. Individuals of low socio-economic status (SES) are more likely to consume higher energy dense diets than their high socio-economic status counterparts. The contribution of supermarket purchases of energy dense, nutrient poor foods has not been well-researched and has largely depended on unverified self-report. We estimated the proportion of supermarket shelf space dedicated to non-core foods in nine supermarkets (in five high and four low SES areas) in metropolitan Sydney. We analysed 204 shoppers' dockets (102 from high and 102 from low SES areas) for purchases of confectionery; sugar sweetened, carbonated beverages and cordials, sweet biscuits and cakes, and crisps and popcorn. After adjusting for the number of people shopped for, low SES shoppers purchased significantly more non-core foods than high SES shoppers (p=0.039), especially chips and sugar sweetened, carbonated beverages and cordials. There was no difference in the shelf space dedicated to non-core foods, or between non-core foods purchased and the proportion of shelf space occupied by them in either low or high SES areas. Increased purchase of non-core foods by low SES shoppers who are already at higher risk of obesity than high SES shoppers is cause for concern. Further research is required to explore underlying reasons for this association.

Can Parenting Practices Explain the Differences in Beverage Intake According to Socio-Economic Status: The Toybox-Study

PubMed Central

Pinket, An-Sofie; De Craemer, Marieke; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Cardon, Greet; Androutsos, Odysseas; Koletzko, Berthold; Moreno, Luis A.; Socha, Piotr; Iotova, Violeta; Manios, Yannis; Van Lippevelde, Wendy

2016-01-01

Previous research indicated that preschoolers of lower socioeconomic status (SES) consume less healthy beverages than high SES preschoolers. The purpose of this study is to investigate the mediating role of parenting practices in the relationship between SES and plain water, soft drink and prepacked fruit juice (FJ) consumption in European preschoolers. Parents/caregivers of 3.5 to 5.5 years old (n = 6776) recruited through kindergartens in six European countries within the ToyBox-study completed questionnaires on socio-demographics, parenting practices and a food frequency questionnaire. Availability of sugared beverages and plain water, permissiveness towards sugared beverages and lack of self-efficacy showed a mediating effect on SES-differences in all three beverages. Rewarding with sugared beverages significantly mediated SES-differences for both plain water and prepacked FJ. Encouragement to drink plain water and awareness significantly mediated SES-differences for, respectively, plain water and prepacked FJ consumption. Avoiding negative modelling did not mediate any associations. Overall, lower SES preschoolers were more likely to be confronted with lower levels of favourable and higher levels of unfavourable parenting practices, which may lead to higher sugared beverage and lower plain water consumption. The current study highlights the importance of parenting practices in explaining the relation between SES and both healthy and unhealthy beverage consumption. PMID:27669290

A pilot assessment of relapse prevention for heroin addicts in a Chinese rehabilitation center.

PubMed

Min, Zhao; Xu, Li; Chen, Hanhui; Ding, Xu; Yi, Zhang; Mingyuang, Zhang

2011-05-01

To conduct a pilot assessment of relapse prevention (RP) group therapy for heroin-dependent patients in a drug rehabilitation center in China. A randomized case-control study was conducted to assess the efficacy of RP delivered over a 2-month period to male heroin addicts (n = 50, RP group) in the Shanghai Labor Drug Rehabilitation Center (LDRC) compared with an equal number of participants (n = 50, labor rehabilitation (LR) group) in the LDRC program receiving standard-of-care treatment. Outcomes were assessed by the Beck Depression Inventory (BDI), the Self-Rating Anxiety Scale (SAS), the Self-Efficacy Scale (SE), and the Self-Esteem Scale (SES) after completion of RP, and by the Addiction Severity Index (ASI) and abstinence rates of heroin use at 3-month follow-up post release from the LDRC for both groups. Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%). An RP component can be effective in increasing abstinence rates among post-program heroin-dependent individuals and may help reduce anxiety and improve self-esteem and self-efficacy during and following treatment. This study suggests RP as a potentially effective component of treatment for heroin addicts.

Socioeconomic status, youth's eating patterns and meals consumed away from home.

PubMed

Hejazi, N; Mazloom, Z

2009-05-01

This study was design to determine whether there is a difference in the number of meals consumed away from home (restaurant or fast food) between low socioeconomic status (SES) and high SES adolescents. Additionally, this study sought to determine if the nutrients and food group chosen differs among children who consume meals away from home versus those who do not. Eighty four adolescences (51 boys and 33 girls) ages 12-16 years and their parents from Shiraz, Iran completed the three 24 h diet recalls (one weekend and two week days). The demographics questionnaire was also completed from each participant. Data analyzed using SPSS and hypothesis tested using one way ANOVA. There was no significant difference in the number of meals consumed away from home in low SES adolescents compared to high SES (p = 0.464). However, those who consumed meals away from home reported a higher percentage of calories from fat (p = 0.007) and serving of fried vegetables (p = 0.010) compared to those who consumed no meals away from home. These findings suggest that intervention for adolescents eating patterns should provide information on choosing healthy meals away from home.

Nutritional and socioeconomic status in cognitive development of Santal children of Purulia district, India.

PubMed

Chowdhury, Sutanu Dutta; Ghosh, Tusharkanti

2011-03-01

Cognitive development of children depends on nutritional and socioeconomic factors. The objectives of the present study were to assess the cognitive development and to investigate the relationship of nutritional and socioeconomic status (SES) to cognitive development in 5-12 year old Santal children of Purulia district of West Bengal, India. The nutritional status of each child was assessed by z-score of height-for-age, weight-for-height and weight-for-age parameters. SES was measured using the updated Kuppusswami scale. Cognitive development was measured by Raven's Coloured Progressive Matrices (RCPM). The growth curve of RCPM scores of Santal children remained around the 5(th) percentile values of British children. The RCPM scores of the adequately nourished children and upper-lower SES were significantly higher (p < 0.05) than the children with lower SES and nutritional status. About 42.96% and 27.69% of Santal children were found to be in the intellectually deficient and below average groups, respectively. RCPM scores of Santal children were significantly correlated with nutritional status and socioeconomic factors (p < 0.01). The surveyed children showed poor cognitive functions. The vulnerable nutritional and socioeconomic statuses of Santal children are the major causes for their poor cognitive development.

Media use and communication inequalities in a public health emergency: a case study of 2009-2010 pandemic influenza A virus subtype H1N1.

PubMed

Lin, Leesa; Jung, Minsoo; McCloud, Rachel F; Viswanath, Kasisomayajula

2014-01-01

Studies have shown that differences among individuals and social groups in accessing and using information on health and specific threats have an impact on their knowledge and behaviors. These differences, characterized as communication inequalities, may hamper the strength of a society's response to a public health emergency. Such inequalities not only make vulnerable populations subject to a disproportionate burden of adversity, but also compromise the public health system's efforts to prevent and respond to pandemic influenza outbreaks. We investigated the effect of socioeconomic status (SES) and health communication behaviors (including barriers) on people's knowledge and misconceptions about pandemic influenza A(H1N1) (pH1N1) and adoption of prevention behaviors. The data for this study came from a survey of 1,569 respondents drawn from a nationally representative sample of American adults during pH1N1. We conducted logistic regression analyses when appropriate. We found that (1) SES has a significant association with barriers to information access and processing, levels of pH1N1-related knowledge, and misconceptions; (2) levels of pH1N1-related knowledge are associated positively with the adoption of recommended prevention measures and negatively with the adoption of incorrect protective behaviors; and (3) people with higher SES, higher news exposure, and higher levels of pH1N1-related knowledge, as well as those who actively seek information, are less likely than their counterparts to adopt incorrect prevention behaviors. Strategic public health communication efforts in public health preparedness and during emergencies should take into account potential communication inequalities and develop campaigns that reach across different social groups.

Socioeconomic Disparities Affect Prefrontal Function in Children

ERIC Educational Resources Information Center

Kishiyama, Mark M.; Boyce, W. Thomas; Jimenez, Amy M.; Perry, Lee M.; Knight, Robert T.

2009-01-01

Social inequalities have profound effects on the physical and mental health of children. Children from low socioeconomic status (SES) backgrounds perform below children from higher SES backgrounds on tests of intelligence and academic achievement, and recent findings indicate that low SES (LSES) children are impaired on behavioral measures of…

Socioeconomic Status, Parenting, and Child Development.

ERIC Educational Resources Information Center

Bornstein, Marc H., Ed.; Bradley, Robert H., Ed.

Noting that there is near universal agreement that children from families with higher socioeconomic status (SES) have access to more of the resources needed to support their positive development than do lower SES children, this monograph examines the myriad questions remaining regarding relations among SES, parenting, and child development from a…

Parental concerns, socioeconomic status, and the risk of autism spectrum conditions in a population-based study.

PubMed

Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Baron-Cohen, Simon; Brayne, Carol

2014-12-01

A total number of 11,635 screening packs were distributed to 5-10 year-old children in 136 schools in Cambridgeshire to investigate the associations between levels of parental concern (none/minor/strong), socioeconomic status and the risk of having Autism Spectrum Conditions (ASC). The variables for investigating associations and possible confounders were extracted for analysis, including parental concern question score, SES, age of the child, sex, maternal age at birth, paternal age at birth, mother's age of leaving education, father's age of leaving education, birth order and the number of children in the family. The SES, age of the child, sex and mother's age at leaving education were associated with parental concern. Parents with higher SES reported higher levels of concern (Chi-square = 11.8; p = 0.02). However, a higher SES was not associated with the risk of having ASC (p = 0.50). After adjusting for potential confounders, the odds of children meeting ASC criteria whose parents had reported strong parental concern were 8.5 times (odds ratio: 8.5; 95%CI: 4.5, 16.2; p < 0.001) the odds of children having ASC whose parents reported minor concern. No child met ASC criteria where parents expressed no concerns. Parents with higher social class express more concerns than those from lower social classes. However, the concerns reported by parents in higher SES did not appear to be specific for ASC as there was no relationship between ASC and SES. Copyright © 2014 Elsevier Ltd. All rights reserved.

Poverty, Race, and CKD in a Racially and Socioeconomically Diverse Urban Population

PubMed Central

Crews, Deidra C.; Charles, Raquel F.; Evans, Michele K.; Zonderman, Alan B.; Powe, Neil R.

2010-01-01

Background Low socioeconomic status (SES) and African American race are both independently associated with end-stage renal disease and progressive chronic kidney disease (CKD), however, despite their frequent co-occurrence, the effect of low SES independent of race has not been well-studied in CKD. Study Design Cross-sectional study. Setting & Participants 2,375 community-dwelling adults age 30-64 years residing within 12 neighborhoods selected for both socioeconomic and racial diversity in Baltimore City, Maryland. Predictors Low SES [self-reported household income <125% of 2004 Department of Health and Human Services guideline], higher SES (≥125% of guideline); white and African American race. Outcomes & Measurements CKD defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Logistic regression used to calculate odds ratios (OR) for relationship between poverty and CKD, stratified by race. Results Of 2,375 participants; 955 were white (347 low SES and 608 higher SES); 1,420 were African American (713 low SES and 707 higher SES). A total of 146 (6.2%) participants had CKD. Overall, race was not associated with CKD [OR, 1.05; 95% confidence interval (CI), 0.57-1.96]; however, African Americans had a much greater odds of advanced CKD (eGFR <30 mL/min/1.73 m2). Low SES was independently associated with 59% greater odds of CKD after adjustment for demographics, insurance status and comorbid disease (OR, 1.59; 95% CI, 1.27-1.99). However, when stratified by race, low SES was associated with CKD in African Americans (OR, 1.91; 95% CI, 1.54-2.38), but not in whites (OR, 0.95; 95% CI, 0.58-1.55; P for interaction, 0.003). Limitations Cross-sectional design; findings may not be generalizable to non-urban populations. Conclusions Low SES has a profound relationship with CKD in African Americans but not in whites in an urban population of adults, and its role in the racial disparities seen in CKD is worthy of further investigation. PMID:20207457

Socioeconomic Factors for Sports Specialization and Injury in Youth Athletes.

PubMed

Jayanthi, Neeru A; Holt, Daniel B; LaBella, Cynthia R; Dugas, Lara R

The effect of socioeconomic status (SES) on rates of sports specialization and injury among youth athletes has not been described previously. Young athletes from lower socioeconomic status will have lower rates of sports specialization and subsequently lower risk of overuse injuries. Cohort study. Level 3. Injured athletes aged 7 to 18 years were recruited from 2 hospital-based sports medicine clinics and compared with uninjured athletes presenting for sports physicals at primary care clinics between 2010 and 2013. Participants completed surveys on training patterns. Electronic medical records provided injury details as well as patient zip code, race, and health insurance type. SES was estimated from zip codes. The sample was divided into SES tertiles. Analysis of variance and multivariate regression were used for continuous variables, and multivariate logistic regression analyses were conducted to explore relationships between risk factors and injury. Of 1190 athletes surveyed, 1139 (96%) had satisfactory SES data. Compared with low-SES athletes, high-SES athletes reported more hours per week spent playing organized sports (11.2 ± 6.0 vs 10.0 ± 6.5; P = 0.02), trained more months per year in their main sport (9.7 ± 3.1 vs 7.6 ± 3.7; P < 0.01), were more often highly specialized (38.9% vs 16.6%; P < 0.01), and had increased participation in individual sports (64.8% vs 40.0%; P < 0.01). The proportion of athletes with a greater than 2:1 ratio of weekly hours in organized sports to free play increased with SES. Accounting for age and weekly organized sports hours, the odds of reporting a serious overuse injury increased with SES (odds ratio, 1.5; P < 0.01). High-SES athletes reported more serious overuse injuries than low-SES athletes, potentially due to higher rates of sports specialization, more hours per week playing organized sports, higher ratio of weekly hours in organized sports to free play, and greater participation in individual sports. As SES increases, young athletes report higher degrees of sports specialization, greater participation in individual sports, and more serious overuse injuries.

A population-based analysis of use and outcomes of laparoscopic bariatric surgery across socioeconomic groups in Taiwan.

PubMed

Huang, Chun-Che; Huang, Yu-Tung; Chiu, Chong-Chi

2015-11-11

With the growing development of minimally invasive techniques for the treatment of morbid obesity, laparoscopic bariatric surgery (LBS) is increasingly performed. This study aimed to assess the association between patients' socioeconomic status (SES) and the likelihood of undergoing LBS and related outcomes in Taiwan. This nationwide population-based study was conducted by using data from Taiwan's National Health Insurance Research Database. A total of 3678 morbidly obese patients aged 18 years and older who underwent conventional open bariatric surgery or LBS were identified between 2004 and 2011. Regression analyses were performed using generalized estimating equation (GEE) models to account for the nesting of patients within physician to assess patients' SES category associated with the use of LBS and related outcomes. Odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated. Compared with those with medium and low SES (84.6 % and 80.2 %), patients with high SES (88.1 %) had the highest percentage of undergoing LBS (P < 0.001). After adjusting for patient demographics, institution and surgeon characteristics, the multivariate GEE analysis revealed that the highest likelihood of undergoing LBS was noted in morbidly obese patients with high SES (OR = 1.45, 95 % CI 1.10-1.90), followed by those with medium SES (OR = 1.27, 95 % CI 1.04-1.56). In addition, patients with high SES had slightly lower length of hospital stay (LOS; OR = 0.90, 95 % CI 0.82-0.99) and hospital treatment cost (OR = 0.93, 95 % CI 0.87-0.99) than their counterparts after adjustment. The increased likelihood of undergoing LBS and lower LOS and hospital treatment cost were noted among morbidly obese patients with higher SES. This finding suggests there is the need to improve clinical practice and reduce health disparities in the surgical treatment of morbidly obese patients.

The influence of individual socioeconomic status on the clinical outcomes in ischemic stroke patients with different neighborhood status in Shanghai, China

PubMed Central

Yan, Han; Liu, Baoxin; Meng, Guilin; Shang, Bo; Jie, Qiqiang; Wei, Yidong; Liu, Xueyuan

2017-01-01

Objective: Socioeconomic status (SES) is being recognized as an important factor in both social and medical problems. The aim of present study is to examine the relationship between SES and ischemic stroke and investigate whether SES is a predictor of clinical outcomes among patients with different neighborhood status from Shanghai, China. Methods: A total of 471 first-ever ischemic stroke patients aged 18-80 years were enrolled in this retrospective study. The personal SES of each patient was evaluated using a summed score derived from his or her educational level, household income, occupation, and medical reimbursement rate. Clinical adverse events and all-cause mortality were analyzed to determine whether SES was a prognostic factor, its prognostic impact was then assessed based on different neighborhood status using multivariable Cox proportional hazard models after adjusting for other covariates. Results: The individual SES showed a significant positive correlation with neighborhood status (r = 0.370; P < 0.001). The incidence of clinical adverse events and mortality were significantly higher in low SES patients compared with middle and high SES patients (P = 0.001 and P = 0.037, respectively). After adjusting other risk factors and neighborhood status, Kaplan-Meier analysis showed clinical adverse events and deaths were still higher in the low SES patients (all P < 0.05). Multivariate Cox regression analysis demonstrated that both personal SES and neighborhood status are independent prognostic factors for ischemic stroke (all P < 0.05). Besides, among patients with low and middle neighborhood status, lower individual SES was significantly associated with clinical adverse events and mortality (all P < 0.05). Conclusion: Both individual SES and neighborhood status are significantly associated with the prognosis after ischemic stroke. A lower personal SES as well as poorer neighborhood status may significantly increase risk for adverse clinical outcomes among ischemic stroke patients. PMID:28138313

Learning Ability, Socioeconomic Status, and Student Placement for Undergraduate Studies in Israel

ERIC Educational Resources Information Center

Dar, Yechezkel; Getz, Shlomo

2007-01-01

Choice of institution and field of study for a bachelor's degree in Israel was found essentially meritocratic although influenced by socioeconomic status (SES) as well. As expected, students of higher ability attend universities and those of lower apply to academic colleges. However, among students of higher ability, those of higher SES opt for…

THE VARIED INFLUENCE OF SES ON ENVIRONMENTAL CONCERN

PubMed Central

Pampel, Fred C.

2013-01-01

Objective Cross-national studies have found positive relationships of socioeconomic status (SES) with environmental concern at the individual level but have not systematically examined how the relationships may differ across nations. Such comparisons have relevance to identifying the generality of theories of postmaterialism, affluence, and global environmentalism. Methods This study specifies how the individual-level influence of SES varies across national contexts and tests predictions using four waves of the World Values Survey on up to 96 nations. Results The results show that SES is associated only weakly with environmental concern in lower income nations with poor environmental conditions but is associated strongly and positively in higher income nations with better environmental conditions. Conclusion SES has a contingent relationship with environmental concern such that the global environmentalism theory receives support for lower income nations, while the postmaterialism and affluence theories receive support for higher income nations. PMID:24678128

The Impact of Educational Attainment on Observed Race/Ethnic Disparities in Inflammatory Risk in the 2001–2008 National Health and Nutrition Examination Survey

PubMed Central

Dinwiddie, Gniesha Y.; Zambrana, Ruth E.; Doamekpor, Lauren A.; Lopez, Lenny

2015-01-01

Inflammation has shown to be an independent predictor of cardiovascular disease (CVD) and growing evidence suggests Non-Hispanic Blacks (NHBs) and certain Hispanic subgroups have higher inflammation burden compared to Non-Hispanic Whites (NHWs). Socioeconomic status (SES) is a hypothesized pathway that may account for the higher inflammation burden for race/ethnic groups yet little is known about the biological processes by which SES “gets under the skin” to affect health and whether income and education have similar or distinct influences on elevated inflammation levels. The current study examines SES (income and education) associations with multiple levels of C-Reactive Protein (CRP), an important biomarker of inflammation, in a sample of 13,362 NHWs, 7696 NHBs and 4545 Mexican Americans (MAs) in the United States from the 2001 to 2008 National Health and Nutrition Examination Survey. After adjusting for age, sex, and statin use, NHBs and MAs had higher intermediate and high CRP levels compared to NHWs. Income lessened the magnitude of the association for both race/ethnic groups. The greater intermediate and high CRP burden for NHBs and MAs was strongly explained by educational attainment. MAs were more vulnerable to high CRP levels for the lowest (i.e., less than nine years) and post high school (i.e., associates degree) educational levels. After additional adjustment for smoking, heavy drinking, high waist circumference, high blood pressure, diabetes and statin use, the strength of the association between race/ethnicity and inflammation was reduced for NHBs with elevated intermediate (RR = 1.31; p ≤ 0.001) and high CRP levels (RR = 1.14; p ≤ 0.001) compared to NHWs but the effect attenuated for MAs for both intermediate (RR = 0.74; p ≤ 0.001) and high CRP levels (RR = 0.38; p ≤ 0.001). These findings suggest educational attainment is a powerful predictor of elevated CRP levels in race/ethnic populations and challenges studies to move beyond examining income as a better predictor in the SES-inflammation pathway. PMID:26703686

The Impact of Educational Attainment on Observed Race/Ethnic Disparities in Inflammatory Risk in the 2001-2008 National Health and Nutrition Examination Survey.

PubMed

Dinwiddie, Gniesha Y; Zambrana, Ruth E; Doamekpor, Lauren A; Lopez, Lenny

2015-12-22

Inflammation has shown to be an independent predictor of cardiovascular disease (CVD) and growing evidence suggests Non-Hispanic Blacks (NHBs) and certain Hispanic subgroups have higher inflammation burden compared to Non-Hispanic Whites (NHWs). Socioeconomic status (SES) is a hypothesized pathway that may account for the higher inflammation burden for race/ethnic groups yet little is known about the biological processes by which SES "gets under the skin" to affect health and whether income and education have similar or distinct influences on elevated inflammation levels. The current study examines SES (income and education) associations with multiple levels of C-Reactive Protein (CRP), an important biomarker of inflammation, in a sample of 13,362 NHWs, 7696 NHBs and 4545 Mexican Americans (MAs) in the United States from the 2001 to 2008 National Health and Nutrition Examination Survey. After adjusting for age, sex, and statin use, NHBs and MAs had higher intermediate and high CRP levels compared to NHWs. Income lessened the magnitude of the association for both race/ethnic groups. The greater intermediate and high CRP burden for NHBs and MAs was strongly explained by educational attainment. MAs were more vulnerable to high CRP levels for the lowest (i.e., less than nine years) and post high school (i.e., associates degree) educational levels. After additional adjustment for smoking, heavy drinking, high waist circumference, high blood pressure, diabetes and statin use, the strength of the association between race/ethnicity and inflammation was reduced for NHBs with elevated intermediate (RR = 1.31; p ≤ 0.001) and high CRP levels (RR = 1.14; p ≤ 0.001) compared to NHWs but the effect attenuated for MAs for both intermediate (RR = 0.74; p ≤ 0.001) and high CRP levels (RR = 0.38; p ≤ 0.001). These findings suggest educational attainment is a powerful predictor of elevated CRP levels in race/ethnic populations and challenges studies to move beyond examining income as a better predictor in the SES-inflammation pathway.

Entry risk into the juvenile justice system: African American, American Indian, Asian American, European American, and Hispanic children and adolescents.

PubMed

Vazsonyi, Alexander T; Chen, Pan

2010-06-01

Findings on disproportionate minority contact remain mixed. Few empirical studies have examined to what extent entry risk into juvenile justice varies across ethnic/racial groups, and to what extent childhood aggressive behaviors foretell later deviance and entry risk. In the current study, we sought to address these shortcomings by implementing a survival analysis on a representative sample of youth followed from age 8 to 18. The sample included N = 2,754 lower to lower-middle SES youth from five different ethnic/racial groups (African American, American Indian, Asian American, European American, and Hispanic youth), part of a large-scale violence prevention effort. Aggressive behaviors were rated by teachers during elementary school, entry risk into juvenile justice was measured by official data, while SES was based on census data. Developmental entry risk into the juvenile justice system peaked at age 14 and subsequently declined. No differences were found across the four racial groups; however, Hispanic youth were at elevated risk (by 73%). Only childhood physical aggressive behavior increased entry risk (by 87%); this was above and beyond a 'simple' maturational liability we found and net any effects by sex, race/ethnicity, and SES. Some evidence suggested disproportionate minority contact, but only for Hispanic youth. Entry risk was invariant by race, but differed for males versus females and for youth from relatively higher socioeconomic status (SES) strata compared to youth from lower ones. Intervention efforts should target physically aggressive children during the elementary school years; however, some of the evidence also suggests that there exists a 'maturational liability' developmentally over time, between the ages of 8 and 18, independent of any of the focal predictors tested.

Socio-economic status and overweight or obesity among school-age children in sub-Saharan Africa - a systematic review.

PubMed

Fruhstorfer, B H; Mousoulis, C; Uthman, O A; Robertson, W

2016-02-01

Childhood overweight and obesity have emerged as a public health concern in sub-Saharan Africa. We conducted a systematic review with the aim to examine the association between socio-economic status (SES) and overweight or obesity among school-age children in sub-Saharan Africa. In March 2014 we searched five electronic databases for reports which presented cross-sectional data on prevalence levels of overweight or obesity stratified by SES groups among school-age children in sub-Saharan Africa. We used a random-effect model to pool the relative indexes of inequality of the association from the individual studies. In total, 20 reports satisfied the inclusion criteria providing results of 21 datasets. The risk of overweight or obesity in children from highest SES households was 5.28 times as high as that of children from lowest SES households (95% confidence interval [CI] 2.62 to 10.66). On subgroup analysis, this association was statistically significant for household income and composite SES measures but not for parental educational attainment and occupation type. Similarly, the risk of overweight or obesity in children attending affluent (private) schools was 15.94 times as high as that of children going to either urban or rural public schools (95% CI 5.82 to 43.68). The magnitude of the association tended to be stronger for area or school-type compared with composite measures. In summary, children from higher SES households and those attending private schools tended to be overweight and obese. © 2016 World Obesity.

Socioeconomic gradient in consumption of whole fruit and 100% fruit juice among US children and adults.

PubMed

Drewnowski, Adam; Rehm, Colin D

2015-01-05

The consumption of fruit is generally associated with better health, but also higher socioeconomic status (SES). Most previous studies evaluating consumption of fruits have not separated 100% fruit juice and whole fruit, which may conceal interesting patterns in consumption. To estimate demographic and socioeconomic correlates of whole fruit versus 100% juice consumption among children and adults in the United States. Secondary analyses of two cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES) from 2007-2010, by gender, age group, race/ethnicity and SES among 16,628 children and adults. Total fruit consumption (population average of 1.06 cup equivalents/d) fell far short of national goals. Overall, whole fruit provided about 65% of total fruit, while 100% juice provided the remainder. Whereas 100% juice consumption was highest among children and declined sharply with age, whole fruit consumption was highest among older adults. Total fruit and whole fruit consumption was generally higher among those with higher incomes or more education. By contrast, the highest 100% juice consumption was found among children, racial/ethnic minorities and lower-income groups. Consumption patterns for whole fruit versus 100% fruit juice showed different gradients by race/ethnicity, education, and income. The advice to replace 100% juice with whole fruit may pose a challenge for the economically disadvantaged and some minority groups, whose fruit consumption falls short of national goals.

Life-Course Relationship between Socioeconomic Circumstances and Timing of First Birth in a Birth Cohort

PubMed Central

van Roode, Thea; Sharples, Katrina; Dickson, Nigel; Paul, Charlotte

2017-01-01

Objectives This study examines the influence of socioeconomic circumstances in childhood (childhood SES) and adulthood (adult SES) on timing of first birth by age 37. Methods A longitudinal study of a 1972–1973 New Zealand birth cohort collected information on socioeconomic characteristics from age 3–32 and reproductive histories at 21, 26, 32 and 38; information on first birth was available from 978 of the original 1037. Relative Risks (RR) and 95% Confidence Intervals (CI) were calculated using Poisson regression to examine first live birth prior to age 21, from 21–25, from 26–31, and from 32–37, by socioeconomic characteristics at different ages. Results Overall, 68.5% of men had fathered a child and 75.9% of women had given birth, by age 37; with overall differences in parenthood to age 31 for men, and 37 for women evident by childhood SES. While parenthood by age 20 was strongly associated with lower childhood SES for both sexes, first entry into motherhood from 32–37 was more likely with higher adult SES at age 32 (RR = 1.8, 95% CI 1.1–3.0 for medium and RR = 1.9, 95% CI 1.1–3.3 for high compared with low). Education also differientated age at parenthood, with those with higher education more likely to defer fatherhood past age 31, and motherhood past age 25 followed by a period of increased likelihood of motherhood for women with higher levels of education from age 32–37 (RR = 1.4, 95% CI 0.87–2.2 and RR = 1.7, 95% CI 1.1–2.6 for medium and high respectively compared with low). Conclusions SES varies across the lifecourse, and SES at the time has the strongest association with first births at that time. Low childhood SES drives adolescent parenthood, with resulting cumulative differences in parenthood past age 30. Those with more education and higher adult SES are deferring parenthood but attempt to catch up in the mid to late thirties. PMID:28085935

Anti-Inflammatory Effect of Gallic Acid-Eluting Stent in a Porcine Coronary Restenosis Model

PubMed Central

Seob Lim, Kyung; Park, Jun-Kyu; Ho Jeong, Myung; Ho Bae, In; Sung Park, Dae; Won Shim, Jae; Ha Kim, Jung; Kuk Kim, Hyun; Soo Kim, Sung; Sun Sim, Doo; Joon Hong, Young; Han Kim, Ju; Ahn, Youngkeun

2018-01-01

Background Gallic acid (3,4,5-trihydroxybenzoic acid) is a natural polyphenol and strong natural antioxidant found abundantly in red wine and green tea. The aim of this study was to examine the anti-inflammatory effect of a novel gallic acid-eluting stent in a porcine coronary restenosis model. Methods Fifteen pigs were randomized into three groups; in which a total of 30 coronary arteries (10 in each group) were implanted with gallic acid-eluting stents (GESs, n = 10), gallic acid and sirolimus-eluting stents (GSESs, n = 10), or sirolimus-eluting stents (SESs, n = 10). Histopathologic analysis was performed 28 days after stenting. Results There were no significant differences in injury score and fibrin score among the groups, however there were significant differences in the internal elastic lamina (4.0 ± 0.83 mm2 in GES vs. 3.0 ± 0.53 mm2 in GSES vs. 4.6 ± 1.43 mm2 in SES, p < 0.0001), lumen area (2.3 ± 0.49 mm2 in GES vs. 1.9 ± 0.67 mm2 in GSES vs. 2.9 ± 0.56 mm2 in SES, p < 0.0001), neointimal area (1.7 ± 0.63 mm2 in GES vs. 1.1 ± 0.28 mm2 in GSES vs. 1.7 ± 1.17 mm2 in SES, p < 0.05), and percent area of stenosis (42.4% ± 9.22% in GES vs. 38.2% ± 12.77% in GSES vs. 33.9% ± 15.64% in SES, p < 0.05). The inflammation score was significantly lower in the GES and GSES groups compared to that in the SES group [1.0 (range: 1.0 to 2.0) in GES vs. 1.0 (range: 1.0 to 1.0) in GSES vs. 1.5 (range: 1.0 to 3.0) in SES, p < 0.05]. Conclusions The GES group had a greater percent area of stenosis than the SES group. Although gallic acid in the GES and GSES groups did not show a synergistic effect in suppressing neointimal hyperplasia, it resulted in greater inhibition of the inflammatory reaction in the porcine coronary restenosis model than in the SES group. PMID:29844643

Childhood socioeconomic status and race are associated with adult sleep.

PubMed

Tomfohr, Lianne M; Ancoli-Israel, Sonia; Dimsdale, Joel E

2010-01-01

Race and current socioeconomic status (SES) are associated with sleep. Parental education, a commonly studied component of childhood SES, is predictive of adult health outcomes; yet, its impact on adult sleep remains unclear. In this study, the sleep of 128 Black and White adults was investigated. Participants with lower childhood SES (assessed via parental education) spent more time in Stage 2 sleep and less time in slow-wave sleep (SWS) than those with higher childhood SES. In addition, women from low childhood SES backgrounds took longer to fall asleep than women from high SES backgrounds. Black participants spent less time in SWS than their White counterparts, and an Age × Race interaction was detected in the prediction of subjective sleep quality. Results were not mediated via current SES or health practices.

Ideal Body Size as a Mediator for the Gender-Specific Association Between Socioeconomic Status and Body Mass Index: Evidence From an Upper-Middle-Income Country in the African Region.

PubMed

Yepes, Maryam; Maurer, Jürgen; Stringhini, Silvia; Viswanathan, Barathi; Gedeon, Jude; Bovet, Pascal

2016-04-01

While obesity continues to rise globally, the associations between body size, gender, and socioeconomic status (SES) seem to vary in different populations, and little is known on the contribution of perceived ideal body size in the social disparity of obesity in African countries. We examined the gender and socioeconomic patterns of body mass index (BMI) and perceived ideal body size in the Seychelles, a middle-income small island state in the African region. We also assessed the potential role of perceived ideal body size as a mediator for the gender-specific association between SES and BMI. A population-based survey of 1,240 adults aged 25 to 64 years conducted in December 2013. Participants' BMI was calculated based on measured weight and height; ideal body size was assessed using a nine-silhouette instrument. Three SES indicators were considered: income, education, and occupation. BMI and perceived ideal body size were both higher among men of higher versus lower SES (p< .001) but lower among women of higher versus lower SES (p< .001), irrespective of the SES indicator used. Multivariate analysis showed a strong and direct association between perceived ideal body size and BMI in both men and women (p< .001) and was consistent with a potential mediating role of perceived ideal body size in the gender-specific associations between SES and BMI. Our study emphasizes the importance of gender and socioeconomic differences in BMI and ideal body size and suggests that public health interventions that promote perception of healthy weight could help mitigate SES-related disparities in BMI. © 2016 Society for Public Health Education.

Perceptions of Mindfulness in a Low-income, Primarily African American Treatment-Seeking Sample.

PubMed

Spears, Claire Adams; Houchins, Sean C; Bamatter, Wendy P; Barrueco, Sandra; Hoover, Diana Stewart; Perskaudas, Rokas

2017-12-01

Individuals with low socioeconomic status (SES) and members of racial/ethnic minority groups often experience profound disparities in mental health and physical well-being. Mindfulness-based interventions show promise for improving mood and health behaviors in higher-SES and non-Latino White populations. However, research is needed to explore what types of adaptations, if any, are needed to best support underserved populations. This study used qualitative methods to gain information about a) perceptions of mindfulness, b) experiences with meditation, c) barriers to practicing mindfulness, and d) recommendations for tailoring mindfulness-based interventions in a low-income, primarily African American treatment-seeking sample. Eight focus groups were conducted with 32 adults (16 men and 16 women) currently receiving services at a community mental health center. Most participants (91%) were African American. Focus group data were transcribed and analyzed using NVivo 10. A team of coders reviewed the transcripts to identify salient themes. Relevant themes included beliefs that mindfulness practice might improve mental health (e.g., managing stress and anger more effectively) and physical health (e.g., improving sleep and chronic pain, promoting healthier behaviors). Participants also discussed ways in which mindfulness might be consistent with, and even enhance, their religious and spiritual practices. Results could be helpful in tailoring mindfulness-based treatments to optimize feasibility and effectiveness for low-SES adults receiving mental health services.

The sirolimus-eluting Cypher Select coronary stent for the treatment of bare-metal and drug-eluting stent restenosis: insights from the e-SELECT (Multicenter Post-Market Surveillance) registry.

PubMed

Abizaid, Alexandre; Costa, J Ribamar; Banning, Adrian; Bartorelli, Antonio L; Dzavik, Vladimir; Ellis, Stephen; Gao, Runlin; Holmes, David R; Jeong, Muyng Ho; Legrand, Victor; Neumann, Franz-Josef; Nyakern, Maria; Orlick, Amy; Spaulding, Christian; Worthley, Stephen; Urban, Philip M

2012-01-01

This study sought to compare the 1-year safety and efficacy of Cypher Select or Cypher Select Plus (Cordis Corporation, Bridgewater, New Jersey) sirolimus-eluting stents (SES) with the treatment of bare-metal stents (BMS) and drug-eluting stent (DES) in-stent restenosis (ISR) in nonselected, real-world patients. There is paucity of consistent data on DES for the treatment of ISR, especially, DES ISR. The e-SELECT (Multicenter Post-Market Surveillance) registry is a Web-based, multicenter and international registry encompassing virtually all subsets of patients and lesions treated with at least 1 SES during the period from 2006 to 2008. We enrolled in this pre-specified subanalysis all patients with at least 1 clinically relevant BMS or DES ISR treated with SES. Primary endpoint was major adverse cardiac events and stent thrombosis rate at 1 year. Of 15,147 patients enrolled, 1,590 (10.5%) presented at least 1 ISR (BMS group, n = 1,235, DES group, n = 355). Patients with DES ISR had higher incidence of diabetes (39.4% vs. 26.9%, p < 0.001), renal insufficiency (5.8% vs. 2.3%, p = 0.003), and prior coronary artery bypass graft (20.5% vs. 11.8%, p < 0.001). At 1 year, death (1.4% for BMS vs. 2.1% for DES, p = 0.3) and myocardial infarction (2.4% for BMS and 3.3% for DES, p = 0.3) rates were similar, whereas ischemia-driven target lesion revascularization and definite/probable late stent thrombosis were higher in patients with DES ISR (6.9% vs. 3.1%, p = 0.003, and 1.8% vs. 0.5%, p = 0.04, respectively). Use of SES for either BMS or DES ISR treatment is safe and associated with low target lesion revascularization recurrence and no apparent safety concern. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Relationship between neighborhood socioeconomic status and venous thromboembolism: results from a population-based study.

PubMed

Kort, D; van Rein, N; van der Meer, F J M; Vermaas, H W; Wiersma, N; Cannegieter, S C; Lijfering, W M

2017-12-01

Essentials Literature on socioeconomic status (SES) and incidence of venous thromboembolism (VTE) is scarce. We assessed neighborhood SES with VTE risk in a population of over 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. These findings are helpful to inform policy and resource allocation in health systems. Background The association between socioeconomic status and arterial cardiovascular disease is well established. However, despite its high burden of disability-adjusted life years, little research has been carried out to determine whether socioeconomic status is associated with venous thromboembolism. Objective To determine if neighborhood socioeconomic status is associated with venous thromboembolism in a population-based study from the Netherlands. Methods We identified all patients aged 15 years and older with a first event of venous thromboembolism from inhabitants who lived in the urban districts of The Hague, Leiden and Utrecht in the Netherlands in 2008-2012. Neighborhood socioeconomic status was based on the status score, which combines educational level, income and unemployment on a four-digit postal code level. Incidence rate ratios of venous thromboembolism were calculated for different levels of neighborhood socioeconomic status, with adjustments for age and sex. Results A total of 7373 patients with a first venous thromboembolism (median age 61 years; 50% deep vein thrombosis) were identified among more than 1.4 million inhabitants. Higher neighborhood SES was associated with lower incidence of VTE. In the two highest status score groups (i.e. the 95-99th and > 99th percentile), the adjusted incidence rate ratios were 0.91 (95% confidence interval [CI], 0.84-1.00) and 0.80 (95% CI, 0.69-0.93), respectively, compared with the reference status score group (i.e. 30-70th percentile). Conclusions High neighborhood socioeconomic status is associated with a lower risk of first venous thromboembolism. © 2017 International Society on Thrombosis and Haemostasis.

[Socioeconomic status and risky health behaviors in Croatian adult population].

PubMed

Pilić, Leta; Dzakula, Aleksandar

2013-03-01

Based on the previous research, there is strong association between low socioeconomic status (SES) and high morbidity and mortality rates. Even though association between SES and risky health behaviors as the main factors influencing health has been investigated in Croatian population, some questions are yet to be answered. The aim of this study was to investigate the presence of unhealthy diet, physical inactivity, smoking and excessive drinking in low, middle, and high socioeconomic group of adult Croatian population included in the cohort study on regionalism of cardiovascular health risk behaviors. We also investigated the association between SES measured by income, education and occupation, as well as single SES indicators, and risky health behaviors. We analyzed data on 1227 adult men and women (aged 19 and older at baseline) with complete data on health behaviors, SES and chronic diseases at baseline (2003) and 5-year follow up. Respondents were classified as being healthy or chronically ill. SES categories were derived from answers to questions on monthly household income, occupation and education by using two-step cluster analysis algorithm. At baseline, for the whole sample as well as for healthy respondents, SES was statistically significantly associated with unhealthy diet (whole sample/healthy respondents: p = 0.001), physical inactivity (whole sample/healthy respondents p = 0.44/ p = 0.007), and smoking (whole sample/healthy respondents p < 0.001/p = 0.002). The proportion of respondents with unhealthy diet was greatest in the lowest social class, smokers in the middle and physically inactive in the high social class. During the follow up, smoking and physical inactivity remained statistically significantly associated with SES. In chronically ill respondents, only smoking was statistically significantly associated with SES, at baseline and follow up (p = 0.001/p = 0.002). The highest share of smokers was in the middle social class. Results of our study show that risky health behaviors are associated with SES and are divergently represented across socioeconomic groups of adult Croatian population. There is an obvious need for interventions targeting the specific socioeconomic group and behavior characteristic of that group.

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.

The effect of socioeconomic indicators and macronutrient intake rate on body composition in adolescents 12 to 16 years old in Merida, Yucatan.

PubMed

Datta Banik, Sudip; Andrade Olalde, Ana Carolina; Rodriguez, Luis; Dickinson, Federico

2014-01-01

Intake pattern of macronutrients (protein, lipid, carbohydrate) and socioeconomic status (SES) are major causes of high child and adolescent overweight and obesity prevalences in Mexico. An evaluation was done of the relationship between body mass index (BMI)-based nutritional status and body composition (BC), macronutrient intake rates (MIR) and SES indicators in 127 boys and 156 girls aged 12 to 16 years attending schools in Merida, Mexico. Anthropometric variables included height, weight, and BMI. The BC (body fat mass, fat-free mass, dry lean mass) was estimated by bioelectrical impedance (Bodystat 1500 MDD). The MIR were estimated following FAO/WHO/UNO standard (1985). Proxy socioeconomic indicators included parents' age (as a maturity indicator) and education, fathers' occupation, school type and monthly household food expenditure per capita. Excess weight (overweight + obesity) assessed by BMI, was higher in boys (40.16 %) than in girls (33.97 %). Boys had higher BMI, less fat mass and higher fat-free mass than girls. The MIR did not vary significantly in response to age, sex, BC or SES. Participants with higher SES were taller and heavier, had higher fat-free mass and lower fat mass. In the studied adolescents, anthropometric and BC values, and overweight and obesity rates were more associated with SES than MIR.

A Socioeconomic Comparison of Emergent Literacy and Home Literacy in Australian Preschoolers

ERIC Educational Resources Information Center

Neumann, Michelle M.

2016-01-01

Family socioeconomic status (SES) and home literacy practices impact upon children's early literacy development. The present study explored where current emergent literacy and home literacy differences lie in Australian preschoolers aged three to five years from lower SES (n = 49) and higher SES (n = 52) homes. Children were assessed on letter…

Socioeconomic status is positively associated with measures of adiposity and insulin resistance, but inversely associated with dyslipidaemia in Colombian children

PubMed Central

Buitrago-Lopez, Adriana; van den Hooven, Edith H; Rueda-Clausen, Christian F; Serrano, Norma; Ruiz, Alvaro J; Pereira, Mark A; Mueller, Noel T

2015-01-01

Background Low socioeconomic status (SES) has been associated with higher risk of cardiometabolic diseases in developed societies, but investigation of SES and cardiometabolic risk in children in less economically developed populations is sparse. We aimed to examine associations among SES and cardiometabolic risk factors in Colombian children. Methods We used data from a population-based study of 1282 children aged 6–10 years from Bucaramanga, Colombia. SES was classified according to household wealth, living conditions and access to public utilities. Anthropometric and biochemical parameters were measured at a clinic visit. Cardiometabolic risk factors were analysed continuously using linear regression and as binary outcomes—according to established paediatric cut points—using logistic regression to calculate OR and 95% CIs. Results Mean age of the children was 8.4 (SD 1.4) and 51.1% of the sample were boys. Odds of overweight/obesity, abdominal obesity and insulin resistance were greater among higher SES. Compared with the lowest SES stratum, children in the highest SES had higher odds of overweight/obesity (OR=3.25, 95% CI 1.89 to 5.57), abdominal obesity (OR=2.74, 95% CI 1.41 to 5.31) and insulin resistance (OR=2.60, 95% CI 1.81 to 3.71). In contrast, children in the highest SES had lower odds of hypertriglyceridaemia (triglycerides ≥90th centile; OR=0.28, 95% CI 0.14 to 0.54) and low (≤10th centile) high-density lipoprotein (HDL) cholesterol (OR=0.35, 95% CI 0.15 to 0.78). Conclusions In Colombian children, SES is directly associated with obesity and insulin resistance, but inversely associated with dyslipidaemia (hypertriglyceridaemia and low HDL cholesterol). Our findings highlight the need to analyse cardiometabolic risk factors separately in children and to carefully consider a population's level of economic development when studying their social determinants of cardiometabolic disease. PMID:25691273

"Sense of Place" and College Placement

ERIC Educational Resources Information Center

Getz, Shlomo; lev-Ari, Lilach

2017-01-01

It is generally assumed that young people with lower socioeconomic status (SES) face restricted access to higher education institutions, and particularly to those which are considered to be more prestigious. Differences in student placement in higher education institutions by place of residence are usually explained by their SES. We argue that…

Disparities in Cardiac Rehabilitation Among Individuals from Racial and Ethnic Groups and Rural Communities-A Systematic Review.

PubMed

Castellanos, Luis R; Viramontes, Omar; Bains, Nainjot K; Zepeda, Ignacio A

2018-03-13

Despite the well-described benefits of cardiac rehabilitation (CR) on long-term health outcomes, CR is a resource that is underutilized by a significant proportion of patients that suffer from cardiovascular diseases. The main purpose of this study was to examine disparities in CR referral and participation rates among individuals from rural communities and racial and ethnic minority groups with coronary heart disease (CHD) when compared to the general population. A systematic search of standard databases including MedlLine, PubMed, and Cochrane databases was conducted using keywords that included cardiac rehabilitation, women, race and ethnicity, disparities, and rural populations. Twenty-eight clinical studies from 1990 to 2017 were selected and included 478,955 patients with CHD. The majority of available clinical studies showed significantly lower CR referral and participation rates among individuals from rural communities, women, and racial and ethnic groups when compared to the general population. Similar to geographic region, socioeconomic status (SES) appears to directly impact the use of CR programs. Patients of lower SES have significantly lower CR referral and participation rates than patients of higher SES. Data presented underscores the need for systematic referrals using electronic health records for patients with CHD in order to increase overall CR referral and participation rates of minority populations and other vulnerable groups. Educational programs that target healthcare provider biases towards racial and ethnic groups may help attenuate observed disparities. Alternative modalities such as home-based and internet-based CR programs may also help improve CR participation rates among vulnerable populations.

Engaging Parents in Preventive Parenting Groups: Do Ethnic, Socioeconomic, and Belief Match between Parents and Group Leaders Matter?

ERIC Educational Resources Information Center

Dumas, Jean E.; Moreland, Angela D.; Gitter, Alexandra H.; Pearl, Amanda M.; Nordstrom, Alicia H.

2008-01-01

The authors evaluate the relation of ethnic, socioeconomic status (SES), and belief match between parents and group leaders and engagement in a preventive intervention for parents of preschoolers. Engagement was assessed through attendance, retention, and quality of participation in sessions with 171 parents and 11 group leaders. SES match…

Feeling frugal: socioeconomic status, acculturation, and cultural health beliefs among women of Mexican descent.

PubMed

Borrayo, Evelinn A; Jenkins, Sharon Rae

2003-05-01

Psychosocial and socioeconomic variables are often confounded. The authors combined quantitative with grounded theory analysis to investigate influences of acculturation, socioeconomic status (SES), and cultural health beliefs on Mexican-descent women's preventive health behaviors. In 5 focus group interviews sampling across levels of acculturation and SES, women expressing more traditional Mexican health beliefs about breast cancer screening were of lower SES and were less U.S. acculturated. However, SES and acculturation were uncorrelated with screening behaviors. Qualitative analysis generated hypotheses about joint influences of SES and traditional health beliefs; for example, low-SES women may learn frugal habits as part of their cultural traditions that influence their health care decision making, magnifying SES-imposed structural restrictions on health care access.

Analysis of the Effect of Race, Socioeconomic Status, and Center Size on Unrelated National Marrow Donor Program Donor Outcomes: Donor Toxicities Are More Common at Low-Volume Bone Marrow Collection Centers.

PubMed

Shaw, Bronwen E; Logan, Brent R; Kiefer, Deidre M; Chitphakdithai, Pintip; Pedersen, Tanya L; Abdel-Azim, Hisham; Abidi, Muneer H; Akpek, Gorgun; Diaz, Miguel A; Artz, Andrew S; Dandoy, Christopher; Gajewski, James L; Hematti, Peiman; Kamble, Rammurti T; Kasow, Kimberley A; Lazarus, Hillard M; Liesveld, Jane L; Majhail, Navneet S; O'Donnell, Paul V; Olsson, Richard F; Savani, Bipin N; Schears, Raquel M; Stroncek, David F; Switzer, Galen E; Williams, Eric P; Wingard, John R; Wirk, Baldeep M; Confer, Dennis L; Pulsipher, Michael A

2015-10-01

Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index, and age in unrelated donors undergoing collection at National Marrow Donor Program centers. We hypothesized that other important factors (race, socioeconomic status [SES], and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week after donation (P = .017). For BM donors, black males reported significantly higher levels of pain (OR, 1.90; CI, 1.14 to 3.19; P = .015). No differences were noted by SES group. BM donors from low-volume centers reported more toxicity (OR, 2.09; CI, 1.26 to 3.46; P = .006). In conclusion, race and SES have a minimal effect on donation-associated symptoms. However, donors from centers performing ≤ 1 BM collection every 2 months have more symptoms after BM donation. Approaches should be developed by registries and low-volume centers to address this issue. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

An Analysis of the Effect of Race, Socioeconomic Status and Center Size on Unrelated NMDP Donor Outcomes: Donor Toxicities are More Common at Low Volume Bone Marrow Collection Centers

PubMed Central

Shaw, Bronwen E.; Logan, Brent R.; Kiefer, Deidre M.; Chitphakdithai, Pintip; Pedersen, Tanya L.; Abdel-Azim, Hisham; Abidi, Muneer H.; Akpek, Gorgun; Diaz, Miguel A.; Artz, Andrew S.; Dandoy, Christopher; Gajewski, James L.; Hematti, Peiman; Kamble, Rammurti T.; Kasow, Kimberley A.; Lazarus, Hillard M.; Liesveld, Jane L.; Majhail, Navneet S.; O’Donnell, Paul V.; Olsson, Richard F.; Savani, Bipin N.; Schears, Raquel M.; Stroncek, David F.; Switzer, Galen E.; Williams, Eric P.; Wingard, John R.; Wirk, Baldeep M.; Confer, Dennis L.; Pulsipher, Michael A.

2015-01-01

Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index (BMI), and age in unrelated donors undergoing collection at National Marrow Donor Program (NMDP) centers. We hypothesized that other important factors (race, socioeconomic status (SES), and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2,726 bone marrow (BM) and 6,768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week post donation (p=0.017). For BM donors, black males reported significantly higher levels of pain (OR=1.90, CI=1.14-3.19, p=0.015). No differences were noted by SES groups. BM donors from low volume centers reported more toxicity (OR=2.09, CI=1.26-3.46, p=0.006). In conclusion, race and SES have a minimal effect on donation associated symptoms. However, donors from centers performing ≤1 BM collection every 2 months have more symptoms following BM donation. Approaches should be developed by registries and low volume centers to address this issue. PMID:26116089

Socioeconomic Status and Improvements in Lifestyle, Coronary Risk Factors, and Quality of Life: The Multisite Cardiac Lifestyle Intervention Program

PubMed Central

Govil, Sarah R.; Merritt-Worden, Terri; Ornish, Dean

2009-01-01

Objectives. We sought to clarify whether patients of low socioeconomic status (SES) can make lifestyle changes and show improved outcomes in coronary heart disease (CHD), similar to patients with higher SES. Methods. We examined lifestyle, risk factors, and quality of life over 3 months, by SES and gender, in 869 predominantly White, nonsmoking CHD patients (34% female) in the insurance-sponsored Multisite Cardiac Lifestyle Intervention Program. SES was defined primarily by education. Results. At baseline, less-educated participants were more likely to be disadvantaged (e.g., past smoking, sedentary lifestyle, high fat diet, overweight, depression) than were higher-SES participants. By 3 months, participants at all SES levels reported consuming 10% or less dietary fat, exercising 3.5 hours per week or more, and practicing stress management 5.5 hours per week or more. These self-reports were substantiated by improvements in risk factors (e.g., 5-kg weight loss, and improved blood pressure, low-density lipoprotein cholesterol, and exercise capacity; P < .001), and accompanied by improvements in well-being (e.g., depression, hostility, quality of life; P < .001). Conclusions. The observed benefits for CHD patients with low SES indicate that broadening accessibility of lifestyle programs through health insurance should be strongly encouraged. PMID:18923113

An Examination of Fast Mapping Skills in Preschool Children from Families with Low Socioeconomic Status

ERIC Educational Resources Information Center

Spencer, Elizabeth J.; Schuele, C. Melanie

2012-01-01

Researchers consistently report that children from low socioeconomic status (SES) families have, on average, smaller vocabularies as assessed by measures of existing vocabulary knowledge than children from higher SES families. Yet, few studies have examined the word-learning process of children from low SES families. The present study was an…

Counteracting Summer Slide: Social Capital Resources within Socioeconomically Disadvantaged Families

ERIC Educational Resources Information Center

Slates, Stephanie L.; Alexander, Karl L.; Entwisle, Doris R.; Olson, Linda S.

2012-01-01

Research on summer learning has shown that children from a higher socioeconomic status (SES) continue to learn during the summer months of elementary school, but lower-SES students tend to stagnate or lose ground. However, not all low-SES students experience summer learning loss. Drawing on the Beginning School Study (BSS), a longitudinal study of…

The Effects of Socio-Economic Status on Prospective English Language Teachers' Academic Achievement

ERIC Educational Resources Information Center

Koban Koç, Didem

2016-01-01

Socioeconomic status (SES), which generally involves factors such as parental educational background, occupation and income level, is a strong predictor of student achievement. That is, students with higher parental SES demonstrate increased academic performance when compared to those with lower parental SES. The purpose of the present study is to…

Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients

PubMed Central

Tang, Wen; Grace, Blair; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil C.; Brown, Fiona G.; Clayton, Philip A.; Johnson, David W.

2015-01-01

♦ Background: The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦ Methods: Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦ Results: 7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 – 9; IRSD deciles 4 – 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦ Conclusions: In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories. PMID:24497587

Pre-typhoon socioeconomic status factors predict post-typhoon psychiatric symptoms in a Vietnamese sample.

PubMed

Brown, Ruth C; Trapp, Stephen K; Berenz, Erin C; Bigdeli, Tim Bernard; Acierno, Ron; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda B

2013-11-01

Exposure to natural disasters has been associated with increased risk for various forms of psychopathology. Evidence indicates that socioeconomic status (SES) may be important for understanding post-disaster psychiatric distress; however, studies of SES-relevant factors in non-Western, disaster-exposed samples are lacking. The primary aim of the current study was to examine the role of pre-typhoon SES-relevant factors in relation to post-typhoon psychiatric symptoms among Vietnamese individuals exposed to Typhoon Xangsane. In 2006, Typhoon Xangsane disrupted a mental health needs assessment in Vietnam in which the Self Reporting Questionnaire-20 (SRQ-20), and the Demographic and Health Surveys Wealth Index, a measure of SES created for use in low-income countries, were administered pre-typhoon. The SRQ-20 was re-administered post-typhoon. Results of a linear mixed model indicated that the covariates of older age, female sex, and higher levels of pre-typhoon psychiatric symptoms were associated with higher levels of post-typhoon psychiatric symptoms. Analysis of SES indicators revealed that owning fewer consumer goods, having lower quality of household services, and having attained less education were associated with higher levels of post-typhoon symptoms, above and beyond the covariates, whereas quality of the household build, employment status, and insurance status were not related to post-typhoon psychiatric symptoms. Even after controlling for demographic characteristics and pre-typhoon psychiatric symptoms, certain SES factors uniquely predicted post-typhoon psychiatric distress. These SES characteristics may be useful for identifying individuals in developing countries who are in need of early intervention following disaster exposure.

Neighborhood socioeconomic status, sleep duration and napping in middle-to-old aged US men and women.

PubMed

Xiao, Qian; Hale, Lauren

2018-04-25

Earlier studies have linked neighborhood disadvantage with poor sleep outcomes. However, little is known about the association between changes in one's neighborhood over time and night sleep and napping. In over 300,000 middle-to-old aged Americans, we examined neighborhood socioeconomic status (SES) and change in neighborhood SES in relation to nocturnal sleep duration and napping. Nocturnal sleep duration and daytime napping were self-reported at baseline (1995-1996). Participants also reported baseline residential addresses, which were linked to US censuses. We derived a neighborhood SES index using census variables and calculated the baseline level and change (1990-2000) in neighborhood SES. Multinomial logistic regression was used to estimate the associations between neighborhood SES over time and nocturnal sleep and napping. Lower baseline neighborhood SES was associated short sleep, long sleep and napping. When compared with the highest quintile of neighborhood SES, the lowest was associated with 46% and 72% increase in relative risk (RR) of reporting very short (< 5 hours) sleep, 28% and 19% higher RR of long (≥9 hours) sleep and 95% and 85% increase in long (≥1 hours) nap in men and women, respectively. Moreover, a decrease in neighborhood SES was associated with higher RR of reporting very short sleep in women; while an improvement in neighborhood SES was associated with an increase in RR of long sleep in men. Neighborhood disadvantage and worsening neighborhood conditions were associated with unhealthy sleep behaviors. These results reinforce a growing literature on the potential importance of neighborhood context for understanding sleep health.

Neighborhood disadvantage and adolescent stress reactivity

PubMed Central

Hackman, Daniel A.; Betancourt, Laura M.; Brodsky, Nancy L.; Hurt, Hallam; Farah, Martha J.

2012-01-01

Lower socioeconomic status (SES) is associated with higher levels of life stress, which in turn affect stress physiology. SES is related to basal cortisol and diurnal change, but it is not clear if SES is associated with cortisol reactivity to stress. To address this question, we examined the relationship between two indices of SES, parental education and concentrated neighborhood disadvantage, and the cortisol reactivity of African–American adolescents to a modified version of the Trier Social Stress Test (TSST). We found that concentrated disadvantage was associated with cortisol reactivity and this relationship was moderated by gender, such that higher concentrated disadvantage predicted higher cortisol reactivity and steeper recovery in boys but not in girls. Parental education, alone or as moderated by gender, did not predict reactivity or recovery, while neither education nor concentrated disadvantage predicted estimates of baseline cortisol. This finding is consistent with animal literature showing differential vulnerability, by gender, to the effects of adverse early experience on stress regulation and the differential effects of neighborhood disadvantage in adolescent males and females. This suggests that the mechanisms underlying SES differences in brain development and particularly reactivity to environmental stressors may vary across genders. PMID:23091454

"I Am Working-Class": Subjective Self-Definition as a Missing Measure of Social Class and Socioeconomic Status in Higher Education Research

ERIC Educational Resources Information Center

Rubin, Mark; Denson, Nida; Kilpatrick, Sue; Matthews, Kelly E.; Stehlik, Tom; Zyngier, David

2014-01-01

This review provides a critical appraisal of the measurement of students' social class and socioeconomic status (SES) in the context of widening higher education participation. Most assessments of social class and SES in higher education have focused on objective measurements based on the income, occupation, and education of students'…

Social vulnerabilities as determinants of overweight in 2-, 4- and 6-year-old Spanish children.

PubMed

Iguacel, Isabel; Fernández-Alvira, Juan M; Labayen, Idoia; Moreno, Luis A; Samper, María Pilar; Rodríguez, Gerardo

2018-04-01

Differences in obesity prevalence among vulnerable groups exist in childhood but it remains unclear whether these differences may be partly determined by socioeconomic status (SES), parental body mass index (BMI) and early life risk factors. We aimed to explore (i) longitudinal associations between belonging to a minority group and being overweight/obese at age 2, 4 and 6 and (ii) associations between accumulation of social vulnerabilities and being overweight/obese at age 6. In total, 1031 children (53.8% boys) were evaluated at birth and re-examined during a 6-year follow-up in a representative cohort of Aragon (Spain). Children from minority (vulnerable) groups included Spanish Roma/gypsies, Eastern Europeans, Latin Americans and Africans. Two more vulnerable groups were defined at baseline as children whose parents reported low occupation and education. Ethnicity, SES and parental BMI were collected via interviews. We used logistic mixed-effects models and adjusted for parental BMI, SES, mother's tobacco use, maternal weight gain, birth weight, infant weight gain and breastfeeding practices. Regardless of confounders, Roma/gypsy children (OR = 4.63;[1.69-12.70]95%CI) and with Latin American background (OR = 3.04;[1.59-5.82]95%CI) were more likely to be overweight/obese at age 6 compared with non-gypsy Spanish group. Children with three vulnerabilities (OR = 2.18;[1.31-3.64]95%CI) were more likely to be overweight/obese at age 6 compared with children with no vulnerabilities. No associations were found between belonging to a minority group and overweight/obesity in children under 6. Interventions should target Roma/gypsy children, Latin American children and those who accumulate more vulnerabilities as they are at higher risk of being overweight/obese at age 6.

Responsiveness of Endoscopic Indices of Disease Activity for Crohn's Disease.

PubMed

Khanna, Reena; Zou, GuangYong; Stitt, Larry; Feagan, Brian G; Sandborn, William J; Rutgeerts, Paul; McDonald, John W D; Dubcenco, Elena; Fogel, Ronald; Panaccione, Remo; Jairath, Vipul; Nelson, Sigrid; Shackelton, Lisa M; Huang, Bidan; Zhou, Qian; Robinson, Anne M; Levesque, Barrett G; D'Haens, Geert

2017-10-01

The Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD) are commonly used to assess Crohn's disease (CD) activity; however neither instrument is fully validated. We evaluated the responsiveness to change of the SES-CD and CDEIS using data from a trial of adalimumab, a drug therapy of known efficacy. Paired video recordings (N=112) of colonoscopies (baseline and week 8-12) obtained from patients with CD who participated in a trial of adalimumab therapy were reviewed in random order, in duplicate, by four central readers (56 pairs of videos by 2 groups of readers). Responsiveness of the SES-CD and the CDEIS was evaluated by comparing correlations between the observed and pre-specified predictions of change scores for these endoscopic indices with a global endoscopic evaluation of severity (GELS), a patient reported outcome (PRO2), and the Crohn's disease activity index (CDAI), and by calculation of the standardized effect size, and Guyatt's Responsiveness statistic (GRS) using 2 definitions of change; (1) treatment assignment and (2) an absolute change in total PRO2 of 50. The potential application of effect size estimates was demonstrated by calculating hypothetical sample sizes for comparing two independent groups. The impact of removing stenosis as an index item and adjusting for the number of segments observed was also assessed. Changes in both endoscopic instruments and the GELS were highly correlated. The SES-CD displayed numerically higher effect sizes for both definitions of change. The standardized effect size and GRS estimates (95% confidence interval) for the SES-CD based on treatment assignment were 0.84 (0.53, 1.15) and 0.79 (0.48, 1.09). Corresponding values for the CDEIS were 0.72 (0.42, 1.02) and 0.75 (0.45, 1.06). The standardized effect size and GRS estimates for the SES-CD based on an absolute change in total PRO2 of 50 points or greater were 0.76 (0.49, 1.02) and 0.93 (0.64, 1.21). Corresponding values for CDEIS were 0.70 (0.44, 0.97), 0.83 (0.55, 1.10). Removal of stenosis as an index item and adjusting for observed segments did not improve responsiveness estimates. Although both the SES-CD and CDEIS are valid measures of endoscopic disease activity that are moderately responsive to changes in endoscopic disease activity, the SES-CD displayed numerically greater responsiveness in this data set.

Turning the Curve on Obesity Prevalence Among Fifth Graders in the Los Angeles Unified School District, 2001-2013.

PubMed

Kamali, Amanda; Hameed, Heena; Shih, Margaret; Simon, Paul

2017-02-16

After multiple decades of increasing childhood obesity prevalence in the United States, findings from recent studies suggest that prevalence has leveled or is decreasing in some populations. However, demographic and socioeconomic disparities in prevalence remain and may be increasing. To assess recent trends and disparities in childhood obesity prevalence in Los Angeles County, we analyzed data from 2001 through 2013 in fifth graders in the Los Angeles Unified School District (LAUSD). Obesity was defined as a body mass index at or above the 95th percentile for children of the same age and sex as compared with Centers for Disease Control and Prevention growth charts, on the basis of measured height and weight. Trends were examined by sex, race/ethnicity, and socioeconomic status (SES). SES was determined by using school-level data on the percentage of students participating in a free and reduced-price meal program. Obesity prevalence increased from 27.5% in 2001 to 31.6% in 2005, was stable from 2005 through 2010, and decreased from 31.6% in 2010 to 28.5% in 2013. Similar trajectories in prevalence were observed for all demographic and SES subgroups, although the decline in prevalence began earlier among whites and students attending schools in the highest SES group. Disparities in prevalence by race/ethnicity and SES were observed during the entire study period but narrowed slightly from 2010 through 2013. Although obesity prevalence among fifth graders in LAUSD declined from 2010 through 2013, prevalence remains higher than in 2001, and demographic and socioeconomic disparities in prevalence persist. Future interventions in the county should prioritize Latinos and students attending low SES schools.

Assessment of numeracy in sports and exercise science students at an Australian university

NASA Astrophysics Data System (ADS)

Green, Simon; McGlynn, Susan; Stuart, Deidre; Fahey, Paul; Pettigrew, Jim; Clothier, Peter

2018-05-01

The effect of high school study of mathematics on numeracy performance of sports and exercise science (SES) students is not clear. To investigate this further, we tested the numeracy skills of 401 students enrolled in a Bachelor of Health Sciences degree in SES using a multiple-choice survey consisting of four background questions and 39 numeracy test questions. Background questions (5-point scale) focused on highest level of mathematics studied at high school, self-perception of mathematics proficiency, perceived importance of mathematics to SES and likelihood of seeking help with mathematics. Numeracy questions focused on rational number, ratios and rates, basic algebra and graph interpretation. Numeracy performance was based on answers to these questions (1 mark each) and represented by the total score (maximum = 39). Students from first (n = 212), second (n = 78) and third (n = 111) years of the SES degree completed the test. The distribution of numeracy test scores for the entire cohort was negatively skewed with a median (IQR) score of 27(11). We observed statistically significant associations between test scores and the highest level of mathematics studied (P < 0.05), being lowest in students who studied Year 10 Mathematics (20 (9)), intermediate in students who studied Year 12 General Mathematics (26 (8)) and highest in two groups of students who studied higher-level Year 12 Mathematics (31 (9), 31 (6)). There were statistically significant associations between test scores and level of self-perception of mathematics proficiency and also likelihood of seeking help with mathematics (P < 0.05) but not with perceived importance of mathematics to SES. These findings reveal that the level of mathematics studied in high school is a critical factor determining the level of numeracy performance in SES students.

Increased urinary excretion rates of serotonin and metabolites during bedrest

NASA Astrophysics Data System (ADS)

Platen, Petra; Lebenstedt, Marion; Schneider, Myriam; Boese, Andrea; Heer, Martina

2005-05-01

Astronauts are often on a voluntarily reduced energy intake during space missions, possibly caused by a metabolic or emotional stress response with involvement of the central serotonergic system (SES). We investigated 24 h urinary excretion (24 h-E) of serotonin (5-HT) and 5-hydroxyindol acidic acid as indicators of the SES in healthy males under two different normocaloric conditions: normal physical activity (NPA) and -6∘ head-down-tilt (HDT). HDT or NPA were randomly arranged with a recovery period of 6 months in between. 24 h-E of hormones varied widely among individuals. Values were higher in HDT compared to NPA. Assuming that the 24 h-E values are, beside being indicators for alterations in the number and metabolism of platelets, Also indicators of central SES, HDT condition seems to activate central SES in a higher degree compared to NPA. Therefore, changes in central SES might be involved in the mechanisms associated with space flight or microgravity, including possible maladaptations such as voluntary undernutrition.

The relationship of sport participation to provision of sports facilities and socioeconomic status: a geographical analysis.

PubMed

Eime, Rochelle M; Harvey, Jack; Charity, Melanie J; Casey, Meghan; Westerbeek, Hans; Payne, Warren R

2017-06-01

Ecological models have been applied to investigate multiple domains influencing physical activity behaviour, including individual, social, organisational, community, environmental and policy factors. With regard to the built environment, research to date has been limited to small geographical areas and/or small samples of participants. This study examined the geographical association between provision of sport facilities and participation in sport across an entire Australian state, using objective total enumerations of both, for a group of sports, with adjustment for the effect of socioeconomic status (SES). De-identified membership registration data were obtained from state sport governing bodies of four popular team sports. Associations between participation rate, facility provision rate and SES were investigated using correlation and regression methods. Participation rate was positively associated with provision of facilities, although this was complicated by SES and region effects. The non-metropolitan region generally had higher participation rates and better provision of facilities than the metropolitan region. Better provision of sports facilities is generally associated with increased sport participation, but SES and region are also contributing factors. Implications for public health: Community-level analysis of the population, sport participation and provision of facilities should be used to inform decisions of investments in sports facilities. © 2017 The Authors.

Association of age specific body mass index, dental caries and socioeconomic status of children and adolescents.

PubMed

Subramaniam, P; Singh, D

2011-01-01

The purpose of this study was to determine the association of BMI-for-age with dental caries and socioeconomic status. A random sample of 2033 school going children aged 6-15 years were selected from ten different schools located in the south of Bangalore city. Height and weight of each child was recorded to obtain BMI-for-age. The socioeconomic status (SES) was assessed based on educational status, profession and annual income of parents. Dental caries was recorded according to WHO criteria. A diet recording sheet was given to each child to record his/her dietary intake of the four basic food groups and snacks for 5 consecutive days including one weekend day. The data obtained was subjected to statistical analysis. The results showed that a higher number of children who were overweight and at a risk of overweight were seen in the upper SES and both showed a higher mean dietary intake of all the four food groups and snacks. The mean deft score was significantly higher in underweight children. A significantly higher mean DMFT score was observed in children at risk of overweight and overweight children. Children from the upper classes consumed more food, including snacks and were either at a risk of overweight or overweight. They had more caries in their permanent dentition. Underweight children were seen in the lower class. Although their intake of snacks was less, they had higher caries in their primary dentition.

Socioeconomic Status and Cardiovascular Responses to Standardized Stressors: A Systematic Review and Meta-Analysis.

PubMed

Boylan, Jennifer Morozink; Cundiff, Jenny M; Matthews, Karen A

2018-04-01

Disparities in cardiovascular health by socioeconomic status (SES) are a pressing public health concern. Hypothesized mechanisms linking low SES to poor health are large cardiovascular responses to and delayed recovery from psychological stress. The current study presents a meta-analysis of the literature on the association of SES with blood pressure and heart rate reactivity to and recovery from acute stress tasks. The PubMed database was searched, and 26 unique studies with relevant data were identified (k = 25 reactivity [n = 14,617], k = 6 recovery [n = 1,324]). Using random-effects models, no significant association between SES and cardiovascular reactivity to stress emerged (r = .008, 95% confidence interval = -.02 to .04), although higher SES was associated with better recovery from stress (r = -.14, 95% confidence interval -.23 to -.05). Stressor type moderated the reactivity effect, wherein higher SES was associated with greater reactivity to cognitive stressors (r = .036, p = .024), not with reactivity to interpersonal stressors (r = -.02, p = .62), but was associated with lower reactivity to tasks with combinations of cognitive, interpersonal, and physical challenges (r = -.12, p = .029). Accounting for publication bias revealed a significant association between SES and reactivity in the opposite direction of hypotheses. Cardiovascular recovery from acute stress, but not reactivity to stress, may be a key pathway between low SES and risk for cardiovascular diseases. Heterogeneity in effect size and direction, challenges related to working across temporal dynamics, and recommendations for future research are discussed.

A randomized controlled study of neuromuscular electrical stimulation in oropharyngeal dysphagia secondary to acquired brain injury.

PubMed

Terré, R; Mearin, F

2015-04-01

To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) treatment in patients with oropharyngeal dysphagia secondary to acquired brain injury. Twenty patients with neurological oropharyngeal dysphagia (14 stroke and six severe traumatic brain injury) were enrolled in a prospective randomized study, with patients and assessors blinded (to group allocation): 10 patients underwent NMES and conventional swallowing therapy and 10 patients underwent sham electrical stimulation (SES) and conventional swallowing therapy. Both groups completed 20 sessions. At baseline, at the end of treatment (1 month) and at 3-month follow-up, clinical, videofluoroscopic and esophageal manometric analyses were done. Feeding swallowing capacity was evaluated using the functional oral intake scale (FOIS). Mean FOIS score before treatment was 1.9 for the NMES group and 2.1 for the SES group. After treatment, the NMES group increased by 2.6 points (4.5 points) compared with only 1 point (3.1 points) for the SES group (P = 0.005). At 3 months of follow-up, mean scores were 5.3 and 4.6 respectively; thus, both groups improved similarly. At that time point (3 months), tracheal aspiration persisted in six patients in each group. However, a significant improvement in relation to the bolus viscosity at which aspiration appeared was found in the NMES group versus the SES group (P = 0.015). Also, a significant increase (P = 0.04) in pharyngeal amplitude contraction was observed at the end of treatment (1 month) in the NMES group compared with the SES group. Neuromuscular electrical stimulation significantly accelerated swallowing function improvement in patients with oropharyngeal dysphagia secondary to acquired brain injury. © 2015 EAN.

Effort-reward imbalance at school and depressive symptoms in Chinese adolescents: the role of family socioeconomic status.

PubMed

Guo, Hongxiang; Yang, Wenjie; Cao, Ying; Li, Jian; Siegrist, Johannes

2014-06-10

Depression is a major mental health problem during adolescence. This study, using a sample of Chinese adolescents, examined the separate and combined effects of perceived school-related stress and of family socioeconomic status (SES) on the prevalence of depressive symptoms. A total of 1774 Chinese students from Grades 7-12 were recruited into our questionnaire survey. School-related stress was measured by the Effort-Reward Imbalance Questionnaire-School Version, family SES was assessed by a standardized question, and depressive symptoms were evaluated by the Center for Epidemiological Studies Depression Scale for Children. Multivariate logistic regression was applied, adjusting for age, gender, grade, smoking, alcohol drinking and physical activity. It was found that high school-related stress and low family SES were associated with elevated odds of depressive symptoms, respectively. The effect of school-related stress was particularly strong in low SES group. In adolescents with both high stress at school and low SES, the odds ratio was 9.18 (95% confidence interval = 6.53-12.89) compared to the reference group (low stress at school and high SES). A significant synergistic interaction effect was observed (synergy index = 2.28, 95% confidence interval = 1.56-3.32). The findings indicated that perceived school-related stress, in terms of effort-reward imbalance, was related to depressive symptoms in this sample of Chinese adolescents. The strong interaction with family SES suggests that health promoting efforts in school settings should be targeted specifically at these socially deprived groups.

Tobacco industry marketing to low socioeconomic status women in the U.S.A.

PubMed

Brown-Johnson, Cati G; England, Lucinda J; Glantz, Stanton A; Ling, Pamela M

2014-11-01

Describe tobacco companies' marketing strategies targeting low socioeconomic status (SES) females in the U.S.A. Analysis of previously secret tobacco industry documents. Tobacco companies focused marketing on low SES women starting in the late 1970s, including military wives, low-income inner-city minority women, 'discount-susceptible' older female smokers and less-educated young white women. Strategies included distributing discount coupons with food stamps to reach the very poor, discount offers at point-of-sale and via direct mail to keep cigarette prices low, developing new brands for low SES females and promoting luxury images to low SES African-American women. More recently, companies integrated promotional strategies targeting low-income women into marketing plans for established brands. Tobacco companies used numerous marketing strategies to reach low SES females in the U.S.A. for at least four decades. Strategies to counteract marketing to low SES women could include (1) counteracting price discounts and direct mail coupons that reduce the price of tobacco products, (2) instituting restrictions on point-of-sale advertising and retail display and (3) creating counteradvertising that builds resistance to psychosocial targeting of low SES women. To achieve health equity, tobacco control efforts are needed to counteract the influence of tobacco industry marketing to low-income women. 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.

Understanding the Relationship between Parental Education and STEM Course Taking through Identity-Based and Expectancy-Value Theories of Motivation

ERIC Educational Resources Information Center

Svoboda, Ryan C.; Rozek, Christopher S.; Hyde, Janet S.; Harackiewicz, Judith M.; Destin, Mesmin

2016-01-01

High school students from lower-socioeconomic status (SES) backgrounds are less likely to enroll in advanced mathematics and science courses compared to students from higher-SES backgrounds. The current longitudinal study draws on identity-based and expectancy-value theories of motivation to explain the SES and mathematics and science…

Family Socioeconomic Status and Choice of STEM Major in College: An Analysis of a National Sample

ERIC Educational Resources Information Center

Niu, Lian

2017-01-01

The current study uses the data of Education Longitudinal Study of 2002 (ELS: 2002) to examine patterns of choice of STEM majors in college by students from different family socioeconomic (SES) backgrounds. Logistic regression results show that low-SES students are disadvantaged in the pursuit of STEM majors. Higher family SES compensates for…

Childhood socioeconomic status and longitudinal patterns of alcohol problems: Variation across etiological pathways in genetic risk.

PubMed

Barr, Peter B; Silberg, Judy; Dick, Danielle M; Maes, Hermine H

2018-05-14

Childhood socioeconomic status (SES) is an important aspect of early life environment associated with later life health/health behaviors, including alcohol misuse. However, alcohol misuse is modestly heritable and involves differing etiological pathways. Externalizing disorders show significant genetic overlap with substance use, suggesting an impulsivity pathway to alcohol misuse. Alcohol misuse also overlaps with internalizing disorders, suggesting alcohol is used to cope. These differing pathways could lead to different patterns over time and/or differential susceptibility to environmental conditions, such as childhood SES. We examine whether: 1) genetic risk for externalizing and internalizing disorders influence trajectories of alcohol problems across adolescence to adulthood, 2) childhood SES alters genetic risk these disorders on trajectories of alcohol problems, and 3) these patterns are consistent across sex. We find modest evidence of gene-environment interaction. Higher childhood SES increases the risk of alcohol problems in late adolescence/early adulthood, while lower childhood SES increases the risk of alcohol problems in later adulthood, but only among males at greater genetic risk of externalizing disorders. Females from lower SES families with higher genetic risk of internalizing or externalizing disorders have greater risk of developing alcohol problems. Copyright © 2018 Elsevier Ltd. All rights reserved.

Poverty, hunger, education, and residential status impact survival in HIV.

PubMed

McMahon, James; Wanke, Christine; Terrin, Norma; Skinner, Sally; Knox, Tamsin

2011-10-01

Despite combination antiretroviral therapy (ART), HIV infected people have higher mortality than non-infected. Lower socioeconomic status (SES) predicts higher mortality in many chronic illnesses but data in people with HIV is limited. We evaluated 878 HIV infected individuals followed from 1995 to 2005. Cox proportional hazards for all-cause mortality were estimated for SES measures and other factors. Mixed effects analyses examined how SES impacts factors predicting death. The 200 who died were older, had lower CD4 counts, and higher viral loads (VL). Age, transmission category, education, albumin, CD4 counts, VL, hunger, and poverty predicted death in univariate analyses; age, CD4 counts, albumin, VL, and poverty in the multivariable model. Mixed models showed associations between (1) CD4 counts with education and hunger; (2) albumin with education, homelessness, and poverty; and (3) VL with education and hunger. SES contributes to mortality in HIV infected persons directly and indirectly, and should be a target of health policy in this population.

Social Consciousness of Low-Income College Students in Taiwan: The Effects of Socioeconomic Status and Collegiate Involvement

ERIC Educational Resources Information Center

Wu, Ching-Ling

2014-01-01

This study examined the socioeconomic status (SES), collegiate involvement, and social consciousness of low-income college students (LICSs) and higher-income college students (HICSs) in Taiwan. The study analyzed 1,453 LICSs and 1,453 HICSs from 156 colleges in Taiwan. The results showed that the two student groups exhibited different SESs and…

Widening the Educational Capabilities of Socio-Economically Disadvantaged Students through a Model of Social and Cultural Capital Development

ERIC Educational Resources Information Center

Hannon, Cliona; Faas, Daniel; O'Sullivan, Katriona

2017-01-01

Widening participation programmes aim to increase the progression of students from low socio-economic status (SES) groups to higher education. This research proposes that the human capabilities approach is a good justice-based framework within which to consider the social and cultural capital processes that impact upon the educational capabilities…

What explains the socioeconomic status gap in activity? Educational differences in determinants of physical activity and screentime.

PubMed

Hankonen, Nelli; Heino, Matti T J; Kujala, Emilia; Hynynen, Sini-Tuuli; Absetz, Pilvikki; Araújo-Soares, Vera; Borodulin, Katja; Haukkala, Ari

2017-02-01

Designing evidence-based interventions to address socioeconomic disparities in health and health behaviours requires a better understanding of the specific explanatory mechanisms. We aimed to investigate a comprehensive range of potential theoretical mediators of physical activity (PA) and screen time in different socioeconomic status (SES) groups: a high SES group of high school students, and a low SES group of vocational school students. The COM-B system, including the Theoretical Domains Framework (TDF), was used as a heuristic framework to synthesise different theoretical determinants in this exploratory study. Finnish vocational and high school students (N = 659) aged 16-19, responded to a survey assessing psychological, social and environmental determinants of activity (PA and screen time). These determinants are mappable into the COM-B domains: capability, opportunity and motivation. The outcome measures were validated self-report measures for PA and screen time. The statistical analyses included a bootstrapping-based mediation procedure. Regarding PA, there were SES differences in all of the COM-B domains. For example, vocational school students reported using less self-monitoring of PA, weaker injunctive norms to engage in regular PA, and fewer intentions than high school students. Mediation analyses identified potential mediators of the SES-PA relationship in all of three domains: The most important candidates included self-monitoring (CI95 for b: 0.19-0.47), identity (0.04-0.25) and material resources available (0.01-0.16). However, SES was not related to most determinants of screentime, where there were mainly gender differences. Most determinants were similarly related with both behaviours in both SES groups, indicating no major moderation effect of SES on these relationships. This study revealed that already in the first years of educational differentiation, levels of key PA determinants differ, contributing to socioeconomic differences in PA. The analyses identified the strongest mediators of the SES-PA association, but additional investigation utilising longitudinal and experimental designs are needed. This study demonstrates the usefulness of combining constructs from various theoretical approaches to better understand the role of distinct mechanisms that underpin socioeconomic health behaviour disparities.

Ethnic differences in current smoking and former smoking in the Netherlands and the contribution of socioeconomic factors: a cross-sectional analysis of the HELIUS study.

PubMed

Brathwaite, Rachel; Smeeth, Liam; Addo, Juliet; Kunst, Anton E; Peters, Ron J G; Snijder, Marieke B; Derks, Eske M; Agyemang, Charles

2017-07-10

Data exploring how much of the ethnic differences in smoking prevalence and former smoking are explained by socioeconomic status (SES) are lacking. We therefore assessed ethnic differences in smoking prevalence and former smoking and the contribution of both educational level and occupational-related SES to the observed ethnic differences in smoking behaviour. Data of 22 929 participants (aged 18-70 years) from the multiethnic cross-sectional Healthy L i fe in an Urban Setting study in the Netherlands were analysed. Poisson regression models with a robust variance were used to estimate prevalence ratios. Compared with the Dutch, after adjustment for age and marital status, smoking prevalence was higher in men of Turkish (prevalence ratio 1.69, 95% CI 1.54 to 1.86), African Surinamese (1.55, 95% CI 1.41 to 1.69) and South-Asian Surinamese origin (1.53, 95% CI 1.40 to 1.68), whereas among women, smoking prevalence was higher in Turkish, similar in African Surinamese but lower in all other ethnic origin groups. All ethnic minority groups, except Ghanaians, had a significantly lower smoking cessation prevalence than the Dutch. Socioeconomic gradients in smoking (higher prevalence among those lower educated and with lower level employment) were observed in all groups except Ghanaian women (a higher prevalence was observed in the higher educated). Ethnic differences in smoking prevalence and former smoking are largely, but not completely, explained by socioeconomic factors. Our findings imply that antismoking policies designed to target smoking within the lower socioeconomic groups of ethnic minority populations may substantially reduce ethnic inequalities in smoking particularly among men and that certain groups may benefit from targeted smoking cessation interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Independent and combined influence of homeownership, occupation, education, income, and community poverty on physical health in persons with arthritis.

PubMed

Callahan, Leigh F; Martin, Kathryn Remmes; Shreffler, Jack; Kumar, Deepak; Schoster, Britta; Kaufman, Jay S; Schwartz, Todd A

2011-05-01

To examine the independent and combined influence of individual- and community-level socioeconomic status (SES) measures on physical health status outcomes in people with self-reported arthritis. From 2004-2005, 968 participants completed a telephone survey assessing health status, chronic conditions, community characteristics, and sociodemographic variables. Individual-level SES measures used included homeownership, occupation (professional or not), educational attainment (less than high school, high school degree, and more than high school), and income (<$15,000, $15,000-$45,000, and >$45,000). Community poverty (2000 US Census block group percentage of individuals living below the poverty line [low, medium, and high]) was used as a community-level SES measure. Outcomes were physical functioning (Medical Outcomes Study Short Form 12 version 2 physical component summary [PCS]), functional disability (Health Assessment Questionnaire [HAQ]), and the Centers for Disease Control and Prevention (CDC) Health-Related Quality of Life (HRQOL) Healthy Days physical and limited activity days, and were analyzed via multivariable regressions. When entered separately, all individual-level SES variables were significantly (P < 0.01) associated with poorer PCS, HAQ, and CDC HRQOL scores. A higher magnitude of effect was seen for household income, specifically <$15,000 per year in final models with all 4 individual SES measures and community poverty. The magnitude of effect for education is reduced and marginally significant for the PCS and number of physically unhealthy days. No effects were seen for occupation, homeownership, and community poverty. Findings confirm that after adjusting for important covariates, lower individual- and community-level SES measures are associated with poorer physical health outcomes, while household income is the strongest predictor (as measured by both significance and effect) of poorer health status in final models. Studies not having participant-reported income available should make use of other SES measures, as they do independently predict physical health. Copyright © 2011 by the American College of Rheumatology.

Feeling Frugal: Socioeconomic Status, Acculturation, and Cultural Health Beliefs among Women of Mexican Descent.

ERIC Educational Resources Information Center

Borrayo, Evelinn A.; Jenkins, Sharon Rae

2003-01-01

Investigates influences of acculturation, socioeconomic status (SES), and cultural health beliefs on Mexican-descent women's preventive health behaviors. In 5 focus group interviews sampling across levels of acculturation and SES, women expressing more traditional Mexican health beliefs about breast cancer screening were of lower SES and were less…

Socioeconomic differences in hearing among middle-aged and older adults: cross-sectional analyses using the Health Survey for England

PubMed Central

Scholes, Shaun; Biddulph, Jane; Davis, Adrian; Mindell, Jennifer S.

2018-01-01

Background Hearing loss impacts on cognitive, social and physical functioning. Both hearing loss and hearing aid use vary across population subgroups. We examined whether hearing loss, and reported current hearing aid use among persons with hearing loss, were associated with different markers of socioeconomic status (SES) in a nationally representative sample of community-dwelling middle-aged and older adults. Methods Hearing was measured using an audiometric screening device in the Health Survey for England 2014 (3292 participants aged 45 years and over). Hearing loss was defined as >35 dB HL at 3.0 kHz in the better-hearing ear. Using sex-specific logistic regression modelling, we evaluated the associations between SES and hearing after adjustment for potential confounders. Results 26% of men and 20% of women aged 45 years and over had hearing loss. Hearing loss was higher among men in the lowest SES groups. For example, the multivariable-adjusted odds of hearing loss were almost two times as high for those in the lowest versus the highest income tertile (OR 1.77, 95% CI 1.15 to 2.74). Among those with hearing loss, 30% of men and 27% of women were currently using a hearing aid. Compared with men in the highest income tertile, the multivariable-adjusted odds of using a hearing aid nowadays were lower for men in the middle (OR 0.50, 95% CI 0.25 to 0.99) and the lowest (OR 0.47, 95% CI 0.23 to 0.97) income tertiles. Associations between SES and hearing were weaker or null among women. Conclusions While the burden of hearing loss fell highest among men in the lowest SES groups, current hearing aid use was demonstrably lower. Initiatives to detect hearing loss early and increase the uptake and the use of hearing aids may provide substantial public health benefits and reduce socioeconomic inequalities in health. PMID:29391384

Searching for the Golden Model of Education: Cross-National Analysis of Math Achievement

PubMed Central

Bodovski, Katerina; Byun, Soo-yong; Chykina, Volha; Chung, Hee Jin

2017-01-01

We utilized four waves of TIMSS data in addition to the information we have collected on countries’ educational systems to examine whether different degrees of standardization, differentiation, proportion of students in private schools and governmental spending on education influence students’ math achievement, its variation and socioeconomic status (SES) gaps in math achievement. Findings: A higher level of standardization of educational systems was associated with higher average math achievement. Greater expenditure on education (as % of total government expenditure) was associated with a lower level of dispersion of math achievement and smaller SES gaps in math achievement. Wealthier countries exhibited higher average math achievement and a narrower variation. Higher income inequality (measured by Gini index) was associated with a lower average math achievement and larger SES gaps. Further, we found that higher level of standardization alleviates the negative effects of differentiation in the systems with more rigid tracking. PMID:29151667

Development of the Spanish Healthy Food Reference Budget for an adequate social participation at the minimum.

PubMed

Carrillo Álvarez, Elena; Cussó-Parcerisas, Irene; Riera-Romaní, Jordi

2016-12-01

It has been observed that diet quality and food choices vary depending on socio-economic status (SES), especially when measured through income and educational level. Although the reasons behind these differences are multiple, diet cost is a critical determinant in those groups that spend a higher proportion of their budget on food. Reference budgets are priced baskets containing the minimum goods and services necessary for well-described types of families to have an adequate social participation. In the current paper we describe the development and content of the Spanish Healthy Food Basket (SHFB). National dietary guidelines were translated into monthly food baskets. Next, these baskets were validated in terms of acceptability and feasibility through focus group discussions, and finally they were priced. The focus group discussions and the pricing were performed in Barcelona, Spain. Twenty adults aged 30-50 years from different SES backgrounds and their children aged 2-22 years participated in three discussion groups. The SHFB complies with the dietary recommendations for the Spanish population. The monthly cost of this basket ranges from 131·63 € to 573·80 € depending on the type of family. The SHFB does not have the purpose of prescribing what people should eat, but of estimating a minimum budget threshold below which healthy eating is not possible for well-described types of families. Thus, the SHFB is an educative guide on how to plan a healthy food budget and orient policies designed to guarantee food access and reduce SES inequalities.

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…

Socioeconomic status and fertility intentions among Chinese women with one child.

PubMed

Zheng, Yumei; Yuan, Jingqin; Xu, Tan; Chen, Mei; Liang, Hui; Connor, Donovan; Gao, Yongqing; Sun, Wenjie; Shankar, Nivedita; Lu, Chuanwen; Jiang, Yan

2016-04-01

There has been a lack of socioeconomic status (SES) disparity analysis on women in China with only one child, the family planning target population. In 2008, the National Research Institute for Family Planning of China conducted a study investigating the relationship between SES and fertility intentions among 17,093 women in China who already had one child. A questionnaire was used to collect information on SES and fertility intentions, and logistic regression models were used to estimate the odds ratios and 95% CIs of fertility intentions according to SES. Compared with female farmers, women in other occupations intended to have fewer children (p < 0.05). Additionally, compared with women with low educational level (illiterate/primary), women with secondary and postsecondary education intended to have fewer children (p < 0.05) (OR = 0.70; 95% CI: 0.61-0.81 and OR = 0.56; 95% CI 0.47-0.66). A mother's education level was significantly and negatively associated with fertility intentions after adjustment for potential confounders (p < 0.05). Among Chinese women who had one child, the women with higher SES (e.g. higher educational level) had lower fertility intentions. There is an SES disparity in the fertility intention among Chinese women who already have one child. China's policy-makers should consider increasing high SES women's fertility intention.

Interpersonal conflict and depression among Japanese workers with high or low socioeconomic status: findings from the Japan Work Stress and Health Cohort Study.

PubMed

Inoue, Akiomi; Kawakami, Norito

2010-07-01

Research that focuses on the relationship between interpersonal conflict at work (i.e., intragroup conflict and intergroup conflict) and depression that also considers differences in socioeconomic status (SES) is limited. The purpose of the current study is to investigate the relationship between interpersonal conflict at work and depression at different levels of SES. A cross-sectional study was conducted with a total of 17,390 males and 2923 females employed in nine factories located in several regions of Japan. These participants were surveyed using a self-administered questionnaire that included self-reported measures of interpersonal conflict at work (intragroup conflict and intergroup conflict), SES (education and occupation), worksite support (supervisor support and coworker support), depression (assessed using the Center for Epidemiologic Studies Depression [CES-D] scale), and other demographic covariates. Those who had scores of 16 + on the CES-D scale (4066 males and 873 females) were classified as experiencing depression. The association of interpersonal conflict with depression was significantly greater among males of a high SES (i.e., higher educational status and non-manual workers) than males of a low SES (i.e., lower educational status and manual workers) after adjusting for demographic variables, supervisor support, and coworker support. More specifically, the association of intergroup conflict with depression was significantly greater among males of a high SES than males of a low SES. However, this pattern was not observed in females. The current study suggests that males of a higher SES are more vulnerable to interpersonal conflict at work in terms of developing depression than males of a lower SES. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Individual and neighborhood socioeconomic status and inflammation in Mexican American women: what is the role of obesity?

PubMed

Gallo, Linda C; Fortmann, Addie L; de Los Monteros, Karla Espinosa; Mills, Paul J; Barrett-Connor, Elizabeth; Roesch, Scott C; Matthews, Karen A

2012-06-01

Inflammation may represent a biological mechanism underlying associations of socioeconomic status (SES) with cardiovascular disease. We examined relationships of individual and neighborhood SES with inflammatory markers in Mexican American women and evaluated contributions of obesity and related heath behaviors to these associations. Two hundred eighty-four Mexican American women (mean age = 49.74 years) were recruited from socioeconomically diverse South San Diego communities. Women completed measures of sociodemographic characteristics and health behaviors, and underwent a physical examination with fasting blood draw for assay of plasma C-reactive protein (CRP), interleukin 6 (IL-6), and soluble intercellular adhesion molecule 1 (sICAM-1). Neighborhood SES was extracted from the US Census Bureau 2000 database. In multilevel models, a 1-standard deviation higher individual or neighborhood SES related to a 27.35% and 23.56% lower CRP level (p values < .01), a 7.04% and 5.32% lower sICAM-1 level (p values < .05), and a 10.46% (p < .05) and 2.40% lower IL-6 level (not significant), respectively. Controlling for individual SES, a 1-standard deviation higher neighborhood SES related to a 18.05% lower CRP level (p = .07). Differences in body mass index, waist circumference, and dietary fat consumption contributed significantly to SES-inflammation associations. The findings support a link between SES and inflammatory markers in Mexican American women and implicate obesity and dietary fat in these associations. Additional effects of neighborhood SES were not statistically significant; however, these findings should be viewed tentatively due to the small sample size to evaluate contextual effects. Trial Registration ClinicalTrials.gov identifier: NCT00387166.

Associations among socioeconomic status, patterns of care and outcomes in breast cancer patients in a universal health care system: Ontario's experience.

PubMed

Kumachev, Alexander; Trudeau, Maureen E; Chan, Kelvin K W

2016-03-15

The Canadian health care system provides equitable access to equivalent standards of care. The authors investigated to determine whether patients with breast cancer who had different socioeconomic status (SES) received different care and had different overall survival (OS) in Ontario, Canada. Women who were diagnosed with breast cancer between 2004 and 2009 were identified from the Ontario Cancer Registry and linked to provincial databases to ascertain patient demographics, screening, diagnosis, treatment patterns, and survival. SES was defined as neighborhood income by postal code and was divided into income quintiles (Q1-Q5; with Q5 the highest SES quintile). Univariable and multivariable analyses were used to examine the associations between: 1) SES and mammogram screening and breast cancer treatments, and 2) SES and OS. In total, 34,776 patients with breast cancer who had information on disease stage available at diagnosis were identified. Seventy-six percent of women were aged >50 years. Patients with higher SES were more likely to be diagnosed at an earlier stage (Q5 [44.3%] vs Q1 [37.7%]; odds ratio [OR], 1.31; 95% confidence interval [CI], 1.23-1.41; P < .0001) and also were more likely to receive adjuvant chemotherapy (Q5 vs Q1: OR, 1.18; 95% CI, 1.10-1.26; P < .0001) and radiotherapy (Q5 vs Q1: OR, 1.24; 95% CI, 1.15-1.33; P < .0001). The 5-year OS rates for Q1 through Q5 were 80%, 81%, 82.2%, 83.9%, and 85.7%, respectively (P < .0001). After adjusting for patient demographics, cancer stage at diagnosis, adjuvant chemotherapy, trastuzumab, radiotherapy and surgery types, higher SES remained associated with better OS (P = .0017). In a universal health care system, higher SES is associated with greater screening and treatments and with better OS after adjusting for screening, cancer stage at diagnosis, and treatments. © 2015 American Cancer Society.

Malaria, anaemia and under-nutrition: three frequently co-existing conditions among preschool children in rural Rwanda.

PubMed

Kateera, Fredrick; Ingabire, Chantal M; Hakizimana, Emmanuel; Kalinda, Parfait; Mens, Petra F; Grobusch, Martin P; Mutesa, Leon; van Vugt, Michèle

2015-11-05

Malaria, anaemia and under-nutrition are three highly prevalent and frequently co-existing diseases that cause significant morbidity and mortality particularly among children aged less than 5 years. Currently, there is paucity of conclusive studies on the burden of and associations between malaria, anaemia and under-nutrition in Rwanda and comparable sub-Saharan and thus, this study measured the prevalence of malaria parasitaemia, anaemia and under-nutrition among preschool age children in a rural Rwandan setting and evaluated for interactions between and risk determinants for these three conditions. A cross-sectional household (HH) survey involving children aged 6-59 months was conducted. Data on malaria parasitaemia, haemoglobin densities, anthropometry, demographics, socioeconomic status (SES) and malaria prevention knowledge and practices were collected. The prevalences of malaria parasitaemia and anaemia were 5.9 and 7.0 %, respectively, whilst the prevalence of stunting was 41.3 %. Malaria parasitaemia risk differed by age groups with odds ratio (OR) = 2.53; P = 0.04 for age group 24-35 months, OR = 3.5; P = 0.037 for age group 36-47 months, and OR = 3.03; P = 0.014 for age group 48-60 months, whilst a reduced risk was found among children living in high SES HHs (OR = 0.37; P = 0.029). Risk of anaemia was high among children aged ≥12 months, those with malaria parasitaemia (OR = 3.86; P ≤ 0.0001) and children living in HHs of lower SES. Overall, under-nutrition was not associated with malaria parasitaemia. Underweight was higher among males (OR = 1.444; P = 0.019) and children with anaemia (OR = 1.98; P = 0.004). In this study group, four in 10 and one in 10 children were found stunted and underweight, respectively, in an area of low malaria transmission. Under-nutrition was not associated with malaria risk. While the high prevalence of stunting requires urgent response, reductions in malaria parasitaemia and anaemia rates may require, in addition to scaled-up use of insecticide-treated bed nets and indoor residual insecticide spraying, improvements in HH SES and better housing to reduce risk of malaria.

Relationship between Self Concept, School Performance, and Divergent Thinking. Final Report.

ERIC Educational Resources Information Center

Trowbridge, Norma

This investigation attempts to explore the relationship between self concept and socio-economic status (SES) of children from 8 to 14 years of age. In a sample of 3789 children in central U. S. children of low SES scored higher than children of middle SES at all ages, in both sexes, among blacks as well as whites, and in rural areas as well as…

Can negative life events and coping style help explain socioeconomic differences in perceived stress among adolescents? A cross-sectional study based on the West Jutland cohort study

PubMed Central

2013-01-01

Background Previous research suggests that perceived stress in adolescence is socially patterned, but that this relationship may depend on the measure of socioeconomic status (SES) used. This study examines if social gradients in perceived stress, negative life events, and coping exist amongst Danish adolescents, and, if life events and coping strategies can partly account for an association between SES and perceived stress. These relationships are studied separately for two different measures of SES. Methods Questionnaire data were collected from 3054 14–15 year old youths (83% response rate) during baseline measurement in the West Jutland birth cohort study. Parents were identified via the Central Office of Civil Registration in which the respondents are linked to their parents or guardians via their CPR-number, a personal identification number given to everyone in Denmark. The study employs data from two independent sources, adolescent self-report data (stress, life events and coping) and national registers (parental educational level, household income and confounder variables). Ordinary Least Squares regression estimated the effects of parental SES, negative life events and coping on perceived stress. Analyses were stratified by gender. Results Girls reported more perceived stress than boys. SES accounted for a small but significant amount of the variance in perceived stress. Lower parental education and lower household income were associated with higher stress levels irrespective of gender, but the social gradient was strongest amongst girls when parents’ education was used to measure SES, and strongest for boys when income was used. Life events and coping were also found to be associated with SES and both mediated part of the SES-perceived stress relationship. In general, the social gradient in perceived stress was accounted for by the study variables to a higher degree among girls than among boys. Conclusions Lower parental education and household income are associated with higher levels of perceived stress amongst Danish adolescents. Furthermore, both life events and coping appear to mediate this relation. Gender differences in the ways SES and stress are related may exist. PMID:23724872

Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster

PubMed Central

Esteban-Vasallo, María D; Domínguez-Berjón, M Felicitas; Gil-Prieto, Ruth; Astray-Mochales, Jenaro; Gil de Miguel, Ángel

2014-01-01

The objectives of this study were to estimate incidence density rates (IDR) of herpes zoster (HZ) and to analyze the association with sociodemographic characteristics and selected chronic medical conditions. The study cohort consisted of the adult population included in the Public Health System of the Autonomous Community of Madrid, Spain on 1/10/2009 (5 244 402 persons). Data source were electronic medical records from primary care between 1/10/2009–31/12/2012. Individual socioeconomic status (SES) was inferred by geocoding. Poisson regression analyses were stratified by sex, to identify factors associated with HZ. We identified 81 541 incident cases of HZ (61.7% in women and 46.5% in the group aged 60 and over). IDR was 4.11 per 1000 person-years in men and 5.95 in women. IDR were higher with age, in autochthonous population, those with lower SES and in patients with immunodeficiencies. After adjustment, higher incidence rate ratios were found with age, autochthonous origin, lower SES, and in patients with HIV-infection/AIDS (3.20, CI95% 2.90–3.53 in men and 2.98, CI95% 2.58–3.45 in women), and other immunodeficiencies (1.57, CI95% 1.41–1.75 and 1.65, CI95% 1.50–1.80). COPD, asthma, DM, ischemic heart disease, other cardiovascular diseases, and cancer were also associated with an increased incidence of HZ. We conclude that older, autochthonous patients with lower SES and with certain underlying medical conditions had a higher probability of suffering HZ. Electronic databases are useful for estimating the incidence of HZ, and for finding associations with sociodemographic and clinical characteristics. Identifying unrecognized risk factors for HZ, such as asthma or cardiovascular diseases, is crucial to interpret the epidemiology of HZ, to target vaccination programs and to monitor their effect. PMID:24805130

Sociodemographic characteristics and chronic medical conditions as risk factors for herpes zoster: a population-based study from primary care in Madrid (Spain).

PubMed

Esteban-Vasallo, María D; Domínguez-Berjón, M Felicitas; Gil-Prieto, Ruth; Astray-Mochales, Jenaro; Gil de Miguel, Angel

2014-01-01

The objectives of this study were to estimate incidence density rates (IDR) of herpes zoster (HZ) and to analyze the association with sociodemographic characteristics and selected chronic medical conditions. The study cohort consisted of the adult population included in the Public Health System of the Autonomous Community of Madrid, Spain on 1/10/2009 (5 244 402 persons). Data source were electronic medical records from primary care between 1/10/2009-31/12/2012. Individual socioeconomic status (SES) was inferred by geocoding. Poisson regression analyses were stratified by sex, to identify factors associated with HZ. We identified 81 541 incident cases of HZ (61.7% in women and 46.5% in the group aged 60 and over). IDR was 4.11 per 1000 person-years in men and 5.95 in women. IDR were higher with age, in autochthonous population, those with lower SES and in patients with immunodeficiencies. After adjustment, higher incidence rate ratios were found with age, autochthonous origin, lower SES, and in patients with HIV-infection/AIDS (3.20, CI95% 2.90-3.53 in men and 2.98, CI95% 2.58-3.45 in women), and other immunodeficiencies (1.57, CI95% 1.41-1.75 and 1.65, CI95% 1.50-1.80). COPD, asthma, DM, ischemic heart disease, other cardiovascular diseases, and cancer were also associated with an increased incidence of HZ. We conclude that older, autochthonous patients with lower SES and with certain underlying medical conditions had a higher probability of suffering HZ. Electronic databases are useful for estimating the incidence of HZ, and for finding associations with sociodemographic and clinical characteristics. Identifying unrecognized risk factors for HZ, such as asthma or cardiovascular diseases, is crucial to interpret the epidemiology of HZ, to target vaccination programs and to monitor their effect.

Race, Socioeconomic Status, and Health during Childhood: A Longitudinal Examination of Racial/Ethnic Differences in Parental Socioeconomic Timing and Child Obesity Risk.

PubMed

Jones, Antwan

2018-04-11

Prior research suggests that socioeconomic standing during the early years of life, particularly in utero, is associated with child health. However, it is unclear whether socioeconomic benefits are only maximized at very young ages. Moreover, given the link between socioeconomic status (SES) and race, research is inconclusive whether any SES benefits during those younger ages would uniformly benefit all racial and ethnic groups. Using 1986-2014 data from the National Longitudinal Study of Youth (NLSY79), this study examines the impact of socioeconomic timing on child weight outcomes by race. Specifically, this research investigates whether specific points exist where socioeconomic investment would have higher returns on child health. Findings suggest that both the timing and the type of socioeconomic exposure is important to understanding child weight status. SES, particularly mother's employment and father's education, is important in determining child health, and each measure is linked to weight gain differently for White, Black, and Hispanic children at specific ages. Policies such as granting more educational access for men and work-family balance for women are discussed.

Cognitive Abilities That Mediate SES's Effect on Elementary Mathematics Learning: The Uruguayan Tablet-Based Intervention

ERIC Educational Resources Information Center

Valle-Lisboa, Juan; Cabana, Álvaro; Eisinger, Robert; Mailhos, Álvaro; Luzardo, Mario; Halberda, Justin; Maiche, Alejandro

2016-01-01

In unequal societies the effectiveness of formal education depends on the socioeconomic status (SES) of students. Studies have shown that poverty affects the development of the brain in ways that might compromise future learning, thus increasing the differences between groups with different SES. Interest is growing in the development of tools that…

Equity impact of population-level interventions and policies to reduce smoking in adults: a systematic review.

PubMed

Brown, Tamara; Platt, Stephen; Amos, Amanda

2014-05-01

There is strong evidence about which tobacco control policies reduce smoking. However, their equity impact is uncertain. The aim was to assess the effectiveness of population-level interventions/policies to reduce socioeconomic inequalities in adult smoking. Systematic review of studies of population-level interventions/policies reporting smoking-related outcomes in adults of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed. Results are presented in a narrative synthesis. Equity impact was assessed as: positive (reduced inequality), neutral (no difference by SES), negative (increased inequality), mixed (equity impact varied) or unclear. 117 studies of 130 interventions/policies were included: smokefree (44); price/tax (27); mass media campaigns (30); advertising controls (9); cessation support (9); settings-based interventions (7); multiple policies (4). The distribution of equity effects was: 33 positive, 36 neutral, 38 negative, 6 mixed, 17 unclear. Most neutral equity studies benefited all SES groups. Fourteen price/tax studies were equity positive. Voluntary, regional and partial smokefree policies were more likely to be equity negative than national, comprehensive smokefree policies. Mass media campaigns had inconsistent equity effects. Cigarette marketing controls were equity positive or neutral. Targeted national smoking cessation services can be equity positive by achieving higher reach among low SES, compensating for lower quit rates. Few studies have assessed the equity impact of tobacco control policy/interventions. Price/tax increases had the most consistent positive equity impact. More research is needed to strengthen the evidence-base for reducing smoking inequalities and to develop effective equity-orientated tobacco control strategies. Copyright © 2014. Published by Elsevier Ireland Ltd.

The impact of nutritional labels and socioeconomic status on energy intake. An experimental field study.

PubMed

Crockett, Rachel A; Jebb, Susan A; Hankins, Matthew; Marteau, Theresa M

2014-10-01

There is some evidence for paradoxical effects of nutritional labelling on energy intake particularly amongst restrained eaters and those with a higher body mass index (BMI) resulting in greater consumption of energy from foods with a positive health message (e.g. "low-fat") compared with the same foods, unlabelled. This study aimed to investigate, in a UK general population sample, the likelihood of paradoxical effects of nutritional labelling on energy intake. Participants (n = 287) attended a London cinema and were offered a large tub of salted or toffee popcorn. Participants were randomised to receive their selected flavour with one of three labels: a green low-fat label, a red high-fat label or no label. Participants watched two film clips while completing measures of demographic characteristics, emotional state and taste of the popcorn. Following the experiment, popcorn consumption was measured. There were no main effects of nutritional labelling on consumption. Contrary to predictions neither BMI nor weight concern moderated the effect of label on consumption. There was a three-way interaction between low-fat label, weight concern and socioeconomic status (SES) such that weight-concerned participants of higher SES who saw a low-fat label consumed more than weight unconcerned participants of similar SES (t = -2.7, P = .04). By contrast, weight-concerned participants of lower SES seeing either type of label, consumed less than those seeing no label (t = -2.04, P = .04). Nutritional labelling may have different effects in different socioeconomic groups. Further studies are required to understand fully the possible contribution of food labelling to health inequalities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICS study.

PubMed

Fernández-Alvira, J M; Bammann, K; Pala, V; Krogh, V; Barba, G; Eiben, G; Hebestreit, A; Veidebaum, T; Reisch, L; Tornaritis, M; Kovacs, E; Huybrechts, I; Moreno, L A

2014-07-01

Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.

Microbial quality of food available to populations of differing socioeconomic status.

PubMed

Koro, Marlen E; Anandan, Shivanthi; Quinlan, Jennifer J

2010-05-01

Low SES has been shown to be linked to poorer-quality diets, decreased consumption of fresh produce, and an increased reliance on small retail stores. The objective of this research was to determine if there is a difference in the microbial quality and potential safety of food available to low-SES versus high-SES populations at the retail level. Aerobic plate count (APC); yeast and mold counts (Y & M); and total coliforms were determined in ready-to-eat (RTE) greens, pre-cut watermelon, broccoli, strawberries, cucumbers, milk, and orange juice and compared among products purchased in stores in low- versus those purchased in high-SES neighborhoods between June 2005 and September 2006. APC, fecal coliforms, and E. coli in ground beef and the presence of Salmonella and Campylobacter in chicken were also compared. Results showed higher microbial loads on produce from markets in low-SES areas. Significant differences observed included (1) APC and Y&M in RTE greens, (2) APC and Y&M in strawberries, and (3) YMCs in cucumbers. No difference was detected in the level of pathogens in raw meat and poultry; however, the APC in ground beef available in high-SES markets was significantly higher compared with that found in low-SES markets. The results presented here indicate that populations of low SES may be more likely to experience produce of poorer microbial quality, which may have an impact on both the appeal and potential safety of the produce. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Impact of neighbourhood socio-economic status on bystander cardiopulmonary resuscitation in Paris.

PubMed

Dahan, Benjamin; Jabre, Patricia; Karam, Nicole; Misslin, Renaud; Tafflet, Muriel; Bougouin, Wulfran; Jost, Daniel; Beganton, Frankie; Marijon, Eloi; Jouven, Xavier

2017-01-01

No European data currently describe the relation between neighbourhood socio-economic status (SES) and rates of out-of-hospital cardiac arrest (OHCA) bystander cardiopulmonary resuscitation (CPR). This study aims to analyse this effect with a robust deprivation index. Data about all OHCA in Paris were collected prospectively between 2000 and 2010. A geographical neighbourhood unit was assigned to each case. Median household income, and rates of blue-collar workers, unemployment, and adults without high school diplomas were selected as SES characteristics and used to classify neighbourhoods as low SES or higher SES. We analysed the relationship between neighbourhood SES characteristics and the probability of receiving bystander CPR. Of the 4009 OHCA with mappable addresses recorded, 777 (19.4%) received bystander CPR. Compared to OHCA who did not receive bystander CPR, those receiving CPR were significantly more likely to have occurred in public locations, have had a witness to their OHCA, and not to have collapsed in a low SES neighbourhood, or in a neighbourhood with a median household income in the lowest quartile and with rates of no high school diplomas and blue-collar workers in the highest quartile. In the multilevel analyses, bystander CPR provision was significantly less frequent in low than in higher SES neighbourhoods (OR 0.85; 95% confidence interval [CI] 0.72-0.99). In the city of Paris, OHCA victims were less likely to receive bystander CPR in low SES neighbourhoods. These first European data are consistent with observations in North America and Asia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effort-Reward Imbalance at School and Depressive Symptoms in Chinese Adolescents: The Role of Family Socioeconomic Status

PubMed Central

Guo, Hongxiang; Yang, Wenjie; Cao, Ying; Li, Jian; Siegrist, Johannes

2014-01-01

Depression is a major mental health problem during adolescence. This study, using a sample of Chinese adolescents, examined the separate and combined effects of perceived school-related stress and of family socioeconomic status (SES) on the prevalence of depressive symptoms. A total of 1774 Chinese students from Grades 7–12 were recruited into our questionnaire survey. School-related stress was measured by the Effort-Reward Imbalance Questionnaire-School Version, family SES was assessed by a standardized question, and depressive symptoms were evaluated by the Center for Epidemiological Studies Depression Scale for Children. Multivariate logistic regression was applied, adjusting for age, gender, grade, smoking, alcohol drinking and physical activity. It was found that high school-related stress and low family SES were associated with elevated odds of depressive symptoms, respectively. The effect of school-related stress was particularly strong in low SES group. In adolescents with both high stress at school and low SES, the odds ratio was 9.18 (95% confidence interval = 6.53–12.89) compared to the reference group (low stress at school and high SES). A significant synergistic interaction effect was observed (synergy index = 2.28, 95% confidence interval = 1.56–3.32). The findings indicated that perceived school-related stress, in terms of effort-reward imbalance, was related to depressive symptoms in this sample of Chinese adolescents. The strong interaction with family SES suggests that health promoting efforts in school settings should be targeted specifically at these socially deprived groups. PMID:24919130

Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women

PubMed Central

Gregory, Rebecca; Cheng, Hu; Rupp, Heather A.; Sengelaub, Dale R.; Heiman, Julia R.

2015-01-01

After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother–infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual desire was positively correlated with VTA activation to sexual images and with SES. Our findings show that postpartum decreases in sexual desire may in part be mediated by VTA activation, and oxytocin increased activation of the VTA but not NAc in response to sexual and infant stimuli. Oxytocin may contribute to the altered reproductive priorities in postpartum women by increasing VTA activation to salient infant stimuli. PMID:25562711

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 risk of cardio metabolic diseases in later life. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of dietary selenium source (organic vs. mineral) and muscle pH on meat quality characteristics of pigs.

PubMed

Calvo, Luis; Toldrá, Fidel; Rodríguez, Ana I; López-Bote, Clemente; Rey, Ana I

2017-01-01

This study evaluates the effect of organic (Se-enriched yeast; SeY) versus inorganic selenium (sodium selenite; SeS) supplementation and the different response of selenium source according to muscle pH on pork meat quality characteristics. Pigs ( n  = 30) were fed the Se-supplemented diets (0.3 mg/kg) for 65 days. Neither electric conductivity (EC) nor drip loss were affected by the selenium source. The SeY group had lower TBARS in muscle samples after day 7 of refrigerated storage and higher a * values on days 1 and 7 than the SeS group. The effect of dietary selenium source on some meat quality characteristics was affected by muscle pH. Hence, as the muscle pH increases, the drip loss decreases but this effect is more marked with the dietary organic Se enrichment. Muscle pH seems to modulate the action of selenium in pork, especially some meat characteristics such as drip loss.

Iodine Intake Estimation from the Consumption of Instant Noodles, Drinking Water and Household Salt in Indonesia

PubMed Central

Sutrisna, Aang; Knowles, Jacky; Basuni, Abas; Menon, Ravi; Sugihantono, Anung

2018-01-01

The objective of this study was to assess the contribution of iodine intake from iodised household salt, iodised salt in instant noodles, and iodine in ground water in five regions of Indonesia. Secondary data analysis was performed using the 2013 Primary Health Research Survey, the 2014 Total Diet Study, and data from food industry research. Iodine intake was estimated among 2719 children, 10–12 years of age (SAC), 13,233 women of reproductive age (WRA), and 578 pregnant women (PW). Combined estimated iodine intake from the three stated sources met 78%, 70%, and 41% of iodine requirements for SAC, WRA and PW, respectively. Household salt iodine contributed about half of the iodine requirements for SAC (49%) and WRA (48%) and a quarter for PW (28%). The following variations were found: for population group, the percentage of estimated dietary iodine requirements met by instant noodle consumption was significantly higher among SAC; for region, estimated iodine intake was significantly higher from ground water for WRA in Java, and from household salt for SAC and WRA in Kalimantan and Java; and for household socio-economic status (SES), iodine intake from household salt was significantly higher in the highest SES households. Enforcement of clear implementing regulations for iodisation of household and food industry salt will promote optimal iodine intake among all population groups with different diets. PMID:29517995

Iodine Intake Estimation from the Consumption of Instant Noodles, Drinking Water and Household Salt in Indonesia.

PubMed

Sutrisna, Aang; Knowles, Jacky; Basuni, Abas; Menon, Ravi; Sugihantono, Anung

2018-03-08

The objective of this study was to assess the contribution of iodine intake from iodised household salt, iodised salt in instant noodles, and iodine in ground water in five regions of Indonesia. Secondary data analysis was performed using the 2013 Primary Health Research Survey, the 2014 Total Diet Study, and data from food industry research. Iodine intake was estimated among 2719 children, 10-12 years of age (SAC), 13,233 women of reproductive age (WRA), and 578 pregnant women (PW). Combined estimated iodine intake from the three stated sources met 78%, 70%, and 41% of iodine requirements for SAC, WRA and PW, respectively. Household salt iodine contributed about half of the iodine requirements for SAC (49%) and WRA (48%) and a quarter for PW (28%). The following variations were found: for population group, the percentage of estimated dietary iodine requirements met by instant noodle consumption was significantly higher among SAC; for region, estimated iodine intake was significantly higher from ground water for WRA in Java, and from household salt for SAC and WRA in Kalimantan and Java; and for household socio-economic status (SES), iodine intake from household salt was significantly higher in the highest SES households. Enforcement of clear implementing regulations for iodisation of household and food industry salt will promote optimal iodine intake among all population groups with different diets.

Craniofacial asymmetry as a marker of socioeconomic status among undocumented Mexican immigrants in the United States.

PubMed

Weisensee, Katherine E; Spradley, M Katherine

2018-05-01

This study examines levels of fluctuating asymmetry (FA) in Mexican residents, U.S. residents, and undocumented border crossers (UBCs) from Mexico to the United States. Craniofacial structures develop symmetrically under ideal circumstances; however, during periods of developmental stress random deviations from perfect symmetry, or FA, can occur. It is hypothesized that the UBC sample would represent individuals of a lower socioeconomic status (SES) who experienced higher stress levels during development, and that these individuals would consequently have higher levels of FA. Three-dimensional cranial landmarks were collected from 509 individuals representing the three resident groups. Geometric morphometric methods were used to calculate an FA score for each individual. The FA score provides a distance measure that is a scalar measure of the magnitude of FA in each individual. The results show that the difference in the means of the FA scores between UBCs and U.S. residents is 0.43 (p = 0.02), with UBCs showing significantly higher levels of FA compared to U.S. residents. Moreover, Mexican residents' FA levels are intermediate between and not significantly different from the other two samples. These results suggest that levels of FA may prove useful for reconstructing individuals' social and economic circumstances, and that craniofacial asymmetry provides a suitable biological marker for analyzing differences in SES among different groups. Copyright © 2018 Elsevier B.V. All rights reserved.

Sex Differences in Language Across Early Childhood: Family Socioeconomic Status does not Impact Boys and Girls Equally.

PubMed

Barbu, Stéphanie; Nardy, Aurélie; Chevrot, Jean-Pierre; Guellaï, Bahia; Glas, Ludivine; Juhel, Jacques; Lemasson, Alban

2015-01-01

Child sex and family socioeconomic status (SES) have been repeatedly identified as a source of inter-individual variation in language development; yet their interactions have rarely been explored. While sex differences are the focus of a renewed interest concerning emerging language skills, data remain scarce and are not consistent across preschool years. The questions of whether family SES impacts boys and girls equally, as well as of the consistency of these differences throughout early childhood, remain open. We evaluated consistency of sex differences across SES and age by focusing on how children (N = 262), from 2;6 to 6;4 years old, from two contrasting social backgrounds, acquire a frequent phonological alternation in French - the liaison. By using a picture naming task eliciting the production of obligatory liaisons, we found evidence of sex differences over the preschool years in low-SES children, but not between high-SES boys and girls whose performances were very similar. Low-SES boys' performances were the poorest whereas low-SES girls' performances were intermediate, that is, lower than those of high-SES children of both sexes but higher than those of low-SES boys. Although all children's mastery of obligatory liaisons progressed with age, our findings showed a significant impeding effect of low-SES, especially for boys.

Low socioeconomic status may increase the risk of central obesity in incoming university students in Taiwan.

PubMed

Chao, Chi-Yuan; Shih, Chi-Chen; Wang, Chi-Jen; Wu, Jin-Shang; Lu, Feng-Hwa; Chang, Chih-Jen; Yang, Yi-Ching

2014-01-01

Obesity is related to social disparity. The objective of the study was to evaluate different indicators of parental SES with the association of central obesity in young adult Taiwanese students. This study was cross-sectionally designed and a total of 4552 subjects were recruited. Each subject completed a self-administrated questionnaire and received anthropometric and laboratory measurements. The indicators of SES in study subjects included parental education, occupation, household incomes, childhood and current index of social position (ISP), measured according to the modified Hollingshead's ISP. Central obesity was defined as waist circumference ≥90 cm in men and ≥80 cm in women. The prevalence of central obesity was 10.7% in this study. When compared to subjects with normal waist circumferences, subjects with central obesity were older, had a higher BMI, both systolic and diastolic blood pressure, a higher proportion of male gender, family history of diabetes and hypertension, alcohol consumption habit, and a higher proportion of low current household income, current parental blue collar occupational level, and lower current and childhood parental ISP level. Multivariate analysis showed the current parental household income and ISP were significantly higher indicators of risk of central obesity after adjustment for possible confounding factors. The odds ratios were 1.26 and 1.30, respectively. Our results showed that low household income and current ISP were independently associated with the risk of central obesity. Therefore, young adults with low SES should be an important target group for prevention and management of central obesity in school health promotion programs. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

Psychometric Evaluation of the Adolescent Health Promotion Scale in Chile: Differences by Socioeconomic Status and Gender.

PubMed

Rojas-Barahona, Cristian A; Gaete, Jorge; Olivares, Esterbina; Förster, Carla E; Chandia, Eugenio; Chen, Mei-Yen

2017-12-01

The promotion of healthy behaviors is a relevant issue worldwide, especially among adolescent populations, as this is the developmental stage where most unhealthy behaviors become ingrained. The aim of this study was to analyze the psychometric properties of the Spanish version of the Adolescent Health Promotion Scale (AHPS) in a Chilean sample of early adolescents. The sample was composed of 1,156 adolescents aged 10-14 years from schools in San Felipe, Chile. Item structure was assessed using exploratory and confirmatory factor analyses; reliability was measured using Cronbach's alpha; and differences in terms of gender, age, and socioeconomic status (SES) were established using analysis of variance. The analyses of item structure identified all of the six original factors (nutrition behaviors, health responsibility, social support, life appreciation, stress management and exercise behavior) as significant. However, eight items did not fit the Chilean population well. Therefore, the AHPS in Chile has been reduced to 32 items. The Cronbach's alpha of the 32-item Chilean AHPS was .95, with the subscale coefficients ranging from .76 to .94. In addition, female subjects performed better than male subjects, and individuals of higher SES scored higher than the middle and lower socioeconomic groups. No differences on AHPS scores were found in different age groups. The AHPS appears to have good psychometric properties in terms of item structure and reliability. Consistent with studies carried out in other countries, health promotion behavioral differences were observed in association with gender and SES. The results support the Chilean version of the AHPS as an appropriate instrument for measuring the health promotion behaviors of early adolescents in Chile and for comparing results with those from other countries.

COHORT CHANGES IN THE SOCIAL DISTRIBUTION OF TOLERANT SEXUAL ATTITUDES

PubMed Central

Pampel, Fred C.

2017-01-01

Though many studies have described societal-wide changes in tolerance for sexual behaviors outside marriage, few have examined how the social distribution of tolerant attitudes has changed. A diffusion-of-innovations approach predicts nonlinear change in the distribution: high SES groups adopt the attitudes first, which produces a positive relationship, but diffusion to other SES groups subsequently weakens the association with SES. I test this argument using the General Social Survey from 1973 to 2014 to compare the SES determinants of attitudes toward premarital sex, extramarital sex, same-gender sex, and teenage sex across 86 cohorts born from around 1900 to 1985. Multilevel age, period, and cohort models support diffusion arguments concerning tolerance of premarital sex by demonstrating that the effects of indicators of SES first strengthen and then weaken across cohorts. Little support emerges for diffusion arguments concerning tolerance of extramarital sex and teenage sex, and preliminary but suggestive support emerges concerning tolerance of same-gender sex. PMID:28533566

Neural Correlates of Math Gains Vary Depending on Parental Socioeconomic Status (SES)

PubMed Central

Demir-Lira, Özlem Ece; Prado, Jérôme; Booth, James R.

2016-01-01

We used functional magnetic resonance imaging (fMRI) to examine the neural predictors of math development, and asked whether these predictors vary as a function of parental socioeconomic status (SES) in children ranging in age from 8 to 13 years. We independently localized brain regions subserving verbal versus spatial processing in order to characterize relations between activation in these regions during an arithmetic task and long-term change in math skill (up to 3 years). Neural predictors of math gains encompassed brain regions subserving both verbal and spatial processing, but the relation between relative reliance on these regions and math skill growth varied depending on parental SES. Activity in an area of the left inferior frontal gyrus (IFG) identified by the verbal localizer was related to greater growth in math skill at the higher end of the SES continuum, but lesser improvements at the lower end. Activity in an area of the right superior parietal cortex identified by the spatial localizer was related to greater growth in math skill at the lower end of the SES continuum, but lesser improvements at the higher end. Results highlight early neural mechanisms as possible neuromarkers of long-term arithmetic learning and suggest that neural predictors of math gains vary with parental SES. PMID:27378987

‘Obesogenic’ School Food Environments? An Urban Case Study in The Netherlands

PubMed Central

Timmermans, Joris; Dijkstra, Coosje; Kamphuis, Carlijn; van der Zee, Egbert; Poelman, Maartje

2018-01-01

(1) Background: This study aimed to explore and define socio-economic (SES) differences in urban school food environments in The Netherlands. (2) Methods: Retail food outlets, ready-to-eat products, in-store food promotions and food advertisements in public space were determined within 400 m walking distance of all secondary schools in the 4th largest city of The Netherlands. Fisher’s exact tests were conducted. (3) Results: In total, 115 retail outlets sold ready-to-eat food and drink products during school hours. Fast food outlets were more often in the vicinity of schools in lower SES (28.6%) than in higher SES areas (11.5%). In general, unhealthy options (e.g., fried snacks, sugar-sweetened beverages (SSB)) were more often for sale, in-store promoted or advertised in comparison with healthy options (e.g., fruit, vegetables, bottled water). Sport/energy drinks were more often for sale, and fried snacks/fries, hamburgers/kebab and SSB were more often promoted or advertised in lower SES areas than in higher SES-areas. (4) Conclusion: In general, unhealthy food options were more often presented than the healthy options, but only a few SES differences were observed. The results, however, imply that efforts in all school areas are needed to make the healthy option the default option during school time. PMID:29597308

Socioeconomic inequalities in risk of hospitalization for community-acquired bacteremia: a Danish population-based case-control study.

PubMed

Koch, Kristoffer; Søgaard, Mette; Nørgaard, Mette; Thomsen, Reimar Wernich; Schønheyder, Henrik Carl

2014-05-01

In a Danish population-based case-control study, we examined the association between socioeconomic status (SES) and risk of community-acquired bacteremia, as well as the contribution of chronic diseases and substance abuse to differences in bacteremia risk. Analyses were based on 4,117 patients aged 30-65 years who were hospitalized with first-time community-acquired bacteremia during 2000-2008 and 41,170 population controls matched by sex, age, and region of residence. Individual-level information on SES (education and income), chronic diseases, and substance abuse was retrieved from public and medical registries. Conditional logistic regression was used to compute odds ratios for bacteremia. Persons of low SES had a substantially higher risk of bacteremia than those of high SES (for short duration of education vs. long duration, odds ratio = 2.30 (95% confidence interval: 2.10, 2.52); for low income vs. high income, odds ratio = 2.77 (95% confidence interval: 2.54, 3.02)). A higher prevalence of chronic diseases and substance abuse in low-SES individuals versus high-SES individuals explained 43%-48% of the socioeconomic differences in bacteremia risk. In a country with a universal welfare system, differences in the burden of chronic diseases and substance abuse seem to have major importance in explaining inequalities in bacteremia risk.

Lower education and living in countries with lower wealth are associated with higher disease activity in rheumatoid arthritis: results from the multinational COMORA study.

PubMed

Putrik, Polina; Ramiro, Sofia; Keszei, Andras P; Hmamouchi, Ihsane; Dougados, Maxime; Uhlig, Till; Kvien, Tore K; Boonen, Annelies

2016-03-01

To investigate the relationship of socioeconomic status (SES) on an individual and country level with disease activity in rheumatoid arthritis (RA) and explore the mediating role of uptake of costly biological disease-modifying antirheumatic drugs (bDMARDs) in this relationship. Data from a cross-sectional multinational study (COMOrbidities in RA) were used. Contribution of individual socioeconomic factors and country of residence to disease activity score with 28-joint assessment (DAS28) was explored in regression models, adjusting for relevant clinical confounders. Next, country of residence was replaced by gross domestic product (GDP) (low vs high) to investigate the contribution of SES by comparing R(2) (model fit). The mediating role of uptake of bDMARDs in the relationship between education or GDP and DAS28 was explored by testing indirect effects. In total, 3920 patients with RA were included (mean age 56 (SD 13) years, 82% women, mean DAS28 3.7 (1.6)). After adjustment, women (vs men) and low-educated (vs university) patients had 0.35 higher DAS28. Adjusted country differences in DAS28, compared with the Netherlands (lowest DAS28), varied from +0.2 (France) to +2.4 (Egypt). Patients from low GDP countries had 0.98 higher DAS28. No interactions between individual-level and country-level variables were observed. A small mediation effect of uptake of bDMARDs in the relationship between education and DAS28 (7.7%) and between GDP and DAS28 (6.7%) was observed. Female gender and lower individual or country SES were independently associated with DAS28, but did not reinforce each other. The association between lower individual SES (education) or lower country welfare (GDP) with higher DAS28 was partially mediated by uptake of bDMARDs. 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/

Subjective Socioeconomic Status Moderates the Association between Discrimination and Depression in African American Youth.

PubMed

Assari, Shervin; Preiser, Brianna; Lankarani, Maryam Moghani; Caldwell, Cleopatra H

2018-04-20

Background: Most of the literature on the association between socioeconomic status (SES) and health is focused on the protective effects of SES. However, a growing literature suggests that high SES may also operate as a vulnerability factor. Aims: Using a national sample of African American youth, this study compared the effects of perceived discrimination on major depressive disorder (MDD) based on SES. Methods: The current cross-sectional study included 810 African American youth who participated in the National Survey of American Life-Adolescent supplement. The independent variable was perceived discrimination. Lifetime, 12-month, and 30-day MDD were the dependent variables. Age and gender were covariates. Three SES indicators (subjective SES, income, and poverty index) were moderators. We used logistic regressions for data analysis. Results: Perceived discrimination was associated with higher risk of lifetime, 12-month, and 30-day MDD. Interactions were found between subjective SES and perceived discrimination on lifetime, 12-month, and 30-day MDD, suggesting a stronger effect of perceived discrimination in youth with high subjective SES. Objective measures of SES (income and poverty index) did not interact with perceived discrimination on MDD. Conclusion: While perceived discrimination is a universally harmful risk factor for MDD, its effect may depend on the SES of the individual. Findings suggest that high subjective SES may operate as a vulnerability factor for African American youth.

Socioeconomic Status Index to Interpret Inequalities in Child Development

PubMed Central

AHMADI DOULABI, Mahbobeh; SAJEDI, Firoozeh; VAMEGHI, Roshanak; MAZAHERI, Mohammad Ali; AKBARZADEH BAGHBAN, Alireza

2017-01-01

Objective There have been contradictory findings on the relationship between Socioeconomic Status (SES) and child development although SES is associated with child development outcomes. The present study intended to define the relationship between SES and child development in Tehran kindergartens, Iran. Materials & Methods This cross-sectional survey studied 1036 children aged 36-60 month, in different kindergartens in Tehran City, Iran, in 2014-2015. The principal factor analysis (PFA) model was employed to construct SES indices. The constructed SES variable was employed as an independent variable in logistic regression model to evaluate its role in developmental delay as a dependent variable. Results The relationship between SES and developmental delay was significant at P=0.003. SES proved to have a significant (P<0.05) impact on developmental delay, both as an independent variable and after controlling risk factors. Conclusion There should be more emphasis on developmental monitoring and appropriate intervention programs for children to give them higher chance of having a more productive life. PMID:28698723

Impact of socioeconomic factors on informed decision making and treatment choice in patients with hip and knee OA.

PubMed

Youm, Jiwon; Chan, Vanessa; Belkora, Jeffrey; Bozic, Kevin J

2015-02-01

It is unclear how socioeconomic (SES) status influences the effectiveness of shared decision making (SDM) tools. The purpose of this study was to assess the impact of SES on the utility of SDM tools among patients with hip and knee osteoarthritis (OA). We performed a secondary analysis of data from a randomized controlled trial of 123 patients with hip or knee OA. Higher education and higher income were independently associated with higher knowledge survey scores. Patients with private insurance were 2.7 times more likely than patients with Medicare to arrive at a decision after the initial office visit. Higher education was associated with lower odds of choosing surgery, even after adjusting for knowledge. Patient knowledge of their medical condition and treatment options varies with SES. Copyright © 2014 Elsevier Inc. All rights reserved.

Maternal Styles of Talking about Child Feeding across Sociodemographic Groups

PubMed Central

Pesch, Megan H.; Harrell, Kristina J.; Kaciroti, Niko; Rosenblum, Kate; Lumeng, Julie C.

2011-01-01

This study sought to identify maternal styles of talking about child feeding from a semi-structured interview and to evaluate associated maternal and child characteristics. Mothers of preschool-aged children (n = 133) of diverse race/ethnicity and socioeconomic status (SES) (45 lower SES black, 29 lower SES white, 32 lower SES Hispanic, 15 middle to upper SES white, 12 middle to upper SES Asian) participated in a semi-structured interview about feeding. Interviews were audio-taped and transcribed. Themes were identified, and individual interviews were coded within these themes: authority (high/low), confidence (confident/conflicted/unopinionated), and investment (deep/mild/removed). Demographic characteristics were collected and a subset of children had measured weights and heights. Cluster analysis was used to identify narrative styles. Participant characteristics were compared across clusters using Fisher’s exact test and analysis of variance. Six narrative styles were identified: Easy-Going, Practical No-Nonsense, Disengaged, Effortful No-Nonsense, Indulgent Worry, and Conflicted Control. Cluster membership differed significantly based on maternal demographic group (P < .001) and child weight status (P < .05). More than half (60%) of children of mothers in the Conflicted Control cluster were obese. Maternal styles of talking about feeding are associated with maternal and child characteristics. PMID:22117662

Differences in the association between childhood trauma and BMI in black and white South African women.

PubMed

Goedecke, J H; Forbes, J; Stein, D J

2013-05-01

Childhood trauma has previously been associated with adult obesity. The aim of this study was to determine if ethnicity altered the relationship between childhood trauma and obesity in South African women. Forty-four normal-weight (BMI < 25kg/m(2)) and obese (BMI > 30kg/m(2)), black and white premenopausal women completed the Childhood Trauma Questionnaire (CTQ), which retrospectively assessed emotional and physical neglect, and emotional, physical and sexual abuse in childhood. Body composition did not differ by ethnicity in the normal-weight and obese groups. However,independent of BMI group, there were significant differences in socioeconomic status (SES) between black and white women (P < 0.01). Total CTQ score, as well as the sub-scales, physical and emotional neglect, and physical and sexual abuse were higher in black than white women (all P < 0.05), but these scores did not differ between BMI groups. Apart from the sexual abuse score, the differences in physical and emotional neglect and physical abuse scores were no longer significant after adjusting for ethnic differences in age and SES. For sexual abuse, there was a significant interaction between ethnicity and BMI group(P = 0.04), with scores in normal weight women being higher in black than white women, but scores in obese women not differing by ethnicity. Ethnicity alters the association between childhood sexual abuse and BMI status. Larger studies are required to verify this finding, including measures of body image and body size satisfaction that may explain these findings.

Gene-by-Socioeconomic Status Interaction on School Readiness

PubMed Central

Rhemtulla, Mijke; Tucker-Drob, Elliot M.

2017-01-01

In previous work with a nationally representative sample of over 1,400 monozygotic and dizygotic twins born in the United States, Tucker-Drob, Rhemtulla, Harden, Turkheimer, and Fask (2011; Psychological Science, 22, 125–133) uncovered a gene × environment interaction on scores on the Bayley Short Form test of mental ability at 2 years of age—higher socioeconomic status (SES) was associated not only with higher mental ability, but also with larger genetic contributions to individual differences in mental ability. The current study examined gene × SES interactions in mathematics skill and reading skill at 4 years of age (preschool age) in the same sample of twins, and further examined whether interactions detected at 4 years could be attributed to the persistence of the interaction previously observed at 2 years. For early mathematics skill but not early reading skill, genetic influences were more pronounced at higher levels of SES. This interaction was not accounted for by the interaction observed at 2 years. These findings indicate that SES moderates the etiological influences on certain cognitive functions at multiple stages of child development. PMID:22350185

Social inequalities in suicide: the role of selective serotonin reuptake inhibitors.

PubMed

Clouston, Sean A P; Rubin, Marcie S; Colen, Cynthia G; Link, Bruce G

2014-10-01

We aimed to examine the relationship between socioeconomic status (SES) and suicide associated with the introduction and diffusion of selective serotonin reuptake inhibitors (SSRIs). Negative binomial regression was used to estimate county-level suicide rates among persons aged 25 years or older using death certificate data collated by the National Center for Health Statistics from 1968 to 2009; SES was measured using the decennial US Census. The National Health and Nutrition Examination Survey and the Medical Expenditure Panel Survey were used to measure SSRI use. Once SSRIs became available in 1988, a 1% increase in SSRI usage was associated with a 0.5% lower suicide rate. Prior to the introduction of SSRIs, SES was not related to suicide. However, with each 1% increase in SSRI use, a 1-standard deviation (SD) higher SES was associated with a 0.6% lower suicide rate. In 2009, persons living in counties with SES 1 SD above the national average were 13.6% less likely to commit suicide than those living in counties with SES 1 SD below the national average--a difference of 1.9/100,000 adults aged ≥25 years. Higher SSRI use was associated with lower suicide rates among US residents aged ≥25 years; however, SES inequalities modified the association between SSRI use and suicide. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

School-level economic disadvantage and obesity in middle school children in central Texas, USA: a cross-sectional study

PubMed Central

2015-01-01

Background Although children of lower socio-economic status (SES) in the United States have generally been found to be at greater risk for obesity, the SES-obesity association varies when stratified by racial/ethnic groups-with no consistent association found for African American and Hispanic children. Research on contextual and setting-related factors may provide further insights into ethnic and SES disparities in obesity. We examined whether obesity levels among central Texas 8th grade students (n=2682) vary by school-level economic disadvantage across individual-level family SES and racial/ethnicity groups. As a secondary aim, we compared the association of school-level economic disadvantage and obesity by language spoken with parents (English or Spanish) among Hispanic students. Methods Multilevel regression models stratified by family SES and ethnicity were run using cross-sectional baseline data from five school districts participating in the Central Texas CATCH Middle School project. For family SES, independent multi-level logistic regression models were run for total sample and by gender for each family SES stratum (poor/near poor/just getting by, living comfortably, and very well off), adjusting for age, ethnicity, and gender. Similarly, multi-level regression models were run by race/ethnic group (African American, Hispanic, and White), adjusting for age, family SES, and gender. Results Students attending highly economically disadvantaged (ED) schools were between 1.7 (95% CI: 1.1-2.6) and 2.4 (95% CI: 1.2-4.8) times more likely to be obese as students attending low ED schools across family SES groups (p<.05). African American (ORAdj =3.4, 95% CI: 1.1-11.4), Hispanic (ORAdj=1.8, 95% CI 1.1-3.0) and White (ORAdj=3.8, 95% CI: 1.6-8.9) students attending high ED schools were more likely to be obese as counterparts at low ED schools (p<.05). Gender-stratified findings were similar to findings for total sample, although fewer results reached significance. While no obesity differences across school ED categories were found for Hispanic Spanish-speaking students, Hispanic English-speaking students (HES) attending high ED schools were 2.4 times more likely to be obese as HES students at low ED schools (p=.003). Conclusion Findings support the need to prioritize economically disadvantaged schools for obesity prevention efforts and support further exploration of school SES context in shaping children’s physical activity and dietary behaviors. PMID:26222099

Social class, sense of control, and social explanation.

PubMed

Kraus, Michael W; Piff, Paul K; Keltner, Dacher

2009-12-01

Lower social class is associated with diminished resources and perceived subordinate rank. On the basis of this analysis, the authors predicted that social class would be closely associated with a reduced sense of personal control and that this association would explain why lower class individuals favor contextual over dispositional explanations of social events. Across 4 studies, lower social class individuals, as measured by subjective socioeconomic status (SES), endorsed contextual explanations of economic trends, broad social outcomes, and emotion. Across studies, the sense of control mediated the relation between subjective SES and contextual explanations, and this association was independent of objective SES, ethnicity, political ideology, and self-serving biases. Finally, experimentally inducing a higher sense of control attenuated the tendency for lower subjective SES individuals to make more contextual explanations (Study 4). Implications for future research on social class as well as theoretical distinctions between objective SES and subjective SES are discussed.

Surface electrical stimulation in dysphagic Parkinson patients: a randomized clinical trial.

PubMed

Baijens, Laura W J; Speyer, Renée; Passos, Valéria Lima; Pilz, Walmari; van der Kruis, Jolien; Haarmans, Saskia; Desjardins-Rombouts, Christel

2013-11-01

A new treatment for oropharyngeal dysphagia in Parkinson's disease was evaluated in the present study. Prospective randomized controlled trial. The study describes the effects of surface electrical stimulation (SES) of the neck (submental region) in dysphagic Parkinson patients using different intensities of electrical current. Quasi-random allocation was performed when assigning patients to treatment groups. Three groups consisting of dysphagic patients with idiopathic Parkinson's disease (N = 90) received daily treatment for 15 days with periods of no treatment during the weekend. All three received traditional logopedic dysphagia treatment. In addition, two groups received SES, either motor-level or sensory-level stimulation. A standardized measurement protocol, including fiber optic endoscopic evaluation of swallowing (FEES) and videofluoroscopy of swallowing (VFS), was performed before and after therapy. A team of experienced raters was blinded to the treatment group and to the moment of measurement. Intrarater and interrater reliability were calculated. Using proportional odds models (POMs), some of the visuoperceptual ordinal outcome variables showed significant improvement in all groups following treatment. Following 15 days of SES of the submental region, few significant effects were found, suggesting a therapy effect of traditional logopedic dysphagia treatment without any additional influence of SES. On the grounds of this study, it is concluded that further research is needed on the exact mechanism of SES and its effects on the neural pathways involved in swallowing. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

The Impact of Socioeconomic Status on Patients Supported with a Left Ventricular Assist Device: An Analysis of the UNOS Database

PubMed Central

Clerkin, Kevin J.; Garan, A. Reshad; Wayda, Brian; Givens, Raymond C.; Yuzefpolskaya, Melana; Nakagawa, Shunichi; Takeda, Koji; Takayama, Hiroo; Naka, Yoshifumi; Mancini, Donna M.; Colombo, Paolo C.; Topkara, Veli K.

2016-01-01

Background Low socioeconomic status (SES) is a known risk factor for heart failure, mortality among those with heart failure, and poor post heart transplant (HT) outcomes. This study sought to determine if SES is associated with decreased waitlist survival while on LVAD support and after HT. Methods and Results 3,361 adult patients bridged to primary HT with an LVAD between May 2004 and April 2014 were identified in the UNOS database. SES was measured using the AHRQ SES index using data from the 2014 American Community Survey. In the study cohort, SES did not have an association with the combined endpoint of death or delisting on LVAD support (p=0.30). In a cause-specific unadjusted model, those in the top (HR 1.55, 95% CI 1.14–2.11, p=0.005) and second greatest SES quartile (HR 1.50, 95% CI 1.10–2.04, p=0.01) had an increased risk of death on device support compared to the lowest SES quartile. Adjusting for clinical risk factors mitigated the increased risk. There was no association between SES and complications. Post-HT survival, both crude and adjusted, was decreased for patients in the lowest quartile of SES index compared to all other SES quartiles. Conclusions Freedom from waitlist death or delisting was not impacted by SES. Patients with a higher SES had an increased unadjusted risk of waitlist mortality during LVAD support, which was mitigated by adjusting for increased comorbid conditions. Low SES was associated with worse post-HT outcomes. Further study is needed to confirm and understand a differential effect of SES on post-transplant outcomes that was not seen during LVAD support prior to HT. PMID:27758810

Associations between neighborhood socioeconomic environment and physical activity in Cuban immigrants.

PubMed

Affuso, Olivia; Singleton, Chelsea R; Brown, Scott C; Perrino, Tatiana; Huang, Shi; Szapocznik, José

2016-12-01

Physical inactivity is a major public health concern because it is a determinant of obesity and obesity-related chronic diseases. Few longitudinal studies have examined the association between neighborhood socioeconomic (SES) environment and change in physical activity behaviors. Additionally, few studies have examined this association in immigrant groups or Hispanic subgroups such as Cubans. This research aimed to determine if neighborhood SES is associated with longitudinal change in moderate-to-vigorous physical activity (MVPA) among Cuban immigrants who participate in the Cuban Health Study in Miami, Florida. Data on 280 participants [mean age: 37.4 (± 4.6), 48.9% women, mean body mass index: 25.0 (± 2.5)] collected at baseline, 12 months and 24 months were analyzed. Minutes of MVPA were objectively measured during each data collection period using accelerometers. A neighborhood SES score was calculated for each participant's residential census tract from American Community Survey data on median household income, median housing value, educational attainment and occupation. The neighborhood SES score was grouped into tertiles, reflecting low, moderate and high neighborhood SES environment. Multilevel linear models were used to examine the relationship between neighborhood SES and change in MVPA over 24 months. At baseline, 94 (33.6%), 108 (38.6%) and 78 (27.9%) participants resided in low, moderate, and high SES neighborhoods, respectively. After adjusting for age, sex, and body mass index, no difference in average change in MVPA over time was observed between participants residing in low and moderate SES neighborhoods ( p =0.48) or low and high SES neighborhoods ( p =0.62). In Cuban immigrants, longitudinal change in MVPA may not vary by neighborhood socioeconomic environment.

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.

Infant SES as a Predictor of Personality—Is the Association Mediated by Intelligence?

PubMed Central

Flensborg-Madsen, Trine; Mortensen, Erik Lykke

2014-01-01

Background Although research into the continuity and change of personality traits during a lifespan has been fairly extensive, little research has been conducted on childhood predictors of adult personality. Purpose We aimed to investigate the association between infant socioeconomic status (SES), and Eysenck personality traits in adulthood. An additional aim was to investigate whether intelligence and education may mediate this association. Methods SES of 9125 children in the Copenhagen Perinatal Cohort was recorded at a 1-year examination. A subsample of this cohort, comprising 1182 individuals, participated in a follow-up at 20–34 years and was administered the Eysenck Personality Questionnaire (EPQ) which includes measures of neuroticism, extraversion, psychoticism and the so-called lie-scale. Associations of SES with each of the four personality traits were analysed by bivariate and partial correlations, and the mediating effects of intelligence and years of education were analysed. Results Higher SES in infancy was associated with lower neuroticism (r = −0.06; p = 0.05), lower lie-scale scores (r = −0.11; p = 0.0002), and higher psychoticism (r = 0.09; p = 0.003). However, analyses of mediation revealed no direct effect of infant SES on any of the adult personality traits, but only indirect effects mediated by intelligence and years of education, with intelligence being the main mediating factor. Conclusion Only weak associations were observed between infant SES and personality in young adulthood, and the observed associations were mediated by adult intelligence and educational level. Thus, factors associated with infant SES or family background appears to have weak direct effects on personality development. PMID:25078408

Food insecurity, socio-economic factors and weight status in two Iranian ethnic groups.

PubMed

Rezazadeh, Arezoo; Omidvar, Nasrin; Eini-Zinab, Hassan; Ghazi-Tabatabaie, Mahmoud; Majdzadeh, Reza; Ghavamzadeh, Saeid; Nouri-Saeidlou, Sakineh

2016-01-01

To study the association of weight status with food insecurity (FI) and socio-economic status (SES) in Azeri and Kurd ethnic groups living in Urmia city, North-Western Iran. In this cross-sectional study, 723 participants (427 women and 296 men) aged 20-64 years old, from two ethnic groups (445 Azeri and 278 Kurd), were selected through a combination of cluster, random and systematic sampling methods. Demographic and socio-economic characteristics were assessed by a valid questionnaire, and household food security status was analyzed using an adapted household food insecurity access scale through face-to-face interviews at homes. General and central obesities were measured and evaluated using standard methods. Based on the findings, moderate-to-severe FI, as well as low SES, was more dominant in Kurds, compared to Azeris. After adjusting for confounders, being female (OR = 4.33, CI 95%: 2.35-7.97) and moderate-to-severe FI (OR = 2.00, CI 95%: 1.01-3.97) in Azeris and being female (OR = 5.39, CI 95%: 2.28-12.23) and higher total cost of household/capita (OR = 1.005, CI 95%: 1.002-1.009) in Kurds were related to higher odds of general obesity while low (OR = 0.41, CI 95%: 0.18-0.91) and moderate (OR = 0.13, CI 95%: 0.02-0.60) education levels were linked to lower chance of general obesity. Furthermore, the chance of central obesity was lower in Azeris with high educational levels (OR = 0.64, CI 95%: 0.21-0.94), females (OR = 0.72, CI 95%: 0.34-0.86), home owners (OR = 0.56, CI 95%: 0.31-0.91) and females Kurds (OR = 0.60, CI 95%: 0.37-0.97) with moderate-to-severe FI and higher total income per capita. In contrast, the chance of central obesity increased in Kurds with increased age (OR = 1.06, CI 95%: 1.02-1.10) and total cost of household per capita (OR = 1.004, CI 95%: 1.000-1.008). These findings show that the association between moderate-to-severe FI and risk of general/central obesity varies in Azeris, compared to Kurds. However, better SES decreased the chance of general/central obesity in both ethnic groups.

The long-term decline of adult tobacco use in Victoria: changes in smoking initiation and quitting over a quarter of a century of tobacco control.

PubMed

Germain, Daniella; Durkin, Sarah; Scollo, Michelle; Wakefield, Melanie

2012-02-01

To examine changes in regular smoking prevalence among demographic and socioeconomic groups of Victorian adults from 1984 to 2008. Data were drawn from face-to-face and telephone surveys of randomly sampled Victorians conducted annually from 1984 to 2008. Regular smoking in Victoria declined from 33.2% in 1984 to 15.5% in 2008, a relative decline of 53%. This change was largely accounted for by significant drops in 'ever smoking' among 18-29 year olds (from 59% to 35%, a relative decline of 41%) and by increased quitting among those aged 30 and older (from a quit proportion [% of those ever smoked who have quit] of 37% to 61% among 30-49 year olds, a relative increase of 64%; and from 53% to 79% among 50+ years, an increase of 48%). Over time, smoking prevalence became more similar between males and females. Regular smoking declined significantly across all socioeconomic status (SES) groups. Victorians living in low SES areas experienced the greatest relative increase in quit proportions of 75% (from 34% to 60%), helping to reduce the gap between low and higher SES groups in terms of smoking prevalence. Regular smoking in Victoria has declined substantially across all demographic groups. Victorians are taking up smoking at much lower levels than 25 years ago, while quit proportions have more than doubled. The continuation and extension of comprehensive, multi-level approaches to tobacco control is likely to be required for the maintenance of the downward trend in smoking. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

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.

Equity impact of interventions and policies to reduce smoking in youth: systematic review.

PubMed

Brown, Tamara; Platt, Stephen; Amos, Amanda

2014-11-01

A systematic review to assess the equity impact of interventions/policies on youth smoking. Biosis, Cinahl, Cochrane Library, Conference Proceedings Citation Index, Embase, Eric, Medline, Psycinfo, Science Citation Index Expanded, Social Sciences Citation Index and tobacco control experts. Published January 1995 to October 2013. Primary studies of interventions/policies reporting smoking-related outcomes in youth (11-25 years) of lower compared to higher socioeconomic status (SES). References were screened and independently checked. Studies were quality assessed; characteristics and outcomes were extracted. A narrative synthesis by intervention/policy type. Equity impact was assessed as: positive (reduced inequity), neutral (no difference by SES), negative (increased inequity), mixed (equity impact varied) or unclear.Thirty-eight studies of 40 interventions/policies were included: smokefree (12); price/tax (7); mass media campaigns (1); advertising controls (4); access controls (5); school-based programmes (5); multiple policies (3), individual-level cessation support (2), individual-level support for smokefree homes (1). The distribution of equity effects was: 7 positive, 16 neutral, 12 negative, 4 mixed, 1 unclear. All 7 positive equity studies were US-based: price/tax (4), age-of-sales laws (2) and text-messaging cessation support (1). A British school-based intervention (A Stop Smoking in Schools Trial (ASSIST)) showed mixed equity effects (neutral and positive). Most neutral equity studies benefited all SES groups. Very few studies have assessed the equity impact of tobacco control interventions/policies on young people. Price/tax increases had the most consistent positive equity impact. There is a need to strengthen the evidence base for the equity impact of youth tobacco control interventions. 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.

Motivating Low Socioeconomic Status Smokers to Accept Evidence-Based Smoking Cessation Treatment: A Brief Intervention for the Community Agency Setting

PubMed Central

Reeder, Kevin M.; TerBeek, Erin G.; Fiore, Michael C.; Baker, Timothy B.

2015-01-01

Introduction: Individuals of low socioeconomic status (SES), smoke at very high rates but make fewer and less successful quit attempts than do other smokers. Low-SES smokers have specific beliefs about smoking and quitting that may serve as barriers to making quit attempts. The purpose of this study was to test the impact of a brief intervention addressing these beliefs on making calls to a telephone quit line. Methods: Of 522 smokers entering the study at 5 Wisconsin Salvation Army (SA) sites, 102 expressed motivation to quit and served as a comparison group. The remaining 420 smokers were not motivated to quit and were randomly assigned to 1 of 3 conditions: an intervention group who received brief counseling focused on cessation goals and beliefs, an attention-control group, and a low contact control group. The primary outcome was the rate at which smokers made a call to the Wisconsin tobacco quit line (WTQL) during their SA visit. Secondary outcome measures included motivational variables, stage of change, changes in beliefs about smoking and quitting, and self-reported abstinence. Results: Unmotivated participants in the intervention condition called the WTQL at a significantly higher rate (12.2%) than did those in the 2 control conditions (2.2% and 1.4%) (p < .01) and approached the rate of calling by participants who were initially motivated to quit (15.7%). Intervention condition participants also showed improved motivation to quit and stage of change. Conclusions: A brief, targeted motivational intervention focusing on cessation goals and beliefs increased the initiation of an evidence-based tobacco cessation treatment by low-SES smokers. PMID:26180226

Randomized Trial of a Children's Book Versus Brochures for Safe Sleep Knowledge and Adherence in a High-Risk Population.

PubMed

Hutton, John S; Gupta, Resmi; Gruber, Rachel; Berndsen, Jennifer; DeWitt, Thomas; Ollberding, Nicholas J; Van Ginkel, Judith B; Ammerman, Robert T

Sleep-related infant deaths have plateaued in the past decade, disproportionately affecting low socioeconomic status (SES) families. Printed materials are widely used for anticipatory guidance, yet none for safe sleep has been studied. We tested the efficacy of a specially designed children's book compared to brochures for safe sleep knowledge and adherence, which we hypothesized would be greater due to superior readability and engagement. This randomized controlled trial involved low-SES mothers (n = 282) enrolled in a home visiting program. Home visitors (n = 56) were randomly assigned to perform safe sleep teaching and assessments during 3 visits: third trimester, 1 week old, and 2 months old, exclusively utilizing a specially designed children's book or brochures, and surveys incorporating the American Academy of Pediatrics' safe sleep recommendations. Outcomes were safe sleep knowledge, adherence, and usefulness of materials, controlling for maternal health literacy. Safe sleep knowledge increased across all time points with no overall group difference, though gains for sleep-evocative and general health items varied. Odds of bed sharing were higher and exclusive crib use lower for the brochure group (P < .05). Mothers and home visitors reported similar usefulness, though home visitors reported greater dialogue via the book and mothers in the book group reported more book sharing with their baby. While a specially designed children's book and brochures were equally effective conveying aggregate safe sleep knowledge in low-SES mothers, adherence to exclusive crib use and avoiding bed sharing were greater in the book group, attributable to enhanced dialogue, readability and emotional engagement. Children's books are a promising mode of anticipatory guidance, warranting further investigation. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Socioeconomic Differences in the Risk Profiles of Susceptibility and Ever Use of Tobacco Among Indian Urban Youth: A Latent Class Approach

PubMed Central

2014-01-01

Purpose: To empirically determine the socioeconomic differences in risk profiles of susceptibility and ever use of tobacco among adolescents in India and to investigate the association between the risk profiles and the psychosocial factors for tobacco use. Methods: Students in 16 private (higher socioeconomic status [SES]; n = 4,489) and 16 government (lower SES; n = 7,153) schools in two large cities in India were surveyed about their tobacco use and related psychosocial factors in 2004. Latent class analysis was used to identify homogenous, mutually exclusive typologies existing within the data. Results: Overall, 3 and 4 latent classes of susceptibility and ever use of tobacco best described students in higher- and lower- SES schools, respectively. Profiles with various combinations of susceptibility and ever use of tobacco were differentially related to psychosocial factors, with lower- SES students being more vulnerable to increased levels of tobacco use than higher- SES students. Conclusions: Acknowledging the multiple dimensions of tobacco use behaviors and identifying constellations of risk behaviors will enable more accurate understanding of etiological processes and will provide information for refining and targeting preventive interventions. Additionally, identifying the socioeconomic differences in susceptibility and ever use risk profiles and their psychosocial correlates will enable policy makers to address these inequities through improved allocation of resources. PMID:24271966

Influenza-Related Hospitalizations and Poverty Levels - United States, 2010-2012.

PubMed

Hadler, James L; Yousey-Hindes, Kimberly; Pérez, Alejandro; Anderson, Evan J; Bargsten, Marisa; Bohm, Susan R; Hill, Mary; Hogan, Brenna; Laidler, Matt; Lindegren, Mary Lou; Lung, Krista L; Mermel, Elizabeth; Miller, Lisa; Morin, Craig; Parker, Erin; Zansky, Shelley M; Chaves, Sandra S

2016-02-12

Annual influenza vaccine is recommended for all persons aged ≥6 months in the United States, with recognition that some persons are at risk for more severe disease (1). However, there might be previously unrecognized demographic groups that also experience higher rates of serious influenza-related disease that could benefit from enhanced vaccination efforts. Socioeconomic status (SES) measures that are area-based can be used to define demographic groups when individual SES data are not available (2). Previous surveillance data analyses in limited geographic areas indicated that influenza-related hospitalization incidence was higher for persons residing in census tracts that included a higher percentage of persons living below the federal poverty level (3-5). To determine whether this association occurs elsewhere, influenza hospitalization data collected in 14 FluSurv-NET sites covering 27 million persons during the 2010-11 and 2011-12 influenza seasons were analyzed. The age-adjusted incidence of influenza-related hospitalizations per 100,000 person-years in high poverty (≥20% of persons living below the federal poverty level) census tracts was 21.5 (95% confidence interval [CI]: 20.7-22.4), nearly twice the incidence in low poverty (<5% of persons living below the federal poverty level) census tracts (10.9, 95% CI: 10.3-11.4). This relationship was observed in each surveillance site, among children and adults, and across racial/ethnic groups. These findings suggest that persons living in poorer census tracts should be targeted for enhanced influenza vaccination outreach and clinicians serving these persons should be made aware of current recommendations for use of antiviral agents to treat influenza (6).

The role of attachment relationship in adolescents' problem behavior development: a cross-sectional study of Kenyan adolescents in Nairobi city.

PubMed

Wambua, Grace Nduku; Obondo, Anne; Bifulco, Antonia; Kumar, Manasi

2018-01-01

There is a significant link between insecure attachment and the development of psychopathology in adolescence. We investigated the relationship between adolescent attachment styles and the development of emotional and behavioral problems among adolescents in Kenya. We also examined the modifying influence of socio-economic-status (SES). One hundred and thirty-seven adolescents who were attending two schools participated in the study. One school (low SES school) catered for children from predominantly low-income households, while the second school (middle SES school) catered for children from predominantly middle-income households. The data were collected using three instruments: researcher designed questionnaire to obtain socio-demographic information, the Strength and Difficulties Questionnaire (SDQ) that is designed to assess symptoms of disorder, and the Vulnerable Attachment Scale Questionnaire (VASQ) that is designed to measure attachment style. Adolescents from the low SES school had higher vulnerable attachment scores than those from the middle SES school ( t (135) = - 2.5, P  =  0.02 ). Male students had higher vulnerable attachment scores than females ( P  =  0.03 ). Adolescents who had experienced adversity in childhood had higher vulnerable attachment scores than those who had not ( P  <  0.00 ). Results from Pearson's correlation showed moderate to strong positive correlations between attachment insecurity and emotional and behavioral problems with participants who had higher emotional symptoms (r = 0.47, P  < 0.01), conduct problem score (r = 0.33, P  < 0.01), hyperactivity (r = 0.26, P  < 0.01) and total difficulty scores (r = 0.47, P  < 0.01), experiencing significantly higher levels of attachment insecurity than those with lower scores. This study supports the notion that attachment insecurity increases the adolescents' susceptibility to develop psychological problems.

Rheological investigation of self-emulsification process: effect of co-surfactant.

PubMed

Biradar, Shailesh V; Dhumal, Ravindra S; Paradkar, Ananat R

2009-01-01

The aim of study is to investigate role of co-surfactant in self-emulsification through rheological analysis of intermediate liquid crystalline (LC) phase formed during self-emulsification. To mixture of Captex 200P (C200) and tween 80 (T80) (SES Plain), either medium hydrocarbon chain co-surfactant (Capmul MCM (CMCM): SES C) or long hydrocarbon chain co-surfactant (Peceol (P): SES P) was added separately at different concentration levels. Self-emulsification was monitored by visual observations, turbidimetric and droplet size measurement. Mesophases were obtained by 30% v/v aqueous hydration of SES and characterized by polarizing microscopy, differential scanning calorimetry (DSC) and rheological studies. SES Plain exhibited 'bad' emulsification owing to instantaneous gel formation in aqueous media. Almost all SES C have shown 'good' emulsification with transparent appearance, very low turbidity value and nano size droplets. All SES P presented 'moderate' emulsification with milky appearance, high turbidity value and coarse droplets. Polarizing microscopy revealed formation of lamellar phase in SES Plain and in all SES P while almost all SES C exhibited formation of micellar cubic phase. In DSC studies, higher extent of LC phase formation was observed in SES C as compared to SES P. Rheological study clearly demonstrated presence of elastic and partially recoverable mesophase in SES Plain, which was transformed into a viscous and non-recovering mesophase with addition of CMCM while there was no change in rheological status of SES Plain after addition of P. The weak and viscous LC phase in SES C must have not presented any resistance to strain induced deformation. Therefore, it might have ruptured easily and quickly, releasing jet of nanosize droplets whereas elastic mesophase in SES P might have ruptured with little resistance resulting in coarse droplets. The ability of co-surfactant to promote self-emulsification was attributed to their influence on viscoelastic properties of intermediate LC phase.

[Evaluation of the Relapse Prevention Guidance for drug-dependent inmates: the intervention using self-teach workbook and group therapy in a "Private Finance Initiative" prison --the second report].

PubMed

Kobayashi, Ohji; Matsumoto, Toshihiko; Imamura, Fumi; Wada, Kiyoshi; Ozaki, Shiro; Takeuchi, Yoshio; Hasegawa, Masahiko; Imamura, Yoko; Tania, Yuko; Adachi, Yasumori

2011-06-01

There has been no relapse prevention program for drug dependent inmates in Japanese prisons. Recently, "Relapse Prevention Guidance" program is provided to the adult male inmates in Harima Rehabilitation Program Center (HRPC), one of the newly founded "Private Finance Initiative" prisons. To evaluate the effectiveness of the program by comparing the outcomes between groups of inmates with different severity level of dependence. The program was provided to 89 subjects in HRPC. Inmates were classified into 4 groups according to the severity measured by the Drug Abuse Screening Test (DAST). After a month of waiting period, self-teaching workbook was provided to each inmate for 4 weeks. The educational program consisting of 8 weekly psychoeducational group therapies was then provided to each group of 10 inmates. The evaluation was conducted both at the beginning and at the end of the workbook and the educational program intervention by administering 2 self-reporting questionnaires; the Self-efficacy Scale for drug dependence (SES), and the 8th version of the Stages of Change Readiness and Treatment Eagerness Scale for drug dependence (SOCRATES-8D). Only the "mild" group showed significant increase in SES during waiting period. After the workbook intervention, "moderate" group showed significant decrease in SES, and increase in the recognition and the ambivalence subscale of the SOCRATES-8D. The same increase in the subscales of SOCRATES-8D was noted in "Severe" group. Educational program produced increase in the recognition and the taking steps subscales of SOCRATES-8D in "mild" group, increase in SES score and the taking steps subscale in "moderate", increase in SES score and total score of SOCRATES-8D in "severe" group. No significant change was noted in "very severe" group in any of the interventions. The "Relapse Prevention Guidance" is sufficiently effective, improving self-efficacy and motivation for change in drug dependent adult male inmates.

Effectiveness of population-based service screening with mammography for women ages 40 to 49 years with a high or low risk of breast cancer: socioeconomic status, parity, and age at birth of first child.

PubMed

Hellquist, Barbro Numan; Czene, Kamila; Hjälm, Anna; Nyström, Lennarth; Jonsson, Håkan

2015-01-15

Invitation to mammography screening of women aged 40 to 49 years is a matter of debate in many countries and a cost-effective alternative in countries without screening among women aged 40 to 49 years could be inviting those at higher risk. The relative effectiveness of mammography screening was estimated for subgroups based on the breast cancer risk factors parity, age at time of birth of first child, and socioeconomic status (SES). The SCReening of Young Women (SCRY) database consists of all women aged 40 to 49 years in Sweden between 1986 and 2005 and was split into a study and control group. The study group consisted of women residing in areas in which women aged 40 to 49 years were invited to screening and the control group of women in areas in which women aged 40 to 49 years were not invited to screening. Rate ratio (RR) estimates were calculated for 2 exposures: invitation and attendance. There were striking similarities noted in the RR pattern for women invited to and attending screening and no statistically significant difference or trend in the RR was noted by risk group. The RR estimates increased by increasing parity for parity of 0 to 2 and ranged from 0.55 (95% confidence interval [95% CI], 0.38-0.79) to 0.79 (95% CI, 0.65-0.95) for attending women. The RR for women with high SES was lower than that for women with low SES (RR, 0.72 [95% CI, 0.60-0.86] and RR, 0.79 [95% CI, 0.63-0.99], respectively). For women aged 20 to 24 years at the time of the birth of their first child, the RR was 0.73 (95% CI, 0.58-0.91) and estimates for other ages were similar. There was no statistically significant difference noted in the relative effectiveness of mammography screening by parity, age at the time of birth of the first child, or SES. © 2014 American Cancer Society.

Dietary Patterns and Their Socioeconomic and Behavioral Determinants in 6- to 8-Year-Old Portuguese Children.

PubMed

Rodrigues, D; Muc, M; Rodrigues, P R M; Pinto, A Mota; Padez, C

2016-01-01

Adherence to a healthier diet is declining, with children consuming more saturated fats and simple carbohydrates. Factors influencing this choice were studied using a cross-sectional study with children (6 to 8 years old) living in Coimbra. Socioeconomic and behavioral factors were obtained from the parents. Dietary patterns of 1,063 children were identified: Mediterranean (MedDiet), saturated fats (SFatDiet), and base of Portuguese diet (BPDiet). Their relationship with socioeconomic and behavioral determinants was analyzed. SES determined strongly the dietary choices with lower SES being associated with higher consumption of SFatDiet and higher SES with BPDiet. Worse diet quality was shown to coexist with other unhealthy behaviors.

Maternal Evaluations of Children's Emergent Literacy Level, Maternal Mediation in Book Reading, and Children's Emergent Literacy Level: A Comparison Between SES Groups

ERIC Educational Resources Information Center

Korat, Ofra; Haglili, Sharon

2007-01-01

This study examined whether maternal evaluations of children's emergent literacy (EL) levels, maternal mediation during a book-reading activity with children, and the children's EL levels differ as a function of socioeconomic status (SES; low vs. high), and whether the relationships between these variables differ as a function of SES levels. Study…

Mass Media Campaign Improves Cervical Screening across All Socio-Economic Groups

ERIC Educational Resources Information Center

Anderson, Jenny O.; Mullins, Robyn M.; Siahpush, Mohammad; Spittal, Matthew J.; Wakefield, Melanie

2009-01-01

Low socio-economic status (SES) has been associated with lower cervical screening rates. Mass media is one known strategy that can increase cervical screening participation. This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all SES groups to screen. Data…

Academic Achievement of LEP Students After Reclassification: A Southern California Study.

ERIC Educational Resources Information Center

Nava-Hamaker, Mary Lou

Gains and grade level achievement in Total Reading and Language of four groups of fifth grade students, including LEP (Limited English Proficient) students, in SES (socioeconomic status) 1 and SES 2 schools were compared to determine whether the students were achieving at grade level in reading and at an equivalent level in language. Groups from…

Barriers and Bridges to Positive Cross-Ethnic Relations: African American and White Parent Socialization Beliefs and Practices.

ERIC Educational Resources Information Center

Hamm, Jill V.

2001-01-01

Using interviews and focus groups, lower and middle socioeconomic status (SES) African American parents and middle SES white parents discussed their objectives regarding cross-ethnic relations and how they helped their children forge positive cross-ethnic relations. The groups relied on different methods to promote socialization. Parents' efforts…

Sex Differences in Language Across Early Childhood: Family Socioeconomic Status does not Impact Boys and Girls Equally

PubMed Central

Barbu, Stéphanie; Nardy, Aurélie; Chevrot, Jean-Pierre; Guellaï, Bahia; Glas, Ludivine; Juhel, Jacques; Lemasson, Alban

2015-01-01

Child sex and family socioeconomic status (SES) have been repeatedly identified as a source of inter-individual variation in language development; yet their interactions have rarely been explored. While sex differences are the focus of a renewed interest concerning emerging language skills, data remain scarce and are not consistent across preschool years. The questions of whether family SES impacts boys and girls equally, as well as of the consistency of these differences throughout early childhood, remain open. We evaluated consistency of sex differences across SES and age by focusing on how children (N = 262), from 2;6 to 6;4 years old, from two contrasting social backgrounds, acquire a frequent phonological alternation in French – the liaison. By using a picture naming task eliciting the production of obligatory liaisons, we found evidence of sex differences over the preschool years in low-SES children, but not between high-SES boys and girls whose performances were very similar. Low-SES boys’ performances were the poorest whereas low-SES girls’ performances were intermediate, that is, lower than those of high-SES children of both sexes but higher than those of low-SES boys. Although all children’s mastery of obligatory liaisons progressed with age, our findings showed a significant impeding effect of low-SES, especially for boys. PMID:26696938

Socioeconomic status and quality of life in patients with locally advanced head and neck cancer.

PubMed

Tribius, S; Meyer, M S; Pflug, C; Hanken, H; Busch, C-J; Krüll, A; Petersen, C; Bergelt, C

2018-05-07

Socioeconomic aspects play an important role in health care. Patients with locally advanced head and neck cancer (LAHNC) experience detrimental effects on their quality of life (QoL). This prospective study examines QoL differences between patients with different socioeconomic status (SES) after intensity-modulated radiation therapy (IMRT). In all, 161 patients were questioned at the end of IMRT and at 12 and 24 months follow-up using the questionnaires of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-30 and QLQ-HN35. Patients' QoL 2 years after IMRT was compared to a population reference sample and QoL of patients from lower, middle, and higher social class 2 years after IMRT was analyzed by ANCOVA using baseline QoL (end of radiation treatment) as a covariate. Patients with high SES report worse QoL at the end of IMRT in the domains global health status (-15.2; p = 0.005), role function (-23.8; p = 0.002), and social function (-19.4; p = 0.023) compared to patients with middle and low SES. QoL improved during the first 12 and 24 months. However, 2 years after IMRT, middle and low SES patients report lower QoL in the domains global health status, physical function, and role function, and report a higher general (fatigue, pain, dyspnea) and head and neck cancer-specific symptom burden (pain, swallowing, senses, speech, social eating, opening mouth, and felt ill) than patients with high SES. After IMRT for LAHNC, patients with high SES report worse QoL compared to patients with middle or low SES. There is a marked improvement within the first 24 months in many domains. However, the magnitude of improvement in patients with middle or low SES is significantly smaller compared to patients with high SES.

Individual and Neighborhood Socioeconomic Status and the Association between Air Pollution and Cardiovascular Disease.

PubMed

Chi, Gloria C; Hajat, Anjum; Bird, Chloe E; Cullen, Mark R; Griffin, Beth Ann; Miller, Kristin A; Shih, Regina A; Stefanick, Marcia L; Vedal, Sverre; Whitsel, Eric A; Kaufman, Joel D

2016-12-01

Long-term fine particulate matter (PM2.5) exposure is linked with cardiovascular disease, and disadvantaged status may increase susceptibility to air pollution-related health effects. In addition, there are concerns that this association may be partially explained by confounding by socioeconomic status (SES). We examined the roles that individual- and neighborhood-level SES (NSES) play in the association between PM2.5 exposure and cardiovascular disease. The study population comprised 51,754 postmenopausal women from the Women's Health Initiative Observational Study. PM2.5 concentrations were predicted at participant residences using fine-scale regionalized universal kriging models. We assessed individual-level SES and NSES (Census-tract level) across several SES domains including education, occupation, and income/wealth, as well as through an NSES score, which captures several important dimensions of SES. Cox proportional-hazards regression adjusted for SES factors and other covariates to determine the risk of a first cardiovascular event. A 5 μg/m3 higher exposure to PM2.5 was associated with a 13% increased risk of cardiovascular event [hazard ratio (HR) 1.13; 95% confidence interval (CI): 1.02, 1.26]. Adjustment for SES factors did not meaningfully affect the risk estimate. Higher risk estimates were observed among participants living in low-SES neighborhoods. The most and least disadvantaged quartiles of the NSES score had HRs of 1.39 (95% CI: 1.21, 1.61) and 0.90 (95% CI: 0.72, 1.07), respectively. Women with lower NSES may be more susceptible to air pollution-related health effects. The association between air pollution and cardiovascular disease was not explained by confounding from individual-level SES or NSES. Citation: Chi GC, Hajat A, Bird CE, Cullen MR, Griffin BA, Miller KA, Shih RA, Stefanick ML, Vedal S, Whitsel EA, Kaufman JD. 2016. Individual and neighborhood socioeconomic status and the association between air pollution and cardiovascular disease. Environ Health Perspect 124:1840-1847; http://dx.doi.org/10.1289/EHP199.

Socioeconomic status can affect pregnancy outcomes and complications, even with a universal healthcare system.

PubMed

Kim, Min Kyoung; Lee, Seung Mi; Bae, Sung-Hee; Kim, Hyun Joo; Lim, Nam Gu; Yoon, Seok-Jun; Lee, Jin Yong; Jo, Min-Woo

2018-01-05

Low socioeconomic status can increase the risk of adverse pregnancy outcomes, but it remains unclear whether this negative association is attributed to inadequate prenatal care. Korea has been adopting a universal healthcare system. All Korean citizens must be enrolled National Health Insurance (NHI) or be recipient of Medical Aid (MA). In addition, Korean government launched a financial support system for antenatal care for all pregnant women in 2008. Therefore, in theory, there is no financial barrier to receive prenatal cares regardless of someone's social class. However, it is still unclear whether adverse pregnancy outcomes observed in low-income women are attributable to low SES or to economic barriers specific to the utilization of medical services. The purpose of this study was to investigate whether socioeconomic status affects pregnancy outcomes after the introduction of this support system, which allows all pregnant women to receive adequate prenatal care regardless of socioeconomic status. Using the National Health Insurance database in Korea, we selected women who gave birth between January 1, 2010 and December 31, 2010. As a proxy indicator reflecting socioeconomic status, we classified subjects as MA recipient ("low" SES) or a NHI beneficiary ("middle/high" SES). In the MA group, 29.4% women received inadequate prenatal care, compared to 11.4% in the NHI group. Mothers in the MA group were more likely to have an abortion (30.1%), rather than deliver a baby, than those in the NHI group (20.7%, P < 0.001). Mothers in the MA group were also more likely to undergo a Caesarean delivery (45.8%; NHI group: 39.6%, P < 0.001), and have preeclampsia (1.5%; NHI group: 0.6%, P < 0.001), obstetric hemorrhage (4.7%; NHI group: 3.9%, P = 0.017), and a preterm delivery (2.1%; NHI group: 1.4%, P < 0.001) than those in the NHI group. Women in the MA group tended to show higher rates of abortion, Caesarean delivery, preeclampsia, preterm delivery, and obstetrical hemorrhage than those in the NHI group Therefore, health authorities should consider investigating what kind of barriers exist or what factors may affect these inequitable outcomes.

Home environment relationships with children's physical activity, sedentary time, and screen time by socioeconomic status.

PubMed

Tandon, Pooja S; Zhou, Chuan; Sallis, James F; Cain, Kelli L; Frank, Lawrence D; Saelens, Brian E

2012-07-26

Children in households of lower socioeconomic status (SES) are more likely to be overweight/obese. We aimed to determine if home physical activity (PA) environments differed by SES and to explore home environment mediators of the relation of family SES to children's PA and sedentary behavior. Participants were 715 children aged 6 to 11 from the Neighborhood Impact on Kids (NIK) Study. Household SES was examined using highest educational attainment and income. Home environment was measured by parent report on a survey. Outcomes were child's accelerometer-measured PA and parent-reported screen time. Mediation analyses were conducted for home environment factors that varied by SES. Children from lower income households had greater media access in their bedrooms (TV 52% vs. 14%, DVD player 39% vs. 14%, video games 21% vs. 9%) but lower access to portable play equipment (bikes 85% vs. 98%, jump ropes 69% vs. 83%) compared to higher income children. Lower SES families had more restrictive rules about PA (2.5 vs. 2.0). Across SES, children watched TV/DVDs with parents/siblings more often than they engaged in PA with them. Parents of lower SES watched TV/DVDs with their children more often (3.1 vs. 2.5 days/week). Neither total daily and home-based MVPA nor sedentary time differed by SES. Children's daily screen time varied from 1.7 hours/day in high SES to 2.4 in low SES families. Media in the bedroom was related to screen time, and screen time with parents was a mediator of the SES--screen time relationship. Lower SES home environments provided more opportunities for sedentary behavior and fewer for PA. Removing electronic media from children's bedrooms has the potential to reduce disparities in chronic disease risk.

Socioeconomic status moderates age-related differences in the brain's functional network organization and anatomy across the adult lifespan.

PubMed

Chan, Micaela Y; Na, Jinkyung; Agres, Phillip F; Savalia, Neil K; Park, Denise C; Wig, Gagan S

2018-05-14

An individual's environmental surroundings interact with the development and maturation of their brain. An important aspect of an individual's environment is his or her socioeconomic status (SES), which estimates access to material resources and social prestige. Previous characterizations of the relation between SES and the brain have primarily focused on earlier or later epochs of the lifespan (i.e., childhood, older age). We broaden this work to examine the relationship between SES and the brain across a wide range of human adulthood (20-89 years), including individuals from the less studied middle-age range. SES, defined by education attainment and occupational socioeconomic characteristics, moderates previously reported age-related differences in the brain's functional network organization and whole-brain cortical structure. Across middle age (35-64 years), lower SES is associated with reduced resting-state system segregation (a measure of effective functional network organization). A similar but less robust relationship exists between SES and age with respect to brain anatomy: Lower SES is associated with reduced cortical gray matter thickness in middle age. Conversely, younger and older adulthood do not exhibit consistent SES-related difference in the brain measures. The SES-brain relationships persist after controlling for measures of physical and mental health, cognitive ability, and participant demographics. Critically, an individual's childhood SES cannot account for the relationship between their current SES and functional network organization. These findings provide evidence that SES relates to the brain's functional network organization and anatomy across adult middle age, and that higher SES may be a protective factor against age-related brain decline. Copyright © 2018 the Author(s). Published by PNAS.

Why do some women know more? An exploration of the association of community socioeconomic characteristics, social capital, and HIV/AIDS knowledge.

PubMed

Jesmin, Syeda S; Chaudhuri, Sanjukta

2013-01-01

The objective of this study was to investigate the associations of community-level socio-economic status (SES) characteristics and social capital with women's knowledge of HIV/AIDS. We used a representative national sample of 6,771 women ages 15-49 years from the Bangladesh Demographic Health Survey of 2007. We extended the findings of prior studies by providing new evidence that both community and social capital were related to having knowledge of AIDS. The significant community characteristics associated with women's greater knowledge of AIDS were: women's higher mean age at first marriage, higher mean years of education, the higher percentage of women in the community who work, and higher mean household living standard in the community. Regardless of individual-level SES, living in a community with higher community-level SES and having greater social capital were associated with having a greater likelihood of hearing about AIDS. However, we found that once women knew about AIDS, not all of the community-SES and social capital indicators explained their advanced knowledge of AIDS prevention and transmission. Our findings underscore the importance of HIV/AIDS education campaigns in the disadvantaged communities, specifically targeting women who are not members in any non-governmental organizations, as well as greater use of media in educating women about AIDS.

Contribution of Socioeconomic Status to Racial/Ethnic Disparities in Adverse Pregnancy Outcomes Among Women With Systemic Lupus Erythematosus.

PubMed

Kaplowitz, Elianna T; Ferguson, Sancia; Guerra, Marta; Laskin, Carl A; Buyon, Jill P; Petri, Michelle; Lockshin, Michael D; Sammaritano, Lisa R; Branch, D Ware; Merrill, Joan T; Katz, Patricia; Salmon, Jane E

2018-02-01

We examined rates of adverse pregnancy outcomes (APO) by race/ethnicity among women with systemic lupus erythematosus (SLE), with and without antiphospholipid antibodies (aPL), and whether socioeconomic status (SES) accounted for differences. Data were from the PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study, a multicenter study that enrolled 346 patients with SLE and 62 patients with SLE and aPL (50% white, 20% African American, 17% Hispanic, 12% Asian/Pacific Islander). Measures of SES were educational attainment, median community income, and community education. Logistic regression analyses were conducted to determine odds of APO for each racial/ethnic group, controlling first for age and clinical variables, and then for SES. The frequency of APO in white women with SLE, with and without aPL, was 29% and 11%, respectively. For African American and Hispanic women it was approximately 2-fold greater. In African American women with SLE alone, adjustment for clinical variables attenuated the odds ratio (OR) from 2.7 (95% confidence interval [95% CI] 1.3-5.5) to 2.3 (95% CI 1.1-5.1), and after additional adjustment for SES, there were no longer significant differences in APO compared to whites. In contrast, in SLE patients with aPL, whites, African Americans, and Hispanics had markedly higher risks of APO compared to white SLE patients without aPL (OR 3.5 [95% CI 1.4-7.7], OR 12.4 [95% CI 1.9-79.8], and OR 10.4 [95% CI 2.5-42.4], respectively), which were not accounted for by clinical or SES covariates. This finding suggests that for African American women with SLE without aPL, SES factors are key contributors to disparities in APO, despite monthly care from experts, whereas other factors contribute to disparities in SLE with aPL. © 2017, American College of Rheumatology.

30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015.

PubMed

Hardy, L L; Mihrshahi, S; Gale, J; Drayton, B A; Bauman, A; Mitchell, J

2017-01-01

To report 30-year (1985-2015) prevalence trends in overweight, obesity and abdominal obesity among children by school level and socioeconomic status (SES). Five cross-sectional, population child surveys (age 4-18 years; n=27 808) conducted in 1985-1997-2004-2010-2015 in New South Wales, Australia. Outcomes were prevalence of measured overweight, obesity and waist-to-height ratio (WHtR⩾0.5) by sex, school level (children (primary) and adolescents (high)) and SES tertile. In 2015, the prevalences of overweight, obesity and WHtR⩾0.5 in children were 16.4%, 7.0% and 14.6%, respectively, and in adolescents 21.9%, 17.2% and 4.6%, respectively. Obesity prevalence has not significantly changed in children or adolescents since 1997, nor since 2010 (children, P=0.681; adolescents, P=0.21). Overweight has not significantly changed in children since 1997, but has in adolescents since 1985, with a relative increase of 16 percentage points (P<0.001) between 2010 and 2015. WHtR⩾0.5 prevalence has significantly changed since 1985, except in adolescent girls between 2010 and 2015. Between 2010 and 2015 the relative increase in WHtR⩾0.5 was 17 and 40 percentage points in children and adolescent boys, respectively. Significant disparities in prevalence rates between children and adolescents from low and high SES backgrounds began in 2010 for overweight, since 1997 for obesity and since 2004 for WHtR⩾0.5. Differences between SES groups have become larger over the past 18 years. Since 1997, obesity has remained stable, and overweight has stabilized in children, not in adolescents. WHtR⩾0.5 significantly increased between 1985 and 2015, with prevalence rates at each survey around twice the obesity prevalence. Compared with high SES children and adolescents, the risk of overweight, obesity and WHtR⩾0.5 was significantly higher for low SES children and adolescents. The findings are highly relevant to policy makers involved in child obesity prevention interventions and highlight the need for better targeted interventions among children and adolescents from low SES backgrounds, and adolescents in particular.

Youth's Causal Beliefs About Success: Socioeconomic Differences and Prediction of Early Career Development.

PubMed

Kay, Joseph S; Shane, Jacob; Heckhausen, Jutta

2017-10-01

Youth's career attainment is associated with socioeconomic background, but may also be related to their beliefs about causes of success. Relationships between 17-year-olds' socioeconomic status (SES) and causal beliefs about success, and whether these beliefs predict career attainment after completing a vocational or university degree were examined using data from the German Socio-Economic Panel Study (n = 997, 48.5% female). Youth with higher SES parents and those who attended higher levels of high schools were less likely to believe that success in society is due to external causes, but SES was unrelated to the belief that success is due to personal merit or ability. Youth who believe that success is due to external causes attained lower income, occupational prestige, and job autonomy, and slower increases in income over time. There were also significant indirect effects of youth's parents' SES and their own high school levels on career attainment through such external causal beliefs; merit beliefs, by contrast, were largely unrelated to career attainment. These results suggest that beliefs about external causes of success may uniquely contribute to the transmission and maintenance of SES across generations and over time.

Sociodemographic Differences Between Alcohol Use and Sickness Absence: Pooled Analysis of Four Cohort Studies.

PubMed

Ervasti, Jenni; Kivimäki, Mika; Head, Jenny; Goldberg, Marcel; Airagnes, Guillaume; Pentti, Jaana; Oksanen, Tuula; Salo, Paula; Suominen, Sakari; Jokela, Markus; Vahtera, Jussi; Zins, Marie; Virtanen, Marianna

2018-01-01

We examined differences in sickness absence in relation to at-risk drinking and abstinence, taking into account potential changes in consumption. We used individual-participant data (n = 46,514) from four prospective cohort studies from Finland, France and the UK. Participants responded to a survey on alcohol use at two time points 4-6 years apart, and were linked to records of sickness absence for an ~6-year follow-up after the latter survey. Abstainers were those reporting no alcohol use in either survey. At-risk drinkers at T1 were labelled as 'former', at-risk drinkers at T2 as 'current' and at-risk drinkers at both times as 'consistent' at-risk drinkers. The reference group was low-risk drinkers at both times. Study-specific analyses were stratified by sex and socioeconomic status (SES) and the estimates were pooled using meta-analysis. Among men (n = 17,285), abstainers (6%), former (5%), current (5%) and consistent (7%) at-risk drinkers had an increased risk of sickness absence compared with consistent low-risk drinkers (77%). Among women (n = 29,229), only abstainers (12%) had a higher risk of sickness absence compared to consistent low-risk drinkers (74%). After adjustment for lifestyle and health, abstaining from alcohol was associated with sickness absence among people with intermediate and high SES, but not among people with low SES. The U-shaped alcohol use-sickness absence association is more consistent in men than women. Abstinence is a risk factor for sickness absence among people with higher rather than lower SES. Healthy worker effect and health selection may partly explain the observed differences. In a pooled analysis from four cohort studies from three European countries, we demonstrated a U-shaped association between alcohol use and sickness absence, particularly among men. Abstinence from alcohol was associated with increased sickness absenteeism among both sexes and across socioeconomic strata, except those with low SES. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Sports participation and physical education in American secondary schools: current levels and racial/ethnic and socioeconomic disparities.

PubMed

Johnston, Lloyd D; Delva, Jorge; O'Malley, Patrick M

2007-10-01

The purpose of this study was to determine the current levels of physical education (PE) and sports participation among American secondary school students, and to establish the extent to which they vary by grade level, racial/ethnic background, and socioeconomic status (SES) of the students. Nationally representative data were used from over 500 schools and 54,000 students surveyed in 2003, 2004, and 2005 as part of the Youth, Education, and Society (YES) study and the Monitoring the Future (MTF) study. As part of YES, school administrators completed questionnaires on physical activity (including rates of sports and PE participation) of students in their schools. Students in the same schools completed self-administered questionnaires in the same year as part of MTF, providing individual background data, including their gender, racial/ethnic identification, and parents' education level. Data were analyzed in 2006. Physical education requirements, and actual student participation rates, decline substantially between 8th and 12th grades. About 87% of 8th graders were in schools that required them to take PE, compared to only 20% of 12th graders. Principals estimate that over 90% of 8th graders actually take PE, compared to 34% of 12th graders. Subgroup differences in PE participation rates were small. Only a fraction of all students participate in varsity sports during the school year, with girls participating only slightly less than boys (33% vs 37%). Participation correlates negatively with SES and was lower among black and Hispanic students than white students, even after controlling for other variables. Participation rates in intramural sports were even lower, declined in higher grades, and were lower among low-SES and Hispanic students (after controlling for other variables). Physical education is noticeably lacking in American high schools for all groups. Racial/ethnic minorities and low-SES youth, who are at higher than average risk of being overweight in adolescence, are getting less exercise due to their lower participation in school sports. Disparities in resources available to minorities and lower-SES youth may help explain the differences in participation rates.

Socioeconomic Status (SES) and Children's Intelligence (IQ): In a UK-Representative Sample SES Moderates the Environmental, Not Genetic, Effect on IQ

PubMed Central

Hanscombe, Ken B.; Trzaskowski, Maciej; Haworth, Claire M. A.; Davis, Oliver S. P.; Dale, Philip S.; Plomin, Robert

2012-01-01

Background The environment can moderate the effect of genes - a phenomenon called gene-environment (GxE) interaction. Several studies have found that socioeconomic status (SES) modifies the heritability of children's intelligence. Among low-SES families, genetic factors have been reported to explain less of the variance in intelligence; the reverse is found for high-SES families. The evidence however is inconsistent. Other studies have reported an effect in the opposite direction (higher heritability in lower SES), or no moderation of the genetic effect on intelligence. Methods Using 8716 twin pairs from the Twins Early Development Study (TEDS), we attempted to replicate the reported moderating effect of SES on children's intelligence at ages 2, 3, 4, 7, 9, 10, 12 and 14: i.e., lower heritability in lower-SES families. We used a twin model that allowed for a main effect of SES on intelligence, as well as a moderating effect of SES on the genetic and environmental components of intelligence. Results We found greater variance in intelligence in low-SES families, but minimal evidence of GxE interaction across the eight ages. A power calculation indicated that a sample size of about 5000 twin pairs is required to detect moderation of the genetic component of intelligence as small as 0.25, with about 80% power - a difference of 11% to 53% in heritability, in low- (−2 standard deviations, SD) and high-SES (+2 SD) families. With samples at each age of about this size, the present study found no moderation of the genetic effect on intelligence. However, we found the greater variance in low-SES families is due to moderation of the environmental effect – an environment-environment interaction. Conclusions In a UK-representative sample, the genetic effect on intelligence is similar in low- and high-SES families. Children's shared experiences appear to explain the greater variation in intelligence in lower SES. PMID:22312423

Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention.

PubMed

Wee, Liang En; Koh, Gerald Choon-Huat; Chin, Run Ting; Yeo, Wei Xin; Seow, Branden; Chua, Darren

2012-07-01

Inequalities in cancer screening are little studied in Asian societies. We determined whether area and individual measures of socio-economic status (SES) affected cancer screening participation in Singapore and prospectively evaluated an access-enhancing community-based intervention. The study population involved all residents aged >40 years in two housing estates comprising of owner-occupied (high-SES area) and rental (low-SES area) flats. From 2009 to 2011, non-adherents to regular screening for colorectal/breast/cervical cancer were offered free convenient screening over six months. Pre- and post-intervention screening rates were compared with McNemar's test. Multi-level logistic regression identified factors of regular screening at baseline; Cox regression analysis identified predictors of screening post-intervention. Participation was 78.2% (1081/1383). In the low-SES area, 7.7% (33/427), 20.4% (44/216), and 14.3% (46/321) had regular colorectal, cervical and breast cancer screening respectively. Post-intervention, screening rates in the low-SES area rose significantly to 19.0% (81/427), 25.4% (55/216), and 34.3% (74/216) respectively (p<0.001). Area SES was more consistently associated with screening than individual SES at baseline. Post-intervention, for colorectal cancer screening, those with higher education were more likely to attend (p=0.004); for female cancer screening, the higher-income were less likely to attend (p=0.032). Access-enhancing community-based interventions improve participation among disadvantaged strata of Asian societies. Copyright © 2012 Elsevier Inc. All rights reserved.

Exploring moderating effects of John Henryism Active Coping on the relationship between education and cardiovascular measures in Korean Americans.

PubMed

Logan, Jeongok G; Barksdale, Debra J; Chien, Lung-Chang

2014-12-01

John Henryism Active Coping (JHAC) is defined as a strong behavioral predisposition to cope with stressors in an effortful and determined manner. The well-known inverse relationship between socioeconomic status (SES) and blood pressure (BP) has been hypothesized to be stronger for individuals who have high JHAC than those with low JHAC, suggesting that JHAC may place people with low SES at higher cardiovascular risk. Previous studies testing this hypothesis have presented mixed findings; therefore, this study was conducted to test the JHAC hypothesis by examining the main and interaction effects of SES and JHAC on cardiovascular risk (measured by BP and arterial stiffness [AS]). The sample was 102 Korean Americans (aged 21-60years). Measures included age, sex, body mass index, smoking, SES (measured by income and education), JHAC (measured by the 12-item JHAC Scale), BP, and AS. In terms of the SES measures, only education was significantly related to systolic BP (p=0.003), diastolic BP (p=0.001), and AS (p<0.000). The interaction effects of education and JHAC on systolic BP and AS were also significant (p=0.019 and p=0.018, respectively), indicating that the inverse relationships of education to systolic BP and AS were more prominent in subjects with lower JHAC scores. Contrary to the JHAC hypothesis, JHAC may be associated with low cardiovascular risk in people with low education in certain groups. Studies are recommended to examine potential beneficial effects of JHAC on cardiovascular health in a larger sample and to identify their mechanisms. Copyright © 2014 Elsevier Inc. All rights reserved.

The Relation of Socioeconomic Status and Parent Education on the Vocabulary and Language Skills of Children who do and do not Stutter

PubMed Central

Richels, Corrin G.; Johnson, Kia N.; Walden, Tedra A.; Conture, Edward G.

2013-01-01

Purpose The purpose of this project was to investigate the possible relation between standardized measures of vocabulary/language, mother and father education, and a composite measure of socioeconomic status (SES) for children who do not stutter (CWNS) and children who stutter (CWS). Methods Participants were 138 CWNS and 159 CWS between the ages of 2;6 and 6;3 and their families. The Hollingshead Four Factor Index of Social Position (i.e., Family SES) was used to calculate SES based on a composite score consisting of weighted values for paternal and maternal education and occupation. Statistical regression analyses were conducted to investigate the relation between parental education and language and vocabulary scores for both the CWNS and CWS. Correlations were calculated between parent education, Family SES, and stuttering severity (e.g., SSI-3 score, % words stuttered). Results Results indicated that maternal education contributed the greatest amount of variance in vocabulary and language scores for the CWNS and for participants from both groups whose Family SES was in the lowest quartile of the distribution. However, paternal education generally contributed the greatest amount of variance in vocabulary and language scores for the CWS. Higher levels of maternal education were associated with more severe stuttering in the CWS. Conclusion Results are generally consistent with existing literature on normal language development that indicates maternal education is a robust predictor of the vocabulary and language skills of preschool children. Thus, both father and mothers’ education may impact the association between vocabulary/language skills and childhood stuttering, leading investigators who empirically study this association to possibly re-assess their participant selection (e.g., a priori control of parental education) and/or data analyses (e.g., post hoc covariation of parental education). PMID:23906898

Characterizing internet health information seeking strategies by socioeconomic status: a mixed methods approach.

PubMed

Perez, Susan L; Kravitz, Richard L; Bell, Robert A; Chan, Man Shan; Paterniti, Debora A

2016-08-09

The Internet is valuable for those with limited access to health care services because of its low cost and wealth of information. Our objectives were to investigate how the Internet is used to obtain health-related information and how individuals with differing socioeconomic resources navigate it when presented with a health decision. Study participants were recruited from public settings and social service agencies. Participants listened to one of two clinical scenarios - consistent with influenza or bacterial meningitis - and then conducted an Internet search. Screen-capture video software captured the Internet search. Participant Internet search strategies were analyzed and coded for pre- and post-Internet search guess at diagnosis and information seeking patterns. Individuals who did not have a college degree and were recruited from locations offering social services were categorized as "lower socioeconomic status" (SES); the remainder was categorized as "higher SES." Participants were 78 Internet health information seekers, ranging from 21-35 years of age, who experienced barriers to accessing health care services. Lower-SES individuals were more likely to use an intuitive, rather than deliberative, approach to Internet health information seeking. Lower- and higher-SES participants did not differ in the tendency to make diagnostic guesses based on Internet searches. Lower-SES participants were more likely than their higher-SES counterparts to narrow the scope of their search. Our findings suggest that individuals with different levels of socioeconomic status vary in the heuristics and search patterns they rely upon to direct their searches. The influence and use of credible information in the process of making a decision is associated with education and prior experiences with healthcare services. Those with limited resources may be disadvantaged when turning to the Internet to make a health decision.

Socio-economic status and cardiovascular risk factors in rural and urban areas of Vellore, Tamilnadu, South India.

PubMed

Samuel, Prasanna; Antonisamy, Belavendra; Raghupathy, Palani; Richard, Joseph; Fall, Caroline H D

2012-10-01

We examined associations between socio-economic status (SES) indicators and cardiovascular disease (CVD) risk factors among urban and rural South Indians. Data from a population-based birth cohort of 2218 men and women aged 26-32 years from Vellore, Tamilnadu were used. SES indicators included a household possessions score, attained education and paternal education. CVD risk factors included obesity, hypertension, impaired glucose tolerance or diabetes, plasma total cholesterol to high density lipoprotein (HDL) ratio and triglyceride levels and consumption of tobacco and alcohol. Multiple logistic regression analysis was used to assess associations between SES indicators and risk factors. Most risk factors were positively associated with possessions score in urban and rural men and women, except for tobacco use, which was negatively associated. Trends were similar with the participants' own education and paternal education, though weaker and less consistent. In a concurrent analysis of all the three SES indicators, adjusted for gender and urban/rural residence, independent associations were observed only for the possessions score. Compared with those in the lowest fifth of the score, participants in the highest fifth had a higher risk of abdominal obesity [odds ratio (OR) =6.4, 95% CI 3.4-11.6], high total cholesterol to HDL ratio (OR=2.4, 95% CI 1.6-3.5) and glucose intolerance (OR=2.8, 95% CI 1.9-4.1). Their tobacco use (OR=0.4, 95% CI 0.2-0.6) was lower. Except for hypertension and glucose intolerance, risk factors were higher in urban than rural participants independently of SES. In this young cohort of rural and urban south Indians, higher SES was associated with a more adverse CVD risk factor profile but lower tobacco use.

Do Children Who Read More Books Know "What is Good Writing" Better Than Children Who Read Less? A Comparison Between Grade Levels and SES Groups

ERIC Educational Resources Information Center

Korat, Ofra; Schiff, Rachel

2005-01-01

We investigated how SES, grade level, and book reading experiences are related to children's writing self-efficacy as well as to their knowledge of "good writing" and "writing difficulties." The sample included 199 middle-high (HSES) and low (LSES) SES children (63 second graders, 67 fourth graders, and 69 sixth graders).…

Intersections between nativity, ethnic density, and neighborhood SES: using an ethnic enclave framework to explore variation in Puerto Ricans' physical health.

PubMed

Roy, Amanda Leigh; Hughes, Diane; Yoshikawa, Hirokazu

2013-06-01

Although past research has demonstrated a "health disadvantage" for Puerto Rican adults, very little is known about correlates of health among this group. Given Puerto Ricans' unique experiences of migration and settlement, an ethnic enclave framework that integrates nativity, ethnic density, and neighborhood SES may offer insight into factors influencing Puerto Ricans' health. This study uses a sample of 449 adult mainland- and island-born Puerto Ricans living in New York City and Chicago. The data, collected as a part of the MIDUS Survey of Minority Groups, are stratified by neighborhood ethnic density and neighborhood SES, allowing for the examination of the individual and joint influences of neighborhood characteristics on physical health. Results revealed that ethnic density and neighborhood SES were not independently or interactively related to physical health for mainland-born Puerto Ricans. However, the interaction between ethnic density and neighborhood SES was related to self-reported health, functional limitations, and health symptoms for island-born Puerto Ricans. Island-born Puerto Ricans living in ethnically dense, low SES neighborhoods reported worse health than island-born Puerto Ricans living in other types of neighborhoods. This may be a result of isolation from resources both within and outside the neighborhood.

Maternal styles of talking about child feeding across sociodemographic groups.

PubMed

Pesch, Megan H; Harrell, Kristina J; Kaciroti, Niko; Rosenblum, Katherine L; Lumeng, Julie C

2011-12-01

This study sought to identify maternal styles of talking about child feeding from a semistructured interview and to evaluate associated maternal and child characteristics. Mothers of preschool-aged children (n=133) of diverse race/ethnicity and socioeconomic status (SES) (45 lower SES black, 29 lower SES white, 32 lower SES Hispanic, 15 middle to upper SES white, and 12 middle to upper SES Asian) participated in a semistructured interview about feeding. Interviews were audiotaped and transcribed. Themes were identified, and individual interviews were coded within these themes: authority (high/low), confidence (confident/conflicted/unopinionated), and investment (deep/mild/removed). Demographic characteristics were collected and a subset of children had measured weights and heights. Cluster analysis was used to identify narrative styles. Participant characteristics were compared across clusters using Fisher's exact test and analysis of variance. Six narrative styles were identified: Easy-Going, Practical No-Nonsense, Disengaged, Effortful No-Nonsense, Indulgent Worry, and Conflicted Control. Cluster membership differed significantly based on maternal demographic group (P<0.001) and child weight status (P<0.05). More than half (60%) of children of mothers in the Conflicted Control cluster were obese. Maternal styles of talking about feeding are associated with maternal and child characteristics. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Older Adults' Internet Use for Health Information: Digital Divide by Race/Ethnicity and Socioeconomic Status.

PubMed

Yoon, Hyunwoo; Jang, Yuri; Vaughan, Phillip W; Garcia, Michael

2018-04-01

Building upon literature suggesting low Internet use among racial/ethnic minorities and socioeconomically disadvantaged groups, this study examined how race/ethnicity and socioeconomic status (SES) influence the Internet use for health information, addressing both independent and interactive effects. Using data from 17,704 older adults in the California Health Interview Survey, logistic regression models were estimated with race/ethnicity (Whites, African Americans, Latinos, and Asians), SES index, and the interaction between race/ethnicity and SES index. Overall, approximately 40% of participants were Internet-users for health information. Direct effects of race/ethnicity and SES-and their interactions-were all found to be significant. Minority status combined with the lowest levels of SES substantially reduced the odds of using Internet for health information. Findings suggest the combination of racial/ethnic minority status and low SES as a source of digital divide, and provide implications for Internet technology training for the target population.

Mothers' and Teachers' Estimations of First Graders' Literacy Level and Their Relation to the Children's Actual Performance in Different SES Groups

ERIC Educational Resources Information Center

Korat, Ofra

2011-01-01

The relationship between mothers' and teachers' estimations of 60 children's literacy level and their actual performance were investigated in two different socio-economic status (SES) groups: low (LSES) and high (HSES). The children's reading (fluency, accuracy and comprehension) and spelling levels were measured. The mothers evaluated their own…

Relation of socioeconomic status to overweight and obesity: a large population-based study of Chinese adults.

PubMed

Zhang, Hua; Xu, Hui; Song, Fei; Xu, Weili; Pallard-Borg, Stephanie; Qi, Xiuying

2017-09-01

China has been going through significant changes in social and economical aspects and with great socioeconomic disparity in different regions. However, data on the association between socioeconomic status (SES) and obesity are not available in Tianjin, China. This study aimed to investigate the association between SES and high adiposity among the adult population in Tianjin. A total of 7351 individuals aged 20-79 were included in this study. Socioeconomic information was collected through an interview following a structured questionnaire. Waist circumference, body weight and height were measured following standard procedures. Overweight and obesity were defined according to the criteria of the Working Group on Obesity in China. Data were analysed using multinomial logistic regression with adjustment for potential confounders. Stratified analysis showed that higher monthly income and education were related to decreased odds of abdominal overweight/obesity in women, while high education was associated with increased odds of general overweight/obesity in men. Retirement increased the odds of abdominal overweight and obesity and non-manual work was associated with low odds of abdominal obesity in women. SES was associated with general and abdominal overweight/obesity and sex may play a role in such an association.

Cross race comparisons between SES health gradients among African-American and white women at mid-life

PubMed Central

Salsberry, Pamela J.

2014-01-01

This study explored how multiple indicators of socioeconomic status (SES) inform understanding of race differences in the magnitude of health gains associated with higher SES. The study sample, 1268 African-American women and 2066 white women, was drawn from the National Longitudinal Surveys of Youth 1979. The outcome was the Physical Components Summary from the SF-12 assessed at age 40. Ordinary least squares regressions using education, income and net worth fully interacted with race were conducted. Single measure gradients tended to be steeper for whites than African-Americans, partly because “sheepskin” effects of high school and college graduation were higher for whites and low income and low net worth whites had worse health than comparable African-Americans. Conditioning on multiple measures of SES eliminated race disparities in health benefits of education and net worth, but not income. A discussion of current public policies that affect race disparities in levels of education, income and net wealth is provided. PMID:24632052

Does reading keep you thin? Leisure activities, cultural tastes, and body weight in comparative perspective

PubMed Central

Pampel, Fred C.

2011-01-01

While sedentary leisure-time activities such as reading, going to movies, attending cultural events, attending sporting events, watching TV, listening to music, and socializing with friends would seem to contribute to excess weight, a perspective focusing on SES differences in cultural tastes suggests the opposite, that some sedentary activities are associated with lower rather than higher body weight. This study aims to test theories of cultural distinction by examining relationships between leisure-time activities and body weight. Using 2007 data on 17 nations from the International Social Survey Program, the analysis estimates relationships between the body mass index and varied leisure-time activities while controlling for SES, physical activities, and sociodemographic variables. Net of controls for SES and physical activities, participation time in cultural activities is associated with lower rather than higher body weight, particularly in high-income nations. The results suggest that both cultural activities and body weight reflect forms of distinction that separate SES-based lifestyles. PMID:21707664

"Macho men" and preventive health care: implications for older men in different social classes.

PubMed

Springer, Kristen W; Mouzon, Dawne M

2011-06-01

The gender paradox in mortality--where men die earlier than women despite having more socioeconomic resources--may be partly explained by men's lower levels of preventive health care. Stereotypical notions of masculinity reduce preventive health care; however, the relationship between masculinity, socioeconomic status (SES), and preventive health care is unknown. Using the Wisconsin Longitudinal Study, the authors conduct a population-based assessment of masculinity beliefs and preventive health care, including whether these relationships vary by SES. The results show that men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventive care. Furthermore, in contrast to the well-established SES gradient in health, men with strong masculinity beliefs do not benefit from higher education and their probability of obtaining preventive health care decreases as their occupational status, wealth, and/or income increases. Masculinity may be a partial explanation for the paradox of men's lower life expectancy, despite their higher SES.

Understanding the Relationships between Gender Inequitable Behaviours, Childhood Trauma and Socio-Economic Status in Single and Multiple Perpetrator Rape in Rural South Africa: Structural Equation Modelling.

PubMed

Jewkes, Rachel; Nduna, Mzikazi; Jama-Shai, Nwabisa; Chirwa, Esnat; Dunkle, Kristin

2016-01-01

Interventions to prevent rape perpetration must be designed to address its drivers. This paper seeks to extend understanding of drivers of single and multiple perpetrator rape (referred to here as SPR and MPR respectively) and the relationships between socio-economic status, childhood trauma, peer pressure, other masculine behaviours and rape. 1370 young men aged 15 to 26 were interviewed as part of the randomised controlled trial evaluation of Stepping Stones in the rural Eastern Cape. We used multinomial to compare the characteristics of men who reported rape perpetration at baseline. We used structural equation modelling (SEM) to examine pathways to rape perpetration. 76.1% of young men had never raped, 10.0% had perpetrated SPR and 13.9% MPR. The factors associated with both MPR and SPR (compared to never having raped) were indicators of socio-economic status (SES), childhood trauma, sexual coercion by a woman, drug and alcohol use, peer pressure susceptibility, having had transactional sex, multiple sexual partners and being physically violent towards a partner. The SEM showed the relationship between SES and rape perpetration to be mediated by gender inequitable masculinity. It was complex as there was a direct path indicating that SES correlated with the masculinity variable directly such that men of higher SES had more gender inequitable masculinities, and indirect path mediated by peer pressure resistance indicated that the former pertained so long as men lacked peer pressure resistance. Having a higher SES conveyed greater resistance for some men. There was also a path mediated through childhood trauma, such that men of lower SES were more likely to have a higher childhood trauma exposure and this correlated with a higher likelihood of having the gender inequitable masculinity (with or without the mediating effect of peer pressure resistance). Both higher and lower socio-economic status were associated with raping. Prevention of rape perpetration must focus on changing men's gender ideals, entitlements and inequitable practices. Reducing poverty and adverse childhood experiences should also be of benefit.

Understanding the Relationships between Gender Inequitable Behaviours, Childhood Trauma and Socio-Economic Status in Single and Multiple Perpetrator Rape in Rural South Africa: Structural Equation Modelling

PubMed Central

Jewkes, Rachel; Nduna, Mzikazi; Jama-Shai, Nwabisa; Chirwa, Esnat; Dunkle, Kristin

2016-01-01

Background Interventions to prevent rape perpetration must be designed to address its drivers. This paper seeks to extend understanding of drivers of single and multiple perpetrator rape (referred to here as SPR and MPR respectively) and the relationships between socio-economic status, childhood trauma, peer pressure, other masculine behaviours and rape. Method 1370 young men aged 15 to 26 were interviewed as part of the randomised controlled trial evaluation of Stepping Stones in the rural Eastern Cape. We used multinomial to compare the characteristics of men who reported rape perpetration at baseline. We used structural equation modelling (SEM) to examine pathways to rape perpetration. Results 76.1% of young men had never raped, 10.0% had perpetrated SPR and 13.9% MPR. The factors associated with both MPR and SPR (compared to never having raped) were indicators of socio-economic status (SES), childhood trauma, sexual coercion by a woman, drug and alcohol use, peer pressure susceptibility, having had transactional sex, multiple sexual partners and being physically violent towards a partner. The SEM showed the relationship between SES and rape perpetration to be mediated by gender inequitable masculinity. It was complex as there was a direct path indicating that SES correlated with the masculinity variable directly such that men of higher SES had more gender inequitable masculinities, and indirect path mediated by peer pressure resistance indicated that the former pertained so long as men lacked peer pressure resistance. Having a higher SES conveyed greater resistance for some men. There was also a path mediated through childhood trauma, such that men of lower SES were more likely to have a higher childhood trauma exposure and this correlated with a higher likelihood of having the gender inequitable masculinity (with or without the mediating effect of peer pressure resistance). Discussion Both higher and lower socio-economic status were associated with raping. Prevention of rape perpetration must focus on changing men’s gender ideals, entitlements and inequitable practices. Reducing poverty and adverse childhood experiences should also be of benefit. PMID:27182972

Gender differences in mathematics achievement in Beijing: A meta-analysis.

PubMed

Li, Meijuan; Zhang, Yongmei; Liu, Hongyun; Hao, Yi

2017-12-19

The topic of gender differences in mathematical performance has received considerable attention in the fields of education, sociology, economics and psychology. We analysed gender differences based on data from the Beijing Assessment of Educational Quality in China. A large data set of Grade 5 and Grade 8 students who took the mathematical test from 2008 to 2013 (n = 73,318) were analysed. Meta-analysis was used in this research. The findings were as follows. (1) No gender differences in mathematical achievement exist among students in Grade 5, relatively small gender differences exist in Grade 8, females scored higher than males, and variance of male students is larger than that of females in both Grade 5 and Grade 8. (2) Except for statistics and probability, gender differences in other domains in Grade 8 are significantly higher than those in Grade 5, and female students outperform males. (3) The ratio of students of both gender in Grade 5 and Grade 8 at the 95-100% percentile level shows no significant differences. However, the ratio of male students is significantly higher than that of females at the 0-5% percentile level. (4) In Grade 5, the extent to which females outperformed males in low SES group is larger than that in higher SES groups, and in Grade 8, the magnitude of gender differences in urban schools is smaller than that in rural schools. There is a small gender difference among the 8th graders, with the male disadvantage at the bottom of the distribution. And gender differences also vary across school locations. © 2017 The British Psychological Society.

Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL

PubMed Central

Gorely, Trish; Atkin, Andrew J; Biddle, Stuart JH; Marshall, Simon J

2009-01-01

Background Identification of non-modifiable correlates of physical activity and sedentary behaviour in youth contributes to the development of effective targeted intervention strategies. The purpose of this research was to examine the relationships between family circumstances (e.g. socio-economic status, single vs. dual parent household, presence/absence of siblings) and leisure-time physical activity and sedentary behaviours in adolescents. Methods A total of 1171 adolescents (40% male; mean age 14.8 years) completed ecological momentary assessment diaries every 15 minutes for 3 weekdays outside of school hours and 1 weekend day. Analysed behaviours were sports/exercise, active travel, TV viewing, computer use, sedentary socialising (hanging-out, using the telephone, sitting and talking) and total sedentary behaviour. Linear regression was employed to estimate levels of association between individual family circumstance variables and each behaviour. Results Compared to girls from higher socioeconomic status (SES) groups, girls from low SES groups reported higher weekend TV viewing and higher weekday total sedentary behaviour. For boys, single parent status was associated with greater total sedentary behaviour compared to those from dual parent households. Boys and girls from low socio-economic neighbourhoods reported lower participation in sports/exercise compared to those living in higher socio-economic neighbourhoods. Conclusion Associations were not consistent across behaviours or between genders. Overall, findings indicate that boys from single parent households and girls from low socio-economic families may be at increased risk of high sedentary behaviour. Those living in low socioeconomic neighbourhoods may be at increased risk of reduced participation in sports and exercise. PMID:19519913

The sociodemographic correlates of nutritional status of school adolescents in Jiangsu Province, China.

PubMed

Shi, Zumin; Lien, Nanna; Kumar, Bernadette Nirmal; Dalen, Ingvild; Holmboe-Ottesen, Gerd

2005-10-01

The objective of this article was to describe the relationship between sociodemographic factors and nutritional status (body mass index [BMI], height for age, and anemia) in adolescents. In 2002, a cross-sectional study comprising 824 students aged 12 to 14 years from 8 schools in 2 prefectures in Jiangsu province of China had their height, weight, and hemoglobin level measured. Self-administered questionnaires were used to collect sociodemographic information. The prevalence of underweight was low in the overall sample (5.2%). The prevalence of stunting also was low (2.9%), and the differences between residential areas and sociodemographic groups were small. The percentage of overweight/obesity was higher among boys (17.9%) than girls (8.9%). Male students having fathers with a high educational level had the highest percentage of overweight and obesity (27.8%). Household socioeconomic status (SES) was associated positively with BMI. Family size, gender, and the father's level of education also were related to BMI. The percentage of anemia was somewhat higher among girls (23.4%) than boys (17.2%). Anemia coexisted with underweight. No urban/rural or SES differences in the percentage of students with anemia were observed in the sample, but differences between regions and schools were very significant. Undernutrition was not a problem in the research area. Nutritional status was associated with SES and region. Overnutrition and anemia in adolescents are important nutritional problems in Jiangsu, China. Intervention programs are needed to address these problems.

Academic Self-Efficacy Partially Mediates the Relationship between Scottish Index of Multiple Deprivation and Composite Attainment Score.

PubMed

Perry, John L; Dempster, Martin; McKay, Michael T

2017-01-01

A developing literature continues to testify to the relationship between higher socio-economic status (SES) and better academic attainment. However, the literature is complex in terms of the variety of SES and attainment indicators used. Against the backdrop of a Scottish Government initiative to close the attainment gap between higher and lower SES children, the present study examined the relationship between individual-level Scottish Index of Multiple Deprivation (SIMD) and National Lower Tariff Score in school children in the West of Scotland. Results showed a practically significant relationship between SIMD and Tariff Score. This relationship was partially mediated by higher academic self-efficacy, so that higher belief in academic competency partially mediated the SIMD-Tariff Score relationship. Further, this partial mediation was robust to the influence of gender, sensation seeking, level of school attendance and past month frequency of Heavy Episodic Drinking. It is suggested that increasing attendance and perceived academic competence are viable ways (among others) of attempting to close the attainment gap.

Academic Self-Efficacy Partially Mediates the Relationship between Scottish Index of Multiple Deprivation and Composite Attainment Score

PubMed Central

Perry, John L.; Dempster, Martin; McKay, Michael T.

2017-01-01

A developing literature continues to testify to the relationship between higher socio-economic status (SES) and better academic attainment. However, the literature is complex in terms of the variety of SES and attainment indicators used. Against the backdrop of a Scottish Government initiative to close the attainment gap between higher and lower SES children, the present study examined the relationship between individual-level Scottish Index of Multiple Deprivation (SIMD) and National Lower Tariff Score in school children in the West of Scotland. Results showed a practically significant relationship between SIMD and Tariff Score. This relationship was partially mediated by higher academic self-efficacy, so that higher belief in academic competency partially mediated the SIMD-Tariff Score relationship. Further, this partial mediation was robust to the influence of gender, sensation seeking, level of school attendance and past month frequency of Heavy Episodic Drinking. It is suggested that increasing attendance and perceived academic competence are viable ways (among others) of attempting to close the attainment gap. PMID:29163281

Change in Tobacco Use Over Time in Urban Indian Youth: The moderating Role of Socioeconomic Status

PubMed Central

Mathur, Charu; Stigler, Melissa H.; Erickson, Darin J.; Perry, Cheryl L.; Finnegan, John R.; Arora, Monika; Reddy, K. Srinath

2014-01-01

This study investigates socioeconomic differences in patterns and trends of tobacco consumption over time among youth in India. Additionally, the distribution of tobacco use risk factors across social class was examined. The data were derived from a longitudinal study of adolescents, Project MYTRI. Students in eight private [high socioeconomic status (SES)] (n=2881) and eight government (lower SES) (n=5476) schools in two large cities in India (Delhi and Chennai) were surveyed annually about their tobacco use and related psychosocial risk factors from 2004 to 2006. Results suggest the relationship between SES and tobacco use over time was not consistent. At baseline (in 2004), lower SES was associated with higher prevalence of tobacco use but the relation between SES and tobacco use reversed two years later (2006). These findings were mirrored in the distribution of related psychosocial risk factors by SES at baseline (in 2004), and thereafter in 2006. Implications for prevention scientists and future intervention programs are considered. PMID:23444321

Moving in and out of Poverty: The Within-Individual Association between Socioeconomic Status and Juvenile Delinquency.

PubMed

Rekker, Roderik; Pardini, Dustin; Keijsers, Loes; Branje, Susan; Loeber, Rolf; Meeus, Wim

2015-01-01

A family's SES can be changeable over time. This study was the first to investigate if such within-individual changes in family SES are associated with parallel fluctuations in boys' delinquent behavior from childhood to adolescence. Participants were a community sample of boys and their caregivers (N = 503) who were assessed annually for ten consecutive years spanning ages 7-18. Fixed effects models revealed that changes in familial SES were related to changes in delinquency: Youths were more likely to offend during years in which their parents' SES was lower than during years in which their parents' SES was higher. Contrary to expectations, we found no evidence that this association was accounted for by families moving to different neighborhoods or by changes in parenting. Since within-individual models provide a stricter test of causality than between-individual models, these findings support claims that impacting familial SES may have a direct effect on youths' delinquency.

Moving in and out of Poverty: The Within-Individual Association between Socioeconomic Status and Juvenile Delinquency

PubMed Central

Rekker, Roderik; Pardini, Dustin; Keijsers, Loes; Branje, Susan; Loeber, Rolf; Meeus, Wim

2015-01-01

A family’s SES can be changeable over time. This study was the first to investigate if such within-individual changes in family SES are associated with parallel fluctuations in boys’ delinquent behavior from childhood to adolescence. Participants were a community sample of boys and their caregivers (N = 503) who were assessed annually for ten consecutive years spanning ages 7–18. Fixed effects models revealed that changes in familial SES were related to changes in delinquency: Youths were more likely to offend during years in which their parents’ SES was lower than during years in which their parents’ SES was higher. Contrary to expectations, we found no evidence that this association was accounted for by families moving to different neighborhoods or by changes in parenting. Since within-individual models provide a stricter test of causality than between-individual models, these findings support claims that impacting familial SES may have a direct effect on youths’ delinquency. PMID:26575271

Variation in sport participation, fitness and motor coordination with socioeconomic status among Flemish children.

PubMed

Vandendriessche, Joric B; Vandorpe, Barbara F R; Vaeyens, Roel; Malina, Robert M; Lefevre, Johan; Lenoir, Matthieu; Philippaerts, Renaat M

2012-02-01

Socioeconomic status (SES) is often indicated as a factor that influences physical activity and associated health outcomes. This study examined the relationship between SES and sport participation, morphology, fitness and motor coordination in a sample of 1955 Flemish children 6-11 years of age. Gender, age and SES-specific values for morphologic dimensions, amount and type of sport participation and fitness and motor coordination tests were compared. SES was positively and significantly associated with sport participation and sports club membership in both sexes. Although differences were not consistently significant, morphologic dimensions and tests of fitness and motor coordination showed a trend in favor of children from higher SES. The results suggest that public and local authorities should consider providing equal opportunities for children in all social strata and especially those in the lower SES to experience the beneficial effects of sport participation through which they can enhance levels of physical fitness and motor coordination.

Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study.

PubMed

Chen, H Y; Ivers, R Q; Martiniuk, A L C; Boufous, S; Senserrick, T; Woodward, M; Stevenson, M; Norton, R

2010-11-01

Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES. Information on risk factors for crash collected from 20,822 newly licenced drivers aged 17-24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity--urgency of treatment and length of hospital stay--were examined by SES. Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES. The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural-urban differences. This finding may help improve and better target interventions for youth of low SES.

Association of Socioeconomic Status (SES) and Social Support with Depressive Symptoms among the Elderly in Singapore.

PubMed

Ng, Charis W L; Tan, Woan Shin; Gunapal, Pradeep P G; Wong, Lai Yin; Heng, Bee Hoon

2014-12-01

Depression in the elderly is a major public health issue. Socioeconomic status (SES) and social support are strong risk factors for depression. This study aimed to investigate the influence of SES and social support in elderly depression, and the modifying effect of social support on the relationship between SES and depression. A community-based survey was conducted on residents≥60 years old. Depressive symptoms were determined with scores≥5 using the 15-item Geriatric Depression Scale (GDS). Multivariable logistic regression was performed to determine the odds ratio (OR) of depressive symptoms with respect to SES and social support, and interaction terms between the two variables. Of 2447 responses analysed, 188 (7.8%) respondents had depressive symptoms. Living in 2-room housing, living alone/with a domestic helper, infrequent leisure time with children/grandchildren or being childless, and feeling socially isolated were independently associated with depressive symptoms. Relative to residents living with spouse and children in 4-/5-room housing, the highest ORs for depressive symptoms were those living with spouse and children in 2-room (OR: 3.06, P<0.05), followed by living with children only in 3-room (OR: 2.98, P<0.05), and living alone/with a domestic helper in 4-/5-room (OR: 2.73, P<0.05). Living with spouse only appears to buffer against depressive symptoms across socioeconomic classes, although the effect was not statistically significant. Low social support and low SES significantly increased the odds of depressive symptoms. The moderating effect of social support on depression was however not consistent across SES groups. Specific interventions need to target different SES groups to better help older adults at risk of developing depression.

Impact of Socioeconomic Status on Patients Supported With a Left Ventricular Assist Device: An Analysis of the UNOS Database (United Network for Organ Sharing).

PubMed

Clerkin, Kevin J; Garan, Arthur Reshad; Wayda, Brian; Givens, Raymond C; Yuzefpolskaya, Melana; Nakagawa, Shunichi; Takeda, Koji; Takayama, Hiroo; Naka, Yoshifumi; Mancini, Donna M; Colombo, Paolo C; Topkara, Veli K

2016-10-01

Low socioeconomic status (SES) is a known risk factor for heart failure, mortality among those with heart failure, and poor post heart transplant (HT) outcomes. This study sought to determine whether SES is associated with decreased waitlist survival while on left ventricular assist device (LVADs) support and after HT. A total of 3361 adult patients bridged to primary HT with an LVAD between May 2004 and April 2014 were identified in the UNOS database (United Network for Organ Sharing). SES was measured using the Agency for Healthcare Research and Quality SES index using data from the 2014 American Community Survey. In the study cohort, SES did not have an association with the combined end point of death or delisting on LVAD support (P=0.30). In a cause-specific unadjusted model, those in the top (hazard ratio, 1.55; 95% confidence interval, 1.14-2.11; P=0.005) and second greatest SES quartile (hazard ratio 1.50; 95% confidence interval, 1.10-2.04; P=0.01) had an increased risk of death on device support compared with the lowest SES quartile. Adjusting for clinical risk factors mitigated the increased risk. There was no association between SES and complications. Post-HT survival, both crude and adjusted, was decreased for patients in the lowest quartile of SES index compared with all other SES quartiles. Freedom from waitlist death or delisting was not affected by SES. Patients with a higher SES had an increased unadjusted risk of waitlist mortality during LVAD support, which was mitigated by adjusting for increased comorbid conditions. Low SES was associated with worse post-HT outcomes. Further study is needed to confirm and understand a differential effect of SES on post-transplant outcomes that was not seen during LVAD support before HT. © 2016 American Heart Association, Inc.

Ethnic Variations in Psychosocial and Health Correlates of Eating Disorders.

PubMed

Assari, Shervin; DeFreitas, Mariana R

2018-04-25

The aim of this study is to explore ethnic variations in psychosocial and health correlates of eating disorders in the United States, Specifically, we compared associations between gender, socioeconomic status (SES), body mass index (BMI), physical and mental self-rated health (SRH), and major depressive disorder (MDD) with eating disorders (EDs) across 10 different ethnic groups in the United States. Data was obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES), a national household probability sample collected in 2001⁻2003. Data for this study included a sample of 17,729 individuals with the following ethnic profile: 520 Vietnamese, 508 Filipino, 600 Chinese, 656 Other Asian, 577 Cuban, 495 Puerto Rican, 1442 Mexican, 1106 Other Hispanic, 4746 African American, and 7587 Non-Latino Whites. Gender, SES (education and income), BMI, SRH, MDD, and presence of EDs were measured across different ethnic groups. Logistic regression analysis was conducted for each ethnic group with lifetime EDs as the main outcome. Ethnic group varied in psychosocial and health correlates of EDs. In most ethnic groups, gender and SES were not associated with EDs. In almost all ethnic groups, EDs were associated with MDD and BMI. EDs were found to be associated with SRH in half of the ethnic groups studied. The associations between gender, SES, BMI, SRH, MDD, and EDs vary across different ethnic groups. These differences must be considered in further studies and in clinical practice in order to improve our approach towards diagnosis and treatment of EDs.

Socioeconomic status, labour market connection, and self-rated psychological health: the role of social capital and economic stress.

PubMed

Lindström, Martin; Ali, Sadiq M; Rosvall, Maria

2012-02-01

To investigate the association between socioeconomic status, unemployment and self-rated psychological health, taking economic stress and horizontal trust into account. The 2008 public health survey in Skåne is a cross-sectional postal questionnaire study with a 55% participation rate. A random sample was invited and 28,198 persons aged 18-80 participated. Logistic regression models were used to investigate associations between socioeconomic status by occupation (SES), labour market connection and self-rated psychological health (GHQ12). The multiple regression analyses included age, country of birth, education, economic stress and generalized (horizontal) trust. 13.8% of the men and 18.2% of the women had poor psychological health. Poor psychological health was more common among the young, among those born abroad, among those with lower education, with economic stress, and low horizontal trust. There were no significant differences between the employed and self-employed groups. However, the people who had retired early, the unemployed and those on long-term sick leave had significantly higher odds ratios of poor psychological health than higher non-manual employees throughout the analyses. There were no differences in psychological health between non-manual employees in higher positions and other employed and self-employed SES groups among men or women. In contrast, the early retired, the unemployed and the category on long-term sick leave had significantly higher odds ratios of poor psychological health among both men and women throughout the multiple analyses. Both economic stress and trust affected this association (i.e., lowered the odds ratios of poor psychological health), but affected by economic stress to a somewhat higher extent.

Authoritarianism, conservatism, racial diversity threat, and the state distribution of hate groups.

PubMed

McCann, Stewart J H

2010-01-01

On the basis of K. Stenner's (2005) authoritarian dynamic theory, the author hypothesized that there is an interaction between U.S. state conservatism-liberalism and state racial heterogeneity threat, such that greater diversity threat tends to be associated with more hate groups in more conservative states and fewer hate groups in more liberal states. State aggregates of the conservative-liberal ideological preferences of 141,798 participants from 122 CBS News/New York Times national telephone polls conducted between 1976 and 1988 (R. S. Erikson, G. C. Wright, & J. P. McIver, 1993) served as proxies for authoritarian-nonauthoritarian dispositions. For the 47 states with complete data, the hypothesized interaction was tested for 2000, 2005, and 2006 with hierarchical multiple regression strategies and supported. The author's hypothesis was also affirmed with SES and the interaction of SES and diversity threat controlled for. In contrast, SES entirely accounted for simple relationships between threat and hate group frequency.

Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood.

PubMed

Stroup, Antoinette M; Herget, Kimberly A; Hanson, Heidi A; Reed, Diana Lane; Butler, Jared T; Henry, Kevin A; Harrell, C Janna; Sweeney, Carol; Smith, Ken R

2017-01-01

Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology. For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression. Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HR Q1/Q4 = 0.83; 95% confidence interval (CI), 0.72-0.97; HR Q2/Q4 = 0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HR Q1/Q4 = 0.81; 95% CI, 0.67-0.98) and prostate cancer (HR Q1/Q4 = 0.70; 95% CI, 0.56-0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HR Q1/Q4 = 1.44; 95% CI, 1.12-1.85; HR Q2/Q4 = 1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers. Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites. This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk. Cancer Epidemiol Biomarkers Prev; 26(1); 75-84. ©2016 AACR. ©2016 American Association for Cancer Research.

Baby Boomers and Birth Certificates: Early Life Socioeconomic Status and Cancer Risk in Adulthood

PubMed Central

Stroup, Antoinette M.; Herget, Kimberly A; Hanson, Heidi A; Reed, Diana Lane; Butler, Jared T; Henry, Kevin A; Harrell, C Janna; Sweeney, Carol; Smith, Ken R

2016-01-01

BACKGROUND Early life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology. METHODS For a Baby-Boom cohort born in 1945–1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression. RESULTS Females with low Np-SES at birth had lower risk of breast cancer compared to those in the highest Np-SES group (HRQ1/Q4=0.83 95% CI: 0.72–0.97; HRQ2/Q4=0.81 95% CI: 0.69–0.96). Np-SES was inversely associated with melanoma (HRQ1/Q4=0.81 95% CI: 0.67–0.98) and prostate cancer (HRQ1/Q4=0.70 95% CI: 0.56–0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HRQ1/Q4=1.44 95% CI: 1.12–1.85; HRQ2/Q4=1.33 95% CI: 1.04–1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers. CONCLUSION Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites. IMPACT This novel methodology can contribute to improved understanding of the role of early-life SES in affecting cancer risk. PMID:27655898

Preferences for female body size in Britain and the South Pacific.

PubMed

Swami, Viren; Knight, Daniel; Tovée, Martin J; Davies, Patrick; Furnham, Adrian

2007-06-01

To assess current attitudes to body weight and shape in the South Pacific, a region characterised by relatively high levels of obesity and traditionally positive views of large bodies, 38 high socio-economic status (SES) adolescent males and 38 low SES adolescent males in Independent Samoa were asked to rate a set of images of real women for physical attractiveness. Participants in both SES settings preferred women with a slender figure, as did a comparison group in Britain, suggesting that the traditional veneration of large bodies is no longer apparent in Samoa. However, the results also showed that low SES adolescents were more likely to view overweight figures as attractive, which suggests that the veneration of slim figures may be associated with increasing SES. Implications of this finding are discussed in conclusion.

Forced sex: a critical factor in the sleep difficulties of young Australian women.

PubMed

Astbury, Jill; Bruck, Dorothy; Loxton, Deborah

2011-01-01

The prevalence of forced sex and its contribution to sleep difficulties among young Australian women aged 24-30 years (n=9,061) was examined using data from the 2003 Australian Longitudinal Study of Women's Health. The lifetime prevalence of reported forced sex was 8.7%. Significantly higher levels of recurrent sleep difficulties, prescription sleep medication, clinical depression, anxiety disorder, self-harm, and substance use, as well as lower socioeconomic status (SES) indicators, were reported by the forced sex group compared to the no forced sex group. Hierarchical logistic regression revealed the high odds (OR=1.95, CI=1.66-2.26) of recurrent sleep difficulty in such women becomes partially attenuated, but remains statistically significant, after adjusting for key psychological, SES, and behavioral variables. Clinical implications for primary care providers and sleep specialists are discussed. Sleep difficulties are highly prevalent and affect more than 30% of those seeking primary health care (Kushida et al., 2005). They negatively impact on the way a person feels and functions (Dinges et al., 1997) and make a significant contribution to accidents, health care costs, and problems at work (Roth, 2005).

The association between high-sensitivity C-reactive protein and metabolic risk factors in black and white South African women: a cross-sectional study.

PubMed

George, Cindy; Evans, Juliet; Micklesfield, Lisa K; Olsson, Tommy; Goedecke, Julia H

2018-01-01

High-sensitivity C-reactive protein (hsCRP) is associated with metabolic risk, however it is unclear whether the relationship is confounded by racial/ethnic differences in socioeconomic status (SES), lifestyle factors or central adiposity. The aims of the study was, (1) to investigate whether hsCRP levels differ by race/ethnicity; (2) to examine the race/ethnic-specific associations between hsCRP, HOMA-IR and serum lipids [total cholesterol (TC), triglycerides (TG), high-density lipoproteins (HDL-C) and low-density lipoproteins (LDL-C)]; and (3) to determine whether race/ethnic-specific associations are explained by SES, lifestyle factors or waist circumference (WC). The convenience sample comprised 195 black and 153 white apparently health women, aged 18-45 years. SES (education, assets and housing density) and lifestyle factors (alcohol use, physical activity and contraceptive use) were collected by questionnaire. Weight, height and WC were measured, and fasting blood samples collected for hsCRP, glucose, insulin, and lipids. Black women had higher age- and BMI-adjusted hsCRP levels than white women ( p  = 0.047). hsCRP was associated with HOMA-IR ( p  < 0.001), TG (p < 0.001), TC ( p  < 0.05), HDL-C (p < 0.05), and LDL-C ( p  < 0.05), independent of age and race/ethnicity. The association between hsCRP and lipids differed by race/ethnicity, such that hsCRP was positively associated with TG and LDL-C in white women, and inversely associated with HDL-C in black women. Higher hsCRP was also associated with higher TC in white women and lower TC in black women. Furthermore, when adjusting for SES and lifestyle factors, the associations between hsCRP, and TC and TG, remained, however the associations between hsCRP, and HDL-C and LDL-C, were no longer significant. Although circulating hsCRP may identify individuals at increased metabolic risk, the heterogeneity in these associations between racial/ethnic groups highlights the need for prospective studies investigating the role of hsCRP for risk prediction in different populations.

Obesity and cardio-metabolic risk factors in urban adults of Benin: Relationship with socio-economic status, urbanisation, and lifestyle patterns

PubMed Central

Sodjinou, Roger; Agueh, Victoire; Fayomi, Benjamin; Delisle, Hélène

2008-01-01

Background There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD) risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES), urbanisation as well as lifestyle patterns. Methods Anthropometric parameters (height, weight and waist circumference), blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides) were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS) was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income). Results The most prevalent CVD risk factors were overall obesity (18%), abdominal obesity (32%), hypertension (23%), and low HDL-cholesterol (13%). Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%). After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors. Conclusion Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the rise of diet-related chronic diseases. People with higher SES and those with a longer exposure to the urban environment are priority target groups for interventions focusing on environmental risk factors that are amenable to change in this population. Lifestyle interventions would appear appropriate, with particular emphasis on physical activity. PMID:18318907

Gender differences in the association between socioeconomic status and subclinical atherosclerosis.

PubMed

Grimaud, Olivier; Lapostolle, Annabelle; Berr, Claudine; Helmer, Catherine; Dufouil, Carole; Kihal, Wahida; Alpérovitch, Annick; Chauvin, Pierre

2013-01-01

This study explored the pattern of associations between socioeconomic status (SES) and atherosclerosis progression (as indicated by carotid intima media thickness, CIMT) across gender. Cross-sectional analysis of a sample of 5474 older persons (mean age 73 years) recruited between 1999 and 2001 in the 3C study (France). We fitted linear regression models including neighborhood SES, individual SES and cardiovascular risk factors. CIMT was on average 24 µm higher in men (95% CI: 17 to 31). Neighborhood SES was inversely associated with CIMT in women only (highest versus lowest tertiles: -12.2 µm, 95%CI -22 to -2.4). This association persisted when individual SES and risk factors were accounted for. High individual education was associated with lower CIMT in men (-21.4 µm 95%CI -37.5 to -5.3) whereas high professional status was linked to lower CIMT among women (-15.7 µm 95%CI: -29.2 to -2.2). Adjustment for cardiovascular risk factors resulted in a slightly more pronounced reduction of the individual SES-CIMT association observed in men than in women. In this sample, neighborhood and individual SES displayed different patterns of associations with subclinical atherosclerosis across gender. This suggests that the causal pathways leading to SES variations in atherosclerosis may differ among men and women.

Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews-a systematic methodology review.

PubMed

Maden, Michelle; Cunliffe, Alex; McMahon, Naoimh; Booth, Andrew; Carey, Gina Michelle; Paisley, Suzy; Dickson, Rumona; Gabbay, Mark

2017-12-29

Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty-one studies tested their a priori programme theory. The use of programme theory to inform considerations of if, what and how interventions lead to differential effects on health in different SES groups in the systematic review process is not yet widely adopted, is used implicitly, is often fragmented and is not implemented in a systematic way.

Does a Change Over All Equal a Change in All? Testing for Polarized Alcohol Use Within and Across Socio-Economic Groups in Germany.

PubMed

Gomes de Matos, Elena; Kraus, Ludwig; Pabst, Alexander; Piontek, Daniela

2015-11-01

This study aimed at testing whether drinking volume and episodic heavy drinking (EHD) frequency in Germany are polarizing between consumption levels over time. Polarization is defined as a reduction in alcohol use among the majority of the population, while a subpopulation with a high intake level maintains or increases its drinking or its EHD frequency. The polarization hypothesis was tested across and within socio-economic subgroups. Analyses were based on seven cross-sectional waves of the Epidemiological Survey of Substance Abuse (ESA) conducted between 1995 and 2012 (n = 7833-9084). Overall polarization was estimated based on regression models with time by consumption level interactions; the three-way interaction with socio-economic status (SES) was consecutively introduced to test the stability of effects over socio-economic strata. Interactions were interpreted by graphical inspection. For both alcohol use indicators, declines over time were largest in the highest consumption level. This was found within all SES groups, but was most pronounced at low and least pronounced at medium SES. The results indicate no polarization but convergence between consumption levels. Socio-economic status groups differ in the magnitude of convergence which was lowest in medium SES. The overall decline was strongest for the highest consumption level of low SES. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The joint contribution of maternal history of early adversity and adulthood depression to socioeconomic status and potential relevance for offspring development.

PubMed

Bouvette-Turcot, Andrée-Anne; Unternaehrer, Eva; Gaudreau, Hélène; Lydon, John E; Steiner, Meir; Meaney, Michael J

2017-01-01

We examined the interactive effects of maternal childhood adversity and later adulthood depression on subsequent socioeconomic status (SES). Our community sample ranged from 230 to 243 mothers (across measures) drawn from a prospective, longitudinal cohort study. Maternal childhood adversity scores were derived using an integrated measure derived from the Childhood Trauma Questionnaire (CTQ) and the Parental Bonding Index (PBI). Maternal depression was measured in the prenatal period with the Center for Epidemiologic Studies Depression Scale (CES-D). SES measures included maternal highest level of education and family income as obtained prenatally. The analyses yielded significant interaction effects between maternal childhood adversity and prenatal depression that predicted income, prenatally. Women who reported higher levels of childhood adversity combined with higher levels of self-reported depressive symptoms were significantly more likely to live in low SES environments. Results also showed that level of education was predicted by childhood adversity independent of maternal symptoms of depression. The results suggest that SES is influenced by a life course pathway that begins in childhood and includes adversity-related mental health outcomes. Since child health and development is influenced by both maternal mental health and SES, this pathway may also contribute to the intergenerational transmission of the risk for psychopathology in the offspring. The results also emphasize the importance of studying potential precursors of low SES, a well-documented environmental risk factor for poor developmental outcomes in the offspring. Copyright © 2016. Published by Elsevier B.V.