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The relationship between unemployment and health status is examined in a comparative study of five European countries using a time series model. "The hypothesis considered in this paper is that the secular decline in mortality rates can be attributed to the secular rise in real per capita income and that the remaining fluctuations in mortality rates can be explained by cyclical movements in income and variations in unemployment." The data concern the Federal Republic of Germany, France, Italy, Sweden, and Ireland., (excerpt)

Conspiracy Beliefs (CB) are a key vector of violent extremism, radicalism and unconventional political events. So far, social‐psychological research has extensively documented how cognitive, emotional and intergroup factors can promote CB. Evidence also suggests that adherence to CB moves along social class lines: low‐income and low‐education are among the most robust predictors of CB. Yet, the potential role of precarity—the subjective experience of permanent insecurity stemming from objective material strain—in shaping CB remains largely unexplored. In this paper, we propose for the first time a socio‐functional model of CB. We test the hypothesis that precarity could foster increased CB because it undermines trust in government and the broader political 'elites'. Data from the World Value Survey (n = 21,650; Study 1, electoral CB) and from representative samples from polls conducted in France (n = 1760, Study 2a, conspiracy mentality) and Italy (n = 2196, Study 2b, COVID‐19 CB), corroborate a mediation model whereby precarity is directly and indirectly associated with lower trust in authorities and higher CB. In addition, these links are robust to adjustment on income, self‐reported SES and education. Considering precarity allows for a truly social‐psychological understanding of CB as the by‐product of structural issues (e.g. growing inequalities). Results from our socio‐functional model suggest that implementing solutions at the socio‐economic level could prove efficient in fighting CB. [ABSTRACT FROM AUTHOR]

Breastfeeding is recommended until 6 months of age, but a wide range of infant formula is available for nonbreastfed or partially breastfed infants. Our aim was to describe infant formula selection and to examine social- and health-related factors associated with this selection. Analyses were based on 13,291 infants from the French national birth cohort Etude Longitudinale Française depuis l'Enfance. Infant diet was assessed at Month 2 by phone interview and monthly from Months 3 to 10 via internet/paper questionnaires. Infant formulas were categorized in 6 groups: extensively or partially hydrolysed, regular with or without prebiotics/probiotics, and thickened with or without prebiotics/probiotics. Associations between type of infant formula used at 2 months and family or infant characteristics were assessed by multinomial logistic regressions. At Month 2, 58.1% of formula-fed infants were fed with formula enriched in prebiotics/probiotics, 31.5% with thickened formula, and 1.4% with extensively hydrolysed formula. The proportion of formula-fed infants increased regularly, but the type of infant formula used was fairly stable between 2 and 10 months. At Month 2, extensively hydrolysed formulas were more likely to be used in infants with diarrhoea or regurgitation problems. Partially hydrolysed formulas were more often used in families with high income, with a history of allergy, or with infants with regurgitation issues. Thickened formulas were used more with boys, preterm infants, infants with regurgitation issues, or in cases of early maternal return to work. The main factors related to the selection of infant formula were family and infant health-related ones. [ABSTRACT FROM AUTHOR]

Background The prevalence of overweight and obesity has increased in various countries. Normal weight before pregnancy is important to protect maternal and newborn health. This study aimed to describe the evolution of body mass index (BMI) before pregnancy in France and explore its association with two measures of socioeconomic status (SES), education and household income. Methods Data were from four national perinatal surveys in France in 1998, 2003, 2010 and 2016 to describe the time evolution of maternal BMI. We explored the links between BMI and women's characteristics in the most recent period (2010–2016 surveys) since income information was not available before. Risk ratios (RRs) of underweight, overweight and obesity for each measure of SES were computed by using multivariable Poisson regression models. Results Overweight and obesity prevalence increased between 1998 and 2016, from 6% to 12% for obesity. Both were inversely associated with SES (higher prevalence among least educated and poorest women), with strong variations for each social indicator, even in multivariable analyses including both. Combining education and income revealed a wide gradient; RR for obesity was 6.01 (95% confidence interval 4.89–7.38) with low education and income <2000 euros/month vs. high education and income ≥4000 euros/month. Conclusions Public policies must implement programs to limit the increase in overweight and its unequal distribution in the population, alongside other policies to address the societal determinants of the obesogenic environment. Health professionals need to advise women to improve their eating and physical activity to limit weight gain from childhood to early adulthood. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several studies have been performed on the relationship between working conditions and health. Numerous parameters still require further study, including working hours and obesity among different groups, specifically older workers in national, regional, and international levels. OBJECTIVE: Working hours have considerable effects on the socio-cultural, psychological, and economic aspects of people's lives and health. While long working hours increases income level and raises living standards, it increases the risk of certain health problems. This study investigated whether working hours are associated with obesity in upper-middle-aged workers. METHODS: The Survey of Health, Ageing and Retirement in Europe (SHARE) dataset was used for the analyses. Analyses were carried out by means of a Cox regression of the panel dataset created with the data in question, surveyed by European Commission to 12,000 participants. RESULTS: The survey was performed in Austria, Belgium, Switzerland, Germany, Denmark, Spain, France, Greece, Italy, the Netherlands, Sweden, the Czech Republic, Poland, and Ireland. We found that in most countries, especially Sweden and the Netherlands, upper-middle-aged employees working > 59 hours per week are more likely to gain weight than their counterparts working < 59 hours. CONCLUSIONS: Our findings raise awareness of obesity in older workers, and highlight the need to regulate working conditions and hours in the European Union and other countries. [ABSTRACT FROM AUTHOR]

Objectives Even during pregnancy women may suffer from violence. We estimated the prevalence of physical abuse during pregnancy, we analyzed the main risk factors and described the relationship between physical violence, psychological wellbeing and pregnancy outcome. Methods We used a national representative sample of births, in all public and private maternity units, in 2016 in France. Women were interviewed after delivery, on their living conditions and occurrence of physical violence at least once during pregnancy. The study of risk factors and pregnancy outcome was done with multivariable logistic regressions. Results Of 12,330 women included in the analysis 1.8% (95% CI 1.6–2.0) had been exposed to physical violence during pregnancy. Risk of violence was associated with the couple situation [women without a partner or in couple not cohabiting (OR 2.89, 95% CI 1.96–4.26)], household income (less than 3000 euros monthly), and state medical assistance coverage. Physical violence was more prevalent in case of a history of induced abortion or cannabis use during pregnancy. Psychological distress was more frequent with than without physical violence (e.g., 62% vs. 24% had a sadness period during pregnancy, p < 0.001). The risk of spontaneous preterm birth and transfer of the newborn to a neonatal intensive care unit were significantly higher among women experiencing physical violence during pregnancy compared to other women. Conclusions for Practice Main factors associated with increased risk of violence during pregnancy were socio-economics. The identification by caregivers of women exposed to violence during pregnancy needs to be improved to develop preventive and care strategies. [ABSTRACT FROM AUTHOR]

Background: In aggregate studies, ecological indices are used to study the influence of socioeconomic status on health. Their main limitation is ecological bias. This study assesses the misclassification of individual socioeconomic status in seven ecological indices.Methods: Individual socioeconomic data for a random sample of 10,000 persons came from periodic health examinations conducted in 2006 in 11 French departments. Geographical data came from the 2007 census at the lowest geographical level available in France. The Receiver Operating Characteristics (ROC) curves, the areas under the curves (AUC) for each individual variable, and the distribution of deprived and non-deprived persons in quintiles of each aggregate score were analyzed.Results: The aggregate indices studied are quite good "proxies" for individual deprivation (AUC close to 0.7), and they have similar performance. The indices are more efficient at measuring individual income than education or occupational category and are suitable for measuring of deprivation but not affluence.Conclusions: The study inventoried the aggregate indices available in France and evaluated their assessment of individual SES. [ABSTRACT FROM AUTHOR]

Aim A split-mouth randomized clinical trial was carried out to assess the effectiveness of a school-based dental sealant ( SBDS) program for French children from low-income backgrounds within 3 years of follow-up. The secondary objectives were to determine the risk factors for the occurrence of new carious lesions ( ICDAS 3-6) on first permanent molars, to evaluate the effectiveness of the program according to risk factors and to assess sealant retention. Methods The study included 276 6- to 7-year old pupils (457 pairs of first permanent molars) from Nice. The sealing was performed in first- or second-grade children. The first permanent molars were randomized into two groups: One received resin-based sealant and the other formed a nontreatment group. Carious lesions ICDAS 3-6 on permanent and primary teeth, visible plaque, streptococcus mutans and/or lactobacillus counts were recorded at baseline to assess individual caries risk ( ICR). The putative confounders recorded at baseline were sex, grade level, and characteristics of first permanent molars. An intent-to-treat analysis was performed, where the study outcome was the occurrence of new carious lesions within 3 years of follow-up. Univariate and multivariate Cox proportional hazards models (hazard risk, HR) using the procedure PHREG with the option of Covsandwich were performed in SAS to assess the effectiveness of the SBDS program. Results At 3 years of follow-up, 228 children (378 tooth pairs) remained in the analysis. The survival analysis showed that first permanent molars that received sealants had 67% (adjusted HR: 0.33; 95% CI: 0.24-0.46) less risk of developing new carious lesions during all the follow-up than molars without sealant. In addition, children with carious lesions ICDAS 3-6 on permanent and primary teeth, that is, high ICR, had three times the risk of having a new carious lesion than others without, independently of the sealant treatment (adjusted HR: 3.00; 95% CI: 1.55-5.75). Effectiveness of the SBDS program at 3 years of follow-up depended on the presence of carious lesions ICDAS 3-6 ( HR in 173 children with carious lesions: 0.32; 95% CI: 0.23-0.46) at baseline ( HR in 103 children without carious lesions: 0.42; 95% CI: 0.16-1.12). Finally, the overall retention rate was 32.3%. Conclusion The effectiveness of the SBDS program was demonstrated in low socioeconomic areas. Selection of schoolchildren according to the presence of carious lesions ICDAS 3-6 should be considered in a SBDS program. [ABSTRACT FROM AUTHOR]

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

Background: Over the past decades, both health inequalities and income inequalities have been increasing in many European countries, but it is unknown whether and how these trends are related. We test the hypothesis that trends in health inequalities and trends in income inequalities are related, i.e. that countries with a stronger increase in income inequalities have also experienced a stronger increase in health inequalities. Methods: We collected trend data on all-cause and cause-specific mortality, as well as on the household income of people aged 35-79, for Belgium, Denmark, England & Wales, France, Slovenia, and Switzerland. We calculated absolute and relative differences in mortality and income between low- and high-educated people for several time points in the 1990s and 2000s. We used fixed-effects panel regression models to see if changes in income inequality predicted changes in mortality inequality. Results: The general trend in income inequality between high- and low-educated people in the six countries is increasing, while the mortality differences between educational groups show diverse trends, with absolute differences mostly decreasing and relative differences increasing in some countries but not in others. We found no association between trends in income inequalities and trends in inequalities in all-cause mortality, and trends in mortality inequalities did not improve when adjusted for rising income inequalities. This result held for absolute as well as for relative inequalities. A cause-specific analysis revealed some association between income inequality and mortality inequality for deaths from external causes, and to some extent also from cardiovascular diseases, but without statistical significance. Conclusions: We find no support for the hypothesis that increasing income inequality explains increasing health inequalities. Possible explanations are that other factors are more important mediators of the effect of education on health, or more simply that income is not an important determinant of mortality in this European context of high-income countries. This study contributes to the discussion on income inequality as entry point to tackle health inequalities. More research is needed to test the common and plausible assumption that increasing income inequality leads to more health inequality, and that one needs to act against the former to avoid the latter. [ABSTRACT FROM AUTHOR]

Background. Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method. Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition. Results. Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4 % money, while 24.4-30.6 % felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle- income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. Conclusions. Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries. [ABSTRACT FROM AUTHOR]

Background: Studying social disparities in health implies the ability to measure them accurately, to compare them between different areas or countries and to follow trends over time. This study proposes a method for constructing a French European deprivation index, which will be replicable in several European countries and is related to an individual deprivation indicator constructed from a European survey specifically designed to study deprivation. Methods and Results: Using individual data from the European Union Statistics on Income and Living Conditions survey, goods/services indicated by individuals as being fundamental needs, the lack of which reflect deprivation, were selected. From this definition, which is specific to a cultural context, an individual deprivation indicator was constructed by selecting fundamental needs associated both with objective and subjective poverty. Next, the authors selected among variables available both in the European Union Statistics on Income and Living Conditions survey and French national census those best reflecting individual experience of deprivation using multivariate logistic regression. An ecological measure of deprivation was provided for all the smallest French geographical units. Preliminary validation showed a higher association between the French European Deprivation Index (EDI) score and both income and education than the Townsend index, partly ensuring its ability to measure individual socioeconomic status. Conclusion: This index, which is specific to a particular cultural and social policy context, could be replicated in 25 other European countries, thereby allowing European comparisons. EDI could also be reproducible over time. EDI could prove to be a relevant tool in evidence-based policymaking for measuring and reducing social disparities in health issues and even outside the medical domain. [ABSTRACT FROM AUTHOR]

Background: Few studies have specifically focused on demographic and socio-economic characteristics associated with snacking in adults, whereas their identification could be useful for defining effective public health measures. The aim of our study was to assess the associations of these factors with daily snacking behavior and its dietary quality. Methods: This cross-sectional study included 84,692 women and 23,491 men from the NutriNet-Santé cohort study. Occurrence of snacking, energy intake from snacks, snack nutrient, and energy densities were assessed using 24-h dietary records of weekdays at baseline. Associations between socio-economic and demographic factors (age, presence of children in the household, education, income, occupation), and snacking behavior were examined using multivariable logistic regression and analysis of covariance, stratified by sex and adjusted for total daily energy intake. Results: Older individuals were more likely to snack during the day in both sexes while individuals with primary education (OR = 0.79 (0.71;0.87) in women; OR = 0.71 (0.60;0.83) in men), female employees (OR = 0.94 (0.89;0.99), and self-employed women were less likely to snack during the day. Older individuals, in particular middle-aged subjects, had higher snack nutrient density, and lower energy intake and density from snacks compared with younger adults. Presence of a child in the household was associated with higher energy density, lower nutrient density (in women), and lower energy intake from snacks (in men), compared with those who lived without a child in household. In low income individuals and manual workers, snacks had lower nutrient density and higher energy content than in higher socioeconomic categories. At last, energy intake from daily snacking occasions was higher in women with low education level. Conclusions: Although snacking was less prevalent in low socioeconomic categories and young adults, their snacks had higher energy content and were of poorer nutrient density. Such findings provide useful information on mechanisms of social disparities in dietary behavior. Trial registration: This study was conducted according to the guidelines laid down in the Declaration of Helsinki. All procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No.908450 and No.909216). Clinical Trial no. NCT03335644 [ABSTRACT FROM AUTHOR]