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The purpose of this study was to examine the dietary views and practices and to identify associated barriers to and facilitators of healthy eating of rural residents emerging from poverty in the context of rapid socio-economic development. A qualitative design with semi-structured interviews was utilized to collect detailed insights into the dietary behaviors of 22 rural residents from 10 villages in Fengshan town, Dafang county, Guizhou province, China. Thematic analysis was applied to interpret the interview data, guided by the socio-ecological model. Four themes were identified: traditional eating patterns, factors influencing food choice, limited knowledge of healthy diet, and lack of nutritional guidance. Barriers to healthy eating included traditional but unhealthy foods, limited nutritional knowledge, inadequate understanding of nutritional requirements, overwhelming nutritional information, and limited professional guidance. Facilitators encompassed healthy traditional eating patterns, household composition, home gardening, preference for traditional bean and soy products, improved food supply and availability owing to poverty alleviation efforts, and being open to receiving professional dietary guidance. As a preliminary investigation into the dietary views and practices of this population, the study highlights a significant gap in the nutritional knowledge and guidance available to rural residents in China, emphasizing the need for comprehensive strategies that address the complex socio-ecological factors influencing dietary behaviors. [ABSTRACT FROM AUTHOR]

We aimed to investigate health care needs, health service utilization, and their socio-economic and health-related determinants in people with spinal cord injury (SCI) living in Jiangsu and Sichuan Provinces of China. A total of 1355 participants with SCI living in the community were recruited using a multi-stage stratified random sample and surveyed by telephone or online. Outcomes evaluated included the presence of health care needs, mode of health service utilization, and specific provider types seen within 12 months preceding the survey. The prevalence of healthcare needs was 92%. Needs were higher in Sichuan (98%) as compared to Jiangsu (80%). Of those in need of health care, 38% reported not having utilized care, more in Sichuan (39%) than in Jiangsu (37%). In Jiangsu, inpatient care was more often used than in Sichuan (46% vs. 27%), while in Sichuan outpatient services were utilized more often (33% vs. 17%). On average, 1.6 provider types were seen, with Sichuan reporting fewer different provider types. Considerable differences in the prevalence of health care needs and service utilization patterns were found between provinces, mostly in favour of the economically more developed Jiangsu Province. People with low income, particularly those below the World Bank poverty line for middle-income countries, had increased health care needs but utilized health care less often. Moreover, environmental barriers contributed significantly to unmet health care needs. This implies the necessity to provide better accessible and more affordable rehabilitation services for people with spinal cord injury (SCI) in China such as community-based rehabilitation programming. Policies for alleviation of poverty in the case of SCI including insurance for catastrophic health expenditure should also be reviewed and adapted where applicable. [ABSTRACT FROM AUTHOR]

Growing evidence exists about the candidate factors of childhood cognitive performance, but mainly limited to single-exposure studies. We sought to systematically and simultaneously identify and validate a wide range of potential modifiable factors for childhood cognitive performance. We used data from five waves of data from the China Family Panel Studies (CFPS-2010, 2012, 2014, 2016 and 2018). Our analytical sample was restricted to those children aged 2–5 at baseline with valid exposure information. A total of 80 modifiable factors were identified. Childhood cognitive performance was assessed using vocabulary and mathematics test at wave 5. We used an environment-wide association study (EnWAS) to screen all exposure-outcome associations independently and used the least absolute shrinkage and selection operator (LASSO) variable selection algorithm to identify factors associated with cognitive performance. Multivariable linear model was then used to evaluate causal relationships between identified factors and cognitive performance. Of the 1305 participants included in the study (mean ± SD, 3.5 ± 1.1 years age at baseline, 45.1% girls). Eight factors were retained in the LASSO regression analysis. Six factors across community characteristics (percentage of poverty in the community; percentage of children in the community), household characteristics (family size), child health and behaviors (mobile internet access), parenting behaviors and cognitive enrichment (parental involvement in child' s education), and parental wellbeing (paternal happiness) domains were significantly associated with childhood cognition. Using a three-stage approach, this study validates several actionable targets for improving childhood cognitive performance. [ABSTRACT FROM AUTHOR]

A large literature has examined early-life insult and later-life health outcomes. However, whether early-life exposure might persist into the outcomes of future generations remains unclear. Using data from the China Family Panel Studies, this study examines the intergenerational effects of early-life health shocks during the great famine in China, distinguishes the intergenerational effects of in utero and early-life famine exposure, and estimates whether there is a sex-specific transgenerational response. Difference-in-difference results show that first-generation male in utero famine exposure (1959–1961) is associated with a series of health and economic disadvantages in the second generation, compared with the unexposed post-famine-born cohort (1964–1965) in China. The effect persists in the third generation but attenuates, and there is no same-sex transgenerational response. These findings may suggest a novel source of multigenerational persistence in health and economic poverty and may point to a need to consider evidence of transgenerational mechanisms. [ABSTRACT FROM AUTHOR]

Based on the ecological systems theory, this study examined the multiple risk factors experienced by children from low-income families in China and their subsequent impact on children's psychological adaptation. A cumulative ecological risk questionnaire was constructed to examine the exploratory and descriptive risk factors most commonly exposed to children in families, schools and communities. The study sample consisted of 428 children from low-income families (N = 428; Mage = 12.35, SD = 2.51) from 20 ordinary primary and secondary schools across China. We conducted an exploratory latent class analysis using the responses from the cumulative ecological risk questionnaire. The results showed that a three-group solution fit the data best, with the following breakdown: "low-risk" = 41.1%, "family-risk" = 21.7%, and "school-risk" = 37.2%. The three groups showed significant differences in terms of psychological adaptation. The "low-risk" group exhibited fewer problem behaviors and higher prosocial behavior than the other groups. The "family-risk" group showed more significant adaptation difficulties, while the "school-risk" group showed lower levels of prosocial behavior. The results suggest that the ecological risks experienced by children from low-income families had significant group heterogeneity, which may further affect their psychological adaptation. Highlights: The ecological risks of children from low-income families were heterogeneous and may affect children's psychological adaptation. Latent class analysis favored a three-group solution: low-risk, family-risk, and school-risk groups. The three groups showed significant differences in terms of the children's psychological adaptation. [ABSTRACT FROM AUTHOR]

Background: The determinants of access to immunizers are still poorly understood, leading to questions about which criteria were considered in this distribution. Given the above, the present study aimed to analyze the determinants of access to the SARS-CoV-2 vaccine by different countries. Methods: The study covered 189 countries using data from different public databases, and collected until February 19, 2021. We used eight explanatory variables: gross domestic product (GDP), extreme poverty, human development index (HDI), life expectancy, median age, coronavirus disease 2019 (COVID-19) cases, COVID-19 tests, and COVID-19 deaths. The endogenous variables were total vaccine doses, vaccine doses per thousand, and days of vaccination. The structural equation modeling (SEM) technique was applied to establish the causal relationship between the country's COVID-19 impact, socioeconomic variables, and vaccine access. To support SEM, we used confirmatory factor analysis, t-test, and Pearson's correlation. Results: We collected the sample on February 19, and to date, 80 countries (42.1%) had already received a batch of immunizers against COVID-19. The countries with first access to the vaccine (e.g., number of days elapsed since they took the first dose) were the United Kingdom (68), China (68), Russia (66), and Israel (62). The countries receiving the highest doses were the United States, China, India, and Israel. The countries with extreme poverty had lower access to vaccines and the richer countries gained priority access. Countries most affected by COVID (deaths and cases) also received immunizers earlier and in greater volumes. Unfortunately, similar to other vaccines, indicators, such as income, poverty, and human development, influence vaccines' access. Thus affecting the population of vulnerable and less protected countries. Therefore, global initiatives for the equitable distribution of COVID need to be discussed and encouraged. Conclusions: Determinants of vaccine distribution consider the impact of the disease in the country and are also affected by favorable socioeconomic indicators. The COVID-19 vaccines need to be accessible to all affected countries, regardless of their social hands. [ABSTRACT FROM AUTHOR]

Background Previous reports about health-related quality of life (HRQoL) of type 2 diabetes mellitus (T2DM) concentrated on general patients rather than patients in rural areas with poor infrastructure and limited resources. Thus, the aims of this study were to evaluate the HRQoL of diabetics in the countryside and explore its influencing factors. Methods A total of 23 053 participants aged from 18 to 79 years were drawn from the Henan Rural Cohort Study for this cross-sectional study. The HRQoL of participants were assessed by utility index and VAS-score of European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Binary logistic regression, generalized linear and tobit regression models were used to estimate the potential influencing factors on HRQoL. Results This study (23 053 participants) included 2231 T2DM patients with a crude prevalence of 9.68%. The utility index and VAS-score in health group were 0.96 ± 0.10 and 78.85 ± 14.53, while in T2DM group were 0.93 ± 0.15 and 74.09 ± 16.09, respectively. In total, most diabetics reported problem about pain/discomfort dimension. Being old, poverty, low physical activity, and with comorbidities was negatively related to HRQoL of diabetics, while high educational level was positively related to HRQoL. Conclusion HRQoL of rural T2DM patients depended on several sociodemographic factors. More attention should be paid to diabetics with poor socioeconomic status in rural areas. Clinical trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375. [ABSTRACT FROM AUTHOR]

The socioeconomic disadvantage may adversely affect HIV treatment outcomes, particularly in resource-limited settings. Data from people living with HIV (PLWH) who were receiving antiretroviral therapy (ART) in Guangxi, China were analyzed to investigate the impact of socioeconomic status (SES) on the immunologic outcome (i.e., CD4 counts). Among 1198 participants, 55.0% were having CD4 counts ≤500 cells/mm3 and over two-third (68.5%) were considered to have a low level of SES. PLWH with high SES were more likely to have higher CD4 counts (adjusted Odds Ratio [aOR]: 1.44, 95%CI: 1.08–1.91) than PLWH with low SES, after adjusting for potential confounders. CD4 counts were also significantly associated with certain socio-demographic characteristics such as age, gender, and sexual orientation. In order to reduce SES-related disparity, a holistic approach may be needed to address the barriers to successful HIV treatment and care among PLWH with low SES. Poverty reduction and other structural interventions in addressing the socioeconomic disadvantages among PLWH should be key components of the national response to improving HIV treatment outcomes and ending the HIV epidemic in China and other low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Purpose: The current study developed a strength-based flourishing intervention (SFI) and examined its efficacy on fostering the resilience of people with physical disabilities in poor areas, using a randomized (1:1) parallel-group controlled, and single-blind trial. Method: A total of 51 participants (M age = 42.16, standard deviation = 8.42; 43.14% males; 29 for the intervention group, whereas 22 for the control group) completed preintervention, postintervention, and 3-month follow-up tests. Results: The 2 × 3 mixed repeated measure analyses and post hoc analyses revealed a significant main group effect (F = 4.46, p =.04) and a short-term effect (i.e., 3 month; F = 6.35, p =.02) of the SFI. The results indicated that the SFI could significantly promote resilience in the intervention group. However, the effects of the intervention did not immediately appear. Discussion: The SFI could assist in providing research-based and cost-effective health services to promote flourishing and resilience in vulnerable populations. [ABSTRACT FROM AUTHOR]

There is a large body of literature asserting that household asset holdings play a critical role in prospects of economic and social well-being. This study examines asset-poverty rates in China using the 2013 survey data from the Chinese Household Income Project (CHIP). The results indicate that asset-poverty rates in urban China were lower than those of developed countries, whereas rural and migrant households experienced more serious asset poverty than their counterparts in urban China. In addition, the asset-poverty rates were at least twice the income-poverty rates in China according to the different poverty lines used in the study. Several demographic characteristics were found associated with asset poverty. To assist the Chinese government in reaching its goal of eradicating absolute poverty by 2020 through targeted poverty alleviation, this study suggests including assets in the description and alleviation of poverty. [ABSTRACT FROM AUTHOR]

With visions of a better life through transnational marriage, women immigrants are often quickly disappointed when they are faced with social isolation as a result of heavy household responsibilities. The current study investigates 506 Chinese migrant mothers living in areas of concentrated poverty in Hong Kong. Using path analysis the study examines how several exogenous variables, such as marital contentment, household finances, and social support, predict perceived integration into the host society, and how hope for a better future might mediate the relationship between these variables and perceived integration. The results of the study have implications for social service practice in low-income neighborhoods. [ABSTRACT FROM PUBLISHER]

Following the dramatic socioeconomic transition since the 1980s in China, some people became unemployed and experienced a significant drop in income. The aim of this study was to assess the effects of low income on health-related quality of life (HRQOL) among the population in northeast China. A total of 5100 individuals in northeast China were randomly sampled and investigated using the 36-item Short-Form Health Survey (SF-36) from November 2005 to October 2006. According to the monthly per capita income level, the population was divided into different groups for analysis. Multiple linear regressions showed that low income, older age, disease, and unemployment were the important factors that could lead to worse HRQOL. Covariance analysis showed that there were significant differences in HRQOL scores among the subgroups of the low-income population. When the income level increased, HRQOL scores improved. This study could provide valuable information for planning integrated economic and public health policies to improve the health of people living in poverty. [ABSTRACT FROM PUBLISHER]