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Although economic inequality has increased over the last few decades, support for redistributive policies is not widely accepted by the public. In this paper, we examine whether attitudes towards redistribution are a product of both perceptions of, and beliefs about, inequality. Specifically, we argue that the association between perceived inequality and support for redistribution varies by beliefs that justify inequality. We investigated this hypothesis in a cross-cultural/country sample (N = 56,021 from 41 countries) using two different operationalizations of support for redistribution and two distinct beliefs that justify inequality. As hypothesized, the perceived size of the income gap correlated positively with believing that it is the government's responsibility to reduce inequality among those who rejected beliefs that justify inequality, whereas there was no association for those who endorsed these beliefs. Similarly, perceived economic inequality correlated positively with support for progressive taxation, but this association was weaker among those who endorsed meritocratic and equal opportunity beliefs. Together, these results demonstrate that ideologies influence the relationship between perceived inequality and attitudes towards redistribution, and that support for redistribution varies by how the policy is framed., (© 2019 The British Psychological Society.)

Socioeconomic position ( SEP) is a well-known risk indicator for chronic periodontitis. However, it is still unclear how SEP during the life course influences periodontal outcomes in adulthood. This study aimed to systematically review longitudinal studies investigating the influence of individual-level SEP during the life course on subsequent periodontitis in adulthood. Inclusion criteria were epidemiological longitudinal observational studies, in which indicators of relative SEP were assessed prior to clinical assessment of periodontitis. Six electronic databases (PubMed, EMBASE, Web of Science, Scopus, Latin American and Caribbean Health Sciences Literature ( LILACS) and Scie LO) were searched. The methodological quality of the studies was assessed using the Newcastle-Ottawa Quality Assessment Scale ( NOS). The search identified 1720 papers. After removal of duplicates (n=697), title and abstract screening (n=996), and full-text review (n=19), eight original manuscripts from seven studies were finally included. Sample sizes ranged from 167 to 2806, and the follow-up time from exposure to outcome ranged from 2 to 28 years. Studies evaluated education, occupation or income as SEP indicators. Prevalence, extent and severity of periodontal attachment loss, probing pocket depth and alveolar bone loss were the studied outcomes. Based on NOS, studies presented low risk of bias. Six of eight papers reported that relatively low SEP earlier in life was associated with poorer periodontal health in adulthood. The available scientific evidence demonstrates potential longitudinal impact of earlier lower SEP on later periodontal health. The findings were consistent despite differences in study methods. [ABSTRACT FROM AUTHOR]

Do wage‐setting institutions, such as collective bargaining, improve health and, if so, is this because they reduce income inequality? Wage‐setting institutions are often assumed to improve health because they increase earnings and reduce inequality and yet, while individual‐level studies suggest higher earnings improve well being, the direct effects of these institutions on mortality remains unclear. This paper explores both the relationship between wage‐setting institutions and mortality rates whether income inequality mediates this relationship. Using 50 years of data from 22 high‐income countries (n ~ 825), I find mortality rates are lower in countries with collective bargaining compared to places with little or no wage protection. While wage‐setting institutions may reduce economic inequality, these institutions do not appear to improve health because they reduce inequality. Instead, collective bargaining improves health, in part, because they increase average wage growth. The political and economic drivers of inequality may not, then, be correlated with health outcomes, and, as a result, health scholars need to develop more nuanced theories of the political economy of health that are separate from but in dialogue with the political economy of inequality. [ABSTRACT FROM AUTHOR]

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]

The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social‐ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work. [ABSTRACT FROM AUTHOR]

This paper examines the effect of terrain ruggedness on child stunting in Burundi, Cameroon, Ethiopia and Nigeria. Using a cross‐section analysis with data from the Demographic and Health Surveys (DHS) and a measure that captures variation in the terrains of the countries, we find that the more difficult it is to traverse the terrain in Burundi, Cameroon and Nigeria, the higher the likelihood of child stunting. However, this association is not consistent for Ethiopia until we account for the Oromia region, which has the capital city Addis Ababa. These results remain robust with the inclusion of socio‐economic factors related to child health (e.g. maternal health, maternal education and household income), demographic factors (e.g. gender of child), other geographical factors (e.g. rainfall patterns and malaria prevalence) and survey and region effects. The results suggest that there are complementary factors to geography that may contribute to poor child health outcomes, such as the quality of infrastructure and the ability to access healthcare services. Given that child health is a key development outcome, understanding such spatial variations associated with child health inequalities can assist in designing effective intervention programmes and allocating resources where they are most needed. [ABSTRACT FROM AUTHOR]

Background In many countries, those with lower socioeconomic status are disproportionately affected by poor oral health. This can be attributed, at least in part, to differences in preventive dental visiting. While several theories have been applied to the area, they generally fail to capture the recursive nature of dental visiting behaviour, and fall short of informing the design of complex interventions to tackle inequalities. Objective To undertake a systematic review and synthesis of theory in order to provide an overview of the pathways which bring about socioeconomic inequalities in early dental visiting, and identify possible intervention points. Methods Electronic searching identified 8947 titles and abstracts. Paper screening and citation snowballing left 77 included papers. Drawing on the tenets of Critical Interpretive Synthesis, data extraction involved capturing concepts and relationships and translating these sometimes into synthetic constructs. Results We theorize that at the individual (micro-level), dental visiting behaviour is influenced by: the ' Importance of obtaining care', ' Emotional response' and ' Perceived control', which feed into a balancing of ' Competing Demands' against ' Internal resources' (coping, self-identity), although attendance is tempered by the effective ' Affordability and Availability of services'. Positive Care experiences are theorized to lower the demands and increase internal resources associated with dental visiting. We also outline meso-level factors ' Social norms and sanctions', 'Obligations, expectations and trust', 'Information channels', 'Social structures' and theorize how these can exert an overwhelming influence in deprived areas. Conclusions Socioeconomic inequalities in early dental visiting emerge from several stages in the care-seeking process. Dental visiting behaviour should be viewed not just as a one-off event, but extending over time and social space. Since there is recursivity in peoples' most recent dental experience any future visits we identify that interventions which make care a positive experience for low socioeconomic patients may be particularly beneficial in reducing inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Students from low‐income backgrounds (LIB) have been under‐represented in Canadian medical schools for over fifty years. Despite our awareness of this problem, little is known about the experiences of aspiring physicians from LIB in Canada who are working towards medical school admission. Consequently, we have little insight into the barriers and facilitators that may be used to increase the representation of students from LIB in Canadian medical schools. Methods: This paper describes a qualitative description interview study aimed at understanding the experiences of aspiring physicians from LIB as they attempt to gain entry to medical school. We conducted semi‐structured interviews with 21 participants at different stages of their undergraduate, master's, and non‐medical professional education, and used the theories of intersectionality and identity capital as a theoretical framework for identifying barriers and facilitators to a career in medicine. Results: Participants experienced social, identity‐related, economic, structural and informational barriers to a career in medicine. Intrinsic facilitators included motivation, self‐confidence, attitude, strategy, information‐seeking and sorting, and financial literacy and increasing income. Extrinsic facilitators were social, informational, financial and institutional in nature. Conclusion: This study fills existing knowledge gaps in the literature by identifying the pre‐admissions barriers and facilitators encountered by aspiring physicians from LIB in Canada. The barriers and facilitators outlined in this study offer a framework for identifying target areas in developing support for admitting medical students from LIB. Given that medical students from LIB are more likely to serve underserved populations, our study is relevant to Canadian medical schools' social accountability commitment to producing physicians that meet the health needs of marginalised and vulnerable patients. Out of concern for socioeconomic diversity, the authors apply an intersectional approach to examine the barriers and facilitators faced by aspiring physicians from low‐income backgrounds. [ABSTRACT FROM AUTHOR]

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Consumption of energy is a determinant of the socioeconomic status of many citizens across the globe. The majority of rural households in India are dependent on biomass fuels. Existing data on the factors affecting fuel switching in rural India are insufficient to analyze a behavioral change among families. This paper evaluates the influence of four variables income, education, cost of fuel, and clean fuel supply on fuel adoption decisions. To understand the study population's behavioral change, a Household Survey is conducted in 20 villages (in India's rural district). Along with field observation, data are also collected on energy usage at the household level using a formal questionnaire. Binary logistic regression is applied to establish a link between the variables. Both biomass fuels and Liquefied Petroleum Gas are used mostly for cooking. The prevalence of energy stacking behavior is observed even among middle and upper‐income families. Modest evidence for the "energy ladder" hypothesis is seen, however, a "switch over" to cleaner fuels is not. [ABSTRACT FROM AUTHOR]

SUMMARY Background Whether or not patients follow the advice given by their healthcare professional is commonly referred to as adherence. In the case of kidney transplantation, transplant recipients need to take immunosuppressive drugs on a regular basis to prevent rejection of their transplant. However, medication adherence can be problematic for many patients. Objectives This critical appraisal of evidence aimed to gain insights into factors contributing to adherence and non-adherence in recipients of kidney transplants, and to explore patients' perceptions regarding adherence to immunosuppression. Methods A comprehensive literature search was performed using Medline, PsycInfo, the Joanna Briggs Institute, CINAHL and the Cochrane Library. Included were primary research studies or reviews of primary research, independent of their research paradigms, on adult kidney or kidney/pancreas transplant recipients published in English or German. Children or adolescents were not considered. No time-frame was applied Results Fifty-two papers were included in the review. All extracted findings of included papers were organised according to the five factors influencing medication-taking behaviour as defined by the World Health Organisation: social and economic factors; therapy-related factors; patient-related factors; condition-related factors; healthcare team and system-related factors. Conclusion Reasons for non-adherence after kidney transplantations are diverse. Attention is attracted by the fact that potentially modifiable factors such as social support, experiences on dialysis, side effects, features of the treatment regimen, intentions and beliefs, forgetfulness and mental health issues play a greater role than other factors in the development of medication non-adherence. Factors not related to patient characteristics seem to be under researched. [ABSTRACT FROM AUTHOR]

A link between higher rates of childhood obesity and deprivation has been noted in the UK, as well as several other European countries and the US. The drivers of obesity are complex and multi‐factorial, but socially and economically disadvantaged groups may be more vulnerable to many of these. Evidence that rates of obesity are rising faster in low‐income population groups, resulting in widening inequalities indicates that prevention policies must take account of socio‐economic factors. It has been suggested that community‐wide approaches placing less emphasis on individual responsibility or 'agency' (i.e. have less emphasis on aspects that require cognitive, psychological and material resources and time) can be more effective and equitable. This paper outlines examples of community approaches that may have contributed to the reported reductions in childhood obesity in some areas, particularly amongst deprived groups including Health, Exercise and Nutrition in the Really Young in Leeds, UK; Ensemble Prévenons l'Obésité Des Enfants and Amsterdam's citywide Healthy Weight Programme. The policies enacted that improved the nutrition environment and increased opportunities for physical activity in four US sites (the Childhood Obesity Declines project) are also considered. It is clear that there is no silver bullet for tackling childhood obesity. A whole systems approach that takes into account more holistically the reasons why healthy diet and lifestyles may be less available to families on low incomes is needed. [ABSTRACT FROM AUTHOR]

Background: Value chain interventions have become widespread throughout the international development sector over the last 20 years, and there is a need to evaluate their effectiveness in improving women's welfare across multiple dimensions. Agricultural value chains are influenced by socio‐cultural norms and gender dynamics that have an impact on the distribution of resources, benefits, and access to opportunities. While women play a critical role in agriculture, they are generally confined to the least‐valued parts of the value chain with the lowest economic returns, depending on the local, social and institutional contexts. Objectives: The review assesses the effectiveness of approaches, strategies and interventions focused on women's engagement in agricultural value chains that lead to women's economic empowerment in low‐ and middle‐income countries. It explores the contextual barriers and facilitators that determine women's participation in value chains and ultimately impact their effectiveness. Search Methods: We searched completed and on‐going studies from Scopus, Web of Science Core Collection (Social Sciences Citation Index [SSCI], Science Citation Index Expanded [SCI‐EXPANDED], Conference Proceedings Citation Index – Science [CPCI‐S], Conference Proceedings Citation Index – Social Science & Humanities [CPCI‐SSH], and Emerging Sources Citation Index [ESCI]), International Bibliography of the Social Sciences, EconLit, Business Source Premier, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane, Database of Systematic Reviews, CAB Abstracts and Sociological Abstracts. We also searched relevant websites such as Consortium of International Agricultural Research Centers (CGIAR); the International Fund for Agricultural Development (IFAD); AgriProFocus; the Bill & Melinda Gates Foundation (BMGF); Donor Committee for Enterprise Development; the UN Food and Agriculture Organisation (FAO); the International Labour Organisation (ILO); the Netherlands Development Organisation; USAID; the Swiss Agency for Development and Cooperation; the International Food Policy Research Institute; World Agroforestry; the International Livestock Research Institute; the Foreign, Commonwealth & Development Office; the British Library for Development Studies (BLDS); AGRIS; the IMMANA grant database; the 3ie impact evaluation database; Innovations for Poverty Action (IPA); The Abdul Latif Jameel Poverty Action Lab (J‐PAL); the World Bank IEG evaluations; the USAID Development Data Library; Experience Clearinghouse; the proceedings of the Agriculture, Nutrition and Health Academy conference; the proceedings of the Centre for the Study of African Economies (CSAE) Conference; the proceedings of the North East Universities Development Consortium (NEUDC) Conference; and the World Bank Economic Review. The database search was conducted in March 2022, and the website search was completed in August 2022. Selection Criteria: The review includes value chain interventions evaluating the economic empowerment outcomes. The review includes effectiveness studies (experimental and non‐experimental studies with a comparison group) and process evaluations. Data Collection and Analysis: Two review authors independently assessed studies for inclusion, extracted data, critically appraised the studies, and synthesised findings. Results: We found that value chain interventions are successful in improving the economic conditions of their intended beneficiaries. The interventions were found to improve women's economic outcomes such as income, assets holdings, productivity, and savings, but these effects were small in size and limited by low confidence in methodological quality. The meta‐analysis suggests that this occurs more via the acquisition of skills and improved inputs, rather than through improvement in access to profitable markets. The qualitative evidence on interventions points to the persistence of cultural barriers and other constraints. Those interventions implemented in Sub‐Saharan Africa and South Asia are consistently more successful for all outcomes considered, although there are few studies conducted in other areas of the world. Conclusions: The review concludes that value chain interventions empower women, but perhaps to a lesser extent than expected. Economic empowerment does not immediately translate into empowerment within families and communities. Interventions should either moderate their expectations of empowerment goals, or they should be implemented in a way that ensures higher rates of participation among women and the acquisition of greater decision‐making power. [ABSTRACT FROM AUTHOR]

It is argued that far‐right (FR) populism in the West is fuelled by inequality. In this paper, we argue that three social psychological processes are central to explaining these phenomena. We suggest that these processes are recursive although we do not specify their temporal order. Drawing on the social identity tradition, we first examine how inequality is linked to reduced social trust and cohesion, which has consequences for both low‐ and high‐income groups. We examine the known effects of perceived threat in amplifying tensions between groups and consolidating identity positions. Second, we argue that national identity consolidation is a particularly likely response to inequality, which, in turn, reduces tolerance of cultural diversity as an associated consequence. Finally, we consider the value of these strengthened national identities to those who harness them effectively to gain political ground. In this way, those who offer FR populist rhetoric aligned with nationalism can blame immigrants, "foreign" powers, and mainstream politics for both the lack of social cohesion and reduced economic circumstances of many. We conclude that FR populist leaders not only tap into the negative social consequences of inequality, their policy positions also fail to address and may even compound the situation. [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]

The aim of this paper is to develop a better understanding of the relationship between income and health using a cross-sectional survey of the general British population. It is divided into two parts. First, it examines a number of methodological inconsistencies in the existing literature and assesses their consequences for the inferences that can be drawn about the income-health association. These issues include: the measurement of income and its functional form; health selection; and the role of confounders. Second, it explores the relative strength of the income-health association in contrast to that of other socioeconomic measures. The relationship between income and health is complex. However, having taken into account a range of methodological problems, income is still significantly associated with health. The association appears to be non-linear and is attenuated but not removed by controlling for health selection effects. The inclusion of a wide range of confounders into models of income and health reduces the association between them, but does not make it insignificant. In comparison to other socioeconomic measures, income appears to be a better discriminator of health status than education or occupation. However, tenure and car ownership seem to be at least as good if not better than current income. [ABSTRACT FROM AUTHOR]

Many children in low‐ and middle‐income countries are not attaining their developmental potential. Stunting is associated with poor child development, but it is not known which correlates of stunting are impairing child development. We explored potential socioeconomic, nutritional, clinical, and household correlates of early child development among 12–59‐month‐old children with stunting in a cross‐sectional study in Uganda. Development was assessed using the Malawi Development Assessment Tool (MDAT) across four domains of gross and fine motor, language, and social skills. Linear regression analysis was used to assess correlates of development in the four domains and total MDAT score. Of 750 children included, the median [interquartile range] age was 30 [23−41] months, 55% of the children resided in rural settings with 21% from female‐headed households and 47% of mothers had no schooling. The mean ± standard deviation height‐for‐age z‐score (HAZ) was −3.02 ± 0.74, 40% of the children had a positive malaria test and 65% were anaemic (haemoglobin < 110 g/L). One‐third had children's books at home, majority (96%) used household objects to play with and most of them (70%) used toys as pretence items like those to mimic cooking. After age, sex, and site adjustments, HAZ (0.24, 95% confidence interval [CI]: 0.14−0.33) and head circumference (0.07, 95% CI: 0.02−0.12) were positive correlates of total MDAT score, whereas weight‐for‐height z‐score (WHZ) was not. Current breastfeeding was associated with 0.41 (95% CI: 0.17−0.65) lower total MDAT score. Children from households with a single income earner had 0.22 (95% CI: 0.06−0.37) lower total MDAT score. Furthermore, severe food insecurity, inflammation and positive malaria test were associated with lower scores for motor development. All family care indicator subscales (FCIs) positively correlated with the total MDAT score and this association was independent of household's socioeconomic status. In conclusion, stunting degree, head circumference, number of household income earners and stimulation by improved FCIs correlate with early child development among stunted children. The negative association with prolonged breastfeeding is likely due to reverse causality. Identified correlates may inform initiatives to support children with stunting attain their development potential. Key messages: Our findings reinforce the association between stunting and early child development.The negative association with prolonged breastfeeding is likely due to reverse causality as a result of mothers nursing their smaller, thinner, and more sickly children longer.The strong correlation between all family care indicators with development may express the benefit of improved home stimulation such as provision of reading materials and varied play materials on early child development even among already stunted children in poor settings. [ABSTRACT FROM AUTHOR]

Background and Aims If socio-economic disadvantage is associated with more adolescent smoking, but less participation in tertiary education, and smoking and tertiary education are both associated with heavier drinking, these may represent opposing pathways to heavy drinking. This paper examines contextual variation in the magnitude and direction of these associations. Design Comparing cohort studies. Setting United Kingdom. Participants Participants were from the 1958 National Child Development Study (NCDS58; n = 15 672), the British birth cohort study (BCS70; n = 12 735) and the West of Scotland Twenty-07 1970s cohort (T07; n = 1515). Measurements Participants self-reported daily smoking and weekly drinking in adolescence (age 16 years) and heavy drinking (> 14/21 units in past week) in early adulthood (ages 22-26 years). Parental occupational class (manual versus non-manual) indicated socio-economic background. Education beyond age 18 was coded as tertiary. Models were adjusted for parental smoking and drinking, family structure and adolescent psychiatric distress. Findings Respondents from a manual class were more likely to smoke and less likely to enter tertiary education (e.g. in NCDS58, probit coefficients were 0.201 and -0.765, respectively; P < 0.001 for both) than respondents from a non-manual class. Adolescent smokers were more likely to drink weekly in adolescence (0.346; P < 0.001) and more likely to drink heavily in early adulthood (0.178; P < 0.001) than adolescent non-smokers. Respondents who participated in tertiary education were more likely to drink heavily in early adulthood (0.110 for males, 0.182 for females; P < 0.001 for both) than respondents with no tertiary education. With some variation in magnitude, these associations were consistent across all three cohorts. Conclusions In Britain, young adults are more likely to drink heavily both if they smoke and participate in tertiary education (college and university) despite socio-economic background being associated in opposite directions with these risk factors. [ABSTRACT FROM AUTHOR]

The Hmong, who began migration to the United States of America in the latter half of the 1970s, represent a largely unstudied segment of the Asian-American population. Traditional practices such as teenage marriage were widely reported in the early years after migration began, but have been left relatively unexamined more recently. Explicit focus on Hmong women has been largely absent in recent research. This paper examines the relationships between marriage patterns, education and earnings among Hmong women in the United States. Using results from a survey of 186 Hmong women, the results of this study indicate high rates of teenage marriage, as well as associations between early marriage, marital abuse, and both low earnings and lower levels of educational attainment among women married as teenagers compared to Hmong women who waited until adult age to marry. There were signs of encouragement, including higher than anticipated rates of educational attainment among the sample overall. Marital stressors such as spousal abuse remain prevalent, especially among Hmong women who married in their teenage years. Implications of this research are discussed for both practitioners and for future directions in research within the Hmong-American community. [ABSTRACT FROM AUTHOR]

Does money buy happiness? Or is happiness derived from looking outwards towards our social networks? Many researchers have answered these questions by exploring whether the best predictor of well-being is either economic or social (or some fixed combination of the two). This paper argues for a dynamic perspective on the capacity for economic and social factors to predict well-being. In two studies, we show that both money (individual income) and community (social capital) can be the basis for individual happiness. However, the relative influence of each factor depends on the context within which happiness is considered, and how this shapes the way people define the self. Study 1 primes either money or community in the laboratory and demonstrates that such priming shifts individual values (so that they are economic vs. communal) and determines the extent to which income is more (vs. less) predictive of life satisfaction than social relations. Study 2 looks at these same priming processes in the external world (with people travelling to vs. from work). Both studies show that while money can become the basis of happiness when the self is defined in economic terms, the role of community relations in predicting happiness is more stable across contexts. [ABSTRACT FROM AUTHOR]

SummaryIntroduction1Definitions of ethnic groups and demographics of minority ethnic groups in the UK○ 1.1 Definitions of 'ethnic groups' and 'ethnicity'○ 1.2 Demographics and characteristics of minority ethnic groups in the UK– Countries of origin– Age/sex distribution and life expectancy– Geographical distribution and size of household– Religious beliefs– Education and employment patternsKey points2Overview of the health profile and dietary habits of minority ethnic groups in the UK○ 2.1 Available surveys○ 2.2 Overview of the health profiles among adults from minority ethnic groups– Overall health– Cardiovascular disease (CVD)– Coronary heart disease (CHD)– Stroke– Type 2 diabetes– Obesity○ 2.3 Possible causes of increased disease risk among minority ethnic groups○ 2.4 Smoking, drinking and physical activity habits○ 2.5 Dietary habits and nutritional status○ 2.6 Overview of the health profiles and dietary and health behaviour patterns of children from minority ethnic groups– Overall health– Diet and health behaviour patterns○ 2.7 Gaps in data availabilityKey points3Factors affecting food choice– Income and socio‐economic status– Food availability and access– Awareness of healthy eating– Religious beliefs– Food beliefs– Time and cooking skills– Generation and genderKey points4Traditional diets of minority ethnic groups○ 4.1 Overview of traditional diets of minority ethic groups– South Asians– African‐Caribbeans– Chinese○ 4.2 Dietary acculturation○ 4.3 Nutritional composition of ethnic‐style cuisineKey points5Nutritional interventions and health promotion among minority ethnic groups○ 5.1 Effective nutritional interventions○ 5.2 Health promotion interventions to prevent problems associated with fasting○ 5.3 Priorities for nutritional interventions and health promotion○ 5.4 Using behaviour change models○ 5.5 Current community initiatives○ 5.6 Catering for institutionalised individuals○ 5.7 Recommendations for future research, policy and practiceKey points6Conclusion• Acknowledgements• References Summary: According to the latest census, non‐white minority ethnic groups made up 7.9% of the UK's population in 2001. The largest of these groups were South Asians, Black African‐Caribbeans and Chinese. Studies have shown that some minority ethnic groups are more likely to experience poorer health outcomes compared with the mainstream population. These include higher rates of cardiovascular disease (CVD), type 2 diabetes and obesity. The differences in health outcomes may reflect interactions between diet and other health behaviours, genetic predisposition and developmental programming, all of which vary across different groups. As is the case for the rest of the population, the dietary habits of minority ethnic groups are affected by a wide variety of factors, but acquiring a better understanding of these can help health professionals and educationalists to recognise the needs of these groups and help them to make healthier food choices. Unfortunately, to date, there have been few tailored, well‐designed and evaluated nutritional interventions in the UK targeting minority ethnic population groups. Further needs assessment and better evaluation of nutritional interventions have been recommended to enhance the understanding of the effectiveness of different approaches amongst minority ethnic groups. This briefing paper will provide an overview of the health profile, dietary habits and other health behaviours of the three largest non‐white minority ethnic groups in the UK, explore the factors affecting their food choices, provide a summary of their traditional diets and review the evidence base to identify the factors that support successful nutrition interventions in these groups. [ABSTRACT FROM AUTHOR]

This paper presents a comparative overview of mobility patterns in 14 Latin American countries between 1992 and 2003. Using three alternative econometric techniques on constructed pseudo-panels, the paper provides a set of estimators for the traditional notion of income mobility as well as for mobility around extreme and moderate poverty lines. The estimates suggest very high levels of time-dependent unconditional immobility for the Region. However, the introduction of socioeconomic and personal factors reduces the estimate of income immobility by around 30 percent. There are also large variations in country-specific income mobility (estimated to explain some additional 10 percent of inter-temporal income variation). Analyzing the determinants of changes in poverty incidence within cohorts revealed statistically significant roles for age, gender, and education of the household head, the latter subject to distinctive effects across levels of attainment and transition in and out of poverty. [ABSTRACT FROM AUTHOR]

Weight perception has been studied with a limited focus on 'feeling overweight.' This study, using a more inclusive definition of overestimation and underestimation, examines adolescents' weight perception focusing on how accurate it is in relation to body mass index (BMI)-based weight status and how it varies across socio-demographic factors. Data are from the 2007 Minnesota Student Survey, a paper-and-pencil survey completed in the classroom by students in public schools. The final analyses were based on the data from 87,418 high school students who were asked about their height and weight. Weight perception and the BMI-based weight status (based on self-reported weight and height) were strongly and positively correlated, but substantial discordance was observed with more than a quarter of the students (27.6%) having discordant weight perception. Males, minorities, and those from low-income households were more likely than their respective counterparts to have a discordant weight perception. Overall, underestimation was more prevalent than overestimation. Girls were more likely to overestimate, while boys were more likely to underestimate. Black and Hispanic females and those from low-income households were more likely to underestimate than overestimate their weight, while Asian/Pacific Islander males were more likely to overestimate than underestimate. If underestimation is more prevalent among Black or Hispanic females and those from low-income households, the already higher prevalence of obesity among these groups is unlikely to decrease. Overestimation, on the other hand, can be a risk factor for unhealthy weight-control behaviors. Monitoring adolescents' perceived weight in addition to their BMI is critical to understanding the challenge we face with childhood obesity. [ABSTRACT FROM AUTHOR]

Recent research in epidemiology has identified a number of factors beyond access to medical care that contribute to health disparities. Among the so-called socioeconomic determinants of health are income, education, and the distribution of social capital. One factor that has been overlooked in this discussion is the effect that stigmatization can have on health. In this paper, I identify two ways that social stigma can create health disparities: directly by impacting health-care seeking behaviour and indirectly through the internalization of negative interpersonal judgments. I then argue that social arrangements that foster self-respect can reduce the impact of stigmatization on health disparities. I conclude by showing how John Rawls' conception of justice can be used to address the intersection of stigma, health, and self-respect, in contrast to critics of his position, who have seen him as excessively focused on the allocation of material goods. [ABSTRACT FROM AUTHOR]

Objectives: With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective mechanisms of financial barriers to the utilization of dental services in an Australian adult population. Methods: South Australian survey data from the Dental Care and Oral Health Study (2015) were analysed. Following the flexible mediation approach, the direct effect of income and indirect effect of income through mediators (insurance, concession card and service sector) on the outcomes (visit avoidance and treatment prevention due to the cost) were calculated. Results: Findings showed that around half of the low‐income people and one‐third of the high‐income South Australians experienced a financial burden on receiving a dental visit or service. The indirect effect of income on both outcomes of financial burden was negligible, while the direct effect was significant. By changing the potential outcome distribution to their counterfactual exposure distribution and if the mediators are drawn from their counterfactual exposure (lower/higher income) distribution, the odds of visit avoidance and treatment prevention due to the cost were almost twice (Odds Ratio: 2.13, 95% CI 1.72–2.60) and 98% (Odds Ratio: 1.98, 95% CI 1.67–2.35) than in the lower‐income individuals, respectively. Conclusions: It can be concluded that the level of household income, directly and regardless of insurance status, concession card ownership and whether the service sector was public or private, affected the financial burden on utilization of dental services. [ABSTRACT FROM AUTHOR]

Studies on detailed types of health changes and the associations between the types and income inequality are inadequate. This study analyses the global distribution of the compression and expansion of morbidity in 194 countries and territories between 1990 and 2016, and investigates the role of income inequality in the distribution. This study shows that all seven types of health changes coexist, despite being distributed unevenly. The relative expansion of morbidity with increased or constant life expectancy (Type 6, 54.48%) is the most popular type, followed by the relative compression of morbidity with increased or constant life expectancy (Type 3, 30.71%). Income distribution within a society matters for health changes. Societies with greater income inequality tend to have Type 6, a worse scenario of health changes. Measures to reduce income inequality or mitigate its adverse effects will contribute to the relative compression of morbidity with increased or constant life expectancy. [ABSTRACT FROM AUTHOR]

Adolescents growing up outside their birth homes are at major risk for multiple adversities in early adulthood, including low education and unemployment. The transition from out‐of‐home placement to independent living overlaps with the transition from school to work and higher education. However, the support during this critical phase is often inadequate. Adolescents ageing out of care are also more likely to have faced adversities in their birth families. Yet, the interplay between different risk factors and having aged out of care has gained little attention. This study aimed to assess known risk factors for low education and unstable employment and their interaction with ageing out of care, controlling for birth‐home‐related adversities. We assessed this topic using logistic and linear regression modelling based on the Finnish birth cohort 1987 (n = 59 476) registry. Our analysis showed that obtaining upper secondary and higher education was much less likely among those ageing out of care, and they had spent 52–80 fewer days annually in employment after graduation. Few interactions with other risk factors were, however, found. Efforts are needed to prevent inequalities in education and employment for those ageing out of care in the transition phase from school to work. [ABSTRACT FROM AUTHOR]

By generalizing Stigler and Becker's idea of maintaining the "capital stock intact," and incorporating it with other contributions to welfare economic analysis, this paper presents a modified conceptual framework for measuring and adjusting impacts of socioeconomic and environmental factors when income or consumption expenditure is used solely as a quality of life indicator. Such measurements and adjustments are made for differences in public needs and in the process of satisfying these needs. Application of this conceptual framework is illustrated, using statistics on police protection and crime rates. [ABSTRACT FROM AUTHOR]

Status anxiety theory posits that higher income inequality leads people to attribute more importance to their socioeconomic status and to worry about the position they occupy on the social ladder. We investigated through two experimental studies (N = 1117) the causal effect of economic inequality on status anxiety and whether expected upward and downward mobility mediates this effect. In Study 1, perceived economic inequality indirectly increased status anxiety through lesser expected upward mobility. In Study 2, perceived economic inequality decreased both expected upward and downward mobility, with opposite indirect effects on status anxiety. This suggests that the relationship between inequality and status anxiety is not straightforward, and could implicate the presence of multiple processes working at the same time—whereas lower expected downward mobility could suppress the effect of inequality, lower expected upward mobility could exacerbate it. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the economic impacts of the COVID‐19 lockdown in Thailand on low‐income older people concerning their employment, household income and food security. The study also aimed to identify which socioeconomic characteristics of low‐income older Thais are at higher risk of being negatively affected and whether they can access state economic relief during the pandemic response in Thailand. Methods: Economic, health and social well‐being questionnaires were completed by low‐income older Thais (n = 808) holding a State Welfare Card during the COVID‐19 lockdown in 2020. Descriptive analyses and multivariate logistic regressions were utilized in the data analysis. All analyses were performed using Stata 15. Results: This study found that 62% of participants experienced a negative impact on their household income, 35% had a negative impact on employment and 20% had a negative impact on food security. However, the impact level depended upon their vulnerability before the pandemic. The study also reveals that older Thais who experienced a negative impact on household income could access monetary relief schemes from the government during the pandemic. Conclusions: This study reveals the layers of economic vulnerability among the population of low‐income older Thais negatively affected by the 2020 lockdown. Despite the accessible state monetary relief, differential skills with the use of digital technology could create inequitable access to aid measures among older Thais. The findings highlight the need for longitudinal studies to track changes in the economic impacts arising from subsequent waves of COVID‐19 on low‐income older people. [ABSTRACT FROM AUTHOR]

Policy PointsToday's housing disparities are rooted in the increasing commodification of housing that has taken precedence over the need for shelter, a basic human right.With rising housing costs across the country, more residents are finding their monthly income going to rent, mortgage payments, property taxes, and utilities, leaving little for food and medication.Housing is a determinant of health, and with increasing housing disparities, action must be taken to ensure no individual is displaced, communities remain intact, and cities continue to thrive. [ABSTRACT FROM AUTHOR]

The purposes of this study were to develop a profile of households who purchase coffee, to determine the socioeconomic determinants of the demand for coffee by US households, and to update the own‐price, cross‐price, and income elasticities of demand for US households. The profile suggests to targeting wealthier households, households without children living in the household, older households, white households, and households located in the Pacific region and in New England. The own‐price elasticity of −1.93 indicates that the demand for at‐home purchases of coffee is elastic. Tea is a substitute for coffee. Given the income elasticity of 0.20, changes in household income are not likely to have sizeable impacts on at‐home coffee consumption. Nevertheless, coffee is a necessity in economic parlance. The source of data for this analysis was the NielsenIQ pertaining to 61,380 households for calendar year 2015. [EconLit Citations: D1, D9, D12]. [ABSTRACT FROM AUTHOR]

Income inequality is commonly posited to elevate concerns about social status that undermine psychological health, but the empirical evidence is inconsistent. Here we propose that these inconsistencies conceal opposing processes: Income inequality prompts perceived competitiveness, which can both negatively predict psychological health via avoidance motivation and positively predict psychological health via approach motivation. First, we conducted a two‐year longitudinal study (1,700+ participants from 500+ county identifiers) and provided support for our opposing processes model. Second, we conducted three pre‐preregistered studies using an experimental‐causal‐chain design. We sequentially showed that induced income inequality increased perceived competitiveness (Study 2a; 444 participants), induced perceived competitiveness increased avoidance and approach motivation (Study 2b; 1,018 participants), and induced avoidance/approach motivation decreased/increased psychological health (Study 2c; 562 participants). These findings suggest that scholars should shift from studying the main effects of income inequality on psychological health to studying the psychological processes involved in the inequality‐health relation. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to describe different eHealth literacy domains among parents of children needing paediatric surgery in Sweden, and the correlation between these eHealth literacy domains and parents' socioeconomic factors and demographic characteristics. Design: Descriptive correlational design. Method: Thirty‐five Swedish‐speaking parents participated as a historical control group within an ongoing Swedish clinical trial developing eHealth solutions for families after hospital care; of these, 30 completed the eHealth Literacy Questionnaire and the socioeconomic and demographic questionnaire. Results: Of the seven eHealth literacy domains assessed, parents' strengths lay in those pertaining to their own digital competence, control and safety, while their weakness concerned their motivation to engage with digital services, and their ability to access eHealth platforms that work. Overall, parents presented adequate eHealth literacy. Of the five socioeconomic and demographic variables assessed (i.e. monthly wages, education levels, age, gender and residency), monthly wages correlated the strongest, and positively, with the seven eHealth literacy domains. [ABSTRACT FROM AUTHOR]

The expansion of protected areas (PAs) is feared to negatively affect the local economy, as every PA, albeit to different degrees, entails restriction to the economic activities. The literature on the topic has started assessing what is the socioeconomic impact of PAs, mostly focusing on the Global South. The objective of this article is the analysis of the socioeconomic impact of three Italian national parks (NPs), established in the 2000s, using a counterfactual approach based on both the outcome regression diff‐in‐diff and the doubly robust diff‐in‐diff combined with different propensity score‐based and Mahalanobis distance matching procedures. We find that the three Italian NPs have a robust and statistically significant impact on average income of residents in municipalities hosting them. Conversely, there is weak evidence that population and local establishments are positively affected, and touristic local establishments and employment are negatively affected by the three NPs. All together the results indicate that the three NPs have no negative effect on the socioeconomic dynamics of the territories impacted, although additional investigations are required to shed lights to the impact mechanisms. [ABSTRACT FROM AUTHOR]

Aims: Socioeconomic disparities have been reported in the outcomes of patients with atrial fibrillation (AF). We assessed the hypothesis that AF patients with higher income or educational level are more frequently initiated with oral anticoagulant (OAC) therapy for stroke prevention. Methods: The nationwide registry‐based Finnish AntiCoagulation in Atrial Fibrillation cohort covers all patients with AF from all levels of care in Finland. Patients were divided into income quartiles according to their highest annual income during 2004‐2018 and into three categories based on educational attainment. The outcome was the first redeemed OAC prescription. Results: We identified 239 222 patients (mean age 72.7 ± 13.2 years, 49.8% female) with incident AF during 2007‐2018. Higher income was associated with higher OAC initiation rate: compared to the lowest income quartile the adjusted SHRs (95% CI) for OAC initiation were 1.09 (1.07‐1.10), 1.13 (1.11‐1.14) and 1.13 (1.12‐1.15) in the second, third and fourth income quartiles, respectively. Patients in the highest educational category had a slightly lower OAC initiation rate than patients in the lowest educational category (adjusted SHR 0.92 [95% CI 0.90‐0.93]). Income‐related disparities were larger and education‐related disparities only marginal among patients at high risk of ischemic stroke. The socioeconomic disparities in OAC initiation within 1‐year follow‐up decreased from 2007 to 2018. The adoption of direct OACs as the initial anticoagulant was faster among patients with higher income or educational levels. Conclusion: These findings highlight potential missed opportunities in stroke prevention, especially among AF patients with low income, whereas the education‐related disparities in OAC initiation appear controversial. [ABSTRACT FROM AUTHOR]

Objectives: The understanding of how subjective socioeconomic status (SSS) relates to objective socioeconomic status (OSS), and how both conditions act together in oral health outcomes is still unclear. This study aims to test the independent and joint association between OSS and SSS with oral health, to assess the role of socioeconomic status discrepancies, and to evaluate the role of SSS in the association between OSS and oral health. Methods: Data from 1140 adults from a population‐based study in Southern Brazil were used. We applied diagonal reference models DRM to disentangle the effects of OSS (education) and SSS (MacArthur Scale) to oral health outcomes. The outcomes were functional dentition clinically evaluated (FD ≥20 teeth) and self‐reported oral health SROH. We also examined the discrepancy between OSS and SSS to oral health indicators and the effect measure modification (EMM) of SSS on the association between OSS and oral health. Results: Subjective socioeconomic status and OSS contributed equally to SROH, while OSS explained a substantially higher amount of FD than SSS (0.85 vs 0.15). An EMM of SSS was found on the association between OSS and fair/poor SROH, with a relative excess risk due to interaction (RERI) of 1.08. Less evidence of EMM was found for FD (RERI = 0.14). Individuals with lower SSS and OSS had four times the risk of the outcomes than the reference group. Conclusions: Adults with concordant lower SSS and OSS have a worse oral health than those with concordant higher status. There was evidence that the association between OSS and SROH is modified by SSS. [ABSTRACT FROM AUTHOR]

Background: We examine (1) the frequency of financial difficulties in Australian families with young children (0–8 years) in the early and later phases of the pandemic; (2) the extent to which parents' pre‐pandemic socio‐economic disadvantage (SED) predicted financial difficulties; and (3) whether grandparent intergenerational SED further amplified this risk. Method: Data: Australian Temperament Project (ATP; established 1983, N = 2443) and ATP Generation 3 study (ATPG3; established 2012; N = 702), of which 74% (N = 553) completed a COVID‐specific module in the early (May–September 2020) and/or later (October–December 2021) phases of the pandemic. Outcomes: Parent‐reported loss of employment/reduced income, difficulty paying for essentials, and financial strain. Exposures: Pre‐pandemic parent and grandparent education and occupation. Analysis: Logistic regressions, estimated via generalized estimating equations, were used to examine associations between the pre‐pandemic SED of parents and grandparents and their interaction with financial difficulties, adjusting for potential confounders. Results: At both pandemic time points, a third of parents reported adverse financial impacts (early: 34%, 95% confidence interval [CI] = 30–38; later: 32%, 95% CI = 28–36). Each standard deviation increase in the parents' pre‐pandemic SED was associated with a 36% increase in the odds of reporting multiple financial difficulties (odds ratio [OR] = 1.36, 95% CI = 1.04–1.78). There was little evidence of an interaction between the SED of parents and grandparents. Conclusions: Financial impacts related to the COVID‐19 pandemic were common and, irrespective of grandparent SED, disproportionately borne by parents with higher pre‐pandemic SED. Given the well‐established relationship between disadvantage and child health and development, sustained and well‐targeted government supports will be critical to minimizing adverse impacts in years to come. [ABSTRACT FROM AUTHOR]

Summary: Background: The complex multifactorial nature of childhood obesity makes community interventions difficult to evaluate using traditional approaches; innovative methods are needed. Objective: To evaluate the impact of various interventions targeting childhood obesity‐related behaviours, and classified as using a micro‐level (e.g., home visitation programs) or macro‐level (e.g., business practices) strategy, on obesity among children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods: We simulated a population of 1500 children enrolled in WIC, with specific diet, physical activity, breastfeeding behaviours and body mass index z‐scores (BMIz), following them from age 2 to 5 years. Results: Combined interventions targeting breastfeeding appeared to be moderately effective, reducing BMIz by 0.03 (95% CI −005, −0.01). Two strategy‐specific interventions, home visitation programs and business practices targeting obesity‐related behaviours, appeared to be moderately effective at reducing BMIz by 0.04 (95% CI −0.06, −0.02) and 0.02 (95% CI −0.04, 0.00), respectively. Contrary to expectation, combining all micro and macro interventions appeared to have no impact or moderately increased the proportion of obesity/overweight among children. Conclusion: Interventions targeting breastfeeding behaviour were most effective when both micro and macro strategies were implemented. Interventions targeting obesity‐related behaviours in general were effective for two strategies, home visitation and business practices. [ABSTRACT FROM AUTHOR]

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Objective: To understand how contemporary socio‐cultural factors may impact medical students' rural career intent. Design: Cross‐sectional study using data from the national Federation of Rural Australian Medical Educators survey. Participants/setting: Medical students across 18 Australian universities who completed a full academic year of clinical training in rural areas in 2019. Main outcome measure(s): Preferred location of practice post‐training reported to be either: (i) a major city; (ii) a regional area or large town; or (iii) a small rural location. Results: In total, 626 students completed the survey (70.1% response rate). A small rural location was the most preferred location of practice after graduation for 28.3% of the students (95% CI 21.6–36.0). Four socio‐cultural factors were positively associated with a preference for a rural career location: poor health status of rural people, motor vehicle traffic congestion in cities, rural generalist training opportunities in the state and the Royal Flying Doctor Service. Other socio‐cultural factors, including specialists' under‐employment, Medicare freeze effect on doctors' income, bullying/sexual harassment in hospitals, climate change/natural disasters or recognised rural health personalities did not influence the investigated outcome. Conclusions: Our findings indicate a novel association between contemporary socio‐cultural factors and rural career intention in a cohort of Australian rural clinical school students. These findings advocate for further consideration of research exploring socio‐cultural factors shaping rural career intent and workforce outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim was to assess the reported family relationships during the COVID‐19 pandemic and the association between these relationships and individual, interpersonal, and country‐level income in eight Middle East and North Africa (MENA) countries. Background: COVID‐19 causes fear of infection, loss of loved ones, and economic problems that may affect family relationships. Methods: Data were collected from eight MENA countries using an online survey (July–August 2020). The dependent variable was change in family relationship during COVID‐19, and the independent variables were individual, interpersonal, and country‐level factors represented by sociodemographic factors, COVID‐19 status, financial impact (whether participants lost or had reduced wages) and country income. Multilevel logistic regression analysis was conducted. Results: There were 1854 responses, mean (SD) age of 30.6 (9.9) years, 65.8% were female, 3.4% tested COVID‐19 positive, and 20.8% reported lost/reduced wages. Family relationships were more likely to improve or remain unchanged (84.3%) for participants who had a history of COVID‐19 (adjusted odds ratio [AOR] = 3.54, 95% confidence interval [CI]: [1.25, 10.01]). However, family relationships were more likely to not improve for those who knew someone who died of COVID‐19 (AOR = 0.76, 95% CI [0.58, 0.99]) and those with lost/reduced wages (AOR = 0.69, 95% CI [0.52, 0.94]). Conclusion: Family relationship improved or remained unchanged for those who tested positive for COVID‐19 and did not improve for those who lost wages or lost someone due to COVID‐19. Implications: Policy makers should develop strategies to provide social and financial support to employees to reduce the losses and adverse social impact caused by the pandemic. [ABSTRACT FROM AUTHOR]

The article informs about psychology of economic inequality and social class. Topics include Empirical research has gathered growing evidence that economic inequality and social class divisions shape key psychological processes and behaviors; and using qualitative and quantitative approaches, they found that individuals perceived economic inequality among their friends through daily indicators.

Policy PointsPolicies that increase county income levels, particularly for middle‐income households, may reduce low birth weight rates and shrink disparities between Black and White infants.Given the role of aggregate maternal characteristics in predicting low birth weight rates, policies that increase human capital investments (e.g., funding for higher education, job training) could lead to higher income levels while improving population birth outcomes.The association between county income levels and racial disparities in low birth weight is independent of disparities in maternal risks, and thus a broad set of policies aimed at increasing income levels (e.g., income supplements, labor protections) may be warranted. Context: Low birth weight (LBW; <2,500 grams) and infant mortality rates vary among place and racial group in the United States, with economic resources being a likely fundamental contributor to these disparities. The goals of this study were to examine time‐varying county median income as a predictor of LBW rates and Black‐White LBW disparities and to test county prevalence and racial disparities in maternal sociodemographic and health risk factors as mediators. Methods: Using national birth records for 1992–2014 from the National Center for Health Statistics, a total of approximately 27.4 million singleton births to non‐Hispanic Black and White mothers were included. Data were aggregated in three‐year county‐period observations for 868 US counties meeting eligibility requirements (n = 3,723 observations). Sociodemographic factors included rates of low maternal education, nonmarital childbearing, teenage pregnancy, and advanced‐age pregnancy; and health factors included rates of smoking during pregnancy and inadequate prenatal care. Among other covariates, linear models included county and period fixed effects and unemployment, poverty, and income inequality. Findings: An increase of $10,000 in county median income was associated with 0.34 fewer LBW cases per 100 live births and smaller Black‐White LBW disparities of 0.58 per 100 births. Time‐varying county rates of maternal sociodemographic and health risks mediated the association between median income and LBW, accounting for 65% and 25% of this estimate, respectively, but racial disparities in risk factors did not mediate the income association with Black‐White LBW disparities. Similarly, county median income was associated with very low birth weight rates and related Black‐White disparities. Conclusions: Efforts to increase income levels—for example, through investing in human capital, enacting labor union protections, or attracting well‐paying employment—have broad potential to influence population reproductive health. Higher income levels may reduce LBW rates and lead to more equitable outcomes between Black and White mothers. [ABSTRACT FROM AUTHOR]

We explored socioeconomic gradients in self‐rated overall health (SROH) using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial perspectives (subjective social status (SSS)) among adults living in countries with varying levels of income inequality, and the importance of psychosocial stress in mediating these associations. If psychosocial processes at the individual and societal levels correspond, associations between SSS and SROH should be higher among adults in countries with higher income inequality, and psychosocial stress should be a more important mediator of these associations. We used multigroup structural equation models to analyse cross‐sectional data from the International Food Policy Study of adults (n = 22,824) in Australia, Canada, Mexico, the UK and the United States. Associations between SSS and SROH were not higher in more unequal countries, nor was psychosocial stress a more important mediator of these associations. Inequities in SROH in more unequal countries may not predominantly reflect stress‐related pathways of social status differentiation. [ABSTRACT FROM AUTHOR]

Objective: This study used factorial survey data from five countries to assess the factors that shape young adults' attitudes toward the ideal number of children for described couples. Background: Continuously low fertility rates in many Asian and European countries generate an interest in understanding the fertility attitudes of young adults—and the implications for family policies. Method: The causal impact of socioeconomic and cultural factors on the ideal number of children for couples described in the vignettes was tested using a factorial survey experiment (vignette analysis). Data were collected from Germany, Japan, Russia, Ukraine, and the United Arab Emirates (UAE) to represent five different contexts each with different economies, political regimes, cultural and religious backgrounds, and population structures. Seven vignette‐level and four respondent‐level factors were assumed to affect the conditional ideal number of children. Results: The strongest predictors of the higher ideal number of children for couples described in the vignettes were income, availability of childcare, and husband's full employment. The highest average ideal number of children for described couples was observed in the UAE (2.8 children), followed by Germany (1.6 children), Ukraine and Russia (1.3 children), and Japan (1.2 children). Conclusion: The existing gap between public attitudes and fertility behaviors could be addressed by child‐friendly policies which allow a better reconciliation of work and family life. [ABSTRACT FROM AUTHOR]

The burden of falls amongst the elderly raises important public health concerns. Empirical evidence suggests that macroeconomic growth may not be sufficient to reduce mortality and morbidity from injuries among the elderly. This paper consolidates macro- and microeconomic evidence of the effect of income on elderly falls in Latin America. Using household databases, we estimate an empirical model to assess the relationship between income and falls. The estimations indicate that an increase in personal income reduces the probability of falling; yet, the size of the effect is negligible. A 10% increase in income reduces the probability of falling between 0.001 and 0.002% while a 20% increase reduced the probability by up to 1%. These findings are consistent with macroeconomic data where morbidity and mortality among seniors are inelastic to economic growth. Policy implications of cash transfer programs targeting the elderly are discussed. [ABSTRACT FROM AUTHOR]

Objective: The main purpose of this study was to evaluate the association between age at onset and social support in outpatients with bipolar disorder who were in the recovery phase. We also investigated the association between age at onset and disability. Methods: A total of 180 bipolar disorder I outpatients, of whom 50 had early onset with age at onset ≤18 years old, 108 had middle onset with age at onset between 19 and 39 years old, and 22 had late onset with age at onset ≥40 years old, were assessed with the Medical Outcomes Study Social Support Scale and Sheehan Disability Scale. Results: The early onset group had lower tangible social support, longer length of illness, more childless participants, lower income and more suicide attempters than the late onset group. Conclusions: Early onset seems to have inferior outcomes in tangible social support than late onset, but this trend should be considered as a starting point for future studies. [ABSTRACT FROM AUTHOR]

Children living in low socioeconomic communities are vulnerable to poor health outcomes, especially when critically ill. The purpose of this study was to investigate the association between socioeconomic status (SES) and illness severity upon pediatric intensive care unit (PICU) admission in children with acute respiratory failure. This secondary analysis of the multicenter Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial includes children, 2 weeks to 17 years old, mechanically ventilated for acute respiratory failure; specifically, subjects who had parental consent for follow‐up and residential addresses that could be matched with census tracts (n = 2006). Subjects were categorized into quartiles based on income, with a median income of $54,036 for the census tracts represented in the sample. Subjects in the highest income quartile were more likely to be older, non‐Hispanic White, and hospitalized for pneumonia. Subjects in the lowest income quartile were more likely to be Black, younger, and hospitalized for asthma or bronchiolitis, to have age‐appropriate baseline functional status, and history of prematurity and asthma. After controlling for age group, gender, race, and primary diagnosis, there were no associations between income quartile and either Pediatric Risk of Mortality scores or pediatric acute respiratory distress syndrome. As measured, income‐based SES was not associated with illness severity upon PICU admission in this cohort of patients. More robust and reliable methods for measuring SES may help to better explain the mechanisms by which socioeconomic affect critical illness. [ABSTRACT FROM AUTHOR]

Policy PointsPurchasing health insurance is a complex task with multiple potential points of failure.In 2018, following the silver‐loading price shock, 20.2% of households earning above 200% of the federal poverty level with coverage through the two Covered California insurers who sold dominated silver plans purchased the inferior, dominated silver plan.Individuals who were automatically reenrolled were more likely to purchase an inferior, dominated plan.Automatic reenrollment rules and marketplace choice architecture should be modified to avoid placing people into dominated health insurance policies and help consumers more easily select superior coverage for themselves. Context: The Affordable Care Act (ACA) individual health insurance marketplaces rely on purchasers to make informed choices to impose price and quality discipline on a complex array of insurance products. A sudden and minimally expected policy shock in the fall of 2017—the termination of direct federal payment for cost‐sharing reduction (CSR) subsidies—led to a substantial change in the relative prices of silver and gold plans on the Covered California insurance marketplace. From 2014 to 2017, all gold plans in California were more expensive than comparable silver plans that were offered by the same insurer using the same network in the same county. For the 2018 plan year, however, some gold plans that had lower cost sharing also had lower premiums than did comparable silver plans, resulting in silver "dominated" plans being sold through Covered California. Methods: We used the Covered California enrollment and product files from 2014 to 2018 in a retrospective data analysis of plan choice. We examined individuals earning above 200% of the federal poverty level who purchased plans from insurers who sold dominated silver plans in 2018. Findings: We found that 3.9% of all Covered California enrollees in 2018 chose a strictly and transparently dominated plan. Among households with incomes above 200% of the federal poverty level that were enrolled in plans from the two insurers that offered dominated plans, 20.2% chose a dominated plan. Households that actively enrolled in 2018 and were enrolled in a silver plan in the previous year enrolled in a dominated plan at higher rates than did new enrollees and those who were enrolled in nonsilver plans in the previous year. More than 30% of households that had their coverage automatically renewed in 2018 enrolled in a dominated plan. On average, households enrolled in dominated plans in 2018 spent an additional $38.87 per month in premiums. Conclusions: Households routinely chose dominated plans and were exposed to both higher monthly premiums and higher potential cost sharing. Health insurance marketplaces should improve decision supports and choice curation to eliminate the possibility of individuals choosing dominated plans. [ABSTRACT FROM AUTHOR]