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Background: Oral language competence provides children with an essential foundation for academic achievement and emotional well-being, yet many children enter school with delayed language and those living in economically disadvantaged areas are at disproportionate risk of experiencing language difficulties. A tiered system, offering high-quality language teaching for all children in early years classrooms, is widely acknowledged as an appropriate means of supporting language learning need. An understanding of the current quality of language supporting practices in English early years settings is essential to inform teaching practice and professional development, but evidence is limited. Methods: This study employed the Communication Supporting Classroom Observation tool in 39 nursery classrooms in economically disadvantaged areas of England to identify strengths of practice and key areas for development. Results: Observations revealed well-equipped physical learning environments and responsive teaching practices, but few structured opportunities for language learning and development. Variation in quality was observed across the nursery session. Conclusions: Findings suggest a need for adaptive professional development programmes supporting the more consistent use of structured language learning opportunities, the enhanced use of interaction promoting strategies and the provision of more complex and contingent language models. Further investigation of language supporting practice at a fine-grained level is desirable. [ABSTRACT FROM AUTHOR]

We evaluated the available literature on the association between characteristics of the food environment and household food insecurity. Systematic review. Studies published until January 9th, 2023, were searched in the PubMed, Web of Science, Science Direct, EMBASE and LILACS databases. The included studies were summarized with a narrative synthesis with information on the study location, population studied, prevalence and type of measure/instrument used to assess food (in)security, method of evaluating the food environment and measure between food insecurity and food environment. Twenty-two articles were included. Different methods were used to measure food security and the food environment. Most food insecurity assessment tools assessed the dimension of access to food, more precisely economic access. The dimensions of the food environment most evaluated were food availability and affordability. An association between characteristics of the food environment and food insecurity was found in 18 of these studies. Homes with food insecurity have a greater availability of unhealthy foods, more frequent purchasing of foods in convenience stores and small markets as well as a lower availability of healthy foods, such as fruits and vegetables. This review revealed that household food insecurity was associated with the food environment, highlighting the importance of policies to promote healthy diets, especially in vulnerable communities. Few studies were found in the Global South, demonstrating the gap in this knowledge in these locations. [ABSTRACT FROM AUTHOR]

Background and aims Design, setting and participants Intervention and comparator Measurements Conclusion Signficant inequalities in tobacco smoking exist, with higher smoking rates among people from low‐socio‐economic status (low‐SES) populations. Tailored technology‐based programs for low‐SES smoking populations have the potential for high reach, but require effectiveness data from large‐scale trials. This trial among Australians who smoke from a low‐SES background will determine the effectiveness and cost‐effectiveness of tailored text‐message (TTM) support compared with standard Quitline (SQL) telephone support service.This is a two‐arm, parallel group, randomized, non‐inferiority trial with allocation concealment and blinded outcome assessment in an Australian population within the greater Sydney region in New South Wales. Participants are adults who smoke daily (n = 1246), are interested in quitting and currently receiving a government pension or allowance, and will be recruited via advertisements.Participants will be randomized (1:1 ratio) to receive either 12 months of TTM quit support or enrolment in SQL telephone support.Assessments will be completed at baseline (telephone interview), within 1 month (check‐in call), at 3 months (on‐line questionnaire) and 12 months (telephone interview) post‐randomization. The primary outcome will be 6‐month continuous abstinence verified by carbon monoxide breath test at 12‐month follow‐up. The study will test whether TTM is non‐inferior to SQL by a non‐inferiority margin of 2%, i.e. the quit rate in the TTM group will be no worse than 2% less than the quit rate in the SQL group. Secondary outcomes will include self‐reported continuous and point prevalence abstinence and acceptability and cost‐effectiveness of TTM versus SQL.Should the tailored text‐message support prove non‐inferior and more cost‐effective than Quitline for this population, this will provide an opportunity for the upscaling of an effective, inexpensive and tailored quit support service. The trial findings will inform cessation treatment policy for priority populations in Australia and globally. [ABSTRACT FROM AUTHOR]

Current public debates about rising violence against police officers, and conversely, criticism of racial profiling by the police force, contradict the high levels of trust in the German police reported by public surveys. This raises the question of why the tension between the police and citizens arises. German Criminology has not yet exploited the potential of procedural justice theory to explain the shifting dynamics of trust. Empirical studies on how evaluations of police fairness and effectiveness influence police legitimacy in Germany have long been overdue. Additionally, there is minimal evidence of whether police fairness is experienced differently in different social contexts. Therefore, this study answers two pertinent research questions: (1) To what extent does trust in German police and police legitimacy depend on procedural fairness? (2) To what extent do residents in socially disadvantaged neighbourhoods have lower levels of trust in police fairness? Consistent with international research on procedural justice theory, the results reveal significant effects of normative predictors of trust in the police, such as perceived fairness and neighbourhood trust. Using advanced multilevel modelling, this study observes the effects of two contextual variables (welfare recipients and official crime rates) on neighbourhood levels of trust in police fairness. The results reveal that the impact of personal assessments of the neighbourhood, personal disadvantages, and experiences with the police exceeds neighbourhood context effects. [ABSTRACT FROM AUTHOR]

Fuel taxes are seen as an important instrument in the fight against climate change, including in the European Green Deal. From a social-ecological policy perspective, it is important to understand current high levels of public opposition to fuel taxes. If social disadvantage is an important driver of opposition, this would strengthen arguments that fuel taxes need to be designed in a fairer way. However, it remains unclear how important social disadvantage – here defined as a combination of low income, fuel poverty risk, low education, low occupational status and job insecurity – is for explaining opposition compared to factors such as political trust and climate change attitudes, and how the role of social disadvantage varies with welfare regimes in Europe. In this article, we examine how strongly social disadvantage is associated with opposition to fuel taxes once political trust and climate change attitudes are controlled for, and we compare results across welfare regimes. The article uses data from the 2016 European Social Survey and employs logistic regression and decomposition analysis. We find that social disadvantage contributes nearly as much to fuel tax opposition as climate change attitudes and political trust together, with 10.9 and 16.6 percentage points respectively. However, the role of social disadvantage varies by welfare regime. It matters most in Southern and Eastern Europe, where opposition is particularly high, as are poverty and inequality. We discuss implications for social-ecological policy strategies that aim to increase public acceptability of fuel taxes in Europe. [ABSTRACT FROM AUTHOR]

The neurodiversity concept can now be found in many places. However, it is often misunderstood and many people are not aware of its complexity. The aim of this paper is to highlight the different facets of the term neurodiversity as well as the discourses around the neurodiversity movement in order to bring together the interconnections around identity politics, diversity and social disadvantage. This article is intended as a contribution to the advancement of neurodiversity studies, which could be understood as a branch of disability studies. Finally, it will be argued that neurodiversity can be understood (1) as a natural and equal diversity of neuronal structures, (2) as a concept of identity politics, (3) as social critique of hegemonic structures and practices, and (4) as a subject that can be examined systematically on the basis of a praxeological research methodology that integrates neurodiversity in the concept of performativity of embodied thought and action. [ABSTRACT FROM AUTHOR]

Culturally responsive parenting interventions are crucial for immigrant parents in disadvantaged areas. This qualitative study delves into the experiences of 18 immigrant mothers (Mage = 41.2 years) from Somalia, Syria, Turkey, Eritrea, and Iraq participating in the Swedish Self-Assured Parents programme, targeting immigrant parents who live in social disadvantage with teenage children. Thematic analysis revealed seven main themes (1) the meaning of the programme content and structure, (2) enjoying oneself and being comfortable, (3) putting the adolescent in the centre, (4) mothers' own socioemotional development, (5) changing from being a passive reactor to an active agent, (6) empowered citizenship, and (7) having always been a strong and good mother. Overall, the mothers were positive about both the content and the format of the programme, appreciating the warm and supportive climate. They also perceived themselves as being more attentive to adolescent needs, having improved their own socio-emotional skills, and being empowered both as a citizen and as a mother on account of attending the programme. With the development of culturally responsive programmes that take into account the unique needs and experiences of diverse populations, governments can effectively support parents, promote child positive development, and help cultivate social cohesion among the members of society. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has influenced all children's motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. Methods: Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). Results: Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018–6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2–10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. Conclusion: Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children. [ABSTRACT FROM AUTHOR]

Background Class and social disadvantage have long been identified as significant factors in the etiology and epidemiology of psychosis. Few studies have explicitly examined the impact of intersecting social disadvantage on long-term employment and financial independence. Methods We applied latent class analysis (LCA) to 20-year longitudinal data from participants with affective and non-affective psychosis (n = 256) within the Chicago Longitudinal Research. LCA groups were modeled using multiple indicators of pre-morbid disadvantage (parental social class, educational attainment, race, gender, and work and social functioning prior to psychosis onset). The comparative longitudinal work and financial functioning of LCA groups were then examined. Results We identified three distinct latent classes: one comprised entirely of White participants, with the highest parental class and highest levels of educational attainment; a second predominantly working-class group, with equal numbers of Black and White participants; and a third with the lowest parental social class, lowest levels of education and a mix of Black and White participants. The latter, our highest social disadvantage group experienced significantly poorer employment and financial outcomes at all time-points, controlling for diagnosis, symptoms, and hospitalizations prior to baseline. Contrary to our hypotheses, on most measures, the two less disadvantaged groups did not significantly differ from each other. Conclusions Our analyses add to a growing literature on the impact of multiple forms of social disadvantage on long-term functional trajectories, underscoring the importance of proactive attention to sociostructural disadvantage early in treatment, and the development and evaluation of interventions designed to mitigate ongoing social stratification. [ABSTRACT FROM AUTHOR]

Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children's Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities. [ABSTRACT FROM AUTHOR]

Background: Early language delay is exacerbated by social disadvantage. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. Methods used to achieve successful health outcomes in socially disadvantaged clinical populations may need enhancing. Aims: To compare the impact of standard parent‐based intervention (PBI) to enhanced PBI for young children with speech, language and communication needs (SCLN) and their families living in more socially disadvantaged populations. Methods and Procedures: A multicentre clustered blind randomised controlled trial was used to compare the effect of parent‐based group interventions to improve early language development with children (mean age 27.5 months) from more socially disadvantaged populations with an expressive vocabulary of 40 or less single words. Intervention sessions were delivered by a speech and language therapist, over a 20‐week period. Participants received one of two interventions: (1) Standard Care – indirect group PBI – (PBI) (2) Enhanced Care: indirect group enhanced PBI – (EPBI). Both standardised and non‐standardised measures were used as outcomes. Parent engagement in the intervention was captured through analysis of attendance and the Parent Activation Measure – Speech & Language Therapy (PAM‐SLT) (Insignia Health, 2014). The PAM measures a person's knowledge, skills and confidence to manage their own health and well‐being (NHS England, 2018). In this study, activation referred to parents' knowledge, skills and confidence to manage their child's language development. Outcomes and Results: One hundred fifty‐five participants were randomised at baseline. Children in both groups made significant improvements in the outcome on MacArthur‐Bates Communicative Development Inventories Sentence Length, from pre‐intervention to post‐intervention and 6 months post‐intervention (p < 0.05). Changes in vocabulary and expressive language skills were more equivocal, showing wide variation in confidence intervals for both groups. Where parents attended at least one intervention session almost all effect sizes were in favour of the EPBI intervention. Parents' activation levels significantly increased for both groups (EPBI p < 0.001, PBI p = 0.003), with a moderate effect size in favour of EPBI (Hedges' G 0.37, confidence interval –0.02 to 0.76), although wide variation was found. Conclusions and Implications: This trial provides some evidence of facilitating the language development of children with SLCN from more socially disadvantaged areas through supporting caregivers. However, we found variation in outcomes; some children made excellent progress, whilst others did not. Further exploration of parent engagement and its relationship to child language outcomes will be valuable to understanding more about mechanisms of change in interventions that involve parents. WHAT THIS PAPER ADDS: What is already known on the subject: Speech, language and communication needs (SLCN) have a knock‐on effect on emotional well‐being, school readiness, literacy and school attainment, putting children at increased risk of long‐term consequences such as poor literacy, mental health problems and unemployment. In disadvantaged areas, the prevalence of language difficulties is higher than elsewhere. Factors such as parents' low levels of literacy, confidence and self‐perception can affect the capacity to act on advice received, critical to empowerment. What this paper adds to existing knowledge: Children with SLCN from more socially disadvantaged areas can make improvements in their language development through parent intervention, although wide individual variation was found. There was some evidence that children achieve better outcomes with EPBI, which employed an interagency collaborative approach. Parent's engagement (activation levels) increased significantly over time with intervention, with the increase twice as big for EPBI. What are the potential or actual clinical implications of this work?: This trial provides some evidence that it is possible to facilitate the language development of children from more socially disadvantaged areas through supporting their caregivers. Further research would be useful to determine whether increases in parent engagement are related to adherence to intervention and change in child outcomes. [ABSTRACT FROM AUTHOR]

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Abstract Background Despite advances in cancer research and treatment, the burden of cancer is not evenly distributed. People experiencing socioeconomic disadvantage have higher rates of cancer, later stage at diagnoses, and are dying of cancers that are preventable and screen-detectable. However, less is known about barriers to accessing cancer treatment. Methods We conducted a scoping review of studies examining barriers to accessing cancer treatment for populations experiencing socioeconomic disadvantage in high-income countries, searched across four biomedical databases. Studies published in English between 2008 and 2021 in high-income countries, as defined by the World Bank, and reporting on barriers to cancer treatment were included. Results A total of 20 studies were identified. Most (n = 16) reported data from the United States, and the remaining included publications were from Canada (n = 1), Ireland (n = 1), United Kingdom (n = 1), and a scoping review (n = 1). The majority of studies (n = 9) focused on barriers to breast cancer treatment. The most common barriers included: inadequate insurance and financial constraints (n = 16); unstable housing (n = 5); geographical distribution of services and transportation challenges (n = 4); limited resources for social care needs (n = 7); communication challenges (n = 9); system disintegration (n = 5); implicit bias (n = 4); advanced diagnosis and comorbidities (n = 8); psychosocial dimensions and contexts (n = 6); and limited social support networks (n = 3). The compounding effect of multiple barriers exacerbated poor access to cancer treatment, with relevance across many social locations. Conclusion This review highlights barriers to cancer treatment across multiple levels, and underscores the importance of identifying patients at risk for socioeconomic disadvantage to improve access to treatment and cancer outcomes. Findings provide an understanding of barriers that can inform future, equity-oriented policy, practice, and service innovation.

Abstract Background ‘Culturally And Linguistically Diverse (CALD)’ populations have diverse languages, ethnic backgrounds, societal structures and religions. CALD populations have not experienced the same oral health benefits as non-CALD groups in Australia. However, the socio-demographic profile of Australian CALD populations is changing. This study examined how household income modifies the oral health of CALD and non-CALD adults in Australia. Methods Data were from two National Surveys of Adult Oral Health (NSAOH) conducted in 2004-06 (NSAOH 2004-06) and 2017-18 (NSAOH 2017-18). The outcome was self-reported number of missing teeth. CALD status was identified based on English not the primary language spoken at home and country of birth not being Australia. Social disadvantage was defined by total annual household income. Effect-measure modification was used to verify differences on effect sizes per strata of CALD status and household income. The presence of modification was indicated by Relative Excess Risk due to Interactions (RERIs). Results A total of 14,123 participants took part in NSAOH 2004-06. The proportion identifying as CALD was 11.7% and 56.7% were in the low-income group, and the mean number of missing teeth was 6.9. A total of 15,731 participants took part in NSAOH 2017-18. The proportion identifying as CALD was 18.5% and 38.0% were in the low-income group, and the mean number of missing teeth was 6.2. In multivariable modelling, the mean ratio (MR) for CALD participants with low household income in 2004-06 was 2% lower than the MR among non-CALD participants with high household income, with the RERI being − 0.23. Non-CALD participants from lower income households had a higher risk of having a higher number of missing teeth than low income CALD individuals (MR = 1.66, 95%CI 1.57–1.74 vs. MR = 1.43 95%CI 1.34–1.52, respectively). In 2017-18, the MR for CALD participants with low household income was 3% lower than the MR among non-CALD participants with high household income, with the RERI being − 0.11. Low income CALD participants had a lower risk of missing teeth compared to their non-CALD counterparts (MR = 1.43, 95% CI 1.34–1.52 vs. MR = 1.57, 95% CI 1.50–1.64). Conclusions The negative RERI values indicate that the effect-measure modification operates in a negative direction, that is, there is a protective element to being CALD among low income groups with respect to mean number of missing teeth.

This article presents a mixed-methods research protocol suitable for studying everyday mobility and its effects on life chances for a wide range of populations. We argue that it can address, among other issues, two important methodological challenges in the study of mobility: addressing pre-reflexivity and habits, as well as differentiating between voluntary and forced movements. The research protocol combines a problem-centered interview, two weeks of GPS tracking, and a subsequent mobility interview. It has been shaped by its application to more than 60 socially disadvantaged residents of rural peripheries as part of an international research project. It contributes to existing qualitative methods of spatial analysis because its design incorporates not only theoretical considerations but also insights of real-world application from conducting it in varied contexts and with different populations, which are typically underrepresented in more elaborate research designs. Nevertheless, due to its thematic openness, the design is not only interesting for mobility research, but also for other research focusing on spatial phenomena at the individual level. We provide a detailed account of the method's implementation, contextualize it in relation to previous approaches, and discuss the analytical potential of the data obtained. We suggest that by triangulating movement data with interview data, perceptions and meanings of everyday mobility can be uncovered that would otherwise remain at a pre-reflexive level. [ABSTRACT FROM AUTHOR]

Background: Despite advances in cancer research and treatment, the burden of cancer is not evenly distributed. People experiencing socioeconomic disadvantage have higher rates of cancer, later stage at diagnoses, and are dying of cancers that are preventable and screen-detectable. However, less is known about barriers to accessing cancer treatment. Methods: We conducted a scoping review of studies examining barriers to accessing cancer treatment for populations experiencing socioeconomic disadvantage in high-income countries, searched across four biomedical databases. Studies published in English between 2008 and 2021 in high-income countries, as defined by the World Bank, and reporting on barriers to cancer treatment were included. Results: A total of 20 studies were identified. Most (n = 16) reported data from the United States, and the remaining included publications were from Canada (n = 1), Ireland (n = 1), United Kingdom (n = 1), and a scoping review (n = 1). The majority of studies (n = 9) focused on barriers to breast cancer treatment. The most common barriers included: inadequate insurance and financial constraints (n = 16); unstable housing (n = 5); geographical distribution of services and transportation challenges (n = 4); limited resources for social care needs (n = 7); communication challenges (n = 9); system disintegration (n = 5); implicit bias (n = 4); advanced diagnosis and comorbidities (n = 8); psychosocial dimensions and contexts (n = 6); and limited social support networks (n = 3). The compounding effect of multiple barriers exacerbated poor access to cancer treatment, with relevance across many social locations. Conclusion: This review highlights barriers to cancer treatment across multiple levels, and underscores the importance of identifying patients at risk for socioeconomic disadvantage to improve access to treatment and cancer outcomes. Findings provide an understanding of barriers that can inform future, equity-oriented policy, practice, and service innovation. [ABSTRACT FROM AUTHOR]

We aimed to compare disclosure of social risks according to self-report on an iPad versus face-to-face questions from a health professional and to explore carers' experiences of screening. This two-arm, parallel group, randomized trial was conducted from January 19, 2021, to December 17, 2021, in a public hospital pediatric ward serving a disadvantaged area of an Australian capital city. Carers of children aged ≤ 5 years admitted to the Children's Ward were eligible. The primary outcome was disclosure of social risks. The screener included nine items on food security, household utilities, transport, employment, personal and neighborhood safety, social support, housing and homelessness. Disclosure of social risks was similar between the self-completion (n = 193) and assisted-completion (n = 193) groups for all 9 items, ranging 4.1% higher for worrying about money for food (95% CI − 11.4, 3.1%) among the assisted-completion group, to 5.7% (−1.6, 13.0%) higher for unemployment among the self-completion group. In qualitative interviews, participants were positive about screening for social risks in the hospital ward setting and the majority indicated a preference for self-completion. Conclusion: Differences in the disclosure of social risks according to self- versus assisted-completion were small, suggesting that either method could be used. Most carers expressed a preference for self- completion, which is therefore recommended as the ideal mode for such data collection for Australian pediatric inpatient settings. Trial registration: Australia New Zealand Clinical Trial Registry (www.anzctry.org.au; #ACTRN12620001326987; date of registration 8 December 2020). What is Known: • Most evidence on screening of social risks in pediatric inpatient settings is from the USA. • Little is known about disclosure of social risks in countries with universal health care and social welfare. What is New: • Disclosure of social risks was similar for electronic compared with face-to-face screening. • Carers preferred electronic completion over face-to-face completion. [ABSTRACT FROM AUTHOR]

Simple Summary: The vaginal microbiome may play a role in racial disparities in ovarian cancer; there is evidence suggesting that it differs according to race and contributes to inflammation by producing or consuming compounds that can shape how ovarian cancer progresses. Our cross-sectional study aimed to investigate the extent to which chemical compounds, or metabolites, from vaginal fluid, also differ by race, and whether these metabolites are linked to systemic inflammation. Our study of 20 White and 16 Black patients identified 1 out of 99 metabolites, arachidonoylcarnitine (C20:4), as occurring at lower levels in Black and higher levels in White patients with ovarian cancer. More than one-third of vaginal fluid metabolites considered showed correlations with biomarkers of systemic inflammation. Our findings suggest that vaginal fluid metabolites likely differ by race, and may play an important role in inflammatory processes, which may be relevant to racial differences in ovarian cancer outcomes. These pilot findings have the potential to improve our understanding of biological mechanisms underlying racial disparities in ovarian cancer but need verification with larger sample sizes. The vaginal microbiome differs by race and contributes to inflammation by directly producing or consuming metabolites or by indirectly inducing host immune response, but its potential contributions to ovarian cancer (OC) disparities remain unclear. In this exploratory cross-sectional study, we examine whether vaginal fluid metabolites differ by race among patients with OC, if they are associated with systemic inflammation, and if such associations differ by race. Study participants were recruited from the Ovarian Cancer Epidemiology, Healthcare Access, and Disparities Study between March 2021 and September 2022. Our study included 36 study participants with ovarian cancer who provided biospecimens; 20 randomly selected White patients and all 16 eligible Black patients, aged 50–70 years. Acylcarnitines (n = 45 species), sphingomyelins (n = 34), and ceramides (n = 21) were assayed on cervicovaginal fluid, while four cytokines (IL-1β, IL-10, TNF-α, and IL-6) were assayed on saliva. Seven metabolites showed >2-fold differences, two showed significant differences using the Wilcoxon rank-sum test (p < 0.05; False Discovery Rate > 0.05), and 30 metabolites had coefficients > ±0.1 in a Penalized Discriminant Analysis that achieved two distinct clusters by race. Arachidonoylcarnitine, the carnitine adduct of arachidonic acid, appeared to be consistently different by race. Thirty-eight vaginal fluid metabolites were significantly correlated with systemic inflammation biomarkers, irrespective of race. These findings suggest that vaginal fluid metabolites may differ by race, are linked with systemic inflammation, and hint at a potential role for mitochondrial dysfunction and sphingolipid metabolism in OC disparities. Larger studies are needed to verify these findings and further establish specific biological mechanisms that may link the vaginal microbiome with OC racial disparities. [ABSTRACT FROM AUTHOR]

Women referred to social work services during pregnancy are more likely to experience social disadvantage than those who are not, resulting in reduced antenatal care attendance. Lack of antenatal care engagement leads to poor identification and management of concerns that can have immediate and long-term health consequences for women and their babies. Identifying the barriers and enablers to antenatal care attendance for women referred to social work services is important for designing models of care that promote effective engagement. This study aimed to explore the barriers and enablers to antenatal care attendance by women referred to social work services from the perspectives of women, and clinicians who provide antenatal healthcare. A qualitative descriptive study using constructivist grounded theory methods was undertaken. Ten women referred to social work services and 11 antenatal healthcare providers were purposively recruited for interviews from a regional maternity service in Victoria, Australia. Continuity of care and healthcare providers partnering with women were central to effective engagement with antenatal care services. Three interrelated concepts were identified: 1) experiences of the hospital environment and access to care; 2) perceptions of care influence engagement, and 3) motivations for regularly attending services. Continuity of care is essential for supporting women referred to social work services to attend antenatal appointments. Women are better equipped to overcome other barriers to antenatal service attendance when they have a strong partnership with clinicians involved in their care. [ABSTRACT FROM AUTHOR]

Abstract Women are at greater risk of common mental disorders. The intersectionality concept provides a framework to examine the effects of multiple social disadvantages on women’s mental health. We conducted a systematic review to collect and analyse information to identify the quantitative methodologies and study designs used in intersectional research to examine women’s mental health and multiple social disadvantages. Included studies used accepted statistical methods to explore the intersectional effects of gender and one or more types of social disadvantage from the PROGRESS-Plus inequity framework: a place of residence, race/ethnicity, occupation, gender/ sex, religion, education, socioeconomic status, social capital (O’Neill et al. J Clin Epidemiol 67:56–64, 2014). The scope of this systematic review was limited to studies that analysed common mental disorders in women and men comparatively. Studies focusing on only one gender were excluded, ensuring a comprehensive comparative analysis of the intersection of social disadvantages in mental health. Twelve papers were included in the narrative synthesis (Table 1). Eight of the included papers (67%) reported an intersectional effect of gender and one or more additional types of social disadvantage. The multiplicative effect of gender and socioeconomic status on the risk of common mental disorders was the most commonly reported interaction. This systematic review shows that multiplicative and simultaneous interactions of multiple social disadvantage increase the risk of common mental disorders experienced by women. Moreover, it underlines the potential for quantitative research methods to complement qualitative intersectionality research on gender and mental health. The findings of this systematic review highlight the importance of multiple social disadvantage in understanding the increased risk of mental health experienced by women.

This study investigated whether support from teachers could serve as a protective factor and reduce disproportionality in problematic behavior. Data from the CILS4EU project on 14-year-old European students were used (N = 18,308). Students reported on their social background (parental resources, migrant background and adverse family risks), experiences of teacher support (academic and social) and problematic behavior (getting angry, acting impulsively and skipping classes). Multilevel regression analyses showed that students' disadvantageous social background was associated with more problematic behavior. Teacher support had a beneficial effect: academic support from teachers was associated with less problematic behavior for almost all students, while social support reduced problematic behavior among students with low educated parents. Enhancing academic and social support from teachers could thus help reduce educational inequalities by protecting vulnerable students against negative behavioral outcomes. [ABSTRACT FROM AUTHOR]

Our societies struggle to provide a good life for all without overconsuming environmental resources. Consequently, scholarly search for approaches to meet environmental and social goals of sustainability have become popular. In transport research, accessibility is a key tool to characterise linkages between people, transport, and land use. In the current paper, we propose a conceptual framework for measuring just accessibility within planetary boundaries. We reviewed transport studies and discovered a substantial literature body on accessibility and social disadvantage, much vaster compared to the literature around environmental and ecological impacts of accessibility. We also show a gap in approaches that have integrated these two perspectives. Building on the review, we suggest a conceptual framework for incorporating environmental and social sustainability goals in accessibility research. We conclude the paper by pointing to key challenges and research avenues related to the framework, including (i) dealing with uncertainty and complexity in socio-ecological thresholds, (ii) integrating environmental limits into the conceptualisations of transport equity, (iii) measuring accessibility through other costs than travel time, and (iv) integrating both quantitative and qualitative data. [ABSTRACT FROM AUTHOR]

The article addresses the issue of interaction between teachers and students in the context of primary schools with varying levels of representation of students experiencing social disadvantage. The research was conducted on a sample of 479 students from grade 6 to grade 9 of selected primary schools, utilizing the standardized questionnaire "Teacher-Student Interaction" (Gillernová and Krejčová, 2011). The obtained results can serve as a basis for revising educational strategies in schools with above-average representation of students facing social disadvantage and as a launching pad for further research. [ABSTRACT FROM AUTHOR]

Women are at greater risk of common mental disorders. The intersectionality concept provides a framework to examine the effects of multiple social disadvantages on women's mental health. We conducted a systematic review to collect and analyse information to identify the quantitative methodologies and study designs used in intersectional research to examine women's mental health and multiple social disadvantages. Included studies used accepted statistical methods to explore the intersectional effects of gender and one or more types of social disadvantage from the PROGRESS-Plus inequity framework: a place of residence, race/ethnicity, occupation, gender/ sex, religion, education, socioeconomic status, social capital (O'Neill et al. J Clin Epidemiol 67:56–64, 2014). The scope of this systematic review was limited to studies that analysed common mental disorders in women and men comparatively. Studies focusing on only one gender were excluded, ensuring a comprehensive comparative analysis of the intersection of social disadvantages in mental health. Twelve papers were included in the narrative synthesis (Table 1). Eight of the included papers (67%) reported an intersectional effect of gender and one or more additional types of social disadvantage. The multiplicative effect of gender and socioeconomic status on the risk of common mental disorders was the most commonly reported interaction. This systematic review shows that multiplicative and simultaneous interactions of multiple social disadvantage increase the risk of common mental disorders experienced by women. Moreover, it underlines the potential for quantitative research methods to complement qualitative intersectionality research on gender and mental health. The findings of this systematic review highlight the importance of multiple social disadvantage in understanding the increased risk of mental health experienced by women. [ABSTRACT FROM AUTHOR]

Regional peripheralisation has been repeatedly described as a process resulting in the combination of regional structural and social disadvantage. In theory, peripheries are characterised by the interdependence of these two types of disadvantage. Few studies have examined this interdependence in rural peripheries across several countries. In this study, we operationalise rural peripherality combining poor opportunity structures that constrain the social and economic opportunities of the local population, and increased concentrations of social disadvantage and decreased quality of life. Comparing Czech and eastern German regions, we uncovered intercorrelated spatial patterns of low education, poor employment quality, deficient labour market opportunity and accessibility to medical, educational and other services, which together represent key aspects of rural peripherality from the perspective of disadvantage. Although there is a clear coincidence of structural and social disadvantage in rural peripheries, neither increased levels of poverty nor long‐term unemployment are typical of these areas. [ABSTRACT FROM AUTHOR]

The analysis of environmental issues and the pursuit of environmental justice have gained significant attention in modern times. While progress has been made in understanding environmental impacts and establishing the right to access environmental information, the need to examine environmental inequalities persists. This study aimed to propose a methodology to identify and analyse potential 'sacrifice zones' within a region of interest using: (i) Exploratory Spatial Data Analysis (ESDA), (ii) Municipal Risk Indicators, and (iii) Spatial Autoregressive (SAR) models. The relationship between environmental hazards and social disadvantage in the Campania region of Italy was estimated and the findings of this preliminary study in this area are presented. Our preliminary results: (i) reveal a non-random distribution of contaminated sites and waste management plants (ii) localize the 'sacrifice zones' that are predominantly located in municipalities between the provinces of Naples and Caserta, (iii) show a disproportionately burdened with higher environmental risk and greater social vulnerability in some specific areas. Further investigations are required to replicate the results of this study under different environmental conditions. Additionally, enabling more precise identification of affected populations and areas subjected to heightened environmental pressures that would enhance the potential of the proposed approach. The proposed methodology can be adapted to different spatial contexts and data sources. [ABSTRACT FROM AUTHOR]

The article discusses the labor market trajectories of Australian university graduates from various disadvantaged social backgrounds over a ten-year period using population-wide linked administrative data. It addresses gaps in existing research by providing a comprehensive and methodologically robust analysis of post-graduation outcomes, including income, employment, and unemployment benefit receipt, while emphasizing the implications for labor market policies aimed at improving social equity.

Background: COVID-19 pandemic has influenced all children’s motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. Methods: Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). Results: Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018–6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2–10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. Conclusion: Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children.

Abstract Aim The objective was to identify if family social exclusion is associated with child motor and social development delay in Southeastern Brazil. Design A cross‐sectional study was conducted using data from a sample of 348 children under 3 years, proportional to the number of children registered in the primary care centres of the municipality. Methods Child development was measured using the “Developmental Surveillance Instrument” which was developed by the Ministry of Health in Brazil and is used for public health nurses and clinicians in their practice. An index was used to evaluate social exclusion. Results The prevalence of child motor and socioemotional developmental delay was 27.6% and 17.2%, respectively. Children in the most social excluded group were more likely to have delayed motor development (OR = 3.4; 95% CI = 1.14; 10.55) and socioemotional developmental delay (OR = 3.9; 95% CI = 1.05; 9.02) than children in the least social excluded group.

Abstract Background Neighborhood deprivation is associated with both race and cancer incidence, but there is a need to better understand the effect of structural inequities on racial cancer disparities. The goal of this analysis was to evaluate the relationship between a comprehensive measure of neighborhood‐level social disadvantage and cancer incidence within the racially diverse population of metropolitan Detroit. Methods We estimated breast, colorectal, lung, and prostate cancer incidence rates using Metropolitan Detroit Cancer Surveillance System and US decennial census data. Neighborhood socioeconomic disadvantage was measured by the Area Deprivation Index (ADI) using Census Bureau's American Community Survey data at the Public Use Microdata Areas (PUMA) level. Associations between ADI at time of diagnosis and cancer incidence were estimated using Poisson mixed‐effects models adjusting for age and sex. Attenuation of race‐incidence associations by ADI was quantified using the “mediation” package in R. Results ADI was inversely associated with incidence of breast cancer for both non‐Hispanic White (NHW) and non‐Hispanic Black (NHB) women (NHW: per‐quartile RR = 0.92, 95% CI 0.88–0.96; NHB: per‐quartile RR = 0.94, 95% CI 0.91–0.98) and with prostate cancer incidence only for NHW men (per‐quartile RR = 0.94, 95% CI 0.90–0.97). ADI was positively associated with incidence of lung cancer for NHWs and NHBs (NHW: per‐quartile RR = 1.12, 95% CI 1.04–1.21; NHB: per‐quartile RR = 1.37, 95% CI 1.25–1.51) and incidence of colorectal cancer (CRC) only among NHBs (per‐quartile RR = 1.11, 95% CI 1.02–1.21). ADI significantly attenuated the relationship between race and hormone receptor positive, HER2‐negative breast cancer (proportion attenuated = 8.5%, 95% CI 4.1–16.6%) and CRC cancer (proportion attenuated = 7.3%, 95% CI 3.7 to 12.8%), and there was a significant interaction between race and ADI for lung (interaction RR = 1.22, p

The aim of this study was to examine contextual antecedents and well‐being indicators associated with children's and adolescents' access to supportive nonparent adults (SNPAs). We conducted secondary data analysis of the 2016 National Survey of Children's Health, a large‐scale caregiver‐reported survey. We analyzed separate subsamples of children (ages 6–11, n = 12,849) and adolescents (ages 12–17, n = 17,628). For both children and adolescents, markers of social advantage (e.g., White race, nonimmigrant families, neighborhood/community capital, access to extracurriculars) increased the likelihood of having SNPAs, according to parent or caregiver reports. Familial factors (e.g., parent participation in school and extracurricular activities) were stronger predictors of SNPA presence for children. Access to SNPAs was negatively associated with social difficulties among children and adolescents and positively associated with curiosity and overall health among adolescents. In conclusion, disadvantage across multiple ecological levels impairs children's and adolescents' access to SNPAs. Having an SNPA may be associated with some aspects of youth well‐being, although causality cannot be inferred in cross‐sectional data. [ABSTRACT FROM AUTHOR]

Background: In developed economies, most children attend Early Childhood Education and Care (ECEC) services before school entry, many from early life and across long days. For this reason, ECEC services present significant potential to provide food environments that positively influence eating behaviours and food preferences with attendant effect on life course trajectories of health and wellbeing. Yet there is evidence that feeding practices that limit optimal ongoing nutrition, such as pressure and restriction, are amplified in ECEC services serving disadvantaged communities. We sought to identify underlying explanatory mechanisms through observation of children's feeding experiences and educator explanations comparing, family‐provided and service‐provided meals. Method: This study used qualitative analyses of educator interviews and observation records from 55 mealtimes in 10 ECEC services: 5 providing food and 5 requiring family food provision. Results: High levels of concern drove educator's controlling feeding practices at mealtimes but presented differently across meal provision modes. In centres that provided food, educators' concern focused on food variety, manifesting in pressure to 'try' foods. In centres requiring family‐provided food, concern focused on nutrition quantity and quality and manifested as control of order of food consumption and pacing of intake to ensure food lasted across the day. Interview data suggested that conflict aversion limited optimal nutrition. In centres providing food, this was seen in menus that prioritized child food preferences. In centres requiring family meal provision, conflict aversion was seen as reticence to discuss lunchbox contents with families. Conclusion: The findings direct attention to public health intervention. Currently, ECEC face significant barriers to realizing their potential to support child nutrition and establish positive life course trajectories of nutrition. To do so requires targeted supports that enable sufficient supply and quality of food in the context of poverty. [ABSTRACT FROM AUTHOR]

There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families. [ABSTRACT FROM AUTHOR]

In Germany, there is still a great need for research on the quality of teacherchild interactions in ECEC institutions. Especially, because social interactions and relationships are crucial for (early) learning and development (Ulferts et al., 2019). However, there are hardly any results on factors influencing the interaction quality. This paper addresses the issue by assessing interaction quality of 48 ECEC teachers in German Kindergartens using the CLASS (Pianta et al., 2008). The influences of two factors - the activity setting and the attributed social disadvantage on the child - are explored. Interaction quality analyses show mid to high quality scores for Emotional Support and Classroom Organization whereas the Instructional Support domain is rated low. Concerning the influencing factors, we find significant differences in interaction quality between the activity settings and significantly higher Instructional Support scores for the dyads with the child with an attributed social disadvantage. [ABSTRACT FROM AUTHOR]

Many philosophers and legal theorists worry about punishing the socially disadvantaged as severely as their advantaged counterparts. One philosophically popular explanation of this concern is couched in terms of moral standing: seriously unjust states are said to lack standing to condemn disadvantaged offenders. If this is the case, institutional condemnation of disadvantaged offenders (especially via hard treatment) will often be unjust. I describe two problems with canonical versions of this view. First, its proponents groundlessly claim that disadvantaged offenders may be punished as severely as advantaged ones, even though such punishment is unjust in light of the state's loss of standing. Second, and more importantly, moral standing arguments prohibit states from blaming advantaged as well as disadvantaged offenders. This unwelcome outcome suggests that standing approaches incorrectly analyze the source of moral misgivings about punishing the disadvantaged. I conclude that those who share such concerns should put standing accounts aside. [ABSTRACT FROM AUTHOR]

This think piece suggests that Children's Court Care Plans should include a new section that documents poverty and social disadvantage, especially of Aboriginal and Torres Strait Islander families, when they are under investigation for child abuse and neglect. New South Wales in Australia is used as the exemplar state, but this suggestion may find an echo elsewhere. Points for practitioners: As a general proposition social and economic circumstances should be considered in addition to parental dysfunction in child protection proceedings in Children's court.Care Plans prepared for hearings in the NSW Children's Court, often developed in response to serious harm report investigations, currently do not contain information about parents' poverty and social disadvantage and hence decontextualise family living circumstances.Consistent with international evidence, Care Plans should require information about parents' socioeconomic situation, including social disadvantage of residential neighbourhood, status and cost of household tenancy, and household income.Taking account of social and economic circumstances has the potential to generate savings in out‐of‐home care that can be re‐allocated to support services to reduce poverty and social disadvantage and thereby reduce the need for removal of children from parental care. [ABSTRACT FROM AUTHOR]

Abstract Cars are dominating urban traffic in cities around the world, even though daily trips in many cities are often realized with active modes of transportation or public transport. Urban transport planning processes need to adapt to this reality and the necessity of climate change mitigation. Against this background, the research project “Mobility Reporting”, a joint undertaking of the district Pankow in Berlin and researchers from TU Berlin and TU Dresden, established a new, goal-driven, and participative planning process. The process identified local mobility as one of the central planning goals. The 15-min city (FMC) was thus adduced as a benchmark to analyze the district’s current mobility system and development potential. We conducted extensive accessibility analyses to examine the status quo concerning the FMC. We calculated travel times to essential destinations in daily life by foot, public transport, and car. This analysis was accompanied by a mixed online and paper–pencil survey conducted to evaluate the perceived accessibility of people in Pankow. The survey results shed light on the question of which walking time thresholds constitute a “very good” or “good” accessibility. Further analyses included environmental and social variables, allowing us to check whether areas with different accessibility levels also differ regarding the socio-economic characteristics of their inhabitants. For example, do socially advantaged neighborhoods have better local accessibility? Is there a trade-off between exposure to environmental pollution and good accessibility? With this contribution, we shed light on what an FMC is and ought to be. Results from the survey support the normative and political vision of the FMC. Pankow generally offers the merits of a walkable city, showing the expected travel time differences between the dense inner city and the outskirts. Socially disadvantaged neighborhoods are not consistently less accessible. However, there seems to be a trade-off between good accessibility (especially PT accessibility) and correlated externalities of transport, namely air pollution and noise.

Introduction Since the last decade, social determinants of health (SDOH) have become a vital component of the liturgy of public health. From that time, the number of articles on SDOH cited in PubMed has increased from approximately 775 to over 4,700. Issue In obstetrics, social determinants of health have particular resonance in discussions of maternal mortality and health disparities and the number of articles on SDOH in obstetrics has increased sixfold during the same interval. However, while most obstetricians are now aware of SDOH, many are unsure about how to address them within the context of their own practice. Summary In this piece, we will discuss the importance of SDOH in obstetrics, the reasons why most obstetricians have not engaged with it and suggest steps to help bridge the gap between merely accepting SDOH's importance and implementing strategies to mitigate their effects. Key Points Obstetricians believe SDOH can lead to adverse outcomes but few feel confident addressing social needs. Three suggested steps in addressing SDOH are identifying needs, identifying resources, and then linking the two. Organizations are as vital as individual physicians in implementing strategies to address SDOH. [ABSTRACT FROM AUTHOR]

Aim: The objective was to identify if family social exclusion is associated with child motor and social development delay in Southeastern Brazil. Design: A cross‐sectional study was conducted using data from a sample of 348 children under 3 years, proportional to the number of children registered in the primary care centres of the municipality. Methods: Child development was measured using the "Developmental Surveillance Instrument" which was developed by the Ministry of Health in Brazil and is used for public health nurses and clinicians in their practice. An index was used to evaluate social exclusion. Results: The prevalence of child motor and socioemotional developmental delay was 27.6% and 17.2%, respectively. Children in the most social excluded group were more likely to have delayed motor development (OR = 3.4; 95% CI = 1.14; 10.55) and socioemotional developmental delay (OR = 3.9; 95% CI = 1.05; 9.02) than children in the least social excluded group. [ABSTRACT FROM AUTHOR]

Background: Neighborhood deprivation is associated with both race and cancer incidence, but there is a need to better understand the effect of structural inequities on racial cancer disparities. The goal of this analysis was to evaluate the relationship between a comprehensive measure of neighborhood‐level social disadvantage and cancer incidence within the racially diverse population of metropolitan Detroit. Methods: We estimated breast, colorectal, lung, and prostate cancer incidence rates using Metropolitan Detroit Cancer Surveillance System and US decennial census data. Neighborhood socioeconomic disadvantage was measured by the Area Deprivation Index (ADI) using Census Bureau's American Community Survey data at the Public Use Microdata Areas (PUMA) level. Associations between ADI at time of diagnosis and cancer incidence were estimated using Poisson mixed‐effects models adjusting for age and sex. Attenuation of race‐incidence associations by ADI was quantified using the "mediation" package in R. Results: ADI was inversely associated with incidence of breast cancer for both non‐Hispanic White (NHW) and non‐Hispanic Black (NHB) women (NHW: per‐quartile RR = 0.92, 95% CI 0.88–0.96; NHB: per‐quartile RR = 0.94, 95% CI 0.91–0.98) and with prostate cancer incidence only for NHW men (per‐quartile RR = 0.94, 95% CI 0.90–0.97). ADI was positively associated with incidence of lung cancer for NHWs and NHBs (NHW: per‐quartile RR = 1.12, 95% CI 1.04–1.21; NHB: per‐quartile RR = 1.37, 95% CI 1.25–1.51) and incidence of colorectal cancer (CRC) only among NHBs (per‐quartile RR = 1.11, 95% CI 1.02–1.21). ADI significantly attenuated the relationship between race and hormone receptor positive, HER2‐negative breast cancer (proportion attenuated = 8.5%, 95% CI 4.1–16.6%) and CRC cancer (proportion attenuated = 7.3%, 95% CI 3.7 to 12.8%), and there was a significant interaction between race and ADI for lung (interaction RR = 1.22, p < 0.0001) and prostate cancer (interaction RR = 1.09, p = 0.00092). Conclusions: Area‐level socioeconomic disadvantage is associated with risk of common cancers in a racially diverse population and plays a role in racial differences in cancer incidence. [ABSTRACT FROM AUTHOR]

Abstract Natural soundscapes experienced in parks are increasingly recognised as a valuable ecosystem service, yet urban parks soundscapes also commonly contain anthropogenic noise. While studies show bird calls can promote psychological restoration, the factors that might influence actual experiences of these sounds by individuals in urban parks are less clear. Equally, continual exposure to anthropogenic noise, such as vehicle traffic, is associated with negative health outcomes, but determinants influencing negative experiences of such sounds within a park soundscape are poorly understood. To address this gap we used an ex situ survey of over 4000 Australian residents and examined a range of spatial and social factors in influencing perceptions towards noticing and pleasantness of bird sounds and traffic noise within urban parks. The results indicate older age, recent park use, and valuing parks for uses such as exercising, socialising and to hear nature, were positively associated with pleasant bird sound experiences in parks. For traffic sounds, we found indicators of disadvantage, such as renting a home were associated with a higher likelihood of unpleasant experiences of traffic noise within parks. Notably, individuals using parks for social activities were still positively associated with pleasant bird sound experiences and less likely to perceive traffic sounds as unpleasant. Conversely, whilst those with greater nature‐relatedness had a strong positive association with pleasant bird sound experiences, they were more likely to perceive traffic as unpleasant. Overall, these findings suggest that whilst many types of park users can potentially experience the beneficial effects from bird sounds, the detrimental effects of traffic noise may constrain these benefits in certain social groups, particularly those of greater socio‐economic disadvantage. We discuss strategies to promote greater equity of therapeutic experiences of bird sounds in parks, whilst outlining traffic mitigation measures within urban parks. Read the free Plain Language Summary for this article on the Journal blog.

Abstract Background In Australia, tobacco smoking rates have declined but inequalities remain with significantly higher smoking prevalence among low-socioeconomic populations. Clinical trial data suggest vaporized nicotine products (VNPs) aid smoking cessation. Most VNP trials have used refillable tank systems, but newer generation (pod) devices now comprise the largest market share yet have limited clinical trial evidence on safety and effectiveness. This study evaluates the effectiveness, safety and cost-effectiveness of VNPs (pod and tank device) compared with nicotine replacement therapy ([NRT]—gum or lozenge) for smoking cessation. Methods This is a two-arm, open-label, superiority, parallel group, randomized controlled trial (RCT) with allocation concealment and blinded outcome assessment. The RCT is conducted at the National Drug and Alcohol Research Centre at the University of New South Wales, Sydney, Australia. Participants are people who smoke daily, are interested in quitting and receive a government pension or allowance (N = 1058). Participants will be randomized (1:1 ratio) to receive 8 weeks of free: VNPs, with pod (40 mg/mL nicotine salt) and tank device (18 mg/mL freebase nicotine) in mixed flavours; or NRT (gum or lozenge; 4 mg). All participants will receive daily text message behavioural support for 5 weeks. Assessments will be undertaken by telephone at baseline, with three follow-up calls (two check-in calls within the first month and final follow-up at 7 months post randomization) to ascertain smoking status, treatment adherence and adverse events. The primary outcome is 6-month continuous abstinence verified by carbon monoxide breath test of ≤5ppm at 7-month follow-up. Safety and cost-effectiveness of VNPs versus NRT will also be evaluated. Discussion Further data are required to strengthen certainty of evidence for VNPs aiding smoking cessation, particularly for newer generation pod devices. To our knowledge, this trial is the first to offer choice of VNPs and no comparative effectiveness trial data exists for new pod devices. If effective, the findings can inform wider implementation of VNPs to aid smoking cessation in a priority group. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12621000076875. Registered on 29 January 2021. https://www.anzctr.org.au

Abstract Background Late access to antenatal care is a contributor to excess mortality and morbidity among ethnic minority mothers compared to White British in the UK. While individual ethnicity and socioeconomic disadvantage are linked to late antenatal care initiation, studies have seldom explored patterns of late initiation and associated factors in ethnically dense socially disadvantaged settings. This study investigated disparities in the timing of antenatal care initiation, and associated factors in an ethnically dense socially disadvantaged maternal cohort. Methods A retrospective cross-sectional study using routinely collected anonymous data on all births between April 2007—March 2016 in Luton and Dunstable hospital, UK (N = 46,307). Late initiation was defined as first antenatal appointment attended at > 12 weeks of gestation and further classified into moderately late (13–19 weeks) and extremely late initiation (≥ 20 weeks). We applied logistic and multinomial models to examine associations of late initiation with maternal and sociodemographic factors. Results Overall, one fifth of mothers (20.8%) started antenatal care at > 12 weeks of gestation. Prevalence of late initiation varied across ethnic groups, from 16.3% (White British) to 34.2% (Black African). Late initiation was strongly associated with non-White British ethnicity. Compared to White British mothers, the odds of late initiation and relative risk of extremely late initiation were highest for Black African mothers [adjusted OR = 3.37 (3.05, 3.73) for late initiation and RRR = 4.03 (3.51, 4.64) for extremely late initiation]. The odds did not increase with increasing area deprivation, but the relative risk of moderately late initiation increased in the most deprived ([RRR = 1.53 (1.37, 1.72)] and second most deprived areas [RRR = 1.23 (1.10, 1.38)]. Late initiation was associated with younger mothers and to a lesser extent, older mothers aged > 35 years. Mothers who smoked during pregnancy were at higher odds of late initiation compared to mothers who did not smoke. Conclusions There is a need to intensify universal and targeted programmes/services to support mothers in ethnically dense socially disadvantaged areas to start antenatal care on time. Local variations in ethnic diversity and levels of social disadvantage are essential aspects to consider while planning services and programmes to ensure equity in maternity care provision.

The question, whether and how spatial and social disadvantages overlap and what this means in terms of individual achievements is of crucial importance to rural sociology. Empirically, however, only few studies on this topical issue are available so far. The paper presents the conceptual and methodological approach as well as selected findings of a recently completed cross-national, German-Czech research project. Our research focusses on three socially disadvantaged groups: persons experiencing difficulties in the labour market, single parents and elderly persons living alone. They are living in four rural peripheries in Eastern Germany and Czechia, regions which are similar in their distance to metropolitan areas, low population density, weak economic structure and poor accessibility of public and private services. Our main interest is on the question whether social and spatial disadvantages accumulate and lead to a double disadvantage. We conducted 113 qualitative interviews in both countries. Overall, most respondents rate their lives in the four regions positively. Often, they describe a rural idyll, naming for example direct access to nature as important source of their well-being. However, they also point to a variety of everyday challenges due to a lack of services and infrastructures and the need to have access to a car and to travel long distances. They highlight the important role played by rural and small towns (and their supply services) in rural peripheries. Social relationships are also important for well-being. The respondents’ everyday narratives attest to the fact that they have found multiple ways of dealing with spatial constraints. Thus, our results paint a nuanced picture of rural peripheries where social and spatial disadvantages do not necessarily accumulate and people do not inevitably see themselves as disadvantaged – either socially or spatially. Central to this is a high degree of agency, manifesting in a variety of coping strategies. The respondents apply these to meet daily challenges and to live more self-determined lives than the spatial structures of a rural periphery and the conditions of various forms of social disadvantage would initially suggest. [ABSTRACT FROM AUTHOR]

Cars are dominating urban traffic in cities around the world, even though daily trips in many cities are often realized with active modes of transportation or public transport. Urban transport planning processes need to adapt to this reality and the necessity of climate change mitigation. Against this background, the research project "Mobility Reporting", a joint undertaking of the district Pankow in Berlin and researchers from TU Berlin and TU Dresden, established a new, goal-driven, and participative planning process. The process identified local mobility as one of the central planning goals. The 15-min city (FMC) was thus adduced as a benchmark to analyze the district's current mobility system and development potential. We conducted extensive accessibility analyses to examine the status quo concerning the FMC. We calculated travel times to essential destinations in daily life by foot, public transport, and car. This analysis was accompanied by a mixed online and paper–pencil survey conducted to evaluate the perceived accessibility of people in Pankow. The survey results shed light on the question of which walking time thresholds constitute a "very good" or "good" accessibility. Further analyses included environmental and social variables, allowing us to check whether areas with different accessibility levels also differ regarding the socio-economic characteristics of their inhabitants. For example, do socially advantaged neighborhoods have better local accessibility? Is there a trade-off between exposure to environmental pollution and good accessibility? With this contribution, we shed light on what an FMC is and ought to be. Results from the survey support the normative and political vision of the FMC. Pankow generally offers the merits of a walkable city, showing the expected travel time differences between the dense inner city and the outskirts. Socially disadvantaged neighborhoods are not consistently less accessible. However, there seems to be a trade-off between good accessibility (especially PT accessibility) and correlated externalities of transport, namely air pollution and noise. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and associated school closures may have constrained educational participation particularly for students in disadvantaged circumstances. We explore how 30 disadvantaged students in secondary school (14 mainstream/16 Flexible Learning Programme) from Queensland, New South Wales and Tasmania experienced home learning during the first wave of COVID‐19, teasing out nuances across two educational models. Drawing on semi‐structured interviews with these students, our analysis revealed three interconnected themes inflecting their learning: connection, connectivity and choice. Connection captures the desire for belonging and practices that facilitated meeting this desire during system‐wide disruptions to school routines and face‐to‐face learning. Connectivity captures the impact of digitally facilitated learning at home on students' ability to engage with curriculum content and with their learning community. Choice captures the availability of viable options to overcome barriers students encountered in their learning and possibilities to flexibly accommodate student preferences and learning needs. Students from Flexible Learning Programmes appeared generally better supported to exercise agency within the scope of their lived experience of home‐based learning. Findings indicate a need for strengthening student‐centred policy and practices aimed at leveraging the affordances of information technology, balancing self‐directed and structured learning and providing holistic support to enable meaningful student choice. [ABSTRACT FROM AUTHOR]

Background and Objectives The aim of this study is to contribute to the literature on variation in later-life outcomes by sexual identity. Drawing on the Iridescent Life Course framework, we examined differences in loneliness trajectories, and tested the roles of social connectedness and support, and socioeconomic and health statuses in explaining any observed disparities. Research Design and Methods Using growth models, we analyzed 19 years of data (2001–2019) from adults aged 50 years and older from the Household, Income and Labour Dynamics in Australia Survey (n = 5,500 individuals), where a question on sexual identity was asked twice in the study. Results One percent of our sample reported a change in their sexual identity, which we grouped with individuals who reported as bisexual. Our sample comprised of 45.3% heterosexual men, 52.2% heterosexual women, 0.6% gay men, 0.6% lesbian women, 0.6% bisexual-plus men, and 0.6% bisexual-plus women. We found bisexual-plus men were vulnerable to loneliness as they aged. This group had the highest levels of loneliness at age 50, and differences compared with heterosexual men persisted over time. Loneliness of bisexual-plus men increased steeply from age 70. Socioeconomic and health statuses did not explain the increased loneliness of older bisexual-plus men. Lower social support and connectedness partly accounted for these disparities. Discussion and Implications Findings are discussed with regards to existing research and theories on social disadvantage and resilience over the life course. We expand knowledge on factors explaining loneliness and how it varies in women and men by sexual identity. [ABSTRACT FROM AUTHOR]