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Abstract Aims Heart failure (HF) is a common cause of morbidity and mortality, related to a broad range of sociodemographic, lifestyle, cardiometabolic, and comorbidity risk factors, which may differ according to the presence of atherosclerotic cardiovascular disease (ASCVD). We assessed the association between incident HF with baseline status across these domains, overall and separated according to ASCVD status. Methods and results We included 5758 participants from the Baker Biobank cohort without HF at baseline enrolled between January 2000 and December 2011. The primary endpoint was incident HF, defined as hospital admission or HF‐related death, determined through linkage with state‐wide administrative databases (median follow‐up 12.2 years). Regression models were fitted adjusted for sociodemographic variables, alcohol intake, smoking status, measures of adiposity, cardiometabolic profile measures, and individual comorbidities. During 65 987 person‐years (median age 59 years, 38% women), incident HF occurred among 784 participants (13.6%) overall. Rates of incident HF were higher among patients with ASCVD (624/1929, 32.4%) compared with those without ASCVD (160/3829, 4.2%). Incident HF was associated with age, socio‐economic status, alcohol intake, smoking status, body mass index (BMI), waist circumference, waist–hip ratio, systolic blood pressure (SBP), and low‐ and high‐density lipoprotein cholesterol (LDL‐C and HDL‐C), with non‐linear relationships observed for age, alcohol intake, BMI, waist circumference, waist–hip ratio, SBP, LDL‐C, and HDL‐C. Risk factors for incident HF were largely consistent regardless of ASCVD status, although diabetes status had a greater association with incident HF among patients without ASCVD. Conclusions Incident HF is associated with a broad range of baseline sociodemographic, lifestyle, cardiometabolic, and comorbidity factors, which are mostly consistent regardless of ASCVD status. These data could be useful in efforts towards developing risk prediction models that can be used in patients with ASCVD.

Abstract Background Pakistan, the world's sixth most populous country and the second largest in South Asia, is facing challenges related to reproductive, maternal, newborn and child health (RMNCH) that are exacerbated by various inequities. RMNCH coverage indicators such as antenatal care (ANC) and deliveries at health facilities have been improving over time, and the maternal mortality ratio (MMR) is gradually declining but not at the desired rates. Analysing and documenting inequities with reference to key characteristics are useful to unmask the disparities and to amicably implement targeted equity-oriented interventions. Methods Pakistan Demographic Health Survey (PDHS) based UHC service coverage tracer indicators were derived for the RMNCH domain at the national and subnational levels for the two rounds of the PDHS in 2012 and 2017. These derivations were subgrouped into wealth quintiles, place of residence, education and mothers’ age. Dumbbell charts were created to show the trends and quintile-specific coverage. The UHC service coverage sub-index for RMNCH was constructed to measure the absolute and relative parity indices, such as high to low absolute difference and high to low ratios, to quantify health inequities. The population attributable risk was computed to determine the overall population health improvement that is possible if all regions have the same level of health services as the reference point (national level) across the equity domains. Results The results indicate an overall improvement in coverage across all indicators over time, but with a higher concentration of data points towards higher coverage among the wealthiest groups, although the poorest quintile continues to have low coverage in all regions. The UHC service coverage sub-index on RMNCH shows that Pakistan has improved from 45 to 63 overall, while Punjab improved from 50 to 59 and Sindh from 43 to 55. The highest improvement is evident in Khyber Pakhtunkhwa (KP) province, which has increased from 31 in 2012 to 51 in 2017. All regions made slow progress in narrowing the gap between the poorest and wealthiest groups, with particularly noteworthy improvements in KP and Sindh, as indicated by the parity ratio. The RMNCH service coverage sub-index gap was the greatest among women aged 15–19 years, those who belonged to the poorest wealth quintile, had no education, and resided in rural areas. Conclusions Analysing existing data sources from an equity lens supports evidence-based policies, programs and practices with a focus on disadvantaged subgroups.

Abstract Objective: Low childhood socio-economic status (SES) and adverse childhood experiences (ACE) are associated with poor health outcomes in adulthood. Determining how ACE may be linked to food insecurity among young people from socio-economically diverse households can inform health-protective strategies. This study examined if ACE are associated with food insecurity during the transition to adulthood and investigated prevalence differences across SES strata. Setting: Participants were recruited from twenty secondary schools in Minneapolis-St. Paul, Minnesota. Participants: The analytic sample (n 1518) completed classroom surveys in 2009–2010 (mean age = 14·5 years) and follow-up surveys in 2017–2018 (mean age = 22·0 years). Design: Past-year food insecurity was reported at both time points, and ACE were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle and high). Results: The adjusted prevalence of food insecurity was 45·3 % among emerging adults who reported three or more ACE compared with 23·6 % among those with one or two ACE and 15·5 % among those with no ACE (P < 0·001). All forms of ACE were related to an elevated prevalence of food insecurity in emerging adulthood. ACE–food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity. Conclusions: Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACE.

Urban green and blue space (UGBS) contribute to a variety of nature-based values and human health benefits. As such, they play a critical role for the quality of life and sustainability in cities. Here, we use the metropolitan area of Geneva, Switzerland, as a case study to illustrate that UGBS are heterogeneous in spatial characteristics, such as surface area, naturality, or noise levels, which are associated with key cultural ecosystems services. For each characteristic, we defined a threshold with the realization of an associated cultural ecosystem service, including a novel noise threshold (LAeq < 45 dB) compatible with the notion of "quiet". We then used geospatial information to generate place-based and people-based indicators that collectively describe the variation in key dimensions of UGBS. We found that, in Geneva, the typical (median) resident has access to 4.7 ha of UGBS, and 89% of residents live within 300 m of the nearest UGBS. Accessible surfaces of UGBS per capita, however, were highly variable by type of UGBS and across neighbourhoods. For example, residents from precarious neighbourhoods are less likely to live within 300 m of quiet UGBS than residents of privileged neighbourhoods, and when they do, these UGBS tend to be smaller. The proposed methodology categorizes UGBS in a manner that both captures their distinct social roles and highlights potential social injustice issues. [ABSTRACT FROM AUTHOR]

Introduction: Chronic respiratory diseases are known risk factors for Coronavirus Disease-2019 (COVID-19) associated morbidity and mortality. With the fourth wave of COVID-19 looming in India, it is crucial to prioritise preventive measures at both individual and community levels. However, following the third wave of COVID-19, adherence to preventive measures has declined. Aim: To assess the socio-clinical factors affecting COVID-19 preventive behaviour among patients with chronic respiratory diseases. Materials and Methods: This cross-sectional observational study was conducted at the outpatient department of Respiratory Medicine, Narayana Medical College Hospital, Nellore, a tertiary care centre in Andhra Pradesh, India from March to April 2022. The estimated sample size was 600 patients. Data was collected using a validated questionnaire, and analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 28.1 {International Business Machines (IBM) Corporation}. The association between independent and dependent variables was assessed using binary logistic regression. Results: A total of 671 patients’ data were analysed. The mean age was 51.45 (±14.397) years, with 390 (58.1%) being male. Among the participants, the prevalence of wearing face masks in workplaces was 47.8%, wearing face masks in public places was 43.6%, frequent hand sanitisation was 39.9%, and maintaining physical distance in public areas was 35.2%. The main factors associated with non adherence were women, rural dwellers, non smokers, patients with co-morbidities, those who had not experienced a detrimental impact of COVID-19 on themselves, and the perception that COVID-19 was a mild disease. Conclusion: Among patients with chronic respiratory diseases, the practice of COVID-19 preventive measures was inadequate. Factors that positively influenced COVID-19 behaviour were being married, having a high school education level or above, and being a smoker. The impact of age varied depending on the type of preventive measure. Socio-economic status had no significant impact. [ABSTRACT FROM AUTHOR]

Previous studies on health and socio-economic determinants of later-life labour force participation have mainly come from high-income European countries and the United States of America (USA). Findings vary between studies due to different measures of socio-economic status and labour force outcomes. This study investigated longitudinal associations of physical incapacity and wealth with remaining in paid employment after age 60 in middle- and high-income countries. Using harmonised cohort data in the USA, England, Japan, Mexico and China (N = 32,132), multilevel logistic regression was applied for main associations. The age-related probabilities of remaining in paid employment by physical incapacity and wealth were estimated using marginal effects. This study found that physical incapacity predicted lower odds of remaining in paid employment in each country. Wealth was associated with higher odds of remaining in paid employment in the USA, England and Japan, but not in Mexico. Probabilities of remaining in paid employment were high in Mexico but low in China. The absolute difference in the probability of remaining in paid employment between the richest and the poorest groups was greater in the USA than that in any other country. In the USA, England and Japan, the inverse association between physical incapacity and remaining in paid employment could be partially compensated by wealth only when physical incapacity was not severe. National policies, including considering older adults' changing capacities for job placement and prioritising the provision of supportive services for socio-economically disadvantaged older adults, developing pathways for informal workers to access social security and pension coverage, and encouraging employers to hire socio-economically disadvantaged older workers and enhancing their employability, could be facilitated. Future studies, such as exploring health and socio-economic determinants of remaining in part-time and full-time paid employment separately in more countries, and the moderating effects of relevant policies on these associations, are needed. [ABSTRACT FROM AUTHOR]

Objective To investigate the influence of socio-economic status (SES) on the incidence of overweight and obesity. Methods By using the method of multi-stage cluster random sampling, a baseline survey was conducted on 9 280 people in Guizhou Province in 2010. All participants in the cohort were followed up from 2016 to 2020. In total 2 681 people were included in the analysis after excluding those who lost follow-up and did not meet the requirements. Univariate analysis and COX proportional regression model were used to analyze the effects of SES comprehensive score and SES single index on the incidence of overweight and obesity. Results The median follow-up was 6.42 years, and the population incidence density was 41.72/1 000 person-years. The results of multivariate COX regression showed that compared with the people with per capita annual income less than 2 667 yuan, the risks of disease for those with income of 5 000 to < 10000 yuan and ≥ 10 000 yuan were HR=0.756 (95%CI: 0.611-0.934) and HR=0.626 (95%CI: 0.498-0.787), respectively (Ptrend < 0.001). Compared with illiterate and semi-illiterate, the disease risk was lower for people with education of primary school (HR=0.740, 95%CI: 0.599-0.914), junior high school (HR=0.666, 95%CI: 0.541-0.820), and senior high school/technical secondary school and above HR=0.634 (95%CI: 0.468-0.859), respectively (Ptrend <0.001). There was no correlation between occupation and disease risk. Compared with the population with SES comprehensive score < 6, the risks of disease in the population with 8 points and ≥ 9 points were HR=0.735 (95%CI: 0.566-0.955) and HR=0.540 (95%CI: 0.417-0.700), respectively (P<0.001). The results of urban and rural subgroup analysis showed that the effect of comprehensive score of SESS on the risk of disease was more significant in rural population. In terms of single index, the incidence of urban population was only related to individual education level (Ptrend =0.008), and the incidence of rural population was only related to family per capita annual income (Ptrend =0.002). Conclusion The risk of overweight and obesity is closely related to SES, and SES inequality causes health differences. Attention should be paid to urban low-education and rural low-income population. [ABSTRACT FROM AUTHOR]

Irrigation plays a pivotal role in enhancing agricultural production and shaping the socioeconomic well-being of farmers. Consequently, the judicious and efficient utilization of irrigated water resources is imperative. This paper aims to investigate the spatial disparities in the level of irrigation development facilitated by tube wells and assess their influence on farmers' socio-economic conditions through a comprehensive cost-benefit analysis. Drawing from both primary and secondary data sources, our study unveils a positive correlation between the extent of tube well-irrigated areas and the overall irrigated land within the district. Notably, changes in the area under tube well irrigation exert a significant impact on the entire irrigation system. Among the various blocks in the district, Hili block exhibits the highest percentage of land allocated to tube well irrigation, while the Tapan block has the lowest proportion of such irrigated areas. The predominant occupation in the study area is agriculture, and a majority of the farmers have received education only up to the upper primary level, indicating limited educational representation. Our analysis reveals a positive impact of tube well irrigation on farmers' income, as evidenced by the results of the costbenefit analysis. In conclusion, the findings of this study herein underscore the importance of efficient water resource management and the role of tube well irrigation in bolstering agricultural productivity and livelihoods within the region. [ABSTRACT FROM AUTHOR]

Research related to consumers' ethical judgments has generally neglected the effects of psycho-social variables (variables with both social and personal psychological components), e.g., perceived income inequality and subjective socio-economic status. In order to address this gap, an online survey of 373 US consumers was conducted to examine relationships between perceived income inequality and judgments regarding unethical and prosocial consumer actions. The mediating role of trust (general distrust of others and distrust of corporations) and moderating role of subjective socio-economic status were examined. Moderated mediation analyses demonstrated that the effects of perceived income inequality on consumers' ethical judgments were mediated by distrust of corporations (but not by general distrust of others), for consumers who had higher subjective socio-economic status. These novel findings related to the effects of distrust of corporations highlight that, in order to explain consumers' ethical judgments, it is essential to focus on trust relationships between consumers and other participants in the marketing system. Perceived income inequality erodes trust within marketing systems leading to negative effects on consumers' ethical judgments. These effects are paradoxically only evident among consumers with higher subjective socio-economic status. Findings contribute to the macromarketing literature on marketing systems, marketing ethics, sustainable consumption, and distributive justice. [ABSTRACT FROM AUTHOR]

Aims: Heart failure (HF) is a common cause of morbidity and mortality, related to a broad range of sociodemographic, lifestyle, cardiometabolic, and comorbidity risk factors, which may differ according to the presence of atherosclerotic cardiovascular disease (ASCVD). We assessed the association between incident HF with baseline status across these domains, overall and separated according to ASCVD status. Methods and results: We included 5758 participants from the Baker Biobank cohort without HF at baseline enrolled between January 2000 and December 2011. The primary endpoint was incident HF, defined as hospital admission or HF‐related death, determined through linkage with state‐wide administrative databases (median follow‐up 12.2 years). Regression models were fitted adjusted for sociodemographic variables, alcohol intake, smoking status, measures of adiposity, cardiometabolic profile measures, and individual comorbidities. During 65 987 person‐years (median age 59 years, 38% women), incident HF occurred among 784 participants (13.6%) overall. Rates of incident HF were higher among patients with ASCVD (624/1929, 32.4%) compared with those without ASCVD (160/3829, 4.2%). Incident HF was associated with age, socio‐economic status, alcohol intake, smoking status, body mass index (BMI), waist circumference, waist–hip ratio, systolic blood pressure (SBP), and low‐ and high‐density lipoprotein cholesterol (LDL‐C and HDL‐C), with non‐linear relationships observed for age, alcohol intake, BMI, waist circumference, waist–hip ratio, SBP, LDL‐C, and HDL‐C. Risk factors for incident HF were largely consistent regardless of ASCVD status, although diabetes status had a greater association with incident HF among patients without ASCVD. Conclusions: Incident HF is associated with a broad range of baseline sociodemographic, lifestyle, cardiometabolic, and comorbidity factors, which are mostly consistent regardless of ASCVD status. These data could be useful in efforts towards developing risk prediction models that can be used in patients with ASCVD. [ABSTRACT FROM AUTHOR]

In this paper we explore perspectives of academically successful students from low socio-economic status (LSES) backgrounds in an Australian university regarding their success. In response to initiatives arising from the Australian Government's 2008 Review of Australian Higher Education, university cohorts have increasingly diversified. This diversification of student cohorts has been especially apparent for students from LSES backgrounds, who were found to be underrepresented in higher education. Previous researchers have investigated how traditional cultural norms within the field of higher education, and deficit perspectives of LSES background students, place these students at a disadvantage. Utilising a capital-based approach, we were interested in understanding students' awareness of their strengths, and how they utilised and exchanged resources (i.e., capital) to leverage these strengths for success. It was indicated by participants that whilst they entered the field of higher education with little formal 'know-how', through a strong sense of identity and motivation they developed strategies to succeed. Of significance, these processes occurred with little institutional assistance. [ABSTRACT FROM AUTHOR]

Aim: To examine the mediators between lower socio‐economic status (SES) in adolescence and oral health at an older age to uncover the underlying mechanisms of the association. Methods: Participants (n = 21 536) aged ≥65 years from the Japan Gerontological Evaluation Study were evaluated. The dependent variables were self‐rated chewing difficulty and having ≤19 remaining teeth. The main independent variable was self‐perceived SES in adolescence. The Karlson–Holm–Breen method was used for mediation analysis. Results: Mean age of the participants was 74.8 years (standard deviation = 6.4), and 51.5% were female. Overall, 5598 (26.0%) participants reported chewing difficulty and 9404 (43.7%) had ≤19 remaining teeth. Lower SES in adolescence was associated with a higher prevalence of chewing difficulty (odds ratio [OR] = 1.38, 95%confidence interval [CI] = 1.29–1.48; total effect). After controlling for mediators, OR for lower SES in adolescence was 1.22 (95%CI = 1.13–1.30; direct effect) and 1.13 (95%CI = 1.11–1.16; indirect effect). Mediators, prominently the number of teeth and income, explained 39.3% of the associations. Lower SES in adolescence increased the odds of ≤19 remaining teeth by OR = 1.23 (95% CI = 1.16–1.31; total effect). After controlling for mediators, the OR for lower SES in adolescence was 1.03 (95%CI = 0.97–1.10; direct effect) and 1.19 (95%CI = 1.16–1.23; indirect effect). Mediators, prominently educational attainment, explained 85.0% of the associations. Conclusions: Lower SES in adolescence was associated with poor oral health at an older age through mediators. Approaches that consider social determinants from the beginning of the life course are required. [ABSTRACT FROM AUTHOR]

The influence of kin on various outcomes is heavily debated. However, kinship size itself conditions the probability of potential effects. Socio-economic gradients in the prevalence, variance, and types of kin are, therefore, a vital aspect of the functions of kin. Unfortunately, these parameters are largely unknown. We used Swedish register data to enumerate consanguine and in-law kin across the life course of the 1975 birth cohort. We calculated differences in kinship size between this cohort’s income quartiles and educational groups. We decomposed how specific kin relations, generations, and demographic behaviours contributed to these differences. Among low socio-economic status (SES) groups, higher fertility in earlier generations resulted in more kin compared with high-SES groups. Low-SES groups had more horizontal consanguine kin, while high-SES groups had more in-laws. Lower fertility and higher union instability among low-SES men substantially narrowed SES differences in kinship size. Kinship size varied substantially within SES groups. [ABSTRACT FROM AUTHOR]

Introduction: The health and well-being of adolescent girls are of paramount importance for their overall development and the progress of any society. The present study was aimed to assess the Socio economic and health status of adolescent girls in the rural area of Khammam. Materials and methods: A Community based cross-sectional study conducted during October 2018 to September 2020. The study was carried out among 600 adolescent girls residing in the rural area of Khammam. Results: The age group of adolescent girls in the present study was between 10-19 years. The mean age of study subjects was 14.5±2.87 years. In the present study, 44.34 % and 9.33 % of the girls belonged to lower middle class and upper middle-class of socio-economic status. Various surgeries were done in the subjects; there were multiple responses by the participants for the given morbidities. Numbers of morbidities maximum four were observed per person in the study. Conclusion: The study identified common morbidities among adolescent girls in rural Khammam, These insights contribute to understanding the health conditions and needs of adolescent girls in rural Khammam. [ABSTRACT FROM AUTHOR]

Much previous international research has demonstrated links between general school attainment and active engagement with music. The research reported here compared the change in examination outcomes in English and mathematics in national examinations at ages 11 and 16 of instrumentalists and non-instrumentalists. Data from 701 pupils showed statistically significant differences in examination outcomes between instrumentalists and non-instrumentalists, which was also related to the duration of learning and the instrument played. Instrumentalists had greater change scores in mathematics, but not English, although instrumentalists of lower socio-economic status showed greater change in both subjects. The implications for music education are discussed. [ABSTRACT FROM AUTHOR]

Background: Few family interaction processes are more detrimental to children's health than family conflicts. Conflictual relationships in childhood predict a host of adverse health outcomes across the life course. The current study examines associations between household conflicts and the health of children aged 6–12 years and explores to which extent this may vary by socioeconomic status (SES) and multimorbidity (MM) in the household. Methods: Cross‐sectional study using questionnaire data gathered between 2016 and 2020 as part of the Lolland‐Falster Health Study (LOFUS) combined with routine register data on health care use and socio‐demography from the Danish nationwide administrative databases. The study sample consisted of 1065 children 6–12 years old, who answered LOFUS4 or LOFUS11, from 777 households for which at least one adult answered LOFUS18. Main outcome was children's health complaints, defined as headache, abdominal pain, back pain, and sleep difficulties. Covariates included MM, SES, and conflicts, all three measured at household level. Multivariable logistic regression models were used. Results: Conflicts were negatively associated with children's health. This was most pronounced for general conflicts in the household, with increased complaints of abdominal pain, back pain, and sleep difficulties. The associations varied when we stratified the households according to MM and SES. Significant associations were found within households without MM for abdominal pain, and within households with MM and low SES, and without MM and with high SES for sleep difficulties. While the higher level of abdominal pain for the above indicated households were found for both internal and external conflicts in the household, the higher level in sleep difficulties was mostly driven by internal conflicts. Conclusion: Children reporting frequent health complaints have a higher future health care use compared with children without such complaints. Our results indicate that growing up in a household with a high conflict level might be a predisposing factor. [ABSTRACT FROM AUTHOR]

To evaluate how educational, economic, and racial residential segregation may impact congenital heart disease infant mortality (CHD-IM). This is a population-based US ecological study. This study evaluated linked live birth-infant death files from the National Center for Health Statistics for live births from 2006 to 2018 with cause of death attributed to CHD. Maternal race and education data were obtained from the live birth-infant death files, and income data were obtained from the American Community Survey. A spatial social polarization measure termed the Index of Concentration at the Extremes (ICE) was calculated and split by quintiles for maternal education, household income, and race for all US counties (n = 3142). The lowest quintile represents counties with highest concentration of disadvantaged groups (income < $25K, non-Hispanic Black, no high school degree). Proximity to a pediatric cardiac center (PCC) was also analyzed in a categorical manner based on whether each county was in a metropolitan area with a US News and World Report top 50 ranked PCC, a lower ranked PCC, or not proximal to any PCC. Between 2006 and 2018, 17,489 infant deaths were due to CHD, an unadjusted CHD-IM of 0.33 deaths per 1000 live births. The risk of CHD-IM was 1.5 times greater among those in the lowest ICE-education quintile (0.41 [0.39–0.44] vs 0.28 deaths/1000 live births [0.27–0.29], P < 0.0001) and the lowest ICE-income quintile (0.44 [0.41–0.47] vs 0.29 [0.28–0.30], P < 0.0001) in comparison to those in the highest quintiles. CHD-IM increases with higher ICE-race value (counties with a higher concentration of non-Hispanic White mothers). However, after adjusting for proximity to a US News and World Report top 50 ranked PCC in the multivariable models, CHD-IM decreases with higher ICE-race value. Counties with the highest concentration of lower-educated mothers and the highest concentration of low-income households were associated with higher rates of CHD-IM. Mortality as a function of race is more complicated and requires further investigation. [ABSTRACT FROM AUTHOR]

Personal identity formation is a key developmental task of adolescence, with the educational domain being a core life domain. Parents are gatekeepers of adolescent career development but their role in facilitating educational identity formation still needs to be uncovered. The present study investigated developmental trajectories of educational identity processes (commitment, in-depth exploration, and reconsideration of commitment) across two academic years. Educational identity processes, parental socio-economic status, and parental career-related behaviors (support, interference, lack of engagement) were appraised through a four-wave longitudinal study with 5- to 6-month intervals (N = 744; M a ge = 15.2 years, 55% girls). Results of the latent class growth analysis revealed five educational identity trajectories (i.e., Undifferentiated, Searching moratorium, Foreclosed, Diffusion, and Achievement). Commitment and in-depth exploration processes were stable for all five trajectories. The undifferentiated trajectory (medium stable levels for all identity processes) was the most prevalent. Parental socio-economic status and perceived parental support correlated positively with achievement and searching moratorium trajectories and negatively with diffused and undifferentiated trajectories. Foreclosed adolescents perceived their parents as the most engaged. Trajectories characterized by high reconsideration of commitment also correlated the most with perceived parental interference. The results bring forward valuable insights into the role parents play in their adolescents' educational identity development. [ABSTRACT FROM AUTHOR]

Background: Pakistan, the world's sixth most populous country and the second largest in South Asia, is facing challenges related to reproductive, maternal, newborn and child health (RMNCH) that are exacerbated by various inequities. RMNCH coverage indicators such as antenatal care (ANC) and deliveries at health facilities have been improving over time, and the maternal mortality ratio (MMR) is gradually declining but not at the desired rates. Analysing and documenting inequities with reference to key characteristics are useful to unmask the disparities and to amicably implement targeted equity-oriented interventions. Methods: Pakistan Demographic Health Survey (PDHS) based UHC service coverage tracer indicators were derived for the RMNCH domain at the national and subnational levels for the two rounds of the PDHS in 2012 and 2017. These derivations were subgrouped into wealth quintiles, place of residence, education and mothers' age. Dumbbell charts were created to show the trends and quintile-specific coverage. The UHC service coverage sub-index for RMNCH was constructed to measure the absolute and relative parity indices, such as high to low absolute difference and high to low ratios, to quantify health inequities. The population attributable risk was computed to determine the overall population health improvement that is possible if all regions have the same level of health services as the reference point (national level) across the equity domains. Results: The results indicate an overall improvement in coverage across all indicators over time, but with a higher concentration of data points towards higher coverage among the wealthiest groups, although the poorest quintile continues to have low coverage in all regions. The UHC service coverage sub-index on RMNCH shows that Pakistan has improved from 45 to 63 overall, while Punjab improved from 50 to 59 and Sindh from 43 to 55. The highest improvement is evident in Khyber Pakhtunkhwa (KP) province, which has increased from 31 in 2012 to 51 in 2017. All regions made slow progress in narrowing the gap between the poorest and wealthiest groups, with particularly noteworthy improvements in KP and Sindh, as indicated by the parity ratio. The RMNCH service coverage sub-index gap was the greatest among women aged 15–19 years, those who belonged to the poorest wealth quintile, had no education, and resided in rural areas. Conclusions: Analysing existing data sources from an equity lens supports evidence-based policies, programs and practices with a focus on disadvantaged subgroups. [ABSTRACT FROM AUTHOR]

Research indicates that social capital can influence the extent to which socio-economic status (SES) and information and communications technology (ICT) affect mental health. This study uses empirical data to examine the veracity of this claim by examining the effect of SES and ICT use on the mental health of older persons in Ghana, as well as the moderating role of bonding (i.e. strong ties) and bridging (i.e. weak ties) social capital in these associations. Data were drawn from 409 older persons from four regions in Ghana as part of a broader cross-sectional survey. Ordinal logistic regression analyses showed that SES and ICT use had positive associations with mental health after adjusting for other socio-demographic factors. Bridging social capital modified the association between SES and mental health positively. Bonding social capital also moderated the relations between ICT use on mental health positively. We argue that the prevalent nature of resources embedded in strong ties and the diversity of support that emerge from weak ties account for the difference in their influence observed in this study. Thus, while advances in socio-economic and technological conditions can enhance older persons' mental health, equal attention must be paid to the characteristics of their strong and weak ties as they possess the resources to make socio-technological policies even more meaningful. [ABSTRACT FROM AUTHOR]

The article presents the contribution of socio-demographic, socio-economic, employment status and level of education of parents/guardians to students' school success. The aim of this article is to discover the causes of school (un)success given the contribution of predictor variables. The predictor set of variables consists of four scales: socio-demographic status (total number of brothers, total number of sisters, marital status of parents, distance from home to school and number of members households), socio-economic status (total monthly income of parents/guardians, place to study in the house/apartment, possession of laptop/computer, constant internet access in the house/apartment and the way they come to school), employment status of parents/guardian and educated status of parent/guardian. In addition to the set of predictors, a criterion variable was used, which consists of three dimensions, namely school success at the end of the sixth, seventh and eighth grade of primary school. The results of the research confirm a statistically significant correlation between sociodemographic, socio-economic, employment status and the level of education of parents/guardians and school success of children, provided that socio-demographic status has a higher predictive power on students' school success. It was confirmed that students have a positive attitude about the importance of the grade as well as that they perceive that their parents have the same attitude. [ABSTRACT FROM AUTHOR]

Objective: Low childhood socio-economic status (SES) and adverse childhood experiences (ACE) are associated with poor health outcomes in adulthood. Determining how ACE may be linked to food insecurity among young people from socio-economically diverse households can inform health-protective strategies. This study examined if ACE are associated with food insecurity during the transition to adulthood and investigated prevalence differences across SES strata. Setting: Participants were recruited from twenty secondary schools in Minneapolis-St. Paul, Minnesota. Participants: The analytic sample (n 1518) completed classroom surveys in 2009–2010 (mean age = 14·5 years) and follow-up surveys in 2017–2018 (mean age = 22·0 years). Design: Past-year food insecurity was reported at both time points, and ACE were reported at follow-up. Logistic regression models were used to estimate emerging adult food insecurity prevalence by ACE exposure; models were stratified by childhood SES (low, middle and high). Results: The adjusted prevalence of food insecurity was 45·3 % among emerging adults who reported three or more ACE compared with 23·6 % among those with one or two ACE and 15·5 % among those with no ACE (P < 0·001). All forms of ACE were related to an elevated prevalence of food insecurity in emerging adulthood. ACE–food insecurity associations were strongest for emerging adults from lower and middle SES households. Among emerging adults from low SES households, childhood experiences of emotional abuse and substance use by a household member were associated with the largest prevalence differences in food insecurity. Conclusions: Findings suggest a need for trauma-informed services within food assistance programs to better serve individuals with a history of ACE. [ABSTRACT FROM AUTHOR]

By relying on longitudinal data on two rural parishes in the Russian Baltic province of Livland, the article analyses two questions concerning famine's short‐run effects on mortality in a manorial system: (1) whether there is evidence of a social gradient in mortality during the famine of 1844–6 and (2) whether the manors could protect the peasants against the hardships. The analysis reveals that neither the status of a farmer peasant nor the landlord saved the local inhabitants from an increased risk of dying during the famine of 1844–6. The conventional assumptions about the protective effect of the higher socio‐economic status or type of manor against subsistence crisis found very little support in the study. [ABSTRACT FROM AUTHOR]

The aim of this study is to provide evidence to support the measurement of psychological concepts of family functioning in Slovakia. The first objective was to verify the psychometric properties of two scales assessing family quality of life and family satisfaction: the Beach Center Family Quality of Life Scale (BFQOLS) and the Family APGAR in people from a standard population (without disabilities). The second objective was to determine the relationship between family quality of life and family satisfaction with life satisfaction, self-esteem, income, and socio-economic status. The sample of participants comprised 499 adult respondents from Slovakia, 250 men and 249 women aged 18–60 years. In addition to the BFQOLS and the Family APGAR, scales were used to measure socioeconomic status, self-esteem, and satisfaction with life. As the results indicate, the factor structure of scales with acceptable fit indices was confirmed using confirmatory factor analysis. The scales showed good reliability and further analyses appear to support convergent and discriminatory validity of the scales. Based on the results obtained, the Slovak translation of the scales can be recommended for further verification and use in the standard population (without disabilities). [ABSTRACT FROM AUTHOR]

Background Incidence of end-stage renal disease (ESRD) is higher in Israel than the European average. Socio-economic differences in ESRD have been reported globally, but many countries lack a national register. Using national data, we assessed which socio-demographic factors are associated with 5-year incidence of ESRD in Israel, where there is universal access to renal replacement therapy (RRT). Methods Data on all incident ESRD cases aged ≥20 years receiving chronic RRT between 1 January 2014 and 31 December 2018 (N  = 7883) were collected from Israel's National Dialysis & Renal Transplant Register. Individual-level data on ESRD cases requiring RRT included residential area, age, gender, ethnicity (Jewish or Arab) and ESRD cause (diabetes, other, unknown/missing). Area-level data included age and sex distribution, socio-economic status (SES) and proportion of Arab population. The associations between individual-level socio-demographic characteristics and ESRD cause were tested in bivariate comparisons. The risk of developing ESRD during the study period (from all and specific causes) was estimated using multiple Poisson regression models with negative binomial distribution, using four parameters, namely sex, ethnicity, SES category and age strata, based on area-level distribution of these parameters, and with the whole population (aged ≥20 years) as the denominator. Results A socio-economic gradient was seen for ESRD from all causes, more marked for diabetic aetiology [rate ratio (RR)=0.45, 95% CI: 0.39–0.52 highest vs lowest SES categories] than from other (RR = 0.64, 95% CI: 0.55–0.75) or unknown cause (RR = 0.79, 95% CI: 0. 62–0.99). Based on population area-level data, predominantly Arab neighbourhoods showed higher risk for ESRD requiring RRT for all causes, with the strongest association for diabetes (RR = 1.69, 95% CI: 1.53–1.86) adjusted for SES, age and sex. Conclusions A strong socio-economic gradient was demonstrated for ESRD requiring RRT. Arab ethnicity was associated with higher risk for ESRD, especially due to diabetes. Our findings suggest the need for allocation of health resources according to needs and culturally appropriate interventions for improving control of modifiable risk factors for chronic renal failure. [ABSTRACT FROM AUTHOR]

While the health risks of Covid-19 for young people are low, they have borne a heavy cost of the pandemic through intense disruption to their education and social lives. These effects have not been experienced equally across social and demographic groups. Using data from a nationally representative survey of 4,000 young people in England linked to their education records, we study inequalities in late adolescents' experiences of the Covid-19 pandemic. We find particularly stark inequalities by socio-economic status, with those from poorer families facing disadvantage on multiple fronts, particularly in their experiences of home learning, returning to school, and exam cancellations compared to their more advantaged peers. Gender and ethnic inequalities were more mixed, though young females reported significantly lower wellbeing scores than males. This evidence suggests that the pandemic has exacerbated existing inequalities, meaning policymakers concerned with increasing equity and social mobility now face an even bigger task than before. [ABSTRACT FROM AUTHOR]

Aims: Studies of social inequality and risk of developing type 1 diabetes are inconsistent. The present review aimed to comprehensively review relevant literature and describe what has been reported on socio‐economic status or parental occupation and risk of type 1 diabetes in children. Methods: We searched for publications between 1 January 1970 and 30 November 2021. We focused on the most recent and/or informative publication in cases of multiple publications from the same data source and referred to these as primary studies. Results: Our search identified 69 publications with relevant data. We identified eight primary cohort studies with individual‐level data, which we considered the highest quality of evidence. Furthermore, we identified 13 primary case–control studies and 14 semi‐ecological studies with area‐level socio‐economic status variables which provided a weaker quality of evidence. Four of eight primary cohort studies contained data on maternal education, showing non‐linear associations with type 1 diabetes that were not consistent across studies. There was no consistent pattern on the association of parental occupation and childhood‐onset type 1 diabetes. Conclusions: There is a need for more high‐quality studies, but the existing literature does not suggest a major and consistent role of socio‐economic status in the risk of type 1 diabetes. [ABSTRACT FROM AUTHOR]

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The stage of pregnancy is crucial for women of reproductive age and their families. However, in low- and middle-income countries like Bangladesh, antenatal and postnatal care are not widely practiced due to various socio-economic factors, such as low education levels, income, age, pregnancy knowledge, and limited healthcare facilities. The objective of this study was to examine the factors associated with antenatal care in two locations in Bangladesh based on the data collected from the Bangladesh Demographic and Health Survey (BDHS) 2017–2018. We explored different variables as explanatory variables related to ANC service. The results showed that most of the respondents were from rural areas, with 77.02% receiving antenatal care at home. Women with secondary education were more likely to receive care at home than those without education. The Chi-square test indicated a positive correlation between antenatal care at home with several variables, whereas, in the case of Upazila health complexes, only three variables showed a positive association. Logistic regression analysis further showed some specific variables such as geographical division, religion, iron intake during pregnancy, and reporting pregnancy complications had a significant impact on ANC at home. In contrast, covariates such as residence, division, and wealth index were significant for antenatal care at Upazila health complexes. The division was a significant covariate in both cases. Interestingly, we observed that mothers who had been informed about the signs of pregnancy complications were 92% more likely to receive antenatal care at home than those who had not experienced pregnancy complications. Conversely, the results revealed that mothers who were unaware of pregnancy complications were 32% more likely to receive antenatal care at home than those who had been informed about complications. This suggests that when women are educated about pregnancy complications, they are more likely to receive more antenatal care. However, Bangladesh's situation is quite different due to a lack of proper education and knowledge of antenatal care services.

There are unexpectedly a few statistics about the socio-economic status (SES) and related socio-demographic factors (SDFs) of parents having child with ASD in Bangladesh. The prevalence of ASD might correlate with SES and related SDFs. A case-control study was conducted in 24 locations across 21 districts, encompassing all divisions, to assess the association between SES and the risk of developing ASD in Bangladesh. The structured questionnaire was administered through face-to-face interviews with 620 parents of the subject (310 ASD and 310 healthy controls) from January 2020 to June 2021. For univariate, bivariate and multivariate analyses, IBM SPSS version 23 was employed. The significance level was set at P ≤ 0.05, and the Odds Ratio (OR) within a 95 % CI was used to determine whether the variable poses a higher odd or not. After adjusting all significant covariates of binary logistic regression (including some dummy variables) in forward logistic regression model analysis, the higher level of SES, advanced level of father’s education (≥master), 22–35 years old age group of the father, and nuclear family were strongly associated with decreased odds of ASD compared to healthy controls. Only the male gender was strongly associated with an increased odds of ASD compared to the control. The results will aid policymakers in developing plans considering the SES and related SDFs that influence the risk of developing ASD in Bangladesh. Further research using population-based cohorts or nested case-control designs with matched control is necessary to observe and generalize the association.

The lack of physical activity was one of the causes of several health problems and deaths whose prevalence was increasing throughout the world. University was a gathering place for all university members including students, lecturers and teaching staff who were at risk of low physical activity and other lifestyle behaviors. Penelitian ini bertujuan untuk mengetahui hubungan indeks massa tubuh (IMT), status sosial ekonomi dan motivasi terhadap aktivitas fisik pada usia produktif di Universitas ‘Aisyiyah Yogyakarta. A cross-sectional method was used, and a random sampling technique was taken. The sample was 380 respondents with an age range of 20-59 years. Data analysis used the chi square test to determine the relationship between physical activity and its determinants and logistic regression to determine the predictors of physical activity. Based on 380 respondents, 47.2% were in the inactive category with an average of Metabolic Equivalent Task (METs)= 402.56 ± 121,140 and duration = 88.67 ± 59,600 per minute per week. There was a significant correlation between age, occupation, body mass index (BMI), motivation, availability of sports facilities with physical activity. Based on multivariate analysis, it was found that BMI, age and motivation had an influence on physical activity. The level of physical activity among university members was still low and there was a need for university strategies to increase knowledge and behavior to become an active campus with healthy campus campaigns, organizing health checks, championships between campus sports clubs and other strategies.

Abstract Background Socioeconomic status has long been associated with population health and health outcomes. While ameliorating social determinants of health may improve health, identifying and targeting areas where feasible interventions are most needed would help improve health equity. We sought to identify inequities in health and social determinants of health (SDOH) associated with local economic distress at the county-level. Methods For 3,131 counties in the 50 US states and Washington, DC (wherein approximately 325,711,203 people lived in 2019), we conducted a retrospective analysis of county-level data collected from County Health Rankings in two periods (centering around 2015 and 2019). We used ANOVA to compare thirty-three measures across five health and SDOH domains (Health Outcomes, Clinical Care, Health Behaviors, Physical Environment, and Social and Economic Factors) that were available in both periods, changes in measures between periods, and ratios of measures for the least to most prosperous counties across county-level prosperity quintiles, based on the Economic Innovation Group’s 2015–2019 Distressed Community Index Scores. Results With seven exceptions, in both periods, we found a worsening of values with each progression from more to less prosperous counties, with least prosperous counties having the worst values (ANOVA p

Background: Cadavers are essential for anatomical education, yet their scarcity plagues medical colleges in Kerala and India. However, the Government Medical College in Thrissur has experienced a rise in annual body donations. Aims and Objectives: This study aims to explore the motivating factors behind this increase among the population of Thrissur. Materials and Methods: This study employed a cross-sectional survey design conducted at the Department of Anatomy, Government Medical College in Thrissur, Kerala. The study utilized data from the Body Donation Register, which covered a period from May 1st, 2011 to April 30th, 2012, encompassing a total of 223 individuals. During this specific period, which was selected due to the notable surge in body donation trends, there was a significant increase observed. The sample size was set at 110 participants. Data collection was conducted through face-to-face interviews with the voluntary body donors and was analyzed using the statistical package for the social sciences, version 16.0. Results: Gender distribution: Among 120 donors, 56.7% were male and 26.7% were female. Age groups 61–70 had the highest percentage (36%) of body donors. Socioeconomic status: the majority were above the poverty line (78.2%). Religious affiliation: Hindus had the largest representation (40 individuals). Marital status: Most donors were married (92 out of 110). Number of children: Most donors had two children (64 individuals). Sources of information: Family and relatives were the primary sources. Awareness of dissection: An equal number of donors were aware and unaware. Motivations for donation varied, including social service and avoiding burden after death. Conclusion: A good proportion of donors had a socioeconomic status above the poverty line, and most of them were graduates or postgraduates. The majority of body donors did not have a religious affiliation. However, they had a strong family background and received support from their families. Interestingly, most of the donors were unaware of how their bodies would be used after donation.

Abstract Objective: The purpose of this study is to determine if healthier neighbourhood food environments are associated with healthier diet quality. Design: This was a cross-sectional study using linear regression models to analyse data from the Maastricht Study. Diet quality was assessed using data collected with a FFQ to calculate the Dutch Healthy Diet (DHD). A buffer zone encompassing a 1000 m radius was created around each participant home address. The Food Environment Healthiness Index (FEHI) was calculated using a Kernel density analysis within the buffers of available food outlets. The association between the FEHI and the DHD score was analysed and adjusted for socio-economic variables. Setting: The region of Maastricht including the surrounding food retailers in the Netherlands. Participants: 7367 subjects aged 40–75 years in the south of the Netherlands. Results: No relationship was identified between either the FEHI (B = 0·62; 95 % CI = –2·54, 3·78) or individual food outlets, such as fast food (B = –0·07; 95 % CI = –0·20, 0·07) and diet quality. Similar null findings using the FEHI were identified at the 500 m (B = 0·95; 95 % CI = –0·85, 2·75) and 1500 m (B = 1·57; 95 % CI = –3·30, 6·44) buffer. There was also no association between the food environment and individual items of the DHD including fruits, vegetables and sugar-sweetened beverages. Conclusion: The food environment in the Maastricht area appeared marginally unhealthy, but the differences in the food environment were not related to the quality of food that participants reported as intake.

Abstract Background While the human oral microbiome is known to play an important role in systemic health, its average composition and diversity patterns are still poorly understood. To gain better insights into the general composition of the microbiome on a global scale, the characterization of microbiomes from a broad range of populations, including non-industrialized societies, is needed. Here, we used the portion of non-human reads obtained through an expanded exome capture sequencing approach to characterize the saliva microbiomes of 52 individuals from eight ethnolinguistically diverse southern African populations from Angola (Kuvale, Kwepe, Himba, Tjimba, Kwisi, Twa, !Xun) and Zimbabwe (Tshwa), including foragers, food-producers, and peripatetic groups (low-status communities who provide services to their dominant neighbors). Results Our results indicate that neither host genetics nor livelihood seem to influence the oral microbiome profile, with Neisseria, Streptococcus, Prevotella, Rothia, and Porphyromonas being the five most frequent genera in southern African groups, in line with what has been shown for other human populations. However, we found that some Tshwa and Twa individuals display an enrichment of pathogenic genera from the Enterobacteriaceae family (i.e. Enterobacter, Citrobacter, Salmonella) of the Proteobacteria phylum, probably reflecting deficient sanitation and poor health conditions associated with social marginalization. Conclusions Taken together, our results suggest that socio-economic status, rather than ethnolinguistic affiliation or subsistence mode, is a key factor in shaping the salivary microbial profiles of human populations in southern Africa.

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder affecting children and causing significant impairment. It is not clear to what extent ADHD differs between population groups. This study aims to assess prevalence, diagnosis and treatment of ADHD among Arab and Jewish children of primary school age in Israel. Methods Cross-sectional survey, including 517 parents of children ages 7–10 (225 Jewish and 292 Arab) and 60 homeroom teachers of the corresponding children. Both parents and homeroom teachers completed the ADHD Rating Scale-V-RV. ADHD was defined according to DSM-5 ADHD criteria by both parents and teachers, or clinical diagnosis. In addition, parents reported ADHD medication and adherence to medication. Results Prevalence of ADHD was similar for both groups. Yet, seeking diagnosis was lower among Arab Muslim children (9.2%) compared to Jewish children (17.8%). Arab Muslim children received significantly less medication compared to Jewish children. Parental decision to seek diagnosis was associated with education (OR = 6.14, CI 1.74–21.71), not ethnicity. Ethnicity predicted parents’ decisions to pharmacologically treat their children with ADHD (OR = 7.61, CI 1.14–50.86) and adherence to medication (OR = 10.19, CI 1.18–88.01). Conclusion Education is critical in the help-seeking process, affecting the rate of ADHD diagnosis. Pharmacological treatment and adherence are correlated with ethnicity. Parents with limited education and minorities should be targeted for interventions to increase awareness regarding ADHD and treatment.