Analysis of influencing factors and trend prediction based on quantile regression and GM(1, 1) model

Obesity has emerged as an epidemic worldwide. The present study was conducted to assess the prevalence of overweight and obesity amongst children in the age group of 5-18 years belonging to low, middle and high income group in National Capital Territory NCT of Delhi. A total of 16,595 children (LIG 5087, MIG 5134 and HIG 6368) were covered in the present study. Overweight and obesity were assessed using Body Mass Index (BMI) and Triceps Skin Fold Thickness (TSFT) utilizing age and sex specific cut off points. Considering the BMI cut off points, the prevalence of obesity and overweight in Low Income Group (LIG) school children was 0.1 and 2.7 percent respectively, amongst Middle Income Group (MIG) school children it was 0.6 and 6.5 percent and in High Income Group (HIG) school children was 6.8 and 15.3 percent respectively (p<0001). With regard to the TSFT criteria, the prevalence of obesity and overweight in LIG school children was 1.2 and 2.4 percent, amongst MIG school children it was 2.5 and 4.9 percent and in children belonging to HIG schools was 9.3 and 13.1 percent respectively (p<0.001). The present study documented that the prevalence of overweight and obesity was higher in the HIG children as compared to the MIG and the LIG for all age groups, highlighting the possible role of change in the dietary pattern and physical activities with increase in income levels.

China's rapid socioeconomic growth in recent years and the simultaneous increase in many forms of pollution are generating contradictory pictures of residents' well-being. This paper applies multilevel analysis to the 2013 China General Social Survey data on social development and health to understand this twofold phenomenon. Multilevel models are developed to investigate the impact of socioeconomic development and environmental degradation on self-reported health (SRH) and self-reported happiness (SRHP), differentiating among lower, middle, and higher income groups. The results of the logit multilevel analysis demonstrate that income, jobs, and education increased the likelihood of rating SRH and SRHP positively for the lower and middle groups but had little or no effect on the higher income group. Having basic health insurance had an insignificant effect on health but increased the likelihood of happiness among the lower income group. Provincial-level pollutants were associated with a higher likelihood of good health for all income groups, and community-level industrial pollutants increased the likelihood of good health for the lower and middle income groups. Measures of community-level pollution were robust predictors of the likelihood of unhappiness among the lower and middle income groups. Environmental hazards had a mediating effect on the relationship between socioeconomic development and health, and socioeconomic development strengthened the association between environmental hazards and happiness. These outcomes indicate that the complex interconnections among socioeconomic development and environmental degradation have differential effects on well-being among different income groups in China.

A questionnaire based survey of three hundred families from Udaipur city was performed to know their consumption pattern of Gheeanhydrous milk fat. The respondents were divided into Low income group (LIG), Middle income group (MIG) and High income group (HIG) based on their total family income. It was observed 34.3%, 30.0%, 35.7% of these families were from LIG, MIG, HIG respectively. Out of these families 5 were those which did not consumed ghee at all while 7 families were those consuming hydrogenated fat partially. Monthly consumption analysis revealed that majority of three income groups consumed 3 kg / month consumption was observed in MIG and HIG families. Where as on basis of per capita per day consumption in majority families from all three income groups it was less than 20 g per day which is the normal range for the ghee consumption as recommended by NNMB. Evaluation of purchasing of practice of ghee showed that most the LIG and MIG families purchased ghee as and when required, while majority of families of HIG purchased ghee on monthly basis. The purchase in bulk i.e. 15 kg was also correlated to the socio economic status and was prevalent in HIG families. Branded ghee was mostly preferred by HIG families where as in LIG families Homemade ghee was preferred. It was observed that choice for specified brands was 83.4% where as only 18.9% families were for no specific choice of branded ghee. Awareness related to Agmark certification on ghee was observed in majority of HIG families while awareness was lowest in LIG families. Amongst various food items ghee usage found highest score for chapati (88.7%, 76.7%, 93.5%) followed by sweets (38.8%, 58.9%, and 80.4%) in all three income groups LIG, MIG and HIG respectively.

BACKGROUNDThere are only a few studies on the influence of economic inequalities on young-onset type 2 diabetes (T2D).AIMTo examine the impact of different family incomes on the development of young-onset T2D.METHODSWe identified 7505336 young adults aged 20-39 years from the 2008 Taiwan National Health Insurance Research Database. The young adults were divided into low-income, middle-income, and high-income groups. Cox proportional hazards models were used to determine the risks of young-onset T2D and all-cause mortality in low-income and middle-income groups compared with the high-income group.RESULTSWith a mean follow-up of 8.0 years, the incidence rates of young-onset T2D were 3.39, 3.10, and 2.88 per 1000 person-years in the low-income, middle-income, and high-income groups, respectively. Compared with the high-income group, the risk of young-onset T2D was significantly higher in the low-income [adjusted hazard ratio (aHR) (95%CI): 1.46 (1.44–1.48)] and middle-income [aHR (95%CI): 1.29 (1.27–1.31)] groups. All-cause mortality was also higher in the low-income [aHR (95%CI): 2.79 (2.70–2.88)] and middle-income [aHR (95%CI): 1.59 (1.53–1.65)] groups. Older age, male sex, obesity, smoking, alcohol-related disorders, hypertension, dyslipidemia, gout, and psychotic disorders were significantly associated with increased risks of both young-onset T2D and mortality.CONCLUSIONThis nationwide cohort study demonstrated that young people from low-income and middle-income groups had a higher risk of youth-onset T2D and mortality than those from the high-income group.

Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear. Using data from the National Population Health Survey and the Canadian Community Health Survey, we examined national trends in heart disease, hypertension, diabetes mellitus, obesity and smoking prevalence from 1994 to 2005, adjusting for age and sex. We stratified data by income adequacy category, body mass index and region of residence. An estimated 1.29 million Canadians reported having heart disease in 2005, representing increases of 19% for men and 2% for women, relative to 1994. Heart disease increased significantly in the lowest income category (by 27%), in the lower middle income category (by 37%) and in the upper middle income category (by 12%); however, it increased by only 6% in the highest income group. Diabetes increased in all but the highest income group: by 56% in the lowest income group, by 93% in the lower middle income group and by 59% in the upper middle income group. Hypertension increased in all income groups: by 85% in the lowest income group, by 80% in the lower middle income group, by 91% in the upper middle income group and by 117% in the highest income group. Obesity also increased in all income groups: by 20% in the lowest income group, by 25% in the lower middle income group, by 33% in the upper middle income group and by 37% in the highest income group. In addition to socio-economic status, obesity and overweight also modified the trends in risk factors. Diabetes increased to a greater extent among obese participants (61% increase) and overweight participants (25% increase), as did hypertension, which increased by 80% among obese individuals and by 74% among overweight individuals. Trends in diabetes, hypertension and obesity were consistent for all provinces. During the study period, heart disease, hypertension, diabetes and obesity increased for all or most income groups in Canada. Further interventions supporting modification of lifestyle and risk factors are needed to prevent future cardiovascular disease.

The metabolic syndrome is a complex condition in which numerous aspects of normal metabolism are perturbed. The syndrome represents a cluster of the major risk factors for cardiovascular disease i.e. obesity, insulin resistance / hyperinsulinemia, impaired glucose tolerance / diabetes, dyslipidemia and hypertension. The syndrome is also described by a procoagulant state that is attributed, in part, to an elevation in circulating lipoprotein, fibrinogen and plasminogen activator inhibitor one levels. This in turn contributes to the metabolic abnormalities that lead to cardiovascular disease. Several hypothesis have been proposed for the etiology of the metabolic syndrome, and the potential role of insulin resistance, leptin resistance, and other disturbances as major contributing factors. Hyperinsulinemia and insulin resistance are predictors of type 2 diabetes and are key factors in the development of the metabolic syndrome. A survey was conducted to study the clinical correlation of metabolic syndrome in Indian type -2 diabetic patients with their socioeconomic status (high income group, middle income group & low income group) under different age group (upper age group, middle age group & low income group) in western Uttar Pradesh, India. Four hundred five type 2 diabetic patients aged 52 ±17 year including 215 (53.09%) males and 190 ( 46.91%) females were surveyed for this purpose. Of these hypertension & diabetics were simultaneously diagnosed in 196 (48.39%) & 152 (37.53%) patients. Family history of these patients showed the occurrence of diabetes , hypertension & concurrent hypertension with diabetes mellitus in about 59 (14.0%), 56 (13.8%) & 77 (19.1%) respectively. The frequencies of individual component of the metabolic syndrome were as follows: dyslipidemia - 68.4%, systemic hypertension - 54.3% , obesity - 42.5% microalbuminuria - 44.9% & hyperuracemia 58.3% . Ischemic heart disease (myocardial infarction) occurs in - 2.4%. Of these 405 diabetic studies, 278(68.2%) had metabolic syndrome victims occurs in the high income group & the low income group.

This study investigated the attribution of kinship responsibility by drawing on attribution theory of locus and controllability. The analysis draws on the actor versus observer model using income as an intervening variable. A cluster sampling technique resulted in a sample of 935 respondents. Analysis of covariance using gender as a covariate resulted in non-significant main effects. An interaction effect was statistically significant in the high income group who supported the attribution of responsibility of the government and the low and middle income groups who supported their parents. Social actors were more inclined to provide an attribution of the responsibility for elderly care to the government, whereas high income individuals than those in the middle and low income group.

<i>Background</i>: HIV/AIDS is one of the major diseases with multifaceted burdens; health, emotional and financial. After the introduction of the Antiretroviral Therapy (ART), HIV/AIDS became a chronic disease that requires long-term management thus competing with other day-to-day economic obligations of People Living with HIV/AIDS (PLWH). There have been limited studies assessing economic burden of accessing ART treatment vis-a-vis catastrophic health expenditure (CHE) in this environment. Therefore, this survey explores the CHE resulting from accessing ART treatment and identifying some of the predictors for CHE among PLWH in Lagos State, Nigeria. <i>Materials and methods</i>: This study was a descriptive cross-sectional, quantitative survey that was carried out among 217 consenting PLWH recruited from 15 Support groups in Lagos State, Nigeria. The data was collected using 29-items self-administered questionnaire (research assistants aided PLWH who cannot read or write) developed from the review of relevant literatures. The data were analyzed using SPSS version 20. Chi-square at p-value of < 0.05 was used to determine significance of factors associated with CHE. Results: Age of the respondents was 42.81±8.517 years. Female respondents were more than 70% (171) and about half of the respondents, 109 (50.2%) were married. Above half, 129 (59%), of the respondents attend drug pick-up sites for their ARVs monthly. Less than 60% of the respondents (mean annual income 1111.203±821.371 dollars) earn below $1000 annually with 41.2%, 39.0% and 19.8% of the respondents in low, middle and high income groups respectively. Only 5% of the PLWH expend $200 annually for refill of ARVs. Considering the global definition of CHE (health expenditure>10% of household consumption,) 40% of the surveyed respondents experienced CHE. Using chi-square to determine factors associated with CHE among respondents; occupation, income group and ARVs refill frequency were significant at P<0.05. However, the binary logistic regression identified formal occupation (aOR=0.025, 95% C.I=0.02-0.35, p-value=0.006), being in middle income group (aOR=0.007, 95% C.I=0.001-0.05, p-value=0.0001) and high income group (aOR=0.035, 95% C.I=0.10-0.12, p-value=0.0001) and visiting health care facility for ARVs refill bi-monthly (aOR=17.555, 95% C.I=4.64-66.40, p-value=0.0001) as predictors of CHE among respondents. Conclusions: The results of this survey revealed that having formal employment, belonging to middle and high income groups protects respondents from CHE while bi-monthly ARVs refill predisposes PLWH in this survey to CHE.

Between January 1980-February 1981, researchers enrolled 400 low and middle socioeconomic women who were pregnant (at least 12 weeks gestation) from 2 prenatal clinics in Shiraz, Iran to assess their dietary patterns, food consumption, and iron intake. 294 women attended the prenatal clinic at the Helal-Ahmar Maternity Hospital and 106 the prenatal clinic at the Hafez Hospital. The researchers determined food consumption by dividing household consumption by an adjusted household size which included caloric needs of various age groups. Pregnant women of higher income tended to consume rice (p.005), meat (p.0001), poultry (p.0001), and greens and herbs (p.0001) more so than low income women. The poorer a household was the more likely the pregnant woman would eat more bread (p.005). The same foods, except bread, were negatively associated with household size, however (at most p.002). All women consumed 28 mg/day of iron and total iron intake of low income women was comparable to that of higher income groups. The leading source of dietary intake was bread regardless of income group. Yet as income rose, the proportion of dietary iron from bread fell and that from meat and poultry rose. For example, bread provided 82.3% of dietary iron for the very low income group, but only provided 59.2% for the middle and high income group. On the other hand, meat and poultry only provided 3.7% for the very low income group, but 15.2% for the middle and high income group. Moreover 14.8% of pregnant women in the very low and low income groups were anemic compared to only 3.4% in the middle low and middle high income groups during 31-40 weeks gestation. Perhaps the iron in the diet of the more affluent women was more bioavailable than that in the diet of the less affluent women.

A study was conducted to assess the prevalence of obesity and its relationship with cardiovascular diseases (CVD) in women from low, middle and high income group. A total of 150 women in the age group of 40-50 years, belonging to low (LIG), middle (MIG) and high (HIG) income group were selected from sub-mountainous region of Hoshiarpur city. The Body Mass Index (BMI) criterion was used for the assessment of obesity. Twenty five normal (BMI 20-22.9 kg/m&lt;sup&gt;2&lt;/sup&gt;) and 25 obese (BMI ≥ 27.5 kg/m&lt;sup&gt;2&lt;/sup&gt;) women from each income group i.e. LIG, MIG and HIG were selected to study the relationship of obesity with CVD. The data on anthropometric measurements and blood lipid profile was collected. The obese subjects belonging to MIG and HIG were found to have higher risk factors of CVD such as total cholesterol, triglycerides was LDL as compared to subjects in LIG.

The study of the relationship between inflation and growth is important as it provides crucial information for policy decisions. In this study, we seek to investigate the short-run and long-run relationship between inflation and growth in 3 groups of countries: high income, low income and middle income groups using the Auto Regression Distributed Lag models. The MG (Mean Group) and PMG (Pooled Mean Group) estimations are applied in this analysis. The Hausman Test is conducted to decide between the MG and PMG estimators. The panel data take the period of 1960-2012. As the result, MG estimator is preferred by all the 3 groups of countries. The results provide the dynamic relationships (short-run and the long-run relationships) between the three variables tested. The highly significant error correction term in the low income and middle income group further confirms the existence of a stable long-run relationship. The long-run relationship exists in the high income group but it is not significant. Comparisons of the results across the three groups of countries have revealed deeper information on the relationship across different income levels.

Ventilation practice may be affected by economic variations, which might result in different outcomes to mechanically ventilated patients. We aimed to investigate the important effect of economic variations in patients with mechanical ventilation (MV) in China. We carried out a national prospective multicentre cross-sectional observational study over 1 month of all patients receiving invasive MV for more than 24 hours in 20 intensive care units (ICUs), including patient characteristics, practice of MV, weaning modalities and outcomes, including probability of weaning and survival. Based on the 2012 World Bank classification of counties, patients were divided into high-income and middle-income groups according to gross domestic product per capita in their province of origin. Of the 483 patients enrolled, 291 (60.2%) were from high-income provinces and 192 (39.8%) were from middle-income provinces. Tidal volume, peak pressure, plateau and driving pressure were significantly lower, and the proportion of patients receiving protective ventilation (71.1% vs. 59.9%, P=0.014) was significantly higher in the high-income group than in the middle-income group. The probability of weaning within 28 days was significantly greater in the high-income group than in the middle-income group (P=0.046). Patients in the high-income group had significantly higher median numbers of ventilator-free days within 14 and 28 days than those in the middle-income group (P<0.05). Although the patients did not differ in terms of their demographics, survival within 28 days was significantly higher in the high-income group than in the middle-income group (P=0.025). Driving pressure, positive end-expiratory pressure and spontaneous breathing trial were independently associated with hospital mortality. Important economic differences exist in the management of MV and patient outcomes. Higher income is associated with a higher proportion of protective ventilation, lower driving pressure, shorter weaning and better survival in mechanically ventilated patients in China.

Increasing the proportion of the middle income group is key to shrinking the income gap and developing an olive-shaped distribution structure in China. Data from the Chinese Social Survey for 2006 to 2013 show that the proportion of the middle income group oscillates between 27 percent and 28 percent. It is estimated that by 2020, we will have achieved an initial olive-shaped distribution structure (larger in the middle and smaller at each end) if the average income of the lower and lower middle income groups can be quadrupled and that of the middle and high income groups can be doubled. To achieve this aim, we need to ensure that residents’ incomes rise faster than GDP, continue large-scale poverty reduction, endeavor to improve the employment situation for college graduates and the new generation of migrant workers, improve the social security system, stabilize the price of goods and housing, and alleviate the pressure on the lower middle income group.

To assess sex-specific associations of educational and income levels with Type 2 diabetes mellitus. Logistic regression analyses (Canadian Community Health Survey, cross-sectional) adjusted for ethnicity, immigration, urban/rural, overweight/obesity, physical inactivity, smoking, chronic conditions and regular physician. Compared to women with some post-secondary education, Type 2 diabetes was more likely in both high school graduates without post-secondary education [odds ratio (OR) 1.27, 95% confidence interval (CI) 1.07-1.51] and high school non-completers (OR 1.73, 95% CI 1.47-2.04); among men, definitive conclusions in high school graduates without post-secondary education could not be drawn (OR 0.93, 95% CI 0.78-1.12), but Type 2 diabetes was more likely in high school non-completers (OR 1.26, 95% CI 1.08-1.48). Compared to women with the highest income, Type 2 diabetes was three times more likely in the lowest income group (OR 2.90, 95% CI 2.25-3.73), 2.53 times more likely in the low middle income group (OR 2.53, 95% CI 1.98-3.24) and 55% more likely in the high middle income group (OR 1.55, 95% CI 1.20-2.01). Among men, Type 2 diabetes was approximately 40% more likely in both the lowest (OR 1.41, 95% CI 1.10-1.80) and low middle income groups (OR 1.39, 95% CI 1.12-1.71); definitive conclusions in the high middle income group could not be drawn (OR 1.05, 95% CI 0.87-1.28). In women, Type 2 diabetes increased monotonically with lower educational and income levels; in men, Type 2 diabetes was concentrated in the least educated and least affluent. Our findings support the need for policies and practices that lower diabetes risk among the most disadvantaged women and men and moderately disadvantaged women.

Assessing the impact of local meteorological variables on surface ozone in Hong Kong during 2000–2015 using quantile and multiple line regression models