Household income among families with autistic children and youths in Canada: a cross-sectional matched cohort study

ObjectiveTo assess the proportion of, and reasons for, households not utilising the policy of free healthcare for children under 6 years of age (FCCU6) for hospitalisation with diarrhoea, and assess the risk of catastrophic expenditure for households that forgo FCCU6 and pay out of pocket.MethodsInvoices detailing insurance information and charges incurred from 472 hospitalised diarrhoeal cases in one paediatric hospital in Ho Chi Minh City were retrieved. Hospital charges and the utilisation of elective services were analysed for patients utilising and not utilising FCCU6. Associations between socio-economic factors with non-utilisation of FCCU6 were evaluated.ResultsOverall, 29% of patients were FCCU6 non-users. The FCCU6 non-users paid a median hospital charge of $29.13 (interquartile range, IQR: $18.57–46.24), consuming no more than 1.4% of a medium-income household's annual income. Seventy per cent of low-income FCCU6 non-users utilised less-expensive elective services, whereas only 43% of medium income patients and 21% of high-income patients did (P = 0.036). Patients from larger households and those with a parent working in government were more likely to use FCCU6.ConclusionsThe rate of FCCU6 non-usage in this study population was 29%. A significant proportion of those that did not use FCCU6 was from lower income households and may perceive a justifiable cost–benefit ratio when forgoing FCCU6. Although a single diarrhoeal hospitalisation is unlikely to induce a catastrophic expenditure, FCCU6 non-usage may disproportionately increase the risk of catastrophic expenditure for lower income households over multiple illnesses.

Objectives The purpose of this study was to investigate the inequality tendency of household medical expenditure distribution and associated factors with household catastrophic medical expenditure. Methods The current study analyzed the raw data of the Korean Health Panel over the years 2009 to 2014. Results The proportion of household medical expenditure to household income in 2014 was 16.9% in 1st income quartile, 9.7% in 2nd income quartile, 5.7% in 3rd income quartile, 4.1% in 4th income quartile, and 2.5% in 5th income quartile. The Gini coefficient for distribution of household medical expenditure was 0.548, 0.536, 0.533, 0.527, 0.523, 0.528 respectively between 2009 and 2014. The Gini coefficient for distribution of household medical expenditure according to income quartile was higher in lower income household than that of higher income household. The incidence rate of household catastrophic medical expenditure was higher when the total annual household income was lower, the age of the householder was older, the number of household members was smaller, the education level of the householder was lower, the healthcare coverage type was National Health Insurance, the householder had disability, and the prevalence rate of the chronic disease of the household was higher (p<0.05). Conclusions In consideration of above findings, there was inequality of household medical expenditure distribution and the household medical expenditure was higher when the total household income was lower. Therefore, a policy for vulnerable households should be established. Key words: Inequality, Household medical expenditure, Catastrophic medical expenditure

In the framework of this research, we assumed that digitalization is one of the factors influencing the growth of welfare of the population of Ukraine, the main criterion of which is the total household income. To confirm this hypothesis, we used general and unique methods of cognition, in particular comparative analysis and synthesis – in studying the dynamics of growth of total household income in Ukraine compared to other countries and determining the level of access to the Internet; regression analysis – in establishing the relationship between the determinants and the total income of households in Ukraine, etc. Using regression analysis, based on statistics for the period 2001-2019 on the total income of the population of Ukraine (Y) and the percentage of households with Internet connection (variable x), we hypothesized that digitalization has an impact on the level of total household income by detecting the dependence of Y on x. The parameters were estimated using the least-squares method at the specification stage, and even exponential regression was chosen. The statistical significance of the regression equation was verified using the coefficient of determination and Fisher’s test. It is established that in the studied situation, the general variability of the total average monthly income of households in Ukraine is explained by the change x, i.e., the share of households with access to the Internet. This hypothesis also confirmed by constructing a regression equation based on spatial data on household income in several countries and the percentage of their connection to the Internet as of 2019. The theory of discrete Markov processes, the so-called Markov chain theory, was chosen as a mathematical tool for forecasting structural changes in the total income of Ukrainian households in the conditions of digitalization, which allows considering the change in the structure of a given population as a stochastic (random) process.

BackgroundThe rapid growth of economy and increasing cost of living in Malaysia have given significant impact especially to the lowest household income population. The main objective of this study was to determine risk factors for low quality of life (QOL) and poor health status of this population.MethodsThis was a cross sectional study design. A total of 347 respondents from low household income groups, including persons with disability and Orang Asli were recruited from E-kasih. A semi-guided self-administered questionnaire was used. QOL measured by EQ. 5D utility value and health status measured by visual analogue score (VAS). Descriptive statistic, bivariate Chi-square analysis and binary logistic regression were conducted to determine factors influencing low QOL and poor health status.ResultsMajority of the respondents were Malay, female (61%), 63% were married, 60% were employed and 46% with total household income of less than 1 thousand Ringgit Malaysia. 70% of them were not having any chronic medical problems. Factors that associated with low QOL were male, single, low household income, and present chronic medical illness, while poor health status associated with female, lower education level and present chronic medical illness. Logistic regression analysis has showed that determinants of low QOL was present chronic illness [AOR 4.15 95%CI (2.42, 7.13)], while determinants for poor health status were; female [AOR 1.94 95%CI (1.09,3.44)], lower education [AOR 3.07 95%CI (1.28,7.34)] and present chronic illness [AOR 2.53 95%CI (1.39,4.61)].ConclusionLow socioeconomic population defined as low total household income in this study. Low QOL of this population determined by present chronic illness, while poor health status determined by gender, education level and chronic medical illness.

Wild aquatic resources are important for the livelihoods of rural communities in the Greater Mekong. This study assessed the economic value of wild aquatic animals and plants in the total mean annual net income of sample households in the study site which were divided into aquatics-non-dependent, and aquatics-dependent households. It was hypothesized that there is a significant difference in income between aquatics-non-dependent, and aquatics-dependent households, and among different sub-groups of aquatics-dependent households. Data was collected by direct structured questionnaire interviews and was analyzed using One-way analysis of variance; Independent sample t tests, and one-sample t test. Aquatics-dependent households have a greater total mean annual disposable income than their counterparts. Wild aquatics make a major contribution to the income of aquatics-dependent households. There was a significant difference of income among the three subgroups of aquatics-dependent households: full-time fishing provided a higher income than part-time fishing and non-fishing. Income from fish is the most important contribution to the total income of full-time fishing and part-time fishing households when compared with other aquatic animals and plants. We therefore conclude that among different groups of aquatics-dependent households, the full-time fishing households are more dependent on aquatics, especially fish compared with the part-time fishing and non-fishing counterparts.

Agricultural cooperative is widely considered as a vital foundation that can help smallholder farmers to overcome the constraints that hinder them from taking advantages of their business. The major concern of this study is, to evaluate the impact of agricultural cooperative on total annual income of participant households in Ejere district of West Shewa Zone, Ethiopia. To meet the objectives of study a total of 430 sample households were randomly interviewed. Descriptive statistics, logistic regression and propensity score matching were used to analyze data. The logistic regression output showed that access to extension services, marital status, clarity of cooperative objectives, perception and access to credit service were positively and significantly influenced the participation of household head in agricultural cooperative at (P&lt;0.01) whereas access to market information and total livestock unit positively and significantly influenced the participation of household head in agricultural cooperatives at (P&lt;0.05). Propensity score matching estimation result significant difference between agricultural cooperative participant and non-participant in terms of total annual income. That is, the total annual income of agricultural cooperative participants is 14,990.076Birr higher than that of non-participants. Thus, policy makers should focus on providing extension services, raising market information as well as increasing access to credit services of cooperatives in the study area. Keywords: Annual income, Cooperatives, Impact, logistic, outcome JEL: M2 L3 R2 DOI: 10.7176/EJBM/13-9-03 Publication date: May 31 st 2021

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.MethodsData 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).ResultsA 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).ConclusionsThe 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.

In wrongful death damages, personal consumption dollars represent the portion of total household expenditures that are exclusive to the decedent. Most of the personal consumption estimates in the forensic economic literature are computed from Bureau of Labor Statistics (BLS) published tables of Consumer Expenditure Survey (CEX) data. Those tables delineate, by household size and income, the average total dollars spent on approximately 20 summary expenditure groupings.1 Ireland and Depperschmidt (1999) presented a compilation of personal consumption articles that rely on such CEX summary table data with recent like-articles being written by Ajwa, Martin and Vavoulis (2000) and Ruble, Patton, and Nelson (2004). Trout and Foster (1993) and Scoggins (2001) both used the CEX Interview microdata to compute personal consumption estimates specific to husbands and wives. Unfortunately, those two studies ignored the Diary part of the CEX which includes significant household expenditures relevant to personal consumption and they continued to use the BLS’s summary group tabulations of each household’s expenditures. This paper uses CEX microdata to provide new personal consumption estimates for husbands and wives by their work status and by the number of children living in the home. Instead of relying on summary expenditures, all 700 micro-expenditure items within the CEX Interview and Diary surveys are incorporated into the analysis. Like Trout and Foster and Scoggins, the expenditure data is specific to husbands and wives, but this study goes further by using all of the CEX Interview and Diary microdata instead of just summary Interview data. Husband and wife specific data, by work status and number of children living at home, are important delineations in reliably computing personal consumption applicable to the loss of wage earnings of a married person. Assume the case of a wrongful death of a working married male living only with his wife. If a traditional two-person household personal consumption table were used to offset the husband’s earnings loss, such an analysis would mix the expenditure data of working and retired husbands and wives along with mixing in the data of households consisting of two single persons or one single person living with a child, etc. Another problem with studies based on summary tables is that total expenditures are usually shown to exceed income at the lower income levels. That result is not necessarily a fault of the CEX, but its presenta-

Outcomes in heart failure with reduced ejection fraction (HFrEF) are influenced by access and adherence to guideline-directed medical therapy. Our objective was to study the association between annual household income and: (1) the odds of having a claim for sacubitril/valsartan among insured patients with HFrEF and (2) medication adherence (measured as the proportion of days covered). We hypothesized that lower annual household income is associated with decreased odds of having a claim for and adhering to sacubitril/valsartan. Using the Optum de-identified Clinformatics Data Mart, patients with HFrEF and ≥6 months of enrollment for follow-up (2016-2020) were included. Covariates included age, sex, race, ethnicity, educational attainment, US region, number of prescribed medications, and Elixhauser Comorbidity Index. Prescription for sacubitril/valsartan was defined by the presence of a claim within 6 months of HFrEF diagnosis. Adherence was defined as proportion of days covered ≥80%. We fit multivariable-adjusted logistic regression models and hierarchical logistic regression accounting for covariates. Among 322 007 individuals with incident HFrEF, 135 282 had complete data for analysis. Of the patients eligible for sacubitril/valsartan, 4.7% (6372) had a claim within 6 months of HFrEF diagnosis. Following multivariable adjustment, individuals in the lowest annual income category (<$40 000) were significantly less likely (odds ratio, 0.83 [95% CI, 0.76-0.90]) to have a sacubitril/valsartan claim within 6 months of HFrEF diagnosis than those in the highest annual income category (≥$100 000). Annual income <$40 000 was associated with lower odds of proportion of days covered ≥80% compared with income ≥$100 000 (odds ratio, 0.70 [95% CI, 0.59-0.83]). Lower household income is associated with decreased likelihood of a sacubitril/valsartan claim and medication adherence within 6 months of HFrEF diagnosis, even after adjusting for sociodemographic and clinical factors. Future analyses are needed to identify additional social factors associated with delays in sacubitril/valsartan initiation and long-term adherence.

PurposeThe main purpose of this study is to assess the impact of small-scale irrigation on the total income of small farm households. Additionally, it aims to identify the factors influencing the total income of households who have adopted small-scale irrigation methods.Design/methodology/approachThe study utilized cross-sectional data sourced directly from primary channels. Primary data collection was facilitated through the administration of semi-structured questionnaires and conducting in-depth interviews. Both propensity score matching (PSM) and an ordinary least squares (OLS) model were employed to assess the impact of small-scale irrigation on total income and to identify factors affecting the effectiveness of SSI. In order to ensure that the PSM model’s findings were consistent, we used instrumental variables (IV) estimation, which was conducted using two stages least squares (2SLS) regression.FindingsThe study findings reveal that small-scale irrigation adopters earn, on average, 12,947.32 Birr more than non-adopters. The PSM model reveals that households engaged in small-scale irrigation experience a significant increase in total income compared to non-irrigating households. The study underscores the need to address key factors influencing the treatment effect on household income, including distance to farm training centers, proximity to water sources, access to transportation, availability of family labor and frequency of extension contact.Research limitations/implicationsThis paper only examines the effect of small-scale irrigation on small farm households’ total income. This study encourages future studies to investigate the effects of small-scale irrigation on small farm household food security, total spending, poverty reduction, welfare and net earnings in the study area.Originality/valueMost studies only analyze how small-scale irrigation affects the total income of small-scale farm households. This study fills a knowledge gap by identifying the key elements that influence the extent of the impact on user households.

Socioeconomic Factors Contribute to the Higher Risk of COVID-19 in Racial and Ethnic Minorities With Chronic Liver Diseases

Economic dependence on mangrove forest resources for livelihoods in the Sundarbans, Bangladesh

In this study the determinants of household income in Afghanistan: case study of Samangan province has been researched, In the literature review, generally the factors affecting household income in developing and undeveloped countries have been greatly examined. In this study, bachelor degree, high school, household size and over the age of 25 have been taken as the variables affecting total household income in Samangan province. For this purpose, firstly in order to know weather, the variances of the predication determined by regression remain constant or differ heteroscedasticity test was run and the result showed that there is no heteroscedasticity in our model, also by running Ramsey Reset test we found that our model is well-fitted. According to regression results all variables except household size have significantly affect household income in Samangan province. If we subtilize on the result, a person with having bachelor degree in Samangan province can affect his or her total household income, it means that a person with bachelor degree can affect 14.9 percent total household income. A person with having high school degree in Samangan province can affect his or her total household income about 15.2 percent. if a household increase with one person over the age of 25 it can affect total household income approximately 24.3 percent. But household size has negative affect on total household income it means by increasing one person in the family, total household income decreases -4 percent.

To inform policy-making, we measured the risk, causes and consequences of catastrophic expenditures for tuberculosis and investigated potential inequities. Between August 2008 and February 2009, a cross-sectional study was conducted among all (245) smear-positive pulmonary tuberculosis patients of six health districts from southern Benin. A standardised survey questionnaire covered the period of time elapsing from onset of tuberculosis symptoms to completion of treatment. Total direct cost exceeding the conventional 10% threshold of annual income was defined as catastrophic and used as principal outcome in a multivariable logistic regression. A sensitivity analysis was performed while varying the thresholds. A pure gradient of direct costs of tuberculosis in relation to income was observed. Incidence (78.1%) and intensity (14.8%) of catastrophic expenditure were high; varying thresholds was insensitive to the intensity. Incurring catastrophic expenditure was independently associated with lower- and middle-income quintiles (adjusted odd ratio (aOR) = 36.2, 95% CI [12.3-106.3] and aOR = 6.4 [2.8-14.6]), adverse pre-diagnosis stage (aOR = 5.4 [2.2-13.3]) and less education (aOR = 4.1[1.9-8.7]). Households incurred important days lost due to TB, indebtedness (37.1%), dissaving (51.0%) and other coping strategies (52.7%). Catastrophic direct costs and substantial indirect and coping costs may persist under the 'free' tuberculosis diagnosis and treatment strategy, as well as inequities in financial hardship.

Importance, determinants and gender dimensions of forest income in eastern highlands of Ethiopia: The case of communities around Jelo Afromontane forest