Children In Low-income Families Research Articles

Vaccination Timeliness Among US Children Aged 0-19 Months, National Immunization Survey–Child 2011-2021

Delays in receiving vaccinations lead to greater vaccine-preventable disease risk. Timeliness of receipt of recommended vaccinations is not routinely tracked in the US, either overall or for populations that have known barriers to accessing routine health care, including lower-income families and children. To measure vaccination timeliness among US children aged 0 to 19 months, overall and by socioeconomic indicators. This serial, cross-sectional study analyzed nationally representative data from the 2011 to 2021 National Immunization Survey-Child (NIS-Child), an annual survey of parents, with immunization histories collected from clinicians administering vaccines. The 2020 and 2021 surveys largely reflected vaccinations in the US before the COVID-19 pandemic. Study participants included US children surveyed at ages 19 to 35 months. Data were analyzed from January to August 2023. Survey year. The primary outcomes were average days undervaccinated (ADU) and percentage of children who received all vaccine doses on time (ie, 0 days undervaccinated) for the combined 7-vaccine series up to age 19 months. The mean adjusted annual change in on-time vaccination by socioeconomic indicators was calculated by use of multivariable log-linked binomial regression models. The surveys included 179 154 children (92 248 boys [51.2%]); 74 479 (31.4%, weighted) lived above the federal poverty level with more than $75 000 in annual family income, 58 961 (32.4%) lived at or above the poverty level with $75 000 or less in annual family income, and 39 564 (30.2%) lived below the poverty level. Overall, the median (IQR) ADU for the combined 7-vaccine series in the US decreased from 22.3 (0.4-71.5) days in the 2011 survey to 11.9 (0.0-55.5) days in the 2021 survey. The prevalence of on-time receipt of the combined 7-vaccine series increased from 22.5% (95% CI, 21.4%-23.6%) to 35.6% (95% CI, 34.2%-37.0%). Although children with more than $75 000 in annual family income had a 4.6% (95% CI, 4.0%-5.2%) mean annual increase in on-time vaccination, the mean annual increase was 2.8% (95% CI, 2.0%-3.6%) for children living at or above the poverty level with $75 000 or less in annual family income and 2.0% (95% CI, 1.0%-3.0%) for children living below the poverty level. In this cross-sectional study of NIS-Child data, improvements in vaccination timeliness were observed from the 2011 to the 2021 survey. However, widening disparities by socioeconomic indicators signal that increased efforts to facilitate timely vaccination among children in lower-income families are needed.

The unseen victims: psychological effects of food insecurity on children in low-income families.

The unseen victims: psychological effects of food insecurity on children in low-income families.

Oral Health Care Strategies in Rural Communities: A Case Study.

Dental caries affect 97% of the world's population during their lifetime. Early childhood caries are the number one chronic disease affecting young children, and it disproportionately affects children of low-income families. American Academy of Pediatrics recommends fluoridated toothpaste to all children starting at tooth eruption, regardless of caries risk. In addition, fluoride varnish is recommended in all children every 3 to 6 months from tooth emergence until they have an established dental home. The health disparities that are most apparent in the rural communities are inadequate prenatal care, low birth weight, cancer, chronic respiratory disease, heart disease, unintentional injury, and stroke. When it comes to oral health, water fluoridation is one of the most cost-effective strategies in preventing dental caries. The need for oral health education in physician assistant/associate (PA) programs is well documented. Implementation has largely been performed using interprofessional education. This article describes an interprofessional education program that teaches PA students to apply fluoride varnish so that they are practice-ready when they graduate and practice medicine.

Increased WIC Benefits for Fruits and Vegetables Increases Food Security and Satisfaction Among California Households with Young Children.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a critical source of nutrition support for young children in low-income families, providing access to healthy foods and a cash value benefit (CVB) for the purchase of fruits and vegetables (FV). In 2021, the WIC CVB increased substantially for women and children aged 1 to 5 years. To investigate whether or not the increased WIC CVB for purchasing FV was associated with greater redemption of the FV benefit, satisfaction, household food security, and child FV intake. Longitudinal study of WIC participants receiving WIC benefits from May 2021 through May 2022. Through May 2021, the WIC CVB for children aged 1 to 4 years was $9/month. The value increased to $35/month from June through September 2021, and changed to $24/month starting October2021. WIC participants from seven WIC sites in California with one or more child aged 1 to 4 years during May 2021 and one or more follow-up surveys during September 2021 or May 2022 (N= 1,770). CVB redemption (in US dollars), satisfaction with the amount (prevalence), household food security (prevalence), and child FV intake (cups per day). Associations of increased CVB issuance following the June 2021 CVB augmentation with child FV intake and CVB redemption were assessed using mixed effects regression, and associations with satisfaction and household food security were assessed using modified Poisson regression. The increased CVB was associated with significantly greater redemption and satisfaction. At the second follow-up (May 2022), household food security increased by 10% (95% CI 7% to 12%); total FV intake decreased by 0.03 c/day (95% CI -0.06 to -0.01) in the overall sample, but increased by 0.23 c/day (95% CI 0.17 to 0.29) among children with the lowest baseline FV intake. This study documented benefits of augmentation to the CVB for children. WIC policy augmenting the value of WIC food packages to increase access to FV had the intended effects, lending support to making the increased FV benefit permanent.

School-Based Health Centers, Access to Care, and Income-Based Disparities

School-based health centers (SBHCs) are primary care clinics colocated at schools. SBHCs have the potential to improve health care access and reduce disparities, but there is limited rigorous evidence on their effectiveness at the national level. To determine whether county-level adoption of SBHCs was associated with access, utilization, and health among children from low-income families and to measure reductions in income-based disparities. This survey study used a difference-in-differences design and data from a nationally representative sample of children in the US merged with SBHC indicators from the National Census of School-Based Health Centers. The main sample included children aged 5 to 17 years with family incomes that were less than 200% of the federal poverty level observed in the National Health Interview Survey, collected between 1997 to 2018. The sample was restricted to children living in a county that adopted a center between 2003 and 2013 or that did not have a center at any time during the study period. Analyses of income-based disparities included children from higher income families (ie, 200% or higher than the federal poverty level). Data were analyzed between January 2020 and July 2023. County-by-year SBHC adoption. Outcomes included access (usual source of care, insurance status, barriers), ambulatory care use (general physician, eye doctor, dental, mental health visits), and health (general health status, missed school days due to illness). P values were adjusted for multiple comparisons using the sharpened q value method. This study included 12 624 unweighted children from low-income families and 24 631 unweighted children from higher income families. The weighted percentage of children in low-income families who resided in counties with SBHC adoption included 50.0% aged 5 to 10 years. The weighted percentages of the race and ethnicity of these children included 36.7% Hispanic children, 25.2% non-Hispanic Black children, and 30.6% non-Hispanic White children. The weighted percentages of children in the counties that never adopted SBHCs included 50.1% aged 5 to 10 years. The weighted percentages of the race and ethnicity of these children included 20.7% Hispanic children, 22.4% non-Hispanic Black children, and 52.9% non-Hispanic White children. SBHC adoption was associated with a 6.4 percentage point increase in dental visits (95% CI, 3.2-9.6 percentage points; P < .001), an 8.0 percentage point increase in having a usual source of care (95% CI, 4.5-11.5 percentage points; P < .001), and a 5.2 percentage point increase in insurance (95% CI, 1.2-9.2 percentage points; P = .03). No other statistically significant associations were found with other outcomes. SBHCs were associated with relative reductions in income-based disparities to dental visits by 76% (4.9 percentage points; 95% CI, 2.0-7.7 percentage points), to insured status by 63% (3.5 percentage points; 95% CI, 1.3-5.7 percentage points), and to having a usual source of care by 98% (7.2 percentage points; 95% CI, 5.4-9.1 percentage points). In this survey study with difference-in-differences analysis of SBHC adoption, SBHCs were associated with access to care and reduced income-based disparities. These findings support additional SBHC expansion.

Health of Children in Low-Income Families: A Multiple Disadvantage Model

ABSTRACT This study investigated relationships between low-income children’s health and six factors: social disorganization, social structural, social relationship, parent health/mental health, parent substance use, and access to healthcare. A sample of 7,349 low-income children extracted from a national data set. Logistic regression results showed low-income children’s excellent or very good health to be associated positively with safe neighborhood, family cohesiveness, family support, caregiver health, and caregiver mental health. Children’s health was associated negatively with racial discrimination experience, professional support, Medicaid receipt, and child age. Implications included promotion of neighborhood safety, cultural competency of professionals, respect racial/ethnic diversity, and cohesive families.

Social assistance to children from low-income families in the conditions of the Comprehensive Center for Social Services to the Population

The problem of poverty for a modern Russian family with children is one of the most acute social issues of Russia nowadays. The low level of income of a significant part of families causes social tension and provokes crisis processes in the family and society. Practice shows that children in low-income families often face problems that neither they themselves nor their family members, friends, or neighbors can solve. The purpose of the research is to study the features of the implementation of the technology of social service for children in low-income families in the conditions of the Comprehensive Center for Social Services to the Population of the Pravoberezhny District of Magnitogorsk.

Association of Integrating Mental Health Into Pediatric Primary Care at Federally Qualified Health Centers With Utilization and Follow-up Care

More than 1 in 5 children in low-income families report a mental health (MH) problem, yet most face barriers accessing MH services. Integrating MH services into primary care at pediatric practices such as federally qualified health centers (FQHCs) may address these barriers. To examine the association of a comprehensive MH integration model with health care utilization, psychotropic medication use, and MH follow-up care among Medicaid-enrolled children at FQHCs. This retrospective cohort study used Massachusetts claims data from 2014 to 2017 to conduct difference-in-differences (DID) analyses before vs after implementation of a complete FQHC-based MH integration model. The sample included Medicaid-enrolled children aged 3 to 17 years who received primary care at 3 intervention FQHCs or 6 geographically proximal nonintervention FQHCs in Massachusetts. Data were analyzed in July 2022. Receipt of care at an FQHC implementing the Transforming and Expanding Access to Mental Health Care in Urban Pediatrics (TEAM UP) model, which began fully integrating MH care into pediatrics in mid-2016. Utilization outcomes included primary care visits, MH service visits, emergency department (ED) visits, inpatient admissions, and psychotropic medication use. Follow-up visits within 7 days of a MH-related ED visit or hospitalization were also examined. Among the 20 170 unique children in the study sample, at baseline (2014), their mean (SD) age was 9.0 (4.1) years, and 4876 (51.2%) were female. In contrast to nonintervention FQHCs, TEAM UP was positively associated with primary care visits with MH diagnoses (DID, 4.35 visits per 1000 patients per quarter; 95% CI, 0.02 to 8.67 visits per 1000 patients per quarter) and MH service use (DID, 54.86 visits per 1000 patients per quarter; 95% CI, 1.29 to 108.43 visits per 1000 patients per quarter) and was negatively associated with rates of psychotropic medication use (DID, -0.4%; 95% CI -0.7% to -0.01%) and polypharmacy (DID, -0.3%; 95% CI, -0.4% to -0.1%). TEAM UP was positively associated with ED visits without MH diagnoses (DID, 9.45 visits per 1000 patients per quarter; 95% CI, 1.06 to 17.84 visits per 1000 patients per quarter), but was not significantly associated with ED visits with MH diagnoses. No statistically significant changes were observed in inpatient admissions, follow-up visits after MH ED visits, or follow-up visits after MH hospitalizations. The first 1.5 years of MH integration enhanced access to pediatric MH services while limiting the use of psychotropic medications. Additional implementation time is necessary to determine whether these changes will translate into reductions in avoidable utilization.

Milk purchase and consumption patterns in peri-urban low-income households in Kenya

Milk plays an important role in the growth and development of children. In Kenya, it is one of the most produced and consumed animal-sourced foods, but often consumed in small amounts among children of low-income families, especially in urban settings. The aim of the study was to identify household milk purchase and consumption patterns of milk, with emphasis on young children, as well as estimate key determinants of such patterns to identify areas of leverage to increase milk consumption. Results showed that 98% of households purchased unprocessed fresh milk at least once during the 7 days prior to the survey, while only 17% purchased packed pasteurized milk. Findings from the Ordinary Least Squares (OLS) model of purchase behavior suggest that the amount of unpacked milk purchased by households is positively and significantly related to household income, the number of children below the age of 4, and the budget of animal-sourced food. The price and quantities of pasteurized milk purchased were negatively related to the amount of unpacked milk purchased. Consumption patterns for children below the age of 4 showed that milk and dairy products are most commonly consumed as part of dishes than as individual products. Informal markets played a key role in meeting the milk needs of children, but consumption was below recommended amounts. The clear association of income and milk intake calls for efforts from the government to support the dairy sector with policies that promote the availability and affordability of milk, especially for a sector that feeds low-income families, as it is the case with the informal dairy markets.

An Interactive Live and Online Cooking Program for Children in Vulnerable Families-An Exploratory Study.

The COVID-19 pandemic has highlighted the importance of technology for communication and social interactions. Especially for children in low-income families-a vulnerable population suffering from health and digital disparities-the situation worsened during the pandemic. Earlier studies in times of COVID-19 suggested that the children in Korea who usually do homework and dine at community childcare centers (CCCCs, free after-school care places) need to learn more about how to eat healthily and how to interact with others using digital technology. Therefore, to reduce these children's health and digital inequalities, an interactive live and online cooking program was developed and provided to 313 children and 95 staff members at the 29 CCCCs located in the southern provinces in South Korea. The aim of the current study was to explore the experiences of children and staff with the program. After surveying their experiences, a high degree of satisfaction was found (children: 3.60 ± 0.10; staff: 3.63 ± 0.08 points out of 4.00). Aspects that needed improvement in the program were related to (in)experience in online technology, the frequency and timing of the cooking classes, and the communication between the centers and (online) chefs. In addition, in a word cloud analysis, terms such as 'fun', 'delicious', and 'want' were highlighted for children, and terms such as 'participating' and 'preparation' dominantly appeared for the staff. In the analysis of negative experiences, terms related to environmental factors such as 'sound', 'hear', and 'voice' were highlighted. This novel but preliminary approach for children from low-income families, by integrating cooking with digital technology, indicates that with enough digital support, the CCCCs are a promising platform to promote healthy eating and digital literacy. Optimizing and disseminating these strategies during this pandemic period, and future pandemics, could be beneficial to keep children in their communities healthy, and ultimately reduce socioeconomic health disparities.

Preschool Children’s Evaluations of Prototypic and Accidental Moral Transgressions Differ by Economic Strata

ABSTRACT Research Findings: Research with older children and adults reliably demonstrates that individuals raised in poverty tend to evaluate concerns related to moral concerns (i.e., related to harm, welfare, and justice) differently than do wealthier individuals. However, little work has examined these patterns in young children. Children (N=214, Mage = 53.30 months, SD = 18.3 months) completed tasks regarding accidental and prototypic moral transgressions, and a standard verbal assessment. Parents reported family size and household income, which were used to compute individuals’ income-to-needs ratio (INR) compared to federal standards. Using generalized linear mixed modeling (GLMM), a repeated-measure analysis, results indicate that children in low-income families (INR < 2.0) were more lenient in how they evaluate both accidental and prototypic issues, compared to more affluent children. Moreover, they were more likely to evaluate issues based on communal welfare (e.g., equitable resource distribution), whereas more affluent children were more likely to reference psychological harm. Practice or Policy: Practitioners and researchers of early childhood should be cognizant and sensitive to differences in children’s social understanding. We encourage scholars to use a strength-based, adaptive approach in future research on children’s cognition, particularly involving SES, class, and the like.

The impact of an early intervention home-based program on body composition in preterm-born preschoolers with very low birth weight.

Early child interventions focused on the family prevented neurodevelopmental and behavioral delays and can provide more knowledge regarding responsive feeding, thus creating learning opportunities to promote better quality nutrition and preventing failure to thrive. The aim is to verify the impact of a continuous program of early home-based intervention on the body composition of preschool infants who were born preterm with very low birth weight (VLBW). This is a longitudinal analysis from a randomized controlled trial, including VLBW preterm children, born in a tertiary hospital in Southern Brazil and followed up at the high-risk institutional ambulatory clinic. Participants were divided into the intervention group (IG): skin-to-skin care with the mother (kangaroo care), breastfeeding policy, and tactile-kinesthetic stimulation by mothers until hospital discharge. Subsequently, they received a program of early intervention with orientation and a total of 10 home visits, independently from the standard evaluation and care that was performed following the 18 months after birth; conventional group (CG): standard care according to the routine of the newborn intensive care unit (NICU), which includes kangaroo care, and attending to their needs in the follow-up program. Body composition estimation was performed using bioelectrical impedance analyses (BIA), and physical activity and feeding practices questionnaires were evaluated at preschool age, as well as anthropometric measurements and biochemical analysis. Data of 41 children at 4.6 ± 0.5 years old were evaluated (CG n = 21 and IG n = 20). Body weight, height, body mass index, waist and arm circumferences, and triceps and subscapular skinfold did not differ between groups. The IG presented higher segmented fat-free mass (FFM) when compared to the CG (right arm FFM: 0.74 vs. 0.65 kg, p = 0.040; trunk FFM: 6.86 vs. 6.09 kg, p = 0.04; right leg FFM: 1.91 vs. 1.73 kg, p = 0.063). Interaction analyses showed that segmented FFM and FFM Index were associated with higher iron content in the IG. In the CG, interaction analyses showed that increased visceral fat area was associated with higher insulin resistance index. An early intervention protocol from NICU to a home-based program performed by the mothers of VLBW preterm children of low-income families presents a small effect on FFM.

Families with high school children: the need for social assistance

Families with children in Russia have a high risk of poverty. Often mothers do not work in these families, and the income of working family members together with social support measures are not sufficient. In recent years, support for families with children has been priority of social policy. At the same time, the State social assistance depends on the age of a child, and as the child is growing older the social assistance is decreasing. Until 2021 the whole variety of monetary payments to children was limited to the age category of 7 years (for all families) and up to 17 years (for single-parent families). These age limits put other children at a disadvantage as compared to children receiving assistance. That's why in March 2022 the Government announced a monthly cash payment for all children living in low-income families aged from 8 to 17 years. The next age limit for children in low-income families getting social support leaves without benefits children aged 17-18 years. Usually they do not have their own income, but they require not less, but more family expenses for their maintenance. The main goal of the study was to show that families with children aged 16-17 bear the same expenses as families with children under 16 years of age, but they have no additional sources of income. The study was based on the data from a population survey (Household Budget Survey-2019) and a longitudinal survey of families with school-age children (Russian Longitudinal Monitoring Survey of HSE2018-2019). The study emphasized the need of social support for families with senior school-age children.

Maternal predictors of children's mental health in low-income families: A structural equationmodel.

Low-income populations are particularly susceptible to mental health problems, and the susceptibilities of family members may be interconnected. In particular, maternal factors are known to be linked to their children's outcomes. This study aims to investigate how maternal cognition, depression, and the mother-child relationship, as well as children's cognition, predict the mental health of children in low-income families. Pairs of mothers and children from families receiving governmental assistance were surveyed between January 2018 and March 2019. Korean versions of the following instruments were used: Strengths and Difficulties Questionnaire (children's mental health problems), Cognitive Triad Inventory for Children (children's cognition), Kerns' Security Scale (mother-child relationship), Center for Epidemiologic Studies Depression Scale (maternal depression), and Automatic Thoughts Questionnaire-Negative (maternal cognition). A structural equationmodel was used to examine how maternal cognition, depression, the mother-child relationship, and children's cognition predict children's mental health. Maternal negative cognition and depression mediated by the children's relationships with their mothers negatively predicted their cognition and mental health problems. Enhancing maternal mental health and a mother-child relationship can help improve positive cognition and mental health of children from low-income families.

Physical and Psychological Maltreatment of Deaf and Hard of Hearing Children: Frequency and Associated Factors in a Low Socioeconomic Setting.

Few studies have assessed frequency of maltreatment and other factors associated with maltreatment of deaf and hard of hearing children. The present study's objective was to verify the frequency of physical and psychological maltreatment and associated factors experienced by DHH children. DHH children from low-income families in Maceió, Brazil, were studied (N = 265). The Parent-Child Conflict Tactics Scales (Straus et al., 1998) were used to identify nonviolent discipline, psychological aggression, and physical assault (minor, severe, very severe). The study found that 221 children (83.4%) experienced physical assault; 238 (89.8%) experienced psychological aggression. Both physical and psychological aggression was reported for 94.3%. Most mothers (98.1%) reported using nonviolent discipline. Maltreatment was associated with male children, mothers' job dissatisfaction, religiously nonobservant families, and children born of unintended pregnancy. In conclusion, high frequencies of physical and psychological maltreatment of DHH children of low-income families were found.

Habilidades prelectoras en niños uruguayos de diferente nivel socioeconómico

Learning to read transforms lives. Reading contributes to knowledge acquisition, cultural engagement, and success in the school. The unequal distribution of literacy skills in a society is associated with economic and social inequalities as a result, children with a poor foundation in literacy before entering formal schooling are more likely to struggle academically and to drop out of school. For these reasons, there has been an intense scientific interest for decades in understanding how children learn to read. It is well established that in the early stages of reading development, phonological awareness, letter name-sounds knowledge, and the naming speed are three independent longitudinal predictors of children’s later word-reading skills in alphabetic-writing systems. Phonological awareness constitutes the ability to recognize and manipulate the sounds of their own language, meanwhile letter knowledge promotes the discovery of systematic relationships between writing and oral language. As early readers develop some level of phonological awareness and some level of letter knowledge, they can recognize written words through phonological recoding processes, in which graphemes are recoded as phonemes and assembled to pronounce words. In addition, rapid naming expresses the speed at which phonological information is accessed from a graphic label. Phonological processing and letter knowledge are powerfully affected by the experience, stimulation, and support that children receive before beginning formal education. Most children acquire these abilities relatively effortlessly during early childhood. However, there is a significant number of children in Latin America who experience difficulties in their pre-literacy skills development. This study examined the cognitive profiles of a total of 50 Uruguayan preschoolers from different socioeconomic backgrounds from two public schools in Montevideo, Uruguay. Twenty-six children from low-income households were compared to peers from middle-income. At the end of the pre-schooling period (time 1) receptive vocabulary, phonological awareness, letter name-sounds knowledge, and object naming speed tests were administered to children. One year later (time 2), word -reading of a subgroup of children was measured. Significant correlations were observed between all predictors at time 1; between predictors at time 1 and word reading at time 2; and between all measured abilities and socioeconomic status. Comparative analysis between children of different socioeconomic status showed that children growing up in poverty contexts performed more poorly than their peers from middle-income families in all the tests. Nonetheless, both groups performed poorly in word reading. Descriptive statistics indicated that, out of a total of 26 words, low SES children correctly read a total of 7 words per minute, and medium SES children a total of 14 words. Finally, regression analyses indicated that phonological awareness contributed 30 % variance in predicting the total score achieved in a reading-word test in children of low-income families, meanwhile letter name knowledge contributed 74 % variance in predicting the total score achieved in a reading-word test in their peers from middle-income families. In general terms, results of pre-reading skills and reading performance seem to indicate that children of different socioeconomic status use different word recognition strategies according to their level of letter-knowledge of and phonological processing. Discussion considers international literature pointing out that children who enter elementary school with limited reading-related skills are unlikely to be able to keep pace with their peers. These findings warn about the importance to elaborate systematic and high-quality educational proposals to try to reduce the gap in reading development for children from low-income families. Developing literacy and language skills before formal schooling sets a child up for success in school and life. Results also suggest the importance of analyzing the variables that affect reading development in populations that are not the majority described. https://doi.org/10.16888/interd.2022.39.3.5

The Earned Income Tax Credit, Family Complexity, and Children’s Living Arrangements

Demographic shifts over the last half-century have resulted in dramatic changes in family structure. These changes have implications for the social safety net because public assistance programs define families differently. This article focuses on a critical poverty-alleviation policy, the Earned Income Tax Credit (EITC), to document family complexity in the United States. We find that more than 60 percent of children in lower-income families reside in households with ambiguity in tax filing and thus in claiming valuable credits. Tax filing ambiguity driven by family complexity is especially common among households with Black children, highlighting significant racial inequities in the tax treatment of complex families. We also consider two reforms to reflect the realities of families today: the childless EITC and a noncustodial parent EITC.

Potential Sociodemographic Predictors of Childhood Anxiety Disorders: A Cross-Sectional Study

Background: Previous studies have shown that the prevalence of anxiety among primary school students in rural areas is relatively high. Also, this stage is a critical developmental stage of academic life. Childhood anxiety disorders lead to significant disruption and interference with other aspects of life, including behavioral, emotional, cognitive, and academic achievement. Aims: This study aimed to find the frequency of 6 subtypes of anxiety disorders and to determine the potential sociodemographic factors of anxiety disorders among primary school students in a rural area of Malaysia. Methods: This was a cross-sectional study in which 411 students answered the Spence Children’s Anxiety Scale-Child version (SCAS-C). Descriptive analyses elucidated at-risk students, and multivariate analysis of variance and multiple linear regression presented potential predictors of anxiety disorders. Results: The most common abnormal level was for social phobia (SP) (n = 109/18.6%), and the least common were panic/agoraphobia (n = 85/14.1%) and physical injury fears (PIF) (n = 82/13.6%). Multivariate analysis of variance revealed that age ( P &lt; .05), gender ( P &lt; .05), father’s employment ( P &lt; .05), and mother’s educational level (EL) P &lt; .05) were predictors of overall anxiety. A Tukey post-hoc test revealed that older children are more likely to suffer from overall anxiety, separation anxiety (SA), SP, and obsessive-compulsive problems. Children of low-income families were less likely to suffer from SA than those of middle-income families. Children of stay-at-home mothers were less likely to suffer from overall anxiety, SA, and SP than mothers who worked more than 8 h per day. Multiple linear regression could predict 6 models of anxiety based on sociodemographic factors. Conclusion: According to our findings in this study, promoting mental health by providing preventive strategies and screening programs is more recommended for students with sociodemographic risk factors for anxiety disorders.

In Whose Best Interest? Parental Hesitancy toward the COVID-19 Vaccine for Children in Japan: A Literature Survey Study

In early February 2022, the Japanese government sent COVID-19 vaccine vouchers to children ages 5–11. Using keywords obtained from the voucher, the frequently asked questions section, and experts, we descriptively analyzed the advantages and disadvantages of vaccination for children and their parents through a web-based literature survey of media articles and government homepage statements in Japan. For children, vaccination helps prevent severe symptoms and may be particularly beneficial for children in low-income families by lowering the rate of suicide and at-home child abuse. For parents, not vaccinating their child allows them to fulfill a more traditional role as a parent (mothers in particular), reduces the gender gap for mothers, and provides greater peace of mind about their child’s future fertility. We also examined the governmental vaccination campaigns targeting children from public health perspectives. We argue that the letter accompanying the vaccine voucher should clearly emphasize that further transmission will be prevented, reducing domestic infection. In addition to the biological dimensions of COVID-19 in Japan, we emphasize cultural issues and hope that these can be useful for other countries as they create their own vaccination strategies. Public health in Japan could be promoted if all citizens, regardless of age, acquired fundamental knowledge and skills, the motivation to learn, and the ability to utilize knowledge and skills and think, judge, and express personal ideas.

Support Strategy for Executive Function in Children of Low-Income Families: The Marshmallow Test Has a Learning Value

Executive function (EF) development is an important part of infancy and childhood, promoting success in later life. Developing targeted methods is desirable to enable EF. There is an urgent need for easily implementable proposals to ameliorate educational disparities between income groups. EF is a skill that its possessor can use to inhibit thoughts and emotions. There is a relationship between EF and the prefrontal cortex. The Wechsler Intelligence Scale for Children’s (WISC-IV) Working Memory Index (WMI) task for thinking and the marshmallow test for emotions have been used to measure EF, but these tests themselves carry a load of inhibitions. Therefore, we can assume a natural value in learning to improve on the test. The marshmallow test does not require parental expertise in preparation or implementation, and it entails little financial burden. If there is a potential value in learning how to do better on the test, it will be easy for parents in low-income families to help their children improve. I examined whether the marshmallow test itself can support EF. Measurements of brain activity in the prefrontal cortex over 8 days showed that the marshmallow test was more active than the WMI task or the abacus task. Therefore, the results suggest that continued use of the marshmallow test can support EF even in low-income families.