Context Of Socioeconomic Status Research Articles

Ambient air pollution and mortality: The role of socioeconomic conditions.

There is a vast body of literature covering the association between air pollution exposure and nonaccidental mortality. However, the role of socioeconomic status (SES) in this relationship is still not fully understood. We investigated if individual and contextual SES modified the relationship between short-term exposure to ozone (O3), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameter <10 µm (PM10) on cardiovascular, respiratory, and all nonaccidental mortality. We conducted a time-stratified case-crossover study. Analyses were based on information on 280,685 deaths from 2011 to 2015 in the city of São Paulo. Education was used as an individual SES, and information on the district of residence was used to build a contextual SES. Exposure to PM10, NO2, and O3 was accessed from monitoring stations and linked to each case based on the date of death. Conditional logistic regression models were used to estimate the effects of air pollutants, and interaction terms were added to access the effect modification of SES. Individuals with lower education had an increased chance of dying for all nonaccidental outcomes (1.54% [0.91%, 2.14%]) associated with exposure to PM10. Individuals living in lower SES areas had an increased chance of dying for nonaccidental (0.52% [0.16%, 0.88%]), cardiovascular (1.17% [0.88%, 1.46%]), and respiratory (1.70% [0.47%, 2.93%]) causes owing to NO2 exposure. Exposure to air pollutants increases the chance of dying by nonaccidental, cardiovascular, and respiratory causes. Lower educational levels and living on lower contextual SES increased the risk of mortality associated with air pollution exposure.

Culture, Social Class and the Dynamics of the Self

In an ongoing cycle of mutual constitution, culture, the self, and associated psychological tendencies dynamically interact. Prior studies show that people from Western individualist cultures construe the self in independent terms (stressing their uniqueness and separation from others), promoting analytic, context-independent ways of thinking. In contrast, people from Eastern collectivist cultures emphasize their interdependence and connectedness with others, promoting more holistic, context-sensitive ways of thinking. Recently, this literature has been extended to study within-culture variations by socio-economic status (SES). This work has suggested that higher SES contexts foster the view of the self as an independent agent and analytic cognitive tendencies. By contrast, individuals from lower SES tend to emphasize interdependence with others while displaying more holistic cognitive tendencies. Of importance, these SES differences are embedded in larger socio-cultural contexts differing in individualism and collectivism. Hence, the relationship among SES, self-construal, and cognitive tendencies can sometimes vary dramatically between cultures.

Community and individual socioeconomic inequalities and dental caries from childhood to adolescence: A 10-year cohort study.

To evaluate the effect of individual and contextual socioeconomic inequalities in the occurrence of untreated dental caries during the transition from childhood to adolescence. This 10-year prospective cohort study followed up an initial sample of 639 1-5 years old schoolchildren from southern Brazil. After 7 and 10 years from the baseline (T1), two other reassessments were conducted (T2 and T3), respectively. Untreated dental caries was measured through the International Caries Detection and Assessment System (ICDAS- scores 3, 5 and 6) at T1 and T3. Socioeconomic status (SES) at the contextual and individual level was assessed at T1. At T2, socioeconomic, behavioural and psychosocial characteristics were evaluated as possible pathways of explanation. Structural equation modelling was used to estimate the direct and indirect effects among the variables over 10 years. A total of 429 adolescents were reevaluated at 10-year follow-up (cohort retention rate of 67.1%). About 30.6% presented untreated dental caries at T3. Low individual SES at T1 directly impacted a higher occurrence of dental caries at T3. Non-white skin colour at T1 also indirectly impacted a higher occurrence of dental caries at T3 through low individual SES at T1 and lower household income at T2. Contextual SES did not predict, directly or indirectly, dental caries at T3. There is strong evidence that socioeconomic inequalities at the individual level play an important role on the occurrence of dental caries from childhood to adolescence. On the other hand, there was no evidence that contextual SES influences the occurrence of dental caries over time.

Gender differences in the association of individual and contextual socioeconomic status with hypertension in 230 Latin American cities from the SALURBAL study: a multilevel analysis

BackgroundDespite global interest in gender disparities and social determinants of hypertension, research in urban areas and regions with a high prevalence of hypertension, such as Latin America, is very limited.The objective of this study was to examine associations of individual- and area-level socioeconomic status with hypertension in adults living in 230 cities in eight Latin America countries.MethodsIn this cross-sectional study, we used harmonized data from 109,184 adults (aged 18–97 years) from the SALURBAL (Salud Urbana en America Latina/Urban Health in Latin America) project. Hypertension was assessed by self-report. Individual-, sub-city- and city-level education were used as proxies of socioeconomic status. All models were stratified by gender.ResultsHigher individual-level education was associated with lower odds of hypertension among women (university education or higher versus lower than primary: odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.61–0.74) but higher odds among men (OR = 1.65; 95%CI 1.47–1.86), although in men an inverse association emerged when measured blood pressure was used (OR = 0.86; 95%CI 0.76–0.97). For both genders, living in sub-city areas with higher educational achievement was associated with higher odds of hypertension (OR per standard deviation [SD] = 1.07, 95%CI = 1.02–1.12; OR = 1.11 per SD, 95%CI = 1.05–1.18, for women and men, respectively). The association of city-level education with hypertension varied across countries. In Peru, there was an inverse association (higher city level education was associated with lower odds of hypertension) in women and men, but in other countries no association was observed. In addition, the inverse association of individual-level education with hypertension became stronger (in women) or emerged (in men) as city or sub-city education increased.ConclusionThe social patterning of hypertension differs by gender and by the level of analysis highlighting the importance of context- and gender-sensitive approaches and policies to reduce the prevalence of hypertension in Latin America.

Parental Objective, Subjective, and Contextual Socioeconomic Status and Children's Mental Health in Iran: The Mediating Effect of the Subjective Measure

Background: Children from lower socioeconomic status (SES) households are at greater risk for mental illnesses. Socioeconomic status has different dimensions: Objective SES, subjective SES, and contextual SES. Evidence suggests that subjective SES partially mediates the impact of objective SES on mental health. However, these hypotheses have not been tested in Middle Eastern cultures, including Iran. Objectives: We aimed to investigate: (1) if there is an association between parental objective, subjective, and contextual SES measures and their children's mental health in a network of general practitioners' clients, (2) if such an association exists for objective or contextual indicators, is it partially or fully mediated through subjective measure? and (3) if such an association exists, is it affected by children's age? Methods: We assessed 1,103 parent-child pairs in the general practitioners' network of clients. The child's mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ) and parental objective SES by education level, subjective SES by the MacArthur scale, and contextual SES by the household neighborhood. Linear regression models were used to investigate the impact of different SES measures on the SDQ score both bivariately and adjusted for each other. A mediation analysis was performed for objective SES' indirect effect on SDQ score through subjective SES. Results: We found a significant association between objective and subjective SES and the SDQ score, which remained significant after adjusting for each other. Both objective and subjective measures had a small effect size (Cohen's f-squared = 0.03). There was no association between contextual SES and SDQ scores in our sample. Conclusions: Socioeconomic status impacts children and adolescents' mental health. However, SES is a multi-dimensional concept. Further research considering different dimensions is needed to understand the interplay of these dimensions in different cultures and contexts. Addressing such exploratory questions may help pave the way for detecting and addressing these social determinants in primary care settings.

Antecedents Predicting Students' Active Use of Learning Strategies in Schools of Low SES Context within the Framework of Self-Determination Theory.

Meeting a student's autonomy, competence, and relatedness needs is one of the conditions to help him/her learn effectively. In this study, we aim to understand how teacher support (relationship with students, their autonomy support) and general classroom atmosphere (equity, relationships between students) predict students' learning; that is, the learning strategies they use. Data were collected from 24 secondary schools in 9 municipalities in Lithuania with low SES (socioeconomic status) contexts (N = 632 students; 330 girls and 302 boys). The following instruments were used in the research: What Is Happening in this Class? (WIHIC) questionnaire, a short form of the Learning Climate Questionnaire (LCQ), and the Learning Strategies scale. The results showed that girls use learning strategies statistically significantly more actively than boys. Students' use of learning strategies in a sample of both boys and girls are predicted by perceived teacher support, student cohesiveness, and perceived autonomy support. Therefore, responding to the relatedness and autonomy needs of students from low SES is very significant because it can increase their engagement in the learning process. The difference found, that equity is a significant predictor of learning strategies in the sample of girls, but not in boys, encourages further research and interpretation of such research results.

Association between socio-economic status and non-communicable disease risk in young adults from Kenya, South Africa, and the United Kingdom

There is a pressing need for global health preventions to curb the escalating burden of non-communicable diseases (NCDs). Utilising multi-country study designs can improve our understanding of how socio-economic context shapes the aetiology of NCDs, and this has great potential to advance global health interventions. We examined the association between socio-economic status (SES) and NCD risk, and the potential confounding effects of smoking and alcohol intake in young adults (18–35-year-olds) from Kenya, South Africa (SA), and the United Kingdom (UK). Our study was a cross-sectional online survey that included 3000 respondents (n = 1000 per country, 50% women) conducted in April 2022. We utilised information on twelve NCDs to classify respondents as having “no condition”, “one condition”, and “multimorbidity” (having two or more conditions). A total household asset score was calculated and used as a proxy of SES, and subsequently categorised into quintiles (Q1–Q5; lowest-highest). Ordered logistic regression was used to test the associations between NCD risk and exposure variables. In the UK sample, we found that those in the second lowest SES quintile (Q2) had lower odds of developing NCDs than their lowest SES counterparts (Q1). In contrast, South African and Kenyan youth with a SES score between middle and highest quintiles (Q3–Q5) were more likely to develop NCDs than the lowest SES quintile group. In all countries, smoking and/or alcohol intake were associated with higher odds of developing NCDs, and showed some confounding effects on the SES-NCD relationships. Specifically, in Kenya, the risk of developing NCD was more than two times higher in those in the middle (Q3) SES group (OR 2.493; 95% CI 1.519–4.091; p < 0.001) compared to their lowest (Q1) SES counterparts. After adjusting for smoking and alcohol, the ORs of middle (Q3) SES group changed from 2.493 to 2.241 (1.360–3.721; p = 0.002). Overall, we found that the strength and direction of SES-NCD associations differed within and between countries. This study highlights how different SES contexts shape the risk of NCDs among young adults residing in countries at different levels of economic development.

Districts' and schools' role in identifying and providing services for homeless students: Nested ecological case studies in school districts with high- and low-socioeconomic status.

Even though homeless students are nested in schools and districts with different socioeconomic status (SES) contexts, little is known about the role of schools and districts for homeless students in these differing contexts. This comparative case study explored the identification, service provision, and school experience of homeless students in high- and low-SES districts. Mixed-methods case study methodology was used to compare two school districts and their four elementary and middle schools in California. The districts differed based on their SES: low to medium versus high. Findings show that despite differences in theSES context, both districts were underidentifying homeless students. Hence, both districts were underserving and lacking awareness of homeless students thatwere not identified. However, the low-SES district had far greater poverty awareness and, subsequently, an existing organizational structure than the high-SES district to support identified homeless students. Poverty awareness and districts' organizational structure are important contextual factors to consider in designing local and tailored interventions and services for homeless students.

Teachers’ Autonomy-Supportive Behaviour and Learning Strategies Applied by Students: The Role of Students’ Growth Mindset and Classroom Management in Low-SES-Context Schools

This study explored a moderated mediation model, which is based on the assumption about the direct relationship between teachers’ autonomy-supportive behaviours and students’ learning strategies and via perceived classroom management as well as the effect of growth mindset for the relationships between (1) teachers’ autonomy-supportive behaviours and learning strategies applied by students and (2) perceived classroom management and learning strategies applied by students. Data were collected from 23 secondary schools in municipalities in Lithuania with low SES (socioeconomic status) contexts (N = 581 students). The results showed that teachers’ autonomy-supportive behaviours are directly and positively related to the increased use of learning strategies applied by the student. The perceived classroom management mediates the relationship between teachers’ autonomy-supportive behaviours and learning strategies applied by the students. In this case, we have an inconsistent mediation, so the mediator acts as a suppressor (the indirect path through mediator is negative, while the direct is positive). The growth mindset does not moderate the relationship between perceived teachers’ autonomy supportive behaviours and the students’ use of learning strategies, but growth mindset moderates the relationship between perceived classroom management and learning strategies applied by the student. For students with a lower or moderate growth mindset, greater perceived classroom management is related to the lesser use of learning strategies. However, for those with a higher growth mindset, greater perceived classroom management is related to greater use of learning strategies. This study contributes to the understanding of the importance of teachers’ behaviours for students’ learning by focusing on classroom management and growth mindset.

Dietary disparities among adolescents according to individual and school socioeconomic status: a multilevel analysis

This study aimed to estimate disparities in dietary habits according to the individual and contextual socioeconomic status (SES), while taking into account school nutrition-related characteristics. Data came from the 2018 cross-sectional “Health Behaviour in School-aged Children” (HBSC) survey. Multilevel multiple logistic regressions were performed. Over two-thirds of the observed variance was explained by individual and school characteristics, with SES being the main contributors. For example, 76.9% of the variance in daily sugar-sweetened beverage (SSB) intake was explained by individual and school characteristics. Adolescents of a secondary or lower parental education level were more likely to consume SSB daily than those of a post-secondary level (aOR = 1.46 (1.29–1.66)). Compared to those in a high SES school, the odds to consume SSB daily was higher for adolescents in low SES schools (aOR = 2.37(1.90–2.96)). These findings support the need for schools to pursue a consistent nutrition policy, with an increased support in low socioeconomic populations.

The Importance of Teacher Support and Equity in Student Engagement and Achievement in Low SES School Contexts

Low socioeconomic status (SES) is often seen as a risk factor for lower academic achievement, so this study explains how teacher support and equity are related to higher student engagement and achievement in low SES school contexts. Based on the results, student behavioural engagement is related to their achievement. The results of the multiple regression analysis show that teacher support and equity predict student emotional engagement statistically significantly, while behavioural engagement predicts only equity. No significant teacher support and equity prognostic values were found for student achievements. The study’s results encourage further research and the search for answers to the question of what kind of teacher behaviour creates a favourable learning environment for all students in low SES context schools.

Individual and contextual socioeconomic status as effect modifier in the air pollution-birth outcome association

BackgroundSeveral studies have examined whether air pollution is associated with adverse births outcomes, but it is not clear if socioeconomic status (SES) modifies this relationship. ObjectivesWe investigated if maternal education and area-level socioeconomic status modified the relationship between ozone, nitrogen dioxide and particulate matter with aerodynamic diameter <10 μm (PM10) on preterm births (PTB; gestational age <37 weeks) and term low birth weight (TLBW; weight < 2500 g on term deliveries). MethodsAnalyses were based on almost 1 million singleton live births in São Paulo municipality between 2011 and 2016. The final sample included 979,306 births for PTB analysis and 888,133 for TLBW analysis. Exposure to PM10, NO2 and O3 were based on date of birth and estimated for the entire gestation and for each trimester. Multilevel logistic regression models were conducted to examine the effect of air pollutants on both adverse birth outcomes and whether it was modified by individual and area-level SES. ResultsIn fully adjusted models, over the entire pregnancy, a 10 μg/m3 increase in O3 and PM10 was associated with increased chance of PTB (odds ratio; OR = 1.14 CI 1.13, 1.16 and 1.08 CI = 1.02, 1.15 respectively) and PM10 with TLBW (OR = 1.08 CI 1.03, 1.14). Associations were modified by maternal educational and area-level SES for both outcomes. Mothers of lower education had an additional chance of PTB and TLBW due to PM10 exposure (OR = 1.04 CI 1.04, 1.05 and 1.10 CI 1.08, 1.14 respectively), while mothers living in low SES areas have an additional chance for TLBW (OR = 1.05 CI 1.03, 1.06). Similar modification effects were found for O3 exposure. Trimester specific associations were weaker but followed a similar pattern. ConclusionSocioeconomic status modifies the effect of air pollution on adverse birth outcomes. Results indicate that mothers with lower SES may be more susceptible to air pollution effects.

The Role of Socioeconomic Status in Latino Health Disparities Among Youth with Type 1 Diabetes: a Systematic Review.

Type 1 diabetes (T1D) incidence is growing faster among Latino than non-Latino White youth, but ethnic disparities in self-management behaviors and HbA1c are unclear. Socioeconomic status (SES) is a key factor in T1D, which may confound or contribute to disparities in Latino pediatric T1D management. A systematic review examined whether ethnic differences in pediatric T1D outcomes occur and are independent of socioeconomic status (SES). Latino youth displayed lower self-management and higher HbA1c in approximately half of the identified studies prior to including SES in analyses. Ethnic differences in self-management were found for objective (i.e., frequency of blood glucose checks), but not subjective measures. Ethnic differences were often eliminated when SES was statistically controlled. SES moderated some differences, suggesting complex sociocultural processes. Articles varied widely in SES measures and the analytic methods used to evaluate ethnic disparities. Pediatric Latino T1D disparities are inconsistent and at least partially dependent on the SES context. Recommendations for future research to systematically evaluate SES and Latino T1D disparities are made.

Abstract A006: Multi-modal estimation of causal influences of environmental agents on colorectal cancer in an understudied population

Abstract Background: While there is a well-established causal relationship between several individual factors and contextual socioeconomic status with colorectal cancer, there is still a lack of strong evidence that the prevalence of environmental agents is independently associated with colorectal cancer in various geographical areas. Population-based studies assessing the causal relationship between environmental agents and colorectal cancer are limited by the scarcity of comprehensive data. Most previous studies have relied on the recall of self-reported exposures. Objective: In this study, we provide new and important insights by integrating publicly available ‘big data’ resources with hospital data to identify causal influences on colorectal cancer in an understudied rural population in Virginia. Methods: Data linkage was achieved by geocoding patients zip codes at diagnosis and spatially assigning contextual and environmental data to the hospital cancer records. Machine learning imputation methods were used to fill in the missing values that resulted from the linkage. A “Big Data” science approach was used to develop a multi-scale modeling of individual and contextual data with national and local exposomes from environmental exposures sources. The methodology is based on training a Bayesian causal network to better understand the causal inference from individual and contextual level data, as well as environmental exposures data on the outcomes of colorectal cancer. The primary source of data for this project is the Sentara Cancer Registry (SCR). The SCR collects data on cancer cases from eight Sentara hospitals. The information collected by SCR includes patient characteristics and clinical outcomes. The secondary source of data come from the U.S. Census Bureau (Census 2010). This data source is used to determine zip-code level socioeconomic status of each colorectal cancer case. Environmental data such as water quality, Superfund site locations, toxic release sites, and heavy metals were obtained from the Virginia Department of Environmental Quality. Environmental data was supplemented with Toxics Release Inventory (TRI) database, considered to be the most comprehensive data source on industrial toxic emissions in the US. Conclusion: This study contributed to the scientific innovation of leveraging mixed-methods data collection by building a comprehensive database for cancer research in an understudied population. Citation Format: Hadiza Galadima, Georges Adunlin, James Blando. Multi-modal estimation of causal influences of environmental agents on colorectal cancer in an understudied population [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A006.

Process and context: Longitudinal effects of the interactions between parental involvement, parental warmth, and SES on academic achievement

Parents' involvement in their children's education and parental warmth have been linked to many positive child outcomes. In addition to these positive associations, contemporary developmental theory stresses the interaction between different parenting variables and the interaction between parenting and broad contextual factors such as family socioeconomic status (SES). Thus, the purpose of this study was to examine main and interaction effects of parent home-based involvement and parental warmth on achievement outcomes. Additionally, we evaluated whether these variables also interacted with SES to predict students' achievement growth. Using the Early Childhood Longitudinal Study – Kindergarten Cohort of 2010–11 (N = 2352), growth of academic outcomes was modeled from kindergarten to the fourth grade. We then used latent variable interaction (Maslowsky, Jager, & Hemken, 2015) procedures to examine interaction effects of our primary study variables. Few significant effects were noted for children's reading and mathematics scores, but more substantial main (home-based involvement) and interaction (parental warmth and SES) effects emerged for science achievement. At high SES levels, warmth negatively predicted growth in science, whereas at lower SES levels, warmth positively predicted growth. Findings are discussed in relation to importance of parent involvement, differential effects across SES contexts, and curricular emphasis in contemporary schools.

Socioeconomic Status, Health Inequalities, and Solidarity Trends in a Mass Vaccination Campaign

Abstract Background In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity. Methods The study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013. Results The higher the SES level of the area where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake. As time passed in the vaccination campaign, vaccination uptake increased regardless of the location of the mother-and-child clinics. The highest vaccination uptake rate was found among populations of low SES and low Gini inequality index. The lowest vaccination uptake rate was found among populations of high SES/high Gini inequality index. Conclusions Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities. Key messages The higher the SES in municipalities with mother-and-child clinics, the less likely children were to be vaccinated. The lower the Gini inequality index, there is a higher polio vaccination uptake among of children.

Socioeconomic inequalities in cognitive performance among early ageing people: The Constances cohort

Abstract Background In spite of the recent awareness of environmental characteristic’s impact on brain aging, links between contextual socioeconomic status and cognitive performance (CP) remains unclear. The objective was to investigate the influence of individual and contextual deprivation on cognitive performance in order to better characterize vulnerable population. Methods We performed cross-sectional analyses on 44,762 participants (45-70 y) of the French Constances cohort. Cognitive performance was assessed using a global cognitive score calculated with 6 cognitive tests evaluating global cognitive function, episodic verbal memory, language abilities, and executive functions. Poor performance was defined as a score below or equal to the 25th percentile of the distribution. We approached the deprivation by two validated multidimensional index: at individual level with the EPICES score (deprived if &amp;lt; 30.17) and contextual level with the FDep09 score divided in quintile (Q5 being the most deprived). Associations were estimated with multilevel logistic regressions. Results At the individual level, participants more deprived had poorer CP independently to sex, age, education and health status (OR 1.58 [1.48; 1.69]). At the contextual level, the more people lived in deprived environment, the poorer their CP (p&amp;lt;.0001), even after adjustment on individual deprivation and other individual characteristics (Q5 vs Q1: OR 1.28 [1.15; 1.41]). Conclusions In this large cohort of early-ageing people, area-based disparities in cognitive impairment were highlighted. A better understanding of the influence of living environment deprivation level on cognitive aging could help to define new strategies in prevention by targeting at-risk populations in interventions studies in order to reduce social health inequalities. Key messages Our study evidenced a strong socio-economic gradient of cognitive performance identifiable on both individual and contextual level, in a large sample of middle-aged volunteers. Independently to individual deprivation and other individual characteristics, living in a deprived environment may be detrimental to the brain health.

Vaccination uptake and income inequalities within a mass vaccination campaign

BackgroundIn July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity.MethodsThe study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013 (the “campaign period”). The analysis was carried out at the municipality level as well as the statistical area level.ResultsThe higher the SES level of the municipality where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake.ConclusionsPublic health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.

Socioeconomic Disadvantage, Chronic Diseases and their Association with Cognitive Functioning of Adults in India: A Multilevel Analysis

Cognitive functioning is an important factor in determining overall well-being in adults. The research conducted in this area has mainly focused on dementia and gender differentials in cognitive ability. Using data from WHO’s Study on global AGEing and adult health (SAGE), this study examines the association of individual, household, contextual socioeconomic status, and chronic morbidities with cognitive abilities of younger (18-49) and older adults (50+) in India. Multilevel linear hierarchical model was used to examine this association. Results show that the years of schooling and household income were positively and significantly associated with cognitive abilities in younger and older adults. Community level socioeconomic status was positively associated with cognition in adults. Females had significantly lower cognitive abilities than male counterparts. Further, chronic morbidites and edentulism were negatively associated with cognition, especially the association of chronic morbidities was stronger in younger adults (β = −0.11; p < .001). Measures to prevent chronic health conditions and edentulism are mportant to improve the quality of aging in India.

The role of contextual and individual factors on periodontal disease in Uruguayan adults.

The present study aimed at understanding the relationship between periodontitis and socio-contextual and individual determinants of health. Data from "The First Uruguayan Oral Health Survey, 2011", which included 223 and 455 individuals with 35-44 and 65-74 years old respectively, were used. A stratified, multistage cluster sampling design was adopted (cities with ≥ 20.000 residents). Periodontitis was assessed using the modified Community Periodontal Index (CPI) and clinical attachment loss (CAL) (periodontal pocket and CAL ≥ 4 mm). Independent variables included contextual socioeconomic status (SES) measured by proportion of houses with Unsatisfied Basic Needs (UBN) and individual demographic and behavioral factors. Logistic regression multilevel models were generated. Living in contexts with a higher UBN was associated with higher odds for periodontitis in both age groups, even when adjusting for individual level variables (odds ratio [OR] = 1.51, 95%CI = 1.42-1.60 and 1.31, 95%CI = 1.21-1.42, respectively). Being male or heavy smoker increased the odds of periodontitis in this population for both age groups. Social structure impacts periodontal disease by modifying individual socioeconomic situations: in better socioeconomic context, UBN acts increasing the protector role of socioeconomic situation but in a poverty context the role is attenuated. Conclusions for this study are that periodontitis varies across contextual socio-demographic groups being higher in the population with a lower SES, challenging health authorities to integrate oral health into national non-communicable diseases programs.