Differences In Socioeconomic Characteristics Research Articles

A Geospatial Study of Opioid Overdose Risk in Diverse Regions

Over the past two decades fatalities from opioid overdoses (OD) in the United States have increased at an alarming rate, and there exist regional disparities in the number of opioid fatalities within the US. A comprehensive understanding of the underlying factors contributing to this geographic variation remains elusive however. In this study, we consider the Social Vulnerability Index (SVI) census variables and their influence on opioid overdose within diverse geographic regions, each exhibiting different socio-economic factors. To investigate these disparate outcomes, we use Social Vulnerability Index data from the year 2018 alongside mortality data obtained from the CDC WONDER database. The factors that contribute to opioid OD fatalities can vary from one region to another due to differences in socio-economic characteristics. To investigate these regional differences, we have chosen a set of variables for each region which are relevant to understanding the opioid OD fatalities in three different geographical regions: the Washington D.C metropolitan area, Wyoming, Tennessee. The impact of each factor on the epidemic's propagation varies between these regions however. To identify patterns in socioeconomic factors driving the opioid crisis, we applied methods from topological data analysis to identify potential correlations between social vulnerability factors and the distribution of drug overdose fatalities. In conclusion, our work highlights the importance of the socio-economic factors in understanding the dynamics of the opioid epidemic.

Socioeconomic variations in walking rates in the United States: Recent evidence from the 2022 National Household Travel Survey

IntroductionWe use the 2022 National Household Travel Survey for the USA—the first since the peaking of the COVID-19 pandemic—to examine variations in walking rates related to differences in socioeconomic characteristics. Our analysis provides the most recent national estimates of socioeconomic variation in walking, by far the most important form of daily physical activity in the USA. MethodsWe used graphical bivariate analysis and multiple regressions to explore the relationship between each of the socioeconomic variables and the following daily walk rates: the number of walk trips, time walked, and distance walked. We also analyzed three binary variables indicating whether a person made at least one walk trip during the travel day, achieved the equivalent of 150 min of walking per week, and walked on five or more days during the previous 30 days. ResultsHigher education levels, not owning a car, not having a driver's license, not working, working from home, and high density are strongly related to higher levels of walking. We found no significant differences or mixed results for gender, age, race, and income. Because the 2022 NHTS incorporated significant changes in methodology, sample size, survey questions, and variable definitions, its estimated trip rates cannot be compared directly to the 2017 NHTS—the last survey prior to COVID. Moreover, the 2022 NHTS greatly underestimated walk trips because—unlike previous NHTS surveys—it omitted the trip diary as well as multiple prompts to remember short trips, especially walk trips. ConclusionsThe relationships we estimated between various walk rates and the nine socioeconomic variables for 2022 were generally consistent with the results of previous studies, including those examining the 2001, 2009, and 2017 NHTS. That suggests that these relationships have remained stable over time—even if absolute rates of walking have changed, as indicated by other studies.

Dietary Intake and Snacking Behaviour of Children Aged 3-5 in Urban and Rural Areas of Thailand’s Southernmost Border Provinces

Thailand suffers from the double burden of malnutrition due to the nutrition transition(1). Shifts in eating patterns from traditional foods to more processed foods, an increase in snacking and urbanisation are associated with the nutrition transition(2). We aimed to explore eating, feeding, and snacking behaviours in children aged 3-5 living in urban and rural areas of Thailand’s Southernmost Border Provinces (SBPs).A cross-sectional survey was conducted among 279 parent-child dyads recruited from one urban (n=135) and three rural schools (n=144) in the SBPs. The International Eating and Feeding Tool (ICFET)(3) was used to collect sociodemographic data, feeding frequency, food and snack consumption. Weight and height were measured to calculate WHZ (weight- for-height z score) and HAZ (heigh-for-age z score) scores. The frequency of consumption for groups and types of food were summed to give a monthly frequency. A 24-hour recall of intake of plated foods and drinks during five potential eating occasions was taken. Carers rated the applicability of statements regarding their use and control of snacks. Descriptive statistics and Mann-Whitney U test for comparisons between urban and rural areas were analysed using SPSS V28.Socioeconomic disparities between caregivers from urban and rural areas were observed. Onefourth (22%) of rural caregivers reported senior high school education and no income (16%) compared to 0.7%, (P<0.001) and 1% respectively in urban caregivers (P<0.001). Child stunting was more prevalent in rural areas (24% vs 6% urban, P<0.001). No difference in wasting was observed between the two settings (7% rural vs 9% urban, P<0.423). Monthly food frequencies (times) (Median, IQR) were higher in urban compared to rural areas for milk and dairy products (30, 15-45) urban vs (15, 15-30) rural (P<0.001) and fruits and vegetables (Mean, SD) (53, 31) urban vs (43, 29) rural, (P=0.008). Half the children (56%) had three between-meals snacks and dry finger foods (mean, SD) (1.7, 0.5) times daily. Rural parents described higher scores of snack control (Median, IQR) (16, 15-18) rural vs (15, 13-16) urban, (P<0.001), and felt children were more likely to seek snacks in response to hunger compared to urban children (5, 2-5) rural vs (4, 2-5) urban, (P<0.001). Surprisingly, more snack foods were consumed in rural areas (50, 33-75) rural vs (45, 33-60) urban, (P=0.042).Eating snacks between meals is common in Thai children living in SBPs. Snack foods are widely eaten, even more in rural than urban children. Despite the substantial differences in socioeconomic characteristics and levels of stunting, there was little variation between urban and rural areas in the commonness of snacking.

Analysis of anthropometric outcomes in Indian children during the COVID-19 pandemic using National Family Health Survey data

BackgroundDisruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health. There is currently limited research on the potential effects of the COVID-19 pandemic on stunting, wasting, and underweight status of young children.MethodsWe examine the short-term associations between the pandemic and anthropometric outcomes of under-5 children (n = 232,920) in India, using data from the National Family Health Survey (2019–2021). Children surveyed after March 2020 are considered as the post-COVID group, while those surveyed earlier are considered as pre-COVID. Potential biases arising from differences in socioeconomic characteristics of the two groups are mitigated using propensity score matching methods.ResultsPost-COVID children surveyed in 2020 and 2021 have 1.2% higher underweight rates, 1.2% lower wasting rates, 0.1 lower height-for-age z-scores (HAZ), and 0.04 lower weight-for-height z-scores as compared with matched pre-COVID children. Post-COVID children surveyed in 2020 have 1.6%, 4.6%, and 2.4% higher stunting, underweight, and wasting rates, respectively, and 0.07 lower HAZ, as compared with matched pre-COVID children. Reductions in nutritional status are largest among children from households in the poorest wealth quintiles.ConclusionsThese findings indicate a trend towards a recovery in child anthropometric outcomes in 2021 after the initial post-pandemic reductions. The resilience of health and food systems to shocks such as COVID-19 should be strengthened while immediate investments are required to decrease child malnutrition and improve broader child health outcomes.

The socioeconomic epidemiology of inherited retinal diseases in Portugal

BackgroundInherited retinal diseases (IRDs) are a group of rare degenerative disorders of the retina that can lead to blindness from birth to late middle age. Knowing the target population and its resources is essential to better plan support measures. The aim of this study was to evaluate the socioeconomic characteristics of regions in Portugal where IRD patients reside to inform the planning of vision aid and rehabilitation intervention measures.ResultsThis study included 1082 patients from 973 families, aged 3 to 92 years, with a mean age of 44.8 ± 18.1 years. Patients living with an IRD were identified in 190 of the 308 municipalities. According to this study, the estimated IRD prevalence in Portugal was 10.4 per 100,000 inhabitants, and by municipalities, it ranged from 0 to 131.2 per 100,000 inhabitants. Overall, regions with a higher prevalence of IRD have a lower population density (r=-0.371, p < 0.001), a higher illiteracy rate (r = 0.404, p < 0.001) and an overall older population (r = 0.475, p < 0.001). Additionally, there is a lower proportion of doctor per capita (r = 0.350, p < 0.001), higher social security pensions beneficiaries (r = 0.439, p < 0.001), worse water quality for human consumption (r=-0.194, p = 0.008), fewer audiences at the cinema (r=-0.315, p < 0.001) and lower proportion of foreign guests in tourist accommodations (r=-0.287, p < 0.001).ConclusionThe number of identified patients with IRD varied between regions. Using data from national statistics (PORDATA), we observed differences in socioeconomic characteristics between regions. Multiple targeted aid strategies can be developed to ensure that all IRD patients are granted full clinical and socioeconomic support.

Abstract 14: Associations Between Measures of Structural Racism and Acute Ischemic Stroke Incidence in the US

Introduction: Racial differences in socioeconomic characteristics are believed to be secondary to structural racism. While socioeconomic factors explain some of the racial disparity in stroke incidence at an individual level, little is known about the association between societal-level structural racism and the incidence of acute ischemic stroke (AIS). Methods: We conducted a national cross-sectional analysis of 71,078,619 adults aged &gt;65 years enrolled in Medicare from January 1, 2016 to December 31, 2019. The primary exposure was a county-level composite structural racism score that was calculated from constituent measures of structural racism: segregation indices (delta index, dissimilarity index, isolation index), Gini index, housing discrimination, educational attainment ratio, employment ratio, income ratio. The primary outcome was AIS incidence. Results: The composite structural racism score identified significant geographic variation in structural racism across the U.S. (mean 0.818, SD 2.874, IQR 3.02). Among 844,406 Medicare beneficiaries with incident AIS, Black individuals had a 19% increased hazard of AIS compared to White individuals (HR 1.19, 95% CI 1.14-1.25, p&lt;0.0001). Increasing segregation conferred increased incidence of AIS for both Black and White populations. Each standard deviation increase in the composite structural racism score was associated with an 18% increased incidence in AIS (HR 1.18, 95% CI 1.12-1.24) in the total population. This association interacted with race (p=0.03), with a greater magnitude of association for White (HR 1.19, 95% CI 1.13-1.25, p&lt;0.0001) versus Black (HR 1.09 ,95% CI 1.03-1.16, p=0.0073) individuals. Conclusions: There is significant geographic variation in structural racism at the county level across the US, and increasing levels of structural racism are associated with increased incidence of AIS, regardless of race.

Where the Landlords Are: A Network Approach to Landlord-Rental Locations

The United States is home to more than 100 million renters and approximately 11 million landlords, yet these two sides of the rental market are rarely studied in tandem. This study uses a multiscalar network-based approach to identify landlord market areas. Building on administrative data of the locations of rental properties and landlords, I define a landlord–property network as a spatial bipartite network, where landlords’ addresses are connected to their properties’ addresses, and vice versa. I first examine the location of landlords relative to their properties. I then compare the differences in socioeconomic characteristics in landlord and rental tracts. I simplify this network by extracting its backbone, defining a core component of a landlord market. I compare these networks to Metropolitan Statistical Areas and commuting networks to evaluate the performance of the backbone extraction method. I find that most landlords are local, and, perhaps unsurprisingly, that landlord neighborhoods are richer, Whiter, and more expensive than where their properties are located. Extracting the backbone of the commuting network results in a network that mirrors a regional definition, whereas the landlord market area is much more national in scope. These two networks differ geographically and also with regard to their network statistics. Whereas renters and homeowners search within a region for new housing, landlords and capital can search nationally for locations in which to invest. This article provides a new, robust foundation to understanding rental market investor dynamics and the relationship among owner, renter, and property.

Prevalence and risk factors of physical violence against husbands: evidence from India.

As the proportion of women being victims of spousal violence in India is higher than men, laws are usually framed to safeguard women. However, men who have experienced physical spousal violence are not unheard of. The study aims to provide the nationwide prevalence of physical violence against husbands and the risk factors for such violence, using large-scale nationally representative 'National Family Health Survey' (NFHS 4) data. The study used descriptive, bivariate, logistic, and multilevel regression models with a random intercept clustering within states and households to explain the physical violence against husband. Sample size for the analysis was 62,716 currently married women aged 15-49 years. Findings revealed that in most of the states of India, physical spousal violence has increased over time. Behavioural characteristics like marital control, alcoholism, and childhood experience of parental violence have a consistent and strong role in explaining the experience of physical violence across states. With age, experience of violence against husbands increases. Differences in socio-economic characteristics do not have unidirectional effect on violence experienced by husbands across regions of India. Working women who are earning cash and having access to mobile phones perpetrate more physical violence in selected regions. Education shows a gradient on such violence perpetration, indicating that only after achieving a certain level of education, chances of violence reduce. Regionally contrasting social and economic risk factors in explaining violence strengthen the argument that violence is space and culture-specific, and development alone may not resolve violence unless the system is addressing the behavioural aspects. There is a need for supporting men experiencing domestic violence within the existing system facilities. Revisiting the present domestic violence laws and programmes for inclusivity is the need of the hour.

The gendered effects of the COVID-19 pandemic on adolescent literacy and schooling outcomes in India

The COVID-19 pandemic disrupted education delivery around the world, with school closures affecting over 1.6 billion students worldwide. In India, schools were closed for over 18 months, affecting 248 million students. This study estimates the effect of the pandemic on adolescent literacy and schooling outcomes in India. We used data from the National Family Health Survey. (NFHS-5) which covered 636,699 households across all districts of India from June 2019 to April 2021. We considered 15–17 year old adolescents who were surveyed after March 2020 as the post-COVID group while those surveyed earlier were included in the pre-COVID group. We used propensity score matching and inverse propensity score weighted regression methods to account for differences in socioeconomic characteristics between the two groups. Rates of literacy (ability to read a complete sentence) were 1.5–1.6% lower among post-COVID girls as compared with similar pre-COVID girls. Among post-COVID girls in the lowest wealth quintile, rates of literacy were 3.1–3.8% lower than similar pre-COVID girls. There was no loss in literacy among post-COVID girls in the highest wealth quintile. COVID-induced loss in literacy among girls was twice in rural areas as compared to urban areas, and substantially higher among socioeconomically disadvantaged caste groups as compared with privileged caste groups. Post-COVID girls also had 0.08–0.1 lower years of schooling completed than similar pre-COVID girls but there was no difference in out-of-school rates. In a smaller subsample of 15–17 year old boys, the post-COVID group had 2% lower out-of-school rates and there was no difference in literacy or years of schooling completed as compared with matched pre-COVID boys. While markers of vulnerability such as residence, caste, and poverty further amplified the risk of learning. loss for girls, they did not have the same effect on boys.

Developing digital tools for health surveys in low- and middle-income countries: Comparing findings of two mobile phone surveys with a nationally representative in-person survey in Bangladesh.

Non-communicable disease (NCD) risk factor data from low- and middle-income countries (LMICs) are inadequate, mostly due to the cost and burden of collecting in-person population-level estimates. High-income countries regularly use phone-based surveys, and with increasing mobile phone subscription in developing countries, mobile phone surveys (MPS) could complement in-person surveys in LMICs. We compared the representativeness and prevalence estimates of two MPS (i.e., interactive voice response (IVR) and computer-assisted telephone interview (CATI)) with a nationally representative household survey in Bangladesh-the STEPwise approach to NCD risk factor surveillance (STEPs) 2018. This cross-sectional study included 18-69-year-old respondents. CATI and IVR recruitments were done by random digit dialing, while STEPs used multistage cluster sampling design. The prevalence of NCD risk factors related to tobacco, alcohol, diet, and hypertension was reported and compared by prevalence differences (PD) and prevalence ratios (PR). We included 2355 (57% males), 1942 (62% males), and 8185 (47% males) respondents in the CATI, IVR, and STEPs, respectively. CATI (28%) and IVR (52%) had a higher proportion of secondary/above-educated people than STEPs (13%). Most prevalence estimates differed by survey mode; however, CATI estimates were closer to STEPs than IVR. For instance, in CATI, IVR, and STEPs, respectively, the prevalence was 21.4%, 17.9%, and 23.5% for current smoking; and 1.6%, 2.2%, and 1.5% for alcohol drinking in past month. Compared to STEPs, the PD ranged from '-56.6% to 0.4%' in CATI and '-41.0% to 8.4%' in IVR; the PR ranged from '0.3 to 1.1' in CATI and '0.3 to 1.6' in IVR. There were some differences and some similarities in NCD indicators produced by MPS and STEPs with differences likely due to differences in socioeconomic characteristics between survey participants.

The Impact of Socioeconomic and Cultural Differences on Online Trade

We use eBay data to investigate how within-U.S. trade is influenced by differences in socioeconomic characteristics. States’ similarity in cultural characteristics (ethnicity, religious affiliations, and political behavior) predicts online trade; cultural similarity similarly predicts trade within product categories. The culture-trade relationship is stronger for transactions with sellers who lack extensive reputations or certification, suggesting that consumers infer seller trustworthiness from cultural similarity. There is no correlation between cultural similarity and buyer satisfaction, suggesting that perceived differences in trustworthiness are not validated in actual transactions. This paper was accepted by Alfonso Gambardella, business strategy. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4681 .

Assessing the inequality in out-of-pocket health expenditure among the chronically and non-chronically ill in Saudi Arabia: a Blinder-Oaxaca decomposition analysis

BackgroundMany high-income countries have made significant progress towards achieving universal health coverage. Nevertheless, out-of-pocket (OOP) health expenditure continues to undermine the effectiveness of the universal healthcare system. In Saudi Arabia, due to the overburdened free public health services, many people opt for alternative healthcare services, risking high OOP payments. The presence of chronic illness further exacerbates this situation. However, there is limited evidence on the extent of the gap in OOP health expenditure between the chronically and non-chronically ill and the associated drivers contributing to this gap. The aim of this study was to assess inequalities in relative OOP health expenditure, estimated as the percentage of income spent on healthcare, between the chronically and non-chronically ill in Saudi Arabia and their associated drivers.MethodsData from 10,785 respondents were obtained from a national cross-sectional survey conducted in Saudi Arabia as part of the 2018 Family Health Survey. Inequalities in relative OOP health expenditure were measured using concentration indices and curves. A Blinder-Oaxaca decomposition analysis was used to assess the differences in relative OOP health expenditure between the chronically and non-chronically ill.ResultsThe results showed that the chronically ill experience a higher financial burden due to healthcare services in absolute costs and relative to their income compared to the non-chronically ill. In addition, there was higher pro-poor inequality (–0.1985) in relative OOP health expenditure among the chronically ill compared to that (–0.1195) among the non-chronically ill. There was a 2.6% gap in relative OOP health expenditure among the chronically and non-chronically ill, of which 53.8% was attributable to unexplained factors, with explained factors accounting for the 46.2% difference. Factors that significantly contributed to the overall gap (i.e. both explained and non-explained factors) included employment status, insurance status, self-rated health, and periodic check-ups.ConclusionThis study underscores the high financial burden due to OOP payments among the chronically ill and the existence of pro-poor inequalities. In addition, there is a significant gap in relative OOP health expenditure between the chronically and non-chronically ill, which is mainly attributable to differences in socio-economic characteristics. This indicates that the existing financial mechanisms have not been sufficient in cushioning the chronically ill and less well off in Saudi Arabia. This situation calls for health policymakers to integrate a social safety net into the health financing system and to prioritize the disadvantaged population, thereby ensuring access to health services without experiencing financial hardship.

Regional Swedish study found that one in seven coeliac patients experienced loss of follow up during childhood.

To examine the clinical follow up of paediatric coeliac disease and the rate of loss of follow up during childhood, for which data are scarce. In a cohort of coeliac children diagnosed in 2013-2018 in Gothenburg, Sweden, we retrospectively explored the follow-up practice of paediatric coeliac disease until June 2021. We used medical records from hospital-based paediatric gastroenterology and general paediatric outpatient clinics, laboratory records, and questionnaires. Loss of follow up was defined no coeliac disease-related follow up or tissue transglutaminase test over the past 2 years of study enrolment. We included 162 children (58% girls) aged 7.8-18.2 years (average 12.7). Most participants (76%) were followed at general paediatric outpatient clinics rather than hospital-based clinics. After 2.3-8.8 (average 5.3) years since diagnosis, 23 patients (14%; 95% confidence interval, 9%-21%) had been lost to follow up. Patients with loss of follow up were more often boys (61% versus 39%, p=0.08), with a somewhat longer average disease duration of 5.8 versus 5.2 years (p=0.11). There were no between-group differences in socio-economic characteristics and patient-reported experience measures of coeliac disease care. One in seven coeliac patients may experience loss of follow up during childhood.

Effect of Socio-Economic Characteristics and Cultural Areas on the Educated Poor in East Java Province

Education is one way to save oneself from poverty. There are 19.5 percent of poor people in East Java who have completed education at the senior high school level and above but are still in poor condition. This study aims to examine the effect of socio-economic and regional characteristics on the status of the poor with upper secondary education in each cultural area in the province of East Java. Using the 2021 Susenas data which was analyzed with binary logistic regression, it was found that there were differences in socio-economic characteristics in each cultural area. Disability disorders and gender affect educated poverty in the Arek area but have no effect in the Pandalungan, Mataraman, and Madura Islands areas. Formal and informal sector jobs only have an effect in the Pandalungan area and have no effect in other areas. Choosing to work in the primary sector only affects the Mataraman area. While the factors of age, access to technology and use of the internet reduce the opportunities for poverty in all cultural areas. Keywords: Poverty, Logistic Regression, Susenas, educated poor, cultural area

Socio-Economic Determinants of Credit Access in Micro Enterprises Household of East Java During New Normal Era

The lack of micro-enterprises household in East Java that access business credit can affect the integration of MSMEs in the Global Value Chain (GVC) and exports acceleration in new normal era. This study aims to analyze the socio-economic determinants of microenterprise household credit access in East Java, and specific to each Bakorwil. Multinomial logistic regression analysis on the Susenas March 2021 and Potensi Desa 2021 found that there were differences in socio-economic characteristics in each Bakorwil. Important issues in accessing KUR/KUBE/KUB are poverty status, social protection programs, entrepreneur status, and internet use. Regional-based policies can be applied for business development and encourage integration into GVC by considering the socio-economic characteristics of each Bakorwil

Green Behaviors and Green Buildings: A Post-Occupancy Evaluation of Public Housing Estates in Hong Kong

A green building is believed to promote green behaviors from energy-saving to waste recycling. Green building certifications have attracted wide interest, and some were made mandatory for publicly funded developments in cities such as Hong Kong. Policymakers debate whether the city’s expanding public housing stock should be exempted from the green certification mandate for reasons of cost, while evidence of behavioral benefits in green residential buildings is thin, or non-existent for public housing estates. This paper describes a post-occupancy evaluation study on self-reported green behaviors in Hong Kong’s public housing estates. The study subjects are 400 occupants from two pairs of public rental housing estates with or without green certifications. A natural experiment was conducted, in which surveyed occupants were allocated to certified and uncertified estates via a random lottery, without significant differences in socioeconomic characteristics and propensity to green behaviors a priori. The results show that green-certified housing estates partially induced energy-saving behaviors, but not water saving or waste recycling, nor does it enhance satisfaction or green awareness. A certification alone is insufficient to induce behavioral changes, rather, efforts should be invested in conveying the green message, public education, and appropriate fiscal incentives.

Assessing press releases as a data source for spatial research

Describing the distribution and development of socio-economic activities in space is frequently limited due to data availability, as official statistical data sources are often restricted to specific topics and geographical scales. Consequently, new and alternative data sources are needed as complements. This paper presents, discusses, and empirically explores an example of such an alternative data source that promises to give detailed and novel insights into regions' socio-economic structures: press releases. While press releases have seen some use in the literature, they have hardly seen any applications in regional research. Consequently, it is still largely unknown to what extent their information content gives systematic insights into regional socio-economic patterns. The paper closes this gap by assessing the degree to which the content of press releases corresponds to the socio-economic characteristics of regions, by means of an empirical analysis of German NUTS-3 regions. The results confirm that press release content varies systematically between regions, and regional differences in socioeconomic characteristics, events, and activities seem to be well-presented by press releases. This suggests that press releases offer substantial potential and might be a useful complementary data source in regional studies.

Determinants of overweight and/or obesity among school adolescents in Butajira Town, Southern Ethiopia. A case-control study.

BackgroundThe global rise of adolescent overweight and obesity is posing a new challenge to the public health sector by determining the forthcoming generation for the most awful and upsetting quality of social life by inducing bantering, social isolation, and stigmatization among children that contribute to the mental wellbeing of the growing adolescents. Risk factors for overweight and/or obesity might not be the same across different regions due to differences in socioeconomic characteristics, culture, ethnicity, and geographical location. Moreover, in this study area, no report has been documented so far on the determinant factors of overweight and/or obesity among school adolescents. Hence, this study aimed at identifying context-specific determinants of overweight and/or obesity among adolescents in the study area.Methods and materialsSchool-based unmatched case-control study design was employed from March 1–30, 2019, in Butajira town, Southern Ethiopia. Data were collected regarding sociodemographic, dietary practice, physical activity, nutritional knowledge-related factors, and anthropometric measurements. Multivariable logistic regression models were fitted to identify independent predictors of overweight/obesity.ResultsWe enrolled 297 adolescents: 99 cases, 198 controls. Multivariable binary logistic regression analysis revealed that those in high socioeconomic status [AOR = 5.8, 95% CI (2.66, 12.5)], consumed soft drinks 3 and above times per week [AOR = 3.7, 95% CI (1.8, 7.3)], physically inactive [AOR = 4.4 95% CI (1.68, 11.6)], spent free time by watching television/movies for 3 and above hours per day [AOR = 8.6, 95% CI (4.3, 17)] and with poor nutritional knowledge [AOR = 3.4, 95%CI (1.7, 6.9)] were significantly associated with overweight and/obesity.ConclusionHigh socioeconomic status, consumption of soft drinks, physical inactivity, sedentary behavior, and poor nutritional knowledge were significantly associated with overweight/obesity. Therefore, strengthening parent and school-based health education in healthy nutrition behaviors and promotion tactics such as enhancing physical activity, limiting watching television, and soft drinks will be helpful to minimize overweight and obesity among adolescents.

Health-related selection into employment among the unemployed

BackgroundSuccessful transitions from unemployment to employment are an important concern, yet little is known about health-related selection into employment. We assessed the association of various physical and psychiatric conditions with finding employment, and employment stability.MethodsUsing total population register data, we followed Finnish residents aged 30–60 with an unemployment spell during 2009–2018 (n = 814,085) for two years from the onset of unemployment. We predicted any, stable, and unstable employment by health status using Cox proportional hazards models. The data on specialized health care and prescription reimbursement were used to identify any alcohol-related conditions and poisonings, psychiatric conditions and self-harm, injuries, and physical conditions. We further separated physical conditions into cancer, diabetes, heart disease, and neurological conditions, and psychiatric conditions into depression, anxiety disorders and substance use disorders.ResultsThe likelihood of any employment was lower among those who had any of the assessed health conditions. It was lowest among those with alcohol-related or psychiatric conditions with an age-adjusted hazard ratio of 0.45 (95% confidence interval 0.44, 0.46) among men and 0.39 (0.38, 0.41) among women for alcohol-related and 0.64 (0.63, 0.65) and 0.66 (0.65, 0.67) for psychiatric conditions, respectively. These results were not driven by differences in socioeconomic characteristics or comorbidities. All the included conditions were detrimental to both stable and unstable employment, however alcohol-related and psychiatric conditions were more harmful for stable than for unstable employment.ConclusionsThe prospects of the unemployed finding employment are reduced by poor health, particularly alcohol-related and psychiatric conditions. These two conditions may also lead to unstable career trajectories. The selection process contributes to the health differentials between employed and unemployed people. Unemployed people with health problems may therefore need additional support to improve their chances of employment.

Vaccine hesitancy among parents and its influencing factors: a cross-sectional study in Guangzhou, China

ABSTRACT Vaccine hesitancy is a major obstacle to the achievement of universal child vaccination, which has been studied extensively in Western countries but much less so in Asian countries, especially China. This cross-sectional survey is aimed to assess the prevalence of vaccine hesitancy and to explore the reasons for vaccine hesitancy among parents in Guangzhou. In January 2020, a questionnaire adapted to the Chinese setting from a widely-used hesitancy scale was administered to a sample of parents who brought their children aged <13 years to Community Health Service Centers for vaccination in Guangzhou. The incidence of vaccine hesitancy among those parents was 6.6% (50/755). Regression analysis showed that differences in socio-economic characteristics were not associated with the occurrence of vaccine hesitancy among parents in Guangzhou. However, strong distrust of domestic vaccine quality (OR = 10.9, 95% CI = 1.5–81.4), being required to have their children vaccinated for nursery and school entry (OR = 3.6, 95% CI = 1.7–7.7), and not being aware of which vaccines are officially required and which are optional (OR = 2.1, 95% CI = 1.1–4.3) were the risk factors significantly associated with vaccine hesitancy. In order to increase parents’ trust in domestic vaccine quality and reduce the prevalence of vaccine hesitancy, it is essential to strengthen quality control in domestic vaccine manufacturing and to proactively disseminate clear and accurate information about vaccines to parents. Furthermore, advocating the value of vaccination among all citizens of Guangzhou is crucial.