Differences In Sociodemographic Composition Research Articles

Association of Race, Ethnicity, Age and Socioeconomic Status with Access to Virtual Visits within the Brigham & Women's Hospital Division of Hematology during the COVID-19 Pandemic

Background: The COVID-19 pandemic prompted an expedited shift towards expanding telemedicine services. Historically, telemedicine has been shown to increase healthcare access for those in rural communities but widen care gaps for other vulnerable populations by exacerbating existing digital divides and clinician biases in offering telemedicine services. The purpose of this study is to understand the demographic and socioeconomic characteristics of patients completing telephone, video, and in-person visits at the Brigham and Women's Hospital Division of Hematology (BWH DOH) during the COVID-19 pandemic.Methods: This was a retrospective chart review of patients who completed clinical encounters within the BWH DOH between March 19, 2020, when the division switched to virtual visits, and December 31 st, 2020 (pandemic). Patients who completed visits between January 1, 2019 and March 18, 2020 (pre-pandemic) served as a comparator group. Differences in socio-demographic composition of patients completing telephone only (TO), video only (VO), or a mix of in-person and telemedicine visits (IPTM) were tested for significance using Kruskal-Wallis and Chi-square tests.Results: A total of 8307 pre-pandemic visits and 5910 pandemic visits were included in analysis. Almost all visits (99.8%) were in-person pre-pandemic compared to 32.4% in-person, 42.6% by telephone, and 25% by video during pandemic. Median age was significantly different between patients who had only pre-pandemic visits, only pandemic visits, and both (55 vs 52 vs 58 years; p=0.003). Otherwise, there was no significant difference in racial and median income distributions pre-pandemic to pandemic. Table 1 shows the socio-demographic characteristics of patients who completed TO (1536), VO (1065), or IPTM (1518) visits during the pandemic. VO patients were significantly younger than TO and IPTM patients (p<0.001). The majority of patients identified as White (61.3%) with Black and Hispanic patients accounting for 13.8% and 11.4% of the pandemic population, respectively. A higher proportion of White patients had VO visits (29.9%) compared to Black (15.2%) and Hispanic patients (13%) who both had a higher proportion of TO visits (34.7% vs 40.4% vs 50.9%, p<0.001). More patients with a college (29.9%) or post-graduate (34.3%) degree had VO visits than patients with a high school (16.3%) or other levels of education (21.5%) who were more likely to have TO visits (p<0.001). Median household incomes approximated from patient zip codes were significantly higher in patients with VO visits than those with TO or IPTM visits (p<0.001).Discussion: This study shows that during the COVID-19 pandemic, there were significant differences in the socio-demographic composition of patients completing VO versus TO versus IPTM visits within the BWH DOH. Overall, individuals from groups that historically experience health inequities in the United States including the elderly, African Americans, Hispanics, and those with lower educational levels and socioeconomic status had fewer VO visits and more TO visits compared to patients who were younger, White, and had higher levels of education and socioeconomic status. These differences have important implications as VO visits may offer better clinical interaction when compared to TO visits. The younger age of patients seen during the pandemic compared to pre-pandemic suggests that some older adults lost access to hematology care altogether during the pandemic. This disparity pre-pandemic to pandemic was not observed in other demographic subsets. Our work reveals a need to focus on digital inclusion efforts centered around device access, internet access, and digital literacy. Additionally, while TO and VO visits are temporarily equally reimbursed as in person visits under the U.S government's COVID emergency declaration, there has already been a return to markedly lower reimbursement for TO visits. Many practices and hospital system have lost significant revenue due to the pandemic and this differential reimbursement may disincentivize providing care through TO, even if that is the patient's only means of access. This could pose as a further barrier to telemedicine access for individuals from vulnerable populations and exacerbate structural racism, ageism, and other inequities. Care must be taken moving forward that actions to cope with the pandemic or modernize health care serve all patients. [Display omitted] DisclosuresNeuberg: Pharmacyclics: Research Funding; Madrigal Pharmaceuticals: Other: Stock ownership. Achebe: Fulcrum Therapeutics: Consultancy; Pharmacosmos: Membership on an entity's Board of Directors or advisory committees; Global Blood Therapeutics: Membership on an entity's Board of Directors or advisory committees.

Mind the gap, please! Pinpointing the influence of municipal size on local electoral participation

ABSTRACT Turnout rates vary between local and national elections. This paper promotes the national–local turnout gap as the best way to pinpoint the local component of voting at local elections. By analysing the national–local turnout gap instead of the raw local turnout rate, one can reduce the potential bias originating from the differences in socio-demographic composition and civic skills existing between municipalities of various sizes. Including data from 12 countries and almost 15,000 municipalities, it is demonstrated that a clear and consistent relationship between municipal size and local turnout exists: the larger the municipality the fewer eligible voters turn out at local elections (compared to national elections).

Users of the main smartphone operating systems (iOS, Android) differ only little in personality

The increasingly widespread use of mobile phone applications (apps) as research tools and cost-effective means of vast data collection raises new methodological challenges. In recent years, it has become a common practice for scientists to design apps that run only on a single operating system, thereby excluding large numbers of users who use a different operating system. However, empirical evidence investigating any selection biases that might result thereof is scarce. Henceforth, we conducted two studies drawing from a large multi-national (Study 1; N = 1,081) and a German-speaking sample (Study 2; N = 2,438). As such Study 1 compared iOS and Android users across an array of key personality traits (i.e., well-being, self-esteem, willingness to take risks, optimism, pessimism, Dark Triad, and the Big Five). Focusing on Big Five personality traits in a broader scope, in addition to smartphone users, Study 2 also examined users of the main computer operating systems (i.e., Mac OS, Windows). In both studies, very few significant differences were found, all of which were of small or even tiny effect size mostly disappearing after sociodemographics had been controlled for. Taken together, minor differences in personality seem to exist, but they are of small to negligible effect size (ranging from OR = 0.919 to 1.344 (Study 1), ηp2 = .005 to .036 (Study 2), respectively) and may reflect differences in sociodemographic composition, rather than operating system of smartphone users.

Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children

To explore whether regional variations in the initiation of attention-deficit hyperactivity disorder (ADHD) medication among school-age children are explained by differences in sociodemographic composition and/or ADHD prescribing practice, especially in children who face social adversity (low parental education and single parenthood). A cohort of Danish school-age children (ages 5-17) without previous psychiatric conditions (N = 813,416) was followed during 2010-2011 for incident ADHD prescribing in the individual-level Danish registers. Register information was retrieved for both children and their parents. Regional differences were decomposed into contributions from differences in sociodemographic composition and in prescribing practices. Incidence rate ratios (IRR) with 95% confidence interval (CI) of ADHD prescribing were calculated using demographically standardized multivariable Poisson regression models. Compared with the Capital, prescribing rates were significantly higher in regions North and Zealand (IRR, 1.19; 95% CI, 1.08-1.32 and 1.17; 1.08-1.28, respectively) and lower in South (IRR, 0.60; 95% CI, 0.54-0.66). After inclusion of the interaction term (region*social adversity), the multivariable analyses revealed a higher rate for the most disadvantaged children in North (IRR, 2.00; 95% CI, 1.51-2.66) and a lower rate in South (IRR, 0.47; 95% CI, 0.3-0.65). Prescribing rates were the highest for disadvantaged children in all regions, demonstrating the steepest social gradient in North and the smoothest in South. Demographic composition explained little of the variation: 3% for North and 13% for Zealand. Differences in sociodemographic composition explain little of regional variation in incident ADHD prescribing for children. However, large regional differences prevail in prescribing practices for children facing social adversity, indicating that local cultures shape the interpretation and handling of children with ADHD-like behaviors.

Culture, Institutions, and Morally Dubious Behaviors: Testing Some Core Propositions of the Institutional-Anomie Theory

This study draws on self-report data on the prevalence of morally dubious behaviors in Europe to examine Messner and Rosenfeld's institutional-anomie theory. Institutional-anomie theory tries to explain cross-national differences in crime rates through the interplay between the cultural commitments and the institutional arrangements characterizing a society. The relevant state of research is unsatisfactory and full of gaps. Deficiencies exist, especially with regard to the postulated cultural dynamics. Findings from a series of multilevel models testing the combined effects of cultural forces and social institutions on respondents’ engagements in morally dubious behaviors that are committed in pursuit of self-interest—thereby controlling for differences in sociodemographic composition—shed doubt on the theory's explanatory power. Neither the cultural imperatives of the “American Dream” nor the extent of anomic orientations are linked in the expected manner to the observed cross-national variation in rates of moral misconduct across Europe.

Social Capital and Women's Reduced Vulnerability to HIV Infection in Rural Zimbabwe

Social capital—especially through its “network” dimension (high levels of participation in local community groups)—is thought to be an important determinant of health in many contexts. We investigate its effect on HIV prevention, using prospective data from a general population cohort in eastern Zimbabwe spanning a period of extensive behavior change (1998–2003). Almost half of the initially uninfected women interviewed were members of at least one community group. In an analysis of 88 communities, individuals with higher levels of community group participation had lower incidence of new HIV infections and more of them had adopted safer behaviors, although these effects were largely accounted for by differences in socio-demographic composition. Individual women in community groups had lower HIV incidence and more extensive behavior change, even after controlling for confounding factors. Community group membership was not associated with lower HIV incidence in men, possibly refecting a propensity among men to participate in groups that allow them to develop and demonstrate their masculine identities—often at the expense of their health. Support for women's community groups could be an effective HIV prevention strategy in countries with large-scale HIV epidemics.

Perceptions of the neighbourhood environment and self rated health: a multilevel analysis of the Caerphilly Health and Social Needs Study

BackgroundIn this study we examined whether (1) the neighbourhood aspects of access to amenities, neighbourhood quality, neighbourhood disorder, and neighbourhood social cohesion are associated with people's self rated health, (2) these health effects reflect differences in socio-demographic composition and/or neighbourhood deprivation, and (3) the associations with the different aspects of the neighbourhood environment vary between men and women.MethodsData from the cross-sectional Caerphilly Health and Social Needs Survey were analysed using multilevel modelling, with individuals nested within enumeration districts. In this study we used the responses of people under 75 years of age (n = 10,892). The response rate of this subgroup was 62.3%. All individual responses were geo-referenced to the 325 census enumeration districts of Caerphilly county borough.ResultsThe neighbourhood attributes of poor access to amenities, poor neighbourhood quality, neighbourhood disorder, lack of social cohesion, and neighbourhood deprivation were associated with the reporting of poor health. These effects were attenuated when controlling for individual and collective socio-economic status. Lack of social cohesion significantly increased the odds of women reporting poor health, but did not increase the odds of men reporting poor health. In contrast, unemployment significantly affected men's health, but not women's health.ConclusionThis study shows that different aspects of the neighbourhood environment are associated with people's self rated health, which may partly reflect the health impacts of neighbourhood socio-economic status. The findings further suggest that the social environment is more important for women's health, but that individual socio-economic status is more important for men's health.

Age differences in memory performance and memory ratings as measured in a sample survey.

Age differences in memory performance were studied in a probability sample of a cross-section of 1,491 adults living in the Detroit metropolitan area, with an oversample of those age 60 and older. Both a recall and a recognition measure were adapted to the survey context by querying respondents about the nature of the questions asked in an immediately preceding interview. Subjective memory assessment was also measured, using global memory ratings performed by the respondent, his or her spouse, and the interviewer. A clear, age-related decline in memory performance was found in this population sample. Subjective memory assessment also declined across age groups, but the relation was weaker. On the basis of multiple regression analyses of the recognition measure and the respondent's self-rated memory, which were judged to have the best measurement qualities, a substantial part of these age differences can be accounted for by differences in sociodemographic composition between age groups, by cognitive functioning and physical health.

Age differences in memory performance and memory ratings as measured in a sample survey.

Age differences in memory performance were studied in a probability sample of a cross-section of 1,491 adults living in the Detroit metropolitan area, with an oversample of those age 60 and older. Both a recall and a recognition measure were adapted to the survey context by querying respondents about the nature of the questions asked in an immediately preceding interview. Subjective memory assessment was also measured, using global memory ratings performed by the respondent, his or her spouse, and the interviewer. A clear, age-related decline in memory performance was found in this population sample. Subjective memory assessment also declined across age groups, but the relation was weaker. On the basis of multiple regression analyses of the recognition measure and the respondent's self-rated memory, which were judged to have the best measurement qualities, a substantial part of these age differences can be accounted for by differences in sociodemographic composition between age groups, by cognitive functioning and physical health.