Household Economic Status Research Articles

Prevalence and correlates of paediatric guideline non-adherence for initial empirical care in six low and middle-income settings: a hospital-based cross-sectional study

ObjectivesThis study evaluated the prevalence and correlates of guideline non-adherence for common childhood illnesses in low-resource settings.Design and settingWe used secondary cross-sectional data from eight healthcare facilities in six Asian...

Generalized Anxiety Disorder Due to Household Type and Economic Status during COVID-19 Pandemic: Focusing on Gender Differences

Objectives: This study was conducted to determine whether household type and economic status affect generalized anxiety disorder during COVID-19 (Coronavirus disease 2019).Methods: This study included 5,615 participants from the Korea National Health and Nutrition Examination Survey (2021). Multiple logistic regression analysis was performed to determine the association between household type, economic status and generalized anxiety disorder. Additionally by combining the two variables of interest, we examined the combined effect of sex on household type and economic status.Results: The unemployed in single person-households had 3.4 times more likely to become a high-risk group for generalized anxiety disorder than the employed in multiple person-households (odds ratio, OR = 3.42, 95% confidence interval, CI: 1.99-5.85). In male, the unemployed in single person-households was 7.1 times more likely to be a high-risk group than the employed in multiple person-households (OR = 7.11, 95% CI: 2.49-20.31) and was 2.8 times more likely to be a high-risk group than the reference group in female (OR = 2.82, 95% CI: 1.46-5.44).Conclusions: This study confirmed that during COVID-19 pandemic, the unemployed and single person-households tended to be a high-risk group for generalized anxiety disorder and differed by sex and age. Therefore, generalized anxiety disorder policies for single person-households and the unemployed and customized welfare by sex are needed.

Rural‒urban disparities in household catastrophic health expenditure in Bangladesh: a multivariate decomposition analysis.

Rural‒urban disparity in catastrophic healthcare expenditure (CHE) is a well-documented challenge in low- and middle-income countries, including Bangladesh, limiting financial protection and hindering the achievement of the Universal Health Coverage target of the United Nations Sustainable Development Goals. However, the factors driving this divide remain poorly understood. Therefore, this study aims to identify the key determinants of the rural‒urban disparity in CHE incidence in Bangladesh and their changes over time. We used nationally representative data from the latest three rounds of the Bangladesh Household Income and Expenditure Survey (2005, 2010, and 2016). CHE incidence among households seeking healthcare was measured using the normative food, housing, and utilities method. To quantify covariate contributions to the rural‒urban CHE gap, we employed the Oaxaca-Blinder multivariate decomposition approach, adapted by Powers et al. for nonlinear response models. CHE incidence among rural households increased persistently during the study period (2005: 24.85%, 2010: 25.74%, 2016: 27.91%) along with a significant (p-value ≤ 0.01) rural‒urban gap (2005: 9.74%-points, 2010: 13.94%-points, 2016: 12.90%-points). Despite declining over time, substantial proportions of CHE disparities (2005: 87.93%, 2010: 60.44%, 2016: 61.33%) are significantly (p-value ≤ 0.01) attributable to endowment differences between rural and urban households. The leading (three) covariate categories consistently contributing significantly (p-value ≤ 0.01) to the CHE gaps were composition disparities in the lowest consumption quintile (2005: 49.82%, 2010: 36.16%, 2016: 33.61%), highest consumption quintile (2005: 32.35%, 2010: 15.32%, 2016: 18.39%), and exclusive reliance on informal healthcare sources (2005: -36.46%, 2010: -10.17%, 2016: -12.58%). Distinctively, the presence of chronic illnesses in households emerged as a significant factor in 2016 (9.14%, p-value ≤ 0.01), superseding the contributions of composition differences in household heads with no education (4.40%, p-value ≤ 0.01) and secondary or higher education (7.44%, p-value ≤ 0.01), which were the fourth and fifth significant contributors in 2005 and 2010. Rural‒urban differences in household economic status, educational attainment of household heads, and healthcare sources were the key contributors to the rural‒urban CHE disparity between 2005 and 2016 in Bangladesh, with chronic illness emerging as a significant factor in the latest period. Closing the rural‒urban CHE gap necessitates strategies that carefully address rural‒urban variations in the characteristics identified above.

The Socioeconomic Impact: Assessing the Risk and Burden of Malaria on Vulnerable Populations in Kenya

This paper seeks to explore the significance and impact of malaria on Kenya’s economic growth. This will help to understand the impact that malaria has or have had on household economic status especially for the vulnerable population in Kenya and how it has been unfolding slowly over time. This will also seek to understand the coping strategies adopted by the said population and the negative implications that have influenced these household’s abilities to withstand malaria and other eventualities that may happen in the future.
 The risk and burden of malaria on vulnerable population together with its economic effects have been presented. Search engines such as Google Scholar and PubMed as well as related economics and medical journals were instrumental for this study. To protect the poor and vulnerable population against these adverse effects of malaria and from malaria itself, there is a great need to draft and enact policies that will be able control the effects as well as integration development and poverty reduction programs. The future work and focus for government and all stakeholders should be to focus more energy and work on achievable health services that will eliminate the burden of health especially malaria and its effects on Kenyan economic activities undertaken by the vulnerable population and to address the burden and risk of malaria on the productive under privileged within their environment, as well as study the epidemiological and socio-economic geographical dissimilarities of the vulnerable population and the normal population.

Associations of latent patterns of parent‒child communication with communication quality and mental health outcomes among Chinese left-behind children

BackgroundParent‒child communication in migrant families is essential to family bonds and the mental health of left-behind children (LBC). Little is known about the different patterns of communication between migrant parents and LBC and associated communication quality and mental health outcomes.MethodsA sample of 2,183 Chinese children (mean age = 12.95 ± 1.29 years) from Anhui province, including LBC whose parents had both migrated (n = 1,025) and children whose parents had never migrated (never-LBC, n = 1,158), was analyzed. With the LBC sample, latent class analysis was applied to identify the patterns of parent‒child communication. Multinomial logistic regression analysis was conducted to assess the associations between the sociodemographic variables and class membership of LBC. Analysis of covariance and chi-square tests were used to compare communication quality and mental health outcome differences among the classes of LBC and between each of the classes and never-LBC.ResultsFive latent classes of communication formed through different media or channels between migrant parents and their LBC were identified. Higher household economic status (OR = 2.81, p < 0.05) was associated with adequate communication. LBC in Class 1, defined by frequent technologically-mediated and face-to-face communication, had a significantly higher quality of communication with their migrant parents (F = 8.92, p < 0.001) and better mental health than those in other latent classes; these children did not have significantly worse mental health outcomes compared to never -LBC.ConclusionsFacilitating multichannel parent‒child communication is a practical way of reducing mental health inequities between LBC and their peers.

Factors Contributing to Stunting in Indonesia: A Review

Stunting prevalence in Indonesia has exhibited a relatively consistent trend, with rates of 36.8% in 2007, 35.6% in 2010, and a slight increase to 37.2% in 2013, though showing a decline to 30.8% in 2018. Despite this decrease, Indonesia's stunting rates remain higher than the global prevalence of 22.2%, indicating a significant public health concern. Stunting poses long-term health risks, and early prevention is crucial. This article review aims to identify factors contributing to child stunting in Indonesia, utilizing the WHO's conceptual framework. Employing various study designs and extensive literature search, the review identified 15 relevant articles, highlighting factors like exclusive breastfeeding, household economic status, maternal education, and environmental conditions as key determinants of child stunting.

Multi-Level Mixed-Effects Analysis of Stunting Among 6 to 59 Months Children in Ethiopia: Evidenced from Analysis of Health and Demographic Survey, 2000 to 2019

Background. Stunting remains a major public health issue in developing countries like Ethiopia. It is termed as a chronic malnutrition which leads to morbidity and mortality among children. This study aimed to assess the prevalence and factors associated with stunting among 6 to 59 months children in Ethiopia. Methods. A total weighted sample of 34 930 children aged 6 to 59 months was included in this study. A Multilevel Mixed-Effect logistic regression was carried out. The Median Odds Ratio (MOR) and the Intra class Correlation Coefficient (ICC) were calculated. An adjusted odds ratio along with a 95% confidence interval was reported and statistical significance was declared at a P-value ≤ .05. Results. The weighted prevalence of stunting in Ethiopia was 48.3% (95% CI: 47.8%, 48.8%). Being male, increased in age, having multiple births (twin), having less than 2 years birth interval, history of diarrhea, anemia, lack of maternal and paternal formal education, having poor and middle-wealth status, and living in rural areas were significantly associated with stunting. Conclusions. The prevalence of stunting is high in Ethiopia. The risk factors mentioned above increase the likely hood of stunting among children. Therefore, we recommend that responsible bodies place a greater emphasis and priority on promoting parental education, awareness on the impact of the birth interval on child nutrition, the prevention of childhood diarrhea and anemia, improving household economic status, and reducing rural-urban disparities.

Dietary diversity moderates household economic inequalities in the double burden of malnutrition in Tanzania.

Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities. We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey. A nationally representative survey. Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity. The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (Pfor interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (Pfor trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (Pfor trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers). Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.

Association Between Risk Perceptions of COVID-19, Political Ideology, and Mask-Wearing Behavior After the Outbreak: A Cross-Sectional Survey in South Korea.

After the declaration by the World Health Organization signaling the conclusion of the COVID-19 pandemic, most countries lifted mandatory mask-wearing regulations. This study aimed to investigate factors such as risk perception and political ideology associated with continued adherence to mask-wearing among specific populations, particularly when it is no longer deemed necessary. We conducted a cross-sectional study including a sample of 1001 respondents stratified by sex, age (≥ 18 years), and region from January 31 to February 2, 2023, after the mandatory mask regulation was lifted in South Korea. Multivariate logistic regression models were applied to estimate the relationships between risk perceptions, political ideology, and mask-wearing maintenance, adjusting for factors such as sex, age, occupation, and trust in the government. Our results indicated significant associations between age, self-reported household economic status, political ideology, affective risk perception, and perceived effectiveness of the government's COVID-related measures with indoor mask-wearing. Specifically, liberals were more likely to keep mask-wearing indoors than conservatives (adjusted odds ratio [aOR]: 2.19; 95% confidence interval [CI]: 1.33-3.59); and those who perceived a greater affective risk of COVID-19 (aOR: 2.47; 95% CI: 1.96-3.10), along with those who perceived the government's countermeasures as inadequate, were more inclined to maintain the habit of wearing masks indoors (aOR: 1.90; 95% CI: 1.19-3.03). Our study highlighted the multifaceted factors influencing mask-wearing behavior in the post-COVID-19 era. Even after adjusting for various confounding factors, such as age, sex, and trust in the government, an association remained between affective risk perception, political ideology, and mask-wearing behavior. However, further research for psychological mechanisms is needed to foster a culture of preventive behaviors proportional to the risk of infection.

Intra-urban Differences in Maternal Health Care Service Utilization in Nepal: Results from 2016 Nepal DHS

After restructure of local bodies in Nepal, some rural settings before 2015 fall under urban set tings. It is advantageous to understand the situation of maternal health care utilization among poor and non-poor in the new urban structure. Officially, one-fifth of the total population is poor in the country. The objective of this study is to explore the differentials in utilization of all the care designed during the course of reproduction from the notice of pregnancy to postnatal care within two days of delivery among urban poor and non-poor in Nepal. Differentials and roles in utilization of all care, utilization of full maternal health care service for the healthy pregnancy and childbirth are explored among the two economic groups living in urban setting of Nepal. This study has utilized Nepal demographic and health survey 2016 women’s data file. The data used for the analysis came from the 2016 Nepal Demographic and Health Survey (NDHS). This survey is nationally representative population-based household surveys that collected information on fertility, family planning, maternal and child health etc among other data. Details about the survey designs and sampling procedures of this survey are explained in publicly available final report. Using wealth index used as a proxy for household economic status, the lowest wealth quintile is taken as poor and the remaining as non-poor. Result shows that nearly 10 percentage point differences have been observed in utilizing recommended months of antenatal care visits as well as full antenatal care among poor and non-poor. Such differences remained three times more extensive in receiving de livery care from skilled birth attendants and the postnatal care within two days of delivery among those groups. Even, urban poor women are less likely to receive all components of maternal health care. Results of logistic regression confirm the lower chance of receiving full maternal health care by urban poor. The study concludes that urban setting, as local body of Nepal, needs to address the urban poor especially in utilization of maternal health care in protecting and saving health of mother and the newborn.

Effect of Smuggling on Economic Status of Households of District Loralai: An Analysis

This study analyzes the effect of smuggling on the economic status of households in District Loralai. The data of 400 households were collected by using a simple random sampling technique from the Loralai district. The ordinary least square method was applied to estimate the results. Both rural and urban households were sampled. The economic status of the households was measured with household monthly income, household monthly expenditures, and household value of physical assets. The core independent variable used in the study was the participation of respondents in smuggling and price differences. Results show that smuggling boosts the economic status of households but harms the country's economic growth.

IMPLEMENTATION OF RANDOM FOREST AND SMOTE METHODS FOR ECONOMIC STATUS CLASSIFICATION IN CIREBON CITY

The Indonesian government has tried various methods to eradicate poverty throughout the country, one of which is the fair distribution of social assistance to households based on their economic status classification. The determination of social assistance recipients can be influenced by political factors or personal relationships and can be misused, leading to assistance being given to individuals with specific political connections or support. This research aims to develop a household economic status classification system in Cirebon City using the Random Forest algorithm to address these issues. The data used in this research experienced an imbalance in the number of class instances, where the high-class instances were much fewer than the low and medium classes. To address this, the Synthetic Minority Oversampling Technique (SMOTE) was employed. In this study, various testing scenarios were conducted to obtain the best model for accurately predicting household economic status. Based on the research results, the best testing was achieved using Random Forest and SMOTE with a random state of 0, obtaining an accuracy of 93% and excellent performance in classifying each class. When testing unlabeled data, Random Forest successfully predicted 24 out of 30 actual data, resulting in an accuracy rate of 80%. Although this accuracy is lower than what was achieved by Random Forest and SMOTE with a random state of 0, it can be said that the application successfully classifies household economic status in Cirebon City effectively.

HOUSEHOLD ENVIRONMENTS AND COGNITIVE DECLINE AMONG MIDDLE-AGED AND OLDER ADULTS IN CHINA

Abstract Household conditions play a crucial role in the well-being of older adults, who usually spend much longer time in their homes than younger adults. Few studies have examined the compound effects of multiple household conditions on trajectory of cognition function among older adults. This study examines the relationship between household environments and trajectories of cognitive function among middle-aged and older adults in China. It also examines urban/rural, gender, and age variations in this relationship. Using a representative sample of 16,111 respondents aged 45 years and over from four waves of the China Health and Retirement Longitudinal Study (2011-2018), we estimated multi-level linear growth curve models of household social, economic, and physical conditions on cognitive decline over seven years. The results show that older people who lived with spouse but not with children and those with higher living expenditures, better housing quality, and indoor clean fuels for cooking had slower cognitive decline. Living arrangement more strongly predicted men’s cognitive decline while living expenditure, solid fuel use and housing quality significantly predicted only women’s cognitive decline. Only for adults aged 60 year and over, living alone or living with spouse and adult children significantly predicted a faster cognitive decline. Only for rural residents, living alone or living with young children and no adult children significantly predicted a faster cognitive decline. These findings underscore the importance of social policies and programs targeting at improving the living conditions of older adults to help mitigate their cognitive decline.

Explaining the rise of economic and rural-urban inequality in clean cooking fuel use in Tanzania

Despite the high rate of economic growth and electrification in the last two decades in Tanzania, only 6.9 % of the nation's households have access to clean cooking fuel technology which is concentrated among the rich urban households. Analysing data from two waves of the Tanzania National Panel Survey (2014/15 and 2020/21), we estimate the economic and rural-urban inequalities in the use of clean cooking fuel. Using the concentration curve, Erreygers concentration index and non-linear Fairlie decomposition, we find an increase in economic inequality and rural-urban inequality in the use of clean cooking fuel. Based on our analysis, factors such as the household head's education, household economic status and household connection to electricity contribute to the rural-urban inequality in the use of clean cooking fuel. Policy changes are vital for ensuring both rural and urban households have equitable access to education, electricity connection and household economic status to address inequality in the use of clean cooking fuel.

Socioecological and Dietary Change from 2001 to 2015 in Rural West Java, Indonesia

We assessed changes in the sociodemographic structure, land use, diet, and nutritional status of the population of a rural village in West Java, Indonesia between 2000–2001 and 2015–2017, a period of rapid socioeconomic change in the country. Over this period, the village’s population increased by 50%, largely comprised of individuals engaged in non-agricultural employment in the village or in nearby cities, and the village maintained its farming characteristics without major changes in the local land use or ecosystem. In 2000, the diet, nutritional intake, and health status of the villagers were generally uniform. Indicators based on BMI, for example, classified 98% of target children and 70% of target mothers as ‘normal’, regardless of household economic status. However, by 2015, more people worked outside the village and dependence on a market economy had increased. Dependence on food from outside the village, such as processed foods that are cheap and easy to obtain and store, had also increased. Foods such as cassava, taro, and sweet potatoes, which were grown and consumed in 2000, were not consumed in 2015. The quantities of beans, nuts, and vegetables consumed had also decreased. Additionally, the use and sharing of natural resources and the accompanying knowledge transfer had been gradually lost. As a result, variation in diet, nutritional intake, and health conditions within the village significantly increased over time, and overnutrition and undernutrition coexisted by 2015.

Economics of widowhood mortality in adult women in India

The economic consequence of widowhood on health is well-established, demonstrating that economic factors can significantly link with health outcomes, even the risk of mortality for widows. However, empirical evidence is restricted only to developed countries. Thus, this study assesses the role of economic factors (paid work, pension and household economic status) on the mortality of widows in broad age groups in India. We used two waves of the India Human Development Survey (IHDS), a nationally representative prospective dataset in India for 42,009 women (married and widows) aged 25 years and above at IHDS wave 1 whose survival status was observed between two waves. Further, 6,953 widows were considered for sub-sample analysis in this study. Logistic regression and propensity score matching (PSM) were applied to understand the association and causality between economic factors and mortality for widows. Poor household economic status, paid regular work, and receiving a widowed pension were significantly associated with lower mortality risk for young widows. In comparison, unpaid and paid regular work was linked with lower mortality risk for old widows. The result of causal analysis suggests that receiving a widows' pension had a slight impact on mortality reduction for young widows while engaging in paid regular work significantly reduced the mortality of old widows. This research confirms that the link between economic factors and mortality among widows is age dependent in the Indian context.

Factors Influencing Adolescent Generalized Anxiety Disorder: A Zero-Inflated Negative Binomial Regression Model.

The current study used secondary data from the 17th Korea Youth Risk Behavior Survey conducted in 2021 to identify risk factors influencing the frequency with which adolescents in Korea experience generalized anxiety. Participants were 54,848 adolescents. Risk factors for generalized anxiety were analyzed using a zero-inflated negative binomial regression model. Of participants, 23.7% reported no generalized anxiety experiences. Risk factors identified in the count model were being female and having low household economic status as well as perceived stress, sadness, subjective sleep insufficiency, and loneliness. In the logit model, being female, in middle school, having middle and low household economic status, not living with family, having perceived stress, sadness, suicidal ideation, subjective sleep insufficiency, loneliness, and body image distortion were significant predictors of future anxiety among participants without anxiety. These results may be useful for planning nursing interventions to improve and prevent future health problems in adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 46-55.].

Ignorance of Local Needs in Construction of New Houses of the Earthquake Hit Dalit Community in Central Nepal

This article asserts ignorance of local knowledge system, need, social, and cultural settings in construction of earthquake resilient houses in Dalit community. Dalit communities are considered as economically backward ethnic caste group in Nepal. The article is based on the field study carried out in Dhading district of Bagmati Province. The guiding theoretical framework of the study is the anthropology of disaster focusing on resilience through holistic approach to reveal undermining of local contexts in reconstruction of private houses. The methodological approach consists of qualitative research tools supplemented by household census.&#x0D; As part of earthquake resilient house construction, the government of Nepal provided cash grant support to the families with severely damaged houses. Such families identified as red card holders. Findings of the study clearly reveal that the cash support is not enough to address the local social and cultural needs of Dalits in construction of houses. There is heterogeneity in Dalit communities in terms of social cultural bonding, social relations, and economic status. The cash support in the lump sum basis under the blanket policy approach regardless of household income, family background, and economic status hardly address the local contexts. Most importantly, the construction process highly concentrated on building of house structures in the prescribed standards of the government focusing on technical engineering rather than accommodation of local settings and needs.

Depression prediction based on LassoNet-RNN model: A longitudinal study

Depression has become a widespread health concern today. Understanding the influencing factors can promote human mental health as well as provide a basis for exploring preventive measures. Combining LassoNet with recurrent neural network (RNN), this study constructed a screening model ,LassoNet-RNN, for identifying influencing factors of individual depression. Based on multi-wave surveys of China Health and Retirement Longitudinal Study (CHARLS) dataset (11,661 observations), we analyzed the multivariate time series data and recognized 27 characteristic variables selected from four perspectives: demographics, health-related risk factors, household economic status, and living environment. Additionally, the importance rankings of the characteristic variables were obtained. These results offered insightful recommendations for theoretical developments and practical decision making in public health.

Undernutrition Among the Children from Different Social Groups in India: Prevalence, Determinants, and Transition Over Time (2005-2006 to 2019-2021).

Combating undernutrition among children under 5 years is presently an enormous challenge for India. The study aims to determine the prevalence of undernutrition by the Composite Index of Anthropometric Failure (CIAF) and the time-dependent significant determinants of undernutrition among children under 5 years from four recognized social groups, i.e., Scheduled Tribe (ST), Scheduled Caste (SC), Other Backward Class (OBC), and Others, or General group, between 2005-2006 and 2019-2021 in India. It also explains the transition in the probability of CIAF among ST, SC, OBC, and General children belonging to different socio-demographic, economic backgrounds, and geographic regions from 2005-2006 to 2015-2016, 2015-2016 to 2019-2021, and 2005-2006 to 2019-2021 in India. Time-dependent and time-independent logistic regression models are employed to identify the major determinants and predicted probabilities of CIAF, respectively, among four social groups. The predicted probabilities of CIAF among ST, SC, OBC, and General children belonging to various socio-demographic, economic backgrounds, and geographic regions are extracted from logistic regression models and represented graphically. The study outlines a higher prevalence of CIAF among ST children, followed by SC, OBC, and General children throughout the last 15 years. Since 2005-2006, the magnitude of CIAF risk elimination has been comparatively higher among socially marginalized children (ST, SC, OBC) than in General. The investigation also outlines a significant (p < 0.001), and consistent effect of child age, maternal nutritional level, education status, household economic status, and geographic regions on the prevalence of undernutrition among all four social groups in India from 2005-2006 to 2019-2021. The policymakers must focus much on the ST, SC, and OBC sections for eliminating childhood undernutrition. Specifically, more attention is needed for the ST, SC, and OBC children living with non- or less-educated mothers, belonging to poor families, living in central, western, and eastern Indian states for eliminating the childhood CIAF. This might contribute to lowering intergroup inequality (SDG 10.2) in India in terms of the incidence of hunger (SDG 2.2), undernutrition, and child mortality (SDG 3.2).