Economic Disadvantage Research Articles

Heterogeneous Associations Between Pandemic-Induced Socioeconomic Hardships and COVID-19 Vaccine Uptake by Sexual Orientation and Gender Identity: A Nationally Representative Analysis in the United States

Background/Objectives: Socioeconomic hardship during the COVID-19 pandemic was associated with lower vaccine uptake. Since the pandemic has exacerbated socioeconomic challenges faced by sexual and gender minority populations, including employment income loss, housing instability, food insufficiency, and household expense difficulty, this study investigated the disparities in COVID-19 vaccine uptake among these populations. Methods: Using the U.S. Census Bureau Household Pulse Survey, a nationally representative sample of 1,767,966 individuals (6% gay or lesbian, 4.2% bisexual, 1.6% something else, and 90.6% heterosexual respondents), we quantified the COVID-19 vaccine uptakes among sexual and gender minorities, as well as the effect measure modifications by socioeconomic hardships. Results: Despite higher vaccine uptake rates among sexual and gender minorities compared to their heterosexual counterparts, socioeconomic hardships triggered by the pandemic among these populations were associated with decreased vaccine uptake. Importantly, the effect measure modifications by socioeconomic hardships were more pronounced among sexual and gender minority status compared to heterosexual individuals. Conclusions: These results highlight the critical need to address socioeconomic hardships among sexual and gender minorities to enhance vaccine uptake, along with the pre-existing and exacerbated social and economic disadvantages during the COVID-19 pandemic.

Spatial overlap: trade-offs in refugees’ residential choices

ABSTRACT Social science research gives rise to what we call the ‘refugee mobility puzzle’: While restrictions on the freedom of residence limit refugees’ socio-economic integration, those who do not face such restrictions often move to areas with high unemployment that similarly hinder their labor market prospects. This study addresses a central element of this puzzle: What draws refugees to high unemployment areas? We propose the spatial overlap hypothesis arguing that refugees in comparatively generous reception systems initially prioritize or are forced to prioritize non-labor-market resources such as affordable housing and proximity to social networks. Thereby they often settle in areas with general economic disadvantage as such areas frequently overlap with said resources. Based on the IAB-BAMF-SOEP Survey of Refugees this study tracks residential histories of more than 2,400 refugee respondents across all German counties and postcodes. Discrete choice models show that preferences for cities, lack of affordable housing, the presence of small, service-oriented companies, and co-ethnic communities explain refugees’ gravitation to disadvantaged areas. These results support the spatial overlap hypothesis and suggest that recently approved refugees face trade-offs: area characteristics that are initially attractive tend to spatially overlap with such that likely inhibit longer-term integration prospects.

Early‐life disadvantage and parent‐to‐child financial transfers

AbstractObjectiveTo determine (1) how parental childhood disadvantage is associated with parent‐to‐child financial transfers for schooling and other unspecified purposes and (2) whether the association holds when parental socioeconomic status (years of education, family income, wealth) is considered.BackgroundCumulative inequality theory posits that early life disadvantage may not only adversely affect one's resource accumulation across the life course, but it may also shape one's ability to provide assistance to offspring.MethodData from the Panel Study of Income Dynamics were used to estimate zero‐inflated negative binomial regression models to predict the amount of parent‐to‐child transfers (N = 2364 for school transfers, N = 3618 for other transfers), controlling for parents' and children's sociodemographic factors. Childhood disadvantage score (0 as reference, 1, 2, 3, 4+) was constructed using 13 items that reflect the economic, psychosocial, environmental, and health domains of early life. The associations of each domain with financial transfers were also estimated.ResultsParents with 4+ disadvantages gave about $2200 less for schooling. Economic and environmental disadvantage lessened levels of school transfers, while environmental disadvantage decreased the odds of being a non‐provider of other transfers. The disparity in transfer amounts generally narrowed when the mediating role of parental socioeconomic status was accounted for.ConclusionHigher education has become one of the major mechanisms through which class stratification, social inequality, and health disparities ensue. Educational outcomes among current cohorts of young adults could have been shaped by the preceding generation's childhood through intergenerational exchanges.

Helping the Noncompliant Child and Child Behavior Outcomes: An Exploratory Examination of Financial Strain.

Theoretical models and empirical research have highlighted the impact of economic disadvantage on children's psychosocial development broadly and the onset, maintenance, and treatment of early-onset (3-8 years) behavior disorders (BDs) more specifically. In the context of intervention, evidence suggests that economic disadvantage may pose risk for diminished parent-mediated treatment efficacy (e.g., Behavioral Parent Training [BPT]) given its impact on salient factors in the family system. Though, studies have shown significant variability in BPT outcomes within families experiencing economic disadvantage, suggesting that additional influences may further contribute to disparities in the trajectory of treatment and maintenance of treatment gains for this population. To address this gap in existing knowledge, financial strain, or the inability to meet financial needs, was examined in families (N = 54) of young children (3-8 years old) with low-income and clinically elevated behavior problems participating in one BPT program, Helping the Noncompliant Child (HNC). Results demonstrated that families who experienced greater levels of financial strain prior to engaging in HNC exhibited diminished maintenance of parent reported child behavior gains following treatment. Financial strain did not significantly influence rate of change or maintenance of treatment gains for HNC clinician-coded child compliance. Clinical implications and directions for future research are discussed. ClinicalTrials.gov Identifier: NCT02191956, registered on 6/18/2014.

Assessing Socioeconomic Disparities and Health Outcomes among Cancer Patients in a Nigerian Teaching Hospital

Background: Cancer affects all population groups in the Nigeria, but due to social, environmental, and economic disadvantages, certain groups bear a different burden of cancer. Disparities in health among populations account for preventable morbidity and mortality. Research in this area is focused on identifying health disparities and outcomes contributing to overall wellbeing. Different groups may experience cancer disparities and these groups can be defined by age, gender, education, ethnicity, income, race, origin, and other characteristics. Health disparities can affect cancer outcomes, from diagnosis to treatment. This study evaluates the health disparities and outcomes of cancer patients in a Nigerian Teaching Hospital. Methods: This is a descriptive cross-sectional study using a structured questionnaire among patients visiting the oncology unit in the hospital. The questionnaire was interviewer- administered. Descriptive statistics was used to present respondents’ sociodemographic characteristics. Pearson correlation test was used to determine relationship between the determinant of cancer disparity (social demographics) and the outcomes (from patient perspective). Results: A total of 150 patients participated in the study. More female respondents (70%) than male respondents (45%), mostly within the age range of 62 and above (56.7%) participated in this study. The disparities examined include: age, gender, marital status, educational level, occupatina, montly income, religion and health insurance. There was a correlation between the different disparities and health outcomes. All disparities except gender were statistically significant (P = 0.05 & 0.01). Age, marital status, occupation status, religion and health insurance associated postively, while educational level and monthly income associated negatively. Gender had no associaton at all. Overall, patients (50%) were a little satisfied with the overall health outcomes.

A high-stakes reading test as the White listening subject: Applying an antiracist validation lens

ABSTRACT In this paper, the White listening subject takes the form of a standardized high-stakes reading test, the State of Texas Assessment of Academic Readiness (STAAR). Although the test does not actually listen, it ‘hears’ and evaluates children’s responses to its questions. I present the results of the 2017 Grade 8 reading exams, from the March, May, and June administrations, with a focus on results for students who are learning English as an additional language, who are racially minoritized, and who are economically disadvantaged. The analysis looks at factors predicting test completion, passing rates, and test resitting: language proficiency status, race/racism, and economic disadvantage. In the discussion, I question these results’ validity by examining the STAAR validity arguments including the construct definition, development and scoring of the assessment, retake administration policies, and consequences for language minoritized and racialized students. I hope this study may spur changes in policy and practice, and the institution of a re-humanizing lens in assessment policies in Texas and beyond.

Gender Inequality in Economic Participation: A Socio-Economic Analysis in Indonesia

This research addresses gender inequality in economic participation in Indonesia, an issue that poses a barrier to sustainable development and social equality. Although there has been an increase in women's participation in the economic sector, women's labor participation rate is still significantly lower than men's, with an average labor participation rate of 83-84% for men and only 50-53% for women (BPS, 2018-2023). Various social and structural barriers, including patriarchal culture and the burden of domestic responsibilities, limit women's role in the public sector. This study uses descriptive analysis to evaluate trends and patterns of gender inequality in the Indonesian economy from 2018 to 2023, utilizing data from BPS. The findings show that gender inequality in economic participation disadvantages women and slows national economic growth. With more inclusive policies, Indonesia can correct this imbalance and increase its potential productivity and economic competitiveness.

Economic disadvantage during childhood, obesity, and diabetes across three birth cohorts of older Mexicans.

Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in three cohorts of Mexican adults. Data on those 60-69 years old from the 1930-39, 1940-49, and 1950-59 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent reports. Supplementary analyses using HbA1c as a criterion for diabetes were conducted. A regression-decomposition approach was implemented. Logistic regression models included adjustments for sociodemographic characteristics and access to medical care. Diabetes prevalence was 23% overall and 11%, 25%, and 26% in the 1930-39, 1940-49, and 1950-59 cohorts, respectively. EDDC declined across successive cohorts, while the prevalence of overweight/obesity at age 50 increased. EDDC and overweight/obesity were associated with higher odds of reporting diabetes. A scenario that eliminates disadvantaged EDDC reduced diabetes prevalence by 11% in a pooled sample, while eliminating overweight/obesity reduced it by 30%. Overweight/obesity explained 42% of the rise in diabetes prevalence between the 1930-39 and 1950-59 cohorts. Improvement in EDDC explained 18% of the rise in diabetes prevalence between 1930-39 and 1950-59 cohorts. High body weight across Mexican birth cohorts seemed to offset the potential benefits from improvements in childhood conditions on adult diabetes risk.

EHT and environmental justice at EPA Victoria: Aspirations and regulatory realities

Abstract EPA Victoria (Australia) is a statutory authority that regulates polluting activities and advises other Victorian government departments on relevant policy settings. In 2016, a public health function was installed at EPA Vic to provide emergency health messaging during pollution events, review research evidence of environmental-health relationships and assess industry-contracted health risk assessments of polluting entities. An Environmental Health Tracking Network (EHTN) is under development to support these activities. The EHTN is an agile data and analytical infrastructure for translating expertise across an expanding multidisciplinary network of public health researchers, EPA operational staff and public sector policy makers. Its current interactive dashboards calculate health impacts and associated costs of air pollution scenarios, model land-use influences on land and water contamination and identify coincidences of sociodemographic-, urban environment- and pollution exposure-disadvantage in a high spatial resolution environmental justice (EJ) framework. Regulatory leverage of EHTN intelligence, however, requires legislated EJ thresholds and/or legally tractable costing of industry-externalised human health impacts. Thus, to establish triggers for more stringent conditions on polluting activities and promote equity of interventions and regulations, novel regionally and EJ specific health risk functions are required. Considering these ambitions and challenges, the EHTN at EPA Vic is focussed on 1) identifying and characterising vulnerable populations at high spatial resolution, 2) estimating associated exposure-health effect size modifications using primary epidemiological methods and 3) applying these to health impact and cost assessments of pollution and waste. We seek defensible grounds on which to impose more stringent standards for polluters and redress entrenched social, health and economic disadvantage. Speakers/Panelists Hanna Tolonen THL, Helsinki, Finland

Sexuality and Gender Diversity Among Adolescents in Australia, 2019-2021

Sexuality- and gender-diverse (SGD) young people experience substantial health disparities relative to cisgender heterosexual peers. Little is known about SGD adolescents younger than 15 years. To describe SGD prevalence and associated factors in a population-representative cohort of younger adolescents in Australia. This prospective cohort study was part of the Future Proofing Study, with enrollment of year 8 students at 134 Australian secondary schools from 2019 to 2021 and annual follow-ups for 5 years. Data were analyzed from June 20, 2023, to June 6, 2024. Outcomes of interest were baseline self-reported gender and sexuality identities, individual characteristics, and mental health and disability diagnoses, as well as school characteristics. Among 6388 participants, median (IQR) age was 13.9 (13.6-15.8), with a range of 10.7 to 17.5 years. Most participants attended school in a major city (76.0%), were born in Australia (91.4%), and spoke English at home (93.7%). Approximately half (3122 participants; 48.9% [95% CI, 45.2%-59.0%]) identified as female or girls, and 46.5% (2973 participants; 95% CI, 39.8%-53.4%) identified as male or boys. The overall proportion of transgender identity was 3.3% (95% CI, 2.7%-3.9%), with 23 participants (0.4%) identifying as transgender boys, 10 participants (0.2%) identifying as transgender girls, 117 participants (1.8%) identifying as transgender nonbinary, and 59 participants (0.9%) identifying as another transgender identity. The overall proportion of sexuality diversity was 12.0% (95% CI, 10.4%-13.8%). The proportion of cisgender participants who were sexuality-diverse (13.0% [95% CI, 11.4%-14.8%] of girls and 4.7% [95% CI, 3.7%-5.9%] of boys) was lower than the proportion among gender-diverse participants, which ranged from 30.0% (95% CI, 9.3%-64.1%) of transgender girls to 91.5% (95% CI, 81.3%-96.4%) of those with another diverse gender identity. Gender diversity and sexuality diversity were strongly associated (odds ratio [OR], 66.24; 95% CI, 38.23-114.80), and both were negatively associated with age (gender diversity: OR per 1-year older, 0.61; 95% CI, 0.49-0.76; sexuality diversity: OR per 1-year older, 0.78; 95% CI, 0.65-0.93) and positively with mental health diagnosis (gender diversity: OR, 2.41; 95% CI, 1.79-3.24; sexuality diversity: OR, 2.50; 95% CI, 2.10-2.98), and disability diagnosis (gender diversity: OR, 2.39; 95% CI, 1.68-3.40; sexuality diversity: OR, 1.96; 95% CI, 1.64-2.36). While there were significant associations between individual and school characteristics and responses to gender and sexuality identity items, patterns of association differed, with no consistent association with economic disadvantage. This cohort study of young adolescents found higher rates of SGD than among samples of older adolescents. The significant associations with younger age, poorer mental health, and disability underscored the urgent need for inclusive programs to promote a safe and welcoming environment in schools, health care settings, and communities.

Considerations of Intersectionality in Psychological research

At the forefront of the increasingly popular intersectionality agenda in psychology is the wellbeing of individuals. The British Psychological Society states that a key principle of psychological research is to “consider societal benefits” and “contribute to the common good” (BPS, 2021). There is an abundance of evidence on the harmful outcomes of negative intergroup relations and systemic oppression on marginalised individuals. For example, marginalised groups often experience educational and economic disadvantages (Porter, 2011) alongside both physical and mental health disparities (English et al., 2022; Mitchell et al., 2021; Stevens-Watkins et al., 2014). Consequently, psychology as a discipline should prioritise advocating for a more equitable society.

Distribution and determinants of early marriage and motherhood: a multilevel and geospatial analysis of 707 districts in India

BackgroundEarly marriage and motherhood have long been prevalent in India, with 44.5% of women aged 20–24 reporting marriage before 18 in NFHS 3 (2005–2006), dropping to 26.8% in NFHS 4 (2015–2016). Early motherhood has also seen a significant decline, with first births by age 18 decreasing from 34.3% in NFHS I to 8.2% in NFHS V. Despite these improvements, significant regional disparities persist due to social, normative, and legal factors. This study investigates the spatial heterogeneity of early marriage and motherhood across Indian districts, offering a multilevel analysis that reveals critical local variations often obscured at broader levels. Understanding these patterns is crucial for targeted policy interventions and addressing the root causes of early marriage and motherhood.MethodsUtilizing data from the fifth round of National Family Health Survey, this study employs multilevel logistic regression and geospatial analysis to assess the determinants and spatial distribution of early marriage and early motherhood among ever-married women in India. The analysis incorporates individual, household, and community-level variables, complemented by spatial analysis techniques, including Empirical Bayes Bivariate Moran’s I values and LISA cluster maps, to identify regional patterns and hotspots.ResultsThis study revealed that educational attainment emerged as a critical determinant, with uneducated women significantly more likely to marry early. Socioeconomic factors, such as poverty and limited mass media exposure, also heightened the risk of early marriage and motherhood. Caste and religion were significantly associated with these events, with marginalized groups facing higher prevalence. Spatial analysis revealed significant geographic disparities, with central and eastern regions showing higher concentrations of early marriage and motherhood. District-level characteristics and the influence of neighboring districts were also significant, highlighting the importance of localized interventions.ConclusionsThe findings underscore the critical role of education, economic empowerment, and media literacy in mitigating early marriage and motherhood risks. The study calls for multi-sectoral interventions in geographical hotspots to break the cycle of early family formation and promote reproductive health. Policies enhancing educational opportunities, addressing economic disadvantages, and considering district-specific factors are essential. Comprehensive strategies are necessary to empower women, foster reproductive health, and address the multifaceted nature of early marriage and motherhood in India.

Exploring the characteristics and antecedents of clinically significant long COVID: A longitudinal cohort study

BackgroundA significant number of coronavirus disease 2019 (COVID-19) survivors are experiencing long COVID, with symptoms lasting beyond three months. While diverse long COVID symptoms are established, there are gaps in understanding its long-term trends, intensity, and risk factors, requiring further investigation. AimsThis study aimed to investigate the long COVID characteristics and associated factors by following COVID-19 survivors for one year post-infection and comparing them with healthy counterparts. Main methodsIn this longitudinal, correlational study, COVID-19 survivors diagnosed between November 2021 and February 2023 were monitored every three months for a year. Participants aged ≥18 years who had reported a positive COVID-19 test were recruited via social media and healthcare provider referrals. Key findingsOut of 182 survivors who initially agreed to participate, 176 completed the study. The mean age was 47.56 years (SD = 16.2), and 51.1 % were female. There was a clinically significant decline in cognitive function and health-related quality of life over time, with symptoms like shortness of breath, reduced physical fitness, and increased health concerns. Those with severe acute COVID-19 symptoms experienced greater cognitive and physical declines and more shortness of breath a year later. Lower financial status was linked to poorer health-related quality of life and increased health concerns. SignificanceA year post-infection, COVID-19's impact on cognitive function and health-related quality of life remains significant, affecting individuals and communities. Survivors with severe initial symptoms and economic disadvantages need more attention. Future research should identify additional predictors of severe long COVID.

Factors associated with colon cancer fragmentation in the Keystone state.

120 Background: Fragmentation of cancer care delivery across multiple providers can impact care quality and patient outcomes. Management of non-metastatic colon cancer often involves adjuvant chemotherapy, which increases the risk of potentially deleterious care dispersion. This study assesses the extent of care fragmentation across different inpatient facilities and examines patient characteristics associated with inpatient care fragmentation. Methods: We adapt the modified Herfindahl-Hirschman market concentration index to construct a Fragmentation Index (FI) capturing the distribution of a patient’s care across inpatient facilities. For patients who underwent oncologic surgery for colon cancer from 2010-2016, we calculate FI for the 15 months post-diagnosis if at least 2 admissions occur during the study period. We use Pennsylvania Cancer Registry data linked to all-payer statewide facility discharge records to estimate the relationship between FI and patient demographics, rurality, area deprivation index (ADI), and payer status using adjusted multivariable linear regression models. Results: For the operative cohort (28.6% Stage I, 34.7% Stage II, 36.7% Stage III, n = 7803), 86% of patients lived in urban areas, 9.5% in large towns and 5% in rural areas. 60% had Medicare, 6.1% Medicaid and 7.1% were uninsured or had unknown payer status. 52% of patients were female and 87% were non-Hispanic White. The overall mean FI was 0.192; 60% (n = 4693) had an FI of 0, indicating all admissions were at the same hospital, and among those with FI> 0 (n = 3110), mean FI was 0.483. The mean FI for patients potentially eligible for adjuvant chemotherapy (Stage II, III) was 0.188: 61% of patients had an FI of 0 and among those with FI > 0 (n = 2173), mean FI was 0.482. Stratification by stage reveals similar proportions of FI > 0.5 (stage I: 24.6%, stage II: 22.3%, stage III: 21.3%). Increased care dispersion was observed in patients from large towns (ΔFI 0.04, CI 0.03—0.06) or rural areas (ΔFI 0.04, CI 0.02—0.08) relative to urban areas, as well as for patients with relatively higher number of hospitalizations (ΔFI 0.04, CI 0.03—0.04). Less care dispersion was seen in patients with stage III disease (relative to stage I ΔFI -0.02, CI -0.03 — -0.01), uninsured status (relative to private insurance ΔFI -0.03, CI -0.05 – -0.01) or residence in the most disadvantaged ADI quartile (relative to Q1 ADI ΔFI -0.02, CI -0.04 — 0.00). Conclusions: Among patients with operatively managed colon cancer, slightly more than half did not experience inpatient care fragmentation. As expected, a higher number of total admissions and non-urban residence were associated with increased inpatient care dispersion. However, our findings of more concentrated care among patients with stage III disease, higher levels of relative economic disadvantage, and uninsured status suggest potentially complex and divergent forces driving hospital selection, to be explored in future work.

Fifty Shades of Deprivation: Disaggregating Types of Economic Disadvantage in Studies of Terrorism

Fifty Shades of Deprivation: Disaggregating Types of Economic Disadvantage in Studies of Terrorism

Why Are Children of Immigrants Less Geographically Mobile? Examining the Role of Economic Disadvantage and Family Networks

Previous work has found that adult children of international migrants in Western Europe have lower internal migration rates than individuals of native origin. This gap is important for differences in well-being, educational opportunities, and labor market outcomes. So far, however, little is known about the reasons for the greater geographical stability of migrant children. Theories suggest that structural differences such as economic resources as well as preferences for living near family may explain their lower internal migration rates. The current study tests these explanations by examining unique longitudinal register data from the Netherlands in which we follow the internal migration trajectories of people aged 18–50 in an observation window of 16 years between 2006 and 2022. We compare individuals of native origin with children of immigrants from Turkey and Morocco, two of the largest migrant populations in the country. Event history models confirmed that once socio-demographic characteristics were controlled for, children of migrants were less likely to migrate internally than individuals of native origin. Mediation analysis showed that economic resources did not explain the negative association; instead, the lower migration rates observed among children of migrants were mediated by geographical proximity to kin. Because migrant family networks are more geographically concentrated, children of migrants are more often discouraged from moving away. These findings highlight the pivotal role of family networks in explaining migrant-native differences in migration decision-making.

Synthetic small interfering RNAs selectively suppress the expression of proinflammatory cytokine genes (IL-25 and TSLP) in experiments in vitro

Allergic rhinitis (AR) is an inflammatory disease of the upper respiratory tract (nasal mucosa). AR affects up to 40% of the world’s population; in the Russian Federation, the incidence is 18% to 30%, depending on the region. Despite the fact that AR is not a severe pathology, it causes significant economic burden. Another threat associated with this disease is that in 40% of cases, patients with AR eventually develop a more severe disabling pathology – AD. Widespread prevalence and significant economic disadvantages caused by AR determine the importance of developing new ways of prevention and control of this disease, as the existing methods of therapy are insufficient. However, the search for new ways of therapy is impossible without a detailed investigation of the molecular mechanisms of AR pathogenesis. For a long time it was considered that this allergic inflammation is formed by Th2-dependent mechanism with involvement of Th2-lymphocytes, B-cells and eosinophils and pro-inflammatory cytokines: IL-4, IL-5 and IL-13. However, experimental evidence has now accumulated on the role of epithelial cells of the respiratory tract and the proinflammatory cytokines they secrete (IL-25, IL-33 and TSLP) in the pathogenesis of AR and AD. IL-25 has been shown to induce the production of IL-4, IL-5 and IL-13, directing a Th2-type immune response. At the same time, mice with inactivated IL-25 developed barely any Th2-immune response. Inactivation of IL-33 significantly reduces inflammation (mediated by eosinophils) of the respiratory tract. Mice knockout for the cytokine receptor TSLP did not develop nasal hyperreactivity in response to allergen, but the level of nasal mucosal inflammation remained high. Currently, work is actively progressing on the development of new drugs capable of specifically blocking the activity of the listed cytokines; first of all, drugs based on neutralizing monoclonal antibodies. However, there are other technologies that can be used to regulate the activity of genes, such as the technology based on the RNA interference. It can be used to suppress the expression of any gene with a known nucleotide sequence, including genes encoding pro-inflammatory cytokines.Considering the above, the aim of this work was to design synthetic miRNA molecules and study their ability to specifically block the expression of genes encoding proinflammatory cytokines IL-25 and TSLP in experiments in vitro.

Abstract A046: Disparities in cancer burden and survival rates in persistent poverty communities in Los Angeles County

Abstract Objective: Persistent poverty census tracts (PPT) are those with socioeconomic challenges where prolonged economic disadvantages may significantly influence health outcomes. This study examined the cancer burden and survival patterns in PPTs compared to non-PPTs in Los Angeles County (LAC) considering disparities by race/ethnicity and stage at diagnosis. Methods: A comprehensive analysis of 2012-2021 Cancer Registry data examined age-adjusted incidence rates (AAIRs) and survival rates for lung, colorectal, liver, stomach, breast, and prostate cancers, which are the Norris Comprehensive Cancer Center priority cancers. Cancer-specific data were further stratified by racial/ethnic group and stage at diagnosis, and compared across residents in PPTs, non-PPTs, and LAC overall. Survival rates were calculated using the Kaplan-Meier method and differences between groups were assessed by log-rank tests. Results: PPTs in LAC were characterized by a higher proportion of racial/ethnic minorities, lower education levels, and higher unemployment compared to non-PPTs. In all racial/ethnic groups combined, AAIRs for lung, breast, and prostate cancers were lower in PPTs than non-PPTs, whereas AAIRS for liver and stomach cancers were higher in PPTs, with no differences for colorectal cancer. Disparities emerged when considering race and ethnicity, with higher lung cancer AAIRs among Non-Hispanic White (NHW) and Black/African American (B/AA) PPT residents compared to non-PPT, while AAIRs for lung and colorectal cancers were lower among Hispanic/Latino (H/L) PPT residents compared to non-PPTs. Breast and prostate cancer AAIRs remained lower in PPTs than in non-PPTS regardless of racial/ethnic group. Patients in PPTs exhibit significantly lower five-year survival rates across all studied cancers, except stomach, compared to non-PPTs. B/AA patients showed the lowest five-year survival rates for lung and colorectal cancer, with patients in PPTs experiencing significantly lower rates than patients in non-PPTs regardless of disease stage (p < 0.01 for early- or late-stage). Liver cancer survival rates were notably low, especially for H/L and Asian/Pacific Islander patients in PPTs, with five-year survival for late-stage cancer at 4.9% (95%CI: 2.8-8.5) and 5.4% (95%CI: 2.1-14.0), respectively. Patients in PPTs with late-stage breast or prostate cancer exhibited significantly lower 5-year survival (compared to non-PPTs) across all race/ethnicities, with B/AA patients experiencing the lowest survival rates for breast cancer and NHW patients experiencing the lowest survival rates for prostate cancer. Conclusions: Cancer outcomes for patients in PPTs were significantly poorer compared to those in non-PPT communities. The notably lower AAIRs in PPTs versus non-PPTs for more screen-able cancers, such as breast, prostate, and early-stage colorectal cancer, suggest a need for greater efforts to provide access to routine screening in areas affected by persistent poverty, though other causes cannot be ruled out. Citation Format: Miriam L Gorbatov, Joel S. Mendez, Myles Cockburn, Laura K. Thompson, Lihua Liu, Jennifer Tsui, Kali Zhou, V. Wendy Setiawan, Chanita Hughes-Halbert, Mariana C. Stern. Disparities in cancer burden and survival rates in persistent poverty communities in Los Angeles County [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A046.

Poor-quality jobs and economic disadvantage in the United States’ spectator sports industry

Poor-quality jobs and economic disadvantage in the United States’ spectator sports industry

Understanding the Intersection Between Racial Segregation, Social Isolation and Safety Perceptions on Health for an Economically Disadvantaged Urban Community

ABSTRACT Safety concerns continue to be challenging amid racially segregated communities of urban concentrated disadvantage. Although contributing factors to crime in such neighborhoods have been described, there is a lack of knowledge regarding how social isolation and perceptions of safety impact community health. This qualitative study explored how minoritized residents (N = 23) from an urban community of economic disadvantage perceived the influence of environmental and residential conditions on their health. Use of the grounded theory method produced conceptual insights into the process of how safety concerns led to fear, which created stress and prevented residents from using outdoor public spaces. Additionally, results indicated how the cyclical nature of such physical withdrawal reinforced social isolation and stigma by those outside the community, ultimately affecting residents’ ability to maintain healthy living. Implications include implementing a multi-pronged public health policy that addresses safety perceptions, crime exposure, and social inclusion to improve health conditions in low-income communities.