Equivalent Household Income Research Articles

What is driving food insecurity risks in UK households with children?

Abstract Background Food insecurity is a global public health issue, disproportionately affecting households with children in the UK. Despite increased research attention, there remains a gap in understanding why prevalence of food insecurity is higher in this demographic. This study aims to address this gap. Methods Utilising data from the 2021/22 and 2022/23 Family Resources Survey, an UK annual cross-sectional survey, we investigate the association between sociodemographic and economic factors, and the risk of food insecurity among households with children. Logistic regression analysis was used, with food security treated as a binary outcome variable. Control variables included receiving means-tested benefits, disabilities in a household, region within the UK, and the ethnicity, highest education level and marital status of the household reference person. A total of 41127 households were included, with 10137 being households with children. Results Our preliminary findings reveal stark inequalities, with 12.0% of households with children experiencing food insecurity, compared to 6.4% of households without children (p-value for comparison <0.0001). After adjusting for control variables, the odds of food insecurity among households with children was 1.40 (95% CI: 1.27, 1.54) compared to households without children. Adding equivalised household income after housing costs attenuated the relationship but households with children remained at significantly higher odds of food insecurity (OR: 1.32 (1.20, 1.45)). Conclusions This preliminary analysis demonstrates that, after adjusting for control variables and equivalised household income after housing costs, having children in a household is still associated with a higher risk of food insecurity. This underscores the need to understand the mechanisms underlying this relationship further. Such insights are essential for informing targeted policies and interventions aimed at mitigating food insecurity among households with children. Key messages • Having children independently increases the risk of food insecurity in households in the UK. • Moving forward, our aim is to understand the mechanisms underlying the relationship between households with children and food insecurity.

Childhood socioeconomic differences in type 2 diabetes: longitudinal results of The Maastricht study

Abstract Background Type 2 diabetes mellitus (T2DM) is a common chronic disease that disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have an increased risk of developing T2DM. Knowing the potential influence of early life on T2DM risk later in life, this study aims to examine longitudinal associations between childhood SEP and type 2 diabetes, independent of adult SEP. Methods Longitudinal data was used from 6,727 participants of The Maastricht Study without T2DM at baseline (participants with prediabetes were included in the study sample). T2DM status was determined by a standardized oral glucose test. Sample mean (SD) age was 58.7 (8.7) years and 55.2% was female. Childhood SEP was determined by the highest level of completed education for father and mother and a measurement for childhood income inadequacy. Adult SEP was determined by the highest completed level of education, equivalent household income and occupational position. Incident T2DM was self-reported yearly. Associations were studied annually over a 12-year period (median (IQR) 8.2 (4.9) years) with Cox regression analyses. Results A total of 247 participants (3.7%) without T2DM at baseline reported incident T2DM. Incident T2DM was more common in people with low childhood SEP versus high childhood SEP (4.5% vs. 2.7%, p = 0.008) and for people with low adult SEP versus high adult SEP (5.2% vs. 2.1%, p < 0.001). The impact of parental education on incident T2DM is mitigated by adult SEP. Childhood income inadequacy did predict T2DM independently of adult SEP, with a HR of 1.22 (1.01, 1.45). Conclusions Socioeconomic inequalities in childhood and adulthood are both predictive for incident T2DM. Experiencing income inadequacy in childhood increases the risk of developing T2DM in later life, independent of adulthood SEP. More attention is needed for deprivation in childhood and its impact on T2DM. Key messages • People who have experienced income inadequacy as a child have a higher risk of developing T2DM in later life, independent of their adult SEP. • More attention and research is needed for the impact of childhood poverty on developing T2DM in later life.

Inequities in child health in Luxembourg

Abstract Background In Luxembourg, despite its economic prosperity, 28.6 % of children are estimated to be at the risk of poverty. Research has shown that growing up with socioeconomic disadvantage is associated with worse physical and mental health in childhood. We explore the association of socioeconomic status with health, health behaviours and access to healthcare in Luxembourg for children up to age twelve. Methods We used data from 2014 to 2022 for 11-12 year old children from the Health Behaviour in School-aged Children (HBSC) survey as well as social security data from Luxembourg for a similar time period and children 0 to 12 years old. To assess socioeconomic status, we used information on self-perceived household wealth for the HBSC results and stratified health and health behaviours by well-off, average, or less well-off households. For the social security data, we stratified access to care indicators by equivalized household income quintiles. Results We found that physical activity levels, nutritional quality and daily routines such as eating breakfast and brushing teeth are significantly lower in children from less affluent families. For example, 61% of 11-12-year-old children from well-off families reported eating breakfast every day, but only 41% of children from less well-off families. Only 23% of 11-12 year olds from less affluent families rated their health as excellent, compared to 52% of children from affluent families. There were similarly large differences for multiple health complaints, with 63% of children from less affluent families reporting this indicator for psychosomatic problems, compared to 34% of children from affluent families. We did not find differences in the use of pre- and postnatal care visits. Conclusions Socioeconomic differences in child health, mental health and health behaviours are large, with children from poorer households being in worse physical and mental health and less likely to report positive health behaviours. Key messages • Many children in Luxembourg face socioeconomic challenges that are adversely associated with health and health behaviours. The underlying reasons require further attention to improve child health. • Children from poorer backgrounds are in significantly worse mental health than children from better off families in Luxembourg.

Early life socioeconomic inequalities and type 2 diabetes incidence: Longitudinal analyses in the Maastricht study

AimType 2 diabetes (T2D) is a common chronic disease that disproportionally affects groups with a low socioeconomic position (SEP). This study aimed to examine associations between childhood SEP and incident T2D, independent of adult SEP. MethodsLongitudinal data from The Maastricht Study were used (N=6,727, 55.2 % female, mean (SD) age 58.7(8.7) years). Childhood SEP was determined by asking for the highest completed educational level for the father and mother and childhood income inadequacy. Adult SEP was determined by highest completed educational level, equivalent household income, and occupational position. Incident T2D was self-reported yearly (up to 12 years of follow-up). Associations were studied with Cox regression analyses. ResultsIn participants without T2D at baseline, 3.7% reported incident T2D over 8.2 (median) years of follow-up. Incident T2D was most common in people with low childhood and adult SEP and lowest in those with high childhood and adult SEP (1.7 vs. 7.5 per 1,000 person years). The association between childhood SEP and incident T2D was mainly explained by adult SEP, except for childhood income inadequacy which was independently associated with incident T2D. ConclusionSocioeconomic inequalities in childhood and adulthood are risk factors for incident T2D. More attention is needed to reduce childhood poverty and improve adult SEP to reduce the T2D risk.

Regarding the influence of national factors on the biotic component of the enterprise's material backpack formation

Relevance of research. Sustainable Development Goal No. 12 refers to reducing the resource intensity of the economy by reducing the costs of material input in production chains. The famous German scientist Friedrich Schmidt-Blick proposed the concept of an ecological backpack as a characteristic of hidden material flows accompanying the entire life cycle of a product. A separate component of the backpack is the biotic part, which was heavy enough when, for example, horse traction was used in old mines. Food self-satisfaction of the staff based on the salary led to the fact that the consumption of food in the production process remained outside the analysis of the company's material flows. The purpose of the study is to prove/refute the validity of the hypothesis regarding the significant dependence of the biotic component of the material backpack on national traditions and the material income of workers of industrial enterprises. Research methods: mathematical statistics. The basis of research is long-term observation of food consumption in Ukraine and abroad, in particular, Poland and China. Main results. In the course of research, certain traditions characteristic of Ukrainian realities were revealed: consumption of food products by the average Ukrainian with a probability of 0.95 is 58.75±0.04 kg per month (698±0.5 kg per year); the structure of the consumer basket in Ukraine contains 33% – milk and dairy products, 15% – vegetables; 14% – bakery products and cereals, 11% – potatoes, 8% – meat and meat products; the average person in Ukraine consumes more food than recommended by the Ministry of Health of Ukraine (by approximately 5%); residents of rural areas consume more food than urban residents (by almost 6% – 57.9 kg per month versus 54.7 kg). It has been statistically proven that the annual volume of food consumption by residents of Ukraine (689 kg) is significantly greater than that of residents of Poland (456 kg) and, even more so, China (413 kg). National differences concerning food preferences have been revealed. Quantitative differences in the national consumption of food products by producers determine the different content of the material backpack of industrial products, which provides certain competitive advantages/disadvantages to the subjects of international market activity. In addition to the national traditions of food consumption, there are laws that determine the influence of the average per capita household equivalent total income on the weight of the food basket. On the basis of official statistical data, a mathematical dependence of the logarithmic form of the amount of food consumption on the average per capita income of a household member is proposed.

Remoteness-attributable financial inequality in dental service utilization in Australian older adults: A Blinder-Oaxaca decomposition.

Oral health is often overlooked in ageing health issues, despite its impact on overall health and quality of life. Older Australians, especially those in rural and remote areas, face difficulties accessing oral health services. The aim of the study was to investigate the factors that contribute to financial barriers to accessing dental services among the ageing population in Australia in relation to their residential location. The study included a weighted sample of Australian adults aged 65 years and over from a population-based survey called the National Study of Adult Oral Health (NSAOH) conducted in 2017-18. Descriptive analysis was conducted and generated cross-tabulation tables to investigate the distributions of the outcome, exposure and covariates, including Sex, Education level (the highest level of education), Equivalised household income, Dental insurance, Concession card ownership, Difficulty paying a dental bill and last dental visit. Blinder-Oaxaca decomposition counterfactual analysis was used to explore the potential impact of a person's residence on their financial difficulty accessing dental services. The findings showed that 26.2% (95% CI: 24.3-29.3) of major city residents and 30.1% (95% CI: 26.9-33.3) of rural residents avoided or delayed dental visits due to cost. The decomposition analysis indicated that 53.8% of the disparities in the prevalence of avoided or delayed dental visits due to cost were explained by the selected variables, while 46.2% remained unexplained. The explanatory variable with the largest contribution was difficulty paying a $200 dental bill, accounting for 62.4% of the differences, followed by dental insurance, last dental visit and equivalised household income, which explained 42.1%, 20.8% and 14.9% of the differences, respectively. Regional/remote populations experience more financial barriers to accessing dental care than major city populations and the identified factors explain a significant proportion of these disparities. Based on the study findings, recommendations include expanding public dental service coverage, evaluating concession card mechanisms and advocating for regular dental visits to mitigate disparities in dental care access.

Social Inequities in Access to Dental Care in Australian Adults over Time.

Social inequities in dental caries are reflected by both inequities in the social structures that contribute to disease severity and inequities in the provision of dental care. This study aimed to describe social differentials in the dental caries experience among Australian adults across a 13-y period and to examine if the highest magnitude of oral health inequities persisted across dental caries prevalence (decayed teeth [DT]) or its management (missing teeth [MT], filled teeth [FT]). Data were from 2 population-based cross-sectional surveys of Australian adult oral health conducted in 2004-2006 (National Survey of Adult Oral Health-1 [NSAOH-1], n = 5,505) and 2017-2018 (NSAOH-2, n = 5,022). In each survey, representative samples of adults were obtained through a 3-stage, stratified sample design within metropolitan and regional areas in each state/territory. Clinical outcomes included the prevalence and mean of DT, MT, FT, and DMFT. Equivalized household income was grouped into approximately quartiles from low to high. Across all income quartiles, the mean DT and % DT >0 was higher in NSAOH-2 than in NSAOH-1. The increase in prevalence was highest in the third highest income group (prevalence difference [PD] = 8.4, from 24.1 to 32.5). Similarly, % MT >0 was lower in NSAOH-2 than in NSAOH-1 across all income groups, with the decrease most marked for the lowest income group (PD = -6.5, from 74.1 to 67.8). Across all income quartiles, % FT >0 was lower in NSAOH-2 than in NSAOH-1. The decrease was the most marked for the lowest income group (PD = -8.9, from 81.1 to 72.2). The findings confirm that although oral health inequities decreased for the most extreme management outcome of dental caries (MT), inequities increased for experience of that disease (DT) and the more conservative management of dental caries (FT). For all D, M, and F components (DMFT), inequities between the lowest and highest household income groups increased from 2004-2006 to 2017-2018. This study found that social inequities in oral health (experience of untreated dental caries and missing teeth) increased between the most socially advantaged and disadvantaged groups between 2004-2006 and 2017-2018. This suggests that models of dental service provision in Australia are increasingly benefitting those who can afford and access the care and who arguably need the services less than their less socially advantaged counterparts do.

To renovate or build with wood? Results from Finnish citizen survey data

Finland shows strong support for reducing its climate footprint originating from the built environment as part of the national carbon neutrality goal by 2035. Two prime examples are increasing wood use in construction and favoring building renovation to alleviate emissions from the use of virgin construction materials. However, the open question remains whether citizens also support these decarbonization pathways. By using national-level data from a randomly sampled citizen survey in Finland (n = 1448), we model citizen preferences to these two decarbonization pathways. The results suggest that a preference to renovate rather than to build anew is shown by respondents of the female gender; over 55 years of age; with a lower household equivalent income; and possessing housing property investment. Wood material is positively favored by respondents with higher age; a lower household equivalent income; living in smaller population centers in the countryside; and owning forestland. Interestingly, the effect of climate agency was negative in both models. This can be interpreted in the wood material case as reflecting conflicting views of negative environmental effects from forest harvesting to produce renewable building materials. In the renovation model case, we argue that the climatic impact of renovations remain weakly understood by citizens in Finland, given that the media and national regulations emphasize operational emissions. These results benefit both policy makers and municipal-level decision making in understanding of acceptability of wood material use and building retrofits among the general public.

Food Insecurity Is Associated with Diet Quality in Pregnancy: A Cross-Sectional Study.

Household food insecurity (HFI) and poorer prenatal diet quality are both associated with adverse perinatal outcomes. However, research assessing the relationship between HFI and diet quality in pregnancy is limited. A cross-sectional online survey was conducted to examine the relationship between HFI and diet quality among 1540 pregnant women in Australia. Multiple linear regression models were used to examine the associations between HFI severity (marginal, low, and very low food security compared to high food security) and diet quality and variety, adjusting for age, education, equivalised household income, and relationship status. Logistic regression models were used to assess the associations between HFI and the odds of meeting fruit and vegetable recommendations, adjusting for education. Marginal, low, and very low food security were associated with poorer prenatal diet quality (adj β = -1.9, -3.6, and -5.3, respectively; p < 0.05), and very low food security was associated with a lower dietary variety (adj β = -0.5, p < 0.001). An association was also observed between HFI and lower odds of meeting fruit (adjusted odds ratio [AOR]: 0.61, 95% CI: 0.49-0.76, p < 0.001) and vegetable (AOR: 0.40, 95% CI: 0.19-0.84, p = 0.016) recommendations. Future research should seek to understand what policy and service system changes are required to reduce diet-related disparities in pregnancy.

Social support in older adults: Validation and norm values of a brief form of the Perceived Social Support Questionnaire (F-SozU K-6).

Social relations are crucial for maintaining physical and mental health across the life span. As social roles, networks and needs change with age a valid assessment of social support in older adults and age-specific norms are necessary. The present work aims to [1) assess the level of social support in individuals > 60 years of the general German population, [2) evaluate the brief six-item form of the Perceived Social Support Questionnaire (F-SozU K-6) in this age group and to [3) provide age-specific norm values. We analyze data of N = 706 people representative for the German population collected in 2021. To assess social support, we used the F-SozU K-6. We tested for selectivity, item difficulty, internal consistency, construct and factor validity, as well as factorial invariance. Additionally, we assessed correlations and associations with depression, loneliness, and sociodemographic factors. Furthermore, we reported norm values for respondents > 60 years. Participants > 60 years reported a mean level of 23.97 (SD = 4.82) of social support. Results of the CFA confirmed a very good model fit. Measurement invariance across sex and age was shown. Associations with ADS and LS-S supported construct validity. Multiple regression analysis showed that female sex, increasing age, having a partner, and a higher equivalized household income were associated with higher levels of social support. The F-SozU K-6 is a reliable and economical tool to assess perceived social support in older adults. Norm values for individual > 60 years are provided.

Promoting Social Participation in the Primary Care Field: An Ecological Study on the Potential Reduction of Multimorbidity Prevalence.

No municipal-level study has elucidated the social determinants associated with multimorbidity prevalence (MP). This article aimed to determine the differences in MP among municipalities and investigate factors associated with such differences through an ecological study of data obtained from a nationwide survey. This article focused on social participation and household income, which are associated with single chronic diseases, such as hypertension. Study design was a cross sectional study, which used the data from the Japan Gerontological Evaluation Study, a population-based gerontological study among functionally independent older adults aged ≥65 years in Japan. Overall, 152 212 participants from 2016 to 2017 across 91 municipalities were included in the final analysis. Multiple regression analysis was performed with MP as objective variable; social participation or household income were explanatory variables, and education, population density, and health check-ups were adjustment variables. Intermunicipal differences in MP were 28.4% to 43.1% and 23.2% to 38.8% among men and women, respectively. Significant negative correlation was observed between MP and proportion of social participation (non-standardized coefficient [B] = -.18 for men and women). A significant positive correlation was noted between MP and equivalent household income of ≤2 million yen in women (B = .21). Considerable differences in MP existed among municipalities. Areas with high proportion of social participation showed significantly lower MP. Considering the difficulty in managing multimorbidity within the primary care field and limited evidence on effective interventions, community-level interventions encouraging social participation among older individuals might reduce MP. Primary care physicians should consider a community health approach for multimorbidity.

Sex and Age Differences in the Association Between Social Determinants of Health and Cardiovascular Health According to Household Income Among Mongolian Adults: Cross-Sectional Study.

Although social determinants of health (SDH) are an underlying cause of poor cardiovascular health (CVH), there is insufficient evidence for the association between SDH and CVH, which varies by sex and age among Mongolian adults. We aimed to explore whether education, household income, and health insurance were associated with CVH according to sex and age among Mongolian adults. The final sample included data on 5691 participants (male: n=2521. 44.3% and female: n=3170, 55.7%) aged 18-69 years from the 2019 World Health Organization STEPwise approach to noncommunicable disease risk-factor surveillance. CVH was measured using a modified version of Life's Simple 7 with 4 health behaviors (cigarette smoking, BMI, physical activity, and a healthy diet) and 3 biological factors (blood pressure, fasting glucose, and total cholesterol blood levels) and classified into poor, intermediate, and ideal levels as recommended by the American Heart Association. Multinomial logistic regression analyses examined the associations between SDH and CVH by monthly equivalized household income after adjusting for age, sex, work status, area, history of myocardial infarction or stroke, use of aspirin, and use of statin. Subgroup analyses were conducted to examine the associations between SDH and CVH based on sex and age, considering monthly equivalized household income as a key variable. Using the ideal level of CVH as a reference, among those with the lowest household income, having less than 12 years of education, and not having health insurance were associated with poor CVH (education level: odds ratio [OR] 2.42, 95% CI 1.30-4.51; P=.006; health insurance: OR 2.17, 95% CI 1.13-4.18; P=.02). These associations were more profound among female individuals (education level: OR 2.99, 95% CI 1.35-6.63; P=.007; health insurance: OR 2.54, 95% CI 1.09-5.90; P=.03) and those aged 18-44 years (education level: OR 3.22, 95% CI 1.54-6.72; P=.002; health insurance: OR 2.03, 95% CI 0.98-4.18; P=.06). Participants in the lowest household income group with lower educational levels and without health insurance were more likely to have poor CVH, and these results were more pronounced in female individuals and young adults. These findings suggest the need to develop strategies for CVH equity in Mongolian female individuals and young adults that consider income levels, education levels, and health insurance.

The Use of Spatial Information in Area-level Models: An Evaluation Based on Auxiliary Data Availability

The small area estimation (SAE) theory is widely used when local or domain-specific reliable estimates based on survey data are needed. Small area model-based estimates use a model that links the response variable to some auxiliary information borrowing strength from the related areas. When geographical information on the areas of interest is available, the specification of a spatial area level model can increase the estimates’ efficiency, depending on available auxiliary data. In this article, we first review the most popular area level spatial models, and we then compare their performance under two alternative scenarios of auxiliary information availability to estimate the average equivalized household income in Italian Local Labour Market Areas (LLMAs) using the EU-SILC (European Union Statistics on Income and Living Conditions) survey data. Our findings suggest that the spatial information can “fill the gap” when the covariates do not have a high predictive power, a crucial result when there is lack of auxiliary data. AMS Subject Classification: 62D05, 62G05, 62H11

Prevalence of dental visits in older Japanese adults receiving public assistance.

Exemption from paying dental care costs among recipients of public assistance contributes to universal health care coverage. Although this system might reduce the financial barriers to dental care among patients, there are still several other barriers for public assistance recipients. Therefore, this study examined whether receiving public assistance was associated with a higher prevalence of dental visits for any reason, treatment and prevention. Data were obtained from 16 366 respondents from the 2019 wave of a nationwide cohort study on older adults in Japan. Poisson regression analyses with robust error variance were used to examine the associations between receiving public assistance and dental visits, adjusting for number of teeth, dental pain, periodontal conditions, age, sex, number of family members, education, equivalent household income, working status, instrumental activities of daily living, medical conditions, depressive symptoms, instrumental support and geographical variations. More than half of the non-recipients of public assistance visited a dentist for some reason in the past 6 months. Meanwhile, only 37% of the recipients visited a dentist. In addition, almost half of the non-recipients had treatment visits, while only 34% of the recipients visited. Furthermore, 46% of the non-recipients had dental visits for prevention, while 32% of the recipients had preventive visits. In the fully adjusted models, compared to non-recipients, public assistance recipients were 24% (Prevalence Ratio [PR]: 0.76, 95% Confidence Intervals [CI]: 0.64, 0.90), 23% (PR: 0.77, 95% CI: 0.65, 0.92) and 21% (PR: 0.79, 95% CI: 0.65, 0.95) less likely to have dental visits for any reason, treatment, and prevention, respectively. Although recipients were exempted from dental treatment fees, receiving public assistance was associated with a lower prevalence of dental visits for any reason, treatment and prevention. Future studies should identify the barriers to accessing dental care among public assistance recipients to improve dental visits.

Association of child-specific and household material deprivation with depression among elementary and middle school students in Japan.

This study aimed to investigate the association between child-specific and household material deprivation with depression among elementary and middle school students in Japan. We used cross-sectional data from 10,505 and 10,008 students for fifth-grade elementary school students (G5) and second-grade middle school students (G8), respectively, and their caregivers. The data were collected from August to September 2016 in 4 municipalities of Tokyo and from July to November 2017 in 23 municipalities of Hiroshima prefecture. Caregivers completed questionnaires including household income and material deprivation, and children completed child-specific material deprivation and depression status using the Japanese version of the Birleson depression self-rating scale for children (DSRS-C). To explore the associations, logistic regression was used after conducting multiple imputation for the missing data. 14.2% of G5 students and 23.6% of G8 students had DSRS-C scores of more than or equal to 16, denoting the risk of depression. We found that household equivalent income was not associated with childhood depression in both G5 and G8 students when adjusted for material deprivations. While at least one item of household material deprivation was significantly associated with depression in G8 students (OR = 1.19, CI = 1.00, 1.41), but not in G5 children. Child-specific material deprivation of more than 5 items was significantly associated with depression in both age groups (G5: OR = 1.53, CI = 1.25, 1.88; G8: OR = 1.45, CI = 1.22, 1.73). Future research on child mental health needs to consider children's perspectives, especially material deprivation in young children.

Impact of the COVID-19 Pandemic on the Socioeconomic Inequality of Health Behavior Among Japanese Adolescents: A 2-Year Repeated Cross-Sectional Survey.

Although disparities in socioeconomic status in health behaviors have been highlighted globally, they are not well understood in Japanese adolescents. The purpose of this study was to clarify the changes in socioeconomic disparities in adolescents' fundamental health behaviors, such as physical activity, screen time (ST), sleep, breakfast intake, and bowel movement before and during COVID-19. This was a repeated cross-sectional study which used data from the 2019 and 2021 National Sports-Life Survey of Children and Young in Japan. Data of 766 and 725 participants in 2019 and 2021, respectively, were analyzed. Favorable health behaviors were defined as daily moderate to vigorous physical activity (MVPA) of at least 60minutes, ST of less than 2hours, sleep of 8 to 10hours, daily breakfast intake, and bowel movement frequency of at least once in every 3days. We calculated the slope index of inequality and relative index of inequality in each health behavior for equivalent household income levels for assessing absolute and relative economic inequalities. Compliance with MVPA and ST recommendation significantly declined from 20.1% and 23.0% in 2019 to 11.7% and 14.9% in 2021, respectively. The slope index of inequality and relative index of inequality increased in MVPA for income levels, but decreased in daily breakfast in 2019 to 2021. Although the widening and narrowing of the disparity were inconclusive for ST, it exacerbated for the higher-income groups. Our study revealed widening of economic disparities in the achievement of recommended MVPA and narrowing of it in breakfast intake among adolescents before and during COVID-19.

The international role of education in sustainable lifestyles and economic development

Improved economic growth and environmental protection are necessary to achieve the United Nations’ Sustainable Development Goals. This study examines the relationship between people’s education levels and sustainable lifestyles in protecting the environment and economic growth, as expressed by the increase in household equivalent income. We conducted an original cross-sectional survey, which yielded 100,956 valid observations in 37 countries. The factors included educational level, sustainable lifestyle with natural resource consumption, and household equivalent income for economic development. We used logit and ordered logit model and applied an ordinary linear regression model after confirming the association between education and income. Our analyses found that higher educational levels were associated with an increase in specific environmentally friendly behaviors and sustainable energy consumption. Individuals in the higher educational level group tended to consume recycled goods, purchase energy-saving household products, conserve electricity, and separate their waste. Additionally, higher levels of education were positively associated with equivalent household income in all 37 countries, indicating better economic development. Thus, our study underscores the importance of improving education at the broad population level to promote economic development and establish cooperative human behaviors necessary to sustain the environment.

The Small Area Estimation of Economic Security: A Proposal

The objective of this work is to propose a small area estimation strategy for an economic security indicator. In the last decade the interest for the measurement of economic security or insecurity has grown constantly, especially since the financial crisis of 2008 and the pandemic period. In this work, economic security is measures through a longitudinal indicator that compares levels of equivalized household income over time. To solve a small area estimation problem, due to possible sample sizes too low in some areas, a small area estimation strategy is suggested to obtain reliable estimates of the indicator of interest. We consider small area models specified at area level. Besides the basic Fay-Herriot area-level model, we propose to consider some longitudinal extensions, including time-specific random effects following an AR(1) process or an MA(1) process. A simulation study based on EU-SILC data shows that all the small area models considered provide a significant efficiency gain with respect to the Horvitz-Thompson estimator, especially the small area model with MA(1) specification for random effects.

Retrospectives: Edgar Sydenstricker: Household Equivalence Scales and the Causes of Pellagra

In the early part of the 20th century the disease pellagra, now almost unknown, affected and killed thousands of people in the United States. Some claimed it was an infection, while others maintained it was due to a dietary deficiency. The economist Edgar Sydenstricker (1881-1936), who was a member of a US Public Health Service team examining the disease, argued it was critical to understand how pellagra varied by levels of income. Collecting survey data, he realized equivalence scales were needed to adjust household incomes. His research demonstrated that there was a strong negative correlation between the incidence of pellagra and equivalized household income. Further analysis of the dietary differences between households suggested that a dietary deficiency associated to a restricted availability of animal protein food was the cause of pellagra. This was confirmed more than a decade later when a deficiency of vitamin B-3 was identified as the cause.

Mobility restriction and barrier-reduced housing among people aged 65 or older in Germany: Do those who need it live in barrier-reduced residences?

Older people spend a lot of time at home and in the area near where they live. Housing conditions ensure their ability to participate in social life, especially when they suffer from mobility restrictions. Barrier-free access to the residence and to rooms within the residence is a key condition for their everyday mobility. As a result, this is what we define as minimal criteria for barrier-reduced residences. This article examines the extent to which people aged 65 and over (including people with mobility issues) live in barrier-reduced housing and what factors influence the chance of living in such residences. Cross-sectional data from the German Ageing Survey (DEAS) 2020/21 (persons aged 65 and over, n = 2,854) were used. The DEAS is a representative cross-sectional and longitudinal survey of the population aged 40 and over in Germany. In our analyses, we used logistic regression models to investigate the probability of living in a barrier-reduced residence. We defined housing as barrier-reduced when the apartment/house and the rooms inside it can be reached without steps or stairs. As explanatory variable, we considered mobility restrictions, defined as limited ability to climb a flight of stairs. In addition, the model includes other individual factors (age, gender, equivalized household income), regional factors (living in East vs. West Germany, in urban vs. rural region) and moving to the current residence after the age of 65. Of all individuals aged 65 or older, 19.3 percent live in a barrier-reduced residence. Also, of mobility-restricted elders, only 21.4 percent have such residences. The logistic regression results show that mobility restrictions are associated with a higher probability of living in a barrier-reduced residence. Compared to the lowest income group, older people in the highest income group are more likely to live in barrier-reduced housing. East Germans and people in urban areas are less likely to live in a barrier-reduced home. The likelihood of barrier-reduced living is higher among seniors who moved into their current residence after age 65. No significant differences were found for age groups and gender. The findings show that not enough seniors have barrier-reduced access to their homes and rooms, even if they suffer from mobility restrictions. Preventing functional restrictions must therefore also include improvements in the residential environment, especially in disadvantaged residential areas.