Favorable Socioeconomic Status Research Articles

Exploring Diversity of Hispanic Health Outcomes Through Prism of Environmental Justice

In environmental economics studies US Hispanics are frequently depicted as one large homogeneous group, despite diversity in their countries’ cultural traditions, genetic background and socioeconomic status (SES). This study aimed to compare Florida’s very diverse Hispanic population of Caribbean, Mexican, Central, and South American ancestry.Twelve independent variables were selected from environmental pollution, geospatial challenges, and SES categories. Dependent variables included the relative prevalence of three major chronic diseases: asthma, diabetes, and heart disease. Analysis of pairs correlations was supplemented by multi-variable linear regression. Majority-Hispanic areas have higher than average pollution, diabetes, proximity to disadvantaged neighborhoods, and lower SES. Despite lower pollution than in urban areas, Florida’s inland rural areas had higher rates of all major diseases and lower life expectancies. Cuban and Puerto Rican populations of Miami and Orlando metro areas, respectively, have less favorable SES outcomes and higher diabetes. Columbian and Venezuelan communities have significantly higher education levels than other Hispanic cohorts, and they have the best relative outcome among US Hispanics in SES and health, although still lagging US averages. African-American community in Miami-Dade County was by far the most disadvantaged, with significantly lower SES and health outcomes than any other group in the study, including the nearby Cuban-majority community. Our results confirmed the view that Hispanics are environmentally disadvantaged in Florida, with worse outcomes than the US and Florida average in health and economic factors. Furthermore, the study highlighted significant differentiation of SES and health outcomes among various regional Hispanic cohorts.

Assessment of adherence to treatment recommendations among patients with heart failure: a cross-sectional study

BackgroundHeart failure (HF) is a chronic condition characterized by significant impairment of the cardiovascular system, leading to a decline in health-related quality of life, recurrent hospitalizations, and increased mortality risk. It poses a substantial challenge for modern medicine, particularly when patients fail to adhere to therapeutic recommendations. The primary aim of this study was to evaluate the level of adherence to therapeutic guidelines among patients with HF and identify factors influencing adherence levels.MethodsThe study comprised 105 HF patients admitted to the cardiology department. A diagnostic survey approach was utilized, employing the Adherence in Chronic Diseases Scale (ACDS) along with a self-developed questionnaire.ResultsThe findings revealed that 39.05% of participants exhibited a moderate level of adherence to therapeutic recommendations, while 34.29% reported high adherence and 26.67% displayed low adherence. Most of the patients (n = 66) had a rather good level of knowledge. Factors such as higher education (p < 0.001), engagement in mental work (p = 0.001), favorable socioeconomic status (p < 0.001), being in a stable relationship (p < 0.001), and residing with family (p < 0.001) were associated with increased adherence levels. The multivariable linear regression model indicated significant (p < 0.05) independent predictors that positively influenced the ACDS score, including being in a relationship, widowhood, and average or poor financial situation. Conversely, factors such as obesity and respiratory diseases were associated with a decrease in the ACDS score (p < 0.05).ConclusionsThis study underscores the moderate adherence level to therapeutic recommendations among HF patients. Sociodemographic factors including education level, relationship status, occupation, financial stability, and living arrangements significantly impact adherence. Conversely, patients with obesity, respiratory conditions, or frequent HF-related hospitalizations demonstrate lower adherence. Patient education emerges as a pivotal factor influencing adherence. Tailored interventions targeting these factors could enhance adherence and optimize HF management outcomes.

Socioeconomic factors and long-term mortality risk after surgical aortic valve replacement

BackgroundThere is scarce knowledge about the association between socioeconomic status and mortality in patients undergoing surgical aortic valve replacement. This study explores the associations between income, education and marital status, and long-term mortality risk. MethodsIn this national registry-based observational cohort study we included all 14,537 patients aged >18 years who underwent isolated surgical aortic valve replacement for aortic stenosis in Sweden 1997–2020. Socioeconomic status and comorbidities were collected from three mandatory national registries. Cox regression models adjusted for patient characteristics and comorbidities were used to estimate the mortality risk. ResultsMortality risk was higher for patients in the lowest versus the highest income quintile (adjusted hazard ratio [aHR] 1.36, 95 % confidence interval [CI]: 1.11–1.65), for patients with <10 years education versus >12 years (aHR 1.20, 95 % CI:1.08–1.33), and for patients who were not married/cohabiting versus those who were (aHR 1.24, 95 % CI:1.04–1.48). Patients with the most unfavorable socioeconomic status (lowest income, shortest education, never married/cohabiting) had an adjusted median survival of 2.9 years less than patients with the most favorable socioeconomic status (14.6 years, 95 % CI: 13.2–17.4 years vs. 11.7 years, 95 % CI: 9.8–14.4). ConclusionsLow socioeconomic status in patients undergoing surgical aortic valve replacement is associated with shorter survival and an increased long-term adjusted mortality risk. These results emphasize the importance of identifying surgical aortic valve replacement patients with unfavorable socioeconomic situation and ensure sufficient post-discharge surveillance.

Evaluation of an advanced oral hygiene regimen on maternity outcomes in a randomized multicenter clinical trial (Oral Hygiene and Maternity Outcomes Multicenter Study)

During pregnancy, dental plaque-induced gingivitis prevalence and subsequent risk of periodontal disease increases substantially as a consequence of both inadequate oral hygiene and changes in sex steroid hormone levels. Although maternal periodontal disease has been associated with adverse pregnancy outcomes, including spontaneous preterm birth, previous clinical trials involving mechanical debridement (e.g., scaling and root planing) to remove plaque biofilm have not yielded decreased rates of preterm birth. We hypothesized that an advanced oral hygiene program, including an antibacterial regimen coupled with a power toothbrush and hygiene instruction, may improve the periodontal milieu and reduce the rate of spontaneous preterm birth. Therefore, we conducted a clinical trial of obstetrical patients with moderate-to-severe gingivitis who were randomized to an advanced oral hygiene program versus usual oral hygiene care, and the primary obstetric outcome compared between the treatment groups was gestational age at delivery. Obstetrical patients with singleton pregnancies between 8 and 24 weeks gestation were screened by trained dentists at two clinical sites for moderate-to-severe gingivitis (more than 30 intra-oral sites with gingival bleeding on probing). Eligible participants were randomized to an advanced oral hygiene regimen, including antibacterial mouth wash, dental floss, antibacterial toothpaste, a power toothbrush, and intensive oral hygiene education versus standard oral home care instructions and regimen. The primary obstetric outcome assessed was gestational age at delivery. The overall primary (dental) outcomes were gingival index, bleeding sites, and pocket depth (reported elsewhere). Secondary obstetric outcomes included birthweight and incidence of preterm birth at <37 weeks. Regression models were utilized and included factors such as treatment group, gestational age at enrollment, preterm birth history, and potential markers of health disparities (i.e., education, employment status). A total of 817 obstetrical patients underwent dental screening at the two sites, 789 were identified with moderate-to-severe gingivitis, 746 were randomized, and birth outcomes were available for 613 of the study participants. The gestational age at delivery was two days earlier in the control group (p=0.040), but the clinical significance of this finding was limited (39.13 vs 38.85 weeks). Overall rates of spontaneous preterm birth <37 weeks and <34 weeks were not statistically different between the two treatment groups (7.0% advanced oral hygiene regimen versus 10.3% controls, OR=1.63 (0.90, 3.00), p=0.11; and 2.3% versus 3.9%, OR=1.88 (0.71, 4.98), p=0.20, respectively). However, we observed lower rates of spontaneous preterm birth among unemployed participants with less favorable socioeconomic status (4.7% advanced oral hygiene regimen versus 16.0% controls, OR=4.04 (1.34, 15.12), p=0.01). An advanced oral hygiene program may reduce the risk of spontaneous preterm birth among pregnant patients with moderate-to-severe gingivitis and health disparities. This is the same group that may be at highest risk of poor dental hygiene and preterm birth.

Abstract P634: Life’s Essential 8 and the Role of Sleep in Atherosclerotic Cardiovascular Disease: Coronary Artery Risk Development in Young Adults (CARDIA) Study and Multi-Ethnic Study of Atherosclerosis (MESA)

Introduction: Sleep affects other cardiovascular health (CVH) behaviors and factors, and it is associated with cardiovascular disease. The AHA recently updated the definition of CVH to include sleep (“Life’s Essential 8”; LE8). Associations of the LE8 CVH score (with or without sleep) with atherosclerotic cardiovascular disease (ASCVD) risk have not been described. Methods: We included CARDIA and MESA participants (ppts), stratified into younger (ages 30-45, n=4332), middle-aged (ages 45-60, n=4793), and older groups (ages 60-75, n=3168). CVH score (range: 0-100) with sleep (8 metrics) and without sleep (7 metrics) was scored separately and categorized by age-specific quartiles. Reclassification of CVH score with the addition of sleep and associations with ASCVD events were assessed at each age. Results: Mean (SD) CVH scores with and without sleep were 72.8 (13.2) and 73.0 (14.2) for younger, 67.1 (14.6) and 65.6 (15.8) for middle-aged, 64.6 (13.6) and 63.0 (14.9) for older ppts. Self-reported Black race and less favorable socioeconomic and psychosocial status were associated with shorter sleep duration, as were lower CVH scores. When sleep was included in the CVH score, 81.9%-83.0% (by age group) of ppts had consistent CVH score quartiles, 7.7%-8.9% were reclassified into a higher CVH score quartile, and 7.8%-9.3% were reclassified into a lower CVH score quartile. Including sleep tended to result in worse CVH scores for men and Black ppts. Higher CVH scores were associated with significantly greater probability of ASCVD-free survival (Figure 1A). Each 10-point higher CVH score was associated with 21%-39% lower hazards for ASCVD across age groups, and the CVH score including sleep had somewhat stronger associations with ASCVD than the CVH score without sleep (Figure 1B). Conclusion: Higher CVH using the LE8 score is associated with lower ASCVD risk. The inclusion of sleep in the CVH score reclassified almost 20% of participants and resulted in somewhat stronger associations between CVH score and ASCVD. Characters: 1730/1750 max allowed Figure 1: Age, sex, race, and education adjusted association of LE8 and ASCVD(A-adjusted ASCVD-free Survival Curves by quartile of CVH score; B-adjusted hazard ratio and 95%CI)

Association and Interaction of Genetics and Area-Level Socioeconomic Factors on the Prevalence of Type 2 Diabetes and Obesity.

Quantify the impact of genetic and socioeconomic factors on risk of type 2 diabetes (T2D) and obesity. Among participants in the Mass General Brigham Biobank (MGBB) and UK Biobank (UKB), we used logistic regression models to calculate cross-sectional odds of T2D and obesity using 1) polygenic risk scores for T2D and BMI and 2) area-level socioeconomic risk (educational attainment) measures. The primary analysis included 26,737 participants of European genetic ancestry in MGBB with replication in UKB (N = 223,843), as well as in participants of non-European ancestry (MGBB N = 3,468; UKB N = 7,459). The area-level socioeconomic measure most strongly associated with both T2D and obesity was percent without a college degree, and associations with disease prevalence were independent of genetic risk (P < 0.001 for each). Moving from lowest to highest quintiles of combined genetic and socioeconomic burden more than tripled T2D (3.1% to 22.2%) and obesity (20.9% to 69.0%) prevalence. Favorable socioeconomic risk was associated with lower disease prevalence, even in those with highest genetic risk (T2D 13.0% vs. 22.2%, obesity 53.6% vs. 69.0% in lowest vs. highest socioeconomic risk quintiles). Additive effects of genetic and socioeconomic factors accounted for 13.2% and 16.7% of T2D and obesity prevalence, respectively, explained by these models. Findings were replicated in independent European and non-European ancestral populations. Genetic and socioeconomic factors significantly interact to increase risk of T2D and obesity. Favorable area-level socioeconomic status was associated with an almost 50% lower T2D prevalence in those with high genetic risk.

Religiosity as a Factor Supporting Parenting and Its Perceived Effectiveness in Hungarian School Children’s Families

The impact of a family’s socio-economic status on parenting activities has been a thoroughly researched topic. Parental involvement, which refers to parenting that supports school achievement, may be home-based and school-based, as typified by Epstein and Sanders. Earlier findings suggest that a more favorable socioeconomic status results in more active and effective parental involvement. Only a few studies show low-status parents can be more effective, whereby some factor compensates for the negative impact of low status. Our hypothesis is that parents’ self-identified religiosity can reduce the disadvantages arising from the family’s unfavorable socio-economic status. We use data from a survey conducted in 2020 among the parents of fourth-grade Hungarian primary school children, which is geographically and socially representative with a sample size of 1156. Our results show that religiosity has a significant positive influence on parenting activities and their perceived effectiveness, even after controlling for other variables. In addition, our indicator of home-based parental attention in itself is also strongly supportive of parents’ perceived effectiveness in parenting. Our findings suggest that parental religiosity and home-based parental attention are important factors that can make parenting effective despite social and cultural disadvantages.

Epidemiological Indices of Gynecological Fungal Infections Referred to the Mycology Laboratory of Kermanshah

Introduction: Candidiasis vaginitis, Tinea cruris and Erythrasma are the most common fungal and Corynebacterium infections in women. Favourable conditions, socio-economic status and age and occupation in different regions play a role in the frequency and severity of these diseases. Given that women make up half of the population of any society, knowing the frequency of fungal diseases of this genus and the severity of the disease their values are of great importance. Methods: In a descriptive study, it was decided to evaluate the frequency, variety and conditions of fungal infections in women referred to the Medical Mycology Laboratory of Kermanshah University of Medical Sciences from the beginning of 1994 to the end of 2014. Considering that the mycology laboratory is the only specialized mycology laboratory in Kermanshah province, this study will be able to show us comprehensive information about the status of mycoses of women groin. In this study types and agents of mycoses and conditions such as age, job, season and place that predisposing factor role for infection were collected. Results: The highest prevalence of groin dermatophytosis is in the age group of 40-49 years with ٪ 28 و and the lowest is in the age group of 0-9 years and more than 70 years with ٪ 1. The present study shows that the highest prevalence of fungal species was in the years 1994-1998 and gradually declined and had the lowest prevalence in recent years. In this study, the most common fungal species of tinea cruris was Epidermophyton floccosum with a prevalence of ٪ 40 and the lowest was related to Trichophyton rubrum and Microsporum gypsum with a prevalence of 4, 0.4 percent. The most common agents of candidiasis were Candida albicans. The most common job of patients was Housewife and most common patient’s place was Kermanshah. Conclusion: The most important factor in preventing fungal infections is public health. For example, dry yourself carefully after taking a bath, don’t sit in a wet bath, and change your clothes after sweating in hot seasons. Tinea cruris is contagious. Be sure to prevent the spread of disease in gyms and swimming pools.

High blood pressure in children and adolescents from urban peripheral areas of La Plata, Argentina

Objective: The aim of the present study was to estimate the prevalence of high blood pressure in schoolchildren aged 4-14 years from urban peripheral areas of the city of La Plata, and analyze variations in high blood pressure prevalence by sex, age, excess weight and family socioeconomic status. Materials and methods: Systolic and diastolic blood pressure, body weight and height were measured in 3,312 schoolchildren of both sexes. The prevalence of high blood pressure (HBP), overweight and obesity was calculated. Socioeconomic information was obtained through a semi-structured survey and processed by categorical principal-component analysis. The prevalence of HBP was compared with sex, age and nutritional status (chi square test) and family socioeconomic status (generalized linear model) (p&lt; 0.05.). Results: The results showed that the prevalence of HBP, was 20.5% and that it varied by age, nutritional status and family socioeconomic status. Sexual differences were observed only in HBP obese schoolchildren. Conclusions: Children and adolescents living in urban peripheral areas of the city of La Plata, Argentina, presented higher HBP prevalence. While HBP prevalence was higher among overweight/obese children, those aged &gt;8 years and those of more favorable family socioeconomic status, sex did not affect HBP development. However, when HBP was analyzed associated with nutritional status, obese boys were more likely to have HBP than girls.

Food Insecurity and Preeclampsia: A Case-Control Study

Background: Household food insecurity is defined as the limited or uncertain access to adequate and safe food or limited ability to obtain food in a socially acceptable manner. Preeclampsia is a severe case of high-risk pregnancy, which endangers the health of women across the world, especially in developing countries. The current study aimed to use the nutritional deficiencies theory in pathogenesis of preeclampsia and determine the correlation between food insecurity and preeclampsia. Methods: This case-control study was conducted on 100 women with preeclampsia and 200 normal pregnant women with the gestational age of 20 weeks. Participants were selected via purposive sampling according to the eligibility criteria. Data were collected using the USDA questionnaire for food insecurity, socioeconomic data, and demographic data through interviews. Results: The findings indicated that the frequency of food insecurity was significantly higher in the preeclampsia women than the healthy women (71% vs. 21%; P &lt; 0.001). Logistic regression indicated that the risk of preeclampsia was six times higher among pregnant women in the unsafe food status group than those in safe food status group [odds = 6.4; 95%CI: 3.3-12.4; P &lt; 0.001]. Among the studied variables, socioeconomic status, history of stillbirth, history of preterm delivery, and ethnicity were significantly associated with preeclampsia during pregnancy (P &lt; 0.05). In addition, women with low socioeconomic status were twice at the higher risk of preeclampsia compared to those with favorable socioeconomic status [odds = 2.7; 95%CI: 1.1-6.2; P = 0.01]. Conclusion: The current study indicated that the prevalence of food insecurity was high in Iranian women with preeclampsia, especially those with a history of preterm labor, history of stillbirth, low socioeconomic status, or non-Persian.

The effects of computer-assisted adaptive instruction and elaborated feedback on learning outcomes. A randomized control trial

Using a computer-based learning environment, the present paper studied the effects of adaptive instruction and elaborated feedback on the learning outcomes of secondary school students in a financial education program. We randomly assigned schools to four conditions on a crossing of two factors: the type of instruction (uniform or adaptive) and feedback (verification or elaborated). A total of 1177 students in 32 schools completed the program in ability groups in the classroom. The results showed that the program, on average, enhanced the financial knowledge of students by almost half of a standard deviation. No significant changes in students’ financial behavior were found. Despite the promise of adaptive practices to address the individual needs of students, we observed no additional learning gains associated with adaptive instruction and elaborated feedback. A marginally significant heterogeneous effect for gender was reported, where girls were negatively affected by adaptive instruction. Moreover, despite our sample included more students from a favorable socioeconomic status, the adaptive practices seemed to lower the motivation level. Hence, while no information on the time spent on the instruction and feedback was retrieved, the latter finding suggested that the practices may have been perceived as burdensome by students, thereby rendering them ineffective.

Gender differences in factors associated with body weight misperception.

Gender analysis in health research is important to strengthen our health system. The current study aimed to explore factors related to body weight misperception in a national sample of the general Korean population. Cross-sectional study. South Korea, general population. 12,900 adults enrolled from the Seventh Korea National Health and Nutrition Examination Survey (2016-2018). Disadvantageous socio-economic status was considered a predictor of participants' misperceptions of themselves as being of a healthy weight despite being overweight and as underweight despite being of a healthy weight, mainly in men. Favourable socio-economic status was considered a predictor of participants' misperceptions of themselves as being of a healthy weight despite being underweight and as overweight despite being of a healthy weight, mainly in women. Living in an urban area was an independent predictor of men's misperception of themselves as being of a healthy weight despite being overweight and women's misperception of themselves as being underweight despite being of a healthy weight. Physical inactivity was a predictor of most misperceptions in women. Psychological variables, such as stress and depression, were not significant predictors of misperception. The current study highlighted the gender differences in factors related to body weight misperception. These differences suggested that more sophisticated policies should be formulated to identify solutions to health problems related to body weight.

Socioeconomic status and brain injury in children born preterm: modifying neurodevelopmental outcome.

Improved intensive care therapies have increased the survival of children born preterm. Yet, many preterm children experience long-term neurodevelopmental sequelae. Indeed, preterm birth remains a leading cause of lifelong neurodevelopmental disability globally, posing significant challenges to the child, family, and society. Neurodevelopmental disability in children born preterm is traditionally linked to acquired brain injuries such as white matter injury and to impaired brain maturation resulting from neonatal illness such as chronic lung disease. Socioeconomic status (SES) has long been recognized to contribute to variation in outcome in children born preterm. Recent brain imaging data in normative term-born cohorts suggest that lower SES itself predicts alterations in brain development, including the growth of the cerebral cortex and subcortical structures. Recent evidence in children born preterm suggests that the response to early-life brain injuries is modified by the socioeconomic circumstances of children and families. Exciting new data points to the potential of more favorable SES circumstances to mitigate the impact of neonatal brain injury. This review addresses emerging evidence suggesting that SES modifies the relationship between early-life exposures, brain injury, and neurodevelopmental outcomes in children born preterm. Better understanding these relationships opens new avenues for research with the ultimate goal of promoting optimal outcomes for those children born preterm at highest risk of neurodevelopmental consequence.

Measuring Livelihood Diversification and Forest Conservation Choices: Insights from Rural Cameroon

While forests’ contribution to rural livelihoods has been unearthed scientifically, the patterns, determinants and forest conservation policy implications of livelihood diversification still beg for more scientific and policy edification. This paper makes a contribution in this regard, using household data (N = 200) from eight villages around the Kilum-Ijim Forest Landscape of Cameroon. The ordinary least square and the logit model are used to explore the determinants of livelihood diversification and the likelihood of forest dependence, respectively. The diversification patterns were analysed using a simple t-test, and the multinomial logit for conservation choices. We find that forest-related activities are a source of livelihood diversification for 63% of households, with non-timber forest products (NTFP) domestication (31%) and medicinal plant extraction (30%) being the most preferred. For non-forest activities, migration is the most preferred diversification strategy. Generally, households with favourable socio-economic status prefer non-forest to forest activities for livelihood diversification. The regression estimates indicate that older respondents are more likely to depend on the forest than the young, whereas males and individuals with at least some secondary education are less likely than their respective counterparts to rely on the forest. The results also suggest those who participated in training, educated household heads and older individuals are significantly more likely to choose high-valued diversification strategies. Concerning conservation activities, households with favourable socio-economic status are on average less likely to adopt NTFP domestication and more likely to adopt bee-keeping as a conservation choice. The results suggest the need for policy considerations to: (i) effectively integrate women in forest management processes, (ii) intensify trainings for conservation-friendly diversification approaches, (iii) regulate unclean energy use and (iv) encourage value chain improvement for conservation-friendly products.

Evolution of fetal mortality in the setting of Argentine socioeconomic inequalities. Period 2007-2014.

Few studies have established a relationship between adverse social conditions by geographic area (GA) and fetal mortality (FM). Objective. To assess health inequalities in relation to FM by GA. Descriptive, ecological study. The principal components of 525 GAs were analyzed. A socioeconomic status indicator and indices of inequality were developed and estimated, and the FM ratio was calculated. The Kunst and Mackenbach relative index of inequality ranged from 1.8 to 1.4 in the 2007/2008 and 2013/2014 biennia, and a higher FM ratio was estimated for the highly unfavorable socioeconomic level stratum. The FM ratio is higher in this stratum. The gap between the ends of the socioeconomic spectrum narrowed towards the latest biennium. Regardless of this, in the GAs with a very unfavorable socioeconomic status, the FM ratio reduced in the latest biennium and increased in those with a very favorable socioeconomic status.

شواهد تازه از سقط جنین عمدی در شهر تهران: میزان‌ها، دلایل و تغییرات

Introduction: Awareness of the incidence of abortion in Iran is essential to promoting maternal health. Therefore, it is of paramount importance to estimate the rate of induced abortion. The present study aimed to investigate the rate, causes, and changes associated with induced abortion during 2009-2014. Methods: This survey was conducted using the abortion data collected from two fertility surveys preformed in 2009 and 2014 on a respective sample of 2,934 and 3,012 married women aged 15-49 years in Tehran, Iran. The incidence of abortion was estimated based on the age-specific abortion rate, general abortion rate, total abortion rate, and abortion ratio. Results: During 2009-2014, total abortion rate reduced from 0.16 to 0.14 cases per woman, while the general abortion rate decreased from 5.5 to 4.4 cases per 1,000 women, and the annual rate of abortion declined from 11,500 to 11,400 cases. Assuming the estimated abortion rate in Tehran as a national average rate, it is estimated that approximately 101,000 abortions are performed in Iran annually. Moreover, about 9% of known pregnancies are reported to be terminated in Tehran. Mean age at abortion is 33.5±6.3 years, and the rate of induced abortion is comparatively higher among the women with academic education, proper employment, favorable socioeconomic status, and low religious tendencies, as well as the migrants of urban areas and those with no or one living child. The proportion of abortions for non-medical reasons was found to increase from 69% in 2009 to 82% in 2014. In addition, half of the induced abortions were due to withdrawal failure; however, only one-third of the women with withdrawal failure switched to modern contraceptives after abortion. Conclusion: According to the results, the high prevalence of induced abortions in Iran highlights the need for effective family planning services and counseling in order to prevent unintended pregnancies among women.

Alcohol's Collateral Damage: Childhood Exposure to Problem Drinkers and Subsequent Adult Mortality Risk.

The importance of childhood circumstances, broadly defined, for shaping adult health and longevity is well-established. But the significance of one of the most prevalent childhood adversities-exposure to problem drinkers-has been understudied from a sociological perspective and remains poorly understood. We address this gap by drawing on cumulative inequality theory, using data from the 1988-2011 National Health Interview Survey-Linked Mortality Files, and estimating Cox proportional hazards models to examine the relationship between exposure to problem drinkers in childhood and adult mortality risk. Childhood exposure to problem drinkers is common (nearly 1 in 5 individuals were exposed) and elevates adult overall and cause-specific mortality risk. Compared to individuals who had not lived with a problem drinker during childhood, those who had done so suffered 17 percent higher risk of death (p<.001) over the follow-up period, net of age, sex, and race/ethnicity. We find compelling evidence that the duration, source, and intensity of exposure to problem drinkers in childhood contributes to inequality in adult mortality risk. Favorable socioeconomic status in adulthood does not ameliorate the consequences of childhood exposure to problem drinkers. The primary intervening mechanisms are risky behaviors, including adult drinking and smoking. The findings-which reveal that the influence of problem drinking is far-reaching and long-term-should inform policies to improve childhood circumstances, reduce detrimental effects of problem drinking, and increase life expectancy.

Favorable Socioeconomic Status and Recreational Polydrug Use Are Linked With Sexual Hepatitis C Virus Transmission Among Human Immunodeficiency Virus-Infected Men Who Have Sex With Men.

Background. Sexual transmission of hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) is an emerging issue. Studies addressing the temporal trends and risk factors associated with incident HCV in HIV-infected MSM in the community-based primary care settings in the United States are scarce. Methods. Using a retrospective cohort study design, HCV incidence, defined as HCV antibody seroconversion, was determined in 1147 HIV-infected men receiving care at Chase Brexton Health Care clinics in Baltimore, Maryland between 2004 and 2014. Multivariate regression analyses were used to identify factors associated with incident HCV. Results. There were 42 incident HCV infections during 5242 person-years (PY) of follow up (incidence rate [IR], 8.01/1000 PY). Thirty-seven (88%) of the incident infections were in MSM, of whom 31 (84%) reported no injection-drug use (IDU). The annual IRs for MSM were 13.1-15.8/1000 PY between 2004 and 2007, decreased to 2.7-6.2/1000 PY between 2008 and 2011, and increased to 10.4/1000 PY and 13.3/1000 PY in 2013 and 2014, respectively. Injection-drug use was strongly associated with incident HCV among all MSM (IR ratio [IRR], 14.15; P = .003); however, among MSM without IDU, entering care between 2010 and 2013 (IRR, 3.32; P = .01), being employed (IRR, 3.14; P = .03), and having a history of ulcerative sexually transmitted infections (IRR, 3.70; P = .009) or of polydrug use (IRR, 5.54; P = .01) independently predicted incident HCV. Conclusions. In this cohort of HIV-infected men, a re-emerging HCV epidemic was observed from 2011 to 2014 among MSM. In addition to IDU, high-risk sexual behaviors, favorable socioeconomic status, and polydrug use fueled this increase in HCV infections.

Reproductive behavior in carrier couples for transfusion-dependent thalassemia major: evaluation of knowledge, attitude and practice

Background and Purpose: Despite extensive research on family planning and education, reproductive behavior of high-risk couples for thalassemia remains a major concern among medical professionals. This study aimed to evaluate the knowledge and attitude of carrier couples for transfusion-dependent thalassemia major (TDTM). Methods: This case-control study was conducted 327 carrier couples for thalassemia minor. Contact information of the couples was obtained from three healthcare centers randomly selected from the eastern, central and western parts of Mazandaran province, Iran. To match the socioeconomic status, two control families (right and left neighbors) were interviewed per each carrier couple. Epidemiological characteristics and knowledge of the carrier couples were assessed via 10 and 20 questions, respectively, and scores above 15 were interpreted as adequate knowledge. Moreover, attitude of the subjects was evaluated via 16 items scored based on a four-point Likert scale. Data analysis was performed in SPSS V.16 using Mann-Whitney U test and T-test for the comparison of study groups, and P value of less than 0.05 was considered significant. Results: In total, 327 high-risk couples for minor thalassemia and 660 control families were enrolled in this study. Among the subjects, 32.6% and 22.3% had adequate knowledge about thalassemia. In addition, attitude of the carrier couples was positive in 58% and 41% of the cases. Also, 30.5% and 31.2% of case and control subjects had favorable socioeconomic status, respectively. Conclusion: According to the results of this study, knowledge of carrier couples was adequate with regard to TDTM, and they had a positive attitude toward receiving prenatal diagnosis for this syndrome. However, reproductive practice of high-risk couples was relatively poor. Therefore, it is recommended that reproductive behavior of high-risk couples for TDTM be monitored regularly in order to improve their practice.

Comparison General Health and Life Expectancy between Students with Favorable and Unfavorable Socioeconomic Status

Introduction: The present study aims to compare general health and life expectancy between students with favorable and unfavorable socioeconomic status. Methods: The statistical population in this study consists of all the students of Lamerd city in the second semester of the academic year of 2013-2014. The sample of this study consists of 200 male and female students. A hundred of them are in the favorable socioeconomic status and the other 100 are in the unfavorable socioeconomic status which were selected by multistage random sampling. Results: The results of the analysis of MANOVA on the mean of life expectancyand general health scores indicated that there is a significant difference between the two groups regarding the investigated variables. Conclusion: In general, given the vulnerability of people who are in low socioeconomic status compared to the other segments of the society, more attention should be paid to this issue by the authorities.