High-income Groups Research Articles

Impact of the presence of a family member with dementia on the prevalence of depression: a comparison based on household income level

BackgroundFamilies caring for patients with dementia are more vulnerable to depression. This cross-sectional study compared differences in socioeconomic status and gender related to depression among families of patients with dementia and identified associated factors.MethodsInequality in depression according to household income level among families of patients with dementia was assessed using the Korean Community Health Survey, which included a sample of over 200,000 participants. Depression prevalence was assessed using the Patient Health Questionnaire-9 (PHQ-9) and each independent variable was calculated. Significant differences were analyzed using the chi-square test. Complex-sample multivariate logistic regression was performed to examine the association between the income levels of families of patients with dementia and depression. Additionally, an analysis of depression, stratified by income level and gender, was conducted.ResultsThe prevalence of depression among families of patients with dementia was 4.41%. The odds ratio (OR) for depression among families of patients with dementia compared to the population of families without patients with dementia was 1.49. Depression was significantly more likely in families with lower income levels (adjusted OR [aOR]: 2.17, 95% confidence interval [CI]: 2.16–2.18). The magnitude of the impact of having a family member with dementia on depression varied by income level, being highest in the lowest income group (aOR: 1.64, 95% CI: 1.63–1.66) and lowest in the highest income group (aOR: 1.26, 95% CI: 1.24–1.27). Stratification by gender showed that both men and women in families of patients with dementia were more likely to experience depression than those in families without patients with dementia. Women had a higher likelihood of depression across all income levels than men; however, the impact of having a family member with dementia was more pronounced among men, especially those from lower-income groups.ConclusionsOur findings suggest the necessity for support policies tailored to low-income groups and women among families of patients with dementia. This is crucial given the higher prevalence of depression among families of patients with dementia than among families without patients with dementia.

The Impact of Floods on the Mobility of Automobile Commuters in Shanghai Under Climate Change

AbstractAs sea level rises, low-lying coastal cites face increasing threat of flood disruption, particularly in terms of human mobility. Commuters are vulnerable to bad weather, as it is difficult to cancel trips even in extreme weather conditions. Using Shanghai’s automobile commuting population as an example, we categorized commuters by travel distance and income level to assess disruptions and delays due to floods, considering future sea level rise. The results show that local flooding disrupts commuting patterns by affecting roadways, with disruption decreasing with distance from the flooded area. This offers a mobility perspective on the indirect impacts of floods. During baseline flood events, long-distance commuters and the low-income group are most affected, while short-distance commuters and the high-income group are less impacted. As sea level rises, floods will threaten all commuting groups, especially the high-income group. Using inaccessibility-commuting delay bivariate maps, this study revealed how socioeconomic differences impact mobility recovery after floods under climate change. The research highlights the differential impacts of floods on various socioeconomic groups in the context of climate change, offering insights for future urban planning and disaster mitigation strategies.

Multi-source tri-environmental conceptual framework for fire impact analysis

The summer of 2023 highlighted the growing threat of wildfires in isolated areas, with Maui Island in Hawaii experiencing one of its largest wildfires. Our study employs a multi-source approach, integrating high-resolution optical data, thermal infrared data, and demographic information to assess the environmental, built, and social impacts of this event. Our innovative tri-environmental framework reveals significant vegetation degradation, land cover change, and disproportionate effects on various demographic groups. The fire caused extensive damage, with residential properties incurring 77.6% of the total losses, equating to approximately $563.2 million. Social impacts were profound, particularly among females, children, and the elderly, with employment and commuting disruptions affecting both low- and high-income groups. The study highlights the effectiveness of combining dasymetric mapping with real-time satellite data to refine population distribution estimates in affected areas. Our findings are applicable beyond wildfires, offering valuable insights into disaster response and mitigation strategies across various natural hazards like floods and earthquakes.

Attitude toward body donation among the non-medical support staffs in a tertiary care center of Eastern India

Background: Anatomy is a basic fundamental subject of medical science. Cadaveric dissection is an essential part of the anatomy teaching-learning process to provide detailed in-depth knowledge about the structural organization of organs in human the body to medical students. Human cadavers are mainly obtained by the body donation program, but the rate of body donation is not adequate in various parts of the country. Aims and Objectives: This study was conducted to assess the attitude toward body donation among the non-medical support staffs in a tertiary health care setup in Eastern India. Materials and Methods: After ethical approval was obtained, a face-to-face interview was conducted among 151 non-medical support staffs using a structured questionnaire. The data were analyzed using Microsoft Excel and Epicollect5 software. Results: This study revealed that 44.37% of the participants were willing to donate their bodies for medical science after their death. The willingness was relatively higher among the male population, with urban residence, higher education level, and higher income group. The main motivation toward body donation was to help society by helping medical science. The main reason behind unwillingness was being uncomfortable about donating own body. Conclusion: Target-oriented awareness program could be conducted to increase motivation toward body donation. Publicly acknowledging the body donors and showing respect to the cadaver and donor family might increase willingness toward body donation.

Inequalities in accessibility to daily opportunities in the metropolitan region of Belo Horizonte (Brazil)

Despite the historical core-periphery urbanization pattern marked by profound inequalities in Latin American cities, the emergence of new suburban structures may introduce more complex dynamics of accessibility. In this study, we conduct a novel investigation into inequalities in accessibility to non-work urban opportunities in the Metropolitan Region of Belo Horizonte (MRBH), utilizing a combined analysis of a cumulative opportunity accessibility indicator and population distribution to assess both social and spatial discrepancies. The findings reveal that low-income households experience significantly lower accessibility to urban opportunities, while the development of new suburban structures results in high accessibility levels in high-income neighborhoods. These results highlight two contrasting processes of segregation: low-income groups being displaced to distant peripheral areas with limited accessibility, while high-income groups settling in low-density residential developments with abundant motorized accessibility to nearby opportunities.

The COVID-19 Pandemic and the Proportion of People Diagnosed with Hypertension among Daegu Citizens

Objectives: Daegu Metropolitan City was a region that experienced the pandemic in the early stages of the COVID-19 outbreak, and the rate of physical activity practice decreased significantly compared with other metropolitan cities in 2020. In 2023, when it transitioned to an endemic, the proportion of people diagnosed with hypertension (standardized) increased the most among metropolitan cities. Methods: Using data from the Community Health Survey in Daegu, we examined changes in the proportion of people diagnosed with hypertension before and after the COVID-19 pandemic and changes according to sociodemographic characteristics. Results: The proportion of people diagnosed with hypertension, adjusted for gender, age, obesity, income, and occupation, was not different in 2019 and 2020 compared to 2018, and was likely to be higher in 2021, 2022, and 2023. The proportion of people diagnosed with hypertension was higher among men and women, ages in the 30s, 40s, and 50s, and income level in the 2 million won, 3 million won, and 4 million won and occupation in simple labor, others (students, housewives, unemployed) after the COVID-19 outbreak (2019-2023) than before the COVID-19 outbreak (2015-2019). In particular, there was a significant increase among women, 30s, 3 million won, and those in simple labor.Conclusions: In this study, the proportion of people diagnosed with hypertension increased significantly compared to before the outbreak of COVID-19, not only in vulnerable groups but also in younger age groups and high-income groups. In the physical activity aspect alone, the reason is interpreted as the result of the discontinuation of intense exercise, which can prevent hypertension by stimulating the cardiovascular system. Therefore, public health intervention is needed for vulnerable groups and maintain an intensity of exercise that can prevent hypertension. There is also a need to prepare to prevent a pandemic of chronic diseases from being caused by new infectious diseases.

Shining a light on disparities: A comparative analysis of residential photovoltaic adoption inequality in Australia and Brazil

There is a growing consensus that the energy transition must also be just. In this context, the inequality in the adoption of residential photovoltaic (PV) systems is under scrutiny as solar energy adoption rises. Despite the existing evidence of the inequality in PV adoption, there is a need to examine how this issue has evolved across different contexts, particularly in developing countries. This paper aims to compare the inequality in PV adoption between Australia and Brazil over the last decade. The mix of methods includes analyzing descriptive statistics, a Solar Gini index, and regression models. The findings reveal that inequality in residential PV adoption in both countries has not changed substantially. Lower-income quintiles have faced lower adoption probabilities than higher-income groups. However, Australia demonstrates a better position, with a more equitable distribution of solar systems across income groups. The lack of inequality change suggests that technology diffusion alone may not eliminate PV access inequality for low-income groups. It emphasizes the ongoing need for targeted policies to enhance justice in solar access.

Characteristics of Extreme Poverty in the Province of Bangka Belitung Islands

This study aims to analyze the characteristics of poverty in seven districts and cities in the Bangka Belitung Islands Province. This study uses primary and secondary data from the Central Bureau of Statistics (BPS) and other relevant sources. The analysis was conducted descriptively to identify factors that influence poverty, such as the age of the poor, marriage, education level, number of dependents, type of employment, income, living conditions, government assistance and health. The results show that poverty in Bangka Belitung is more dominant in rural areas than urban areas. Low education levels and limited access to health services are the main causes of poverty in this area. In addition, the community's dependence on the fluctuating mining sector also affects the economic stability of households. This study also found significant income inequality between low- and highincome groups. Based on these findings, efforts to improve access to education and health, as well as economic sector diversification to reduce unemployment are recommended. More inclusive policies are needed to sustainably address poverty in the region.

Can the Use of Digital Finance Promote the Enhancement and Quality Improvement of Household Consumption Among Farmers?

The key strategic point for facilitating domestic circulation is to enhance and expand household consumption. Based on a survey of 1080 farming households in Hunan, Hubei, and Jilin Provinces, this study examines the impact of digital finance use on the scale and structural upgrading of household consumption among farmers. The findings indicate that digital finance use effectively expands the scale of household consumption and promotes structural upgrades. The results remain robust through various endogenous and robust methods. Heterogeneity analysis reveals that the benefits of digital finance use are greater for middle- to high-income groups and those with lower education levels, indicating the presence of a digital divide effect. Furthermore, the construction of village communities, skill training, improvements in village logistics services, and the availability of medical clinic facilities can enhance the consumption-promoting effects of digital finance use. Mechanism analysis shows that digital finance primarily operates through alleviating credit constraints, enhancing risk prevention, and improving financial returns to influence the scale and structural upgrading of household consumption. This study provides policy insights for rural revitalization and unlocking the consumption potential of rural residents.

Analysis of Anthropometric Measurement during Pregnancy

ABSTRACT Anthropometric assessment during pregnancy is a widely used; low technology procedure that has not been rigorously evaluated. Our objective is to study and determine the anthropometric measurement and examining changes during pregnancy. The study was performed the total 480 pregnant women from urban and rural area of Marathwada region. The height and weight were measured by using digital scale and BMI (Body Mass Index) was Calculated. The collected data was tabulated and analysed statistically. The result of the present study regarding the selected anthropometric measurement of the selected pregnant women indicated that there was non-significant effect of different education over body height. Result also revealed that the pregnant women belonging to low, medium and high-income group were significantly affected on height, Weight & BMI. The mean value of height and body weight of pregnant women of urban areas was noticed to be significantly more than that of the pregnant women of rural areas (p<0.01). Whereas statistical analysis of the data revealed that the pregnant women from urban and rural area did not differ significantly in their body mass index values.

Assessment of HIV and STI vulnerabilities and associated factors among street children in Islamabad capital territory, Pakistan

PurposePakistan like most developing countries is challenged by the issue of street children, which has not been addressed optimally. This study assessed HIV (Human immunodeficiency virus) and other STI (Sexually transmitted infection) vulnerabilities and its associated factors among street children in Islamabad Capital Territory (ICT) in Pakistan. MethodsUsing an analytical cross-sectional design, structured questionnaires were administered to 450 street children between 12–18 years to explore HIV and STI vulnerabilities (particularly focusing on unprotected sex and injecting drug use). Data were collected by trained interviewers from randomly selected street boys recruited from various street spots. HIV and STI vulnerability were defined as anyone who had unprotected sex and/or had history of injecting drug use. Multivariable logistic regression was conducted to identify factors associated with HIV and STIs vulnerability. All ethical protocols including taking assent were followed ensuring the safety and protection of all children. ResultsA high level of HIV and STI vulnerability (73%) was reported among street children in ICT. Various factors found to have an independent association with this vulnerability included children of older age (aOR 4.5; 95% CI 2.5 – 8.3), those having higher income [aOR 2.6 (1.4 – 4.8)] for middle income group and [aOR 5.1(2.3–11)] for highest income group, those who work for more than 10 h on the street [aOR 1.9 (1.1–3.3)], initiated work at young age [aOR 2.2 (1.3–3.8)], and children who sleep on the street at night (aOR 1.9; 95% CI 1.0–4.8). ConclusionsThis study has highlighted a high level of HIV and STIs vulnerability among street boys in ICT, which underscores the importance of intensified and coordinated efforts for this extremely vulnerable population.

Association between family income to poverty ratio and severe headache/migraine in the American adults: data from NHANES 1999-2004.

The relationship between family income to poverty ratio (PIR) and severe headache/migraine remains unclear. Data for this cross-sectional study were obtained from NHANES 1999-2004. PIR was the exposure variable, and severe headache/migraine was the dependent variable. We performed univariate analyses of severe headache/migraine, PIR, and other covariates. The association between PIR and severe headache/migraine was tested using multiple regression models. Furthermore, interaction tests and stratified analyses assessed the relationship between PIR and severe headache/migraine across subgroups. There were a total of 8,800 participants: 4,833 (54.92%) males and 3,967 (45.08%) females, 1,714 (19.48%) with severe headache/migraine and 7,086 (80.52%) without severe headache/migraine. After adjustment for all variables, PIR negatively correlated with severe headache/migraine OR = 0.86 95% CI (0.83, 0.90) p < 0.0001. The variable PIR was categorized as the low-income (PIR < 1), the middle-income (PIR1-4), and the high-income (PIR > 4). Notably, there was a significant difference in trend for the high-income group (PIR > 4) compared to the control low-income group (PIR < 1) (all P for interaction<0.05). Dose-response correlations were also analyzed using smoothed curve fitting, revealing a negative correlation between PIR and severe headache/migraine (p < 0.0001). Subgroup analysis results indicated that the negative association between PIR and severe headache/migraine was more pronounced in the following populations: males (OR = 0.84 95% CI (0.79, 0.90), <60 years old [Age < 45 group OR = 0.81 95% CI (0.76, 0.85)], Age 45-60 group OR = 0.86 95% CI (0.79, 0.93), and those with education levels ≥high school [High School OR = 0.87 95% CI (0.81, 0.95), >High School OR = 0.82 95% CI (0.78, 0.87)]. There is a negative correlation between PIR and the incidence of severe headaches/ migraine in Americans aged 20 years or older. This study has implications for the comprehensive management of patients with severe headache/migraine.

Association of frailty with functional difficulty in older Ghanaians: stability between women and men in two samples with different income levels

BackgroundResearch to date suggests that frailty is higher in women and is associated with functional difficulty. This study builds on the evidence by examining the association between frailty and functional difficulty between low- and higher-income groups and between older men and women in these income groups.MethodsThis study adopted a cross-sectional design that complied with the STROBE checklist and included steps against confounding and common methods bias. The population was community-dwelling older adults aged 50 years or older in two urban neighbourhoods in Accra, Ghana. Participants were either in the low-income group in a low socioeconomic neighbourhood (n = 704) or the higher-income group in a high socioeconomic neighbourhood (n = 510). The minimum sample necessary was calculated, and the hierarchical linear regression analysis was utilised to analyse the data.ResultsFrailty was positively associated with functional difficulty in the low- and higher-income samples, but this association was stronger in the higher-income sample. Frailty was positively associated with frailty in men and women within the low- and higher-income samples.ConclusionThe association of frailty with functional difficulty was consistent between low- and higher-income samples, although the strength of the relationship differed between these samples. In both income samples, the foregoing relationship was consistent between men and women, although the strength of the relationship differed between men and women.

Drinking practices: The variation of drinking events across intersections of sex, age and household income.

Investigations of drinking practices often rely on cross-country comparisons of population averages in beverage preferences, drinking volumes and frequencies. Here, we investigate within-culture patterns and variations in where, why and how people drink, answering the research question: how does engagement in drinking practices vary by sex, age and household income? We conducted a cross-sectional analysis examining the societal distribution (by age, sex, household income) of 12 drinking practices: four off-trade practices (in-home consumption; e.g., evening at home with partner) and eight on-trade practices (licensed-venue consumption, e.g., family meal, big night out). Practices were identified in previous analyses of 2019 British event-level diary data (14,742 drinkers aged 18+ reporting 26,220 off-trade and 8768 on-trade occasions). The level of engagement in practices varied by sex, age and income. In the on-trade sector, men, particularly those in low-income groups, engaged in traditional pub-drinking, while women, especially older women, engaged in sociable drinking occasions with family and friends which commonly involved food. Young men and women were similarly likely to engage in heavier on-trade practices, which remained commonplace into midlife. Drinking while socialising with friends, both inside and outside the home, was common among younger age groups across all income bands. From midlife, home drinking often involved a partner, especially for higher income groups. Most drinking practices were shared across the whole population, but level of engagement in them is strongly patterned by age, household income and, particularly in the on-trade sector, sex.

The association between voluntary health insurance and health outcomes in older adults in Europe: A survival analysis

ObjectivesVoluntary health insurance (VHI) often serves a supplementary role in Europe. The ageing population and adoption of cost-sharing models in response to economic pressures raise concerns that VHI could contribute to health inequalities among older people. This study investigates the association of VHI with health outcomes among older people across 16 European countries and Israel. Study designProspective cohort study. MethodsData on participants aged ≥50 years across 16 European countries and Israel were obtained from four waves (2013–2020) of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Gompertz proportional hazards models assessed the association of VHI with mortality and multimorbidity. Hazard ratios (HR) and 95 % confidence intervals (CI) are reported. ResultsVHI prevalence was 38.2 % in 2013 and 34.9 % in 2015, with a higher prevalence among higher-income groups. VHI was associated with a 13 % lower risk of mortality (HR: 0.87, 95% CI: 0.81–0.94) after accounting for demographic, socioeconomic, lifestyle, and health-related factors. VHI was also associated with a lower risk of multimorbidity (HR: 0.92, 95 % CI: 0.87–0.97). ConclusionsVHI was associated with a reduced risk of mortality and multimorbidity, after adjusting for demographic, socioeconomic, lifestyle, and health-related factors. VHI might facilitate the access to timely and high-quality healthcare services, which may exacerbate health inequalities among older individuals.

The impact of information intervention on urban residents' willingness to sort domestic waste

Although many studies have assessed the effectiveness of waste sorting policies, few studies have explored residents' waste sorting behavior from the perspective of information intervention as a nudge. This study conducts an online survey to empirically examine the effects of information intervention on residents' willingness to sort domestic waste in urban China. We design and implement three types of randomized information interventions (positive, negative, and neutral) to 720 residents in the city of Beijing. Results from ordered probit models show that, despite the large amount of intervention-related policy context that the sampled subjects already possess before the intervention, information intervention can still effectively improve urban residents' willingness to sort domestic waste, and that the information framing effect exists. Specifically, while neutral information intervention does not affect urban residents' willingness to sort domestic waste, both positive and negative information interventions improve residents' willingness to sort domestic waste, and positive information intervention has a stronger effect. These effects are heterogeneous depending on gender, age, and income of residents, with the effect in male, young-age, and low-income groups stronger than that of female, old-age, and high-income groups respectively.

Aging population in urban India: Challenges and insights from Kolkata

In Kolkata, the elderly people represent 11.76% of the total population. Here we present new data on the aging population of Kolkata, and address its causes, and consequences. We interviewed 110 elderly male and female who are living with their family members and in old age homes in Kolkata. The data was collected from low, medium, and high-income groups from three urban housing societies as well as five old age homes. It has been observed that the elderly male and female of the low-income group have no medical and life insurance, and many of them are suffering from health issues. Although females up to 60 years are part of Self-Help Group, males are suffering from Loneliness. The elderly male and female of the medium, and high-income group do not have financial issues, but most of them do not visit doctors and health care centers for regular health check-ups. Digital literacy has to be improved. Elderly people staying in old age homes are mentally and physically much better than their counterparts who live with family members. Analysis of existing government policies reveal scope for improvement of the elderly people. We propose social innovation for the elderly population in Kolkata.

Determinants of Public Support for Fee-Contracts in Uzbekistan's Higher Education

This study examines the impact of fee-contract funding (FCF) systems on state higher education (SHES) in Uzbekistan, addressing a gap in existing literature that has primarily focused on standard tuition fees and state subsidies without exploring fee contracts, especially in emerging markets. Using a logistic regression analysis on survey data from 120 participants, the study aims to identify predictors influencing policy support for fee contracts. Findings indicate that income level and education are the strongest predictors of policy favorability, while cultural factors elevate support for "fee contract will make college access easier" as a predictor, though with weaker direct effects. Age and private sector contributions, though correlated with the outcome, were not statistically significant. These results suggest that policy elites in high-income and educated groups favor FCF systems, yet promoting fee contracts as accessibility-enhancing may garner broader support. The study underscores the need for policy interventions and expanded financial aid to promote equitable access, recommending further research into the long-term social and economic effects of fee contracts in similar contexts.

Perceptions of building-integrated nature-based solutions by suppliers versus consumers in Egypt

Can Building-Integrated Nature-based Solutions (BI-NbS) reach their full potential in the Global South? In the Egyptian context, BI-NbS are relatively new with an identified gap between the high potential in theory and low implementation rates in practice. To bridge this gap, the study conducts an in-depth investigation of BI-NbS market conditions to reveal the current trends in the residential buildings market in Egypt. It also identifies the gaps and overlaps in the perceptions of the suppliers and consumers of BI-NbS. Results reveal that the residential sector sales mainly target high-income groups yet very limited and dominated by rooftop systems. Suppliers advocate for high-tech systems over low-tech systems, whereas consumers prefer the latter. The perceptions of suppliers and consumers mostly align regarding the basic aspects such as the production and operation preferences as well as the anxieties and concerns about the relatively new BI-NbS in this regional context. However, they diverge in key aspects affecting market penetration such as implementation conditions, aims, and barriers. Accordingly, the study identified the gap between suppliers and consumers, and outlined recommendations, directed to suppliers and policymakers, for improved market development and local implementation of BI-NbS in emerging markets of the Global South, such as Egypt.

Food insecurity is associated with poor mental health and health risk behaviors in Czechia

Abstract Background Food insecurity (FI) is one of social determinants of health and a profound public health concern because it leads to malnutrition and hence poor health. COVID-19 impacted people disproportionately and exacerbated preexisting social and health inequalities. The aim of this study was to understand how socioeconomic and health conditions affected one’s FI in Czechia during the pandemic using a representative panel of Czech adults from a longitudinal survey, Life During the Pandemic collected in October 2022 as part of a Czech longitudinal survey. Methods A study sample of 1,499 respondents was included in our multiple logistic regression models. Depressive symptoms and anxiety symptoms were assessed using validated questionnaires PHQ-2 and DAG-2. Results Approximately one third of the study sample (32.4%) reported being food insecure. In the fully-adjusted model, adults with depressive symptoms (OR 2.37, CI 1.49, 5.02), problems with sleeping (OR 2.20, CI 1.64, 2.96), smoking habit (OR 2.27, CI 1.68, 3.07), lower fruit and vegetable consumption (OR 1.50, CI 1.04, 2.17) had greater odds of experiencing FI. The lowest income group was associated with 6.2 times greater odds of reporting FI as compared to the high-income group (CI 3.96, 9.67). Lower education attainment also had higher odds of experiencing FI (OR 2.15, CI 1.40, 3.31). Anxiety was not a significant predictor for FI. Conclusions Our study highlights that food insecurity is associated with depressive symptoms, poor quality of sleep and lower consumption of fruit and vegetables among adults. Food insecurity was also evident among lower income and lower education attainment. Funding source This study was supported by The Charles University Grant Agency (GA UK). Key messages • Our study suggests that adults with poor mental health and diet quality experience food insecurity. • Given the established link between a balanced diet and mental well-being, interventions should encompass not only food security but also the quality of dietary intake.