High-income Participants Research Articles

Correlation analysis of exercise volume and musculoskeletal disorders in people with income level differences: research based on the 2011–2018 NHANES dataset

ObjectivesSocioeconomic factors significantly impact human health; however, the impact of exercise and income on musculoskeletal system health remains unclear. Our study aims to explore the relationship between exercise and income with musculoskeletal system health in young and middle-aged adults.DesignThis cross-sectional study used data from 7,515 adults aged 20–59 years, which were obtained from the US NHANES, 2011–2018. Participants’ musculoskeletal system health was evaluated on the basis of them having osteopenia, osteoporosis, or sarcopenia.MethodsOrdinal regression was used to explore the correlation between income level, exercise volume, and musculoskeletal system health. Mediating effect analysis was used to assess whether the exercise volume affected the impact of income levels on musculoskeletal system health. Ordinal regression and restricted cubic spline curve were used to further analyze the relationship between exercise and income level.ResultsIn the analysis of adjusted all covariates, the probability of having good musculoskeletal system health in high-income participants was higher than that of low- or middle-income participants. The probability of having good musculoskeletal system health in the actively exercising group higher than that of the participants exercised insufficiently or sufficiently. Mediating effect of exercise masked the effect of income on musculoskeletal system health. Participants with low income levels tended to spend more time exercising that those who had high income levels; exercise volume and income level had a significant non-linear relationship.ConclusionThe findings presented will help identify young and middle-aged adults who are most at risk of developing musculoskeletal health problem and will likely benefit from certain lifestyle interventions.

Association Between Family Income, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population.

Both low family income and subclinical myocardial injury (SCMI) are risk factors for cardiovascular disease (CVD) mortality. However, the impact of their joint association on CVD mortality is unclear. This analysis from the third National Health and Nutrition Examination Survey included 6805 participants (age 59.1 ± 13.4 years, 52.3% women, and 49.8% White) free of CVD at baseline. Family income was assessed using the poverty-income ratio (PIR) and categorized into low (PIR < 1), middle (PIR = 1-4), and high (PIR > 4) income. A validated ECG-based cardiac infarction injury score (CIIS) ≥ 10 was considered positive for SCMI. CVD mortality was determined using the National Death Index. Cox-proportional hazard analysis was used to evaluate the associations of family income and SCMI, separately and jointly, with CVD mortality. A total of 1782 (26.2%) participants had SCMI at baseline. During a median follow-up of 18.2 years, 856 (12.6%) events of CVD mortality occurred. In separate multivariable Cox models, SCMI (vs. no SCMI) and middle- and low-income (vs. high-income) were each associated with a higher risk of CVD mortality (HR [95% CI]: 1.34 [1.16-1.54], 1.44 [1.16-1.78], and 1.59 [1.22-2.07], respectively). Compared to high-income participants without SCMI, those with low-income and SCMI had an increased risk of CVD mortality (HR [95% CI]: 2.17 [1.53-3.08]). The multiplicative interaction between PIR and SCMI was not significant (p = 0.054). Lower family income and SCMI are associated with CVD mortality, and their concomitant presence is associated with the highest risk. Family income and SCMI may help in the individualized assessment of CVD risk.

Navigating the personal carbon inclusion scheme: An evolutionary game theory approach to low-carbon behaviors among socio-economic groups

In response to the challenges posed by climate change, China has launched the Personal Carbon Inclusion (PCI) scheme to encourage individuals to transition towards low-carbon lifestyles. This study investigates the behaviors of participants within the PCI scheme using a tripartite evolutionary game model, encompassing high-income and low-income individuals, as well as the PCI platform itself. The research analyzes participants' strategies, examines the evolutionary stability of different strategies, and assesses the robustness of equilibrium points within the game dynamics. Key findings reveal: (1) High-income participants tend to be less willing to adopt low-carbon behaviors compared to low-income participants. (2) The PCI platform displays limited proactive engagement in promoting low-carbon policies. (3) Factors, particularly the cost and pricing mechanisms of low-carbon actions, significantly impact the evolutionary progression of the system. Moreover, practical recommendations are provided to enhance the effectiveness of PCI schemes.

Unveiling food safety knowledge and practices among pet owners in Lebanon

Owning pets offers various potential health benefits; however, it can be associated with gastrointestinal illnesses due to poor food safety knowledge and practices. This study aimed to evaluate the level of food safety knowledge and practices among pet owners in Lebanon, exploring the association between their knowledge/practices and socio-demographic characteristics. The participants included 300 pet owners, representing various genders, ages, educational levels, educational backgrounds, and incomes. They completed a questionnaire of 72 food handling practices and knowledge questions related to preparation, cross-contamination, storage and hygiene. In parallel, 300 non-pet owners with comparable sociodemographic characteristics to pet owners (control group) completed the questionnaire. On average, food safety knowledge scores were 62.1 ± 14.9% and 58.7 ± 15.5% among pet and non-pet owners, respectively, and the difference was significant (p = 0.05). On the other hand, mean food safety practice scores were 41.3 ± 14.8% and 40.4 ± 15.3% among pet and non-pet owners, respectively, and the difference was not significant (p = 0.41). In the food safety knowledge part, non-pet owners who were young, high income, university graduate, and from health-related majors scored significantly (p < 0.05) higher, while among pet-owners, only participants with a university degree and from health-related majors scored significantly (p < 0.05) higher, in terms of knowledge. On the other hand, In the food safety practices part, non-pet owners who were young, high income, and university graduates scored significantly (p < 0.05) higher, while among pet-owners, only young and high-income participants scored significantly (p < 0.05) higher. These results highlight the need for ongoing educational initiatives to improve food safety practices among both pet owners in Lebanon. The study suggests that targeted educational programs should be developed, considering specific socio-demographic characteristics, to enhance overall food safety awareness and practices among the population.

Enhancing Oral Health via the Sense of Coherence Approach Among Adult Patients at University Dental Hospital.

The purpose of the study was to assess the sense of coherence and its relationship with oral health and other study variables among adult patients at university dental hospital. This cross-sectional study included adult patients visiting the Dental Hospital of the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam. Sense of coherence was determined by Antonovsky's Sense of Coherence scale (SOC-13), which consists of 13 items on a 7-point Likert. DMFT index, plaque index, gingival index, and simplified oral hygiene index were used to evaluate the oral health of study participants. Bivariate and multivariable analyses were performed, and 0.05 level of significance was used in the study. The study included the data of 558 participants with a mean age of 32.19±10.11 years. The mean score of SOC was 52.77±13.11, which was significantly higher in high-income participants (P <0.001), participants without a medical condition (P=0.021), non-smokers (P <0.001), and those who visited the dentist in less than one year (P=0.028). Bivariate analysis showed statistically significant negative correlations between SOC and DMFT index (P=0.002), SOC and plaque index (P <0.001), SOC and gingival index (P=0.002), and SOC and simplified oral hygiene index (P=0.001). Multivariable analysis also showed that SOC was significantly correlated with DMFT index (P=0.001), plaque index (P <0.001), gingival index (P <0.001), and oral hygiene index (P=0.004) after controlling for age, gender, education, and monthly income. This study found that high-income and healthy participants, non-smokers, and those who visited the dental office during the last one year demonstrated significantly higher SOC. In addition, there was a statistically significant correlation between SOC and oral health. These study findings highlight the importance of raising awareness about SOC to improve oral health outcomes in adult patients.

Adherence to the planetary health diet and cognitive decline: findings from the ELSA-Brasil study.

The EAT-Lancet Commission proposed a planetary health diet to improve human health within planetary boundaries; however, little is known about the association between adherence to this diet and cognitive decline. We used data from three waves of the Brazilian Longitudinal Study of Adult Health to evaluate the association between the planetary health diet and cognitive decline using linear mixed-effects models. Here we show that in 11,737 participants (mean (s.d.) age 51.6 (9.0) years, 54% women and 53% white), higher adherence to the planetary health diet was associated with slower memory decline (P = 0.046) and that income was a modifier in this association (P < 0.001). Adherence to the planetary health diet was associated with slower decline of memory (P = 0.040) and global cognition (P = 0.009) in high-income participants. No association was found among low-income participants. The results of our study highlight that the promotion of healthy dietary patterns should take into consideration income barriers as well as differences in dietary habits to achieve high adherence.

“I find it hard to change poor food habits”: Measuring food choice motives in an emerging economy

Food choices are driven by an array of motives that have been approached, determined and quantified in a number of ways, mainly in developed countries. The objective of this study was to better understand the motives behind food choices in an emerging economy by collecting information from urban people in South Africa in a series of four studies. (1) Items generated through focus group discussions with low, middle and high income participants by Magano et al. (2023) were checked for content and face validity and (2) 123 statements derived from them were evaluated by 621 respondents. After exploratory factor analysis (EFA), 46 statements best representing the motivational space were (3) presented to another group of respondents (n = 259). Here, the EFA resulted in a 31-item, 7-factor food choice questionnaire for emerging economies (FCQ-EE) which was (4) confirmed by a nationwide sample (n = 814) and further refined to an alternative 19-item, 7-factor solution. The emerging factors were: Healthy eating constraints (HEC), Frugality (FR), Emotional eating (EE), Meat appeal (MA), Weather (WE), Quality seeking (QS) and Cooking constraints (CC). Whether used in the 31-item or 19-item format, this set of statements highlights factors underlying food choice in an emerging economy and offers a way to study their importance in similar contexts. Further research is needed to show the extent to which these factors can predict actual food choices.

Smartphone usage and daily trips: an empirical study of small and rural communities in Texas

ABSTRACT This study investigated stated trip changes related to smartphone usage among the residents in nine small and rural communities in Texas, based on a 419-respondent online survey. The survey results showed that most participants always used smartphones to perform tasks. After controlling for socioeconomic status, perceived adaptability to technology, and population density, smartphone usage was generally positively associated with the stated impact on daily trip frequency. High-income participants were less likely to report a positive impact of smartphone usage on work-related trips. Compared to younger adults, smartphone use among older adults (aged 50 years or older) was less likely to influence trip-making. Based on the study findings, policy recommendations about smartphone-based information provision systems and information accessibility were discussed. The findings could help policymakers and practitioners design planning protocols that encourage sustainable travel and build the next-generation small and rural communities.

Changing sustainable diet behaviours during the COVID-19 Pandemic: inequitable outcomes across a sociodemographically diverse sample of adults.

The objective of this study was to describe changes in sustainable dietary behaviours (those that support environmental, economic, and physical health) among a sample of US adults during the COVID-19 pandemic and to examine differences in changes by individuals' race/ethnicity and socioeconomic status. Therefore, a cross-sectional online survey study was conducted in April 2021 (N = 1,488, mean age = 42.7 (SD = 12.6)) receiving outpatient care from Michigan Medicine, the University of Michigan health system. Enrolment quotas were established to ensure a diverse sample-one-third of participants identified as African American/Black, one-third Hispanic/Latino, one-third White, and one-third low-income. Participants reported engaging in more behaviours that are supportive of a sustainable diet one year into the COVID-19 pandemic compared to before. This is particularly true regarding ecologically and economically sustaining behaviours such as taking fewer trips to the grocery store, increased use of home grocery delivery, increased cooking at home, and greater consumption of healthy foods. Not all behaviour changes promoted sustainable food systems; namely, the use of farmer's markets and Community Supported Agriculture (CSAs) declined. White and high-income participants were more likely than African American/Black, Hispanic/Latino, and low-income individuals to engage in ecologically and economically sustainable dietary behaviours during the pandemic. Meanwhile, African American/Black participants reported large increases in physical health sustainable dietary behaviours. To support the continuation of greater engagement with sustainable diets, policies that increase access to public transportation, limit the frequency with which consumers have groceries delivered, increase work-from-home options, and improve access for low-income populations should be prioritised.

Investigation of Knowledge, Attitudes, and Healthy Lifestyle Behaviors on Bladder Cancer in Turkey.

The prevalence of bladder cancer increases rapidly among individuals. The knowledge, attitude, and healthy lifestyle behaviors of individuals in Turkey regarding bladder cancer are unknown. The present study aim was to examine the knowledge and attitudes of the participants about bladder cancer and healthy lifestyle behaviors. Methods?:?This cross-sectional study was conducted with 400 participants from outpatient clinic at Erciyes University. Data were collected by using a socio-demographic form and Healthy Lifestyle Behaviors Scale. Results?:?Findings revealed that 55% of the participants were aware of bladder cancer risks?;?smoking 55.5%, older ages 67%, synthetic dyes and some chemicals 43.7%, and overweight 34.5% increases the risk of bladder cancer. The findings showed that economic status and education effect on the Healthy Lifestyle Behaviors Scale scores. The positive relationship was found between self-realization, exercise, and interpersonal subscale in those with high-income participants. It is found that exercise, nutrition, and stress management that have a positive attitude among non-smokers toward the risk factors of bladder cancer. Conclusion?:?The information obtained from the study can be used to inform patients about bladder cancer, risk factors, and cancer prevention. In this regard, healthcare professionals can increase patients f knowledge and create awareness by preparing informative brochures, giving information during the examination, or making presentations. J. Med. Invest. 71 : 40-46, February, 2024.

Socioeconomic inequalities in health-related functioning among people with Type 2 Diabetes

Abstract Background Type 2 Diabetes mellitus (T2DM) is a common chronic disease which disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have increased risk of T2DM and people with a low SEP and T2DM have higher HbA1c levels and a higher risk to develop T2DM complications compared to their high SEP counterparts. The aim of this study is to analyze longitudinal socioeconomic differences in health-related functioning in people living with T2DM. Methods Cross-sectional and longitudinal data from 2,004 participants of The Maastricht Study with T2DM were used. SEP was determined by baseline measures of education, occupation and income. Health-related functioning (physical, mental and social) was measured with the SF-36 and the Impact on Participation and Autonomy survey (scores 0-100). Associations of SEP and health-related functioning were studied over a 10-year period (baseline 2010-2018) using linear mixed methods adjusting for demographics, disease characteristics and lifestyle factors. Results Low SEP participants had significantly worse health-related functioning compared to those with a high SEP. For example, participants with low income had lower scores for physical (-4.00[CI 2.62;-5.38]), mental (-2.81[-1.52;-4.10]) and social functioning (-9.10[-6.35;-11.85]) compared to high-income participants. In addition, participants with a low education significantly declined more in mental (interaction estimate time -0.21[-0.05;-0.37]) and social functioning (-0.39[-0.02;-0.76]) compared to participants with high education. Conclusions In individuals with T2DM, socioeconomic health differences are apparent in health-related functioning. Moreover, differences in mental and social functioning widened even more between different levels of education. Beyond disease characteristics and lifestyle, more attention is needed for socioeconomic differences in health-related functioning for people living with T2DM, both in research and practice. Key messages • Among people with T2DM, those with a lower SEP have worse health-related function then individuals with a higher SEP, even with similar demographics, disease characteristics and lifestyle patterns. • Additionally, people with T2DM and low education decline more over time in mental and social functioning than people with T2DM and high education.

Income and Oral and General Health-Related Quality of Life: The Modifying Effect of Sense of Coherence, Findings of a Cross-Sectional Study

ObjectivesTo investigate whether a strong sense of coherence (SOC) modifies the association between low-income and oral and general health-related quality of life (OHRQoL and HRQoL, respectively) among a South Australian population sample; and to explore the main and interaction effects of income and SOC on OHRQoL and HRQoL.MethodsBaseline data from the Dental Care and Oral Health Study (DCOHS, a South Australian representative study, 2015–2016) were used for cross-sectional analysis (n = 3,786). Four multivariable factorial ANOVA models were applied to assess the effect measure modification, main effects, and interaction of income and SOC on OHRQoL (measured using the OHIP-14) and HRQoL (measured using the EQ-5D-3L).ResultsIncome and SOC had small main effects on OHRQoL. Income had a small effect and SOC had an intermediate effect on HRQoL, meaning that individuals with strong SOC had better OHRQoL and HRQoL in all income categories. Also, high-income participants had better OHRQoL and HRQoL. The interaction between income and SOC was statistically significant on HRQoL. Among participants from low-income group, those with strong SOC had better OHRQoL (mean = 8.8, 95% CI[7.9, 9.7]) and HRQoL (mean = 1.1, 95% CI[1.0, 1.3]) than others with weak SOC (OHIP-14 mean = 12.7, 95% CI[11.7, 13.6]) and (EQ-5D-3L mean = 2.0, 95% CI[1.9, 2.2]).ConclusionThe findings showed the main effects and interaction between SOC and income on OHRQoL and HRQoL. Income had different effects on OHRQoL and HRQoL depending on whether SOC was strong or weak. Findings suggested that strong SOC modified the association between low-income and OHRQoL and HRQoL.

Relationships of beans intake with chronic kidney disease in rural adults: A large-scale cross-sectional study.

Dietary factors play an important role in the development of chronic kidney disease (CKD). However, evidence on the relationship of beans consumption with CKD remains limited and inconclusive, especially in the middle-and low-income populations. The current study aimed to investigate the relationships of beans intake with indicators of kidney injury and CKD prevalence in rural adults. A total of 20,733 rural adults from the Henan Rural Cohort Study in 2018-2022 were included. The total beans intake was collected using a validated food frequency questionnaire. Indicators of kidney injury and CKD was determined by the estimated glomerular filtration rate and the urinary albumin to creatinine ratio. Generalized linear regression and logistic regression models were applied to estimate the relationship of beans intake with continuous and dichotomized indicators of renal function, respectively. Of the 20,733 participants, 2,676 (12.91%) subjects were identified as CKD patients. After adjusting for potential confounders, participants in the higher quartiles of beans intake had a lower prevalence of CKD (odds ratio and 95% confidence interval, OR (95%CI); Q2: 0.968(0.866-1.082); Q3: 0.836(0.744-0.939); Q4: 0.854(0.751-0.970)) and albuminuria (Q2: 0.982(0.875-1.102); Q3: 0.846(0.750-0.954); Q4: 0.852 (0.746-0.973)), compared with the Q1. Per 50 g/day increment in beans intake was significantly associated with a 5 and 4% decreased prevalence of albuminuria and CKD, respectively. These inverse relationships were also significant in the subgroups of men, elder, and high-income participants (p < 0.05). Dietary beans intake was inversely associated with the prevalence of albuminuria and CKD in rural adults, suggesting that promoting soy food intake might help reduce the occurrence of CKD in rural adults.

Serum concentration of zinc, copper, iron, and its associated factors among pregnant women of small-scale farming in western Ethiopia

Micro-nutrients are required in small amounts to maintain growth and cell functioning to complete the life cycle through reproductions. However, pregnant women in developing countries like Ethiopia are vulnerable to multiple micro-nutrient deficiencies. Therefore, this study aimed at assessing the serum level of metals and associated factors like dietary diversity, and health-related problems in pregnant women among small-scale farming in Kellem Wellega, western Ethiopia. A cross-sectional laboratory-based study was conducted from June to August 2021 on 417 pregnant women attending antenatal care at rural healthcare facilities. Data was collected by using per-tested structured questionnaires via face-to-face interviews. The data analysis was conducted using SPSS version 24.0, and multivariate logistic regression analysis was performed to determine the association between predictor and outcome variables. A statistically significant was considered at p value < 0.05 for all the analyses. Our study findings showed that 62.1, 80.9, and 71.9% of the participants were deficient in iron, zinc, and copper micro-nutrient levels, respectively. Pregnant women who could not have formal education were 3.24 (AOR = 3.24, 95% CI 1.33–7.91) and 3.98 (AOR = 3.98, 95% CI 1.2–13.15) times more likely to show zinc and copper deficiency than those who attended secondary school and above, respectively. Furthermore, pregnant women involved only in farming activities were 0.57 (AOR = 0.57, 95% CI 0.36–0.91) and 4.33 (AOR = 5.72, 95% CI 2.34–13.97) times more likely to be exposed to iron and zinc deficiency than those who were engaged in other activities. This study revealed that pregnant women with low income were 6.36 times more likely to be exposed to zinc micro-nutrient deficiencies than those with high-income participants (AOR = 6.36, 95% CI 1.47–27.61). Additionally, those participants who ate a varied diet between 1 and 4 items per day were 2.26 (AOR = 2.26, 95% CI 1.43–3.59) and 2.77 (AOR = 2.77, 95% CI 1.6–4.61) times more likely to suffer zinc and copper micro-nutrient insufficiency than those who consumed 5–10 items per day. Finally, pregnant women who developed diarrhea in the past three months were 1.82 (AOR = 2.77, 95% CI 1.14–2.92) and 2.52 (AOR = 2.52, 95% CI 1.3–4.91) times more likely to be exposed to iron and copper deficiency than those who never show the symptoms, respectively. This study identified low concentrations of zinc, iron, and copper in the blood serum of pregnant women of small-scale farmers.

Prevalence and Awareness of Hypertension in Pazar District of Tokat Province: A Community-Based Study

Purpose: This study was conducted to evaluate the prevalence of hypertension in individuals over the age of 18, risk factors, knowledge and opinions of society about hypertension, and awareness of hypertension in Pazar district of Tokat province. Materials and Methods: This descriptive cross-sectional study was carried out in Pazar district of Tokat province between February and May 2022. The research was conducted with 270 individuals over the age of 18 who agreed to participate in the study in each neighborhood in the district center using the proportional cluster sampling method. Results: While the prevalence of hypertension was 27%, awareness of hypertension was 21.9% in individuals. Both the prevalence of hypertension and awareness of hypertension were statistically significantly high in individuals with a family history of hypertension and comorbidities. Each unit increase in age increases the probability of hypertension by 1.112 times. Low-income participants were 8.381 times more likely to have hypertension than high-income participants. Comorbidities increase the risk of hypertension by 4.541 times. The rate of individuals who were diagnosed with hypertension by a physician was 5.9%, and the rate of regular use of the drugs recommended by the physician was only 62.5%. Conclusion: Hypertension is observed in approximately one in every three people, and the rate of awareness of hypertension is quite low. It is recommended that individuals in society should be screened for hypertension with blood pressure measurements at regular intervals, and health education should be planned for awareness.

What is in a Meter? A Qualitative Exploration into the Implementation of Electricity Metering Across Mumbai Communities Using Normalisation Process Theory

Metering is fundamental in the efficient operation of electricity networks, as meters facilitate controlled usage and improve health and well-being. However, across the Global South, meters have often been found to be lacking or not fit for purpose. Therefore, this study sought to determine residents’ perceptions and access to electricity metering across a community in Mumbai, with the goal of developing recommendations to support the implementation of meters in the future. Fifty semi-structured interviews were conducted by phone, with participants from different areas and socioeconomic classes, within Greater Mumbai. The sample consisted of 20 low-income, 20 middle-income, and 10 high-income participants. The Normalisation Process Theory (NPT) was used to inform the interview schedule and to organise the thematic analysis. Meter accessibility and location was variable across the participant groups, as was the education and awareness of metering technology. Socio-political factors were found to directly affect the use of meters, specifically in the low-income group. The high cost associated with metering was a prominent finding; with a preconception that introducing meters would only increase utility expenditure. Future work should focus around ensuring meters are easy to use, practical and accessible to all residents and supporting education programmes around how to use a meter and how they can reduce utility expenditure. The cost of meters should also be investigated, to establish that the costs, associated with introducing new meters, are not passed disproportionately to consumers.

Association Between Cancer Prevalence and Different Socioeconomic Strata in the US: The National Health and Nutrition Examination Survey, 1999-2018.

BackgroundInequality in health outcomes in relation to Americans' socioeconomic status (SES) is rising. American Cancer Society depicts that the most common cancers are diagnosed in men and women in 2021. We aim to study socioeconomic inequalities in related cancers to investigate whether the cancer prevalence differs within the family income to poverty ratio (PIR).MethodsThe study investigated data from adults aged 20–85 years participated in the 1999–2018 National Health and Nutrition Examination Survey (NHANES) who had complete data available on PIR and cancer or malignancy information (n = 49,720). Participants were stratified into 3 categories of PIR: high income (PIR ≥ 4), middle income (>1 and <4), or at or below the federal poverty level (≤1).ResultsThe prevalence of prostate cancer was higher in the middle-income (3.61% [n = 464]) and high-income groups (3.36% [n = 227]) than in the low-income group (1.83% [n = 84], all p < 0.001). The prevalence of breast cancer was higher in middle-income (2.86% [n = 390]) and high-income participants (3.48% [n = 218]) than in low-income participants (2.00% [n = 117], all p < 0.001). Compared with the low-income group in men (0.48% [n = 22]), a higher prevalence of colon and rectum cancer occurs in the middle-income (0.87% [n = 112], p = 0.012) and high-income groups (0.89% [n = 58], p = 0.018). The prevalence of lung cancer in women was lower in high-income participants than middle-income participants (0.10% [n = 6] vs. 0.29% [n = 39], p = 0.014).ConclusionsIncreasing disparities in cancer prevalence were identified across all socioeconomic categories analyzed in this study. To ensure the sustainable development goals, it is a global health priority to understand inequalities in health and to target interventions accordingly.

Flavoring Patterns of Exclusive and Dual-Use of Cigarettes and E-Cigarettes Among US Adults: Results from the TUS-CPS 2018-2019.

To describe patterns of menthol/non-menthol cigarettes with flavored e-cigarettes (tobacco, menthol, sweet/spicy, and other flavorings) use. We used cross-sectional data from the 2018-2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). United States. Adults over 18years old. A nationally representative sample (n = 135329). We generated a 15-category variable of all combinations of cigarette and e-cigarette flavoring use. We estimated population prevalence (PP) for the 15-category flavored cigarette and e-cigarette use variable and proportion of flavored cigarette and e-cigarette use among adults who used cigarettes or e-cigarettes (PAU) by age, sex, race/ethnicity, and income. Exclusive menthol cigarette use was higher among NH Black (PP = 8.79%, PAU = 68.96%) and low-income (PP = 4.86%, PAU = 29.09%) compared to NH White (PP = 2.63%, PAU = 18.83%) and high-income participants (PP = 1.25%, PAU = 19.02%). Exclusive sweet/spicy e-cigarette use (PP = 1.32%, PAU = 10.22%) and exclusive menthol e-cigarette use (PP = .95%, PAU = 7.40%) was higher in younger (18-34) vs older (35+) adults (PP = .34% and PAU = 2.76%, and PP = .14%, PAU = 1.11%, respectively). Older dual users tended to combine the same flavor in both products (eg, menthol cigarettes + menthol e-cigarettes), while younger adults were more likely to combine menthol and non-menthol cigarettes with sweet/spicy e-cigarettes. Findings suggest that a menthol cigarette ban might be most effective in conjunction with sweet/spicy e-cigarette flavor restrictions, given these flavors are attractive for younger adults.

Association Between Adherence to the MIND Diet and Cognitive Performance is Affected by Income: The ELSA-Brasil Study.

The relationship between the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) diet and cognition has not been widely investigated in low- to middle-income countries. We investigated the relationship between MIND diet and cognition in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We included 11,788 participants. MIND diet adherence was based on the intake of 15 components according to a food frequency questionnaire. We analyzed the association between MIND diet adherence and global cognition, memory, and executive function using adjusted linear regression. We examined the interaction between income and MIND diet adherence on cognition and presented income stratified analyses. MIND diet adherence was not associated with cognition in the whole sample. Income was an effect modifier of MIND adherence on global cognition (P=0.03) and executive function (P<0.001). For participants with high income, greater adherence was associated with better executive function [β=0.015, 95% confidence interval (CI)=0.002; 0.028, P=0.025]; while for participants with low income, greater adherence was associated with lower global cognition (β=-0.020, 95% CI=-0.036; -0.005, P=0.010) and executive function (β=-0.023, 95% CI=-0.039; -0.007, P=0.004). Adherence to the MIND diet was higher among participants with high income (P<0.001). For high-income participants, greater adherence was associated with better cognitive performance; for low-income participants, greater adherence was associated with lower cognitive performance.

Prevalence of Pesticide Use and Occupational Exposure Among Small-Scale Farmers in Western Ethiopia.

Objective:This study aims to assess the prevalence of pesticide use and its occupational exposure among small-scale farmers in the Kellem Wellega Zone of western Ethiopia.Methods:A cross-sectional study design using a structured questionnaire was used to collect data from 249 small-scale farmers’ households through face-to-face interviews. Statistical analysis such as descriptive statistics, Chi-square test, and binary logistic regression analysis was applied, and a P-value <.05 at 95% CI was considered statistically significant.Results:The prevalence of pesticide use was 87.15%. About 44.2%, 40.2%, and 43.8% of the study participants were classified as having poor knowledge, poor practice, and negative attitude toward pesticide use, respectively. Thus, small-scale farmers whose age was greater than 40 years were 7.87 times more likely to be exposed to skin irritation than those whose age was less than 20 years (AOR = 7.87; 95% CI: 1.75-35.45) and skin contact (AOR = 0.37; 95% CI: 0.15-0.91). Most farmers who were directly involved in agriculture were 2.22 times more likely to be exposed to the inhalation of pesticide chemicals than those involved in another activity (AOR = 2.22; 95% CI: 1.14-4.33). Based on educational level, small-scale farmers who have a primary school and above were 81% less likely to inhale pesticide chemicals than those who did not have formal education (AOR = 0.19; 95% CI: 0.09-0.41). Furthermore, low-income small-scale farmers were 2.62 times more likely to be exposed to coughing (AOR = 2.62; 95% CI: 1.25-5.51) than high-income participants. Furthermore, farmers with good knowledge were 1.79 times more likely to be exposed to skin irritation than those with poor knowledge (AOR = 1.79; 95% CI: 1.0-3.17). Farmers with poor practice were 1.85 times more likely to show coughing symptoms than those with good practice (AOR = 1.85; 95% CI: 1.08-3.2), and farmers with good practice were 48% less likely to be exposed to headache than those with poor practice (AOR = 0.52; 95% CI: 0.31-0.88).Conclusions:This study shows that small-scale farmers were exposed to pesticides through coughing, headache, skin irritation, inhalation, and skin contact. Low level of knowledge, poor practice, job, low income, older age, and educational level.