Higher Socioeconomic Status Groups Research Articles

Relationship between academic achievement, visual-motor integration, gender and socio-economic status: North-West Child Health Integrated with Learning and Development study

Background: Inconsistencies are found regarding the relationship between academic achievement and visual-motor integration (VMI), gender and socio-economic status (SES). Aim: The study examined the associations between academic achievement in different compulsory learning areas and VMI skills, and what role gender and SES play. Setting: A total of 863 participants ( n = 538, low SES group; n = 325, high SES group) from 20 schools in four school districts in the North West province of South Africa were randomly selected to participate. Methods: The Beery Visual-Motor Integration Test, 4th edition (VMI-4) was used to evaluate the VMI, visual perception and motor coordination skills; and the June mid-year school assessment (JMSA) and the Annual National Assessment (ANA) marks were used to examine their academic achievements. Spearman rank-order correlations and stepwise regression analyses were used to, examine significant associations and unique contributors, respectively. Results: Small-to-moderate significant correlations were found between all the learning areas assessed during the JMSA and the ANA examinations and the VMI-4. The strongest correlations occurred between visual perception and most of the learning areas. Socio-economic status had the greatest predictive association with most of the academic learning areas. The largest contributions (≥ 10% moderate, ≥ 25% great) of SES were found during the JMSA in English, life orientation, mathematics, natural science, social sciences and in the grade point averages. During the ANA, SES had the highest predictive contribution to English and mathematics. Conclusion: The overall academic achievement of learners could be negatively affected by their SES and visual perception skills, that suggest timeously prevention strategies to counter these effects.

Economic inequality in prevalence of underweight and short stature in children and adolescents: the weight disorders survey of the CASPIAN-IV study.

The aim of this study was to determine the determinants of socio-economic inequality in the prevalence of short stature and underweight in Iranian children and adolescents. This cross-sectional nationwide study was conducted on 36,486 participants, aged 6-18 years. This school-based surveillance (CASPIAN- IV) program and its complementary part on weight disorders evaluation was conducted in urban and rural areas of 30 provinces in Iran. In addition to physical examination, a validated questionnaire was completed from students and their parents. Socio-economic status (SES) was determined using principal component analysis, and was classified in quintile scale. Inequality in the prevalence of underweight and short stature was assessed using concentration (C) index and slop index of inequality (SII) by the Oaxaca-Blinder decomposition method. The prevalence (95% CI) of underweight and short stature at national level was 10.89 (10.55, 11.23) and 4.15 (3.94, 4.38), respectively; it had a downtrend from the lowest to highest SES quintile. Furthermore, the value of C for underweight and short stature was negative, i.e. inequality was in favor of high SES groups. Moreover, the prevalence gap of underweight and short stature in the first and fifth quintiles of SES was 6.58% and 5.80%, respectively. The highest proportion of this gap was explained by living area. In the multiple logistic model, odds of underweight and short stature were significantly lower in individuals with higher SES. Compared to boys, odds of underweight were decreased in girls, whereas odds of short stature were increased in them. Odds of underweight and short stature were increased in participants from rural areas than in urban areas. With increasing age, the odds of underweight and short stature decreased significantly. The results of this study showed that inequality in the prevalence of short stature and underweight was in favor of high SES groups. Moreover, living area was one of the most important determinants that explained this inequality. Therefore, this issue needs to be considered in health promotion policies.

Study the Impact of Corporate Social Responsibility Funds of Usha Martin for Socio-economic Development in Ranchi District of Jharkhand

The impact of Corporate Social responsibility (CSR) funds was studied in Hutup village in Ormanjhi Block of Ranchi district of Jharkhand, where CSR sponsored project was implemented by KGVK under the guidance of Usha Martin Ranchi for improving the quality of life of the work fore and their families as well as of the community and society at a large. Out of total 270 beneficiaries 30 farmers were selected as respondents in the study. It was observed that 27.40 percent of farmers come below the socio-economic status group, whereas 61.1240 in medium and 11.48% comes from a high socio-economic status group. Due to the creation of water harvesting structure in the village overall 38.21% assured irrigation has been increased. The productivity of cereals, pulses, oilseeds and vegetables has been increased 76.47, 116.66, 125 and 88.23 percent respectively, resulting thereby 24.56, 52.94, 60.86 and 83.33 percent income of farmers has been increased through cultivation of Cereal, Pulses, Oilseeds and vegetables respectively. Result reveals that development of water harvesting structure is an important intervention for enhancing production and productivity of agricultural crops in Jharkhand. The results also suggested that demonstration of improved production technologies coupled with capacity building of farmers through trainings of improved package of practices of different crops and vegetables as well as timely input support services increase the production and availability of local market for selling of produce at remunerative price enhance the income of farmers.

Food choice motives among two disparate socioeconomic groups in Brazil

Understanding the motives influencing food intake is indispensable for effective dietary recommendations aimed at promoting healthy eating in an integrative way. The objective of this study was to evaluate food choice motives across two socioeconomically different cities in Brazil. A cross-sectional study with a convenience sample (n = 473) of adults living in both places was evaluated. Food choice motives were assessed by The Eating Motivation Survey (TEMS) with 15 dimensions, and economic classifications were made according to the Brazilian Economic Classification Criteria (CCEB). Data analysis used both a general linear model (GLM) and a Structural Equation Model (SEM) adjusted for age, ethnicity, income and educational degree. Participants were mainly women (74.6%) with a mean age of 36.6 years. Cities were not invariant (Δχ2 = 314.165, p < 0.001) and two distinct prediction models for food choice motives emerged. Fit indices indicate acceptable model fit for both low (CFI = 0.911; TLI = 0.898; RMSEA = 0.041) and high socioeconomic status groups (CFI = 0.808; TLI = 0.717; RMSEA = 0.081). Although cities differ in the prediction models for food choice motives, we demonstrated that there are two main networks of predictors: one related to social context predictors of food choice motives and another related to hedonic-oriented ones. Particularly, hedonic-oriented motives (i.e., pleasure) were the most relevant predictors to the group of high socioeconomic status followed by social context predictors (traditional eating and sociability). On the other hand, the group of low socioeconomic status had most of its predictors related to social context (i.e., visual appeal, traditional eating, sociability, social norms and social image) and also price, but this last one was the least important among the most important predictors.

Fragility fractures and health-related quality of life: does socio-economic status widen the gap? A population-based study

The aim of this study was to explore the short-term and long-term impact of fractures on health-related quality of life (HRQoL) and to study the effect of educational attainment as a proxy for socio-economic status (SES) on post-fracture HRQoL. In a population-based survey including 12,839 fracture cases and 91,426 controls, HRQoL was measured using the physical component score (PCS) and the mental component score (MCS) of the 12-Item Short Form Health Survey (SF-12). Information about fractures, age, sex, ethnicity, comorbidity and SES was obtained from national registers. Multiple regression analysis was conducted to measure the mean HRQoL difference, termed deficit, between non-fracture controls and fracture cases (all fractures combined and fractures at six different skeletal sites). PCS and MCS were significantly lower among fracture cases than among controls. Statistically and clinically important PCS deficits (≥ 5 points) were observed among people with fractures of the spine and hip up to 5years post-fracture and among people with upper arm fractures up to 1year post-fracture. Greater deficits were observed for MCS but not for PCS in post-fracture HRQoL in the low than in the high SES group. Fractures of the spine and hip are associated with clinically important deficits in physical HRQoL up to 5years post-fracture. Low educational attainment widened the gap in mental but not in physical post-fracture HRQoL. However, due to low pre-fracture PCS and MCS, people with a low educational attainment and fractures were more likely to report very low HRQoL post-fracture.

Desired Smile and Effect of Facial Esthetics on the Confidence Level of Saudi Public: A Survey-based Study

Aim: To assess the perception of the general public towards an ideal smile, to determine an association of good facial esthetics with the high confidence level, to compare the findings based on age, gender, and socioeconomic status. Materials and methods: This study was targeted towards the Saudi general public in Riyadh city; therefore, all males and females more than 18 years of age were recruited to fill up the questionnaire. A total of 10000 Saudi general public were targeted in this study. The survey was sent using online links via social media and other sources. Results: A total of 8437 Saudis male and females filled up the online survey, which comprised of 39% (n=3307) males and 61% (n=5130) females. The participants were grouped based on their education level, which demonstrated that 3% (n=230) are primary level, 34% (n=2861) are high school level, 63%(n=5320) are university graduates. The participants were also grouped based on their socio-economic status, which demonstrated that 5% (n=428) are low status, 89% (n=7539) are moderate status and 6%(n=460) are high status. The participants were also grouped based on their dental visits, which demonstrated that 68% (n=5671) visit 0-2 times, 22% (n=1823) visit 3-5 times and10%(n=911) visit 6 times or more. Conclusion: Females were found to be more concerned about their smile, Educational levels did not affect the decision making, Higher socioeconomic status groups had more concern about their aesthetic smile, Patients with an increased number of dental visits had greater concern about their smile.

Predicted DRD4 prefrontal gene expression moderates snack intake and stress perception in response to the environment in adolescents.

Body weight is substantially determined by eating behaviors, which are themselves driven by biological factors interacting with the environment. Previous studies in young children suggest that genetic influences on dopamine function may confer differential susceptibility to the environment in such a way that increases behavioral obesity risk in a lower socioeconomic status (SES) environment but decreases it in a higher SES environment. We aimed to test if this pattern of effect could also be observed in adolescence, another critical period for development in brain and behavior, using a novel measure of predicted expression of the dopamine receptor 4 (DRD4) gene in prefrontal cortex. In a sample of 76 adolescents (37 boys and 39 girls from Baltimore, Maryland/US, aged 14-18y), we estimated individual levels of DRD4 gene expression (PredDRD4) in prefrontal cortex from individual genomic data using PrediXcan, and tested interactions with a composite SES score derived from their annual household income, maternal education, food insecurity, perceived resource availability, and receipt of public assistance. Primary outcomes were snack intake during a multi-item ad libitum meal test, and food-related impulsivity assessed using a food-adapted go/no-go task. A linear regression model adjusted for sex, BMI z-score, and genetic ethnicity demonstrated a PredDRD4 by composite SES score interaction for snack intake (p = 0.009), such that adolescents who had lower PredDRD4 levels exhibited greater snack intake in the lower SES group, but lesser snack intake in the higher SES group. Exploratory analysis revealed a similar pattern for scores on the Perceived Stress Scale (p = 0.001) such that the low PredDRD4 group reported higher stress in the lower SES group, but less stress in the higher SES group, suggesting that PredDRD4 may act in part by affecting perceptions of the environment. These results are consistent with a differential susceptibility model in which genes influencing environmental responsiveness interact with environments varying in obesogenicity to confer behavioral obesity risk in a less favorable environment, but behavioral obesity protection in a favorable one.

An Innovative Individual-Level Socioeconomic Measure Predicts Critical Care Outcomes in Older Adults: A Population-Based Study.

Little is known about the impact of socioeconomic status (SES) as a key element of social determinants of health on intensive care unit (ICU) outcomes for adults. We assessed whether a validated individual SES index termed HOUSES (HOUsing-based SocioEconomic status index) derived from housing features was associated with short-term outcomes of critical illness including ICU mortality, ICU-free days, hospital-free days, and ICU readmission. We performed a population-based cohort study of adult patients living in Olmsted County, Minnesota, admitted to 7 intensive care units at Mayo Clinic from 2011 to 2014. We compared outcomes between the lowest SES group (HOUSES quartile 1 [Q1]) and the higher SES group (HOUSES Q2-4). We stratified the cohort based on age (<50 years old and ≥50 years old). Among 4134 eligible patients, 3378 (82%) patients had SES successfully measured by the HOUSES index. Baseline characteristics, severity of illness, and reason for ICU admission were similar among the different SES groups as measured by HOUSES except for larger number of intoxications and overdoses in younger patients from the lowest SES. In all adult patients, there were no overall differences in mortality, ICU-free days, hospital-free days, or ICU readmissions in patients with higher SES compared to lower SES. Among older patients (>50 years), those with higher SES (HOUSES Q2-4) compared to those with lower SES (HOUSES Q1) had lower mortality rates (hazard ratio = 0.72; 95% CI: 0.56-0.93; adjusted P = .01), increased ICU-free days (mean 1.08 days; 95% CI: 0.34-1.84; adjusted P = .004), and increased hospital-free days (mean 1.20 days; 95% CI: 0.45-1.96; adjusted P = .002). There were no differences in ICU readmission rates (OR = 0.74; 95% CI: 0.55-1.00; P = .051). Individual-level SES may be an important determinant or predictor of critical care outcomes in older adults. Housing-based socioeconomic status may be a useful tool for enhancing critical care research and practice.

The Impact of Socio Economic Factors on the Adherence of Patients with Gestational Diabetes Mellitus to Medical Recommendations

Adherence to medical recommendations is very important to control gestational diabetes mellitus (GDM), as one of the most important disorders during pregnancy. In this study, we explored the impact of socio-economic status (SES) on the adherence of a cohort of GDM in Iran. In this prospective study, 230 pregnant women with confirmed GDM were followed from Feb to Jun 2013 in a referral diabetic care center in Iran. The SES of subjects were quantified using a combined score generated by principal component analysis (PSA). Medical adherence score of subjects was measured in three follow up visits in a range of 0 to 10 and were linked to SES using linear regression model. The adherence scores women in the first, second, and third follow up visits were 5.06±2.12, 5.46±2.06, and 5.08±1, respectively. Women fourth quartile of SES (the highest level of SES) has a least compliance to medical orders in comparison to first quartile of SES (the lowest level of SES) with the OR -2.75 (95% Cl: -3.17, -2.23). The medical adherence of pregnant women with GDM is significantly poorer in high SES groups. Therefore, as an important determinant, we may target high SES pregnant women to control the adverse effects of the disorder more efficiently.

Abstract C053: Identification of factors contributing to breast cancer mortality disparities in the metropolitan Atlanta area

Abstract Background: Racial disparities in breast cancer outcomes persist in the US, in which black women are more likely to die from breast cancer than white women. Despite levels of mammographic screening comparable to the US, Atlanta has a disproportionate burden of late-stage breast tumors and higher mortality rates, especially among black women. To better understand this disparity, we sought to identify tumor, treatment, and patient characteristics that may contribute to the observed differences in breast cancer mortality between black and white women in the metropolitan Atlanta area. Methods: In this study, patients were identified from the Georgia Cancer Registry. We included 4943 non-Hispanic white and 3580 non-Hispanic black women with an initial diagnosis of stage I-IV primary breast cancer between January 2010 and December 2014 in Atlanta. Cox proportional hazard regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) to compare black vs. white breast cancer mortality by tumor (stage, grade, ER status, and molecular subtype), treatment (surgery type, receipt of chemotherapy, radiation, hormone therapy, and trastuzumab), and patient (insurance, marital status, SES, and location of service) characteristics. We performed a mediation analysis to evaluate the contribution of subtype, stage, and socioeconomic status (SES) as mediators on the path between race and breast cancer mortality. Results: Compared with white breast cancer patients, black women were younger with tumors that were higher stage, higher grade, and more likely to be larger, node positive and triple negative. In fully adjusted models, black women diagnosed with Luminal A subtype were 58% more likely to die of breast cancer compared to their white counterparts (HR=1.58, 95%CI 1.31-2.00). Similarly, black women with private insurance were 60% more likely to die of breast cancer (HR=1.61, 95%CI 1.25-1.98), and black women in the highest SES group were more than twice as likely to die from breast cancer (HR=2.26, 95%CI 1.26-4.06) than white women with comparable SES. The smallest disparities in breast cancer mortality by race were observed among women without insurance, in the lowest SES index, or those diagnosed with triple-negative breast cancer. The mediation analysis showed 84.8% of the effect between race and breast cancer mortality was through stage, subtype, and SES. Conclusion: Our results indicate variation in racial disparities in breast cancer mortality by tumor and patient characteristics. Consistent with previous reports, our mediation results suggest that later stage and triple-negative subtype among black women are major contributors of the observed disparity. However, our results also shed new light on the disparity, suggesting that the largest disparities are observed among women with ER+ tumors amenable to adjuvant therapies and are most pronounced among women of high SES. More research is needed to understand the drivers of disparities in these treatable tumors. Citation Format: Lindsay J. Collin, Renjian Jiang, Kevin C. Ward, Keerthi Gogineni, Preeti D. Subhedar, Mark Sherman, Mia M. Gaudet, Carmen Radecki Breitkopf, Olivia D'Angelo, Sheryl Gabram-Mendola, Jolie Siegel, Rana Aneja, Anne Gaglioti, Lauren E. McCullough. Identification of factors contributing to breast cancer mortality disparities in the metropolitan Atlanta area [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C053.

Abstract A102: Association of lymphoid malignancies and area-based socioeconomic status with survival in the United States

Abstract Background: Over 114,000 new cases of lymphoid malignancies (LM), including Hodgkin lymphoma (HL), Non-Hodgkin lymphoma (NHL) and multiple myeloma (MM), are diagnosed annually. However, little is known about the influence of socioeconomic status (SES) on LM survival among Hispanics, who comprise 18% of the US population. This study evaluates the association between area-based SES and survival of Hispanic LM patients compared with non-Hispanic whites and non-Hispanics blacks. Methods: All LM reported to the NCI Surveillance, Epidemiology, and End Results Program (SEER-18) diagnosed between 2000-2015 were included. Census tract-level socioeconomic status (SES) was assessed in tertiles. Cox proportional hazards models estimated hazard ratios (aHR) to evaluate SES with cause-specific survival, adjusted for sex, stage at diagnosis, radiation, surgery and chemotherapy. All analyses were stratified by race/ethnicity. Results: Hispanics with low SES diagnosed with MM were 30% (aHR:1.3, 95% CI: 1.0-1.6) more likely to die from MM than those Hispanics with high SES. Whites and blacks with low SES diagnosed with MM were 20% (95% CIwhites: 1.1-1.3; 95% CIblacks: 1.0-1.4) more likely to die from MM than those with high SES. An association of low SES and death from NHL also found among Hispanics (aHR: 1.2; 95% IC: 1.1-1.5), whites (aHR: 1.3; 95% IC: 1.2-1.4) and blacks (aHR: 1.3; 95% IC: 1.0-1.7) compared to high SES groups. No association was found for HL. Conclusion: Low SES was associated with worse LM survival among different races/ethnicities. These results suggest SES is an important factor in determining long-term outcomes of patients diagnosed with LM. Citation Format: Maira A Castaneda-Avila, Bill Jesdale, Mara Epstein. Association of lymphoid malignancies and area-based socioeconomic status with survival in the United States [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A102.

Clinical correlates of socioeconomic status in adolescent bipolar disorder

BackgroundLower socioeconomic status (SES) is associated with symptomatic severity, comorbidity, and functional impairment in adults with bipolar disorder (BD). Little is known about clinical correlates of SES in adolescents with BD. MethodsParticipants included 195 adolescents, 13–20 years old, with BD type I, II or not otherwise specified (NOS). Diagnoses were determined by standardized semi-structured interviews. Based on the Hollingshead scale, participants were divided into “low” (SES 1–3) and the “high” (SES 4–5) SES groups. Demographic and clinical correlates of SES were evaluated in univariate analyses; significant variables were evaluated in a logistic regression model. ResultsCompared to participants in the high SES group (n = 150), participants in the low SES group (n = 45) were significantly younger, less likely to be of Caucasian race and living with natural parents. In the logistic regression model, controlling for age and race, the low SES group had higher risk of police contact or arrest (OR = 2.41, 95% CI:1.14–5.11, p = 0.022), less treatment with stimulants(OR = 0.20 95% CI: 0.06–0.67, p = 0.009), and more post-traumatic stress disorder (PTSD) (OR = 4.08, 95% CI:1.33–12.46, p = 0.014) compared to the high SES group. In sensitivity analyses that further controlled for intact family, the finding of higher rates of police contact or arrest was no longer significant. LimitationsCross-sectional design; higher-skewed SES sample. ConclusionsLower SES in adolescent BD is associated with higher legal risk, increased PTSD, and under-treatment of attention-deficit/hyperactivity disorder (ADHD). Future studies are needed to evaluate the inter-relationships of these correlates, using prospective designs that can evaluate the direction of these associations. Further studies incorporating neurobiological markers are also needed to explore mechanisms underlying SES-related differences in BD.

Socioeconomic status, race, and mortality disparities in insured patients in southern California.

e19060 Background: One known factor related to increased mortality is lack of health insurance coverage. To eliminate this variable we evaluated overall mortality by socioeconomic status (SES) in an insured southern California population diagnosed with cancer accounting for confounding factors including race/ethnicity. Methods: We identified adults diagnosed with eight common cancers from 2009-2014 from the California Cancer Registry and followed them through 2017. We calculated person-year mortality rates by SES and race/ethnicity. Adjusted hazard ratios for the association between all-cause mortality and SES were estimated using Cox proportional hazards models accounting for covariates (race/ethnicity, demographics, stage, treatments). Results: A total of 164,197 adults were diagnosed with cancers of the breast, prostate, lung, colon, melanoma, uterus, kidney and bladder; total of numbers of deaths was N=41,727. Compared to subjects in the highest SES quintile, we found an increased overall mortality risk in each of the lower SES quintiles. In multivariable models, mortality risk was 16% to 37% greater in the lower SES groups versus the highest SES group. Conclusions: After multivariable adjustment that accounted for race/ethnicity, cancer treatments and tumor factors, insured individuals in lower SES groups had a significantly higher overall mortality risk compared those in the highest SES group. [Table: see text]

Inequalities in health-related quality of life and the contribution from socioeconomic status: evidence from Tibet, China

BackgroundThis study aimed to understand the association between socioeconomic status (SES) and Health Related Quality of Life (HRQoL) and the contribution of SES to health inequality among Tibetans of agricultural and pastoral areas (APA) in Tibet, China.MethodsThe data were from Health Survey of Tibetans in APA conducted in 2014. A total of 816 respondents were enrolled for the analysis Multiple linear regression was employed to examine the relationship between SES and HRQoL. Concentration index (CI) was used to measure the degree of health inequality and a Wagstaff-type CI decomposition method was applied to measure the contribution of SES to inequality.ResultsSES had significant association with HRQoL among the Tibetans in APA. The high SES group was more likely to have a higher Eq-5d index (0.77 vs. 0.67, P < 0.001) and VAS (72.94 vs. 62.41, P < 0.001) than the low SES group. The Concentration index of the Eq-5d index and VAS for total sample was 0.022 and 0.026 respectively, indicating a slight pro-rich inequality among this population. The decomposition analyses showed the SES is the main contributor to health inequality and contributed 45.50 and 41.39% to inequality for the Eq-5d index and VAS, respectively.ConclusionThe results showed SES is positively associated with HRQoL among Tibetans in APA. There was a slight pro-rich inequality in the health of the participants and most health inequality was attributable to SES. This study is helpful in gaining an insight into the HRQoL, health inequality and the relationship between SES and health inequality among Tibetans of APA in China.

Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam

BackgroundThis study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA).MethodThis analyze used data of 3068 Vietnamese people aged 18–65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score – the indicator of individual PA – as the dependent variable.ResultsMale and female participants with insufficient PA accounted for 20.2 and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level. As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreased.ConclusionOur data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.

The association of chronic spontaneous urticaria (CSU) with anxiety and depression: a nationwide cohort study.

Chronic spontaneous urticaria (CSU) is a dermatological disease associated with significant impairment of overall quality of life as well as psychological distress. Previous studies have demonstrated significant comorbidity between CSU and a wide range of mental illnesses. In this study we aimed to focus on the association between CSU and anxiety and depression, using an optimized matched controlled design. A nationwide matched control study was conducted using the Clalit Health Services (CHS) database. The study included 12,539 CSU patients and 60,510 age and sex matched controls. Three multiple logistic regression models were conducted to assess the association between CSU and anxiety and depression, while adjusting for age, sex, socioeconomic status (SES), diabetes, obesity, hypertension, and smoking status. A higher frequency of anxiety and depression was found in CSU patients compared to that in controls (anxiety frequency of 9.6% vs. 5.7%, p < 0.001; depression frequency of 11% vs 7.9%, p < 0.001, respectively) after adjustment for demographic and clinical factors. The association of CSU with anxiety was the strongest in the 18-29 age group, and in the high SES group, while the association of CSU with depression was the highest in the 50-69 age group, and in the low SES group. Chronic spontaneous urticaria is associated with anxiety and depression. In light of the clinical implications of a comorbid mental disorder, dermatologists should consider employing mental health screening procedures, especially for patients from specific risk groups.

Growth patterns from birth to overweight at age 5-6 years of children with various backgrounds in socioeconomic status and country of origin: the ABCD study.

SummaryIntroductionChildren from minority groups are at increased risk of overweight. This study compared BMI growth patterns from birth onwards of boys and girls with overweight at 5‐6 years, according to socioeconomic status (SES) and country of origin, in order to gain more insight into the critical periods of growth to overweight.MethodsA total of 3714 singletons of the multi‐ethnic ABCD study were included. Within children with overweight at age 5‐6 years (N = 487, prevalence boys: 11.6%, girls: 14.6%), BMI growth patterns from birth onwards (12.8 serial measurements; SD = 3.1) were compared between children from European (69.4%) and non‐European mothers (30.6%), and between children from low (20.8%), mid (37.0%) or high SES (42.2%), based on maternal educational level.ResultsBMI growth to overweight did not differ between children of European or non‐European mothers, but it did differ according to maternal SES. Children with overweight in the low and mid SES group had a lower BMI in the first 2 years of life, an earlier adiposity rebound and increased in BMI more rapidly after age 2, resulting in a higher BMI at age 7 years compared to children with overweight in the high SES group [∆BMI (kg/m2) between high and low SES: boys 1.43(95%CI:0.16;3.01) and girls 1.91(0.55;3.27)].ConclusionChildren with overweight from low SES have an early adiposity rebound and accelerated growth to a higher BMI at age 5‐6 years compared to children with overweight from the high SES group. These results imply that timing of critical periods for overweight development is earlier in children with a low socioeconomic background as compared to other children.

Male-Dominated Occupations and Substance Use Disorders in Young Adulthood.

This article examined associations between male-dominated occupations and substance use disorders in young adulthood, accounting for adolescent experiences of work intensity (more than 15 hr a week at 16 to 17 years of age) and substance use (i.e., smoking, heavy drinking, cannabis, and illicit drug use). The moderating effects of biological sex and coming from a family with a low socioeconomic status (SES) were also assessed. Data were from a 10-year prospective study of community-based youth aged 12–18 in 2003 (T1; N = 662; 48% male; Mage = 15.5, SD = 1.9). Their occupations at ages 22–29 were categorized so that higher scores indicated more male-dominated occupations. Young adults in male-dominated occupations (more than 75% males) had lower education, worked in less prestigious occupations, and earned higher hourly wages than those in the other gendered-occupation groups. Work intensity in high school was associated with substance use at ages 18–25 and substance use was also associated with alcohol- and cannabis-use disorder symptoms and illicit drug use in young adulthood (ages 22–29). Adding to these effects, employment in a male-dominated occupation was associated with more cannabis-use disorder symptoms for the low, but not the high SES group. Public health messages need greater focus on preventing substance use disorders among individuals employed in male-dominated jobs in young adulthood. Efforts to promote self-assessment of problematic substance use and motivation to change may be particularly important for young workers.

Secular trends in age at menarche in 20th century Mexico: Differences by ethnicity, area of residency, and socioeconomic status.

This study aims to assess the secular trend in age at menarche (AAM) in Mexico over the 20th century, and compare the patterns according to area of residence (rural/urban), socioeconomic status (SES), and ethnicity (indigenous/nonindigenous). Data on AAM from 24 380 women aged ≥20 years born between 1906 and 1986 were obtained from the Mexican National Health and Nutrition Survey 2006. Birth cohorts were compared to test for a secular trend and differences in mean AAM by area of residence, SES, and ethnicity were evaluated using the Welch test for heterogeneous variances followed by Tamhane T2 for post hoc comparisons. Mean AAM declined from 13.3 years among Mexican women born before the 1940s to 12.56 years among those born in the 1980s. Across birth cohorts, urban women had significantly earlier AAM than their rural counterparts. Nonindigenous urban women reached menarche the earliest and rural indigenous women the latest of all groups. Nonindigenous urban residents experienced a comparatively earlier decline, while that for the indigenous rural women occurred last. High SES women reached menarche the earliest and low SES women the latest. The historical decline in AAM for high and medium SES groups occurred relatively early, whereas that for the low SES occurred last. Mean AAM was associated with area of residence, ethnicity, and SES. Our findings indirectly suggest that advances in living conditions experienced in Mexico during the 20th century appear to have been insufficient to overcome the social and biological inequalities accumulated over centuries in some groups.

A method of estimating age of undocumented children and young adults of different socioeconomic status in Cambodia

A growing number of Cambodian children without legal documentary evidence of date of birth are vulnerable to exploitation. This study aimed to evaluate the applicability of southern Chinese reference dataset for dental age estimation on Cambodian children and young adults of different socioeconomic status. Dental panoramic tomographs (DPT) of 371 Cambodian children and young adults belonging to lower and higher socioeconomic status (SES) groups were analyzed. All the left maxillary and mandibular permanent teeth including the third molars were scored based on Demirjian's classification of tooth development stages. Chronological age (CA) was calculated from the date of birth and date of exposure of radiograph. The mean age of attainment for each stage of development was obtained from the southern Chinese reference dataset. Dental age (DA) was calculated by averaging the mean age scores for all the teeth. Paired t-test and correlation analysis were conducted to measure associations between the chronological age and the dental age for males and females in the lower and higher socio-economic status groups. Underestimation of age was observed in both SES groups using the southern Chinese reference dataset. For the higher SES group, the difference between the chronological and dental age (CA-DA) was 0.26 years for females and 0.11 years for males. The difference was statistically significant only in females (p < 0.05). In the low SES group, the results showed a difference of 0.07 years in females and 0.01 years in males; the differences were not statistically significant in both sexes (p > 0.05). A strong correlation was observed between the CA and DA in both sex and SES groups ranging from 0.969 to 0.988 (p < 0.05). The southern Chinese dental reference dataset can be used to estimate the age of undocumented Cambodian male and female children and young adults of both higher and lower SES.