High-income Groups Research Articles

Analysis of the Phenomenon of Star Tax Evasion and Countermeasures for Governance

Against the backdrop of steady economic development in China, the quality of life of the people is constantly improving, and their spiritual needs are gradually increasing. The film and television industry has ushered in unprecedented development opportunities and produced superstars, forming a fan economy. Therefore, industry practitioners, especially film and television stars, have a relatively high-income level. However, due to the development of the film and television industry, there has been a mismatch in the personal income tax collection and management system, resulting in a significant loss of tax revenue. The frequent occurrence of high-income celebrities evading huge taxes indicates that there are certain loopholes in the personal income tax collection and management of high-income groups in China's film and television industry. This article is based on the problems discovered in the Zheng Shuang tax evasion case, delving into the issue of personal income tax collection and management, and proposing beneficial solutions. In response to the current issue of personal income tax collection and management in China's film and television industry, the following suggestions are proposed: optimizing the tax system, strengthening tax collection and management, and improving the tax related environment. Through the research in this article, we hope to provide some ideas for the tax authorities to strengthen the personal income tax collection and management of the film and television industry, and reduce the loss of personal income tax.

Switch or continue to use? An empirical investigation into mobile payment applications

ABSTRACT Using a push-pull mooring framework, this study investigates the diverse factors that influence users’ intention to switch and continue using mobile payment applications (apps). A survey comprising 180 respondents based in Hong Kong was conducted. The results demonstrate that users’ intention to switch is influenced by their dissatisfaction with system quality, perceived benefits, and social influence. Conversely, their intention to continue using their current mobile payment apps is associated with inertia. Furthermore, users who have used their current mobile payment app for three years or more comprise an active switching group, whereas those in the high-income group show the highest inertia and willingness to continue using it. These findings enrich the push-pull mooring framework by incorporating switching and continued use intentions, thus providing a more comprehensive understanding of the impact of social influence and other factors on user behaviors. Furthermore, this study provides insights into the impact of user characteristics on mobile payment app usage, which can benefit application providers in developing tailored promotions, referrals, and retention campaigns to meet the needs and expectations of different user groups.

Longitudinal associations between socioeconomic position and overall health of children with chronic kidney disease and their carers.

Disadvantaged socioeconomic position (SEP) is an important predictor of poor health in children with chronic kidney disease (CKD). The time course over which SEP influences the health of children with CKD and their carers is unknown. This prospective longitudinal study included 377 children, aged 6-18years with CKD (stages I-V, dialysis, and transplant), and their primary carers. Mixed effects ordinal regression was performed to assess the association between SEP and carer-rated child health and carer self-rated health over a 4-year follow-up. Adjusted for CKD stage, higher family household income (adjusted odds ratio (OR) (95% CI) 3.3, 1.8-6.0), employed status of primary carers (1.7, 0.9-3.0), higher carer-perceived financial status (2.6, 1.4-4.8), and carer home ownership (2.2, 1.2-4.0) were associated with better carer-rated child health. Household income also had a differential effect on the carer's self-rated health over time (p = 0.005). The predicted probabilities for carers' overall health being 'very good' among lower income groups at 0, 2, and 4years were 0.43 (0.28-0.60), 0.34 (0.20-0.51), and 0.25 (0.12-0.44), respectively, and 0.81 (0.69-0.88), 0.84 (0.74-0.91), and 0.88 (0.76-0.94) for carers within the higher income group. Carers and their children with CKD in higher SEP report better overall child and carer health compared with those in lower SEP. Carers of children with CKD in low-income households had poorer self-rated health compared with carers in higher-income households at baseline, and this worsened over time. These cumulative effects may contribute to health inequities between higher and lower SEP groups over time. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information.

The effect of the COVID-19 pandemic on Malaysian residential customers’ energy-saving appliance purchasing behaviour

Purpose The COVID-19 pandemic has caused a dramatic impact on energy supply and demand. It is vital to understand households’ behaviour with regard to energy, particularly during the pandemic, to deploy future sustainable energy systems. This study aims to investigate the nexus of Malaysian households’ energy consumption behaviour in relation to various electrical appliances, their energy-saving appliance purchasing behaviour and their current possession of energy-saving appliances during the pandemic, especially during the lockdown period, from the perspective of the energy cultures framework. Design/methodology/approach The partial least squares structural equation modelling technique was used to test hypothesised relationships based on the 1,485 pieces of household data collected using an online and physical survey during the lockdown period in Malaysia. Findings The energy-saving behaviour cultivated due to the impact of the COVID-19 pandemic led to residential customers’ intentions to purchase energy-saving appliances which subsequently led to their current possession of energy-saving appliances. Indeed, energy-saving behaviours in the kitchen, entertainment, office, home lighting and cooling appliances have more than 77.4% influence on their purchasing behaviour. The consumer’s purchase behaviour for energy-saving appliances has a significant, partially mediating influence on the energy-saving behaviour of various electrical appliances and the consumers’ current possession of energy-saving appliances. Research limitations/implications This study could be enhanced by improving the sample using a higher-income group and involving other parts of Malaysia such as the southern region. The findings do extend the energy cultures framework by demonstrating the mediating role of households’ energy-saving appliance purchasing behaviour on the relationship between their energy consumption behaviour in relation to various electrical appliances and their current possession of energy-saving appliances. Practical implications The results of this study will help develop future action plans for transitioning to energy-saving appliance practices. Originality/value This paper examines the effects of the COVID-19 pandemic on future energy efficiency practices in developing countries from the perspective of the energy cultures framework.

Does environmental regulation limit the income growth of Chinese migrant population? Empirical evidence from the CHIPS

It is a controversial question of whether environmental regulation can achieve the double dividend of improving environmental quality and increasing employment and income. This paper takes Chinese migrant population as the main research object and uses the Chinese Household Income Projects data (CHIPS) and the emission data of major pollutants at the prefecture-level city jointly. Based on the classic Mincer wage equation, we investigate the impact and mechanisms of environmental regulation on the income of Chinese migrant population. The results show that: (1) The intensity of environmental regulation significantly improves the income level of the migrant population, and for every 1% increase in the intensity of environmental regulation, the wage income of the mobile population will rise by 4.96%. (2) The documented positive effect of environmental regulation is more significant in non-public firms, the eastern regions and high-skilled workers. Conversely, for the female and elderly group, 1% increase in environmental regulations will restrain their income growth by 4.95% and 0.37%, respectively. (3) The influencing mechanisms include both the direct effect of labor demand and the indirect effects of firm performance and technological innovation. (4) we find that 1% increase in environmental regulations respectively raise the income of the low- and moderate-income migrant population by 10.834% and 3.579%, while having no significant impact on the high-income group, thus reducing the income gap of the migrant population. The findings of this paper provide theoretical support and practical evidence for achieving a coordinated development of ecological environmental protection and income improvement for socially disadvantaged groups in China.

Parental Income Level and Risk of Developing Type 2 Diabetes in Youth

In recent years, the global incidence of type 2 diabetes in young people has increased, especially among minoritized, Indigenous, or financially disadvantaged populations. However, few studies have examined whether poverty is associated with increased risk of youth-onset type 2 diabetes. To examine the association of family income level with the risk of youth-onset type 2 diabetes. This nationwide, population-based retrospective cohort study used data from the 2008 National Health Insurance Research Database of Taiwan, with follow-up through December 31, 2019. Participants included children and adolescents aged 0 to 19 years. Data analysis was performed from June 9, 2022, to January 16, 2023. Family income, classified as very low, low, middle, and high. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the risks of youth-onset type 2 diabetes and all-cause mortality for all income groups vs the high-income group. The cohort included a total of 5 182 893 children and adolescents (mean [SD] age, 11.2 [5.2] years; 2 477 807 girls [48.3%]). The mean (SD) follow-up duration was 9.0 (0.3) years. The incidence rates of youth-onset type 2 diabetes were 0.52 cases per 1000 person-years for the very-low-income group, 0.40 cases per 1000 person-years for the low-income group, 0.35 cases per 1000 person-years for the middle-income group, and 0.28 cases per 1000 person-years for the high-income group. Children and adolescents from very-low-income (aHR, 1.55; 95% CI, 1.41-1.71), low-income (aHR, 1.34; 95% CI, 1.27-1.41), and middle-income (aHR, 1.27; 95% CI, 1.20-1.34) families had a significantly higher hazard of youth-onset type 2 diabetes than those from high-income families. Children and adolescents from very-low-income (aHR, 2.18; 95% CI, 1.97-2.41), low-income (aHR, 1.51; 95% CI, 1.42-1.60), and middle-income (aHR, 1.22; 95% CI, 1.14-1.31) families also had a significantly higher hazard of all-cause mortality than those from high-income families. Children and adolescents who were older, female, and obese and had dyslipidemia, gout, or psychiatric disorders had a significantly higher risk of youth-onset type 2 diabetes than children without those characteristics. This population-based cohort study showed that children and adolescents from very-low-income to middle-income families had a higher hazard of youth-onset type 2 diabetes and mortality than those from high-income families. Further research to reveal the factors underlying this association may improve the accuracy of identifying individuals at greatest risk for developing type 2 diabetes in youth.

문화복지의 쟁점과 문화의 복지적 역할

This paper aims at examining the significance and limitations of culture in welfare from the perspective of welfare, focusing on 2022 National Culture and Arts Activity Survey [abbreviated as 2022 Survey]. 2022 Survey shows that low-income group show more interest in improving the quality of works than cost, and that it is the high-income group that brings up the cost. The fact that low-income people have a high participation rate in cultural volunteering and clubs, showing their will and passion for culture and arts means that nostalgia for culture and arts is universal regardless of income. The welfare role of culture includes helping vulnerable group reflect on their lives, provide emotional comfort, discover hidden creativity, raise their intellectual level, and strengthen their sense of community integration. In this regard, this study is significant in that it has made it possible to supplement the weakening of welfare in cultural welfare and to rethink the quality of life based on the results of the 2022 Survey that expanded the cultural entertainment rate by income level.

The Impact Mechanism of Work Experience on the Income of Flexible Workers: Evidence from China

Numerous workers have adopted the flexible working approach due to its accommodating and job-sharing features, which play a key role in easing the employment pressure and maintaining socio-economic sustainability in China. This paper will study the impact of work experience on the income of flexible workers and the characteristics of impact mechanism. We use micro survey data from CFPS2020 to analyze flexible workers in China. This study found that, firstly, while the feature of flexible employment may be very different from formal employment, its relationship with work experience and income is as significantly correlated as it is for formal employment with a rise–fall, inverted U-shaped trend, but the return on work experience is lower than the employment level in the labor market. Secondly, there is an income gap between genders, especially in physical labor-intensive forms of flexible work; women can gradually narrow the gender income gap through continuous learning. Thirdly, the return on work experience in the older age group is lower than that in the youth group of flexible workers, and this may be due to the dynamic evolution of the elimination of existing work experience and the accumulation of new work experience. Fourthly, in contrast with the findings of the labor market as a whole, the trend of work experience return in flexible employment is reversed; the low-income group’s return rate of work experience is higher than that of the high-income group, and it can be seen that flexible employment is conducive to the development of new and young workers.

Treatment Outcomes with Hypomethylating Agents and Venetoclax for AML in the Community Compared to an Academic Setting

Background: The treatment of acute myeloid leukemia (AML) in older and/or unfit patients consists of a combination of a hypomethylating agent (HMA), such as decitabine and azacitidine, with venetoclax, which can be safely administered in the ambulatory setting. In this study, we aimed to compare the outcomes of the treatment of patients with AML who received chemotherapy with venetoclax and an HMA in an ambulatory setting at an academic center or at a community practice with academic center support. Methods: This was a retrospective review of patients with de novo or relapsed/refractory AML treated with a combination of venetoclax and either decitabine or azacitidine between February 2018 and June 2023. Patients were included if they received treatment at an academic center or if they received their treatment at a community practice with ongoing consultation at an academic center. Drugs were administered per the standard of care and local practice. The primary objective was to evaluate the overall response rate (ORR). Secondary objectives were to evaluate differences in chemotherapy management between locations, potential socioeconomic disparities, and to identify adverse events that affect the dosing or administration of therapy. Results: A total of 129 patients received venetoclax plus HMA for AML for a minimum of one cycle as seen in table 1. Of these patients, 77 (60%) received treatment at an academic center, and 52 (40%) received treatment in the community setting. The average age at treatment initiation was 67 years. Disease risk was stratified according to the 2022 European LeukemiaNet (ELN) guidelines. While not statistically significant, there was a tendency for more patients at the academic center to have adverse risk disease (77.9% vs. 69.2%, p=0.364). They were also more likely to have had exposure to a previous HMA (n=10 vs. n=7, p=1) and prior AML treatment (n=20 vs. n=17, p=0.529). Additionally, patients were more likely to have been diagnosed with secondary AML in an academic setting (n=29 vs. n=18, p=0.868). In a multivariate Cox regression model, patients in the middle- and high-income groups, defined as a median household income greater than $52,000, had a 17% lower relative risk regarding survival probability than those in the lower-income group (HR=0.83, 95% CI 0.39-1.73, p=0.622). Overall, patients in the academic setting had a 33% higher relative risk regarding survival probabilities than the community-treated with covariate consideration of performance status, ELN risk, poverty status and exposure to prior-treatments (HR=1.33, 95% CI 0.78-2.26, p=0.285). The OS of all patients was 9.67 months (95% CI 8.33-12.7), with no significant difference between the groups as seen in figure 1. Additionally, the overall response rates (ORR) of the two groups were similar at 38.5% (n=20) and 35.1% (n=27) in community and academic settings, respectively. The complete remission (CR) rate in the community was 11%, while there was an increase of 18% in the academic setting. There were also increased CR rates in the academic compared to the community setting after cycle 1 (4.7 vs. 2.9%, p=0.33), cycle 2 (11.1 vs. 4.8%, p=0.858), and cycle 3 (18.2 vs. 0%, p=0.27). Adverse events in the study were similar except for increased rates of fatigue in the academic setting (76.6% vs. 55.8%, p=0.021). Only 67% of patients underwent a bone marrow biopsy after cycle 1 in the community versus 83% in the academic setting (p=0.101). Lastly, 67% of patients underwent dose reduction with the decitabine with venetoclax regimen in the community setting versus 31% in the academic setting (p=0.012). Conclusion: This study shows that the use of venetoclax plus HMA allows patients to safely receive AML treatment in the community with support from an academic center. Although there are some significant differences in management, such as increased rates of dose reduction in the community setting, the OS and ORR are similar. However, CR rates remain lower in the community setting. It is important to note that the patients in our study, who were treated at an academic center, had disease characteristics that were more resistant to treatment. Ultimately, this study identifies our efforts in creating community partnerships. Our goal is to further evaluate this partnership with quality improvement projects to bridge the gap in AML care between the community and academic practices.

Incidence trend and epidemiology of tic disorders among youths and adults in Korea from 2003 to 2020: A national population-based study

Tic disorder is a highly prevalent neurodevelopmental disorder; however, research on its incidence trends is still rare. We aimed to investigate its annual incidence rates and the characteristics of incident cases in the general Korean population using data from the National Health Insurance Service-National Health Information Database as a proxy measurement for true incidence in the community. The total number of incident cases and incidence rates of tic disorders from 2003 to 2020 were compared between youths and adults. Both the number of incident cases and the annual incidence rates of tic disorders significantly increased from 2003 to 2020. The overall increasing trend in the incidence rates was significantly greater in youths than in adults; however, the incidence rates in adults showed a relatively recent increase. The male predominance regarding the newly diagnosed case number in youths was no longer observed in adults. Tic disorders occurred more commonly in the low-income group than in the high-income group. Neurodevelopmental comorbidities in youths and mood or anxiety disorders and schizophrenia in adults were more frequently observed. Antipsychotic medication adherence was higher in youths than in adults. Efforts are required to raise awareness and promote expert education for adult patients with tic disorders.

The Influence of Socioeconomic Factors on Access to Biologics in Psoriasis

Background: Since the introduction of biologics for psoriasis, uptake has been uneven and limited. Few studies have investigated the influence of socioeconomic factors on access to biologics. Objective: To investigate how socioeconomic factors influenced access to biologics. Methods: Biologic-naïve patients in the Swedish National Register for Systemic Treatment of Psoriasis (PsoReg) for the years 2006–2014 were included. For patients who remained on nonbiologic treatments during their entire registration (n = 1851), the most recent registration was analyzed. For patients who began treatment with biologics during registration in PsoReg (n = 665), the last observation before initiation of biologics was analyzed. A logistic regression model was used to investigate whether education and income influenced the probability of a switch to biologics, whilst adjusting for demographic and individual factors such as age, sex, disease severity, and clinical characteristics. Results: The odds ratio of access to biologics was 1.8 (CI = 1.3–2.6) in the group with a high level of disposable income, compared with the middle-income group. No differences were found concerning educational levels. The odds ratios of access to biologics decreased with age. Patients with psoriatic arthritis had odds ratios of access to biologics which were more than 50 percent higher, controlling for other variables. High disease severity, in terms of physician- and patient-reported severity, increased the odds ratios of access to biologics. Conclusions: The higher-income group had better access to biologics than the middle-income group when adjusting for disease severity and lifestyle factors. This may not only be an equity problem, as a better allocation of society’s resources might have resulted in a higher overall effectiveness of biologics.

Cardiovascular Health of Middle-Aged U.S. Adults by Income Level, 1999 to March 2020 : A Serial Cross-Sectional Study.

Although cardiovascular mortality has increased among middle-aged U.S. adults since 2011, how the burden of cardiovascular risk factors has changed for this population by income level over the past 2 decades is unknown. To evaluate trends in the prevalence, treatment, and control of cardiovascular risk factors among low-income and higher-income middle-aged adults and how social determinants contribute to recent associations between income and cardiovascular health. Serial cross-sectional study. NHANES (National Health and Nutrition Examination Survey), 1999 to March 2020. Middle-aged adults (aged 40 to 64 years). Age-standardized prevalence of hypertension, diabetes, hyperlipidemia, obesity, and cigarette use; treatment rates for hypertension, diabetes, and hyperlipidemia; and rates of blood pressure, glycemic, and cholesterol control. The study population included 20 761 middle-aged adults. The prevalence of hypertension, diabetes, and cigarette use was consistently higher among low-income adults between 1999 and March 2020. Low-income adults had an increase in hypertension over the study period (37.2% [95% CI, 33.5% to 40.9%] to 44.7% [CI, 39.8% to 49.5%]) but no changes in diabetes or obesity. In contrast, higher-income adults did not have a change in hypertension but had increases in diabetes (7.8% [CI, 5.0% to 10.6%] to 14.9% [CI, 12.4% to 17.3%]) and obesity (33.0% [CI, 26.7% to 39.4%] to 44.0% [CI, 40.2% to 47.7%]). Cigarette use was high and stagnant among low-income adults (33.2% [CI, 28.4% to 38.0%] to 33.9% [CI, 29.6% to 38.3%]) but decreased among their higher-income counterparts (18.6% [CI, 13.5% to 23.7%] to 11.5% [CI, 8.7% to 14.3%]). Treatment and control rates for hypertension were unchanged in both groups (>80%), whereas diabetes treatment rates improved only among the higher-income group (58.4% [CI, 44.4% to 72.5%] to 77.4% [CI, 67.6% to 87.1%]). Income-based disparities in hypertension, diabetes, and cigarette use persisted in more recent years even after adjustment for insurance coverage, health care access, and food insecurity. Sample size limitations could preclude detection of small changes in treatment and control rates. Over 2 decades in the United States, hypertension increased in low-income middle-aged adults, whereas diabetes and obesity increased in their higher-income counterparts. Income-based disparities in hypertension, diabetes, and smoking persisted even after adjustment for other social determinants of health. National Institutes of Health.

Ride-hailing and transit accessibility considering the trade-off between time and money

Ride-hailing services can expand access to opportunities in urban areas, but out-of-pocket costs may limit its benefits for low-income individuals. This paper examines how ride-hailing shapes spatial and socioeconomic differences in access to opportunities while accounting for the trade-off between travel time and monetary costs. Using one year of aggregate Uber trip data for Rio de Janeiro in 2019 and a new multi-objective routing algorithm, we analyze the potential for ride-hailing services to improve employment accessibility when used as a standalone transportation mode and in conjunction with transit as a first-mile connection. We find that, compared to transit, standalone ride-hailing can significantly expand accessibility as a standalone mode for short trips, and as a first-mile feeder to transit in trips longer than 30 min. However, the accessibility benefits of ride-hailing accrue mostly to high-income groups due to affordability barriers. These findings suggest that policy efforts to integrate rideshare with transit are likely not going to benefit low-income communities without some form of subsidized fare discounts to alleviate affordability barriers. The paper also highlights how accounting for trade-offs between travel-time and monetary costs can importantly influence the results of transportation accessibility and equity studies.

Differential patterns of lifestyle behaviors among low- and high-income postmenopausal women in Korea: a latent class analysis

BackgroundHealthy lifestyle behaviors among postmenopausal women are important to prevent chronic diseases and improve health later in life. Heterogeneous lifestyle patterns may exist among postmenopausal women, and socioeconomic status (SES) is a critical determinant of lifestyle behaviors. However, little is known about distinct SES-specific patterns of lifestyle behaviors among postmenopausal women. Thus, this study used latent class analysis to identify subgroups of postmenopausal women with different health behaviors according to income and to examine the predictors of income-specific subgroups.MethodsWe analyzed nationally representative data from the Eighth Korea National Health and Nutrition Examination Survey, collected in 2019 and 2020. We used nine lifestyles (i.e., current smoking and drinking, high-risk drinking, walking, muscle-strengthening exercise, sleep, vegetable and fruit intakes, and weight control efforts). We conducted a multiple-group latent class analysis using monthly household income as a proxy for SES. The monthly household income variable was calculated by standardizing monthly household income by the number of family members and then divided into quintiles. We classified the participants into low- (i.e., Q1 and Q2) and high-income (i.e., Q3, Q4, and Q5) groups.ResultsAlthough the three-class models best fit the data of low- and high-income groups, we found differential patterns by income: (a) for low-income group, “relatively healthy (RH),” “lowest physical activity, insufficient fruit intake, and no intention to control weight,” and “high-risk drinking and insufficient fruit intake” classes and (b) for high-income group, “RH,” “lowest physical activity,” “high-risk drinking and insufficient fruit intake and sleep” classes. The proportion of the RH class was largest in both groups. However, lifestyle patterns in low-income group showed multiple and unhealthy characteristics than those in high-income group.ConclusionsThis study suggests that different underlying lifestyle patterns exist in postmenopausal women with low- and high-income. To promote healthy behaviors among postmenopausal women, health professionals should develop and apply lifestyle interventions tailored to lifestyle pattern characteristics according to income.

Stability and optimal control of two products innovation diffusion system

The current study is aimed at analysing a four-compartmental system to examine the interaction and market dissemination of two product categories. In the first category, the product is low-priced and preferred by economically backward people. In the second category, the product is high-priced and liked by people in high-income groups. The non-user population is the potential buyer of products in the market, and frustrated people are fed up with both products. The nonnegativity and boundedness of the solution to the system help in ensuring the well-defined nature of the model. The viability of the model with UFE (user-free equilibrium), an equilibrium point in the absence of users of low-priced products, and interior equilibria is analysed. The analysis of the local and global stability of the model’s equilibria is conducted with reference to ℛ0. We examine the system’s transcritical bifurcation using the Centre Manifold Theory at ℛ0=1. The Hopf bifurcation’s occurrence condition has been identified. The frustration class population gets reduced using the optimal control theory. The extended optimum control model is used to build the Hamiltonian function, which is then solved using Pontryagin’s maximum principle to obtain the lowest cost. To realize which parameters impact the basic influence numbers most, we also run a sensitivity analysis on them. Finally, simulations are conducted to support the theoretical model.

Demographic and socioeconomic determinants of access to care: A subgroup disparity analysis using new equity-focused measurements.

Disparities in healthcare access and utilization associated with demographic and socioeconomic status hinder advancement of health equity. Thus, we designed a novel equity-focused approach to quantify variations of healthcare access/utilization from the expectation in national target populations. We additionally applied survey-weighted logistic regression models, to identify factors associated with usage of a particular type of health care. To facilitate generation of analysis datasets, we built an National Health and Nutrition Examination Survey (NHANES) knowledge graph to help automate source-level dynamic analyses across different survey years and subjects' characteristics. We performed a cross-sectional subgroup disparity analysis of 2013-2018 NHANES on U.S. adults for receipt of diabetes treatments and vaccines against Hepatitis A (HAV), Hepatitis B (HBV), and Human Papilloma (HPV). Results show that in populations with hemoglobin A1c level ≥6%, patients with non-private insurance were less likely to receive newer and more beneficial antidiabetic medications; being Asian further exacerbated these disparities. For widely used drugs such as insulin, Asians experienced insignificant disparities in odds of prescription compared to White patients but received highly inadequate treatments with regard to their distribution in U.S. diabetic population. Vaccination rates were associated with some demographic/socioeconomic factors but not the others at different degrees for different diseases. For instance, while equity scores increase with rising education levels for HBV, they decrease with rising wealth levels for HPV. Among women vaccinated against HPV, minorities and poor communities usually received Cervarix while non-Hispanic White and higher-income groups received the more comprehensive Gardasil vaccine. Our study identified and quantified the impact of determinants of healthcare utilization for antidiabetic medications and vaccinations. Our new methods for semantics-aware disparity analysis of NHANES data could be readily generalized to other public health goals to support more rapid identification of disparities and development of policies, thus advancing health equity.

Change in women's work burden and gender norms of unpaid care work after the second wave of the COVID-19 pandemic in India.

The COVID-19 pandemic and resultant lockdown has increased the burden of unpaid care work. Hence it is essential to evaluate the crisis response in change of women's work burden and gender norms of their unpaid care work and social status. To investigate change in women's job roles after second the wave of the COVID-19 pandemic and its effect on physical and psychological burden of work along with identification of common contributors of gendering of care work. Using a structured questionnaire and simple random sampling technique, the study was conducted on married women (n = 691) in West Bengal, India after the second wave of the COVID-19 pandemic. Significant job loss (p = 0.014) occurred during COVID-19. Unpaid care work increased (p = 0.04) with reduction in rest hours (p = 0.002). 62.3% women felt increased burden of work. Work burden score increased with age (p = 0.003), reduction of rest (p < 0.001) and increased care work (p = 0.022). Gendering occurred due to male partner's less contribution to care work and respondents' cognitive agreement with expected gender role. Gendering of work is less in urban areas (OR = 0.379, p = 0.008) and higher income group (OR = 5.37, p = 0.026). Women faced more gendering in case of job loss (OR = 9.27, p = 0.001) or if burdened with work (OR = 3.92, P < 0.001). The impact of employability of women on their work role during the COVID-19 outbreak has highlighted both theoretical and practical significance that opens up the scope of further studies at national and larger ethno-geographic levels.

Measuring energy sufficiency: A state of being neither in energy poverty nor energy extravagance

There is growing interest in energy sufficiency (ES); however, it remains conceptually debated and contested. This study presents a novel approach to measuring ES using unique microdata on the energy consumption of Japanese households. This approach determines lower and upper thresholds regarding domestic energy consumption for each household type and then identifies whether people really meet an adequate level of domestic energy services, with their diverse energy needs considered. The result illustrates that most people in Japan live in ES, despite about one-tenth being in energy poverty (EP) and one-twentieth in energy extravagance (EE). In addition, this study empirically clarifies the characteristics of people in ES, as well as those in EP and EE. People in ES and EE generally belong to higher income groups, live in larger houses, and are less committed to energy-saving behaviours; the opposite applies to people in EP. As a policy implication, this study suggests more progressive energy tariffs and carbon pricing, as well as improvement in access to renewable energy for the EP population, to engender an inclusive low-carbon energy transition and allow everyone to achieve ES.

Inequality and Crime in Latin America and the Caribbean: New Data for an Old Question

The purpose of this paper is to revisit the relationship between inequality and crime, with a focus on the Latin America and Caribbean region. We find a significant, positive, and robust association between these variables. Moreover, inequality is the only variable showing this robust regularity. Education levels, economic activity, income per capita, and poverty show weaker and unstable relationships with crime. With due caution, the use of historical variables to instrument for inequality in crime regressions suggests that a causal interpretation of this relationship is plausible. In addition, the analysis of the distribution of crime victimization indicates that men suffer more crime than women, and that the male-to-female homicide ratio grows with inequality. By socio-economic strata, high-income groups suffer more victimization relative to poorer groups in LAC countries, but the poor suffer more homicides. JEL Classification Codes: D63; K42; O15; O54

Abstract 12487: Healthcare Access and Cardiovascular Risk Factor Management in Low-Income Working-Age Adults After the COVID-19 Pandemic

Background: Low-income working age adults disproportionately experienced disruptions in care and deepening financial hardship at the onset of the COVID-19 pandemic. Little is known about how health care access and cardiovascular (CV) risk factor management changed as the pandemic went on, and if these patterns differed by state Medicaid expansion status. Methods: We identified adults aged 18-64 using the CDC’s Behavioral Risk Factor Surveillance System. Low-income adults were defined as those with incomes &lt;138% of the federal poverty level (FPL), and high-income adults &gt;400% FPL. We fit logistic regression models to compare changes in measures of health care access and CV risk factor management in 2021 to a pre-pandemic baseline (2019), adjusted for age and sex. We included an interaction term for income level and year, to evaluate whether there was a differential change between low- and high-income adults. We also evaluated changes among low-income adults in Medicaid expansion vs. non-expansion states. Results: As shown in the Table , health insurance coverage, access to personal health care provider, and ability to afford care all improved in 2021 compared to pre-pandemic baseline (2019), although gains were more pronounced for high-income vs low-income groups. In contrast, the proportion of adults with a check-up in the past 12 months, or who received recommended cardiovascular risk factor screening, worsened in both low- and high-income groups. Among the low-income group, those in Medicaid expansion states experienced greater increases in insurance coverage than those in non-expansion states (OR 1.53 [1.40,1.68] vs 1.27 [1.11,1.46], p = 0.0283). Conclusion: In this national study, low- and high-income working-age adults experienced decreases in outpatient check-ups and CV risk factor screening in 2021 compared with pre-pandemic baseline. Public health initiatives are needed to improve screening for CV risk factor as the US emerges from the pandemic.