Higher Levels Of Household Income Research Articles

Factors associated with patient activation among patients with diabetes on hemodialysis: a multicenter cross-sectional study from a developing country

BackgroundDiabetes mellitus (DM) is a major public health concern with considerable morbidity and mortality. DM affects patients’ quality of life and can lead to multiple complications, including chronic kidney disease (CKD) and the need for dialysis. Higher patient activation can improve health outcomes in hemodialysis patients with DM. This study aimed to explore the factors associated with higher patient activation and health-related quality of life (HRQoL) among hemodialysis patients with DM.MethodsThis was a cross-sectional, questionnaire-based study conducted on hemodialysis patients with DM in Palestine. The quota sampling method was utilized to draw samples from six dialysis centers. The questionnaire consists of three sections. The first section includes demographic, socioeconomic and clinical questions. The second section utilizes the patient activation measure-13 (PAM-13) to measure patient activation, while the third section assesses HRQoL using the EQ-5D-5 L tool and the visual analog scale (VAS). Mann‒Whitney and Kruskal‒Wallis tests were employed to examine the relationships between variables at the bivariate level, and multiple regression analysis was employed at the multivariate level.ResultsOf the 200 patients who were approached, 158 were included. The median PAM, EQ-5D index, and VAS score were low at 51.0, 0.58, and 60.0, respectively. A higher PAM score was independently associated with a higher household income level and taking medications independently. A higher EQ-5D index was associated with taking more than eight medications, taking medications independently, living with fewer than three comorbid conditions, and having a higher PAM. A higher VAS score was associated with being married, and receiving less than 3.5 hours of hemodialysis.ConclusionsA higher patient activation level was associated with a higher income level and independence in taking medications. Interventions designed to improve patient activation, such as medication management programs, should address these factors among the target population. Longitudinal studies are needed to assess the time effect and direction of causation between health status and patient activation.

Determinants of sexual and reproductive health concerns among youngsters in Albania during COVID-19 pandemic

The COVID-19 pandemic has affected all communities, including youngsters. Our aim was to assess the key sexual and reproductive health (SRH) concerns of young people in Albania during the pandemic as well as the factors associated with the main health concern. A cross-sectional study was carried out in Albania in 2021. Multivariable logistic regression analysis was used to assess the association of being concerned about mental health & psychological well-being, urgency for mental health information, and difficulty in getting mental health information with independent variables. In total 340 youngsters aged 14-30 years participated (66% female, 89% Albanian ethnicity, about 20% belonging to the LGBT community). Mental health & psychological well-being were the main SRH topics youngsters were concerned about, reported by 48% of them. About 37% of youngsters had an urgent need for mental health information during the pandemic and 18% experienced difficulty in getting this information. Being part of the LGBT community was associated with a significantly higher likelihood of being concerned about mental health (OR=3.15;95%CI:1.36-7.33), being in urgent need of mental health information (OR=3.68;95%, CI:1.63-8.32) and experiencing difficulties in getting mental health information (OR=3.48;95% CI:1.49-8.13). Higher household income levels also increased the likelihood of being concerned about mental health (OR=4.28;95%CI:1.55-11.77) and being in urgent need of mental health information (OR=4.15;95%CI:1.43- 12.01). In conclusion, young people in Albania have been concerned about various SRH topics during the COVID-19 pandemic, but the major concern was mental health & psychological well-being, especially for the LGBT community. The findings should guide future interventions for addressing youth mental health concerns in emergency situation.

Inequality in dental flossing behavior among Korean adults based on household income levels.

The aim of this study was to estimate the association between household income and dental flossing. This cross-sectional study investigated the impact of household income on flossing among 9,391 adults aged 30+ with ≥20 natural teeth, utilizing data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018). Outcome measures included flossing (yes/no), with income categorized into 4 levels: lowest, medium to low, medium to high, and highest. Logistic regression, adjusted for age, gender, brushing frequency, recent dental exams, periodontitis, smoking, and alcohol use, was employed to evaluate the influence of socioeconomic status on oral hygiene practices. In the highest income group, flossing was 62.6% more prevalent than in the lowest income group (adjusted odds ratio [aOR], 1.63; 95% CI, 1.27-2.08). The strongest association between income levels and flossing was observed in individuals aged ≥70 years (aOR, 3.64; 95% CI, 1.86-7.11), with a decreasing strength of association in the 60s (aOR, 1.72; 95% CI, 1.05-2.84) and 50s age groups (aOR, 1.69; 95% CI, 1.07-2.68). Higher-income women demonstrated a higher frequency of flossing than their lower-income counterparts (aOR, 1.67; 95% CI, 1.24-2.23). Higher-income individuals without periodontitis were more likely to floss (aOR, 1.64; 95% CI, 1.23-2.18), and among those with periodontitis, flossing was significantly associated only with the highest income category (aOR, 1.64; 95% CI, 1.10-2.44). The findings of this study indicate a significant correlation between higher household income levels and an increased prevalence of flossing.

Socioeconomic Factors, Movement Behavior Context, and Self-reported Physical and Mental Health in Adults Living in New York City

Objective: The purpose of this study was to examine the associations of socioeconomic factors, movement behavior context, and self-reported physical and mental health in adults living in New York City. Methods: Participants were adults from the Physical Activity and Transit Survey (N = 3811; 53.2% female). The dependent variables were items asking about the number of days the participant experienced poor physical and mental health. Independent variables were socioeconomic factors and items asking about the frequency of physical activity (PA) within certain contexts and rest/sleep behaviors. Weighted multivariable negative binomial regression models examined the associations. Results: More days of bicycling transit (IRR = 0.79, p = .001) and higher levels of household income (IRR range = 0.44-0.66, p < .025) were associated with lower rates of poor physical health. More days of poor rest/sleep (IRR = 1.05, p < .001) and labor PA (IRR = 1.10, p < .001) were associated with higher rates of poor mental health, and higher household income (IRR range = 0.58-0.65, p < .01) were associated with a lower rate of poor mental health. Conclusions: The strength and direction of associations with self-reported health varied according to PA context. Poor rest/sleep and low household income were strongly associated with both poor physical and mental health.

Medical, dental, and optical care utilization among community-living people with spinal cord injury in the United States

Context/Objective Information about patterns of healthcare utilization for people living with spinal cord injury (SCI) is currently limited, and this is needed to understand independent community living after SCI. This study investigates self-reported healthcare utilization among community-living people with SCI and assesses disparities across demographic, socioeconomic, and injury-related subgroups. Design Secondary analysis of cross-sectional survey data administered via telephone interview. Setting 6 SCI Model Systems centers in the United States (California, Colorado, New Jersey, New York, Ohio, and Pennsylvania). Participants Adults with chronic, traumatic SCI who were community-living for at least one year after the completion of an inpatient rehabilitation program (N = 617). Interventions Not applicable. Outcome Measures Utilization of a usual source of 4 types of health care in the past 12 months: primary, SCI, dental, and optical. Results 84% of participants reported utilizing primary care in the past year. More than half reported utilizing SCI (54%) and dental (57%) care, and 36% reported utilizing optical care. There were no significant differences across key subgroups in the utilization of primary care. Participants who had been injured for 5 years or less and participants with greater educational attainment were more likely to report utilizing SCI care. Participants with higher household income levels were more likely to report using dental care. Female participants and older age groups were more likely to report using optical care. Conclusion Rates of healthcare utilization among people with SCI are below recommended rates and vary across demographic, socioeconomic, and injury-related subgroups. This information can inform future research to target barriers to using healthcare services among community-living people with SCI.

교원 임용시험 지원자의 사교육비 지출 실태와 영향

This study analyzed the level and impact of private education expenditure of teachers appointment exam applicants using five waves of Graduates Occupational Mobility Survey. Considering heterogeneous characteristics of primary and secondary teacher resources and different pass rates of appointment exams, we divided samples of primary and secondary teacher applicants.
 The findings are as follows. First, primary teacher applicants spent about 310 thousand won for private education on average. Private education expenditure for Hagwon was 470 thousand won while that for lectures on campus cost 220 thousand won. Second, secondary teacher applicants spent about 420 thousand won for private education on average. The higher household income level was, the higher private education expenditure was. Private education expenditure for Hagwon cost statistically significantly higher than other exam preparation methods. The lower rank university graduates and private university graduates spent more on private education for exam preparation. Third, private education expenditure was not a significant determinant of probability of passing both primary and secondary teacher appointment exams. Particularly for secondary teacher appointment exams, graduates with higher college GPA, higher satisfaction of college education, and from higher rank university and public university were more likely to pass the exam.
 In conclusion, this study found private education expenditure, which is associated with the level of household income, was not a significant determinant and the teacher appointment exams in Korea worked on the basis of meritocracy.

Establishing a Relationship Between Demographic Factors and Students' Environmental Awareness

A lack of environmental education has been shown to lead to lower levels of environmental awareness and consequently fewer climate change prevention measures (Toksoz et al., 2011). Researchers who study this issue focus on identifying the populations most vulnerable to a lack of environmental awareness based on demographic factors like household income and education level (Ajuang et al., 2016; Philippsen et al., 2017; Sun et al., 2020). This research is essential in guiding future climate-related education efforts, but there is limited data on the topic. In order to fill in this research gap, this project focuses on the relationship between demographic factors and the environmental awareness of high school students in the Washington, D.C., metropolitan area. One hundred twenty-five high school students were surveyed, and data were collected relating to students' annual household income, parental/guardian education, age, gender, race, household recycling and gardening practices, and environmental awareness. It was found that, in general, students with higher household income levels, parental/guardian education levels, or age had higher levels of environmental awareness. However, students with the lowest parental education levels also showed increased environmental awareness compared to other lower levels. Male students tended to be slightly more environmentally aware than female students, and students whose families recycled or gardened regularly had higher levels of environmental awareness than those who did not. This information can help to guide future environmental education campaigns to improve environmental awareness levels and environmental relationships, which is needed to effectively address the risks posed by climate change.

Education, household income, and depressive symptoms in middle-aged and older Japanese adults

BackgroundIncome inequality has dramatically increased worldwide, and there is a need to re-evaluate the association between socio-economic status (SES) and depression. Relative contributions of household income and education to depression, as well as their interactions, have not been fully evaluated. This study aimed to examine the association between SES and depressive symptoms in Japanese adults, focusing on interactions between education and household income levels.MethodsThis cross-sectional study used data from baseline surveys of two cohort studies. Participants were 38,499 community-dwelling people aged 40–74 years who participated in baseline surveys of the Murakami cohort study (2011–2012) and Uonuma cohort study (2012–2015) conducted in Niigata Prefecture, Japan. Information regarding marital status, education level, household income, occupation, activities of daily living (ADL), and history of cancer, myocardial infarction, stroke, and diabetes was obtained using a self-administered questionnaire. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression analysis was used to obtain odds ratios (ORs). Covariates included age, sex, marital status, education, household income, occupation, ADL, and disease history.ResultsIndividuals with higher education levels had lower ORs (adjusted P for trend = 0.0007) for depressive symptoms, independently of household income level. The OR of the university-or-higher group was significantly lower than that of the junior high school group (adjusted OR = 0.79). Individuals with lower household income levels had higher ORs (adjusted P for trend< 0.0001) for depressive symptoms, independently of education level. The type of occupation was not associated with depressive symptoms. In subgroup analyses according to household income level, individuals with higher education levels had significantly lower ORs in the lowest- and lower-income groups (adjusted P for trend = 0.0275 and 0.0123, respectively), but not in higher- and highest-income groups (0.5214 and 0.0915, respectively).ConclusionsBoth education and household income levels are independently associated with the prevalence of depressive symptoms, with household income levels showing a more robust association with depressive symptoms than education levels. This suggests that a high household income level may offset the risk of depressive symptoms from having a low education level.

The associations of socioeconomic status and financial strain with restrained and emotional eating among 42-year-old women and men

The current study investigated how different aspects of socioeconomic status (SES) and experiencing financial strain are associated with restrained and emotional eating among 42-year-old Finnish women and men. Lower SES is shown to be associated with diets of poorer nutritional quality and obesity. Nevertheless, little research has been done on the association between SES, financial strain and psychological dimensions of eating behaviour. The study was based on questionnaire data from 734 women and 600 men aged 42 years who were participants in a Finnish cohort study.SES was measured through three different dimensions: education, occupation and household income. Data were analyzed using binary logistic regression models.Results showed that restrained eating was associated with higher household income level in women and with higher occupational position in men. Emotional eating was associated with higher financial strain among women. Also, women with lower college education had higher odds for emotional eating compared to women with vocational education or less. Among men, emotional eating was not statistically significantly associated with any of the SES variables nor with financial strain, which may also be due to the very low level of emotional eating reported by men. In conclusion, our findings indicate that restrained eating would be associated with higher status brought by belonging to a higher income or occupational group. Emotional eating, in turn, would be related to experiencing financial strain, rather than to traditional SES dimensions, in women. These results are relevant when health-related interventions are targeted to different SES groups.

The Defamiliarization of Childcare in Uruguay: What Factors Contribute to the Use of Care Centers?

The purpose of the following article is to analyze childcare strategies in Uruguay with data from the recent Care Strategies Survey. The main question that guides this article is what are the elements that favor the institutionalization of part of the burden of childcare (attendance and hours at childcare facilities for children under and over the age of 3). Gender mandates, which manifest through the maternalism index, contribute to the use of institutions, since traditional ideas about the caregiving role of mothers have effects on less institutionalization. At the same time, mothers’ access to work and higher levels of household income increases the probability of using institutions. Lastly, the defamiliarization of childcare depends on cultural mandates and, to the same extent, on the material conditions to access services.

COVID-19 vaccine hesitancy and resistance: Correlates in a nationally representative longitudinal survey of the Australian population.

High levels of vaccination coverage in populations will be required even with vaccines that have high levels of effectiveness to prevent and stop outbreaks of coronavirus. The World Health Organisation has suggested that governments take a proactive response to vaccine hesitancy 'hotspots' based on social and behavioural insights. Representative longitudinal online survey of over 3000 adults from Australia that examines the demographic, attitudinal, political and social attitudes and COVID-19 health behavior correlates of vaccine hesitance and resistance to a COVID-19 vaccine. Overall, 59% would definitely get the vaccine, 29% had low levels of hesitancy, 7% had high levels of hesitancy and 6% were resistant. Females, those living in disadvantaged areas, those who reported that risks of COVID-19 was overstated, those who had more populist views and higher levels of religiosity were more likely to be hesitant or resistant while those who had higher levels of household income, those who had higher levels of social distancing, who downloaded the COVID-Safe App, who had more confidence in their state or territory government or confidence in their hospitals, or were more supportive of migration were more likely to intend to get vaccinated. Our findings suggest that vaccine hesitancy, which accounts for a significant proportion of the population can be addressed by public health messaging but for a significant minority of the population with strongly held beliefs, alternative policy measures may well be needed to achieve sufficient vaccination coverage to end the pandemic.

Personal social capital and self-rated health among middle-aged and older adults: a cross-sectional study exploring the roles of leisure-time physical activity and socioeconomic status

BackgroundPersonal social capital, which refers to the scope and quality of an individual’s social networks within a community, has received increasing attention as a potential sociological factor associated with better individual health; yet, the mechanism relating social capital to health is still not fully understood. This study examined the associations between social capital and self-rated health while exploring the roles of leisure-time physical activity (LTPA) and socioeconomic status (SES) among middle-aged and older adults.MethodsCross-sectional data were collected from 662 middle-aged and older adults (Mean age: 58.11 ± 10.59 years old) using the Qualtrics survey panel. Personal Social Capital Scale was used to measure bonding and bridging social capital and the International Physical Activity Questionnaire was used to assess LTPA levels. SES was assessed by education and household income levels. Self-rated health was assessed using a single item, by which the participants were categorized into the two groups, having ‘good’ vs. ‘not good’ self-rated health. A series of univariate and multivariate logistic regression models were established to examine the independent and adjusted associations of social capital with self-rated health and to test mediating and moderating roles of LTPA and SES, respectively.ResultsBonding and bridging social capital were positively associated with self-rated health (Odds ratios = 1.11 and 1.09; P’s < .05, respectively), independent of LTPA that was also significantly associated with greater self-rated health (P-for-linear trends = .007). After adjusting SES, the associations of social capital were significantly attenuated and there was a significant interaction effect by household income (P-for-interaction = .012). Follow-up analyses stratified by household income showed that beneficial associations of social capital with self-rated health were more apparent among the people with low and high levels of household income; yet, LTPA was the stronger predictor of self-rated health among those in the middle class of household income.ConclusionsFindings suggest that both social capital and LTPA are associated with better self-rated health; yet, these associations vary by SES. The health policymakers should address both social capital and LTPA for enhancing perceived health among aging populations but may need to consider varying SES backgrounds.

Risk Markers for Women's Physical Intimate Partner Violence Victimization in Iran: A Meta-Analysis.

In this study, evidence from 14 studies examines 16 unique risk markers for intimate partner violence (IPV) victimization for Iranian women. Large-to-medium effect sizes were found for emotional abuse victimization, depression, poor mental health, poor physical health, partner's drug use, living in a patriarchal household, and partner having experienced child abuse as risk markers. Higher levels of education and higher levels of household income were significant protective markers against IPV victimization for Iranian women. Partner's education, partner's employment, being employed, being pregnant, age, partner's age, and length of the relationship were not significant risk markers for IPV victimization among Iranian women.

Depressive Symptoms and Suicidality of Those Raised in Kincare: A Peer Comparison Study.

The rate at which children are raised in kincare has steadily been on the rise. Prior research indicates that this group of individuals are at an increased risk of mental health problems. The current study examined the suicidality and depressive symptoms of adults who were raised in kincare compared to those raised by their parents. There were a total of 1,486 participants, 171 of whom were adults raised in kincare, and 1,315 who were raised by one or both of their parents. Participants completed a measure of suicide risk and reported symptoms of depression and anhedonia.Those raised in kincare scored significantly higher on the measures of anhedonia and suicide risk. However, there were no differences in general depressive symptoms. Further analyses found that more frequent attendance of religious activities and higher levels of household income acted as protective factors. These findings suggest kincare is associated with adverse mental health outcomes.

Trends in hospitalization and readmission for pediatric epilepsy and underutilization of epilepsy surgery in the United States

BackgroundPrevious studies have shown the healthcare utilization for medically refractory epilepsy and epilepsy surgery until 2012 with disparities according to race/ethnicity and socioeconomic status. To extend these data and add other utilization information, we retrospectively investigated the nationwide trends in hospitalization and readmission during 2010–2015. MethodWe extracted data on inpatients who were diagnosed with epilepsy and those who received epilepsy surgery using the national inpatient sample and nationwide readmission database during 2010–2015. We estimated healthcare utilization related to pediatric epilepsy, the number of epilepsy surgeries, hospitalization rates and 30-day readmission rates. Results100,000–120,000 children were hospitalized due to epilepsy each year. Hospitalization rates and 30-day readmission rates were 214.6–262.3 per 1000 patient-years and 72.4–78.0 per 1000 discharges, respectively. 1400–2000 children with epilepsy received epilepsy surgery, but the proportions of medically refractory epilepsy were estimated as 0.8 %–1.2 %. Disparities in patients receiving epilepsy surgery by race/ethnicity were observed during 2010–2012, but they were not after 2013. Children with higher household income levels had consistently higher proportions of receiving epilepsy surgery than those with lower levels. The hospitalization costs for epilepsy surgery were constant at $55,780–$60,813 after adjusting for healthcare cost inflation, whereas the cost for epilepsy were slightly elevated from $15,984 to $17,426. ConclusionsWe provide novel insights into the current healthcare utilization for epilepsy and epilepsy surgery. Although the disparity of epilepsy surgery seemed to be mitigated, surgery in children with medically refractory epilepsy was still underutilized.

Analysis on adulthood weight change in adults in China

Objective: To understand the characteristics of adulthood weight change through the analysis on data from China Kadoorie Biobank (CKB) Study of 0.5 million adults from ten areas in China. Methods: An electronic questionnaire was used to collect the information about the body weight at age 25 years, social-demographic characteristics and lifestyle of the study subjects and their body weight were measured. After excluding the adults with self-reported histories of coronary heart disease, stroke, cancer or diabetes and those who had no data of body weight at age 25 years and those aged outside of 35-70 years, a total of 360 903 adults were included in the analysis. Adulthood weight change were defined as difference value between current body weight and body weight at age 25 years. Results: The mean adulthood weight change of the participants was 4.9 kg. The adults living in urban area showed more body weight increase compared with those living in rural area, so did the adults in northern area compared with those in southern area. Among the ten areas in China, Qingdao reported the highest adulthood weight increase (9.3 kg), and Gansu reported the lowest adulthood weight increase (1.5 kg). Older adults had higher BMI at early adulthood (25 years old), but the adults aged 45-50 years had the highest adulthood body weight increase. Adults with higher educational level, higher household income level, but lower physical activity level had more body weight increase, while current smokers, farmers and workers had less body weight increase. BMI at age 25 years was negatively associated with adulthood body weight change, but current BMI was positively associated with adulthood body weight change (P<0.001). Conclusion: Adulthood body weight change varied greatly among population with different demographic characteristics and lifestyle and in ten areas in China.

Social Insurance and Older Adults in China: Effect of Education and Household Income on Coverage Following the 2009 Health Reform

Education and income have been considered two primary determinants to affect individuals’ health outcomes. China initiated a comprehensive health reform in 2009, with the goals to provide equal access yet sufficient healthcare to all residents. However, social disparities continue to persist following this large reform. This research hypothesized that older adults’ years of education and income are determinants of participation in each social insurance scheme following the 2009 health reform. Multilevel logistic regression models were used with a nationally representative sample (n = 5,274) to investigate the education and income disparities in each social insurance scheme for older adults, with random effects among provinces at the national level. The analyses show that years of education was not associated with enrollment in three social insurances, with the exception of the association between 11 years of formal education or above and the rural coverage. Participants with higher levels of household income had greater odds of having urban social insurances, but had lower odds of having the rural scheme. Further research should continue to investigate the disparities of enrollment of each social insurance. Chinese policy makers should consider these social factors carefully to reach a true universal coverage.

Gender differences in heart diseases: Evidence from Turkey

ObjectivesThis study examines gender differences in heart disease experiences of individuals in Turkey by employing individual level data from a nationally representative survey. MethodsBy using Turkish Health Survey, this study constructs a binary indicator for heart disease experiences of individuals, which accounts for heart problems such as myocardial infarction, coronary heart disease and angina pectoris. Binary logistic regression models are estimated for quantification of associations between prevalence of heart diseases, gender and other risk factors. ResultsEmpirical results imply that females are significantly less likely to experience heart diseases in Turkey. Age and hypertension issues are directly correlated with heart problems for both males and females. Perceived health status is negatively associated with probability of experiencing heart diseases for both males and females in Turkey. Having diabetes is a positive significant predictor of heart disease experiences for Turkish females. Females with higher household income level are less likely to have heart diseases. Finally, education level and lifestyle indicators such as smoking, physical activity, fruit, vegetable and alcohol consumption display mixed results. ConclusionsThis study suggests that there are gender differences in prevalence and risk factors of heart diseases in Turkey. Complementing the earlier literature, findings of this study imply that gender specific health interventions would be effective in coping with heart related diseases.

Factors Related to Employment Situation among Korean Cancer Survivors: Results from a Population-Based Study

Background:Due to the increased incidence and survival rate of cancer, the number of cancer survivors has been increasing. In addition, many problems have been reported regarding the employment of these survivors. Therefore, this study aims to investigate the employment situation of cancer survivors and associated factors.Methods:We analyzed data from the Korean National Health and Nutrition Examination Survey (2010-2014), which is a nationwide cross-sectional health survey, and included a total of 1,060 participants who were diagnosed with cancer. Multivariate logistic regression analysis was conducted to investigate the factors associated with the participants’ employment situation.Results:The employment rate among cancer survivors was 42.0%. The variables found to be associated with being employed were male gender, younger age, higher household income level, educational level at middle school level or under, and not having activity limitations.Conclusion:These findings suggest that, in addition to cancer-related factors, general characteristics such as gender, age, household income, and education level are important factors associated with the employment status of Korean cancer survivors.

Febrile seizures: Are they truly benign? Longitudinal analysis of risk factors and future risk of afebrile epileptic seizure based on the national sample cohort in South Korea, 2002–2013

PurposeWe performed a large, population-based study to analyze the risk factors of the febrile seizures and the subsequent afebrile epileptic seizures. MethodsRelevant data from children born between 2002–2007 were retrieved from the Korean National Health Insurance Service-National Sample Cohort 2002-2013. Children who did not survive the first five years were excluded from the analysis. The risk factors for febrile seizures were assessed separately in per-person and per-febrile case analyses, and factors contributing to an increased risk of subsequent afebrile epileptic seizures were identified. ResultsA total of 54,233 children were included and the five-year prevalence rate of febrile seizure was 11.19%. In the per-person analysis, male sex, preterm birth and brain injury at birth increased the risk of febrile seizure with odds ratios of 1.17, 1.40 and 1.97 (all p < 0.001), respectively. A high household income level was associated with reduced odds of febrile seizure. In the per-febrile illness analysis, male sex, brain injury at birth, presumed bacterial infection, gastrointestinal or genitourinary infection and unspecified sepsis were independent risk factors of a febrile seizure during febrile illness. The cumulative number of febrile seizure episodes, especially more than the third episodes, was associated with a new diagnosis of an afebrile epileptic seizure within one year. ConclusionSex, preterm birth, brain injury at birth, presumed bacterial infection, genitourinary and gastrointestinal infections and unspecified sepsis were identified as likely risk factors for febrile seizures. A greater number of febrile seizure episodes was associated with a higher probability of subsequent afebrile epileptic seizures.