Higher Socioeconomic Groups Research Articles

The distribution of hunger in Canadian youth.

As a foundation for prevention, evidence is required to establish the contemporary distribution of hunger in Canadian adolescents. We present findings from a nationally representative survey of young Canadians on how perceived hunger is distributed demographically, socially and contextually. A probability-based sample of 15 656 young Canadians aged 11 to 15 years who completed the 2017/18 cycle of the Health Behaviour in School-aged Children study was used. Descriptive statistics and multivariable regression analyses were used to profile the study population and the distribution of hunger attributed to "not having enough food at home." Overall, one in six (16.6%) survey participants reported experiencing hunger. There was a strong and significant correlation between low socioeconomic status and hunger (p $lt; 0.001 for the low and middle socioeconomic groups, compared to the high socioeconomic status group). Notably, 12.5% of participants with high levels of affluence also reported such experiences of hunger; however, this was not a statistically significant finding. Hunger was less frequently reported in older participants and in higher grade levels, with some level of significance. Regression analyses indicated that, within the sample, some demographic characteristics correlated with experiences of hunger: lower levels of affluence, identifying as male or nonbinary gender, long-term immigrant status, and identifying as Black, Latin American or mixed ethnicity. Clear disparities exist in the self-reported experience of hunger among young people in Canada.

Is Mandatory Community Service a Catalyst for Civic Growth or Fruitless Servitude?: Evidence from a Natural Experiment in South Korea

AbstractDiminishing civic vitality has been reported in numerous societies, irrespective of democratic maturity. Mandatory community service initiatives in schools have garnered attention as a strategy for fostering long-term civic engagement. However, methodological challenges such as selection bias and observation timing have led to inconsistent empirical results. This study leverages a unique natural experimental context where mandatory community service requirements were nationally implemented in middle and high schools in South Korea. Employing a non-parametric regression-discontinuity design, we provide robust evidence that such programs increase the likelihood of volunteering in adulthood among lower socioeconomic groups. We found no indications that these mandates increase or decrease the propensity for civic engagement among higher socioeconomic groups.

Sugar-sweetened beverage consumption in Thailand: Determinants and variation across socioeconomic status

ObjectivesReducing consumption of sugar-sweetened beverages (SSBs) is a primary public health goal in Thailand, but information on the characteristics of SSB consumers remains limited. This study aims to gain knowledge about the characteristics of SSB consumers in Thailand. Study designSecondary analysis of survey data. MethodsThe study used data from the Health Behaviour of Population Survey conducted by Thailand's National Statistics Office between February and May 2021. SSB consumption was sourced from a survey question about the consumption of prepackaged sugar-sweetened non-alcoholic beverages. The influence of demographic, socioeconomic, behavioural, habitual, and health factors on mean daily intake and daily consumption was assessed using a two-part model and logistic regression analysis, respectively. Decomposition analysis was conducted to understand how the impact of these factors affecting SSB consumption varied across socioeconomic groups. ResultsFrequent SSB consumers exhibited various unhealthy behaviours, including smoking, unhealthy food consumption, low physical activity, and making food selections driven by appetitive motivations. Although higher socioeconomic status was associated with greater consumption of SSBs, it stabilised at elevated income levels. Increased SSB consumption in higher socioeconomic groups was linked to mixed eating habits, being overweight, and occasional drinking, while in lower socioeconomic groups, it was associated with unhealthy behaviours like smoking, regular alcohol drinking, appetitive food choices, and low physical activity. ConclusionsSSB consumption in Thailand is multifactorial, varying by socioeconomic status. These insights are crucial for policy formation aimed at reducing SSB consumption in the country. Policymakers should explore interventions that address overall unhealthy behaviours alongside those targeting overconsumption of SSBs.

The double disadvantage faced by adolescents from low socioeconomic backgrounds with mental health problems affects earnings up to mid-life

Early childhood socioeconomic disadvantage and mental health problems are both important determinants of adult social and economic experiences, but little is known about how they interact in this respect. We aimed to assess whether poor mental health in adolescence exacerbates labour market inequalities originating from low socioeconomic status (SES) in childhood. We use a birth cohort of individuals born in 1958 in England and follow their employment experiences and cumulative earnings up to age 55. We proxy low SES in childhood with father's occupational class at the time the respondent was aged 11, and use caregiver (usually, parent) ratings of the Rutter inventory at age 16 to identify mental health problems in adolescence. We fit ordinary least squares (OLS) models to estimate the effect of growing up in a low-SES family and experiencing mental health problems (conduct or emotional problems) in adolescence on cumulative earnings (log-transformed). We use an interaction term to test whether the association between mental health problems (conduct and emotional separately) and earnings differed by socioeconomic group. Individuals who experienced conduct problems in adolescence had lower cumulative earnings and employment levels up to age of 55. Moreover, the association between mental health problems and cumulative earnings was higher among individuals who also experienced low SES in childhood. Families from a higher socioeconomic group may have more effective means to counteract the adverse impacts of adolescent mental health problems, likely due to broader access to resources, support systems and opportunities. This underscores the role of structural supports in addressing socioeconomic inequalities in mental health outcomes and their long-terms implications.

Biological Reference Ranges for Healthy Indian Blood Donors: Experience of a Tertiary Care Center Vis-à-Vis International Literature.

Complete blood count is the most common, basic test requisitioned in hematology. The normal reference ranges of hematological parameters are required owing to variable socioeconomic, environmental, and genetic factors in populations. The current study determines the reference ranges of the healthy Indian donor population of a high socioeconomic group. The study was conducted in the Department of Transfusion Medicine at a tertiary care hospital in India and included 4098 individuals, aged 18-65 years coming for voluntary blood donation from July 2021 to October 2022. Blood samples were collected in K2EDTA, analyzed on the Sysmex XN-31 hematology analyzer, and using statistical tools, the normal reference ranges were calculated. The reference ranges for hemoglobin (HB) (137-185 g/L), WBC (5.1-1.7 × 109/L), platelet count (115.6-370.0 × 109/L) were noted. No statistically significant changes were observed in different age groups. There were gender-wise differences noted in nearly all parameters. The HB and hematocrit (HCT) range was slightly higher in other Indian and other Asian populations with comparable values with the Chinese, Korean populations, and Western populations; RBC parameters were overall comparable with minor differences; the WBC count was higher than the other Indian and Asian populations particularly the upper limit of lymphocyte and monocyte; and the range of platelet counts had a comparable upper limit with all populations and had the lowest lower value in males in our study, which was comparable to only the Chinese population. It is concluded that reference ranges of common parameters were calculated with minor changes noted in all hematological parameters on comparing with other Indian, Asian population, and Western data.

Consumer Locus of Control Scale: Validity, and Measurement Invariance Evidence in Low and High Socioeconomic Status Groups

Consumer locus of control is a key factor in purchase decisions, where consumers perceive outcomes as either dependent on or external to their own actions. These beliefs vary among individuals from different socioeconomic backgrounds, except when it comes to consumption. However, the assumption of measurement invariance across all socioeconomic groups has not been proven. To address this, a study was conducted to develop, validate, and test the invariance of the Consumer Locus of Control Scale. The first study (n = 300) involved exploratory factor analysis and reliability testing. The second study (n = 309) examined confirmatory factor analysis, convergent and discriminant validity, and measurement invariance. Results showed high explained variance and internal consistency. The five-factor structure demonstrated a good fit, supporting the scale's structural validity. Furthermore, the scale was invariant between high and low socioeconomic groups. This study provides valuable evidence for the reliability and validity of the Consumer Locus of Control Scale.

Association of Socioeconomic Status and Reasons for Companion Animal Relinquishment.

It is important to understand the reasons for companion animal relinquishment to help reduce the financial and ethical problems arising from too many dogs and cats in shelters. This study investigates the socioeconomic factors and reasons behind companion animal relinquishment in Australia, utilizing data from five animal shelters, over a five-year period (Financial Year 2018/19 to 2022/23). Descriptive statistics reveal that the median Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD) decile of companion animal guardians who relinquished their companion animal was decile 4 out of 10, indicating that they live in areas of lower-than-average socioeconomic status. Cats accounted for 59.4% and dogs for 40.6% of all relinquishments, with more relinquishments from lower socioeconomic deciles (1-5) (cats: 62.6%, dogs: 65.8%). The median age of relinquished cats was 5 months and dogs 16 months, with human factor-related issues (e.g., Housing, Financial Constraints, Human Healthcare) cited in 86% of cases. Descriptive analysis for the five financial years shows a declining trend in numbers of relinquishments, with housing issues (31.2%) identified as the primary reason, followed by ownership decisions (16.2%), financial constraints (11.2%), and human health issues (10.4%). Comparing the reasons for relinquishment between lower (decile 1-5) and higher (decile 6-10) socioeconomic status demonstrated that financial difficulties were a more common reason in lower vs. higher socioeconomic groups, while human health and family-related issues are more common in higher vs. lower socioeconomic groups. These findings highlight the critical role of socioeconomic factors in understanding why people relinquish their companion animals, which can inform targeted interventions to support companion animal welfare across different socioeconomic backgrounds.

Evaluation of the quality of life among transgender men before and after gender reassignment surgery: a survey from Iran

BackgroundGender dysphoria, characterized by a misalignment between one’s gender identity and assigned sex, propels individuals towards medical interventions like gender reassignment surgery (GRS) to harmonize their bodies with their gender. This process aims to enhance overall quality of life (QoL), functioning, and body image. Recognizing the importance of cultivating a positive body image for transgender individuals navigating societal norms, this narrative highlights the ongoing debate surrounding QoL post-GRS. In response, our study is outlined, aiming to scrutinize QoL and self-image among transgender men post-GRS, offering valuable insights into societal perceptions and psychological well-being in this context.MethodThis cross-sectional survey focused on transgender men aged 15 to 35 who underwent gender reassignment surgery (GRS) in 2018–2022 in Shiraz, Iran. Participants, after passing psychiatric evaluations, completed World Health Organization Quality of Life (WHOQOL-100) questionnaires pre- and at least one-year post-surgery. The scores of the Brief-WHOQOL questionnaire were evaluated in four domains of physical health, psychological health, social relationships, and environmental health.ResultsA total of 60 individual who underwent GRS completed our questionnaire. The average age of the patients was 24.1 ± 3.8 years. Following GRS, the most increase was observed in the psychological factor (by 25.6%). The increase in score was statistically significant in all subgroups (P < 0.001) after operation. Urban living location had a significant association with higher increase in physical health (P < 0.010), psychological health (P = 0.005), and environmental health (P = 0.012) after GRS. In regards to physical health, the low socioeconomic group had a significantly less physical score improvement in QoL compared to the moderate group (P = 0.024) following GRS. In regards to environmental health, the high socioeconomic groups had significantly higher improvement in QoL compared to the low (P = 0.006) and moderate (P < 0.001) group after operation.ConclusionThe results demonstrate that GRS brings about improvements across all aspects of QoL. However, this enhancement is less pronounced among patients hailing from low socioeconomic backgrounds and rural areas.

Socioeconomic inequality in child health outcomes in India: analyzing trends between 1993 and 2021

BackgroundThe health of India’s children has improved over the past thirty years. Rates of morbidity and anthropometric failure have decreased. What remains unknown, however, is how those patterns have changed when examined by socioeconomic status. We examine changes in 11 indicators of child health by household wealth and maternal education between 1993 and 2021 to fill this critical gap in knowledge. Doing so could lead to policies that better target the most vulnerable children.MethodsWe used data from five rounds of India’s National Family Health Survey conducted in 1993, 1999, 2006, 2016, and 2021 for this repeated cross-sectional analysis. We studied mother-reported cases of acute respiratory illness and diarrhea, hemoglobin measurements for anemia, and height and weight measurements for anthropometric failure. We examined how the prevalence rates of each outcome changed between 1993 and 2021 by household wealth and maternal education. We repeated this analysis for urban and rural communities. ResultsThe socioeconomic gradient in 11 indicators of child health flattened between 1993 and 2021. This was in large part due to large reductions in the prevalence among children in the lowest socioeconomic groups. For most outcomes, the largest reductions occurred before 2016. Yet as of 2021, except for mild anemia, outcome prevalence remained the highest among children in the lowest socioeconomic groups. Furthermore, we show that increases in the prevalence of stunting and wasting between 2016 and 2021 are largely driven by increases in the severe forms of these outcomes among children in the highest socioeconomic groups. This finding underscores the importance of examining child health outcomes by severity.ConclusionsDespite substantial reductions in the socioeconomic gradient in 11 indicators of child health between 1993 and 2021, outcome prevalence remained the highest among children in the lowest socioeconomic groups in most cases. Thus, our findings emphasize the need for a continued focus on India’s most vulnerable children.

Temporal Trends in Air Pollution Exposure across Socioeconomic Groups in The Netherlands.

Air pollution exposure has been linked to detrimental health outcomes. While cross-sectional studies have demonstrated socioeconomic disparities in air pollution exposure, longitudinal evidence on these disparities remains limited. The current study investigates trends in residential air pollution exposure across socioeconomic groups in the Netherlands from 2014 to 2019. Our dataset includes over 12.5 million individuals, aged 18 years and above, who resided in the Netherlands between 2014 and 2019, using Statistics Netherlands data. The address-level air pollution concentrations were estimated by dispersion models of the National Institute of Public Health and the Environment. We linked the exposure estimations of particulate matter < 10 or <2.5 μm (PM10, PM2.5) and nitrogen dioxide (NO2) to household-level socioeconomic data. In highly urbanized areas, individuals from both the lowest and highest socioeconomic groups were exposed to higher air pollution concentrations. Individuals from the lowest socioeconomic group were disproportionally located in highly urbanized and more polluted areas. The air pollution concentrations of PM10, PM2.5, and NO2 decreased between 2014 and 2019 for all the socioeconomic groups. The decrease in the annual average air pollution concentrations was the strongest for the lowest socioeconomic group, although differences in exposure between the socioeconomic groups remain. Further research is needed to define the health and equity implications.

Overweight/obesity, pre-diabetes, diabetes and its association with hypertension and other factors among rural adults (≥18 years) in India

BackgroundNon-communicable diseases are important causes of morbidity and mortality throughout the world. MethodsA community-based cross-sectional study conducted in 10 Indian states using multi-stage random sampling procedures. Information was collected on socio-economic and demographic particulars, anthropometric measurements such as height, weight and waist circumference, fasting blood glucose and blood pressure was measured. One day 24-h dietary recall was done for foods and nutrient intakes. Bivariate and multivariate step-wise logistic regression analyses was done. ResultsThe prevalence of overweight/obesity among rural adults was 23.4 % (95 % CI: 22.9–23.9), while age adjusted prevalence of pre-diabetes was 8.4 % (95 % CI: 8.1–8.7) and diabetes was 6.8, (95 % CI 6.7–7.1), respectively. The prevalence of diabetes was lowest in Uttar Pradesh, West Bengal and Odisha (3–4%) and higher in Kerala and Tamil Nadu (12–15 %). The odds of diabetes was 5.5 times more among elderly, 1.3 times higher among Christians and among high income groups, and 2 times among overweight (CI: 1.50–2.50), obese (CI: 1.61–2.76) and abdominal obesity (OR; 1.57; CI: 1.29–1.91) and 1.6 times more among hypertensives. The odds of diabetes were high among those consuming the lower tertiles of carbohydrates, pulses, milk and milk products and folic acid. Conclusionthe age-adjusted prevalence of diabetes and pre-diabetes was 6.8 % and 8.4 % respectively and the odds of diabetes was high among elderly, among high socio-economic groups, overweight/obese subjects and among hypertensives. Also, knowledge about symptoms of diabetes was low. There is a need to improve awareness for early diagnosis and treatment for control of diabetes and hypertension.

Role of food choice motives in the socio-economic disparities in diet diversity and obesity outcomes in Kenya.

The increased prevalence of overweight and obesity, along with high diet diversity, is observed among higher socio-economic groups in Sub-Saharan Africa. One contributing factor to these observed variations is food choice motives. However, the role of these motives in explaining the observed differences has not been thoroughly explored in this context. This study investigates whether there are significant differences in food choice motives among socio-economic groups and whether these variations can partly explain the socio-economic disparities in diet diversity and overweight and obesity outcomes. This study utilizes cross-sectional data from four counties in Kenya: Kiambu, Murang'a, Uasin Gishu, and Nakuru. The survey employed a three-stage cluster sample design to gather data using structured questionnaires on food choice motives, diet diversity, and anthropometrics from 381 adults in 2022. The mediating effects of 8 food choice motives (health, mood, convenience, sensory appeal, natural content, price, weight control, and familiarity) were analyzed using the Karlson-Holm-Breen method. The results show that individuals with higher household incomes place greater importance on health, mood, sensory, and weight concerns. The probability of an overweight and obesity outcome increases by 19% for a standard deviation change in the asset score, and by 8% for a standard deviation change in the years of schooling. Sensory motives significantly mediated these relationships. Sensory motives explained 29% of the income-BMI association and 30% of the education-BMI relationship. Higher education was also associated with increased diet diversity (β = 0.36, P < 0.001) mediated by higher health and sensory concerns. The findings suggest significant differences in food choice motives among socio-economic groups, which contribute to outcomes such as overweight and obesity. Therefore, educational and other policies aimed at reducing obesity should also address food choice motives, while considering the disparities among socio-economic segments within populations.

STUDY OF PHYSIOLOGICAL AND BIOCHEMICAL VARIATIONS IN POPULATION GROUPS UNDERGOING ACUTE OR CHRONIC STRESS

Objective: Stress arises from derangements of personal and professional activities. The basic reason is changes in lifestyle and psychosocial adaptations. Life becomes demanding, complicated, mechanical, and devoid of health. In today’s modern world, occupational stress has become the major factor for loss of health and peacefulness of mind. Methods: This is an observational descriptive study which was conducted in a group of 84 people between 25 and 60 years of age to study the association of acute stress on salivary amylase level and effect of chronic stress on lipid profile, glycosylated hemoglobin and certain inflammatory markers in people representing different forms of stress. Three groups of the population were studied. Group 1 (n=20) - Patients undergoing any elective surgery (abdominal/genitourinary) or an invasive diagnostic procedure (upper GI endoscopy, lymph node biopsy) Group 2 (n=32) – High/middle socio-economic male or female working for ≥8 h/day with or without stress. Group 3 (n=32) – Low socioeconomic male or female earning &lt;100 Rs/day with or without stress. Salivary alpha-amylase and chromogranin A (CgA) levels are good markers of stress. Results: There was increased levels of cortisol (p&lt;0.0001), alpha amylase (p&lt;0.01), and decreased levels of CgA (p&lt;0.001) pre-procedure period as a marker of acute stress. In the chronic stress group of low income as well as high-income status, glycosylated hemoglobin, and blood lipid profile in both males and females were significantly deranged. Plasma malondialdehyde (MDA) levels and interleukin (IL)-1 and IL-2 were significantly raised in both groups. Serum ferritin level was low in the low socioeconomic group but normal in the high socioeconomic group. Conclusion: Salivary amylase level was raised in acute stress and there is a direct correlation of chronic stress with high low-density lipoprotein/ high-density lipoprotein ratio, raised glycosylated Hemoglobin, serum MDA, IL-1, 2 levels irrespective of economic group.

Socio-environmental factors contributing to the high incidence of COVID-19 in a border city in northern Uruguay

Background and Objectives: the present study was conducted in the city of Rivera, situated in northern Uruguay on the border with Brazil. The disease initially progressed slowly in 2020, with subsequent outbreaks followed by a rapid increase in incidence. The objective was to explore the relationship between the spatial distribution of COVID-19 cases in a binational city and variables such as socioeconomic status, population density, and mobility patterns, with the aim of informing public policies. Methods: an exploratory study was conducted between August 2020 and January 2021 using data obtained from the Ministry of Health. The explanatory variables considered included population density, socioeconomic level, and mobility. Three distinct periods from 2020 to 2021 were identified. Spatial autocorrelation was analyzed using Moran’s Index and the Gi* statistic (Getis &amp; Ord). Hierarchical cluster analysis was employed to identify homogeneous groups of census segments. Results: a total of 1,846 cases were georeferenced. Through hierarchical cluster analysis, seven homogeneous groups were identified. Mobility was found to explain the incidence of cases among the high socioeconomic level group, while population density accounted for the differences observed in the low socioeconomic group. Conclusion: in this city, priority should be given to populations residing in areas with higher population density and greater mobility. This small-scale territorial analysis provides valuable information for developing localized policies aimed at addressing health crises.

Prevalence, trends, and inequality in noncommunicable diseases in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys 2011 and 2017–2018

AbstractWe investigated the change of the prevalence of noncommunicable diseases (NCDs) in Bangladesh from 2011 to 2018 across different socioeconomic groups as well as the factors associated with the changes in prevalence. We used the two waves of the Bangladesh Demographic and Health Surveys conducted in 2011 and 2017–2018. Modified Poisson regression model was used to estimate the prevalence rate and ratio of NCDs and to test the association with different demographic and socioeconomic variables. The study found an upward trend of NCDs from 2011 to 2017 in which overweight and obesity, hypertension, and diabetes increased by 1.8, 1.5, and 1.1 times, respectively. In 2011, people from the richest households had 5.6 higher odds of being overweight compared to the poorest, which was reduced to 3.0 in 2017. However, the increment for overweight and hypertension was the highest among the poor and manual workers from 2011 to 2017. The age‐adjusted prevalence ratio of overweight increased 4.4 times for the poorest, compared to 1.7 times for the richest. For manual workers, overweight increased 3.8 times, whereas hypertension increased by 2.4 times. The pooled analysis revealed that participants from the richest households have the highest risk of NCDs, with 3.3 times for overweight, 2.3 times for diabetes, and 1.3 times for hypertension, compared to the poorest. However, the prevalence of NCDs is rising quickly among the low socioeconomic groups in Bangladesh, narrowing the gap with higher socioeconomic groups. Our findings call for immediate policy interventions and targeted programs to curb NCD escalation in Bangladesh.

Health Literacy Among Non-Communicable Disease Service Seekers: A Nationwide Finding from Primary Health Care Settings of Bangladesh.

Considering the health literacy status of service seekers is crucial while developing programs and policies to improve service delivery in primary health care settings. Our aim was to assess health literacy among adults seeking non-communicable disease (NCD)-related services in primary health care centers (PHC) of Bangladesh and identify its contributing factors and its preventive effect on risky behaviors. In this cross-sectional study, 2,793 NCD service seekers were interviewed face-to-face from eight rural and three urban PHCs selected by a multi-stage random sampling method. We used the European Health Literacy Survey Questionnaire to collect data on health literacy. We applied logistic regression analysis to identify the contributing factors related to adequate health literacy. Odds ratios were used to calculate the preventive fraction of health literacy for NCD risk behaviors. Limited health literacy was found among 43% of the respondents. Adequate health literacy was associated with younger age, male sex, having a formal education, living in an extended family, hailing from a high socioeconomic group, and attending urban PHC. After adjusting the sociodemographic factors, the prevalence of smoking, smokeless tobacco usage, and inadequate fruits and vegetables consumption among participants were found to be 25%, 51%, and 18% lower for people with sufficient health literacy. NCD service seekers have a high rate of inadequate health literacy. Adequate health literacy has the potential to lower the behavioral risk factors of NCDs. [HLRP: Health Literacy Research and Practice. 2024;8(1):e12-e20.].

Determinants of the low use of Thailand's Universal Coverage Scheme: a national cross-sectional study.

Thailand's Universal Coverage Scheme (UCS) has increased overall healthcare use by offering free healthcare for about 76% of the entire population since it was introduced in 2002. However, a considerable number of beneficiaries have continued to depend on private healthcare, and the low use of the UCS has been cited as a challenge to accomplishing the policy's goal of universal access to healthcare. Thus, this study divided healthcare use into three patterns (self-medication, private providers, and UCS) and investigated the socio-demographic characteristics of non-users of the UCS and their reasons for non-use. A cross-sectional quantitative analysis was performed using data from the 2019 Health and Welfare Survey. UCS beneficiaries aged 15 years or older who had used healthcare during the past month were included in the sample. Descriptive analysis and multinomial logistic regression were performed to analyze associations between patterns of healthcare use and socio-demographic factors chosen based on Aday and Andersen's access to medical care model. Of the study sample (n = 5,636), about 46.1% used healthcare services outside the UCS delivery system, of whom 33.8 and 12.3% used self-medication and private healthcare providers, respectively. Non-users generally had a higher socio-demographic status than UCS users. Specifically, they were young, had a high income, were employed, lived in urban areas, or did not have a chronic disease. The most common reason for non-use of the UCS was accessibility barriers (59.6%; e.g., long queues in public providers), followed by availability (25.4%; e.g., limited operating hours of public providers) and quality barriers (14%; e.g., unsureness of the quality of medicine offered by public providers). Moreover, self-medication users tended to be concerned about availability barriers, while private-provider users tended to be concerned about quality barriers for using the UCS. Under the UCS policy, there is a gap between the demands for healthcare and the resources assigned to increase the capability of public healthcare providers. That is, the UCS has increased financial accessibility for the use of the UCS (i.e., free healthcare from public providers). However, it probably has not yet increased healthcare resources and infrastructure facilitating the use of the UCS. This may have prevented the UCS from meeting the demands of its intended beneficiaries, especially those in high socio-economic groups, and ultimately forced them to use private healthcare.

Social stratifying Kazakhstan: A Bourdieusian social reproduction analysis of higher education internationalisation

This study addresses educational disparities faced by socioeconomically disadvantaged students, particularly in accessing international higher education in the post-Soviet region, focusing on Kazakhstan. While studies of social class formation in developing countries are inconclusive, the literature overwhelmingly shows that high socioeconomic groups dominate access to international education. In this qualitative study, we conducted semi-structured interviews and open-ended questionnaires with 98 undergraduate and graduate students who accessed English language degrees at home and abroad. We used Bourdieu’s conceptual tool of embodied, objectified, and institutionalised cultural capital to demonstrate how (1) educational resources in the home country, (2) English language proficiency, and (3) access to international English higher education function as pillars of social class reproduction. We argue that the process is skewed in favour of students from privileged classes and that the pursuit of meritocratic policies only reinforces elites’ capital accumulation and promotes social stratification.

Habits and the socioeconomic patterning of health-related behaviour: a pragmatist perspective

AbstractUnhealthy behaviours are more prevalent in lower than in higher socioeconomic groups. Sociological attempts to explain the socioeconomic patterning of health-related behaviour typically draw on practice theories, as well as on the concept of lifestyles. When accounting for “sticky” habits and social structures, studies often ignore individuals’ capacity for reflection. The opposite is also true: research on individual-level factors has difficulty with the social determinants of behaviour. We argue that the pragmatist concept of habit is not only a precursor to practice theories but also offers a dynamic and action-oriented understanding of the mechanisms that “recruit” individuals to health-related practices. In pragmatism, habits are not merely repetitive behaviours, but creative solutions to problems confronted in everyday life and reflect individuals’ relationships to the material and social world around them. Ideally, the pragmatist conception of habits lays the theoretical ground for efficient prevention of and effective support for behaviour change.

Evaluation of the prevalence of asthma and chronic obstructive pulmonary disease among opium users, and cigarette smokers and comparison with normal population in Kharameh: a cross-sectional study.

Recent studies have suggested that opium use may increase mortality from pulmonary diseases. However, there are limited comprehensive studies regarding the prevalence of Asthma and Chronic Obstructive Pulmonary Disease (COPD) among tobacco and opium users has been published. We aimed to determine the prevalence of respiratory disease among tobacco and opium users. This cross-sectional study of tobacco and opium users and matched controls was conducted in the Kharameh Cohort, Fars, Iran. The prevalence of COPD and asthma, along with the participants demographical and spirometry data were examined. The average age of participants was 57 ± 8 years. Never smokers had a significant higher BMI (26.6 vs. 24.8), FEV1 (91% vs. 82%) and FVC (96% vs. 88%) values compared to participants with a positive smoking status. There was a statistical difference in the prevalence of COPD, asthma, and asthma COPD overlap (ACO) based on the participants smoking status, with the highest prevalence among opium and cigarette smokers, followed by opium users alone. Based on multivariate analysis, higher age, lower BMI, lower education than under diploma, cigarette smoking and opium use were significantly correlated with higher COPD prevalence; while lower age, cigarette smoking and opium use were significantly correlated with higher asthma prevalence. Illiterate participants had a significantly higher prevalence of COPD (23.6%), asthma (22%), and ACO (7.9%) among the educational groups. Regarding the prevalence of asthma, the higher socio-economic group had the lowest prevalence. Opium and tobacco users had a significantly higher prevalence of respiratory diseases, along with lower lung function tests based on spirometry evaluation.