Higher Socioeconomic Status Groups Research Articles

The Inverted U-Shaped Relationship Between Socio-Economic Status and Infections During the COVID-19 Pandemic.

Although the World Health Organization has declared that the COVID-19 pandemic no longer qualifies as a global public health emergency, it still needs to explore the response of society to the COVID-19 pandemic. Socio-economic status (SES) was proven to be linearly associated with the COVID-19 pandemic, although this relationship may be more complex due to regional differences. In the study, we analyzed and revealed the effects and mechanisms of SES on infections among low, lower-middle, upper-middle and high SES group (LSG, LMSG, UMSG, and HSG, respectively). The results showed that the relationship between SES and infections was inverted U-shaped, especially in the first three phases. In Phase I, UMSG had the highest number of infections, with an average of 238.31/1M people (95%CI: 135.47-341.15/1M people). In Phases II and III, infections decreased insignificantly with increasing SES (r=-0.01, p=0.92; r=-0.11, p=0.22) and the highest number of infections were found in the LMSG. In Phase IV, SES was positively related to the number of infections (r=0.54, p<0.001). Furthermore, the nonlinear impact of multiple factors related to SES on the infections explains the complex relationships between SES and infections. SES affected infections mainly through medical resources, demographics and vaccination, and differed across the SES groups. Particularly, demographics could exert an impact on population mobility, subsequently influencing infections in LMSG, with an indirect effect of 0.01 (p<0.05) in Phase II. This study argues for greater attention to countries with middle SES and the need for future targeted measures to cope with infectious diseases.

Trends in mental health problems among Swedish adolescents: Do school-related factors play a role?

The aim of this study is to investigate the extent to which school-related factors, such as school liking, participation in decision-making, school-related parental support, teachers' support, and school physical environment, explain trends in mental health problems. The problems considered are psychosomatic symptoms (PSS), depressive symptoms (DS), suicidal ideations (SI), and suicide attempts (SA) among Swedish adolescents of varying socioeconomic status (SES) from 2004 to 2020. We analyzed data collected through repeated cross-sectional surveys from 19,873 15-year-old students at schools in a county in Sweden. Boys and girls each constituted 50% of the participants. We fitted linear and logistic regression models to investigate associations between the school-related factors and trends in mental health problems. Increased school-related parental support and school liking were cross-sectionally associated with decreased PSS, DS and SI, with school liking also associated with decreased SA. Conducive school physical environment was also found to be cross-sectionally associated with lower PSS and DS scores. Over time, mental health problems have shown a general increase among adolescents in the low SES group and a decrease among those in the high SES group. While school-related factors explained the improvement in mental health in the high SES group, we found such association only between parental support trends in PSS and DS, along with participation and trends in SA over time among adolescents in the low SES group. The results show that school-related factors play significant roles in influencing adolescent mental health. The influence, however, varied across SES gradients over time. This suggests that working against inequities in school-related factors would help address inequities in mental health.

Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020

BackgroundThe use of opioids has increased dramatically over the past several years in Israel. The aim of this study was to explore the trends of opioid consumption in Israel over a decade (2010–2020) stratified by socioeconomic status (SES), residence in the periphery, and ethnic background.MethodsThis cross-sectional study included all adult Maccabi Healthcare Services (MHS) patients who filled at least one prescription for opioids during the past decade. In order to standardize dosages and compare different opioid medications, we used the Morphine Milligram Equivalent (MME) conversion factor. We performed The Mann–Kendall test with autocorrelation correction to assess each trend. We then checked the differences between the trends with the Mann–Whitney test (for periphery) and the Kruskal Wallis (for SES and ethnic background).ResultsBetween the years 2010–2020, 261,270 MHS members met the study's inclusion criteria. The proportions of opioids consumption were 23.9/1000 patients in 2010 and 27.6/1000 patients in 2020, representing a 15% increase. The average daily consumption of opioids was 4.6 and 10.5 MME in 2010 and 2020, respectively, an increase of 227%. The daily MME during 2020 was higher for residents of the periphery compared to non-periphery residents (daily MME of 14.0 compared to 10.1, respectively). Average daily MME increased gradually during the study period for all levels of SES; the values were highest for the low SES group and the lowest for the high SES group (daily MME in 2020 for the lowest, middle, and high SES groups were 15.2 vs. 11.8 vs. 6.7 respectively).ConclusionsThis study highlights that the primary concern in the increase of opioid use is the increasing dosages. The increase in the number of patients using opioids is also significant but to a minor extent. These phenomena disproportionately impact vulnerable populations. Education programs should be offered to physicians regarding the possible harms of long-term use of opioids. These programs should emphasize the risk factors associated with the development of opioid use disorder (OUD) and the caution needed when increasing dosages or switching to higher-potency drugs. Pain clinics and centers for rehabilitation for patients with chronic pain or OUD should be available, not only in central areas but also in the periphery of the country. These clinics and centers should use a holistic approach and a multidisciplinary team that includes specialists in pain and addiction. They should be financially accessible for patients from low SES group and provide solutions in multiple languages.

Bridging the Knowledge Gap in Artificial Intelligence: The Roles of Social Media Exposure and Information Elaboration

This study examined how social media influence the knowledge gap between low and high socioeconomic status (SES) groups in artificial intelligence (AI), a highly debated scientific subject warranting immediate scholarly attention. A national survey of U.S. adults ( N = 965) was conducted. The results showed that education and social media exposure to AI information (SME) predicted greater AI knowledge, and SME did not moderate the SES-based AI knowledge gap. Furthermore, information elaboration moderated the association between SME and the AI knowledge gap. SME was associated with a smaller AI knowledge gap when information elaboration was high rather than low.

Welfare Euroscepticism and socioeconomic status

While the European Union (EU) increasingly strengthens its social integration, opposition towards this process can also be observed, here defined as ‘welfare Euroscepticism’. To better understand this newly defined policy paradigm, this article aims to explain longstanding cleavages in both social policy and EU research: socioeconomic status (SES) divides. Contrary to the literature on public support for European integration, this article argues that higher SES groups are more likely to be welfare Eurosceptics than lower SES groups. This argument and its underlying explanations are examined through a multilevel approach using European Social Survey data from 18 EU member states, using the example of a potential EU-wide minimum income scheme. First, the results demonstrate that welfare Euroscepticism is indeed more prevalent among higher SES groups than lower SES groups (measured through occupation, education, income, and employment). The results indicate robust self-interest patterns among higher SES groups that do not want to carry (perceived) financial burdens of EU social policies. The opinion patterns also emphasize the multidimensionality of attitudes towards EU policies since the SES cleavages can reverse, depending on the policy in focus. Overall, the results indicate much potential to mobilize the larger proportion of the public to support EU social policies, that is, lower SES groups. However, potential conflicts may arise when the EU expands on policies that their traditional supporters – higher SES groups – are more likely to oppose. The article also shows that welfare solidarity on the individual and the country level can mitigate such conflicts. This is because higher levels of welfare generosity and lower levels of welfare chauvinism on the individual and the country level are related to smaller SES cleavages.

Association of Socioeconomic Status With Worse Overall Survival in Patients With Bone and Joint Cancer.

The effect of socioeconomic status (SES) on the outcomes of patients with metastatic cancer to bone has not been adequately studied. We analyzed the association between the Yost Index, a composite geocoded SES score, and overall survival among patients who underwent nonprimary surgical resection for bone metastases. This population-based study used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results database (2010 to 2018). We categorized bone and joint sites using International Classification of Disease-O-3 recodes. The Yost Index was geocoded using a factor analysis and categorized into quintiles using census tract-level American Community Service 5-year estimates and seven measures: median household income, median house value, median rent, percent below 150% of the poverty line, education index, percent working class, and percent unemployed. Multivariate Cox regression models were used to calculate adjusted hazard ratios of overall survival and 95% confidence intervals. A total of 138,158 patients were included. Patients with the lowest SES had 34% higher risk of mortality compared with those with the highest SES (adjusted hazard ratio of 1.34, 95% confidence interval: 1.32 to 1.37, P < 0.001). Among patients who underwent nonprimary surgery of the distant bone tumor (n = 11,984), the age-adjusted mortality rate was 31.3% higher in the lowest SES patients compared with the highest SES patients (9.9 versus 6.8 per 100,000, P < 0.001). Patients in the lowest SES group showed more racial heterogeneity (63.0% White, 33.5% Black, 3.1% AAPI) compared with the highest SES group (83.9% White, 4.0% Black, 11.8% AAPI, P < 0.001). Higher SES patients are more likely to be married (77.5% versus 59.0%, P < 0.0001) and to live in metropolitan areas (99.6% versus 73.6%, P < 0.0001) compared with lower SES patients. Our results may have implications for developing interventions to improve access and quality of care for patients from lower SES backgrounds, ultimately reducing disparities in orthopaedic surgery.

The dilution effect of healthy lifestyles on the risk of cognitive function attributed to socioeconomic status among Chinese older adults: A national wide prospective cohort study.

Lower socioeconomic status (SES) is a risk factor for poor cognitive function, while a healthy lifestyle is associated with better cognitive function. We examined the complex relationship between SES and a healthy lifestyle and cognitive function among older Chinese adults. We used a national prospective cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008-18, aged 65 years and older with normal cognition at baseline. Participants were categorised into the favourable group if they had four to six healthy lifestyle factors and the unfavourable group for zero to three factors. SES was classified as higher and lower by assessing the socioeconomic vulnerability index (SEVI) with six components. Cognitive function was measured using the Mini-Mental State Examination (MMSE) scores and the standardised Z-scores. We applied the linear mixed effects and time-dependent Cox regression models to explore associations and further stratified the analysis by healthy lifestyles. A total of 6851 participants were included (the mean age was 80.87, 43.44% had a favourable lifestyle, and 49.29% had higher SES). Over the 10-year follow-up period, SES status and lifestyle profiles significantly affected the decline in the standardised Z-scores (P < 0.05). The higher SES group with favourable lifestyles exhibited a slower cognitive decline than those with lower SES (by 0.031 points per year, P < 0.05). The association was not observed in those in the unfavourable group (0.010 points per year, P > 0.05). During a follow-up, 25.06% of participants developed cognitive impairment (MMSE<18). We also observed a significant interaction between SES and healthy lifestyles (P < 0.05), with the corresponding associations of SES being more pronounced among participants with unfavourable lifestyles (hazard ratio (HR) = 0.821; 95% confidence interval (CI) = 0.701-0.960) than those with favourable lifestyles (HR = 1.006; 95% CI = 0.844-1.200). A healthy lifestyle may attenuate the adverse impacts of lower SES on cognitive function among older adults. This study might provide important information for protecting cognitive function, especially in low- and middle-income countries.

The Impact of Morphological Intervention on Literacy Knowledge and Reading Motivation: A Cluster-Randomized Comparison Trial in Diverse Socioeconomic Status Kindergartens.

This study investigated the effectiveness of a storytelling-based morphological intervention program on the language and literacy knowledge and reading motivation of kindergarten children from low and mid socioeconomic status (SES) backgrounds. It also explored how these groups compared in change scores against a non-intervened high SES group. Employing a cluster randomization approach, this study included 158 kindergarten children, comprising intervention and comparison groups from low and mid SES backgrounds, as well as a non-intervened high SES group. Assessments were conducted on morphological awareness (MA), print concepts, vocabulary, and reading motivation. Children in the intervention groups showed better performance in MA and print concept scores than those in their respective comparison groups. The mid SES intervention group also displayed significant improvement in vocabulary and motivation scores compared to its counterpart. When examining the effects of SES on change scores, the low SES intervention group achieved superior results in vocabulary and print concept scores compared to both the mid SES intervention and the non-intervened high SES groups. For reading motivation, the mid SES group outperformed the low SES group. The morphological intervention program using storytelling positively impacts both the literacy skills and reading motivation of kindergarten children, especially those from low and mid SES backgrounds. This study emphasizes the significance of designing interventions that cater to the distinct educational needs of children from different SES backgrounds.

The Influence of Race, Socioeconomic Status, and Physical Activity on the Mental Health Benefits of Sport Participation During COVID-19.

The purpose of this study was to compare the benefits of sport participation with no sport participation during the COVID-19 pandemic and determine the moderating effects of race and ethnicity, socioeconomic status (SES), and physical activity (PA) on mental health in adolescent athletes. Sport participation would be associated with greater improvements in mental health for athletes from racial and ethnic minority and lower SES groups compared with White and high SES groups. PA would mediate <30% of the mental health benefits of sport participation. Cross-sectional study. Level 4. In May 2021, adolescent athletes completed an online survey (demographics, sport participation, measures of anxiety and depression, PA). Participants were classified as those who played sports (PLY) and those who did not (DNP). Mental health symptoms for the PLY and DNP groups were compared via analysis of variance models that controlled for demographic variables. Moderating analyses assessed the interaction of sport participation status by (1) race and ethnicity (White/non-White) and (2) SES (high/low) with mental health. Mediation analyses assessed the degree that PA scores explained the differences in anxiety and depression between the 2 groups. Participants included 4874 adolescent athletes (52% female; age, 16.1 ± 1.3 years; PLY, 91%). Athletes who returned to sport from racial minority groups and low SES had greater decreases in anxiety (race and ethnicity: interaction estimate (b) = -1.18 ± 0.6, P = 0.04; SES, b = -1.23 ± 0.5, P = 0.02), and depression (race and ethnicity: b = -1.19 ± 0.6, P = 0.05; SES, b = -1.21 ± 0.6, P = 0.03) compared with White and high SES athletes, respectively. PA explained 24% of anxiety (P < 0.01) and 20% of depression scores (P < 0.01). Athletes who identify as a racial or ethnic minority and from areas of lower household income experienced disproportionately greater negative mental health impacts from sport restrictions during COVID-19. Improving access to sports in traditionally underserved areas may have significant mental health impact for adolescents.

Influence of Socioeconomic Status on the Presence of Obstructive Coronary Artery Disease and Cardiovascular Outcomes in Patients Undergoing Invasive Coronary Angiography.

This retrospective study investigated the impact of socioeconomic status (SES) on patients at high risk of cardiovascular disease, focusing on obstructive coronary artery disease (CAD) presence and long-term cardiovascular outcomes in individuals undergoing invasive coronary angiography (ICA). Analyzing data from 9530 patients categorized by health insurance type (medical aid beneficiaries (MABs) as the low SES group; national health insurance beneficiaries (NHIBs) as the high SES group), this research explores the relationship between SES and outcomes. Despite a higher prevalence of cardiovascular risk factors, the MAB group exhibited similar rates of obstructive CAD compared to the NHIB group. However, over a median 3.5-year follow-up, the MAB group experienced a higher incidence of composite cardiovascular events, including cardiac death, acute myocardial infarction, coronary revascularization, and ischemic stroke, compared with the NHIB group (20.2% vs. 16.2%, p < 0.001). Multivariable Cox regression analysis, adjusting for potential confounders, revealed independently worse clinical outcomes for the MAB group (adjusted odds ratio 1.28; 95% confidence interval 1.07-1.54; p = 0.006). Despite comparable CAD rates, this study underscores the fact that individuals with low SES encounter an elevated risk of composite cardiovascular events, emphasizing the association between socioeconomic disadvantage and heightened susceptibility to cardiovascular disease, even among those already at high risk.

Future Time Perspective, Beliefs, Strategies and Academic Achievement: Examining the Role of Socioeconomic Status

The primary objective of this research is to investigate the intermediary function of long-term self-regulation and perceptions of instrumentality in the correlation between Future Time Perspective (FTP) and academic achievement. Additionally, the study aims to explore the moderating impact of Socio-Economic Status (SES). The sample comprised 572 third-year high school students majoring in Science, selected through a meticulous stratified sampling process. Participants completed a comprehensive questionnaire encompassing the Future Time Perspective Scale (FTPS), Adolescent Self-Regulatory Inventory (ASRI), and Perceptions of Instrumentality (PI) Scale. SES was assessed in relation to parental education and household income indices, while academic achievement was gauged based on mean scores in three core courses: physics, chemistry, and biology. The study's conceptual model, as assessed through structural equation modeling, demonstrated a good fit for both high and low SES in the student cohorts. However, an analysis of the Chi-square for model fit revealed significant differences between the two groups, indicating non-identical structural relationships. Notably, in both groups, value and speed exhibited impacts on academic achievement, while the influence of connectedness varied between the groups. The research findings revealed that academic achievement in both groups was influenced by value through PI and by speed through long-term self-regulation. Connectedness affected academic achievement in both groups, but its impact was indirect through long-term self-regulation. Furthermore, in the high SES group, connectedness had a direct effect on academic achievement and also an indirect effect through PI. Interestingly, these direct and indirect effects were not statistically significant in the low SES group.

Characterization of the maternal serum inflammatory profile during pregnancy according to socioeconomic status.

In pregnancy, lower socioeconomic status (SES) is associated with adverse outcomes, which is partly attributed to chronic inflammation. Our study compared the maternal serum cytokine profiles in patients with low and high SES. This retrospective cohort study compared maternal serum cytokine profiles between Medicaid-insured patients who delivered at an urban safety-net hospital (low SES) and privately-insured patients who delivered at a community-based academic hospital (high SES) in Atlanta, GA (n=32-33/group). Serum samples were obtained during prenatal venipuncture from 13 to 38 weeks' gestation and the cohorts were matched by gestational age. Interferon (IFN)-γ, Interleukin (IL)-10, IL-1β, IL-4, IL-6, IL-8, and Tumor Necrosis Factor (TNF)-α were assayed from maternal serum samples using a standard ELISA assay. Median concentrations of IL-6, a promotor of chronic inflammation, were higher in the low SES group (0.85 vs. 0.49 pg/mL, p<.001), while median levels of IL-1β, a potent monocyte activator, and TNF-α, a master regulator of acute inflammation, were lower in the low SES group (0.09 vs. 0.46 pg/mL, p<.001, and 1.23 vs. 1.58 pg/mL, p=.002, respectively) as compared to the high SES group. After adjusting for maternal age, obesity, hypertensive disorders, and gestational age at delivery, the differences in IL-6 and IL-1β by SES persisted (p=.0002 and p<.0001, respectively). In this retrospective cohort study, there were significant differences in levels of pro-inflammatory cytokines during pregnancy for groups defined by SES, even after adjustment for confounding variables. Our data are foundational for further research to investigate SES-associated inflammation that may contribute to adverse pregnancy outcomes.

Trends in adolescent mental health problems and the role of lifestyle factors

Abstract Background Adolescent mental health problems are on the rise globally, including in Sweden. One indicator is an increase in psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the trends in PSS. However, we found limited research on such associations. Methods This study is based on data collected every four years from nationally representative samples of 15-year-old boys and girls in Sweden (N = 9,196, 50.5% girls), as part of the Health Behavior in School-aged Children (HBSC) study. PSS was measured using a scale developed from the HBSC symptom checklist. We analyzed the trends in PSS from 2002 to 2018 and fitted models to investigate the associations between the trends and lifestyle factors. We included interaction terms between time and each lifestyle factor and fitted separate models for the high and low socioeconomic status (SES) groups. Results In general, the mean scores for PSS increased from 2.26 in 2002 to 2.49 in 2018 (p&amp;lt;.001). Compared to the average mean scores during preceding years, the changes in PSS mean scores at each survey year were also significant in all years except 2010. More frequent breakfast intake, daily consumption of fruits and vegetables, and higher PA were associated with lower PSS mean scores while smoking and alcohol consumption had the opposite association. The only significant interaction (B = .050; CI: .015, ¬ .085; p&amp;lt;.01) was observed in the high SES group, indicating that the increasing trend in PSS was stronger among those who had been drunk once or more in a lifetime, compared to those who had never been drunk. Conclusions The results indicate increasing trends in mental health problems among young people in Sweden. Furthermore, the study revealed that alcohol drunkenness was associated with a more substantial rise in PSS over time among those in the high SES group. Further research is needed to understand the reasons behind these findings. Key messages • Psychosomatic complaints have increased among Swedish adolescents in recent decades. • Although alcohol drunkenness has significantly declined among Swedish adolescents, it was not sufficient to influence trends in psychosomatic symptoms among those in the high socioeconomic group.

Are there social inequalities in caesarean section rates in Europe?

Abstract Background Lower socioeconomic status (SES) is strongly associated with adverse perinatal health outcome, such as preterm birth and stillbirth. We investigated whether the caesarean section (CS) rate, which may reflect a greater prevalence of maternal health complications, was also higher in disadvantaged populations. Methods The study uses aggregate routine birth data from European countries collected with the Euro-Peristat federated analysis protocol. We analysed CS rates (total births by CS/total births) by SES from 2015 to 2020. Mothers’ education level (primary/lower secondary; upper secondary; postsecondary) was the preferred SES indicator; if unavailable, parents’ occupation or area-based deprivation scores were used and harmonised into three groups (low, medium, high). Results 17 countries provided data on maternal education, 5 on area-based deprivation, 1 on parents’ occupation. CS rates ranged from 16.7% (Lithuania) to 48.5% (Cyprus) in the low SES group and from 16.8% (the Netherlands) to 55.2% (Cyprus) in the high SES group. Patterns across SES groups were diverse, with greater use of CS in higher SES groups (Croatia: 19.6%, 24.1%, 26.7% and Ireland: 30.3%, 33.4%, 35.5% for low, medium and high SES respectively), whereas elsewhere, more disadvantaged SES groups had higher CS rates: Italy: 37.1%, 35.2%, 33.7%, Denmark: 22.0%, 21.9%; 19.8% and Luxembourg: 34.5%, 33.2%, 29.9%. In some countries, rates were similar across groups (France: 21.3%, 20.7%, 21.3% and the Netherlands: 17.2%, 17.0%, 16.8%). Risk ratios of CS in low versus high SES groups ranged from 0.74 (95% CI R0.70-0.77) in Croatia to 1.15 (95% CI 1.12-1.19) in Luxembourg. Conclusions Our results do not show that CS was consistently associated with social disadvantage. Instead, we found surprising variations in the SES gradient between countries, raising questions about CS practices and their interaction with maternal characteristics in European countries.

Socio-Economic study of the Beneficiaries and Non-Beneficiaries of Kisan Credit Card Scheme in Kannuaj District of Uttar Pradesh, India

The studies of socio-economic characteristics of farmers are important for better policy options. The Kannuaj district of Uttar Pradesh is also an agriculture dominated region. Approximately 70% of the rural population of Uttar Pradesh is engaged in primary sector but at present agriculture sector is facing lots of problems such as credit, irrigation HYVs and other capital equipments etc. Kisan Credit Card (KCC) scheme playing a significant role in the development of agriculture Sector because the objective of the scheme is to eliminate exploitations of the farmers by the moneylenders by providing the farmers loans at cheaper rates of Interest. Kisan Credit Card (KCC) is very useful policy for rural development because these policy as the only medium of short-term credit for agriculture. From the year 1998-99, the scheme was implemented by public sector commercial banks, RRBs (Regional Rural Banks) and cooperative banks in the country. The present paper is aimed to study role of Kisan Credit Card scheme in the rural credit facilitation and impact of KCC scheme on socio-economic status of beneficiaries and non-beneficiaries in Kannuaj district of Uttar Pradesh. It is found that 36.08 per cent beneficiaries were from high socio-economic status group while 43.03 per cent beneficiaries were from medium and 20.89 per cent were in low socio-economic status group. In non-beneficiaries, 27.32 per cent were from high socio-economic status group while 37.34 per cent non beneficiaries were from medium socio-economic status group. 35.44 per cent non beneficiaries were from lower socio-economic group.

Cognitive Neuroimaging Studies on Poverty and Socioeconomic Status Differences in Children and Families across the World: Translational Insights for Next Decade’s Policy, Health, and Education

This systematic review and meta-analysis of global peer-reviewed neuroimaging findings preliminarily assessed the magnitude of effect sizes (ES) of the influences of family poverty/low socioeconomic status (SES) on children’s neurocognition and whether these were consistently detrimental. The literature search (Web of Science; PUBMED; MEDLINE: PSYCNET; GOOGLE SCHOLAR; SCIENCEDIRECT) included 66 studies from 1988 to 2022; 85% of the studies included were conducted in Western, high-income nations. Bayesian models, corrected by study sizes and variances, revealed ESs were heterogeneous across countries and measurements. Bayesian and standard hypothesis testing indicated high and low SES groups showed similar behavioral performances in neuroimaging-concurrent tasks. Except for Magnetic Resonance Imaging studies, ESs were small-to-intermediate with modest reliability. The strongest ESs were found for attention, mathematical performance, language, and cortical volume, followed by intermediate ESs for reading and socioemotional processes. Differentials in resting activity and connectivity, working memory, and executive functions yielded small effects. A bibliometric analysis showed a significant proportion of the literature attributed neurocognitive deficits to low SES, despite overlooking the under-representativity of non-Western and low-income countries, potential influences of racial/ethnic differences, and measurement sensitivity/specificity discrepancies. To reach United Nations Sustainable Development Goals, policies and interventions should consider regional, structural, or environmental ecologies beyond the individual, critically probing implicit deficit attributions.

Speaking the language of market segmentation: How newsworkers describe their organization’s target audience

News organizations are placing a greater emphasis on knowing their audience as a route to facilitate engagement and generate revenue. Drawing on a national survey of individuals working for U.S. news organizations, we examine how newsworkers describe their organization’s target audience. Combining quantitative content analysis with a qualitative thematic analysis of open-ended survey responses, we find that the majority of U.S. newsworkers use some combination of demographics or psychographics to describe the audience for their work—representing a substantial uptake of marketing segmentation language compared to earlier research on how journalists understand their audiences. However, that marketing-like sophistication comes with a cost: Newsworkers' target audience descriptions are shaped by financial imperatives, emphasizing white, older, high socioeconomic status groups. These findings are discussed in terms of the journalism industry’s lack of diversity, suggesting that this issue also extends to the imagined target audiences of news media organizations.

Neighborhood socioeconomic status and length of stay after congenital heart disease surgery.

Socioeconomic factors are associated with health outcomes and can affect postoperative length of stay after congenital heart disease (CHD) surgery. The hypothesis of this study is that patients from neighborhoods with a disadvantaged socioeconomic status (SES) have a prolonged length of hospital stay after CHD surgery. Pre- and postoperative data were collected on patients who underwent CHD surgery at the University of Maryland Medical Center between 2011 and 2019. A neighborhood SES score was calculated for each patient using data from the United States Census Bureau and patients were grouped by high vs. low SES neighborhoods. The difference of patient length of stay (LOS) from the Society for Thoracic Surgeons median LOS for that surgery was the primary outcome measure. Linear regression was performed to examine the association between the difference from the median LOS and SES, as well as other third variables. The difference from the median LOS was -4.8 vs. -2.2 days in high vs. low SES groups (p = 0.003). SES category was a significant predictor of LOS in unadjusted and adjusted regression analyses. There was a significant interaction between Norwood operation and SES-patients with a low neighborhood SES who underwent Norwood operation had a longer LOS, but there was no difference in LOS by SES in patients who underwent other operations. Neighborhood SES is a significant predictor of the LOS after congenital heart disease surgery. This effect was seen primarily in patients undergoing Norwood operation.

Caloric reductions needed to achieve obesity goals in Mexico for 2030 and 2040: A modeling study.

In Mexico, obesity prevalence among adults increased from 23% in 2000 to 36% in 2018, approximately. Mexico has not defined short- or long-term obesity goals, obscuring the level of effort required to achieve a relevant impact. We aimed to explore potential obesity goals for 2030 and 2040 in Mexico and to estimate the required caloric reductions to achieve them. We obtained anthropometric and demographic information on the Mexican adult population (age ≥20 years) from the Health and Nutrition Surveys conducted in 2000, 2006, 2012, 2016, and 2018 (n = 137,907). Each survey wave is cross-sectional, multistage, and representative of the Mexican population at the national, regional, and urban/rural levels. Obesity prevalence was projected for 2030 and 2040 by combining population projections of energy intake by socioeconomic status (SES) with a weight-change microsimulation model taking into account individual-level information on sex, age, physical activity, and initial body weight and height. If current trends continue, Mexico's obesity prevalence is expected to increase from 36% (95% CI 35% to 37%) in 2018 to 45% (uncertainty interval [UI] 41% to 48%) in 2030 and to 48% (UI 41% to 55%) in 2040. Based on expert opinion, we identified 3 obesity goals scenarios: (1) plausible (38% in 2030 and 36% in 2040); (2) intermediate (33% in 2030 and 29% in 2040); and (3) ideal based on the average prevalence of Organization for Economic Co-operation and Development countries (OECD; 19%). We estimated the caloric reductions needed to achieve the goal scenarios using the microsimulation model. Obesity was projected to increase more rapidly in the low SES (around 34% in 2018 to 48% (UI 41% to 55%) in 2040), than in the middle (around 38% to 52% (UI 45% to 56%)), or high SES group (around 36% to 45% (UI 36% to 54%)). Caloric reductions of 40 (UI 13 to 60), 75 (UI 49 to 95), and 190 (UI 163 to 215) kcal/person/day would be needed to reach the plausible, intermediate, and the ideal (OECD) average scenarios for 2030, respectively. To reach the 2040 goals, caloric reductions of 74 (UI 28 to 114), 124 (UI 78 to 169), and 209 (UI 163 to 254) kcal/person/day would be required, respectively. Study limitations include assuming a constant and sedentary physical activity level, not considering cohort-specific differences that could occur in the future, and assuming the same caloric trends under no intervention and the obesity goal scenarios. To reach the 3 obesity goals in 2040, caloric reductions between 74 and 209 kcal/day/person would be needed in Mexico. A package of new and stronger interventions should be added to existing efforts such as food taxes and warning labels on non-nutritious food.

RWD26 Variation in Demographic Characteristics, Socioeconomic Status, Clinical Presentation and Selected Treatments in Mortality Among Patients with a Diagnosis of COVID-19 in the United States

COVID-19 infected over 150 million people and caused over 1 million deaths in the US. This study evaluates several variables thought to be associated with mortality risk in the COVID-19 population. The IQVIA longitudinal medical and pharmacy claims databases identified 17,682,111 patients with a COVID-19 diagnosis between 4/1/2020-4/30/2022 from a population of >277 million patients in the US. Patients were linked to Veritas Data Research fact-of-death records (90% complete compared to CDC reporting) and confirmed deaths were flagged. Confirmed mortality rates (CMR) were evaluated by age group, socioeconomic status (SES) using the Area Deprivation Index (v2.0, University of Wisconsin, 2015), co-morbidities and COVID-specific (approved and unapproved) treatments. Of the 563,744 patients (3.2%) identified as dead (3.67% in men, 2.85% in women overall), CMR was lowest in patients aged 0-17 (0.08%), highest in age 65-75 (5.92%) and >75 (16.40%). Patients in the lowest 40% of SES had CMR of 4.43% while in the highest 20% was 1.56%. Respiratory failure, pneumonia and sepsis were the most common acute diagnoses accompanying COVID-19 deaths in all SES. In patients with comorbid dementia or Alzheimer’s disease, CMR were 21.62% and 23.40% respectively. Additionally, congestive heart failure (15.79%), atrial fibrillation (15.50%), chronic kidney disease (15.30%) and COPD (12.19%) were associated with high CMR. Among patients receiving approved therapies, casirivimab/imdevimab and remdesivir had CMR of 1.41% and 12.63% respectively, while for those receiving unapproved therapies, ivermectin and hydroxychloroquine had CMR of 2.54% and 2.45%. Compared to the 1.1% case-mortality rate (Johns Hopkins 2023) among US COVID-19 patients, we found CMR exceeded 3% among those with a medical claim for COVID-19. Advanced age, dementia, and cardio-renal disease were associated with mortality. Patients with the lowest SES had approximately 3 times the confirmed mortality rate compared to those in the highest SES group.