Household Characteristics Research Articles

Addressing Barriers to Timely Orthopaedic Follow-up for Foot and Ankle Fractures After Emergency Department Visits.

Foot and ankle fractures present common challenges in emergency departments, warranting careful follow-up protocols for optimal patient outcomes. This study investigates the predictors of orthopaedic follow-up for these injuries after an emergency department (ED) visit. A retrospective observational study of 1450 patients seen in the ED with foot or ankle fractures from July 2015 to February 2023 was conducted. All included patients were discharged with instructions to follow-up with an orthopaedic provider. Demographic data, fracture details, and follow-up patterns were extracted from medical records. Social vulnerability was assessed using the Centers for Disease Control (CDC) Social Vulnerability Index. Univariate and multivariate analyses were performed to identify predictors of follow-up. A subgroup analysis comparing patients who followed up >7 days from ED presentation (ie, delayed follow-up) to those who followed up within 7 days of presentation was then performed. Statistical significance was assessed at P < .05. Overall, 974/1450 (67.2%) patients followed up with orthopaedics at an average time of 4.16 days. After risk adjustment, Medicaid coverage (odds ratio [OR] = 0.56, P = .018), increased overall social vulnerability (OR = 0.83, P = .032), and increased vulnerability across the dimensions of socioeconomic status (P = .002), household characteristics (P = .034), racial and ethnic minority status (P = .007), and household type and transportation (P = .032) were all associated with lower odds of follow-up. Phalangeal fractures were also associated with decreased odds of follow-up (OR = 0.039, P < .001), whereas ankle fractures were more likely to follow-up (OR = 1.52, P = .002). In the subgroup analysis, patients of older age (P = .008), non-white race (P = .024), motor vehicle accident (MVA) (P = .027) or non-private insurance (P = .027), those experiencing phalangeal fractures (P = .015), and those seen by an orthopaedic provider in the ED (P = .006) were more likely to present with delayed follow-up. Patients with increased social vulnerability and Medicaid insurance are less likely to seek follow-up care after presentation to the ED with foot and ankle fractures.

The Impacts of the Poverty Alleviation Relocation Program (PARP) on Households’ Education Investment: Evidence from a Quasi-Experiment in Rural China

Families’ education investment in their children is crucial for fostering and accumulating human capital among rural children in China. This study examines the impact of the Poverty Alleviation Relocation Program (PARP) on household education investment using panel data from a large-scale survey conducted in 16 counties across 8 provinces over three waves. Employing a staggered difference-in-differences (DID) method, we find a significant increase in average education investment per student in households following the PARP’s implementation, supported by multiple robustness tests. Mechanism analysis reveals that the increase is primarily driven by a higher household income and lower medical expenses among relocated families. Heterogeneity analysis shows notable variations based on relocation attributes and household characteristics, with stronger effects particularly observed for dispersed relocation, scattered resettlement, and household heads with over 6 years of education or in good health. The impact is sustained and strengthens with longer durations of relocation. Our findings offer valuable insights for enhancing rural household education investment.

Why Survey-Based Subjective Expectations Are Meaningful and Important

For decades, households’ subjective expectations elicited via surveys have been considered meaningless because they often differ substantially from the forecasts of professionals and ex-post realizations. In sharp contrast, the literature we review shows that household characteristics and the ways in which households collect and process economic information help us understand previously considered puzzling facts about their subjective expectations. In turn, subjective expectations contribute to explain heterogeneous consumption, saving, investment, and debt choices as well as different reactions by similar households to the same monetary and fiscal policy measures. Matching microdata on households’ characteristics with the price signals the same households observe, their subjective expectations, and their real-world economic decisions is crucial to establishing these facts. Our growing understanding of households’ subjective expectations inspires several theoretical and empirical research directions and begets the design of innovative and more effective policy instruments.

Assessing the Impact of Risk Factors on Vaccination Uptake Policy Decisions Using a Bayesian Network (BN) Approach

This study evaluates the propagation impact of three risk categories (hazard and exposure, socio-economic vulnerability, and lack of coping capacity) and their associated factors on vaccination uptake policy decisions in Pakistan. This study proposed Bayesian influence diagrams using expert elicitation and data-driven approaches. The Bayesian network (BN) approach uses the best policy algorithm to determine the expected utility of decisions. The study found that the government’s firm vaccine uptake decisions had a positive effect in Pakistan. The findings on hazard and exposure-related factors show that people living in rural areas were more susceptible to COVID-19 than people living in urban areas. Among socio-economic vulnerability factors, household characteristics were affected due to household economic situations, fear of using health facilities due to the spread of COVID-19, lack of public transportation services, food insecurity, a temporary halt in education, and weak governance, which affected the vaccination uptake decision. The factors linked with coping capacity show that the government’s financial assistance and development of digital platforms raised digital health literacy and increased vaccine uptake decision utility. The proposed methodology and results of this study can be used to develop contingency planning for any future potential pandemic situations.

Is Development Type a Determinant of College and Graduate Students’ Commute Time to School? The Case of Seoul Metropolitan Area

This study examines the impact of large-scale suburban new town development on the commuting time of college and graduate students in the Seoul Metropolitan Area. Household travel diary data from 2016 were analyzed to categorize residential areas and quantify the impacts on commute time to school. Multiple linear regression modeling is used to explore the relationships between development type, individual, and household characteristics and their impact on commute times. The results of the study show that students living in new urban areas have significantly longer commute times than those living in central Seoul, highlighting the differences that result from urban expansion policies targeting middle-class housing. These results suggest that the development of suburban new towns, which was intended to alleviate the housing shortage, has inadvertently lengthened the daily commute time of many students. Thus, a critical reassessment of suburban development strategies is needed to better balance the advantages of residential neighborhoods against the educational and living costs associated with increased travel time.

Conflict Governance between Protected Areas and Surrounding Communities: Willingness and Behaviors of Communities—Empirical Evidence from Tanzania

Under the dual pressures of climate change and human activities, the restrictions imposed by conservation policies, along with the increasing overlap between wildlife protected areas (PAs) and community living areas, have intensified the contradictions and conflicts between PAs and surrounding communities. Effective governance of such conflicts is particularly crucial to reconciling the contradictions between conservation and development. This study takes the Mikumi–Selous areas in Tanzania, Africa, as a case study. Through questionnaires and semi-structured interviews, it explores the current state of conflicts between PAs and communities in the study area and summarizes conflict governance measures. Moreover, this research focuses on identifying various factors that influence the conservation willingness and action of community residents, further validating the relationships between residents’ household characteristics, conservation costs and benefits, conservation cognition, willingness, and behaviors through empirical analysis methods. The results indicate that residents’ conservation cognition significantly positively impacts their conservation willingness and behaviors, while conservation willingness also positively affects their conservation behaviors. Additionally, it was found that conservation costs inhibit residents’ conservation willingness and behaviors. This study primarily explores, from a community governance perspective, the participation willingness and behaviors of core stakeholders in conflict governance, emphasizing the critical role of community involvement in achieving biodiversity conservation and coordinated community development and providing a new perspective for alleviating conservation and development issues.

Sense of community (SOC) in gated urban neighborhoods: Empirical insights from Accra, Ghana

ABSTRACT Despite gated communities becoming a prominent form of housing in the Global South cities, the extent to which these privatized neighborhoods foster a sense of community remains understudied. Most of the studies on sense of community are based on experiences from the Global North. To address this lacuna, this paper examines the extent to which residents of gated communities develop a sense of community and the different factors that are associated with this sense of community. We conducted regression analysis on cross-sectional survey data from Devtraco and Manet gated communities, to determine factors associated with a sense of community in these gated communities. Our findings demonstrate that residents of gated communities exhibit a stronger sense of community—shaped by different individual, household, and environmental characteristics. Interestingly, our study reveals that males have a higher sense of community compared to females. Age, length of residence, tenure status, household size, and proximity to community features were significant factors associated with sense of community. Our study adds to the extant literature on a sense of community among individuals living in gated communities in the Global South.

Predictors of accessing seasonal malaria chemoprevention medicines through non-door-to-door distribution in Nigeria

BackgroundIn Nigeria, seasonal malaria chemoprevention (SMC) is typically administered door-to-door to children under five by community medicine distributors during high transmission seasons. While door-to-door distribution (DDD) is exclusively employed in Nigeria as part of standard operating procedures of SMC programmes, some households access SMC through non-DDD channels, such as fixed-point distributions, health facilities, and private purchase. However, analysis of access to SMC medicines through non-DDD has been limited, with little evidence of its outcomes on adherence to the three-day complete course of SMC medicines and caregiver actions in the event of adverse reactions to SMC medicines.MethodsData were obtained from SMC end-of-round coverage surveys conducted in Nigeria in 2021 and 2022, including 25,278 households for the analysis. The proportion of households accessing SMC medicine through non-DDD and the distribution of various non-DDD sources of SMC medicines were described. Multivariate random-effects logistic regression models were performed to identify predictors of accessing SMC medicines through non-DDD. The associations between non-DDD, and caregiver-reporting of adherence to complete administration of SMC medicines and caregiver actions in the event of adverse reactions to SMC medicines were also assessed.ResultsLess than 2% (314/24003) of households accessed SMC medicines through non-DDD in the states surveyed. Over 60% of non-DDD access was via health facility personnel and community medicine distributors from different locations. Variables associated with non-DDD access included heads of household being born in the local state (OR = 0.68, 95% CI 0.47 to 0.90), households residing in the study state since the first cycle of the SMC round (OR = 0.39, 95% CI 0.17 to 0.88), households with high wealth index (OR = 1.36, 95% CI 1.01 to 1.82), and caregivers hearing about date of SMC delivery in the previous cycle (OR = 0.18, 95%CI 0.14 to 0.24). Furthermore, non-DDD was associated with reduced SMC adherence and higher caregiver non-reporting of adverse reactions to SMC medicines in children compared with DDD.ConclusionThis study provides evidence on the characteristics of households accessing SMC medicines through non-DDD and its potential negative outcomes on adherence to SMC medicine and adverse reaction reporting, underscoring potential implementation issues that may arise if non-DDD delivery models are adopted in SMC, particularly in places where DDD had been firstly used.

Determinants of School Dropouts and the Impact on Youth Unemployment: Evidence from Ethiopia

Despite significant youth school dropouts in Ethiopia, the household characteristics that contribute to dropouts and the impact of dropouts on youth unemployment remain unclear. To fill this gap, this study analyzes the factors that influence youth dropouts and evaluates the impact of dropouts on youth unemployment in Ethiopia using data from the 2019 World Bank Living Standards Measurement Study-Integrated Surveys on Agriculture. We employ endogenous switching regression to estimate the impact of youth dropouts on the likelihood that a household has unemployed youths and the number of unemployed youths in the household. The findings reveal that different parental characteristics such as age, education, and whether parents live together are negatively associated with the probability of youth dropouts, while households with a Muslim head are more likely to have school dropouts than Orthodox-headed households. Households who have multiple income sources, are located in rural areas, are located far from the school, and have disabled family members are also found to be more likely to have youth dropouts. In addition, our findings reveal that youth dropouts increase the probability of having unemployed youths in the household and raise the number of unemployed youths in the household. The study’s findings highlight the need for considering households’ characteristics and other factors associated with youth dropouts when developing educational interventions to reduce youth dropouts in Ethiopia. Furthermore, investment in parental education and infrastructural facilities such as roads and schools could reduce youth unemployment in Ethiopia, particularly in rural areas where public schools are the only option.

Early life ambient air pollution, household fuel use, and under-5 mortality in Ghana

IntroductionEnvironmental exposures, such as ambient air pollution and household fuel use affect health and under-5 mortality (U5M) but there is a paucity of data in the Global South. This study examined early-life exposure to ambient particulate matter with a diameter of 2.5 µm or less (PM2.5), alongside household characteristics (including self-reported household fuel use), and their relationship with U5M in the Navrongo Health and Demographic Surveillance Site (HDSS) in northern Ghana. MethodsWe employed Satellite-based spatiotemporal models to estimate the annual average PM2.5 concentrations with the Navrongo HDSS area (1998 to 2016). Early-life exposure levels were determined by pollution estimates at birth year. Socio-demographic and household data, including cooking fuel, were gathered during routine surveillance. Cox proportional hazards models were applied to assess the link between early-life PM2.5 exposure and U5M, accounting for child, maternal, and household factors. FindingsWe retrospectively studied 48,352 children born between 2007 and 2017, with 1872 recorded deaths, primarily due to malaria, sepsis, and acute respiratory infection. Mean early-life PM2.5 was 39.3 µg/m3, and no significant association with U5M was observed. However, Children from households using “unclean” cooking fuels (wood, charcoal, dung, and agricultural waste) faced a 73 % higher risk of death compared to those using clean fuels (adjusted HR = 1.73; 95 % CI: 1.29, 2.33). Being born female or to mothers aged 20–34 years were linked to increased survival probabilities. InterpretationThe use of “unclean” cooking fuel in the Navrongo HDSS was associated with under-5 mortality, highlighting the need to improve indoor air quality by introducing cleaner fuels.

Exploring farmer choices in Southern Togo: Utilizing a strategy game to understand decision-making in agricultural practices

CONTEXTAgriculture plays a vital role in African countries, driving economic growth, employment, and non-agricultural sector improvements. However, persistent food insecurity and poverty among smallholder families raise concerns. Land fragmentation compounds these issues, limiting agricultural productivity and pushing farmers towards off-farm activities, despite Africa's potential agricultural markets. OBJECTIVEThe study's focus is Donomadé, a remote village in southern Togo. This study pursues a dual objective. Firstly, it investigates how household characteristics, including family size and resource availability, influence farmers' resource management decisions. Secondly, the research employs serious games to comprehend farmers' livelihood strategy choices within constrained real-world-like conditions. METHODSThe iterative and participatory Companion Modelling (ComMod) approach was utilized for the co-design and co-development of a serious game. This involved close collaboration with a local research team from the University of Lomé, a local NGO, and Donomadé village farmers. Various farming systems were characterized, and collective insights into Donomadé's agricultural dynamics were gathered through surveys, interviews, and workshops. RESULTS AND CONCLUSIONSRegardless of their in-game roles, farmers prioritize fulfilling basic family needs, such as food security and education instead of investing in agriculture. The study underscores the significance of household composition and resource availability when designing technology interventions or support mechanisms for farmers. Aligning interventions with farmers' overarching goals and challenges can enhance technology adoption. Furthermore, addressing food security remains crucial for sustainable development, as it not only improves human welfare and alleviates hunger but also forms the foundation for comprehensive solutions in the face of climate change, resource constraints, and population growth. SIGNIFICANCEThis research highlights that heavy investment in agriculture is not the priority for many farmers in southern Togo, despite it being their main source of sustenance and income. Addressing immediate family needs, especially food security, education, and housing, takes precedence over long-term agricultural investments. Given the persistent challenge of food security amidst global uncertainties, addressing these priorities is paramount to stimulate more significant interest in agricultural investment.

The effects of mother's schooling on next generation’s schooling: evidence from Bangladesh

PurposeThis paper aims to find the effects of mothers’ schooling on child schooling.Design/methodology/approachThis paper uses Bangladesh's Household Income and Expenditure Survey (HIES), which is a nationally representative survey. It employs the instrumental variable technique to estimate the intergenerational model.FindingsInterestingly, the results show that the intergenerational transmission of schooling from mothers is slightly higher than that of fathers in Bangladesh.Research limitations/implicationsEstimating the intergenerational model is challenging due to the endogeneity issue. The methodology used in this paper may help to find similar evidence from other countries.Practical implicationsThe findings of the study may help to design and evaluate the educational policies in Bangladesh or a country like Bangladesh. For instance, the results of this paper suggest that the female stipend program (FSP) in Bangladesh is effective for the next generation’s schooling.Originality/valueThis paper is among the first to analyze the effect of mother’s schooling on the child’s schooling, controlling the father’s education and other household characteristics. In addition, it controls for endogeneity bias due to genetic transmission.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-06-2023-0491

Who is missed in a community-based survey: Assessment and implications of biases due to incomplete sampling frame in a community-based serosurvey, Choma and Ndola Districts, Zambia, 2022.

Community-based serological studies are increasingly relied upon to measure disease burden, identify population immunity gaps, and guide control and elimination strategies; however, there is little understanding of the potential for and impact of sampling biases on outcomes of interest. As part of efforts to quantify measles immunity gaps in Zambia, a community-based serological survey using stratified multi-stage cluster sampling approach was conducted in Ndola and Choma districts in May-June 2022, enrolling 1245 individuals. We carried out a follow-up study among individuals missed from the sampling frame of the serosurvey in July-August 2022, enrolling 672 individuals. We assessed the potential for and impact of biases in the community-based serosurvey by i) estimating differences in characteristics of households and individuals included and excluded (77% vs 23% of households) from the sampling frame of the serosurvey and ii) evaluating the magnitude these differences make on healthcare-seeking behavior, vaccination coverage, and measles seroprevalence. We found that missed households were 20% smaller and 25% less likely to have children. Missed individuals resided in less wealthy households, had different distributions of sex and occupation, and were more likely to seek care at health facilities. Despite these differences, simulating a survey in which missed households were included in the sampling frame resulted in less than a 5% estimated bias in these outcomes. Although community-based studies are upheld as the gold standard study design in assessing immunity gaps and underlying community health characteristics, these findings underscore the fact that sampling biases can impact the results of even well-conducted community-based surveys. Results from these studies should be interpreted in the context of the study methodology and challenges faced during implementation, which include shortcomings in establishing accurate and up-to-date sampling frames. Failure to account for these shortcomings may result in biased estimates and detrimental effects on decision-making.

Climate change adaptation and smallholder farmers welfare: Empirical evidence from the Sahelian Region of West Africa

Global climate change has threatened sustainable agricultural growth over the years, severely affecting food sufficiency and the livelihood of farmers. The Climate-Smart Agricultural Technologies (CSAT), as a form of adaptation, offer pathways for mitigating the negative effect of climate change on crop producers in developing countries. This study uses cross-country (Mali and Niger) cross-sectional data to examine the welfare (proxied by crop sales revenue and income) impact of multiple adoptions of CSAT on smallholder farm households. To control for potential endogeneity that leads to bias estimates, we employ the multinomial endogenous treatment effect (METE) model, complemented with the inverse probability weighted regression adjustment (IPWRA) for the analysis. The result reveals that household (education, location, and assets) and plot (plot size, plot topography, and soil fertility) characteristics, institutional factors (farmer-based organization, access to formal credit, and extension service) and crop disease shock significantly influence different combinations of CSAT adoption. The impact estimates show that adopting joint combinations of CSAT leads to higher crop sales revenue and income among the farmers in most cases. These findings suggest that the adoption of CSAT as a package should be encouraged and disseminated in the West Africa Sahel region. Moreover, some sociodemographic and institutional factors such as education, credit access, farmer-based organizations, and extension services could be strengthened for easy and rapid adoption of CSAT by smallholder farmers, which subsequently improves their economic welfare.

Geographical altitude and stunting among children aged under 5 years in India

IntroductionPrevious studies have found positive associations between higher geographical altitude and increased risk of stunting in children under 5 years old, but little evidence exists on this relationship in the...

Good agricultural practices (GAP) adoption intensity and production constraints in apple orchards of western Nepal

The declaration of ‘Fruits Decade 2016/17–2026/27’ and the enaction of the ‘NepalGAP Scheme’ by the Government of Nepal has redirected increased public investments to promote apple production and marketability in the western high hills of Nepal. This study explores major good agricultural practices (GAP) related to orchard management, factors influencing their adoption intensity, and key underlying constraints to production using cross-sectional survey data from apple growers in Dolpa district, Nepal. The results showed that farmers mostly adopted GAP such as frequent weeding, intercropping, and nutrient management in apple orchards. Based on the negative binomial regression estimates, household characteristics such as gender of the orchard owner, experience, and number of literate household members were found influential in determining the GAP adoption intensity. The analysis of the problem severity index implied that apple production is mostly constrained by limited access to production inputs and transportation. The findings provide useful insights to the farmers and policymakers regarding the current scenario of GAP adoption along with the diversity of barriers that severely limits the realization of apple production potential in western Nepal.

Household carbon monoxide (CO) concentrations in a large African city: An unquantified public health burden?

Carbon monoxide (CO) is a poisonous gas produced by incomplete combustion of carbon-based fuels that is linked to mortality and morbidity. Household air pollution from burning fuels on poorly ventilated stoves can lead to high concentrations of CO in homes. There are few datasets available on household concentrations of CO in urban areas of sub-Saharan African countries. CO was measured every minute over 24 h in a sample of homes in Nairobi, Kenya. Data on household characteristics were gathered by questionnaire. Metrics of exposure were summarised and analysis of temporal changes in concentration was performed. Continuous 24-h data were available from 138 homes. The mean (SD), median (IQR) and maximum 24-h CO concentration was 4.9 (6.4), 2.8 (1.0–6.3) and 44 ppm, respectively. 50% of homes had detectable CO concentrations for 847 min (14h07m) or longer during the 24-h period, and 9% of homes would have activated a CO-alarm operating to European specifications. An association between a metric of total CO exposure and self-reported exposure to vapours >15 h per week was identified, however this were not statistically significant after adjustment for the multiple comparisons performed. Mean concentrations were broadly similar in homes from a more affluent area and an informal settlement. A model of typical exposure suggests that cooking is likely to be responsible for approximately 60% of the CO exposure of Nairobi schoolchildren. Household CO concentrations are substantial in Nairobi, Kenya, despite most homes using gas or liquid fuels. Concentrations tend to be highest during the evening, probably associated with periods of cooking. Household air pollution from cooking is the main source of CO exposure of Nairobi schoolchildren. The public health impacts of long-term CO exposure in cities in sub-Saharan Africa may be considerable and should be studied further.

Modelling interest in co-adoption of electric vehicles and solar photovoltaics in Australia to identify tailored policy needs

Electric vehicles (EVs) and solar photovoltaic systems (PVs) are two technologies that are gaining popularity in households as a means of reducing carbon emissions and improving energy security. However, little is known about the characteristics of households that adopt these technologies jointly. This study investigates the adoption patterns of electric vehicles and solar photovoltaics in Australia. We explain the likelihood of consumers belonging to four distinct groups (those who adopt both PVs and EVs, those who only adopt EVs, those who only adopt PVs, and those who adopt none) based on demographic and attitudinal factors. Using survey data from a representative sample of 2219 Australian heads of households, we found that dwelling ownership, ownership of a home energy management system, gender, and household size were significant predictors of the joint adoption of EVs and PVs. While both pro-environmental and pro-technology attitudes demonstrated a significant role in shaping PV-EV co-adoption patterns, the latter has a much stronger effect than the former. Based on the results, we identified that actions are needed in three key areas to encourage co-adoption: reducing technology adoption constraints associated with living arrangements (such as dwelling type and ownership), providing bundled financial incentives for both technologies, and fostering technology awareness and perceived usefulness among consumers.

The Roles of Housing and Household Characteristics in U.S. Residential Heat Risk

This study uses data from the 2020 nationally-representative U.S. Residential Energy Consumption Survey (RECS) to analyze the under-explored relationship between housing type, household characteristics, and two novel heat health risk measures. We use a combination of descriptive analysis and logistic regression models. The results show that renters and residents of lower-cost housing types – multifamily and manufactured housing – are much more likely to keep their homes at unhealthy temperatures and require medical attention due to hot indoor temperatures. We also find stark disparities in heat risk for households with lower incomes, seniors, and Black, Native American, multiracial, and Hispanic households.

The impact of accredited social health activists in India on uptake of modern contraception: A nationally representative multilevel modelling study

ABSTRACT The government of India introduced the Accredited Social Health Activist (ASHA) programme in 2006 to connect marginalised communities to the health system. ASHAs are mandated to increase the uptake of modern contraception through the doorstep provision of services. There is currently no evidence on the impact of ASHAs on the uptake of contraception at the national level. This paper examines the impact of ASHAs on the uptake of modern contraception using nationally representative National and Family Health Survey data collected in 2019–21 in India. A multilevel logistic regression analysis was performed to determine the effect of contact with ASHAs on the uptake of modern contraception, controlling for regional variability and socio-demographic variables. The data provide strong evidence that ASHAs have succeeded in increasing modern contraceptive use. Women exposed to ASHAs had twice the odds of being current users of modern contraception compared to those with no contact, even after controlling for household and individual characteristics. However, only 28.1% of women nationally reported recent contact with ASHA workers. The ASHA programme should remain central to the strategy of the government of India and should be strengthened to achieve universal access to modern contraception and meet sustainable development goals by 2030.