Household Income Groups Research Articles

ANALISIS KETAHANAN PANGAN RUMAH TANGGA PETANI LAHAN KERING DI KABUPATEN SUMBAWA: SUATU TINJAUAN PROPORSI PENGELUARAN PANGAN

Food security is an important issue in agricultural development in developing countries where the majority of the population depends on the agricultural sector. Poor households have low purchasing power, resulting in access to low quality food and unbalanced food consumption patterns. The aim of this research is to analyze the level of food security of dry land farming households in Sumbawa Regency. The research was conducted in Alas Barat District, Sumbawa Regency, from April to July 2023. The respondents used were 55 farming households who were determined based on the Slovin formula. The data collection technique was carried out using an accidental sampling survey method. Data were analyzed using income analysis and food security analysis based on the ratio approach of the share of food expenditure to total expenditure of farmer households. Analysis of food security is also seen from the aspects of household distribution and income groups. The results of the research show that farmers in the research location are declared as food secure farming households. Based on the distribution, there were 15 farmers who were declared as food insecure households (27.27%). Meanwhile, 40 households (72.73%) were declared food secure farmers. Based on income group, of the 12 high-income farmers, 41.67 percent of them were in the food insecure category.

National Trends in the Prevalence of Screen Time and Its Association With Biopsychosocial Risk Factors Among Korean Adolescents, 2008–2021

PurposePrior studies suggested an increase in screen time among adolescents during the COVID-19 pandemic; however, due to limited sample size and a short-term observation period, these associations are inconclusive and inconsistent. Thus, we aimed to compare screen time during the pandemic and the long-term trend through a Korean large-scale and long-term study of one million adolescents. MethodsData from 2008 to 2021 on 913,191 Korean adolescents aged 12–18 years were obtained via a nationwide, large-scale, and serial study. We investigated the change of screen time use over time and the change in trend before and during the pandemic (2008–2019 vs. 2020–2021) by using weighted linear regression model with estimates of β-coefficients and 95% confidence intervals (CIs). Moreover, we analyzed the differences in vulnerability of biopsychosocial factor before and during the pandemic. ResultsA total of 913,191 adolescents were included in this analysis. During the pandemic, the overall screen time of Korean adolescents significantly increased compared to the expected based on the prepandemic period during the pre–COVID-19 period (weighted screen time before the pandemic [133.24 min/day; 95% CI, 132.08–134.40] vs. during the pandemic [303.66 min/day; 95% CI, 300.59–306.73]; βdiff 0.331; 95% CI, 0.311–0.351). Comparing before and during the pandemic, potential risk factors associated with screen exposure included female sex, sadness, suicidal thoughts, alcohol consumption, low educational level of parents, low level of vigorous physical activity, middle school students, and low household income. DiscussionThrough large-scale nationwide study, this study described the 14-year trend of screen time among Korean adolescents. In the era of COVID-19, the prevalence of screen exposure has been increasing more rapidly than before at the population level. Also, the pandemic amplified the differences in screen time across grade, sex, sadness, suicidal thoughts, smoking, alcohol consumption, education level of parents, physical activity, and household income groups.

Sex and Age Differences in the Association Between Social Determinants of Health and Cardiovascular Health According to Household Income Among Mongolian Adults: Cross-Sectional Study.

Although social determinants of health (SDH) are an underlying cause of poor cardiovascular health (CVH), there is insufficient evidence for the association between SDH and CVH, which varies by sex and age among Mongolian adults. We aimed to explore whether education, household income, and health insurance were associated with CVH according to sex and age among Mongolian adults. The final sample included data on 5691 participants (male: n=2521. 44.3% and female: n=3170, 55.7%) aged 18-69 years from the 2019 World Health Organization STEPwise approach to noncommunicable disease risk-factor surveillance. CVH was measured using a modified version of Life's Simple 7 with 4 health behaviors (cigarette smoking, BMI, physical activity, and a healthy diet) and 3 biological factors (blood pressure, fasting glucose, and total cholesterol blood levels) and classified into poor, intermediate, and ideal levels as recommended by the American Heart Association. Multinomial logistic regression analyses examined the associations between SDH and CVH by monthly equivalized household income after adjusting for age, sex, work status, area, history of myocardial infarction or stroke, use of aspirin, and use of statin. Subgroup analyses were conducted to examine the associations between SDH and CVH based on sex and age, considering monthly equivalized household income as a key variable. Using the ideal level of CVH as a reference, among those with the lowest household income, having less than 12 years of education, and not having health insurance were associated with poor CVH (education level: odds ratio [OR] 2.42, 95% CI 1.30-4.51; P=.006; health insurance: OR 2.17, 95% CI 1.13-4.18; P=.02). These associations were more profound among female individuals (education level: OR 2.99, 95% CI 1.35-6.63; P=.007; health insurance: OR 2.54, 95% CI 1.09-5.90; P=.03) and those aged 18-44 years (education level: OR 3.22, 95% CI 1.54-6.72; P=.002; health insurance: OR 2.03, 95% CI 0.98-4.18; P=.06). Participants in the lowest household income group with lower educational levels and without health insurance were more likely to have poor CVH, and these results were more pronounced in female individuals and young adults. These findings suggest the need to develop strategies for CVH equity in Mongolian female individuals and young adults that consider income levels, education levels, and health insurance.

Unraveling the Link: Cannabis Use Disorder and Pulmonary Embolism-Related Hospital Outcomes in Female Breast Cancer Survivors

Background: The use of cannabis in cancer patients has gained significant attention due to its analgesic properties, which help alleviate cancer-related pain. Studies have also shown the interference of cannabis with the coagulation system. We aimed to study the impact of cannabis use disorder (CUD) and Pulmonary embolism (PE) on outcomes in female breast cancer survivors, considering reports suggesting significant overlap between recreational and medicinal use. Our objective was to compare outcomes in CUD+ (with cannabis use disorder) and CUD- (without cannabis use disorder) cohorts to gain critical insights into this group and understand the impact of CUD on PE-related hospitalization and outcomes. Methods: National Inpatient Sample (NIS) data from 2020 was utilized in order to analyze inpatient cohorts of PE hospitalizations. The International Classification of Diseases 10 (ICD 10) codes for pulmonary embolism, cannabis use disorder, and female breast cancer were utilized to classify cohorts. All cases of female breast cancer and pulmonary embolism with an age >18 years were included in the final analysis. The primary outcome was the impact of CUD on PE-related hospitalizations in female breast cancer survivors. We also compared demographic correlations and comorbidities affecting outcomes between cohorts. Results: This study included a total of 508065 admissions among breast cancer survivors, with a median age of 74 years for the entire cohort. The prevalence of PE admissions was lower in CUD+ cohort compared to CUD- cohort (1.3% vs. 2.1%). The CUD+ cohort was relatively younger (median 66 vs 74 years, p<0.001). Overall, admission rates were higher among white patients (77%) and this trend was statistically significantly higher in the 76-100 th percentile household income group (p<0.002) compared to CUD+(50%) and CUD-(26.5%). Most admissions were non-elective (95.4%), with no statistical significance between CUD- and CUD+ patients (p=0.16). The majority of readmissions occurred in urban teaching hospitals (75.5%), with no significant difference observed between CUD- and CUD+ patients (p=0.111). Regionally, the South had a higher admission rate (37.2%) compared to other regions and this difference was statistically significant (p<0.001) between CUD- and CUD+ patients. Among the coexisting comorbidities, hypertension showed a significant difference between CUD- (70%) and CUD+(37.5%) patients (p<0.001). Alcohol use disorder (p<0.001) and cancer (p<0.001) had significant associations with CUD+, along with prior myocardial infarction (p=0.005) and drug use (p<0.001) were significantly associated with CUD+.Furthermore, there was difference in routine patient disposition between between CUD-(45.3%) and CUD+(37.5%),(p=0.033) and length of stay (4 VS 2 days), (p=0.033) and cost of stay (47033 vs 27668 $), (p=0.017). The multivariable logistic regression analysis showed that the odds of PE-related hospitalization in CUD+ vs CUD- cohorts among female breast cancer survivors were not statistically significant, with an OR of 0.79 (CI: 0.38-1.62, p=0.512). Subgroup analysis by age demonstrated no statistically significant differences in odds for PE-related hospitalization between CUD+ and CUD- cohorts. For the age group of 18-44 years, the OR was 1.37 (CI: 0.18-10.60, p=0.762). In the 45-64 years age group, the OR was 0.48 (CI: 0.15-1.53, p=0.215), and for those aged ≥65 years, the OR was 1.32 (CI: 0.48-3.67, p=0.590). Furthermore, the analysis by race indicated that the odds of PE-related hospitalization did not reach statistical significance in both white and black female breast cancer survivors with CUD. For white patients, the OR was 0.64 (CI: 0.23-1.73, p=0.375), while for black patients, the OR was 1.15 (CI: 0.38-3.46, p=0.804). Conclusion: Among female breast cancer survivors, the presence of CUD did not show a statistically significant impact on the odds of PE-related hospitalization. Subgroup analysis by age and race also revealed no significant differences in the odds of PE-related hospitalization between CUD+ and CUD- cohorts. These findings underscore the importance of considering CUD when managing pulmonary embolism in breast cancer survivor females and emphasize the need for further research to understand the complex interplay between these factors.

Characteristics of dietary intakes including NOVA foods among pre-adolescents living in urban Kuala Lumpur – Findings from the PREBONE-Kids study

Introduction: Evidence showed considerable variability of health risk factors within different socioeconomic groups. This study aimed to characterise dietary intakes by total household income among a sample of Malaysian pre-adolescents in urban Kuala Lumpur. Methods: Baseline data of 243 healthy, pre-adolescent children between 9 and 11 years old including socio-demographic background (gender, ethnicity, and total household monthly income), anthropometry (body weight and height), and 7-day diet histories were collected. Secondary analysis was performed on dietary intakes to quantify food groups based on the Malaysian Dietary Guidelines and NOVA classification systems besides nutrients. Differences and associations between total monthly household income categories with anthropometry and dietary intakes were tested using independent t-test/Mann-Whitney U (depending on normality) and chi-square tests, respectively. Results: Most children in this study population had dietary intakes below the recommended serving sizes for five food groups, except meat/poultry (195.2±107.2%) and fish (110.1±106.3%) and consumed about 32% of energy from ultra-processed foods (NOVA food group 4). While there was no difference in dietary intake between the bottom 40% with the middle 40% and high 20% household income groups, the percentage of energy contributed by NOVA food group 4 (processed fats/oils, condiments, and sauces) was higher in the bottom 40% households (p=0.024). Conclusion: Most pre-adolescent children in this study, regardless of household income, did not meet dietary recommendations and ate diets comprised of less nutritious foods. Comprehensive approaches that aim to improve dietary patterns and reduce the risk of diet-related chronic diseases are warranted.

Association between dietary potassium intake and severe headache or migraine in US adults: a population-based analysis.

Migraine is a prevalent neurovascular headache disorder. The link between dietary potassium and blood pressure has been established. We sought to delineate the relationship between dietary potassium intake and the prevalence of migraines. We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2004, comprising 10,254 participants aged ≥20 years. Participants who reported severe headaches or migraine in the self-report questionnaire were identified as migraineurs. A 24-h dietary recall methodology was used to assess dietary potassium intake. Multivariate regression analysis and restricted cubic spline (RCS) modeling were utilized to elucidate the relationship between dietary potassium and migraines. Among the 10,254 participants, 20.1% were identified with migraine or severe headaches. The adjusted odds ratio (OR) for migraine occurrence in the Q2 dietary potassium intake (1771-2,476 mg/d) was 0.84 (95% CI: 0.73-0.97, p = 0.021) compared to the lowest quartile (Q1, ≤ 1771 mg/d). The relationship between dietary potassium and migraine exhibited an L-shaped pattern (non-linear, p = 0.016) with an inflection at approximately 1439.3 mg/d. In the subgroup analysis, when compared to Q1, who had the lowest dietary potassium intake, the adjusted OR for Q2 in females, those in the medium-high household income group, and with a Body Mass Index (BMI) ≥ 25 kg/m2 were as follows: (OR, 0.82; 95% CI, 0.69-0.98), (OR, 0.79; 95% CI, 0.66-0.95), and (OR, 0.78; 95% CI, 0.66-0.93), respectively. No significant interaction was observed across groups after adjusting for all possible covariates. The relationship between dietary potassium intake and migraine prevalence among US adults appears to follow an L-shaped curve.

Household consumption and indebtedness: Are there disparities between genders, rural–urban areas, and among income groups?

Recently, household debt has been steadily increasing across the globe. Household consumption is an essential factor in household debt, along with households' characteristics, such as their location, the gender of the household head, and their income group. Therefore, this research investigates the disparities in the impacts of households' characteristics on their indebtedness and consumption. The study utilizes the Household Expenditure and Income Survey conducted in 2019 by the Department of Statistics of Malaysia, which included a simple random sample of 4,730 households. A simultaneous equations model is the employed method of analysis, and the results reveal that the gender of the household head, residential areas, and income groups have differential effects on household consumption and indebtedness through predetermined variables. Specifically, results show that indebtedness has a negative effect on household consumption for the middle-income group (M40); savings are negatively associated with consumption for households living in rural areas and the M40 group. Furthermore, income is positively associated with consumption for rural households and when the household head is female. Finally, household size also has a positive effect on consumption.

Data-driven analysis of influential factors on residential energy end-use in the US

Decarbonizing the residential buildings sector is important to realize a net-zero future. However, little research comprehensively explores how residential energy by end-uses, i.e., space heating, space cooling, water heating, and appliances, vary across different climate, building, and occupant characteristics. Therefore, based on Residential Energy Consumption Survey 2015, this study investigates how these energy end-uses correlated with different influential factors, i.e., climate, demographics, housing and appliance features. Recursively random forest regression and partial dependency plots were employed to analyze and quantify the impact of influencing factors on end-use energy usage. The developed models illustrate nonlinear and varying impacts of influential factors on different end-uses, with R-square from 0.481 (appliance) to 0.885 (space cooling). Specifically, housing size and climate are determinant factors of space heating/cooling, while family size and total appliance number determine water heating and appliance usage, respectively. Use frequency, size, and vintage of appliances (e.g., refrigerator, laundry) affect appliance energy consumption. Furthermore, one-way ANOVA confirms the statistically significant differences in energy consumption across varying household income groups, i.e., households with higher incomes consume more energy. Houses with older vintages use more total energy, especially in space heating, while less in cooling due to lower penetration of air conditioners. Finally, the analysis proves that residential end-use electrification, mainly space heating and water heating, is beneficial for energy efficiency. The findings contribute to understanding influential factors on different end-uses in households, which from a holistic level informs the potential pathway for building decarbonization, especially targeting at specific end-uses or occupant groups.

Unequal burdens of COVID-19 infection: a nationwide cohort study of COVID-19-related health inequalities in Korea.

While the Korean government's response to the coronavirus disease 2019 (COVID-19) pandemic is considered effective given the relatively low mortality rate, issues of inequality have been insufficiently addressed. This study explored COVID-19-related health inequalities in Korea. Age standardization for various health inequality indices was derived using data from the Korean National Health Insurance Service, the Korea Disease Control and Prevention Agency, and the Microdata Integrated Service of Statistics Korea. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for socioeconomic variables, while absolute difference (AD) and relative difference (RD) were used for gender and disability inequalities. We observed a number of COVID-19-related health outcome inequalities. Gender inequality was particularly noticeable in infection rates, with the rate of women 1.16 times higher than that of men. In contrast, socioeconomic inequality was evident in vaccination rates, with a 4.5-fold (SII, -4.519; 95% confidence interval, -7.403 to -1.634) difference between the highest and lowest household income groups. Regarding clinical progression post-infection, consistent findings indicated higher risk for men (RD for hospitalization, 0.90; severe cases, 0.54; and fatality, 0.65), individuals with disabilities (RD for hospitalization, 2.27; severe cases, 2.29; and fatality, 2.37), and those from lower socioeconomic groups (SII for hospitalization, 1.778; severe cases, 0.089; and fatality, 0.451). While the infection risk was nearly ubiquitous, not everyone faced the same level of risk post-infection. To prevent further health inequalities, it is crucial to develop a thoughtful policy acknowledging individual health conditions and resources.

Substance Use Disorders (SUDs) and Risk of Cardiovascular Disease (CVD) and Cerebrovascular Disease (CeVD): Analysis of the Nationwide Inpatient Sample (NIS) Database.

Substance use continues to be on the rise in the United States and has been linked to new onset cardiovascular diseases (CVDs) and cerebrovascular disorders (CeVDs). We aimed to study the association between the types of substance use disorders (SUDs) with specific subtypes of CVDs and CeVDs among hospitalized patients using the National Inpatient Sample (NIS) Database. A retrospective study of the NIS database (2016-2017) using the ICD-10-CM codes was performed. The hospitalizations with a secondary diagnosis of SUDs were identified. Weighted univariate analysis using the Chi-square test and multivariate survey logistic regression analysis was performed to evaluate for the incidence, prevalence, and odds of association between vascular events and SUDs. There were a total of 58,259,589 hospitalizations, out of which 21.42% had SUDs. SUDs were more common in the younger age group of 18-50, males, and the lower median household income group. We found a significant association of acute ischemic stroke (AIS) with amphetamine dependence (adjusted odds ratio, aOR 1.23, 95% confidence interval, CI 1.14-1.33), cocaine-related disorders (1.17, 1.12-1.23), and nicotine dependence (1.42, 1.40-1.43). There was a significant association between intracerebral hemorrhage with amphetamine dependence (2.58, 2.26-2.93), cocaine-related disorders (1.62, 1.46-1.79), and alcohol-related disorders (1.35, 1.01-1.82). The association of subarachnoid hemorrhage (SAH) was noted to be higher with amphetamine dependence (1.82, 1.48-2.24) and nicotine dependence (1.47, 1.39-1.55). The patients with nicotine dependence had greater odds of having a myocardial infarction (1.85, 1.83-1.87), those with cocaine-related disorders had higher odds of having angina pectoris (2.21, 1.86-2.62), and patients with alcohol-related disorders had higher odds of developing atrial fibrillation (1.14, 1.11-1.17) in comparison to non-SUDs. Our study demonstrates the variability of CVD and CeVD in patients hospitalized for SUD. Findings from our study may help promote increased awareness and early management of these events. Further studies are needed to evaluate the specific effects of frequency and dose on the incidence and prevalence of CVD and CeVD in patients with SUD.

A Study on Income Inequality and Nutritional Status of Children in Rural Areas of Jammu and Kashmir: Evidence from Jammu District, India

Children nutritional status is a powerful indicator of nutrition security and well-being of individual and reflects the nutritional and poverty situation of household. Good nutritional status of children under five years of age is very crucial for the foundation of a healthy life. This study is a small attempt to highlight the extent of malnutrition in rural areas of Jammu district on the basis of households’ economic status. It empirically investigates the relationship between income inequality and nutritional status of children under age of five years of age (stunting) in the rural areas of Jammu district of Jammu and Kashmir. To determine the prevalence of undernutrition among different income groups of rural households, the study uses the data of a primary household survey. In order to measure the level of undernutrition (stunting), gender-specific anthropometric z-scores for height-for-age are calculated by using new child growth standards which are developed by the World Health Organisation (WHO). The study finds that children from households in the poorest quintile have significantly higher odds of stunting compared to those in the highest income quintile. The study revealed a negative association between income and the prevalence of stunting in the study area. It means the proportion of stunted children under five years of age decreases as the level of income increases among rural households. The study suggests that the government can help improve the nutritional status of children by taking important policy initiatives that addresses income inequality and poverty in rural areas.

Adherence to 24-h movement guidelines among Chinese children and adolescents with intellectual disabilities.

Meeting 24-h movement guidelines for children and adolescents has been associated with improved health indicators. However, the literature examining adherence to 24-h movement guidelines among Chinese children and adolescents with intellectual disability (ID) remains lacking. This study aims to investigate the prevalence of meeting the 24-h movement guidelines and its socio-demographic correlates for this population. The sample includes 319 Chinese students with ID. Accelerometers are used to measure moderate-to-vigorous physical activity time and sleep duration. Questionnaires are adopted to measure screen time (ST) and demographic factors. Associations among socio-demographic factors, body mass index and 24-h movement are analysed by using multivariable logistic regressions. The proportions of participants who meet none, moderate-to-vigorous physical activity, ST, sleep duration and all three recommendations are 8.15%, 33.54%, 54.23%, 75.55% and 17.55%, respectively. In general, multivariable logistic regression analysis indicates that older participants are less likely to meet the ST guidelines [odds ratio (OR): 0.931; 95% confidence interval (CI): 0.869-0.998] and more likely to meet the sleep guidelines (OR: 1.106; 95% CI: 1.016-1.204) than younger individuals. Participants with moderate ID are less likely to meet the sleep guidelines (OR: 0.345; 95% CI: 0.140-0.850) than those with profound ID. Individuals from families with middle-income (OR: 0.434; 95% CI: 0.226-0.836) and high-income (OR: 0.219; 95% CI: 0.080-0.605) levels were less likely to meet the physical activity guidelines than those from low-income families. Furthermore, participants from high-income families were less likely to meet ST (OR: 0.426; 95% CI: 0.187-0.969) and all three movement guidelines (OR: 0.083; 95% CI: 0.010-0.659) than those in the low household income groups. Interventions that improve the health-related behaviours of children and adolescents with ID are needed, particularly those that target their increased engagement in physical activity.

Association between socioeconomic status and treatment in patients with low back or neck pain: a population-based cross-sectional study in South Korea

IntroductionSocioeconomic status affects the treatment of patients with low back pain and/or neck pain. We examined the relationship between socioeconomic status (occupation and household income level) and treatments such as...

The distributional effects of a nitrogen tax: Evidence from Germany

The high level of nitrogen emissions over the last decades and their adverse impact on the natural environment and human health are a pressing environmental issue. A nitrogen tax can be a cost-efficient and effective policy instrument to reduce nitrogen emissions. However, adverse effects on low- and middle-income households might lead to societal and political frictions that could end up in resistance. In this paper we investigate how a hypothetical nitrogen tax covering the specific external costs of nitrogen could be implemented and estimate its short-term distributional effects on household income groups in Germany. The findings show that the proposed tax would be regressive. However, if the tax rate is set equal to the true cost of nitrogen, the monetary impacts would overall be small, ranging from 1.15% of income for the first income quintile to 0.66% for the fifth. Complementary policy measures to lower the burden on low-income households, farmers and the energy sector could preempt social resistance against the tax.

Differences in COVID-19 Policies and Income Distribution: A Cross-Country Comparison

This paper looks at the distribution of disposable income by deciles to indicate how specific mitigating measures have influenced income groups and considers the effectiveness of different combinations of containment measures in the European Union. Simulations using the EUROMOD tax-benefit microsimulation model imply that the mitigating effects of the simulated measures are regressive, with a bigger influence on the bottom part of the income distribution. It is also observed that old democracies benefit from these measures more than new democracies. Surprisingly, our results further reveal that for the two highest decile income groups, the COVID-19 containment measures are stronger in new democracies. Finally, a qualitative comparative analysis of 19 EU countries suggests that each country should apply mixes of containment measures that fit its own context. Although there is no one-size-fits-all policy, old democracies seem more successful at handling the consequences of the COVID-19 crisis than new democracies. This study complements the literature as it shows how COVID-19 measures have influenced household income groups, and second, it adds to earlier studies by clarifying that only specific context-dependent combinations of containment measures are successful at preventing the loss of people’s living standards, thereby giving policymakers the necessary leeway to formulate effective policies.

THE IMPACT OF INCREASING COOKING OIL PRICES ON FOOD CONSUMPTION PATTERNS IN VARIOUS HOUSEHOLD INCOME GROUPS IN ACEH PROVINCE

Consumption of cooking oil from year to year continues to increase, especially in Aceh Province. In general, almost all people in this area consume cooking oil derived from oil palm plants for household needs. As one of the basic needs, the increase in the price of cooking oil has affected changes in household consumption patterns. This study aims to analyze the impact of rising cooking oil prices on changes in people's food consumption patterns in various household income groups in a quantitative descriptive manner. The results of the analysis show that the increase in the price of cooking oil has an impact on changes in food consumption patterns, namely a decrease in consumption of several food needs other than cooking oil. This decline occurred in various household income groups in Aceh Province.

Socioeconomic inequalities in burden of disease due to traffic noise in the Nordic countries

Environmental noise is the second largest environmental risk factor in disease burden estimates for Europe. While socioeconomic inequalities in noise exposure have been reported, the impact of socioeconomic status (SES) on the disease burden attributable to noise exposure has to our knowledge not been reported previously. The aim of this study is to assess the impact of SES on traffic noise exposure and the associated disease burden in selected Nordic populations. We employed nationwide data on road traffic noise exposure and SES from Danish and Norwegian Nationwide Models. The impact of household income and education on traffic noise exposure was assessed using linear regression analyses. Burden of disease estimates were calculated for populations stratified according to their level of income and education in terms of Disability-Adjusted Life Years (DALY) for high degree of noise annoyance, high degree of sleep disturbance and ischaemic heart disease. The most consistent finding observed for the Danish population was that, compared to medium and low household income, high household income was associated with lower noise exposure. Moreover, the burden of disease estimates for high noise annoyance were up to 20% lower in the high compared to the lower household income groups.

Reverse subsidy dilemma caused by the transformation from individual heating to central heating

With the increase in household income enhancing people's expectations for life comfort, the demand for central heating in hot summer and cold winter areas (HSCWs) has increased. This study aims to explore whether it is appropriate to promote central heating in HSCWs from the perspectives of inequality and reverse subsidies. Reverse subsidy dilemma caused by the transformation from individual heating to central heating was proposed by the analysis relying on utility theory. This paper presents data suggesting that individual heating could provide more options for different household income groups than could central heating. Furthermore, the heating inequality among different income groups is assessed, and reverse subsidies from the poor to the rich are discussed. We find that the implementation of central heating leads to few adverse effects and high utility for the rich and increased expenditures and low utility satisfaction for the poor at the same price level.

Changes in COVID-19 Vaccine Hesitancy within Pennsylvania over the Course of the Pandemic

Background: The global COVID-19 pandemic highlighted vaccination concerns in Pennsylvania. Limited information on vaccine hesitancy in the state prompted this study, which aimed to characterize demographic determinants of changes in hesitancy since the COVID-19 vaccine's availability. Methods: The US Census Bureau's Household Pulse Survey (N = 62,826) provided vaccine hesitancy/status data from January 2021 to April 2022. Specifically surveys from January 2021, June 2021, and April 2022 were utilized. Demographics (race, age, education status, household income, and sex at birth) were compared using odds ratios (ORs) and CI. Results: Significant changes in vaccine hesitancy occurred among certain populations. Initially, odds of vaccination for African Americans were lower (OR 0.683) compared to Whites, but in the latest survey, the odds were higher (OR 1.443). Asians consistently had the highest odds (OR 9.009) of vaccination. In January 2021, odds of vaccination among men were lower (OR 0.856) than women, but later, the odds increased (OR 1.402). Patterns in household income, age, and education status groups remained consistent. Those aged 65 years and over, with a household annual income of more than $150,000, or a bachelor's degree or higher had the highest vaccination rates. Conclusion: Findings indicate stable vaccination patterns among non-race demographic categories during the pandemic. However, the relationship between vaccination status and race was more dynamic. Further qualitative investigations are needed to understand these changes and address inaccurate beliefs surrounding COVID-19 vaccination in Pennsylvania.

A case-crossover study of the effect of vaccination on SARS-CoV-2 transmission relevant behaviours during a period of national lockdown in England and Wales.

Studies of COVID-19 vaccine effectiveness show increases in COVID-19 cases within 14days of a first dose, potentially reflecting post-vaccination behaviour changes associated with SARS-CoV-2 transmission before vaccine protection. However, direct evidence for a relationship between vaccination and behaviour is lacking. We aimed to examine the association between vaccination status and self-reported non-household contacts and non-essential activities during a national lockdown in England and Wales. Participants (n=1154) who had received the first dose of a COVID-19 vaccine reported non-household contacts and non-essential activities from February to March 2021 in monthly surveys during a national lockdown in England and Wales. We used a case-crossover study design and conditional logistic regression to examine the association between vaccination status (pre-vaccination vs 14days post-vaccination) and self-reported contacts and activities within individuals. Stratified subgroup analyses examined potential effect heterogeneity by sociodemographic characteristics such as sex, household income or age group. 457/1154 (39.60%) participants reported non-household contacts post-vaccination compared with 371/1154 (32.15%) participants pre-vaccination. 100/1154 (8.67%) participants reported use of non-essential shops or services post-vaccination compared with 74/1154 (6.41%) participants pre-vaccination. Post-vaccination status was associated with increased odds of reporting non-household contacts (OR 1.65, 95% CI 1.31-2.06, p<0.001) and use of non-essential shops or services (OR 1.50, 95% CI 1.03-2.17, p=0.032). This effect varied between men and women and different age groups. Participants had higher odds of reporting non-household contacts and use of non-essential shops or services within 14days of their first COVID-19 vaccine compared to pre-vaccination. Public health emphasis on maintaining protective behaviours during this post-vaccination time period when individuals have yet to develop full protection from vaccination could reduce risk of SARS-CoV-2 infection.