Household Income Groups Research Articles

Relationship between financial well-being, life satisfaction, and cognitive function among low-income community-dwelling older adults: the moderating role of sex.

Low financial well-being is a common predicament among older adults living in poverty. The existing literature suggests a correlation between financial well-being and mental health in old age. Therefore, this study aimed to identify the relationships among financial well-being, life satisfaction, and cognitive function among low-income older adults and to examine the moderating effect of sex on these relationships. This study involved 2004 nationally representative community-dwelling older Malaysians from the bottom 40% household income group. Financial well-being was assessed by the four-item financial satisfaction scale, while life satisfaction was measured by the Satisfaction with Life Scale. Cognitive function was measured by using the Malay version of the Mini-Mental State Examination. Hierarchical multiple regression was used as the prime method for statistical analysis. Financial well-being was positively associated with life satisfaction and cognitive function. Sex moderated the relationship between financial well-being and life satisfaction but not between financial well-being and cognitive function. Financial well-being and life satisfaction were strongly correlated among older women, although no gender difference was found for the relationship between financial well-being and cognitive function. It appears financial well-being strongly predicts mental health. As such, poverty eradication initiatives targeting low-income older adults should be implemented to sustain life satisfaction and cognitive function.

Sodium intake assessed by 24-h urine excretion and its relationship with anthropometric measurements in Malaysian adults

BackgroundSodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia.MethodsA cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents’ 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0.ResultsOf 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl.ConclusionOur study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.

Dependent, Poorer, and More Care-Demanding? An Analysis of the Relationship between Being Dependent, Household Income, and Formal and Informal Care Use in Spain.

Population ageing is one of the current challenges that most societies are facing, with great implications for health systems and social services, including long-term care. This increasing long-term care use is particularly rising for dependent older people, motivating the implementation of regional dependency laws to ensure their care needs’ coverage. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from the year 2004 until 2017, the aim of this study is to assess the impact that the Spanish System for Personal Autonomy and Dependency might have on (i) household income, according to different needs for care levels, by running Generalized Linear Models (GLMs); and (ii) formal and informal care use depending on the income-related determinant through the performance of logit random-effects regression models. We show that the different degrees of needs for personal care are associated with a lower household income, being associated with an income reduction from €3300 to nearly €3800, depending on the covariates included, per year for the more severely in-need-for-care older adults. Moreover, our findings point towards a higher use of formal and informal care services by the moderate and severe dependents groups, regardless of the household income group and time period. Bearing in mind the demographic ageing, our results highlight the need for the identification of potentially vulnerable populations and the efficient planification of long-term care systems and social support services.

Wellbeing recovery inequity following the 2010/2011 Canterbury earthquake sequence: repeated cross‐sectional studies

ObjectiveTo track population mental wellbeing following the 2010/2011 Christchurch earthquakes and after‐shocks. MethodsThe Canterbury Wellbeing Survey, a cross‐sectional survey of randomly selected adults aged ≥18 years resident in Christchurch, was repeated biannually from April 2013 until June 2017 and annually thereafter. The self‐reported 5‐item World Health Organization Well‐Being Index (WHO‐5) has been elicited from April 2013. Regression analysis was employed to model WHO‐5 score patterns over time and between important socio‐demographic groups. ResultsBetween 1,137 and 1,482 adults participated in each survey, totalling 14,100 overall. The mean WHO‐5 significantly increased (p<0.001) from 52.4 (95% confidence interval [CI]: 51.1, 53.8) in the April 2013 survey to 60.8 (95%CI: 59.7, 61.9) in the June 2019 survey. A significant and sustained household income group disparity existed (p<0.001), even when adjusting for age, gender and ethnic differences. ConclusionsThe disaster appeared to affect the mental wellbeing of all, and recovery was incremental and prolonged, taking a number of years. Those within the lowest household income group had lower mean WHO‐5 scores than their wealthier counterparts at every measured time point. Implications for public healthRecovery takes time, and pre‐existing inequities persist despite the implementation of recovery processes aimed at mitigating these risks.

Kültür Turistlerinin Seyahat Harcamalarına Yönelik Bir Araştırma: Bergama Antik Kenti Örneği

Nowadays, Today, cultural tourists are considered as a vital element in the spread of tourism to twelve months. Travel expenditures of cultural tourists contribute to economic growth. In this respect, it is very important to examine the travel expenses of cultural tourists. In this study, various hypotheses are developed in order to examine the differences between the total travel expenditures of local and foreign cultural tourists visiting the Pergamon Ancient City according to socio-economic, socio-demographic, travel-related and psycho-graphic variables. Independent groups tested in hypotheses are determined by gender, nationality, and willingness to pay for the travel expenses of others and to have spent the expenses elsewhere. According to t-test results, there is a significant difference between independent groups and total travel expenditure averages. ANOVA analysis of variance was also applied in the study to examine the difference in total travel expenditures according to household income levels. As the household income groups are examined, it is determined that the third group spends more than the first and second groups. According to these results, household income has an effect on travel expenses.

Associations of active travel with adiposity among children and socioeconomic differentials: a longitudinal study

ObjectivesExamine longitudinal associations between modes of travel to school and adiposity.SettingThe UK.Participants8432 children surveyed at ages 7, 11 and 14 years from the UK Millennium Cohort Study.Primary and secondary outcomesObjective...

Trends in the Prevalence of Major Depressive Disorder by Sociodemographic Factors in Korea: Results from Nationwide General Population Surveys in 2001, 2006, and 2011.

BackgroundThis study investigated trends in the prevalence of major depressive disorder (MDD) by sociodemographic factors in South Korea.MethodsNational samples of the general population aged 18 years or older collected from the nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001 (n = 6,206), 2006 (n = 6,466), and 2011 (n = 5,986) were used. For MDD diagnosis, we conducted face-to-face interviews using the Korean version of the Composite International Diagnostic Interview. We performed logistic regression analyses stratified by gender, after adjusting for other sociodemographic variables, to calculate the 2006-to-2001 odds ratio (OR) and 2011-to-2001 OR by subgroups of sociodemographic factors to explore the association of MDD prevalence with sociodemographic factors over time.ResultsThe prevalence of MDD in the general population of South Korea increased steadily from 2001, to 2006, and to 2011 (1.6%, 2.5%, and 3.1%, respectively). Among the men, the prevalence of MDD continued to increase significantly in 18–29 years of age group (2006: adjusted OR [AOR], 3.32; 2011: AOR, 7.42), at-risk drinking group (2006: AOR, 3.56; 2011: AOR, 4.77), and not living with a partner group (2006: AOR, 3.24; 2011: AOR, 3.25). Meanwhile, among the women, the prevalence of MDD continued to significantly increase in the below-average household income group (2006: AOR, 2.58; 2011: AOR, 2.59), at-risk drinking group (2006: AOR, 2.02; 2011: AOR, 2.47), and unemployed group (2006: AOR, 1.48; 2011: AOR, 2.04).ConclusionThis study may provide significant information for public policymakers to allocate sufficient health resources on MDD to vulnerable groups, particularly, men aged 18–29 years and women living in households with below-average income, and for clinicians to develop appropriate screening and treatment modalities for MDD.

Climate change and income inequality: An I-O analysis of the structure and intensity of the GHG emissions in Mexican households

Household consumption is not sufficiently studied in climate change research, despite the fact that it is a variable related to GHG emissions. The objective of this paper is to assess the amount, structure, and intensity of total GHG emissions (direct and indirect) related to Mexican household consumption by income level by means of an Input-Output analysis. Our study produced the following three main findings: 1) Large carbon inequality among household income groups, with the bottom household decile emitting 2.7% of the total CO2e emissions, and the top decile emitting 26.8%. 2) Three needs are the main drivers of carbon emissions of Mexican households: transportation (39.9%), dwelling energy consumption (26.9%), and food (15.2%). The share of transportation (public and private) is higher when the households are in higher deciles (24% in the bottom decile vs 40% in the top decile). Private transportation in the top decile is of particular concern. The CO2e emissions from private transport from the richest decile represent more than 10% of the total CO2e emissions. 3) The total carbon intensity of the household expenditure is depicted in an obtuse inverted U curve as a function of income distribution. The top and the bottom deciles present the lowest carbon intensities because of the composition of their basket of consumer goods and services. In the top decile, there is a significant share of expenditure on financial and educational services (with low carbon intensity), while in the bottom decile there is a high proportion of low-carbon basic products such as food. From all these results, we concluded that, in order to be effective and sustainable from a social and economic point of view, the formulation of policy to mitigate GHG must take into account both household income inequality and the diverse quantity and structure of consumption as a function of income level.

The impact of social insurance on health among middle-aged and older adults in rural China: a longitudinal study using a three-wave nationwide survey

BackgroundMany studies have examined the impact of social insurance on health, but the results have generally been mixed, presumably because they have not fully addressed potential biases related to the study’s cross-sectional design. In this study, we conducted a longitudinal analysis to investigate how participation in two social insurance programs in China—the New Rural Social Pension Insurance (NRSPI) and the New Rural Cooperative Medical Scheme (NRCMS)—was associated with health outcomes among middle-aged and older adults in rural China.MethodsUsing three-wave longitudinal data from the China Health and Retirement Longitudinal Study conducted in 2011, 2013, and 2015, we estimated the dynamic fixed-effects regression models to examine the association between participation in the NRCMS/NRSPI and six types of health outcomes.ResultsParticipation in the NRSPI was positively associated with some health outcomes, but the associations were relatively modest and were observed only for some specific age and household income groups. Participation in NRCMS was not associated with any health outcomes.ConclusionsThe results provide limited evidence of the positive impact of social insurance on health among middle-aged and older adults in rural China. Thus, social insurance programs should be reformed to enhance their positive impact on health.

Knowledge, Attitude and Practices of Sugar-Sweetened Beverages: A Cross-Sectional Study among Adolescents in Selangor, Malaysia.

This study aims to examine the level of knowledge, attitude and practices (KAP) of adolescents towards sugar-sweetened beverages (SSB), together with the associated factors that determine their KAP. Data were collected using self-administered questionnaires that consisted of sociodemographic, the KAP for the SSB questionnaire, and the Beverage Intake Questionnaire (BEVQ). The respondents’ heights, weights, waist circumferences and body fat percentages were measured. This study involved 439 adolescents aged between 13 and 17 years old, in public secondary schools in Selangor, Malaysia. The results reveal that 35% of the adolescents were overweight, 26% had a high waist circumference, and 45% had a high body fat percentage. Caffeinated drinks and full cream milk were the most frequently consumed SSBs. The KAP score revealed a good attitude (88.4%), a moderate knowledge (51.8%) and a poor practice (40.5%). Those with a higher body fat percentage showed significantly good attitude scores (p < 0.05). Low household income groups, females, adolescents aged 16–17 years old and being from an urban area demonstrated a significant (p < 0.05) positive determinant towards the KAP score. In conclusion, high awareness of negative health outcomes associated with SSBs among adolescents was not in accordance with the level of their lifestyle choices.

Abstract 16364: Effect of Social Determinants on Outcomes in a High-risk Cardio-obstetrics Population

Introduction: Cardiovascular disease is the leading cause of maternal mortality. The hemodynamic changes that occur during pregnancy make this a particularly vulnerable time for women with heart disease. Additionally, it is known that social determinants have an effect on certain outcomes in pregnancy, although research to quantify this effect is limited. We compared demographics and outcomes for women in upper- and lower-income brackets based on zip codes. Methods: We performed a retrospective cohort study of high-risk pregnant patients with cardiac diagnoses between November 2010 and June 2019. Patients were stratified into upper- and lower-income based on median household income in their zip code (2018 U.S. census). Results: We studied 191 pregnancies. Patients were stratified by zip code into lower (&lt;$118,201/yr, N = 95) and upper median household income (N = 96) groups (Table 1). Women in the lower income bracket had more antepartum hospitalizations (38.3% vs 17.9%), were younger (30.6 vs 33.9 years), Hispanic (42.1% vs 10.4%), and more likely to have public insurance (46.8% vs 21.3%). There was a difference in cardiac diagnoses between the two groups; those with lower income had more structural heart disease (41.1% vs 17.7%) and fewer arrhythmias (25.3% vs 39.6%). In the lower income group, there were 2 maternal deaths and 1 neonatal death before discharge, while in the upper income there was 1 neonatal death. Conclusions: Our study examined the relationship between median income per zip code and pregnancy outcomes, and demographics in women with heart disease. Our observations demonstrate a significant difference in maternal age, race, distribution of cardiac diagnoses, and antepartum hospitalizations. Despite all women being treated at the same facility, antepartum hospitalizations differed based on income bracket. Social determinants of health are important factors that impact outcomes in the cardiac-obstetric population and require further investigation.

PIN51 Out-of-Pocket Healthcare Expenditure in Various Household Income Groups Among Patients with Hepatitis C Disease Stages: Findings from a Tertiary Care Centre in Malaysia

PIN51 Out-of-Pocket Healthcare Expenditure in Various Household Income Groups Among Patients with Hepatitis C Disease Stages: Findings from a Tertiary Care Centre in Malaysia

Household income and the risk of incident hypertension in employees at multiple workplaces in Japan: J-HOPE

This cohort study aimed to investigate the association between household income and incident hypertension in a Japanese employed population. During 2012, a total of 4314 normotensive daytime employees (3153 men and 1161 women) were included in this study. Participants had a wide range of occupations and were employed at one of 12 workplaces from various economic sectors in Japan. After a 2-year follow-up, incident hypertension was compared among groups according to household income: <5.0, 5.0-7.9, 8.0-9.9, and ≥10.0 million Japanese yen (¥)/year. A Cox proportional hazard model was used to calculate the hazard ratio for incident hypertension in each household income group, compared with the group earning <5.0 million ¥/year. The hazard ratios for men were 1.52 (95% confidence interval, 1.08-2.18) for 5.0-7.9 million ¥/year, 1.49 (0.98-2.27) for 8.0-9.9 million ¥/year, and 1.92 (1.23-3.01) for ≥10.0 million ¥/year after adjusting for age, baseline systolic blood pressure, worksite, type of occupation, number of family members, and smoking status. This positive relationship was attenuated but remained significant after further adjustment for alcohol consumption and body mass index, both of which were higher among men with higher household income. Conversely, there was no significant difference for women in the risk of incident hypertension among household income groups, although those with higher household income tended to have a lower risk of incident hypertension. Household income is positively associated with the onset of hypertension in Japanese employed men working daytime hours.

How eco-compensation contribute to poverty reduction: A perspective from different income group of rural households in Guizhou, China

In recent years, eco-compensation in China, or more internationally termed as the payments for ecosystem services (PES) has emerged as an important policy instrument for not only environment management, but also poverty reduction. In the individual eco-compensation programs, there are usually some additional objectives other than ecosystem protection, among which poverty alleviation is the most important. In the policies on poverty alleviation, the central government of China lists eco-compensation as one of the five major approaches to alleviate poverty. However, there is little empirical evidence of the effectiveness of eco-compensation programs on poverty alleviation. This paper uses the field survey data of rural households in three poverty-stricken counties in Guizhou Province, China to evaluate the poverty alleviation effect of different eco-compensation programs on different income group of rural households. Research indicates that: for the eco-compensation programs with direct cash payment, the Sloping Land Conversion Program has a significantly positive impact on high-to-medium income group. The project of Ecological Forest Compensation Program has no significant impact on all income groups. The Ecological Job Offer Program has a great positive impact on the income of low-income households. Our research highlights that i) different eco-compensation programs might have different impacts on the same income group of households; ii) a specific eco-compensation might have different income impacts on different income groups of households; and iii) eco-compensation does not necessarily contribute to poverty reduction unless the eco-compensation scheme is purposely designed for it.

Spatial Pattern of Affordability and Overhang in Selangor

The provision of affordable housing is being developed rapidly whilst the mismatch between demand and supply in the residential market was reported as a crisis causing an increased in the overhang of residential accommodation. To date, no detailed analysis in the form of a spatial pattern for affordable housing has been studied to illustrate the crisis. Thus, this paper aims to analyse patterns for affordable house prices by using a spatial model in Selangor state with further analysis of overhang units in the Selangor district. Secondary data were obtained from various sources and the spatial model was formed and generated to examine the spatial patterns within the study area, which is in Selangor. Although previous research has found that the median household income group intended to purchase a type of landed house, for example terraced houses, the offered prices in the property market were not affordable to this particular group. Further analysis of residential overhang found that Gombak district has a high density of land use zoned for housing supply whilst facing the increased overhang. The findings of this research may guide the stakeholders on proper planning for near future of the affordable housing development with suitable type of residential to meet the residential market segmentation and demand.

Model Calibration and Forecasts of Air Travel Demand with Categorized Household Socioeconomic Attributes

The objectives of this study were to (1) construct an air demand model based on household data and (2) forecast future air demand to explain the relationship between air demand and individual travel behavior. To this end, domestic passenger air travel demand at Jeju Island in South Korea was examined. A multiple regression model with numerous explanatory variables was established by examining categorized household socioeconomic data that affected air demand. The air travel demand model was calibrated for 2009–2015 based on the annual average number of visits to Jeju Island by households in certain income groups. The explanatory variable was set using a dummy variable for each household income group and the proportion of airfare to GDP per capita. Higher household income meant more frequent visits to Jeju Island, which was well-represented in the model. However, the value of the coefficient for the highest income was lower than the value for the second-highest income group. This suggested that the highest income group preferred overseas travel destinations to domestic ones. The future air demand for Jeju airport was predicted as 26,587,407 passengers in 2026, with a subsequent gradual increase to approximately 33,000,000 passengers by 2045 in this study. This study proposed an air travel demand model incorporating household socioeconomic attributes to reflect individual travel behavior, which contrasts with previous studies that used aggregate data. By constructing an air travel model that incorporated socioeconomic factors as a behavioral model, more accurate and consistent projections could be obtained.

Influence of Socioeconomic Status on Adverse Outcomes in Pregnancy [15C

INTRODUCTION: Lower socioeconomic status (SES) has been associated with adverse pregnancy outcomes. We determined whether ZIP-code level-based SES indicator was associated with adverse pregnancy outcomes. METHODS: Retrospective study of OHSU births from 2009–2014 compared adverse pregnancy outcomes among women living in 88 Portland metro-area ZIP-codes stratified into 3 median household income groups: Low (below 10th percentile), medium (10th-90th percentile), and high (above 90th percentile) socioeconomic status (SES). Perinatal outcomes were compared by univariate analysis; multivariable logistical regression determined strength of association of low and high SES with adverse outcomes (medium SES=reference group), adjusting for significant variables. RESULTS: Of 8,118 deliveries included, 1,654 (20%) were in low SES, 5,856 (72%) were in medium SES, and 608 (8%) were in high SES. Women in low SES were more likely to be younger, have higher BMI and tobacco use, and have less private insurance. Lower SES was associated with higher rates of preeclampsia (PEC) (9.02% vs 7.48% vs 5.93%, P&lt;.028) and small for gestational age (SGA) (10.7% vs 9.34% v 6.61%, P&lt;.012), and lower birth weights (mean 3,280 g vs 3,340 g vs 3,592 g, P&lt;.001). High SES was associated with lower gestational diabetes mellitus (GDM) rates (10.8% vs 11.0% vs 7.58%, P&lt;.036), even after adjusting for confounders (aRR high SES 0.710, 95% CI 0.507–0.995). CONCLUSION: In the Portland metro-area, low SES is associated with higher rates of PEC and SGA. High SES is associated with lower rates of GDM. ZIP-code level SES indicator detects perinatal outcome differences and may be useful for identifying healthcare disparities.

Consumption Aspects that Create Life Satisfaction

Consumption is one of the main activities in life. Given the many aspects of this activity, it is the interest of this study to investigate the contribution of these aspects of consumption on life satisfaction. These consumption aspects include quality products, fair prices, easily accessible products, promotions, time-saving products, luxury products, eco-friendly products, new technology products, and consumption expenditure. A total of 450 responses were collected from adult shoppers in Bangkok, Thailand. The results of the multiple regression analysis indicated that among the various aspects of consumption, time-saving products was the sole determinant of people’s life satisfaction. In addition, age and household income were two other demographic variables that were seen to have a positive effect on a person’s life satisfaction. Regarding the high household income group, consumption expenditure and age were positively related to life satisfaction.

Association of long working hours and health-related productivity loss, and its differential impact by income level: A cross-sectional study of the Korean workers.

ObjectivesWe aimed to explore the association between long working hours and health‐related productivity loss (HRPL), due to either sickness, absenteeism or presenteeism, stratified by household income level.MethodsFrom January 2020 to February 2020, data were collected using a web‐based questionnaire. A total of 4197 participants were randomly selected using the convenience sampling method. The nonparametric association between weekly working hours and HRPL was determined. Subsequently, a stratified analysis was conducted according to household income (1st, 2nd, and 3rd tertiles). Finally, the differences in HRPL of the different working hour groups (<40, 40, 40‐51, and ≥52 hours) were investigated using a multivariate linear regression model.ResultsLong working hours were more significantly associated with HRPL, as compared to the ‘standard’ working hours (40 hours/week). A larger proportion of productivity loss was associated with the presenteeism of workers, rather than absenteeism. The relationship between HRPL and weekly working hours was more prominent in the lower household income group.ConclusionsThe results of our study indicate that HRPL is associated with long working hours, especially in the lower household income group. Reducing the workload for the individual employee to a manageable level and restructuring sick leave policies to effectively counteract absenteeism and presenteeism may be a feasible option for better labor productivity and employee health.

Pain and Psychological Distress: Effect of Microvascular Decompression on Sleep Disorders and Obsessions in Trigeminal Neuralgia.

Objective This study was aimed to investigate the effects of microvascular decompression (MVD) on sleep disorders and obsessions in trigeminal neuralgia. Methods Clinical data from 115 patients with trigeminal neuralgia treated with MVD from August 1, 2017 to May 31, 2018 at Jining First People's Hospital were analyzed retrospectively. The preoperative and postoperative risk factors for sleep disorders and obsessions, as well as the effects of MVD on sleep disorders and obsessions, were examined. Results In 115 patients, there were significant differences in preoperative sleep disorders associated with sex, monthly household income, pain in multiple branches, visual analog scale (VAS) score, and Self-Rating Depression Scale (SDS) score ( p < 0.05). Preoperative obsessions were significantly different according to age, gender, pain in multiple branches, monthly household income, VAS score, and Self-Rating Anxiety Scale (SAS) score groups ( p < 0.05). A 1-year recurrence was positively correlated with sleep disturbance (odds ratio = 3.829) and obsessions (odds ratio = 4.507). In addition, the results revealed a negative correlation between the manipulation of trigeminal neuralgia and postoperative sleep disorders ( B ≥ 1.043). Moreover, there was a significant difference in sleep disorders and obsessions before and 1 year after MVD ( p < 0.05). Conclusion For patients with trigeminal neuralgia, pain caused by sleep and obsession disorders should be examined early to identify an effective solution. Moreover, MVD, as a first treatment, is valuable for improving the physiological and psychological prognosis of patients.