Household Income Level Research Articles

Willingness to pay for broadband: A case study of Wisconsin

As broadband expansion efforts in the U.S. continue with historic investments, consumer demand for residential broadband services is of first-order importance. Several past broadband willingness to pay studies estimate the value of broadband to be low, compared to the current national average cost of internet subscriptions being around $65 per month. Additional estimates of household's willingness to pay for broadband are needed to provide more insight into how much households value these services and what type of support would be most efficient in increasing broadband adoption to close the digital divide. These estimates are helpful for policymakers, internet service providers, and community leaders working on broadband subsidy programs, trying to bring ISPs to communities, and setting service prices. Using choice experiment data from a 2022 broadband survey in Wisconsin, I find households are willing to pay $45-$334 per month to go from not having internet at home to having speeds between 25 Mbps and 1,000 Mbps and are willing to pay $10-$38 for greater reliability, depending on household income level. While consumers are willing to pay more for speed than reliability, the value consumers place on speed is diminishing. Connection is valuable to people, but getting connected at a much faster speed is not seen as worth a lot more. These estimates suggest households place a high value on home internet and are willing to pay at least, if not more, than prices already available on the market in many places.

Factors influencing the social acceptance of brain-computer interface technology among Chinese general public: an exploratory study.

This study investigates the impact of social factors on public acceptance of brain-computer interface (BCI) technology within China's general population. As BCI emerges as a pivotal advancement in artificial intelligence and a cornerstone of Industry 5.0, understanding its societal reception is crucial. Utilizing data from the Psychological and Behavioral Study of Chinese Residents (N = 1,923), this research examines the roles of learning ability, age, health, social support, and socioeconomic status in BCI acceptance, alongside considerations of gender and the level of monthly household income. Multiple regression analysis via STATA-MP18 reveals that while health, socioeconomic status, social support, and learning ability significantly positively correlate with acceptance, and age presents an inverse relationship, gender and household income do not demonstrate a significant effect. Notably, the prominence of learning ability and social support as principal factors suggests targeted avenues for increasing BCI technology adoption. These findings refine the current understanding of technology acceptance and offer actionable insights for BCI policy and practical applications.

Factors of unmet dental care needs due to the time, economic, and physical constraints among older people

Objectives: We aim to identify factors associated with unmet dental care needs in older adults and explore the impact of time, economic and physical constraints on each. Methods: The analysis was based on the 2023 Community Health Survey. Statistical analyses were conducted using chi-square test and multinomial logistic regression for 65,952 people aged 65 years and older. Results: First, we looked whether subjects experienced unmet dental care needs and found that 8.4% did. Second, according to the type of unmet dental care needs, 54.1% of the time, economic, and physical constraints were economic constraints. Analyzing each of the time, economic, and physical constraints, we found that time constraints were associated with younger age. For economic constraints, lower education level and health security type of recipients in medical aid program were more likely to experience unmet dental care needs. In terms of physical constraints, those living in rural areas were more than three times more likely to experience unmet dental care needs than those living in urban areas. Conclusions: The results showed that time constraints were related to age, economic constraints were related to household income level, and physical constraints were related to residential area.

National trends in adolescents’ mental health by income level in South Korea, pre– and post–COVID–19, 2006–2022

Despite the significant impact of the COVID–19 pandemic on various factors related to adolescent mental health problems such as stress, sadness, suicidal ideation, and suicide attempts, research on this topic has been insufficient to date. This study is based on the Korean Youth Risk Behavior Web–based Survey from 2006 to 2022. We analyzed the mental health problems of adolescents based on questionnaires with medical interviews, within five income groups and compared them with several risk factors. A total of 1,138,804 participants were included in this study, with a mean age (SD) of 15.01 (0.75) years. Of these, 587,256 were male (51.57%). In 2022, the recent period from the study, the weighted prevalence of stress in highest income group was 40.07% (95% CI, 38.67–41.48), sadness was 28.15% (26.82–29.48), suicidal ideation was 13.92% (12.87–14.97), and suicide attempts was 3.42% (2.90–3.93) while the weighted prevalence of stress in lowest income group was 62.77% (59.42–66.13), sadness was 46.83% (43.32–50.34), suicidal ideation was 31.70% (28.44–34.96), and suicide attempts was 10.45% (8.46–12.45). Lower income groups showed a higher proportion with several risk factors. Overall proportion had decreased until the onset of the pandemic. However, a significant increase has been found during the COVID–19 pandemic. Our study showed an association between household income level and the prevalence of mental illness in adolescents. Furthermore, the COVID–19 pandemic has exacerbated mental illness among adolescents from low household income level, underscoring the necessity for heightened public attention and measures targeted at this demographic.

Dietary Patterns Associated with Body-Composition Phenotype in a Middle-Aged and Elderly Population: A Population-Based Cross-Sectional Study.

There is currently limited understanding of the intricate dynamics between fat and muscle mass and the potential effect of dietary patterns. This study aimed to investigate the effects of overall dietary patterns on four body composition phenotypes associated with central obesity and low muscle mass in the middle-aged and elderly population of Korea. We examined data from 6120 adults aged ≥ 50 years, collected during the 4th (2008-2009) and 5th (2010-2011) Korea National Health and Nutrition Examination Survey. Participants were classified into four groups according to their combined status of central obesity and low muscle mass: healthy control, central obesity, low muscle mass, and sarcopenic obesity. Using factor analysis on the twenty-two pre-defined food groups, we identified three distinct dietary patterns: the "Healthy dietary pattern", "Convenience-based dietary pattern", and "Alcohol and side dish pattern". Multivariate analysis included potential confounders such as age, sex, place of residence, marital status, educational level, occupation, household income, and physical activity level. Higher scores in the "Healthy dietary pattern" were associated with lower odds of sarcopenic obesity (OR = 0.61, 95% CI = 0.40-0.92, p for trend = 0.018). For the "Convenience-based dietary pattern", individuals in the third tertile of the dietary pattern score showed a marginal association with low muscle mass (OR = 1.18, 95% CI = 0.99-1.41, p for trend = 0.056). The "Alcohol and side dish pattern" was linked to higher odds of central obesity (OR = 1.22, 95% CI = 1.03-1.44, p for trend = 0.016) and low muscle mass (OR = 1.21, 95% CI = 1.01-1.45, p for trend = 0.043). The drinking practice of consuming foods high in saturated fats and salt alongside alcoholic drinks may negatively affect fat accumulation and muscle composition among older adults. Adopting a healthy eating pattern characterized by grains, vegetables, legumes, fruits, fish, and seaweed could be notably advantageous for promoting and maintaining healthy body composition and optimal skeletal muscle health.

Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

Eradicating Poverty and Unshackling from Illness Expense: The Impact of Targeted Poverty Alleviation Policy on Medical Burden

Health poverty alleviation is a crucial aspect of targeted poverty alleviation policy, with easing the medical burden being its primary goal. This study evaluates China's targeted poverty alleviation policy's impact on reducing the medical burden of impoverished households, using data from the China Health and Retirement Longitudinal Survey (CHARLS) for the years 2011, 2013, 2015, and 2018. Employing Difference-in-Differences (DID) methodology, this paper finds significant reductions in both the out-of-pocket to income ratio and catastrophic medical expenditure among targeted households. The policy's success is attributed to the "income effect", raising household income levels, and the "safety-net effect" increasing the reimbursement ratio for inpatient expenses. These results are valid across several robustness tests including propensity score matching (PSM-DID) and placebo test. The findings have implications for global health policy, suggesting that targeted poverty alleviation interventions can effectively alleviate medical burden and prevent poverty due to health expenses, offering a viable model for other developing countries facing similar challenges.

Use of Complementary and Integrative Health Approaches in Adults with Long COVID in the US, a Nationally Representative Survey.

Background: Long COVID is a serious, complex condition that has affected the lives of millions of people globally. Complementary and integrative health (CIH) approaches offer a wide range of potential therapies for the management of long COVID symptoms. However, there is limited information available about the utilization of CIH among long COVID patients. Methods: Nationally representative cross-sectional data from the United States 2022 National Health Interview Survey (NHIS, response rate 47.7%, n = 27,651) were used to investigate prevalence and predictors of CIH use in the past 12 months among individuals who experienced long COVID. The 12-month prevalence of CIH use was descriptively analyzed for those with long COVID versus those without using chi-squared tests or unpaired t-tests. Independent predictors of CIH use among individuals with long COVID were analyzed using a stepwise multiple logistic regression analysis. Results: A weighted total of 17,610,801 US adults (19.7%) who had a confirmed case of coronavirus disease 2019 (COVID-19) developed long COVID symptoms. A slightly greater proportion of individuals with long COVID (44.4%) than those without (40.9%) used CIH approaches in the past 12 months. The most used approaches were meditation, yoga, and massage therapy. CIH use by those with long COVID was significantly associated with younger age, female sex, higher education level, having health insurance coverage, higher household income level, receiving three or more COVID-19 vaccination doses, ever having asthma, and ever having an anxiety or depression diagnosis. Conclusions: Long COVID represents a major challenge for patients, health care providers, health care systems, economies, and global public health. CIH approaches may play an important role in symptom management for some patients, and additional research is needed to identify which modalities are most effective. Patients and health care providers may benefit from better information about the available options for treatment.

Health disparities in the risk of severe acidosis: real-world evidence from the All of Us cohort.

To assess the health disparities across social determinants of health (SDoH) domains for the risk of severe acidosis independent of demographical and clinical factors. A retrospective case-control study (n = 13310, 1:4 matching) is performed using electronic health records (EHRs), SDoH surveys, and genomics data from the All of Us participants. The propensity score matching controls confounding effects due to EHR data availability. Conditional logistic regressions are used to estimate odds ratios describing associations between SDoHs and the risk of acidosis events, adjusted for demographic features, and clinical conditions. Those with employer-provided insurance and those with Medicaid plans show dramatically different risks [adjusted odds ratio (AOR): 0.761 vs 1.41]. Low-income groups demonstrate higher risk (household income less than $25k, AOR: 1.3-1.57) than high-income groups ($100-$200k, AOR: 0.597-0.867). Other high-risk factors include impaired mobility (AOR: 1.32), unemployment (AOR: 1.32), renters (AOR: 1.41), other non-house-owners (AOR: 1.7), and house instability (AOR: 1.25). Education was negatively associated with acidosis risk. Our work provides real-world evidence of the comprehensive health disparities due to socioeconomic and behavioral contributors in a cohort enriched in minority groups or underrepresented populations. SDoHs are strongly associated with systematic health disparities in the risk of severe metabolic acidosis. Types of health insurance, household income levels, housing status and stability, employment status, educational level, and mobility disability play significant roles after being adjusted for demographic features and clinical conditions. Comprehensive solutions are needed to improve equity in healthcare and reduce the risk of severe acidosis.

Comparative analysis of income level in matched small farms with and without eucalyptus plantations in Senan, Ethiopia

The cultivation of eucalyptus trees is a widely practiced economic activity in the highlands of the Amhara region, Ethiopia. This study investigates the causal impact of eucalyptus plantation ownership on household income within the Senan District of Ethiopia. Using cross-sectional data from 332 rural households, comprising 166 households with eucalyptus plantations and 166 without, the study employed a two-sample t-test comparison to compare the income level of households in the two groups. To identify the key factors influencing household income, the study conducted a Principal Component Analysis (PCA) and Propensity Score Matching (PSM) to isolate the causal impact of eucalyptus plantations on household income. This involved estimating propensity scores using a binary logistic regression model. The Average Treatment Effect on the Treated (ATT) analysis revealed that households that plant eucalyptus trees had 40.2 % higher total household income than those that did not participate in such activities. Therefore, considering potential demand and market fluctuations, eucalyptus tree growers need to diversify their livelihood strategies by utilizing the income generated from their plantations.

The association between arterial stiffness and socioeconomic status: a cross-sectional study using estimated pulse wave velocity

BackgroundThe impact of socioeconomic status (SES) on arterial stiffness remains unclear. This study aimed to explore the association between both personal and household income, as well as education level, and estimated pulse wave velocity (ePWV).MethodsA total of 13,539 participants (mean age 52.9 ± 16.7 years; 57.1% women) from the Korean National Health and Nutrition Survey database were analyzed. For SES variables, information on personal and household income and education level was collected using standardized questionnaires.ResultsThe ePWV did not show significant differences across groups categorized by individual income levels (P = 0.183). However, there was a noticeable trend of decreasing ePWV with increasing household income levels (P < 0.001). Additionally, ePWV demonstrated a significant negative correlation with higher education levels, indicating that ePWV decreased in groups with higher educational attainment (P < 0.001). In multiple linear regression analyses, both household income (β = -0.055; P < 0.001) and education level (β = -0.076; P < 0.001) were negatively associated with ePWV, even after adjusting for potential confounders.ConclusionsLower household income and lower education levels were associated with higher ePWV, providing further evidence of the influence of SES on arterial stiffness.Graphical abstract

Antiseizure Medications and Cardiovascular Events in Older People With Epilepsy

How epilepsy may promote cardiovascular disease remains poorly understood. To estimate the odds of new-onset cardiovascular events (CVEs) over 6 years in older people with vs without epilepsy, exploring how enzyme-inducing antiseizure medications (EIASMs) and traditional cardiovascular risk factors mediate these odds. This was a prospective cohort study using the comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA), with 6 years of follow-up (2015-2021, analysis performed in December 2023). The CLSA is an ongoing, national study of 51 338 adults aged 45 to 85 years at baseline who are recruited in Canada. The comprehensive cohort includes 30 097 individuals living near 1 of 11 data collection centers. Participation in the CLSA was voluntary; participation rate was 45%. Among those in the comprehensive cohort, individuals reporting no previous history of CVEs (ie, stroke, transient ischemic attack [TIA], or myocardial infarction [MI]) at baseline were excluded. No other exclusion criteria were applied. A total of 86% of participants completed follow-up. Lifetime history of epilepsy. The primary outcome was new-onset CVEs over 6 years. Secondary outcomes were new-onset strokes, TIAs, and MIs. Logistic models were fitted for these outcomes as a function of epilepsy, age, sex, household income, and education level. Mediation analyses were conducted for strong EIASM use, weak EIASM use, Framingham score, Physical Activity Scale for the Elderly (PASE) score, and waist to hip ratio. Among the 30 097 individuals in the comprehensive cohort, a total of 27 230 individuals (mean [SD] age, 62.3 [10.1] years; 14 268 female [52.4%]) were included, 431 with a lifetime history of epilepsy. New-onset CVEs were more likely in epilepsy, with an adjusted odds ratio of 2.20 (95% CI, 1.48-3.27). The proportion of the effect of epilepsy on new-onset CVEs was mediated as follows by each of the following variables: strong EIASM use, 24.6% (95% CI, 6.5%-54.6%), weak EIASM use, 4.0% (95% CI, 0.8%-11.0%), Framingham score, 1.4% (95% CI, -1.6% to 4.5%), PASE score, 3.3% (95% CI, 1.4%-6.8%), and waist to hip ratio, 1.6% (95% CI, 0.4%-3.7%). Results of this cohort study reveal that epilepsy was associated with new-onset CVEs. Nearly one-third of this association can be explained by EIASMs. These findings should be considered when choosing an antiseizure medication for a person at risk for cardiovascular disease.

Impact of Rural E-Commerce on Farmers’ Income and Income Gap

Rural e-commerce, as a new form of digital economy, is of great significance in promoting the income of rural households and realizing common prosperity. Based on the 2021 China Rural Revitalization Survey (CRRS), the impact of rural e-commerce on farmers’ income and the intra-rural income gap is explored using quantile regression. The results found that (1) rural e-commerce can effectively promote the level of farm household income and alleviate the intra-rural income disparity, with this finding still holding after addressing the potential endogeneity problem and conducting robust-type tests. (2) Rural e-commerce has the most pronounced income-generating effect on low-income households in the southern region; participation in rural e-commerce has a more “center-expanding” effect on households in the secondary education and high material capital groups. (3) Saving production and operation costs, shortening the product circulation chain, and improving access to information are channels through which rural e-commerce affects households’ income. It is recommended to actively promote the deep integration and development of rural e-commerce in rural areas, establish a sound mechanism for bridging the “digital divide”, encourage e-commerce “leaders” to build a perfect industrial chain, and guide smallholders to integrate into the rural e-commerce industrial chain to enjoy the digital dividend.

Impact of self-perceived oral health and socio-economic factors on oral health-related behavior in Estonian adults.

To identify which socioeconomic factors are affecting oral health-related behavior and to provide suggestions for improving the population's oral health. Materials and methods: The survey includes population groups from age 35 and older from all 15 Estonian counties and major cities (n = 2,376). The study is based on data from a nationwide Estonian Adult Oral Health Survey questionnaire. In addition to analyzing eight aspects of oral health-related behavior and self-perceived oral health variables, the survey also includes participants' socio-economic and demographic characteristics. The study utilizes frequency tables (including cumulative distributions), means, correlations, and regression analysis as its methods. The mean number of beneficial behaviors reported by the participant was 4.2 (SD 1.6). The value of the oral health-related behavior index (OHBI, the number of reported behaviors from the eight) is initially determined by the optimal timing between meals, abstinence from smoking, and the choice of drinking water or refraining from any intake between meals. Participants with higher OHBI tended to rate their self-perceived oral health better. Adherence to beneficial dental health-related behavior in Estonian adults is primarily influenced by gender, educational level, type of settlement, and household income level. In order to significantly improve oral health and related behaviors, it is imperative to integrate dental services into universal health coverage and deliver ongoing oral health education for adults.

Abstract B149: Investigating Disparities in Cost-Associated Barriers to Medication Adherence in Breast Cancer Survivors in the National Institutes of Health All of Us Research Program

Abstract Purpose: Medication adherence (e.g., endocrine therapy, antihypertensives) during survivorship remains suboptimal. Racial disparities in medication adherence continue to persist, yet reasons for this disparity are not fully understood. This study aimed to assess racial differences in cost-associated barriers to medication adherence. Methods: This cross-sectional analysis utilized data from the National Institutes of Health All of Us Research Program. Cohort eligibility included identifying as Black/African American or White, being at least 18 years old, and having a diagnosis of breast cancer. Survivors must have completed the Healthcare Access and Utilization survey, a validated assessment of factors impacting healthcare behaviors. Comparisons between patient characteristics (e.g., age, annual income, marital status, employment, education, etc.) and survey responses were analyzed by race using Pearson’s chi-square tests. Univariable and multivariable logistic regression models were fitted to investigate the unadjusted and adjusted associations of cost-related barriers to medication adherence and race. Results: Among the 1,840 breast cancer survivors included in this cohort, the mean age was 63.8 (standard deviation (sd) = 10.4). The majority of survivors were White (94.3%) (5.7% Black), married (58.9%) and unemployed (57.4%). The mean score for racial discrimination in healthcare was 10.3 (sd = 3.8) (range = 7 - 35). Most survivors did not report any cost-related barriers to adherence (74.9%); however, 19.5% of survivors asked their doctor for lower cost medication to save money. When compared with White survivors, a higher proportion of Black survivors reported that they could not afford prescription medicines (6.5% vs. 12.4%). In the multivariable model, no significant association by race was observed (p=0.387). Survivors who reported annual household income levels above $50k were less likely to report cost-reported barriers when compared to survivors who reported a household income of &amp;lt;$25k (p&amp;lt;0.001). Each one-point increase in perceived discrimination in healthcare increased the odds of reporting a cost-related barrier to adherence by a factor of 1.10 (95% confidence interval: 1.07, 1.13). Conclusions: Although racial differences were not noted for overall cost-related barriers, results highlight a need to understand nuanced differences in perceived cost-related barriers to adherence and how survivors navigate those differences. Further research is needed to understand providers’ roles in encouraging medication adherence and how discrimination in healthcare may serve as a barrier to adherence. Citation Format: Arnethea L. Sutton, Jian He, Lakeshia Cousin, Keesha Powell-Roach, Mandy J. Hill, Wendy Bottinor. Investigating Disparities in Cost-Associated Barriers to Medication Adherence in Breast Cancer Survivors in the National Institutes of Health All of Us Research Program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B149.

Abstract C064: Racial and Ethnic Variation in Referral Times for Thoracic Oncologic Surgery in a Major Metropolitan Area

Abstract Objective The study objective was to understand the impact of race/ethnicity on access to thoracic surgical care for patients undergoing lung resection for cancer. Methods We performed a retrospective analysis on 206 consecutive patients who underwent lung resection for cancer (120 female, 86 male; median age 66 years), with respect to how race and ethnicity impact time to referral for thoracic surgery to a major healthcare center. Time between initial radiographic appearance of a lung nodule/mass 1 cm or greater to surgical referral and time from surgical referral to operation were evaluated for 121 White, 30 Asian, 26 Hispanic, 12 African American, and 17 mixed or other race patients. The impact of age, sex, median income of patient's household, national and state Area Deprivation Indices, insurance type, and distance between the patient's domicile and our hospital was evaluated. The influence of the referring physician's practice (hospital-based, hospital-affiliated, or private), internal or external referral, race/ethnicity, and level of specialization was also studied. Results African American, Asian, Hispanic, and mixed/other race patients had significantly longer wait times between initial radiographic finding of a lung nodule/mass 1 cm or greater and surgical referral compared with White individuals (median days: African American, 78; Asian, 95; Hispanic, 92; mixed or other, 65; White, 35). Multiple linear regression analysis demonstrated that race/ethnicity was the only significant predictor of prolonged time to surgical referral when adjusted for age, sex, median household income level, national and state Area Deprivation Indices, insurance type, and distance between patient's home and our hospital. The referring physician's type of practice and internal versus external referral were not significant. However, the physician's race/ethnicity and level of specialization had an impact on referral times, with non-specialists referring patients sooner to thoracic surgery compared with specialists who ordered more workup tests. For all patient races/ethnicities, there was no difference in time between surgical referral and day of operation. Conclusions Race and ethnicity have a major impact on the time from initial radiographic appearance of a lung nodule/mass 1 cm or greater to referral for surgical resection for cancer. This study suggests the need to develop strategies to reduce minority wait times and improve timely access to surgery for patients with thoracic malignancies. Citation Format: Moises Hernandez, Cristian Puerta, Nolan Winicki, Patricia Thistlethwaite. Racial and Ethnic Variation in Referral Times for Thoracic Oncologic Surgery in a Major Metropolitan Area [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C064

Spatiotemporal variability of the association between greenspace exposure and depression in older adults in South Korea

Abstract Background A number of studies based on young to middle aged adult and child samples have found that exposure to greenspace and bluespace can have a positive impact on mental health and well-being. However, there is limited research among older adults and the extant studies have provided mixed results. The present study was designed to examine how the association between these forms of exposure and depressive symptoms among older adults varies as a function of different spatially and temporally resolved exposure metrics. Methods The sample consisted of 617 individuals (46.19% female) aged ≥ 60 years of age. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Individuals’ greenspace exposure was quantified using spatially and temporally resolved metrics, including monthly and annual averaged satellite-derived normalized difference vegetation index (NDVI) across multiple buffer distances (250 m to 2,000 m) centered at participants’ home address. We also quantified exposure to blue-greenspace from a highly detailed land use and land cover dataset. A multivariable logistic regression model assessed the association between greenspace and blue-greenspace exposure and depressive symptoms, adjusting for age, sex, income, education, marital status, current smoking, alcohol status, medical conditions, temperature, crime rate, population density, and per capita park area. Results We found a significant association between exposures to greenspace and blue-greenspace and depressive symptoms (CES-D cutoff ≥ 4) among older adults. After adjusting for confounding variables, the odds of depressive symptoms were significantly decreased by an IQR increment in residential exposure to greenspace [odds ratio (OR) = 0.67; 95% confidence interval (95% CI), 0.49 ~ 0.91] and blue-greenspace (OR = 0.59; 95% CI, 0.41 ~ 0.84) measured nearby their home address (i.e., as close as 250 m). When stratified by household income level, the association was only significant among low-income individuals. We also found temporal variation in the association between depressive symptoms and monthly NDVI-based greenspace exposure, in which the odds of depressive symptoms were the lowest for greenspace in cold months (i.e., January, February, and March). Conclusions Our findings suggest that neighborhood greenspace may serve as a protective factor against depression among older adults, but the benefits may depend on the spatial and temporal context. More investigation is needed to replicate our findings on the spatial and temporal variations of greenspace exposure metrics and their effects on depressive symptoms.

Prevalence and sociodemographic associations with weight discrimination in early adolescents

ObjectivesTo evaluate the prevalence of weight discrimination (the perception of being treated unfairly based on weight) and its sociodemographic associations among early adolescents aged 10 to 13 in the United States. MethodsWe analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study in Year Two (2018–2020). Multivariable logistic regression analyses were conducted, with perceived weight discrimination as the dependent variable and age, sex, sexual orientation, race and ethnicity, body mass index (BMI) category, household income, and highest parental education level as adjusted independent variables. Interaction with BMI category and weight discrimination by sex, sexual orientation, race and ethnicity, and household income was tested for. ResultsIn our analytical sample (N = 7129), we found that 5.46 % of early adolescents reported experiencing weight discrimination. Adolescents with BMI percentile ≥95th (adjusted odds ratio [AOR], 6.41; 95 % confidence interval [CI], 4.71–8.70), <5th (AOR, 3.85; 95 % CI, 2.10–7.07), and ≥85th to <95th (AOR, 2.22; 95 % CI, 1.51–3.25) had higher odds of experiencing weight discrimination compared to adolescents with BMI percentile 5th to <85th. Sex and race and ethnicity modified the relationship between BMI category and weight discrimination. Adolescents who identified as gay/bisexual (AOR, 3.46; 95 % CI, 2.19–5.45) had higher odds of experiencing weight discrimination compared with heterosexual adolescents. ConclusionsOur results underscore the need for anti-bullying campaigns and positive media representation of all body types. Clinicians should recognize that sexual minority youth disproportionately experience weight discrimination, emphasizing the need for affirmative healthcare and early intervention to prevent the mental health impacts of such discrimination.

Influence falling income inequality for social stability: Case study of four European countries

AbstractThis study aims to assess the relationship between income inequality and social solidarity as a measure of societal stability, using European countries as a case study. Data from 20 European countries were included in the research. The primary dependent variable was defined as social solidarity, serving as an indicator of societal stability. The analysis of social solidarity was conducted concerning various social groups, including overall solidarity and solidarity towards vulnerable societal categories. Responses to questions were evaluated using the Likert scale. Income inequality within each country, measured by the Gini coefficient, was designated as the explanatory variable. Control variables were incorporated, including GDP per capita and the percentage of social expenditure relative to a country's GDP. The conducted analysis demonstrates a negative correlation between income inequality and the manifestation of social solidarity. The analysis of individual characteristics reveals that specific groups exhibit greater social solidarity compared to others. The conclusion drawn is that both lower and higher household income levels lead to a decrease in the overall manifestation of social solidarity in the face of increasing income inequality. The study's findings contribute theoretically to the discourse on income inequality and its impact on societal stability.

Socioenvironmental Factors are Associated With Dopamine Transporter Availability in Healthy Individuals but not in Parkinson's Disease.

Social factors can influence the brain's dopaminergic function. This study investigated the relationship between socioenvironmental factors and dopamine transporter (DaT) availability in healthy individuals (n = 74) and those with Parkinson's disease (PD) (n = 240). All single photon emission computed tomography (SPECT) DaT data and clinical data used in this study were obtained from the Parkinson's Progression Markers Initiative (PPMI) dataset. Socioenvironmental data was obtained from Social Explorer analyses of the American Community Survey (2014-2018) using the residential ZIP codes of the subjects available in the PPMI dataset. Participants resided in 302 ZIP code tabulation areas across 38 U.S. states. In healthy individuals, DaT signals were significant and negatively correlated in the caudate with median household income (r = -0.27, P = 0.02) and educational level of the living area (r = -0.23, P = 0.04), but not significant in the putamen (r = -0.21, P = 0.08; r = -0.11, P = 0.37 respectively). Also, there was a significant positive correlation between DaT signals in caudate and poverty rates (r = 0.29, P = 0.01), but not in the putamen (r = 0.16, P = 0.19) in healthy subjects. No significant associations were observed in the PD group for any variables. The study findings suggest that socioenvironmental factors, such as median household income, education level, and poverty rate, are significantly associated with DaT availability in the caudate of healthy individuals but not in those with PD. This indicates that PD might disrupt the connection between the social environment and dopaminergic function. These results underscore the importance of considering socioenvironmental variables when studying dopaminergic function in the human brain.