Household Socioeconomic Status Research Articles

Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana.

This paper describes sexual behaviours and their associated factors among young people. The study design is cross-sectional. Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana's Shai-Osudoku and Ningo Prampram districts. Young people aged 10 to 24 years, median age 17 years. Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant. Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures. Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required. No funding was obtained for this paper.

Black-White Differences in the Protective Effects of Income against Perceived Financial Difficulties in the United States

One of the components of the protective effects of overall high socioeconomic status (SES) on health is high subjective SES. As SES has shown weaker health effects for marginalized groups, a phenomenon called Marginalization-related Diminished Returns (MDRs), we conducted this study to test differential associations between two objective SES indicators, namely education and household income, with a subjective SES indicator (perceived financial difficulties) by race. For this cross-sectional analysis, we used the Health Information National Trends Survey (HINTS 2020) data. Participants included 1403 individuals who identified as either non-Latino Black or non-Latino White. Age, sex, marital status, and employment were used as control variables, while education and income were used as independent variables. Perceived financial difficulties were the outcome. Binary logistic regression was used for main data analysis. Linear regression was used for sensitivity analysis. Overall, high education and household income were associated with lower odds of perceived financial difficulties. We documented a statistical interaction between race and income on subjective SES indicating a weaker inverse association between household income and perceived financial difficulties for non-Latino Black than non-Latino White individuals. The results remained similar using linear or logistic regression models. We did not find racial differences in the association between education and perceived financial difficulties. In the US, and under structural racism, the link between objective SES indicators such as income and perceived financial difficulties differs for non-Latino Black and non-Latino White people. Income may better reduce perceived financial difficulties for non-Latino Black than non-Latino White individuals. This finding is in line with the MDRs framework and suggests a mechanism for why we observe weaker health effects of objective SES indicators, such as income, for racial minorities in the US, and why we observe racial health disparities across class lines.

Socioeconomic determinants of nutritional behaviors of households in Fars Province, Iran, 2018.

IntroductionHouseholds' dietary habits are affected by their environment and socioeconomic status (SES). This study aims to investigate eating behaviors and determine the factors affecting nutritional status in households in Fars Province in 2018.MethodIn this cross-sectional study, urban and rural households were selected using the multistage sampling method. A questionnaire was employed to interview the mother or householder to record the demographic, SES, and dietary habits of the family for major food items commonly used. A logistic regression model was used to analyze the data. The p-value less than 0.05 was considered significant.ResultsIn total, 6,429 households participated in the study. The majority of households use traditional flatbread, low-fat milk, and liquid/cooking oil. Frying was the most prevalent method of cooking. Parents' level of education and SES were associated with type of consumed bread, milk and dairy, methods of food preparation, adding salt at the table, eating out, and fast-food usage. Parents' higher level of education was significantly associated with salt storage in optimal conditions and not using salt before tasting the meal.ConclusionMost of the households had healthy practices, especially in consumption of certain oils and methods of preparing their food as well as keeping salt in an optimal condition and using iodized salt. The most important unhealthy nutritional behavior was high consumption of fast food and outdoor food, especially in urban regions. Unhealthy dietary habits were more prevalent in households with low household and regional SES. Both households and regions with higher SES had better dietary habits.

Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents.

This study investigated the short-term (in 2020) and long-term (in 2021) impacts of the COVID-19 pandemic on suicide-related characteristics in Korean adolescents in comparison with the pre-pandemic period (in 2019) and examined the factors associated with those impacts. Secondary data of the cross-sectional 15th–17th (2019–2021) Korea Youth Risk Behavior Web-based Survey targeting adolescents in school were utilized. The proportions of adolescents with depression, suicidal ideation, suicide planning, and suicide attempts were 26.5%, 12.2%, 3.7%, and 2.4%, respectively. Following an adjustment, depression, suicidal ideation, and suicide attempts significantly improved in the short term and depression and suicide attempts improved significantly in the long term (i.e., 2021), albeit to a lesser degree. The associated variables in the short-term analysis (i.e., 2020) reflected the socioeconomic vulnerabilities (e.g., lower household socioeconomic status [SES], unhealthy status, and unhealthy behaviors), as well as the socioeconomically favorable indicators (e.g., high household SES and high academic achievement). In the long-term, suicidal ideation was no longer associated with a lack of engagement in hand washing, and suicide attempts were no longer associated with the amount of internet time used for studying. For a successful suicide prevention, it is necessary to develop in-school interventions that address the relevant factors identified in this study and the community-based interventions that target out-of-school adolescents.

Determinants of depressive symptoms among postpartum mothers: a cross-sectional study in Ethiopia

ObjectiveThis study aims to assess the determinants of depressive symptoms among postpartum mothers.DesignA community-based cross-sectional study was conducted.SettingTen randomly selected rural kebeles of Meket district of Ethiopia.ParticipantsA random sample of...

Development, Validity, and Cross-Context Equivalence of the Child Food Insecurity Experiences Scale for Assessing Food Insecurity of School-Age Children and Adolescents

BackgroundChildren ages 6 to 17 years can accurately assess their own food insecurity, whereas parents are inaccurate reporters of their children’s experiences of food insecurity. No globally applicable scale to assess the food insecurity of children has been developed and validated. ObjectivesWe aimed to develop a globally applicable, experience-based measure of child and adolescent food insecurity and establish the validity and cross-contextual equivalence of the measure. MethodsThe 10-item Child Food Insecurity Experiences Scale (CFIES) was based on items previously validated from questionnaires from the United States, Venezuela, and Lebanon. Cognitive interviews were conducted to check understanding of the items. The questionnaire then was administered in 15 surveys in 13 countries. Other items in each survey that assessed the household socioeconomic status, household food security, or child psychological functioning were selected as criterion variables to compare to the scores from the CFIES. To investigate accuracy (i.e., criterion validity), linear regression estimated the associations of the CFIES scores with the criterion variables. To investigate the cross-contextual equivalence (i.e., measurement invariance), the alignment method was used based on classical measurement theory. ResultsAcross the 15 surveys, the mean scale scores for the CFIES ranged from 1.65 to 5.86 (possible range of 0 to 20) and the Cronbach alpha ranged from 0.88 to 0.94. The variance explained by a 1-factor model ranged from 0.92 to 0.99. Accuracy was demonstrated by expected associations with criterion variables. The percentages of equivalent thresholds and loadings across the 15 surveys were 28.0 and 5.33, respectively, for a total percentage of nonequivalent thresholds and loadings of 16.7, well below the guideline of <25%. That is, 83.3% of thresholds and loadings were equivalent across these surveys. ConclusionsThe CFIES provides a globally applicable, valid, and cross-contextually equivalent measure of the experiences of food insecurity of school-aged children and adolescents, as reported by them.

Risk factors for intestinal parasite portage in an informal suburb on the West coast of Madagascar

The deprived area of the Metzinger Valley in the city of Mahajanga has many healthcare concerns due to repeated flooding during the rainy season. Improving this health situation requires a better knowledge of the pathogens present in this area and of the risk factors favoring their propagation. The aim of this study was to analyze the relationship between the household socioeconomic status and the presence of parasites in the faeces of children between 1 and 10 years of age in order to determine the risk factors for intestinal parasitosis. The study included 746 children, of whom 30% were infected with parasites. Entamoeba coli, a good indicator of environmental fecal contamination, was the most prevalent parasite with an observation frequency of 16.7% followed by Giardia lamblia with a prevalence of 10%. For helminths, Trichuris and Ascaris were the most prevalent respectively 5.4% and 1.8%. A large heterogeneity in the prevalence of parasites was observed from one neighborhood to another. However, multivariate analysis showed that these differences were not related to environmental factors or household structure, but rather to the economic level of the family, the education level of the mother as well as the age of the child. For example, the prevalence of Giardia decreased from 23.5% to 8% for children of mothers with little education to those with higher education, respectively. For E. coli, the prevalence is higher among poor households and school-aged children. In the frame of IRCOD project, mothers are being sensitized to hygiene and risk factors for transmission by intestinal parasites and the present study proposes a multidimensional approach as an assessment tool.

Does maternal empowerment improve dietary diversity of children? Evidence from Pakistan demographic and health survey 2017-18.

The role of maternal empowerment (ME) to improve child nutrition in patriarchal societies of developing countries remains ambiguous. This study provides empirical evidence about the impact of ME and some other factors selected under United Nations International Children's Emergency Fund theoretical framework, on dietary diversity of children (under 5years age) in Pakistan. Partial proportional odds model is estimated to obtain varying estimates of the parameters by using data of Pakistan Demographic and Health Survey 2017-18. Significant positive role of empowered mothers to improve child dietary diversity (CDD) is explored (OR=1.135; Confidence Interval [CI]=1.001-1.288). Moreover, positive association of maternal higher education on CDD (OR=1.329; 95% CI=1.085-1.628) supports the productive and allocative efficiency hypotheses of health economics. Maternal agricultural employment, paternal education, and paternal employment were not significantly associated with CDD. This requires further exploration. Positive association of household socioeconomic status with CDD (OR=1.768; 95% CI=1.314-2.380) and significance of some demographic variables call for social welfare programs. Positive association of mother's age and CDD demands for amendment in Child Marriage Restraint Act. The observed adverse association of family size with CDD induces effective family planning to control high birth rate in Pakistan. It may be concluded that ME and creation of awareness about nutrition security through maternal education are the important factors to overcome child malnutrition in Pakistan. Since, socioeconomic and cultural environment in South Asian countries is homogeneous, the analysis in this study might be relevant to the South Asian region. Moreover, the study provides evidence informing the debate on the role of ME to improve child nutrition in patriarchal societies.

Chronic Disease Comorbidities Among Injured Patients in Cameroon: A Retrospective Cohort Study

IntroductionChronic diseases are increasing but underdiagnosed in low-income and middle-income countries (LMICs), where injury mortality is already disproportionately high. We estimated prevalence of known chronic disease comorbidities and their association with outcomes among injured patients in Cameroon. Materials and methodsInjured patients aged ≥15 y presenting to four Cameroonian hospitals between October 2017 and January 2020 were included. Our explanatory variable was known chronic disease; prevalence was age-standardized. Outcomes were overall in-hospital mortality and admission or transfer from the emergency department (ED). Associations between known chronic disease and outcomes were evaluated using logistic regression adjusted for age, gender, estimated injury severity score (eISS), hospital, and household socioeconomic status. Unadjusted eISS-stratified and age-stratified outcomes were also compared via chi-squared tests. ResultsOf 7509 injured patients, 370 (4.9%) reported at least one known chronic disease; age-standardized prevalence was 8.4% (95% confidence interval [CI] 7.5%-9.2%). Patients with known chronic disease had higher mortality (4.6% versus 1.5%, adjusted odds ratio [aOR]: 2.61 [95% CI: 1.25-5.47], P = 0.011) and were more likely to be admitted or transferred from the ED (38.7% versus 19.8%, aOR: 1.40 [95% CI: 1.02-1.92], P = 0.038) compared to those without known comorbidities. Crude differences in mortality (11.3% versus 3.3%, P = 0.002) and hospital admission or transfer (63.8% versus 46.6%, P = 0.011) were most notable for patients with eISS 16-24. ConclusionsDespite underdiagnosis among Cameroonians, we demonstrated worse injury outcomes among those with known chronic diseases. Integrating chronic disease screening with injury care may help address underdiagnosis in Cameroon. Future work should assess whether chronic disease prevention in LMICs could improve injury outcomes.

Priced out? Household migration out of “superstar” US city-regions

The high cost-of-living in “superstar” US metropolitan areas has become an area of increasing scholarly and policy concern. One question relates to whether low socioeconomic status (SES) and other historically disadvantaged residents are getting pushed out of these city-regions. To unpack what is occurring with respect to migration out of large expensive metros, I examine who is moving out of these areas in the US and where they are going. I use regression, coarsened exact matching, and latent class analysis to understand who is staying within large expensive US metros and who moves out of them, as well as what revealed preferences underlie these moves. I find evidence that lower SES households are slightly more likely to leave superstar US city-regions, though Black, Latinx, and immigrant households are less likely to leave than White and US-born households. Rather than leaving, many low SES households may instead continue to live in these areas while enduring increasingly crowded living arrangements and/or long commutes. The results also highlight substantial heterogeneity in where households go to once they move, suggesting migration out of these urban areas may be more complex than simply the push of high cost-of-living.

The socioeconomic gradient of alcohol use: an analysis of nationally representative survey data from 55 low-income and middle-income countries

SummaryBackgroundAlcohol is a leading risk factor for over 200 conditions and an important contributor to socioeconomic health inequalities. However, little is known about the associations between individuals’ socioeconomic circumstances and alcohol consumption, especially heavy episodic drinking (HED; ≥5 drinks on one occasion) in low-income or middle-income countries. We investigated the association between individual and household level socioeconomic status, and alcohol drinking habits in these settings.MethodsIn this pooled analysis of individual-level data, we used available nationally representative surveys—mainly WHO Stepwise Approach to Surveillance surveys—conducted in 55 low-income and middle-income countries between 2005 and 2017 reporting on alcohol use. Surveys from participants aged 15 years or older were included. Logistic regression models controlling for age, country, and survey year stratified by sex and country income groups were used to investigate associations between two indicators of socioeconomic status (individual educational attainment and household wealth) and alcohol use (current drinking and HED amongst current drinkers).FindingsSurveys from 336 287 participants were included in the analysis. Among males, the highest prevalence of both current drinking and HED was found in lower-middle-income countries (L-MICs; current drinking 49·9% [95% CI 48·7–51·2] and HED 63·3% [61·0–65·7]). Among females, the prevalence of current drinking was highest in upper-middle-income countries (U-MIC; 29·5% [26·1–33·2]), and the prevalence of HED was highest in low-income countries (LICs; 36·8% [33·6–40·2]). Clear gradients in the prevalence of current drinking were observed across all country income groups, with a higher prevalence among participants with high socioeconomic status. However, in U-MICs, current drinkers with low socioeconomic status were more likely to engage in HED than participants with high socioeconomic status; the opposite was observed in LICs, and no association between socioeconomic status and HED was found in L-MICs.InterpretationThe findings call for urgent alcohol control policies and interventions in LICs and L-MICs to reduce harmful HED. Moreover, alcohol control policies need to be targeted at socially disadvantaged groups in U-MICs.FundingDeutsche Forschungsgemeinschaft and the National Center for Advancing Translational Sciences of the US National Institutes of Health.

How unique are terrorist suspects? Investigating similarities and differences between terrorist suspects, their siblings, and other suspects

This article contributes to the debate in terrorism research on how unique terrorist suspects (i.e. individuals suspected of crimes with terrorist intent) actually are and whether or not specific theories are necessary to explain their behavior. Our study compares terrorist suspects from the Netherlands with their siblings and nonterrorist suspects to find out whether and how terrorist suspects are unique. Inspired by criminological theories involving social bonds, regression analyses were conducted utilizing registry data on household compositions, socio-economic status (SES), and criminal histories. A key finding is that terrorist suspects seem to have more in common with other suspects than with their siblings; besides prior criminal involvement, no significant differences were found between terrorist suspects and other suspects. Terrorist suspects were significantly less often married, had a lower SES, and were more often previously suspected of crimes as compared to their siblings. Particularly, lacking employment is a differentiating factor for terrorist suspects and siblings. Our findings stress the necessity to investigate in-depth under what circumstances and how a disadvantaged background (e.g. lack of social bonds, criminal history) can lead to becoming a terrorist suspect.

Child development at age 5 years: The effects of maternal education, socioeconomic status and early-life growth examined prospectively in a lowresource setting

&#x0D; Background. Deeper insight into relationships between social factors and early childhood growth and development is required, particularly in low-resource settings.&#x0D; Objectives. To determine (i) associations between early linear growth and child development at 5 years; and (ii) whether early childhood growth mediates relationships between maternal education, household socioeconomic status (SES) and subsequent child development.&#x0D; Methods. This study used data from the Birth to Twenty Plus study, a longitudinal South African birth cohort study. The study sample comprised 636 participants with complete data at all relevant time points for the analysis. Household SES and maternal education were measured during pregnancy and the first two years of life, and growth between birth and 4 years of age. Child development was assessed using the Revised Denver Pre-screening Developmental Questionnaire (R-DPDQ). Multivariable regression analyses were used to investigate the association between SES, maternal education, growth and child development, and structural equation modelling was used to analyse the mediation of growth.&#x0D; Results. In both sexes, higher birthweight and household SES were associated with higher R-DPDQ scores. Increased relative linear growth, particularly between 0 and 2 years, was associated with higher R-DPDQ scores among boys (β=0.82; 95% confidence interval (CI): 0.27 - 1.37) at age 5. Growth status but not SES mediated the association between maternal education and R-DPDQ scores.&#x0D; Conclusion. Child development at 5 years was independently associated with SES and birthweight. The negative effects of lower maternal education on child development was attenuated by better growth.&#x0D;

Socio-Economic Status of Households and the Determinants of Asset Poverty: A Case of South Africa

When measuring poverty in South Africa, much of the theoretical and empirical work has focused on money-metric measures of poverty. The conventional approach has been the use of a poverty line sufficient to meet primary human needs, often derived from consumption, expenditure or income levels. This narrow perspective has tended to divert the attention of development economists towards the pursuit of income growth, which has been associated with development and a necessary condition for poverty reduction. However, with a changing emphasis on development, the model, analytical methods, and related frameworks have been subjected to critical scrutiny by populists and neoliberals alike. The purpose of this study is to contribute to the existing literature by using an alternative approach ─ a non-monetary approach to the measurement of poverty in South Africa. To the best of our knowledge, this is the first study in South Africa to compute an asset poverty index using principal component analysis in a panel setting and use appropriate panel data models to investigate the key determinants of asset poverty. We used data drawn from the existing five waves of the National Income Dynamic Study. Using the random effect probit model, we found that some factors, such as levels of education of the head of household (primary, secondary, matric and tertiary) and land ownership, have a reducing influence on asset poverty. Factors The results also revealed that household size and unemployed people are more prone in South Africa.

Spatial Variations and Determinants of Anemia among Under-five Children in Nepal, DHS (2006-2016).

Anemia among under-five children is the major health problem in Nepal. The lack of nutritional supplementation and lack of healthcare facilities are influential factors of anemia. Thus, the main objective of this study is to explore spatial variations and determinants of anemia among under-five children in Nepal. Nepal Demographic and Health Survey (NDHS) data from 2006 to 2016 were used in this study, which includes: household and individual-level data of 8555 under-five children, whose anemia was measured. In addition, a total of 260 (2006), 281 (2011), and 383 DHS clusters (2016) were taken in consideration for spatial analysis. The overall prevalence of anemia was 48.9%, 46.4%, and 52.2% in 2006, 2011, and 2016 respectively. The spatial analysis revealed a nonrandom spatial distribution, where statistically significant hotspots and coldspots were detected in different parts of the country. The results also identified mother’s age, mother’s educational level, socioeconomic status of household, number of under-5 children, household size, birth weight, underweight, stunting, diarrhea, and fever as associated factors of anemia among under-5 children. These findings may provide assistance to concerned health officials in adopting anemia-related programs and policies to address the anemia problems that plague Nepalese children under the age of five.

Determinants of exclusive breastfeeding among Haitian children under 6 months of age.

ABSTRACTObjective.To identify the determinants of exclusive breastfeeding (EBF) among children under 6 months of age from three regions in the South and Grand’Anse Departments of Haiti.Methods.Data were pooled from three cross-sectional surveys conducted yearly from 2017 to 2019 with the guardians of 638 children under 6 months of age. A non-quantitative 24-hour dietary recall was used to assess EBF the day before the survey. Using unadjusted and adjusted prevalence ratios, associations were assessed between EBF and several explanatory factors: infant’s age and sex; maternal age, educational attainment, mid-upper arm circumference (MUAC), dietary diversity, number of children under 5 years of age, responsibility for the main or secondary source of income of the household, initiation of breastfeeding within one hour, knowledge of EBF duration; household severe food insecurity, socioeconomic status, dependency ratio, region, and residential zone (urban/rural).Results.Prevalence of EBF was 68% in the study sample. From the fully adjusted model, prevalence of EBF was statistically significantly higher among younger infants, mothers with larger MUAC, who met or exceeded Minimum Dietary Diversity for Women (MDD-W), who initiated breastfeeding within one hour, who were knowledgeable of the recommendations for EBF duration, and living in the Jérémie region.Conclusions.The main determinants of EBF identified in this study attest to the importance of breastfeeding mothers’ access to nutritious food for the practice and maintenance of EBF and the need for geographically equitable access to health services and education that support breastfeeding.

Cross-sectional and longitudinal associations between the built environment and walking: effect modification by socioeconomic status

BackgroundAlthough socioeconomic status (SES) has been shown to modify associations between the neighborhood built environment and physical activity, contradictory results exist. Objectives of this cross-sectional and longitudinal analysis were to: 1) examine whether overall neighborhood walkability and specific built characteristics were associated with walking among adults at a single point in time and after they relocate neighborhoods, and 2) test for effect modification of these associations by SES.MethodsWe linked longitudinal data from 703 adults who relocated urban neighborhoods between two waves of Alberta’s Tomorrow Project (2008–2015) to neighborhood built environment data. We created a walkability index from measures of population counts, street connectivity, and destination diversity within 400 m of participants’ homes. In cross-sectional analyses, we used generalized linear models to estimate associations between built characteristics and minutes walked per week at baseline. For the longitudinal analyses, we used fixed-effects linear regression models to estimate associations between changes in built characteristics and minutes walked per week. We also assessed if indicators of SES (individual education or household income) modified both sets of associations.ResultsMost cross-sectional and longitudinal associations were small and statistically non-significant. Neighborhood population count (b = 0.03, 95% CI: 0.01, 0.07) and street connectivity (b = − 1.75, 95% CI: − 3.26, − 0.24) were cross-sectionally associated with walking duration among the overall sample. None of the longitudinal associations were statistically significant among the overall sample. There was limited evidence of effect modification by SES, however, we found negative cross-sectional associations between street connectivity and walking among adults with lower education and income, and a positive association between percent change in walkability and change in walking among lower educated adults.ConclusionsDespite population count and street connectivity being associated with walking at baseline, changes in these built environment variables were not associated with changes in walking following residential relocation. Our findings also provide evidence, albeit weak, that changes in neighborhood walkability, resulting from residential relocation, might more strongly affect walking among low SES adults. Further longitudinal research is needed to examine built environment characteristics with walking for different purposes and to test for inequitable socioeconomic impacts.

The relationships between socioeconomic status, dietary knowledge and patterns, and physical activity with adiposity in urban South African women

Background: This cross-sectional study examined the relationship between socioeconomic status (SES), dietary knowledge and patterns, and physical activity level with body mass index of urban South African young women. Methods: Data were collected on 160 black South African women (aged 18–24 years) and included household SES, food frequency and nutritional knowledge questionnaires, self-reported physical activity and anthropometry. To assess household SES index, 1–7 assets were categorised as a lower household SES and those with 8–13 assets as a higher household SES. Structural equation modelling analysis was used to determine the direct, indirect and total effects on adiposity of household SES, age, education, nutrition knowledge score, dietary patterns and physical activity. Results: The prevalence of overweight and obesity was similar among women from high SES households compared with their low SES peers (48.4 vs. 44.8%). More than half (53%) of the women had poor dietary knowledge. Women from low SES households spent more time in moderate to vigorous intensity exercise (MVPA) compared with their high SES counterparts. Two distinct dietary patterns (Western and mixed) were identified. SEM results show that a unit increase in adherence to the ‘Mixed’ dietary pattern compared with ‘Western’ was associated with a 0.81 lower BMI kg/m2 (95% CI −1.54; −0.08), while ≥ 150 minutes’ MVPA per week was associated with a 1.94 lower BMI kg/m2 (95% CI −3.48; −0.41). Conclusion: The associations of SES, diet and physical activity on BMI must be taken into account when developing and designing interventions that target improvement in young women’s health.

Estimated Consumption of Discretionary Salt and Salt From Bouillon Among Households, Women, and Children in the Northern Region of Ghana: CoMIT Project

ObjectivesTo 1) estimate discretionary salt (‘table salt’) consumption and the proportion of salt from bouillon, among households, women and children; 2) compare estimated salt consumption of women and children to recommendations; and 3) identify factors related to household salt consumption in 2 districts in the Northern Region, Ghana. MethodsWe enrolled households in the Condiment Micronutrient Innovation Trial (CoMIT) Project pilot survey from 14 urban and 14 rural clusters in the Tolon and Kumbungu districts. Using the Fortification Assessment Coverage Toolkit (FACT), households (n = 369) reported most recent purchases of discretionary salt (DS) and bouillon cubes (SB, ‘salt from bouillon’; bouillon assumed to be 55% salt). From the purchase data, we calculated median (IQR) household salt consumption (g/d) by summing DS and SB, and calculated the proportion from SB. Salt consumption for women of reproductive age (15–49 yrs, WRA) and children 2–5 yrs was estimated by the Adult Male Equivalent method and compared to recommendations from the World Health Organization (WRA < 5 g/d) and the National Academy of Sciences (children 2–5 yrs < 3.75 g/d). We used Spearman’s rank test to assess partial correlations between household salt consumption and household size, food insecurity (USAID Household Food Insecurity Access Scale score), socioeconomic status (SES, index score of home asset ownership), and household head education level while controlling for district, setting (urban/rural), and cluster. ResultsMedian (IQR) household salt consumption was 56.2 (40.3,116.2) g/d, 23% of which was contributed by SB. Median household size was 10 (8, 14) members. Estimated salt consumption was 6.0 (4.0, 10.2) g/d for WRA and 2.9 (1.9, 5.2) g/d for children; an estimated 50% of WRA and 31% of children potentially exceeded recommendations. Household size and food insecurity, but not education level or SES, were positively correlated with household salt consumption (r = 0.3, p < 0.001; r = 0.2, p < 0.001). ConclusionsHousehold salt and bouillon purchase data suggest that salt consumption among women and children in this area exceeds recommendations; food prepared outside the home may further contribute to salt consumption. Salt reduction interventions may be warranted in this context. Funding SourcesHelen Keller International through support from the Bill & Melinda Gates Foundation.

Racial and ethnic disparities in lifestyle changes during the COVID-19 pandemic: Exploring the socioeconomic and psychosocial mechanisms.

10558 Background: Obesity, physical inactivity, excessive alcohol consumption, and poor diet are all modifiable risk factors for cancer. These unhealthy behaviors are disproportionally concentrated in racial and ethnic minorities and these disparities may have been exacerbated during the COVID-19 pandemic. This study examined racial and ethnic disparities in weight gain and other undesirable lifestyle changes during the COVID-19 pandemic and explored mechanisms underlying these lifestyle disparities. Methods: We used data from the 2020 Health, Ethnicity and Pandemic Study, a national survey representative of US households conducted in October 2020. Racial and ethnic minorities were oversampled. Participants were asked to report lifestyle behaviors before and during the COVID-19 pandemic. We examined two outcomes in this study: weight gain and experiencing any undesirable lifestyle changes (i.e., reduced exercise time, increased alcohol drinking, or increased fast-food meal consumption). The primary exposure was race-ethnicity (non-Hispanic (NH) white, NH black, Hispanic, NH Asian, NH other race). Four sets of mediators were examined: socioeconomic status (education, household income, and undesirable job changes), family and friend social relationship change, perceived and experienced racism, and psychological distress. Weighted multivariable logistic regression models were performed. Mediation effects were examined with variance decomposition method. Results: A total of 2,709 participants were included in our sample. Compared with white respondents, black (OR = 1.71; p &lt; 0.001) and Hispanic respondents (OR = 2.17; p &lt; 0.001) were more likely to experience weight gain, controlling for age and sex. Among the hypothesized mediators, undesirable job changes during the pandemic, experiencing worse family relationship, and higher levels of psychological distress were all linked to higher odds of weight gain, but none of these variables played a salient role in mediating the black-white and Hispanic-white disparities in weight gain during the pandemic. As to the odds of experiencing undesirable lifestyle changes, black (OR = 1.76; p &lt; 0.001), Hispanic (OR = 2.12; p &lt; 0.001), and Asian respondents (OR = 1.42; p &lt; 0.01) all exhibited disadvantages relative to white respondent. These disadvantages were largely attributable to perceived racism toward one’s own group and psychological distress for all three minority groups. Conclusions: Racial and ethnic minorities were more likely to experience unhealthy lifestyle changes relative to white individuals during the pandemic in the United States, which can be partly attributable to higher levels of perceived racism and psychological distress. The long-term effects of racial/ethnic disparities of lifestyle change during the pandemic on cancer prevention warrant further research.