Household Economic Status Research Articles

Social determinants of inequalities in child undernutrition in Bangladesh: A decomposition analysis

Socioeconomic inequalities in child undernutrition remain one of the main challenges in Bangladesh. The social determinants of health are mostly responsible for such inequalities across different population groups. However, no study has examined the relative contribution of different social determinants to the socioeconomic inequality in child undernutrition in Bangladesh. Our objective is to measure the extent of socioeconomic-related inequalities in childhood stunting and identify the key social determinants that potentially explain these inequalities in Bangladesh. We used data for children younger than 5years of age for this analysis from 2 rounds of Bangladesh Demographic and Health Surveys conducted in 2004 and 2014. We examined the socioeconomic inequality in stunting using the concentration curve and concentration index. We then decomposed the concentration index into the contributions of individual social determinants. We found significant inequality in stunting prevalence. The negative concentration index of stunting indicated that stunting was more concentrated among the poor than among the well-off. Our results suggest that inequalities in stunting increased between 2004 and 2014. Household economic status, maternal and paternal education, health-seeking behavior of the mothers, sanitation, fertility, and maternal stature were the major contributors to the disparity in stunting prevalence in Bangladesh. Equity is a critical component of sustainable development goals. Health policymakers should work together across sectors and develop strategies for effective intersectoral actions to adequately address the social determinants of equity and reduce inequalities in stunting and other health outcomes.

Rural development program in tribal region: A protocol for adaptation and addressing climate change vulnerability

Tribal peoples globally are among the most vulnerable groups to climate change and variability. This is due to a combination of their relative poverty and their dependence on agriculture and natural support systems (NSS). Hence programmes that simultaneously help to reduce poverty and vulnerability to climate change are needed. The Indian Government has launched the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), an incentive-based programme addressing vulnerability to poverty, climate change and NSS by integrating natural systems (water, land, soil) and human systems (employment opportunities). Here we show that the vulnerability related to climate variability, agriculture, water and household economic conditions has decreased significantly due to MGNREGA interventions. Specifically, water availability, diversification of agriculture, crop yield and income have all increased. Besides the decreased vulnerability to climate change due to better access to water, the intervention has also increased employment opportunities and daily wage levels have almost doubled, thus improving the economic status of tribal peoples. These changes have led to improved living conditions, facilitating better adaptation to both natural and economic stresses. This case study illustrates the potential of well-designed government programmes to contribute to sustainable development through improving adaptive capacity and by combating poverty and vulnerability to climate change among marginalised people.

Socio-economic status and self-rated health: Are they good predictors of income? An analysis of survey panel data from Turkey

Background: The socioeconomic dynamics and economic status of households are changing rapidly all over the world, especially for middle-income and developing countries such as Turkey. It is well known that income is one of the most important determinants of socioeconomic status (SES) and health. There is a need to analyze changing trends and relationships among SES variables over time. Unfortunately, such changes remain undetected in cross-sectional studies. However, panel data cover multiple sequential time periods for the same firms or individuals and allow analysis of these changing patterns. Objectives: This study aims to determine predictive factors of income on a decision tree and to observe changes of predictive role of SES and health indicators over time, to predict income using three different panel datasets. Materials and Methods: Data from the Income and Living Conditions Survey in Turkey between 2008 and 2011 were used. A random effects and expectation maximization tree algorithm were also used in the analysis. Results: This study results show that education is the variable that is the most influential in predicting income between 2008 and 2011 and between 2009 and 2011; on the other hand, current economic status is a determining factor of income between 2010 and 2011. Conclusion: Experimental results highlight that education outperforms SES and health indicators in the prediction of personal income.

Maternal education and child immunization: the mediating roles of maternal literacy and socioeconomic status.

IntroductionPrevious studies in Nigeria have documented significant association between maternal education and child immunization. However, little is known about the pathway through which maternal education improves immunization uptake. This study aims to examine whether maternal literacy and socioeconomic status mediates the relationship between maternal education and complete immunization coverage in children.MethodsNationally representative data from the first wave of the Nigeria General Household Survey-Panel were used, which includes 661 children aged one year and below. Regression analyses were used to model the association between maternal education and child's immunization uptake; we then examined whether maternal literacy and household economic status mediates this association.ResultsOf the 661 children, 40% had complete immunization. The prevalence ratio (PR) of complete immunization in children whose mothers were educated versus those whose mothers were not educated was 1.44 (95% CI: 1.16-1.77). Maternal literacy substantially reduced the estimated association between maternal education and complete immunization by 90%, whereas household economic status reduced the estimates by 27%.ConclusionThese findings suggest that complete immunization was higher in children whose mothers were educated, partly because maternal education leads to acquisition of literacy skills and better health-seeking behavior which then improves immunization uptake for their children. Socioeconomic status is an alternative pathway but with less substantial indirect effect.

Barriers and facilitators of antiretroviral therapy adherence in rural Eastern province, Zambia: the role of household economic status

Barriers and facilitators of antiretroviral therapy adherence in rural Eastern province, Zambia: the role of household economic status

Household debt, economic conditions, and income inequality: A state level analysis

This paper uses OLS regressions to understand the relationship between household debt, income inequality, and economic growth in the United States. For robustness we use two different measures of income inequality. The results show that, for the period 2003–2012, there is statistical evidence that increases in household debt are associated with lower levels of economic growth and higher rates of unemployment. In addition, we uncover evidence that high growth rates in household debt are associated with negative growth in income inequality, likely because debt caused economic growth to slow, diminishing the returns of top earners.

Timely initiation of breastfeeding is associated with the practice of exclusive breastfeeding in Indonesia.

Exclusive breastfeeding has been proven to be essential for optimal health, and for reducing infections and mortality in children. However, exclusive breastfeeding coverage both in Indonesia and in globalremains low. This study evaluated the relationship between the timely initiation of breastfeeding and the practice of exclusive breastfeeding in Indonesia. This cross-sectional study used Riskesdas 2013 data. Participants were 7,667 mothers whose children were aged 6-23 months in Indonesia, and were selected based on the completeness of the variables. The data were analysed using descriptive statistics, chisquare tests, and a multiple logistic regression that considered the sampling weight. STATA 13.0 was used for the analyses, and the significance level was set at p<0.05. Timely initiation of breastfeeding within 1 hour of parturition (OR=3.66, 95% CI: 2.14-3.64), timely initiation of breastfeeding at or after 1 hour following parturition (OR=2.79, 95% CI: 3.00-4.46), and neonatal illness (OR=0.69, 95% CI: 0.53-0.91) were significantly associated with an exclusive breastfeeding history among children aged 6-23 months. Other factors, such as the mother's age, mother's educational level, child's birth weight, household economic status, and residential area were not associated with an exclusive breastfeeding history. Timely initiation of breastfeeding and the prevention of neonatal illness should be the main interventions to improve exclusive breastfeeding coverage in Indonesia.

Socioeconomic factors associated with diarrheal diseases among under-five children of the nomadic population in northeast Ethiopia.

BackgroundDiarrheal disease remains the leading cause of morbidity and mortality among under-five children worldwide. Every day, more than 4000 children lose their lives due to diarrhea. In Ethiopia, diarrhea is the second killer of under-five children next to pneumonia.MethodsA cross-sectional study was conducted to assess the prevalence of under-five diarrhea and socioeconomic factors among the nomadic people in Hadaleala District. A total of 704 under-five children were included in this study, and subjects were recruited by the multistage cluster sampling technique. Data were collected by a pre-tested questionnaire. The multivariable logistic regression analysis was used to identify socioeconomic variables associated with childhood diarrhea.ResultsThe 2-week period prevalence of diarrhea among under-five children was 26.1% (95% CI 22.9, 29.3%). The highest prevalence (37.5%) of diarrhea occurred among children aged between 12.0 and 23.0 months. The occurrence of diarrheal disease was associated with the presence of two (AOR = 4.3, p < 0.001) and three (AOR = 22.4, p < 0.001) under-five children in each household. The age of the children ranged between 6.0 and 11.0 months (AOR = 4.8, p < 0.001), 12.0 and 23.0 months (AOR = 6.0, p < 0.001), and 24.0 and 35.0 months (AOR = 2.5, p < 0.05), illiterate mothers (AOR = 2.5, p < 0.05), and poor households (AOR = 1.6, p < 0.05).ConclusionsDiarrhea prevalence was quite high among under-five children in Hadaleala District, and it was significantly concentrated among children aged between 12.0 and 23.0 months. The number of under-five children, age of children, mothers’ education, and household economic status were significantly associated with childhood diarrhea. To minimize the magnitude of childhood diarrhea, implementing various prevention strategies such as health education, child care, personal hygiene, and household sanitation which can be integrated with the existing national health extension program are essential.

PHP314 - Socio-economic status and self-rated health: are they good predictors of income? An analysis of survey panel data from turkey

Background: The socioeconomic dynamics and economic status of households are changing rapidly all over the world, especially for middle-income and developing countries such as Turkey. It is well known that income is one of the most important determinants of socioeconomic status (SES) and health. There is a need to analyze changing trends and relationships among SES variables over time. Unfortunately, such changes remain undetected in cross-sectional studies. However, panel data cover multiple sequential time periods for the same firms or individuals and allow analysis of these changing patterns. Objectives: This study aims to determine predictive factors of income on a decision tree and to observe changes of predictive role of SES and health indicators over time, to predict income using three different panel datasets. Materials and Methods: Data from the Income and Living Conditions Survey in Turkey between 2008 and 2011 were used. A random effects and expectation maximization tree algorithm were also used in the analysis. Results: This study results show that education is the variable that is the most influential in predicting income between 2008 and 2011 and between 2009 and 2011; on the other hand, current economic status is a determining factor of income between 2010 and 2011. Conclusion: Experimental results highlight that education outperforms SES and health indicators in the prediction of personal income.

Fertility Status of Married Women and Its Determinants in Ethiopia

This study investigates determinant factors of fertility among married women in Ethiopia, the second most populous country in Africa with rapid population growth. The data used for the analysis was obtained from the 2014 Ethiopia Mini Demographic and Health Survey which was carried out by the Central Statistical Agency. A generalized linear model (GLM) analysis was carried out to investigate the effect of socioeconomic and demographic factors on the number of children ever born by a married woman of age 15-49 years. High fertility was independently associated with residing in urban areas, increased household economic status, younger age at first birth and not using contraceptives. Current age and media exposure, household head gender and media exposure, household head gender and regional state, mother’s education and, regional state and media exposure and regional state were found to jointly affect fertility level.

Household food insecurity and its association with school absenteeism among primary school adolescents in Jimma zone, Ethiopia.

BackgroundHousehold food insecurity and lack of education are two of the most remarkable deprivations which developing countries are currently experiencing. Evidences from different studies showed that health and nutrition problems are major barriers to educational access and achievement in low-income countries which poses a serious challenge on effort towards the achieving Sustainable Development Goals. Evidence on the link between food security and school attendance is very important to address this challenge. This study aimed to assess to what extent food insecurity affects school absenteeism among primary school adolescents.MethodsA school based cross-sectional study was conducted among primary school adolescents in Jimma zone from October-November, 2013. Structured questionnaire was used to collect data on the household food security and socio-demographic variables. Data were analyzed using SPSS for windows version 16.0 after checking for missing values and outliers. Multivariable logistic regression analyses were used to determine the association of school absenteeism and food insecurity with independent variables using odds ratio and 95 % of confidence intervals. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression analysis to control for associations among the independent variables.ResultsThe frequency of adolescent school absenteeism was significantly high (50.20 %) among food insecure households (P < 0.001) compared to their peers whose households were food secure (37.89 %). Findings of multivariable logistic regression analysis also showed that household food insecurity [AOR = 2.81 (1.70, 4.76)] was positively associated with poor school attendance while female-headed household [AOR = 0.23 (0.07, 0.72)], urban residence [AOR = 0.52 (0.36, 0.81)] and male-gender [AOR = 0.64 (0.54, 0.74)] were inversely associated with school absenteeism. Household food insecurity was positively associated with lack of maternal education [AOR = 2.26 (0.57, 8.93)] and poor household economic status [AOR = 1.39 (1.18, 2.83)]. However, livestock ownership [AOR = 0.17 (0.06, 0.51)] was negatively associated with household food insecurity.ConclusionsFindings of this study showed that household food insecurity has strong linkage with adolescent school absenteeism. Maternal education and household economic status were significantly associated with household food security status. Therefore, national policies and programs need to stress on how to improve family income earning capacity and socioeconomic status to handle household food insecurity which is a key contributor of adolescent school absenteeism.

PEDAGANG KAKI LIMA PADA MASA KRISIS

Based on a survey of 325 street vendors in Yogyakarta Special Region that was conducted by the Population Studies Center of Gadjah Mada University, this study would like to analyze the contribution of income and prospect of the informal sector on household economy. It was found that earning in the informal sector constitutes the source of household income. Most street vendors said that income in the informal sector would help them improve on the household economic status. Working as a street vendor is a good choice. It has a good prospect and can be developed in the future.This research has also shown that the informal sector is capable to survive in the crisis. Caused by more flexibility, the number of people absorbed in the informal sector are even able to earn higher incomes. This implies that providing access to informal sector with such a high commitment of both government and non- governmental institutions, it is one important policy in helping them have better conditions in a economic household. Accordingly, it will in turn have an impact on increasing the economic scale of the informal sector.

Patterns and Determinants of Double-Burden of Malnutrition among Rural Children: Evidence from China.

Chinese children are facing dual burden of malnutrition—coexistence of under-and over-nutrition. Little systematic evidence exists for explaining the simultaneous presence of under-and over-nutrition. This study aims to explore underlying mechanisms of under-and over-nutrition among children in rural China. This study used a nationwide longitudinal dataset of children (N = 5,017) from 9 provinces across China, with four exclusively categories of nutritional outcomes including under-nutrition (stunting and underweight), over-nutrition (overweight only including obesity), paradox (stunted overweight), with normal nutrition as reference. Multinomial logit models (Level-1: occasions; Level-2: children; Level-3: villages) were fitted which corrected for non-independence of observations due to geographic clustering and repeated observations of individuals. A mixture of risk factors at the individual, household and neighbourhood levels predicted under-and over-nutrition among children in rural China. Improved socioeconomic status and living in more urbanised villages reduced the risk of stunted overweight among rural children in China. Young girls appeared to have higher risk of under-nutrition, and the risk decreased with age more markedly than for boys up to age 5. From age 5 onwards, boys tended to have higher risk of under-nutrition than girls. Girls aged around 12 and older were less likely to suffer from under-nutrition, while boys’ higher risk of under-nutrition persisted throughout adolescence. Children were less likely to suffer from over-nutrition compared to normal nutrition. Boys tended to have an even lower risk of over-nutrition than girls and the gender difference widened with age until adolescence. Our results have important policy implications that improving household economic status, in particular, maternal education and health insurance for children, and living environment are important to enhance rural children’s nutritional status in China. Investments in early years of childhood can be effective to reduce gender inequality in nutritional health in rural China.

Family and community level stigma and discrimination among women living with HIV/AIDS in a high HIV prevalence district of India

ABSTRACTTo examine HIV/AIDS-related stigma and discrimination in a high-HIV-prevalence district in India, we used data from a cross-sectional survey conducted recently among randomly selected married HIV-positive women, 15–29 years of age. Overall, 88% of respondents experienced stigma and discrimination from family and community. Factors associated with stigma and discrimination differed in the family and community contexts. Higher age gap between spouses and poor household status were significant in explaining the stigma and discrimination from husbands. Older age of the husband and lower household economic status significantly increased the stigma and discrimination from husbands’ family as well as from friends and neighbors. Different interventions should be developed for family and community contexts focusing on counseling for husbands, couples, family, and educational programs at the community level to reduce stigma and discrimination.

Household vulnerability and economic status during disaster recovery and its determinants: a case study after the Wenchuan earthquake

Although poverty analyses have dominated post-disaster assessments, household vulnerability analyses should receive more attention. Various methods have been developed to measure household vulnerability, and some studies have attempted to apply them to post-disaster assessments in China. Based on survey data collected after the Wenchuan earthquake in China, this paper attempts to compare the following three methods for assessing household vulnerability and household economic status during disaster recovery in China: vulnerability measured by expected poverty (VEP), vulnerability measured by household income (VHI), and vulnerability measured by subjective evaluation (VSE). The VEP method is a relatively more comprehensive method when combined with poverty analysis. The VHI method is useful when the main research aim is to identify households’ vulnerability in income generation and long-term regional economic development. Studies that aim to identify the direct impact of a disaster and research on relief work will find the VSE method very relevant. Bearing this in mind, understanding the specific advantages and focus of each method is crucial to conducting needs-assessment studies on household vulnerability and to forming and implementing policies for disaster recovery and poverty alleviation.

Investigations of latrine coverage and associated factors among Debretabor town, Amhara Region North west Ethiopia

&lt;span style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"&gt;Background: Studies in a number of countries have shown that wherever inappropraite waste disposal morbidity and mortality rates are high. Although latrine coverage is an important indicator for measuring success of the health service program; data on latrine coverage scarce in the study area. Objective: To investigate latrine coverage and associated factors in among households of Debretabor town, Amhara region, Ethiopia.&lt;span&gt; &lt;/span&gt;&lt;/span&gt;&lt;span style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-style: initial; text-decoration-color: initial; display: inline !important; float: none;"&gt;Methods: A community based cross sectional study was conducted in Debretabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. Result: In this study. Ninety three point five percent of households have latrine. Graduated as model family was predictor for availability of latrine (AOR= 3.18,). Income and house ownership were also found to be predictors for availability of latrine (AOR=3.70), (AOR=8.46), respectively. Educational status of respondents was found to be predictors for availability of latrine (AOR= 2.65). Conclusion: latrine coverage was relatively lower from the national target of 100%, still there are households that use open defication. Educational status, house owner shipe, income and graduated as model family were main factors affecting latrine availability. Improving socio economic status of households, provision of continuous advice and technical support at household level on the availability of latrine are recommended.&lt;/span&gt;

Hidden burden of non-medical spending associated with inpatient care among the poor in Afghanistan.

To elucidate the household payments required for medical and non-medical spending for inpatient health care and examine the pattern of household payments according to household economic status and the degree of remoteness of the area of residence. The subjects were 5490 individuals included in a nationally representative survey in 2010. Their medical (diagnosis and medicine) and non-medical (accommodation and transportation) expenses for their most recent hospitalization were analyzed. Compared with the richest group, the poorest group paid less for diagnosis and medicine (AOR=0.37, P<0.001; AOR=0.78, P=0.009, respectively), paid similar amounts for accommodation (AOR=1.19, P=0.164), and more for transportation (AOR=2.09, P<0.001). Residents in urban areas paid less than residents in rural areas for accommodation and transportation (AOR=0.73, P<0.001; AOR=0.58, P<0.001, respectively). Poor households paid less for diagnosis and medicine, but more for transportation related to inpatient care. Non-medical spending for inpatient care among the poor should be considered for affordable and accessible health-care utilization.

Schooling Achievement among Rural Zimbabwean Children during a Period of Economic Turmoil

Zimbabwe suffered severe economic crisis in the decade before 2009, and anecdotal evidence indicates that public education suffered due to uncertainty about salary payments and inflation. As the country recovers, it is important to understand how this crisis affected schooling participation before and during the crisis. This study focuses on the relationship between schooling achievement, measured by enrollment and enrollment in the age-appropriate grade, and household economic conditions in rural Zimbabwe for 2001 and 2007. A wealth index is used to reflect household economic conditions. Results indicate that children in the bottom 20 percent of the economic status distribution were less likely than others to be enrolled or attend the age-appropriate grade in both periods, but the impact of the crisis on indicators of school attendance are surprisingly modest. Findings indicate that the economy may be poised to rebound as macro-economic conditions stabilize since schooling attainment did not slip substan...

Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran.

One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform, thus financially protecting public against CHE.

The Association of Level of Internet Use with Suicidal Ideation and Suicide Attempts in South Korean Adolescents: A Focus on Family Structure and Household Economic Status

To examine the association between the level of Internet addiction and suicidal ideation and suicide attempts in South Korean adolescents, focusing on the roles of family structure and household economic status. Data from 221265 middle and high school students taken from the 2008-2010 Korea Youth Risk Behavior Web-based Survey were used in this study. To identify factors associated with suicidal ideation/attempts, multiple logistic regression analysis was performed. The level of Internet use was measured using the simplified Korean Internet Addiction Self-assessment Tool. Compared with mild users of the Internet, high-risk users and potential-risk users were more likely to report suicidal ideation (nonuser, odds ratio [OR] 1.10, 95% confidence interval [CI] 1.05 to 1.15; potential risk, OR 1.49, 95% CI: 1.36 to 1.63; high risk OR 1.94, 95% CI 1.79 to 2.10) or attempts (nonuser, OR 1.33, 95% CI 1.25 to 1.42; potential risk, OR 1.20, 95% CI 1.04 to 1.38; high risk, OR 1.91, 95% CI 1.71 to 2.14). The nonuser group also had a slightly higher risk of suicidal ideation/attempts compared with mild users. This association appeared to vary by perceived economic status and family structure. Our study suggests that it is important to attend to adolescents who are at high risk for Internet addiction, especially when they do not have parents, have stepparents, or perceive their economic status as either very low or very high.