Household Education Research Articles

Factors associated with HIV-positive status awareness among adults with long term HIV infection in four countries in the East and Southern Africa region: A multilevel approach.

Antiretroviral treatment (ART) appropriately and regularly used decreases the human immunodeficiency virus (HIV) viral load in the bloodstream, preventing HIV-infected people from spreading the infection to others. Disparities in ART adoption persists in East and Southern Africa, with low HIV-positive status knowledge being the primary factor. We investigated individual and household characteristics of HIV-positive status awareness among adults with long-term HIV infection in four East and Southern African countries: Eswatini, Malawi, Tanzania, and Zimbabwe. The study analyzed data from surveys conducted in Eswatini, Malawi, Tanzania, and Zimbabwe in 2015-2016. Only individuals who tested positive for HIV through rapid tests were included in the analysis. Those who already knew they were HIV-positive were categorized as aware, while those who reported being negative, never tested, or didn't know their status were categorized as unaware. Statistical models were used to examine various factors related to HIV awareness. Pooled and country-specific odds ratios were computed. The percentage of people who knew they had HIV ranged from 58% (Tanzania and Malawi) to 87% (Eswatini). After adjusting for other variables, young persons in all countries were less likely to be aware of their HIV-positive status. Gender, marital status, education, working status, household wealth, and urbanization level of households were also associated with HIV-positive status awareness but inconsistent across countries. HIV-positive status awareness in these four East and Southern African nations remained unsatisfactory as compared to the United Nations' 95% guideline, indicating that testing and knowledge of HIV testing in this region still has a lot of potential for improvement. The observed variations among nations may be attributable to differences in HIV pandemic culture and policies. The findings of this study will assist governments determining which subpopulations to target to boost adoption of HIV testing services, as well as in designing and development of policies.

Early Child Marriages, Unintended Pregnancies, and its impact on the Health of Young Girls in South Punjab

Background: Unwanted pregnancies are a significant public health issue in South Punjab, Pakistan, largely due to low contraception use and a substantial unmet need for family planning. The high fertility rate and maternal mortality in the region are further compounded by the prevalence of unwanted pregnancies, which also contribute to educational dropouts among girls and affect maternal health adversely. Objective: This study aimed to analyze the impact of education level, household size, wealth index, and type of residency on pregnancy intentions among women in Southern Punjab. Methods: Utilizing a survey design, data from 1,100 women aged 13 to 49, both from slum and non-slum areas across several districts in Southern Punjab, were analysed. Logistic regression and simple percentages were employed to assess the associations between socio-demographic factors and pregnancy intentions. Results: The results indicated that women with higher education levels had a higher proportion of intended pregnancies (220 out of 320, 68.75%) compared to those with no education (20 out of 70, 28.57%). In terms of household size, smaller households (1-2 persons) had a higher incidence of intended pregnancies (60 out of 130, 46.15%) compared to larger households (6 or more persons, 230 out of 490, 46.94%). Regarding the wealth index, the 'rich' category showed a higher likelihood of intended pregnancies (200 out of 255, 78.43%) compared to the 'poor' category (200 out of 530, 37.74%). Additionally, women residing in non-slum areas reported a higher rate of intended pregnancies (340 out of 550, 61.82%) than those in slum areas (350 out of 550, 63.64%). Conclusion: The study underscores the influence of socio-demographic factors on pregnancy intentions. Education level, household size, wealth index, and type of residency are pivotal in determining the likelihood of intended pregnancies. Tailoring family planning initiatives to these factors can significantly improve reproductive health outcomes in Southern Punjab.

Women empowerment in agriculture and its effect on household food security: evidence from Gamo Zone of Southern Ethiopia

BackgroundWomen empowerment and food security are supposed to be two mutually reinforcing goals of the 2030 Sustainable Development Agenda of the United Nations. However, the measurement of women’s empowerment and its relationship with household food security in the agricultural context is too limited, especially in Ethiopia. The main objective of this study is to examine the effect of women’s empowerment in agriculture on household food security in the Gamo zone of Ethiopia.MethodsCross-sectional data were collected from 385 dual-adult households, selected through a multistage random sampling procedure from two districts—Chencha and Kucha of Gamo zone in Ethiopia. The data were collected on the sample households’ demographic, socioeconomic, women empowerment, food consumption and livelihood activities—crop production, livestock holding and off-farm participation by interviewing both primary male and female decision-makers from each household. Household food security was measured using Calorie Availability, Household Food Consumption and Dietary Diversity Score, while women’s empowerment in agriculture was measured using the Abbreviated Women Empowerment in Agriculture Index. Ordinary Least Square, Two-Stage Least Square, Poisson and Instrumental Variable Poisson regression were used as analytical models.ResultsOur study shows that increases in women’s empowerment are positively and significantly associated with all food security indicators—adult equivalent calorie availability, household-level food consumption and dietary diversity. The result also shows that food security is positively related to the proportion of adult household members, age and education of primary female, landholding size, crop diversification, food crop production, the number of dairy cows owned and off-farm participation. However, food security is negatively related to household size.ConclusionThe implication of the finding is that stakeholders should give due attention to promoting women’s empowerment and eliminating the gender gap in agriculture through appropriate gender mainstreaming intervention in dual-adult households. Food security programmes could also gain from prioritizing female education and promoting agricultural diversification (crop and livestock) and off-farm income diversification strategies as valuable investments to improve household food security. This study is the first application of the Abbreviated Women’s Empowerment in Agriculture Index in Ethiopia as a predictor to household food security, and contributes to the women’s empowerment–household food security nexus literature in developing countries.

Abstract C082: Survival and treatment disparities of Hmong patients diagnosed with gastrointestinal cancer

Abstract Purpose: This study seeks to investigate disparities in treatment and survival for Hmong patients with gastrointestinal cancers in Wisconsin. Background: The Hmong community is one of the largest resettled communities in the U.S composed of ethnic minority refugees from Southeast Asia that migrated during the Vietnam War and as political refugees. Wisconsin has the third largest Hmong population in the U.S. Compared to Non-Hispanic Whites (NHW), Hmong face greater cancer mortality rates; distinct disparities may be underappreciated, as Hmong outcomes are often grouped with Asian Americans. Thus, differences in treatment and survival between NHW and Hmong populations remain understudied. Methods: Adults with liver, pancreas, or colorectal cancer diagnosed from 2004-2018 in the Wisconsin Cancer Reporting System were included. Summary statistics comparing Hmong, NHW, and Non-Hmong Asian individuals were generated. Adjusted logistic regression models were used to test differences in treatments. Adjusted Cox proportional hazard regression models were constructed to test differences in cause-specific survival (CPS) for liver and CRC and all-cause survival for pancreas cancer. Model A (A) adjusted for sociodemographic variables only: age, sex, race/ethnicity, rurality, county, median household income and education status, insurance, and stage. Model B (B) added treatment variables chemotherapy, surgery, and radiation. Results: Of 56,163 patients, 5,822 had liver cancer with 22 (0.4%) identifying as Hmong, 8,490 had pancreatic cancer with 11 (0.001%) identifying as Hmong, and 37,851 had CRC with 50 (0.001%) identifying as Hmong. For all cancer types, Hmong patients were diagnosed at a younger age and trended toward decreased survival. The average age at diagnosis was significantly lower for Hmong patients with liver cancer compared to NHW patients (55.3 years VS 67.6 years, p<0.001). Hmong patients with liver and pancreatic cancers had lower odds of receiving chemotherapy (OR=0.28, [0.09, 0.80], OR=0.03, [0.003, 0.24], and a trend towards lower odds of receiving chemotherapy (OR=0.60, [0.27, 1.20]) for CRC. All cancers trended toward lower odds of receiving surgery (OR=0.46, [0.12, 1.74], OR=0.61, [0.06, 5.42], OR=0.62, [0.26, 1.47], respectively. Compared to NHW patients, Hmong patients with liver cancer had an increased hazard of death (HR 2.67, [1.54, 4.63]) when considering sociodemographic variables (A). Adjustment for treatment variables reduced this disparity in (B) (HR 1.56, [0.90-2.72]). Conclusions: Hmong patients across all cancers were more likely to be diagnosed at a younger age and trended toward lower survival. Those with liver and pancreatic cancer also had lower odds of receiving chemotherapy. These findings highlight inequities in healthcare with the goal to drive greater access to and acceptance of treatment and community outreach. Future efforts will focus on disseminating this information and developing community-based approaches for health screening and prevention. Citation Format: Cinthya Maldonado Avila, Andrea Schiefelbein, Margaret Walker, Kajua Lor, John Hampton, Roberto J. Vidri, Noelle K. LoConte, Melissa Skala, Nabeel Zafar. Survival and treatment disparities of Hmong patients diagnosed with gastrointestinal cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C082.

Abstract C075: Socioeconomic status and genetic ancestry correlate with differences in clinical outcomes for colorectal cancer patients treated at a single tertiary cancer center

Abstract Intro: Lower socioeconomic status (SES) and African ancestry have been linked to poor overall survival (OS) in colorectal cancer (CRC). To better understand the interplay between these variables, we analyzed clinical and genomic real-world data from a large cohort of patients treated at a single tertiary center. Methods: Clinical annotations including sex, primary tumor location, age and stage at diagnosis were extracted from the electronic health record for 3,817 CRC patients who underwent clinical genomic sequencing at Memorial Sloan Kettering Cancer Center between 2014 and 2022. We also cataloged each patient’s type of primary health insurance (commercial, Medicare, Medicaid or self-pay). Socioeconomic status was assessed from each patient’s billing address using the Yost index (YI), which is a location-dependent percentile score based on household incomes, house values, rent, poverty, education, and employment statistics. Genetic ancestry was determined from DNA sequencing data using reference populations from the 1000 Genomes project, including European (EUR), African (AFR), East Asian (EAS), and Southeast Asian (SAS). Specific ancestries were assigned based on an ancestral fraction of >80%, otherwise patients were labeled as admixed (ADM). OS was measured from time of diagnosis to last follow-up. Results: Our cohort included 2,627 EUR, 195 EAS, 206 AFR, 61 SAS and 728 ADM patients. The median YI within our cohort was 18 [IQR: 30]. No significant associations were observed between YI and primary tumor location, age or stage at diagnosis. We observed significant differences in YI based on type of health insurance (median 15 for commercial vs. 29 for Medicaid, p<0.0001) and sex (median 15 in males vs. 17 in females, p=0.0113). YI was also strongly associated with genetic ancestry, with AFR patients exhibiting significantly higher YI values than other ancestries (median 45.5 vs. 14, p<0.0001). No significant differences in YI were observed among EUR, EAS and SAS patients. When all ancestries were analyzed together, patients within the bottom YI quartile (most affluent) had significantly longer OS than patients from the top YI quartile (most deprived) (median 52.3 vs. 61.6 months, p=0.023). No differences in OS were observed between EUR, EAS and SAS patients, but patients of AFR ancestry had significantly shorter OS than the rest (median 44.5 vs. 56.5 months, p= 0.016). When the analysis was restricted to patients of EUR, EAS and SAS ancestry, OS was still significantly shorter for patients within the top vs. bottom YI quartile (median 52.6 vs. 64.4 months, p=0.011). Conclusions: Patients of African ancestry exhibited lower socioeconomic status and shorter survival. Even when the analysis was restricted to other genetic ancestries, patients with the lowest socioeconomic status still had poorer clinical outcomes. The existence of these differences within a relatively homogeneous cohort of patients treated at the same institution highlights the need to better understand and address health disparities in CRC. Citation Format: Tejiri Agbamu, Xuechun Bai, Henry Walch, Michele Waters, Anisha Luthra, Kanika Arora, Christopher Fong, Doori Rose, Hannah Williams, Michael Berger, Karuna Ganesh, Julio Garcia-Aguilar, Nikolaus Schultz, Rona Yaegar, Walid Chatila, Francisco Sanchez-Vega. Socioeconomic status and genetic ancestry correlate with differences in clinical outcomes for colorectal cancer patients treated at a single tertiary cancer center [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C075.

고령자의 자기효능감이 돌봄로봇 수용에 미치는 영향

This study verified the effect of the older adults’ self-efficacy on acceptance of care robots according to the gender groups. This study used the data of the ’2022 Korea Older Adults Technology Acceptance Panel Survey’ conducted by the Department of Gerontology, Kyung Hee University, and multiple regression analysis was conducted by the all and gender groups on 506 older adults (203 males, 276 females) aged 60 or older nationwide. STATA 17.0 statistical program was used for analysis. As a result of the analysis by gender, in the case of men, the higher the technology self-efficacy and general self-efficacy, the higher the acceptance of care robot. In women, it was found that the higher the technology self-efficacy, the higher the education level and household income, and the better the Activities of Daily Living, the higher the acceptance of care robot. This study divided self-efficacy into general self-efficacy and technical self-efficacy and verified the impact of the two self-efficacy on the acceptance of care robots. This study has academic implications in that it divided self-efficacy into general self-efficacy and technical self-efficacy and verified the impact of the two self-efficacy on the acceptance of care robots. In addition, this study has practical implications in that it suggests separate action plans to increase the acceptance of care robots depending on the gender group of the older adults.

Evaluating modified effects of family factors on intervention to protect primary school students from the impact of heatwave

Identifying the factors that may impact intervention effectiveness of primary students is crucial for developing targeted intervention strategies on heatwave adaption. The purpose of the study was to assess how the family factors could affect the intervention effects of primary school students to adapt heatwave, using the data from a previously conducted primary school-based intervention study. The study recruited 648 students (9–13 years old) and their parents from two primary schools in Dongtai of Jiangsu province, China. From May to September 2017, a 5-mon intervention for enhancing knowledge, attitude and practice (KAP) was implemented at the intervention school. The students' KAP scores and the family-related information were measured by designed self-administered questionnaires at intervention school and control school separately before and after intervention. The effects of the intervention were explored through the propensity score matching and difference-in-difference method (PSM-DID), and stratified analysis were conducted by family factors. The overall KAP score increased by 2.391 (95% CI: 1.881, 2.902) after intervention, which shows that the intervention was effective. The students whose parents with higher school educational attainment, parents with employment, and household number ≤3 achieved significantly higher increment of KAP scores than their counterparts. Although students whose parents in marriage achieved higher score increasing than parents not in marriage, the difference was non-significant. Our findings indicated that parental education status, working status and the household size were the influence factors of heatwave adaption interventions for primary school students. Future interventions should take parental education status, working status and household size into account to improve the effectiveness of heatwave adaption intervention for primary school students.

Racial inequalities in mental healthcare use and mortality: a cross-sectional analysis of 1.2 million low-income individuals in Rio de Janeiro, Brazil 2010–2016

IntroductionMental health inequalities across racial and ethnic groups are large and unjust in many countries, yet these inequalities remain under-researched, particularly in low-income and middle-income countries such as Brazil. This...

Prenatal tobacco exposure associations with physical health and neurodevelopment in the ABCD cohort.

To investigate the strength and reproducibility of the teratogenic impact of prenatal tobacco exposure (PTE) on child physical health and neurodevelopmental outcomes, in the context of intersecting sociodemographic and other prenatal correlates, and test if early postnatal health mediates PTE associations with childhood outcomes. Among 9-10-year-olds (N = 8,803) in the Adolescent Brain Cognitive Development Study, linear mixed-effect models tested PTE associations with birth and childhood outcomes of physical health, cognitive performance, and brain structure, controlling for confounding sociodemographic and prenatal health correlates. Mediation analysis tested the extent to which health at birth explained the associations between PTE and childhood outcomes. PTE was reported by 12% of mothers (8% [n = 738] pre-knowledge of pregnancy only, and 4% [n = 361] pre- and post-knowledge of pregnancy). PTE was highest for children with a risk for passive smoke exposure. Overall, children with any PTE had shorter breastfeeding durations than those without PTE, and PTE following knowledge of pregnancy was associated with being small for gestational age having lower birth weight, and obesity and lower cortical volume and surface area in childhood. Among children from high-parent education households, any PTE was related to lower cognitive performance, which was partially mediated by duration of breastfeeding. PTE was linked to poorer health indicators at birth and neurodevelopmental outcomes at age 9-10 years in a large community cohort, independent of sociodemographic factors. Efficacious interventions for smoking-cessation during pregnancy are still needed and should incorporate support for breastfeeding to promote healthier development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Functional limitation in the older Brazilian adults: Association with multimorbidity and socioeconomic conditions.

The aim of this study was to assess the association between multimorbidity and the presence of functional limitation in basic (BADL) and instrumental activities of daily living (IADL) among Brazilian older adults and to verify whether this association is moderated by socioeconomic conditions. Cross-sectional study with data from the Brazilian National Health Survey (PNS) (2019) for the Brazilian population aged 60 years and over. The dependent variables were functional limitation, based on self-reported difficulty in performing one or more activities of daily living, including six BADL (feeding, bathing, using the toilet, dressing, crossing a room on the same floor and getting out of bed) and four IADL (shopping, managing money, taking medication and using transportation). The independent variables were multimorbidity (presence of two or more self-reported chronic diseases) and socioeconomic measures (per capita household income, asset score, and education level). The association between multimorbidity and outcomes was assessed using adjusted logistic regression models. The moderating effect of socioeconomic conditions on the association between multimorbidity and functional limitations was assessed by including an interaction term. The final sample consisted of 22,725 individuals. The prevalence of functional limitation was 8.5% (95%CI: 7.9-9.2) and 18.6% (95%CI: 17.8-19.5) in BADL and IADL, respectively. Multimorbidity was associated with BADL [OR: 2.30 (95%CI: 1.93-2.74)] and IADL [OR: 2.26 (95%CI: 1.98-2.57)]. The odds of functional limitation were higher among individuals with lower levels of education and income, but there was no interaction between multimorbidity and socioeconomic position measures. Multimorbidity was associated with functional limitation (BADL and IADL) and socioeconomic conditions, and this association was constant across socioeconomic position levels.

A study on the consumption of safe drinking water and its determinants using the weighted multinomial logistic model

Abstract This study introduces a novel approach by incorporating weighted analyses along with unweighted to comprehensively examine the decision-making processes related to drinking water sources and treatment in Pakistani households, utilizing 2018 Pakistan Demographic and Health Survey (PDHS) data for weighted descriptive statistics and weighted multinomial logistic models. This research uncovers distinct preferences between urban and rural regions, with urban areas favoring piped water and rural areas relying on surface water and unprotected wells. The age of the household head, household size, media exposure, education, women's empowerment, and wealth are identified as crucial factors influencing these choices. Furthermore, this study delves into household water treatment (HWT) adoption and finds varying rates among rural and urban areas, with household head age and education level playing pivotal roles. Remarkably, household size and media exposure exhibit no significant impact on HWT adoption. The incorporation of weighted and unweighted analyses enriches the understanding of safe drinking water preferences, highlighting regional disparities and influential factors in water source and treatment method adoption within Pakistani households.

Exploring the Impact of Household Spending Patterns on Education Outcomes among Residents in Malappuram District, Kerala, India

This study investigates the relationships between household expenditure patterns and education status, based on 386 households in Malappuram district between December 2021 and September 2022. Malappuram district, located in the southern Indian state of Kerala, is known for its distinctive features that encompass cultural, historical, and demographic aspects. Employing statistical tools such as Correlation, multiple regression, ANOVA, and chi-square, the research scrutinizes and quantifies these relationships. Notable findings underscore the prioritization of food and education in household budgets, emphasizing their pivotal role. The strong connection between education level and marital status unveils the interdependence of these decisions, reflecting societal norms. Financial implications of educational achievement shed light on how education acts as a mitigator of economic inequality by exposing income disparities. The correlation between total expenditure and education is positive, indicating that household spending plays a crucial role in achieving educational goals. The impact of food and medical expenses in affecting educational status is further highlighted by the regression analysis. When taken as a whole, these results add to a more sophisticated picture of the relationship between spending patterns and academic achievement. In the particular context of the Malappuram district, this knowledge provides insightful information for policymakers and programmes aiming to improve economic prosperity and educational accomplishment at the same time.

Association between Self-Reported Oral Health and Parkinson’s Disease: Evidence from UK Biobank

Objectives: Oral health problem is prevalent in the elderly population which is also at high risk of Parkinson’s disease (PD). However, the association between self-reported oral health and PD is still unclear. We aimed to explore the association between baseline self-reported oral health (mouth ulcers, painful gums, bleeding gums, loose teeth, toothache, dentures) and future incidence of PD. Methods and Participants: Participants were enrolled in the UK Biobank from 2006 to 2010 and those without PD at baseline were included in the current study. We used Cox regression analysis to explore the question and adjusted for age, sex, body mass index, smoking, drinking, ethnicity, education, socioeconomic status, and average total household income before tax. Results: We included 421,180 participants with a mean age of 56.26 years old, and 46.5% of them were male. And 2,339 participants were diagnosed with PD in the follow-up. Mouth ulcers, loose teeth, dentures, toothache, and bleeding gums were not related to the risk of PD. Painful gums were related to a higher risk of PD (HR: 1.39, 95% CI: 1.12–1.72, p = 0.003), and similar results were reached after adjusting for gene risk (HR: 1.39, 95% CI: 1.12–1.73, p = 0.003), or source of diagnosis (HR: 1.39, 95% CI: 1.12–1.72, p = 0.002), and time of diagnosis (HR: 1.29, 95% CI: 1.03–1.63, p = 0.02). Conclusions: Our study has demonstrated a substantial correlation between painful gums and elevated susceptibility to PD, underscoring the potential advantages of implementing oral health interventions for decreasing the risk of PD.

Factors influencing household expenditure on school education in Karnataka

Private expenditure on school education is one of the sources of education expenditure other than state and central government spending. The 86th Constitutional Amendment Act 2002, and the Right to Education (RTE) Act, 2009 introduced a rights-based approach to free and compulsory education for all children in the age group of six to fourteen years in India. Under the Right to Education (RTE) Act, a limited number of seats are allocated for free education to economically backward sections in private and private-aided schools. Despite the free education for students in government schools and RTE admissions in private schools, parents incur considerable expenditure. With the increase in the number of private schools, there is an increasing trend in private expenditure on education in India. In this context, this paper analyses factors influencing household expenditure on school education. It is based on primary data collected at the household level in Mysuru district in both rural and urban areas through a survey. The sample consists of 192 households each from urban and rural areas selected randomly from the list available at the schools. Factors influencing the education expenditure of the households on school education were estimated through a linear regression model. Annual Household Income (AHHI), Occupational Status of Father (OSF), Location of Household (LHH), Education Level of Mother (ELM), Education Level of Father (ELF) and Type of Institution (TI) have a positive and significant relationship with total Annual Household Education Expenditure (AHHEE) of the first child in school. In the case of a second school-going child, only Annual Household Income (AHHI) and Type of Institution (TI) were found to have a significant relationship with Annual Household Education Expenditure (AHHEE).

Examining the disparities: A cross-sectional study of socio-economic factors and food insecurity in Togo.

Despite many interventions, Togo continues to have one of the highest rates of poverty and food insecurity in the sub-Saharan African region. Currently there is no systematic analysis of the factors associated with household food-insecurity in this country. This study aimed at exploring the factors associated with food insecurity in Togo. This was a cross-sectional study that used data from five waves (2014 to 2018) of the Gallup World Poll (GWP) for Togo. Sample size included 4754 participants, aged 15 and above. Food insecurity was measured using the Food Insecurity Experience Scale (FIES) questionnaire as per the Food and Agricultural Organization (FAO) guidelines. Our outcome variable was food insecurity, categorized as: 1) food secure (FIES score = 0-3), moderately food insecure (FIES score = 4-6), and severely food insecure (FIES score = 7-8). We did descriptive and multinomial regressions to analyze data using Stata version 16. Between 2014 and 2018, the percentage of severe food insecurity fluctuated-42.81% in 2014, 37.79% in 2015, 38.98% in 2016, 45.41% in 2017, and 33.84% in 2018. Whereas that of moderate food insecurity increased from 23.55% to 27.33% except for 2016 and 2017 where the percentage increased to 32.33% and 27.46% respectively. In the logistic regression analysis, we found that respondents with lower than elementary education had a higher relative risk ratio of moderate (RRR = 1.45,95%CI = 1.22-1.72) and severe (RRR = 1.72, 95%CI = 1.46-2.02) food insecurity compared to those with secondary and higher education. Rural respondents had higher RRR of severe food insecurity (RRR = 1.37, 95%CI = 1.16-1.62) compared to those who lived in the urban areas. Compared with those in the richest wealth quintile, respondents in the poorest wealth quintile had 2.21 times higher RRR of moderate (RRR = 2.21, 95%CI = 1.69-2.87) and 3.58 times higher RRR of severe (RRR = 3.58, 95%CI = 2.81-4.55) food insecurity. About two-thirds of participants experienced some level of food insecurity in 2018. Lower levels of education, rural residency and poorer household wealth index areas were associated with a higher risk of food insecurity. National food security programs should focus on promoting education and improving socioeconomic condition of people especially in rural areas.

How does early-life famine experience influence household energy transition?

The transition of households towards cleaner energy is crucial for achieving sustainable development goals. However, the impacts and associated mechanisms of early-life experiences on household energy transition have not been considered. Based on data from the 2015 Chinese General Social Survey, this study aimed to investigate whether people experiencing China's Great Famine (1959–1961) in their early life promoted household energy transition in adulthood. The varying severity of the Great Famine in different provinces was characterised as a quasi-natural experiment and was used to perform difference-in-differences (DID) estimation analysis for birth cohorts. The results showed that the transitions from firewood, agricultural waste, and animal waste to liquefied petroleum gas and electricity were significant in households with the Great Famine experiences. Specifically, the long-term energy transition effect of the famine was exhibited mostly in those who experienced the famine during childhood (4–11 years old) and adolescence (12–17 years old). Besides, early-life famine experiences led to poor physical health, and more modern forms of energy, such as electricity, were consumed to avoid further deteriorating health. Early-life famine experience also brought psychological trauma to people at that time, which led them to increase Internet use to gain emotional support, and the increased Internet use provided better access to information about the energy transition. Moreover, the household energy transition influenced by early-life famine experience occurred more in female-headed, rural, more educated, and low-income households. Our results illustrated the role of early-life famine experience in household energy transition and provided new insights into developing effective energy policies.

Socioeconomic disparities in mammography screening in the United States from 2012 to 2020

The potential impact of the COVID-19 pandemic on socioeconomic disparities in mammography uptake remain poorly understood. We used repeated cross-sectional data from the 2012, 2014, 2016, 2018, and 2020 waves of the Behavioral Risk Factor Surveillance System, focusing on the U.S. women aged 50–74 years and investigated the relationships of educational attainment, employment status, and household income with a missed mammogram in the past two years. We ran Poisson regression analyses accounting for survey weights. The sample numbers were 139,761 in 2012, 137,916 in 2014, 140,000 in 2016, 116,756 in 2018, and 102,774 in 2020, respectively. Women with the lower educational attainment and lower household incomes reported higher proportions of missed mammography screening. Self-employed women were most likely to miss a mammogram. Accounting for other covariates, there was an increase in the adjusted prevalence ratio (PR) of missed mammography from 2018 to 2020 (pre-pandemic versus post pandemic onset) for self-employed women compared to women in waged work. Non-Hispanic Black women who were self-employed (PR = 0.28, 95% CI: 0.16, 0.51) and employed for wages (PR = 0.58, 95% CI: 0.47, 0.73) were at lower risks of missing a mammogram compared to non-Hispanic White women in the same categories. The findings suggest that disparities for mammography uptake widened after the pandemic onset, especially for employment status, which varied by race/ethnicity.

Disaster risk management of debris flow based on time-series contribution mechanism (CRMCD): Nonnegligible ecological vulnerable multi-ethnic communities

Disaster management often serves as the primary defense against ecological damage and threats to social well-being resulting from natural disasters. However, the quantitative research on unified disaster risk management capacity assessment has not been scrutinized. Based on the time series structure, this study proposes a novel framework and risk management contribution models for exploiting a community risk management capacity to debris flows (CRMCD) assessment system. A comprehensively improved method was utilized for indicator selection by combining R hierarchical clustering (RHC) and coefficient of variation methods (CV). Entropy-weighted grey correlation analysis (EGCA) and geographic information system (GIS) methods are employed to assign weights and visualize the disaster management capacity of research areas. Three risk management contribution models are constructed according to the criterion layers defined by CRMCD: prevention-oriented, emergency-oriented, and recovery-oriented. Furthermore, a questionnaire was designed by introducing multi-ethnic cultural scenarios to assess public risk awareness, avoidance behaviors, and management demands. A total of 3,060 survey samples were conducted among ethnic minority communities in Sichuan that issued debris flow disaster declarations in 2022. Social welfare and public satisfaction were examined to validate the applicability of the CRMCD assessment system and risk management contribution model. The results identified key indices contributing to enhancing CRMCD: The proportion of financial investment in disaster prevention and public security, Professional skills diversity of emergency responders, and Installed power capacity. The multinomial logistic regression analysis revealed public preference for the prevention-oriented type in the risk management contribution model, and interviewees demonstrated a more positive response regarding motivation and participation in disaster prevention under this model. Kruskal-Wallis H significance analysis highlighted that ethnic minorities and elderly populations exhibited lower levels of disaster knowledge reserves, avoidance awareness, and propensity to purchase disaster insurance. Unexpectedly, respondents with higher household income and education levels paid less attention to seeking assistance from professional community organizations. Disaster early warning emerged as a priority for respondents interested in strengthening community disaster management initiatives. Overall, this study outlines a systematic methodology to establish an objective index system and summarize management models, which provide breakthroughs in developing participatory disaster management frameworks and resilience communities.

Food deprivation among adults in India: an analysis of specific food categories, 2016–2021

Adult undernourishment remains pervasive throughout India, and often results from food deprivation, which refers to the inadequate consumption of foods with caloric and nutrient significance. Therefore, understanding the extent to which food groups are missing from an individual's diet is essential to understanding the extent to which they are undernourished. We used data from two National Family Health Surveys conducted in 2016 and 2021 for this cross-sectional analysis. The study population consisted of women and pregnant women between the ages of 15-49, and men between the ages of 15-54. We examined shifts in the percentage of people not consuming dairy, pulses/beans/legumes, dark leafy green vegetables, fruits, eggs, and fish and meat among women, pregnant women, and men between the two time points. We also examined these patterns by household wealth and education, two important markers of socioeconomic status. Overall, we found that fewer women, pregnant women, and men were not eating each of the six food groups in 2021 than in 2016. Additionally, the gap in food group consumption between women, pregnant women, and men in the lowest and highest socioeconomic groups shrank between 2016 and 2021. Yet, food group deprivation remained most prevalent among those in the lowest socioeconomic groups. The two exceptions for this were for eggs and meat/fish. Nevertheless, the majority of India's poorest and least educated adults are not consuming high-quality protein sources, including dairy, the consumption of which is far more common among wealthier and more educated Indian adults. Our results show that fewer adults were not consuming important food groups in 2021 than in 2016. However, many of India's poorest and least educated adults are still not consuming high-quality sources of protein or fruits, two food groups that are essential for good health. While adults might be getting protein and nutrients from pulses, legumes, beans, and other vegetables, efforts are needed to improve affordability of, and access to, high-quality sources of protein and fruits. This work was supported by the Bill & Melinda Gates Foundation, INV-002992.

Impact of the Financial Resources Allocated to Education in Each Region on Family Investment in Education at the Compulsory School Level

Compulsory education has a vital role in the process of national development, so financial education funding is a public expense that must be guaranteed and implemented by all regional governments. And family education investment also plays an important role in education as the supplementary funding for every school-age child to receive education. Due to data limitations, the number of studies on the relationship between the two is relatively small, so this paper, based on the micro-database of the China Education and Finance Household Survey (CIEFR-HS), examines in depth the impact of financial education funding on household education inputs during the compulsory education stage, and accordingly makes recommendations for policy targeting. The result reveals that the local financial expenditures on compulsory education have a significant crowding-in effect on families education investment. The present study provides novel evidence on the relationship between educational investment and household investment and accordingly makes recommendations for policy targeting.