Household Income Research Articles

Vitamin D Status in Roma Mothers and Newborns: Socioeconomic Factors and Impact on Neonatal Outcome

Background: The Roma are a socioeconomically disadvantaged, marginalized community with reduced access to education, social services, and healthcare. Despite the known health risks they are exposed to, we have limited data about a wide range of health outcomes in this population, including vitamin D deficiency. The aim of this study was to investigate prevalence of vitamin D deficiency and its impact on the anthropometric outcomes of newborns in a group of Roma mothers and their infants in Romania. Methods: In total, 131 Roma women and 131 newborns were included in the study. Vitamin D levels in both mothers and newborns, as well as the birth weight, length, and head circumference of newborns, were recorded at birth. We also assessed socioeconomic factors, including education, employment status, income, and living conditions, as well as factors that influence vitamin D status, including sun exposure, use of sunscreen, fish consumption, and skin type. Results: All mothers and almost all newborns had vitamin D insufficiency or deficiency, with 25-hydroxivitamin D levels below 30 ng/mL. Maternal vitamin D status was significantly correlated with neonatal vitamin D levels (p < 0.01) but not with anthropometric outcomes such as birth weight (p = 0.57), birth length (p = 0.53), or head circumference (p = 0.96). Most study participants had a low socioeconomic status, reporting severe deficiencies in education, employment status, household income, and living conditions. Conclusions: Vitamin D deficiency is a significant public health issue among Roma women and their newborns, which may be compounded by the socioeconomic challenges of this vulnerable population.

Health systems responsiveness towards needs of pregnant women in Vietnam

BackgroundHealth systems that are responsive to maternal mental health recognise the importance of integrating mental health services into maternal care. Studies from Vietnam have reported particularly high rates of common perinatal mental health disorders (CPMDs) in both rural and urban areas of the country. Despite the increasing burden of maternal mental health conditions, there is currently no guidance on the screening for CPMDs within maternal care, both antenatal and postnatal. In this paper, we report the findings from a survey that examined health systems responsiveness to the needs of pregnant women at the primary care-level in Vietnam, utilising the WHO’s validated responsiveness questionnaire.MethodsCluster sampling was used in two districts, in Bac Giang Province. Data were collected using the WHO responsiveness tool, including questions on the domains of responsiveness relating to pregnant women’s last antenatal visit. SPSS (version 24) software was used for data entry and analysis, respectively. Bivariate and multivariable logistic regression were computed to identify the associated factors of health system responsiveness in maternity care at 95% CI.ResultsWe found that the overall mean health systems responsiveness score was 2.86 (out of maximum 4), with 30.4% pregnant women rating responsiveness as “poor” for maternal health care (based on the cutoff point of 60 for overall score). The three highest scoring domains were “social support”, “trust”, and “dignity” and lowest scoring domains were “choice of providers”, “prompt attention”, and “communication”. There is a strong preference for seeking maternal health care at private facilities which meet women’s needs of “confidentiality” and “basic amenities”. Household income was found to have a significant impact on the six responsiveness domains. Finally, only a small proportion of pregnant women self-reported having CPMDs and accessed mental health facilities.ConclusionsThese findings highlight the need to improve the responsiveness of the Vietnamese health system to meet pregnant women’s expectations, mainly in relation to prompt attention and communication. This study also highlights the importance of specifically targeting efforts towards improving the responsiveness of the public health sector. Integrating maternal and mental health at the primary care-level can be one approach to tackle the mental health treatment gap experienced by pregnant women in Vietnam. This can promote early detection and intervention of CPMDs, but may also contribute towards reducing mental health-related stigma.

Novel models by machine learning to predict the risk of cardiac disease-specific death in young patients with breast cancer

BackgroundWith the tremendous leap of various adjuvant therapies, breast cancer (BC)-related deaths have decreased significantly. Increasing attention was focused on the effect of cardiac disease on BC survivors, while limited existing population-based studies lay emphasis on the young age population.MethodData of BC patients aged less than 50 years was collected from the SEER database. A competing risk model was introduced to analyze the effects of clinicopathology variables on the cardiac disease-specific death (CDSD) risks of these patients. Further, an XGBoost prediction model was constructed to predict the risk of CDSD. Prediction performance was assessed using the receiver operating characteristic (ROC) analysis, area under the POC curve (AUC) values, calibration curves, decision curves, and confusion matrix, and SHapley Additive exPlanations (SHAP) were used to interpret the models.ResultsOur competing risk analysis proved that young BC patients with older age, low household income, non-metropolitan residential environment, black race, unmarried status, HR + subtype, higher T stage (T2-4), receiving chemotherapy, and non-surgery are under higher risk of CDSD. Further, five machine learning models were constructed to predict the CDSD risks of young BC patients, among which the XGBoost models showed the highest AUC value (train set: AUC = 0.846; test set: AUC = 0.836). The confusion matrix of the XGBoost model demonstrated that the sensitivity, specificity, and correction were 0.81, 0.94, and 0.94 for the train set, and 0.82, 0.95, and 0.96 for the test set, respectively. The SHAP graph indicated that median household income, marital status, race, and age at diagnosis were the top four strongest predictors.ConclusionIndependent CDSD risk factors for young BC patients were identified, and machine-learning prognostic models were constructed to predict their CDSD risks. Our validation results indicated that the predicted probability of our XGBoost model agrees well with the actual CDSD risks, and it can help recognize high-risk populations and therefore develop effective cardioprotection strategies. Hopefully, our findings can support the growth of the new field of cardio-oncology.

Household energy consumption tendencies: The Baltic States context

As energy resource prices are on the rise and the stability of energy supplies is increasingly challenged by the current geopolitical climate, it is essential to scrutinize the capability of households to adapt to the resulting circumstances by assessing the current and potential household energy supply and adapting solutions to energy consumption habits. The aim of the research is to study of the energy consumption behaviour of households in the Baltic States amidst a significant increase in prices. The research methods encompass the examination of literary sources, categorization, amalgamation, abstraction, and juxtaposition in the theoretical segment, as well as a case study focusing on energy consumers in Lithuania, Latvia, and Estonia. Notably, the study presents a unique analysis of the unprecedented scenario of substantial price hikes across all energy usage categories in the region. An examination of individual responses concerning energy consumption illustrates a notable escalation in household expenditures on electricity and heating. Households are endeavouring to curtail energy expenses through various conservation techniques. A correlation between income levels and household energy consumption is evident.

Socioeconomic, health, and social connectedness factors associated with self-rated health of octogenarians and nonagenarians in South Korea: urban and rural comparison

BackgroundThe aging population, including octogenarians (aged 80–89) and nonagenarians (aged 90–99), is rapidly increasing. Understanding their self-rated health in urban and rural settings is vital for public health policy development. This study examined factors associated with self-rated health among octogenarians and nonagenarians across urban and rural areas of South Korea.MethodsWe analyzed data from 21,896 older adults (aged 80–99) from the 2023 Korea Community Health Survey. Self-rated health was assessed on a 5-point scale and categorized as “good” or “poor.” Variables included age, residence area (urban/rural), sociodemographic characteristics, health behaviors, healthcare utilization, morbidity, and social interactions. Descriptive statistics were used to examine variable distributions, and logistic regression models identified factors associated with self-rated health in each age group and residential area.ResultsAmong octogenarians, 18.7% in urban areas reported good self-rated health, compared to 15.0% in rural areas. Conversely, a smaller proportion of nonagenarians in urban areas (13.6%) reported good self-rated health than those in rural areas (14.7%). Among octogenarians, having a high school education or higher was associated with better self-rated health compared to those with no formal education (urban OR = 1.67, 95% CI = 1.39–2.00; rural OR = 1.67, 95% CI = 1.30–2.14). Furthermore, a monthly household income of 3 million Korean Won (KRW) or more, compared to an income of less than 1 million KRW, was associated with better self-rated health among octogenarians (urban OR = 1.35, 95% CI = 1.09–1.66; rural OR = 1.54, 95% CI = 1.19–2.00). The associations between educational level and self-rated health were less pronounced among nonagenarians. Consistently across both age groups and settings, regular walking (OR range: 1.39 [95% CI = 1.21–1.60] for rural octogenarians to 2.17 [95% CI = 1.78–2.64] for urban nonagenarians), good self-rated oral health (OR range: 2.51 [95% CI = 1.96–3.22] for urban nonagenarians to 3.51 [95% CI = 3.01–4.09] for rural octogenarians), and participation in social activities (OR range: 1.23 [95% CI = 1.09–1.41] for urban octogenarians to 1.58 [95% CI = 1.20–2.07] for rural octogenarians) were positively associated with good self-rated health.ConclusionsCharacteristics associated with self-rated health differed significantly between octogenarians and nonagenarians in rural and urban areas. Public health strategies must support health-promoting behaviors such as regular walking, enhance oral health services, improve healthcare accessibility, reduce environmental stressors, and strengthen social support networks to promote health among octogenarians and nonagenarians.

Prevalence and influencing factors of medication-related burden among patients with late-life depression in typical city of eastern China: a cross-sectional study

AimTo evaluate the medication-related burden (MRB) of patients with late-life depression (LLD) and its influencing factors in China using the Living with Medicines Questionnaire-3 (LMQ-3), providing reference for reducing the MRB of those patients.MethodA cross-sectional study was conducted between September 2023 and January 2024 on 588 patients with LLD. LMQ-3 and MRB factors questionnaire were used for data collection. The distribution of variables was assessed using descriptive analysis, while analyses of Mann-Whitney and Kruskal-Wallis were performed to evaluate inter-group differences. To explore the MRB among patients with LLD and influencing factors, multiple linear regression analysis was performed.ResultsThe median (IQR) LMQ-3 score of 588 participants was 102 (18), indicating a moderate MRB level. Regression analysis revealed a significant trend toward higher perceived burden among patients aged 70–79 years old, living in rural areas, receiving more medical insurance settlements, using all cash, taking more than 5 drugs each time, and taking medicine more than 3 times a day (p < 0.05), which were risk factors for higher MRB. Conversely, patients who lived with their children, had an annual household income (including adult children) more than 50,000 Chinese Yuan, and no adverse drug reactions had lower LMQ-3 scores (p < 0.05), which were protective factors. Patients’ concerns about medicine, their lack of autonomy in medicine regimens, and the lack of communication between patients and doctors on treatment regimens were the main causes of the burden.ConclusionsResults of this study provided preliminary evidence of the MRB among patients with LLD. Age, residence, living status, annual household income, type of drug payment, quantity and frequency of medication, and adverse reactions significantly affected the perceived medication burden. It is advisable for health policy makers and health care providers to implement appropriate intervention strategies and burden reduction programs for this vulnerable group.

Sociodemographics and Digital Health Literacy in Using Wearables for Health Promotion and Disease Prevention: Cross-Sectional Nationwide Survey in Germany.

Wearable technologies have the potential to support health promotion and disease prevention. However, it remains unclear how the role of social determinants of health (SDoH) and digital determinants of health (DDoH) plays in this context. This study investigates differences in sociodemographic factors and digital health literacy between wearable users and non-users, whether the association with wearable use varies across age groups and its potential mediator. A cross-sectional nationwide telephone survey was conducted in November 2022 in a panel of adult internet users in Germany. Assessments included self-reported wearable use, sociodemographic factors (sex, age, education, household size and income, and residence region), and digital health literacy (measured with the eHealth Literacy Scale, eHEALS). Associations between wearable use, sociodemographic factors and digital health literacy were analyzed using binomial logistic regression models in the total sample and with age group stratification, with a supplementary mediation analysis examining digital health literacy as a mediator in the relationship between age and wearable use. Overall, 24% (223/932) of participants (52% male, mean age 55.6 years) reported using wearables for health. Wearable use was lower among participants aged 65 and above, with lower educational attainment, living in 1-2 person households, with below-average household income, and residing in smaller cities or former East Germany. Wearable use prevalence is substantially lower in older age groups (18-40: 36%; 41-64: 26%; 65+:14%). Wearable users reported higher levels of digital health literacy (mean: 30.7, SD = 5) than non-users (mean: 28.3, SD = 6). Stratified analyses indicate that the association between digital health literacy and wearable use varies by age group, with significant positive association observed in older age groups (OR = 1.00, 95% CI: 0.94 to 1.07 in age group 18-40; OR = 1.07, 95% CI: 1.03 to 1.12 in age group 41-64; OR = 1.11, 95% CI: 1.04 to 1.19 in age group 65+). Mediation analysis indicated that digital health literacy partially mediates the relationship between age and wearable use (indirect effect: coefficient = -0.0156, 95% CI: -0.0244 to -0.00791, p <.001). This study indicates sociodemographic disparities in wearable use among the German population and differences in digital health literacy between wearable users and non-users. A generational divide in wearable use was identified, with older adults being less likely to embrace this technology. This was especially true for older adults with lower digital health literacy. Future public health initiatives employing health technologies should take SDoH and DDoH into consideration to ensure effective and equitable impacts.

Impact of the presence of a family member with dementia on the prevalence of depression: a comparison based on household income level

BackgroundFamilies caring for patients with dementia are more vulnerable to depression. This cross-sectional study compared differences in socioeconomic status and gender related to depression among families of patients with dementia and identified associated factors.MethodsInequality in depression according to household income level among families of patients with dementia was assessed using the Korean Community Health Survey, which included a sample of over 200,000 participants. Depression prevalence was assessed using the Patient Health Questionnaire-9 (PHQ-9) and each independent variable was calculated. Significant differences were analyzed using the chi-square test. Complex-sample multivariate logistic regression was performed to examine the association between the income levels of families of patients with dementia and depression. Additionally, an analysis of depression, stratified by income level and gender, was conducted.ResultsThe prevalence of depression among families of patients with dementia was 4.41%. The odds ratio (OR) for depression among families of patients with dementia compared to the population of families without patients with dementia was 1.49. Depression was significantly more likely in families with lower income levels (adjusted OR [aOR]: 2.17, 95% confidence interval [CI]: 2.16–2.18). The magnitude of the impact of having a family member with dementia on depression varied by income level, being highest in the lowest income group (aOR: 1.64, 95% CI: 1.63–1.66) and lowest in the highest income group (aOR: 1.26, 95% CI: 1.24–1.27). Stratification by gender showed that both men and women in families of patients with dementia were more likely to experience depression than those in families without patients with dementia. Women had a higher likelihood of depression across all income levels than men; however, the impact of having a family member with dementia was more pronounced among men, especially those from lower-income groups.ConclusionsOur findings suggest the necessity for support policies tailored to low-income groups and women among families of patients with dementia. This is crucial given the higher prevalence of depression among families of patients with dementia than among families without patients with dementia.

The Addition and Expansion of Demographic Characteristics in the NCVS

One of the advantages of the National Crime Victimization Survey (NCVS) is that it is a large-scale data collection that allows data to be analyzed on various subpopulations. Since the survey’s inception, there have been changes to the population, law, and areas of public interest. In July of 2016, questions were added to the NCVS on citizenship, veteran status, sexual orientation, and gender identity. In addition, changes were made to existing questions on disability status and household income. This allowed for analysis of criminal victimization against more demographic groups. This article discusses these changes and provides estimates of violent victimization by these demographic characteristics.

Risk assessment and predictive modeling of suicide in multiple myeloma patients.

Despite advancements in treatment that have extended survival, multiple myeloma (MM) remains a distressing diagnosis with significant health impacts, including an elevated risk of suicide. This study aims to investigate suicide risk among MM patients and develop a predictive model to identify high-risk individuals. We analyzed 83,333 MM cases from the latest Surveillance, Epidemiology, and End Results (SEER) database (2001-2020) to identify suicide risk predictors and develop prediction nomograms. The cohort was randomly allocated into training and validation groups. Validation included assessing the consistency index (C-index), receiver operating characteristic (ROC) curve, and calibration curve. Among the cohort, 89 MM patients died by suicide, reflecting a significantly higher rate compared to the general US population (SMR = 2.186). Key risk factors included household income ≤ $50,000 (SMR = 3.82), male sex (SMR = 3.68), and age ≥ 80years at diagnosis (SMR = 3.05). Additional predictors were unmarried status, Black race, and diagnosis post-2007. The nomogram incorporating these factors demonstrated strong predictive accuracy in both training and validation groups. This study identified critical suicide risk factors in MM patients and developed a predictive nomogram that aids physicians in the early identification of at-risk individuals, facilitating more effective preventive measures. Utilizing the factors and predictive model for suicide risk among MM survivors allows for earlier identification and intervention, significantly enhancing their quality of life and psychological relief in the context of improved MM survival rates.

Examining socio-economic disparities among e-cigarette users and cigarette smokers in three Canadian jurisdictions.

It is well established that a gradient exists among cigarette smokers, such that smoking is more prevalent among individuals who are of lower socio-economic status (SES). In this study, we examined whether a similar SES gradient exists among electronic cigarette (e-cigarette) using youth and adults in three Canadian jurisdictions. A secondary analysis of data from Ontario, Quebec and Yukon respondents (n = 58,592) to the 2017-2018 Canadian Community Health Survey was conducted. Unadjusted and adjusted logistic regression models explored SES measures: total and relative household income, and education level, separately on use of e-cigarettes or cigarettes in the past 30 days. Models adjusted for additional socio-demographic and psychosocial covariates. A significant inverse SES gradient existed for cigarette smoking based on education and income variables, with higher education and income associated with decreasing consumption in a stepwise manner. No SES gradient was observed for e-cigarettes. While a robust SES gradient was observed among cigarette smokers, no gradient for e-cigarette use was observed. Explanations for these findings may be linked to perceptions that e-cigarettes are healthier, have convenient designs and appealing flavours, and less stigmatised. As more becomes known about potential harms from e-cigarettes, effective interventions may be needed to prevent the emergence of a gradient that disproportionately affects those at lowest income and education levels. Continued monitoring of e-cigarette use patterns across SES groups is necessary for public health.

Effect of small-scale irrigation on rural household agricultural income in Demba-Gofa District, Southern Ethiopia

Even though small-scale irrigation (SSI) is a practical solution to address issues like poverty, food insecurity, and low farm production, its promise is often overlooked in Ethiopia. In the Demba Gofa District of southern Ethiopia, many rural households continued to rely primarily on rain-fed agriculture despite the possibility of irrigation. Therefore, the purpose of this study was to determine the factors that influence the adoption of SSI in Demba Gofa and its effect on farm income. A cross-sectional explanatory research design with a mixed-methods approach was employed on a total of 369 households selected through a multistage sampling procedure. An econometric data analysis using the propensity score matching model was employed to evaluate the effect of small-scale participation on households' farm income. The analysis revealed that the gender of the household head, cultivated land area, market accessibility, livestock ownership, and credit service accessibility positively affect irrigation adoption. Households' irrigation adoption was negatively and significantly associated with the age of the household head and the distance of the farm from the irrigation site. Furthermore, households that did not adopt small-scale irrigation schemes lost 4831.77 ETB in farm revenue compared to those that did. Thus, the study advises the government to support the establishment of adequate, long canals and government-guaranteed credit services for smallholder farmers in order to boost household income and, consequently, food security. Agricultural agents ought to conduct routine evaluations of the canals' operation and offer farmers training to enhance their skills in the sustainable use of irrigation systems.

Determinants of last-mile travel mode choice under different COVID-19 alert levels: A case study of Batasan Hills, Quezon City, Philippines

The COVID-19 outbreak has led to remarkable changes in the transport sector and people’s travel behavior. The suspension of public transport leads to an increase in the number of private car users and the number of walking activities. The last mile, being one of the weakest links in the transport network, has become more challenging to manage with the imposition of different travel restrictions. Using the data collected from the households of Barangay Batasan Hills, Quezon City, Philippines, this study aimed to understand people’s travel behavior during the pandemic. Specifically, a binary logit model was used to determine the significant factors that affect the last-mile travel mode choice under different alert levels. Results showed that age during the pandemic, monthly household income, the purpose of travel, travel expense, travel time, departure time, origin, compliance with COVID-19 measures, and trip duration have significant factors in last-mile travel mode choice. In addition, risk perception on public transport was also a determinant of last-mile travel mode under alert levels 1 and 2. Analyzing travel behavior during the COVID-19 pandemic is deemed beneficial in devising strategies and interventions that will help mitigate the spread of the virus while still allowing economic activity and the movement of people to happen.

Multiple Indicator Vulnerability to Energy Poverty: Assessing Spatial Variability Across Chile

This study investigates the multifaceted issue of energy poverty, focusing on its spatial and socioeconomic dimensions, with a particular emphasis on the case of Chile. Despite global initiatives like Sustainable Development Goal 7, which advocates for universal access to affordable and reliable energy, millions remain vulnerable to energy poverty. In Chile, this phenomenon is exacerbated by geographic and climatic variability, resulting in significant disparities in energy access, affordability, and efficiency. Using a multidimensional framework adapted from Bouzarovski and Petrova, we assessed energy poverty through factors including household income, fuel costs, energy infrastructure reliability, and regional climate needs. This analysis integrated composite indicators to map vulnerability at the regional level, highlighting high-risk areas primarily in the central and southern regions, where low incomes and dependency on biomass for heating amplified exposure occur. The findings reveal that approximately 4 million Chileans face a high risk of energy poverty, underscoring the need for regionally tailored policies that address both immediate economic constraints and structural energy inequalities. This research contributes to a comprehensive understanding of energy poverty in Chile and offers policy recommendations aimed at reducing socioeconomic disparities and achieving sustainable, equitable energy access.

The Association between Perinatal Complications and Adverse Childhood Experiences: Findings from a Nationwide Online Survey.

This study aimed to evaluate the association between maternal adverse childhood experiences (ACEs) levels and the risk of perinatal complications. This is a retrospective cohort study of 5,693 mother-child pairs born between 2019 and 2021, who completed questionnaires on maternal ACE scores and perinatal complications such as preterm birth, low birth weight infants, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), and premature rupture of membrane (PROM). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression according to the three ACE score groups after adjusting for confounding factors such as maternal age, child's sex, household income, and maternal education. Maternal ACEs have a significant positive correlation with preterm birth (OR: 1.42, 95% CI: 1.09-1.86, p for trend = 0.009), PIH (OR: 1.55, 95% CI: 1.17-2.07, p for trend = 0.002), and PROM (OR: 1.42, 95% CI: 1.09-1.84, p for trend = 0.01). These associations remained unchanged when stratified according to smoking, alcohol consumption, and obesity. Maternal ACEs were associated with the risk of perinatal complications such as preterm birth, PIH, and PROM. · Maternal ACEs are linked to higher risks of preterm birth, PIH, and PROM.. · Parental divorce, emotional abuse, and neglect were the most common ACEs among Japanese mothers.. · Mothers with ACEs score ≥ 2 had a higher risk of perinatal complications..

Effects of optimal versus suboptimal median household income on the surgically treated traumatic brain injury population at a level I trauma center in the Boston metropolitan area: a propensity score-matched analysis.

The median household income is a useful metric for healthcare disparity assessment. New England holds the highly diverse, densely populated Boston metropolitan area, which is known for having one of the highest living wages in the US. To the authors' knowledge, there is no published data on the effects of optimal versus suboptimal median household income on the surgical treatment of patients with traumatic brain injury (TBI). The authors sought to evaluate the disparities of an optimal versus suboptimal median household income-stratified population of patients with TBI who underwent surgical treatment at a single level I trauma center with a high safety-net burden in a major US metropolitan area. Demographic, clinical, and outcome data of patients who underwent surgery for TBI between 2015 and 2021 were collected and stratified based on optimal (≥ $80,000) and suboptimal (< $80,000) median residential household income. One-to-one tight caliper (0.01) propensity score matching was performed to balance the groups for comparative analysis. From the initial 144 patients in the optimal and 140 patients in the suboptimal income groups, 53 patients were included in each group after propensity matching. The suboptimal income group was significantly more ethnically diverse (p = 0.02), with significantly more ethnic minority patients (p = 0.05). Significantly more patients in the optimal income group presented as transfers from other hospitals (p < 0.001). Insurance status, injury mechanism, type and location, imaging features, length of ICU stay, and distribution of disposition destinations, as well as the follow-up time and outcome measures were not significantly different between the two groups after propensity matching. Although the suboptimal income group is significantly more ethnically diverse, median household income does not seem to affect TBI outcomes and discharge disposition. Patients in the optimal income group more frequently presented as transfers from other facilities, potentially indicating fair high-level care at a specialized trauma center with a high safety-net burden adapted to a diverse patient population.

FACTORS INFLUENCING THE ADOPTION OF AGRICULTURAL INSURANCE AMONG CROP FARMERS AS CLIMATE CHANGE ADAPTATION STRATEGY IN BORNO STATE, NIGERIA

The study examined the adoption of agricultural insurance among crop farmers as climate change adaptation strategy in Borno State, Nigeria. Multistage stage sampling technique was used in selecting 270 respondents for the study. Data were collected using structured questionnaire and analysed using descriptive and inferential statistics. The results reveal that the majority of respondents were between 36 and 49 years old, with a mean age of 37 years. Majority (60.7% and 80%) of the respondents were male and married. The mean household size, farm size, farming experience, and income of the respondents were 7 persons, 2 hectares, 7 years and ₦261,300, respectively. A reasonable proportion (37.8%) of the respondents had secondary education with majority (74.8%) having no access to credit. Most (83.0%) of the respondents in the study area had access to extension services. Majority (69.3%) of the respondents were aware of agricultural insurance. with a mean of 2 years of awareness. Half (50.0%) of the respondents sourced information on agricultural insurance from cooperatives. The major type of insurance adopted by the respondents were theft (20.0%), diseases (17.0%), and pest outbreaks (15.9%). The factors influencing the adoption of agricultural insurance in the study area were age (P &lt; 0.01), educational level (P &lt; 0.05) and access to extension services (P &lt; 0.01). The major constraints to the adoption of agricultural insurance in the study area include high premium costs (71.1%) and inadequate awareness (70.0%) to mention few. The study concludes that age, education level and access to extension services were the factors influencing adoption of insurance as climate change adaptation strategy in the study area. The study recommends that the government and non-governmental extension services should embark on sensitization campaign to raise the awareness crop farmers on the importance of insurance and effort should be made by the concern stakeholders to subsidize the premium in order encourage patronage.

WHO IS SUPPOSED TO GUARANTEE AN INCOME IN OLD AGE?

The amount of old-age pension from the Polish social insurance is based on the amount of accumulated retirement capital (the amount of old-age insurance contributions paid during one's entire professional career) and unisex life expectancy calculated for persons in the same age as an insured person. Most of pensioners' household income is made up of social security benefits, including, but not limited to the old-age pension from the social insurance scheme. This pillar is guaranteed by state. It is possible to increase income in retirement by participating in additional saving programmes organised by employers, and individual plans. Diversification of income sources for old age, extending working life and additional, supplementary savings are driving the amount of retirement income upwards. The results of the study titled "The world tailored for seniors" show that seniors are aware of the link between the amount of retirement benefit and actions taken during one's professional career. But do young persons entering the labour market have such awareness?

Mediating Role of Financial Toxicity in the Relationships Between Health-Related Quality of Life and Its Risk Factors in Chinese Patients With Cancer.

Factors influencing health-related quality of life (HRQoL) and financial toxicity (FT) have been found to overlap, and the robust correlation between HRQoL and FT raises the possibility that FT mediates the relationships between the shared risk factors and HRQoL. However, empirical evidence supporting this hypothesis is limited. This study aimed to explore whether FT mediates the relationships between HRQoL and its risk factors. A cross-sectional study was conducted, with 1208 participants from 12 hospitals (6 tertiary, 6 secondary) in 6 cities across 3 income-level-diverse provinces in China from February to October 2022. FT and HRQoL were measured using the COmprehensive Score for financial Toxicity and the Functional Assessment of Cancer Therapy-General. Twenty-two risk factors for both HRQoL and FT were included for analysis. Mediation analyses were conducted using Mplus 8.3. FT predominantly mediated the relationships between HRQoL and both annual household income and hospital level. Meanwhile, it partially mediated the relationships of HRQoL with the number of treatment modalities, social support, perceived stress, healthcare provider-patient discussion regarding cancer care costs, and social medical insurance, and the mediating effect accounted for 19.7%, 7.8%, 10.7%, 22.3%, and 46.8% of the total effect, respectively. FT plays a significant mediating role in the associations between HRQoL and some of its risk factors among patients with cancer. Developing a more comprehensive and patient-centered approach to cancer care that addresses the unique challenges posed by cancer-related FT is urgently needed to improve the HRQoL among this population.

Social determinants of health as risk factors for keratoconus in the All of Us database

Background/aimsClinical risk factors for keratoconus (KCN) have previously been established. While the impact of the social determinants of health on the epidemiology and pathophysiology of KCN has been explored, further...