Income Class Research Articles

Climate policy and inequality in urban areas: Beyond incomes

Opposition to climate policies is partly due to their impacts on inequality. But with most economic studies focused on income inequalities, the quantitative spatial effect of economic climate policy instruments is poorly understood. Here, using a model derived from the standard urban model of urban economics, we simulate a fuel tax in Cape Town, South Africa, decomposing its impacts by income class, housing type, and location, and over different timeframes, assuming that agents gradually adapt. We find that in the short term, there are both income and spatial inequalities, with low-income households or suburban dwellers more negatively impacted. These inequalities persist in the medium and long terms, as the poorest households, living in informal or subsidized housing, have few or no ways to adapt to fuel price increases by changing housing type, size or location, or transportation mode. Low-income households living in formal housing are also impacted by the tax over the long term due to complex effects driven by competition with richer households in the housing market. Complementary policies promoting a flexible labor market, affordable public transportation, or subsidies that help low-income households live closer to employment centers will be key to the social acceptability of climate policies.

The effect of income distribution on diet‐related environmental footprints: Evidence from urban China

AbstractGiven that income disparity is expanding and diet‐related environmental footprints are increasing in urban China, this study aims to investigate the heterogeneity in these footprints across various income classes and examine the effect of income distribution on the total environmental footprints. Based on the quadratic almost ideal demand system model and taking into consideration the problems of endogeneity of food expenditure and zero expenditure, we estimate the income elasticities for 10 food categories across seven income classes and project the diet‐related environmental footprints under seven scenarios for various strategies of the income distribution. The results show that per capita diet‐related environmental footprints are greater for higher income classes than for lower income classes, as the former consume more animal‐based food. Compared with high‐income classes, income growth favouring low‐income classes results in a rather significant increase in diet‐related environmental footprints. With further economic growth, the lowest income group makes the greatest contribution to the increase in diet‐related environmental footprints. Thus, policymakers should promote a more sustainable diet on the road to alleviating income inequality to ensure sustainable environmental development.

Analyzing Differentiated Climate Change Impacts on Women in the Wetland Area: A Case Study on Sunamganj District

Disadvantageous geo-location, dense population, and poverty make Bangladesh climate-sensitive, particularly in livelihoods. The impacts are detrimental to the economy, environment, and social development of the people of Dowarabazar and Jamalganj Upazila, Sunamganj District. This research aimed to scale the differentiated impacts of climate change on wetland women. To conduct the research, a survey approach following the Community Disaster Resilience Index (CDRI) was applied. The data were collected through questionnaire survey and observation. The sample size was 300 (150 males and 150 females). Simple random samplings were applied. The study included women of middle-aged, young, elderly, disabled, ethnic, religious minorities, widowed, destitute, and all income classes of poor and rich. It is found that the women's community is extremely vulnerable to different climatic impacts affecting women's capital of human, social, economic, physical, and natural. Women's social capital is highly impacted and the impact score is 3.54. Secondly, human capital (score is 3.07). The impact scores of natural and physical are 2.92 and 2.49. The lives and livelihoods of women have been severely curbed by climatic complications, vulnerable sanitation, poor house structure, and illiteracy. Proper management and access to income generation, empowerment, and social services are required for women's adaptation and resiliency.

Behaviour determinants of two Muslims classes towards cash waqf for productive purposes: explanation from Indonesia

Purpose This paper aims to investigate the behaviour determinants towards cash waqf for productive purposes between two different classes of Muslims: the upper-middle class and the lower-middle class. Design/methodology/approach Under the Theory of Planned Behavior framework, this study modified previous literature to investigate the determinants of two Muslim classes’ behaviour towards cash waqf for productive purposes. A structural equation model was applied to test the hypothesis, and an in-depth interview was conducted to explain the findings further. Findings The behaviour of participating in cash waqf for productive purposes differs between the two Muslim segments. Upper-middle-class Muslims’ intentions will not necessarily consider subjective norms, even though they will consider religiosity as their deciding factor. Meanwhile, this study found different results on the influence of attitude, religiosity and subjective norms to intention in the lower-middle-income group. Other attributes such as perceived behaviour control, knowledge, trust and perceived benefits show positive and significant effects on the intention for both income classes of Muslims. Research limitations/implications The current findings may not accurately reflect ideal conditions due to the low level of waqf literacy and actual participation of Muslims in cash waqf for productive purposes. Researchers can conduct further studies based on other criteria, such as gender, age, education level or area of residence, using experimental or simulation methods to complement the research. Practical implications This study’s findings can support policymakers and related waqf stakeholders to set strategies for cash waqf literacy and participation by providing more detailed information about the differences in Muslims characteristics based on the income classes. Originality/value This study specifically modifies the behavioural framework to investigate differences in the behaviour of two classes of Muslims towards their participation in cash waqf for productive purposes in Indonesia.

Effects of Sanctions on Food Intake of Urban Households in Razavi Khorasan Province, Iran (2017-2019)

Background: Sanctions are a type of forfeit aimed at forcing the subject to obey the desired political will. Since sanctions affect various components of the economic sectors. The purpose of this study is to investigate the effect of sanctions on food intake of households living in Khorasan Razavi province, Iran. Methods: To investigate the effect of sanctions on food intake of households living in Khorasan Razavi province, the survey data of the National Statistics Center of Iran (NSCI) on cost and income was used. 2129 households (number of households in 2017: 702, 2018: 726 and 2019: 701) were studied. In the N4 program, macronutrients and micronutrients were calculated. The studied variables were analyzed based on four income categories. In the SPSS software, quantitative variables of 2017 to 2019 were reviewed by ANOVA test and variables in pairs of the same period were reviewed by post hoc Tukey test. Results: The analysis showed that by intensifying sanctions, the cost of food has increased more than the average of income, and prices of all food groups spesifically healthy food groups have increased. The diet quality index has decreased significantly. The lower-income classes had the most insufficient dietary intake of micronutrients and the gap between dietary intake of different income classes increased during the study. Conclusion: Sanctions have affected the dietary intake due to the rise in the price of food expenditure and as a result people tend to consume cheaper and lower quality food.

Optimising fleet sizing and management of shared automated vehicle (SAV) services: A mixed-integer programming approach integrating endogenous demand, congestion effects, and accept/reject mechanism impacts

Shared automated vehicles (SAV) are expected to benefit the sustainable development of urban regions and alleviate the negative impacts brought by the increasing number of private cars. In this paper, we envision a future scenario where non-pooled SAVs replace private cars and provide public on-demand mobility services to satisfy the mobility needs of a city’s residents. To help service providers make profitable fleet sizing and management decisions, we develop a mixed-integer non-linear programming model that considers the congestion effects and the mode choice of urban travellers in different income classes, between SAVs and bicycles. Our model optimises both strategic decisions (fleet size, initial fleet distribution, and service quality level) and operational decisions (trip assignment, vehicle routing, parking, and relocation). Travellers’ preference for both transport modes is described through a binary logit model and congestion effects are described by dynamically varying travel times with respect to traffic flow in a non-linear fashion. In addition, we investigate two types of accept/reject mechanisms (mandatory vs. non-mandatory acceptance) which lead to an endogenously determined acceptance rate that can affect travellers’ willingness to use SAV services. The computational challenge posed by the non-linear and non-convex nature of the model is addressed through reformulation and the use of outer-inner approximation methods combined with a breakpoint generation algorithm. We demonstrate the effectiveness of our proposed method in a case study of the city of Delft in The Netherlands, as well as a scaling analysis on three toy networks with various sizes and demand profiles. A sensitivity analysis of key parameters is carried out to assess system performance. Computational results indicate that fleet sizing decisions are influenced not only by the population’s geographical distribution and land use patterns but also by the pricing strategy, unit operating costs of the SAV fleet, network congestion level, and traveller behaviour. When the price rate of using SAVs is low, the fleet sizing decisions can also be influenced by the trip accept/reject mechanism and the travellers’ sensitivity to the service quality level. In addition, a low price of SAV service will attract more users but may not necessarily bring a higher profit because of the increased traffic congestion.

Abstract 15714: Racial Disparities in Major Adverse Cardiac and Cerebrovascular Events Among Young Women (Aged 18-44) Admitted in Rural Settings: “A Comprehensive National Inpatient Analysis 2019”

Background: Limited research has focused on the rising incidence of major adverse cardiac and cerebrovascular events (MACCE) among young women (aged 18-44) with at least one traditional cardiovascular disease risk factor (CVD), especially in rural hospital settings. We aimed to address this research gap by providing insights into the burden of CVD in this population. Methods: Using data from the National Inpatient Sample (2019), we identified young women (aged 18-44) with at least one cardiovascular risk factor admitted to rural hospitals. Baseline demographics, comorbidities, and outcomes were assessed, including MACCE and all-cause mortality. Multivariable logistic regression was performed, adjusting for age, race, income, and comorbidities. Results: Among 179,410 young women, MACCE occurred in 2,455 individuals (1.4%), with varying rates among racial groups: whites (1.2%), blacks (2.4%), Hispanics (1.3%), Asian or Pacific Islanders (API) (2%), Native Americans (NA) (1.6%), and others (1%). All-cause mortality was observed in 385 women (0.2%), with rates of 0.2% for whites and 0.4% for blacks. Blacks had twice the event rates of MACCE, and all-cause mortality compared to whites. Comorbidities and substance abuse were associated with MACCE (P<0.001). In higher-income households, multivariable analysis adjusted for confounders revealed significantly higher odds of MACCE in blacks (OR 1.23, 95% CI 0.11-14.08), API (OR 4.48, 95% CI 1.06-18.93), and NA (OR 10.22, 95% CI 1.03-101.50) compared to whites. In contrast, mortality rates were lower for Hispanics than whites (OR 0.24, 95% CI 0.02-3.80) (all p < 0.001) (Table 1). Conclusion: In higher-income households, greater odds of MACCE were noted among blacks, API, and NA compared to whites. Future research should focus on understanding factors contributing to these disparities and developing interventions to prioritize equitable healthcare access for rural women across diverse ethnic and income classes.

Social inequality in mortality associated with neurodegeneration: a population-based study in Belgium

Abstract Background Worldwide, population is ageing, leading to a growing burden of neurodegenerative diseases (NDDs) such as Alzheimer's Disease (AD), Parkinson's Disease (PD). Socioeconomic position (SEP) has shown a persistent negative relationship with mortality over the last decades. The most common indicators of SEP such as income, education, and occupational class have shown to significantly impact life expectancy and other mortality indicators. However, studies on the association between SEP and NDD mortality are rather scarce. Therefore, the aim of this study is to assess whether SEP is associated with NDD mortality, which is crucial in understanding and developing preventive interventions for these diseases. Methods A comparative analysis on SEP - in terms of income and education - and deaths associated with dementia and parkinsonism was performed, using log linear Poisson regression. Data consisted of the 2011 Belgian census linked to mortality data for the period 2011-2016. Results During the 2011-2016 study period, 34,700 Belgian inhabitants aged 65 or older died from an NDD (N = 1,883,182). We observed significantly higher mortality in the lowest educational- and income groups. Education had the strongest association in women, with 1.29 (CI 1.21-1.38) times the MRR in the lowest educated group compared to the highest. In men, income showed the strongest association with 1.11 (CI 1.04-1.18) times the MRR in the lowest income group compared to the highest. The biggest disparities were found in dementia mortality, generally negative association with SEP. For income, we observed a strong negative association on parkinsonism mortality, while we found a reversed pattern with education. Conclusions Our study provides evidence supporting the existence of socioeconomic disparities in mortality due to neurodegeneration. We found a strong negative association between SEP and NDD mortality, which varies between men and women and between several NDDs. Key messages • NDDs are rapidly becoming a major public health issue worldwide. • Mortality from these diseases vary between different social groups, differentiated interventions are needed in order to reduce inequalities.

Equity implications of net-zero emissions: A multi-model analysis of energy expenditures across income classes under economy-wide deep decarbonization policies

With companies, states, and countries targeting net-zero emissions around midcentury, there are questions about how these targets alter household welfare and finances, including distributional effects across income groups. This paper examines the distributional dimensions of technology transitions and net-zero policies with a focus on welfare impacts across household incomes. The analysis uses a model intercomparison with a range of energy-economy models using harmonized policy scenarios reaching economy-wide, net-zero CO2 emissions across the United States in 2050. We employ a novel linking approach that connects output from detailed energy system models with survey microdata on energy expenditures across income classes to provide distributional analysis of net-zero policies. Although there are differences in model structure and input assumptions, we find broad agreement in qualitative trends in policy incidence and energy burdens across income groups. Models generally agree that direct energy expenditures for many households will likely decline over time with reference and net-zero policies. However, there is variation in the extent of changes relative to current levels, energy burdens relative to reference levels, and electricity expenditures. Policy design, primarily how climate policy revenues are used, has first-order impacts on distributional outcomes. Net-zero policy costs, in both absolute and relative terms, are unevenly distributed across households, and relative increases in energy expenditures are higher for lowest-income households. However, we also find that recycled revenues from climate policies have countervailing effects when rebated on a per-capita basis, offsetting higher energy burdens and potentially even leading to net progressive outcomes. Model results also show carbon Laffer curves, where revenues from net-zero policies increase but then decline with higher stringencies, which can diminish the progressive effects of climate policies. We also illustrate how using annual income deciles for distributional analysis instead of expenditure deciles can overstate the progressivity of emissions policies by overweighting revenue impacts on the lowest-income deciles.

The Early Childhood Oral Health Impact Scale (ECOHIS): psychometric properties and application on preschoolers.

The concept of oral health related to quality of life involves the impact that oral health has on an individual's well-being. The Early Childhood Oral Health Impact Scale (ECOHIS) was developed to measure the impact of oral health problems on the lives of children and their families. To evaluate the psychometric properties of ECOHIS applied to mothers of preschool children and estimate the influence of demographic characteristics, caries experience, and plaque index on the ECOHIS score. The fit of ECOHIS to the data was assessed by confirmatory analysis. Chi-square for degrees of freedom ratio (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) were used. Reliability was estimated by the ordinal coefficients alpha (α) and omega (ω). The factorial invariance was estimated by the difference in CFI (ΔCFI). Comparisons of the ECOHIS mean scores according to the demographic characteristics, caries experience, and plaque index was performed using analysis of variance (ANOVA). A total of 371 children participated in the study. Mothers' mean age was 33.0 (SD = 7.04) years. The ECOHIS presented a good fit to the data (χ2/df = 4.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.09) and a strict model invariance. Children without caries and from higher income class had lower oral health impact. The data obtained with the ECOHIS were valid, reliable, and invariant. Children with caries experience and from lower income families had a greater impact of oral problems.

OTT구독료 소득공제 도입 논의와 타당성 검토

Since the income deduction system for the expense amount of credit cards and cash receipts was first introduced at 「Restriction of Special Taxation Act」 in Korea, the benefits have also been expanded for traditional market use, public transportation use, and cultural expenditure. In particular, the cultural expense income deduction included the purchase of books and newspapers, ticket payment for performance halls and museums, and the purchase of movie tickets from July this year. In addition, the Ministry of Culture, Sports and Tourism ordered research services to incorporate OTT monthly subscriptions into credit card deductions as cultural expenses, and the National Assembly proposed a partial revision to the 「Restriction of Special Taxation Act」 in July this year. This is because tax cuts on OTT subscription fees can help not only promote people's cultural life but also secure the competitiveness of the OTT industry.
 Tax reductions should be able to take effective measures to achieve the policy objectives pursued by the government, along with a close review of the effects of each income class from the perspective of tax egalitarianism. However, the current credit card income deduction system aims to reveal the tax base of businesses rather than reduce the tax burden on the people, and there is a limit to continuously and stably operating the system due to the limitation of the sunset period under the 「Restriction of Special Taxation Act」.
 Therefore, tax cuts for OTT subscriptions should be legislated in consideration of the improvement of the system to maintain the current cultural expense deduction in preparation for the reduction or abolition of credit card income deductions in the future. In the long run, it is necessary to consider revising the 「Income Tax Act」 etc, not the 「Restriction of Special Taxation Act」, to introduce tax benefits for cultural expenditures as special tax credits or to designate them as VAT exemptions. On the other hand, tax cuts for companies should also be designed to benefit from the revitalization of the cultural content industry. However, in order to prevent tax avoidance of overseas companies, it is necessary to incorporate it into a system that can manage the sales of OTT subscriptions of the operator, such as the current cultural expense income deduction system used by the Ministry of Culture, Sports and Tourism.

Who are the convoys of the happiness of Chinese urban residents? Research on social relations and subjective well-being based on the convoy model.

While the rapid advancement of urbanization has driven the improvement of material living standards, it has also brought about rapid social changes and intensified competition. In this "involutive" environment characterized by highly competitive and strong pressure, urban residents tend to fall into a state of "mental exhaustion." Anxiety, depression, sleep disorders, and other mental illnesses have seriously threatened public health in Chinese cities. Support from social relations is crucial for enhancing residents' subjective well-being (SWB) and promoting their mental health, especially in China's highly contextualized collectivist culture. According to the social structure of China's "difference sequence pattern," this paper constructs a theoretical framework of the relationship between social relations and SWB based on the convoy model and uses CGSS2018 data to verify the applicability of the theoretical framework. Kinship and friendship positively relate to SWB, and their interaction effect is significantly negative. There is no necessary correlation between neighborhood and SWB. The relationship between social relations and SWB of different age groups is heterogeneous. In addition, the moderating effects of relative income and social class are significantly negative. Kinship and friendship are Chinese urban residents' SWB convoys, and these two factors have an obvious substitution effect. The neighborhood has withdrawn from the convoy orbit of Chinese urban residents' SWB, which may be related to neighborhood indifference caused by China's housing system reform. From the life course perspective, the SWB convoys of young and middle-aged groups consist of kinship and friendship, while those of elderly people include kinship and neighborhood. In addition, for poor individuals living at the bottom of society, support from kinship is the most important source of social capital. These findings provide new insights into the relationship between social relations and the welfare of Chinese urban residents.

Impact of medical students’ socioeconomic backgrounds on medical school application, admission and migration in Japan: a web-based survey

ObjectivesThe aim of this study was to clarify and compare the socioeconomic backgrounds of medical students with those of other health professions and non-health faculty students in an era of...

지방자치단체장의 복지권한과 책임 -「국민기초생활보장법」 상 자활센터 운영에 관한 쟁점을 중심으로-

There is a controversy over the authority to designate and cancel a self-sufficiency centers, which is the Minister of Health and Welfare have under the 「National Basic Living Security Act」. This is because the essential authority belongs to the central government even though basic local governments carry out most of the main tasks of centers installed in metropolitan and basic local governments. It is a problem arising from the confusion of the ideology, principles, and standards of the distribution of authority surrounding welfare affairs.
 In details, for the case of self-sufficiency centers, it is appropriate that the head of a local government who have control over area get a core authority to it installed in a metropolitan area or local government. However, in reality, the authority is concentrated in the Minister of Health and Welfare. This situation have a gap with the legislative purpose of the 「Local Autonomy Act」 and 「Special Act On Local Autonomy And Decentralization, And Restructuring Of Local Administrative Systems」.
 Since a self-sufficiency business supports self-reliance of the low income class in the local community, it is a task that should fully consider various regional characteristics. As a similar case, most of the designation and declaration systems stipulated in the 「Welfare Of Senior Citizens Act」, 「Act On Activity Assistant Services For Persons With Disabilities」, and 「Social Welfare Services Act」 are established under the authority of local governments. Therefore, the 「National Basic Living Security Act」 also needs to be improved to give the authority to designate and cancel a self-sufficiency centers to heads of metropolitan and basic local governments.
 On the other hand, 「National Basic Living Security Act」, which is currently the basis for operating a self-sufficiency centers, have insufficient legislative grounds in regulating entry, operation, and exit of the centers. For this reason, a case suspected unconstitutionality were found due to violation of the jurisprudence of the delegated legislation. It is an issue that requires urgent improvement because it can neutralize the self-sufficiency support business for the low-income class in Korea.

Global Burden of Atrial Fibrillation and Flutter by National Income: Results From the Global Burden of Disease 2019 Database.

Background Atrial fibrillation (AF) and atrial flutter (AFL) are common conditions that can lead to significant morbidity and death. We aimed to understand the distribution and disparities of the global burden of AF/AFL as well as the underlying risk factors. Methods and Results Data on the AF/AFL burden from the Global Burden of Disease data set were analyzed for the years 1990 to 2019, with countries grouped into low, lower-middle, upper-middle, and high national income classes according to World Bank categories. Data were supplemented with World Health Organization and World Bank information. The prevalence of AF/AFL has more than doubled (+120.7%) since 1990 in all income groups, though with a larger increment in middle-income countries (+146.6% in lower-middle- and +145.2% in upper-middle-income countries). In absolute numbers, 63.4% of AF/AFL cases originate from upper-middle-income countries, although the relative prevalence is highest in high-income countries. Prevalence of AF/AFL appears to be correlated with medical doctor rate and life expectancy. The most relevant AF/AFL risk factors are unevenly distributed among income classes, with elevated blood pressure as the only risk factor that becomes less common with increasing income. The development of these risk factors differed over time. Conclusions The global burden of AF/AFL is increasing in all income groups and is more pronounced in middle-income countries, with further growth to be expected. Underdiagnosis of AF/AFL in low- and middle-income countries may contribute to lower reported prevalence. The risk factor distribution varies between income groups.

A four-asset technology-based growth policy

Abstract This paper presents the rationale for a four-asset growth policy model, which the US economy has executed only on a partial and intermittent basis over the past four decades. The need for such a model is driven by (1) growing global competition, (2) resulting slower gross domestic product and personal income growth, and (3) a consequent rise in income inequality. Without a more effective growth model to both broaden and deepen the role of technology, declining growth and its skewed distribution among income classes will perpetuate current social and political unrest. To achieve both broader and deeper technology-based growth across the economy, the proposed technology element model specifies the four major asset categories that characterize technology-based economic development, which combine to drive more effective growth policy analysis and development.

Reflections on COP27: How do technological innovations and economic freedom affect environmental quality in Africa?

Studies in literature argue that technological innovation is a crucial component that could provide an enduring solution to the effects of climate change. However, we argue in this study that technology-driven climate solutions may not be sustainable in the absence of robust economic freedom, particularly in Africa where there are manifestly weak governance indices. Hence, we investigate the interaction effects of technological innovation and economic freedom on environmental quality in Africa. By doing this, we deviate from prior studies that have considered only non-interactive regressions and offer a net effect approach which allows us to simultaneously introduce economic freedom as a modulating policy variable. We utilize panel data from the Fraser Institute and the World Bank Database for the period 2000 to 2018 for 31 African nations. Using an array of econometric techniques, our initial findings disclose a significant unconditional negative impact of technological innovation and economic freedom on the proxies of environmental quality. When both variables are interacted, the net effect suggests further negative impact. We account for potential endogeneity, and our results, yet remain consistent. We then evaluate the effect across regions and income classes. Our findings suggest that technological innovation improves environmental quality in low-middle and upper-middle income African nations, whereas the opposite is observed in low-income and Western nations. Our findings offer comprehensive and policy-relevant information to African stakeholders and international organizations, on the suitable strategies to managing environmental degradation.

The income inequality trap: When redistributive preferences do not correct greater inequality

In a lab study, we examine how preferences for redistribution are affected by income inequality, uncertainty of income class, income mobility, and the source of income (random or effort based). Under income class uncertainty we discover an inequality trap where individuals exposed to a more unequal pre-tax distribution also demonstrate greater acceptance of post-tax inequality. This effect is particularly pronounced in the effort condition and with low mobility. However, as individuals become aware of their true economic positions, the conflict between the poor and the rich intensifies, decreasing tolerance for inequality. These findings indicate that traditional rational-expectations models which solely rely on risk aversion and inequality aversion cannot fully explain subjects’ redistributive preferences. We also consider other factors, such as fairness considerations, social class memberships, and overconfidence in income expectations as potential drivers.

Teachers’ Perceived Barriers to Technology Integration during Online Learning

The COVID-19 pandemic has had a significant impact on education, forcing schools to close and move to remote learning. Prospective math teachers are particularly challenged by technology integration. This is because mathematics is a subject that is often taught in a traditional, lecture-based format. It can be challenging for prospective math teachers to find effective ways to use technology online to demonstrate teaching and learning mathematics. In this study, the researchers investigated the perceived barriers to technology integration experienced by prospective math teachers during emergency remote learning. This study used a descriptive correlational survey design given to fifty-one (51) respondents enrolled at Surigao del Norte State University (SNSU). Data analysis was performed using SPSS. Moreover, the researchers utilized descriptive statistics such as frequency distributions and measures of central tendency, and non-parametric tests such as Fisher’s exact tests to treat the data. The results showed that the respondents demonstrated moderately positive beliefs regarding the appropriateness of curriculum content for the technology used and the complementarity of technology and content in the course. Second, the respondents generally had a high level of commitment to attending synchronous online learning sessions. Third, gender, age, and income class do not play a significant role in determining respondents' perceived barriers to technology integration. Lastly, there was no significant relationship between respondents' perceived barriers to technology integration and their self-reported attendance (p = 0.099). However, the p-value was close to the conventional threshold for statistical significance (p 0.05), suggesting that there may be a weak association between these two variables.

Did the socioeconomic inequalities in avoidable and unavoidable mortality worsen during the first year of the COVID-19 pandemic in Korea?

This study examined changes in socioeconomic inequalities in mortality in Korea before and after the outbreak of coronavirus disease 2019 (COVID-19). From 2017 to 2020, age-standardized mortality rates were calculated for all-cause deaths, avoidable deaths (preventable deaths, treatable deaths), and unavoidable deaths using National Health Insurance claims data and Statistics Korea's cause of death data. In addition, the slope index of inequality (SII) and the relative index of inequality (RII) by six income levels (Medical Aid beneficiary group and quintile of health insurance premiums) were computed to analyze the magnitude and change of mortality inequalities. All-cause and avoidable mortality rates decreased steadily between 2017 and 2020, whereas unavoidable mortality remained relatively stable. In the case of mortality inequalities, the disparity in all-cause mortality between income classes was exacerbated in 2020 compared to 2019, with the SII increasing from 185.44 to 189.22 and the RII increasing from 3.99 to 4.29. In particular, the preventable and unavoidable mortality rates showed an apparent increase in inequality, as both the SII (preventable: 91.31 to 92.01, unavoidable: 69.99 to 75.38) and RII (preventable: 3.42 to 3.66, unavoidable: 5.02 to 5.89) increased. In the first year of the COVID-19 pandemic, mortality inequality continued to increase, although there was no sign of exacerbation. It is necessary to continuously evaluate mortality inequalities, particularly for preventable and unavoidable deaths.