Income Level Research Articles

Correlation between employment status and income level of mothers with exclusive breastfeeding

Introduction: Ideally, breastfeeding should begin within one hour of birth and continue for the first six months of life. The percentage of female workers in Indonesia increases year after year, and the country already has an exclusive breastfeeding policy. However, exclusive breastfeeding coverage remains relatively low. The mother's role in exclusive breastfeeding can be influenced by a number of factors. The study aims to determine the correlation between exclusive breastfeeding with employment status and the income level of mothers in Tambak Wedi Public Health Centre in Surabaya. Methods: Observational analysis with cross-sectional approach. The research population is in the area of Tambak Wedi Public Health Centre Surabaya. It Covers 114 mothers with babies aged 6-12 months old obtain from a non-probability sampling technique. Variables included exclusive breastfeeding status, employment status, and income level. The research instrument was a questionnaire and was analyzed using chi-square with a significant degree of < a 0,05. Results: Of 114 mothers, 84 mothers provide exclusive breastfeeding, and 30 mothers not exclusively breastfeeding their babies. The analysis showed there is a correlation between employment status (p-value= 0,00) and income level (p-value= 0,00) of mothers with exclusive breastfeeding. Conclusion: The mother’s employment status and income level positively affect exclusive breastfeeding practice in Tambak Wedi Public Health Centre Surabaya.

Association of periodontal disease with stress levels and drinking frequency in adults: analysis using data from the 7th National Health and Nutrition Examination Survey

Objectives: This study aimed to investigate the association of stress level and alcohol consumption with periodontal disease in adults. Methods: Data from the 7th Korean National Health and Nutrition Examination Survey were used for this study, which included 13,199 Korean adults aged >19 years. The variables analyzed included demographic characteristics (sex and age) and socioeconomic factors (income, education, and marital status). Multiple logistic regression analysis was performed to evaluate the association between periodontal disease, stress level, and drinking frequency after considering confounding factors such as income quartile and marital status. Results: After correcting for all confounding factors, the analysis showed that the group that drank more than four times a week had a 1.541 times higher risk of developing periodontal disease than the group that drank less than once a month (odds ratio [OR]=1.541, 95% confidence interval [CI]=1.245-1.906, p<0.001). The prevalence of periodontal disease was higher in men, in those over 60 years of age, and in those with lower levels of education and income. Interestingly, those with lower perceived stress had a significantly higher disease prevalence (31.5%) than those with higher stress levels (28.0%; p<0.001). Conclusions: The results of this study suggested that the higher the frequency of drinking, the higher the prevalence of periodontal disease.

Internet use and household financial market participation: evidence from China

ABSTRACT This paper examines the effect of internet use on household financial market participation and its underlying mechanism. Using data from the 2018 China Family Panel Studies (CFPS), we find that households with internet use are 4.7% more likely to participate in financial market investments than those without. The finding remains robust after accounting for endogeneity concerns using the instrumental variables approach and a fresh double machine learning approach. We highlight the phenomenon of ‘digital divide’ that the positive effects of internet use on making financial investments are more substantial among families living in economically developed regions, and families with higher income and education levels than their counterparts. We identify three novel mechanisms through which internet use affects household investment decision-making, namely the internet information mechanism, the internet social mechanism, and the internet enabling mechanism. These findings suggest that expanding digital infrastructure building and increasing the number of internet users are important ways to enhance households’ participation in financial markets.

Diagnosis of open defecation in Yamoussoukro District (Central Côte d’Ivoire)

The pathological landscape of Yamoussoukro district is dominated by environmental diseases (malaria, typhoid fever, respiratory infections). These diseases are linked to lack of sanitation and hygiene and open defecation. The objective of this study is to draw up an inventory of fixtures of sanitation in Yamoussoukro district and determine the reasons for the practice of open defecation and thus propose effective strategies to combat this practice. Methodology used consists of direct observation in the field and a household survey. The sampling technique adopted is that of Shawartz, with a sample size of 373 households. Initially, an inventory of the sanitation situation in the study localities was drawn up, revealing a sanitation problem with 62,34 % of households lacking latrines in Kpangbassou, 82,22% in Aboukro, and 82,14% in Duokro. Analysis of the reasons prompting communities to opt for open defecation (OD) highlights determining factors such as the absence of a law prohibiting it, cultural reasons, perceptions of populations, the low level of income and education of household heads. Although socio-economic factors play a predominant role in the adoption of this practice, it is essential to pay particular attention to the economic aspects. Following these results, solutions were proposed to OD. Suggested strategies include the CLTS / EcoSan approach, enhanced CLTS / EcoSan monitoring and community awareness raising.

Factors of unmet dental care needs due to the time, economic, and physical constraints among older people

Objectives: We aim to identify factors associated with unmet dental care needs in older adults and explore the impact of time, economic and physical constraints on each. Methods: The analysis was based on the 2023 Community Health Survey. Statistical analyses were conducted using chi-square test and multinomial logistic regression for 65,952 people aged 65 years and older. Results: First, we looked whether subjects experienced unmet dental care needs and found that 8.4% did. Second, according to the type of unmet dental care needs, 54.1% of the time, economic, and physical constraints were economic constraints. Analyzing each of the time, economic, and physical constraints, we found that time constraints were associated with younger age. For economic constraints, lower education level and health security type of recipients in medical aid program were more likely to experience unmet dental care needs. In terms of physical constraints, those living in rural areas were more than three times more likely to experience unmet dental care needs than those living in urban areas. Conclusions: The results showed that time constraints were related to age, economic constraints were related to household income level, and physical constraints were related to residential area.

Impact of gender-biased parental perceptions on under-immunization in Eastern Sudan: a cross-sectional study

BackgroundDespite global efforts, inequities in vaccine uptake remain, influenced by socioeconomic, geographic, cultural, and gender-related factors. In Eastern Sudan, gender disparities are acknowledged, particularly in livelihoods, but their impact on vaccination uptake is unclear. This study aimed to assess the effect of gender-biased parental perceptions on under-immunization among children in Kassala, Eastern Sudan.MethodsThis study was a community-based cross-sectional in rural and urban districts of Kassala locality in Kassala State, Eastern Sudan in November 2022. Data were collected from parents using a pre-tested, structured questionnaire. The Chi-square or Fisher's exact test was conducted to assess the factors associated with under-immunization among children.ResultsData were collected from 400 parents. Our data reveal that most children were fully vaccinated with the three doses of the pentavalent vaccine (83%), while 14% were partially vaccinated. Findings showed that about one in five parents perceived male vaccination as more important than female vaccination. This parental perception of gender-based importance in vaccination was significantly associated with under-immunization among children (p-value = 0.049). Additionally, males in our study are fully vaccinated 5% more often than females. Socio-economic factors, including mothers’ education and households’ income level, were also significantly associated with the vaccination status of the children.ConclusionThis study shed light on the effect of gender norms and related determinants on equitable access to vaccinations for boys and girls alike. More research is needed to gain a better understanding of the gender norms related to vaccination and their long-term impact on immunization demand and resilience in this region.

Income level is associated with differences in primary and secondary stroke prevention in China

IntroductionThe aim of this study was to assess differences in the effects of income level on the primary and secondary prevention of stroke in the Chinese population.Material and methodsThis was a population-based study using data from a China Kadoorie Biobank survey that began in 2004 in 10 geographical regions. Community residents (n = 512,715) aged 30–79 years were recruited. Stroke was determined by the self-reporting of a doctor’s diagnosis, and participants with a high risk of stroke were identified using the model developed in the Prediction for ASCVD Risk in China study.ResultsThe final numbers of people included in this study were 8,884 with stroke and 218,972 with a high risk of stroke. The participants’ income level was positively associated with high levels of physical activity and the consumption of a healthy diet, but negatively associated with the control of alcohol consumption (all p < 0.05). In addition, positive associations were observed between the control of smoking and the use of antiplatelet and antihypertensive medication for primary prevention (all p < 0.05), but there was a negative association with the control of blood pressure (p < 0.001).ConclusionsLow-income individuals were less likely to control smoking and their diet and use preventive medications, while high-income individuals were less likely to control their alcohol consumption and blood pressure. Moreover, medication use was low for both primary and secondary prevention in high-income individuals.

The Impact of Parental Involvement in Preschool on Children’s Academic Performance

This study aims to examine whether there is a correlation between parental involvement in preschool and children’s academic performance. The study also investigated whether parental involvement (home-based, school-based and home-school conferencing) have an impact on pre-school children’s academic performance. In addition, this study also investigated the effects of parents’ gender, level of education and income on young learners’ academic success at school. This study employed a descriptive research design and used questionnaire to collect the data. The sample consists of 400 parents from five preschools in Henan district, China. Stratified random sampling was used in choosing the sample. The data of the study were analyzed using independent correlation, regression, independent samples t-test and one-way ANOVA. The results revealed that there is a significant positive correlation between parental involvement (home-based involvement, school-based involvement and home-school conferencing) and preschoolers' academic performance. The findings also showed that female parents were more engaged than male parents at preschool. Results of the ANOVA test revealed that parents with higher level of education and higher income were significantly more involved in preschool compared to their counterparts with lower level of education and lower income. These findings are crucial for policy makers to take the right measures in enhancing parental involvement in preschool.

Regional variation of age-related blood pressure trajectories and their association with blood pressure control rates, disability-adjusted life years and death

Abstract Background/Introduction While the relationship between blood pressure (BP) changes and increasing age is well described, age-related BP trajectories may vary substantially across different populations and associated with differential CV risk and outcomes. Purpose The dataset of the May Measurement Month (MMM) international campaigns enables a unique investigation of regional, socio-economic and sex differences in age-BP trajectories and their association with major public-health outcomes. Method Global BP data from more than 4,5 million adult (≥18 years) screenees obtained during the cross-sectional MMM campaigns in 2017, 2018, 2019, and 2021 were used for analysis. Average BP and slopes of BP changes across age groups were calculated within regional, socio-economic and sex strata. BP slopes of individuals between 30 and 70 years of age were derived from adjusted linear regression models, along with baseline BP estimates at young age. These BP slopes were correlated in regression models adjusted for baseline BP at young age with country-specific all-cause rates of DALYs (Disability-Adjusted Life Years), death (both from Global Burden of Disease Study 2019), life expectancy (World Bank data SP.DYN.LE00.IN 2019) and BP control rates (NCD Risk Factor Collaboration). Results Age-related BP changes differed distinctly across global geographic regions, income levels, and between sexes. The steepest increase in BP with age was observed in populations from Africa and Europe, whereas a more gradual rise in BP with increasing age was seen in South-East Asian populations. Women had lower BP levels than men at younger ages (twenties and thirties), but subsequently experienced a more pronounced age-related BP increase resulting in diminishing sex differences across older age groups. Geographically divergent age-related BP trajectories were significantly associated with major national public health indicators. Globally, the steeper the age-related BP slope, the stronger the association with poor BP control (β = -0.46 [95% CI: -0.74; -0.19], p=0.001), increased DALY’s (β = 66155.68 [95% CI: 44847.0; 87464.36], p<0.001) and death rates. (β = 1017.3 [95% CI: 351.72; 1682.89], p=0.003). Conclusion Age-related BP trajectories vary considerably across global populations and contribute considerably to the variability in BP-related risks and adverse outcomes across regions. Effective public health strategies may require region-specific targeting of lifestyle and other factors contributing to adverse BP trajectories to improve health outcomes.Average blood pressure by ageAssiciations with public health metrics

Lipid goal attainment across baseline socioeconomic and clinical factors comparing an "inclisiran first" implementation strategy and usual care: subgroup analysis of VICTORION-INITIATE

Abstract Background Addressing inequities in cardiovascular care has become a public health priority. Recent results from VICTORION-INITIATE, a pragmatically designed, randomised clinical trial showed the benefit of using inclisiran immediately if patients with atherosclerotic cardiovascular disease (ASCVD) fail to achieve low-density lipoprotein cholesterol (LDL-C) <70 mg/dL (1.8 mmol/L) on maximally tolerated statins. Purpose To evaluate effectiveness and safety of an "inclisiran first" implementation strategy (IF) versus usual care (UC) in subgroups that may be associated with healthcare inequities. Methods VICTORION-INITIATE was conducted at 45 representative clinical settings across 20 states in the USA. Patients with ASCVD randomised 1:1 (stratified by insurance status) received open-label inclisiran 284 mg at Days 0, 90 and 270) plus UC or UC alone (lipid management directed by treating physicians). Treating physicians had access to LDL-C measurements and were encouraged to intensify treatment per lipid guidelines. We compared efficacy and safety endpoints for IF and UC in prespecified subgroups (race, ethnicity, sex, renal function and statin intensity) and by income level (post-hoc analysis). Results The study randomised 450 patients. Baseline demographic and clinical parameters were balanced between study arms (≥65 years of age: IF: 63.1%, UC: 61.3%; non-White: IF: 15.6%, UC: 15.1%; Hispanic: IF: 13.8%, UC: 16.9%; female: IF: 29.8%, UC: 32.0%; income ≤$50,000: IF: 58.7%, UC: 58.2%; estimated glomerular filtration rate ≥30 to <60 mL/min/1.73m2: IF: 20.0%, UC: 17.8%; no statins at baseline: IF: 9.8%; UC: 10.2%). Across all subgroups, more patients achieved LDL-C goals at Day 330 with IF vs UC (Figure 1). Within the UC arm, the proportions of patients achieving LDL-C <70 mg/dL and <55 mg/dL, respectively, were numerically lower for non-White (8.8% and 2.9%) and Hispanic (10.5% and 2.6%) than White (24.6% and 10.2%) and non-Hispanic (24.9% and 10.3%) patients. We did not observe differences in LDL-C goal attainment for these subgroups in patients receiving IF. Compared with UC, IF resulted in greater mean percentage change in other lipids and lipoproteins from baseline to Day 330, irrespective of subgroup (Figure 2). Incidence of treatment-emergent adverse events (TEAEs) and serious TEAEs compared similarly between IF and UC for each subgroup (IF: 35.5−69.2%, UC: 34.2−84.2%, and IF: 3.2−16.9%, UC: 0.0−36.8%, respectively). Conclusions VICTORION-INITIATE enrolled a diverse population reflective of "real-world" US clinical practice. The IF strategy consistently resulted in higher rates of LDL-C goal attainment for all subgroups studied and did not lead to differences in lipid outcomes by race or ethnicity as compared to usual care. No additional safety concerns for the IF strategy were identified.

Exploring the Socio-economic Conditions of Potato Farmers in Farrukhabad District of Uttar Pradesh, India

This study investigates the socio-economic profile of potato growers in Farrukhabad district, Uttar Pradesh, aiming to understand their demographic composition, educational background, caste distribution, marital status, family structure, landholding size, occupation, income levels, social participation, and possession of farming resources. A sample of 100 respondents cultivating potatoes as the main crop was selected from Kamalganj block, Farrukhabad district. Data were collected through personal interviews using a pre-structured schedule and analyzed using percentages. The results reveal that the majority of respondents are middle-aged, literate, and belong to scheduled castes. Most respondents are married and come from joint families with medium-sized households. Marginal and small landholdings dominate, and agriculture is the primary occupation, supplemented by subsidiary activities such as dairying and business. Income levels vary, with a significant proportion falling within the medium-income bracket. Social participation is moderate, with most respondents engaging in multiple organizations. Farm resources such as farm power and implements are moderately possessed. Extension services and information sources play a crucial role, with most respondents exhibiting moderate contact. This study provides valuable insights into the socio-economic landscape influencing agricultural practices among potato growers, which can inform policy formulation and extension activities aimed at fostering agricultural development and rural prosperity.

Factors Affecting Household Health Expenditures: Evidence from Iran

Abstract Background Productivity plays a crucial role in driving economic growth, and its primary determinant is human capital. Human capital, in turn, is influenced by health and education investments, leading both households and governments to allocate substantial resources toward these sectors. Understanding the factors influencing health expenses is vital for designing effective policies. Methods This study investigates the factors affecting health costs by analyzing data from various provinces in the Islamic Republic of Iran, spanning from 2006 to 2019. The data, sourced from the Statistics Center of Iran, was analyzed using the panel data approach to uncover the relationships between health expenditure and several key variables. Results The analysis revealed significant disparities in health expenditure among provinces. Sistan & Baluchestan had the lowest health expenditure per household, while Tehran reported the highest. Inflation emerged as a significant factor, having a negative impact on health expenses due to its influence on purchasing power. Conversely, the education and salary of household heads had a positive impact on health expenditure. Notably, economic growth did not exhibit a significant relationship with health expenses. Conclusions The study highlights the importance of education and income levels in shaping health expenditures, while inflation can curtail spending on health due to reduced purchasing power. Policymakers should consider these factors to ensure equitable and effective allocation of health resources. Key messages • Improving health and well-being, essential for comprehensive progress and human development, relies significantly on household health expenditure. • The efforts to enhance human capital should focus on reducing inflation.

Factors Influencing Quality of Life in the Disabled: Focus on Household Members Mental Health

Abstract Background Household members of the disabled experience various difficulties such as social isolation and the burden of caregiving. These difficulties can lead to mental health problems, which in turn affect the quality of life(QoL) of the disabled. Research on the QoL of the disabled is ongoing, but there are few studies addressing the mental health of household members. We aimed to investigate the impact of household members’ mental health on the QoL of the disabled. Methods We used data from the 2021 Disability and Life Dynamics Panel(nationwide survey). On the base of Patrick’s model of disability health promotion, we analyzed the impact of household members’ mental health on the QoL of the disabled by using correlation analysis and multiple regression analysis adjusted for gender, age, income level, employment status, education level, activities of daily living, participation in social activities, type and severity of disability, presence of multiple disabilities, and health status. Results The level of depression(r=-.316, p<.0001) and self-esteem(r=.248, p<.0001) of household members were found to be significantly correlated with the QoL of the disabled. The level of depression of household members had a significant negative impact on the QoL of the disabled(β=-.153, p<.0001), while self-esteem had a significant positive impact(β=.144, p<.0001). It was found that the level of depression had a greater impact on QoL than self-esteem. Conclusions Lower levels of depression and higher levels of self-esteem of household members are associated with higher QoL for the disabled. Improving the mental health of household members is crucial in improving the QoL of the disabled, enabling them to interact more positively with society. Additionally, as 27% of household members experience depressive issues, enhancing their mental health positively impacts on the overall well-being of families with disabilities. Efforts to enhance household members’ mental health are crucial. Key messages • Household members’ mental health significantly influences the quality of life of the disabled. • To improve the quality of life of the disabled, strengthening programs for promoting the mental health of household members and policy improvements are necessary.

Unveiling social disparities in later life: Income’s Impact on mortality among the elderly in Italy

Abstract Background Income is an important predictor of adult mortality, as a proxy of living conditions, capability and access to health services. Previous studies show that mortality decreases by increasing income. In Italy, studies at a national level are missing. This study aims to investigate inequalities in mortality by income in Italy. Methods The analysis is based on the integration of the National Population Register (comprising the resident population as of Dec 31, 2018, and deaths in 2019) and the Income Statistical Register (representing perceived income during 2018). This integration enabled the availability of information on age, sex, residence, education, income, and vital status at the individual level for 13 million people aged 65 or above. Individuals were categorized according to their individual disposable income quintiles both before and after disability benefits. Inequalities by income are assessed by mortality rate ratios (MRR) estimated using negative binomial regression models controlling for demographic and socioeconomic features. The study is carried out within the Next Gen EU-funded project “Age-It Ageing well in an ageing society” (PE0000015), NRRF, M4.C2, Intervention 1.3. Results Considering income net of disability benefits, lower income levels are associated with higher mortality rates compared to the highest income level, for both sexes. Inequalities are more marked for men. The highest excess was observed for individuals with the lowest income (male MRR=1.65, 95%CI: 1.6-1.71; female MRR=1.43, 95%CI: 1.38-1.48). The excess decreases with increasing income. Conclusions The observed relationships between income and mortality are crucial for targeting policies to reduce health inequalities and promote the well-being of the elderly, the goal of which should be to improve access to social and health care and develop supportive policies for the most disadvantaged people. Further research will be devoted to the use of household income for individuals. Key messages • For the elderly, lower income levels are associated with higher mortality, with wider disparities in men. • The choice of definition of income is essential for an accurate assessment of the association between income and mortality.

Transitions in heating systems and impact on perceived wellbeing: a qualitative study

Abstract Background as part of the larger European WELLBASED project an urban program focusing on transitions in heating to tackle energy poverty, is implemented in 4 disadvantaged, predominantly Roma neighborhoods of Edirne, Türkiye. These neighborhoods have high levels of vulnerability, aid dependency, and energy poverty. This study investigated the impact on perceived wellbeing of implementing the heating system transition. Methods A qualitative methodology was applied; data was collected through semi-structured in-depth interviews among participants in the intervention group of the larger WELLBASED evaluation study. Diversity was ensured regarding gender, age, education level, and working status. Participants were 13 individuals from 13 households in which energy-efficient heating systems were installed. Interviews were audio-recorded, transcript verbatim and coded; thematic analysis was conducted. Results 3 main themes and 7 sub-themes (st) emerged in the preliminary analysis with regard to impact on well-being: perceived changes in living conditions (st: physical changes, financial implications, domestic burden), perceived effects on health (st. mental health, physical health), and expectations versus reality (st. insulation, efficiency). Experiences differed as per housing condition, type of energy used, usage proficiency, and income level. Conclusions Energy efficient heating system transition to tackle energy poverty at homes may not be sufficient to realize impact on perceived wellbeing. Housing conditions (ie. insulation), supported energy sources and management of expectations need to be considered as part of the program.

Impact and determinants of depression in cardiac hospitalized patients

Abstract Depression increases cardiovascular risk and involves worse clinical outcomes. Little attention is paid to it in hospitalized patients. We studied prevalence and determinants of depression in this group, in order to select patients for further specific management. Methods Consecutive patients admitted to Cardiology wards were included. Cardiovascular risk factors, clinical and psychosocial data were collected. Self perceived mental and physical health quality were assesed by 12-item Short Form survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) questionnaires were administered. Statistical analysis was performed using Spearman´s correlation, Mann-Whitney and Fisher tests, and Mantel-Cox, linear and logistic regression analyses. Results 170 consecutive patients, median age 74.5 (67.2-81.1), 59.4% male, were included. Most common pathologies were heart failure (44.7%) and coronary syndroms (28.8%). According to HADS results, depression was probable (score >10) in 10%, and at least possible (score > 8) in 27.1%. Both increased duration of hospitalization (Median 14 vs 7 days;p=0.016 and 11 vs 7 days;p=0.005 respectively). Anxiety was present in 16.5 % for probable case and 34.1% for possible case, with no significant change in median duration of hospitalization. 22.9% of patients were under antidepressant treatment, and 24% under anxiolytics, but they were added to treatment only in 1% and 7% respectively. No other not pharmacological measure was initiated. Self perceived mental health was diminished in probable depression (mean difference 14.9%;95%IC 9.7-20.2;p<0.001). Self perceived physical health was also lower (mean difference 6.4%;95%CI:1.1-11.8;p=0.016). Patients with depression were a mean of 5.6 years older (95%CI 1.4-9.8;p=0.032). Less than primary education (OR 5.69 (p 0.021), and Previous hospital admission OR 3.2 (1.0-10.3;p=0.034) increased the risk of depression in univariate analysis. By multivariate analysis, determinants of depression were anxiety (OR 22.5;95%CI 5.9-85.6;p<0.0001), need for surgery (OR 12.3;95%IC 2.1-73.2;p=0.009), need for intensive care unit surveillance (OR 4.2;95%CI 1.1-15.8;p=0.039), and age (OR 1.1;95%IC 1.0-1.2;p=0.001. AUC was 0.89;95%CI 0.81-0.96;p<0.0001. There was no difference in civil status, gender, income level, living accompanied, number of comorbidities, cardiovascular risk factor or reason for hospital admission. Conclusions Depression was prevalent in our hospitalized cardiac patients,in spite of previous pharmacological treatment. It prolongs duration of stay and impacts negatively in self perceived mental and physical health. Risk is increased in older people requiring intensive care surveillance or surgery, and specially by anxiety. These patients could benefit from a preventive multifactorial approach. Attention should also be paid to patients with a previous hospitalization and low educational level.ROC curve for multivariate model

Antibiotic use in the first 1000 days and maternal-infant outcomes: results from the MAMI-MED cohort

Abstract Introduction Antibiotic use within the initial thousand days of life could potentially lead to a range of negative health outcomes for both mothers and infants. This study seeks to identify the primary factors influencing antibiotic use and examine the associations with adverse neonatal outcomes, specifically focusing on neonatal intensive care unit (NICU) admissions. Methods Data were gathered from pregnant women and their offspring enrolled in the ‘MAMI-MED’ study at ARNAS Garibaldi Nesima in Catania (Italy), from December 2020 to January 2024. Information regarding antibiotic exposure and maternal-infant health outcomes was collected through follow-up questionnaires administered at birth, one year, and two years postpartum. Results Among 1492 women (average age: 31 years) included in the study, 20.4% reported using antibiotics during pregnancy. The mean age of antibiotic users during pregnancy was significantly higher compared to non-users (p = 0.008). Among the 304 women who used antibiotics during pregnancy, 45.5% did so during the third trimester, 41.4% during the second trimester, and 13.1% during the first trimester. Furthermore, 47.1% of women reported antibiotic use at delivery or postpartum. Of the 904 children studied, 63% were administered at least one antibiotic between birth and the first year of age. A greater proportion of newborns admitted to the NICU were born to mothers who used antibiotics during the second trimester of pregnancy compared to those who used antibiotics during other trimesters (p = 0.013). Conclusions Comprehensive research is needed to delve deeper into the intricate factors influencing maternal antibiotic use. This should thoroughly explore socio-demographic variables, such as income level, education, and access to healthcare. Understanding these multifaceted influences can provide valuable insights into designing tailored public health interventions aimed at promoting prudent antibiotic use during pregnancy. Key messages • Different factors influence maternal antibiotic use. • Tailored public health interventions aimed at promoting prudent antibiotic use during pregnancy are needed.

The Effect Of Good Dairy Farming Implementation On The Income Level And Efficiency Of Dairy Cows Farmers Businesses In West Malang Regency

The research aims to identify the implementation of Good Dairy Farming Practice, measure the income and efficiency of livestock business. The research was conducted in West Malang Regency from November 2021 to February 2022 in three sub-districts namely Pujon, Ngantang and Kasembon. Samples were taken as many as 100 using purposive sampling method. Data analysis was descriptive quantitative to identify the Good Dairy Farming Practice score, analysis of business efficiency with Cobb Douglass Production Function Regression, analysis of business income and influential factors with Multiple Linear Regression. The results showed that the application of GDFP with sufficient score categories is health aspects (2.84), milking hygiene aspects (2.76), feed nutrition and drinking water aspects (2.43), animal welfare aspects (2.87), environmental aspects (2.64), and unfavorable score category is socio-economic aspects (1.37). The average income of dairy farmers is IDR 70,959,024 per year. The results of income regression analysis showed that the variables of health and nutrition aspects had a very significant effect, the milking hygiene aspect had a significant effect, and the environmental aspect had a less significant effect. The results of the efficiency of the use of factors of milk production with a value of 1.215 showed increasing returns to scale. All aspects of GDFP are in the sufficient category and the socio-economic aspects are in the unfavorable category. This makes the farmer's income less than optimal.

The cost of not getting care: income disparities in the affordability of health services across high-income countries

Abstract This presentation will present findings from the Commonwealth Fund 2023 International Health Policy Survey of the General Population, focusing on financial barriers in accessing healthcare among adults across 10 countries. It highlights significant income-related disparities in healthcare affordability, particularly in the United States, where nearly a quarter of the population lacks affordable access to care. While disparities exist in other countries, Germany and the Netherlands demonstrate lower rates of affordability issues and income disparities, possibly due to their universal health coverage models and cost-sharing caps based on income levels. These countries also prioritize mental health and dental care within their public health plans. The analysis emphasizes the critical need for affordable and comprehensive healthcare coverage to ensure equitable health outcomes. It suggests that policies such as cost-sharing caps and income-based subsidies could mitigate financial barriers to care, drawing insights from successful models in Germany and the Netherlands. Ultimately, addressing affordability is vital for achieving health equity and improving overall population health.

Precarious employment expectancy by history of mental-health-related sickness absence in Finland

Abstract Background Poor mental health may lead to labour market insecurity including precarious employment and vice versa. Less is known of how mental health is associated with cumulative engagement in precarious employment over the working career. We examined how the working career is expected to be distributed into precarious and other types of employment by history of mental-health-related sickness absence. Methods We used a register-based 70% population sample to examine wage-earners living in Finland in 2018. Applying the Sullivan method, we calculated the expectancy of precarious and non-precarious employment between age 25 and 63 (N = 1268666) based on a novel measure (score with items on temporariness, agency employment, multijob holding, underemployment and income level) and limited employment (due to which precariousness could not be assessed) among those with and without compensated (granted after 10 weekdays) sickness absence due to mental disorders in the past five years (mental SA history). Results Precarious employment expectancy was higher among those with than among those without a mental SA history (2.5 vs. 1.5 among men and 3.5 vs. 2.8 years among women). The difference in the limited employment expectancy was in the same direction, but much larger among men (6.5 vs. 3.3 among men and 4.4 vs. 3.4 years among women). Men with a mental SA history were expected to spend almost a fourth of their working career with either precarious or limited employment, whereas for men without such a history the number was 13%. Conclusions Individuals with mental disorders have notable accumulation of precarious employment over the working career. They also spend excessive time with limited employment, which may have similar elements as precarious employment and reflect broader labour market insecurity. Attempts should be made to ensure that insecure employment conditions among people with mental health problems do not further deteriorate their health and work ability. Key messages • People with mental disorders spend a disproportionate part of their working career either precariously employed or facing other insecurities in the labour market. • Interventions aiming to promote health and work ability should take into account the interplay between poor mental health and poor employment conditions.