Individual Socioeconomic Factors Research Articles

Fuzzy Hybrid Approach to Shatter Religious Tolerance and Fundamentalism Stereotypes across Diverse Nations

Abstract The study transcends borders to challenge conventional narratives about religious tolerance and fundamentalism. Leveraging a Fuzzy-Hybrid Approach, we delve into the multifaceted realities of eight diverse nations: Germany, Cyprus, the United States, Lebanon, Palestine, Israel, Turkey, and Kenya. Our innovative analysis unveils surprising complexities, shattering stereotypes and painting a nuanced picture of religious beliefs. Germany emerges as a beacon of tolerance, boasting the highest tolerance levels with the lowest fundamentalism. However, the stark reality for citizens of Lebanon, Kenya, and Palestine reveals a landscape of lower tolerance and higher fundamentalism. This study delves deeper, using quantile regression models to expose the intricate interplay between religious tolerance, individual socioeconomic factors like education and religious discrimination, and even views on the death penalty. Our findings challenge simplistic assumptions, revealing intricate relationships between tolerance and fundamentalism across diverse contexts.

Area and individual level analyses of demographic and socio-economic disparities in COVID-19 vaccination uptake in Belgium

Vaccination has played a major role in overcoming the COVID-19 pandemic. However, vaccination status can be influenced by demographic and socio-economic factors at individual and area level.In the context of the LINK-VACC project, the Belgian vaccine register for the COVID-19 vaccination campaign was linked at individual level with other registers, notably the COVID-19 laboratory test results and demographic and socio-economic variables from the DEMOBEL database. The present article aims at investigating to which extent COVID-19 vaccination status is associated with area level and/or individual level demographic and socio-economic factors. From a sample of all individuals tested for SARS-CoV-2 (LINK-VACC sample) demographic and socio-economic indicators are derived and their impact on vaccination coverages at an aggregated geographical level (municipality) is quantified. The same indicators are calculated for the full Belgian population, allowing to assess the representativeness of the LINK-VACC sample with respect to the impact of demographic and socio-economic disparities on vaccination uptake.In a second step, hierarchical models are fitted to the individual level LINK-VACC data to disentangle the individual and municipality effects allowing to evaluate the added value of the availability of individual level data in this context.The most important effects observed at the individual level are reflected in the aggregated data at the municipality level. Multilevel analyses show that most of the demographic and socio-economic impacts on vaccination are captured at the individual level, although accounting for area level in individual level analyses improve the overall description.

Socioeconomic Disparities in Anal Cancer: Effect on Treatment Delay and Survival.

Socioeconomic inequities have implications in access to health care and may be associated with disparities in treatment and survival. To investigate the impact of socioeconomic inequities on time to treatment and survival of anal squamous cell carcinoma. This is a retrospective study using a nationwide dataset. The patients were selected from National Cancer Database enrolled from 2004 to 2016. We identified patient with stage I-III squamous cell carcinoma of anus who were treated with chemoradiation. Socioeconomic factors, including race, insurance status, median household income, and percentage of no high school degrees were included. The association of these factors with treatment delay and overall survival were investigated. A total of 24,143 patients who underwent treatment for Grade I-III squamous cell carcinoma of anus were identified. Median age was 60 years and 70% were female. The median time to initiation of treatment was 33 days. Patients from zip codes with lower median income, higher percentage of no high school degree, and patients with other government insurance followed by Medicaid insurance had treatment initiated after 60 days from diagnosis. Kaplan-Meier survival analysis showed that the late treatment group had worse overall survival compared to early treatment group (98 vs 125 months; p < 0.001). No detailed information about chemoradiotherapy regimen, completion of treatment, recurrence, disease free survival and individual level socioeconomic condition and risk factors. Patients from communities with lower median income, level of education, and enrolled in public insurance had longer time to treatment. Lower socioeconomic status was also associated with poorer overall survival. These results warrant further analysis and measures to improve access to care to address this disparity. See Video Abstract.

Obesity and Cardiovascular Health.

Obesity has risen to epidemic levels worldwide over the past few decades and has become a huge global health burden owing to its direct contribution to the development of some of the most prevalent chronic diseases including diabetes, hypertension, hyperlipidemia, and other cardiovascular diseases. Obesity is a disease of positive energy balance resulting from complex interactions between abnormal neurohumoral responses and an individual's socioeconomic, environmental, behavioral, and genetic factors leading to a state of chronic inflammation. Understanding the complex nature of the disease is crucial in determining the best approach to combat its rising numbers. Despite recent advancements in pharmacological therapy for treatment of obesity, reversing weight gain and maintaining weight loss is challenging due to the relapsing nature of the disease. Prevention, therefore, remains the key which needs to start in-utero and continued throughout life. This review summarizes the role obesity plays in pathophysiology of various cardiovascular diseases both by directly affecting endothelial and myocyte function and indirectly by enhancing major cardiovascular risk factors like diabetes, hypertension, and hyperlipidemia. We highlight the importance of a holistic approach needed to prevent and treat this debilitating disease. Particularly, we analyze the effects of plant-based diet, regular exercise, and non-exercise activity thermogenesis (NEAT) on obesity and overall cardiorespiratory fitness (CRF). Moreover, we discuss the significance of individualizing obesity management with a multimodal approach including lifestyle modifications, pharmacotherapy, and bariatric surgery to tackle this chronic disease.

Management of Prediabtes (An Increased Risk of Type 2 Diabetes) with Life Style Modifications

Prediabetes, characterized by elevated blood glucose levels that are below the diagnostic threshold for diabetes, poses a significant health challenge worldwide due to its association with an increased risk of developing type 2 diabetes mellitus. This abstract explores the crucial role of lifestyle modifications in the effective management of prediabetes, emphasizing a holistic approach to prevent or delay the progression to overt diabetes. The primary focus of this review is on lifestyle interventions, including dietary changes, regular physical activity, and weight management, as key strategies to address the underlying factors contributing to insulin resistance and impaired glucose metabolism. Evidence from clinical studies underscores the efficacy of these interventions in improving insulin sensitivity, promoting weight loss, and stabilizing blood glucose levels among individuals with prediabetes. Furthermore, the abstract highlights the importance of personalized and sustainable lifestyle modifications, considering individual preferences, cultural influences, and socioeconomic factors. Behavioral interventions, such as motivational coaching and support groups, are discussed as essential components to facilitate long-term adherence to healthy lifestyle practices. In conclusion, this article advocates for a comprehensive and patient-centered approach to managing prediabetes, with a strong emphasis on lifestyle modifications. By empowering individuals with prediabetes to make sustainable changes in their daily habits, there is a promising avenue to curb the progression to type 2 diabetes and improve overall health outcomes.

Cannabis-related arrests and convictions in Canada: Differences by race/ethnicity, individual socioeconomic factors, and neighborhood deprivation

Racialized individuals were disproportionately impacted by cannabis prohibition in Canada; however, the role of socioeconomic factors and neighborhood deprivation are not well understood. The current study examined race/ethnicity, individual socioeconomic factors, and neighborhood deprivation in relation to arrests and convictions for cannabis-related offenses. Repeat cross-sectional data were analyzed from two waves of the International Cannabis Policy Study (ICPS), a web-based survey conducted in 2019 (n = 12,226) and 2020 (n = 12,815) in Canada among those aged 16 to 65. Respondents were recruited through commercial online panels. Respondents’ postal codes were linked to the INSPQ deprivation index. Multinomial regression models examined the association between race/ethnicity, individual socioeconomic factors, neighborhood deprivation, and lifetime arrests or convictions for cannabis offenses. Overall, 4.4% of respondents reported a lifetime arrest or conviction for a cannabis-related offense. Black and Indigenous individuals had more than three times the odds of conviction than White individuals (AOR = 3.90, 95% CI = 2.07–7.35, p = <0.01; AOR = 3.24, 95% CI = 1.78–5.90, p = <0.01, respectively). Differences were still statistically significant after adjusting for cannabis use and socioeconomic factors; however, after adjusting for neighborhood deprivation, only the difference for Black individuals remained. Neighborhood deprivation was associated with cannabis-related convictions: the odds of a conviction among the “most privileged” and “privileged” neighborhoods were approximately half of those in the “most deprived” neighborhoods (AOR = 0.50, 95% CI = 0.29–0.86, p = 0.01; AOR = 0.50, 95% CI = 0.27–0.92, p = 0.03, respectively). Arrests and convictions for cannabis-related offenses were disproportionately higher among racialized individuals and those living in the most marginalized neighborhoods. Future research should examine whether inequities change following the legalization of recreational cannabis in Canada.

Neighborhood disadvantage is associated with changes in cerebrovascular function among older adults over a 9 year follow‐up period

AbstractBackgroundStressful social environments exert a strong influence on unhealthy aging, both in greater magnitude and independent of individual socioeconomic and lifestyle factors. Neighborhood disadvantage specifically has been linked to accelerated biological aging, cognitive decline, and core Alzheimer’s disease (AD) neuropathology, but little is known about whether neighborhood disadvantage contributes to cerebrovascular dysfunction commonly observed in aging and AD. We examine whether neighborhood disadvantage relates to changes in cerebrovascular outcomes over time, including blood‐brain barrier (BBB) integrity, cerebral blood flow (CBF), and small vessel disease (SVD) biomarkers.MethodsVanderbilt Memory and Aging Project participants (n = 296, 73±7 years, 40% female) underwent fasting blood and cerebrospinal fluid (CSF) acquisition serially over a 9‐year follow‐up period (mean follow‐up = 5.5 years). Area Deprivation Index (ADI), representing neighborhood disadvantage, was quantified at baseline based on 17 components [e.g., housing, income, education, and household characteristics (Kind &amp; Buckingham, 2018)]. BBB markers (MMP‐2, MMP‐3, MMP‐9, TIMP‐1, TIMP‐2, PDGFRβ) were quantified from CSF and CSF/plasma albumin ratio was quantified from both CSF and plasma. 3T multimodal MRI images were used to quantify grey matter CBF and SVD markers, including white matter hyperintensities (WMHs), perivascular spaces (PVS), and lacunes. Linear mixed effects regression models related time x ADI to longitudinal BBB, CBF, and SVD outcomes adjusting for age, sex, race/ethnicity, education, cognitive status, Framingham Stroke Risk Profile (minus age), apolipoprotein ε4 status, and follow‐up time. CBF models additionally adjusted for corresponding grey matter volume while SVD models adjusted for T1‐weighted intracranial volume.ResultsBaseline ADI related to increased MMP‐9 (β = 0.03, p‐value = 0.01) and decreased PDGFRβ (β = ‐0.1407, p‐value&lt;0.05) over time but unrelated to longitudinal changes in CBF (p‐values&gt;0.35), SVD (p‐values&gt;0.36), or other BBB outcomes (p‐values&gt;0.07).ConclusionsNeighborhood socioeconomic disadvantage relates to changes in BBB integrity among older adults over time, particularly molecular markers of barrier disruption and pericyte damage. Findings support the hypothesis that adverse environmental conditions, including low quality housing and community‐wide resource constraints, may contribute to early‐stage cerebrovascular dysfunction beyond individual socioeconomic and lifestyle factors.FundingHHMI James H. Gilliam Fellowship for Advanced Study; IIRG‐08‐88733; R01‐AG034962; R01‐AG056534; K24‐AG046373; P20‐AG068

Abstract 15494: Racial and Ethnic Differences in Cardiovascular Health Among US Adults With a History of Cancer

Introduction: Evidence reports co-occurring risk factors between cardiovascular disease (CVD) and cancer and treatment-resultant cardiotoxicities amplifying CVD risks. Hypothesis: Given demographic disparities in CVD and cancer outcomes, we illustrated race and ethnicity-specific distributions of cardiovascular health (CVH) and quantified the contributions of socioeconomic factors to racial disparities in CVH among those with prior cancer. Methods: In the National Health Examination and Nutrition Survey 2011-2020, we identified 2628 adults aged ≥18 years with prior cancer. CVH was assessed based on the American Heart Association’s Life’s Essential 8 metrics. The Kitagawa-Blinder-Oaxaca decomposition quantified the magnitude of individual socioeconomic factors contributing to racial differences in CVH. Results: Of the 2628 US adults with prior cancer (mean[SD] age, 63.4[13.8] years; 57% women), 6.0% identified as Hispanic or Latino, 1.6% as non-Hispanic (NH) Asian, 5.2% as NH Black or African American, 84.1% as NH White, and 3.1% as uncategorized or multiple categories. NH Asian had the highest Life’s Essential 8 score (out of 100, women: 66.0; male: 69.2) in contrast to the poorest CVH in NH Black women (59.0) and Hispanic men (57.7). Overall, diet, physical activity, and body mass index were suboptimal. Across race, NH Black had the poorest blood pressure (women: 52.6, men: 41.8) and sleep (women: 74.3, men: 70.2), whereas uncategorized or multiracial group had high tobacco exposure (women: 43.6; men: 53.2). NH White women had the worst lipids (62.4), whereas NH Asian women (65.2) and Hispanic men (69.0) had the lowest glycemic score. Differences were partly explained by deprivation and low education contributing to poorer CVH among Hispanic and NH Black, whereas lower US nativity contributed to better CVH in NH Asian. Conclusions: CVH in US adults with prior cancer was suboptimal with significant racial disparities explained by socioeconomic factors.

Household Cohabitation Patterns in Multiethnic Seventeenth-Century Lviv

Abstract Lviv, a mid-sized city in the eastern borderlands of the Polish-Lithuanian Commonwealth, numbered approximately 10,000 inhabitants in the second half of the seventeenth century. Its wealth, strategic location, and role as a trade center with the East contributed to significant ethno-religious diversity, with influential communities of Ruthenians (Ukrainians), Armenians, and Jews, alongside the Catholic majority. Detailed analysis of the 1662 Lviv poll tax register and other sources reveals the social composition and size of individual households, as well as their location in the city, houses’ construction material, and plot sizes. The results reveal diverse domestic arrangements influenced not only by individual socio-economic factors but also by the structural and cultural characteristics of the urban space.

Influence of neighborhood-level socioeconomic deprivation and individual socioeconomic position on risk of developing type 2 diabetes in older men: a longitudinal analysis in the British Regional Heart Study cohort

IntroductionEvidence from longitudinal studies on the influence of neighborhood socioeconomic deprivation in older age on the development of type 2 diabetes mellitus (T2DM) is limited. This study investigates the prospective...

Unravelling the Multifaceted Dynamics of Healthcare Expenditure: Exploring the Interplay of Individual Health Status, Lifestyle Choices, and Socio-Economic Factors

This study investigates the relationships between demographic factors and health expenditure based on 387 households in Malappuram district between September 2021 and April 2022. Rigorous statistical methodologies, including ANOVA and t-tests, were applied to scrutinize and quantify these relationships. The findings indicate that health status variations across religious affiliations were present but not statistically significant. Similarly, the regression analysis showed limited predictive power of lifestyle factors (low R-squared, non-significant F-statistics) in explaining health expenditure variations. However, it did reveal a significant correlation between intoxicant use and increased healthcare costs, emphasizing the influence of specific behaviors on healthcare expenses. furthermore, the analysis emphasized the multifaceted nature of healthcare spending, influenced by socio-economic factors, healthcare accessibility, and unobservable variables, extending beyond individual lifestyle choices. With a Gini Coefficient of 0.92 indicating pronounced inequality in healthcare expenditure allocation, policymakers should prioritize equitable healthcare provision, address the complexity of healthcare spending, target interventions as necessary, reduce disparities, and continue relying on data-driven decision-making to enhance the healthcare system in the Malappuram district.

Attitudes towards Religions: The Impact of Being Out of the Religious Group

Religious beliefs are a highly debated topic in the scientific literature. Various authors have approached this issue qualitatively and quantitatively. This study examines the attitudes towards out-religious groups, considering individuals’ socioeconomic characteristics. A new approach is introduced, utilising the Fuzzy-Hybrid TOPSIS method applied to the WZB—Berlin Social Science Center database. Four items that measure the general attitude towards (a) Jews, (b) Christians, (c) Muslims, and (d) atheists, are used, and a synthetic indicator is obtained to represent the individual attitude towards religions of Torah, Koran and Bible followers. Eight countries are analysed, encompassing diverse geographical and cultural backgrounds, including Germany, Cyprus, the United States, Lebanon, Palestine, Israel, Turkey, and Kenya. The results reveal that Germans are more open towards other religious and non-religious groups, while Lebanese citizens demonstrate the lowest levels. The findings show that Jews are the most tolerant towards other religious groups, whereas Muslims have the lowest attitudes level. Also, individual socioeconomic factors determine the attitudes towards other religious groups, such as age, education, income levels, and experiences of discrimination based on religion.

Individual Socioeconomic Factors Have a Greater Impact on End-of-Life Care Outcomes Than Regional Factors.

Background: End-of-life (EoL) care provided to Americans in urban and rural settings is distinct in terms of both available and delivered services. However, much less is known about which geographic, demographic, and health indicators are associated with disparities in EoL care and how individual versus regional characteristics influence quality of care (QoC). Objective: This study aimed to assess how regionality, rurality, and individual socioeconomic factors are associated with QoC in the last month of life (LML). Design: Nationally representative cross-sectional study using the proxy-completed LML questionnaire as part of the National Health and Aging Trends Study (NHATS). The data were linked at the zip code level to geographic and economic indicators. Settings/Subjects: A total of 2778 NHATS enrollees who died from 2012 to 2020. Measurements: Measurements included population density, socioeconomic indicators, health factors, and health outcomes. The primary independent variable was proxy-reported QoC during the LML (excellent vs. not excellent). Results: In our sample, 52.1% (n = 1447) reported not excellent care and 47.9% (n = 1331) reported excellent care. These populations varied in their demographic and socioeconomic characteristics. After accounting for survey weighting and design, decedents in the top (odds ratio [OR]: 1.58; 95% confidence interval [CI]: 1.08-2.32) income quartile had significantly greater odds of receiving excellent care than decedents in the bottom quartile. Decedents in zip codes with top quartile health outcome metrics had significantly greater odds of receiving excellent care (OR: 1.64; 95% CI: 1.17-2.29) than decedents in zip codes with bottom quartile health outcomes. County rurality index and county health factors were not correlated with QoC in the LML. Conclusions: High QoC at the EoL may be more associated with individual socioeconomic factors than regional indicators, including degrees of rurality. Clinicians should strive to recognize the interplay of individual characteristics and regional indicators to provide more personalized care.

Research on racial/ethnic inequities in oral health over the past 80 years: The role of racism.

This study aims to (1) describe trends in explanations provided for racial/ethnic inequities in dental caries and periodontitis, and (2) explore the patterns of relatedness among explanations for these inequities. Highly cited publications based on studies indexed in the Scopus database were retrieved and assessed for eligibility. Explanations for racial/ethnic inequities were classified into eight different, but interrelated domains. We assessed trends and examined the relations among explanations using multiple correspondence analysis. A total of 200 articles among the most cited publications were selected. The proportion of studies invoking racism as an explanation for racial inequities in oral health increased from 0% to 14.3%, from 1937 to 2020. The proportions of individual socio-economic factors increased from 52.0% to 82.9%, and dental care from 28.0% to 62.9%. The remaining explanations were stable: psychological/behavioural processes (62.5%), biological factors (49.5%), contextual/area-level effects (24.0%) and immigrant paradox (4.0%). Multiple correspondence analysis revealed a smaller axial distance between racism and the following categories: studies from Brazil, recent publications and Blacks/Hispanics/mixed-race groups. Publications about immigrants were axially closer to the high-income countries category. Our findings call on dental researchers to consider racism as a cause for existing racial/ethnic inequities in oral health.

Urban-rural differences in perceived environmental opportunities for physical activity: a 2002-2017 time-trend analysis in Europe.

Urban-rural disparities in resources, services and facilities not only impact daily living conditions but also contribute to inequalities in physical activity, which may be associated with variations in basic public resources between urban and rural areas. This study aims to examine the evolution of perceived opportunities for physical activity in European urban and rural environments from 2002 to 2017 and their association with an active lifestyle. Data from four waves (2002, 2005, 2013 and 2017) of cross-sectional Eurobarometer surveys were collected (n = 101 373), and multilevel binomial logistic regressions were conducted. Firstly, the time trend of perceived opportunities for physical activity between urban and rural environments was explored, and secondly, the effect of urban-rural perceived opportunities on achieving an active lifestyle over the years was estimated. The findings revealed that individuals residing in rural settings encountered less opportunities to be physically active. Conversely, urban settings experienced an increase in perceived opportunities. The significance of health promotion through perceived physical activity opportunities lies in the increased likelihood of being physically active, regardless of place of residence or individual socioeconomic factors [in the area: odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.34-1.47; provided by local sport clubs: OR = 1.29, 95% CI = 1.23-1.35]. Modifying environmental aspects, such as enhancing the quantity, quality and accessibility of physical activity opportunities in both rural and urban areas, may lead to improved physical activity and health promotion, particularly among individuals who are more physically inactive.

Patterns of problematic cannabis use in Canada pre- and post-legalisation: Differences by neighbourhood deprivation, individual socioeconomic factors and race/ethnicity.

The legalisation of cannabis in Canada in 2018, and subsequent increase in prevalence of use, has generated interest in understanding potential changes in problematic patterns of use, including by socio-demographic factors such as race/ethnicity and neighbourhood deprivation level. This study used repeat cross-sectional data from three waves of the International Cannabis Policy Study web-based survey. Data were collected from respondents aged 16-65 prior to cannabis legalisation in 2018 (n = 8704), and post-legalisation in 2019 (n = 12,236) and 2020 (n = 12,815). Respondents' postal codes were linked to the INSPQ neighbourhood deprivation index. Multinomial regression models examined differences in problematic use by socio-demographic and socio-economic factors and over time. No evidence of a change in the proportion of those aged 16-65 in Canada whose cannabis use would be classified as 'high risk' was noted from before cannabis legalisation (2018 = 1.5%) to 12 or 24 months after legalisation (2019 = 1.5%, 2020 = 1.6%; F = 0.17, p = 0.96). Problematic use differed by socio-demographic factors. For example, consumers from the most materially deprived neighbourhoods were more likely to experience 'moderate' vs 'low risk' compared to those living outside deprived neighbourhoods (p < 0.01 for all). Results were mixed for race/ethnicity and comparisons for high risk were limited by small sample sizes for some groups. Differences across subgroups were consistent from 2018 to 2020. The risk of problematic cannabis use does not appear to have increased in the 2 years following cannabis legalisation in Canada. Disparities in problematic use persisted, with some racial minority and marginalised groups experiencing higher risk.

Scenarios for Mobility Improvement Based on Individual Socioeconomic Factors

This research investigated various factors related to different mobility improvements based on individual socioeconomic variables. In this study, two sustainable mobility scenarios have been suggested to be implemented in the Central Business District (CBD) area, in which the traffic situation is severely congested. These new mobility improvements are vehicle-free zones and congestion pricing. The two options have been studied and investigated using the binary decision tree method. The main aim of the study is to identify which mobility options are preferred by different groups of people in the city. This will reveal public opinion about the future change in mobility in the city. With the help of the Python programming language and the idea of machine-learning represented by the Decision Tree method, several trials were carried out to get the desired and accurate outcome from the public participation. The study findings showed that the "age" and "gender" variables are significant decision-making factors, whereas the number of trips and mode of transport have no effect on the choice set

884 Frailty and Socioeconomic Status Predict Outcome in Newly Diagnosed Glioblastoma Patients

INTRODUCTION: Identification of molecular markers of glioblastoma (GBM) prognosis has not often led to meaningful intervention. Individual patient and socioeconomic factors are underexplored prognostic factors. Frailty, a measure of physiological vulnerability, and area deprivation, a measure of socioeconomic status, are easily obtained during the preoperative evaluation. Moreover, both are amenable to intervention; the medical conditions that contribute to frailty can be optimized prior to surgery, while barriers to health care (physical, financial, and cultural) can be addressed for patients at risk socioeconomically. METHODS: This is a retrospective review of patients with newly diagnosed GBM undergoing surgery from 2015 through 2020. Demographic and tumor specific data were recorded. Additionally, the 5-factor modified frailty index (mFI-5) and national area deprivation index (ADI) were determined for each patient. RESULTS: There were 244 patients. Compared to patients in the “some or no” frailty category, patients with “significant” frailty had a shorter median survival: 273 days (95% CI 126-339) vs 393 days (95% CI 317-458), p = 0.008. The median survival for patients living in the most disadvantaged neighborhoods, 210 days (95% CI 134-334), is significantly lower than for those living in the least, 384 days (95% CI 239-484), p = 0.17. Twenty-five percent of patients living in the most disadvantaged neighborhoods did not receive postoperative chemoradiation compared to 11% of patients in the least disadvantaged neighborhoods, p=0.046. Similarly, patients of color were less likely to receive standard of care chemoradiation than white patients. CONCLUSIONS: Both increasing frailty and neighborhood disadvantage are associated with worse outcome in newly diagnosed GBM patients undergoing surgery. Patients living in the most deprived neighborhoods and patients of color are less likely to receive postoperative chemoradiation. Identification of non-traditional predictors of treatment and outcome will lead to mitigation strategies.

The Influencing Mechanism of Urban Travel Carbon Emissions from the Perspective of Built Environment: The Case of Guangzhou, China

Urban travel is a major component of urban transport, and the total carbon emissions of urban transport can be effectively reduced if the carbon emissions of residents’ travel can be reasonably controlled. Based on the questionnaire data of many different types of residential areas in Guangzhou, the daily travel behaviour of residents was analysed and their travel carbon emissions were calculated. The differences in travel characteristics and travel carbon emissions of residents in different types of residential areas were compared. The influencing factors of residents’ travel carbon emissions were divided into three categories: individual socio-economic factors, built environment, and residents’ travel behaviour. On this basis, a structural equation model is established to study the impact mechanism of residents’ travel carbon emissions. The path relationship between endogenous variables and endogenous variables, as well as the path relationship between exogenous variables and endogenous variables were investigated. The interactions between various influencing factors of residents’ travel carbon emissions were examined. The results show that: (1) there are significant differences in residents’ travel carbon emissions in different types of municipalities. Residents’ travel carbon emissions in Guangzhou are closer to the 60/20 distribution; (2) compared with individual socio-economic factors, the impact of the built environment on travel carbon emissions is more obvious; (3) travel distance and travel mode are the factors that directly affect residents’ travel carbon emissions. Proposals have been made to reduce the carbon emissions of residents travelling.

Determinants of national health insurance enrolment among people at risk of statelessness in the Awutu Senya East Municipality and Gomoa East District of Ghana

BackgroundThis paper investigates the factors influencing the decision to enrol in Ghana’s National Health Insurance Scheme (NHIS) among people at risk of statelessness, with emphasis on the individual's demographic and socioeconomic factors. MethodsThe study used data from a cross-sectional household survey undertaken in the Awutu Senya East Municipality and Gomoa East District of Ghana's Central Region between March 9 and June 26, 2021, on healthcare utilization culture among people at risk of statelessness. Descriptive statistics and binary logistic regression were used in analysing data from a sample of 384 people at risk of statelessness. ResultsThe results reveal that about 51% of the at-risk population have ever enrolled while 48% of the respondents were enrolled on the NHIS at the time of the survey (active members). The majority of the enrolled members acquired their membership through self-payment of the enrolment fee. Additionally, respondents aged 26–35 had higher odds of enrolling, whiles those within 56–65 years had lower odds of enrolling in health insurance. Also, persons who are married and have a high school education or an equivalent qualification were more likely to enrol, while persons with no employment were less likely to enrol.ConclusionAccording to the paper, while the gap in coverage between rich and poor, married and single appears to have narrowed, these factors continue to determine NHIS coverage among people at risk of statelessness. The same is true for education. Efforts must be increased to ensure equal access to healthcare financing interventions for better access to health services.