Individual Socioeconomic Factors Research Articles

Socially Equitable Public Service Provision: Towards Inclusive Coproduction of Public Infrastructure

ABSTRACT The challenge of building and maintaining public infrastructure in the face of climate change and natural hazards necessitates greater citizen involvement in decision-making processes. Coproduction aims to ensure equitable service distribution by engaging a diverse range of citizens. However, the literature highlights disparities, with certain citizens having greater resources for participation. This study explores how individual socioeconomic factors and risk perceptions influence citizens’ willingness to engage in coproduction. Coproduction has been criticized for excluding marginalized populations, we analyze how multilevel factors shape willingness to participate in two modes of coproduction: co-planning and co-investing. The results indicate that risk perception is the most significant factor driving citizens’ willingness to coproduce. Furthermore, well-educated or wealthy citizens are more inclined to participate. This study proposes an inclusive approach to coproduction, aiming to ensure equitable public service delivery regardless of socioeconomic status.

Effectiveness of targeted financial aid on disability welfare for the ageing population in China: A quasi-experiment study.

Addressing the problem of disabilities and disability deterioration is a key task for healthy ageing. Financial aid has been an effective measure for vulnerable groups, especially ageing people with disabilities. However, the effects of targeted financial aid on preventing disability deterioration remain unknown. The Chinese government launched a targeted financial aid programme aimed at people with disabilities. In this study, we investigated the causal effects of such targeted financial aid on disability deterioration prevention for elderly people with disabilities in China. The data set used in this study included 36 640 elderly individuals with disabilities in China between 2016-19. We constructed a quasi-experiment approach and used a difference-in-differences (DID) method to examine the counterfactual differences between the treatment group in four cities that implemented such targeted financial aid in 2018 and the control group in three cities that did not adopt the policy over the study period. We employed propensity score matching (PSM) jointly with DID to mitigate selective bias. For sensitivity analysis, we conducted supplementary analyses on alternative samples, focusing on each of the treated cities respectively. Besides the main outcome, we also used fixed effect models to test the impact of such financial aid on rehabilitation access. The targeted financial aid significantly reduced the possibility of disability deterioration for elderly people with severe disabilities (0.26%; P < 0.001). Using PSM-DID models, the impact remained significant (0.33%; P < 0.001). Moreover, financial aid was significantly related to their access to rehabilitation services (12.71%; P < 0.001). Further analysis showed the heterogenous effects of targeted financial aid across individual demographic and socioeconomic factors, as well as communities with and without rehabilitation facilities. Targeted financial aid had a positive impact on preventing disability deterioration among elderly individuals aged ≥65 years with severe disabilities. Moreover, rehabilitation care had a potential mediating role in the relationship between targeted financial aid and disability deterioration prevention. This study highlights the effectiveness of targeted financial aid in preventing disability deterioration and improving rehabilitation care for people with disabilities.

Inequalities in the risk and prevention of invasive meningococcal disease in the United States - A systematic literature review.

Vaccination remains the most effective strategy to prevent invasive meningococcal disease (IMD), with MenACWY, MenB and MenABCWY recommended for adolescents/young adults in the United States (US). However, vaccination coverage remains suboptimal, which could be related to population inequalities. To understand the impact of IMD risk, prevention and control inequalities, a global systematic literature review (Medline, Embase, 2012-2022) was conducted on individual, socioeconomic, and environmental inequalities associated with IMD risk, prevention and control in all ages. Studies on IMD risk (n = 15) and prevention (n = 14) inequalities were identified. IMD incidence proportions were higher in Medicaid versus commercially insured populations, and IMD mortality was higher in poorer neighborhoods. White adolescents, adolescents from lower income families, and with lower maternal education were more likely to receive MenB vaccination; while Black and Hispanic adolescents, and adolescents with higher family incomes, were more likely to receive MenACWY vaccination. Meningococcal vaccination was associated with being up-to-date with other vaccinations, having multiple healthcare/well child visits, having a pediatrician as healthcare provider (HCP), and attending private facilities; while being uninsured was associated with lower vaccination. States with a MenACWY vaccination mandate and higher pediatrician-to-children ratios had higher vaccination rates. Important inequalities were due to individual differences, socioeconomic, and environmental factors. IMD prevention is suboptimal, especially among adolescents/young adults. To improve health equity, health policy makers could ameliorate meningococcal vaccination coverage across the US, with simplified and stronger meningococcal vaccine recommendations from public health authorities, and initiatives to enhance parental/patient and HCP knowledge of IMD and vaccine recommendations.

Individual socioeconomic status, neighborhood disadvantage, and cognitive aging: A longitudinal analysis of the CLSA.

There are likely many contributors to variation in the rate of cognitive decline in middle and late adulthood, including individual and neighborhood socio-economic factors. This study examines whether individual socio-economic factors, namely income and wealth, correlate with cognitive decline, in part, through neighborhood-level social and material disadvantage. Using the three waves of data collection from the Canadian Longitudinal Study on Aging (CLSA), this study included 51,338 participants between the age of 45 and 85 years at baseline (51% female). Individual socio-economic status (SES) was assessed by annual household income and by the current value of savings and investments. Neighborhood disadvantage was measured by area-based material and social deprivation indices. Cognition was measured at each wave using verbal fluency, mental alternations, and delayed word recall. Latent change score models, incorporating direct and indirect pathways, were constructed to estimate the indirect effect of individual SES on cognitive change through area-level disadvantage. Multi-group models were constructed on the basis of age-group (45-64 years; 65-74 years; or 75+ years) to allow for varying estimates across age. Among 45-64-year-olds, income and wealth had indirect effects on initial cognitive level and on rate of cognitive decline through material disadvantage (standardized indirect effects = 0.01, p < 0.001), but only wealth had an indirect effect through social disadvantage (p = 0.019). Among 65-74-year-olds, income and wealth had indirect effects on initial cognitive level (p < 0.01) but not on rate of cognitive decline (p > 0.05), and among 75+ year-olds, no indirect effects were observed (p > 0.05). Wealth and income had direct effects, independent of neighborhood disadvantage, on cognition in all age groups (p < 0.05). Among middle-aged adults, greater individual SES may mitigate cognitive decline, in part, by allowing individuals to live in more materially and socially advantaged neighborhoods.

Understanding the determinants of self-reported asthma in Turkey: insights from national data on individual, lifestyle, socioeconomic, and healthcare access factors

Asthma, influenced by genetic, environmental, and social factors is leading to poor outcomes and preventable mortality due to inadequate care and limited access to effective treatments. This study aimed to analyze self-reported asthma prevalence in Turkey, focusing on its determinants, such as individual factors, lifestyle, socioeconomic status, and healthcare access.This study conducts a secondary analysis of the 2019 Turkiye Health Survey (THS), employing a nationally representative cross-sectional design by the Turkish Statistical Institute. The sampling utilized a stratified, two-stage cluster sampling method, with data from 16,976 adults (aged 15 years and older) analyzed for asthma determinants. The independent variables are categorized into four domains: individual factors, lifestyle assessment, socioeconomic factors, and access to the healthcare services.The prevalence of asthma is 9.8%, varying significantly across demographics. Higher asthma rates are observed among older, divorced/widowed individuals, those with communication difficulties, and obese individuals. Cost-related unmet healthcare needs and appointment scheduling delays increase asthma risk. Logistic regression models identified age, marital status, obesity, education level, and healthcare access as significant predictors of asthma.This study underscores the multifaceted determinants of asthma in Turkey, highlighting the necessity for targeted interventions addressing individual, lifestyle, socioeconomic, and healthcare access factors.

Effects of housing stability and contemporary mortgage lending bias on breast cancer stage at diagnosis among older women in the United States.

Interventions aimed at upstream factors contributing to late-stage diagnoses could reduce disparities and improve breast cancer outcomes. This study examines the association between measures of housing stability and contemporary mortgage lending bias on breast cancer stage at diagnosis among older women in the United States. We studied 67,588 women aged 66-90 from the SEER-Medicare linked database (2010-2015). The primary outcome was breast cancer stage at diagnosis. Multinomial regression models adjusted for individual and neighborhood socio-economic factors were performed using a three-category outcome (stage 0, early stage, and late stage). Key census tract-level independent variables were residence in the same house as the previous year, owner-occupied homes, and an index of contemporary mortgage lending bias. In models adjusted for individual factors, higher levels of mortgage lending bias were associated with later stage diagnosis (RR = 1.10, 95% CI 1.02-1.20; RR = 1.31, 95% CI 1.16-1.49; RR = 1.41, 95% CI 1.24-1.60 for least to high, respectively). In models adjusted for individual and neighborhood socio-economic factors, moderate and high levels of mortgage lending bias were associated with later stage diagnosis (RR = 1.16, 95% CI 1.02-1.33 for moderate and RR = 1.18, 95% CI 1.02-1.37 for high). Owner occupancy and tenure were not associated with later stage diagnosis in adjusted models. Contemporary mortgage lending bias demonstrated a significant gradient relationship with later stage at diagnosis of breast cancer. Policy interventions aimed at reducing place-based mortgage disinvestment and its impacts on local resources and opportunities should be considered as part of an overall strategy to decrease late-stage breast cancer diagnosis and improve prognosis.

Socioeconomic inequalities in contraceptive use among Brazilian women: A multilevel analysis stratified by parity

ObjectiveTo investigate if individual and contextual socioeconomic factors are associated with contraceptive use in Brazilian women from 18 to 49 years old, stratified by parity. MethodsCross-sectional, population-based study that analyzed data from 16,879 women from 18 to 49 years old, respondents of the 2013 National Health Survey. Individual factors such as reproductive history, access to health services, and sociodemographic characteristics were considered; and as contextual factors, Human Development Index (HDI), Sociodemographic Index (SDI) Primary Health Care Coverage (PHC coverage) and Average Monthly Income were included. Multilevel logistic regression models were estimated, stratified by parity, with women being level 1 and States and Federal District of level 2 units. ResultsNulliparous women had lower prevalence of contraceptive use (77.9 %) when compared with primiparous and multiparous (88.7 %), as well as greater variability in the chance of using contraception (ICC = 2.1 vs. ICC = 1.1, respectively). Women who lived in States with higher levels of HDI, average monthly income and SDI were more likely to use contraception. The greater PHC coverage was positively associated with the use of contraceptives for primiparous/multiparous women and negatively for the nulliparous. Furthermore, higher education increased the chances of using contraception, both for nulliparous and primiparous/multiparous women. ConclusionsThe high contraceptive coverage in Brazil hides important inequities in access, highlighting contextual characteristics associated with the use of contraceptives, in addition to individual factors. The lower prevalence and chance of using contraceptives for nulliparous women with greater social vulnerability reveal inequity and priority in public policies. Implications for practiceThe need to improve access to contraception is highlighted, considering both the individual and contextual vulnerabilities of women, which implies ensuring timely and qualified access to contraceptive methods, especially for young and nulliparous women who are more socially vulnerable.

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 for 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 data set. The patients were selected from the National Cancer Database and enrolled from 2004 to 2016. We identified patients with stage I to III squamous-cell carcinoma of the anus who were treated with chemoradiation therapy. Socioeconomic factors, including race, insurance status, median household income, and percentage of the population with no high school degrees, were included. The association of these factors with treatment delay and overall survival was investigated. A total of 24,143 patients who underwent treatment for grade I to III squamous-cell carcinoma of the anus were identified. The median age was 60 years, and 70% of patients were women. The median time to initiation of treatment was 33 days. Patients from zip codes with lower median income, patients with a 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 the early treatment group (98 vs 125 months; p < 0.001). No detailed information is available about the 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 . ANTECEDENTES:Las desigualdades socio-económicas tienen implicaciones en el acceso a la atención médica y pueden estar asociadas con disparidades en el tratamiento y la sobrevida.OBJETIVO:Indagar el impacto de las desigualdades socio-económicas sobre el tiempo de retraso en el tratamiento y la sobrevida en casos de carcinoma a células escamosas del ano (CCEA).DISEÑO:Estudio retrospectivo utilizando un conjunto de datos a nivel nacional.AJUSTES:Todos aquellos pacientes inscritos entre 2004 a 2016 y que fueron seleccionados de la Base Nacional de Datos sobre el Cáncer.PACIENTES:Identificamos pacientes con CCEA en estadíos I-III y que fueron tratados con radio-quimioterápia.PRINCIPALES MEDIDAS DE RESULTADOS:Se incluyeron factores socio-económicos tales como la raza, el tipo de seguro de salud, el ingreso familiar medio y el porcentaje de personas sin bachillerato de secundaria (SBS). Se investigó la asociación entre estos factores con el retraso en iniciar el tratamiento y la sobrevida global.RESULTADOS:Se identificaron un total de 24.143 pacientes que recibieron tratamiento para CCEA estadíos I-III. La mediana de edad fue de 60 años donde 70% eran de sexo femenino. La mediana del tiempo transcurrido desde el diagnóstico hasta el inicio del tratamiento fue de 33 días. Los pacientes residentes en zonas de código postal con ingresos medios más bajos, con un mayor porcentaje de individuos SBS y los pacientes con otro tipo de seguro gubernamental de salud, seguidos del seguro tipo Medicaid iniciaron el tratamiento solamente después de 60 días al diagnóstico inicial de CCEA. El análisis de Kaplan-Meier de la sobrevida mostró que el grupo de tratamiento tardío tuvo una peor supervivencia general comparada con el grupo de tratamiento precoz o temprano (98 frente a 125 meses; p <0,001).LIMITACIONES:No se dispone de información detallada sobre el tipo de radio-quimioterapia utilizada, ni sobre la finalización del tratamiento o la recurrencia, tampoco acerca de la sobrevida libre de enfermedad ni sobre las condiciones socio-económicas o aquellos factores de riesgo a nivel individual.CONCLUSIÓN:Los pacientes de comunidades con ingresos medios más bajos, con un nivel de educación limitado e inscritos en un seguro público tardaron mucho más tiempo en recibir el tratamiento prescrito. El nivel socio-económico más bajo también se asoció con una sobrevida global más baja. Los presentes resultados justifican mayor análisis y medidas mas importantes para mejorar el acceso a la atención en salud y poder afrontar esta disparidad. (Traducción-Dr. Xavier Delgadillo ).

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, hyperlipidaemia, 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, behavioural, 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 the 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 the 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 hyperlipidaemia. We highlight the importance of a holistic approach needed to prevent and treat this debilitating disease. Particularly, we analyse the effects of plant-based diet, regular exercise, and non-exercise activity thermogenesis on obesity and overall cardiorespiratory fitness. 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.

Мотивація персоналу міжнародних проєктів для забезпечення конкурентоспроможності підприємства з використанням статистичних та економетричних методів

The aim of the article is to identify the features of modern approaches to the motivation of personnel of international projects to ensure competitiveness and establish, using statistical and econometric methods, the quantitative influence of individual socioeconomic factors on the performance of these employees. The socioeconomic and political situation in Ukraine due to the full-scale military aggression on the part of the russian federation requires the top management of business entities to search for and successfully use statistical and econometric methods to determine and model dependencies between socioeconomic indicators, as well as to provide an opportunity to be involved in international projects in order to obtain additional competitive advantages. In the course of the study with the use of system-structural analysis and synthesis, the stages of personnel management of international projects are determined, as well as the characteristics and functions performed by individual subsystems of personnel management of international projects are identified. According to the results of the review of scientific literature, considerable attention of scientists to the problems of motivation of personnel of international projects to ensure the competitiveness of enterprise has been revealed. Approbation of theoretical studies was carried out based on the results of the activities of JSC «Interpipe NMPP», the main types of products of which are pipes of medium and small assortment. The analytical study revealed a decrease in sales, net profit and the number of employees, which is a consequence of the company’s work in an unstable external environment (COVID, military aggression of the russian federation against Ukraine). With the use of statistical and econometric methods, the degree of influence of individual factors on the efficiency of the personnel of the specified enterprise is determined; in particular, with the use of regression analysis, the author has built econometric models of the impact of personnel development in the form of professional training and advanced training and material incentives (remuneration) on the efficiency of the personnel of the specified enterprise and its involvement in participation in international projects. The author’s vision boils down to the fact that the use of such tools for motivating the personnel of international projects as wages, vocational training and advanced training provide an increase in labor productivity and, accordingly, the formation of competitive advantages of both employees and products, the enterprise, and the country as a whole. Prospect for further scientific research is the formation of a system of non-material factors for increasing labor productivity and personnel evaluation.

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.