Individual Socioeconomic Status Research Articles

The Effect of Neighborhood Deprivation on Mortality in Newly Diagnosed Diabetes Patients: A Countrywide Population-Based Korean Retrospective Cohort Study, 2002-2013.

Background: Neighborhood environmental factors along with individual factors are beginning to make a mark as factors which influence individual health outcomes. The goal of this study is to look at the combined impact of individual and neighborhood socioeconomic status on all-cause mortality in diabetic patients who have just been diagnosed. Methods: The Korean National Health Insurance (2002–2013) was employed in this cohort research, which used a stratified random sample. During the years 2003–2006, a total of 15,882 individuals who were newly diagnosed with diabetes and using oral disease-controlling medication were included in the study. Individual income and neighborhood deprivation index were used to examine the combined effect on all-cause mortality. The frailty model was performed using Cox’s proportional hazard regression. Results: During the study period, 28.3 percent (n = 4493) of the 15,882 eligible individuals died. In a Cox regression analysis after adjusting for all covariates, with advantaged and disadvantaged neighborhoods classified according to individual household income, the adjusted HR for patients living in a disadvantaged area was higher compared to patients living in an advantaged area in patients with middle income, compared to the reference group (a high income within an advantaged neighborhood) (HR, 1.22; 95% CI, 1.09–1.35; HR, 1.13; 95% CI, 1.02–1.25, respectively). The adjusted HR for patients with low income who lived in a disadvantaged location was greater than for patients who lived in an advantaged area (HR, 1.34; 95% CI, 1.18–1.53 vs. HR, 1.28; 95% CI, 1.14–1.49). Conclusions: Individual SES has a greater impact on all-cause mortality among diabetic patients when they live in a low-income neighborhood.

Early-life environmental exposures and anaemia among children under age five in Sub-Saharan Africa: An insight from the Demographic & Health Surveys

BackgroundReports show that the majority (60%) of children under age five years in Sub-Saharan Africa are anaemic. Studies in the region have mainly focused on the effect of individual, maternal and household socioeconomic status on the prevalence of anaemia. Currently, there is limited understanding of the association between early-life environmental exposures and anaemia among children in Sub-Saharan Africa. ObjectiveThe study examines the association between early-life environmental exposures and anaemia among children under five in Sub-Saharan Africa. MethodsThe study used health and demographic data from the Demographic and Health Survey (DHS) program and environmental data from NASA's Geospatial Interactive Online Visualization ANd aNalysis Infrastructure (GIOVANNI) and Atmospheric Composition Analysis Group. Three exposure periods were defined for the study, namely: in-utero, post-utero and cumulative life exposures. Multilevel mixed-effect models were used to assess the associations between environmental exposures and anaemia in each exposure period. ResultsThe findings show that 63% of children in the study were anaemic. It also reveals that mean PM 2.5 exposure for in-utero (34.93 μgm−3), post-utero (35.23 μgm−3) and cumulative exposure (35.08 μgm−3) were seven times higher than the new air quality guideline WHO recommended. A 10 μgm−3 increase in in-utero, post-utero and cumulative PM 2.5 exposures was associated with 4% to 5% increase in the prevalence of anaemia among children. A 10ppbv increase in in-utero, post-utero and cumulative carbon monoxide exposures was associated with 1% increase in the prevalence of anaemia among children. The spatial risk distribution maps show that socioeconomic factors modify the spatial risk distribution pattern. ConclusionThe findings of the study suggest that early-life exposure to ambient air pollution is significantly associated with anaemia among children in Sub-Saharan Africa. Thus, policies aimed at addressing air quality should be incorporated into targeted interventions for anaemia among children in the region.

Coupled social media content representation for predicting individual socioeconomic status

Predicting individual socioeconomic status (SES) from social media content benefits various applications in economic and social fields. Most previous works adopt machine learning methods with predefined features to infer SES. Nevertheless, they ignore some important information of social media content, such as order, structure and relation information, which leads to limited performance. In this paper, we propose a COupled social media content REpresentation model (CORE) for individual SES prediction, which efficiently exploits latent complex couplings of social media content. CORE devises a structure-aware social media text representation method to incorporate the order and the hierarchy of social media text, and leverages a coupled attribute representation method to take into account intra-coupled and inter-coupled interaction relationships among user level attributes. Our experiments on a real data set of a Chinese microblogging platform demonstrate that our approach significantly outperforms benchmark methods, which validates its efficiency and robustness. The proposed model could be applied to improve the SES prediction and other user profiling tasks.

Effect of socioeconomic status on survival in patients on the Diabetes Shared Care Program: Finding from a Taiwan nationwide cohort.

The Diabetes Shared Care Program (DSCP) is an integrated care model in Taiwan to improve the care quality of patients with diabetes. Socioeconomic status (SES) is one of the important factors affecting health, and it is confirmed as a predictor of various diseases and deaths.This study aimed to determine the relationship between survival rate and SES among patients who participated in the DSCP. A cohort population-based study was conducted using the National Health Insurance Research Database of Taiwan from 2008 to 2013. The study subjects were type 2 diabetes. We defined individual SES and neighborhood SES by each patient's job category and household income, which were characterized as advantaged or disadvantaged. Then we compared the survival rates of SES groups by Cox proportional hazards model to adjust risk factors. This study included 16 614 patients with type 2 diabetes who participated in the DSCP program. The DSCP cohort showed a high hospitalization rate in low individual SES. In terms of 10-year overall survival, DSCP participants with high individual SES living in advantaged and disadvantaged neighborhoods had lower risk of mortality than those with low SES living in advantaged and disadvantaged neighborhoods, after adjustment for age and comorbidity. DSCP participants with low individual SES living in disadvantaged neighborhoods had no significant difference of mortality as those with low individual SES living in advantaged neighborhoods. In this study, we found that low individual SES, but not neighborhood SES, was associated with an increased mortality rate among DSCP participants.

Fear of crime and Roma integration

We analyze the majority’s perceptions of Roma as a socio-cultural and crime threat and their evaluations of two key integration measures namely schooling and financial allowances. Following a fear of crime model we test for the effect of community context, disorder/safety, and victimization as the critical parameters of these perceptions and evaluations. Empirical estimations involve a cross-section dataset for Greece and multilevel model techniques. Results verify community context, disorder and victimization as important fear and integration predictors that interact with the socio-economic status of individuals and regional crime rates.

Abstract P136: The Association Between Socioeconomic Status And Use Of Potentially Inappropriate Medications In Older Adults

Introduction: The use of potentially inappropriate medications (PIM), defined as medications for which the risk of adverse events outweighs the expected benefits, increases the risk of hospitalization, adverse drug events, and mortality in older adults. As socioeconomic status (SES) influences health care quality, the purpose of this study is to investigate whether PIM use differs by SES in older adults. Hypothesis: We hypothesized that low SES was independently associated with increased use of PIM. Methods: We studied participants (aged 66-90 years) who were on at least one medication at visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) Study. We created a cumulative SES score, based on neighborhood SES (area deprivation index [ADI]) as well as individual SES (education and income). Because PIM for older adults defined by the 2019 Beers Criteria was extremely common (31% of the population), we focused on the use of two or more PIM. We used multivariable logistic regression to examine the associations between SES and PIM use ≥2. Results: Among 4927 participants (mean age of 75.6 (SD 5.1) years, 19.6% Black, and 57.8% female), 6.9% were on two or more PIMs. Overall, compared with individuals with high cumulative SES, those with lower SES had higher odds of PIM use in a dose-dependent manner (odds ratio [OR]: 1.40 [95% confidence interval (CI), 1.06-1.83] for middle cumulative SES; 1.83 [1.18-2.86] for low cumulative SES, Table ), adjusting for demographics and insurance type. For each SES component, low neighborhood SES (i.e., high ADI) and low education was significantly associated with higher odds of PIM use, but not income. Conclusions: We found that lower SES was associated with greater use of PIM among older adults, suggesting that there exist disparities in quality of care by SES. Focused efforts targeting older adults with low SES to reduce PIM use may be needed to prevent adverse outcomes.

Abstract 075: Sociodemographic And Pregnancy Related Differences In Blood Pressure Phenotypes A Decade Following Pregnancy

Introduction: Hypertensive disorders of pregnancy (HDP) such as preeclampsia are associated with a 3-fold increased risk of chronic hypertension (HTN). Office based measurements alone results in frequent HTN misclassification, prompting the need for out-of-office measurements to ensure proper classification. Hypothesis: We hypothesized that individual and neighborhood level sociodemographic factors and adverse pregnancy outcomes are different within the BP phenotypes of persistent normotension, and sustained, white-coat, masked, and isolated diastolic HTN. Methods: Data were from 401 women who gave birth between 2008 - 2009 and participated in a research study 8-10 years following pregnancy. We determined BP phenotypes by comparing the mean office BP (3 measures) and home BP (13 measures) assessed following research protocols. HTN was defined as BP ≥130/80. Sociodemographic characteristics were age, race, education, adiposity, and perceived stress. Neighborhood characteristics were from the CDC Social Vulnerability Index (i.e., socioeconomic status, household composition, minority status, housing type) measured at the census tract level, with higher values representing greater vulnerability. Chi-square determined differences in BP phenotypes for categorical data, and ANOVA for continuous data, both with Tukey correction. Results: Participants had a mean age of 37.6 (5.9), 15.1 (2.6) years of education, 34.7% (n=155) were Black and 22.8% (n=102) had a history of HDP. BMI and central adiposity were higher in all BP phenotypes compared to the normotensive group. Women with sustained HTN ( 6.2%, n=25) and isolated diastolic HTN (18.2%, n=73,) were more likely to be Black and have a history of HDP. However, only women with isolated diastolic HTN were more likely to have less education and higher stress scores. Compared to the normotensive women, those with masked HTN (n=25, 6.2%) tended to have a history of HDP. The BP phenotype groups did not differ by neighborhood level factors, although there was a trend toward lower neighborhood socioeconomic status among the isolated diastolic and masked HTN groups (p< .10). Conclusion: Isolated diastolic HTN was the most common adverse BP phenotype in this sample of young women, and was more common among Black women and those with a history of HDP. Isolated diastolic HTN may be more prevalent than generally recognized in clinical practice. Research is needed to determine the long-term implications of this phenotype, especially among women with a history of HDP. BP phenotypes differed on individual characteristics and neighborhood socioeconomic status, however, neighborhood characteristics such as violence, air quality, and cohesiveness should be considered in future research. This research was supported by T32HL007560 (PIs: Thurston & Gianaros, Trainee: Scott) and AHA award 16SFRN28930000 (PI: Catov).

Parental feeding practices and child eating behavior in different socioeconomic neighborhoods and their association with childhood weight. The STEPS study.

Child obesity risk, child eating behavior and parental feeding practices show a graded association with individual level socioeconomic status. However, their associations with neighborhood socioeconomic disadvantage are largely unknown. In this study (n=682), we investigated how parental feeding practices and child eating behaviors were associated with body mass index and risk of overweight at preschool age in affluent and disadvantaged neighborhoods. We found that high food approach tendency in disadvantaged neighborhoods predicted higher body mass index and increased the risk of overweight at the age of 6 years compared with affluent neighborhoods. Our results suggest that children's eating habits may have stronger impact on overweight risk in disadvantaged than in affluent neighborhoods.

Abstract P063: Socioeconomic Status And Component Of Iatrogenic Obesity In The United States

Introduction: Overweight and obesity are more prevalent in people with lower socioeconomic status (SES). Use of obesogenic prescription medications such as certain anticonvulsants, antidepressants, beta-blockers, and antidiabetic medications may contribute to the disparities in obesity by SES in US adults. Methods Using data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES), we assessed the use of obesogenic medication by SES among overweight and obese adults aged ≥20 years taking ≥1 prescription medication. Based on low SES indicator – <high school education, household income <federal poverty level, and having public health insurance only, we categorized participants into 3 SES groups (0, 1, and ≥2 low SES indicators as high, intermediate, and low SES). We used logistic regression to examine the association between SES and obesogenic medication use. All analyses accounted for the complex NHANES survey design. Results Among 11,796 participants (mean age 54.6, 54.1% female), the mean body mass index (SE) was 32.5 (0.1) kg/m 2 . Use of obesogenic medication was more common among people with lower SES in all survey years, with a trend toward increased prevalence over time among people with low SES ( Figure ). Lower SES was associated with obesogenic medication use in demographic-adjusted models (OR 1.4 [95%CI 1.2-1.5] for intermediate SES and 1.9 [1.7-2.1] for low SES, compared to high SES). The associations remained significant after further accounting for number of medications (OR [95% CI] =1.1 [1.0-1.3] for intermediate SES and 1.2 [1.0-1.4] for low SES). Results were consistent when assessed by individual SES indicators. Conclusions: Use of obesogenic medication is common in the US. Lower SES was associated with more frequent use of obesogenic medication even after controlling for medication burden. These results suggest that disparities in obesogenic medication use may contribute to the higher obesity prevalence among people with lower SES.

Effects of socioeconomic status on the control of hypertension in patients

ObjectiveImplementation of National Health Insurance in 1995 improved the control of hypertension due to comprehensive coverage of medical costs for all residents in Taiwan. However, the role of individual socioeconomic...

Dietary disparities among adolescents according to individual and school socioeconomic status: a multilevel analysis

This study aimed to estimate disparities in dietary habits according to the individual and contextual socioeconomic status (SES), while taking into account school nutrition-related characteristics. Data came from the 2018 cross-sectional “Health Behaviour in School-aged Children” (HBSC) survey. Multilevel multiple logistic regressions were performed. Over two-thirds of the observed variance was explained by individual and school characteristics, with SES being the main contributors. For example, 76.9% of the variance in daily sugar-sweetened beverage (SSB) intake was explained by individual and school characteristics. Adolescents of a secondary or lower parental education level were more likely to consume SSB daily than those of a post-secondary level (aOR = 1.46 (1.29–1.66)). Compared to those in a high SES school, the odds to consume SSB daily was higher for adolescents in low SES schools (aOR = 2.37(1.90–2.96)). These findings support the need for schools to pursue a consistent nutrition policy, with an increased support in low socioeconomic populations.

STUDENTS’ PREDISPOSITION TO BEING A VICTIM OF INTERNET CRIME IN TERTIARY INSTITUTIONS OF NIGERIA

The intensive and pervasive use of the use of the internet among the youth is an incontrovertible fact. Electronic or cybercrime among the youth has figuratively become endemic beating most security preventive networks and putting online users at the risk of becoming unsuspecting victims. This paper examines students’ Students’ Predisposition to Being a Victim of Internet Crime in Tertiary Institutions of Nigeria. The study employs quantitative research methods, 150 students were selected using multistage sampling procedure. Data were gathered on User’s purpose of using Internet and predisposition to internet Victimization; and Student Socio-economic status and Victimization Experience. Data were analyzed using frequency counts, percentage and correlation analysis. information from the respondents revealed that, students who engaged in online banking had been victimized at least in which their accounts was debited by unknown person without their knowledge/ consent and also, those who engaged in chatting and performing e-business transaction with high social economic status are more susceptible to e-victimization experience, more so, users’ motives of surfing internet are directly related to their vulnerability to victimization experience. Finally, from the study, it was observed that there is positive relationship between individual socio-economic status and their victimization experienced. The study concludes that students who engaged in online banking transaction, both via app, point of sales POS or e-transfer is exposed to fraudsters and more vulnerable to internet fraud experiences therefore recommended that student should try as much as possible not to display wealth or any of their socio-economic information on social media.

Interconnection of severe obesity, gastric intestinal metaplasia, gastric cancer, bariatric surgery and the necessity of preoperative endoscopy

Obesity is a growing challenge around the globe accounting for approximately 1.7 billion adults with reduced life expectancy of 5–20 years and these patients are at greater risk for various cancers. Bariatric surgery is one efficient an approved treatment of severe obesity for losing weight and to decrease associated health complications. Besides correct indications and contraindications as well as the various risks of individual bariatric surgical procedures, many more variables influence decision-makings, such as patient’s family history of diseases, as well as individual patient-specific factors, patient and family socioeconomic and nutrition status, and professionalism of a bariatric surgical unit and the presence of intestinal metaplasia that is the replacement of columnar epithelial cells by intestinal architecture and morphology. Patients with severe obesity undergoing esophagogastroduodenoscopy (EGD) and biopsy prior to bariatric surgery may present with gastric IM because regular follow-up to early diagnosis of any subsequent pathological changes is necessary and reveals the importance of addressing interconnections between pre-existing conditions and outcomes. However, there is currently no unified recommendation about preoperative EGD before bariatric surgery. With this short review, we point out the necessary knowledge that undermines why the responsibility for a patient with severe obesity cannot be divided across various disciplines, and why we recommend that EGD always be performed preoperatively.

Household Carbon Footprint: Rural and Urban Community

A significant disparity exists in the living conditions and lifestyles of people living in rural and urban India. Based on geographical location and lifestyle, an individual's contribution to the global carbon footprint has been estimated in this study. This study examines the household carbon footprint in different rural and urban regions of West Bengal. It analyzes the difference of contribution of the factors based on one’s geographical location and how an individual's socioeconomic status affects carbon footprint. Data on the consumption of goods and services resulting in GHG emissions was gathered at the household (N=243) level through a questionnaire survey in different districts of West Bengal. The average carbon footprint in rural areas is estimated to be 0.56 tones CO2e per capita per year. In urban areas, it is 2.33 tones CO2e per capita per year significant difference is found in the annual per capita carbon footprint (household, travel, lifestyle, and total carbon footprint) among the various income groups of rural and urban areas. Another significant difference is found among different monthly expenditure categories between urban and rural households. Based on the information given by the respondents of the rural and urban areas the difference regarding electricity consumption, travelling details, monthly expenditure category, type of energy used, cooking fuel, annual household, travel, and lifestyle carbon footprint have been discussed graphically. This study looked at the sectoral contribution (activity-wise, e.g., cooking, transportation, etc.) and the rural-urban disparity in the individual carbon footprint.

Neighborhood disadvantage moderates the effect of a mobile health intervention on adolescent depression.

This study leverages data from a pilot randomized controlled trial to investigate whether the effectiveness of a text-delivered mHealth intervention targeting adolescent depression and anxiety differs according to residential- and activity space-based measures of exposure to community-level socioeconomic disadvantage. For depression, we find that intervention efficacy is significantly stronger for youth residing in more disadvantaged neighborhoods, even after controlling for individual level socioeconomic status, as well as marginal moderating effects of activity space-based neighborhood disadvantage on treatment efficacy. We do not find evidence of treatment efficacy moderation by neighborhood disadvantage regarding anxiety. While the generalizability of our findings is restricted to this sample and for this intervention, this research serves as a motivating example and initial evidence for how mHealth intervention efficacy can vary by characteristics of the environment, in particular community-level disadvantage. Future clinical research should investigate whether the effectiveness of mHealth interventions may be enhanced by personalization based on an individual's contextual environmental exposures.

Socioeconomic difference in physical activity in children and their parents: The childhood and adolescence surveillance and prevention of adult noncommunicable disease study.

As a health-related behavior, physical activity (PA) differs according to individual's socioeconomic status (SES). This study aimed to assess the socioeconomic difference in leisure-time PA among Iranian students and their parents at national and regional levels. Nationwide cross-sectional study. This study was conducted as part of a national survey conducted in 2015 among 14400 Iranian students and their parents. Total PA level was measured as the average hours spent on PA per week. Nonlinear principal component analysis was used to construct the households' SES based on household's assets, type of house ownership, occupation of fathers and the educational levels of fathers and mothers. Concentration index was applied to measure the inequality in the PA level in parents and students. Complete data of 13313 students and their parents were available. At the national level, students spent more hours of PA per week (3.753 h per week [h/w]) as compared to their parents. Moreover, PA h/w was higher in fathers (3.488 h/w) as compared to mothers (2.763 h/w). The lowest means of mother's and student's PA were found in the highest SES region. At national level, the concentration indices (CI) of father's and mother's PA were -0.050 (95% CI = -0.067 ~ -0.030) and -0.028 (95% CI = -0.044 ~ -0.012), respectively, indicating pro-poor inequality, but the CI value of student PA was non-significant (CI = -0.007, 95% CI = -0.023-0.008). Given that the mother's and student's PA level was low in the high SES regions, it is suggested that focused PA planning may further increase the level of PA across higher SES regions and might be effective in reducing the PA inequality.

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure.

BackgroundWhile socioeconomic status has been linked to hospital readmissions for several conditions, reliable measures of individual socioeconomic status are often not available. HOUSES, a new measure of individual socioeconomic status based upon objective public data about one's housing unit, is inversely associated with overall hospitalization rate but it has not been studied with respect to readmissions.PurposeTo determine if patients in the lowest HOUSES quartile are more likely to be readmitted within 30 days (short-term) and 180 days (long-term).MethodsA retrospective cohort study of 11 993 patients having 21 633 admissions was conducted using generalized linear mixed-effects models.ResultsHOUSES quartile did not show any significant association with early readmission. However, when compared to the lowest HOUSES quartile, the second quartile (OR = 0.90, 95%CI 0.83-0.98) and the third quartile (OR = 0.91, 95%CI 0.83-0.99) were associated with lower odds of late readmission while the highest quartile (OR = 0.91, 95%CI 0.82-1.01) was not statistically different.ConclusionHOUSES was associated with late readmission, but not early readmission. This may be because early readmissions are influenced by medical conditions and hospital care while late readmissions are influenced by ambulatory care and home-based factors. Since HOUSES relies on public county assessor data, it is generally available and may be used to focus interventions on those at highest risk for late readmission.

Neighborhood and Individual Socioeconomic Disadvantage and Survival Among Patients With Nonmetastatic Common Cancers

Disadvantaged neighborhood-level and individual-level socioeconomic status (SES) have each been associated with suboptimal cancer care and inferior outcomes. However, independent or synergistic associations between neighborhood and individual socioeconomic disadvantage have not been fully examined, and prior studies using simplistic neighborhood SES measures may not comprehensively assess multiple aspects of neighborhood SES. To investigate the associations of neighborhood SES (using a validated comprehensive composite measure) and individual SES with survival among patients with nonmetastatic common cancers. This prospective, population-based cohort study was derived from the Surveillance, Epidemiology, and End Results-Medicare database from January 1, 2008, through December 31, 2011, with follow-up ending on December 31, 2017. Participants included older patients (≥65 years) with breast, prostate, lung, or colorectal cancer. Neighborhood SES was measured using the area deprivation index (ADI; quintiles), a validated comprehensive composite measure of neighborhood SES. Individual SES was assessed by Medicare-Medicaid dual eligibility (yes vs no), a reliable indicator for patient-level low income. The primary outcome was overall mortality, and the secondary outcome was cancer-specific mortality. Hazard ratios (HRs) for the associations of ADI and dual eligibility with overall and cancer-specific mortality were estimated via Cox proportional hazards regression. Statistical analyses were conducted from January 23 to April 15, 2021. A total of 96 978 patients were analyzed, including 25 968 with breast, 35 150 with prostate, 16 684 with lung, and 19 176 with colorectal cancer. Median age at diagnosis was 76 years (IQR, 71-81 years) for breast cancer, 73 years (IQR, 70-77 years) for prostate cancer, 76 years (IQR, 71-81 years) for lung cancer, and 78 years (IQR, 72-84 years) for colorectal cancer. Among lung and colorectal cancer patients, 8412 (50.4%) and 10 486 (54.7%), respectively, were female. The proportion of non-Hispanic White individuals among breast cancer patients was 83.7% (n = 21 725); prostate cancer, 76.8% (n = 27 001); lung cancer, 83.5% (n = 13 926); and colorectal cancer, 81.1% (n = 15 557). Neighborhood-level and individual-level SES were independently associated with overall mortality, and no interactions were detected. Compared with the most affluent neighborhoods (ADI quintile 1), living in the most disadvantaged neighborhoods (ADI quintile 5) was associated with higher risk of overall mortality (breast: HR, 1.34; 95% CI, 1.26-1.43; prostate: HR, 1.51; 95% CI, 1.42-1.62; lung: HR, 1.21; 95% CI, 1.14-1.28; and colorectal: HR, 1.24; 95% CI, 1.17-1.32). Individual socioeconomic disadvantage (dual eligibility) was associated with higher risk of overall mortality (breast: HR, 1.22; 95% CI, 1.15-1.29; prostate: HR, 1.29; 95% CI, 1.21-1.38; lung: HR, 1.14; 95% CI, 1.09-1.20; and colorectal: HR, 1.23; 95% CI, 1.17-1.29). A similar pattern was observed for cancer-specific mortality. In this cohort study, neighborhood-level deprivation was associated with worse survival among patients with nonmetastatic breast, prostate, lung, and colorectal cancer, even after accounting for individual SES. These findings suggest that, in order to improve cancer outcomes and reduce health disparities, policies for ongoing investments in low-resource neighborhoods and low-income households are needed.

Are Age Differences Between Partners Related To Gender and Generations Among Middle-Aged And Older Asian Americans?

Previous research has shown that women who immigrate to the United States tend to partner with much older spouses. However, most studies have focused on young people and first-generations. Spousal age differences among older Asian Americans with different generations have not been well studied. Using data from the Annual Social and Economic Supplement survey (2013-2019), we employed the segmented assimilation theory to test 7,064 married middle-aged and older (50+) Asian Americans. Logistic regression analyses were conducted to understand the association between spousal age differences and individual background, including gender, ethnicity, socioeconomic status, generation, and marriage types. Of the 3,342 men, 20% were married to wives at least 6 years younger and 2% were married to wives at least 6 years older. Men who were Japanese or had inter-ethnical marriages were more likely to marry women at least 6 years older. Men who were Indian, Vietnamese, or having an interracial marriage were more likely to marry women at least 6 years younger. Of the 3,722 women, 3% were married to husbands at least six years younger and 19% were married to husbands at least six years older. Women who were Indian or Vietnamese were more likely to marry men at least six years older. Women who had a high school diploma or were third-plus generation were more likely to marry men at least 6 years younger. The findings reflect the complexity of Asian senior marriage and provide insight for policymakers to design new or improved social integration programs for senior immigrants.

Undervalued Spiny Monkey Orange (Strychnos spinosa Lam.): An Indigenous Fruit for Sustainable Food-Nutrition and Economic Prosperity.

Strychnos spinosa Lam. is among the top nutrient-dense indigenous fruit species that are predominant in Southern Africa. It is a highly ranked indigenous fruit based on the nutrition and sensorial properties, which make it an important food source for the marginalized rural people. On the basis of the high vitamin C, iron, and zinc content, it has the capacity to improve the food- nutrition and the socioeconomic status of individuals, especially those in the rural areas of the developing nations. The nutritional composition of Strychnos spinosa compare favorably with many of the popular fruits, such as strawberries and orange. Additionally, Strychnos spinosa has antioxidant activity similar to well-known antioxidant fruits, which keeps it in the class of the popular fruits, giving it added nutrition–health-promoting benefits. In order to improve the availability of Strychnos spinosa, more research on the domestication, processing, preservation, value chain, and economic potential need to be further explored. Therefore, we recommend more concerted efforts from relevant stakeholders with interest in Strychnos spinosa fruit production as a possible sustainable solution to food shortage, food-nutrition insecurity, malnutrition, and austerity, mainly in the rural communities of the developing countries.