High Socioeconomic Status Individuals Research Articles

Using craniofacial fluctuating asymmetry to examine the effects of sex, socioeconomic status, and early life experiences on adult age at death in industrial England.

Historical evidence from 18th- and 19th-century England suggests that industrialization's impacts on health were largely negative, especially among marginalized groups. However, available documentary evidence is often biased toward adult men and rarely sheds light on the experiences of other members of the population, such as women and children. Craniofacial fluctuating asymmetry (FA) can serve as a proxy measurement of developmental instability and stress during development. This study examines the associations among age, sex, socioeconomic status (SES), and FA in skeletal samples from industrial-era England. The sample for this study comes from four industrial-era cemeteries from England (A.D. 1711-1857). Geometric morphometric analyses of three-dimensional landmark coordinate data were used to generate a measure of FA for each individual (Mahalanobis distance). A three-way ANOVA was used to evaluate the impacts of sex, SES, and FA scores on adult age at death (n = 168). Significant associations existed between age at death and SES (p = 0.004) and FA scores (p = 0.094). Comparisons of the estimated means indicated that age at death was consistently higher among high SES individuals and individuals with FA scores less than one standard deviation from the mean. This study supports findings from previous studies that have suggested that the differences in resource access and environmental buffering generated by socioeconomic inequality can impact longevity and patterns of mortality among socioeconomic status groups. Likewise, stress in early life-evinced by craniofacial fluctuating asymmetry-can influence observed patterns of longevity in adults decades later.

Abstract WP112: Neighborhood Level Characteristics Associated With Adequate Transition of Stroke Care: The Transition of Care Stroke Disparities Study

Objective: Transition of Care Stroke Disparities Study is an observational prospective cohort aimed to investigate disparities in the transition of stroke care (TOSC) post-hospitalization to home and to identify factors associated with adequate TOSC and stroke outcomes. we have demonstrated that higher individual socioeconomic status is associated with adequate TOSC. The present study explores the association between neighborhood-level characteristics (NLC) and adequate TOSC in ischemic stroke patients 1 month after discharge. Methods: Data from 925 ischemic stroke patients discharged from 10 Comprehensive Stroke Centers (CSCs) was obtained from three sources: a. NLC: demographic composition, level of education, and median household income from publicly available data using participants’ Zip codes (independent variables); b. 30-day post-discharge data for 6 categories of TOSC-related behaviors (dependent variables) including medication adherence, weekly exercise, medical follow-up, rehabilitation attendance, toxic habit cessation, diet modification. c. Clinical characteristics from Get with the Guidelines-Stroke (covariates). The primary outcome was 100% adequate transition of care (ATOC), a combined index of ideal adherence to all applicable behavior modifications. Results: The sample included 46% Women, 23% Non-Hispanic Black and 22% Hispanic, the average age was 64 years. NLC ranged as follows: % Black (0-93.9, median 9.1), %Hispanic (3-99.9, median 82.3), % bachelor’s degree (6.3-77.3, median 26.2), and median household income ($18,920-159,914, median $48,816). Almost a third (34%) of participants achieved 100% ATOC. In the adjusted analysis of NLC variables, higher %Hispanic (OR=1.45, 95% CI=1.03-2.04), higher %bachelor's degree recipients (OR=1.62, 95% CI=1.21-2.18), and higher median income (OR=1.12, 95%CI=1.04-1.21) were significantly associated with achieving 100% ATOC. Conclusions: Results suggest that NLC plays a crucial role in adherence to care transition instructions, underscoring the importance of interventions targeted at lower socioeconomic status populations. Future work will determine the impacts of NLC on stroke recurrence and readmission.

How economic development affects healthcare access for people with disabilities: A multilevel study in China

Meeting the healthcare needs of people with disabilities is an important challenge in achieving the central promise of “leave no one behind” during the Sustainable Development Goals era. In this study, we describe the accessibility of healthcare for people living with disabilities, as well as the potential influences of individuals’ socioeconomic status and regional economic development. Our data covered 324 prefectural cities in China in 2019 and captured the access to healthcare services for people with disabilities. First, we used linear probability regression models to investigate the association between individual socioeconomic status, including residence, poverty status, education, and healthcare access. Second, we conducted an ecological analysis to test the association between prefectural economic indicators, including GDP (gross domestic product) per capita, urbanization ratio, average years of education, Engel’s coefficient, and the overall prevalence of access to healthcare for people with disabilities within prefectures. Third, we used multilevel regression models to explore the association between the individual’s socioeconomic status, prefectural economic indicators, and access to healthcare at the individual level for people with disabilities. The results showed, first, that higher individual socioeconomic status (urban residence or higher educational level) was associated with better access to healthcare for people with disabilities. Second, regional economic indicators were positively associated with access to healthcare at the aggregate and individual levels. This study suggests that local governments, particularly in low- and middle-income countries, should promote economic development and conduct poverty alleviation policies to improve healthcare access for disadvantaged groups.

Increasingly Unequal. Electoral Participation and Political Inequalities in a Context of Decreasing Unionization in Italy (1983-2018)

Turnout has become increasingly unequal in many advanced democracies over the last few decades. Disadvantaged social groups are found to exhibit lower turnout compared to their better-off counterparts. According to numerous scholars, this growing gap is mainly attributed to the weakening of mass organizations that traditionally appealed to socio-economically disadvantaged social groups, particularly trade unions. However, very few studies have investigated these trends in Italy, a country that has witnessed a significant decrease in electoral turnout since the late 1970s, and where the socioeconomic causes of this decline have not been systematically explored. Against this backdrop, this paper aims to analyse, first and foremost, whether electoral participation in Italy is becoming increasingly unequal. Then, it moves to explore the extent to which the turnout gap between individuals with low and high socio-economic status (SES) could be moderated by both de-unionization and trade unions’ membership. By utilizing a dataset that combines 10 waves of the Italian National Election Study (1983-2018), the paper demonstrates that the turnout gap between low and high SES individuals has substantially widened over the last decades. Furthermore, it suggests that while the overall turnout gap is at least partially affected by the strength of trade unions in the country, trade unions still seem to be able to mobilize their members, particularly among lower social groups. This finding underscores the potential of trade unions to continue playing a role in equalizing turnout.

Associations of socioeconomic status and obesity with hypertension in tibetan adults in a Chinese plateau area

BackgroundPrevious studies have identified that socioeconomic status (SES) and obesity are associated with hypertension. However, their interaction on hypertension risk has not yet been assessed.MethodsThe study used data from 6,069 Tibetan residents in Chengguan District in Lhasa, the Chinese Tibetan autonomous region’s capital, based on a cohort study conducted from May 2018 to September 2019 in five provinces in southwest China. We used logistic regression models to assess the complex relations of SES and obesity with hypertension.ResultsCompared with individuals of high SES, low and moderate SES were positively associated with high risk of hypertension. SES and obesity have significant additive interaction on hypertension (general obesity by BMI: RERI = 1.33, P < 0.001; abdominal obesity by WC: RERI = 0.76, P < 0.001; abdominal obesity by WHtR: RERI = 0.96, P < 0.001). In people from the low and moderate SES segments, obesity was linked to an increased risk of hypertension, but the correlations were stronger in people from the moderate SES category. Compared with people of high SES and non obese, those with moderate SES and obesity had a higher risk of hypertension, and ORs were 4.38 (2.80, 6.84) for general obesity by BMI, 3.38 (2.05, 5.57) for abdominal obesity by WC, and 3.18 (1.57, 6.42) for abdominal obesity by WHtR.ConclusionThere is an independent and additive interaction effect of obesity and SES on the risk of hypertension. People with obesity, especially those of moderate and low SES, should reduce weight and waist circumference, and pay more attention to blood pressure. Moreover, the government, health administration departments, and society should prioritize improving the socioeconomic status of the Tibetan population and addressing risk factors like obesity.

Lifetime healthcare expenditures across socioeconomic groups in Sweden.

Individuals of lower socioeconomic status generally have higher healthcare expenditures than individuals of higher socioeconomic status. However, little is known about how expenditures are distributed across socioeconomic groups over a lifetime, once accounting for differences in life expectancy. This study describes how lifetime healthcare expenditures are distributed across age, sex and socioeconomic groups in Sweden while adjusting for differences in life expectancy. Healthcare utilization from 2016 were linked to demographic and socioeconomic data for a random sample of individuals aged 20 and above in the four largest Swedish regions (n = 440 659). Mortality data were used to estimate income- and sex-specific survival rates. Expected lifetime healthcare expenditures were estimated by combining survival rates with mean healthcare expenditures over age, by sex, and income quintile. We find that expected lifetime healthcare expenditures are highest among the first (lowest) income quintile despite their evident lower life expectancy. Expected lifetime expenditures were 17.9% (16.8%) higher in the first income quintile compared to the fifth (highest) quintile for women (men). Individuals in the first income quintile had higher expected lifetime expenditures for all care categories except for primary care. We conclude that despite a lower life expectancy, the quintile of the lowest socioeconomic status still had higher lifetime healthcare expenditures.

Experiences of resilience during the COVID-19 pandemic: A qualitative study among high and low socio-economic status individuals in the Netherlands

Resilience to adverse events is increasingly recognized as important for human health. Socio-economic status (SES) is also frequently identified as a predictor of resilience. However, it is not well-understood how people define resilience in their everyday lives, and whether individuals have different experiences of resilience based on their SES. This study sought to fill these gaps, in the context of the COVID-19 pandemic and pandemic mitigation policies in the Netherlands.We interviewed high (n = 38) and low (n = 37) SES participants about their understanding and experiences of resilience during this period. Participants took part in individual interviews and focus groups in September 2021. Transcripts were analyzed thematically.A key theme was coping with adversity, in line with commonly-used definitions of resilience. However, we found that resilience was often defined more broadly. Resilience also encompassed aspects of self-reflection and improvement, and faith in oneself, the community and the nation. There were also key differences by SES background: elaborate and optimistic definitions and experiences of resilience were more often described by high SES individuals. For instance, high SES participants more frequently defined resilience as growing and improving. In contrast, low SES participants more commonly experienced resilience as enduring until better times arrived.Having a higher SES seemed to support resilience during the COVID-19 pandemic. This indicates that adverse events may exacerbate pre-existing financial and material difficulties among low SES individuals. This finding underscores the importance of addressing financial precarity prior to adverse events.

The incidence of periocular melanoma: An epidemiologic study in Olmsted County, Minnesota

To the Editor: Melanoma arising in the periocular area presents a unique treatment challenge due to anatomic and functional constraints. To date, most information regarding periocular melanoma is gleaned from extrapolated data from other sites of the body, assuming similar biologic behavior. We aimed to identify the overall incidence, pathologic features, and surgical outcomes of periocular melanoma. Following Institutional Review Board (IRB) approval, using the Rochester Epidemiology Project (a multicenter medical records–linkage system encompassing the Olmsted County population), we identified patients with a first lifetime diagnosis of periocular melanoma between January 1, 1970, and December 31, 2020, while a local resident of Olmsted County, Minnesota. Outside (nonresident) referral cases were excluded. Periocular melanoma was defined as a melanoma arising within the orbital rim – on the upper or lower eyelid, lateral canthus, or eyebrow. A total of 10 patients with primary periocular melanoma were identified. The overall incidence rate of periocular melanoma was 0.2686 per 100,000 patient-years. Among all melanomas diagnosed during that timeframe in Olmsted County, 0.43% were periocular in location. No cases extended onto conjunctiva. The histogenic subtype was lentigo maligna in 8 (80.0%). There was 1 superficial spreading melanoma and 1 case without documentation of histogenic subtype. Incidence of in situ (50.0%) and invasive (50.0%) melanomas was equal. Among invasive melanomas, the average Breslow depth was 0.90 mm (range, 0.2-2.6 mm). Seven (70.0%) were treated with Mohs micrographic surgery (MMS). One (10%) was treated with wide local excision. The 2 cases that did not undergo further surgical treatment were both diagnosed prior to 2000 and were removed entirely via initial excisional biopsy. There was 1 regional metastasis to the parotid gland and lymph node, 2.5 years after diagnosis of a superficial spreading melanoma, Breslow 0.7 mm, status-post treatment with MMS. There were no other local or distant recurrences. There were no melanoma-specific deaths. Mean follow-up time was 7.4 years (range 3.1-13.2). This study demonstrates the relative rarity of periocular melanoma, comprising only 0.43% of all melanomas. Comparatively, basal cell carcinoma (BCC) occurs on the eyelid 16% of the time.1Salomon J. Bieniek A. Baran E. Szepietowski J.C. Basal cell carcinoma on the eyelids: own experience.Dermatol Surg. 2004; 30: 257-263PubMed Google Scholar Our study found an overall periocular melanoma incidence rate of 0.2686 per 100,000 patient-years. A previous Olmsted County cohort reported an incidence of eyelid BCC as 14.35 per 10,000 individuals per year, and an incidence of eyelid SCC as 1.37 cases per 100,000 individuals per year.2Cook Jr., B.E. Bartley G.B. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota.Ophthalmology. 1999; 106: 746-750Abstract Full Text Full Text PDF PubMed Google Scholar The behavior of melanoma seems to parallel primary cutaneous melanoma of head and neck sites. Most tumors were associated with chronic sun exposure; 80% of cases were lentigo maligna subtype. There was 1 regional recurrence in our study, no distant recurrences, and no deaths due to melanoma. The most significant advantage of our study is in its epidemiologic design. The limitations of this study include the retrospective nature of our analysis and the homogenous demographics of Olmsted County, comprised of mostly Caucasian individuals of higher socioeconomic status.3St Sauver J.L. Grossardt B.R. Leibson C.L. Yawn B.P. Melton 3rd, L.J. Rocca W.A. Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.Mayo Clin Proc. 2012; 87: 151-160Abstract Full Text Full Text PDF PubMed Scopus (487) Google Scholar Additionally, some melanomas may have been missed if the tumor was initially labeled as another anatomic site (cheek, nose, temple, etc.) and had extension onto the lid proper. None disclosed. We would like to acknowledge Austin Todd, MS, for his assistance in statistical analysis.

Socioeconomic Status and Quality of Life: An Assessment of the Mediating Effect of Social Capital

Socioeconomic status has been found to be a significant predictor of quality of life, with individuals of higher socioeconomic status reporting better quality of life. However, social capital may play a mediating role in this relationship. This study highlights the need for further research on the role of social capital in the relationship between socioeconomic status and quality of life, and the potential implications for policies aimed at reducing health and social inequalities. The study used a cross-sectional design with 1792 adults 18 and older from Wave 2 of the Study of Global AGEing and Adult Health. We employed a mediation analysis to investigate the relationship between socioeconomic status, social capital, and quality of life. The results showed that socioeconomic status was a strong predictor of social capital and quality of life. In addition to this, there was a positive correlation between social capital and quality of life. We found social capital to be a significant mechanism by which adults' socioeconomic status influences their quality of life. It is crucial to invest in social infrastructure, encourage social cohesiveness, and decrease social inequities due to the significance of social capital in the connection between socioeconomic status and quality of life. To improve quality of life, policymakers and practitioners might concentrate on creating and fostering social networks and connections in communities, encouraging social capital among people, and ensuring fair access to resources and opportunities.

Effect of Socioeconomic Status on Altruistic Behavior in Chinese Middle School Students: Mediating Role of Empathy.

Previous studies have shown that socioeconomic status is correlated to altruistic behavior. The role of empathy as one of the motivations for altruistic behavior is gradually gaining attention among researchers. This study explores the role of empathy in the mechanisms of socioeconomic status and altruistic behavior in Chinese adolescents. A total of 253 middle school students from Northern China participated in this study, which included the dictator game and Interpersonal Relation Index. Results showed that (1) low-SES students behaved more generously than high-SES students; (2) the students were more generous to the low-SES recipients, as shown when offering them more money in the dictator game; (3) affective rather than cognitive empathy mediates the relationship between socioeconomic status and altruistic behavior. The findings provide evidence for the validation of the empathy-altruism hypothesis in a group of Chinese adolescents. Meanwhile, it reveals the path to improving altruistic behavior through the promotion of empathy, especially for individuals of high socioeconomic status.

Alcohol consumption and related disorders in Iran: Results from the National Surveillance of Non-Communicable Diseases' Survey (STEPs) 2016.

Alcohol consumption is a public health concern which is illegal in Iran. Moreover, due to cultural and religious beliefs, the available population-based research findings on alcohol consumption are inadequate. We aimed to provide an estimate on alcohol consumption using a large-scale population-based survey in Iran. The National Surveillance of Non-Communicable Risk Factors in Iran was a population-based survey conducted in 2016. The epidemiologic distribution of alcohol consumption and its related disorders were assessed using weighted survey methods and multiple logistic regression models. Age standardized rates were calculated using Iran's national population census in 2016. At the national level, the prevalence rates of lifetime and current alcohol consumption were 8.00% (95% CI: 7.67-8.32) and 4.04% (95% CI: 3.81-4.27), respectively. The highest prevalence was reported among 25 to 34 year-olds. Individuals of higher socioeconomic status consumed significantly greater levels of alcohol. At provincial level, the highest and lowest percentages of the current alcohol drinking rates in Iran's provinces were, 23.92% (95% CI: 17.56-30.28) and 0.4% (95% CI: 0-1.18) in males, 1.58% (95% CI: 0.22-2.94) and 0% in females, respectively. In urban regions, the highest alcohol consumption rate was more than 22 times greater than the lowest alcohol consumption rate. Current alcohol drinkers were 2 times more prone to injury as compared to nondrinkers (ORadj: 2.0, 95%CI: 1.7, 2.3). In Iran, the prevalence of alcohol consumption is low, although there is a considerable variation of alcohol consumption at provincial level as well as in different gender groups. Therefore, preventive WHO-recommended measures should be adopted more seriously by vulnerable groups.

Abstract 15871: Associations of Everyday Discrimination and Socioeconomic Status With Insomnia and Short Sleep Duration Among Older Women

Introduction: Discrimination may contribute to sleep disparities, and subsequent adverse cardiovascular health. Despite the higher prevalence of insomnia among women, particularly historically minoritized women compared to men, limited studies examine the association between discrimination and insomnia and sleep duration. Methods: Among 26,616 women (Race/Ethnicity: Asian = 323; Black = 457; Hispanic= 258; White=25,287) in the Women’s Health Study stress follow-up cohort (Mean age =72.3 + 6.1 years), we investigated the relationship of discrimination with insomnia and sleep duration and tested education and income as effect modifiers. Insomnia was self-reported as trouble falling asleep OR waking after sleep onset 3+/week and daytime sleepiness 3+/week. Sleep duration was defined according to weekday and weekend bed and wake times, and categorized as short (&lt;7 hours), recommended ( &gt; 7 and &lt;9 hours), and long ( &gt; 9 hours). Everyday discrimination (e.g., treated with less courtesy or respect, received poorer service, etc.) frequency was divided into tertiles then dichotomized as high (upper tertile) and low (lower &amp; middle tertile). Results: Insomnia, and short and long sleep duration were reported by 11%, 11%, and 15% of women, respectively, and high levels of discrimination were reported by 40% of women. There was a higher proportion of Asian and Black women who reported high discrimination compared to Hispanic and White women (53.2% and 57.3% vs 39.8% and 38.4%, respectively). Women reporting high vs. low discrimination were more likely to have insomnia and short sleep duration, but less likely to have long sleep [Insomnia Adjusted Prevalence Ratio (aPR): 1.33, 95% CI: 1.28-1.38; Short Sleep (aPR): 1.14, 95% CI:1.09-1.19; Long Sleep (aPR): 0.96, 95% CI: 0.95-0.97)]. Associations of discrimination with insomnia and short sleep duration were pronounced among Hispanic and White, but not Asian and Black women, and those of higher education ( &gt; bachelors vs &lt;bachelors) and income ( &gt; $50,000 vs &lt;$50,000). Conclusions: Discrimination may be a target for reducing the prevalence of insomnia and short sleep duration among women. Individuals of higher socioeconomic status may have increased vulnerability to the effects of discrimination on sleep.

Extreme Temperature and Mortality by Educational Attainment in Spain, 2012–2018

Extreme temperatures are a threat to public health, increasing mortality in the affected population. Moreover, there is substantial research showing how age and gender shape vulnerabilities to this environmental risk. However, there is only limited knowledge on how socioeconomic status (SES), operationalized using educational attainment, stratifies the effect of extreme temperatures on mortality. Here, we address this link using Poisson regression and administrative data from 2012 to 2018 for 50 Spanish Provinces on individuals aged above 65 matched with meteorological data provided by the E-OBS dataset. In line with previous studies, results show that hot and cold days increase mortality. Results on the interaction between SES and extreme temperatures show a positive and significant effect of exposure to heat and cold for individuals with medium and low SES level. Conversely, for high SES individuals we do not find evidence of a robust association with heat or cold. We further investigate how the local climate moderates these associations. A warmer climate increases risks with exposures to low temperatures and vice versa for hot temperatures in the pooled sample. Moreover, we observe that results are mostly driven by low SES individuals being particularly vulnerable to heat in colder climates and cold in warmer climates. In conclusion, results highlight how educational attainment stratifies the effect of extreme temperatures and the relevance of the local climate in shaping risks of low SES individuals aged above 65.

Individuals of high socioeconomic status are altruistic in sharing money but egoistic in sharing time

The questions of whether and how socioeconomic status (SES) predicts prosocial behavior have sparked an interest from different disciplines, yet experimental evidence is inconclusive. We embedded two types of dictator games in a web survey with 7772 participants from Germany, Poland, Sweden, and the US. Each participant was asked to split a sum of money and a fixed amount of time between themself and a recipient. While higher-SES individuals are more generous than lower-SES individuals in the money game, they are more egoistic in the time game. In addition, the SES of the recipient matters more in the money game than in the time game. These results point towards the relevancy of a situationally contingent social norm of redistribution in studying the relationship between SES and prosocial behavior.

Dietary Patterns, Socioeconomic Status, and Risk of Type 2 Diabetes in the Sister Study

ObjectivesHigher diet quality is associated with decreased risk of type 2 diabetes (T2D). Socioeconomic status (SES) has been associated with measures of diet quality. However, few studies have investigated whether the association between diet quality and T2D differs by SES. MethodsWe used prospective cohort data from 41,280 Sister Study participants aged 35 to 74 years who enrolled in 2003–2009 and were followed until September 2017. The alternate Mediterranean diet (aMED), Dietary Approaches to Stop Hypertension (DASH), alternative Healthy Eating Index (aHEI), and Healthy Eating Index 2015 (HEI-2015)] scores were calculated using baseline data from a 110-item Block food frequency questionnaire previously validated in women. SES was evaluated by individual and neighborhood levels. The Area Deprivation Index (ADI), a census-based index was used to define neighborhood SES. Incident T2D was defined based on self-reported physician’s diagnosis of T2D or use of anti-diabetic medications on annual follow-up questionnaires. Multivariable-adjusted hazard ratios (aHRs) and 95% CIs were estimated using Cox proportional hazards models with age as the primary time scale. Effect modification was evaluated by stratification and including an interaction term in statistical models. ResultsInverse associations between dietary pattern scores and incident T2D were observed across all four dietary indices after adjustment for potential confounders (aMED: aHRQ4vsQ1: 0.64, 95% CI: 0.56, 0.72; DASH: aHRQ4vsQ1: 0.55, 95% CI: 0.49, 0.62; aHEI: aHRQ4vsQ1: 0.54, 95% CI: 0.48, 0.61; aHEI-2015: HRQ4vsQ1: 0.61, 95% CI: 0.55, 0.69). The inverse association between all four dietary indices and T2D risk was most pronounced among women with higher education and income. The inverse association between HEI-2015 and T2D risk was strongest among women with lower ADI (low ADI aHRQ4vsQ1: 0.49, 95% CI: 0.39, 0.61; high ADI aHRQ4vsQ1: 0.70, 95% CI: 0.58, 0.85; pinteraction: 0.003). Estimates from aMED, DASH, and aHEI models were similar. ConclusionsOur findings suggest that healthy eating patterns may reduce the risk of T2D and may have a greater impact among participants with higher individual SES and lower neighborhood deprivation. Funding SourcesNational Institute of Environmental Health Sciences T32 from NIH-NIGMS

Modulatory effects of SES and multilinguistic experience on cognitive development: a longitudinal data analysis of multilingual and monolingual adolescents from the SCAMP cohort

ABSTRACT Previous research has shown that cognitive development is sensitive to socio-economic status (SES) and multilinguistic experiences. However, these effects are difficult to disentangle and SES may modulate the effects of multilingualism. The present study used data from a large cohort of pupils who took part in the Study of Cognition, Adolescents and Mobile Phones (SCAMP) at ages 11–12 (T1) and 13–15 years old (T2). Cognitive measures were derived from tasks of cognitive flexibility, verbal, spatial and visuo-spatial working memory, speech processing and non-verbal reasoning. Using SES information collected through questionnaires (school type, level of deprivation, parental education and occupation), the sample was clustered into high/medium/low SES groups. Comparisons focused on 517 monolingual and 329 multilingual pupils in the high/low SES groups. Having controlled for multiple comparisons, the results indicated a significant beneficial effect of bilingualism in measures of working memory, visuo-spatial processing and non-verbal reasoning. These effects were present in both high and low SES individuals and sustained at both times of development, with a particularly significant improvement of working memory abilities in low SES bilinguals at T2 as compared to monolingual peers. Theoretical and practical implications of these findings are considered and guidance for educators is discussed.

Connect or protect? Social class and self-protection in romantic relationships.

Lower SES (socioeconomic status) couples tend to face particular challenges in their relationships. Relative to higher SES couples, they are less likely to marry and more likely to divorce-but they do not value their romantic relationships any less. Drawing on risk regulation theory and theories of social class as culture, we suggest that lower SES individuals adapt to their more chronically precarious environments by prioritizing self-protection more than higher SES individuals do, but that the need to self-protect may undermine relationship satisfaction. We investigate these ideas across 3 studies, using cross-sectional, longitudinal, and daily-diary methods. Lower SES individuals were more self-protective, both in their thoughts about their relationship (Studies 2-3), and in the judgments they made about their partner's commitment level over 2 years (Study 1) and 2 weeks (Study 3). Self-protection, in turn, was associated with lower relationship satisfaction (Studies 2-3). However, lower SES individuals were only self-protective when feeling vulnerable in their relationships (Study 3). Taken together, these studies identify psychological mechanisms to explain why the structural challenges that lower SES individuals experience can make it more difficult to achieve satisfying relationships. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social Class and (Un)Ethical Behaviour: Causal and Correlational Evidence

Abstract Are individuals of higher socio-economic status less ethical than those of lower status? Highly popularised research findings claim that this is the case. This paper provides evidence against this claim, based on data from two large survey experiments with more than 11,000 participants. We prime social status in two heterogeneous samples of the German population and then elicit ethical behaviour in an incentivised experimental task. Thus, our data allows us to study both correlation (using demographic data) and causality (using the priming). Our study rejects the claim that higher social status individuals are less ethical on both accounts.

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.

P026 Inflammatory bowel disease does not preclude the presence of environmental enteropathy in Zambian adults

Abstract Background Although data is scarce, inflammatory bowel disease (IBD) seems to be increasing in incidence in newly industrialised countries.(1) The environmental factors driving this change are not entirely clear, although it seems likely that changing diet and improving hygiene and sanitation are involved. In China, incidence of IBD is positively associated with gross domestic product.(2) Environmental enteropathy (EE) is a lesion of the small bowel with villous blunting, chronic inflammation and increased gut permeability seen in people living in insanitary conditions in resource-limited settings. We set out to examine whether EE would be present in patients with IBD in Zambia, as these individuals are likely to come from higher socioeconomic strata hence would be expected to live in more sanitised environments. Here we report preliminary data. Methods IBD cases were recruited at time of diagnosis or follow-up. Two groups of controls were recruited: individuals of higher socioeconomic status attending the GI clinic for investigation of symptoms of dyspepsia who had normal upper GI endoscopy were recruited to control group A, and healthy individuals from Misisi compound where studies on EE have been conducted over the past two decades to control group B (low socioeconomic status). All participants gave informed consent and underwent upper GI endoscopy and collection of duodenal biopsies. Haematoxylin- and eosin-stained sections of paraffin-embedded formalin-fixed biopsies were imaged on an Olympus VS120 scanning microscope then assessed for villous height, crypt depth, and epithelial surface area. Demographic information was collected via questionnaire. Results Biopsies were collected from 13 cases, 7 controls in group A and 10 controls in group B. Demographics are shown in Table 1. Cases and controls in group A had a higher number of rooms in the house than controls in group B but there was no significant difference in other environmental factors. Other than crypt depth, which was greater in controls from the lower socioeconomic group, there was no significant difference in morphometric parameters between IBD cases and controls (Table 2). The most severe enteropathy is seen in the biopsy from control group B (Figure 1c) which is made up of participants recruited a socioeconomically deprived district of Lusaka. Figure 1 Conclusion EE can coexist alongside IBD, suggesting that immunological drivers of these conditions are not distinct, and do not support the hygiene hypothesis. There is evidence of some degree of EE in small bowel biopsies from all cases and controls. Normal villous height to crypt depth ratio is likely to be between 3 and 5 (3) whereas medians for villous height:crypt depth in all groups in this study were less than 2.