Influence Of Socioeconomic Status Research Articles

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.

DIGITAL LITERACY AMONG TEACHERS IN SINGKAWANG CITY: AN ANALYSIS OF GENDER, AGE, AND SOCIO-ECONOMIC STATUS

<em>One of the demands of teachers in Generation Z is being able to have digital literacy content that supports their functions and work. There is no research related to the influence of gender, age, and socioeconomic status on digital literacy competency teachers in Singkawang City. This study aims to review whether there are significant differences in teachers' digital literacy abilities in terms of gender, socioeconomic status aspects of those who are able, moderate, or poor, and the age of teachers in different generations. This research method includes the descriptive quantitative inferential survey method. The number of volunteer respondents as research subjects was 200 teachers from 50 elementary and junior high schools who taught in Singkawang City and were selected by the voluntary response sampling technique. Data collection used a questionnaire instrument for teachers that contained 17 items that had been proven valid. Data were analyzed using the Mann-Whitney test for gender and the Kruskal-Wallish H test for age and socioeconomic status. The results showed that (1) the significance value was 0.063 > 0.005, which did not show a significant difference between teachers' digital literacy skills based on gender; (2) the significance value was 0.075 > 0.05, meaning that there was no difference in teachers' digital literacy seen from socioeconomic status (able, moderate, and underprivileged); and (3) the significance value is 0.106 > 0.05, indicating that there is no difference between teachers whose age includes the baby boomers generation, generation X, and the millennial generation</em>

Assessing the Relationship Between Neighborhood Socioeconomic Disadvantage and Telemedicine Use Among Patients With Breast Cancer and Examining Differential Provisions of Oncology Services Between Telehealth and In-Person Visits: Quantitative Study.

Since the COVID-19 pandemic began, we have seen rapid growth in telemedicine use. However, telehealth care and services are not equally distributed, and not all patients with breast cancer have equal access across US regions. There are notable gaps in existing literature regarding the influence of neighborhood-level socioeconomic status on telemedicine use in patients with breast cancer and oncology services offered through telehealth versus in-person visits. We assessed the relationship between neighborhood socioeconomic disadvantage and telemedicine use among patients with breast cancer and examined differential provisions of oncology services between telehealth and in-person visits. Neighborhood socioeconomic disadvantage was measured using the Area Deprivation Index (ADI), with higher scores indicating greater disadvantages. Telemedicine and in-person visits were defined as having had a telehealth and in-person visit with a provider, respectively, in the past 12 months. Multivariable logistic regression was performed to examine the association between ADI and telemedicine use. The McNemar test was used to assess match-paired data on types of oncology services comparing telehealth and in-person visits. The mean age of the patients with breast cancer (n=1163) was 61.8 (SD 12.0) years; 4.58% (52/1161) identified as Asian, 19.72% (229/1161) as Black, 3.01% (35/1161) as Hispanic, and 72.78% (845/1161) as White. Overall, 35.96% (416/1157) had a telemedicine visit in the past 12 months. Of these patients, 65% (266/409) had a videoconference visit only, 22.7% (93/409) had a telephone visit only, and 12.2% (50/409) had visits by both videoconference and telephone. Higher ADI scores were associated with a lower likelihood of telemedicine use (adjusted odds ratio [AOR] 0.89, 95% CI 0.82-0.97). Black (AOR 2.38, 95% CI 1.41-4.00) and Hispanic (AOR 2.65, 95% CI 1.07-6.58) patients had greater odds of telemedicine use than White patients. Compared to patients with high school or less education, those with an associate's degree (AOR 2.67, 95% CI 1.33-5.35), a bachelor's degree (AOR 2.75, 95% CI 1.38-5.48), or a graduate or professional degree (AOR 2.57, 95% CI 1.31-5.04) had higher odds of telemedicine use in the past 12 months. There were no significant differences in providing treatment consultation (45/405, 11.1% vs 55/405, 13.6%; P=.32) or cancer genetic counseling (11/405, 2.7% vs 19/405, 4.7%; P=.14) between telehealth and in-person visits. Of the telemedicine users, 95.8% (390/407) reported being somewhat to extremely satisfied, and 61.8% (254/411) were likely or very likely to continue using telemedicine. In this study of a multiethnic cohort of patients with breast cancer, our findings suggest that neighborhood-level socioeconomic disparities exist in telemedicine use and that telehealth visits could be used to provide treatment consultation and cancer genetic counseling. Oncology programs should address these disparities and needs to improve care delivery and achieve telehealth equity for their patient populations.

Pengaruh Literasi Ekonomi, Status Sosial Ekonomi, dan Modernitas Terhadap Perilaku Konsumsi Guru Sekolah Dasar di Kecamatan Marioriwawo Kabupaten Soppeng

This research is useful for understanding the influence of economic literacy, socioeconomic status, and modernity on the consumption behavior of elementary school teachers in Marioriwawo District, Soppeng Regency. This study uses a type of quantitative research in analyzing the problem in the phenomenon under study. The sample in this study was 81 teachers from a population of 426 teachers who were taken using Simple Random Sampling using the Slovin formula. In analyzing the data, descriptive percentage analysis was used, as well as hypothesis testing. The results of this study show that partially economic literacy (X1), socioeconomic status (X2), modernity (X3) have a positive and significant impact on the consumption behavior of primary school teachers (Y) in Marioriwawo District, Soppeng Regency. In addition, simultaneously economic literacy (X1), socioeconomic status (X2), modernity (X3) together have an effect on the consumption behavior of primary school teachers (Y) in Marioriwawo District, Soppeng Regency.

How Does Family Socioeconomic Status Influence Children’s Reading Ability? Evidence from Meta-analytic Structural Equation Modeling

How Does Family Socioeconomic Status Influence Children’s Reading Ability? Evidence from Meta-analytic Structural Equation Modeling

Does social well-being predict academic resilience and achievement? Analysis of Swedish PISA 2018 data

In recent years, Sweden has been struggling with issues of educational inequity as the influence of students' socioeconomic status on their academic achievements has amplified. Nonetheless, academically resilient students who demonstrate high achievement despite socioeconomic disadvantages offer hope for a more equitable future. Previous research has primarily focused on the relationship between well-being and academic achievement, with less emphasis on the connection between academic resilience and well-being. Thus, this study investigates the extent to which students’ well-being predicts their academic achievement and resilience, with a special focus on the social well-being of socioeconomically disadvantaged students. Using the Swedish PISA 2018 dataset and structural equation modeling technique, the measurement properties of social well-being were first tested, and its dimensions were then related to students' academic resilience and achievement. The findings reveal that student-reported teacher support positively predicts their academic resilience and achievement, whereas exposure to bullying is detrimental to their academic achievement.

PERBEZAAN GENDER DAN STATUS SOSIOEKONOMI TERHADAP KEBIMBANGAN BAHASA ASING DALAM KALANGAN PELAJAR UNIVERSITI AWAM DI SABAH

This study was conducted to identify the level of foreign language anxiety (FLA), gender differences,and socioeconomic status influence on FLA among public university students in Sabah. The research wascarried out at Universiti Malaysia Sabah (UMS) and Universiti Teknologi Mara (UiTM) branch in KotaKinabalu, Sabah. A total of 358 respondents, consisting of 104 males and 254 females, participated in thisstudy. The research adapted the Foreign Language Classroom Anxiety Scale (FLCAS) questionnaire developedby Horwitz, Horwitz, and Cope (1986). Data analysis was performed using the Statistical Package for SocialScience (SPSS) version 28.0. The study results indicated that the level of FLA among public university studentsin Sabah is at a moderate level. The study also showed gender differences in FLA among male and femalestudents (p < .05), where female students (M = 97.97, SD = 20.88) exhibited higher levels of FLA compared tomale students (M = 91.22, SD = 20.09). Furthermore, the study revealed socioeconomic status differences inFLA among public university students in Sabah (p < .05). The findings showed that students from lowsocioeconomic status were reported to have high levels of FLA (M = 97.72, SD = 21.02). On the other hand,students from high socioeconomic status had lower levels of FLA (M = 83.63, SD = 16.79). The findings of thisstudy can provide a deeper understanding and clarity for students, parents, and educators regarding the issue ofFLA that often occurs among students. Suggestions for future research include expanding the scope of locationsand study samples, diversifying data collection methods, and conducting longitudinal studies.

Influence of socioeconomic status on the presence of obstructive coronary artery disease and cardiovascular outcomes in patients undergoing invasive coronary angiography

Abstract Background Although it has been documented that low socioeconomic status (SES) is associated with increased risk of mortality and cardiovascular disease (CVD), this issue has not been addressed in patients at high CVD risk. This study was performed to investigate the association of the patient’s SES with the presence of obstructive coronary artery disease (CAD) and long-term cardiovascular outcomes who undergo invasive coronary angiography (ICA). Methods A total of 9,530 patients who underwent ICA for the evaluation and treatment of CAD (66.0 ± 12.3 years and 60.2% male) were retrospectively reviewed. The patients were divided into two groups according to the health insurance type: those with low SES who had the Medical aid program (Medical aid beneficiary [MAB] group; n = 1,436) and those with high SES who had the National Health Insurance program (National Health Insurance beneficiary [NHIB] group; n = 8,094). The primary outcome was a composite of cardiac death, acute myocardial infarction, coronary revascularization, and ischemic stroke. Results Of the study patients, 1,436 (15.1%) were in the MAB group. The prevalence of cardiovascular risk factors was higher in the MAB group compared to the NHIB group. However, the prevalence of obstructive CAD was similar between the two groups (62.8% vs. 64.2%; p = 0.306). During a median follow-up period of 3.5 years (interquartile range, 1.0-5.9 years), the incidence of the composite cardiovascular event was significantly higher in the MAB group than in the NHIB group (20.2% vs. 16.2%, p < 0.001). In multivariable Cox regression analysis, compared to the NHIB group, the MAB group was independently associated with worse clinical outcomes even after controlling for potential confounders (adjusted odds ratio, 1.28; 95% confidence interval, 1.07-1.54; p = 0.006). Conclusions Although CAD prevalence was similar, MABs showed an increased risk of composite cardiovascular events than NHIBs in Korean adults undergoing ICA. This provides additional evidence for the association between low SES and an increased risk of CVD, even in high-risk subjects.

Mediation Analyses of the Mechanisms by Which Socioeconomic Status, Comorbidity, Stroke Severity, and Acute Care Influence Stroke Outcome.

Low socioeconomic status (SES) is associated with increased risk of death and disability after stroke, but interventional targets to minimize disparities remain unclear. We aim to assess the extent to which SES-based disparities in the association between low SES and death and dependency at 3 months after stroke could be eliminated by offsetting differences in comorbidity, stroke severity, and acute care. This nationwide register-based cohort study included all 72 hospitals caring for patients with acute stroke in Sweden. All patients registered with an acute ischemic stroke in the Swedish Stroke Register in 2015-2016 who were independent in activities of daily living (ADL) during stroke were included. Data on survival and SES the year before stroke were retrieved by cross-linkage with other national registers. SES was defined by education and income and categorized into low, mid, and high. Causal mediation analysis was used to study the absolute risk of death and ADL dependency at 3 months depending on SES and to what extent hypothetical interventions on comorbidities, stroke severity, and acute care would equalize outcomes. Of the 25,846 patients in the study, 6,798 (26.3%) were dead or ADL dependent 3 months after stroke. Adjusted for sex and age, low SES was associated with an increased absolute risk of 5.4% (95% CI 3.9%-6.9%; p < 0.001) compared with mid SES and 10.1% (95% CI 8.1%-12.2%; p < 0.001) compared with high SES. Intervening to shift the distribution of all mediators among patients with low SES to those of the more privileged groups would result in absolute reductions of these effects by 2.2% (95% CI 1.2%-3.2%; p < 0.001) and 4.0% (95% CI 2.6%-5.5%; p < 0.001), respectively, with the largest reduction accomplished by equalizing stroke severity. Low SES patients have substantially increased risks of death and ADL dependency 3 months after stroke compared with more privileged patient groups. This study suggests that if we could intervene to equalize SES-related differences in the distributions of comorbidity, acute care, and stroke severity, up to 40 of every 1,000 patients with low SES could be prevented from dying or becoming ADL dependent.

The Impact of Educational Attainment and Income on Long-Term Care for Persons with Alzheimer's Disease and Other Dementias: A Swedish Nationwide Study.

Long-term care improves independence and quality of life of persons with dementia (PWD). The influence of socioeconomic status on access to long-term care was understudied. To explore the socioeconomic disparity in long-term care for PWD. This registry-based study included 14,786 PWD, registered in the Swedish registry for cognitive and dementia disorders (2014-2016). Education and income, two traditional socioeconomic indicators, were the main exposure. Outcomes were any kind of long-term care, specific types of long-term care (home care, institutional care), and the monthly average hours of home care. The association between outcomes and socioeconomic status was examined with zero-inflated negative binomial regression and binary logistic regression. PWD with compulsory education had lower likelihood of receiving any kind of long-term care (OR 0.80, 95% CI 0.68-0.93), or home care (OR 0.83, 95% CI 0.70-0.97), compared to individuals with university degrees. Their monthly average hours of home care were 0.70 times (95% CI 0.59-0.82) lower than those of persons with university degrees. There was no significant association between education and the receipt of institutional care. Stratifying on persons with Alzheimer's disease showed significant association between lower education and any kind of long-term care, and between income and the hours of home care. Socioeconomic inequalities in long-term care existed in this study population. Lower-educated PWD were less likely to acquire general long-term care, home care and had lower hours of home care, compared to their higher-educated counterparts. Income was not significantly associated with the receipt of long-term care.

Abstract 267: Neighborhood Socioeconomic Status Influences Rates of Pre-EMS Cardiac Arrest Resuscitation

Introduction: Out-of-hospital cardiac arrest is a leading cause of both morbidity and mortality in the United States and globally. After cardiac arrest onset, emergency medical services (EMS) might not arrive before irreversible injury takes place. Thus, pre-EMS resuscitation - including CPR and automated external defibrillator (AED) use - is associated with improvements in outcomes. We sought to determine if rates of pre-EMS CPR and pre-EMS AED use vary across neighborhood socioeconomic status using a database of EMS activations throughout the United States. Methods: The National Emergency Medical Services Information System (NEMSIS) is a large and nationally-representative database of EMS activations populated from more than ten-thousand EMS agencies throughout the US. We examined cardiac arrests in adult patients (18+ years of age) between January 2017 and December 2019 where EMS providers documented the ZIP code of the arrest, whether CPR prior to EMS arrival was provided, and whether an AED was applied prior to EMS arrival. The ZIP code of the arrest was used to group arrests based on socioeconomic status data from the US Census Bureau. Rates of pre-EMS CPR and pre-EMS AED use were then compared, and ZIP codes with under 5% of residents below the poverty line served as benchmarks. Results: 366,280 cardiac arrests met inclusion criteria. Both Pre-EMS CPR and pre-EMS AED use were highest in ZIP Codes where less than 5% of the population is below the poverty line (p&lt; .00001). Furthermore, a consistent decrease in rates of pre-EMS interventions was seen as the percent of individuals below the poverty line increased (Figure 1). Conclusion: We found a strong relationship between neighborhood socioeconomic status and pre-EMS cardiac arrest interventions. One explanation may be access to CPR training. Further studies should continue to interrogate cardiac arrest disparities that have already been reported and seek to identify new unreported disparities as well.

Parents' attitudes regarding their children's play during COVID-19: Impact of socioeconomic status and urbanicity

ObjectivesThe COVID-19 pandemic has had a profound impact on the daily routines of parents and children. This study explored the influence of socioeconomic status (SES) and urbanicity on parents' attitudes toward their children's active play opportunities 6 months and 1.5 years into COVID-19. MethodsA sample of 239 Ontario parents of children aged 12 and younger completed two online surveys (August–December 2020; 2021) to assess parents' intentions, beliefs, and comforts concerning their child's eventual return to play, in addition to various sociodemographic and physical activity variables. Descriptive analyses were run as well as an exploratory factor analysis (EFA) was conducted to group the 14 attitude items into subscales for analysis, to ensure reliability and validity of attitude measures. ResultsIn general, parents in communities with more urban features (e.g., densely populated areas), single-parents, full-time employed parents, and parents with lower-incomes were more hesitant to return their children to active play during the pandemic. ConclusionFindings from this work highlight SES and urbanicity disparities that continue to exist during COVID-19.

14 The Impact of Socioeconomic Status (SES) on Phonemic Fluency in Patients with Pediatric Brain Tumor (PBT)

Objective:Phonemic fluency, an important cognitive skill for everyday functioning, has been shown to decline in comparison to same-aged peers following pediatric cancer diagnosis and treatment, despite intact semantic fluency. More generally, socioeconomic status (SES) has recently been shown to be one of the strongest predictors of neuropsychological outcomes among pediatric oncology patients, with lower SES predicting worse intellectual and academic functioning. However, the association between SES and phonemic fluency within this population has yet to be explored. The main objective of this project was to determine whether SES (specifically estimated household income) significantly predicts phonemic fluency performance among patients with PBT, and it was hypothesized that higher SES would be associated with better phonemic fluency outcomes.Participants and Methods:136 participants with PBT ages 7-20 (x=14.15 years, SD=3.87), were administered phonemic fluency trials (either from the NEPSY - Second Edition or Delis-Kaplan Executive Function System, with no significant differences in performance between measures). The sample was 58.8% male and half Latino (50.0%), followed by Caucasian (30.1%), Asian American (7.4%), Black (6.6%), and Other (5.9%) ethnicity. All patients identified English as their primary and preferred language regardless of predominant household language, reducing the potential confounding impact of language. Given documented associations between PBT and lower intelligence following diagnosis and treatment, estimated intellectual functioning was included in the first block of hierarchical regression to isolate and further elucidate the potential contributing influence of SES on phonemic fluency. Median household income for specific neighborhoods was used as a proxy for SES, while Wechsler Matrix Reasoning (MR) was used as an estimate of general intellectual functioning given the high correlation between MR and full scale IQ.Results:Consistent with prior literature, phonemic fluency was lower than normative age expectations [t(135)=-3.653, p=.0002], though still within the average range clinically (x=8.93). As hypothesized, SES was positively correlated with phonemic fluency [r(136)=.219, p=.005]. Furthermore, SES significantly predicted phonemic fluency performance above and beyond estimated intelligence, accounting for a significant increase in variance (p=.020). Post-hoc analyses also revealed poorer phonemic fluency among participants with infratentorial brain tumors as compared to supratentorial brain tumors after controlling for SES, t(108)=-1.748, p=.042.Conclusions:Consistent with the known impact of SES on neuropsychological late effects among patients with pediatric cancer, phonemic fluency was positively correlated with SES among participants with PBT above and beyond estimated intelligence, suggesting the distinct role of SES on rapid verbal retrieval within this population. This has important implications for identifying patients at higher risk, helping to ensure timely provision of services and supports. Poorer phonemic fluency was also noted among patients with infratentorial (vs. supratentorial) brain tumors after controlling for SES, which may influence studies combining tumor location as the vast majority of PBTs are infratentorial. This supports prior literature demonstrating the need for increased cerebellar activation during phonemic (vs. semantic) retrieval. Additional research is needed to further explore these findings.

Socioeconomic, Racial, and Insurance Disparities in Clinical Outcomes After Surgery Among Patients With Idiopathic Scoliosis.

Socioeconomic status (SES), race, and insurance type correlate with initial curve severity for patients with idiopathic scoliosis, but less is known regarding how these variables impact surgical outcomes. The objectives of this study were to determine the influence of SES, race, and insurance on preoperative appointment attendance, likelihood of obtaining a preoperative second opinion, brace prescription, missed 6 or 12-month postsurgical appointments, incidence of emergency department visits 0 to 90 days after surgery, and major complications within a year of surgery. A review of 421 patients diagnosed with idiopathic scoliosis who underwent surgery at a single high-volume pediatric spinal deformity institution between May 2015 and October 2021 was conducted. Area Deprivation Index, a quantitative measure of SES, was collected. Scores were stratified by quartile; higher scores indicated a lower SES. χ 2 tests for correlation were performed to determine whether clinical outcomes were dependent upon Area Deprivation Index, race, or insurance type; P ≤0.05 was significant. The sample was 313 Caucasian (74%), 69 (16%) black, and 39 (9.3%) other patients. More patients had private versus public insurance (80% vs 20%) and were of higher SES. The likelihood of missing preoperative appointments was higher for black patients ( P = 0.037). Those with lower SES missed more postoperative appointments and received less bracing and second opinions ( P = 0.038, P = 0.017, P = 0.008, respectively). Being black and publicly insured correlated with fewer brace prescriptions ( P < 0.001, P = 0.050) and decreased rates of obtaining second opinions ( P = 0.004, P = 0.001). Patients with idiopathic scoliosis surgery who were Caucasian, privately insured, and of higher SES were more likely to seek preoperative second opinions, be prescribed a brace, and attend postoperative appointments. Recognition of the inherent health care disparities prevalent within each pediatric spine surgery referral region is imperative to better inform local and national institutional level programs to educate and assist patients and families most at risk for disparate access to scoliosis care. Level III; retrospective case-control study.

Home and preschool influences on early literacy and numeracy development in England, Estonia, and the United States

ABSTRACT This study considered the influences of socioeconomic status (SES), home learning environment, and age of enrollment in early childhood education and care (ECEC) on early literacy and numeracy development of 5-year-olds in England (N = 2,577), Estonia (N = 2,110), and the United States (N = 2,234) by leveraging data from the International Early Learning and Child Well-being Study (conducted by the Organization for Economic Cooperation and Development in 2018). Structural equation modeling indicated that, in all three countries, SES was positively associated with earlier ECEC enrollment, emergent literacy and numeracy. Earlier ECEC enrollment was positively related to emergent literacy and numeracy in England. The home learning environment was positively related to emergent literacy in the United States and emergent numeracy in England and the United States. Overall, SES had a positive indirect effect on emergent literacy and numeracy through ECEC enrollment age in England. Findings are interpreted against country-specific ECEC policies.

O.6.3-3 Gender, ethnicity, and socioeconomic status: intersectoral factors influencing adolescent girls’ participation in sport

Abstract Purpose Adolescent girls’ sports participation are low, particularly among females living in low socioeconomic status (SES) neighbourhoods. Inequalities accumulate at the intersection of gender, ethnicity, and socioeconomic status. Understanding this inequity is essential to support better female opportunities in sports participation to reduce inequalities in health. Therefore, the aim of the current study was to investigate how gender, ethnicity, and socioeconomic status influence girls’ participation in sport. Methods Eleven focus groups were conducted from July-October 2021 with in total 44 adolescent girls living in low SES neighbourhoods. Ten had Danish ethnic origin and 34 had other ethnic minority background of whom 18 were born in Denmark with parents born in non-western countries. 21 of the girls were wearing veil as a symbol of their religious background. The inclusion criteria were non-participation in organised sport in their leisure time. The girls were recruited through purposive sampling via schools placed in five different low SES neighbourhoods. Drawing on an intersectoral framework as a tool to understand the complex interaction between gender, ethnicity, and socioeconomic status, a deductive thematic analysis was conducted from verbatim transcripts using NVivo. Results Capturing the girls’ own voices, the analyses identified three overarching themes; 1) The little voice inside, 2) Sports are not for girls, 3) Can you do sport with veil? Findings revealed that the barriers for this group of girls had more complex intertwined layers, where gender, ethnicity and socioeconomic status were accumulated. The analyse indicates that gendered societal expectations and stereotypes about femininity, along with cultural and religious norms and socioeconomic factors, act as a barrier for girls to participate in sport. Conclusions The results provide insight into intersectional factors that influence sports participation among adolescent girls living in low SES neighbourhoods. The findings among this underrepresented group indicate that gender, ethnicity, and socioeconomic status should be considered to ensure equal opportunities to sports participation. The findings will be useful to shed light on how interventions should be designed to promote sports participation among adolescent girls in low SES neighbourhoods and thus help promote equity.

Social Determinants of Self-rated Health: Patient-provider Communication, Social Support, Socioeconomics, and Demographics among Different Ethnic Groups in the U.S.

Grounded in the theory of social determinants of health, this study clarifies the relationship between social factors and health disparities in the United States. Health disparities as observed in self-rated health (SRH) status were examined across four different ethnic groups of White, Black, Hispanic, and Asian Americans. It further evaluated and compared the social determinants that account for variations in SRH status among these groups. Results from a national sample (HINTS-5 2018) showed a series of significant discrepancies in SRH among the four ethnic groups. In addition, Blacks rated their overall patient-provider communication higher than the other three groups; however, Asians reported lower ratings than the other three groups on all seven measurement items of patient-provider communication. Furthermore, findings underscored the important role of patient-provider communication as a social determinant in predicting SRH among White and Black populations, but not among Asian and Hispanic counterparts. Finally, findings suggested that social support, demographic characteristics (age, gender, and marital status), and socioeconomic status (education, occupation, and household income) influence SRH differently for the four ethnic groups. Important research and intervention implications are discussed, especially for better understanding of differences in effects of patient-provider communication on SRH by race/ethnicity.

Fluctuating asymmetry in third molar agenesis as an aid to estimate socioeconomic status

Traditionally, dental identification techniques are used to establish identity or assist in reconstructing an individual's biological profile. However, other aspects of identity, namely socioeconomic status (SES), can be estimated through teeth. This work aims to evaluate the influence of SES on third molar agenesis in a Portuguese population. X-rays from 448 subjects (223 belonging to a high and 225 to a low socioeconomic status) were assessed and demographic data (age, sex) and dental history were registered. Frequencies and associations between the variables were analyzed using the chi-square test. For each group, differences between third molar agenesis were studied using the Wilcoxon test. The significance level was 5%. X-rays displaying at least one agenesis were more common in females (in both SES groups). Differences between socioeconomic status were found in female subjects' upper right and lower left third molars, with a higher frequency of agenesis in the lower SES group. Agenesis of lower third molars displayed fluctuant asymmetry in both groups, whereas agenesis of upper third molars was also present in the lower SES group. These results suggest that socioeconomic status can affect third molar agenesis prevalence, and fluctuant asymmetry seems more prevalent in the lower SES, as it affects all third molars.

295 Influence of Socio-Economic Status on Radiotherapy Adverse Events

295 Influence of Socio-Economic Status on Radiotherapy Adverse Events

Consumer Perceptions and Behaviors on Digital Payment Adoption Among Older Generation Z and Younger Millennials in Phnom Penh, Cambodia

Purpose: The study's goal is to better understand how older and younger generations in Phnom Penh, Cambodia, behave when it comes to using digital payments. Investigating the choice of mobile payment application in the Phnom Penh region is another objective of this study. Here, it is also investigated how usage, economic situation, and adoption of mobile payments are related.&#x0D; &#x0D; Theoretical framework: One of the most well-known research models on consumer behavior among younger and older generations and the adoption of new technical systems emphasizes the influence of geography, socioeconomic status, and specific traits on consumer acceptance. The concept considers factors including social effects, credibility requirements, effort expectations, and performance requirements when determining the best digital payment application.&#x0D; &#x0D; Design/Methodology/Approach: The Unified Theory of Acceptance and Use of Technology (UTAUT) model and K-mean clustering for distance and economic status studies were used in this research paper to select 150 locals in Phnom Penh from the target population in order to study consumer behavioral intention to accept digital payment method and application.&#x0D; &#x0D; Findings: The result we aimed to show and analyses the Digital payment methods, payments sharing, receiving, storing evidences, that older generation started understanding the digital payment by Khmer language and accepting the digital transactions from known customers. The current generation using Sathapana application and English Language in wide ranges through the Phom Penh region. The study also trying to exhibit the purpose of the digital payment systems in and across the e-commerce activities, through the older and younger generation.&#x0D; &#x0D; Research, Practical &amp; Social implications: The elder generation Z handled digital payments for regional transactions like banking, home tasks, loan repayment, peer lending, travel, and local marketplaces in Khmer. The subsequent generations of millennials also incorporated cross-border payments in English and Khmer.&#x0D; &#x0D; Originality/Value: Bringing up a Digital Platform shall make a positive change in economy and circulation of economy to the people and country. Unless the people trust the digital payments, they cant share their money for the business or basic operations to run the government. Thy the Digital Payment applications shall understand the behavior of the customers and share the services through the digital payment systems.