Income Level Research Articles

Analyzing economic inflation's impact on food security and accessibility through econometric modeling

This study investigates the impact of economic inflation on food security and accessibility through the development of an econometric modeling approach. As inflation rates rise, the purchasing power of consumers diminishes, leading to increased food prices and potentially exacerbating food insecurity. This research aims to quantify the relationship between inflation and food security indicators, such as availability, access, utilization, and stability of food supplies. By employing time-series data and econometric techniques, the model captures the dynamic interactions between inflation rates, food prices, and socioeconomic factors affecting food security. The model incorporates key variables, including consumer price index (CPI), food inflation, income levels, and unemployment rates, to analyze their collective impact on food security across different demographics. The findings indicate that rising inflation significantly correlates with higher food prices, disproportionately affecting low-income households and vulnerable populations. This relationship highlights the necessity of understanding inflation's broader implications on food accessibility, especially in regions where food security is already a pressing issue. Future research directions are proposed, focusing on policy interventions aimed at stabilizing food prices and enhancing food security. Potential strategies include price controls, subsidies for staple foods, and targeted social safety nets for low-income households. Additionally, the study suggests further examination of supply chain factors contributing to food price volatility, such as transportation costs and global market dynamics, which can exacerbate inflation's effects on food security. This research contributes to the literature on food security by providing empirical evidence of inflation's impact on food accessibility and identifying critical areas for policy intervention. By addressing the complex interplay between inflation and food security, stakeholders, including policymakers and food industry leaders, can develop informed strategies to mitigate adverse effects and promote food security in inflationary environments.

The impact of poverty, malnutrition, and household income on human development in Central Sulawesi, Indonesia: A panel data analysis

Central Sulawesi has been grappling with significant challenges in human development, as indicated by its Human Development Index (HDI). Despite recent improvements, the region still lags behind the national average. Key issues such as high poverty rates and malnutrition among children, particularly underweight prevalence, pose substantial barriers to enhancing the HDI. This study aims to analyze the impact of poverty, malnutrition, and household per capita income on the HDI in Central Sulawesi. By employing panel data regression analysis over the period from 2018 to 2022, the research seeks to identify significant determinants that influence HDI and provide evidence-based recommendations for policy interventions. Utilizing panel data regression analysis with a Fixed Effect Model (FEM), the study reveals that while poverty negatively influences with HDI, underweight prevalence is not statistically significant. In contrast, household per capita income significantly impacts HDI, with lower income levels leading to declines in HDI. The findings emphasize the need for comprehensive policy interventions in nutrition, healthcare, and economic support to enhance human development in the region. These interventions are crucial for addressing the root causes of underweight prevalence and poverty, ultimately leading to improved HDI and overall well-being. The originality of this research lies in its focus on a specific region of Indonesia, providing localized insights and recommendations that are critical for targeted policy making.

The perioperative frailty index derived from the Chinese hospital information system: a validation study.

There are various frailty assessment tools in the world, and the application choice of frailty assessment tools for the elderly perioperative population varies. It remains unclear which frailty assessment tool is more suitable for the perioperative population in China. To validate the Perioperative Frailty Index (FI-32) derived from the Chinese Hospital Information System by investigating the impact of preoperative frailty on postoperative outcomes, and ascertain the diagnostic value of FI-32 for predicting postoperative complications through comparing with the FRAIL scale and the modified Frailty Index (mFI-11). A prospective cohort study was conducted in a tertiary hospital. Elderly patients who were 60 years or older and underwent selective operation were included. The FI-32, FRAIL scale, and mFI-11 were assessed. Demographic, surgical variables and outcome variables were extracted from medical records. The data of readmission and mortality within 30 days and 90 days of surgery were ascertained by Telephone follow-up by professionally trained researchers. Multiple logistic regression was used to examine the association between frailty and complications. Receiver operating characteristic curves(ROC) were used to compare FI-32 with mFI-11 and FRAIL, to explore the predictive ability of frailty. 335 patients qualified for the inclusion criteria and were enrolled in the study, and among them, 201 (60.0%) were females, and the Median(P25, P75)age at surgery was 69 (65,74) years. The prevalence of frailty in the study population was 16.4% (assessed by FI-32). After adjusting for concomitant variables including demographic characteristics (such as gender, BMI, smoking, drinking, average monthly income and educational level) and surgical factors (such as surgical approach, surgical site, anesthesia method, operation time, intraoperative bleeding, and intraoperative fluid intake), there was a statistically significant association between frailty and the development of postoperative complication after surgery (OR = 3.051, 95% CI:1.460-6.378, P = 0.003). There were also significant differences in mortality within 30 days of surgery, the length of hospital stay (LOS) and the hospitalization costs. FI-32, FRAIL and mFI-11 showed a moderate predictive ability for postoperative complications, the Area Under Curves (AUCs) were 0.582, 0.566 and 0.531, respectively. With adjusting concomitant variables associated with postoperative complications, the AUCs of FI-32, FRAIL and mFI-11 in the adjusted prediction models were 0.824, 0.827 and 0.820 respectively. The FI-32 has a predictive effect on postoperative adverse outcomes in elderly Chinese patients. Compared to FRAIL and mFI-11, the FI-32 had the same ability to predict postoperative complications, and FI-32 can be extracted directly from HIS, which greatly saves the time for clinical medical staff to evaluate perioperative frailty.

Socioeconomic determinants of malaria and hepatitis infections: insights from the Federal Medical Center, Makurdi, North Central, Nigeria.

Malaria and hepatitis are prevalent public health issues in Nigeria, significantly impacting health outcomes. Given the importance of the Federal Medical Center, Makurdi, as a key healthcare provider in the region, it is crucial to understand the prevalence and factors associated with these diseases within this setting. This study is designed to address this need, aiming to evaluate the prevalence and risk factors of malaria and hepatitis B and C among patients at the Federal Medical Center, Makurdi. A cross-sectional study design was employed, involving the meticulous analysis of patient records and diagnostic data from the Federal Medical Center, Makurdi. Data on malaria and hepatitis B and C prevalence were collected from laboratory reports and patient interviews. Socioeconomic information, including income, education level, and healthcare access, was also gathered. Statistical analyses were performed with utmost care to identify associations between disease prevalence and risk factors. The study examined 248 patients at the Federal Medical Centre, Makurdi, assessing malaria, Hepatitis B surface antigen (HBsAg), and Hepatitis C virus (HCV). Malaria prevalence was 52.4%, with higher rates in males (57.7%) than females (47.2%). HBsAg prevalence was 6.9%, and HCV was 4.8%, with no significant differences by sex or marital status. Income level impacted HCV rates, with middle-income individuals showing higher prevalence (21.4%). Malaria was most common in the 26-40 age group (35.4%). The findings underscore the need for targeted public health interventions. Enhanced access to preventive measures, such as insecticide-treated nets and safer blood transfusion practices, and educational disease prevention programs, are essential. Addressing socioeconomic disparities is crucial for effective disease control. To mitigate the burden of malaria and hepatitis B and C at the Federal Medical Center, Makurdi, a multifaceted approach is required. Improving preventive measures, healthcare access, and addressing socioeconomic determinants will reduce disease prevalence and improve patient outcomes.

The Global Prevalence of Child Sexual Exploitation and Abuse in Schools between 2012 and 2022: A Systematic Review and Meta-Analysis

Purpose This review aimed to synthesize existing research on the prevalence of Child Sexual Exploitation and Abuse (CSEA) in schools, while also identifying key moderators that influence these rates. Methods A comprehensive database search from 2012 to 2022 was conducted. Subgroup analyses and meta-regression were performed to examine the impact of various moderators on prevalence rates. Results 70 studies with sample sizes ranging from 381 to 4,511 were included. The global prevalence of CSEA in schools was found to be 1.6%. Key moderators included the study’s regional origin, the income level of the country, and the type of CSEA, with no significant variations noted based on gender, sample source/participant age, response rate, time period, data collection year, and publication year. Discussion Highlighting the need for ongoing vigilance in CSEA prevention within schools, the study suggested targeted interventions based on identified moderating variables.

Association of frailty with functional difficulty in older Ghanaians: stability between women and men in two samples with different income levels.

Research to date suggests that frailty is higher in women and is associated with functional difficulty. This study builds on the evidence by examining the association between frailty and functional difficulty between low- and higher-income groups and between older men and women in these income groups. This study adopted a cross-sectional design that complied with the STROBE checklist and included steps against confounding and common methods bias. The population was community-dwelling older adults aged 50years or older in two urban neighbourhoods in Accra, Ghana. Participants were either in the low-income group in a low socioeconomic neighbourhood (n = 704) or the higher-income group in a high socioeconomic neighbourhood (n = 510). The minimum sample necessary was calculated, and the hierarchical linear regression analysis was utilised to analyse the data. Frailty was positively associated with functional difficulty in the low- and higher-income samples, but this association was stronger in the higher-income sample. Frailty was positively associated with frailty in men and women within the low- and higher-income samples. The association of frailty with functional difficulty was consistent between low- and higher-income samples, although the strength of the relationship differed between these samples. In both income samples, the foregoing relationship was consistent between men and women, although the strength of the relationship differed between men and women.

Health Disparities and Inequities in the Utilization of Proton Therapy for Prostate Cancer

Our study sought to review and summarize the reported health disparities and inequities in the utilization of proton beam therapy (PBT) for prostate cancer. We queried the PubMed search engine through 12/2023 for original publications examining disparate utilization of PBT for prostate cancer. The query terms included the following: prostate cancer AND proton AND (disparities OR IMRT OR race OR insurance OR socioeconomic OR inequities)”. Studies were included if they involved United States patients, examined PBT in prostate cancer, and addressed health inequities. From this query, 22 studies met the inclusion criteria, comprising 13 population-based analyses, 5 single-institutional analyses, 3 cost/modeling investigations, and 1 survey-based study. The analyses revealed that in addition to age-related and insurance-related disparities, race and socioeconomic status played significant roles in the receipt of PBT. The likelihood of receiving PBT was lower for non-White patients in population-based and single-institution analyses. Socioeconomic metrics, such as higher median income and higher education level, portended an increased likelihood of receiving PBT. Conclusively, substantial age-based, racial, socioeconomic/insurance-related, and facility-associated disparities and inequities existed for PBT utilization in prostate cancer. The identification of these disparities provides a framework to better address these as the utility of PBT continues to expand across the US and globally.

The correlation between social class and public health: The mediating role of health self-management

The relationship between health and social class has been a topic of research for many years. However, the exact mechanism linking them with health self-management is still not completely clear. The main indicators of the independent variable social class are income and education level. The study used a descriptive approach using a social survey method, and collected data from a random sample of 699 individuals from the northern region of Jordan. The data were analyzed using SPSS 26 and EOMS, and we performed regression analysis and Pearson correlation test to examine the relationship between the independent and dependent variables. The results show a positive relationship between social class and health, with lower social classes producing unfavorable health. Although the health self-management of the lower social class has access to good food and self-evaluation, they are less able to provide health care compared to the upper class. Thus, this discrepancy contributes to health inequalities between members of the upper and lower social classes.

Effects of Income on Family Care Organization in Mexico: An Analysis Based on Data from the Encuesta Nacional de Ingreso y Gasto de los Hogares (ENIGH) from 2010 to 2020

This article examines the impact of income level on family care organizations in Mexico to elucidate how families apportion care responsibilities according to their economic standing. The study design employed a quantitative approach, utilizing two distinct methodologies to construct two indices: one representing the time devoted to care and the other representing care transferred to the market. Factor analysis converts minutes and hours into a time index and transforms the number of domestic workers and health and hospital expenses into a market index. A regression model estimates the effect of income on these indices, aiming to analyze the relationship between income and spending on health and services and between income and time spent on home care. The results are based on data from the National Household Income and Expenditure Survey (ENIGH) 2010–2020, using a nationally representative sample of 81 thousand dwellings. The data analysis concluded that households with higher incomes spend a more significant proportion of their expenditure on domestic care-paid services and have greater access to professional care. In contrast, lower-income households face significant challenges due to their limited financial resources and the higher demands for unpaid care.

Pollution Haven Hypothesis and EKC Dynamics: Moderating Effect of FDI. A Study in Shanghai Cooperation Organization Countries

Abstract This paper provides a comprehensive analysis of the nexus between economic growth and environmental degradation, with a specific focus on carbon dioxide (CO2) emissions. It leverages a dataset spanning from 1991 to 2021, encompassing all 12 member nations of the Shanghai Cooperation Organization (SCO). The investigation includes a wide array of statistical examinations, such as stationarity tests, cross-section dependence, and co-integration analysis. The Johansen Fisher Panel co-integration test is employed to reveal long-term correlations between the variables. Furthermore, the paper adopts the Dumitrescu and Hurlin panel causality model, which accommodates variations in causal relationships across different countries. Additionally, the study analyses the asymmetric impact of GDP on carbon emissions across various quantiles using quantile regression. The findings of this research yield valuable insights, highlighting a significant positive correlation between GDP and CO2 emissions, suggesting that higher income levels are associated with greater pollution. However, the paper also illuminates more intricate scenarios, such as those characterized by inverted U-shaped and N-shaped Environmental Kuznets Curve (EKC) patterns, revealed through DOLS estimations. These estimations consider FDI, inflation, and industrialization as control variables. This research delves into the Pollution Haven Hypothesis and examines the interaction effects of FDI with other considered variables. These insights contribute to a deeper understanding of the complex dynamics between economic growth and environmental impact within the SCO member nations.

Impact of family income on the development of gestational diabetes mellitus and the associated birth outcomes: A nationwide study.

The relationship between economic disadvantages and the risk of developing gestational diabetes mellitus (GDM), as well as its impact on birth outcomes, remains uncertain. From the Taiwan Maternal and Child Health Database, we identified 984,712 pregnant women between 1 January 2007 and 31 December 2018. Using propensity score matching, we selected 5,068 pairs of women across four income levels: very low, low, middle and high. We used a multivariable Cox regression model to assess the risk of GDM in these pregnant women and analyzed the birth outcomes. The mean age of the pregnant women was 30.89 years. We found no significant difference in GDM risk among pregnant women with different family income. However, newborns of women with GDM and very low-income were at higher risk for several adverse conditions, such as small for gestational age (adjusted odds ratio (aOR) 1.17, 95% confidence interval (CI) 1.04-1.31), large for gestational age (aOR 1.27, 95% CI 1.08-1.51), hypoxic-ischemic encephalopathy (aOR 3.19, 95% CI 1.15-8.86), respiratory distress (aOR 1.58, 95% CI 1.14-2. 19), congenital anomalies (aOR 1.32, 95% CI 1.08-1.62), jaundice requiring phototherapy or exchange transfusion (aOR 1.14, 95% CI 1.05-1.24) and so on. This study found that low family income alone was not associated with GDM development. However, for a GDM pregnancy, pregnant women with lower income had worse birth outcomes. Improving maternal health and nutrition among low-income pregnant women with GDM might be critical to improving birth outcomes.

Knowledge, attitudes and practices regarding medication splitting and crushing among the general public in Jordan: a cross-sectional study

BackgroundSplitting or crushing medications are used for dosage administration when a certain dose is not easily accessible. Understanding the splitting or crushing of medications is essential to guarantee safe medication...

Subjective well-being and mental health during the COVID-19 pandemic in Hungary

Purpose This study aims to examine the impact of COVID-19 pandemics on subjective well-being (SWB) and mental health in Hungary, with a particular focus on the roles of socioeconomic and COVID-19-related factors in shaping these outcomes. Design/methodology/approach A cross-sectional online survey was conducted among 2,000 Hungarian adults from May 25 to June 8, 2021. The data was collected using standardized questionnaires, including the SWLS, GAD-7 and PHQ-9. Correlation analysis, one-way ANOVA and linear regression were used. Findings The study found significant anxiety (41.5%), depression (48.1%) and life dissatisfaction (41.9%) among 2,000 participants. Females reported higher anxiety and depression than males. Single individuals had the lowest life satisfaction. Higher income levels are correlated with greater life satisfaction. Quarantine and vaccination were linked to higher life satisfaction and lower psychological distress. The regression showed that older age, being married and higher income were linked to lower depression and anxiety. Severity of infection and quarantine increased both depression and anxiety. Infection reduced life satisfaction, but severe cases showed a slight improvement in satisfaction, highlighting complex health and well-being relationships. Practical implications The findings reveal complex relationships, including unexpected resilience in severe COVID-19 cases. Originality/value This study offers insights into the impact of the COVID-19 pandemic on SWB and mental health in Hungary. By analyzing socioeconomic, demographic and pandemic-related factors in a large sample, it highlights complex relationships between quarantine, infection severity, vaccination and well-being. The findings contribute to understanding how these factors influence mental health, informing targeted interventions during health crises.

Community-level Knowledge, Attitudes, and Practices regarding Cardiovascular Diseases and Modifiable Risk Factors in India.

Assessment of knowledge, attitudes, and practices regarding cardiovascular diseases (CVD) and cardiovascular risk factors (CVRF) is critical to inform CVD prevention strategies, but limited community-level data exist from developing countries. To assess the knowledge, attitudes, and practices regarding CVD and CVRF and acceptability of non-physician health workers and text-message based reminders to guide CVD prevention strategies in India. We conducted a telephone-based survey nested in the on-going Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) cohort in Delhi and Chennai, India between January 2021 to February 2021. We randomly selected people with CVRF, but no established CVD and those with existing CVD from the CARRS cohort (n=502 participants) and assessed their 1) knowledge of CVD symptoms and risk factors, 2) attitude towards non-physician health workers (NPHW) facilitated care and text-messages for healthy lifestyle, and 3) practices regarding monitoring of CVRF. We performed logistic regression analyses to investigate the factors associated with KAP. We interviewed 502 participants (283 with CVRF and 219 with CVD); 45.8% were female, and mean age (SD) was 48.1 (11.2) years. The knowledge of heart attack symptoms, stroke symptoms, and CVRF (>75% correct answers) were: 12.9%, 20.7%, and 17.3%, respectively. Individuals with CVRF had 2.5 times lower knowledge of CVD symptoms compared to those with existing CVD. Acceptability of NPHW-facilitated care and text-messages for healthy lifestyle was 60% and 84%, respectively. The knowledge of CVD symptoms and risk factors is below optimal levels, particularly among individuals at high risk of CVD, unskilled workers, those with lower levels of education and income. Innovative use of NPHW along with mHealth tools could potentially offer solutions to reduce the burden of CVD.

Influence of Farmer’s Income Level on Adoption of Agricultural Water Management Practices among Smallholder Farmers in Rongai Sub-county, Kenya

Water is a resource that cannot be replaced and can only be renewed if it is well managed. It is basic for all forms of life, for every aspects of socio-economic development, and for the maintenance of a healthy ecosystem. Agriculture is the biggest water user globally, accounting for 70 percent of total water withdrawals on average. There are different practices that can aid in managing water used for agriculture. Some of these agricultural water management practices are; rainwater harvesting, irrigation, organic farming, and use of drought resistant crops. Farmer’s decision to either adopt or reject these practices can be affected by several factors, some of which are socio-economic. Some of the socio-economic factors that may influence adoption of these practices include farmer’s educational level, income level and farm size. This study examined the influence of farmer’s income level on adoption of agricultural water management practices (Rainwater harvesting, Irrigation Drought resistant crops). Cross-sectional survey design was adopted, while proportionate and simple random sampling technique was used to obtain the respondents. The accessible population was 6,230 smallholder farmers from the target population of 26,804 smallholder farmers in Rongai sub county Kenya. The study was done in August 2023 to November 2023.The study included 120 smallholder farmers in Rongai Sub County. The study used questionnaire to collect data while binary logistic regression was used to analyze the data. The results indicated that adoption of agricultural water management practices is low, only 36% of smallholder farmers had adopted agricultural water management practices. The P value calculated for the 120 smallholder farmers was P=.033 which is < than .05 and therefore the null hypothesis was rejected concluding that in this study income level had statistically significant influence on adoption of agricultural water management practices among smallholder farmers in Rongai sub-county in Nakuru ,Kenya. The findings may help in emphasizing the necessity of assisting farmers in removing financial obstacles that may hinder adoption of agricultural water management practices.

Comprehensive analysis of psychological symptoms and quality of life in early patients with IBD: a multicenter study from China.

To investigate the prevalence and risk factors of psychological symptoms and quality of life (QoL) in early patients with inflammatory bowel disease (IBD). From September 2021 to May 2022, a unified questionnaire was developed to collect clinical data from early patients with IBD from 42 tertiary care hospitals. The influencing factors of psychological symptoms and poor QoL are screened by logistic regression analysis for constructing model in predicting poor QoL. The consistency index, receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration curve, and decision curve analysis (DCA) were used to evaluate the performance of the model. A total of 939 early patients with IBD were surveyed, Among them, 20.3% exhibited anxiety, 21.7% had depression, 57.3% experienced sleep disturbance, and 41.9% reported poor QoL. The factors influencing psychological symptoms varied between ulcerative colitis (UC) and Crohn's disease (CD) patients. The QoL was primarily affected by disease activity, income level and depression. The AUC value of the model in the training group was 0.781 (95% CI: 0.748-0.814). The calibration diagram of the model closely matched the ideal curve. Compared to other prediction models, our model showed superior predictive capability, with NRI and IDI values of 0.324 (95%CI:0.196-0.4513) and 0.026 (95%CI:0.014-0.038), respectively. DCA indicated that the nomogram model could provide clinical benefits. Early patients with IBD exhibit a high prevalence of psychological symptoms and poor QoL. The nomogram prediction model we constructed demonstrates high accuracy and performance in predicting QoL in early patients with IBD.

Abstract 4125581: Association Between Life’s Essential 8 and Premature Atherosclerotic Cardiovascular Disease: A Cross-sectional Study Among Young Adults in the United States

Background: Among patients presenting with atherosclerotic cardiovascular disease (ASCVD), the proportion of young individuals has increased in recent years. Life’s Essential 8 (LE8), containing two domains of health behaviors and health factors, is an updated monitoring measurement of cardiovascular health by assessing 8 modifiable risk factors. Objective: The objective of this study is to investigate the potential relationship between the LE8 score and a history of premature ASCVD among young adults residing in the United States. Methods: This population-based cross-sectional study utilized data from the National Health and Nutrition Examination Survey spanning 2005 to 2018, focusing specifically on adults aged 20 to 45. LE8 score was measured and categorized into low (0-49), moderate (50-79), and high (80-100) levels (Figure 1). Premature ASCVD status was determined by interviews conducted at enrollment, encompassing a self-reported composite disease history of coronary heart disease, angina pectoris, heart attack, and stroke. Following descriptive statistics, weighted multivariable logistic regression and restricted cubic spline models were employed to evaluate the associations between the LE8 score and premature ASCVD. Additionally, subscale and subgroup analysis were developed. Results: Among 17,499 participants, 9846 were eligible for analysis (weighted mean age, 32.7 years; male, 50.3%), and 167 had premature ASCVD history (weighted percentage, 1.46%). The weighted mean LE8 score of the study population was 71.99 (0.3). Following the adjustment for potential confounders, individuals with higher LE8 scores exhibited a reduced risk of developing premature ASCVD (Table 1). A nonlinear relationship was observed and similar patterns were also identified in the association of health behaviors and health factors scores with premature ASCVD (Figure 2). This inverse association was consistently observed across various subgroups, including sex, age strata, ethnicity, education, and income levels, with no significant interactions identified. Conclusions: The LE8 score and its subscale scores exhibited a negative, nonlinear association with premature ASCVD. Maintaining a healthy lifestyle and controlling modifiable risk factors are crucial in preventing premature ASCVD in the younger demographic. Further studies, encompassing prospective cohorts, are needed to confirm this finding.

The Influence of Green Marketing Communication and Brand Credibility through the Mediation of Environmental Attitudes and Moderation of Income Levels on Purchasing Decisions of Green Marketing Products in Aceh

The issue of environmental sustainability has become increasingly important, particularly in the context of green product marketing, making it crucial to understand the factors that influence green product purchasing decisions. This study aims to clarify how brand credibility and green marketing communication affect consumer behavior through environmental attitudes and the moderating impact of income levels. Primary data from 300 green product consumers, gathered via a structured questionnaire and analyzed using Structural Equation Modeling (SEM-PLS), reveal several key findings. Brand credibility significantly enhances both environmental attitudes and purchasing decisions, with environmental attitudes playing a critical mediating role in these relationships. Green marketing communication also positively impacts environmental attitudes and purchasing decisions. Additionally, income levels positively affect purchasing decisions but negatively moderate the interaction between environmental attitudes and purchasing decisions. These results underscore the essential role of environmental attitudes in mediating the effects of brand credibility and green marketing communication on purchasing decisions, as well as the nuanced influence of income levels on consumer behavior regarding sustainable products.

Sugar-sweetened beverage consumption in Thailand: Determinants and variation across socioeconomic status

ObjectivesReducing consumption of sugar-sweetened beverages (SSBs) is a primary public health goal in Thailand, but information on the characteristics of SSB consumers remains limited. This study aims to gain knowledge about the characteristics of SSB consumers in Thailand. Study designSecondary analysis of survey data. MethodsThe study used data from the Health Behaviour of Population Survey conducted by Thailand's National Statistics Office between February and May 2021. SSB consumption was sourced from a survey question about the consumption of prepackaged sugar-sweetened non-alcoholic beverages. The influence of demographic, socioeconomic, behavioural, habitual, and health factors on mean daily intake and daily consumption was assessed using a two-part model and logistic regression analysis, respectively. Decomposition analysis was conducted to understand how the impact of these factors affecting SSB consumption varied across socioeconomic groups. ResultsFrequent SSB consumers exhibited various unhealthy behaviours, including smoking, unhealthy food consumption, low physical activity, and making food selections driven by appetitive motivations. Although higher socioeconomic status was associated with greater consumption of SSBs, it stabilised at elevated income levels. Increased SSB consumption in higher socioeconomic groups was linked to mixed eating habits, being overweight, and occasional drinking, while in lower socioeconomic groups, it was associated with unhealthy behaviours like smoking, regular alcohol drinking, appetitive food choices, and low physical activity. ConclusionsSSB consumption in Thailand is multifactorial, varying by socioeconomic status. These insights are crucial for policy formation aimed at reducing SSB consumption in the country. Policymakers should explore interventions that address overall unhealthy behaviours alongside those targeting overconsumption of SSBs.

Income-Related Disparities in Mortality Among Young Adults With Type 2 Diabetes.

Previous studies have indicated an inverse association between income and mortality. However, differences in health outcomes according to the income level of young adults with type 2 diabetes (T2D) compared with older adults with T2D have not been elucidated. To estimate the overall and cause-specific mortality risks among patients with T2D according to income and age. This retrospective nationwide cohort study in South Korea included adults aged 20 to 79 years who were diagnosed with T2D between January 1, 2008, and December 31, 2013, and followed up until December 31, 2019, and age- and sex-matched controls without diabetes. Data were analyzed between January 1, 2023, and August 27, 2024. Risks of all-cause, cardiovascular, and cancer mortality were estimated according to participants' income, which was categorized into 3 levels (low, middle, and high) based on the health insurance premium. Logistic regression analyses and Cox proportional hazard regression analyses were performed according to age groups (20-39, 40-59, and 60-79 years). A total of 1 240 780 adults (604 975 patients with T2D and 635 805 age- and sex-matched controls without diabetes) were included in the analyses. Their mean (SD) age was 56.9 (11.8) years, and 626 176 (50.5%) were men. Overall, the risk of mortality increased with lower income among patients with T2D, as well as in comparison with controls without diabetes. There was an inverse association between income and mortality risk in younger individuals (adjusted hazard ratios of all-cause mortality in the low income vs high income subgroups with T2D were 2.88 [95% CI, 2.25-3.69] in those aged 20 to 39 years, 1.90 [95% CI, 1.81-2.00] in those aged 40 to 59 years, and 1.26 [95% CI, 1.23-1.29] in those aged 60 to 79 years; P < .001 for comparing risk ratios between age groups). The pattern of income-related disparities in younger individuals was observed in cardiovascular mortality but less in cancer mortality. In this cohort study of 1 240 780 individuals aged 20 to 79 years, the risk of mortality with low income was most prominent among individuals with T2D aged 20 to 39 years. These findings highlight the need for socioeconomic support to reduce income-related health disparities in younger individuals.