Low-income Households Research Articles

Socioeconomic Disparities in Family Well-Being, Family Communication Quality, and Personal Happiness among Chinese: Findings from Repeated Cross-Sectional Studies in 2016–2023

AbstractSignificant socioeconomic changes in Hong Kong have coincided with a conspicuous knowledge gap regarding the impact of disparities on family well-being, family communication quality, and personal happiness. To examine changes on family well-being, family communication quality, and personal happiness before, during, and after the 2019 social unrest and the COVID-19 pandemic in Hong Kong. Five repeated territory-wide cross-sectional surveys were conducted from 2016 to 2023, using telephone and online surveys on 27,074 adults in Hong Kong. Respondents rated their family health, happiness, harmony (family 3Hs), family communication quality, and personal happiness on scales of 0–10. Family well-being was the sum of family 3Hs divided by three (0–10). Trends by socioeconomic factors were analysed using linear prediction and multiple linear regression, weighted for sex and age. Highest scores for all outcomes were observed in 2016 and 2017, followed by a noticeable decline in 2020 and 2021, with the lowest scores recorded in 2023 except for personal happiness with its lowest score recorded in 2021. The decline since 2021 was most noticeable with low monthly household income (predicted margins in 2023 ranged from 5.55 to 6.46 for ≤ HK$19,999; 5.62 to 6.51 for HK$20,000–39,999; 5.81 to 6.78 for ≥ HK$40,000), but no differences were observed by education level. Female, older age, and higher monthly household income were significantly associated with higher family well-being, family communication quality, and personal happiness (all P < 0.001). Higher education level was only significantly associated with personal happiness (P = 0.008). We have first shown socioeconomic disparities in the declining family well-being, family communication quality, and personal happiness from 2016 to 2023 in Hong Kong. These alarming findings require targeted interventions and policies aimed at addressing these disparities and improving wellbeing in the population.

Status and influencing factors of knowledge, attitudes and practices relating to screening for breast and cervical cancer among rural women aged 40–65 years in China: a cross-sectional study

ObjectivesThe objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women...

Influence factors on travel mode preference of working residents living far away from downtown area on workdays: A hybrid method integrating random parameter logit model and Apriori algorithm

This study presents a detailed analysis on the characteristics of travel mode preference of working residents living far away from downtown area on workdays, using GPS-based activity travel diary data from Shangdi area (Beijing). A hybrid method integrating random parameter logit model with systematic heterogeneity (RPL-SH) and Apriori algorithm is put forward to explore the influence factors and interaction effects affecting travel mode preference. First, the RPL-SH model is established to explore significant factors, and capture the unobserved random heterogeneity and systematic heterogeneity due to individual characteristics on the travel mode preference. Then, these significant factors are used to generate association rules by Apriori algorithm to investigate statistical associations between the specific travel mode preference and these significant factors. Ten significant factors are found in the RPL-SH model, in which annual household income is normally distributed. The results of the Apriori algorithm indicate that some factors combined with other factors could significantly influence working residents’ travel mode preference. For example, the combination of lower annual household income and shorter distance between workplace and the nearest bus stop is highly associated with green travel mode preference. Moreover, the results show that the proposed hybrid method not only demonstrates the consistency of the results of the two methods, but also plays a complementary role in exploring more information on travel mode preference. This research hopes to give regulators a better understanding on how working residents living far away from downtown area choose their travel mode, so as to develop more effective and targeted measures for reducing private car use and alleviating workday traffic congestion.

A Study of the Unexplored Aspect of Energy Poverty: Overheating Risk Analysis

Energy poverty, defined as the inability of households to afford adequate heating or cooling, is worsened by anthropogenic climate change, leading to increased energy demand and indoor comfort challenges. This study addresses a gap in summer fuel poverty research by focusing on overheating concerns and energy subsidies. This study defines the indoor temperature and overheating risk of low-income households compared with general dwellings based on field measurements and walkthrough surveys. The difference in indoor temperature and overheating risk according to the provision of energy subsidy is analyzed. We evaluate the impact of energy subsidies on indoor temperature and the adequacy of current subsidy programs. Findings show that households without energy vouchers experience indoor temperatures around 29°C, while voucher recipients see a 2°C decrease. During Tropical Night periods, households with energy vouchers maintain similar indoor temperatures to the overall period, while those without vouchers tend to experience a 2°C increase. Although energy vouchers significantly mitigate overheating risks by approximately 95% during the summer, they are not as effective in fully eliminating summer overheating risks compared to previous winter results. This highlights the persisting issue of traditional policies providing integrated electricity subsidies. Hence, addressing indoor overheating during hot summers requires improvements in alternative subsidy distributions or cooling strategies warrants change to the energy voucher payment method or the cooling method.

Water scarcity and its implications on sanitation: A perspective study in an emerging city in Northern Ghana

Water scarcity is a critical global challenge affecting billions of people, particularly in developing regions like sub-Saharan Africa. In Ghana, this issue has become increasingly pronounced, with limited access to clean and safe water posing serious threats to the health and livelihoods of many communities. This study investigated the intricate relationship between water scarcity and accessibility, and the associated implications on sanitation practices in Damongo, a newly created regional capital and an emerging city. The study showed that the area faced evident water scarcity, with a daily per capita water consumption as low as 0.128 m3. Mechanized boreholes emerged as potential solutions, particularly for the 61.2% of respondents experiencing waiting times exceeding 15 min. The economic repercussions were noteworthy, as high water costs impacted livelihoods, emphasizing the need for policy interventions, especially for low-income households. Sanitation challenges are widespread, with 62.8% relying on pit latrines, and 56.1% lacking proper infrastructure. Water and sanitation-related diseases like typhoid and diarrhoea highlight the need for urgent interventions to enhance water quality and sanitation practices. Household water infrastructure analysis revealed diverse, primarily privately owned sources. Gender imbalances persist in water-fetching responsibilities, with 58.2% relying solely on females. Domestic water sources predominantly involved traditional options, potentially exposing residents to unsafe practices. Sanitation maintenance practices and intervals varied, signaling the necessity for comprehensive solutions. Households without toilets resorted to open spaces (43.6%), gutters (29.1%), and public toilets (12.7%), indicating challenges in waste disposal and sanitation facility access. Insights on the health dimension considered uncovering the prevalence of the top five water and sanitation-related diseases for 2022. These included typhoid (24.3%), diarrhoea (30.0%), Cholera (11.7%), Dysentery (14.6%), and Hepatitis (19.3%). These findings suggest the pressing need for improved sanitation and clean water access, as inadequate infrastructure and water scarcity contribute significantly to these health challenges.

The relation between socioeconomic status and invasive haemodynamics at evaluation for advanced heart failure.

Socioeconomic deprivation is a risk marker for worse prognosis in patients with heart failure (HF), and a potential barrier to referral for advanced HF evaluation. The relationship between socioeconomic status (SES) and invasive haemodynamics in patients undergoing evaluation for advanced HF therapies is unknown. We combined a consecutive clinical registry of patients evaluated for advanced HF with patient-level data on SES (household income, education, workforce status, cohabitant status and distance from home to tertiary HF centre) derived from nationwide registries. Using this information, the cohort was divided into groups of low-, medium- and high degree of socioeconomic deprivation. The associations between SES and invasive haemodynamics were explored with multiple linear regression adjusted for age and sex. A total of 631 patients were included. The median age was 53years, and 23% were women. Patients in the highest income quartile versus the lowest (Q4 vs. Q1) were older (median age 57 vs. 50years) and more often male (83% vs. 67%), both P<0.001. Increasing household income (per 100000 Danish kroner,1 EUR=7.4 DKK) was associated with lower pulmonary capillary wedge pressure (PCWP)[-0.18mmHg, 95% confidence interval (CI) -0.36 to -0.01, P=0.036] but not significantly associated with central venous pressure (CVP) (-0.07mmHg, 95% CI -0.21 to 0.06, P=0.27), cardiac index (-0.004L/min/m2, 95% CI -0.02 to 0.01, P=0.60), or pulmonary vascular resistance (PVR) (-0.003 Wood units, 95% CI -0.37 to 0.16, P=0.84). Comparing the most deprived with the least deprived group, adjusted mean PVR was higher (0.35 Wood units, 95% CI 0.02 to 0.68, P=0.04), but PCWP (0.66mmHg, 95% CI -1.49 to 2.82, P=0.55), CVP (-0.26mmHg, 95% CI -1.76 to 1.24, P=0.73) and cardiac index (-0.03L/min/m2, 95% CI -0.22 to 0.17, P=0.78) were similar. Most haemodynamic measurements were similar across layers of SES. Nevertheless, there were some indications of worse haemodynamics in patients with lower household income or a high accumulated burden of socioeconomic deprivation. Particular attention may be warranted in socioeconomically deprived patients to ensure timely referral for advanced HF evaluation.

Consumption responses to sweetened beverage taxes by household income in four U.S. cities.

Taxes on sweetened beverages have become an important policy response to growing obesity rates and the prevalence of type 2 diabetes in the U.S. and other nations. Since 2015, eight U.S. cities have implemented these taxes, but so far direct evidence of their impacts on household purchasing behavior is scarce. Of particular interest to many researchers and policy makers is the response of lower-income consumers to these taxes, both because they have higher sweetened beverage consumption on average and because of concerns that sweetened beverage taxes are regressive. This project investigates the income-stratified household response to SSB taxes using a data set containing the purchasing behavior of approximately 400 households in the cities of Seattle, San Francisco, Oakland, and Philadelphia, all of which have recently introduced beverage taxes. Using doubly-robust estimation of dynamic and heterogeneous treatment effects relative to a propensity-matched set of households in three comparison cities, we find that households in taxed cities experience increased prices and reduce their purchases of those beverages, with no evidence of cross-border shopping. We further find differential tax impacts by income level, with lower-income households (households with income <200% of the federal poverty line for their size) reducing their purchases of taxed beverages by nearly 50% - more than double the 18% reduction found in higher-income households (households with income >400% of the federal poverty line for their size). Our finding that lower-income households decrease their consumption more than twice as much as higher-income households suggests that these taxes may reduce health disparities and promote population health.

Food Security Sustainability among Urban Low-Income Households in Malaysia: A Systematic Literature Review

Food Security Sustainability among Urban Low-Income Households in Malaysia: A Systematic Literature Review

The association of increased SNAP benefits during COVID-19 with food insufficiency and anxiety among US adults: a quasi-experimental study.

The COVID-19 pandemic and subsequent policy response to mitigate disease spread had far-reaching impacts on health and social well-being. In response, the Supplemental Nutrition Assistance Program (SNAP) underwent several pandemic-era modifications, including a 15 % monthly benefit increase on January 1, 2021. Research documenting the health effects of these SNAP modifications among low-income households and minoritized groups who were most impacted by the economic fallout during the first years of the pandemic is lacking. We aimed to estimate the health effects of the 15 % SNAP benefit increase in January 2021, among SNAP-eligible US households. We estimated the effects of the SNAP increase on food insufficiency, mental health, and financial well-being using a rigorous quasi-experimental difference-in-differences (DID) analysis. August 19, 2020, to March 29, 2021. Participants were drawn from the national US Census Bureau Household Pulse Survey waves 13-27 (n 44 477). Compared with SNAP-eligible non-recipients, SNAP-eligible recipients experienced decreased food insufficiency (-1·9 percentage points (pp); 95 % CI -3·7, -0·1) and anxiety symptoms (-0·09; 95 % CI -0·17, -0·01), and less difficulty paying for other household expenses (-3·2 pp; 95 % CI -4·9, -1·5) after the SNAP benefit increase. Results were robust to alternative specifications. Expansions of federal nutrition programmes have the potential to improve health and financial well-being. This study provides timely evidence to inform comprehensive safety net nutrition policies during future economic crises and public health preparedness response plans.

Impact of Rural E-Commerce on Farmers’ Income and Income Gap

Rural e-commerce, as a new form of digital economy, is of great significance in promoting the income of rural households and realizing common prosperity. Based on the 2021 China Rural Revitalization Survey (CRRS), the impact of rural e-commerce on farmers’ income and the intra-rural income gap is explored using quantile regression. The results found that (1) rural e-commerce can effectively promote the level of farm household income and alleviate the intra-rural income disparity, with this finding still holding after addressing the potential endogeneity problem and conducting robust-type tests. (2) Rural e-commerce has the most pronounced income-generating effect on low-income households in the southern region; participation in rural e-commerce has a more “center-expanding” effect on households in the secondary education and high material capital groups. (3) Saving production and operation costs, shortening the product circulation chain, and improving access to information are channels through which rural e-commerce affects households’ income. It is recommended to actively promote the deep integration and development of rural e-commerce in rural areas, establish a sound mechanism for bridging the “digital divide”, encourage e-commerce “leaders” to build a perfect industrial chain, and guide smallholders to integrate into the rural e-commerce industrial chain to enjoy the digital dividend.

How Farm Machinery Rental Services and Off-Farm Work Affect Household Income in China

(1) Background: Most nations struggle to close significant income gaps between high and low earners. While the adoption of farm machinery rental services and off-farm employment may be beneficial, it is unclear whether jointly applying both approaches can raise income levels in rural households or help narrow the income gap within the farm sector. This study investigated scenarios involving both participation in farm machinery rental markets and in off-farm work, analyzing their varied impacts on household incomes based on survey data from 1027 rice producers in rural China. (2) Methods: We employed a two-stage econometric procedure encompassing a bivariate ordered probit model with an endogeneity-corrected unconditional quantile regression model. (3) Results: Rice farmers often simultaneously rent farm machinery services and engage in off-farm work. Both activities positively affect their household incomes; however, these effects vary across different income levels. Renting farm machinery provides greater marginal benefits for lower-income households, while off-farm employment has a stronger impact on higher-income households. Farm machinery rental services appear to benefit disadvantaged households more than off-farm employment opportunities do. (4) Suggestions: To enhance the welfare of lower-income households, policymakers should focus on expanding access to farm machinery rental services.

Gender, socioeconomic status, and numeracy test scores

We study the interrelationship between the gender gap in numeracy and socioeconomic status (SES) based on household income, parental education, and labor force status. A composite measure of SES confirms the well-established fact that boys from lower SES are more disadvantaged. In contrast, we find that separately the three aspects of higher SES interact uniquely with gender to drive differential outcomes in numeracy for girls and boys. Income and mother’s role in particular, are important drivers of the gender gap at the extremes of the income distribution. Mother’s education and labor force participation is associated with increasingly higher test scores for girls across the income distribution, thus leading to a double disadvantage for poor girls. But the gender gap does not disappear at the top of the income distribution, as for boys, test scores increase with stay-at-home mothers. In high-income households boys benefit from a traditional household structure; while in low-income households, the gap is driven by girls having worse numeracy scores in the traditional household structure.

Impact of Energy Crises on Income Inequality: An Application of Piketty’s Hypothesis to Pakistan

In Pakistan, the majority of people have access to energy supplies. However, people who are underprivileged, below the extreme poverty line, or part of the middle class often spend disproportionate portions of their income on energy supplies and services, to some extent because of higher upfront prices for energy supplies, expensive products, and expensive imported appliances. The nonavailability of low-cost energy supplies is mainly affecting underdeveloped regions that have mostly low-income households. We used the dynamic ordinary least squares method to look at the impact of the energy crisis on income inequality from 1997 to 2021. The results show that the energy crisis exacerbates income inequality as low-income groups end up spending more significant shares of their income on energy products, supplies, and services than higher-income groups. Fair and equal access to energy supplies and services is less likely to reduce income inequality if prices are not cost-efficient. Cautious deliberation regarding the structure of energy tariffs is inevitable; at the same time, safety nets and social security programs for the poorest groups need to be expanded. At this stage, the aim is to target energy prices that will achieve the objectives of reducing polarity and increasing real income.

Equity-based energy retrofits to address energy poverty in Canada

Many energy efficiency and decarbonization retrofit programs aim to alleviate energy poverty by targeting low-income households, but these programs do not always address the multiple determinants of energy poverty. This study develops a vulnerability-based framework to explore the extent to which energy retrofit programs designed for low-income households comprehensively account for socioeconomic, demographic, and cultural structures that shape energy poverty experiences, employing Canada as an empirical case study using key informant interviews with program administrators. The framework conceptualizes energy poverty as the vulnerability to future housing-related harms, amplified by energy-related risk factors, and conditioned by a household's inability to adequately respond. The study finds several key issues limiting the capacity of low-income retrofit programs to address the overlapping and compounding determinants of energy poverty, including inadequate funding, exclusion of the poorest quality housing, limited retrofit options, and a narrow focus on energy efficiency gains. This study shows key opportunities to expand and deepen the current ecosystem of low-income retrofit programs by expanding existing policy innovations. The paper also offers suggestions for widening the policy arena to address energy poverty, both within retrofit programs and beyond.

The Impact of Restrictive Macroprudential Policies through Borrower-Targeted Instruments on Income Inequality: Evidence from a Bayesian Approach

This study used the panel data from 15 emerging markets to examine the impact of restrictive macroprudential policies on income inequality from 2000–2019 using Bayesian panel vector autoregression and Bayesian panel dynamics generalised method of moments models. The chosen models are suitable for addressing multiple entity dynamics, accommodating a wide range of variables, handling dense parameterisation, and optimising formativeness and heterogeneous individual-specific factors. The empirical analysis utilised various macroprudential policy proxies and income inequality measures. The results show that when the central banks tighten systems using macroprudential policy instruments to sticker debt-to-income and financial instruments for lower-income borrowers (the bottom 40% of the income distribution), they promote income inequality in these countries while reducing income inequality for high-income borrowers (the high 1 percent of the income distribution). The impact of loan-to-value ratios was found to be insignificant in these countries. Fiscal policy through government expenditure and economic development reduces income inequality, while money supply and oil-price shocks exacerbate it. The study suggests implementing a progressive debt-to-income (DTI) ratio system in emerging markets to address income inequality among lower-income borrowers. This would adjust DTI thresholds based on income brackets, allowing lenient credit access for lower-income borrowers while maintaining stricter limits for higher-income borrowers. This would improve financial stability and reduce income disparities. Additionally, targeted financial literacy programs and a petroleum-linked basic income program could be implemented to distribute oil revenue to lower-income households. A monetary supply stabilisation fund could also be established to maintain financial stability and prevent excessive inflation.

Toward sustainable energy transition: understanding electricity-use behavior among low-income urban households in Kumasi

ABSTRACT The residential sector is a critical contributor to global energy consumption. In Ghana, it accounts for 47% of the total electricity consumed. However, inadequate knowledge of categories of residential consumers, their profiles, and the implications on their consumption patterns could impede the development of targeted and sustainable interventions. This study examined the behavioral patterns among low-income urban households in Kumasi, using their socio-demographic and housing characteristics, and self-reported values. This is coherent to the current discourse on Ghana’s transition to zero carbon by 2070 given that Kumasi is the fastest-growing city in the country. Using quantitative methods within a transdisciplinary research design, a survey of 285 households was conducted. The findings yielded varied outcomes. Households reported good electricity use behavior (e.g. covering liquids in the refrigerator) and poor behaviors (e.g. not adjusting the power setting of refrigerators to weather conditions). Logistic regression operations showed associations between energy use behavior, the type of housing units and the type of electricity meters. A significant proportion of respondents exhibited pro-environmental behaviors across all nine value domains. The study concludes that low-income households engage in energy-saving practices. We suggest that policy mediation could enhance the effectiveness of behavioral interventions toward electricity use efficiency.

Abstract A114: Inequities in advanced stage at diagnosis of non-small cell lung cancer among people with and without HIV in the US

Abstract Background: Lung cancer is the leading cause of non-AIDS death among people with HIV (PWH). PWH are also more likely to die due to lung cancer compared to people with HIV. Late presentation at diagnosis due to barriers to lung cancer screening may contribute to disproportionate deaths among PWH. Our objective was to evaluate associations of HIV status with advanced stage at diagnosis and evaluate social determinants of health (SDoH) associated with advanced stage at diagnosis of lung cancer among PWH. Methods: We used data from the 2004-2020 National Cancer Database, including patients aged 18-89 years diagnosed with lung cancer (ICD-0-3 codes: C340-C349). PWH were identified using ICD9 (04200 to 04499, 07953, and V08) and ICD10 (B20 to B24, R75, Z21, B97.35).The primary outcome was advanced stage at diagnosis (stage 3/4). Our main SDoH exposures were quantified as quartiles (Q1-Q4) and included measures of area-level SDoH based on a patient’s zip code: (1) % of adults without a high school degree, or area-level education; (2) median household income of adults, or area-level income. We used hierarchical multivariable logistic regression models clustered by facility ID to estimate adjusted odds ratios(aOR) with 95% confidence intervals(95% CI), and evaluated each exposure separately adjusting for age, sex, year of diagnosis, and Charlson comorbidity score, and stratified by race/ethnicity and insurance status. Results: Overall, we identified 6,585 PWH and 1,665,030 without HIV. Seventy one percent of PWH were diagnosed with stage 3 or 4 lung cancer compared to 64.9% of people without HIV (p&amp;lt;0.001). PWH were more likely to be under the age of 60 (43.5% vs.15.1%, p&amp;lt;0.001), After adjustment for sex, age, and year of diagnosis, PWH had 15% higher odds of advanced stage at diagnosis compared to those without HIV (aOR: 1.15; 95% CI: 1.09-1.22). Residing in areas with larger proportions of the population without a HS diploma (Q4 vs. Q1: aOR:1.19; 95% CI: 1.01-1.41) and larger proportions with lower household income (Q1 vs. Q4: aOR: 1.15; 95% CI: 1.01-1.31) were positively associated with advanced stage-at-diagnosis of lung cancer. When we stratified by insurance status, only PWH who were Medicaid insured residing in the least educated areas (aOR: 1.84; 95% CI: 1.11-3.06) and in the lowest income areas (aOR: 1.86; 95% CI: 1.30-2.65) had higher odds of advanced stage at diagnosis with lung cancer. Conclusions: Living with HIV is independently associated with presenting at a later stage of lung cancer at diagnosis. Area-level measures of lower education and lower household income are significantly associated with advanced stage-at- diagnosis of lung cancer regardless, particularly among those who are Medicaid insured. Citation Format: Jessica Y Islam, Yi Guo, Kea Turner, Amir Alishahi Tabriz, Marlene Camacho-Rivera, Gita Suneja. Inequities in advanced stage at diagnosis of non-small cell lung cancer among people with and without HIV in the US [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A114.

Associations between changes in deprivation and alcohol use disorder: a nationwide longitudinal study.

Despite conflicting findings on the association between socioeconomic status and drinking, little is known about the impact of deprivation as a measure of inequality on alcohol use disorders (AUDs). We used the Korea Welfare Panel Study, a longitudinal survey conducted from 2012 to 2022, and included 1569 Korean adult participants. Deprivation (at least one including food, housing, medical, educational, and credit deprivation) was measured by self-report and divided into four categories according to the change in deprivation experience from the previous year to the following year. AUD was measured using the Korean version of the Alcohol Use Disorders Identification Test scale. Multivariable logistic regression was used to estimate odds ratios and 95% confidence intervals and adjusted for confounders. Among 1569 participants, worsened deprivation and consistent deprivation were positively associated with AUD compared to non-deprivation. In particular, worsened deprivation was more likely to be associated with AUD in participants with low household income, high school education level, and economic activity. We found that worsened deprivation and consistent deprivation were associated with AUD. Deprivation should be considered as a health policy intervention to improve drinking problems.

Sex-Specific Effects of Early Life Unpredictability on Hippocampal and Amygdala Responses to Novelty in Adolescents.

Unpredictable childhood experiences are an understudied form of early life adversity that impacts neurodevelopment in a sex-specific manner. The neurobiological processes by which exposure to early-life unpredictability impacts development and vulnerability to psychopathology remain poorly understood. The present study investigates the sex-specific consequences of early-life unpredictability on the limbic network, focusing on the hippocampus and the amygdala. Participants included 150 youth (54% female). Early life unpredictability was assessed using the Questionnaire of Unpredictability in Childhood (QUIC). Participants engaged in a task-fMRI scan between the ages of 8 and 17 (223 total observations) measuring BOLD responses to novel and familiar scenes. Exposure to early-life unpredictability associated with BOLD contrast (novel vs. familiar) in a sex-specific manner. For males, but not females, higher QUIC scores were associated with lower BOLD activation in response to novel vs. familiar stimuli in the hippocampal head and amygdala. Secondary psychophysiological interaction (PPI) analyses revealed complementary sex-specific associations between QUIC and condition-specific functional connectivity between the right and left amygdala, as well as between the right amygdala and hippocampus bilaterally. Exposure to unpredictability in early life has persistent implications for the functional operations of limbic circuits. Importantly, consistent with emerging experimental animal and human studies, the consequences of early life unpredictability differ for males and females. Further, impacts of early-life unpredictability were independent of other risk factors including lower household income and negative life events, indicating distinct consequences of early-life unpredictability over and above more commonly studied types of early life adversity.

Abstract B018: Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024

Abstract Significance: Overall tobacco use rates are higher in the Midwest and Southern regions of the United States (US) than the rest of the US, yet little is known on correlates of tobacco use, or how rates are changing in recent years. This study examines current correlates of tobacco use among individuals living in the 13 most high-risk states in the US over two years. Methods: First, we examined the prevalence of tobacco use and related correlates in a rapid response survey of 4,550 adults collected between April-May 2023 (18+ years) living in the 13 high-risk states collected by the American Cancer Society. Data were weighted to be representative of the states’ population. Bivariate analyses for demographic characteristics were conducted examining cigarette use, e-cigarette use, and cigar use. Additional data collected from April-May 2024 in a second wave of cross-sectional data (n=4,500) for comparison between years and are currently being analyzed to reflect potential changes in correlates from 2023 to 2024. Results: Respondents in Wave 1 were aged 18-65 (Mean = 41.85; SD=0.32) and were majority Non-Hispanic White (70.9%) and female (51.9%). 47.5% of respondents reported an annual household income of &amp;lt;$75,000 USD. Although most respondents lived in urban (50.2%) or mostly urban areas (26.6%), several participants still resided in mostly rural (11.0%) or all rural (10.2%) as defined by US Census demographic data. The prevalence of any tobacco use was high across all 13 states (33.1%), with 29.5% reporting cigarette, e-cigarette and/or cigar use.21.1% of respondents were persons who currently smoke vs. 11.5% for the national average, while 20.7% were persons who previously smoked and 8.0% were persons who occasionally smoke. 14.0% of respondents reported current e-cigarette use vs 4.5% for the national average and 17.5% reported previous e-cigarette use. 8.7% of respondents reported current cigar use vs 3.5% for the national average and 24.1% reported previous cigar use. Respondents identifying as male (&amp;lt;.001) and with a household income &amp;lt;$75,000 (&amp;lt;.001), a disability (p=.014), or military/veteran status (p=.031) were more likely to currently smoke. Respondents who were male (p=.004) or reported household income &amp;lt;$75,000 (p=.011) were more likely to report current e-cigarettes use; higher use was associated with increasing age (&amp;lt;.001). Respondents who were male (&amp;lt;.001), and nonwhite (&amp;lt;.001) were more likely to report current cigar use; higher use was associated with increasing age. Conclusions: Cigarette use is high among individuals living in this region, and is related to lower household income, military/veteran status, disability status, and male identity. E-cigarette and cigar use increased with age. These high tobacco use rates lead to increased health inequities, with related high rates of cancer and cardiovascular disease. Given that tobacco use continues to be high in these states, tailored cessation programs could help reduce the heavy burden of tobacco use among this population. Citation Format: Minal Patel, Laurel Gibson, Presley Cannon, Shanshan Wang, Nigar Nargis. Changes in prevalence and correlates of tobacco use in 13 high-risk states in the United States from 2023-2024 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B018.