Individuals Of Lower Socioeconomic Status Research Articles

Bacterial Load Assessment of some Food Items Sold in Street in Woldia Town, North-East Ethiopia

Infectious diseases due to contaminated street vended food items has happened to an essential concern and public health issue in low socio-economic status individuals. The goal of this study was to evaluate bacterial quality and safety of some food items sold in street based on aerobic mesophilic bacteria, Salmonella, Staphylococcus aureus and Escherichia coli in Woldia town. Cross-sectional study was performed on some selected street vended foods from March 2019 to May 2019 in Woldia town. A total of 36 ready-to-eat food samples such as ‘Sambussa’, ‘Bonbolino’ and ‘Ambasha’ were collected for microbial analysis. Finding of the study indicates that 32(88.9 %) of the vendors were females, 28(77.7%) handled food with bare hands, 28(77.7%) vendors were washing their hands after toilet. The mean total count of aerobic mesophilic bacteria, Salmonella, Staphylococcus aureus and Escherichia coli was 4.5×102±5.2×101 CFUg-1, 1.5×102±4.5×101 CFUg-1, 1.1×102±1.4×101 CFUg-1 and 2×102±3.4×101 CFUg-1, respectively. The dominant bacterial isolate from the street vended foods was Escherichia coli (53.5%), followed by Salmonella (24.1%) and Staphylococcus aureus (22.4%). The result of this study demonstrates the non hygienic practices of the vendors in street vended foods showed high bacterial load. Therefore, the street vended foods were contaminated with food borne pathogenic bacteria that can create a potential risk to public health in the study area. In general, the bacterial quality of the food quality sold in street in Woldia town was very poor and needs especial attention to avoid bacterial contamination.

Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors.

Mobile produce markets (MPM) offering Supplemental Nutrition Assistance Program (SNAP) incentive programmes have the potential to provide accessible and affordable fruits and vegetables (FV) to populations at risk of food insecurity. The objective of this study is to characterise the customer base of an MPM and describe their participation at twelve market sites serving low-income seniors. In 2018, customers from an MPM in Rhode Island (RI) participated in a cross-sectional survey (n 330; 68 % response rate), which measured dietary patterns, food security and food shopping behaviours. We compared the shopping habits and market experiences of customers who currently received SNAP benefits with those who did not currently receive SNAP benefits. An MPM in RI which offers a 50 % discount for FV purchased with SNAP benefits. This study describes current market customers at twelve market sites serving low-income seniors. Market customers were mostly low-income, female, over the age of 50 years and Hispanic/Latino. Most customers received SNAP benefits, and almost half were food insecure. In addition, three quarters of SNAP customers reported their SNAP benefits last longer since shopping at the markets. Mixed logistic regression models indicated that SNAP customers were more likely to report buying and eating more FV than non-SNAP customers. MPM are critical resources of affordable produce and have been successful in improving access to FV among individuals of low socio-economic status in RI. This case study can inform policy and programme recommendations for MPM and SNAP incentive programmes.

Individual and local socioeconomic status: associations in adolescents’ health (Barcelona province)

Abstract Individual-level and local socioeconomic status (SES) are both significant social determinants of adolescents' health, but usually their distinct effects are not properly disentangled. A validated health survey of 76 items was conducted among last compulsory education course students (15/16 years old) in 59 municipalities from Barcelona province, Spain (N = 7351). Individual SES was defined by the Family Affluence Scale and municipal SES by its Gross Disposable Household Income. Both were dichotomized and crossed. Bivariate analyses were performed for all variables, comparing Low (L) and High (H) Individual (i) SES, L and H Municipal (m) SES and then the 4 groups: LiLm, LiHm, HiLm, HiHm. Chi square tests were performed with SAS. The significance level was set to 0.05. Most of the items (self-perceived health, general mood, night leisure, excessive use of internet, and unsafe sex, among others) were only related to individual SES (in the direction usually described in literature) without municipal influence. Only for sexual harassment was found a significant association with the municipal SES (more on Lm) but no differences between individual SES groups. Different patterns emerged when individual and municipal significant associations were detected. In a LiLm-LiHm-HiLm-HiHm order, a healthy gradient was observed in frequency of sport and physical activity, neighbourhood assessment and adherence to Mediterranean Diet. On the contrary, a risk gradient appeared on tobacco, cannabis and alcohol consumption. An opposite SES effect was found on gender violence and on sexual health information demands: Individual SES was positively associated with demand while Municipal SES was negatively associated. No association with neither individual nor municipal SES was found on information interest on bullying. The different effect of individual and municipal SES and their interactions on various aspects of adolescents' health should be taken into account in health promotion. Key messages Individual SES have stronger association with most of adolescents’ health items than Municipal SES. The latter reinforces, except on gender and sexual health information demands where link is opposed. Different effects and interactions between individual and municipal socioeconomic status in adolescents’ health should be incorporated in health promotion priorization.

Pearls for Managing Atopic Dermatitis in Patients With Low Socioeconomic Status

Atopic dermatitis (AD) is a chronic inflammatory dermatosis presenting with inflamed and itchy skin. Recent studies have shown an inverse relationship between socioeconomic status and the severity of AD. Low socioeconomic status (LSES) individuals with AD face specific barriers that may impede management. These include forgoing doctor's appointments due to transportation costs, inability to take time off from work, and lack of affordable childcare services. Unaffordable medications and over-the-counter products for managing AD further present as significant challenges for LSES patients. This article aims to offer practical and affordable recommendations to help mitigate the challenges faced by LSES patients with AD and thereby alleviate disease burden and improve treatment outcomes.

Tobacco control’s effects on social inequalities in smoking: Moving towards a health equity approach

Abstract Population-level public health policies aim to improve health for the entire population. Yet, in doing so, they may unintentionally neglect vulnerable populations' specific needs, which may perpetuate social inequalities in health. As an example, tobacco control policies (e.g. media campaigns, smoke-free places, tax increases, and tobacco product regulation) have been found to significantly reduce overall smoking prevalence in many high-income countries. However, social inequalities in smoking have been increasing, with smoking prevalence being higher, notably for those of low socio-economic status (SES). Low SES individuals start smoking at younger ages, smoke more cigarettes per day, have lower cessation rates, and are exposed to more second-hand smoke than higher SES individuals. These social inequalities in smoking translate into social inequalities in health such that low SES groups carry a disproportionately heavier burden of smoking-related illnesses. Based on data from a critical discourse analysis of tobacco control policy in Quebec, Canada, as well as from a literature review of vulnerable populations' experiences with tobacco control policies, this presentation will: 1) illustrate ways in which tobacco control policies may be increasing social inequalities in smoking, including the absence of vulnerable populations who smoke from policy planning, smoking denormalization's unintended stigmatizing effects, and targeting behaviours rather than the 'causes of the cause' in policy; 2) provide ideas for future population-level policies based on a health equity approach, which includes integrating vulnerable population's voices in policy design, prioritizing vulnerable populations and health equity in policy, and shifting attention towards policies addressing social inequalities in access to social determinants (e.g. education, income, employment security, safe, clean, and affordable housing) to improve health rather than targeting behaviours, such as smoking.

Pediatric ambulatory care sensitive admission and deprivation index, ten years retrospective analysis

Abstract Background Ambulatory Care Sensitive Conditions (ACSCs) are conditions where effective community care and case management can help prevent the need for hospital admission. Even if the ACSC episode itself is managed well, an emergency admission for an ACSC is often symptom of overall poor quality of primary and community care. Lower socioeconomic status individuals show higher rates of hospitalization due to ACSCs. The purposes of this study is to examine the association between socioeconomic status and the risk of hospitalization due to an ACSC in pediatric population through a retrospective analysis of administrative data of the Abruzzo region. Methods We identified hospital discharge records from 2008 to 2018 of subjects under 18 years of age to take into consideration for the study. Hospitalizations due to ACSCs were selected by ICD9-CM coding developed by Billings et al. and implemented by Lu et al. For establishing the socioeconomic status, we used the Italian Deprivation Index (IDI) developed by Caranci et al. as a categorical variable expressed in quintiles. A multilevel logistic regression model was implemented using ACSC vs non ACSC hospitalization as dependent variables. Results In the study period, a total of 317,586 hospital discharge records were selected, 18059 (5.69%) of which related to ambulatory care sensitive hospitalization. After correcting for age, gender, and citizenship, ACSCs hospitalization was associated with lower IDI (aOR1.21;CI95%1.09-1.34) and a slight gradient as the deprivation increased. Moreover, it was also associated with emergency department admission (aOR6.53;CI95%6.19-6.89). Conclusions Avoidable hospitalization in pediatric settings is associated with lower socioeconomic status computed by IDI. This study confirms inequity in primary care or community care after adjusting for age, gender and citizenship. Italian deprivation index represents a useful tool to identify population and areas where improving prevention is necessary. Key messages The Italian deprivation index could be used to implement primary and community care strategies in pediatric settings. Socio-economic factors are associated with the performance of the health services.

Disseminated Cutaneous Leishmaniasis in a Pediatric Patient from Peru

Leishmaniasis is a disease predominantly prevalent in the tropics, considered as one of the primary neglected diseases, preferably affects individuals of low socioeconomic status. Although this condition is well described in children, disseminated cutaneous leishmaniasis is a rare form of increasing importance and multiple cases observed in the adult population; however, still little described in children. We present the case of a 12-year-old male, who has multiple ulcerative and nodular lesions distributed throughout the body, of ∼1 year of evolution that did not respond to antimicrobial treatment. After the diagnostic process, positive serological tests were found for leishmaniasis, with improvement in the picture after the use of sodium stibogluconate. Disseminated cutaneous leishmaniasis is a clinical form that is described with increasing frequency and should be recognized and treated appropriately, mainly in the pediatric population, avoiding complications and sequelae.

Nutritional Psychiatry: A Solution for Socioeconomic Disparities in Access to Mental Health Care?

As in all sectors of healthcare, socioeconomic status (SES) affects an individual’s ability to benefit from psychiatric care.Mood and anxiety disorders are the most common disorders for which psychiatric care is sought, and while there are options for effective treatments available, they are often accompanied by additional costs. Further to costs, issues with the heterogeneity of mental illness have led resarchers to explore other options for psychatric care. Nutritional psychiatry is an emerging field that uses dietary and nutritional approaches to target the gut-brain axis for the prevention and treatment of mental illness, including mood and axiety disorders. Nutritional psychiatry has been promoted as being an advantageous alternative to classic mental health treatments due to it’s broader accessibility, highlighting the lower costs associated with lifestyle changes than medication and psychotherapy. At a glance, this may appear accurate, but upon closer examination, may not be entirely true. Factors surrounding healthy eating, food deserts, the supplement industry, and adherence to lifestyle changes are all barriers present in nutritional psychiatry that are accompanied by added costs. These costs likely contribute to a disparity between low SES and high SES individuals benefitting from the treatment, in a similar way to classic treatments. This commentary reviews these factors to suggest that nutritional psychiatry may not be the accessible treatment option we purport it to be, and that as clinical researchers in the field, we must be aware of these disparities.

Widening Disparities Among Patients With Rheumatic Diseases in the COVID-19 Era: An Urgent Call to Action.

Recent data from multiple public health departments across the U.S. highlighting the disproportionate burden of COVID-19 infections in vulnerable populations serve as an urgent call to action. As rheumatologists, we are acutely aware of the higher morbidity and mortality, and for a number of our diseases, the higher incidence and prevalence among racial/ethnic minorities and individuals of lower socioeconomic status (SES). Comorbidities are frequent, timely access to subspecialty care is limited, receipt of high quality care is less common, and care is more often fragmented with frequent, avoidable acute care use.

Telehealth Conversion of Serious Mental Illness Recovery Services During the COVID-19 Crisis.

Telehealth Conversion of Serious Mental Illness Recovery Services During the COVID-19 Crisis.

Housework, health, and well-being in older adults: The role of socioeconomic status.

For most adults, household chores are undesirable tasks yet need to be completed regularly. Previous research has identified absolute hours spent on household chores and one's perceived fairness of the housework distribution as predictors of romantic relationship quality and well-being outcomes. Drawing from the Equity Theory, we hypothesized that perceived fairness acts as an underlying psychological mechanism linking household chores hours to long-term effects of relationship quality, well-being, physical health, and sleep quality in a sample of 2,644 married and cohabiting adults from the Midlife Development in the U.S. study. Additionally, following the Reserve Capacity Model, socioeconomic status (SES) was tested as a moderator because of its association with exposure to stressors and psychological resources which contribute to perceived fairness. Moderated mediation results showed significant indirect effects of household chore hours through perceived fairness on prospective measures of well-being, marital quality, physical health, and sleep dysfunction among individuals of lower SES but not higher SES when controlling for age, sex, and paid work hours. These results highlight the importance of perceived fairness and the influence of SES in the links among household chores and long-term relationship processes, health, and well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Feasibility of a social media-based weight loss intervention designed for low-SES adults.

Low-socioeconomic status (SES) individuals have higher rates of obesity. Social media platforms are used frequently by low-SES individuals and facilitate important weight loss program components including social support. Very few social media-based weight loss interventions, however, have enrolled or been tailored to low-SES participants. The purpose of this article is to examine the feasibility of a social media-based weight loss intervention among low-SES adults. We conducted a one-group pretest post-test pilot intervention study with two groups (group 1, n = 39, group 2, n = 16) of low-SES overweight/obese adults who were enrolled in a 12-week social media-based weight loss intervention including self-monitoring via Fitbits and participation in a private Facebook group. A moderator provided educational content and encouraged social support via Facebook. Descriptive statistics were used to assess intervention acceptability and engagement. Exploratory analyses were conducted to examine changes in study outcomes and engagement patterns. The study had good retention (86%). Among 55 total participants enrolled, there were 9,175 participant interactions within the Facebook group. Among completers (n = 47), 96% indicated they would recommend the intervention to a friend. Mean weight loss was 1.07 kg (SD = 3.96, p = .0498), and participants reported increases in positive dietary social support (mean = 2.47, SD = 5.09, p = .0007). Engagement in this social media-based pilot intervention was high and exceeded results from previous studies using similar formats. Participants evaluated the intervention favorably. Changes in weight loss and several theoretical mediators were in the desired direction. Overall, our results indicate social media groups as a platform for weight loss intervention delivery among low-SES adults are feasible and should be studied in larger randomized trials.

Socioeconomic determinants and disparities in sarcoidosis

The aim of this article is to describe the known health disparities that exist among patients with sarcoidosis by socioeconomic status, race, and gender, review potential contributors to health disparities in sarcoidosis, investigate the intersectionality among socioeconomic status, race, and gender in sarcoidosis, and outline a research agenda to address these disparities. Recent studies have reported the significant financial strain a diagnosis of sarcoidosis has on individuals and the disproportionate affect the strain has on low socioeconomic status individuals, Blacks, and females. Worse dyspnea, lower health-related quality of life, and higher rates of mortality and hospitalization are more common among those who are Black, female, or of low socioeconomic status. Health disparities in sarcoidosis by socioeconomic status, race, and gender have been described for decades. In this review, we describe potential contributors to health disparities including stress and propose interventions to address disparities including creating educational programs accessible for low-income patients and caregivers, targeting medication adherence and trust in physicians and the medical system, and ensuring access to high-quality care for all patients. As clinicians and researchers, we owe it to our patients to not only describe the health disparities that exist but also stimulate to achieve improvement in sarcoidosis.

Investigating the health disparities in the association between lifestyle behaviors and the risk of head and neck cancer.

Many studies have reported a positive association between lower socioeconomic status (SES) and higher head and neck cancer (HNC) risk. Fewer studies have examined the impact of SES on the association between alcohol or cigarette use and HNC risk. The current case‐control study (1104 HNC cases and 1363 controls) investigated the influence of education, a SES indicator, on the association between HNC and the use of alcohol, cigarettes, or betel quids in Taiwan, a country with universal health care. Our results showed a larger increase in HNC risk associated with alcohol among those with lower educational level (odds ratio [OR] = 2.07; 95% confidence interval [CI], 1.53‐2.80) than those with higher educational level (OR = 1.38; 95% CI, 1.04‐1.85) (heterogeneity‐P = .03). Educational level had an influence on the association between alcohol use and HNC risk among those with genetic susceptibility (ALDH2‐deficient) to the carcinogenic effect of alcohol. The association between cigarette or betel quid use and HNC risk was similar between the high and low educational groups. National policies and social interventions have led to the decline in the prevalence of cigarette and betel quid users in Taiwan. In contrast, due to the lack of adequate alcohol control policies, alcohol consumption in Taiwan has continued to rise. A higher impact of alcohol on HNC risk among lower SES individuals even with universal health care could be the result of insufficient alcohol control policies in Taiwan.

Intersecting vulnerabilities in human biology: Synergistic interactions between climate change and increasing obesity rates.

Increasing obesity rates and accelerating climate change represent two global health challenges shaped by lifestyle change and human environmental modifications. Yet, few studies have considered how these issues may interact to exacerbate disease risk. In this theory article, we explore evidence that obesity-related disease and climatic changes share socio-ecological drivers and may interact to increase human morbidity and mortality risks. Additionally, we consider how obesity-climate change interactions may disproportionately affect vulnerable populations and how anthropological research can be applied to address this concern. Interactions between heat stress and cardiometabolic disease represent an important pathway through which climate change and obesity-related morbidities may jointly impair health. For example, individuals with higher body fatness and obesity-related metabolic conditions (eg, type 2 diabetes) exhibit a reduced ability to dissipate heat. The risk of poor health resulting from these interactions is expected to be heterogeneous, with low- and middle-income countries, individuals of lower socioeconomic status, and minority populations facing a greater disease burden due to relative lack of resource access (eg, air conditioning). Moreover, older adults are at higher risk due to aging-associated changes in body composition and loss of thermoregulation capabilities. Few policy makers appear to be considering how interventions can be designed to simultaneously address the medical burden posed by increasing obesity rates and climate change. Anthropological research is well situated to address this need in a nuanced and culturally-sensitive way; producing research that can be used to support community resilience, promote holistic well-being, and improve health outcomes.

Does air pollution aggravate income inequality in China? An empirical analysis based on the view of health

Given the rapid development of the Chinese economy, especially its accelerated urbanization, air pollution and income inequality, as two of the most important global issues, have also become hot topics in China. However, limited attention has been devoted to understanding their joint evolution in the literature. In this study, we thus investigate the relationship between them using a multi-level nested data model, which enables us to estimate the long-run distribution effect of air pollution on individuals of different socioeconomic statuses, based on China’s city-level PM2.5 emissions and individual-level income. We further examine the mechanisms behind the evolution using a 3SLS model. The estimation results reveal that the increase in air pollution concentration has short-term positive production effects and long-term negative impacts on individual income, and will exacerbate the income inequality across socioeconomic statuses. Individuals of lower socioeconomic status have disadvantages in achieving efficient avoiding knowledge and measures. The results of 3SLS model confirm the existence of the health channel through which air pollution exerts influence on income inequality. These results provide a roadmap for policymakers. First, a comprehensive assessment of the health burden distribution from air pollution on individuals of different socioeconomic statuses should be considered for environmental policymaking. Second, the regional disparities and differences among income groups should also be considered during this process. Third, equal access to basic public services should be the primary target of environmental regulations. Moreover, compensation and assistance for the health issues caused by environmental pollution could be an important supplement to these regulations. Future study could do further analysis of the specific level of health burden due to different types of pollutants and their relationship with income inequality.

Sexual harassment by peers in Chilean schools

BackgroundAlthough a significant amount of literature has explored peer sexual harassment in higher education, little is known about peer sexual harassment in primary and middle school. Among existing studies, most have examined individual student characteristics that predict peer sexual harassment without considering the importance of the classroom and school context, which may prevent or promote such harassment. ObjectiveThe purpose of this study was to identify individual and school-related factors predicting sexual harassment victimization. MethodsA sample of 17,364 Chilean students from Grades 5 through 8 in 405 schools with low socioeconomic status answered instruments concerning peer sexual harassment, other types of peer victimization and discrimination, and perceptions of classroom and school climate and norms against sexual harassment. Data were analyzed through hierarchical multivariate regression. ResultsExperiences of being sexual harassed by other students were reported by 13.5 % of students, with higher frequencies in male students, students from Grades 5 and 6, and students with lower individual socioeconomic status. School-related experiences of being discriminated against due to sexual orientation, ethnic origin, and disability were the strongest predictors of sexual harassment victimization. ConclusionWe discuss how peer sexual harassment might be understood as a consequence of peer social discrimination based on sexism, racism, and ableism. We also discuss the need to provide inclusive school climate policies that allow all students to feel safe and included.

The diffusion of innovative diabetes technologies as a fundamental cause of social inequalities in health. The Nord-Trøndelag Health Study, Norway.

This study investigates patterns of adoption and diffusion of innovative health technologies by socioeconomic status (SES) in order to assess the extent to which these technologies may be a fundamental cause of health-related inequalities. Quantitative analyses examined SES-based inequalities in the adoption and diffusion of diabetes technologies. Diabetes data from three panels of the Nord-Trøndelag Health Study (HUNT), Norway, were combined with income and education data. Cross-sectional and longitudinal regression analyses were used to examine relevant inequalities. Cross-sectional analyses suggest often present SES-based gradients in the adoption of diabetes technologies, favouring high-SES groups. Statistically significant differences (p≤0.05) were most often present when technologies were new. In a cohort followed from 1984 to 1997, high SES individuals were more likely to adopt insulin injection technologies but, due to modest sample sizes, these inequalities were not statistically significant after adjusting for age, gender, and duration of illness. Moreover, compared to low SES individuals, high SES individuals are more active users of diabetes technologies. Results suggest that SES-based variations in access and use of innovative health technologies could act as a mechanism through which inequalities are reproduced. This study provides a discussion of mechanisms and a methodological foundation for further investigation.

Neighbourhood property value and type 2 diabetes mellitus in the Maastricht study: A multilevel study.

Low individual socioeconomic status (SES) is known to be associated with a higher risk of type 2 diabetes mellitus (T2DM), but the extent to which the local context in which people live may influence T2DM rates remains unclear. This study examines whether living in a low property value neighbourhood is associated with higher rates of T2DM independently of individual SES. Using cross-sectional data from the Maastricht Study (2010-2013) and geographical data from Statistics Netherlands, multilevel logistic regression was used to assess the association between neighbourhood property value and T2DM. Individual SES was based on education, occupation and income. Of the 2,056 participants (aged 40-75 years), 494 (24%) were diagnosed with T2DM. Individual SES was strongly associated with T2DM, but a significant proportion of the variance in T2DM was found at the neighbourhood level (VPC = 9.2%; 95% CI = 5.0%-16%). Participants living in the poorest neighbourhoods had a 2.38 times higher odds ratio of T2DM compared to those living in the richest areas (95% CI = 1.58-3.58), independently of individual SES. Neighbourhood property value showed a significant association with T2DM, suggesting the usefulness of area-based programmes aimed at improving neighbourhood characteristics in order to tackle inequalities in T2DM.

Pivoting Research to COVID-19.

Pivoting Research to COVID-19.