Lower Levels Of Socioeconomic Status Research Articles

Abstract P201: Rural/Urban Differences in the Prevalence of Stroke Risk Factors

Introduction: Despite previously reported higher stroke (and heart disease) mortality in rural areas, there are few data on the presence or magnitude of rural-urban disparities in the prevalence of stroke risk factors. Methods: Participants (n = 28,242) of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study were categorized into the 6-level ordinal National Center for Health Statistics Urban-Rural Classification Scheme. The prevalence of 6 traditional risk factors (hypertension, diabetes, cigarette smoking, atrial fibrillation, left ventricular hypertrophy and heart disease) and estimated 10-year risk of stroke (indexed by the Framingham Stroke Risk Function score) was assessed across the rural-urban scale in models adjustment for demographic factors (age, race, sex, and state of residence) and after further adjustment for community-level socioeconomic status disadvantage. Results: Hypertension, diabetes and heart disease were all more prevalent in rural regions (p < 0.05); with respective odds 1.25-times (95% CI: 1.11 - 1.42), 1.15-times (95% CI: 0.99 - 1.33), and 1.19-times (95% CI: 1.02 - 1.39) greater in the most rural as compared to the most urban regions (see Table). The estimated 10-year risk of stroke was also greater in rural areas; however, the estimated magnitude of increased stroke risk was relatively small. Adjustment for neighborhood-level socioeconomic status disadvantage attenuated some, but not all, of these relationships (for example, hypertension OR: 1.25 to 1.21, diabetes OR: 1.15 to 1.00, heart disease OR: 1.19 to 1.10). Discussion: These data suggest that while some of the increased stroke mortality in rural areas may be due to an increased burden of stroke risk factors in rural areas, the contribution of risk factors is quite inconsistent across the rural-urban spectrum. This association was attenuated by the adjustment for socioeconomic status, which suggests that some of the higher stroke risk in rural counties may be due to their lower level of socioeconomic status.

Parental socioeconomic status and the neural basis of arithmetic: differential relations to verbal and visuo-spatial representations.

We examined the relation of parental socioeconomic status (SES) to the neural bases of subtraction in school-age children (9- to 12-year-olds). We independently localized brain regions subserving verbal versus visuo-spatial representations to determine whether the parental SES-related differences in children's reliance on these neural representations vary as a function of math skill. At higher SES levels, higher skill was associated with greater recruitment of the left temporal cortex, identified by the verbal localizer. At lower SES levels, higher skill was associated with greater recruitment of right parietal cortex, identified by the visuo-spatial localizer. This suggests that depending on parental SES, children engage different neural systems to solve subtraction problems. Furthermore, SES was related to the activation in the left temporal and frontal cortex during the independent verbal localizer task, but it was not related to activation during the independent visuo-spatial localizer task. Differences in activation during the verbal localizer task in turn were related to differences in activation during the subtraction task in right parietal cortex. The relation was stronger at lower SES levels. This result suggests that SES-related differences in the visuo-spatial regions during subtraction might be based in SES-related verbal differences.

Racial Discrimination, John Henryism, and Depression Among African Americans.

Evidence from previous studies indicates that racial discrimination is significantly associated with depression and that African Americans with higher levels of socioeconomic status (SES) report greater exposure to racial discrimination compared to those with lower SES levels. Coping strategies could alter the relationship between racial discrimination and depression among African Americans. This study first examined whether greater levels of SES were associated with increased reports of racial discrimination and ratings of John Henryism, a measure of high-effort coping, among African Americans. Second, we examined whether high-effort coping moderated the relationship between racial discrimination and depression. Data were drawn from the National Survey of American Life Reinterview (n = 2,137). Analyses indicated that greater levels of education were positively associated with racial discrimination (p < .001) and increased levels of racial discrimination were positively related to depression (p < .001), controlling for all sociodemographic factors. Greater levels of John Henryism were associated with increased odds of depression but there was no evidence to suggest that the relationship between discrimination and depression was altered by the effects of John Henryism.

Factor affecting the utilization of Antenatal care services among pregnant women at District Headquarter Hospital, Mirpurkhas.

Background: In Pakistan every year 276/100,000 women die during pregnancy related causes, which can beavoided by receive of medical care before (antenatal), during (intranatal) and after (post-natal) childbirth. Thisstudy was design to find out prevalence of Ante natal care (ANC) services and factors associated with its utilization among the pregnant women of rural Sindh.Methodology: It is a hospital based cross sectional study, conducted at District Mirpurkhas in June-August2010. A total of 464 multigravida pregnant women attending antenatal clinic were selected by systematic randomsampling. For data collection face to face Interview was conducted by using a pre-tested semi-structured questionnaire. The variables assess were demographic characteristics, socioeconomic status, and ANC services utilization with reasons of inadequate utilization.Results: Among 464 respondents n=119 (25.7%) didn't received ANC services during last pregnancy due tomultiple reasons lack of awareness n=44 (34.4%) financial constrain n=40 (33%), lack of personal interest n=39(32.5%), busy schedule n=21 (16%), difficulty in access n=25 (21%), shame and embracement n=17(14%),family restriction n=14 (11.6%), fear of illness &amp; preference for traditional practices n=15 (12.6%). Amongtotal6l.6% complain they wait&gt; 2 Hrs. The utilization of services was more in literate respondents n;::365 (85%).Conclusion: The study showed that low level of ANC coverage. The main reason was identify limited knowledge,preference on traditional practices, &amp; low level of socioeconomic status. There is need to uplift the quality of services, socio-economic status &amp; level of awareness are recommended.Keywords: ANC, Reason of low coverage, level of satisfactions.

Country-specific dietary patterns and associations with socioeconomic status in European children: the IDEFICSstudy.

Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. Two to fourdietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereasthe 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food itemprofiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies.

Studying Displacement After a Disaster Using Large-Scale Survey Methods: Sumatra After the 2004 Tsunami

Understanding of human vulnerability to environmental change has advanced in recent years, but measuring vulnerability and interpreting mobility across many sites differentially affected by change remains a significant challenge. Drawing on longitudinal data collected on the same respondents who were living in coastal areas of Indonesia before the 2004 Indian Ocean tsunami and were reinterviewed after the tsunami, this article illustrates how the combination of population-based survey methods, satellite imagery and multivariate statistical analyses has the potential to provide new insights into vulnerability, mobility, and impacts of major disasters on population well-being. The data are used to map and analyze vulnerability to post-tsunami displacement across the provinces of Aceh and North Sumatra and to compare patterns of migration after the tsunami between damaged areas and areas not directly affected by the tsunami. The comparison reveals that migration after a disaster is less selective overall than migration in other contexts. Gender and age, for example, are strong predictors of moving from undamaged areas but are not related to displacement in areas experiencing damage. In our analyses, traditional predictors of vulnerability do not always operate in expected directions. Low levels of socioeconomic status and education were not predictive of moving after the tsunami, although for those who did move, they were predictive of displacement to a camp rather than a private home. This survey-based approach, although not without difficulties, is broadly applicable to many topics in human–environment research and potentially opens the door to rigorous testing of new hypotheses in this literature.

Prevalence and associated factors of microalbuminuria in Chinese individuals without diabetes: cross-sectional study

ObjectiveTo investigate the prevalence of microalbuminuria (MAU) among Chinese individuals without diabetes and the relationship between MAU and metabolic factors, individual socioeconomic status (SES), and regional economic development level.DesignCross-sectional study...

THE ASSOCIATION BETWEEN ADULT MORTALITY RISK AND FAMILY HISTORY OF LONGEVITY: THE MODERATING EFFECTS OF SOCIOECONOMIC STATUS

Studies consistently show that increasing levels of socioeconomic status (SES) and having a familial history of longevity reduce the risk of mortality. But do these two variables interact, such that individuals with lower levels of SES, for example, may experience an attenuated longevity penalty by virtue of having long-lived relatives? This article examines this interaction by analysing survival past age 40 based on data from the Utah Population Database on an extinct cohort of men born from the years 1840 to 1909. Cox proportional hazards regression and logistic regression are used to test for the main and interaction mortality effects of SES and familial excess longevity (FEL), a summary measure of an individual's history of longevity among his or her relatives. This research finds that the mortality hazard rate for men in the top 15th percentile of occupational status decreases more as FEL increases than it does among men in the bottom 15th percentile. In addition, the mortality hazard rate among farmers decreases more as FEL increases than it does for non-farmers. With a strong family history of longevity as a proxy for a genetic predisposition, this research suggests that a gene-environment interaction occurs whereby the benefits of familial excess longevity are more available to those who have occupations with more autonomy and greater economic resources and/or opportunities for physical activity.

AB1347 Influence of low socioeconomic status on autoimmune rheumatic diseases

ObjectivesTo analyze the influence of socioeconomic status (SES) on the course of autoimmune rheumatic diseases (AIRD) in an admixed and socio demographic heterogeneous population.MethodsThis was a cross-sectional analytical study in...

A Study on Relationship between Socio-demographic Factors and Food Consumption Frequencies among Adolescents in South Korea: Using the Korea Youth Risk Behavior Web-based Survey from 2011

The objective of this study was to analyze the influence of socio-demographic factors on food consumption frequencies among adolescents in Korea. Data were obtained from the Seventh Korea Youth Risk Behavior Web-based Survey (2011 KYRBS), a nationwide representative sample of 75,643 (37,873 males and 37,770 females) middle and high school students. It was carried out as a self-administered on-line survey. The frequency of eating breakfast was 4.8 times per week for middle school students and 4.6 times per week for high school students (p < 0.001). Higher levels of perceived household economic status, family affluence scale (FAS) and education attainment of mother were associated with more frequent breakfast eating. The frequencies of consumption of vegetables and milk were higher in males than in females (p < 0.001). The frequency of consumption fruits was higher in females than in males (p < 0.01). Higher levels of perceived household economic status, FAS and education attainment of mother were associated with more frequent consumption of vegetable, fruits and milk. The frequencies of consumption of soda, fast food and instant noodls were higher in males than in females (p < 0.001). The frequency of consumption of snacks was higher in females than in males. Adolescents with lower levels of FAS and education attainment of mother were at risk for skipping breakfast and consuming of soda, fast food and instant noodls more frequently. Whereas, adolescents with higher levels of FAS, education attainment of mother were more likely to be frequent consumers of vegetable, fruits and milk. These findings demonstrated that being high school students and belonging to lower level of socio-economic status (SES) were associated with undesirable food habits. (Korean J Community Nutr 18(2) : 165~176, 2013)

Adolescent work intensity, school performance, and substance use: Links vary by race/ethnicity and socioeconomic status.

High school students who spend long hours in paid employment during the school year are at increased risk of lower grades and higher substance use, although questions remain about whether these linkages reflect causation or prior differences (selection effects). Questions also remain about whether such associations vary by socioeconomic status (SES) and race/ethnicity. This study examines those questions using nationally representative data from two decades (1991-2010) of annual Monitoring the Future surveys involving about 600,000 students in 10th and 12th grades. White students are consistently more likely than minority students to hold paid employment during the school year. Among White and Asian American students, paid work intensity is negatively related to parental education and grade point averages (GPA) and is positively related to substance use. Also among Whites and Asian Americans, students with the most highly educated parents show the strongest negative relations between work intensity and GPA, whereas the links are weaker for those with less educated parents (i.e., lower SES levels). All of these relations are less evident for Hispanic students and still less evident for African American students. It thus appears that any costs possibly attributable to long hours of student work are most severe for those who are most advantaged--White or Asian American students with highly educated parents. Working long hours is linked with fewer disadvantages among Hispanic students and especially among African American students. Youth employment dropped in 2008-2010, but the relations described above have shown little change over two decades.

Assessment of Physical Quality of Life Domain of Adolescents with Acute Lymphocytic Leukemia at Teaching Hospitals in Baghdad City

Objective(s): To assess the physical quality of life's domain of adolescents with acute lymphocytic leukemia at teaching hospitals in Baghdad city and find out the relationships between the physical quality of life domain of adolescents with acute lymphocytic leukemia and their demographic characteristics. Methodology: The study started from the period of 20th November 2011 to 2nd July 2012. A non- probability (purposive) sample of 50 patients was selected from adolescents with ALL. The questionnaire was designed and composed of two parts: the first part includes three sections deal with the adolescent demographic data, disease related information and socio-economic status scale, second include physical quality of life domain. And determined reliability of the questionnaire through a pilot study and determined validity through a panel of (22) experts. The data was collected through questionnaire and semi-structured interviews. The data were described statistically and analyzed through use of the descriptive and inferential statistical analysis procedures. Result: The findings of the present study indicate that (58%) were male, (56%) of the total sample are within the age groups (15-19) years, and (49%) of ALL adolescents were from family of low level of socioeconomic status. While physical domain of the quality of life for these adolescents affected at moderate level. Conclusion: The study concludes that the acute lymphocytic leukemia most occurs in male than in females. Acute lymphocytic leukemia most common occurs among adolescents in urban residential area. Also the study confirmed that the acute lymphocytic leukemia affects negatively on the physical QoL domain of adolescent. Recommendation: The study recommended the establishment of hematology and oncology center, an education program for adolescents with ALL started to help them live a better life

The influence of socioeconomic status on the predictive power of self-rated health for 6-year mortality in English and Brazilian older adults: the ELSA and Bambui cohort studies

PurposeThere is mixed evidence that socioeconomic status (SES) affects the predictive power of self-rated health (SRH) for mortality. We sought to compare the predictive value of SRH for 6-year mortality in English and Brazilian older adults, and to assess whether this association varies by SES in these populations. MethodsData came from the English and the Bambui (Brazil) cohort studies of aging. Potential confounding variables included sociodemographic characteristics, lifestyle, self-reported diseases, physical functioning, mental symptoms, and selected biomarker measures. ResultsParticipants were 5183 English and 1499 Brazilians aged 60 years and over. Low health ratings were independently associated with subsequent mortality in both populations. However, the predictive power of poor SRH for death was much higher for English (a population with higher SES level) than for Brazilians (adjusted hazard ratios 4.45 [95% confidence interval, 3.04–6.51] and 1.88 [1.25–2.81], respectively). In both populations, the predictive value of SRH for mortality was higher among those in the highest income tertile. ConclusionsOur results suggest that the association between SRH and mortality is underestimated in populations and in subgroups of population with low SES level. Further international research is needed to examine the generalizability of this pattern.

Using the Framingham Risk Score to Evaluate Immigrant Effect on Cardiovascular Disease Risk in Mexican Americans

This study uses the Framingham Risk Score (FRS) for 10-year cardiovascular disease (CVD) to evaluate differences between Mexican American immigrants and the U.S.-born population. Data from the Cameron County Hispanic Cohort (N=1,559). Average total risk scores were generated by age group for each gender. Regression analysis was conducted adjusting for covariates and interaction effects. Both women and men in the CCHC sample who were long-term immigrant residents (mean FRS scores women 4.2 with p<.001 vs. men 4.0 with p<.001) or born in the U.S. (mean FRS scores women 4.6 with p<.001 vs. men 3.3 with p<.001) had significantly higher risk scores than immigrants who had only been in this country for less than 10 years. The interaction model indicates that differences between immigrant and native-born Mexican Americans are most greatly felt at lowest levels of socioeconomic status for men in the CCHC. This study suggests that in terms of immigrant advantage in CVD risk, on whom, where, and how the comparisons are being made have important implications for the degree of difference observed.

European ancestry decreases the risk of early onset, severe lupus nephritis in a single center, multiethnic pediatric lupus inception cohort

To determine whether pediatric SLE patients without European ancestry are at higher risk for development of severe lupus nephritis (ISN/RPS class III, IV or V). Ninety-eight of 101 patients with pediatric SLE (age <18 years at diagnosis) were enrolled. Race/ethnicity of four grandparents, socioeconomic status (SES) and language proficiency were collected. The primary outcome was time to development of severe lupus nephritis. Based on patient report of four grandparent ancestry, 29% had at least one grandparent of European ancestry (14% had all four grandparents of European ancestry). Patients without European ancestry were 46% Hispanic, 47% Asian, and 3% African American. In the entire 98 patient cohort, 12% had ≥3 different ancestries. Patients without European ancestry had significantly lower SES levels and English proficiency. There was no significant difference between patients with or without European ancestry in duration of SLE, age of onset, and lag time between symptoms and diagnosis. Patients with at least one grandparent of European ancestry had a decreased risk of developing severe lupus nephritis, which remained significant after controlling for age, gender, SES and English proficiency (hazard ratio 0.4, 95% confidence interval 0.2-0.9). This study demonstrates that presence of at least one grandparent of European ancestry decreases the risk of severe lupus nephritis, a finding that is not explained by measurable socioeconomic differences and language barriers.

Self-medication behaviors among Japanese consumers: sex, age, and SES differences and caregivers’ attitudes toward their children’s health management

BackgroundSince 2009, when the revised Pharmaceutical Affairs Act was enacted in Japan, self-medication practices have increased. Because the concept of self-medication was recently introduced in Japan, few studies exist on this topic. Therefore, it is necessary to explore how self-medication is practiced. This study examined Japanese consumers’ self-medication practices and attitudes toward over-the-counter (OTC) medicines based on their sex, age, and socioeconomic status (SES).MethodsThe participants were 403 adults (Mage = 41.1 years, SD = 16.22). A quota sampling method was employed based on age group, and participants completed an online questionnaire.ResultsParticipants in the 20–29 age group reported medical costs as an obstacle in seeing a doctor; in contrast, transportation was a mitigating factor for elderly people. Regarding SES, people at lower SES levels chose to rest instead of seeing a doctor or purchasing over-the-counter (OTC) medicines when sick. They also placed more value on national brand OTC medicines than private brands (likely due to advertisements). This finding suggests individuals with a low SES do not select OTC medicines based on their effects or ingredients. Regarding attitudes toward OTC medicines, Japanese participants seemed to be unaware of the potential for abuse and side effects associated with OTC medicines. Finally, in relation to caregivers’ self-medication practices for their children, the majority of participants reported taking their children to the hospital since children tend to receive free medical care. Furthermore, caregivers with a high educational background are more confident in being able to help manage their children’s health.ConclusionsOur results suggest that health and medical discrepancies among Japanese consumers pose new social problems. In Japan, universal health care is available, but the cost of receiving medical care is not completely free of charge. Thus, we hope that the government will attempt to meet the various needs of patients and support their well-being. Consumers also have to be more independent and aware of their health management, as self-medication practices will continue to play a more significant role in healthcare. More research is needed to find ways to teach Japanese consumers/patients of both the benefits and risks of over-the-counter (OTC) medicines.

Comparison of Socioeconomic Status and Body Composition of Dietary Energy Under-Reporting and Non-Under-Reporting Youth

1. Characteristics of energy intake under-reporting in French adults Vanrullen Berta, Jean-Luc Volatier, Aurélie Bertaut, Ariane Dufour, Jean Dallongeville British Journal of Nutrition CrossRef

노인소비자의 구매문제 인식 유형과 관련변수: 울산광역시를 중심으로

This paper measured elderly consumers' perceptions of purchasing problems, and classified elderly consumers into 5 categories of purchasing problems using cluster analysis, and analyzed the relationships between the elderly consumers' perception type, socio economic variables, activities of daily living, and activities of healthy living. The data was collected from 500 elderly consumers in Ulsan Metropolitan City. Three clusters were extracted. 56.4% of the sample was included in 'redress and contract problems group', and 22.6% of the sample was included in 'less perception of purchasing problems group, and 21.0% of the sample was included in 'the perception of strong purchasing problems group. The elderly consumers' perception type of purchasing problems were related with socio-economic variables such as sex, existence of a spouse, the number of family living together, the number of children, education, the average monthly household income and allowance, activities of daily living, and activities of healthy living. The redress and contract problems group was found to be of midium level in socio-economic and health status, and included more females and less spouselessness. The perception of less purchasing problems group was found to be the highest level in socio-economic status, and included more males and less spouselessness. The perception of strong purchasing problems group was found to be at the lowest level of socio-economic status.

Disparities in hepatocellular carcinoma survival among Californians of Asian ancestry, 1988 to 2007.

Hepatocellular carcinoma (HCC) represents a significant health disparity affecting Asian Americans, a population comprised of distinct ethnic groups. The purpose of this article is to analyze Californians of Asian ancestry with HCC with respect to socioeconomic status, demographic factors, stage of disease, treatment received, and survival. To investigate ethnic differences in survival, we analyzed ethnically disaggregated data from 6,068 Californians of Asian ancestry with HCC diagnosed in 1988 to 2007 and reported to the California Cancer Registry. Compared with the average of all ethnic groups, cause-specific mortality was significantly higher among Laotian/Hmong [hazard ratio, 2.08; 95% confidence interval (95% CI), 1.78-2.44] and Cambodian patients (hazard ratio, 1.26; 95% CI, 1.06-1.51), groups with higher proportions of their populations at low levels of socioeconomic status; in addition, Laotian/Hmong patients disproportionately presented at later stages of disease, with only 3% receiving local surgical treatment, resection, or liver transplantation. After adjustment for time of diagnosis, age at diagnosis, gender, geographic region, stage at diagnosis, type of surgery, and socioeconomic status, survival disparities remained for both groups (Laotian/Hmong hazard ratio, 1.51; 95% CI, 1.28-1.79; Cambodian hazard ratio, 1.24; 95% CI, 1.03-1.48). Our hypothesis that survival outcomes would differ by ethnicity was verified. Research is needed not only to develop more effective treatments for HCC but also to develop community-based interventions to recruit Asian Americans, particularly Laotian/Hmong and Cambodians, for hepatitis B screening and into medical management to prevent or detect this tumor at an early stage.

Epidemiology of Uninvestigated Gastrointestinal Symptoms in Adolescents: A Population‐based Study Applying the Rome II Questionnaire

: Gastrointestinal (GI) disorders in early life contribute to a lower quality of life and more persistent GI symptoms during the rest of life. Epidemiologic data on adolescence GI disorders are scarce. We aimed to perform a population-based study to assess the prevalence of GI symptoms in adolescents and their relation to sex, age, and socioeconomic status. : A multistage random sample of Tehran middle and high school students (ages 14-19 years) was selected. A validated Persian version of the Rome II questionnaire was used to measure the frequency of different GI disorders as well as demographic socioeconomic variables. : A total of 1436 participants were enrolled in the study, 736 (51.3%) of whom were men. Mean (SD) age was 16.9 (1.8) years. The frequency of at least 1 GI symptom was 32.4%. The 4 most prevalent GI symptoms were bloating (16.9%), heartburn (4.9%), incontinence (4.3%), and irritable bowel syndrome (4.1%). Bloating, irritable bowel syndrome, and proctalgia fugax were significantly more common in girls (P < 0.05). Incontinence was significantly more prevalent in lower socioeconomic status levels (P = 0.01). In logistic regression, age was a risk factor for abdominal bloating and dysphagea and a protective factor for incontinence. : Our study indicates that GI symptoms are common among adolescents. Girls are more prone to these disorders. Special psychological and medical interventions are necessary for high-risk groups.