Low Socioeconomic Neighborhoods Research Articles

Can Improved Environments Alone Ensure Well-Being for Older Adults? Exploring Aging in Disadvantaged Neighborhoods

The concept of aging in place has gained prominence in urban planning, yet few studies have specifically examined the impact of neighborhood environments on the subjective well-being (SWB) of older adults in disadvantaged areas. This study addresses this gap by comparing the SWB of residents in four low socioeconomic neighborhoods in Xi’an, China—two urban renewal areas with improved environments and two traditional neighborhoods with poor conditions. Using surveys, interviews, and statistical analysis, our study uncovers significant insights into the relationship between the built environment and SWB. Surprisingly, residents in urban renewal neighborhoods with better physical environments report lower residential satisfaction and a diminished sense of community. Our findings further suggest that perceptions of the built environment might have a greater influence on older adults’ well-being than objective conditions. In particular, perceived living convenience and affordability are two factors significantly associated with the SWB of older adults in these disadvantaged neighborhoods. These results emphasize the need for planning strategies that integrate both “hard” physical improvements and “soft” measures that enhance social connections, psychological experiences, and neighborhood identity. Additionally, our research reveals that the built environment factors influencing SWB are consistent across age groups, underscoring the potential benefits of developing age-friendly communities that serve all generations. The implications of this study provide valuable guidance for urban planners and policymakers in creating neighborhoods that effectively promote the well-being of older adults.

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

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

Neighborhood Socioeconomic Deprivation is Associated with Worse Outcomes in Pediatric Kidney Transplant Recipients.

Social determinants of health shape a child's transplant course. We describe the association between neighborhood socioeconomic deprivation, transplant characteristics, and graft survival in US pediatric kidney transplant recipients. US recipients <18 years of age at listing transplanted January 1st, 2010, to May 31st, 2022 (N=9,178) were included from the Scientific Registry of Transplant Recipients. Recipients were stratified into three groups according to Material Community Deprivation Index score, with greater score representing higher neighborhood socioeconomic deprivation. Outcomes were modeled using multivariable logistic regression and Cox proportional hazards models. Twenty-four percent (N=110) of recipients from neighborhoods of high socioeconomic deprivation identified as being of Black race, versus 12% (N=383) of recipients from neighborhoods of low socioeconomic deprivation. Neighborhoods of high socioeconomic deprivation had a much greater proportion of recipients identifying as being of Hispanic ethnicity (67%, N=311), versus neighborhoods of low socioeconomic deprivation (17%, N=562). The hazard of graft loss was 55% higher (aHR 1.55, 95% CI: 1.24, 1.94) for recipients from neighborhoods of high versus recipients from low socioeconomic deprivation neighborhoods when adjusted for base covariates, race and ethnicity, and insurance status, with 59% lower odds (aOR 0.41, 95% CI: 0.30, 0.56) of living donor transplantation and, although not statistically significant, 8% lower odds (aOR 0.92, 95% CI: 0.72, 1.19) of preemptive transplantation. The hazard of graft loss was 41% higher (aHR 1.41, 95% CI: 1.25, 1.60) for recipients from neighborhoods of intermediate versus recipients from low socioeconomic deprivation neighborhoods when adjusted for base covariates, race and ethnicity, and insurance status, with 27% lower odds (aOR 0.73, 95% CI: 0.66, 0.81) of living donor transplantation and 11% lower odds (aOR 0.89, 95% CI: 0.80, 0.99) of preemptive transplantation. Children from neighborhoods of high socioeconomic deprivation have worse graft survival and lower utilization of preemptive and living donor transplantation. These findings demonstrate inequities in pediatric kidney transplantation that warrant further intervention.

Rethinking the Social Determination of Food in Chile Through Practices and Interactions of Actors in Food Environments: Nonexperimental, Cross-Sectional Study.

Food environments are crucial for promoting healthy and sustainable eating and preventing obesity. However, existing food environment frameworks assume an already installed causality and do not explain how associations in food environments are established or articulated, especially from an integrative and transdisciplinary approach. This research attempts to bridge these gaps through the use of Actor-Network Theory, which traces the relationship network between human (and nonhuman) actors in order to describe how these interact and what agencies (direct or remote) are involved. This study aims to explain the practices and interactions of actors in food environments in order to approach the problem of unhealthy eating with a transdisciplinary approach. This is a nonexperimental, cross-sectional study. Due to the complexity of the study phenomena, a mixed methods approach with 4 consecutive phases will be developed in Chile. Phase 1 involves a systematic literature review of food environment evidence since 2015, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol; phase 2 involves the application of a shortened version of the Nutrition Environment Measure Scale-Perceptions adapted to Chile (NEMS-P-Ch) in 2 neighborhoods with different socioeconomic levels; in phase 3, six focus groups in each neighborhood will be conducted to address social determinants such as gender, employment status, and migration; and in phase 4, participant observation and in-depth interviews will be used to analyze the direct and empirical exploration of the actors in their daily interaction with food environments. The triangulation and complementarity of the data will allow us to create a practical model about the practices and interactions of actors in their food environments, which reflects the complexity and transdisciplinary nature of the study. We have advanced in phases 1-3 of the study. In phase 1, a total of 109 manuscripts are being revised for data extraction. In phase 2, we applied the NEMS-P-Ch to 785 people, 49.4% (388/785) of whom belong to a low socioeconomic neighborhood. Participants from phase 2 are being contacted to participate in the focus groups (phase 3). By the end of July, we have conducted 6 focus groups with 5-11 participants. This study will provide a comprehensive understanding of how individuals interact with their food environments, offering deep insights into the factors influencing their food-related decisions. In addition, the study aims to develop a model that more accurately reflects reality by examining not only the food environments themselves but also the interactions among various stakeholders within these environments and their daily practices. The findings of this study will offer evidence-based insights to inform public policies tailored to the specific territories and communities under investigation or those with similar characteristics. DERR1-10.2196/62765.

Building a healthy generation together: parents’ experiences and perceived meanings of a family-based program delivered in ethnically diverse neighborhoods in Sweden

Introduction and aimEthnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents’ experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden.MethodsResearchers’ engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis.ResultsThe analysis resulted in three main themes and seven sub-themes representing different aspects of the program’s meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls’ physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences.ConclusionsThe program’s activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.

Congenital Anomalies among Offspring of Women Living in Low Socioeconomic Status Neighborhoods or Hispanic/Latino Enclaves, Texas, 1999-2018

Objectives and ApproachNeighborhood influences pregnancy outcomes through effects on maternal health. We evaluated prevalence of &gt;140 congenital anomalies monitored by the population-based Texas Birth Defects Registry among residents of Hispanic/Latino enclaves (census tracts with high proportions of Hispanic/Latino residents, immigrants, and Spanish-speaking households) and tracts with low socioeconomic status (low nSES). We included all cases regardless of pregnancy outcome (1999-2018) and a reference population of all livebirths, identified by linkage to Texas vital records. We calculated Yost socioeconomic index and Hispanic/Latino enclave index scores using linked U.S. Census Bureau data. We used Poisson regression to estimate the prevalence ratio (PR) and 95% confidence interval of anomalies among residents of: low nSES/enclave (34.5%); low nSES/non-enclave (25.6%); high nSES/enclave (4.6%); and high nSES/non-enclave (referent; 35.3%) tracts. We adjusted for maternal age, education, race/ethnicity, parity, and pre-pregnancy body mass index. ResultsLow nSES was associated with microcephaly, pulmonary artery anomalies, atrial septal defect, and Down syndrome (PRs 1.1-1.6), and inversely associated with hypospadias and other male genital anomalies (PRs 0.8-0.9). Offspring of women in low nSES enclaves were at increased risk of several congenital heart defects relative to those in other neighborhoods. Conversely, prevalence of hypospadias was lowest among offspring of women in low nSES enclaves. ConclusionsLinkage between a population-based registry, vital records, and Census Bureau data revealed novel associations between neighborhood characteristics and congenital anomalies. ImplicationsFurther research is warranted to understand mechanisms linking neighborhood factors to congenital anomalies.

Maternal immigrant status and survival among children with congenital heart disease

ObjectiveTo examine associations between maternal immigrant status and survival of children with congenital heart disease (CHD). ApproachA retrospective population-based cohort study of hospital live births between April 2002 to September 2020 in Ontario, Canada was conducted at ICES. We identified children aged 0-17 years with a diagnosis of CHD from inpatient and health services datasets. The exposure was maternal immigrant status obtained from the IRCC permanent resident database. The outcome was time-to-death from after birth to &lt;18 years olds. Multilevel Cox hazard regression models generated hazard ratios (HR) for associations between maternal immigrant status and children’s deaths while accounting for hospitals as a cluster factor and adjusting for maternal age at birth, neighbourhood income and education quantiles, comorbidities, a composite of severe maternal morbidity, gestational age at birth, birth weight, and infant sex. ResultsRelative to children born to non-immigrant mothers, the adjusted HR for death was 1.17 (95% CI:1.06-1.30) in children whose mothers were immigrants, and 1.33 (95% CI:1.07-1.65) in those from refugees. Moreover, compared to children residing in neighbourhoods with the highest income and educational levels, the adjusted HR of death for children who lived in neighbourhoods with the lowest income and educational level was 1.52 (95% CI: 1.24-1.88) and 1.47 (95% CI: 1.18-1.83) respectively. ConclusionChildren with CHD born to immigrant and refugee mothers, and those living in low socioeconomic status neighbourhoods had worse mortality. Health policy decision makers should target children with CHD from immigrant/refugee families and disadvantaged neighbourhoods to improve their survival.

Accessibility, neighborhood socioeconomic disadvantage and expenditures on electronic gambling machines: a spatial analysis based on player account data

BackgroundGambling and its harmful effects on human health and well-being represent a significant public health concern in many countries, with electronic gambling machines (EGMs) recognized as one of the most detrimental forms of gambling. Previous research has established an association between EGM accessibility, expenditure, gambling harm, and the socioeconomic status (SES) of neighborhoods. However, there is limited understanding of the direct impact of SES and EGM accessibility on individual player expenditures. Prior estimations of expenditure often rely on self-reported data or venue-level revenue statistics. This study uses high spatial resolution socioeconomic data together with individual-level account-based location and expenditure (point of sales) data (71,669 players, 745 EGM venues) to explore the association between EGM accessibility and neighborhood SES and to examine whether the EGM expenditure of neighborhood residents is associated with EGM accessibility and neighborhood SES.Data and methodsPlayer account data include information on the home location and expenditure of the entire EGM gambling population across every EGM venue located in the Helsinki region, Finland. High-resolution (250 × 250 m) grid-level data on socioeconomic variables were used to obtain the local socioeconomic conditions of the players. EGM accessibility was estimated for every grid cell using a calibrated gravity model derived from the player account data. Statistical analyses included correlation analysis, spatial autocorrelation analysis, and regression models.ResultsFirst, significantly higher levels of EGM accessibility were found in areas with lower local SES. Second, regression analysis revealed that both higher EGM accessibility and lower local SES were associated with higher annual losses per adult. These results, in combination with visual and spatial autocorrelation analyses, revealed that accessibility to EGM gambling is highly concentrated, especially in lower socioeconomic neighborhoods with higher levels of EGM expenditure.ConclusionsThe results lay the groundwork for future spatial research on gambling harm, expenditure, accessibility, and SES utilizing detailed account data on the interaction between players and venues. The results underscore the importance of spatial restrictions when regulating EGM accessibility, particularly in areas with vulnerable populations, as a crucial measure for public health and harm prevention. The results also enable targeted gambling harm prevention actions at the local level.

The relationship between mothers' body composition and anthropometric characteristics of baby and breast milk nutrient content: A cross-sectional study.

The composition and amount of breast milk is affected by factors such as the duration and frequency of breastfeeding, the time between two breastfeeding sessions, the effectiveness of breastfeeding, breastfeeding technique, genetic characteristics of the mother and diet. Breast milk macronutrients are provided by milk synthesized in lactocytes, mother's diet and maternal stores. This study was conducted to investigate the relationship between the body composition of mothers and the anthropometric characteristics of the baby and the nutritional content of breast milk. The descriptive study was conducted between March and November 2023 in a hospital in a low socioeconomic neighbourhood in Turkey. The study sample consisted of 96 mothers and ibabies. Anthropometric measurements of mothers and babies and the nutrient content of breast milk were evaluated on the first postpartum day, Days 5 and 15. Breast milk macronutrient content was analyzed by Miris milk analyzer and body composition of mothers was analyzed by TANITA BC 730. From the weight and body composition of the mothers in the study group; a positive correlation was found between body fat, muscle and water ratio, and breast milk carnonhydrate and protein (p < 0.05). There was no correlation between the gestational age of the baby and the content of breast milk (p > 0.05). A positive correlation was found between the weight and height of the babies and the macronutrients of breast milk (p < 0.05). As the weight of mothers increases, breast milk protein and carbohydrate levels increase. As breast milk macronutrients increase, babies' weight and height increase.

Neighborhood-level socioeconomic disparities in Radon testing in North Carolina from 2010 to 2020

Radon is a naturally occurring radioactive gas that poses significant health risks to humans, including increased risk of lung cancer. This study investigates the association of neighborhood-level socioeconomic variables with radon testing and radon exposure levels in North Carolina between 2010 and 2020. Our analysis of the two largest commercial household radon tests reveals that 67% of census tracts had testing rates below 10 tests per 1000 population, indicating low testing prevalence. Low radon levels (<2 pCi/L) were detected in 74.1% of the tracts (n = 1626), while medium levels of 2–4 pCi/L and ≥4 pCi/L were observed in 17.2% (n = 378) and 1.6% (n = 36) of the tracts. A generalized spatial regression model was employed to analyze the association between neighborhood-level socioeconomic variables and radon testing rates (per 1000 households), controlling for median radon testing results. The results show a positive correlation (P-value <0.001) of testing rate with various indicators of neighborhood affluence including education level, income, and occupation. In contrast, neighborhood disadvantage, including poverty, unemployment, and public assistance, was associated with a lower radon-testing rate (P-value <0.001). These findings highlight the need for targeted interventions to address socioeconomic disparities in radon testing and promote awareness and access to testing resources in lower socio-economic neighborhoods. Improving testing rates can effectively address radon-related health risks in North Carolina and across the U.S.

Help Me If You Can I’m Feeling Down: Supporting Children’s Emotion Regulation and Well-Being in the Primary Classroom

Children living in socioeconomically disadvantaged communities face distinct stressors when compared to those from more advantaged backgrounds. Research indicates higher levels of child well-being may buffer against the negative effects of stress and adversities, with supportive teacher behaviors playing a key role in promoting well-being. However, the mechanisms underlying these connections remain unclear. Extending past research linking teacher behaviours and well-being, the present study included emotion regulation as a potential candidate mechanism that might account for these connections. Questionnaire data were collected from 508 pupils (265 female, Mage = 9.9) in 31 classrooms across 8 primary schools in low-socioeconomic neighbourhoods of New Zealand. Utilising multilevel modelling the study found that teacher support significantly predicted emotion regulation and well-being, and that teacher support indirectly predicted well-being through emotion regulation. Both emotion regulation and teacher behaviours are amenable to intervention; thus, a better understanding of how they work together to predict well-being is likely to inform future intervention efforts to promote children’s well-being.

Relationships with teachers and sense of belonging in school: Inter- and intra-individual variations according to adolescent immigrant background

BackgroundSocial well-being arises from the fulfillment of the basic need for relatedness. In school, it largely hinges on teacher-student relationships (TSR) and sense of school belonging (SSB), two important levers for educational success, and especially for immigrant-background youths. AimsThis study aims to disentangle the stable and time-specific associations between the two dimensions of social well-being and test if these associations vary according to student immigrant status. SampleA cohort of 1070 students (51% female) from first- (22%), second- (29%), and third-plus generations (49%) attending 10 schools located in low-socioeconomic neighbourhoods was followed across three time points (grade 7, grade 9, grade 11). MethodMain objectives were tested using random-intercept cross-lagged panel models (RI-CLPM) using Mplus. RI-CLPM disaggregates observed scores into a time-invariant interindividual (stable) and intraindividual (time-specific) components. ResultsTeacher-student closeness was not associated with SSB at the interindividual level. However, autoregressive, cross-sectional, and longitudinally links were found at the intraindividual level for all students. Teacher-student conflict was associated with lower SSB at the interindividual level. These dimensions were also linked at the intraindividual level for third-plus-generation students only, while time-variant autoregressive associations for SSB were stronger for immigrant students. ConclusionsThe links between close TSR and SSB are cross-sectional and time-specific for all students. Conflictual TSR and SSB also showed time-specific and longitudinal associations for nonimmigrants only. For immigrants, we observed stronger time-specific carryover effects in terms of SSB. This research calls for yearly intervention efforts promoting social well-being among immigrants and nonimmigrants attending low-SES secondary schools.

Are All Apartments Equal? An Investigation of Contemporary Apartment Design Quality by Neighbourhood-Level Socioeconomic Disadvantage

ABSTRACT Rapid increases in apartment construction have ignited concerns about design quality. Lower income populations could be disproportionately impacted by poor design as they are more likely to live in apartments and have fewer resources to mitigate design problems. We examined whether there was a socioeconomic gradient in contemporary apartment design by measuring the implementation of quantifiable policy-specific requirements in buildings (n = 172) sampled from relatively low, mid, and high socioeconomic neighbourhoods within Sydney, Melbourne, and Perth. Findings suggest the presence (or absence) of detailed policy instruments interacts with local market conditions to impact apartment design quality.

One size doesn't fit all: methodological reflections in conducting community-based behavioural science research to tailor COVID-19 vaccination initiatives for public health priority populations.

Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs' response by providing insights into human behaviour and informing tailored strategies to enhance vaccination uptake. Community engagement can help broaden the reach of behavioural science research by involving a more diverse range of populations and ensuring that strategies better represent the needs of specific communities. We developed and applied an approach to conducting community-based behavioural science research with ethnically and socioeconomically diverse populations to guide PHUs in tailoring their strategies to promote COVID-19 vaccination. This paper presents the community engagement methodology and the lessons learned in applying the methodology. The community engagement methodology was developed based on integrated knowledge translation (iKT) and community-based participatory research (CBPR) principles. The study involved collaboration with PHUs and local communities in Ontario, Canada to identify priority groups for COVID-19 vaccination, understand factors influencing vaccine uptake and co-design strategies tailored to each community to promote vaccination. Community engagement was conducted across three large urban regions with individuals from Eastern European communities, African, Black, and Caribbean communities and low socioeconomic neighbourhoods. We developed and applied a seven-step methodology for conducting community-based behavioural science research: (1) aligning goals with system-level partners; (2) engaging with PHUs to understand priorities; (3) understanding community strengths and dynamics; (4) building relationships with each community; (5) establishing partnerships (community advisory groups); (6) involving community members in the research process; and (7) feeding back and interpreting research findings. Research partnerships were successfully established with members of prioritized communities, enabling recruitment of participants for theory-informed behavioural science interviews, interpretation of findings, and co-design of targeted recommendations for each PHU to improve COVID-19 vaccination uptake. Lessons learned include the importance of cultural sensitivity and awareness of sociopolitical context in tailoring community engagement, being agile to address the diverse and evolving priorities of PHUs, and building trust to achieve effective community engagement. Effective community engagement in behavioural science research can lead to more inclusive and representative research. The community engagement approach developed and applied in this study acknowledges the diversity of communities, recognizes the central role of PHUs, and can help in addressing complex public health challenges.

Living in a low socioeconomic status neighbourhood is associated with lower cumulative ongoing pregnancy rate after IVF treatment

Research questionDoes an association exist between neighbourhood socioeconomic status (SES) and the cumulative rate of ongoing pregnancies after 2.5 years of IVF treatment? DesignA retrospective observational study involving 2669 couples who underwent IVF or IVF and intracytoplasmic sperm injection treatment between 2006 and 2020. Neighbourhood SES for each couple was determined based on their residential postal code. Subsequently, SES was categorized into low (<p20), medium (p20–p80), and high (>p80). Multivariable binary logistic regression analyses were conducted, with the cumulative ongoing pregnancy within 2.5 years as the outcome variable. The SES category (reference category: high), female age (reference category: 32–36 years), body mass index (reference category: 23–25 kg/m2), smoking status (yes/no), number of oocytes after the first ovarian stimulation, embryos usable for transfer or cryopreservation after the first cycle, duration of subfertility before treatment and insemination type were used as covariates. ResultsA variation in ongoing pregnancy rates was observed among SES groups after the first fresh embryo transfer. No difference was found in the median number of IVF treatment cycles carried out. The cumulative ongoing pregnancy rates differed significantly between SES groups (low: 44%; medium: 51%; high: 56%; P < 0.001). Low neighbourhood SES was associated with significantly lower odds for achieving an ongoing pregnancy within 2.5 years (OR 0.66, 95% CI 0.52 to 0.84, P < 0.001). ConclusionLow neighbourhood SES compared with high neighbourhood SES is associated with reducing odds of achieving an ongoing pregnancy within 2.5 years of IVF treatment.

Marketing Strategies and Consumer and Sellers Perception About Oral Nicotine Pouches in Karachi, Pakistan.

Background: The availability of novel nicotine products like oral nicotine pouches (ONP) has been rising in South Asian countries, including Pakistan. We aimed to assess ONP marketing strategies at point-of-sale (POS) and understand the perceptions among consumers and sellers regarding its use in Karachi, Pakistan. Methods: We conducted a mixed-methods study in low, middle, and high socioeconomic neighborhoods of District East Karachi. For the quantitative component, we used a cross-sectional design, collecting data through observations and surveys. The observation checklist included items about advertising, product placement, display, and promotional aids. The survey questionnaire included questions on marketing tactics, product placement, and advertising strategies for ONP. For the qualitative component, we conducted in-depth interviews with ONP consumers and sellers to explore their perceptions and understand marketing strategies. Frequencies and percentages were used to report quantitative data, while thematic analysis was conducted for qualitative findings. Results: We observed 90 POS of ONP and found that 20% (n = 18) were located within 200meters of schools. ONP advertisements were found in 67% (n = 60) of the surveyed shops, 59% (n = 53) displayed ONP next to candy, and 70% (n = 63) displayed at child's eye level. A higher proportion of consumers (n = 66, 73%) use ONP as a cessation aid for tobacco. Most sellers (n = 48, 53%) were approached by the companies to sell ONP, and 40% received a commission while achieving the targets on ONP sell. About one-fourth of sellers (n = 21, 23%) reported selling ONP to students less than 18 years. Our qualitative findings revealed marketing strategies, peer influence, ease of use in tobacco-restricted areas, and the perception of reduced harm compared to cigarettes as key drivers of ONP consumption. Conclusion: Our study highlights a critical public health concern and offers valuable insights that could inform the development of policies to regulate tobacco sales.

The effects of neighborhood socioeconomic status on ADL/IADL among Chinese older adults-neighborhood environments as mediators.

There have been few consistencies in the effects and pathways of neighborhood socioeconomic status (SES) on functional limitations. This study aimed to investigate whether neighborhood socioeconomic status influences ADL/IADL in older residents in China through the neighborhood built environment and social environment. Activities of daily living/IADL were assessed in a sample of 5,887 Chinese individuals aged 60 or older, utilizing data obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS 2011). Neighborhood SES was measured by the neighborhood per-capita net income. Neighborhood built environment was measured by the security resources, motion resources, living resources, service resources for older adults, and medical resources of neighborhood. Neighborhood social environment was measured by the organizations, unemployment subsidies, minimum living allowance, subsidies to persons older than 65, and pensions to persons older than 80 of the neighborhood. The two-level logistical regression model and multilevel structural equation model (MSEM) were used. The rate of ADL/IADL loss among Chinese older adults aged 60 and above in 2011 were 32.17 and 36.87%, respectively. Neighborhood SES was significantly associated with ADL/IADL in older adults. Compared with the respondents living in communities with lower SES, those living in communities with higher SES possessed better ADL (β = -0.33, p < 0.05) and IADL (β = -0.36, p < 0.05) status. The path of neighborhood socioeconomic status on ADL was completely mediated by the neighborhood built environment (β = -0.110, p < 0.05) and neighborhood social environment (β = -0.091, p < 0.05). Additionally, the effect of neighborhood socioeconomic status on IADL was fully mediated by the neighborhood built environment (β = -0.082, p < 0.05) and neighborhood social environment (β = -0.077, p < 0.05). Neighborhood SES was significantly correlated with ADL/IADL through the neighborhood environment. Improving the ADL/IADL status of older adults residing in low socioeconomic neighborhoods requires enhancing the built and social environment by provisioning additional neighborhood resources.

Fighting for menstrual equity through period product pantries.

Menstruators facing period poverty often struggle with menstrual hygiene and waste management, which can result in harmful short- and long-term health outcomes such as urinary tract infections, yeast infections, and vulvar contact dermatitis. Research indicates that 42% of menstruators in the United States have difficulty affording period products. Traditional methods of distributing period products through social services may unintentionally undermine menstruators' agency, leading to disempowerment and inefficient resource allocation. Period product pantries are a novel approach aimed at addressing period poverty, inequity, and inadequate menstrual health education in the United States. This paper aims to examine the development, organization, and implementation of two distinct period product pantry networks in Ohio and New York. It seeks to compare the advantages and challenges of grassroots versus nonprofit-led models and to provide practical insights for future pantry operators. The study examines two models of period product pantries: a grassroots effort led by three local residents in Ohio and an initiative spearheaded by a nonprofit organization in New York. The design includes a comparative analysis of both models' organization, funding methods, and operational structures. The authors gathered data on the construction, operation, and usage of two pantry networks, focusing on factors such as accessibility, community engagement, and sustainability. The study employed a combination of qualitative methods, including interviews with organizers, and a review of organizational documents to analyze the effectiveness and scalability of each model. Both pantry networks increased accessibility to period products in low socioeconomic neighborhoods, which are disproportionately affected by period poverty. The grassroots model, while resource-limited, fostered strong community ties and local engagement. The nonprofit-led model benefited from dedicated staff and a more stable funding structure but faced bureaucratic challenges. Despite their differences, both models demonstrated the potential to empower menstruators by preserving their dignity and autonomy. Period product pantries represent an innovative and equitable approach to addressing period poverty and inequity. The analysis of the two models offers valuable insights for organizations and individuals interested in establishing similar initiatives. While each model has its unique benefits and challenges, both are effective in empowering menstruators and providing accessible menstrual hygiene products to those in need. Not applicable.

Perceived barriers to sports participation among adolescent girls from low socioeconomic status neighbourhoods

This study examined perceived barriers to sports participation among adolescent girls from low socioeconomic status (SES) neighbourhoods. A total of 11 semi-structured focus groups were conducted, involving 44 adolescent girls who were not engaged in organized sports. Thematic analysis was used to generate themes, and revealed that; 1) Participants prioritized homework, household duties and socializing with friends over sports. 2) Girls refrained from participating in sport due to fear of not fitting in because of ethnic background and reluctance to participate alone. Moreover, 3) feelings of inadequacy in sporting abilities, 4) bodily discomfort, and negative body image were perceived as barriers. 5) Finally, gender stereotypes, depicting sports as unsuitable for girls, along with negative attitudes from boys, further discouraged girls’ engagement. These findings offer a nuanced understanding of the barriers faced by this underrepresented group, informing the design of future interventions aimed at promoting sports participation among adolescent girls from low SES neighbourhoods.

Abstract 18151: Impact of Socioeconomic Disparities in Women With Peripartum Cardiomyopathy

BACKGROUND Peripartum cardiomyopathy(PPCM) is a rare cardiomyopathy associated with pregnancy. Recently there is increased awareness of social determinants and health impact on cardiovascular disease. Hypothesis: We aim to investigate incidence, complication, and prognosis of PPCM in socioeconomically vulnerable South Bronx community and compare it with contemporary data. METHOD A retrospective cohort study was performed from 2009 to 2023 at a single center, BronxCare Health System in United States. A community hospital is located in South Bronx, a low socioeconomic neighborhood where median income is 57th percentile($15,398). South Bronx ethnicity was reported as 34% Black, 60% Hispanic. Statistics for numerical variables were presented as mean±SD and categorical variables were presented as count. Total subjects 52 were identified. After adopting criteria of systolic dysfunction with left ventricular ejection fraction(EF)&lt;45%, 27 patients were included in PPCM group in our study consisting of 14 Black and 13 Hispanic women. RESULT The incidence of PPCM in our study was 1 in 622 live births compared to the incidence of PPCM in the United States 1 in 3,186 live births.(RR=5.12) MAE defined as mortality, heart transplant, mechanical circulatory support, pulmonary edema, thromboembolism, implantable cardioverter defibrillator implantation and cardiogenic shock, occurred in 29.6% compared to 13.5% of patients in a nationwide population-based study.(RR= 6.985) Follow-up echocardiogram in 5 years, 5 patients(18%) recovered their ejection fraction&gt;45%, 11 patients (40%) did not recover, and the other 11(40%) were lost to follow-up, and repeat EF is unknown. 17 patients (62.9%) were counseled contraception. 4 patients had subsequent pregnancy, only 2 had recovered EF prior to subsequent pregnancy. CONCLUSION We observed the significant burden of PPCM in low-socioeconomic South Bronx community, higher incidence, and greater risk of adverse events compared to the nationwide population-based study. Healthcare professionals should be alert and emphasize the importance of close follow-up, patient education, and social support for PPCM patients to prevent complications and improve prognosis to decrease socioeconomic disparity impact on PPCM.