Low Affluence Research Articles

A Daily Diary Study of Adolescents’ Academic Stress, Physical and Psychological Well-Being, and the Moderating Effect of Family Affluence

Although evidence suggests that daily experiences of stress can be detrimental for adolescents, there is a lack of systematic research that methodologically takes into account the fluctuating nature of daily stress. To address this gap, the present study used a daily diary method to examine daily psychological (i.e., feelings of happiness, anxiety, and depression) and physical well-being (i.e., fatigue and sleep quality) every evening, particularly in the day-to-day context of academic stress across the period of seven days among 164 eighth graders in Korea. Same-day and lagged-day associations between academic stress and physical and psychological well-being were examined. Variations in these daily associations by gender and family socioeconomic characteristics were also considered. Results showed that on days in which adolescents experienced more academic stress they were not only more depressed and anxious, but also felt more tired and slept less well. The effect of academic stress was more enduring for fatigue and sleep quality, but not for indicators of psychological well-being. Also, adolescents from families of low affluence reported greater fatigue than their more affluent peers on days when they experienced more academic stress. The scholarly and practical implications of the main findings are discussed.

Etude Socio-Économique De L’exploitation Des Plantes Fourragères Dans Le District d’Abidjan (Côte d’Ivoire)

Forage trading in the city of Abidjan is an activity not known by the population. The objective of the study was to determine the importance of the collection of forage plants in the socio-economic life of the actors of the sector. Prospects and semi-structured interviews were conducted, and we determined the floristic composition of forages sold in the market. The results of the survey show that the forage sold by the farmers is taken free of charge in the city of Abidjan. The unit price (UP) of a bundle of forage is on an average of 50 FCFA when there are few animals on the market, and 100 FCFA or 200 FCFA in case of high affluence such as during holidays. Thus, the estimated average financial income per day of an operator during periods of low affluence of animals in the markets is 875 F CFA. On an average, it is 26250 FCFA per month and 3350 FCFA per day. Also, there is an estimated average of 100 400 FCFA in periods of abundance of animals for sale in the market. The results of investigations showed that forages species sold are composed of species such as Chloris pilosa Schumach. (Poaceae), Panicum maximum Jacq (Poaceae), Brachiaria lata (Schumach.) Hub (Poaceae), Arachis hypogea L. (Fabaceae), and Phaseolus vulgaris L (Fabaceae). In addition to being food reserves, these activities provide work for those who exploit them. It allows them to meet their daily needs and also compensate for the lack of jobs.

Physical fighting, fighting-related injuries and family affluence among Canadian youth.

BackgroundPhysical fighting is an assaultive behaviour that can lead to injury. Family affluence is a health determinant that can influence injury. This study examines the relationship between family affluence and two outcomes: physical fighting and fighting-related injury in Canadian adolescents. Three measurements were used to represent family affluence and assess whether these measures demonstrated different associations with these outcomes.MethodsCanadian data from the 2009/2010 Health Behaviour in School-aged Children Study were used. It consists of a nationally representative sample of 26,078 grade 6–10 students. A subset analysis of 10,429 grade 9–10 students was conducted to account for additional confounders. Modified Poisson regression was used to compare the risk of physical fighting and fighting-related injury in youth from different levels of family affluence. Three indicators were used to represent family affluence: self-perceived affluence, a family affluence scale (FAS), and area-level average household income.ResultsThe overall prevalence was 35.6 % for physical fighting and 2.7 % for fighting-related injuries. Both outcomes were more frequent in males than females. An inverse gradient was present where risk for both outcomes increased with decreasing levels of affluence irrespective of the affluence measurement. The self-perceived affluence variable showed a significantly stronger gradient in girls than boys for both outcomes. For both outcomes, FAS showed a similar inverse gradient within females, but a threshold effect in males where there was a strong effect in the low FAS group, but a null effect in the moderate FAS group. The area-level income variable presented a significantly higher likelihood for physical fighting only in females (p = 0.001–0.075). For fighting-related injury, none of the area-level income models showed significant risk estimates with the exception of the bivariate association where low income females were twice as likely to report a fighting-related injury compared to higher income groups (p = 0.030). Post hoc power calculations indicate that there was not sufficient power to detect injury effects associated with the area level income measure.ConclusionIt appears that a socioeconomic gradient exists where lower affluence is associated with a higher risk of reporting a physical fight and fighting-related injury irrespective of the measure used. While the patterns were generally the same with all three measurements, the strength of this gradient varied across measures. This demonstrates that each indicator may measure different aspects of affluence. Further analyses are needed to explore concepts and mechanisms underlying each affluence measure.

Sociodemographic risk factors of alcohol drinking in Hong Kong adolescents

BackgroundAdolescent drinking in Western countries has been associated with older age and high socioeconomic status, but the association with family structure was inconsistent.MethodsIn a 2012–2013 school-based survey in Hong Kong,...

It still takes a village: an epidemiological study of the role of social supports in understanding unexpected health states in young people.

BackgroundThis study of adolescent Canadians examines two groups who are anomalous in their health experiences: (1) those with perceived low affluence yet who perceive themselves to have excellent general health status; (2) those of perceived high affluence but who are reporting poor health status. Our hope was to explore the role of social supports in explaining such anomalies. We hypothesized that cumulative levels of social support available to these young people would have an influence on their perceived health status, with more support being associated with better self reported health.MethodsYoung people (n = 26,078 from 436 schools) aged 11–15 years were administered a general health survey in classroom settings during the 2009–10 academic school year. Descriptive and regression-based cross-sectional analyses (with an affluence-social support interaction term) were used to relate both individual and cumulative levels of social support in homes, neighborhoods, schools, and peer groups to self-reported health status.ResultsSocial supports and their cumulative availability indeed were strongly related to perceived health, with more supports being associated with better self-perceived health. Less affluent children were much more likely to report excellent health in the presence of numerous social supports. More affluent children were much more likely to report poor health in the absence of such supports. The strength and dose-dependent nature of the findings were consistent and striking.ConclusionsStudy findings from this large, contemporary and national analysis affirm the importance of social supports as potential determinants of health for young people from both high and low affluent groups. Conceptually, findings affirm the wisdom of the ancient principle: “it takes a village to raise a child”.

Socioeconomic differences in emotional symptoms among adolescents in the Nordic countries: recommendations on how to present inequality.

This comparative study examines absolute and relative socioeconomic differences in emotional symptoms among adolescents using standardised data from five Nordic countries and gives recommendations on how to present socioeconomic inequality. The Health Behaviour in School-aged Children (HBSC) international cross-sectional study from 2005/2006 provided data on 29,642 11-15-year-old adolescents from nationally random samples in Denmark, Finland, Iceland, Norway and Sweden. The outcome was daily emotional symptoms. Family Affluence Scale (FAS) was used as indicator of socioeconomic position. We applied four summary measures of inequality: Prevalence Difference, Odds Ratio, Slope Index of Inequality and Relative Index of Inequality, and presented the socioeconomic inequality by a graphical illustration of the prevalence of emotional symptoms, the size of the FAS groups and the summary indices of inequality in each country. The prevalence of emotional symptoms ranged from 8.1% in Denmark to 13.2% in Iceland. There were large country variations in the size of the low FAS-group ranging from 2% in Iceland to 12% in Finland. The largest absolute and relative socioeconomic inequalities were found in Iceland and the smallest in Finland for girls and in Denmark for boys. Emotional symptoms were more common among nordic adolescents from low affluence families this association appeared in the study of both absolute and relative inequality. A comprehensive presentation of socioeconomic inequality should include the prevalence of the health outcome, the size of the socioeconomic groups, and the regression line representing the summary indices of inequality.

Abstract C06: Travel burden to breast biopsy facilities by race and disadvantage in Chicago

Abstract Purpose: The purpose of this analysis is to explore travel burden to biopsy facilities incurred by breast cancer patients. Methods: We geocoded patient residence and biopsy facility addresses from Breast Cancer Care in Chicago, a population-based study of breast cancer patients diagnosed from 2005-2008 (n=989). Street network based drive times from patient residence to the facility where the patient received biopsy services were calculated using ArcGIS. Public transportation times were obtained using Google Transit ‘best route’ and set to arrive at the facility by 11:00am on a Thursday. The percentage of households owning a vehicle for each patient's census tract (US Census 2010) was used to calculate a weighted travel time from both driving and public transportation times. An additional ‘assigned’ travel time was set as the drive time when tract-level vehicle ownership was ≥50% and set as public transportation time when tract-level vehicle ownership was <50%. Kruskal Wallis and Wilcoxon Rank Sum tests were used to examine the differences between travel times by census tract level disadvantage (<1 SD below the mean, within 1 SD of the mean, >1 SD above the mean) and affluence (<1 SD below the mean, within 1 SD of the mean, >1 SD above the mean), race/ethnicity (nH black, Hispanic, nH white), highest education received (<high school, high school, >high school), annual household income (<30k, 30-75k, >75k), insurance status (none, public, private) and region of the city (south side vs. north side). Results: Patient residence and biopsy facility locations were available for 890 patients. Average weighted travel time was 17 minutes (range 0.5 to 85) and average assigned travel time was 11 minutes (range 0.3 to 74), whereas average drive time alone was 9 minutes (range 0.3 to 58) and average public transportation time alone was 45 minutes (range 3 to 190). Non-Hispanic (nH) black and Hispanic women had longer travel times than nH white women for all types of travel time (all p<0.01). Women living in census tracts of higher disadvantage and lower affluence also had longer travel times than their counterparts for each type of travel time (all p<0.001). Women with private insurance had shorter travel times that women with public insurance or women without insurance using the weighted travel time (p=0.01). Women living on the south side of Chicago had longer travel times that women living on the north side for all types of travel time (all p<0.0001). Conclusions: Longer travel times to biopsy services could potentially serve as a barrier causing delays in diagnoses. Prior analysis among this study population found no meaningful differences in travel time to breast cancer care facilities using drive time alone. The addition of public transportation times provides a more realistic estimate of travel burden among women in Chicago. We found that women of greater disadvantage had longer travel times to their biopsy facilities. We also found longer travel times among women living on the south side of Chicago, which is where the most predominately nH black and socioeconomically disadvantaged neighborhoods are located. Greater travel burden incurred by disadvantaged women may be contributing to Chicago's racial disparity in breast cancer stage at diagnosis. Future analyses will explore how travel burden to breast cancer care facilities relates to breast cancer outcomes. Citation Format: Jenna A. Khan, Garth Rauscher. Travel burden to breast biopsy facilities by race and disadvantage in Chicago. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr C06. doi:10.1158/1538-7755.DISP13-C06

Adverse health effects of experiencing food insecurity among Greenlandic school children

BackgroundIn vulnerable populations, food security in children has been found to be associated with negative health effects. Still, little is known about whether the negative health effects can be retrieved in children at the population level.ObjectiveTo examine food insecurity reported by Greenlandic school children as a predictor for perceived health, physical symptoms and medicine use.DesignThe study is based on the Greenlandic part of the Health Behaviour in School-aged Children survey. The 2010 survey included 2,254 students corresponding to 40% of all Greenlandic school children in Grade 5 through 10. The participation rate in the participating schools was 65%. Food insecurity was measured as going to bed or to school hungry because there was no food at home.ResultsBoys, the youngest children (11–12 year-olds), and children from low affluence homes were at increased risk for food insecurity. Poor or fair self-rated health, medicine use last month and physical symptoms during the last 6 months were all more frequent in children reporting food insecurity. Controlling for age, gender and family affluence odds ratio (OR) for self-rated health was 1.60 (95% confidence interval (CI 1.23–2.06) (p<0.001), for reporting physical symptoms 1.34 (95% CI 1.06–1.68) (p=0.01) and for medicine use 1.79 (95% CI 1.42–2.26) (p<0.001). Stratification on age groups suggested that children in different age groups experience different health consequences of food insecurity. The oldest children reported food insecurity less often and experienced less negative health effects compared to the younger children.ConclusionsAll 3 measures of health were negatively associated to the occurrence of food insecurity in Greenlandic school children aged 11–17. Food security must be seen as a public health issue of concern, and policies should be enforced to prevent food poverty particularly among boys, younger school children and children from low affluence homes.

Abstract A04: The distribution of mammography facility and census tract characteristics in Chicago.

Abstract Introduction: Living in neighborhoods with greater socioeconomic disadvantage has been associated with lower use of preventive services and later stage at breast cancer diagnosis. Unequal distribution of quality mammography screening services may contribute to these associations. We compared the distribution of mammography facility characteristics with census tract level measures of social disadvantage and affluence in Chicago. Methods: An index of social disadvantage was defined from 2010 census tract data on the percentage of: families below the poverty line, families receiving public cash assistance, families receiving food stamps, unemployed persons, and female-headed households with children. An index of affluence was defined from the percentage of: families with incomes of $100,000 or more, adults with a college education or more, and in the civilian labor force in a white collar job. High disadvantage and high affluence were each defined as &amp;gt;1 standard deviation above the mean of the corresponding index. Low disadvantage and low affluence were each defined as &amp;gt;1 standard deviation below the mean of the corresponding index. Mammography facilities participating in the Metropolitan Chicago Breast Cancer Task Force 2010 Mammography Capacity Survey were categorized by American College of Radiology accredited Breast Imaging Center of Excellence (BICOE) designation, whether they offered diagnostic mammography, whether they had at least one breast imaging dedicated radiologist on staff (&amp;gt;75% time spent reading breast images), and whether they used digital vs. analog mammography machines. A one-mile buffer was created around facilities to calculate the percentage of nearby tracts with more or less disadvantage and affluence. Results: 47 of the 49 mammography facilities located in or within 1 mile of the Chicago city boundary participated in the survey. More socially disadvantaged tracts were less likely than less socially disadvantaged tracts to be located near any facility (47% vs. 66%), BICOE designated facilities (7% vs. 36%), facilities that offer diagnostic mammography (44% vs. 52%, p=0.21), facilities with at least one breast imaging dedicated radiologist (31% vs. 60%) or facilities with digital machines (32% vs. 53%). Likewise, less affluent tracts were less likely than more affluent tracts be located near any facility (30% vs. 77%), BICOE designated facilities (1% vs. 37%), facilities that offer diagnostic mammography (23% vs. 61%), facilities with at least one breast imaging dedicated radiologist (27% vs. 71%) or facilities with digital machines (16% vs. 61%). All p values were &amp;lt;.01 with the exception noted above. Conclusions: There is an unequal geographic distribution of mammography facilities with higher quality screening characteristics by areas of social disadvantage and affluence in Chicago. This inequity may be a contributing factor to the association between these disadvantaged areas and late stage breast cancer diagnosis. Citation Format: Jenna Khan, Jennifer Orsi, Garth Rauscher, Anne Marie Murphy, Danielle Dupuy. The distribution of mammography facility and census tract characteristics in Chicago. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A04.

Analysis of an Egyptian study on the socioeconomic distribution of depressive symptoms among undergraduates

Worldwide population surveys show that prevalence of mental disorders in developing countries was as common as in industrialized countries. College life is an important stage in every person's life; unfortunately, it may be the time to experience depression for the first time. Latterly, there has been a steady increase in the number of university students diagnosed and treated as depressed patients. This paper presents the results of a study carried out on a representative sample of undergraduate students of an Egyptian University, which aimed to study the relationship between social factors and the occurrence of depression. It was assumed that the poorer the socio-economic background the higher the rates of depression. Data were collected in 2004 from students at Assiut University using the Zagazig Depression scale (ZDS) and an Egyptian socio-economic status measure. This analysis, based on a refined version of the ZDS used STATA (v. 10.1.). Descriptive statistics, univariate and multivariate regression models were used to test for associations with the dimensions of SES and depression. Thirty-seven percent of the students had symptoms scored above the threshold for moderate depression. In the fully adjusted model: faculty of study, father's occupation, family income and number of persons per room were associated with depression in this sample. The high prevalence of depressive symptoms among Egyptian students found in this study call attention to the need for a student counseling service offering mental health support. This service should particularly discover an approach for low affluence students.

Social Volunteering in Welfare States: Where Crowding Out Should Occur

This article evaluates the influence of welfare state policy on individual social volunteering. Unlike previous studies that have investigated the relationship between the welfare state and civic engagement, this contribution focuses on those areas of civil society that are most directly related to public welfare state activities. Moreover, it is assumed that welfare state policy does not uniformly affect the civic engagement of various social groups. The analyses provide support for the crowding out hypothesis: individual social volunteering is lower in extensive welfare states than it is in countries that spend less on welfare state policy. However, when group-specific welfare state effects are modelled, it is revealed that the crowding out effect of public social services does not hold for the low-income group. Additionally, extensive welfare policy reduces the negative effect of low affluence on social volunteering. Crowding out and crowding in thus go hand in hand: while state activities indeed serve as a substitute for social volunteering in some places, in others they are found to have a stimulating effect.

Associations between familial affluence and obesity risk behaviours among children

Results of studies examining associations between socioeconomic status and obesity among children are mixed. To examine whether physical activity, television viewing, computer use, and fruit, vegetable, soft drink and sweet consumption differed according to familial affluence of children attending schools in disadvantaged communities. A total of 218 children (seven to 11 years of age) recruited from three Calgary (Alberta) schools located in two adjacent socioeconomically disadvantaged neighbourhoods completed online surveys during the spring of 2005/2006. The number of days per week participating in vigorous physical activity for more than 20 min, and weekly frequency of fruit, vegetable, sweet and soft drink consumption were collected. Time spent watching television and using a computer during a normal school day was also captured. A family affluence scale was used to assess socioeconomic status (number of family holidays in the past year, ownership of motor vehicles and computers, and bedroom sharing). Associations between familial affluence and obesity risk behaviours were estimated using Pearson's correlation and demographic-adjusted logistic regression ORs. Higher family affluence scale scores were significantly associated with weekly fruit consumption (r=0.14). Children with lower affluence were less likely to participate in vigorous physical activity five days/week or more (OR=0.39), and to use a computer for more than 2 h/day (OR=0.41) than children with higher affluence. Linear trends between familial affluence and the likelihood of participating in physical activity and using a computer were also found. However, no other behaviours were related to affluence. Increasing opportunities for physical activity and accessibility to healthy food may be important for reducing obesity risk among less affluent children.

Demographic and social inequalities in need for orthodontic treatment among schoolchildren in Lithuania

The present study, which focused on Lithuanian 11-15-year-old schoolchildren, was aimed to describe the frequency of orthodontic anomalies in terms of self-reported complaints about malposed teeth and malocclusion and self-reported use of orthodontic appliances (removable or braces) across different sociodemographic strata. The study population comprised 5632 schoolchildren surveyed in the 2005-2006 school year according to the WHO collaborative cross-national HBSC study in Lithuania. Almost half (47.5%) of schoolchildren reported orthodontic complaints. Therefore, only 15.8% of total population or 27.0% of schoolchildren who had orthodontic complaints reported wearing orthodontic appliances. Several municipalities of Lithuania with a high prevalence of orthodontic problems among schoolchildren were identified. Orthodontic problems were more prevalent among girls than boys. The prevalence of orthodontic complaints was not associated with social factors, while the use of orthodontic appliances was significantly related to social determinants. Children from rural areas were 2.44 times less likely of wearing orthodontic appliances than those living in cities, and children from families with low affluence were 2.33 times less likely of wearing orthodontic appliances than children from high-affluence families. There is a considerable variation and high social inequalities in need of orthodontic treatment among schoolchildren across different municipalities in Lithuania.

Socioeconomic Inequality in Exposure to Bullying During Adolescence: A Comparative, Cross-Sectional, Multilevel Study in 35 Countries

We examined the socioeconomic distribution of adolescent exposure to bullying internationally and documented the contribution of the macroeconomic environment. We used an international survey of 162,305 students aged 11, 13, and 15 years from nationally representative samples of 5998 schools in 35 countries in Europe and North America for the 2001-2002 school year. The survey used standardized measures of exposure to bullying and socioeconomic affluence. Adolescents from families of low affluence reported higher prevalence of being victims of bullying (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.10, 1.16). International differences in prevalence of exposure to bullying were not associated with the economic level of the country (as measured by gross national income) or the school, but wide disparities in affluence at a school and large economic inequality (as measured by the Gini coefficient) at the national level were associated with an increased prevalence of exposure to bullying. There is socioeconomic inequality in exposure to bullying among adolescents, leaving children of greater socioeconomic disadvantage at higher risk of victimization. Adolescents who attend schools and live in countries where socioeconomic differences are larger are at higher risk of being bullied.

The Varying Value of Children

Using data from the Value of Children (VOC) replication study in 2002/3, the value of children for their parents is investigated cross-culturally for different age groups in 11 countries (South Korea, People's Republic of China, Indonesia, India, Palestine, Israel, Turkey, South Africa, Ghana, Germany and the Czech Republic). As a prerequisite, the cross-national equivalence of the VOC measurement is established in calculating the overall and the particular country-specific factorial structures. The analysis results in a three-dimensional structure of the VOC, namely comfort, social esteem and affect. This structure is replicated for every national group, and the resulting scales are of high internal consistency as revealed by the respective alpha coefficients. Additionally, the data are also tested for culture-specific response styles, for which the final VOC comparisons are controlled by means of a bias index. The findings indicate children's importance for comfort and esteem to be highest in high-fertility countries with lineage-based kinship systems and low affluence, while it is lowest in low-fertility countries with high affluence and a state-based insurance system. Affect is very high across all countries with only minor variations.

The Ecocultural Framework, Ecosocial Indices, and Psychological Variables in Cross-Cultural Research

Relationships between context variables (ecosocial indices) and psychological variables across different nations were investigated, guided by Berry’s Ecocultural Framework. The psychological variables were values (Hofstede; Inglehart; Schwartz; Smith, Dugan, and Trompenaars) and subjective well-being (Diener). The ecosocial indices of religion and affluence had separate and in some ways contrasting relationships with psychological variables. Some religions were related to higher interpersonal power, loyalty, and hierarchy, but lower affluence. Other religions, (particularly Protestantism) and higher affluence were related to intrapersonal aspects, such as individualism, utilitarian commitment, and well-being. The most important result was the finding that scores of psychological variables showed systematic relationships with cluster membership of countries on ecosocial indices. The study proposes a solution to a theoretical and methodological problem of current cross-cultural psychology: the search for cultural (context) variables that would explain similarities and differences in psychological variables in different clusters of countries.

Norm values for the Generic Children's Quality of Life Measure (GCQ) from a large school-based sample.

This study aimed to assess the quality of life of a population sample of schoolchildren. The Generic Children's Quality of Life Measure (GCQ) has been developed to allow comparison between chronically ill children and the general child population. The measure assesses how the child views his or her life and also how they would like it to be. Quality of life is measured as the discrepancy between the two viewpoints. This large community-based survey aimed to establish GCQ norm values for children aged 6-14 years. The children were from a sample of schools stratified by geographical location and social need: rural affluent, rural low affluence, urban affluent and urban low affluence. 720 completed questionnaires were analysed. The scores were normally distributed with a wide range. The GCQ showed an acceptable reliability with a Cronbach's alpha of 0.75. The quality of life score was not correlated with age (r = -0.02, p = 0.64) nor with the deprivation score of the area in which the children lived (r = -0.026, p = 0.49). There were no significant differences between the scores by gender (p = 0.22) nor by rural/urban location (p = 0.60). Normative values were established. The GCQ is suitable for using with children over a large age range (6-14 years) without the scores being confounded by the age, gender, affluence or geographical location.

Cities and pollution

A study of air, water, noise and land pollution in Greater Manchester is described. Trends, generally downwards, in overall pollution levels are reviewed and the determinants of these levels discussed. The large variation in these determinants between the 71 local authorities which comprised Greater Manchester before reorganisation in April 1974 is reflected in the prevailing pollution levels. The differences in smoke and sulphur dioxide concentrations, average river and canal quality, traffic density (a measure of air and noise pollution from motor vehicles) and the proportion of land polluted by wastes are analysed. Disadvantaged areas, which experience the highest levels of most pollutants, are characterised by high population density, by high industrial activity and by low affluence. They generally appear to be affected by pollution exported by more affluent areas. It is recommended that increased attention be paid to the role of land use planning in controlling pollution and to the development of bro...