Lower Educated People Research Articles

Healthy eating: a privilege for the better-off?

Food subsidies for healthier foods and higher taxes for less healthy alternatives have been increasingly used to promote a healthy diet. Yet, some have argued that the fiscal burden on unhealthy products would fall disproportionately on the worse-off, raising equity concerns. This study estimates the association between income and the consumption of key food groups linked to the Mediterranean diet in the adult Portuguese population. We used data from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015-2016), which observed the daily diet of individuals aged above 18 and below 79 years old (n = 3242). Logistic regression models were used to estimate the magnitude of the association between self-reported household income categories and consumption of foods related to the Mediterranean diet (fish, vegetables, fruits and legumes), and not (sweets, sugar-sweetened beverages, cakes & pastries and processed meats). Stratified analyses were performed by education and age categories. We observed that the intake of fish (35.8 vs 38.8 g p = 0.02), vegetables (146.7 vs 166.2 g p < 0.01), and fruits (119.8 vs 150.1 g p < 0.01) was positively related to income, with a clear gradient for the two latter. Yet, the positive income-consumption link for fish was only observed among low-educated people, and the one for legumes among high educated and youths. Conversely, the consumption of most non-Mediterranean foods was not positively related to income categories, with the exception of sweets (34.8 vs 31.8 g p = 0.01) and cakes (26.4 vs 21.4 g p < 0.01) (more prevalent among the better-off). The consumption of healthy food is mostly consistently related to income, contrary to the intake of unhealthy ones. It may well be, therefore, that subsidies to healthy foods could allow access to the worse-off while taxing unhealthy food will not impose a disproportionate burden on them.

Social Insurance, Welfare Codes, and the Spread of Covid-19

This paper explores disparities in the effect of pollution on confirmed cases of Covid-19 based on counties’ socioeconomic and demographic characteristics. Using data on all US counties on a daily basis over the year 2020 and applying a rich panel data fixed effect model, we document that: 1) there are discernible social and demographic disparities in the spread of Covid-19. Blacks, low educated, and poorer people are at higher risks of being infected by the new disease. 2) The criteria pollutants including Ozone, CO, PM10, and PM2.5 have the potential to accelerate the outbreak of the novel coronavirus. 3) The disadvantaged population is more vulnerable to the effects of pollution on the spread of coronavirus. Specifically, the effects of pollution on confirmed cases become larger for blacks, low educated, and counties with lower average wages in 2019.

Avoidance of dental appointment due to cost and consequences for oral health-related quality of life: 25-yr follow-up of Swedish adults.

We explored how socio-demographic and personal characteristics contribute to avoidance of dental appointment due to cost over time from age 55 (in 1997) to 75 (in 2017) and assessed the implications for oral health-related quality of life. In 1992, 6346 residents born in 1942 consented to participate in a prospective questionnaire survey, and 3060 (48.2%) of them completed postal follow-ups every fifth year until 2017. Oral health-related quality of life was assessed using the Oral Impact on Daily Performance inventory. The frequency of avoidance of dental appointment due to cost declined from 7.0% (in 1997) to 5.4% (in 2017), whereas the frequency of oral impacts declined from 26.0% in 2007 to 24.0% in 2017. Generalized Estimating Equation models revealed that avoidance of dental appointments due to cost was more likely reported in 1997 (OR: 1.5: 1.2-1.8) than in 2017, more likely in low educated people, and less likely in those using private dental care services. Avoidance of dental appointment due to cost was associated with impaired oral health-related quality of life. Social inequalities in avoidance of dental appointment due to cost and oral impacts did not vary across time but persisted into older ages despite the dental health care reforms that had been implemented.

Racial and Socioeconomic Inequality on the Spread of Covid-19: Evidence from US Pollution across Counties

This paper explores disparities in the effect of pollution on confirmed cases of Covid-19 based on counties’ socioeconomic and demographic characteristics. Using data on all US counties on a daily basis over the year 2020 and applying a rich panel data fixed effect model, we document that: (1) there are discernible social and demographic disparities in the spread of Covid-19. Blacks, low educated, and poorer people are at higher risks of being infected by the new disease; (2) The criteria pollutants including Ozone, CO, PM10, and PM2.5 have the potential to accelerate the outbreak of the novel coronavirus; (3) The disadvantaged population is more vulnerable to the effects of pollution on the spread of coronavirus. Specifically, the effects of pollution on confirmed cases become larger for blacks, low educated, and counties with lower average wages in 2019.&amp;nbsp;The results suggest that welfare programs during a global pandemic should be differentially distributed among families with different socioeconomic status since the effects of these programs in reducing the spread of the pandemic is different among subpopulations. This paper is the first study to evaluate the differential effects of pollution on the spread of novel coronavirus across different subpopulations based on their socioeconomic status.

Socioeconomic Disparities in the Effects of Pollution on Spread of Covid-19: Evidence from US Counties

This paper explores disparities in the effect of pollution on confirmed cases of Covid-19 based on counties’ socioeconomic and demographic characteristics. Using daily data on all US counties over the year 2020 and applying a rich panel data fixed effect model, we document that: 1) there are discernible social and demographic disparities in the spread of Covid-19. Blacks, low educated and poorer people are at higher risks of being infected by the new disease. 2) The criteria pollutants including Ozone, CO, PM10, and PM2.5 have the potential to accelerate the outbreak of the novel corona virus. 3) The disadvantaged population is more vulnerable to the effects of pollution on the spread of corona virus. Specifically, the effects of pollution on confirmed cases become larger for blacks, low educated, and counties with lower average wages in 2019. The results suggest that welfare programs during a global pandemic should be differentially distributed among families with different socioeconomic status since the effects of these programs in reducing the spread of the pandemic is different among subpopulations. This paper is the first study to evaluate the differential effects of pollution on the spread of novel corona virus across different subpopulations based on their socioeconomic status.

The association between gaseous pollutants and non-accidental mortality: a time series study.

To evaluate the effects of gaseous pollutants (SO2, NO2) on non-accidental mortality of residents in Hefei city, we collected non-accidental deaths, air pollutants and meteorological data of Hefei city from 2014 to 2017. After controlling confounding factors with Poisson generalized additive model, we analyzed the relationship between air pollutants and non-accidental mortality and used subgroup analysis to identify susceptible groups. The number of non-accidental deaths during the study period was 42,116, with an average of 28.83 per day. The average concentrations of SO2 and NO2 were 16.08μg/m3 and 39.10μg/m3, respectively. In the single-pollutant model, every 10μg/m3 increase in SO2 and NO2 concentrations was significantly associated with non-accidental mortality, and there was a significant lag effect. SO2 increased the risk of non-accidental death by 4.93% (95% CI: 1.94% ~ 8.00%) at lag0-3. In addition, male, the elderly, non-elderly and low-education people were more susceptible (P < 0.05). NO2 increased the risk of non-accidental death by 2.11% (95% CI: 1.18% ~ 3.05%) at lag0-1 and had an effect on all subgroups (P < 0.05). For every 10μg/m3 increase in SO2 and NO2, the two-pollutant model showed that the risk of non-accidental death, respectively, increased by 3.34% (95% CI: 0.29% ~ 6.50%) and 1.82% (95% CI: 0.85% ~ 2.79%), suggesting that the effect was weakened. Our study suggested that SO2 and NO2 were associated with non-accidental mortality, and there were lag effects. Therefore, environmental management should be strengthened and health protection education should be carried out for different groups.

Individual’s gender ideology and happiness in China

Gender ideologies encompass normative beliefs about how men and women should behave in certain contexts. Although many studies have examined factors predicting individuals’ gender ideologies, little research has focused on the implications of gender ideology on individuals’ subjective well-being, especially in Asian contexts. Using the pooled cross-sectional data from the China General Social Survey (CGSS, 2010/12/13/15), we explore the association between individual-level gender ideology and happiness in rural and urban China, paying special attention to potential variations in this association by gender and education level. Results suggest that an egalitarian gender ideology is positively associated with happiness in both rural and urban China. The association is stronger for urban men than for urban women and stronger for higher educated people than for lower educated people. The study highlights the importance of gender equality on individual subjective well-being and extends the literature by contextualizing individual-level gender ideology in China.

The Attitude and Behavior of Chinese Residents During the Outbreak of Coronavirus Disease 2019: A Cross-Sectional Study

Objective: The objective of this study was to assess the behavior and attitude of Chinese residents about the prevention of COVID-19 during the outbreak of global infectious diseases. Design and Methods: A cross-sectional online survey of Chinese residents was conducted using convenience and snowball sampling techniques. Online questionnaire survey was conducted from March 7 to March 14, 2020, and the respondents were community residents who could operate smart phones independently. By 24:00 on March 14, 908 questionnaires had been collected, of which 899 were valid. Findings: Focus on the availability and effectiveness of older adults in accessing vectors for epidemic information. Pay attention to the attitude and behavior of disease prevention measures of the group with low educational background. Monthly income is an important factor in adopting healthy behaviors. Therefore, in the case of shortage of epidemic prevention manpower resources, the focus will be more epidemic prevention manpower distribution in low-income, low educational population population. The community residents with high education and high income can serve as the secondary key area. Give play to the social function of all walks of life to ensure the supply of life materials. In the case of shortage of materials, priority should be given to the distribution of materials to prevent the epidemic, to ensure the basic operation of the city. Positive self-efficacy can encourage people to adhere to healthy behaviors, so as to ensure their health without being infected. Conclusions: In terms of the implementation of epidemic prevention measures, the government or social organizations should pay more attention to the characteristics of the key population and carry out targeted measures, especially the elderly, the elderly living alone, the low-income people with low educational background. At the same time, we will focus on the compliance of prevention and control measures for low-income and low-educated people, and intensify publicity and material support. The government should give full play to the social function of all walks of life, ensure the supply of materials for people who are quarantined at home, intensify the media propaganda, and release the epidemic information in an open, transparent, accurate and timely manner, so as to increase the information of residents against the virus.

Differential Impact of Education on Cognitive Performance in Neurological Patients with Progressive Cognitive Decline.

Education has a protective effect toward cognitive decline in advanced age and is an important factor contributing to cognitive reserve. To elucidate the interaction effect of education and global mental status on cognitive performance of older patients with progressive cognitive decline. This retrospective study included 1,392 patients. We performed moderation regressions to examine the interaction between education and global mental status (Mini-Mental State Examination (MMSE) score) on performance in episodic memory, executive functions (EF), language, and constructional praxis tests. Significant interaction effects were further explored through separate linear regressions by MMSE level (inferior: ≤24; intermediate: 25-27; superior: 28-30). There was an interaction between MMSE and education for some but not all variables. At intermediate and superior MMSE levels, high-educated people had a clear advantage relative to low-educated people in verbal memory and EF tests. This advantage was not significant at an inferior MMSE level. In object naming, constructional praxis recall, and constructional praxis, high-educated people performed better than low-educated people, independently of MMSE level. Education has a differential effect on cognitive performance in patients with cognitive decline. While high education is not helpful for episodic memory and EF at low cognitive levels, it is still beneficial for retrieving words or other semantic knowledge. These findings suggest an interaction between global mental status and education on different cognitive domains and have strong clinical implications. Diagnostic judgments should be based on the knowledge of such interaction. This study highlights the beneficial but selective effects of high education.

Socioeconomic Disparities in the Effects of Pollution on Spread of COVID-19: Evidence from US Counties

This paper explores disparities in the effect of pollution on confirmed cases of COVID-19 based on counties’ socioeconomic and demographic characteristics. Using data on all US counties on a daily basis over the year 2020 and applying a rich panel data fixed effect model, we document that: 1) there are discernible social and demographic disparities in the spread of COVID-19. Blacks, low educated, and poorer people are at higher risks of being infected by the new disease. 2) The criteria pollutants including Ozone, CO, PM10, and PM2.5 have the potential to accelerate the outbreak of the novel coronavirus. 3) The disadvantaged population is more vulnerable to the effects of pollution on the spread of coronavirus. Specifically, the effects of pollution on confirmed cases become larger for blacks, low educated, and counties with lower average wages in 2019.

A Study of Job Mobility in Middle-aged and Older Adults

본 연구는 한국고용정보원의 고령화연구패널을 이용하여 중·고령층의 일자리 이동에 따른 실태와 일자리 이동 이후의 효과에 관하여 분석한 연구이다. 노후의 복지가 빈약하고, 중·고령자의 경제 활동 참여율이 높은 우리나라의 특수한 상황이지만, 50세 이상의 중·고령자를 대상으로 일자리 이동 현황과 이동 효과에 관한 연구는 없는 상황이다. 연구내용은 일자리 이동 실태를 분석하고, 개인이 일자리 이동으로 얻을 수 있는 효과인 고용 형태, 근로 형태, 월평균 임금 등에 대해서 일자리 이동 이전(6차 조사)과 이동 이후(7차 조사)의 상태를 중심으로 분석하였다. 연구결과로서 일자리 이동의 현황으로 6차에서 7차 사이에 일자리 변동이 없는 동일일자리는 77.3%이고, 일자리 변동은 22.7%(일자리 이동 7.5%, 실직 15.2%)를 차지하고, 직종 대분류 기준에서 동일직종으로의 이동은 40.8%, 다른 직종으로의 이동은 59.2%로 분석되었다. 청년층의 일자리 이동과는 달리 전반적으로 여성, 고연령, 저학력 등에서 동일직종으로의 이동 비율이 높으며, 동일직종으로의 이동이 근로일수, 시간, 월평균 임금 등에서 오히려 부정적인 효과가 있었다. 다만, 중·고령자들 중에서 노후 준비가 잘되어있고, 재정적으로 여유가 있는 경우는 비경제활동상태(은퇴)로 전환되는 현실을 고려하여 분석 결과를 이해할 필요가 있다. 연구 결과는 향후 중·고령층의 일자리 연구의 기초를 마련하며, 정책적 결정에 필요한 근거가 되리라 판단된다.This study analyzes the actual conditions of the elderly people s job mobility and the effects after job mobility using the KEIS s Korean Longitudinal Study of Ageing(KLoSA). Through this, the study looks into the status of job mobility, and analyzes the effects that individuals can obtain from job mobility, such as employment type, work type, and average monthly wage, focusing on the status of before job-shift(6th survey) and after movement(7th survey). As for the current status of job mobility, there was no change in 77.3% of the interviewees between the 6th and 7th survey, and 22.7% have moved their jobs(job mobility 7.5%, unemployment 15.2%). Among the people who have shifted their jobs, 40.8% of respondents moved to the same occupational category and 59.2% moved to different type of occupation. Unlike job-shift among young people, women, the elderly, and the low-educated people had a high overall rate of job mobility to the same occupational category, and this shift had a rather negative effect on the number of working days, working hours, and average monthly wages. The results of this study are expected to lay the foundation for future research on jobs for the elderly, and will serve as the basis for policy decisions.

Physical activity prescription from primary care: impact on self steem and quality of life

Abstract Objective To evaluate the benefit in terms of self-esteem, quality of life (QoL) and health perception, in a physical activity (FA) prescription intervention from Primary Care, after three months. Methods Quasi-experimental study before (T0) -after (T1) without a control group, for the evaluation of the pilot phase of the CAS program, implemented (December 2017-May 2018) in 5 primary health centers in Valencia. The questionnaire (T0) was completed with social information, self-esteem (Rosemberg), and QoL (Euroqol-5D, including health perception (HP)). The FA was prescribed with specific hours and days and the participation was monitorized. Three months after starting the FA, the participants completed the same cuestionaire (T1). An descriptive analysis was made, by intention to treat, T0 n = 82 and T1 n = 78, and the scales were compared before and after, using the Wilcoxon Test for related samples. Results The FA prescription was offered to 185 people, acceptance n = 82 (44.3%) and there were 14 dropouts, adherence (83%). The sample at T0 n = 82, people who completed the 3 months, n = 68, and n = 10 people who droppout but answered the questionnaire, (4 not be located them), total analysis T1 n = 78. There were a significant improvement in the QoL (26,5% p ≤ 0.002), the HP (16% p ≤ 0.000) and self-esteem (4,7%p ≤ 0.000) in women when comparing the median of the referred score before and after the intervention. Qol improved more in the low educational level (26.55% p &amp;lt; 0.001), while the perception of health (16% p &amp;lt; 0.000), and self-esteem (9.3% p &amp;lt; 0.038) improved more in the high educational level. Discussion The prescription of FA has an important benefit in improving health with only 3 months of prescription. It also has a greater positive benefit in women and in the population of low educational level, who are those who perform less FA. This study helps build evidence of the positive impact on the health of the social prescription from primary care. Key messages After 3 months of the physical activity prescription the QoL and self-steem improved mainly in women and low educated people. The acceptance to participate was 50% but the adherence was more than 80%.

Bifurcations in business profitability: An agent-based simulation of homophily in self-financing groups

Formal financial institutions inadequately distribute startup capital to business ventures of ethnic minorities, women, low-educated, and young people. Self-financing groups fill this gap because in these associations agents accumulate their savings into a fund that is later used to provide loans to the members. This study builds and simulates an agent-based model that compares the profitability of businesses started by members of self-financing groups against businesses financed by commercial loans. The results indicate that—besides the self-generation of debt capital—businesses of members of self-financing groups can have higher returns due to the consolidation of social capital and the competitive advantage created through a dual process of homophily. Higher quotas of savings boost profits, but only up to a threshold, after which a bifurcation pattern—typical of complexity dynamics—emerges. The practical and theoretical implications of the findings are discussed and future research lines are proposed.

Health Literacy of Rural Population of Kazakhstan.

Background:To date, there is no data available of health literacy of the population in Kazakhstan. This study was aimed to assess the health literacy of the rural population for the development of the targeted health education programs.Methods:The adapted HLS-EU-Q47 survey was carried out among 1650 respondents aged 18–76 from rural settlements in Almaty region of Kazakhstan in 2013. The health literacy competences to assess, understand, appraise and apply health information on healthcare, disease prevention and health promotion were measured. The associations between the health literacy competencies and demographic and socio-economic characteristics were shown through a multiple linear regression analysis.Results:The overall health literacy rate of the rural population of Almaty region was problematic and inadequate. With regards to their age, sex, social and economic characteristics, the health literacy competencies differ according to health literacy domain. Respondents with low education level or perceived social status had respectively low health literacy scores, especially in appraising and applying information of disease prevention.Conclusion:Low educated people and with lower income have lower health literacy in comparison to respondents with higher education level and higher income. Respondents with higher health literacy have higher rate of self-assessed health.

Knowledge, attitudes, risk perceptions, and practices of adults toward COVID-19: a population and field-based study from Iran.

ObjectivesTo determine peoples’ knowledge, attitudes, risk perceptions, and practices to provide policymakers pieces of field-based evidence and help them in the management of the COVID-19 epidemic.MethodsThis population-based survey was conducted using multi-stage stratified and cluster sampling in Shiraz, Iran. A total of 1331 persons were interviewed. The questionnaires were completed by face-to-face interviews. Univariable and multivariable (linear regression) data analyses were done using SPSS.ResultsThe participants answered 63% of questions regarding knowledge, and 78% of questions regarding practice correctly. Only, 4.8% knew about common symptoms of COVID-19 and 7.3% about warning signs that require referral to hospitals. Males, lower educated people, and elders had a lower level of knowledge and poorer practices. Knowledge was also lower in the marginalized (socially deprived) people. Knowledge and practices’ correlation was 37%. Overall, 43.6% considered themselves at high risk of COVID-19, and 50% considered it as a severe disease. This disease had negative effects on most participants’ routine activities (69.1%). The participants preferred to follow the news from the national TV/Radio, social networks, and foreign satellite channels, respectively.ConclusionsEncouragement of people to observe preventive measures and decreasing social stress, especially among males, lower educated people, elders, and marginalized groups, are highly recommended.

Premarital sex and pregnancy in Greater Jakarta

Social taboos and stigmas around sexuality and non-marital sex in Indonesia have led to substantial underreporting of the prevalence of premarital sex. In this study, we explore underreporting amongst young adults in Greater Jakarta. We use the 2010 Greater Jakarta Transition to Adulthood Survey (GJTAS), a survey of more than 3000 people aged 20–34 years, to derive estimates of underreporting based on discrepancies reported in the timing of marriage, first child birth and first sexual intercourse and sexual activities. Survival and life table analyses are utilised to identify individual and societal predictors of premarital sex and its reporting and to estimate cumulative incidence across young adulthood. The results reveal substantial evidence of underreporting, particularly amongst women, arising from premarital pregnancies. We estimate that the proportion of the female cohort who will engage in premarital sex by the age of 35 years increases from 4.4 to 22% after taking into account evidence of underreporting. Premarital pregnancies and unreported premarital sex is found to be particularly common amongst lower educated people. This raises important questions for policy and research in terms of the provision of information and support for young couples and the methodological implications of substantial underreporting.

Implementation of an interactive organ donation education program for Dutch lower-educated students: a process evaluation

BackgroundAs organ donation registration rates remain low, especially among lower-educated people, it is important to support this group in making their registration decision. To prepare lower-educated students in the Netherlands for making a well-informed decision, an interactive educational program was developed. We aim to understand both the (quality of) implementation as well as to contextualize the effects of this program in a lower-educated school setting.MethodsThe process evaluation was part of a Cluster Randomized Controlled Trial, in which 11 schools for Intermediate Vocational Education throughout the Netherlands participated. Teachers who taught a course on Citizenship delivered three intervention elements (i.e. video fragments and discussion, quizzes with tailored feedback and an exercise filling out a registration form) to their students. Implementation was assessed by interviews with teachers, questionnaires from students, logbooks from teachers and user data from Google Analytics.ResultsThe program was well received and implemented, but on-the-spot adaptations were made by teachers to fit their students better. Within the lower-educated target group, differences between students are high in terms of active participation, reading abilities, knowledge and attention span. The program fit well within their regular teaching activities, but the topic of organ donation is not always prioritized by teachers.ConclusionsWe see opportunities to disseminate the program on a larger scale and reach a group that has been neglected in organ donation education before. Within the program, there are possibilities to increase the effectiveness of the program, such as alternative delivery methods for the elements with a lot of text, the addition of booster sessions and guidelines for teachers to adapt the program to students of different levels within Intermediate Vocational Education. Moreover, in order to have an impact on a national level, strategies need to be employed to reach high numbers of students and, therefore, support on a higher level is needed (both within schools and at policy level).Trial registrationDutch Trial Register, NTR6771. Prospectively registered on 24 October 2017.

Demographic Characteristics of People Injured by Driving Accidents and Admitted to Imam Khomeini Hospital in Urmia in 2016

Background and objective: nowadays, one of the most important risks threatening the community health promotion and development is increasing the number of accidents. The aim of this study was to evaluate the demographic characteristics of people injured by driving accidents and admitted to Imam Khomeini Hospital of Urmia in 2016. Methods: This cross-sectional and retrospective study was conducted using the census method. It was conducted on all road accident patients hospitalized in Imam Khomeini Hospital of Urmia in 2016. A total of 2050 records were reviewed and 2015 of them were included in the study. Data were collected using a checklist in which demographic and accidental data of the injured people were recorded. Data were analyzed using descriptive statistics (frequency distribution tables, central indicators, and dispersion). Results: The mean age of the subjects was 33.63± 18.53 years. Most of the injured people were male (73.2%) and self-employed (46.8%). The majority of females were housewives (70.8%). In two gender groups, most accidents occurred on the streets and within the city. Moreover, 48.1% of injured people were male and 48.1% of females were transferred to the hospital by emergency department and 56 (0.20%) of injured people died before discharge from the hospital. Conclusion: Most accidents occurred on the streets and within the city and among males, low education, and self-employed people. Hence, this group of people should be in priority in designing and implementing a variety of educational interventions.

The Impact of the Digital Divide on the Adoption of e-Government in Greece

The adoption of e-government services and the active e-participation of citizens may be affected by the pre-dominant socio-economic inequalities. The current study examined the impact of the digital divide to the use of e-government and e-participation services. We used the micro-data from the national survey on the use of Information and Communication Technologies by the Greek households and individuals. This survey was conducted by the Greek Statistical Authority in 2017, in a representative sample of the Greek population (n = 3321). We analyzed the data using logistic regression equations. According to the results, the social exclusion factors may influence the use of e-government services. The most important socio-economic factors affecting the decision to use e-government services are the educational level, age and citizenship. The e-participation of the citizens in various democratic processes is only influenced by their educational attainment. This work highlights the impact of the digital divide to every aspect of our digital life. The state should implement policies to address the digital divide focusing on the vulnerable social subgroups, such as the low-educated and older people. The findings of our research may help the policymakers to conceptualize the effect of the digital divide to e-government adoption, in a multidimensional and integrative way.&#x0D; Keywords: e-government, Greece, digital divide, e-services, digital skills

Is the European Health Interview Survey online yet? Response and net sample composition of a web-based data collection.

The European Health Interview Survey (EHIS) provides cross-national data on health status, health care and health determinants. So far, 10 of the 30 member states (MS) opted for web-based questionnaires within mixed-mode designs but none used it as the sole mode. In the context of future EHIS, the response rate and net sample composition of a web-only approach was tested. A Belgian study with a target sample size of 1000 (age: 16-85) was organized using the EHIS wave 3 model questionnaire. The sample was selected according to a multistage, clustered sampling procedure with geographical stratification. Field substitution was applied; non-participating households were replaced by similar households regarding statistical sector, sex and age. There was one reminder letter and a €10 conditional incentive. Considering all substitutions, a 16% response rate was obtained after sending one reminder. Elderly, Brussels Capital inhabitants, people living without a partner and those with a non-Belgian nationality were less responding. By design, there were no differences between the initial and final net sample regarding substitution characteristics. Nevertheless, people living without a partner, non-Belgians and lower educated people remain underrepresented. There was a low response rate, particularly for some population groups. The response rate was lower than those of MS using mixed-mode designs including web, especially these comprising interviewer-based approaches. Despite the long and complex questionnaire, there was a low break off rate. So far, web-only data collection is not an acceptable strategy for population-based health surveys but efforts to increase the response should be further explored.