Lower Levels Of Educational Attainment Research Articles

Mortality from type 2 diabetes mellitus across municipalities in Mexico

BackgroundOne in six Mexican adults’ lives with type 2 diabetes mellitus (T2DM), which is the third leading cause of death in the country. Analyzing the geographic distribution of T2DM mortality helps identify regions with higher mortality rates. This study aimed to examine the spatial patterns of mortality from type 2 diabetes mellitus (T2DM) across municipalities in Mexico and to analyze the main contextual factors linked to this cause of death in 2020.MethodsWe employed a spatial Bayesian hierarchical regression model to estimate the risk and probability of death from type 2 diabetes mellitus (T2DM) across Mexico’s municipalities.ResultsThe SMR results revealed geographic and age-specific patterns. Central Mexico and the Yucatán Peninsula exhibited the highest excess mortality rates. For the population under 50 years of age, municipalities in Oaxaca had the highest T2DM mortality rates, whereas those aged 50 years old and older had the highest rates in Tlaxcala and Puebla. Socioeconomic factors such as low levels of educational attainment, lack of health services, dietary deficiency, and marginalization were positively associated with increased T2DM mortality risk. By contrast, GDP per capita showed a negative association. High-risk areas for T2DM mortality were prominent along the south of the Pacific Coast, the Bajío, Central Mexico, and southern Yucatán for those under 50, and along a central strip extending to the Yucatán Peninsula for the older population. Significant uncertainties in mortality risk were identified, with Central Mexico, Oaxaca, Chiapas, and Tabasco showing high probabilities of excess risk for those under 50 years of age and extended risk areas along the Gulf of Mexico for those 50 years old and older.ConclusionsThe assessment and identification of spatial distribution patterns associated with T2DM mortality, and its main contextual factors, are crucial for informing effective public health policies aimed at reducing the impact of this chronic disease in Mexico.

Development of an air quality communication strategy with underserved groups

Abstract Air quality is the greatest environmental health threat. Effective communication can support individuals to take actions to protect themselves, however, we know some groups are less likely to engage with exposure reducing behaviours than others. We aimed to explore what information individuals want to receive about raised air pollution levels, when, where and how they would like to receive it. In this qualitative study individuals participated in either semi-structured interviews (n = 6) or focus groups (n = 8) in North East England between Oct23-Feb24. We used purposive sampling underpinned by extensive community-based engagement to ensure inclusion of those who were underserved and/ or at risk of digital exclusion. The Capability Opportunity Motivation-Behaviour model was used to help guide discussions and the data thematically analysed using an inductive approach. Fifty individuals participated, many of whom were of non-white ethnicity (n = 23, 46%), spoke English as an additional language (n = 12, 24%), and had lower educational attainment levels (i.e., no-qualifications n = 7, 14%). Participants discussed four aspects that they deemed important to include in air quality communication: (1) the risk and harms of air pollution should be stated, and be tailored because “what’s a dangerous level for one person isn’t a dangerous level for another”(P41) (2) Participants felt detail about the pollutants should be included such as: “what is causing the air pollution?”(P15) to “avoid the exposure to this source”(P21). (3) Messages should also include actionable recommendations about how to protect oneself and, (4) various ways to communicate these messages (text-message-based approaches being the most popular) were suggested. Our findings indicated using a combined communication strategy including text messages and community-based approaches. This work can inform the development of inclusive future air quality information communication Key messages • Effective communication can support individuals to take actions to protect themselves from air pollution. • A combined communication strategy including text messages and community-based approaches were suggested as being effective communication strategies.

8361 Impact of Social Vulnerability on Glycemic Control in Primary Care Patients with Diabetes

Abstract Disclosure: J.N. Tich: None. S.R. MacLeod: None. V. Zhang: None. T. Love: None. R.J. Fortuna: None. Introduction: According to the CDC, 29.7 million Americans are diagnosed with diabetes (DM), contributing to morbidity, mortality and strain on the healthcare system. The impact of social determinants of health (SDOH) and social vulnerability (SV), as measured by the social vulnerability index (SVI), on DM care and control is evident. In populations with lower educational attainment levels, lower income and higher rates of poverty, prevalence of DM and rates of complications are higher. However, less is understood about how the intersectionality between SDOH/SV and race impacts diabetes control. Aims: We sought to examine the impact of SV and race on DM control in primary care patients in Upstate NY. Methods: We examined 26,010 patients with DM in Upstate NY. We defined DM control based on national HEDIS standards. SVI were calculated for each patient based on census track data. The SVI is calculated based on 16 variables in four themes: socioeconomic status, household characteristics, racial/ethnic minority status, and housing/transportation. SVI scores range from 0 (lowest vulnerability) to 1 (highest vulnerability). In addition to calculated SVI scores, we examined patient-reported SDOH, including food insecurity, housing insecurity, transportation, and social isolation. Race and ethnicity related parameters were self-reported. We report preliminary descriptive data. Results: Overall, 73.6% of patients were controlled with a HgA1c <8% based on the HEDIS definition. Control rates varied based on race (white 75.9% Black 66.1%; Asian 73.7%; other race 66.6%), calculated SVI, and patient reported SDOH. Within each racial category, diabetes control rates worsened with increasing SVI. Patients who expressed food insecurity had lower rates of DM control than those who had no food insecurity (68.8% vs 79.7%). Similarly, patients with housing insecurity had lower control rates (67.5%) compared to those who had greater housing security (80.0%). Patients with unmet transportation needs had lower rates of diabetic control (67.4%) compared to those with stable transportation (80.6%). Additional statistical tests and multivariate regression models are pending. Conclusions: Across a large sample of patients with diabetes, increasing SV was associated with worsening glycemic control across all racial groups studied. In preliminary analyses, both race and SVI appear to be independently associated with DM control. SVI did not fully mitigate the influence of rate on DM control. Within same SVI category, non-white participants appeared to have a more negative impact on DM control compared to white participants. While SDOH are well known influences, these findings specifically demonstrate the link between SV and glycemic control, highlighting the fact that at the same SVI quartile, non-white participants may be more vulnerable to dysglycemia. Presentation: 6/2/2024 6/2/2024

Status quo and factors influencing dyadic disease appraisal in chronic heart failure based on latent profile analysis in Northern Sichuan Province, China

PurposeThis study explored potential categories of dyadic disease appraisal differences among patients hospitalized with chronic heart failure (CHF) in China and analyzed the main factors influencing these categories.MethodsA survey was conducted using various tools and scales, including the Chinese version of the Memorial Heart Failure Symptom Appraisal Scale, Heart failure self-care index scale, Social Support Rating Scale, Zarit burden interview, and Self-rating anxiety scale. The data was collected from patients who were hospitalized with CHF in the cardiology department of one of two tertiary hospitals in Nanchong City, China. The dyadic disease appraisal categories were identified using latent profile analysis (LPA). Multiple logistic regression analysis was also employed to analyze the factors influencing the formation of potential categories of differences in dyadic disease appraisal in CHF patients.ResultsA total of 262 pairs of hospitalized CHF patients and their caregivers participated in this study. The dyadic disease appraisal of CHF patients was potentially categorized as the "negative difference group" (28 individuals, 10.7%) and the "positive or convergence group" (234 persons, 89.3%). The results showed that the factors influencing the categorization of dyadic disease appraisal differences included the patient's social support, disease progression, and Caregivers anxiety level, burden, gender, educational attainment, and age (p < 0.05).ConclusionThe study findings demonstrated heterogeneity between the two groups of CHF patients in the dyadic disease appraisal. Therefore, it is necessary to focus on patients who have a brief duration of illness and limited social support. Specifically, it is important to prioritize support for female caregivers who are 65 years or older, have lower levels of educational attainment, and experience a significant burden and anxiety. Regular implementation of support person-bilateral co-management strategies can effectively reduce differences in how the disease is perceived and enhance the overall well-being of both caregivers and patients.

Education and Information to Improve Adherence to Screening for Breast, Colorectal, and Cervical Cancer-Lessons Learned during the COVID-19 Pandemic.

The objective of this study was to determine the correlation between adherence to cancer screening programs and earlier diagnosis of the 14 most common types of cancers in the adult population, before and during the COVID-19 pandemic. National data concerning number of admissions and operations in Italy for adult patients admitted with oncologic problems during the COVID-19 pandemic (2020 to 2022) and in the pre-pandemic period (2015 to 2019) were analyzed. We selected 14 types of cancer that present the most common indications for surgery in Italy. This study included 1,365,000 adult patients who had surgery for the 14 most common types of cancer in the period 2015-2022, and interviews concerning adherence rates to screening for breast, colorectal, and cervical cancer were conducted for 133,455 individuals. A higher decrease in the number of operations for the 14 types of cancer (-45%) was registered during the first three acute phases of the pandemic, and it was more evident for screenable cancers like breast, colorectal, and cervical cancer (p < 0.001). During the first year of the COVID-19 pandemic, the number of screened individuals for breast, colorectal, and cervical cancer decreased by 33.8% (from 7,507,893 to 4,969,000) and the number of diagnoses and operations for these three types of cancer decreased by 10.5% (from 107,656 to 96,405). The increase and return to normality of the number of screened individuals in the last year of the pandemic (2022) and in the first post-pandemic year (2023) was associated with a return to the pre-pandemic levels of diagnoses and operations. The adherence rates were lower for individuals living in rural areas, with low socio-economic status, and unmarried persons; however, the most statistically significant factor for reduced adherence was a lower level of educational attainment. Free screening through nationally organized programs reduced social disparities. There were no significant differences between the pre-pandemic and pandemic periods for several types of cancers (stomach, esophagus, pancreas, liver) that are diagnosed for the occurrence of symptoms and for which nationally organized programs might increase the possibility of earlier diagnosis and improved clinical outcomes. Education, information, and appropriate expenditure for preventive care have the potential to reduce cancer mortality. Nationally organized screening programs for several types of cancers, which are often detected for the occurrence of symptoms, may increase the possibility of diagnosis at earlier stages.

How does parental divorce affect children’s long-term outcomes?

Many papers report a negative association between parental divorce and child outcomes. To provide evidence whether this correlation is causal, we exploit idiosyncratic variation in the extent of gender balance in fathers’ workplaces. Fathers who encounter more women in their relevant age–occupation–group at work are more likely to divorce. This result is conditional on the overall proportion of female employees in a firm and on detailed industry affiliation. Parental divorce has persistent, and mostly negative effects on children that differ between boys and girls. Treated boys have lower levels of educational attainment, worse labor market outcomes and are more likely to die early. Treated girls also have lower levels of educational attainment, but they are also more likely to have children at an early age (especially in their teens). However, treated girls lose less in terms of employment. This could be a direct consequence of teenage motherhood, which initiates early entry into the labor market.

Medical Mistrust Among Black Patients with Serious Illness: A Mixed Methods Study.

Medical mistrust among Black patients has been used to explain the existence of well-documented racial inequities at the end of life that negatively impact this group. However, there are few studies that describe patient perspectives around the impact of racism and discriminatory experiences on mistrust within the context of serious illness. To better characterize experiences of racism and discrimination among patients with serious illness and its association with medical mistrust. Seventy-two Black participants with serious illness hospitalized at an academic county hospital. This is a convergent mixed methods study using data from participant-completed surveys and existing semi-structured interviews eliciting participants' perspectives around their experiences with medical racism, communication, and decision-making. The experience of medical racism and its association with Group-Based Medical Mistrust (GBMM) scale scores, a validated measure of medical mistrust. Of the 72 Black participants, 35% participated in interviews. Participants were mostly men who had significant socioeconomic disadvantage, including low levels of wealth, income, and educational attainment. There were reported high levels of race-based mistrust in the overall GBMM scale score (mean [SD], 36.6 [9.9]), as well as high scores within the suspicion (14.2 [5.0]), group disparities in healthcare (9.9 [2.8]), and lack of support (9.1 [2.7]) subscales. Three qualitative themes aligned with the GBMM subscales. Participants expressed skepticism of healthcare workers (HCWs) and modern medicine, recounted personal experiences of discrimination in the medical setting, and were frustrated with poor communication from HCWs. This study found high levels of mistrust among Black patients with serious illness. Suspicion of HCWs, disparities in healthcare by race, and a lack of support from HCWs were overarching themes that influenced medical mistrust. Critical, race-conscious approaches are needed to create strategies and frameworks to improve the trustworthiness of healthcare institutions and workers.

Brexit and the EU Settlement Scheme: Continuity and rupture with the European Union

ABSTRACT The EU Settlement Scheme, a product of Brexit, both continues and breaks with the EU legacy, offering dismantlement for the vulnerable and continuity for the rest. In its attempt to keep the rights of EEA and Swiss citizens as close to their EU format as possible, it borrows from Directive 2004/38 and, in doing so, manages to enhance the conditionality ingrained in the Directive, discriminating against the most vulnerable. At the same time, by breaking with the EU legacy, it also moves the most vulnerable even farther away from the ideal of an unconditional right to return. Through an exploratory opt-in online survey, I observe the Scheme’s intrinsic tension of offering both continuity and dismantlement and the emergence of some vulnerability traits. Non-linear employment histories, older age, and lower levels of educational attainment enhance the difficulty of the process and create the prospects for disentitlement.

Unemployment’s long shadow: the persistent impact on social exclusion

This paper studies the long-term consequences of unemployment on different dimensions of social exclusion. Based on longitudinal linked survey and administrative data from Germany and an event study analysis combined with inverse propensity score weighting, I document that becoming unemployed has lasting adverse effects on both individuals’ material well-being and their subjective perception of social status and integration, persisting even after four years. An examination of effect heterogeneity underscores that the enduring effects of job loss are more pronounced for individuals confronted with challenging labor market conditions, those with a history of repeated unemployment, and individuals with lower levels of educational attainment.

The future of AVS, dizziness, and vertigo in emergency departments Part iii: A tyranny of distance – the persistence of rural health inequity

The future of AVS, dizziness, and vertigo in emergency departments Part iii: A tyranny of distance – the persistence of rural health inequity In the third article of this five-part series, Dr Millie Nakatsuka discusses the impact of isolation on health equity and the medical decision-making for emergency presentations of acute vestibular syndrome (AVS). People in rural and remote areas bear a significantly higher burden of disease and have poorer health outcomes. They have greater socio-economic disadvantage with lower levels of educational attainment, lower rates of employment, lower income and exhibit more health risk factors with markedly increased rates of obesity, tobacco smoking and alcohol consumption.

Travel-time barriers to specialized cancer care for adolescents and young adults with acute lymphoblastic leukemia.

Prior studies demonstrate that 20%-50% of adolescents and young adults (age 15-39 years) with acute lymphoblastic leukemia (ALL) receive care at specialty cancer centers, yet a survival benefit has been observed for patients at these sites. Our objective was to identify patients at risk of severe geographic barriers to specialty cancer center-level care. We used data from the North American Association of Central Cancer Registries Cancer in North America database to identify adolescent and young adult ALL patients diagnosed between 2004 and 2016 across 43 US states. We calculated driving distance and travel time from counties where participants lived to the closest specialty cancer center sites. We then used multivariable logistic regression models to examine the relationship between sociodemographic characteristics of counties where adolescent and young adult ALL patients resided and the need to travel more than 1 hour to obtain care at a specialty cancer center. Among 11 813 adolescent and young adult ALL patients, 43.4% were aged 25-39 years, 65.5% were male, 32.9% were Hispanic, and 28.7% had public insurance. We found 23.6% of adolescent and young adult ALL patients from 60.8% of included US counties would be required to travel more than 1 hour one way to access a specialty cancer center. Multivariable models demonstrate that patients living in counties that are nonmetropolitan, with lower levels of educational attainment, with higher income inequality, with lower internet access, located in primary care physician shortage areas, and with fewer hospitals providing chemotherapy services are more likely to travel more than 1 hour to access a specialty cancer center. Substantial travel-related barriers exist to accessing care at specialty cancer centers across the United States, particularly for patients living in areas with greater concentrations of historically marginalized communities.

Longitudinal gambling risk transitions: evidence from a nationally representative Australian sample

Aims Problem gambling has downstream consequences on individuals, families and the community. While a strong research base now exists on predictors and outcomes of problem gambling risk and severity, few studies have examined the transitions in gambling risk status over time, and factors associated with these transitions. Methods The current study addresses this knowledge gap by examining gambling transitions using two waves of longitudinal, population-representative Australian data (N = 12,364) collected in 2015 and 2018. Focal to our approach is the assessment of predictors of gambling risk status including demographics, and key psychosocial factors that might attenuate the risk of transition into more severe gambling. Results The results show significant stability in gambling risk over time, particularly among individuals who reported no or low gambling risk. Gambling risk transitions were more likely to occur toward less severe than more severe levels of gambling. Furthermore, gambling problems tended to persist in more severe levels of gambling risk. Financial hardship, younger age, male gender, experience of hardship, lower levels of educational attainment, chronic health conditions, risky levels of alcohol consumption, living in low SES areas, and low sense of mastery were associated with transitions from low to more severe gambling over the three-year period. There were no significant predictors of transitions to lower levels of gambling risk in the current data. Conclusions Our findings can help inform public health interventions by better targeting individuals at elevated risk for more severe gambling over time, and we outline a method for analyzing transitions in longitudinal datasets that can be applied in future studies in addiction.

Urban-Rural Health Insurance Integration and China's Rural Household Savings.

A linchpin to realizing the internal circulation (referring to the domestic cycle of production, distribution and consumption) is reducing residents' saving rate and expanding the domestic needs. However, rural residents in China demonstrate a strong propensity to save money. In light of practical characteristics of urban-rural health integration promoted in different places, the three-phase data (from 2014 to 2018) and the dual difference-in-differences model of the China Labor-force Dynamics Survey (CLDS) are used to empirically investigate the impact of urban-rural health insurance integration on rural household savings. Research reveals that urban-rural health integration can reduce the health risks and medical risks facing rural households, thus weakening the motivation of precautionary savings. The analysis of heterogeneity reveals that the integration of urban-rural health insurance significantly influences the savings rates of households headed by older individuals, particularly women, with lower levels of educational attainment. Besides, the single-tier health insurance system can have a more significant impact, whereas the multi-tier insurance system may not significantly affect the savings rate. Based on the aforesaid research conclusions, this article believes that in order to reduce the savings rate of rural households and expand consumption, the health insurance system should be further improved.

Effect of demographic characteristics of enterprises on the implementation of corporate social responsibility in SMEs context

Research background: Corporate social responsibility (CSR) is a rapidly developing field within business management, the effects of which manifest themselves in the practical management of organisations. At present, research within academia is focusing on the analysis and evaluation of the demographic characteristics of enterprises on entrepreneurs’ attitudes towards the implementation of socially responsible business management practices. Purpose of the article: The purpose of the article is to quantify the influence of the demographic characteristics of an enterprise on the implementation of corporate social responsibility. Demographic characteristics, such as the country of business, company size, business sector, gender of the entrepreneur, their age and educational attainment level, are all thought to play important roles in this. Methods: The research was conducted in three European countries on a selected sample set. The research hypotheses were verified by non-parametric testing using the parametric One-way ANOVA test and the Scheffe method. Findings &amp; value added: The results confirm that the country in which a company conducts its business activities and company size are significant factors affecting perceptions concerning the implementation of CSR. Entrepreneurs in the Czech Republic are significantly less likely to agree with the importance and implementation of CSR than entrepreneurs in Poland. Similar results were attained when comparing micro-enterprises and medium-sized enterprises, with micro-enterprises significantly less likely to agree with statements on CSR. Between men and women, no significant differences were found in their attitudes towards the incorporation of CSR into business management practices. The result was likewise with regards to the entrepreneur’s age. However, the business sector in which a company operates and the entrepreneur’s educational attainment level do have an influence on selected CSR indicators, with the impact on financial performance most positively perceived by those companies operating in retail. Those companies operating in the services sector attached the least importance to the implementation of CSR for acquiring new customers and improving financial performance than other sectors. Of interest is also the finding that enterprises run by owners or managers with lower levels of educational attainment neither perceive the concept of CSR nor the implementation thereof as a significant element of future business management.

PERSPECTIVES ON TECHNOLOGY ADOPTION AMONG SPANISH-SPEAKING HISPANIC ADULTS AGE 60+

Abstract By 2060, Hispanics aged 65+ are projected to be 21% (19.9 million) of the total US age 65+ population. Despite the benefits of technology use, such as facilitating social engagement and access to health services, few studies have explored attitudes of older Spanish-Speaking Hispanic adults toward technology adoption. In this secondary analysis of a larger diverse study of attitudes toward technology, we reviewed audio recordings and transcripts of Spanish-language interviews and focus groups with adults ages 63-89. Participants (n=21) self-identified as Hispanic, 67% had less than a high school education, and almost half (n=10) lived alone. Connecting with family members abroad was the primary motivator and a “necessity” for using technology; excess use of a device was negative. As one participant stated: “Technology brings you closer to those far away and pushes you away from those near you.” Those without relatives living with or near them reported greater difficulty using technology and identified living alone as a barrier to adoption. Finally, although the sample had low levels of English proficiency and low educational attainment, characteristics associated with lower use and knowledge of technology, findings challenge stereotypes that these older adults lack the capacity or interest to adopt the technology. Rather, the study identified multiple social factors that may hinder adoption. Understanding these cultural and linguistic barriers is important to promote digital inclusion; overcoming the digital divide will involve more than providing free tablets or classes. It will also require addressing barriers with adequate, culturally competent understanding, training and support.

The impact of training and development facilities on job commitment among entry-level employees: Bangladeshi RMG perspectives

Purpose: The study intended to ascertain whether providing training and development facilities positively impacted the job commitment of entry-level garment employees in Bangladesh. Research Methodology: The response rate for the survey was 44.89%, derived from a sample size of 450 data points obtained by a basic random sampling technique. The study employed Microsoft Excel 2007, SPSS 22.0, and AMOS 23.0 to conduct exploratory and confirmatory factor analysis and structural equation modeling to assess the strength and reliability of the suggested research framework. Results: The study revealed a significant enhancement in the level of commitment among lower-level employees in the Bangladeshi garment industry when provided with training and development potential. Limitations: One primary constraint encountered in this study pertained to issues associated with data collection. The target demographic consists exclusively of individuals with lower levels of educational attainment. Allocating funds for research in finance remained a significant area of focus. As a result of these limitations, the survey was unable to gather nationwide data. Contribution: This study is distinctive as it focuses on individuals occupying lower-level positions within the Bangladeshi garment sector, exploring the potential avenues for professional advancement. Practical Implication: The study may benefit Bangladeshi garment firms' HR strategy and training and development plans. Environmental and internal variables can stress workers. Professional progress and quality training will help dedicated workers overcome these challenges. Novelty: The study is unique in two perspectives: the bottom-level employees and the emerging economy like Bangladesh.

Medical help-seeking intentions among patients with early Alzheimer's disease.

Limited information is available on the active process of seeking medical help in patients with Alzheimer's disease (AD) at early stages. The aim of this study was to assess the phenomenon of medical help-seeking in early AD and to identify associated factors. A multicenter, non-interventional study was conducted including patients of 50-90 years of age with prodromal or mild AD (National Institute on Aging/Alzheimer's Association criteria), a Mini-Mental State Examination (MMSE) score ≥ 22, and a Clinical Dementia Rating-Global score (CDR-GS) of 0.5-1.0. A multivariate logistic regression analysis was conducted. A total of 149 patients were included. Mean age (SD) was 72.3 (7.0) years, 50.3% were female, and 87.2% had a CDR-GS score of 0.5. Mean disease duration was 1.4 (1.8) years. Ninety-four (63.1%) patients sought medical help, mostly from neurologists. Patients with help-seeking intentions were mostly female (60.6%) with a CDR-GS score of 0.5 (91.5%) and had a greater awareness of diagnosis, poorer quality of life, more depressive symptoms, and a more severe perception of their condition than their counterparts. Lack of help-seeking intentions was associated with male sex (p = 0.003), fewer years of education (p = 0.005), a low awareness of diagnosis (p = 0.005), and a low emotional consequence of the condition (p = 0.016). Understanding the phenomenon of active medical help-seeking may facilitate the design of specific strategies to improve the detection of cognitive impairment, especially in patients with a lower level of educational attainment and poor awareness of their condition.

More Choices, More Problems? Ranked Choice Voting Errors in New York City

Examining the impacts of ranked choice voting (RCV) on voter efficacy is important as more areas consider adoption. The greater number of choices provided by longer RCV ballots may introduce opportunities for voters to misunderstand the ballot, make errant marks, or accidentally mark two or more candidates for one ranking, resulting in voidable ballots due to “overvoting.” Using ballot data from the 2013 general election, the 2017, and 2021 New York City democratic mayoral primaries, this paper asks whether voidable overvote ballots are more concentrated in constituencies with lower levels of educational attainment, average household incomes, and differing racial make-ups, and if this relationship is more pronounced under RCV than traditional elections. In the first RCV election in 2021, voters in locations with lower levels of educational attainment and median household incomes had higher shares of overvote voidable ballots than those in locations with higher educational attainment and incomes.

Violence among pregnant women in Denmark from 2019 to 2021 – A hospital-based cross-sectional study

We examined the prevalence of lifetime physical and any recent violence and related maternal characteristics and health in pregnant women. We used Patient Reported Outcomes data retrieved from the Copenhagen Pregnancy Cohort (n = 7,361). The prevalence of lifetime physical and any recent violence was 4.0 % and 1.6 %, respectively. For both lifetime and any recent violence, the highest prevalence rates were seen among women aged 18–24, non-cohabiting, smokers, low levels of educational attainment, and women with chronic medical and psychiatric disease and lower psychological well-being. The prevalence may potentially be underestimated in this study, highlighting the need for improving screening for violence.

Spouses of individuals living with mild cognitive impairment or dementia in the United States: A descriptive, population-based study.

Little is known about the population of individuals who live with a spouse with cognitive impairment (CI) or dementia. Using the US Health and Retirement Study, 2000 to 2018, we estimated the population of adults ≥ 50 years old co-residing with a spouse with probable CI/dementia. We described their socio-demographic and health characteristics and quantified socio-demographic inequities. Among community-dwelling adults ≥ 50 years old, 6% of women and 4% of men co-resided with a spouse with probable CI/dementia. Among those who were married/partnered, the prevalence of spousal dementia was greater for Black and Hispanic adults compared to their White counterparts, and for those with lower versus higher educational attainment. Among spouses, activities of daily living disability, depression, and past 2-year hospitalization was common. Millions of older adults, disproportionately Black and Hispanic people and people with lower levels of educational attainment, live with a spouse with CI while also facing their own major health challenges.