Lower Education Rates Research Articles

THE ROLE OF ISLAMIC MICROFINANCE BANKS IN PROMOTING THE SOCIAL WELFARE: A CASE STUDY OF YOBE MICROFINANCE BANK

The study assesses the Islamic Microfinance Bank’s role in promoting customers’ social welfare, using the newly developed products of Yobe Microfinance Bank to encourage inclusion and alleviate poverty in the Yobe communities. Yobe State is ranked bottom as the poorest in the region and scores low on human development and poverty alleviation. It indicates low education rates, poor implementation of government policies on poverty, and a high financial exclusion rate. The study adopted a qualitative approach using random sampling to collect data from customers of Yobe Microfinance Bank. Using the acceptability of the newly introduced sharia complaint products of Yobe Microfinance among the people in Yobe state, using the Structural Equation Modelling, 300 respondents completed the survey using a Likert scale. The study employed Structural Equation Modeling to analyze and test reliability and validity to provide accuracy of respondents’ information. The finding indicates the positive relationship between Islamic banking products and customer satisfaction. The study concludes that introducing and consistently managing Islamic products can improve social welfare and reduce poverty through financial inclusion in the state.

Does the Disparity Patterning Differ between Diagnosed and Undiagnosed Hypertension among Adults? Evidence from Indonesia.

Healthcare systems in many low- and middle-income countries (LMICs) are not yet designed to tackle the high and increasing burden of non-communicable diseases (NCDs), including hypertension. As a result, a large proportion of people with disease or risk factors are undiagnosed. Policymakers need to understand the disparity better to act. However, previous analyses on the disparity in undiagnosed hypertension, especially from LMICs, are lacking. Our study assessed the geographic and socioeconomic disparity in undiagnosed hypertension and compared it with diagnosed hypertension. We used the Basic Health Survey (Riskesdas) 2018 and performed geospatial and quantitative analyses across 514 districts in Indonesia. Dependent variables included diagnosed and undiagnosed hypertension among adults (18+ years) and by gender. A high prevalence of undiagnosed hypertension at 76.3% was found, with different patterns of disparity observed between diagnosed and undiagnosed hypertension. Diagnosed hypertension was 1.87 times higher in females compared with males, while undiagnosed hypertension rates were similar between genders. Urban areas had up to 22.6% higher rates of diagnosed hypertension, while undiagnosed hypertension was 11.4% more prevalent among females in rural areas. Districts with higher education rates had up to 25% higher diagnosed hypertension rates, while districts with lower education rates had 6% higher rates of undiagnosed hypertension among females. The most developed regions had up to 76% and 40% higher prevalence of both diagnosed and undiagnosed hypertension compared with the least developed regions. The disparity patterning differs between diagnosed and undiagnosed hypertension among adults in Indonesia. This highlights the need for effective measures, including healthcare system reforms to tackle NCDs in LMICs.

Food Security in the Time of COVID-19 for a Marshallese Community

Using an individual and family ecological systems model, we explored food security among a Marshallese cohort in Northwest Arkansas during the COVID-19 pandemic. We hypothesized that Marshallese households were experiencing high rates of food insecurity due to socioeconomic and systemic risk factors. Seventy-one Marshallese adults shared socioeconomic information about their household via an online survey. Descriptive results indicate that 91% of respondents report food insecurity. In terms of systemic barriers, almost half of Marshallese respondents do not have health insurance. Additionally, while most respondents report feeling calm, peaceful, and energetic, paradoxically, 81% report feeling depressed and downhearted at least some of the time. Logistic regression findings suggest that food insecurity is significantly related to education levels and household economic strain. These results are analogous with national findings, whereby non-native households are more likely to experience higher levels of food insecurity, lower rates of education, and higher economic strain than native households. As a collective community, the Marshallese could benefit from culturally responsive individual and family systems approaches for improving educational, social, financial, and health opportunities through workforce development, household income and asset development, and food security initiatives. Additional implications for policy, practice, and research are provided.

Fed up: a qualitative investigation on the influencing factors of food insecurity in the Azores

Abstract Background In 2019, over 1 billion people experienced food insecurity. In the Azores, a 9-island archipelago in the Atlantic Ocean, 13.4% of its population perceived food insecurity, the highest regional rate in Portugal (10.1%). These geographical limitations paired with high unemployment and low education rates, may challenge their access to nutritious food. It is still unclear how these (and other) contextual factors may affect access and availability to food in this remote area, and how they interact with individual determinants. Methods Data collection was conducted in early 2022 with 13, in-depth, 1:1 semi-structured interviews regarding topics of food consumption and supply in the Azores. Non-probability sampling was used, with use of purposive and snowball sampling. We included key-stakeholders currently living in the islands or working in a role related to the islands (i.e., in healthcare, supply chain, agriculture, etc.). We performed a thematic analysis with an inductive-deductive iterative analysis. Results Participants identified several challenges related to access and availability of food. Vegetables, fruit and fish can be scarce and are subject to seasonal variation. There are clear regional disparities in access to food, with more isolated islands having less variety, quality and quantity of healthy foods available. Its topography and weather limit agricultural practices and transportation, but education, culture, and policies subsidizing the production of meat and dairy were also identified as important barriers to local production of fruits and vegetables. Conclusions Food insecurity is a public health concern in this outermost EU region. If topography and geography limit the production and access of nutritious foods, economic and agricultural policies are a leading theme of concern to highlight. The solution for food insecurity thus demands an interdisciplinary dialogue to better adjust future policies in the Azores and in similar regions. Key messages

Healthcare Access and Utilization Among Glaucoma Patients in a Nationwide Cohort.

Despite having lower socioeconomic status on several measures, glaucoma patients do not report more barriers to healthcare access and utilization than non-glaucoma patients. To characterize measures of socioeconomic status and barriers to healthcare access and utilization between patients with and without a diagnosis of glaucoma. Patients aged 65 years and over who enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, were extracted. We analyzed demographic information and several measures of socioeconomic status and healthcare access and utilization. Survey responses were compared by glaucoma status (any type) with Pearson χ 2 tests, univariable logistic regression, and multivariable logistic regression adjusting for age, gender, race/ethnicity, and insurance status. Of the 49,487 patients who answered at least 1 question on the All of Us Healthcare Access and Utilization Survey, 4441 (9.0%) had a diagnosis of glaucoma. Majority of the cohort was female (28,162, 56.9%) and nonHispanic White (42,008, 84.9%). Glaucoma patients were observed to have lower rates of education ( P =0.004), employment ( P <0.001), and home ownership ( P <0.001) on χ 2 tests. On multivariable logistic regression models, those with glaucoma were significantly more likely to speak to an eye doctor (Odds ratio: 2.46; 95% confidence interval: 2.16 to 2.81) and significantly less likely to have trouble affording eyeglasses (OR: 0.85 95% CI: 0.72 to 0.99) in the prior year than those without a diagnosis of glaucoma. No significant association was found for other measures of healthcare access and utilization by glaucoma status. Although glaucoma patients aged 65 years and over fared worse on several measures of socioeconomic status, no significant difference was found in measures of healthcare access and utilization.

Effect of Sociodemographic Factors onUtilization of an Online Patient Portal to Self-Schedule Screening Mammography: A Cross-Sectional Study.

The aim of this study was to assess for sociodemographic factors associated with the use of an online patient portal to self-schedule screening mammography (SM) compared with the traditional scheduling pathway (phone call and referral system). A retrospective study was conducted at an urban quaternary care academic medical center with patient portal access to the electronic health record. All female patients undergoing SM at the institution from January 1, 2019, to December 31, 2019, were included. The institutional data warehouse was queried to extract the following variables: patient scheduling pathway (online self-scheduled vs traditional), age, language, race/ethnicity, health insurance provider, and ZIP code. ZIP code was linked to census data to extract the following: computer with Internet access, median household income, and education level. Multivariable logistic regression was used to identify independent factors associated with using the online self-scheduling pathway for SM. A total of 46,083 patients met the inclusion criteria. Three hundred two (0.7%) used the online self-scheduling pathway. Patients using the online self-scheduling pathway had higher odds of being younger (odds ratio [OR] for age in years, 0.94; 95% confidence interval [CI], 0.93-0.96), being English speakers (OR, 21.3; 95% CI, 2.9-153.9), being White non-Hispanic (OR, 1.7; 95% CI, 1.2-2.5), and having commercial insurance (OR, 1.5; 95% CI, 1.1-2.1). Patients using the online self-scheduling pathway had higher odds of living in ZIP-code areas with higher access to computers with Internet connection (OR, 1.04; 95% CI, 1.01-1.07) and lower rates of education at or above the college level (OR, 0.98; 95% CI, 0.97-1.00). Patient median household income by ZIP code was not significantly associated with use of the online self-scheduling pathway. Patients with limited English proficiency, those of racial/ethnic minorities, those who were older, and those without commercial insurance were less likely to use an online self-scheduling pathway for SM.

Catch Me if You Can

Catch Me if You Can

The Effect of Land Inheritance on Youth Migration and Employment Decisions in Rwanda

There is growing mobility of rural youth mainly caused by limited access to land resources and inadequacy of job opportunities. Increased population density coupled with low education rates has increased pressure on natural resources, especially land. This paper assessed the effect of land inheritance on youth migration and employment in Rwanda using the 2010/11 and 2013/14 Integrated Household Living Conditions Surveys (EICVs) data collected from 8160 households by the National Institute of Statistics of Rwanda (NISR). In-depth key informant interviews and focus group discussions, at institutional and cooperative levels, were conducted to supplement and support survey results. We used the Hausman test to choose between the fixed-effects and random-effects models. Results show that land inheritance has a negative and statistically significant effect on youth migration and non-agriculture-based employment. This implies that greater access to land through inheritance reduces the likelihood of youth migration and their participation in nonagricultural employment. The paper concludes with implications for policy aimed at creating increased access to land, expanding youth employment opportunities in rural areas, and reducing rural–urban youth migration.

Survival in Orthotopic Heart Transplant Recipients: Influence of Neighborhood Income, Education, and Employment

<h3>Purpose</h3> Due to the limited supply of donor heart, orthotopic heart transplant (OHT) programs are tasked with selecting organ recipients who will have good outcomes. Previous studies looking at socioeconomic level and transplant outcomes, have suggested that patients with low socioeconomic level have worse survival. No study has looked at the individual factors comprising socioeconomic status and their effects on survival of OHT patients. <h3>Methods</h3> A retrospective review all patients in Philadelphia County who underwent OHT at a tertiary care center from 1984 to 2015 was done. Data on patient demographics, survival, and zip code demographics were collected. Continuous variables were compared by ANOVA and categorical variables by chi-square test. Survival after OHT was determined by Kaplan-Meier survival analysis and log-rank test was used to analyze the differences in survival by Kaplan-Meier analysis. Cox regression analysis was used to adjust the survival for confounding variables <h3>Results</h3> Of the 456 patients who underwent OHT, 121 (26.5%) were transplant in Philadelphia County. The hazard ratio (HR) for survival in patient who underwent OHT was higher for patients with income < $33,000 (HR 1.35, 95% CI 0.88 to 2.07, p = 0.17) compared to > $66,000 (HZ 0.73, 95% CI 0.39 to 1.35, p = 0.31), but neither had a significant difference. Poverty rate above the mean (23.73%) was associated with a higher HR (HR 1.45, 95% CI 0.98 to 2.12), but this difference was also not significant (p =0.06). Patients in zip codes with lower rates of education had a HZ of 1.45 (95%, CI 0.82 to 1.78). This difference was not significant (p = 0.35). Higher unemployment rates were the only significant (p = 0.04) factor with a HR 1.51 (95% CI 1.02 to 2.23). <h3>Conclusion</h3> There is no significant difference in the survival outcomes of patients who live in areas with lower income, higher poverty rates, or lower levels of education. Higher rate of unemployment may a predictor survival.

Disparities and survival in newly diagnosed gastric cancer in Hispanic patients in the United States: a propensity score matched analysis

The burden of gastric cancer involving Hispanic patients in the United States is growing as both the population and the incidence of gastric cancer in this group increases. This burden is compounded by presentation with advanced disease and socioeconomic challenges shaping cancer care. We sought to describe the demographics, socioeconomic factors, treatment, and survival experience of Hispanic patients with gastric adenocarcinoma. Patients with gastric adenocarcinoma diagnosed between 2004 and 2015 (n=90,737) in the National Cancer Database were retrospectively identified. Patients of Hispanic ethnicity were compared against non-Hispanic white patients. Surgical cohort was further analyzed, and 1:1 propensity score matching was used to balance covariates between Hispanic and non-Hispanic white surgical patients. Survival was compared using Kaplan-Meier method. Cox regression was used to determine prognostic factors for survival. Compared to non-Hispanic white patients, Hispanic patients are more likely to be younger, female, and healthier. They were more likely to be uninsured, reside in poorer neighborhoods and reside in areas with lower rates of education. Hispanic patients were more likely to live in a metropolitan area, travel shorter distances for healthcare, and receive treatment at an academic and high volume centers. Hispanic patients were more likely to have higher stage disease presentation, higher grade tumors, lymphovascular invasion, and poorly cohesive adenocarcinoma. Hispanic patients were more likely to receive surgery, but less likely to receive adjuvant therapy. In Cox regression of all patients, unmatched surgical patients, and matched surgical patients, Hispanic ethnicity was an independent prognostic factor of improved survival. Hispanic patients with gastric adenocarcinoma present with several unfavorable clinicopathologic and socioeconomic factors. Paradoxically, these patients demonstrate improved survival. Further study is warranted to characterize disease biology in this population.

"When They See Someone Who Is Poor, They Step on Them": The Social Determinants of Health Among Survivors of Sex Trafficking in Cambodia

Social determinants of health (SDH) are defined as the non-medical yet health-affecting conditions of a person’s life. They include such considerations as working conditions, discrimination, and access to health services. The aim of this study was to explore the SDH impacting those who have survived sex trafficking in Cambodia. This study employed a mixed methods, secondary analysis, focusing on 52 survivors of sex trafficking in the Butterfly Longitudinal Research Project from 2010 through 2019. Participants described myriad social determinants of health, including: gender, age, relationship status (marriage), ethnicity, national identification documentation (statelessness), social class, formal education, vocational training, occupation, and monthly income. The negative impacts of these social determinants of health included: poor access to basic needs of food and clean water, unstable housing, low education rates, worsening physical health, depression, and suicidal ideation, along with long unresolved STI-like symptoms. As these are multidisciplinary issues, the study concludes with recommendations for remedial actions to be taken by multidisciplinary stakeholders, namely government agencies, healthcare professionals, and survivor aftercare service providers.

Out of School Factors Affecting Indigenous Girls’ Educational Attainment: A Theory of Change for the Opening Opportunities Program in Rural Guatemala

Guatemalans have the lowest education rates in Latin America, and within Guatemala, Indigenous, rural and poor girls have much lower education rates than their peers. The ‘Opening Opportunities’ program attempts to invest in the poorest girls from rural Guatemala to build their personal, social, health and economic assets. Realist evaluation attempts to understand the key mechanisms in complex social interventions, and is under-used in education research. Based on data from life history interviews from graduates, this paper presents a Theory of Change to understand the contexts, mechanisms and outcomes of the ‘Opening Opportunities’ Program relating to educational attainment. The four mechanisms most discussed by program graduates are: leadership and participation create confidence; greater networks (models, mentors, peers); opportunities created to participate in novel paid work; and desire for later marriage and childbearing. This is the first Theory of Change that explains out of school factors affecting educational attainment.

Screening for Alzheimer's disease in low-educated or illiterate older adults in Brazil: a systematic review.

Cognitive screening instruments are influenced by education and/or culture. In Brazil, as illiteracy and low education rates are high, it is necessary to identify the screening tools with the highest diagnostic accuracy for Alzheimer's disease (AD). To identify the cognitive screening instruments applied in the Brazilian population with greater accuracy, to detect AD in individuals with a low educational level or who are illiterate. Systematic search in SciELO, PubMed and LILACS databases of studies that used cognitive screening tests to detect AD in older Brazilian adults with low or no education. We found 328 articles and nine met the inclusion criteria. The identified instruments showed adequate or high diagnostic accuracy. For valid cognitive screening it is important to consider sociocultural and educational factors in the interpretation of results. The construction of specific instruments for the low educated or illiterate elderly should better reflect the difficulties of the Brazilian elderly in different regions of the country.

National School Lunch Nutrition and Cost Profile: A Case Study of the Ghana School Feeding Programme.

Numerous governments in developing countries institute school lunch programs or school feeding programs as a strategy to address high malnutrition and low education rates among children. In 2005, the Ghanaian government launched the Ghana School Feeding Programme (GSFP). The GSFP policy does not document (1) the actual meal and associated nutrient profile received by the student, (2) the cost of the meal ingredients to the caterer who prepares the food, nor (3) the recipe derivations that may supply an enhanced nutritional profile. We address these 3 information gaps by employing a detailed case study of 4 caterers supplying a traditional tomato stew recipe in northern Ghana within GSFP-supported school lunch programs. Specifically, we explore the following propositions: (1) GSFP caterers can deliver a school lunch for under 100 pesewas (1 GH¢ or $0.21 USD) per student; (2) the meal meets the recommended daily allowance for protein; (3) soy can serve as a cost-effective ingredient to fortify the meal in terms of protein level and protein quality; and (4) significant differences exist in the macro- and micronutrient profile due to caterer discretion. We answer the above 4 propositions, and by doing so show the importance of accurately measuring the nutritional content, costs, and quantities of the actual school lunch under study. Second, among our results, we show the economy of locally produced soy flour as an ingredient that can lower costs and raise nutrition when substituting for other locally produced proteins such as ground beef and mackerel.

Public awareness, knowledge, and attitudes regarding epilepsy in the Qassim region, Saudi Arabia

IntroductionEpilepsy is a chronic condition and has significant negative consequences to quality of life. Misconceptions regarding epilepsy among communities with lower rates of education have led to false beliefs and ideas. This study aimed to evaluate the awareness, knowledge, and attitudes about epilepsy in Saudi population at Qassim region, Saudi Arabia. MethodsA cross-sectional study was conducted using a previously validated 14-item questionnaire. The data were collected online via WhatsApp application. The Saudi adult population (18 years and older) within Qassim region was sampled for the present study. ResultsA total of 403 respondents completed the survey and the majority (68.8%) were less than 30 years old. Nearly all participants (97.0%) had heard of epilepsy or convulsive seizures; 43.5% knew a person with the disease; and 48.4% had seen a person having a seizure. Participants cited brain disorders (68.1%) as the most common cause of epilepsy, followed by mental disorders (61.9%) then hereditary diseases (48.8%). Only 5.6% would protest against their children associating with a person who occasionally experiences seizures, and a similarly small percentage (7.9%) would do so if their son or daughter decided to marry such a person. ConclusionThe public's general attitudes and awareness of epilepsy were quite good; however, knowledge regarding this medical condition is still inadequate. Thus, more campaigns are needed in order to increase societal awareness on epilepsy, obtaining help from governmental agencies, health institutions, mass media, and other health-related organizations.

Prevalence of disability in Morocco: Results from a large-scale national survey.

Disability is considered a global health problem, with an increasing number of persons with disabilities. Up-to-date and good-quality data on disability are essential to policymakers in order to establish tailored programmes for persons with disabilities based on the specific needs of each category. The aims of this study were to determine the prevalence of disability in the adult Moroccan population, and its distribution according to socio-demographic characteristics and geographical regions. A national survey was conducted in 2014, including a sample of 47,275 adult participants drawn from 16,044 households from urban and rural areas proportioned to population size. The sample's socio-demographic characteristics were collected in face-to-face interviews. The data were then screened for disability using the Washington Group Short Set of Questions on Disability. Overall prevalence of disability among the Moroccan adult population was 9.5%, with important geographical disparities. Older age, lower education rates, unemployment, being single, and living in rural areas, were associated with higher prevalence rates of disability. Visual and motor deficiencies were the most common disability modalities, and the prevalence of moderate-to-extreme disability, which is associated with more significant limitations in functioning, was 2.6%. Results from this national Survey are critical and would guide national disability policies and programmes, in order to reduce disabling barriers and improve persons with disabilities access to healthcare and participation.

Breathing the same air? Socioeconomic disparities in PM2.5 exposure and the potential benefits from air filtration

Air pollution caused by particulate matter <2.5 μm in diameter (PM2.5) imposes a severe health burden to people worldwide. Across the globe, and even within cities, the health burden of air pollution is not equally shared by citizens. Despite being the region suffering from the most severe air pollution, studies examining the inequity of the burdens of air pollution in Asia are limited. We aim to fill in this gap by analyzing the relationship between PM2.5 pollution and residents' socioeconomic characteristics in Beijing, the icon city for PM2.5 pollution. Our results show that household income and education were negatively correlated with ambient air quality (r = −0.62; p < 0.05 and r = −0.73; p < 0.01 respectively) in 2014. We found in Beijing air quality is worse where residents have less income and lower education rates and are less capable to protect themselves from the potential health risk. To counter the effects of air pollution in Beijing, air filtration has been shown to be an effective means to reduce, at least, indoor PM2.5 levels. We illustrate through a simple scenario analysis that air filtration can reduce exposure (26–79%) to a similar extent as the structural mitigation programs (e.g. closing coal factories) achieved in recent years (53%). We argue government intervention is needed to convey the benefit of air filtration to the socioeconomically disadvantaged groups.

Epidemiology of disability and participation in Morocco: Results from 2014 National household survey

According to the World Health Organization, Over a billion people are estimated to live with some form of disability. A good quality data on disability are essential to policy makers in order to establish tailored programs for persons with disabilities (PWDs) based on the specific needs of each category. In low- and middle-income countries, data on disability are very scarce. The aim of this study is to determine the prevalence of disability and participation in Adult Moroccan population, and its distribution according to socio-demographic characteristics and geographical regions. A national Survey was conducted in 2014, including a sample of 47,275 adult participants drawn from 16,044 households from urban and rural areas proportioned to population size. The sample's socio-demographic characteristics were collected in a face-to-face interview. Then it was screened for disability using the Washington Group Short Set of Questions on Disability. Overall disability prevalence among Moroccan adult population was 9.5%, with important geographical disparities. Older age, lower education rates, unemployment, being single, and living in rural areas, were associated with higher disability prevalence rates. Visual and motor deficiencies were the most common disability modalities, and the prevalence of moderate to extreme disability, that is associated with more significant functioning limitations, was 2.6%. The study was conducted and funded by the Moroccan government as part of a National action plan on Disability.

Exploring infant feeding practices: cross-sectional surveys of South Western Sydney, Singapore, and Ho Chi Minh City

BackgroundInfant feeding practices are known to influence the child’s long-term health. Studies have associated obesity and other diseases with reduced breastfeeding and early introduction of high calorie beverages (HCBs). The rising prevalence of obesity is already a problem in most developed countries, especially Australia, but cultural differences are influential. Our aim is to examine and compare infant feeding practices and educational levels of respondents through questionnaires in three culturally different sites: Campbelltown (South Western Sydney), Australia, Singapore and Ho Chi Minh City, Vietnam (HCMC).MethodsConsenting parents and carers (aged ≥18 years old) of at least one child (≤6 years old) were recruited from paediatric clinics in Campbelltown, Singapore and HCMC. Participants completed an infant feeding practices questionnaire regarding breastfeeding, beverage and solid initiation in addition to the parent’s ethnicity, age, and educational level. Data was analysed quantitatively using SPSS.ResultsTwo hundred eighty-three participants were recruited across the three sites, HCMC (n = 84), Campbelltown (n = 108), and Singapore (n = 91). 237 (82.6%) children were breastfed but in all only 100 (60.2%) were exclusively breastfed for five months or more. There was a statistical difference in rates of breast feeding between each region. HCMC (n = 18, 21.4%) had the lowest, followed by Campbelltown (n = 35, 32.4%), and then Singapore (n = 47, 51.7%). There was also a difference in rates of introduction of HCBs by 3 years of age, with those in HCMC (n = 71, 84.5%) were higher than Campbelltown (n = 71, 65.8%) and Singapore (n = 48, 52.8%). The educational level of respondents was lower in Vietnam where only 46.4% (n = 39) had completed post-secondary education, compared to 75.0% (n = 81) in Campbelltown and 75.8% (n = 69) in Singapore.ConclusionsRates of breast feeding were inversely correlated with rates of introduction of HCB and positively related to educational achievement. Vietnam had lowest rates of breast feeding, higher rates of introduction of HCBs, and lower rates of education. Given rising rates of obesity, there is a need for more effective programmes to promote breast feeding and restrict false advertising of HCBs.

Individual and area-level factors correlated with death by suicide in older adults

ObjectiveTo determine the influence of individual and area-level characteristics associated with suicide in older adults. MethodThis study used two complementary data sources. The first used administrative data from the Quebec Coroner's office and included information on suicide deaths in older adults aged 65years and over who died by suicide between 2000 and 2005 (n=903 persons). The second data source, which was used to identify the control group, came from a longitudinal study on seniors' health that was conducted in Quebec between 2004 and 2005 (n=2493 persons). Logistic regression analyses were used to test for associations between suicide and individual and area-level level characteristics. ResultsSuicide was associated with male gender, age, the presence of a physical and mental disorder and the use of health services. At the area-level level, suicide was associated with a higher population density, concentration of men, lower rates of education and higher rate of unemployment. Gender specific analyses also showed different patterns of associations on suicide risk. ConclusionsSuicide in older adults is associated with area-level and individual characteristics. This suggests that policies targeting only one level of risk factors are less likely to significantly influence suicide among this population.