Low Socioeconomic Backgrounds Research Articles

The double disadvantage faced by adolescents from low socioeconomic backgrounds with mental health problems affects earnings up to mid-life

Early childhood socioeconomic disadvantage and mental health problems are both important determinants of adult social and economic experiences, but little is known about how they interact in this respect. We aimed to assess whether poor mental health in adolescence exacerbates labour market inequalities originating from low socioeconomic status (SES) in childhood. We use a birth cohort of individuals born in 1958 in England and follow their employment experiences and cumulative earnings up to age 55. We proxy low SES in childhood with father's occupational class at the time the respondent was aged 11, and use caregiver (usually, parent) ratings of the Rutter inventory at age 16 to identify mental health problems in adolescence. We fit ordinary least squares (OLS) models to estimate the effect of growing up in a low-SES family and experiencing mental health problems (conduct or emotional problems) in adolescence on cumulative earnings (log-transformed). We use an interaction term to test whether the association between mental health problems (conduct and emotional separately) and earnings differed by socioeconomic group. Individuals who experienced conduct problems in adolescence had lower cumulative earnings and employment levels up to age of 55. Moreover, the association between mental health problems and cumulative earnings was higher among individuals who also experienced low SES in childhood. Families from a higher socioeconomic group may have more effective means to counteract the adverse impacts of adolescent mental health problems, likely due to broader access to resources, support systems and opportunities. This underscores the role of structural supports in addressing socioeconomic inequalities in mental health outcomes and their long-terms implications.

Ritual Child Homicide in Contemporary Africa: A Systematic Review of the Empirical Literature

Ritual child homicide, the killing of children for ritual or occult purposes, is a phenomenon that occurs in many African countries. Prior to the 21st century, very little, if any, criminological analysis of ritual paedicide in African settings existed. However, research on ritual child homicide has increased in recent years, leading to greater knowledge and understanding of the phenomenon. The present study sought to consolidate and synthesize information on ritual child homicide in African communities to facilitate a better appreciation of the phenomenon. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search for empirical studies on ritual paedicide in African settings, spanning the years 2000 to 2022, was conducted across four databases: Scopus, Web of Science, Journal Storage, and Google Scholar. A total of 14 studies met the eligibility criteria and were diligently appraised. The review shows that most ritual paedicide victims are from families of low socioeconomic backgrounds in rural communities. A ritual paedicide typically involves multiple culprits. The actual perpetrators (i.e., body hunters or murderers) are predominantly males of low socioeconomic status, motivated largely by monetary gain. To combat the phenomenon, economic improvement, the promotion of formal and public education, formal regulation of the activities of traditional healers/spiritualists, and the strengthening of the criminal justice system are recommended.

COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.

Health disparities, leading to worse health outcomes such as elevated COVID-19 mortality rates, are rooted in social and structural factors. These disparities notably impact individuals from lower socioeconomic backgrounds and more socially vulnerable areas. We analyzed the relationship between COVID-19 deaths and social vulnerability using the Minority Health Social Vulnerability Index (MHSVI). COVID-19 death data in the U.S. was obtained from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, where COVID-19 deaths were defined using the ICD-10 code U07.1. MHSVI composite scores were calculated for 3089 U.S. counties and categorized into social vulnerability quartiles, where values ranged from 0 (lowest vulnerability) to 1 (highest vulnerability). Negative binomial regression was employed to determine death rate ratios for each quartile within each theme. Finally, a multivariate negative binomial regression including all MHSVI sub-themes, excluding the overall index ranking, was used to assess the association between each theme and COVID-19 death rates independently. There were 1,134,272 COVID-19 deaths from January 1, 2020 through June 24, 2023. Adjusted rate ratios for COVID-19 deaths in the overall index ranking were 1.06 (95% CI 0.99-1.13), 1.14 (95% CI 1.06-1.22), and 1.41 (95% CI 1.31-1.52) for the second, third and fourth quartiles, respectively. Sub-themes of socioeconomic status (SES), household characteristics (HC), racial and ethnic minority status (REMS), housing type and transportation (HTT), and medical vulnerability (MV) revealed increasing death rates in higher vulnerability quartiles. The healthcare infrastructure and access (HIA) theme had decreasing death rate ratios of 0.74 (95% CI 0.71-0.78), 0.59 (95% CI 0.56-0.62), and 0.42 (95% CI 0.39-0.44) for the second, third, and fourth quartiles, respectively. Finally, the multivariate analysis showed that the HC, HTT, HIA, and MV themes were associated with COVID-19 deaths (P < 0.05). Counties that were identified as more socially vulnerable experienced higher death rates from COVID-19. These areas may need additional public health and social support during future pandemics.

Universal Design Element Utilization and Mathematics Performance: Implications for Diverse Student Populations

This empirical research study investigates the relationship between the utilization of Universal Design (UD) elements and math performance among eighth graders. We analyzed 2017 National Assessment of Educational Progress process data using Poisson Generalized Linear Mixed-Effects Models to examine how the frequency of UD element usage varies across diverse student demographics. Our findings reveal a great divide: lower achievers, students with disabilities, those from lower socioeconomic backgrounds, English Language Learners, and African American students predominantly use text-to-speech, whereas high achievers more frequently employ digital pencils (which allow for manual writing or drawing on the screen) and elimination capacity (which enables students to dismiss incorrect multiple-choice answers). Linear Mixed-Effects Models show that higher levels of utilization of digital pencils and elimination capacity are correlated with improved math performance across various student subgroups. However, frequent changes in color themes, intended to enhance visual differentiation, were associated with lower performance, suggesting that these might serve as distractions rather than aids for some students. We discuss the implications of the findings in terms of the design of UD elements, as well as for equity, accessibility, and math education more broadly.

The reasons for and influences of unintended teenage pregnancy in Kericho county, Kenya: a qualitative study.

Unintended teenage pregnancies are associated with greater health and socio-economic risks for teenage mothers and newborns. In Kenya, the government has declared a target for ending teenage pregnancy by 2030. However, the prevalence of teenage pregnancy has only decreased slightly, demonstrating the need for further efforts. Understanding teenage mothers' own experiences and perspectives is necessary to design appropriate interventions. A community-based qualitative study was conducted from March to May 2023. Two focus group discussions were conducted with community health volunteers and the mothers of teenage girls. Semi-structured interviews were conducted on the case histories of 19 teenage mothers and 18 key informants. Thematic analysis was subsequently performed using MAXQDA 2022. Four major reasons emerged for unintended teenage pregnancies: (1) lack of knowledge or awareness about the human reproductive system, (2) lack of knowledge about family planning (FP), (3) financial challenges, and (4) low access to FP. At the study site, cultural norms and stereotypes, such as "infertility caused by FP," "freedom of sex by promoting FP," and "cultural taboos on having sex before marriage and talking about sexuality," were observed as barriers in promoting FP to teenagers. In addition, teenagers from low socio-economic backgrounds were found to be more vulnerable because they can be easily exploited by men who can afford to provide for some of their basic needs. Regarding the influences of unintended teenage pregnancy on teenage mothers' lives, the 19 cases were classified into four categories: (1) dropping out of school, (2) financial challenges, (3) changing relationships with parents, and (4) no major influence. Crucially, unintended teenage pregnancies negatively influenced most study participants. Continuing education, supportive parental attitudes, positive perceptions of the relationship with the child's father, and having future perspectives were identified as factors mitigating the negative influences. Strengthening culturally appropriate comprehensive sexuality education and the school re-entry policy with a supportive environment may prevent unintended teenage pregnancy and mitigate its negative influences. As financial challenges can be both a reason for and a negative influence of unintended teenage pregnancy, economic empowerment interventions are necessary.

12397 Predictors Of Hospital Readmission Within Three Months Among Patients Admitted For Diabetic Ketoacidosis (dka)

Abstract Disclosure: O. Onwudiwe: None. L. Yerashevich: None. C. Onwudiwe: None. B. Baral: None. A. Acharya: None. H. Nguyen: None. Purpose: Diabetic ketoacidosis (DKA) represents a critical, life-threatening complication of diabetes, with higher rates of re-admission noted among individuals from lower socioeconomic backgrounds, those lacking insurance coverage, and those with suboptimal follow-up care. This study seeks to identify predictors of hospital readmission within three months among patients admitted for DKA in a community hospital setting. Methods: Patient data were extracted from electronic medical records from 2019 to 2021 for individuals admitted due to DKA using ICD codes. DKA diagnosis was based on the presence of hyperglycemia, high anion gap metabolic acidosis, and ketonemia. Demographic information, results of routine biochemical tests, insurance status, follow-up with primary care providers (PCP) or endocrinologists, and clinical progression were retrospectively collected from patients' records. Multivariable logistic regression analyses were conducted to identify predictors of readmission. Results: A total of 222 unique DKA admission visits were analyzed. The mean age (standard deviation) of the patients was 48 (16) years, and 58% of them were male. Among these visits, 39% had type 1 diabetes, 43% had type 2 diabetes, and 18% were newly diagnosed diabetes cases. The majority of patients were overweight, with a mean body mass index (BMI) of 27, and the mean glycated hemoglobin level was 10.8. Common triggers for DKA included insulin non-adherence (52%), infection (37.8%), and alcohol use (8.6%). Logistic regression analysis revealed that lack of follow-up significantly increased the odds of readmission within three months (B = 2.025, p = .003, Exp(B) = 7.576, 95% CI [1.952, 29.401]), as did having type 1 diabetes (B = 1.473, p = .019, Exp(B) = 4.364, 95% CI [1.272, 14.978]). However, the association between insulin adherence and readmission was not statistically significant at the conventional alpha level of 0.05 (B = 1.329, p = .112, Exp(B) = 3.777, 95% CI [0.733, 19.458]). Other demographic (age, gender, employment status, insurance status, medication compliance,) and clinical [insulin adherence, presence of infection, blood glucose level at diagnosis of DKA, and level of glycated hemoglobin (Hba1c)] variables did not significantly predict readmission within 3 months. Conclusion: DKA, being preventable with adequate insulin adherence, is also influenced by factors such as infection and lifestyle choices. The findings highlight the critical role of post-discharge follow-up care in reducing readmission rates among DKA patients. Healthcare providers should prioritize ensuring timely and comprehensive follow-up, particularly for patients with type 1 diabetes, to optimize post-hospitalization management and prevent avoidable readmissions. Presentation: 6/3/2024

Linkage to care outcomes for patients in the emergency department referred to a cancer diagnostic program.

79 Background: An estimated 20-50% of patients receive a cancer diagnosis in the emergency department (ED), and a disproportionate share come from minority or lower socioeconomic backgrounds. A new suspected diagnosis of cancer is a critical time for patients and our institution implemented a novel cancer diagnostics program (CDP) to help with diagnosis and linkage to care. The CDP includes a multidisciplinary team and performs outreach after receipt of a referral, coordinating expedited diagnostic work-up and establishment of oncologic care. Here, we explore linkage to care outcomes, including implications for racial equity in access to care. Methods: A retrospective review was conducted for all patients referred from any ED to the Johns Hopkins CDP for suspected cancer from Aug 2021 to Dec 2023. Electronic health record data were manually extracted including demographics and linkage to care outcomes. National area deprivation index (ADI) score was collected using the University of Wisconsin Neighborhood Atlas. A comparison of time to oncologic visit between White and Black patients was performed with the Mann-Whitney test. Results: From Aug 2021 to Dec 2023, 52 patients were referred from the ED to the CDP. Median age was 58 (IQR: 48-68.25); 23 (44.2%) patients were female. 23 (44.2%) were Black. Of the 52 patients referred, 88.5% were successfully contacted by the CDP with median time to contact of 4 days (IQR 2-8). 76.9% of patients were confirmed to have malignancy (47.5% of whom had stage IV disease at diagnosis), while 23.1% had benign findings. Of those with malignancy, 87.5% were successfully contacted by the CDP; all of those contacted were successfully referred to an oncologic provider, with an attendance rate of 91.5% and median time to appointment of 22 days (IQR: 13-29.75). Of the patients referred to the CDP, 25.0% had an ED visit and 17.3% had a hospitalization within 30 days related to the suspected malignancy. Time to oncologic appointments were similar between Black and White patients with malignancy referred to the CDP (median for White patients: 20.5 vs. Black: 24.0; Mann-Whitney p= 0.35). Conclusions: Despite high proportions of minority patients and disadvantaged socioeconomic factors, the CDP had high rates of success in linking patients seen in the ED to outpatient oncologic care. In particular, Black and White patients had similar times to first oncologic appointment. This hypothesis-generating work demonstrates both the need and one potential intervention to improve access to outpatient care for this vulnerable population. Select demographics and clinical data for patients referred from the ED to the CDP. Selected Demographics (N =52) Race, N (%) White Black Other 18 (34.6) 23 (44.2) 11 (21.1) Primary insurance coverage, N (%) Medicare Medicaid Private Self-pay 22 (42.3) 1 (1.9); 11 (21.2) with secondary Medicaid coverage 24 (46.2) 4 (7.7) ADI, median (IQR) 53.5 (27.0, 76) Employed, N (%) 23 (45.1)

Sociodemographic Characteristics and Outcomes of Surgically Managed Central Cord Syndrome Patients

IntroductionUndiagnosed cervical spine stenosis is a risk factor for central cord syndrome (CCS), especially in vulnerable individuals. Social determinants of health (SDOH) are correlated with health outcomes. The aim of this study was to characterize the sociodemographic characteristics and outcomes in surgically-treated central cord syndrome (CCS) patients, and explore potential associations between them. MethodsThis is a retrospective cohort study of surgically-treated CCS patients at a Level-1 trauma center between 2015-2021. Patient demographics, radiological findings, and clinical outcomes were collected. SDOH were estimated using the Social Deprivation Index (SDI) and Area Deprivation Index (ADI). Descriptive statistics and regression analyses assessed associations between SDI/ADI, demographics and clinical outcomes. ResultsOf 56 patients, 75% were insured by Medicare/Medicaid and 70% were discharged to care facilities. Mean SDI was 66.4±24.4, and mean ADI was 7.4±2.2. Three patients required reoperation for post-operative complications. Post-operative neurologic outcomes varied, with 60.7% stable, 30.4% improved, and 8.9% declined. While SDI/ADI did not correlate with outcomes, higher ADI quartiles were associated with decreased likelihood of home discharge (p=0.048). Decline in neurologic function was associated with Medicare/Medicaid or Military insurance (p=0.011). ConclusionsThe results of this study indicated that CCS patients typically come from lower socioeconomic backgrounds, as indicated by high SDI and ADI scores. Despite this, we did not find significant correlations between SDI or ADI with post-operative outcomes, and most patients had stable or improved neurological function post-surgery in our cohort. Future studies with larger sample sizes will provide a more comprehensive understanding of these findings.

SOCIOLINGUISTIC PROFILE RESEARCH PAPER

This research paper explores the sociolinguistic profiles of learners in a sixth-grade classroom, focusing on the intersections between language, society, and individual characteristics. The study investigates the linguistic diversity within a group of Uzbek and Russian pupils learning English as a foreign language, highlighting the role of factors such as language background, socioeconomic status, and cultural identity in shaping their learning experiences. Two distinct learner subgroups are identified: one group of bilingual Russian-speaking students from urban, educated backgrounds, and another group of Uzbek-speaking students from monolingual, low socioeconomic backgrounds. Through analysis of these subgroups, the paper examines the influence of sociocultural dynamics on language learning behaviors and challenges. The study provides pedagogical and assessment implications, aiming to offer educators insights into adapting instructional techniques to accommodate the diverse needs and backgrounds of their students. By addressing these sociolinguistic dimensions, this paper contributes to understanding how language variety and social context affect language education and the notion of pedagogical implications and assessment implications are discussed.

A preliminary study of educational experiences that promote perceptions of college readiness in individuals from lower socioeconomic backgrounds interested in pursuing a career in science, technology, engineering, math, or medicine (STEMM)

IntroductionCollege readiness encompasses many different domains, including content knowledge, metacognitive skills, communication skills, learning strategies, and transitional knowledge. College readiness impacts academic achievement; moreover, student perceptions regarding college readiness impact their behavior and decision to attend college. High-achieving students from lower socioeconomic status (SES) areas possess grit and intelligence, but systemic barriers and inequities can interfere with the achievement of academic success in part due to reduced college readiness.MethodsIn this study, we explore if educational opportunities, such as outreach and pathway programs (OPP), Advanced Placement and International Baccalaureate, and college dual enrollment, impact perceptions of college readiness in a nationwide sample of 339 matriculating college students who wish to enter into Science, Technology, Engineering, Mathematics, and Medicine (STEMM) related fields.ResultsOPPs (p = 0.005) and dual enrollment (p = 0.002) are predictive of higher perceptions of college readiness. When individuals are partitioned into low and high SES by a median-split, OPPs (p = 0.015) and dual enrollment (p &amp;lt; 0.001) are predictive for students from low SES areas only.ConclusionThis work indicates the importance of educational opportunities in improving perceptions of college readiness for students from low SES areas and potentially how resources may be better allocated in the future.

Examining the associations between high achievement in reading and school climate: evidence from five South American countries

An emergent literature has shown that some students overcome adversities related to their low Socio-Economic Status (SES) by attaining high academic achievement. One of the aims of this literature is to identify the factors that explain the capacity of students from low SES backgrounds to attain high academic achievement. However, upon reviewing this literature, I observed that few studies have comparatively investigated the associations between the capacity of students from low SES backgrounds to attain high achievement in reading and school climate characteristics. Additionally, I found that not many studies have researched whether student SES moderates these associations. This paper contributes to fill these two gaps by estimating associations between high achievement in reading and school climate characteristics. Moreover, it examines whether student SES moderates these associations. To do this, this research estimated logit and heterogeneous choice models using representative samples of students from Argentina, Brazil, Chile, Colombia, and Uruguay who participated in the 2018 Programme for International Student Assessment (PISA). The results show that high achievement in reading is positively correlated to certain teaching practices, such as perceived teacher enthusiasm during the instruction and adapting instruction to students’ needs. Conversely, it is negatively correlated to teacher feedback and teacher-directed instruction. Furthermore, the findings indicate that high achievement in reading is negatively correlated to the scarcity and low quality of educational material. Interestingly, the results show that student SES does not moderate these associations. In conclusion, these findings indicate that interventions targeting these areas of school climate may help to increase students’ probability of attaining high achievement in reading, regardless of their SES. Likewise, these results suggest that if these interventions are focused in low SES schools, they may contribute to bridge the gap in reading skills between students from low and middle or high socioeconomic backgrounds.

Social Media Use and Academic Performance in Chinese Children and Adolescents: A Moderated Chain Mediation Model.

Based on data from the 2022 Chinese Minors' Digital Life and Online Protection Survey, this study investigated the status quo of social media use and its influencing mechanism on academic performance among Chinese children and adolescents. The statistical results indicate that the average level of Chinese students' social media use was generally low, with their academic performance varying across socio-demographic and schooling characteristics. After controlling for other variables, it was found that the frequency of social media use could exert a significant positive impact on students' academic performance. Moreover, the mechanism analysis revealed that online learning behavior and prosocial behavior served as chain mediators linking social media use to academic performance. Specifically, students could transfer their social media behavioral patterns to the internet-based learning context, and then effectively utilize remote learning resources. Meanwhile, engagement with social media would cultivate individuals' prosocial personality, thereby stimulating intrinsic motivation for learning and ultimately enhancing academic performance. The heterogeneity analysis further confirmed that the impact of social media use on students' academic performance was stronger in lower-class families, underscoring the moderating role of family socioeconomic status in the relationship between social media use and academic performance. The findings suggest that if academic performance is regarded as an integral part of individual capacity development, then the rational utilization of social media resources might be a pivotal approach to alleviate the predicament of developmental inequality faced by students from low socioeconomic backgrounds.

Shadow education, enabler or barrier: insights from Malaysian secondary school students

ABSTRACT Shadow education (SE) or supplementary private tutoring research has gained significant traction in the past two decades. With extensive implications of SE on the ecology of education and academic performance, this study investigates Malaysian secondary school students’ views on SE and its perceived impact on their academic performance. Eight focus groups with four schools (n = 47) were conducted with students (n = 24) who used SE and those who did not (n = 23) for a more holistic perspective. Findings revealed that all students perceived SE as beneficial for achieving improved academic performance. SE users found SE enhances their mainstream schooling performance. Nonetheless, they reported negative lifestyle impacts due to time demands. Furthermore, students from lower socioeconomic backgrounds reported that they felt educationally disadvantaged by not having access to SE due to its cost. We conclude that the inequality of opportunities requires policy responses to SE for regulation purposes in the Malaysian setting.

Does Childhood Cochlear Implantation Spill Over to Carers' Employment Status?

Carers of children with disabilities, especially primary carers, tend to have poorer labor market outcomes than carers of typically developing children. However, the extant literature has been largely silent on whether interventions for children's disabilities spill over to carers' employment outcomes, if at all. We aimed to fill this gap. We analyzed data from the Longitudinal Outcomes of Children with Hearing Impairment study, which is a unique panel dataset of Australian children who are deaf or hard-of-hearing (DHH). The Longitudinal Outcomes of Children with Hearing Impairment dataset includes information about 449 DHH children. We used 3 waves covering the same children at ages 0 to 3, 5 to 7, and 8 to 10 years during 2005 and 2018. We used a panel random-effects model, the use of which was supported by the Hausman specification test to control for time-invariant individual heterogeneity. We found that primary carers (typically mothers) of DHH children with cochlear implants (CI) were more likely to be employed relative to DHH children without a CI. The positive association was stronger among carers from a lower socioeconomic background. The association between childhood CI and carer employment may potentially be due to relaxed primary carers' time constraints to care for the child, increased self-efficacy, and reduced carer stress, enabling them to engage in other activities, including employment. Further research through large-scale, longitudinal studies is warranted to solidify the findings of this research.

Understanding depression and anxiety rates of school psychology graduate students.

School psychology graduate students experience many risk factors for problems with mental health, including high workloads, financial distress, and challenging relationships with faculty that can exacerbate feelings of anxiety and depression. Although there have been studies that have investigated depression and anxiety amongst graduate students in general (Eisenberg et al., 2007) and health service psychology students in particular (Hobaica et al., 2021), there are reasons to believe that school psychology graduate students may have different experiences. To date, no research has been found investigating the depression and anxiety symptoms of graduate students in school psychology programs. A survey was sent to 194 school psychology training programs, and 291 graduate students completed it. Approximately one in four graduate students reported moderate to severe levels of depressive symptoms, while one in three reported moderate to severe levels of anxiety symptoms. These symptoms were significantly higher in graduate students identifying as lesbian, gay, bisexual, transgender, queer/questioning, and more identities, women, or reported being from a lower socioeconomic background. There were no differences in depression or anxiety symptoms between the type of program (i.e., doctoral or specialist) or years in program. Implications for trainers of school psychology are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Discharge Against Medical Advice: The Causes, Consequences and Possible Corrective Measures.

Patients who discharge themselves against medical advice comprise 1%-2% of hospital admissions. Discharge against medical advice (DAMA) is defined as when a hospitalised patient chooses to leave the hospital before the treating medical team recommends discharge. The act of DAMA impacts on both the patient, the staff and their ongoing care. Specifically, this means that the patient's medical problems maybe inadequately assessed or treated. Patients who decide to DAMA tend to be young males, from a lower socioeconomic background and with a history of mental health or substance misuse disorder. DAMA has an associated increased risk of morbidity and mortality. In this review of studies across Western healthcare settings, specifically adult medical inpatients, we will review the evidence and seek to address the causes, consequences and possible corrective measures in this common scenario.

Socioeconomic determinants of very frequent presentations to emergency departments in New South Wales, Australia: A state wide data linkage study

ObjectivesTo describe the clinical and longitudinal patterns of presentation, and to understand the underlying socioeconomic characteristics of different modes of presentation. DesignRetrospective state-wide data linkage analysis of emergency department (ED) presentations. Patients were included if they were 18 years of age or over and presented to the ED over twenty times within any consecutive 365-day period between January 2015 and December 2020. This analysis used routinely collected data from the Emergency Department Data Collection and Admitted Patient Data Collection. The quintile of Socioeconomic Indexes for Area (SEIFA) defined by Australian Bureau of Statistics was used for equity considerations. Main outcome measuresThe main outcomes of interest included patients’ clinical presentation, demographic information and SEIFA score as represented by Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) quintiles. ResultsThere were 417,154 presentations and 5,244 patients who met the inclusion criteria. The majority of the presentations were from SEIFA groups 1 (28.2 %) and 2 (35.6 %). The most common presentations were for drug and alcohol (17.5 %), followed by abdominal pathology (11.8 %) and mental health (11.5 %). In the lowest SEIFA group, the main presenting complaints were for drug and alcohol and administrative presentations. While in the highest SEIFA group, the main presentations were for mental health then abdominal pain, followed by drug and alcohol presentations. ConclusionPatients in the lower SEIFA groups tended to be older with lower acuity presentations and were more likely to present to the same facility, more regularly. Patients in the lower SEIFA group were also more likely to present with drug and alcohol and administrative presentations while those in the higher SEIFA groups were more likely to present with mental health presentations. System wide interventions are needed to address the needs of both groups, particularly those from lower socioeconomic backgrounds, who would benefit from improved access to primary care either through access to General Practice or Urgent Care Centres.

The effects of duration of any breastfeeding on body mass index in Australian children: Exploration of health, economic and equity impacts.

Breastfeeding is a protective measure against childhood overweight and obesity. However, many children are not breastfed the recommended duration, with those from disadvantaged backgrounds more likely to cease breastfeeding early. Investigate the association between duration of any breastfeeding and body mass index (BMI) and estimate the health, economic and equity impacts of increasing breastfeeding duration to at least 6 months. We modelled the association between any breastfeeding duration and BMI at age 6/7 years, using a nationally representative cohort of 3935 Australian children (survey weighted to 221 103 children). We then used a simulation model to predict the impact of increasing breastfeeding duration to at least 6 months in all children on prevalence of overweight (including obesity) and associated healthcare costs to age 16/17 years. Achieving breastfeeding duration of at least 6 months could prevent 2933 cases of overweight at age 16/17 years, translating to healthcare cost-savings of AUD $4.29 million. Although most cases (68%) would come from low socio-economic backgrounds this would make only a minor difference in reducing inequalities. Efforts to support increased breastfeeding duration could result in reduced prevalence of overweight and obesity and save healthcare costs, however, additional action would be required to improve equity.

Navigating educational inequities in the USA: A statistical analysis of socio-economic and cultural barriers faced by young adults in formal education

Young adults in the USA face a multitude of challenges, particularly those from multi-disadvantaged backgrounds. This paper examines the socio-economic and cultural barriers impacting the educational experiences of young adults aged 18–29 within formal education settings in the USA. Utilising theoretical frameworks of life course research, intersectionality, and spatial justice, this study aims to provide a comprehensive understanding of the multifaceted barriers that hinder educational attainment. Drawing on data collected from surveys, interviews, and secondary sources, we employ robust statistical techniques, including regression and factor analysis, to identify and analyse key socio-economic barriers such as income, employment status, and parental education. Additionally, we explore cultural barriers, including language proficiency, ethnicity, and cultural capital, and conduct an intersectional analysis to uncover the compounded effects of these factors. Our findings reveal significant disparities in educational outcomes linked to socio-economic and cultural factors, highlighting the pervasive nature of educational inequities in the USA. The analysis indicates that young adults from lower socio-economic backgrounds and minority cultural groups face substantial obstacles in accessing and succeeding in formal education. These barriers are exacerbated by institutional and structural factors, emphasising the need for targeted policies and practices to support vulnerable populations.

THE IMPACT OF SOCIOECONOMIC FACTORS ON NUTRITIONAL KNOWLEDGE AND DIETARY PRACTICES AMONG SCHOOL-GOING ADOLESCENTS

Objectives: This study investigates the impact of socioeconomic factors on nutritional knowledge and dietary practices among school-going adolescents in rural areas of Jodhpur, Rajasthan. The primary objectives were to assess the relationship between socioeconomic status and adolescents' nutritional knowledge and dietary practices, and to identify barriers to adopting healthy dietary practices in the context of socioeconomic disparities. Methods: A cross-sectional survey was conducted, encompassing data from 385 adolescents, with variables such as family income, parental education, and access to nutritional resources being analyzed. Results: The results revealed significant correlations between higher socioeconomic status and better nutritional knowledge and dietary practices. Adolescents from wealthier families and those with more educated parents demonstrated superior understanding and adherence to healthy dietary guidelines, while those from lower socioeconomic backgrounds exhibited gaps in knowledge and poorer dietary habits. Additionally, the study highlighted the presence of nutritional health issues, including both underweight and overweight adolescents, indicating a dual burden of malnutrition in the region. Conclusion: The conclusion emphasizes the need for targeted public health interventions that address the socioeconomic disparities influencing adolescent nutrition. Such interventions should include enhanced nutritional education, improved access to affordable nutritious foods, and culturally sensitive programs that respect local dietary practices while promoting balanced nutrition. The findings underscore the critical role of socioeconomic factors in shaping adolescents' nutritional behaviors and call for multi-faceted approaches to improve nutritional outcomes in rural communities. KEYWORDS: Nutrition knowledge, Dietary practices, Adolescent Nutrition, Public Health, Nutritional Education