Lower Socioeconomic Status Groups Research Articles

Associations between the objective and perceived food environment and eating behavior in relation to socioeconomic status among adults in peri-urban settings: results from the CIVISANO study in Flanders, Belgium

Obesity, a significant public health concern, disproportionately affects people with lower socioeconomic status (SES). Food environments have been identified as part of the causal chain of this disparity. This study investigated variations in the food environment across groups with different SES profiles residing in peri-urban municipal settings. In addition, it examined the association of the perceived and objective food environments with eating behaviour and assessed if these associations were moderated by SES. Utilizing GIS and survey data (n = 497, aged 25–65), results showed differences in the objective and perceived food environments based on SES. Respondents with higher SES perceived their food environments as better but resided farther from all food outlets compared to respondents with lower SES. However, there was no difference in outlet density or mRFEI between SES groups. SES moderated associations between the objective and perceived food environments and most eating behavior outcomes except fast food consumption frequency. For fruits and vegetables, SES moderated the association between neighborhood availability and consumption frequency (β0.23,CI0.03;0.49). Stratified analysis revealed a positive association for both lower (β0.15, CI0.03;0.27) and higher (β0.37, CI 0.12;0.63) SES groups. For snack foods, SES moderated the association between healthy outlet density and consumption frequency (β-0.60, CI-0.94; -0.23), showing statistical significance only for respondents with higher SES (β0.36,CI 0.18;0.55). Similarly, for sugar-sweetened beverages, a statistically significant interaction was observed between unhealthy outlet density in the 1000m buffer and consumption frequency (β 0.06, CI 0.02; 0.11). However, this association was only statistically significant for respondents with higher SES (β-0.02,CI -0.05;-0.0002). These results emphasize the significance of SES as a crucial element in comprehending the connection between the food environment and eating behaviour. Indicating the need for policymakers to take SES into account when implementing food environment interventions, particularly when focusing on the neighborhood food environment without considering residents’ SES and their perceptions.

Inequalities in caregiving strain during the COVID-19 pandemic: conceptual framework and review of the empirical evidence

The COVID-19 pandemic poses specific risks to vulnerable population groups. Informal carers for older adults are especially at risk of increased strain, as support from social networks and professional care services is no longer available or in short supply. Already before the pandemic, caring was unequally distributed within societies, with women and people in lower socio-economic status groups bearing a higher risk of caring strain. In this article, we propose a conceptual framework of (unequal) caring strain during the pandemic. We then summarise the state of empirical research, suggest questions for future studies and outline implications for social policy.

Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population?

BackgroundHealth literacy (HL) has been put forward as a potential mediator through which socioeconomic status (SES) affects health. This study explores whether HL mediates the relation between SES and a selection of health or health-related outcomes.MethodsData from the participants of the Belgian health interview survey 2018 aged 18 years or older were individually linked with data from the Belgian compulsory health insurance (n = 8080). HL was assessed with the HLS-EU-Q6. Mediation analyses were performed with health behaviour (physical activity, diet, alcohol and tobacco consumption), health status (perceived health status, mental health status), use of medicine (purchase of antibiotics), and use of preventive care (preventive dental care, influenza vaccination, breast cancer screening) as dependent outcome variables, educational attainment and income as independent variables of interest, age and sex as potential confounders and HL as mediating variable.ResultsThe study showed that unhealthy behaviours (except alcohol consumption), poorer health status, higher use of medicine and lower use of preventive care (except flu vaccination) were associated with low SES (i.e., low education and low income) and with insufficient HL. HL partially mediated the relationship between education and health behaviour, perceived health status and mental health status, accounting for 3.8–16.0% of the total effect. HL also constituted a pathway by which income influences health behaviour, perceived health status, mental health status and preventive dental care, with the mediation effects accounting for 2.1–10.8% of the total effect.ConclusionsAlthough the influence of HL in the pathway is limited, our findings suggest that strategies for improving various health-related outcomes among low SES groups should include initiatives to enhance HL in these population groups. Further research is needed to confirm our results and to better explore the mediating effects of HL.

Socioeconomic status, alcohol use and the role of social support and neighbourhood environment among individuals meeting criteria for a mental health problem: a cross-sectional study.

Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment. A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment. A four-class model of SES was best-fitting; "economically inactive,GCSE-level and lower educated,social renters", "intermediate/routine occupation,GCSE-level educated,mixed owner/renters", "retired, no formal education,homeowners", and "professional occupation,degree-level educated,homeowners". Compared to "professional occupation,degree-level educated, homeowners", SES classes were more likely to be non-drinkers; odds were highest for "economically inactive,GCSE-level and lower educated,social renters" (OR = 4.96,95%CI 3.10-7.93). "Retired, no formal education,homeowners" were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20-0.59). Associations between "economically inactive,GCSE-level and lower educated,social renters" and "retired, no formal education,homeowners" and non- and harmful drinking via social support and neighbourhood environment were significant. In contrast to the alcohol harms paradox, among individuals with a mental health problem, lower SES groups were more likely to be non-drinkers while no associations with harmful drinking were found. There is also a need to examine the alcohol harms paradox in the context of the area in which they live.

Hispanic Ethnicity and Fertility Outcomes

ObjectiveTo assess the association between ethnicity and fertility outcomes for men in a statewide cohort. DesignWe linked data from the Utah Population Database (UPDB) and Subfertility Health Assisted Reproduction and Environment (SHARE) database, to comprise a cohort of sub-fertile men who underwent semen analysis (SA) between 1998-2017 in Utah. A multivariable Cox proportional hazard model was constructed to understand the impact of ethnicity on fertility outcomes in our cohort. Results11,363 men were included. 1,039 (9.1%) were Hispanic. 39.7% of men in the lowest socioeconomic status group (SES) were Hispanic (p<0.001). When controlling for demographic and clinical factors, the number of live births was reduced for Hispanic men (HR=0.62 [0.57-0.67], p<0.001). Though fertility treatment (FT) had a positive effect (HR 1.242 [1.085-1.421], p<0.001), in competing risks models, Hispanic men were less likely to use FT (HR=0.633 [0.526-0.762], p<0.001). ConclusionHispanic ethnicity is significantly associated with a lower likelihood of successful fertility outcomes in Utah. Hispanic men had nearly a 40% reduced likelihood of live births when controlling for sociodemographic factors. Our results indicate that, depending on age, Hispanic men have up to approximately 14 fewer live births per 100 men per year, pointing to a significant disparity in fertility outcomes in the state of Utah. Given 15.1% of Utah’s population identifies as Hispanic and 18.7% of the United States population identifies as Hispanic on the 2020 Census, better understanding of the association of ethnicity and fertility outcomes is imperative.

The Association Between Life Satisfaction and Subjective Social Mobility Status Among Women of Rasht City: A Cross-Sectional Analytical Study

Background: The social causation hypothesis suggests that health is influenced by various social factors, including childhood living conditions and mobility pathways, and individual life satisfaction is primarily derived from the subjective sense of mobility and social class. Objectives: Adverse changes in social factors and their negative effects on health have been observed in numerous studies. This study aimed to investigate the relationship between life satisfaction and subjective social mobility status in women from Rasht. Methods: Conducted between 2020 and 2021, this cross-sectional correlational study examined 800 married women residing in Rasht who met the inclusion criteria. Participants were selected using a cluster random method from various areas of the city. Data collection tools included demographic characteristics, the Ferrans and Powers Quality-of-Life Questionnaire, and the MacArthur Scale to measure participants' socioeconomic status (SES). Data analysis was performed using SPSS software and parametric statistical tests. Results: The samples generally comprised individuals with intermediate socioeconomic status, and most participants indicated that their current living situation was better than that of their parents. The lowest average life satisfaction score was observed in the low socioeconomic status group, with participants experiencing downward mobility reporting the lowest life satisfaction scores. However, the results showed no significant difference in the satisfaction levels among different social mobility groups of women (P = 0.60). Conclusions: Our findings underscore the importance of researchers reflecting on and being sensitive to experiences related to social class and mobility. The study confirmed that individuals with downward social mobility tend to have lower life satisfaction. Social factors are strongly associated with health outcomes, emphasizing the need for the modern healthcare system to consider the impact of social factors on individuals' well-being.

The economic burden of cervical cancer on women in Uganda: Findings from a cross-sectional study conducted at two public cervical cancer clinics.

There is limited research on how a cervical cancer diagnosis financially impacts women and their families in Uganda. This analysis aimed to describe the economic impact of cervical cancer treatment, including how it differs by socio-economic status (SES) in Uganda. We conducted a cross-sectional study from September 19, 2022 to January 17, 2023. Women were recruited from the Uganda Cancer Institute and Jinja Regional Referral Hospital, and were eligible if they were ≥ of 18 years and being treated for cervical cancer. Participants completed a survey that included questions about their out-of-pocket costs, unpaid labor, and family's economic situation. A wealth index was constructed to determine their SES. Descriptive statistics were reported. Of the 338 participants, 183 were from the lower SES. Women from the lower SES were significantly more likely to be older, have ≤ primary school education, and have a more advanced stage of cervical cancer. Over 90% of participants in both groups reported paying out-of-pocket for cervical cancer. Only 15 participants stopped treatment because they could not afford it. Women of a lower SES were significantly more likely to report borrowing money (higher SES n = 47, 30.5%; lower SES n = 84, 46.4%; p-value = 0.004) and selling possessions (higher SES n = 47, 30.5%; lower SES n = 90, 49.7%; p-value = 0.006) to pay for care. Both SES groups reported a decrease in the amount of time that they spent caring for their children since their cervical cancer diagnosis (higher SES n = 34, 31.2%; lower SES n = 36, 29.8%). Regardless of their SES, women in Uganda incur out-of-pocket costs related to their cervical cancer treatment. However, there are inequities as women from the lower SES groups were more likely to borrow funds to afford treatment. Alternative payment models and further economic support could help alleviate the financial burden of cervical cancer care in Uganda.

Trends in mental health problems among Swedish adolescents: Do school-related factors play a role?

The aim of this study is to investigate the extent to which school-related factors, such as school liking, participation in decision-making, school-related parental support, teachers' support, and school physical environment, explain trends in mental health problems. The problems considered are psychosomatic symptoms (PSS), depressive symptoms (DS), suicidal ideations (SI), and suicide attempts (SA) among Swedish adolescents of varying socioeconomic status (SES) from 2004 to 2020. We analyzed data collected through repeated cross-sectional surveys from 19,873 15-year-old students at schools in a county in Sweden. Boys and girls each constituted 50% of the participants. We fitted linear and logistic regression models to investigate associations between the school-related factors and trends in mental health problems. Increased school-related parental support and school liking were cross-sectionally associated with decreased PSS, DS and SI, with school liking also associated with decreased SA. Conducive school physical environment was also found to be cross-sectionally associated with lower PSS and DS scores. Over time, mental health problems have shown a general increase among adolescents in the low SES group and a decrease among those in the high SES group. While school-related factors explained the improvement in mental health in the high SES group, we found such association only between parental support trends in PSS and DS, along with participation and trends in SA over time among adolescents in the low SES group. The results show that school-related factors play significant roles in influencing adolescent mental health. The influence, however, varied across SES gradients over time. This suggests that working against inequities in school-related factors would help address inequities in mental health.

Use of prescription opioids in Israel and socio-economic correlations between 2010 and 2020

BackgroundThe use of opioids has increased dramatically over the past several years in Israel. The aim of this study was to explore the trends of opioid consumption in Israel over a decade (2010–2020) stratified by socioeconomic status (SES), residence in the periphery, and ethnic background.MethodsThis cross-sectional study included all adult Maccabi Healthcare Services (MHS) patients who filled at least one prescription for opioids during the past decade. In order to standardize dosages and compare different opioid medications, we used the Morphine Milligram Equivalent (MME) conversion factor. We performed The Mann–Kendall test with autocorrelation correction to assess each trend. We then checked the differences between the trends with the Mann–Whitney test (for periphery) and the Kruskal Wallis (for SES and ethnic background).ResultsBetween the years 2010–2020, 261,270 MHS members met the study's inclusion criteria. The proportions of opioids consumption were 23.9/1000 patients in 2010 and 27.6/1000 patients in 2020, representing a 15% increase. The average daily consumption of opioids was 4.6 and 10.5 MME in 2010 and 2020, respectively, an increase of 227%. The daily MME during 2020 was higher for residents of the periphery compared to non-periphery residents (daily MME of 14.0 compared to 10.1, respectively). Average daily MME increased gradually during the study period for all levels of SES; the values were highest for the low SES group and the lowest for the high SES group (daily MME in 2020 for the lowest, middle, and high SES groups were 15.2 vs. 11.8 vs. 6.7 respectively).ConclusionsThis study highlights that the primary concern in the increase of opioid use is the increasing dosages. The increase in the number of patients using opioids is also significant but to a minor extent. These phenomena disproportionately impact vulnerable populations. Education programs should be offered to physicians regarding the possible harms of long-term use of opioids. These programs should emphasize the risk factors associated with the development of opioid use disorder (OUD) and the caution needed when increasing dosages or switching to higher-potency drugs. Pain clinics and centers for rehabilitation for patients with chronic pain or OUD should be available, not only in central areas but also in the periphery of the country. These clinics and centers should use a holistic approach and a multidisciplinary team that includes specialists in pain and addiction. They should be financially accessible for patients from low SES group and provide solutions in multiple languages.

Bridging the Knowledge Gap in Artificial Intelligence: The Roles of Social Media Exposure and Information Elaboration

This study examined how social media influence the knowledge gap between low and high socioeconomic status (SES) groups in artificial intelligence (AI), a highly debated scientific subject warranting immediate scholarly attention. A national survey of U.S. adults ( N = 965) was conducted. The results showed that education and social media exposure to AI information (SME) predicted greater AI knowledge, and SME did not moderate the SES-based AI knowledge gap. Furthermore, information elaboration moderated the association between SME and the AI knowledge gap. SME was associated with a smaller AI knowledge gap when information elaboration was high rather than low.

Tracking of MVPA across childhood and adolescence

ObjectivesTracking of physical activity from childhood onwards is an important public health issue, but evidence on tracking is limited. This study quantified the tracking of Moderate-Vigorous Physical Activity (MVPA) across childhood and adolescence in a recent cohort from England. DesignLongitudinal, with a socio-economically representative sample from North-East England, over an 8-year period. MethodsMeasures of time spent in MVPA, with an Actigraph GT1M accelerometer, were made at age 7–8y (n = 622, T1), age 9–10y (n = 585, T2), age 12–13y (n = 525, T3) and age 14–16y (n = 361, T4). Tracking of MVPA was assessed using rank order correlations between time spent in MVPA T1–T2, T1–T3, and T1–T4, and by using Cohen's kappa to examine tracking of meeting the MVPA guideline (mean of 60 min/d). We examined whether tracking varied by sex, socio-economic status (SES), initial MVPA, or initial body fatness. ResultsRank order correlations were all statistically significant at p < 0.01 and moderate: 0.58 between T1 and T2; 0.42 between T1 and T3; 0.41 between T1 and T4. Cohen's kappas for meeting the global MVPA guideline were all significant, weakening from moderate to low over the 8 years. Tracking was stronger in higher SES compared to lower SES groups, and there was some evidence that it was stronger in girls than boys, but the other explanatory variables had little influence on tracking. ConclusionsTracking of MVPA from mid-childhood to mid-adolescence in this cohort was moderate. This study suggests there is a need to establish high MVPA by mid-childhood, and to mitigate the age-related reduction in MVPA which occurs from mid-childhood.

Welfare Euroscepticism and socioeconomic status

While the European Union (EU) increasingly strengthens its social integration, opposition towards this process can also be observed, here defined as ‘welfare Euroscepticism’. To better understand this newly defined policy paradigm, this article aims to explain longstanding cleavages in both social policy and EU research: socioeconomic status (SES) divides. Contrary to the literature on public support for European integration, this article argues that higher SES groups are more likely to be welfare Eurosceptics than lower SES groups. This argument and its underlying explanations are examined through a multilevel approach using European Social Survey data from 18 EU member states, using the example of a potential EU-wide minimum income scheme. First, the results demonstrate that welfare Euroscepticism is indeed more prevalent among higher SES groups than lower SES groups (measured through occupation, education, income, and employment). The results indicate robust self-interest patterns among higher SES groups that do not want to carry (perceived) financial burdens of EU social policies. The opinion patterns also emphasize the multidimensionality of attitudes towards EU policies since the SES cleavages can reverse, depending on the policy in focus. Overall, the results indicate much potential to mobilize the larger proportion of the public to support EU social policies, that is, lower SES groups. However, potential conflicts may arise when the EU expands on policies that their traditional supporters – higher SES groups – are more likely to oppose. The article also shows that welfare solidarity on the individual and the country level can mitigate such conflicts. This is because higher levels of welfare generosity and lower levels of welfare chauvinism on the individual and the country level are related to smaller SES cleavages.

The Impact of Morphological Intervention on Literacy Knowledge and Reading Motivation: A Cluster-Randomized Comparison Trial in Diverse Socioeconomic Status Kindergartens.

This study investigated the effectiveness of a storytelling-based morphological intervention program on the language and literacy knowledge and reading motivation of kindergarten children from low and mid socioeconomic status (SES) backgrounds. It also explored how these groups compared in change scores against a non-intervened high SES group. Employing a cluster randomization approach, this study included 158 kindergarten children, comprising intervention and comparison groups from low and mid SES backgrounds, as well as a non-intervened high SES group. Assessments were conducted on morphological awareness (MA), print concepts, vocabulary, and reading motivation. Children in the intervention groups showed better performance in MA and print concept scores than those in their respective comparison groups. The mid SES intervention group also displayed significant improvement in vocabulary and motivation scores compared to its counterpart. When examining the effects of SES on change scores, the low SES intervention group achieved superior results in vocabulary and print concept scores compared to both the mid SES intervention and the non-intervened high SES groups. For reading motivation, the mid SES group outperformed the low SES group. The morphological intervention program using storytelling positively impacts both the literacy skills and reading motivation of kindergarten children, especially those from low and mid SES backgrounds. This study emphasizes the significance of designing interventions that cater to the distinct educational needs of children from different SES backgrounds.

Differential Associations of Alcohol Use With Ischemic Heart Disease Mortality by Socioeconomic Status in the US, 1997-2018

People with low socioeconomic status (SES) experience greater burden from alcohol-attributable health conditions and mortality at equal levels of alcohol consumption compared with those with high SES. A U-shaped association has been established between alcohol use and ischemic heart disease (IHD), but no study has explored how such an association differs by SES in the US. To investigate how the association of alcohol use with ischemic heart disease mortality differs by SES in the general US population. This cohort study used record-linked, cross-sectional National Health Interview Survey data for US adults aged 25 years and older, covering 1997 to 2018 with mortality follow-up until 2019. Data analysis was performed from March to June 2023. SES (operationalized using education attainment) and alcohol consumption were obtained from self-reported questionnaires. The outcome was time to IHD mortality or last presumed alive by December 31, 2019. Cox proportional hazard models were applied to evaluate the interaction of SES and alcohol use on IHD mortality, with age as the time scale. Sex-stratified analyses were performed, adjusting for race and ethnicity, marital status, smoking, body mass index, physical activity, and survey year. Fine-Gray subdistribution models were applied to account for competing risks. This cohort study of 524 035 participants (mean [SD] age at baseline, 50.3 [16.2] years; 290 492 women [51.5%]) found a statistically significantly greater protective association of drinking less than 20 g per day (vs lifetime abstinence) with IHD mortality in the high-SES group compared with the low-SES group (interaction term hazard ratio [HR], 1.22 [95% CI, 1.02-1.45] in men; HR, 1.35 [95% CI, 1.09-1.67] in women). In addition, the differential associations of drinking less than 20 g per day with IHD mortality by SES were observed only among people with less than monthly heavy episodic drinking (HED) (interaction term, HR, 1.20 [95% CI, 1.01-1.43] in men; HR, 1.34 [95% CI, 1.08-1.67] in women); no difference was found in people with at least monthly HED. Among women there was a greater protective association of drinking less than 20 g per day with IHD mortality in the high-SES group than the middle-SES group (interaction term, HR, 1.35 [95% CI, 1.06-1.72]). Among men, the harmful association of drinking more than 60 g per day with IHD mortality in the low-SES group was largely explained by other behavioral risk factors (ie, smoking, body mass index, and physical activity). This cohort study found a greater protective association between drinking less than 20 g per day with less than monthly HED and IHD mortality in the high-SES group compared with the low-SES group, in both sexes even after adjusting for key covariables and behavioral risk factors. The findings suggest that public health interventions on alcohol use should account for different socioeconomic backgrounds when assessing the level of risk related to alcohol exposure, bearing in mind that levels of consumption deemed safe regarding a specific outcome such as IHD may indeed be less safe or not safe across all sociodemographic groups.

The Influence of Race, Socioeconomic Status, and Physical Activity on the Mental Health Benefits of Sport Participation During COVID-19.

The purpose of this study was to compare the benefits of sport participation with no sport participation during the COVID-19 pandemic and determine the moderating effects of race and ethnicity, socioeconomic status (SES), and physical activity (PA) on mental health in adolescent athletes. Sport participation would be associated with greater improvements in mental health for athletes from racial and ethnic minority and lower SES groups compared with White and high SES groups. PA would mediate <30% of the mental health benefits of sport participation. Cross-sectional study. Level 4. In May 2021, adolescent athletes completed an online survey (demographics, sport participation, measures of anxiety and depression, PA). Participants were classified as those who played sports (PLY) and those who did not (DNP). Mental health symptoms for the PLY and DNP groups were compared via analysis of variance models that controlled for demographic variables. Moderating analyses assessed the interaction of sport participation status by (1) race and ethnicity (White/non-White) and (2) SES (high/low) with mental health. Mediation analyses assessed the degree that PA scores explained the differences in anxiety and depression between the 2 groups. Participants included 4874 adolescent athletes (52% female; age, 16.1 ± 1.3 years; PLY, 91%). Athletes who returned to sport from racial minority groups and low SES had greater decreases in anxiety (race and ethnicity: interaction estimate (b) = -1.18 ± 0.6, P = 0.04; SES, b = -1.23 ± 0.5, P = 0.02), and depression (race and ethnicity: b = -1.19 ± 0.6, P = 0.05; SES, b = -1.21 ± 0.6, P = 0.03) compared with White and high SES athletes, respectively. PA explained 24% of anxiety (P < 0.01) and 20% of depression scores (P < 0.01). Athletes who identify as a racial or ethnic minority and from areas of lower household income experienced disproportionately greater negative mental health impacts from sport restrictions during COVID-19. Improving access to sports in traditionally underserved areas may have significant mental health impact for adolescents.

Influence of Socioeconomic Status on the Presence of Obstructive Coronary Artery Disease and Cardiovascular Outcomes in Patients Undergoing Invasive Coronary Angiography.

This retrospective study investigated the impact of socioeconomic status (SES) on patients at high risk of cardiovascular disease, focusing on obstructive coronary artery disease (CAD) presence and long-term cardiovascular outcomes in individuals undergoing invasive coronary angiography (ICA). Analyzing data from 9530 patients categorized by health insurance type (medical aid beneficiaries (MABs) as the low SES group; national health insurance beneficiaries (NHIBs) as the high SES group), this research explores the relationship between SES and outcomes. Despite a higher prevalence of cardiovascular risk factors, the MAB group exhibited similar rates of obstructive CAD compared to the NHIB group. However, over a median 3.5-year follow-up, the MAB group experienced a higher incidence of composite cardiovascular events, including cardiac death, acute myocardial infarction, coronary revascularization, and ischemic stroke, compared with the NHIB group (20.2% vs. 16.2%, p < 0.001). Multivariable Cox regression analysis, adjusting for potential confounders, revealed independently worse clinical outcomes for the MAB group (adjusted odds ratio 1.28; 95% confidence interval 1.07-1.54; p = 0.006). Despite comparable CAD rates, this study underscores the fact that individuals with low SES encounter an elevated risk of composite cardiovascular events, emphasizing the association between socioeconomic disadvantage and heightened susceptibility to cardiovascular disease, even among those already at high risk.

Impact of socioeconomic status on presentation, care quality and outcomes of patients attended by emergency medical services for dyspnoea: a population-based cohort study

BackgroundLow socioeconomic status (SES) has been linked to poor outcomes in many conditions. It is unknown whether these disparities extend to individuals presenting with dyspnoea. We aimed to evaluate the...

Future Time Perspective, Beliefs, Strategies and Academic Achievement: Examining the Role of Socioeconomic Status

The primary objective of this research is to investigate the intermediary function of long-term self-regulation and perceptions of instrumentality in the correlation between Future Time Perspective (FTP) and academic achievement. Additionally, the study aims to explore the moderating impact of Socio-Economic Status (SES). The sample comprised 572 third-year high school students majoring in Science, selected through a meticulous stratified sampling process. Participants completed a comprehensive questionnaire encompassing the Future Time Perspective Scale (FTPS), Adolescent Self-Regulatory Inventory (ASRI), and Perceptions of Instrumentality (PI) Scale. SES was assessed in relation to parental education and household income indices, while academic achievement was gauged based on mean scores in three core courses: physics, chemistry, and biology. The study's conceptual model, as assessed through structural equation modeling, demonstrated a good fit for both high and low SES in the student cohorts. However, an analysis of the Chi-square for model fit revealed significant differences between the two groups, indicating non-identical structural relationships. Notably, in both groups, value and speed exhibited impacts on academic achievement, while the influence of connectedness varied between the groups. The research findings revealed that academic achievement in both groups was influenced by value through PI and by speed through long-term self-regulation. Connectedness affected academic achievement in both groups, but its impact was indirect through long-term self-regulation. Furthermore, in the high SES group, connectedness had a direct effect on academic achievement and also an indirect effect through PI. Interestingly, these direct and indirect effects were not statistically significant in the low SES group.

Teletherapy Used to Breakdown Access Barriers.

The studies presented in this literature review reveal the numerous ways that teletherapy can be used to treat patients with mental health issues. The literature includes six research articles from published scientific journals that span from 2005 to 2020. The three types of telehealth therapy reviewed include mobile telehealth, telephone, and video technology. The six research articles focus on the ways that telehealth can reach communities of lower socioeconomic status (SES) and those suffering from access barriers. The benefits of teletherapy include cost savings, time efficiency, easier access, and a reduction in recidivism. Challenges include access barriers, financial difficulties, anxiety, and fear of stigmatization. Limitations of the studies presented include a lack of accessibility to internet and technology, privacy issues, and insurance coverage. Overall, results show that teletherapy provides an affordable, accessible alternative to traditional in-person mental health therapy, especially in reaching lower SES groups, Veterans, and patients with access restrictions.

Socioeconomic Status and Dementia Risk Among Intensive Care Unit Survivors: Using National Health Insurance Cohort in Korea.

In aging populations, more elderly patients are going to the intensive care unit (ICU) and surviving. However, the specific factors influencing the occurrence of post-intensive care syndrome in the elderly remain uncertain. To investigate the association between socioeconomic status (SES) and risk of developing dementia within two years following critical care. This study included participants from the Korean National Health Insurance Service Cohort Database who had not been diagnosed with dementia and had been hospitalized in the ICU from 2003 to 2019. Dementia was determined using specific diagnostic codes (G30, G31) and prescription of certain medications (rivastigmine, galantamine, memantine, or donepezil). SES was categorized into low (medical aid beneficiaries) and non-low (National Health Insurance) groups. Through a 1:3 propensity score matching based on sex, age, Charlson comorbidity index, and primary diagnosis, the study included 16,780 patients. We used Cox proportional hazard models to estimate adjusted hazard ratios (HR) of dementia. Patients with low SES were higher risk of developing dementia within 2 years after receiving critical care than those who were in non-low SES (HR: 1.23, 95% CI: 1.04-1.46). Specifically, patients with low SES and those in the high-income group exhibited the highest incidence rates of developing dementia within two years after receiving critical care, with rates of 3.61 (95% CI: 3.13-4.17) for low SES and 2.58 (95% CI: 2.20-3.03) for high income, respectively. After discharge from critical care, compared to the non-low SES group, the low SES group was associated with an increased risk of developing dementia.