Low Socioeconomic Status Research Articles

Health-Promoting Behaviors and Its Relationship With Anxiety, Depression, and Social Support Among Nursing Students in Saudi Arabia: A Cross-Sectional Study.

This study aimed to assess the levels and determinants of health-promoting behaviors (HPBs) and their correlations between HPBs, anxiety, depression, and social support among nursing students. A cross-sectional, correlational study was performed from March to June 2024 with 268 nursing students in the College of Nursing at the University of Hail using aself-structured questionnaire. Data were analyzed using t-test, one-way analysis of variance, Pearson's correlation, and multiple stepwise regression. The mean score of nursing students on the HPLP-II scale was 2.60 ± 0.47 overall, with the spiritual growth subscale scoring the highest (3.05 ± 056) and physical activity scoring the lowest (2.25 ± 0.75). More than a quarter of the students were classified into the borderline range for anxiety (28.4%) and depression (26.9%). In comparison, 19.4% and 16% of the students experienced anxiety and depression, respectively. There were significant weak negative correlations between the HPBs and anxiety (r = -0.396; p <0.001) and between social support and anxiety (r = -0.335; p <0.001). Likewise, there were significant weak negative correlations between HPBs and depression (r = -0.343; p <0.001) and between social support and depression (r = -0.313; p <0.001). In contrast, significant weak positive correlations were observed between HPBs and social support (r = 0.354; p <0.001) and between anxiety and depression (r = 0.380; p <0.001). Multiple linear regression analysis of factors affecting HPBs, anxiety, depression, and social support showed that the model was significant for all (p = 0.026, p = 0.005, p <0.001, p = 0.003, respectively). Although students reported a satisfactory level of HPBs, especially for spiritual growth and social relations, nutrition and physical activity require attention. The presence of anxiety and depression affected asubstantial proportion of the students, especially those from lower socioeconomic status, and studying in the early years of the study. Family income, occupation, and education level have been reported to have a significant impact on health outcomes.

Childhood cancer and parental mental health: role of disease severity, socioeconomic status, and social dynamics

BackgroundThe impact of childhood cancer extends beyond the affected child, significantly influencing the mental health of their families. Since research in psycho-oncology has been carried out almost exclusively in high-income countries, little is known about the impact of childhood cancer on the family level in low- and middle income countries (LMICs). This is a notable gap in the evidence-base, as many LMICs are collectivist cultures, where social and family networks are crucial elements of health care.MethodsThis prospective, cross-sectional study examined the mental health of 307 Kurdish parents of children undergoing cancer treatment in the Kurdistan Region of Iraq (KRI). Data were collected through structured interviews at two major oncology hospitals in the KRI, utilizing standardized instruments to assess mental health symptoms, socioeconomic status, and social constraints. The study focused on understanding the effects of socioeconomic challenges, disease severity, and social support limitations on parental mental health.ResultsSignificant mental health challenges were observed among parents, with mothers experiencing higher symptom levels than fathers. Lower socioeconomic status was linked to poorer parental mental health. Additionally, parents of children with more severe cancer and those reporting their child’s reduced engagement in daily activities experienced heightened mental health symptoms. Social constraints on expressing feelings about the child’s illness further intensified parental stress, underscoring the cumulative impact of economic strain, disease severity, and limited social support on parental mental health.ConclusionsThe study highlights the intricate relationship between socioeconomic factors, the disease severity of the child, and social dynamics in shaping parental mental health in the context of pediatric cancer. Psychosocial interventions that target these specific stressors may aid in better supporting families, particularly those in low-resource settings.

Impact of the COVID-19 Pandemic on Seizure Control in Pediatric Epilepsy: Risk Factors and Clinical Outcomes.

Background: Epilepsy is a common neurological disorder in children, associated with significant morbidity and socioeconomic burden. The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, potentially exacerbating seizure control among pediatric epilepsy patients. This study aimed to evaluate the pandemic's impact on seizure characteristics and identify risk factors contributing to seizure exacerbation in children with epilepsy. Methods: A retrospective cohort study was conducted using medical records of 84 pediatric epilepsy patients at The Catholic University of Korea Yeouido St. Mary's Hospital from July 2019 to July 2022. Data were collected on demographics, epilepsy characteristics, and healthcare accessibility. Changes in seizure outcomes were analyzed alongside potential risk factors, including infections and socioeconomic variables. Statistical analyses assessed correlations between these factors and seizure exacerbations. Results: Among the 84 pediatric epilepsy patients, 25% experienced significant seizure exacerbations during the COVID-19 pandemic. These included increased seizure frequency (18%), prolonged duration (13%), emergence of new seizure types (4%), and status epilepticus requiring hospitalization (5%). Multivariate analysis identified recent epilepsy diagnosis (<1 year) and low socioeconomic status as independent predictors of seizure worsening (p < 0.05). Infections with non-COVID-19 respiratory viruses, such as RSV and influenza, were strongly associated with exacerbated seizure activity (p < 0.001). Dissatisfaction with access to epilepsy care further increased the risk of poor seizure control, reflecting the challenges posed by disrupted healthcare systems. Notably, no significant relationship was observed between SARS-CoV-2 infection and seizure outcomes, suggesting that indirect factors, rather than direct viral effects, were primary contributors to seizure exacerbation. Conclusions: This study highlights the compounded impact of disrupted healthcare access, socioeconomic challenges, and respiratory viral infections on seizure control during the COVID-19 pandemic. Strategies such as telehealth expansion, regular monitoring, and vaccination against respiratory pathogens are essential to optimize seizure management in future health crises.

Gender inequalities in prescribing and initiation patterns of guideline-recommended drugs after acute myocardial infarction

BackgroundEuropean guidelines recommend the prescription of certain drugs after acute myocardial infarction (AMI). The existence of gender differences in pharmacological treatment after an AMI has been described. This study aims to describe and analyse, using real-world data (RWD), whether there are gender differences in the prescribing patterns and initiation of treatment in secondary prevention after a first AMI, and which are the factors that explain these differences.MethodsA population-based observational study of RWD was conducted in the CARhES (CArdiovascular Risk factors for hEalth Services research) cohort. The study included subjects who had experienced a first episode of AMI between 2017 and 2022, had survived the event, and had a minimum follow-up of 180 days.Results3,975 subjects were followed 180 days after a first AMI. Women (27.8% of the study population) were older and had more comorbidities. Of the main guideline-recommended drugs, antiplatelets, lipid modifying agents and beta-blockers, were prescribed less often in women. Comedications such as rivaroxaban and calcium channel blockers were more likely to be prescribed in women. The proportion of subjects initiating treatment was similar in both genders.Overall, age and morbidity burden were the main contributors to differences in the prescribing patterns. Living in an urban area seemed to be a protective or mitigating factor. There were controversial results regarding socioeconomic level. ConclusionIn our study population, women are older, have greater comorbidities and lower socioeconomic status. Despite this, gender inequalities in the prescribing patterns after a first AMI remains, as women appear to experience less therapeutic effort. It is crucial to analyse them from an intersectional perspective, considering the influence of multiple axes of inequality on health, in order to develop gender-sensitive strategies with a multidisciplinary approach.

Novel Fibre-Rich Breads Yield Improved Glucose Release Curves and Are Well Accepted by Children in Primary School Breakfast Clubs.

The average fibre consumption of 4-10-year-old children in the UK is 14.6 g per day, with only 14% of these children reaching the 20 g recommended by the SACN (UK Scientific Advisory Committee on Nutrition), and this 'fibre gap' may be most pronounced in communities with the lowest socioeconomic status. School breakfast clubs target children from disadvantaged communities, but their provision may favour lower-fibre foods, due to perceptions that children will reject higher-fibre foods. Our research programme aims to increase the fibre density, digestive-metabolic quality and acceptability of school breakfast provision. In Study 1, we examined the in vitro digestion of four novel bread products, to determine the relationship between fibre content and glucose release profile, and assess their suitability for sustaining school activity. In Study 2, we introduced the Prograins breads, alongside higher-fibre breakfast cereals and fresh fruit, to primary school breakfast clubs. The Prograins bread products yielded lower peaks and more sustained glucose release curves than the 'standard' white bread control. Many children liked and chose the intervention foods, and the average fibre content of children's breakfasts increased. We conclude from this study that nutritious, fibre-rich bread products can be acceptable to children and that higher-fibre breakfast provision is feasible, and we recommend larger-scale intervention and assessment to validate these real-world findings.

Disparities in Alcohol-Associated Liver Disease Hospital Encounters Amongst a Texas-Based Cohort of Patients.

Alcohol-associated liver disease (ALD) disproportionately impacts men, racial and ethnic minorities, and individuals of low socioeconomic status; however, it's unclear how recent increases in ALD burden have impacted these disparities. We aimed to describe trends in racial, ethnic and socioeconomic disparities in alcohol-associated hospital encounters. We conducted a retrospective cohort study of adult hospital encounters with alcohol-associated diagnoses from three health systems between January 2016 and December 2021. The cohort was divided into three eras: a 'Historical Era,' (Oct 2016-June 2018, used only for trends); 'Era 1' (July 2018-March 2020); and 'Era 2' (April 2020-December 2021). Kaplan Meier and Cox regression analyses were performed to identify factors associated with overall survival. We identified 19,295 individuals with alcohol-associated encounters (44.7% White, 29.8% Hispanic, and 21.8% non-Hispanic Black (NHB) individuals), with a greater increase observed between eras 1 and 2 than the historical era and Era 1 (8.7% vs. 5.0%, p < 0.01). By age and sex, the greatest increases in encounters were observed in the youngest and oldest females but only the oldest males. By race and ethnicity, Hispanic individuals had greater increases in encounters compared to Black and White individuals (14.8% vs. 7.5% and 6.3%, p < 0.01). Older age (aSHR: 1.03, 95% CI: 1.03-1.0), higher MELD (aSHR: 1.08, 95% CI: 1.0-1.09), hepatic encephalopathy (aSHR: 1.42, 95% CI: 1.06-1.90), and hepatocellular carcinoma (HCC) (aSHR: 3.20, 95% CI: 2.29-4.49) were associated with increased mortality. The highest increases of alcohol-associated encounters were observed amongst young Hispanic and NHB women, highlighting variation in trends by age, sex, race and ethnicity. These disparities merit further investigation to elucidate underlying mechanisms and develop tailored interventions to improve ALD burden and outcomes.

Building a Digital Health Research Platform to Enable Recruitment, Enrollment, Data Collection, and Follow-Up for a Highly Diverse Longitudinal US Cohort of 1 Million People in the All of Us Research Program: Design and Implementation Study.

Longitudinal cohort studies have traditionally relied on clinic-based recruitment models, which limit cohort diversity and the generalizability of research outcomes. Digital research platforms can be used to increase participant access, improve study engagement, streamline data collection, and increase data quality; however, the efficacy and sustainability of digitally enabled studies rely heavily on the design, implementation, and management of the digital platform being used. We sought to design and build a secure, privacy-preserving, validated, participant-centric digital health research platform (DHRP) to recruit and enroll participants, collect multimodal data, and engage participants from diverse backgrounds in the National Institutes of Health's (NIH) All of Us Research Program (AOU). AOU is an ongoing national, multiyear study aimed to build a research cohort of 1 million participants that reflects the diversity of the United States, including minority, health-disparate, and other populations underrepresented in biomedical research (UBR). We collaborated with community members, health care provider organizations (HPOs), and NIH leadership to design, build, and validate a secure, feature-rich digital platform to facilitate multisite, hybrid, and remote study participation and multimodal data collection in AOU. Participants were recruited by in-person, print, and online digital campaigns. Participants securely accessed the DHRP via web and mobile apps, either independently or with research staff support. The participant-facing tool facilitated electronic informed consent (eConsent), multisource data collection (eg, surveys, genomic results, wearables, and electronic health records [EHRs]), and ongoing participant engagement. We also built tools for research staff to conduct remote participant support, study workflow management, participant tracking, data analytics, data harmonization, and data management. We built a secure, participant-centric DHRP with engaging functionality used to recruit, engage, and collect data from 705,719 diverse participants throughout the United States. As of April 2024, 87% (n=613,976) of the participants enrolled via the platform were from UBR groups, including racial and ethnic minorities (n=282,429, 46%), rural dwelling individuals (n=49,118, 8%), those over the age of 65 years (n=190,333, 31%), and individuals with low socioeconomic status (n=122,795, 20%). We built a participant-centric digital platform with tools to enable engagement with individuals from different racial, ethnic, and socioeconomic backgrounds and other UBR groups. This DHRP demonstrated successful use among diverse participants. These findings could be used as best practices for the effective use of digital platforms to build and sustain cohorts of various study designs and increase engagement with diverse populations in health research.

Exploring the Accessibility of Community-Based Telerehabilitation for Children with Disabilities from Low-Income Households

Community-Based Rehabilitation (CBR) is a rights-based approach that aims to provide equitable health services and participation opportunities for people with disabilities. Telerehabilitation has emerged as a potential methodology for delivering health care within the CBR framework. However, the accessibility of telerehabilitation presents unique challenges for children with disabilities (CWD) in communities with low socioeconomic status. This phenomenological qualitative study explores the barriers and facilitators that influence the participation of families of CWD in telerehabilitation as a method of CBR in urban poor communities. Nine focus group discussions (FGDs) were conducted involving 75 primary caregivers of CWD. Inductive thematic analysis using NVivo software was employed to analyze the collected data, revealing four themes that impact participation in Telerehabilitation: Economic and Social Resources, Self-Competency Affecting Transition, Flexible Service Delivery Mechanism, and Safety and Security as a Threat to Participation. The findings emphasize the intricate interplay of factors influencing the accessibility of telerehabilitation services for CWD from low-income households. Actionable strategies to address these challenges include providing affordable technology and internet access, offering training and support to families, developing culturally sensitive resources, establishing safety protocols, and advocating for inclusive policies and funding mechanisms. Collaboration among healthcare professionals, policymakers, and families is essential in building a resilient and equitable healthcare system that prioritizes the needs of CWD living in poverty. The insights gained from this study can inform the development of targeted interventions and support systems to ensure that no child is left behind in accessing quality care despite the digital and socioeconomic divides.

Risk factor clusters for non-communicable diseases in adolescents in Eastern Cape, South Africa

Background: The increasing prevalence of non-communicable diseases (NCDs) among adolescents in South Africa is a growing public health concern.Aim: To examine the clustering of NCD risk factors, with a focus on gender, socio-economic status (SES) and perceived stress among adolescents.Setting: The study involved adolescents from eight schools in Buffalo City Metropolitan Municipality and Amatole district, Eastern Cape.Methods: A stratified random sample of 266 adolescents (aged 12 years–18 years) was assessed for anthropometric, physiological, and perceived stress measures. Data included body mass index (BMI), blood pressure (BP), cholesterol, glucose levels, and perceived stress (via the Perceived Stress Scale). Analysis involved descriptive statistics, Chi-square tests, t-tests, and k-means clustering.Results: Females (n = 155) showed a higher prevalence of NCD risk factors, with 80.2% classified as overweight or obese compared to 19.8% of males, and 77.2% had elevated cholesterol versus 22.8% of males. Perceived stress was higher in affluent schools (59.8%) despite fewer metabolic risks. K-means analysis identified four health profiles with significant SES and health differences (p 0.001). Cluster 1 (high SES) showed elevated BP, BMI, and stress, while Clusters 2–4 (low SES) varied in risks, with Cluster 4 showing the highest BP and metabolic risks despite low stress.Conclusion: These results highlight unique health profiles and risk factors across socio- economic contexts, with female adolescents from lower socio-economic backgrounds facing greater metabolic risks.Contribution: This Study provides original insights into the interplay between gender, SES and perceived stress in shaping NCD risk among South African adolescents.

Hospital Health Information Exchange Network Density and Predictors Across U.S. Hospital Referral Regions.

Objective To develop a measure of Health Information Exchange (HIE) for characterizing the density of inter-hospital HIE connections and identify regional characteristics associated with HIE network density Materials and Methods HIE network density was measured as the proportion of hospital pairs within a region that are connected through HIE. The 2022 American Hospital Association's Information Technology Supplement survey was used to calculate HIE network density for US hospital referral regions (HRRs). Bivariate tests and multivariable regression were used to characterize hospital, electronic health record (EHR) vendor, and resident characteristics associated with HIE network density. Results Data on 2,509 hospitals across 274 HRRs were included in the study, with 92% of hospitals participating in at least 1 HIE. On average, hospitals participated in two HIEs and there were 7 HIEs present in each region. HIE network density ranged from 0.0 to 1.0, with a median of 0.78 and an interquartile range of 0.51 to 1.00. Hospital and vendor characteristics associated with greater HIE network density include: more HIEs per hospital, a higher proportion of non-profit hospitals, greater Epic marketshare, and more concentrated hospital and EHR vendor markets. Resident characteristics associated with greater HIE network density include: higher home values, more educated residents, and higher median household incomes. Conclusion We found that, on average, 7 out of 10 hospital-pairs within a given hospital referral regions are connected via at least one HIE, with lower HIE network density in regions with lower socioeconomic status. This measure can be used to track the impact of the Trusted Exchange Framework and Common Agreement on area-level interoperability.

A cross-sectional study of parental perspectives on children about COVID-19 and classification using machine learning models

Background and objectiveThis study delves into the parenting cognition perspectives on COVID-19 in children, exploring symptoms, transmission modes, and protective measures. It aims to correlate these perspectives with sociodemographic factors and employ advanced machine-learning techniques for comprehensive analysis.MethodData collection involved a semi-structured questionnaire covering parental knowledge and attitude on COVID-19 symptoms, transmission, protective measures, and government satisfaction. The analysis utilised the Generalised Linear Regression Model (GLM), K-Nearest Neighbours (KNN), Support Vector Machine (SVM), Random Forest (RF), Naive Bayes (NB), and AdaBoost (AB).ResultsThe study revealed an average knowledge score of 18.02 ± 2.9, with 43.2 and 52.9% of parents demonstrating excellent and good knowledge, respectively. News channels (85%) emerged as the primary information source. Commonly reported symptoms included cough (96.47%) and fever (95.6%). GLM analysis indicated lower awareness in rural areas (β = −0.137, p &amp;lt; 0.001), lower attitude scores in males compared to females (β = −0.64, p = 0.025), and a correlation between lower socioeconomic status and attitude scores (β = −0.048, p = 0.009). The SVM classifier achieved the highest performance (66.70%) in classification tasks.ConclusionThis study offers valuable insights into parental attitudes towards COVID-19 in children, highlighting symptom recognition, transmission awareness, and preventive practices. Correlating these insights with sociodemographic factors underscores the need for tailored educational initiatives, particularly in rural areas, and for addressing gender and socioeconomic disparities. The efficacy of advanced analytics, exemplified by the SVM classifier, underscores the potential for informed decision-making in public health communication and targeted interventions, ultimately empowering parents to safeguard their children’s well-being amidst the ongoing pandemic.

Associations among social mobility beliefs, academic coping strategies and academic persistence in adolescents with lower family socioeconomic status

Associations among social mobility beliefs, academic coping strategies and academic persistence in adolescents with lower family socioeconomic status

Validation of Diagnosis Codes for Low Birth Weight and Small-for-Gestational Age in the Medicaid Analytic Extract Database.

The accuracy of low birth weight (LBW) and small for gestational age (SGA) in administrative healthcare records is crucial for perinatal studies but has few validity studies. Using 1999-2010 MAX linked to birth certificates (BC), we identified mother-infant dyads (≥30 days enrollment after delivery, with valid gestational age (GA) and birth weight (BW)). LBW and SGA were identified based on ICD-9-CM codes. Infants with BW <10% of the U.S. reference were flagged as SGA. For LBW group diagnoses, we imputed birthweight using median, mean BW from BCs, and ICD code boundaries of infants in the same LBW group. We calculated the sensitivity, specificity, and positive/negative predictive values to assess performance. We identified 1,536,272 live births. All LBW groups had low SEs, high SPs, and NPVs, whereas PPVs varied. Among infants with SGA diagnoses based on GA/BW from the BC, SE of the SGA codes was 13.36%; SP 99.01%; PPV 67.37%. Combining imputation with LBW codes increased SE up to 22.09% (lower boundary) but decreased PPV to 41.53% (lower boundary). ICD-9-CM codes from administrative healthcare records had low SE but high SP. Imputation based on GA and BW did not add much value to SGA identification.

The Relationship Between Education Funding and Student Performance in Unity Schools in Nigeria

Developing countries need to significantly increase education funding in order to meet the Sustainable Development Goal 4 (SDG 4) targets. The question remains as to whether increased funding leads to improved learning outcomes and whether allocated scarce resources are used efficiently to maximize learning outcomes. Using ordinary least squares (OLS) regression and stochastic frontier analysis (SFA), we investigate the relationship between education funding and student performance using a representative sample of secondary schools in Nigeria and analyze school efficiency in utilizing the funding (budget). The OLS analysis robustly indicates that an increase in the released budget—in real terms—is consistently associated with a higher pass rate, while the SFA shows that after controlling for past budgets the average inefficiency is approximately 47–60%. Our correlation findings support the argument for more funding to improve performance. However, the SFA shows that more can still be achieved with current levels of funding if schools become more efficient. We observe differences across school type and school geographical location, concluding that these factors also influence performance and efficiency. Future research should examine the performance and efficiency differences between all-girls schools and mixed schools, and the higher efficiency of schools in low socioeconomic status (SES) and conflict-affected states.

Adolescent depression in school: risk factors and consequences on school functioning

Abstract Adolescents spend most of their formative years in school, making it an important context to consider when investigating crises. A personal crisis that often has its onset during adolescence is depression. To gain a better understanding of depression in school, we explore possible individual and school-related risk factors and outcomes of depressive symptoms in line with current etiology models. First, we investigate the intersection of possible demographic risk factors of depression (female gender, immigration background, SES). Second, we explore school-related factors (conscientiousness, parental expectations, social inclusion) that might be associated with students’ depressive symptoms, and whether depressive symptoms mediate the effects of these school-related factors on school-functioning (grades, test anxiety). The representative data was collected in 30 Austrian secondary schools in a survey study with three waves. The sample consisted of 1874 12th-grade students from 93 classes. We used well-established self-report scales for all constructs that showed good reliability and students’ mean grades on the most recent tests. Analyses were pre-registered. In general, students experienced heightened depressive symptoms. More specifically, calculating a dummy-coded regression, we found female students with an immigration background and low SES to be the most burdened. The results of the mediation model showed depressive symptoms to partially mediate the association of conscientiousness, social inclusion, and parental expectations with test anxiety; this was not observed for grades. Furthermore, we only found conscientiousness to be positively associated with grades. Directions for future research and implications are discussed.

Rural Roads to cognitive Resilience (RRR): A prospective cohort study protocol.

Ambient air pollution, detrimental built and social environments, social isolation (SI), low socioeconomic status (SES), and rural (versus urban) residence have been associated with cognitive decline and risk of Alzheimer's disease and related dementias (ADRD). Research is needed to investigate the influence of ambient air pollution and built and social environments on SI and cognitive decline among rural, disadvantaged, ethnic minority communities. To address this gap, this cohort study will recruit an ethnoracially diverse, rural Florida sample in geographic proximity to seasonal agricultural burning. We will (1) examine contributions of smoke-related fine particulate matter (PM2.5) exposures to SI and cognitive function; (2) determine effects of built and social environments on SI and cognitive function; and (3) contextualize SI and cognitive function among residents from different ethnoracial groups during burn and non-burn seasons. We will recruit 1,087 community-dwelling, dementia-free, ≥45-year-olds from five communities in Florida's Lake Okeechobee region. Over 36 months, participants will complete baseline visits to collect demographics, health history, and health measurements (e.g., blood pressure, body mass index) and 6-month follow-ups assessing cognitive function and social isolation at each visit. A subsample of 120 participants representative of each community will wear smartwatches to collect sensor data (e.g., heart rate) and daily routine and predefined activities (e.g., GPS-captured travel, frequent destinations) over two months. Ecological momentary assessments (EMA) (e.g., whether smoke has bothered participant in last 30 minutes) will occur over two months during agricultural burning and non-burning months. PurpleAir monitors (36 total) will be installed in each community to continuously monitor outdoor PM2.5 levels. We expect to identify individual- and community-level factors that increase the risk for SI and cognitive decline in a vulnerable rural population.

Stereotypes and social decisions: The interpersonal consequences of socioeconomic status.

Perceptions of socioeconomic status (SES) can perpetuate inequality by influencing interpersonal interactions in ways that disadvantage people with low SES. Indeed, lab studies have provided evidence that people can detect others' SES and that they may use this information to apply stereotypes that influence interpersonal decisions. Here, we examine how SES and SES-based stereotypes affect real-world social interactions between people from a socioeconomically diverse population. We used the computer-mediated online round-robin method to facilitate interactions among 297 participants from across the U.S. Participants completed a series of dyadic interactions with other participants in virtual rooms in which they discussed a recent negative consumer experience. After each interaction, they judged the interaction partner's SES, personality traits, and credibility of their consumer experience. Results showed that people perceived SES with moderate accuracy in the interactions, which elicited negative interpersonal stereotypes of low-SES individuals for all 12 of the personality traits measured. People also preferred to affiliate with others with high SES, had more sympathy for them, and found their experiences more credible. SES-based interpersonal stereotypes about personality traits mediated these associations. The perception of SES in real-time interactions thus appears to activate stereotypes that guide social judgments, supporting the hypothesis that interpersonal effects contribute to economic inequality. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Estimating the burden of RSV- and influenza-associated hospitalizations, ICU admissions, and deaths across age and socioeconomic groups in New York State, 2005-2019.

Multiple prophylactic products are now available to protect against respiratory syncytial virus (RSV) in different age groups. Assessing the pre-intervention burden of RSV infections across various severity levels and risk groups is crucial, as it provides a baseline for evaluating the impact of these products. We obtained monthly time series data on hospitalizations, intensive care unit (ICU) admissions, and deaths by age group, ZIP code, and cause for New York state from 2005 to 2019. Socioeconomic status (SES) of the ZIP codes was classified using supervised principal component analysis (PCA). We estimated the incidence of hospitalizations, ICU admissions, and deaths attributable to RSV and to influenza using hierarchical Bayesian regression models. Additionally, we assessed severity, defined by ICU admission and mortality risks, as well as recording fraction (i.e., percent of estimated virus-associated hospitalizations recorded as being due to the specific virus), stratified by age, SES, and over time. The estimated annual incidence of RSV-associated hospitalizations and ICU admissions were highest in infants under 1 in the low SES group (2,240 [95% credible interval (CrI): 2,200-2,290] hospitalizations and 330 [95% CrI: 320-350] ICU admissions per 100,000 person-years). The incidence of RSV-associated deaths was highest among adults ≥85 years old (61 [95% CrI: 49-74] per 100,000 person-years). In contrast to RSV, the burden of influenza was greatest in age groups ≥65 years. The risk of ICU admission varied by patients' age and SES, and the mortality risk increased dramatically with age for both pathogens (RSV: 11.9% [95% CrI: 9.6-14.3%], influenza: 14.4% [95% CrI: 13.1-15.6%] among ≥85 year age group). Incidence varied by epidemic year and season, and we observed an increasing recording fraction of RSV among all age groups over the study period. RSV and influenza contribute significantly to the burden of hospitalizations, ICU admissions, and deaths, particularly among infants and older adults. Although the recording fraction of RSV increased over the study period, it remains lower, particularly for adults. Our findings reveal a disparity in hospitalization burden by SES, particularly among younger age groups.

Partnership trajectories toward childlessness in China

AbstractObjectiveDrawing on the life course perspective, this study examined partnership trajectories of childless individuals to understand the drivers and processes of becoming childless in China.BackgroundDespite the rise in childlessness in China, little is known about the within‐group heterogeneity in partnership trajectories leading to childlessness and their sociodemographic correlates.MethodThe study employed sequence analysis and multinomial and ordinary least squares regressions using a sample of 778 childless men and women aged 40 and above from the China Family Panel Studies in 2010, 2012, 2014, 2016, and 2018.ResultsFive clusters of partnership trajectories were identified: never partnered (51.8%), early marriage (24.8%), late marriage (9.4%), on‐time marriage (9.3%), and unpartnered via divorce or widowhood (4.9%). Men with low socioeconomic status were most likely to become childless through never being married, and their privileged counterparts were mostly through on‐time or late marriage. The early‐marriage and unpartnered clusters mostly consisted of women, and among women, those with an urban hukou or low education were more likely to be divorced. The overall heterogeneity in partnership trajectories to childlessness declined, and most complexity observed was limited to the unpartnered cluster.ConclusionPartnership trajectories to childlessness in China are heterogenous and stratified but increasingly homogenous.ImplicationsDue to the persistent connections between marriage and childbearing, Chinese individuals become childless through more standardized life course trajectories than before.

Classroom air quality in a randomized crossover trial with portable HEPA air cleaners.

Children living in communities with lower socioeconomic status and higher minority populations are often disproportionately exposed to particulate matter (PM) compared to children living in other communities. We assessed whether adding HEPA filter air cleaners to classrooms with existing HVAC systems reduces indoor air pollution exposure. From July 2022 to June 2023, using a block randomized crossover trial of 17 Los Angeles Unified School District elementary schools, classroom PM concentrations were monitored and compared for 99 classrooms with HEPA filter air cleaners and 87 classrooms with non-HEPA filter air cleaners. In HEPA classrooms, average school-year PM2.5 was 39.9% lower (0.581 µg/m³; p < 0.001) and infiltration of outdoor PM2.5 into classrooms was 13.8-82.4% lower than non-HEPA classrooms, depending on the school. Few studies have examined HEPA filtration in a classroom environment, and this is one of the first studies since the COVID-19 pandemic to assess PM exposure in the classroom. Using a well powered block randomized crossover trial, we showed that adding portable HEPA air cleaners to classrooms that already had HVAC systems with MERV 13 air filters resulted in lower measurable PM concentrations and less infiltration of outdoor PM2.5 compared to control classrooms with non-HEPA filters. This demonstrates that further improvements in classroom air quality, especially in environmentally burdened communities, can be achieved with additional filtration.