Income Measures Research Articles

Psychometric Evaluation and Validation of the HIV Stigma Scale in Spanish among Men who have Sex with Men and Transgender Women.

Stigma and discrimination toward the LGBTQ community is pervasive and negatively impacts health. Validated measures of stigma in Spanish, however, are limited and none have specifically validated HIV-related stigma in Spanish-speaking men who have sex with men (MSM) and transgender women (TGW) in resource-limited settings. The aim of this study is to evaluate the psychometric properties of a standardized HIV Stigma Scale, translated to Spanish, including its factor structure. Measures consisted of self-reported socio-demographic measures of age, sex, sexual orientation, education, employment status, income, living situation, HIV stigma, depressive symptoms, and social support. Using SPSS AMOS 24, a confirmatory factor analysis (CFA) of the 10-item Wright HIV Stigma Scale translated to Spanish was conducted in 359 MSM and TGW with HIV recruited from HIV clinics in Lima, Peru. The path model with three sub-scales: enacted, anticipated and internalized stigma, with eight items had an adequate fit to the data. The Spanish version (HIV Stigma Scale-ES) and its dimensions are similar to the ones validated in English for people with HIV (not MSM). Each construct was deemed to be reliable and showed good construct validity. Given the need to better understand and measure stigma in Spanish-speaking MSM, the HIV Stigma Scale-ES can be a useful tool to examine stigma.

PREVALENCE AND DETERMINANTS OF PROTEIN-ENERGY MALNUTRITION (PEM) AMONG CHILDREN UNDER 5 YEARS OF AGE IN A RURAL COMMUNITY OF LAHORE

Malnutrition refers to an inadequate supply of nutrients and energy to the body cells, compared to the body's requirements for maintaining growth and ensuring daily functions. It is a major health burden in developing countries and can be categorized as under-nutrition and over-nutrition. This study aimed to determine the prevalence and determinants of Protein Energy Malnutrition (PEM) among children under 5 years of age in a rural community of Lahore. A quantitative descriptive cross-sectional study was conducted in the Lakhodair community of Lahore. A sample of 150 married females participated in the study, and a purposive sampling was used to collect data. The results revealed that 43% of the participants were male mothers, and 57% were female. PEM was categorized as mild, moderate, and severe. Severe PEM was noted in children under the age of 5 years in this Lakhodair community, with an incidence rate of 4.22%. It was concluded that the prevalence rate of PEM among children under 5 years of age in a rural community of Lahore was 4.22%. Protein Energy Malnutrition (PEM) determinants include protein and carbohydrate intake, housing and environmental status, father and mother's education and occupation, monthly income, socio-economic factors, dietary habits, family size, and anthropometric measures.

Socioeconomic inequalities in health-related functioning among people with Type 2 Diabetes

Abstract Background Type 2 Diabetes mellitus (T2DM) is a common chronic disease which disproportionally affects disadvantaged groups. People with a low socioeconomic position (SEP) have increased risk of T2DM and people with a low SEP and T2DM have higher HbA1c levels and a higher risk to develop T2DM complications compared to their high SEP counterparts. The aim of this study is to analyze longitudinal socioeconomic differences in health-related functioning in people living with T2DM. Methods Cross-sectional and longitudinal data from 2,004 participants of The Maastricht Study with T2DM were used. SEP was determined by baseline measures of education, occupation and income. Health-related functioning (physical, mental and social) was measured with the SF-36 and the Impact on Participation and Autonomy survey (scores 0-100). Associations of SEP and health-related functioning were studied over a 10-year period (baseline 2010-2018) using linear mixed methods adjusting for demographics, disease characteristics and lifestyle factors. Results Low SEP participants had significantly worse health-related functioning compared to those with a high SEP. For example, participants with low income had lower scores for physical (-4.00[CI 2.62;-5.38]), mental (-2.81[-1.52;-4.10]) and social functioning (-9.10[-6.35;-11.85]) compared to high-income participants. In addition, participants with a low education significantly declined more in mental (interaction estimate time -0.21[-0.05;-0.37]) and social functioning (-0.39[-0.02;-0.76]) compared to participants with high education. Conclusions In individuals with T2DM, socioeconomic health differences are apparent in health-related functioning. Moreover, differences in mental and social functioning widened even more between different levels of education. Beyond disease characteristics and lifestyle, more attention is needed for socioeconomic differences in health-related functioning for people living with T2DM, both in research and practice. Key messages • Among people with T2DM, those with a lower SEP have worse health-related function then individuals with a higher SEP, even with similar demographics, disease characteristics and lifestyle patterns. • Additionally, people with T2DM and low education decline more over time in mental and social functioning than people with T2DM and high education.

Socioeconomic inequalities in type 2 diabetes and job demands/control/support - The Maastricht Study

Abstract Background Low socioeconomic position (SEP) is an important determinant of Type 2 Diabetes Mellitus (T2DM). Adverse environments in the exposome might be involved; however, the environmental factors are under-studied compared to lifestyle. We explored low job control, high job demands, and low job support as pathways between SEP and T2DM. Methods Cross-sectional and longitudinal data from 8,090 participants of The Maastricht Study were used. Prevalent T2DM was measured by an oral glucose tolerance test and incident T2DM was self-reported in annual follow-up questionnaires. SEP was operationalized by baseline measures of education, occupation, and income. The work stressors were measured by questionnaires at baseline. For Cox regression, the survival time was computed by midpoint imputation. The associations of SEP, job demands, control, and support with T2DM were examined as well as the mediating role of the work stressors by using a counterfactual framework. Results 2.8% (N = 172) of the participants without T2DM at baseline reported incident T2DM. People with lower SEP were more likely to report T2DM during the follow-up course (e.g.; education HR = 2.21, 95%CI: 1.53-3.20) and more often had prevalent T2DM. Low job control was associated with prevalent T2DM (OR = 1.44 95%CI: 1.25-1.67), but not with incident T2DM. Job control explained 7.23% of the relationship between income and prevalent T2DM. Job demand suppressed the relationship of education (3.65%) and occupation (3.72%) with prevalent T2DM. Conclusions Our findings provide modest evidence for environmental injustice in T2DM exposome. The substantial higher risks of diabetes in low SEP is to a small extent explained by lower control at work. Furthermore, by having lower psychosocial job demands, they are protected against T2DM. Key messages • Job demands and control play a role in SEP and prevalent T2DM relationship. • Work stressors might not be a major target for tackling socioeconomic inequalities in type 2 diabetes.

Sustaining Retirement during Lockdown: Annuitized Income and Older American’s Financial Well-Being before and during the COVID-19 Pandemic

The landscape of employer-sponsored retirement plans in the U.S. has changed dramatically during the past few decades as more and more private-sector employers have decided to freeze or terminate traditional pension plans. Defined contribution (DC) plans became the primary choice or the only choice for employees to participate in employer-sponsored retirement plans. In the next ten to twenty years, the income from pension plans will only count for a third of the total retirement income for GenXers when compared to their baby boomer counterparts. It is important for research to provide evidence on how the change in retirement income resources impacts retirees’ retirement security and financial wellness. Using Health and Retirement Study (HRS) data before and during the COVID-19 pandemic, this study examines the association between annuitized income and various measures of older Americans’ financial well-being over time, particularly during the pandemic. This study finds that receiving annuitized income has a statistically significant relationship with reduced subjective financial well-being for both measurements, while only one of the measures of objective well-being, having liquid assets greater than the median household income, has a statistically significant positive relationship with receiving annuitized income.

Neighborhood greenspace and neighborhood income associated with white matter grade worsening: Cardiovascular Health Study.

We examined whether a combined measure of neighborhood greenspace and neighborhood median income was associated with white matter hyperintensity (WMH) and ventricle size changes. The sample included 1260 cognitively normal ≥ 65-year-olds with two magnetic resonance images (MRI; ≈ 5 years apart). WMH and ventricular size were graded from 0 (least) to 9 (most) abnormal (worsening=increase of ≥1 grade from initial to follow-up MRI scans). The four-category neighborhood greenspace-income measure was based on median neighborhood greenspace and income values at initial MRI. Multivariable logistic regression tested associations between neighborhood greenspace-income and MRI measures (worsening vs. not). White matter grade worsening was more likely for those in lower greenspace-lower income neighborhoods than higher greenspace-higher income neighborhoods (odds ratio=1.73; 95% confidence interval=1.19-2.51). The combination of lower neighborhood income and lower greenspace may be a risk factor for worsening white matter grade on MRI. However, findings need to be replicated in more diverse cohorts. Population-based cohort of older adults (≥ 65 years) with greenspace and MRI dataCombined measure of neighborhood greenspace and neighborhood income at initial MRIMRI outcomes included white matter hyperintensities (WMH) and ventricular sizeLongitudinal change in MRI outcomes measured approximately 5 years apartWorsening WMH over time more likely for lower greenspace-lower income neighborhoods.

Analisis Penerapan Pernyataan Standar Akuntansi Pemerintahan No. 02 Tentang Laporan Realisasi Anggaran

This study aims to analyze the LRA preparation procedures carried out by Diskominfo Kalbar and the application of PSAP No. 02 in PP No. 71 of 2010. This study uses a qualitative method by conducting interviews with relevant officials and document analysis, this study identifies the process of preparing the LRA, recognition, measurement, and presentation of income and expenditure, as well as commitment to transparency and accountability in public financial management. The research findings show that the West Kalimantan Diskominfo has carried out the procedures for preparing the LRA properly. PSAP No. 02 in Government Regulation No. 71/2010 has been fully implemented and has been carried out consistently, with the LRA covering all necessary components and the recognition and measurement of revenues and expenditures carried out in accordance with applicable regulations. Diskominfo Kalbar has also demonstrated a commitment to transparency by ensuring that their LRA is easily accessible to the public and interested parties. Nonetheless, there are several suggestions that can be made to improve the effectiveness and efficiency of the LRA preparation process, including improved monitoring and evaluation systems, employee training, and increased internal collaboration. By implementing these suggestions, Diskominfo Kalbar can continue to improve the quality and transparency of its LRA preparation and ensure more effective and efficient financial management, in accordance with the principles of a fiscal management system.

Association of Provider Zip Code Sociodemographic Characteristics with Radiation Therapy Modality Use in the Medicare Population

Variations in healthcare delivery by provider and patient-level characteristics have been well studied in the US health system as a whole, though these patterns are not as well defined in radiation oncology. We evaluated the association of provider zip-code level sociodemographic characteristics with variations in radiation therapy (RT) modality use. We used the Centers for Medicare & Medicaid Services (CMS) Physician and Other Supplier Public Use File, CMS Physician Compare, and National Neighborhood Data Archive databases to link non-facility based radiation oncologists and their submitted Medicare charges in 2020 with sociodemographic information of the provider's zip code. We selected radiation oncologists who submitted for any of the following RT treatments: proton RT (PRT), stereotactic body RT (SBRT), intensity modulated RT (IMRT), 3D conformal RT (3DCRT), and brachytherapy (BT). Sociodemographic covariates included predominant race/ethnicity of area (Black, White, or Hispanic), percentage of population earning above $75,000 annually, provider rurality (metropolitan vs non-metropolitan), and predominant education level attained of area (Bachelor's degree vs no Bachelor's degree). We measured the association of these covariates with the use of different RT modalities with multivariable logistic regression. We identified 1,126 radiation oncologists for analysis. PRT was more likely to be used by providers in areas with a predominantly Black population compared with providers in areas with a predominantly White or Hispanic population (Black as reference, White odds ratio (OR) 0.11; 95% CI 0.05-0.24; Hispanic OR 0.23; 95% CI 0.08-0.56). IMRT was more likely to be used by providers in areas with a predominantly White or Hispanic population compared with providers in areas with a predominantly Black population (White OR 3.40; 95% CI 1.63-6.78; Hispanic OR 2.46; 95% CI 1.04-5.97). SBRT was less likely to be used in non-metro areas compared with metro areas (OR 0.28, 95% CI 0.12-0.56). The annual income measure was not associated with any RT modality. Providers in areas with predominantly Bachelor's degree attained were more likely to use PRT (Bachelor's degree as reference, OR 0.34; 95% CI 0.17-0.64) and less likely to use SBRT (OR 1.53; 95% CI 1.04-2.26), IMRT (OR 2.04; 95% CI 1.20-3.48), and 3DCRT (OR 1.52; 95% CI 1.04-2.22). No covariates were associated with BT use. We identified notable variations in RT delivery with multiple sociodemographic factors. A predominantly Black population was associated with a higher likelihood of PRT use, and BT use was not associated with any sociodemographic covariate. These findings might reflect reduced barriers to care afforded by the universal healthcare setting of Medicare or ongoing improvements in RT delivery with respect to previously identified health disparities. Additional work is needed to further elucidate these patterns of RT use and determine if they represent effective care.

Social Statistics Transformation: Understanding the population through the production of income by ethnicity statistics from administrative data

ObjectivesThe lack of an income question on the Census has meant the production of multivariate income by ethnicity statistics has not been possible in census outputs to date. Our ambition is to provide individual-level records for every member of the usually resident population of England and Wales using admin data.
 MethodExciting progress has been made in the development of admin-based characteristics measures, including the ongoing feasibility research to produce admin-based datasets on ethnic group and income. Demonstrated improved results include the coverage of the population steadily increasing and methods to create these datasets gradually improving.
 Access to these record-level administrative datasets has allowed us to combine admin-based income and ethnicity measures developed in previous research, linking individuals between the two. We review the coverage of the combined dataset and the feasibility of producing multivariate statistics at subnational levels in England and Wales for the first time.
 ResultsThis presentation will showcase our innovative progress so far. By combining admin-based income and admin-based ethnicity datasets, we established an income and a stated ethnicity for 77.1% of people in England and 82.1% of people in Wales aged 16 years and over in the admin-based Statistical Population Dataset (our population base).
 For the first time, we have produced income percentiles for ethnic groups at different levels of geography in England and Wales including national figures, regional figures and figures for local authorities and lower layer super output areas; although statistical disclosure control means that some of the figures have been suppressed.
 We will highlight some of the challenges in using administrative data sources to produce these statistics and in assessing their statistical quality.
 ConclusionOur research developing these statistics is truly novel and shows much promise. Future work will include research to improve the univariate admin-based measures that are used, to continue to explore the limitations of the combined dataset, to explore the data by occupied address, and explore methods to adjust for missingness.

The Association Between the License Fee Increase and the Density of Tobacco Retailers in California-A Segmented Interrupted Time-Series Analysis by Income and Race/Ethnicity.

On May 9, 2016, the State of California passed a law to increase the licensing fee for tobacco retailers from a one-time-only fee of $100 to an annual fee of $265, effective on June 9, 2016. This study investigates the association between this fee increase and retailer densities by neighborhood income and race/ethnicity characteristics. We obtained quarterly data on the number of active tobacco retailer licenses from 2011 to 2020 in every zip code in California from the California Department of Tax and Fee Administration. These data were then linked to zip code-level income, race/ethnicity, and population measures. We used a single-group segmented interrupted time-series analysis to assess the association between the increase in licensing fees and retailer densities by neighborhood income and race/ethnicity. After the implementation of the annual licensing fees, the retailer density decreased both immediately and gradually. Specifically, the retailer density dropped by 0.47 in the first quarter following the intervention. Compared to the pre-intervention time trend, the retailer density decreased quarterly by 0.05. Furthermore, the impacts of increasing licensing fees were more pronounced in low-income and the majority Black zip codes. Given that higher smoking prevalence is associated with greater tobacco outlet density, the licensing fee increase could be an effective policy tool to reduce tobacco use among economically disadvantaged and minority Black communities, thereby addressing tobacco-use disparities. This study used the single-group segmented interrupted time-series analysis to assess the association between the licensing fee increase and tobacco retailer densities by neighborhood income and race/ethnicity. We found that this licensing fee increase was associated with reduced retailer densities and the total number of active retailers right after the implementation. We further found that the annual licensing fee policy had a continuous effect in reducing tobacco retailer densities in all zip codes. The impacts of increasing licensing fees were more pronounced in low-income and majority of Black zip codes.

The Association Between Socioeconomic Status and Use of Time in Australian Children and Adolescents

PurposeThere are well-known socioeconomic status (SES) gradients in children and adolescents' health which may be associated with time use. Our aim was to evaluate the association between Australian children's 24-hour time use and SES using four separate surveys from 2005 to 2021. MethodsTime use was assessed in 4526 8-19-year-olds from the 2005 Health of Young Victorians, 2007 National Children's Nutrition and Physical Activity, 2015 Child Health CheckPoint, and 2019-21 Life on Holidays study. Each survey used the same reliable, valid, 24-hour recall instrument. SES was quantified using tertiles of household income, education, and postcode-level measures. Compositional data analysis was used to compare 24-hour time use between SES categories, adjusting for age, sex, and puberty. ResultsTime-use compositions differed significantly by SES in each survey. Relative to the lowest SES, children from the highest SES accumulated on average 31 min/day more School-related time, 6 min/day more Passive Transport and 6 min/day more Self-care. Conversely, they accumulated 30 min/day less Screen Time (which included computer time), 11 min/day less sleep, and spent 7 min/day less in Domestic/Social activities. There were only small differences in Quiet Time and Physical Activity. DiscussionSES-related differences in time use were robust across ages 8-19, a 16-year timespan, diverse Australian geographical regions, and using different SES metrics. The exchange of about 30 min/day between School-related activities and Screen Time amounts to >180 hours extra exposure to School-related activities annually in the highest SES category relative to the lowest, equivalent to >6 weeks of school time per year.

Global burden and trends of respiratory syncytial virus infection across different age groups from 1990 to 2019: A systematic analysis of the Global Burden of Disease 2019 Study

ObjectiveUnderstanding the global patterns of respiratory syncytial virus (RSV) is crucial for developing effective prevention and control strategies. MethodsData on RSV-related burden were extracted from the Global Burden of Disease 2019. Joinpoint regression models were used to assess the global temporal trends of RSV and further stratified analyses were conducted according to the Socio-demographic Index (SDI), which is a composite measure of income, education, and total fertility. Age-period-cohort model was used to evaluate age, period, and cohort effects. ResultsIn 2019, the global age-standardized rate of mortality (ASMR) and disability-adjusted life years (ASR-DALYs) of RSV were 4.79/100,000 (95% uncertainty interval [95% UI]: 1.82/100,000-9.32/100,000) and 218.34/100,000 (95% UI: 92.06/100,000-376.80/100,000), respectively. The burden of RSV was higher in men than women. The highest ASMR (10.26/100,000, 3.80/100,000-20.16/100,000) and ASR-DALYs (478.71/100,000, 202.40/100,000-840.85/100,000) were reported in low-SDI region. Although mortality and DALYs rates in all age groups declined globally, the pace of decline was not uniform across age groups. Mortality rate in the elderly over 70 years surpassed that in children under 5 years in 2019. ConclusionThis study highlights the need for targeted interventions to reduce the burden of RSV, particularly in low-SDI region, and among the elderly over 70 years.

Association of Childhood and Midlife Neighborhood Socioeconomic Position With Cognitive Decline

Early-life socioeconomic adversity may be associated with poor cognitive health over the life course. To examine the association of childhood and midlife neighborhood socioeconomic position (nSEP) with cognitive decline. This cohort study included 5711 men and women enrolled in the community-based Atherosclerosis Risk in Communities (ARIC) Study with repeated cognitive data measured over a median 27.0 years (IQR, 26.0-27.9 years) (1990-2019). Statistical analysis was performed from December 2022 through March 2023. Residence addresses for ARIC Study cohort participants were obtained at midlife (1990-1993) and as recalled addresses at 10 years of age (childhood). A composite nSEP z score was created as a sum of z scores for US Census-based measures of median household income; median value of owner-occupied housing units; percentage of households receiving interest, dividend, or net rental income; percentage of adults with a high school degree; percentage of adults with a college degree; and percentage of adults in professional, managerial, or executive occupations. Childhood nSEP and midlife nSEP were modeled as continuous measures and discretized into tertiles. A factor score for global cognition was derived from a battery of cognitive tests administered at 5 in-person visits from baseline to 2019. The rate of cognitive decline from 50 to 90 years of age was calculated by fitting mixed-effects linear regression models with age as the time scale and adjusted for race, sex, birth decade, educational level, and presence of the apolipoprotein E ε4 allele. Among 5711 ARIC Study participants (mean [SD] baseline age, 55.1 [4.7] years; 3372 women [59.0%]; and 1313 Black participants [23.0%]), the median rate of cognitive decline was -0.33 SDs (IQR, -0.49 to -0.20 SDs) per decade. In adjusted analyses, each 1-SD-higher childhood nSEP score was associated with a slower (β, -9.2%; 95% CI, -12.1% to -6.4%) rate of cognitive decline relative to the sample median. A comparable association was observed when comparing the highest tertile with the lowest tertile of childhood nSEP (β, -17.7%; 95% CI, -24.1% to -11.3%). Midlife nSEP was not associated with the rate of cognitive decline. In this cohort study of contextual factors associated with cognitive decline, childhood nSEP was inversely associated with trajectories of cognitive function throughout adulthood.

Pelaksanaan Akad Pembiayaan Murabahah Pada Perbankan Syariah yang Terdaftar di Bursa Efek Indonesia

The aim of this research is to analyze the recognition and measurement, presentation and disclosure of murabahah financing transactions based on PSAK 102 murabahah financing at PT. Bank BTPN Syariah Tbk. The research approach used is a qualitative approach with descriptive methods. The research location taken by the author was at PT. Bank BTPN Syariah Tbk. The data used by researchers is secondary data, which collects data through documentation and literature. This research compares the results of the annual report published by PT. Bank BTPN Syariah Tbk with PSAK 102 concerning murabahah financing. The research results show that the recognition and measurement of murabahah income at PT. Bank BTPN Syariah Tbk, murabahah financing consists of recording acquired assets, recognition and measurement of murabahah profits that are not in accordance with the implementation of PSAK 102, and recognition and measurement of receivables regarding murabahah accounting in practice for murabahah financing carried out by PT. Bank BTPN Syariah is in accordance with PSAK 102 concerning murabahah accounting as a guideline.

A reasoning of economic complexity based on simulated general equilibrium international trade model *

By simulating a multi-country general equilibrium international trade model, we investigate how the economic complexity index (ECI) and fitness index (FI) are related directly to economic fundamentals with a clear basis in theory. The model is based on Eaton and Kortum (2002 Econometrica 70 1741–79) and combines factor endowment (Heckscher-Ohlin) and technological (Ricardian) reasons for specialization, which further determines economic complexity across countries. First, we find that FI performs better than ECI in explaining the real-world specialization pattern, where successful countries not only produce complex products due to the comparative advantage but also tend to produce a wide range of possible products due to the absolute advantage. Second, we highlight that the predictive power of various economic complexity measures for income is crucially sensitive to other factors that shift marginal cost from its efficient level in manufacturing sectors. The essence of such an issue lies in the assumption that the revealed comparative advantage (RCA) correctly reflects a country’s real capability of specialization across different goods. However, there would exist a gap between the core idea of learning the national complexity from RCA and the fact that the revealed specialization pattern in data may not necessarily suggest a country’s actual capability in the presence of distortions, the latter of which is ubiquitous across developing countries.

Statistical Measures of Income and Demographic Inequality from Underground Storage Tanks

Statistical Measures of Income and Demographic Inequality from Underground Storage Tanks

Association of neighborhood deprivation with white matter connectome abnormalities in temporal lobe epilepsy.

Social determinants of health, including the effects of neighborhood disadvantage, impact epilepsy prevalence, treatment, and outcomes. This study characterized the association between aberrant white matter connectivity in temporal lobe epilepsy (TLE) and disadvantage using a US census-based neighborhood disadvantage metric, the Area Deprivation Index (ADI), derived from measures of income, education, employment, and housing quality. Participants including 74 TLE patients (47 male, mean age = 39.2 years) and 45 healthy controls (27 male, mean age = 31.9 years) from the Epilepsy Connectome Project were classified into ADI-defined low and high disadvantage groups. Graph theoretic metrics were applied to multishell connectome diffusion-weighted imaging (DWI) measurements to derive 162 × 162 structural connectivity matrices (SCMs). The SCMs were harmonized using neuroCombat to account for interscanner differences. Threshold-free network-based statistics were used for analysis, and findings were correlated with ADI quintile metrics. A decrease in cross-sectional area (CSA) indicates reduced white matter integrity. Sex- and age-adjusted CSA in TLE groups was significantly reduced compared to controls regardless of disadvantage status, revealing discrete aberrant white matter tract connectivity abnormalities in addition to apparent differences in graph measures of connectivity and network-based statistics. When comparing broadly defined disadvantaged TLE groups, differences were at trend level. Sensitivity analyses of ADI quintile extremes revealed significantly lower CSA in the most compared to least disadvantaged TLE group. Our findings demonstrate (1) the general impact of TLE on DWI connectome status is larger than the association with neighborhood disadvantage; however, (2) neighborhood disadvantage, indexed by ADI, revealed modest relationships with white matter structure and integrity on sensitivity analysis in TLE. Further studies are needed to explore this relationship and determine whether the white matter relationship with ADI is driven by social drift or environmental influences on brain development. Understanding the etiology and course of the disadvantage-brain integrity relationship may serve to inform care, management, and policy for patients.

Two sides of the same coin? Absolute income and perceived income inadequacy as social determinants of health

BackgroundAbsolute income is commonly used in studies of health inequalities, however it does not reflect spending patterns, debts, or expectations. These aspects are reflected in measures concerning perceived income inadequacy. While health inequities by absolute income or perceived income inadequacy are well established, few studies have explored the interplay of absolute income and perceived income inadequacy in relation to health.MethodsMultiple data sources were linked into a nationally representative dataset (n = 445,748) of Dutch adults (18 +). The association between absolute income, perceived income inadequacy and health (self-reported health, chronic disease and psychological distress) was tested using logistic and Poisson regressions, controlling for various potential confounders (demographics, education) and mastery. Interactions were tested to check the association between perceived income inadequacy and health for different absolute income groups.ResultsPerceived income inadequacy was reported at every absolute income group (with 42% of individuals in the lowest income group and 5% of individuals in the highest income group). Both absolute income and perceived income inadequacy were independently associated with health. The adjusted relative risk (RR) for lowest absolute income group is 1.11 (1.08–1.1.14) and 1.28 (1.24–1.32) for chronic disease and self-reported health respectively, and the Odds Ratio (OR) for psychological distress is 1.28 (1.16–1.42). For perceived income inadequacy the RR’s were 1.41 (1.37–1.46) and 1.49 (1.44–1.54) and the OR for psychological distress is 3.14 (2.81–3.51). Mastery appeared to be an important mediator for the relationship between perceived income inadequacy, poor self-rated health and psychological distress.ConclusionsAbsolute income and perceived income inadequacy reflect conceptually different aspects of income and are independently associated with health outcomes. Perceived income inadequacy may be accounted for in health inequality studies, alongside measures of absolute income. In policy-making, targeting perceived income inadequacy might have potential to reduce health inequalities.

Economic Security and Physical Safety in the European Union: A Multivariate Statistical Analysis

In recent years, scientific papers pay attention to quality-of-life indicators beyond GDP-based measurements. Material and non-material indicators have become significant parts of life quality evaluations. The economic security concept developed by European Commission consists of disposable income and economic risk measurement. Economic security is also one of the top priorities for the European Union (EU) to achieve its goals and increase its competitiveness in the world economy. EU measures economic security, in the member countries and candidates through some indicators as a sub-dimension under quality-of-life indicators. The aim of this paper is to show the changing relative performance of the old members and the new members of the EU. While the countries that joined the EU before 2004 are accepted as old members, the countries that joined the EU after 2004 are accepted as new members. In relation with this division, Germany, France, Italy, Belgium, Netherlands, Luxembourg, Ireland, Denmark, Greece, Spain, Portugal, Sweden, Austria and Finland are accepted as old members. However, Slovenia, Slovakia, Estonia, Latvia, Lithuania, Cyprus, Malta, Poland, Hungary, Czechia, Bulgaria, Romania, Croatia are the new members. We used two multivariate statistical methods, principal components analysis, and cluster analysis to show the relative and changing performance of the member countries for the years 2008 and 2021. The aim of using principal components analysis is twofold. The first aim is to decrease the dimensionality before cluster analysis. The second aim is to rank the countries in terms of chosen indicators. However, the aim of cluster analysis is to group the countries which have similar performance. According to principal components analysis results, Luxembourg is the most successful country in terms of the variables used to represent economic security and physical safety in the EU. Netherlands, Czechia, Germany, and Sweden are the countries that have the highest rankings. However, Greece is the only country with the lowest economic security and physical safety levels. Countries are grouped under four clusters.

The effect of geographical variation in income measures on measles-mumps-rubella uptake and coverage in England; a protocol for an ecological study.

Measles is a vaccine-preventable disease whose vaccine was introduced in England in 1988, however, Measles outbreaks have still been occurring in the country. Consequently, the World Health Organization (WHO) removed the elimination status of Measles in 2019 from England and the whole United Kingdom. Noticeably, MMR vaccination coverage in England is below the recommended threshold with geographical variations across local authorities (LA). The research into the effect of income disparities on MMR vaccine coverage was insufficiently examined. Therefore, an ecological study will be conducted aiming at determining whether there is a relationship between income deprivation measures and MMR vaccine coverage in upper-tier local authorities in England. This study will be using 2019 publicly available vaccination data for children who were eligible for the MMR vaccine by their second and fifth birthday in 2018/2019. The effect of spatial clustering of income level on vaccination coverage will also be assessed. Vaccination coverage data will be obtained from "Cover of Vaccination Evaluated Rapidly (COVER)". Income deprivation score, Deprivation gap, and Income Deprivation Affecting Children Index will be obtained from Office for National Statistics and Moran's Index will be generated using RStudio. Rural/urban LA classification and mothers' education will be included as possible confounding factors. Additionally, the live births rate per mothers' age group will be included as a proxy for the mothers' age variation in different LA. Multiple linear regression will be used after testing the relevant assumptions, using SPSS software. Moran's I together with income deprivation score will be analysed through regression and mediation analysis. This study will help in determining whether income level is a determinant of MMR vaccination uptake and coverage in LA in England which would help policymakers in designing targeted campaigns, thus preventing measles outbreaks in the future.