Middle Income Category Research Articles

Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors.

Temporal trends in risk factors for cardiovascular disease and the impact of socio-economic status on these risk factors remain unclear. Using data from the National Population Health Survey and the Canadian Community Health Survey, we examined national trends in heart disease, hypertension, diabetes mellitus, obesity and smoking prevalence from 1994 to 2005, adjusting for age and sex. We stratified data by income adequacy category, body mass index and region of residence. An estimated 1.29 million Canadians reported having heart disease in 2005, representing increases of 19% for men and 2% for women, relative to 1994. Heart disease increased significantly in the lowest income category (by 27%), in the lower middle income category (by 37%) and in the upper middle income category (by 12%); however, it increased by only 6% in the highest income group. Diabetes increased in all but the highest income group: by 56% in the lowest income group, by 93% in the lower middle income group and by 59% in the upper middle income group. Hypertension increased in all income groups: by 85% in the lowest income group, by 80% in the lower middle income group, by 91% in the upper middle income group and by 117% in the highest income group. Obesity also increased in all income groups: by 20% in the lowest income group, by 25% in the lower middle income group, by 33% in the upper middle income group and by 37% in the highest income group. In addition to socio-economic status, obesity and overweight also modified the trends in risk factors. Diabetes increased to a greater extent among obese participants (61% increase) and overweight participants (25% increase), as did hypertension, which increased by 80% among obese individuals and by 74% among overweight individuals. Trends in diabetes, hypertension and obesity were consistent for all provinces. During the study period, heart disease, hypertension, diabetes and obesity increased for all or most income groups in Canada. Further interventions supporting modification of lifestyle and risk factors are needed to prevent future cardiovascular disease.

Predictability of hematopoietic stem cell transplantation rates

Hematopoietic stem cell transplantation (HSCT) is a complex and expensive procedure. Trends in the use of this procedure have appeared erratic in the past. Information on future needs is essential for health care administrators. We analyzed the evolution of transplant rates, e.g. numbers of transplants per 10 million inhabitants, in Europe from 1990 to 2004 for all major disease categories and used Gross National Income (GNI) per capita, team density (numbers of teams per 10 million inhabitants) and team distribution (numbers of teams per 10,000 km2) to measure the impact of economic factors in participating countries. Trends were compared by regression analyses, and countries were grouped by World Bank definitions into high, middle and low income categories. Transplant rates increased over time with nearly linear trends, in clear association with GNI per capita (R2=0.72), and distinct by World Bank category within a narrow window of variation for both autologous HSCT (R2=0.95, 0.98 and 0.94 for high, middle and low income categories, respectively) and allogeneic HSCT (R2=0.99, 0.96 and 0.95 for high, middle and low income categories, respectively) when breast cancer (autologous) and chronic myeloid leukemia (allogeneic) were excluded. Team density (R2=0.72) and team distribution (R2=0.51) were also associated with transplant rates. Transplant rates for HSCT in Europe are highly predictable. They are primarily influenced by GNI per capita. The absence of saturation and a nearly linear trend indicate that infrastructure lags behind medical needs. Isolated changes in single disease entities can easily be recognized.

Mexican-American Ethnicity and Cognitive Function: Findings from an Elderly Southwestern Sample

Relatively little is known about late-life patterns of cognitive function among Hispanics of Mexican heritage who reside in the United States. The authors designed a study to assess the association between Mexican-American ethnicity (defined in terms of childhood and adolescent developmental history) and cognitive function among elderly Mexican-American and non-Hispanic white residents of El Paso County, Texas. Our findings indicate significant associations between the degree of Mexican-American ethnicity and cognitive impairment on all three measures of cognitive function. These statistically significant findings remain after effects of education, age, and gender have been removed from the multiple regression equation. The authors conclude that a dependable and clinically meaningful negative association exists between Mexican-American ethnicity and late-life cognitive function in this region that is mediated by as yet unmeasured variables.

Gentrification, use conversion and traditional architecture in Kumasi's central business district – case study of Odum Precinct

The process of gentrification unfolding in parts of Kumasi's Central Business District (CBD) is captured in this paper to facilitate an understanding of the change process at work; namely, the invasion and succession of old run-down traditional residential buildings by high rent yielding commercial developments.The study reveals that the process at work bears semblance with similar processes documented elsewhere in literature. Nonetheless, there are subtle differences. For example, the gentrifiers are not in the middle income category. Instead, they are in the low income category and perceive the process as a way of attracting investments to develop their properties without relinquishing their rights for posterity. The process also involves complete construction of new structures rather than refurbishment, remodelling or renovation. The location of displaced residents affected by the process is varied but is primarily dependent on income and average rents prevailing in various parts of the city. The link between gentrification and traditional architecture is also explored but the impact of the latter on the former is seen largely as being negative although streetscapes have been enhanced and skylines improved to reflect a more productive use of prime land. Consequently, the study has established a close link between gentrification, use conversion and the traditional architecture of the study area. It is argued that an understanding of the gentrification process in the study area is basic to a more efficient management of the change process at play in the CBD of Kumasi. To facilitate this, the extent of invasion and succession of residential uses by commercial interests in the CBD needs to be ascertained. Journal of Science and Technology Vol. 25(2) 2005: 80-90

The mother's health study: A randomised controlled trial of the impact of social support on maternal morbidity in the year after birth

On January 20, 2020, a new coronavirus epidemic with human-to-human transmission was officially declared by the Chinese government, which caused significant public panic in China. In light of the coronavirus disease 2019 outbreak, pregnant women may be particularly vulnerable and in special need for preventive mental health strategies. Thus far, no reports exist to investigate the mental health response of pregnant women to the coronavirus disease 2019 outbreak.This study aimed to examine the impact of coronavirus disease 2019 outbreak on the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women across China.A multicenter, cross-sectional study was initiated in early December 2019 to identify mental health concerns in pregnancy using the Edinburgh Postnatal Depression Scale. This study provided a unique opportunity to compare the mental status of pregnant women before and after the declaration of the coronavirus disease 2019 epidemic. A total of 4124 pregnant women during their third trimester from 25 hospitals in 10 provinces across China were examined in this cross-sectional study from January 1, 2020, to February 9, 2020. Of these women, 1285 were assessed after January 20, 2020, when the coronavirus epidemic was publicly declared and 2839 were assessed before this pivotal time point. The internationally recommended Edinburgh Postnatal Depression Scale was used to assess maternal depression and anxiety symptoms. Prevalence rates and risk factors were compared between the pre- and poststudy groups.Pregnant women assessed after the declaration of coronavirus disease 2019 epidemic had significantly higher rates of depressive symptoms (26.0% vs 29.6%, P=.02) than women assessed before the epidemic declaration. These women were also more likely to have thoughts of self-harm (P=.005). The depressive rates were positively associated with the number of newly confirmed cases of coronavirus disease 2019 (P=.003), suspected infections (P=.004), and deaths per day (P=.001). Pregnant women who were underweight before pregnancy, primiparous, younger than 35 years, employed full time, in middle income category, and had appropriate living space were at increased risk for developing depressive and anxiety symptoms during the outbreak.Major life-threatening public health events such as the coronavirus disease 2019 outbreak may increase the risk for mental illness among pregnant women, including thoughts of self-harm. Strategies targeting maternal stress and isolation such as effective risk communication and the provision of psychological first aid may be particularly useful to prevent negative outcomes for women and their fetuses.

Relationship of socioeconomic status to the incidence and prehospital, 28-day, and 1-year mortality rates of acute coronary events in the FINMONICA myocardial infarction register study.

Low socioeconomic status (SES) is associated with increased coronary heart disease mortality rates. There are, however, very little data on the relation of SES to the incidence, recurrence, and prognosis of myocardial infarction (MI) events. The FINMONICA MI Register recorded detailed information on all MI events among men and women aged 35 to 64 years in 3 areas of Finland during the period of 1983 to 1992. We carried out a record linkage of the MI register data with files of Statistics Finland to obtain information on indicators of SES, such as taxable income and education, for each individual who is registered. In the analyses, income was grouped into 3 categories (low, middle, and high), and education was grouped into 2 categories (basic and secondary or higher). Among men with their first MI event (n=6485), the adjusted incidence rate ratios were 1.67 (95% CI 1.57 to 1.78) and 1.84 (95% CI 1.73 to 1.95) in the low- and middle-income categories compared with the high-income category. For 28-day mortality rates, the corresponding rate ratios were 3.18 (95% CI 2.82 to 3.58) and 2.33 (95% CI 2.03 to 2.68). Significant differentials were observed for prehospital mortality rates, and they remained similar up to 1 year after the MI. Findings among the women were consistent with those among the men. The excess coronary heart disease mortality and morbidity rates among persons with low SES are considerable in Finland. To bring the mortality rates of low- and middle-SES groups down to the level of that of the high-SES group constitutes a major public health challenge.

The Impact of Taxing Unemployment Insurance Benefits on Unemployment Duration and Post-unemployment Earnings

In 1979, unemployment insurance benefits became taxableincome for recipients with income above a specified threshold.Further legislation in 1982 lowered the income threshold. Thispaper uses the Continuous Wage and Benefit History (CWBH) database to evaluate the effects of the 1982 change on the compensatedduration of unemployment and post-unemployment earnings. The1982 episode is a particularly useful “natural experiment”because the “treatment group” (those newly subject to benefittaxation) is the middle income category and the two “controlgroups” (those whose benefits were already taxed and those whosebenefits still were not taxed) are the high and low income categories.If the two control groups show similar trends in unemploymentduration (or post-unemployment earnings) and the treatment groupshows a strikingly different pattern, this is compelling evidenceof a tax effect. The empirical results suggest that taxing unemploymentbenefits reduced the affected workers' mean compensated durationby more than a week, but did not have a statistically significanteffect on their post-unemployment earnings.

Income elasticities of educational expenditure by income class: The case of Japanese households

Using data from Japanese households, this paper calculates the income elasticities of educational expenditure, allowing the elasticities to vary non-monotonically with household income. The paper explores whether income elasticities for education peak in the middle-income categories (have a value of greater than one), and diminish for the lower and upper ends of the income distribution. The results indicate that income elasticities for education follow this basic pattern, but do not fall below one for lower income categories, and become negative for the highest income categories.

Residential Burglary in the United States: Life-Style and Demographic Factors Associated With the Probability of Victimization

This study both ascertains the characteristics of individuals and their life styles that are differentially related to risk of residential burglary and tests a hypothesis that accounts for certain discrepant findings reported in previous studies of burglary victimization. Using Goodman's log-linear technique to analyze (1975-76) Na tional Crime Survey data, we find that 2,133 of 54,343 households in the sample were burglarized in a twelve-month reference period. The following types of persons headed households with greater than average odds of burglary victimization: (1) central city residents, (2) the young, (3) persons with incomes higher or lower than average, (4) nonwhites, and (5) persons whose homes are unoccupied relatively often. The types of persons heading households least likely to be burglarized were the following: (1) older citizens, (2) persons residing outside the central city, (3) citizens in middle-income categories, and (4) persons whose homes are occupied relatively often. In general, the data support Hindelang's hypothesis that differences in the findings of previous burglary studies on variations in the burglary rate for whites across income categories may be due to different sampling procedures.

Free Time Activities and Quality of Urban Life

Abstract The use of human time allocation as an indicator of the quality of life in the urban scene is explored by comparative survey research. Using two measures—the amount of time and the variety reflected in discretionary activities—living patterns of Washingtonians from differing life situations are compared with those of urbanites in the same situations for the nation as a whole. Within the Washington area, by these measures very distinct differences appear to exist along income-race lines. As compared with the national scene, the quality of life for lower income levels in the nation's capital appears to be slightly above that found in U.S. urban areas, and, for middle and upper income categories, well above national levels.