Neighborhood Status Research Articles

The mental health of rural older adults: the role of the built environment in Jintang County.

The mental health of older adults has become one of the major health challenges facing society today, which has attracted wide concerns from scholars in urban areas, but research in rural areas has been neglected. Therefore, this paper took rural older adult residents of 11 sample villages in Jintang County, Chengdu City, Sichuan Province, as the research object. After controlling the demographic characteristics of older adults in rural areas, this paper attempted to explore the effects of the rural built Environment on the mental health of older adults. Through field investigation in the sample villages, 515 valid questionnaires were obtained. The results from the Binary Logistic Regression Model show that good marital status, physical health, education level, well-constructed roads, and safe neighborhoods had significant positive effects on the mental health of rural older adults. Rural older adults who prefer to walk, cycle, and use public transport have better mental health, and accessibility to the periodic market, health station, bus station, village committee, supermarket, and the main road is positively correlated with the mental health of rural older adults, while the distance from home to the town center and coach terminal has a significant negative impact on the mental health of rural older adults. The research results provide a theoretical reference for further construction of rural aging environments.

Sport club dropout under COVID-19 in the Netherlands: do characteristics of the neighbourhood matter?

Sport is considered important to mitigate social and health problems related to the COVID-19 pandemic and thus contributes to a resilient society. Because of poverty, caring responsibilities, social isolation and/or health issues, caused or reinforced by the COVID-19 pandemic, (too) high thresholds may be experienced lowering sports club participation. In this article, we study dropout from sports club membership among the Dutch population in COVID times and relate it to neighbourhood characteristics to determine whether inequality in sports behaviour is increasing or decreasing. Specifically, we analyse changes in the association to sport clubs by utilizing membership register data of the National Sport Federation in the Netherlands (NOC*NSF). This longitudinal information on 3.6 million club members in 2019 within Dutch sport federations was used to analyse developments at the individual level between 2019 (pre-COVID) and 2021. Based on register information on the area of residence of sporters, neighbourhood characteristics were added to these individual membership data. Our results display that the socioeconomic status of a member's neighbourhood and the sport infrastructure in this neighbourhood impacts the likelihood of dropping out of a sport club of both youths and adults during the COVID-19 pandemic. Dropout among members is lower in higher socioeconomic status neighbourhoods and in neighbourhoods with abundant sport facilities. Remarkably, the impact of these living environment features seems higher for youth than for adults. To conclude, our study enhances a further understanding of inequalities in sport club membership dropout during COVID-19. First, it may inform policy makers to intensify sport promotion policies and to especially support sport clubs in lower status neighbourhoods. Second, given the relatively high dropout rates during the COVID-19 pandemic particular attention for retention seems necessary.

Attendance characteristics of the breast and colorectal cancer screening programmes in a highly urbanised region of the Netherlands: a retrospective observational study

ObjectivesThroughout Europe, many countries offer population-based cancer screening programmes (CSPs). In the Netherlands, two implemented CSPs are targeting people of 50 years and older, aiming at breast cancer (BC) and...

Tracking the Transit Divide: A Multilevel Modelling Approach of Urban Inequalities and Train Ridership Disparities in Chicago

Using a multilevel modelling approach, this study investigates the impact of urban inequalities on changes to rail ridership across Chicago’s “L” stations during the pandemic, the mass vaccination rollout, and the full reopening of the city. Initially believed to have an equal impact, COVID-19 disproportionally impacted the ability of lower socioeconomic status (SES) neighbourhoods’ to adhere to non-pharmaceutical interventions: working-from-home and social distancing. We find that “L” stations in predominately Black or African American and Hispanic or Latino neighbourhoods with high industrial land-use recorded the smallest behavioural change. The maintenance of higher public transport use at these stations is likely to have exacerbated existing health inequalities, worsening disparities in users’ risk of exposure, infection rates, and mortality rates. This study also finds that the vaccination rollout and city reopening did not significantly increase the number of users at stations in higher vaccinated, higher private vehicle ownership neighbourhoods, even after a year into the pandemic. A better understanding of the spatial and socioeconomic determinants of changes in ridership behaviour is crucial for policymakers in adjusting service routes and frequencies that will sustain reliant neighbourhoods’ access to essential services, and to encourage trips at stations which are the most impacted to revert the trend of declining public transport use.

(542) Socioeconomic Status is Not Associated with Complications or Patient Satisfaction Following Inflatable Penile Prosthesis Surgery

Abstract Introduction Prior studies have demonstrated that patient socioeconomic background and neighborhood status are associated with health care outcomes. Understanding how a patient’s environment and local community status affect clinical outcomes can vastly impact surgical care, patient education and counseling, as well as surgical outcomes. The Area Deprivation Index (ADI), is a validated measurement evaluating the differences in socioeconomic status between various neighborhoods both on a state and national level. ADI incorporates a composite score of patient income, education level, employment status, and housing quality. No prior studies have looked at how a patient’s socioeconomic status and geographic residence affect postoperative outcomes and patient satisfaction following implantation of inflatable penile prosthesis (IPP). Objective To understand how a patient’s socioeconomic status as measured by the ADI affects overall surgical outcomes and patient satisfaction following IPP placement. Methods Men that underwent a new IPP placement between 6/1/13 and 3/31/22 were included in the study. Using the Neighborhood Atlas National® (Madison, WI), national ADI percentiles (1-100) were calculated for each patient using their home address at the time of surgery. Higher ADIs represent a more disadvantaged socioeconomic status while lower ADIs represent a more advantaged socioeconomic status. Complications were defined as mechanical failure, urethral erosion, infection, intractable pain, or other (ex. hematoma, herniated reservoir, pump revision). A patient satisfaction phone questionnaire was administered measuring overall satisfaction (Likert scale). In order to reduce recall bias and allow for adequate follow-up, the phone questionnaire was limited to men who underwent IPP placement between the 2016-2020. Multivariable logistic regression and multivariable ordinal logistic regression were used to identify the association between ADI and surgical complications and patient satisfaction, respectively. Results A total of 430 men who underwent IPP implantation from 2013 to 2022 were identified and data were retrospectively collected. The final cohort consisted of 83% (n=355) Caucasian men with the median age of 65 (IQR 58-69). The overall complication rate was 11.2% (n=48). Of the 48 total complications, 22 (5.1%) required surgical intervention (mechanical problem n=7, urethral erosion n=1, infection n=9, pain n=1, other n=4). The median national ADI for patients with a complication was 57 (IQR 33-72) compared to 60 (IQR 42-76) in those patients without a complication (p=0.32). A total of 163 men completed the satisfaction phone questionnaire and 70% (n=114) of men stated that they were either very satisfied or satisfied with their IPP. The median ADI for patients who were satisfied was 64 (IQR 43-80) compared to 60 (IQR 42-76) in those patients who were not satisfied (p=0.45). On multivariable analysis, national ADI was not associated with postoperative complications (p=0.57) (Table 1) or with patient satisfaction (p=0.39) (Table 2). Conclusions While living in a disadvantaged neighborhood has been associated with poor health outcomes in other areas of medicine, we found no association between a patient’s socioeconomic status and complications or satisfaction following IPP placement. Regardless of a patient’s geographic residence, patients pursuing an IPP can expect comparable outcomes and overall satisfaction rates suggesting that implant consideration should not be influenced by socioeconomic status. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.

Increased 90-Day Readmissions and Complications Following Hip Arthroscopy in Centers With Low Surgical Volume in New York State

The aims of the study were to (1) classify surgical centers in New York State by volume of hip arthroscopies performed, (2) calculate rates of readmissions and complications by center volume, and (3) identify socioeconomic predictive factors for readmissions and complications following hip arthroscopy. Patients who underwent hip arthroscopy at New York State health care facilities from 2010 to 2020 were retrospectively identified using the New York Statewide Planning and Research Cooperative System (SPARCS) database. Hip arthroscopic procedures were identified using the following Current Procedural Terminology codes. Surgical center volumes were classified into 3 categories: low (<85th percentile), medium (85th-95th percentile), and high (>95th percentile). Incidence of readmissions and complications within 90 days was abstracted from SPARCS. Neighborhood socioeconomic status was quantified using the U.S. Area Deprivation Index. Multivariable logistic regression was used to determine whether center volume and other socioeconomic variables were independent predictors of outcomes. In total, 50,252 patients who underwent hip arthroscopy were identified in SPARCS from 2010 to 2020. Of these patients, 13,861 (27.6%) underwent surgery at low-volume centers, 11,757 (23.4%) at medium-volume centers, and 24,634 (49.0%) at high-volume centers. Minorities, publicly insured patients, and patients from lower socioeconomic status neighborhoods made up a larger proportion of cases seen by low-volume centers versus high-volume centers (P < .001). Patients in the low-volume group experienced significantly greater 90-day rates of readmissions (P < .001) and all-cause complications (P < .001) than the other groups. Furthermore, high-volume centers were independently associated with lower odds of readmission (odds ratio 0.57, P < .001) and all-cause complications (odds ratio 0.73, P < .001) versus low-volume centers. Low-volume surgical centers are associated with increased readmission and complication rates following hip arthroscopy, independent of other socioeconomic factors such as age, sex, race, insurance status, and neighborhood socioeconomic status. III, retrospective comparative prognostic trial.

First Responder CPR and Survival Differences in Texas Minority and Lower Socioeconomic Status Neighborhoods

Introduction First responder (FR) cardiopulmonary resuscitation (CPR) is an important component of out-of-hospital cardiac arrest (OHCA) care. However, little is known about FR CPR disparities. Methods We linked the 2014–2021 Texas Cardiac Arrest Registry to Enhance Survival (TX-CARES) database to census tract data. We included non-traumatic OHCAs that were not witnessed by 9-1-1 responders and did not receive bystander CPR. We defined census tracts as having >50% of a race/ethnicity: White, Black, or Hispanic/Latino. We also stratified patients into quartiles based on socioeconomic status (SES): household income, high school graduation, and unemployment. We also combined race/ethnicity and income to create a total of five mixed strata, comparing lower income and minority census tracts to high income White census tracts. We created mixed model logistic regression models, adjusting for confounders and modeling census tract as a random intercept. Using the models, we compared FR CPR rates for census race/ethnicity (Black and Hispanic/Latino compared to White), and SES quartiles (2nd, 3rd, and 4th quartiles compared to 1st quartiles). Secondarily, we evaluated the association between FR CPR and survival for all strata. Results We included 21,966 OHCAs, and 57.4% had FR CPR. Evaluating the association between census tract characteristic and FR CPR, majority Black (aOR 0.30, 95% CI 0.22–0.41) had a lower bystander CPR rate when compared to majority White. The lowest income quartile had a lower rate of bystander CPR (aOR 0.80, 95% CI 0.65–0.98). The worst unemployment quartile was also associated with a lower rate of FR CPR (aOR 0.75, 95% CI 0.61–0.92). Combining race/ethnicity and income, middle income majority Black (30.0%; aOR 0.27, 95% CI 0.17–0.46) and low income >80% Black (31.8%; aOR 0.27, 95% CI 0.10–0.68) had lower rates of FR CPR in comparison to high income majority White. There were no associations between Hispanic or lower high school graduation and lower rates of FR CPR. We found no association between FR CPR and survival for all three strata. Conclusion While we identified disparities in FR CPR in low SES and majority Black census tracts, we identified no association between FR CPR and survival in Texas.

Does Neighborhood Crime Mediate the Relationship Between Neighborhood Socioeconomic Status and Birth Outcomes? An Application of the Mediational G-Formula.

While the link between living in a low-socioeconomic status (SES) neighborhood and higher risk of adverse birth outcomes has been well established, the underlying mechanisms remain poorly understood. Using the parametric g-formula, we assessed the role of neighborhood crime as a potential mediator of the relationship between neighborhood SES and birth outcomes using data on singleton births occurring in the Netherlands between 2010 and 2017 (n=1,219,470). We estimated total and mediated effects of neighborhood SES on small-for-gestational-age (SGA) birth, low birth weight (LBW), and preterm birth (PTB) for 3 types of crime (violent crimes, crimes against property, and crimes against public order). The g-formula intervention settings corresponded to a hypothetical improvement in neighborhood SES. A hypothetical improvement in neighborhood SES resulted in a 6.6% (95% CI: 5.6, 7.5) reduction in the proportion of SGA birth, a 9.1% (95% CI: 7.6, 10.6) reduction in LBW, and a 5.8% (95% CI: 5.7, 6.2) decrease in PTB. Neighborhood crime jointly accounted for 28.1% and 8.6% of the total effects on SGA birth and LBW, respectively. For PTB, we found no evidence of mediation. The most relevant pathways were crimes against property and crimes against public order. The results indicate that neighborhood crime mediates a meaningful share of the relationship between neighborhood SES and birth outcomes.

An Exploratory Ecological Study between COVID-19 Vaccination Rate and Racial/Ethnic and Socioeconomic Status Neighborhood Conditions in Michigan

COVID-19 vaccination rate disparities continue to persist in the U.S., despite their wide availability. A multidimensional host of sociodemographic, economic, political, and cultural factors have resulted in differences in vaccine coverage rates across the U.S. The present study descriptively explores one component of the complex relationship among what drives COVID-19 vaccination rate differences—specifically, the relationship between neighborhood sociodemographic characteristics and vaccination rates in Michigan. Data from the 2019 5-Year American Community Survey are merged with vaccine coverage rate data at the census tract level for the 18-years-and-older population for Michigan from 15 December 2020 to 19 November 2021. On the one hand, the results reveal that a neighborhood’s racial and ethnic composition and socioeconomic status characteristics are part of the complex bundle of characteristics affecting neighborhood vaccination coverage rates across Michigan. On the other hand, the findings also reveal a set of surprising patterns as they relate to the racial and ethnic composition of neighborhoods in Michigan. Future studies should further explore the extent to which race/ethnicity and class-related neighborhood characteristics are statistically relevant in examining the broader community effects on vaccine coverage rates in Michigan.

Childhood obesity inequality in northeast China: joint effect of social economic status and school neighborhood environment

BackgroundObesogenic environment is important in driving obesity epidemic. Children spend large amount of their time in schools. School neighborhood environment, as well as its interaction with socioeconomic status (SES) needs to be explored to provide evidence for children obesity prevention policies.MethodsObjective anthropometric measurement, a household structured questionnaire, and school geospatial analyses were carried out on 3670 children (aged 9–12 years) of 26 schools in northeast China. Interaction between SES inter-categorical intersectionality group and school neighborhood environment was tested for the effect on children’s body mass index z scores (z-BMI) and waist–hip ratio z scores (z-WHR), following formulation of SES inter-categorical intersectionality group based on household wealth, parental education, and parental occupation.ResultsSES groups formed by household wealth, parental education and parental occupation was associated with z-BMI and z-WHR for girls. Those from moderate wealth & self-employed (M&S) families had the highest adjusted z-BMI and z-WHR among all SES groups. School neighborhood environment factors interacted with SES groups in association with WHR for girls. Number of school neighborhood supermarkets and residential sites were negatively associated with z-WHR for girls from M&S families (β= -0.45 (95%CI: -0.76, -0.15) for supermarkets; β= -0.01 (95%CI: -0.03, 0.00) for residential sites). Number of school neighborhood convenience stores and public transport stops were positively associated with z-WHR for girls from M&S families (β = 0.02 (95%CI: 0.00, 0.03) for convenience stores; β = 0.23 (95%CI: 0.15, 0.31) for public transport stops). While non-significant association was found for number of vegetable stores.ConclusionGirls from moderate wealth & self-employed families may be the group susceptible to school neighborhood environment. Local policies targeted at improving the school neighborhood environment may be one avenue for reducing socioeconomic disparities in obesity especially for girls.

Individual, interpersonal and environmental correlates of sedentary behaviours in adults with intellectual disabilities.

Sedentary behaviours have adverse health outcomes and adults with intellectual disabilities are at a higher risk of unhealthy lifestyle behaviours. The lack of knowledge relating to sedentary behaviours in adults with intellectual disabilities has impeded the development of effective interventions. This study aimed to investigate individual, interpersonal and environmental correlates that are associated with sedentary behaviours in adults with intellectual disabilities. A secondary analysis of data from The UK Household Longitudinal Study (Understanding Society; collected 2011-2013) was conducted. Twenty-two predictor variables were included in a stepwise logistic regression, with TV hours during weekdays (≤3 and >3h/day) used as a proxy for sedentary behaviours. A sample of 266 adults, with mean age of 37.9 and range from 18 to 49years old, with intellectual disabilities were identified. Because 63.9% were female, 62.4% had children and 28.2% were employed, the sample is likely to be most representative of more able adults with intellectual disabilities. A significant interaction term between having children and neighbourhood status was found in the initial model so separate models for good and poor-quality neighbourhoods are reported. Having children only had a significant effect to lower the odds of high TV time among participants living in good quality neighbourhoods (OR 0.10, 95% CI 0.03, 0.25). However, for people living in poor quality neighbourhoods it was better quality leisure services that was associated with lower odds of high TV time (OR 0.48, 95% CI 0.23, 0.90). Being employed only significantly reduced the odds of high TV time in the good quality neighbourhood model (OR 0.35, 95% CI 0.12, 0.78). These effects highlight the importance of environmental effects on lifestyle behaviours of adults with intellectual disabilities. Future research should aim to expand our understanding of environmental effects on the sedentary behaviours and other lifestyle behaviours of adults with intellectual disabilities.

Does the Internet Moderate the Neighborhood Effect? Internet Use, Neighborhoods, and Mental Health among Older Adults in Shanghai.

Internet use may reduce the impact of the neighborhood on residents' well-being by helping people utilize resources beyond their immediate neighborhoods or strengthen neighborhood influences by widening the digital divide across neighborhoods. This study investigates how internet use moderates neighborhood effects on mental health among older adults in Shanghai. Using data from the Shanghai Urban Neighborhood Survey (SUNS) and population census, hierarchical linear models reveal that older adults who more frequently use the internet report lower levels of mental distress. Internet use attenuates the negative effects of living in low-socioeconomic status (SES) neighborhoods. We also examine the roles of three types of internet use: social networking, leisure, and information seeking. The results show that only social networking and leisure internet use are significantly associated with improved mental health among older adults. The results suggest that social programs are needed to increase internet literacy among older adults to promote active aging, and priority should be given to relatively disadvantaged neighborhoods.

Joint effects of individual socioeconomic status and residential neighborhood context on vaginal microbiome composition.

The vaginal microbiome is a dynamic ecosystem that is important for women's health. Its composition has been associated with risk for menopausal symptoms, sexually transmitted infections, gynecologic cancer, and preterm birth. Conventional risk factors for a vaginal microbiome linked with these adverse health outcomes include sexual behaviors, hygiene practices, individual social factors, and stress levels. However, there has been limited research on socio-contextual determinants, and whether neighborhood context modifies the association with individual socioeconomic factors. Socioeconomically diverse pregnant African American women in Atlanta, Georgia (n = 439) provided residential addresses and first trimester vaginal swab samples, which underwent sequencing, taxonomic classification, and assignment into mutually exclusive CST (community state types) via hierarchical clustering. Linear probability models were used to estimate prevalence differences (PD) for the associations of neighborhood factors with vaginal microbiome CST and to evaluate for additive interaction with maternal level of education, health insurance type, and recruitment hospital. Factors such as higher (vs. lower) maternal education, private (vs. public) insurance, and private (vs. public) hospital were associated with higher prevalence of Lactobacillus-dominant vaginal microbiome CSTs typically associated with better health outcomes. When considering the joint effects of these individual socioeconomic status and residential neighborhood factors on vaginal microbiome CST, most combinations showed a greater than additive effect among the doubly exposed; however, in the case of local income homogeneity and local racial homogeneity, there was evidence of a crossover effect between those with less-advantaged individual socioeconomic status and those with more-advantaged individual socioeconomic status. Compared to women at the public hospital who lived in economically diverse neighborhoods, women at the private hospital who lived in economically diverse neighborhoods had a 21.9% higher prevalence of Lactobacillus-dominant CSTs, while women at the private hospital who lived in less economically diverse neighborhoods (the doubly exposed) had only an 11.7% higher prevalence of Lactobacillus-dominant CSTs, showing a crossover effect (interaction term p-value = 0.004). In this study, aspects of residential neighborhood context were experienced differently by women on the basis of their individual resources, and the joint effects of these exposures on vaginal microbiome CST showed a departure from simple additivity for some factors.

"Hard-To-Reach" or Hardly Reaching? Critical Reflections on Engaging Diverse Residents From Low Socio-Economic Status Neighborhoods in Public Health Research.

HINTS AND KINKS Int J Public Health, 05 January 2023 https://doi.org/10.3389/ijph.2022.1605296

Abstract C003: Insurance status and neighborhood poverty as mediators of the racial disparity in advanced disease stage at diagnosis and nonreceipt of surgery for women with breast cancer in Florida

Abstract Background: In our previous study investigating mediators of the Black vs. White disparity in breast cancer survival for women in Florida, the two most important factors explaining the disparity were advanced disease stage at diagnosis and nonreceipt of surgery. Model assumptions of the multiple mediation approach used in that study prohibited examination causally prior (proximal) mediators. The purpose of this study was to: 1) quantify the excess risk of advanced disease stage at diagnosis and nonreceipt of surgery for Black vs. White women, and 2) use multiple mediation analysis to investigate the degree to which insurance status and high neighborhood poverty explain the racial disparity in these two outcomes. Methods: The study population was comprised of women in Florida diagnosed with breast cancer between 2004 and 2015 and who were reported to the Florida Cancer Data System. The potential mediators consisted of insurance status (Medicaid/Uninsured: yes/no) and census tract poverty level (High poverty [≥ 20% of households in poverty]: yes/no). The two outcomes of interest were advanced stage of disease at diagnosis (stages III/IV) and nonreceipt of surgery. The log-binomial model was used to obtain risk ratios (RR) with 95% confidence interval (CI) for the association of race with these two outcomes, adjusted for age. The multiple mediation approach of Yu et. al. was used to obtain log odds ratios (OR) to quantify direct effects, indirect effects, and the relative % of the total effect mediated. Results: There were 101,872 women available for analysis. African American women were 55% more likely to be diagnosed with advanced disease stage (RR = 1.55: 95% CI, 1.50-1.60) and 97% more likely more likely to not receive surgery (RR = 1.97: 95% CI, 1.90-2.04). The results of the multiple mediation analysis revealed that insurance status and high poverty explained 20.2% and 6.8%, respectively, of the racial disparity in advanced stage of disease at diagnosis. For the disparity in nonreceipt of surgery, insurance status explained 14.4% of the race effect and high poverty explained 5.2% of the race effect. Conclusions: Mediation analysis can provide insight into the mechanisms by which racial disparities in health outcomes occur. As was the case in this study, mediation analysis can also lead to new hypotheses concerning the most important factors causing disparities. To wit, contrary to our initial hypothesis, neither insurance status nor high poverty mediated the majority of the racial disparity in advanced disease stage at diagnosis or nonreceipt of surgery. Future research is required to obtain a better understanding of the barriers to screening mammography and receipt surgical treatment in Black women diagnosed with breast cancer. Citation Format: Robert B. Hines, Xiang Zhu, Eunkyung Lee, Bradley Eames, Karolina Chmielewska, Asal Johnson. Insurance status and neighborhood poverty as mediators of the racial disparity in advanced disease stage at diagnosis and nonreceipt of surgery for women with breast cancer in Florida [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C003.

Residential and preschool neighborhoods: Exploring patterns of socioeconomic match and its association with child skills across Massachusetts

The current study analyzed patterns of neighborhood socioeconomic match across 3- and 4-year-old children's (N = 2,029) residential and preschool neighborhoods in Massachusetts. Most children (80%) lived and attended early education and care in different neighborhoods. Children in households with the lowest incomes and those whose families identified as Black or African American were among the likeliest to have mismatched residential and preschool neighborhoods. Yet children's residential and preschool neighborhoods were typically socioeconomically similar across all categories we considered. Associations between residential and preschool neighborhood socioeconomic match and children's skills were inconsistent and depended on the socioeconomic status of children's residential neighborhood. These findings illustrate how the concept of demographic match can be applied to a range of contexts and contribute to the field's understanding of how the dynamic interplay of children's multiple day-to-day contexts may relate to early learning and development.

Analysis of secondary school students’ academic performance and parental involvement in children education at home

Introduction. Parental involvement in children’s education means engagement and participation of parents in the educational activities of their children. The existing body of empirical research shows that parental involvement can influence academic performance of their children in two distinct ways, i.e. parental involvement in children education at home (helping children in homework and other academic discussions, etc.) and parental involvement in children education at school (participation in school function and meetings, etc.). Active involvement of parents in children’s education may even counterbalance the unfavourable effects of low socioeconomic status and underprivileged neighborhood. The overall effect of parental involvement in child education both at home and at school is a worthy source of improving the academic performance of children through securing higher grades at school.Aim. This research aimed to examine the effects of parental involvement in children education at home on academic performance of secondary schools students and to identify the difference of the effects of parental involvement on students of different gender, parent literacy status and parent importance to children education.Methodology and research methods. Cross sectional and a multistage stratified sampling technique was adopted to portray information from sample of 448 students on Likert scale. Chi square, Kendall’s Tau-c tests and Logistic regression analyses were used to determine the level, direction and strength of association among variables.Results. The results showed that the association of children academic performance was significant and positive when parents helped children with their homework (P = 0.000, Tc = 0.231), discussed school progress with children (P = 0.002, Tc = 0.122) and motivated children to work harder when they make a poor grade (P = 0.015, Tc = 0.133). Moreover, the results highlighted variation in the academic performance of children with respect to their gender, parental literacy status, parental importance to children education and parental involvement in children education at home. It was concluded that boys, children of literate parents, children whose parents give more importance to their education and their parents remain involved in their educational activities at home secured higher grades.Scientific novelty. The present study is distinctive in that it examined variations in children’s academic performance with respect to student gender, parental literacy status, and parental importance to their education in addition to focusing on the relationship between parental involvement in their children education at home and academic performance.Practical significance. The analysis of the research outcomes leads to several interesting results and proposes helpful suggestions for important stakeholders. The main study recommendations that will enable parents to promptly meet the educational demands of their children in order to aid them in getting better grades include awareness-raising campaigns for parents, income creation chances for disadvantaged families, and adult literacy initiatives.

Are richer neighborhoods always better for the kids?

Abstract Based on Norwegian administrative registers, we provide new empirical evidence on the effects of the childhood neighborhood’s socioeconomic status on early educational performance. A neighborhood’s status is measured annually by its adult inhabitants’ earnings ranks within larger commuting zones, and the childhood neighborhood status is the average status of the neighborhoods inhabited from the year after birth to age 15. Identification of causal effects relies on within-family comparisons only. Our results reveal a distinct hump-shaped relationship between the socioeconomic status of the childhood neighborhood and school results at age 15–16, such that the optimal neighborhood is of medium rank.

Does neighbourhood crime mediate the relationship between neighbourhood SES and birth outcomes?

Abstract Background Previous studies have consistently found that women living in low socioeconomic status (SES) neighbourhoods are at higher risk of experiencing adverse birth outcomes compared to women from high SES areas. However, the mechanisms through which neighbourhood SES might influence health at birth remain poorly understood. One of the proposed pathways is the exposure to higher crime rates. The aim of this study is to investigate whether neighbourhood crime mediates the relationship between neighbourhood SES and birth outcomes. Methods A retrospective cohort study including over 1.3 million singleton births occurred in the Netherlands between 2010 and 2017. Individual-level data from the Dutch perinatal registry was linked to quintiles of neighbourhood SES scores and neighbourhood-level crime rates. Using the mediational g-formula, we estimated the total effect, natural direct effect, and natural indirect effect of neighbourhood SES on birth outcomes: small-for-gestational-age (SGA), low birth weight, and preterm birth. The neighbourhood SES intervention settings correspond with a hypothetical improvement in neighbourhood SES from the lowest to the highest quintile. Results The hypothetical improvement in neighbourhood SES resulted in a 6.6% (CI = 5.6%; 7.5%) relative reduction in the proportion of SGA births, an 8.9% (CI = 7.6%; 10.3%) reduction in the proportion of low birth weight, and a 5.1% (CI = 4.0%; 6.1%) decrease of preterm birth. Neighbourhood crime accounted for 29.0% (CI = 25.1%; 32.8%) of the total effect of neighbourhood SES on SGA, and for 8.6% (CI = 5.1%; 11.6%) of the total effect on low birth weight. For preterm birth, we found no evidence of mediation by neighbourhood crime. Conclusions Neighbourhood crime mediates the association between neighbourhood SES and key adverse birth outcomes. Interventions targeted at lowering neighbourhood crime rates could improve birth outcomes in disadvantaged areas. Key messages

Distribution of acute appendicitis care in children: A statewide assessment of the surgeons and facilities providing surgical care

BackgroundPediatric appendicitis is managed by general and pediatric surgeons at both children’s hospitals and non-children’s hospitals. A statewide assessment of surgeons and facilities providing appendicitis care was performed to identify factors associated with location of surgical care. MethodsChildren aged <18 years undergoing appendectomy for appendicitis in Wisconsin from 2018-2020 were identified through the International Classification of Diseases, 10th revision, and Current Procedural Terminology codes using Wisconsin Hospital Association data. Patient residence and hospital locations were used to determine travel distance, rurality, and neighborhood-level socioeconomic status. ResultsAmong 3,604 children with appendicitis, 36.0% and 12.8% had an appendectomy at 2 major children’s hospitals and 4 other children’s hospitals, respectively, and 51.2% had an appendectomy at 99 non-children’s hospitals. Pediatric surgeons performed 76.1% of appendectomies at children’s hospitals and 2.9% at non-children’s hospitals. Only 32.2% of patients received care at the hospital closest to their homes. Non-children’s hospitals disproportionally cared for older, non-Hispanic White, and privately insured children, those with uncomplicated appendicitis, and those living in rural areas, in mid-socioeconomic status neighborhoods, and greater distances from children’s hospitals (all P < .001). After multivariable adjustment, receipt of care at children’s hospitals was associated with younger age, minority race, complicated appendicitis, shorter distance to children’s hospitals, and urban residence. ConclusionOver half of surgical care for pediatric appendicitis occurred at non-children’s hospitals, especially among older children and those living in rural areas far from children’s hospitals. Future work is necessary to determine which children benefit most from care at children’s hospitals and which can safely receive care at non-children’s hospitals to avoid unnecessary time and resource utilization associated with travel to children’s hospitals.