Personal Socioeconomic Status Research Articles

Financial hardship and neighborhood socioeconomic disadvantage in long-term childhood cancer survivors.

Long-term survivors of childhood cancer face elevated risk for financial hardship. We evaluate whether childhood cancer survivors live in areas of greater deprivation and the association with self-reported financial hardships. We performed a cross-sectional analysis of data from the Childhood Cancer Survivor Study between 1970 and 1999 and self-reported financial information from 2017 to 2019. We measured neighborhood deprivation with the Area Deprivation Index (ADI) based on current zip code. Financial hardship was measured with validated surveys that captured behavioral, material and financial sacrifice, and psychological hardship. Bivariate analyses described neighborhood differences between survivors and siblings. Generalized linear models estimated effect sizes between ADI and financial hardship adjusting for clinical factors and personal socioeconomic status. Analysis was restricted to 3475 long-term childhood cancer survivors and 923 sibling controls. Median ages at time of evaluation was 39 years (interquartile range [IQR] = 33-46 years and 47 years (IQR = 39-59 years), respectively. Survivors resided in areas with greater deprivation (ADI ≥ 50: 38.7% survivors vs 31.8% siblings; P < .001). One quintile increases in deprivation were associated with small increases in behavioral (second quintile, P = .017) and psychological financial hardship (second quintile, P = .009; third quintile, P = .014). Lower psychological financial hardship was associated with individual factors including greater household income (≥$60 000 income, P < .001) and being single (P = .048). Childhood cancer survivors were more likely to live in areas with socioeconomic deprivation. Neighborhood-level disadvantage and personal socioeconomic circumstances should be evaluated when trying to assist childhood cancer survivors with financial hardships.

Spatial characteristics of non-communicable diseases and their associations to social conditions in a large urban cohort in Germany-Results from the Hamburg City Health Study.

Non-communicable diseases (NCDs) are responsible for many deaths. They are associated with several modifiable and metabolic risk factors and are therefore prone to significant regional variations on different scales. However, only few intra-urban studies examined spatial variation in NCDs and its association with social circumstances, especially in Germany. Thus, the present study aimed to identify associations of personal risk factors and local social conditions with NCDs in a large German city. This study is based on a population-based cohort of the Hamburg City Health Study including 10,000 probands. Six NCDs were analyzed (chronic obstructive pulmonary disease [COPD], coronary heart disease [CHD], diabetes mellitus, heart failure, depression, and hypertension) in 68 city district clusters. As risk factors, we considered socio-demographic variables (age, sex, education) and risk behaviour variables (smoking, alcohol consumption). Logistic regression analyses identified associations between the district clusters and the prevalence rates for each NCD. Regional variation was detected by Gini coefficients and spatial cluster analyses. Local social condition indexes were correlated with prevalence rates of NCDs on city district level and hot-spot analyses were performed for significant high or low values. The analyses included 7,308 participants with a mean age of 63.1 years (51.5% female). The prevalence of hypertension (67.6%) was the highest. Risk factor associations were identified between smoking, alcohol consumption and education and the prevalence of NCDs (hypertension, diabetes, and COPD). Significant regional variations were detected and persisted after adjusting for personal risk factors. Correlations for prevalence rates with the local social conditions were significant for hypertension (r = 0.294, p < 0.02), diabetes (r = 0.259, p = 0.03), and COPD (r = 0.360, p < 0.01). The study shows that regional differences in NCD prevalence persist even after adjusting for personal risk factors. This highlights the central role of both personal socio-economic status and behaviors such as alcohol and tobacco consumption. It also highlights the importance of other potential regional factors (e.g. the environment) in shaping NCD prevalence. This knowledge helps policy- and decision-makers to develop intervention strategies.

Cross-sectional associations between neighborhood characteristics, cognition and dementia risk factor burden in middle-aged and older Australians

Dementia disproportionately affects individuals from disadvantaged backgrounds, including those living in areas of lower neighborhood-level socioeconomic status. It is important to understand whether there are specific neighborhood characteristics associated with dementia risk factors and cognition which may inform dementia risk reduction interventions. We sought to examine whether greenspace, walkability, and crime associated with the cumulative burden of modifiable dementia risk factors and cognition. This was a cross-sectional analysis of 2016–2020 data from the Healthy Brain Project, a population-based cohort of community-dwelling individuals across Australia. Participants were aged 40–70 and free of dementia. Measures included greenspace (greenspace % in the local area, and distance to greenspace, n = 2,181); and intersection density (n = 1,159), and crime (rate of recorded offences; n = 1,159). Outcomes included a modified Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score to index the burden of modifiable vascular dementia risk factors; and composite scores of both memory and attention, derived from the Cogstate Brief Battery. Linear regressions adjusted for age, sex, education, and personal socio-economic status, demonstrated distance to greenspace (b ± SE per 2-fold increase = 0.09 ± 0.03, p =.005) and crime rate (b ± SE per 2-fold increase = 0.07 ± 0.03, p =.018) were associated with higher modified CAIDE. Higher crime was associated with lower memory performance (b ± SE = -0.03 ± 0.01, p =.018). The association between distance to greenspace and modified CAIDE was only present in low-moderate socioeconomic status neighborhoods (p interaction = 0.004). Dementia prevention programs that address modifiable risk factors in midlife should consider the possible role of neighborhood characteristics.

Green infrastructure inequality in the context of COVID-19: Taking parks and trails as examples

Urban green infrastructures play a critical role in enhancing the well-being of residents, yet their equitable access remains a concern, particularly during the COVID-19 outbreak. There is a lack of knowledge on how people respond to the pandemic regarding the usage of green infrastructure in cities. This paper explores the shifts in visitation to parks and trails, two popular types of green infrastructures in Salt Lake County, Utah, by analyzing the results of a survey conducted during the pandemic. Our conceptualization considers personal and neighborhood level factors, including personal socioeconomic status, existing inequalities of green infrastructures, urban form, and neighborhood conditions. People who reside close to the city center tend to go to parks more often, while those living in urban edges use trails more. Visiting green infrastructures less often is more likely in areas with higher COVID-19 infection rates. The regression results confirm the importance of neighborhood level factors and illustrate the intricate elements influencing people's decisions to visit different green infrastructures during the pandemic, which shows non-linear relationships. Wealthier, white, and younger people seem to enjoy green infrastructures more often, leading to the concern of amplified inequality. Higher COVID-19 cases result in higher demands for green infrastructures, which are not fulfilled during the pandemic, especially for vulnerable communities, leading to spatial exclusion. The findings highlight the importance of smart growth, including compact development, public transit, and pocket parks, in promoting the urban resilience of park and trail visits, as they may provide more opportunities for access and alternatives to green infrastructures even in the context of the pandemic.

OUTC-08. IMPLEMENTING SOCIAL DETERMINANT OF HEALTH DATA COLLECTION FOR PEDIATRIC, ADOLESCENT AND YOUNG ADULT NEURO-ONCOLOGY PATIENTS IN THE CLINICAL TRIAL CONSORTIA SETTING: PROGRESS AND CHALLENGES

Abstract Adverse social determinants of health (SDoH) are associated with decreased survival and increased long-term complications amongst pediatric and adolescent and young adult (AYA) neuro-oncology patients. These outcome disparities are in part due to inferior access to clinical trials and comprehensive, multidisciplinary care. SDoH including food insecurity, housing instability, inability to pay for utilities, and personal safety issues have been shown to negatively impact therapy adherence and exacerbate survival disparities. As such, efforts to improve health equity must include evaluating and addressing SDoH at diagnosis. Existing literature has been limited by a reliance on proxy measures of adverse SDOH such as neighborhood or census area-level socioeconomic status data, which poorly reflect individual circumstances. There is a complex interplay between neighborhood and personal socioeconomic status that has not been extensively studied and is poorly understood. In addition, socioeconomic status is only one component of SDoH. No validated tool currently exists to assess SDoH amongst pediatric and AYA cancer patients. It is imperative that multicenter clinical trials collect SDoH data to inform both trial design and interpretation of results. These data will be important to understanding and identifying patterns in tumor and toxicity incidence, as well as understanding the burden on families in adhering to trial therapies. Based on our previous work, we will present the importance of incorporating SDoH data collection within the clinical trial consortia setting. In addition, we will review the development of a comprehensive SDoH questionnaire and discuss facilitators and barriers to the incorporation of SDoH questionnaires into multicenter clinical trials and offer solutions based on our experience.

Fortune favors the experienced: entrepreneurs’ Internet-Era Imprint, digital entrepreneurship and venture capital

This study focuses on entrepreneurs’ Internet-era imprint and its effect on the level of digital entrepreneurship and entrepreneurial firms’ venture capital. From the perspective of imprinting theory and signaling theory, we find that entrepreneurs with Internet-era imprint are more willing to use digital technologies in their entrepreneurial process, which raises the level of digital entrepreneurship within a firm. Imprint-driven digital entrepreneurship acts as a quality signal to increase the success rate of access to venture capital from financial institutions. In addition, venture capital providers do not value the entrepreneurs’ personal socioeconomic status for easier access to external resources, but rather their Internet-era imprint, which is more relevant to the success of digital entrepreneurship. Our hypotheses are supported using data from the Chinese private entrepreneurial firms in 2016. Overall, our efforts to extend imprinting theory to digital entrepreneurship literature suggest that the Internet-era imprint persists in the digital entrepreneurial process. Moreover, this study enriches the signaling mechanisms in entrepreneurial venture capital research by conceptualizing digital entrepreneurship as a signal.

Material deprivation in childhood and unequal political socialization: the relationship between children’s economic hardship and future voting

Abstract Long-term socialization patterns are considered a key explanation for socio-economic inequalities in political participation. Material conditions in youth and childhood are assumed to contribute to rather stable trajectories of political apathy or involvement and lay the foundations for unequal participation from before voting age and far into adulthood. However, our understanding of when such inequalities begin to become noticeable, the importance of parental socio-economic status as opposed to personal socio-economic status, and potential long-term consequences is still limited. We address these issues using the youth questionnaire of the UK Household Longitudinal Study. We show that material deprivation in childhood is negatively related to turnout in young adults’ first election in which they are eligible to vote. This result holds when we control for an unusually exhaustive list of potential confounders, such as psychological childhood characteristics, parental–political interest and education, present material conditions, mental health, and future educational degrees. Our results, hence, suggest that—while personal socio-economic experiences in early adulthood are not irrelevant—socio-economic family background has an independent effect on political participation.

Perceived discrimination in the workplace and mental health from early adulthood to midlife.

Considerable evidence demonstrates that perceiving oneself as an object of discrimination has negative consequences for mental health. However, little is known about whether this experience is more or less harmful in distinct phases of the life course, consistent with the life course principle of timing; or whether, in accord with the principle of lifespan development, it has long-term implications. We draw on longitudinal data addressing perceived workplace discrimination based on race/ethnicity and gender from the prospective Youth Development Study, covering early adulthood to midlife. Hierarchical linear modelling of the effects of discrimination on depressed mood indicates that both forms of discrimination have short-term (within life stages) and long-term (across stages) adverse effects on adult mental health. The impacts of perceived discrimination within stages on depressed mood appear to be greatest in the mid-30s and to weaken by midlife. Lingering effects of discrimination are more pronounced early on. These patterns are observed with controls for key time-varying negative experiences at work and personal socio-economic status, as well as invariant background characteristics (gender, race and parental socio-economic status). We consider these findings in relation to the dynamics of personal change in the context of occupational careers.

Psychiatric care following deliberate self-harm and prospective mortality: evidence from a national cohort of patients in routine care

IntroductionPsychiatric care following self-harm treatment is pivotal in patients´ life both in short- and long-terms.ObjectivesTo examine follow-up psychiatric care received by patients treated for deliberate self-harm (DSH), and to assess the influence of psychiatric referral and treatment attendance on risk for subsequent mortality.MethodsNationwide registries were interlinked to follow all DSH patients for data on personal socioeconomic status, clinical features of DSH, psychiatric treatment and cause of death. Data were analyzed with Logistic regression and cause-specific survival analysis.Results The study identified 43153 patients involving 69569 DSH episodes. Of these patients 15.7% were referred or transferred to psychiatric services and 51.0% attended psychiatric treatment within subsequent 3 months. Evidently, prior psychiatric history and psychiatric comorbidities had strong influence on both referral and attendance to psychiatric healthcare, personal socioeconomic status also deviated the likelihoods. During the follow-up, 7041 patients died from suicide (n=911) or other causes (n=6130). While suicide risk was highly associated with male gender, middle age, and particularly, prior and coexisting psychopathologies, other cause mortality was strongly associated with old age and socioeconomic disadvantages. Meanwhile, a referral to psychiatric services was associated with suicide risk, and the risk was particularly high for patients who received the referral but did not attend psychiatric treatment. The observed effect was more pronounced during the early years, and in patients of young or middle age and those with a clear intent of self-harm.ConclusionsThe insightful findings highlight the importance of patients´ attendance and engagement in follow-up psychiatric care on risk for subsequent mortality.DisclosureNo significant relationships.

The Impact of Secondary Education Choices on Mathematical Performance in University: The Role of Non-Cognitive Skills

(1) Background: this study evaluates the most relevant factors affecting the performance in mathematics of university undergraduates. Precisely, the mathematical background of students. Spanish secondary education provides an opportunity to develop this analysis since students can choose between two secondary education tracks with different mathematical content and depth. (2) Methods: a survey was conducted covering personal characteristics, socioeconomic status, academic choices and academic achievement as well as a set of questions aimed to uncover attitudes towards mathematics. Students that show preferences regarding mathematics are prone to choose the track with more mathematical content, creating a potential confusion between training and attitudes towards mathematics. We propose an index of non- cognitive skills related to mathematics to account for this problem. (3) Results: prior background in mathematics plays a role in mathematical performance at university even after correcting for non-cognitive skills related to mathematics. The effects are heterogeneous with respect to gender. (4) Conclusions: choosing a more mathematical-oriented itinerary in secondary education seems to give an edge to students. Our results shed light on the implications associated with the decision of secondary school track choice made by students. Furthermore, they are meant to serve as a guide to improve the design of remedial courses.

From Income Inequalities to Social Exclusion: The Impact of the Great Recession on Self-Rated Health in Spain During the Onset of the Economic Crisis

The impact of the Great Recession on health stands out due to its implications for the wellbeing of the population. The available empirical evidence suggests that macrosocial inequalities can be a central element in explaining differences in the impact of the crisis on the health of the population during its early years (2008–2011). Specifically, it is necessary to analyze the role played by the processes constituting a model of inequalities based on social exclusion. This study addresses the topic by using longitudinal data taken from the European Union statistics on income and living conditions (EU-SILC) survey ( n = 5.924), with a hierarchical structure of four measurement moments nested in 5,924 individuals nested in 17 regions. Variables from two levels of analysis are considered: individual and ecological (regional) variables. The findings show that personal socioeconomic status (income and education) are significantly associated with changes in self-rated health during the onset of the crisis. The findings for ecological variables show that the variables measuring exclusion (material deprivation and low work intensity) play a significant role in the explanation of inequalities in health and how they changed during the crisis. Both indicators are negatively associated with self-rated health, while the Gini index and the proportion of the population in long-term unemployment do not have a consistent significant effect. These findings support the hypothesis that there are higher risks to wellbeing in more unequal societies compared with more equal societies.

Педіатрична клініка Одеського національного медичного університету: якість невідкладної медичної допомоги дітям

Мета роботи — обговорити питання підвищення якості невідкладної допомоги дітям при найбільш поширених захворюваннях. Матеріали та методи. Якість медичної допомоги включає 6 показників: ефективність, обґрунтованість, економічна доступність, прийнятність/зосередженість на пацієнта, рівність, безпека. Результати. У педіатричній клініці Одеського національного медичного університету (ОНМедУ) створений блок інтенсивного спостереження, основним завданням якого є надання невідкладної допомоги дітям, які потребують моніторингу дихання та серцевої діяльності, проведення кисневої терапії та регідратаційної терапії великого об’єму. У клініці діє система сортування пацієнтів за тяжкістю стану з урахуванням даних обстеження і пульсоксиметрії. Запорукою ефективності медичної допомоги є локальні протоколи, розроблені на принципах доказової медицини; всі ліки, включені в них, входять у Лист необхідних ліків Всесвітньої організації охорони здоров’я. Прийнятність медичної допомоги визначають пацієнторієнтовані технології: спільне перебування матері та дитини; перевага надається оральній регідратації, а не внутрішньовенному введенню рідини; мінімізація болю і відмова від внутрішньом’язових ін’єкцій; зволоження повітря навколо пацієнта та ін. Середня тривалість перебування у блоці інтенсивного спостереження — 2 дні. Культура безпеки пацієнтів є пріоритетом і включає в себе: зміну ставлення співробітників до медичної безпеки; виявлення тригерів і ризиків медичної допомоги; виявлення медичних помилок і промахів; використання безпечних технологій і простих алгоритмів дій; навчання медичного персоналу. Було проведено більше 40 лекцій і практичних занять для медичного персоналу, включаючи тренінги на манекенах Code Blue. Висновки. Заходи, спрямовані на підвищення якості невідкладної медичної допомоги дітям в педіатричній клініці ОНМедУ, включають: 1) організацію блоку інтенсивного спостереження і його оснащення сучасним обладнанням для діагностики та лікування дітей; 2) сортування пацієнтів за тяжкістю стану за об’єктивними критеріями; 3) скорочення термінів госпіталізації; 4) стандартизацію медичної допомоги шляхом розробки локальних протоколів на принципах доказової медицини; 5) підвищення прийнятності медичного обслуговування за рахунок впровадження технологій, орієнтованих на пацієнта; 6) впровадження культури безпеки пацієнта; 7) постійне навчання медичного персоналу.

Impact of paternal education on epigenetic ageing in adolescence and mid-adulthood: a multi-cohort study in the USA and Mexico.

Both parental and neighbourhood socio-economic status (SES) are linked to poorer health independently of personal SES measures, but the biological mechanisms are unclear. Our objective was to examine these influences via epigenetic age acceleration (EAA)-the discrepancy between chronological and epigenetic ages. We examined three USA-based [Coronary Artery Risk Disease in Adults (CARDIA) study, Fragile Families and Child Wellbeing Study (FFCWS) and Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS)] and one Mexico-based (Project Viva) cohort. DNA methylation was measured using Illumina arrays, personal/parental SES by questionnaire and neighbourhood disadvantage from geocoded address. In CARDIA, we examined the most strongly associated personal, parental and neighbourhood SES measures with EAA (Hannum's method) at study years 15 and 20 separately and combined using a generalized estimating equation (GEE) and compared with other EAA measures (Horvath's EAA, PhenoAge and GrimAge calculators, and DunedinPoAm). EAA was associated with paternal education in CARDIA [GEEs: βsome college = -1.01 years (-1.91, -0.11) and β<high school = 1.05 (0.09, 2.01) vs college graduates] and FFCWS [GEEs: β<high school = 0.62 (0.00, 1.24)]. We found stronger associations for some paternal education categories among White adults (for GEE, βsome college = -1.39 (-2.41, -0.38)], men (βsome college = -1.76 (-3.16, -0.35)] and women [β<high school = 1.77 (0.42, 3.11)]. These findings suggest that EAA captures epigenetic impacts of paternal education independently of personal SES later in life. Longitudinal studies should explore these associations at different life stages and link them to health outcomes. EAA could be a useful biomarker of SES-associated health and provide important insight into the pathogenesis and prevention of chronic disease.

Neighborhood Socioeconomic Deprivation and Depression Symptoms in Adults From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Socioeconomic factors appear to impact mental health conditions such as depression, but little is known about the relative and combined role of neighborhood and personal socioeconomic deprivation among Hispanics/Latinos. This study examined cross-sectional associations of neighborhood and personal socioeconomic deprivation with depression symptoms in a US Hispanic/Latino population from the San Diego Field Center of the Hispanic Community Health Study/Study of Latinos (n=3,851). Depression symptoms were assessed with the ten-item Centers for Epidemiological Studies in Depression Scale. Neighborhood socioeconomic deprivation was a composite of eleven variables (e.g., neighborhood income, education, employment, household crowding). Greater personal socioeconomic deprivation based on education, income, and employment was generally associated with higher depression symptoms, including after adjusting for neighborhood socioeconomic deprivation. Greater neighborhood socioeconomic deprivation was associated with higher depression symptoms in females but not males, but the association in females became non-significant when adjusting for personal socioeconomic deprivation. Neighborhood socioeconomic deprivation did not significantly interact with personal socioeconomic deprivation in relation to depression symptoms. The present findings support the association of personal socioeconomic status with mental health (indicated by depression symptoms) among Hispanic/Latino populations, whereas neighborhood socioeconomic deprivation did not relate to depression beyond the impact of personal indicators.

Marital status and suicide risk: Temporal effect of marital breakdown and contextual difference by socioeconomic status

Research has shown that people who have never been married, divorced, or widowed are at an increased risk of suicide compared with those who are married, but we have little knowledge as to how this elevated risk is modified by socioeconomic factors, and little research has studied the risk among persons enduring a marital separation. This study addressed these issues with individual-level data from Norwegian national registers. All suicide cases in people above 18 years that took place in the period 1992–2012 (n = 11 051) were compared with living controls (185 685) matched on sex and age via a nested case control design, and suicide risk associated with marital status was assessed with conditional logistic regression. The results showed that, compared with a status of being married, suicide risk was highly associated with a status of being never married, separated, divorced, or widowed, even after adjustment for income-level, educational attainment, centrality of residence, and immigration status. The strongest effect was seen for a separated status; compared to the married, separated persons were fully 6.06 times more apt to die by suicide, and the effect was strongest in the 30 days following a separation. The observed significant associations remained but differed in strength by sex and age, and there were significant deviations by personal socioeconomic status. Most notably, the increased risk was higher for never-married persons with low educational attainment or income. However, most interaction effects (10/16) did not yield significant results. In conclusion, suicide risk is strongly associated with a single status of any form with the highest risk during a marital separation, but the increased risk varies in strength according to individual-level factors. The stress and loss of support induced by marital dissolution are important contributing risk factors for suicide, and persons with low income may be especially vulnerable.

Work-trip mode choice in Germany – Affected by individual constraints or by partner interaction?

Individuals with young children have additional responsibilities and tend to have different patterns of work-trip mode choice. In this regard, the purpose of the study is to determine if individuals’ commuting mode decisions vary with gender and the presence of young children. In doing so, we develop four separate models for women and men with and without children, respectively. We explore the associations between work-trip mode choice and five key elements: i) personal socio-economic status; ii) household attributes, iii) spatio-temporal fixity, iv) partner interaction and v) working hours preferences. We use the German National Time Use Survey 2012/13 and adopt multinomial logit analysis. In general, our results suggest that the direction of coefficients is more similar than different for both men and women. For respondents without young children, the spatial and temporal fixity attributes strongly predict men’s (also women's) driving, whereas for working in market/non-market sectors, partner attributes significantly decrease men’s driving. For respondents with young children, increase in personal income positively and significantly predicts women's (also men's) driving, whereas high levels of education, increase in household income and partners’ time spent on unpaid work strongly decrease women’s driving. For both the groups, men or women with more egalitarian or reverse working hours preferences are more likely to use sustainable modes.

Irrational Responses to Risk Preference Questionnaires by Patients with Diabetes with or without Retinopathy and Comparison with Those without Diabetes.

PurposeThe risk preferences of patients with diabetes have profound effects on the progression of complications. The present study aimed to clarify whether the preferences of patients with diabetes and retinopathy are deliberately risk-seeking or irrational and whether this propensity is specific to those with retinopathy or is also found in patients without retinopathy compared with those without diabetes.Patients and MethodsA total of 394 patients with diabetes (264 without retinopathy and 130 with retinopathy) and 198 patients without diabetes agreed to participate in this survey. The questions were modified versions of those from the Japan Household Survey on Consumer Preferences and Satisfaction, which sought to determine the participants’ personal socioeconomic status and risk preferences. In the questionnaires, responses were analyzed by determining the participants’ willingness to pay for a lottery ticket and for an insurance policy. Irrational responses were defined as violations of two axioms of the Expected Utility Theory: completeness and transitivity.ResultsThe incidence of irrational responses increased with age and was associated with educational level. The incidence of irrational responses was significantly higher in patients with retinopathy than in those without retinopathy after adjusting for age and educational level. There was no significant difference in the incidence of irrational responses between patients with diabetes but without retinopathy and those without diabetes.ConclusionThe risk-seeking behavior of patients with diabetes and retinopathy was not deliberate but was irrational under uncertainty. Medical professionals should be aware of their patients’ propensity to make irrational decisions, which is an important risk factor for the progression of retinopathy in patients with diabetes regardless of age and educational level.

School Matters: The Contribution of Positive School Climate to Equal Educational Opportunities among Ethnocultural Minority Students

This study carefully examined compensating, mediating, and moderating effects of positive school climate on the relationship of socioeconomic status (SES) and achievement in a nationally representative sample of ethnocultural minority Arabic speaking students in Israel ( N = 21,873). Positive school climate was predominantly influential in schools with vulnerable ethnic groups and students from disadvantaged backgrounds. Narrower achievement gaps among students with different personal SES backgrounds were achieved in schools with positive climates. Results suggest improving school climate can increase students’ academic opportunities and offer special benefits for students from less advantaged backgrounds. Implications for research, practice, and policy are discussed.

Food deserts and cardiovascular health among young adults.

This study assesses the association between living in a food desert and cardiovascular health risk among young adults in the USA, as well as evaluates whether personal and area socioeconomic status moderates this relationship. A cross-sectional analysis was performed using data from Wave I (1993-1994) and Wave IV (2008) from the National Longitudinal Study of Adolescent to Adult Health. Ordinary least squares regression models assessing the association between living in a food desert and cardiovascular health were performed. Mediation and moderation analyses assessed the degree to which this association was conditioned by area and personal socioeconomic status. Sample of respondents living in urban census tracts in the USA in 2008. Young adults (n 8896) aged 24-34 years. Net of covariates living in a food desert had a statistically significant association with cardiovascular health risk (range 0-14) (β = 0·048, P < 0·01). This association was partially mediated by area and personal socioeconomic status. Further analyses demonstrate that the adverse association between living in a food desert and cardiovascular health is concentrated among low socioeconomic status respondents. The findings from this study suggest a complex interplay between food deserts and economic conditions for the cardiovascular health of young adults. Developing interventions that aim to improve health behaviour among lower-income populations may yield benefits for preventing the development of cardiovascular health problems.

Gender differences in treatments and interventions received by children and adolescents with cerebral palsy

BackgroundIn the Swedish population-based follow-up program and national quality registry for individuals with cerebral palsy (CPUP), physiotherapy (PT) and occupational therapy (OT) treatments are regularly recorded along with functional status. By Swedish law, all citizens irrespective of personal characteristics or socioeconomic status, have the right to receive healthcare and medical treatments as applicable. Previous research has shown gender differences in treatments and interventions received by children with cerebral palsy (CP). The purpose of this study was to examine differences in treatments and interventions by gender and place of birth in children and adolescents participating in CPUP.MethodsThis was a cross-sectional registry study. Data from the latest PT (n = 2635) and OT assessment forms (n = 3480) in CPUP were extracted for individuals aged 0–17 years. Logistic regressions were used to assess the relationships between the outcome variables and gender and place of birth (including an interaction term gender X place of birth), adjusted for age, Gross Motor Function Classification System (GMFCS) levels and spasticity scores for PT interventions and Manual Ability Classification System (MACS) for OT interventions.ResultsResults are presented as odds ratios [95% confidence intervals] and p-values. Girls were significantly more likely to have spinal braces than boys; 1.54 [1.07, 2.22] p < 0.05, a significant interaction with place of birth indicated fewer spinal braces prescribed to children born outside of the Nordic countries; 0.20 [0.079, 0.53] p < 0.001. Girls were less likely to have undergone selective dorsal rhizotomy (SDR); 0.49 [0.25, 0.94] p < 0.05. Individuals born outside of the Nordic countries, were significantly less likely to have received intrathecal baclofen (ITB) 0.27 [0.074, 0.98] p < 0.05.ConclusionsOf the treatments prescribed, gender differences were observed for spinal braces and having undergone SDR. A statistically significant difference based on place of birth was noted for spinal bracing and having received ITB treatment. Other PT and OT treatments were associated with age, level of spasticity, and functional severity as classified using the GMFCS and the MACS. Increased awareness of differences based on gender, and where a child is born, could be obtained by inter- and intraprofessional discussions.