Poverty Status Research Articles

Mitigating health disparities by improving access to catheter-based therapies for vulnerable patients with acute pulmonary embolism

Abstract Introduction This study explores the implementation and outcomes of catheter-based thrombectomy (CBT) in acute pulmonary embolism (PE) within a safety-net hospital (SNH), addressing a critical gap in the literature concerning CBT in underserved and vulnerable populations. Methods This is a retrospective study of patients undergoing CBT between October 2020 and January 2024 at a SNH. The primary outcome was 30-day all-cause mortality. Results A total of 107 patients (47.6% female, mean age 58.4 years) underwent CBT for acute PE, with 23 (21.5%) high-risk and 84 (78.9%) intermediate-risk PE. Demographically, 64% identified as Black, 10% White, 19% Hispanic or Latino, and 5% Asian. In terms of insurance coverage, 50% had private insurance or Medicare, 36% had Medicaid, and 14% were uninsured. Notably, 67% of the patients resided in high poverty rate zip codes and 11% were non-citizen non-residents. Markers of risk severity, such as biomarkers (troponin, BNP), PE risk classification (high versus intermediate-risk), rates of low CI, lactate level, CPES/sPESI score, and rates of RV dysfunction did not vary significantly across race/ethnic groups, insurance status, level of poverty and citizenship status. Over a median follow up period of 30 days, 6 (5.6%) patients expired (all high-risk PE), 3 of which presented with cardiac arrest. No patients who presented with intermediate-risk PE died at 30 days. There was no difference in 30-day mortality based on race, insurance type, poverty level or citizenship status. Conclusion The findings emphasize the feasibility and success of implementing PERT and CBT at a SNH, offering a potential model to address healthcare disparities in acute PE on a broader scale.

Spatial–Temporal Analysis of Greenness and Its Relationship with Poverty in China

Ecological environmental protection and poverty alleviation are of great significance for the study of human–land relationship coordination and sustainable development, and they have also been a focus of attention in China in the past few decades. In this study, we chose 13 contiguous poverty-stricken areas in China as the study area. Using MODIS Leaf Area Index (LAI) data from 2000 to 2020, the spatial–temporal changes in greenness were obtained using the Bayesian spatial–temporal model (BYM). Spatial autocorrelation was used to identify the spatial distribution of poverty using socio-economic statistical data. Driving factors, including natural factors, poverty factors, and the Grain for Green Policy (GTGP), and their influence on greenness were analyzed by using the Geodetector model for detecting spatial differentiation and factors’ interactions. The results showed the following: (1) In 13 contiguous poverty-stricken areas (CPSAs) in China, 59% of the area presented an increasing trend of greenness. (2) In 2000, the high poverty levels with larger MPI values were widely distributed. After 20 years, the overall MPI value was lower, except in some northwest regions with increased MPI values. The spatial autocorrelation of poverty, which relates to the mutual influence of poverty in adjacent areas, also decreased. (3) In the study area, 65.24% of the regions showed strong synergistic effect between greening progress and poverty reduction in the interaction between poverty status and green development. With the improvement of greenness level, the positive correlation between poverty alleviation and ecological environment improvement has become increasingly close. (4) The impacts of interaction factors with the highest q values changed from temperature interacting with precision to regional division interacting with the Grain for Green Policy. The conclusions are that from 2000 to 2020, the impact of natural factors, geographical division, and poverty status on greenness has shown a decreasing trend; The effect of the Grain for Green Policy is gradually increasing; At the same time, the interaction and overlapping effects between the Grain for Green Policy and poverty were increasing. Taking into account the needs of ecological environment, poverty alleviation, and rural revitalization, this research provides valuable reference for formulating and implementing relevant policies based on the actual situation in different regions to promote harmonious coexistence between human-land relationship.

Longitudinal association of homocysteine with depressive and anxiety symptoms among urban adults: healthy aging in neighborhoods of diversity across the life span study.

Longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults remain under-studied, especially across sex, race and levels of anxiety. We examined longitudinal associations of homocysteine (HCY) with depressive symptoms scores among urban adults, before and after stratifying by sex, race and anxiety level, using data from 1460 Healthy Aging in Neighborhoods of Diversity across the Lifespan Study (HANDLS) participants aged 30-64 y at v1 (2004-2009), followed across 3 visits up to 2017. In addition to LnHcyv1, we used group-based trajectory models predicting z-transformed likelihood of greater LnHcy with age (Hcytraj). Total and domain-specific depression symptoms were scored using Center for Epidemiologic Studies Depression (CES-D) scale. Mixed-effects linear regression models and Cox proportional hazards models were utilized. A positive association was found between baseline LnHcyv1 and CES-D total scores in reduced socio-demographic- adjusted Model 1 (β (standard error [SE]) = + 2.337 (0.902), P = 0.010), a relationship slightly attenuated in fully adjusted Model 2 (Model 1 adjusting for lifestyle and health factors) with a β (SE) = + 1.825 (0.883), P = 0.039. Individuals with lower anxiety levels experienced faster CES-D domain 2 score annualized increase over time (interpersonal problems) with higher LnHcyv1 (β (SE) = 0.041 (0.018), P = 0.024). Hcytraj was linked to incident elevated depressive symptoms (CES-D total score ≥16) overall (fully adjusted model: HR = 1.09, 95% CI: 1.03-1.14, P = 0.001), particularly among women and those living in poverty. Baseline and "high trajectory" of LnHcy were positively associated with depressive symptoms and elevated depressive symptom incidence, in a sex-, race-, poverty status- and anxiety-level specific manner.

Discourses of Poverty: The Narratives of the Poor in Samar

The study aimed at exploring, through the view of the future for themselves and their children, the perceptions of the poor about the temporal dimensions of poverty. The study adopted a discursive perspective, to illustrate the hopes, dreams and expectations of the poor regarding their future and, ultimately, how they view their status and how the LGU officials would address the different faces and current status of poverty in their respective locality. The researchers used Critical Discourse Analysis (CDA). The following are the themes obtained from the responses of the participants: limited knowledge and lower health status, lack of ambition and motivation to improve the situation, inadequate basic needs like food due to large family size, and poverty are transmitted to the next generation. Eradicating poverty is a challenge that sees no means of receding. LGUs do whatever they can to improve people’s lives. Despite those programs and initiatives of the local government units, there are still municipalities in Samar that are experiencing poverty. The poorest of the poor in Samar suffer from a lack of jobs in rural areas, low motivation to pursue education, and limited resources for large families. This has led to a widening gap between the haves and have-nots. Add to that frequent natural disasters being experienced in Samar at least fifteen typhoons in a year which takes away what little the poor have. The fundamental solution for reducing poverty is to tackle poverty and to pursue equity in income, and education, provide more livelihood programs or interventions, and social participation. Community projects that focus on the restoration and development of social networks and social cohesion and the improvement of the social, communication, and coping skills of the deprived, should be encouraged.

Estimates of multidimensional poverty and its determinants among older people in rural China: evidence from a multicenter cross-sectional survey

BackgroundIn 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China.MethodsA multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people’s information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty.ResultsA total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P < 0.05).ConclusionsChina’s subsidy system and financial support must be enhanced. Particular attention should be given to the re-education of rural older individuals, basic vocational education should be strengthened in rural areas, and social participation should be encouraged.

Comparison of Predictive Factors of Flu Vaccine Uptake Pre- and Post-COVID-19 Using the NIS-Teen Survey

Background: Seasonal influenza vaccination rates are very low among teenagers. Objectives: We used publicly available data from the NIS-Teen annual national immunization survey to explore factors that influence the likelihood of a teen receiving their seasonal flu shot. Methods: Traditional stepwise multivariable regression was used in tandem with machine learning to determine the predictive factors in teen vaccine uptake. Results and Conclusions: Age was the largest predictor, with older teens being much less likely to be vaccinated than younger teens (97.48% compared to 41.71%, p &lt; 0.0001). Provider participation in government programs such as Vaccines for Children and the state vaccine registry positively impacts vaccine uptake (p &lt; 0.0001). Identifying as non-Hispanic Black was a small, negative predictor of teen vaccine uptake (78.18% unvaccinated compared to 73.78% of White teens, p &lt; 0.0001). The state quartile for COVID-19 vaccine uptake also strongly predicted flu vaccine uptake, with the upper quartile of state COVID-19 vaccine uptake being significantly more likely to also get vaccinated for influenza (76.96%, 74.94%, 74.55%, and 72.97%, p &lt; 0.0001). Other significant factors are the number of providers, education of the mother, poverty status, and having a mixed provider facility type. Additionally, the multivariable regression analysis revealed little difference in the predictive factors of vaccine uptake between pre- and post-pandemic datasets.

Ready-to-use therapeutic food as a promising therapy for the prevention and cure of undernutrition in pre-school children: A review

The nutritional status of pre-school children is a reflection of health of children in the world and forms the basis for the development of success-oriented interventional programs. This study indicates the prevalence of under-nutrition in under five children in the world, Africa and Nigeria. It also showed the prevalence of under-nutrition in the six geopolitical regions in Nigeria, with the Northern regions reported to have the highest burden of under-nutrition compared to the other regions due to several factors such as inadequate breast feeding, lack of access to healthcare, lack of clean water, armed conflict, inadequate dietary intake, inappropriate feeding, foetal growth restriction, inadequate sanitation, lack of parental education, large family size, incomplete vaccination, poverty and low socio-economic status and desire to have more children. Several nutritional interventions have been put in place to prevent and cure under-nutrition in pre-school children, which include Promotion of exclusive breastfeeding, Micronutrient supplementation, Food fortification, Nutrition education, Complimentary feeding, and Cash transfer programs, Ready-to-use therapeutics foods (RUTF), Nutritional rehabilitation centers, Parenteral nutrition, and Nutritional counseling and education. However, RUTF has been reported to have an effective intervention in the prevention and treatment of severe acute malnutrition (SAM) in pre-school children. It is an energy dense, shelf stable and ready to eat food which composed of peanut butter, sugar, full fat milk and mineral-vitamin premix. Other plant-based ingredients such as chickpea, soybean, sesame, maize, oats, sorghum and sunflower oil have also, been used in the production of RUTF and reported to be effective for complete recovery of SAM children.

Racial/ethnic disparities in curative-intent treatment for early-stage non-small cell lung cancer patients among heterogeneous Black populations: US-born Black, Afro-Haitian, West Indian Black, and Hispanic Black.

Heterogeneous Black populations encounter significant obstacles in accessing cancer care, yet research on lung cancer treatment disparities remains limited. This study investigates whether the disparity in receiving curative-intent treatment (curative-intent surgery and/or stereotactic body radiation therapy [SBRT]) for early-stage non-small cell lung cancer (NSCLC) between non-Hispanic Whites (NHWs) and total Blacks extends to diverse Black populations, including US-born, Afro-Haitian, West Indian Black, and Hispanic Black individuals. This cross-sectional study included all Florida cancer registry early-stage NSCLC cases 2005-2017, linked to individual-level discharge data containing comorbidity and specific treatment details (surgery and/or SBRT). Multivariable logistic regression assessed the association between race/ethnicity and the receipt of curative-intent treatment, while accounting for sociodemographic factors (poverty, age, insurance, and smoking status) and clinical variables. Among 55,655 early-stage NSCLC patients, 71.1% received curative-intent treatment: 72.1% NHW and 59.7% Black (non-Hispanic and Hispanic)individuals. Black patients had 35% lower odds (ORadj, 0.65; 95% CI, 0.59-0.70) of receiving curative-intent treatment compared to NHW patients. ORs varied from 0.57 (95% CI, 0.59-0.70) for Hispanic Black to 0.76 (95% CI, 0.56-1.02) for West Indian Black. Remarkably, Black-White disparities persisted despite the availability of curative treatment options (SBRT) for both high Charlson Comorbidity Index (CCI) observed among US-born Blacks and surgery for low CCI patients among all other Black subgroups. Pronounced disparities in accessing curative-intent treatments for early-stage NSCLC were evident across all Black subgroups, regardless of treatment availability and comorbidity profile. These findings underscore the need to address Black heterogeneity and prompt further research to rectify treatment disparities in early-stage NSCLC.

Evaluating the effects of digital finance on urban poverty

This study examines the impact of digital financial services development on urban poverty. Utilizing the vicious cycle of poverty theory, we established a multidimensional poverty measurement index to assess the poverty status of urban households and propose strategies for leveraging digital finance to address urban poverty. Through empirical research based on a comprehensive dataset from China covering the period from 2012 to 2020, we evaluated the moderating effect of digital financial growth on urban poverty. Our analysis, which categorized poor urban households into five groups—laid-off workers, unemployed individuals, migrants, the elderly, and disabled persons—revealed that only the unemployed and migrants experience significant benefits from digital financial development. Lastly, we explore the underlying mechanisms and emphasize the role of investment, financing, and entrepreneurship in utilizing digital finance for poverty alleviation.

ASSESSMENT OF POVERTY STATUS OF CASSAVA COOPERATIVE FARMERS IN SOUTH-SOUTH, NIGERIA

The study assessed the poverty status of cassava cooperative farmers in South-South Nigeria, utilizing a multi-stage sampling technique to select 300 members from Delta, Edo, and Akwa Ibom states. The majority of members fall within the 41-60 age range, which accounts for 66% of the total membership. This suggests that middle-aged and older individuals are more likely to participate in cassava cooperatives. There was also a higher representation of female members (58.33%) compared to male members (41.67%). However, majority (75.67%) of the cassava cooperative members were married while 2% were divorced, 10.33% were separated/divorced, and 12% were widowed. Furthermore, majority (51.67%) of the farmers had been in a cooperative for 1-5 years. The result shows that 46.33% of households consist of 1-4 members and most (82%) of the members identify cassava farming as their primary occupation. The relative poverty line was determined based on consumption expenditure, and the Foster-Greer-Thorbecke (FGT) index was employed to assess poverty status. The results indicated that over one-third of members lived below the relative poverty line of ₦882.29, although the depth (8.52%) and severity (3.13%) of poverty were relatively low. Based on these findings, the study recommends targeted poverty reduction programs, strengthening cooperative structures, enhancing access to finance, promoting value addition, investing in infrastructure, empowering women and youth, and further research to develop effective poverty alleviation strategies.

Insights on Poverty-based Inequality in Old-age Mortality in India

BackgroundAs the global population ages, understanding the effect of poverty on old-age mortality becomes increasingly important, especially in India, which is undergoing significant demographic and socio-economic changes. Although previous research has established a link between poverty and mortality, there is a critical need for panel studies to investigate this relationship specifically among older adults. This study addresses this gap by using panel data to examine the association between initial poverty status and subsequent mortality among older adults in India. Additionally, it explores the factors contributing to mortality disparities between poor and non-poor older adults.MethodsWe analyzed panel data from two rounds of the India Human Development Survey. The age-sex standardized old-age mortality rates for poor and non-poor older adults were calculated using direct standardization. Mortality disparities were evaluated through bivariate and proportion tests, as well as multivariable logistic regression analyses. The Fairlie decomposition technique was employed to identify factors contributing to these disparities, with sensitivity analyses performed to ensure the robustness of the findings.ResultsThe age-sex standardized old-age mortality rate for the poor was 31.9 per 100 people, with a 1.15 times higher likelihood of mortality [95% CI: (1.04,1.27)] between round-I to round-II compared to non-poor counterparts. Factors such as household wealth (33.6%), social class (17.1%), education (12%), and occupation (4.3%) were significant indicators of the poverty gap in old-age mortality. Surprisingly, chronic diseases, age, and gender negatively affect mortality disparity, while higher mortality in extended families suggests a weakening traditional support system.ConclusionThe findings underscore the importance of addressing ageist attitudes and enhancing social safety nets and affordable healthcare for older adults, who face higher risks of poverty and premature death. The elevated mortality among those in prolonged poverty cycles highlights the need for policymakers to reconsider universal support policies for older individuals. Specifically, if non-poor older adults have longer lifespans, policies centred solely on poor may not effectively address the needs of all older individuals.

Decline in Vaccination Coverage by Age 24 Months and Vaccination Inequities Among Children Born in 2020 and 2021 - National Immunization Survey-Child, United States, 2021-2023.

Data from the National Immunization Survey-Child (NIS-Child) were analyzed to estimate coverage with childhood vaccines recommended by the Advisory Committee on Immunization Practices among U.S. children by age 24 months. Coverage with nearly all vaccines was lower among children born in 2020 and 2021 than it was among those born in 2018 and 2019, with declines ranging from 1.3 to 7.8 percentage points. Analyses of NIS-Child data for earlier birth cohorts have not revealed such widespread declines in routine childhood vaccination coverage. Coverage among children born during 2020-2021 varied by race and ethnicity, health insurance status, poverty status, urbanicity, and jurisdiction. Compared with non-Hispanic White children, coverage with four of the 17 vaccine measures was lower among non-Hispanic Black or African American children as well as Hispanic or Latino (Hispanic) and non-Hispanic American Indian or Alaska Native children. Coverage was also generally lower among those covered by Medicaid or other nonprivate insurance, uninsured children, children living below the federal poverty level, and children living in rural areas. Coverage varied widely by jurisdiction, especially coverage with ≥2 doses of influenza vaccine. Children born during 2020-2021 were born during or after the period of major disruption of primary care from the COVID-19 pandemic. Providers should review children's histories and recommend needed vaccinations during every clinical encounter. Addressing financial barriers, access issues, vaccine hesitancy, and vaccine-related misinformation can also help to increase coverage, reduce disparities, and protect all children from vaccine-preventable diseases. Strategies that have been found effective include implementation of standing orders and reminder and recall systems, strong physician recommendations to vaccinate, and use of immunization information systems to identify areas of lower coverage that could benefit from targeted interventions to increase immunization rates.

Abstract B131: Disparities in late-stage breast cancer: The impact of socioeconomic status across racial groups by healthcare utilization and community healthcare access

Abstract BACKGROUND: Late-stage breast cancer (LSBC, defined as stage 3 or 4) significantly contributes to breast cancer (BC) mortality, underscoring the importance of early detection and intervention. Understanding the individual and community factors contributing to LSBC is crucial for improving LSBC diagnoses and outcomes. OBJECTIVE: To evaluate the association between LSBC and individual demographic/socioeconomic status (SES) characteristics by race, and describe differences in individual healthcare utilization (IHU) and community healthcare access (CHA). Methods: This population-based retrospective study used demographic and SES data (age at diagnosis, marital status, years of education, income, poverty status, health insurance, and body mass index) from the Carolina BC Study Phase 3, a population-based cohort of women diagnosed with invasive BC from 2008-13. We analyzed all cases of LSBC (n=545) and stage 1 (n=1,225). Age-adjusted relative frequency differences (RFDs) and 95% confidence intervals (CIs) assessed the relationship between LSBC and SES for Black (n=835, 47.2%) and non-Black (n=935, 52.8%) women. Analyses were stratified by IHU status (High vs Low: High: Had regular pre-diagnostic care and were adherent to BC screening guidelines, &amp;gt;0.5 mammograms per year; Low: Lacked one or both forms of care); and stratified by CHA status (High vs Low), a census tract-level measure of cancer-specific healthcare infrastructure (e.g., oncologist density) and utilization (e.g., insurance rates). High CHA had either high or low infrastructure and high use; Low CHA had low infrastructure and low use. Results: Compared to non-Black women, Black women had more LSBC diagnoses (38.7% vs 23.7%), were more likely to be unmarried (59.1% vs 28.7%), have an income of &amp;lt;$50k (71.8% vs 38.2%), and be impoverished (27.0% vs 6.1%). Age at diagnosis, years of education, and income were significantly, positively associated with LSBC for all women, but the age-adjusted RFDs were greater among Blacks. After stratifying by IHU, income remained significantly associated with LSBC for Blacks with low IHU. For those with high IHU, the effects of SES on LSBC were not statistically significant. After stratifying by CHA, income and poverty status were significantly positively associated with LSBC for all women with high CHA; Marital status was significantly associated with LSBC for Blacks. Among the low CHA group, income and poverty were significantly associated for Blacks; RFDs were not estimable for non-Blacks due to small sample size (n=66). Notably, 36.5% of Blacks lived in low CHA areas compared to 7.1% of non-Blacks. Conclusion: Healthcare access exacerbates the effects of IHU but does not mitigate the impact of demographic/SES characteristics on LSBC diagnoses. Enhancing CHA alone is insufficient. Targeted interventions addressing individual and community factors are crucial to reduce LSBC diagnoses and improve outcomes, especially for Black women. Citation Format: Joel A. Begay, Brittney A. Gedeon, Matthew R. Dunn, Melissa A. Troester, Marc A. Emerson. Disparities in late-stage breast cancer: The impact of socioeconomic status across racial groups by healthcare utilization and community healthcare access [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B131.

Abstract A120: Cancer screening uptake among Hispanic survivors of adolescent and young adult cancer

Abstract Introduction: Advances in treatment have significantly improved the survival rates of adolescent and young adult (AYA) cancer patients, with a five-year survival rate reaching 86%. However, these survivors remain at increased risk for developing secondary cancers later in life. Racial and ethnic minority groups, such as Hispanics, often experience significant healthcare disparities, including lower cancer screening rates. Cancer survivors, particularly those who are Hispanic and diagnosed as AYAs, may face unique barriers in adhering to recommended cancer screening guidelines. This study examines the uptake rates of colon, breast, and cervical cancer screenings among Hispanic survivors of AYA cancer compared to their age- and sex-matched Hispanic non-cancer controls. Methods: The National Health Interview Survey data (years 2000 - 2021) [R1] were analyzed to identify Hispanic survivors of AYA cancer and Hispanic age- and sex-matched non-cancer controls. Data on cancer screening, including whether patients were up- to-date and ever screened for colon, breast, and cervical cancers, were assessed. The US Preventive Services Task Force recommendations were used to determine whether survivors were up-to-date for the cancer screening tests. The sample included 92 colon cancer survivors, 113 breast cancer survivors, and 313 cervical cancer survivors, matched with 920, 1130, and 3130 controls, respectively. Weighted percentages and odds ratios (OR) were calculated, adjusting for age at survey, sex, marital status, education, poverty status, and insurance. Results: Colon cancer screening uptake was significantly higher among survivors, with 26.1% up-to-date versus 11.5% of controls (OR=2.49, 95% CI=1.17-5.30, p=0.019). For breast cancer, 14.6% of survivors were up-to-date compared to 5.1% of controls [R2] (OR=2.51, 95% CI=1.33-4.72, p=0.005), and 82.6% of survivors were ever screened versus 38.7% of controls (OR=7.41, 95% CI=4.43-12.41, p&amp;lt;0.001). Cervical cancer screening showed the most pronounced difference, with 40.6% of survivors up-to-date compared to 19.0% of controls (OR=3.36, 95% CI=2.43- 4.65, p&amp;lt;0.001), and 71.2% of survivors ever screened compared to 28.6% of controls (OR=14.16, 95% CI=8.56-23.40, p&amp;lt;0.001). Conclusion: Hispanic AYA cancer survivors exhibit significantly higher cancer screening rates compared to matched controls. Despite these positive findings, the overall low screening rates highlight the need for targeted interventions to ensure that all survivors adhere to recommended screening guidelines. Enhancing access to healthcare and ensuring continuity of care are critical steps toward reducing disparities and improving health outcomes for this vulnerable population. Citation Format: Eunju Choi, Amy M. Berkman, Clark R Andersen, Michael E. Roth. Cancer screening uptake among Hispanic survivors of adolescent and young adult cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A120.

Effect of Flood on Poverty Status: Evidence from Sugar cane Farmers in Kwara State and Osun State of Nigeria

In Nigeria, sugarcane is a prominent crop and the primary crop used to produce sugar. However, floods have been a major tragedy that has troubled Nigeria's small-scale farmers. The bulk of rural poor people are these small-scale farmers, and as poverty rates have been rising over time, corrective action is required. This study was therefore carried out to assess the poverty status of sugar cane farming households (affected by flood, and unaffected by flood) in Kwara/Osun State of Nigeria. The study employed two-stage sampling technique to select 120 sugarcane farming households in the study area. Descriptive statistics, the Flood Loss Estimation, Logit Regression and Foster Greer Thorbecke (FGT) are the empirical analytical tools employed to analyze the data collected for the study. The results of the poverty index analysis revealed that 46 percent of the respondents are relatively poor, the poverty depth was 0.16 which implies that 16 percent were below the poverty line and the poverty severity was 0.07 which implies that 7 percent of the respondents were severely poor. Also, it revealed that flood shocks, gender, household size, household income, access to credit and membership to social organization were significant determinants of poverty. The study then came to the conclusion that many coping mechanisms people employ are corrosive because they have detrimental long-term implications on the sustainability of household subsistence. For future risk assessments and flood mitigation, the study advises using a holistic strategy and adept models. The remedies outlined in this paper would help the government, private sector, and sugar cane farmers economically.

Open defecation among Kenyan households: an analysis of demographic and health survey 2022 and census report of 2019

BackgroundOpen defecation (OD) is the disposal of human excreta in the fields, bushes, water bodies and other open spaces. It poses a public health risk as it can lead to the spread of diarrhoea, cholera, soil-transmitted helminths and trachoma. Kenya aims to achieve 100% open defecation free status by 2030 in line with Sustainable development goal number 6. This study sought to determine factors influencing OD at the household level as well as quantify the number of households practicing OD in each of the 47 Kenyan counties.MethodsData from the household questionnaire of the Kenya Demographic and Health Survey, 2022 was analysed. Bivariate logistic regression was done with open defecation status as the dependent variable. Independent variables were poverty status, place of residence, ownership of farm animals, gender and educational level of household head. The number of households practicing OD per county were determined using the Kenya Census report of 2019.ResultsPoverty was the strongest predictor of a household practicing OD (OR 43.8 95% CI 26.1–73.8) followed by educational status of the household head (OR 3.3 95% CI 2.3–4.6 ) and the household not owning livestock ( OR 0.7 95% CI 0.6–0.9). An estimated 7.4% of households practice OD. These are estimated to be 814,223 households. Out of these, 686,051 households (84.3%) are found in the 15 counties ranked as having a high population practicing OD. Five counties have managed to eliminate OD and another nine have OD rates of less than 0.5%.ConclusionKenya has made commendable progress in eliminating OD. Poverty is a significant predictor of OD at the household level. To eliminate OD, it is advised that more efforts be targeted towards poor households as well as the 15 counties having a high number of OD-practicing households.

Decomposing Variation in Vocabulary and Listening Comprehension Task Performance in Spanish and English Into Person, Ecological, and Assessment Differences for Spanish-English Bilingual Children in the United States.

We investigated the contributions of person, ecological, and assessment characteristics to one's performance on vocabulary and listening comprehension tasks in English and Spanish. Person characteristics included English learner status, ecological characteristics included instructional program enrollment (bilingual vs. English immersion) and poverty status, and assessment characteristics included the language of assessment (Spanish vs. English) and linguistic grain size (vocabulary vs. listening comprehension). Data were from 208 Spanish-English emergent bilingual children in Grade 1 in the United States and were analyzed using explanatory item response models. Substantial variance in the tasks across both languages was attributable to the random effects of assessment/item (74%) and person (26%). English learner status was a significant student predictor of language performance, and the instructional program was a significant ecological predictor of language performance. Regarding assessment characteristics, both the language of assessment and linguistic grain size explained the variance in performance. There were no differences in performance on English assessments between children in the Spanish-English bilingual program and children in the English immersion program. However, on the Spanish tasks, children in the bilingual program outperformed their peers in the English immersion program. These findings highlight the importance of considering not only person/child characteristics but also ecological and assessment characteristics for Spanish-English bilingual children's performance on oral language tasks. https://doi.org/10.23641/asha.26972749.

Temporal Trends in the Epidemiology of Lower Back Pain in the United States.

This was an observational study. This study aims to explore sociodemographic and regional geographic variations in Lower back pain (LBP) incidence, prevalence, and burden in the United States (US from 2000-2019. LBP is a major contributor to lost wages and disability in the US. As LBP is associated with increasing age and sedentary lifestyle, the incidence of LBP is expected to rise. Due to LBP's multifactorial causes, US epidemiological trends lack sufficient data. Descriptive epidemiological data including disability-adjusted life years (DALYs), incidence, and prevalence per 100,000 population from 2000-2019 were collected from the Global Burden of Disease database. State-level data regarding poverty, insurance and employment status were obtained from the US Government Census Bureau and US Department of Labor. Statistical significance was indicated by P<0.05. From 2000-2019, the US demonstrated reductions in LBP incidence, prevalence, and DALYs. Regional analysis demonstrated the Midwest to have the greatest mean incidence, prevalence, and DALYs; with Midwestern females significantly more affected than females in other regions. Those aged 25-49 in the Midwest were impacted significantly more across all measures compared to age-matched populations in other regions. Nationally, there were no significant associations between unemployment and LBP. Poverty was inversely correlated with LBP incidence. Uninsured status was positively correlated with prevalence and DALYs. Although there has been progress in reducing the impact of LBP in the US, the Midwest region has greater rates for all measures compared to other US regions. Further, females and those aged 25-49 in the Midwest were more likely to be affected by LBP compared to counterparts in other regions. Future studies should identify specific factors contributing to elevated LBP rates in the Midwest in order to guide targeted interventions to reduce the incidence and burden of LBP there.

Determinants of exclusive breastfeeding among infants under six months in Nepal: multilevel analysis of nationally representative household survey data

BackgroundThe benefits of exclusive breastfeeding (EBF) have been universally documented, with evidence of positive impacts on a child’s optimal growth, development, and survival. However, EBF practices in Nepal have fluctuated and declined over the last 25 years. In addition to the individual factors of mothers and infants, EBF practices are affected by multiple community-level factors. Understanding these factors is essential for designing breastfeeding promotion programs to improve child nutritional status in Nepal. This study investigated the individual- and community-level determinants of EBF practices among young infants aged 0–5 months in Nepal.MethodWe used the dataset from the Nepal Demographic and Health Survey 2022. Information on EBF in the past 24 h was available for 540 infants aged 0–5 months. A multilevel mixed-effect logistic regression was used to identify individual- and community-level factors associated with EBF among infants aged 0–5 months in Nepal.ResultsThe 24-hour prevalence of EBF among infants aged 0–5 months was 57.46% (95% confidence interval (CI): 52.18, 62.57). The infant’s age was inversely associated with EBF prevalence at the individual level. Compared with infants aged < 1 month, infants aged three months (adjusted odds ratio (AOR): 0.14, 95% CI: 0.05, 0.40), four months (AOR: 0.11, 95% CI: 0.04, 0.28), and five months (AOR: 0.07, 95% CI: 0.03, 0.20) were less likely to receive EBF. At the community level, community-level variables such as ≥ 4 ANC visits coverage, maternal employment status, and poverty level were generated by aggregating the individual characteristics in a cluster and were categorized using quartiles into low (“< 25%”), moderate (25–75%), and high (≥ 75%). Mothers from communities with moderate ≥ 4 ANC visits (AOR: 3.30, 95% CI: 1.65, 6.57) and high ≥ 4 ANC visits (AOR: 2.70, 95% CI: 1.40, 5.22) coverage had higher odds of EBF practices than did those from communities with low ≥ 4 ANC visits coverage. Similarly, communities with moderate (AOR: 2.67, 95% CI: 1.34, 5.30) and high (AOR: 2.34, 95% CI: 1.10, 4.99) levels of maternal employment status and moderate levels of poverty (AOR: 2.20, 95% CI: 1.13, 4.28) were associated with a higher likelihood of EBF practices. Subnational level variation was evident, with infants in Lumbini province having lower odds of EBF (AOR: 0.32, 95% CI: 0.13, 0.77) relative to Koshi province. Approximately 9% of the variation in EBF practices was observed among mothers while mapping across clusters in this study.ConclusionVarious individual- and community-level factors influence the uptake of EBF in Nepal, underscoring the need to improve the approaches and strategies of EBF programs. This study highlighted the significant association of community-level factors (≥ 4 ANC visits coverage, poverty level, and maternal employment status) with EBF among infants under 6 months. It revealed approximately 9% variability in EBF across clusters. Future efforts to promote EBF should focus on older infants and communities with low poverty levels and low coverage of recommended ≥ 4 ANC visits. Furthermore, context-specific adaptation of such efforts might be required considering the variation observed between the communities in the present study.

ESTIMATING THE POVERTY STATUS AMONG GINGER WOMEN FARMERS IN KADUNA STATE, NIGERIA

This research estimated the poverty status among ginger women farmers in Kaduna State, Nigeria. Primary data were used based on a well-designed questionnaire. Data were analyzed using descriptive statistics, Foster, Greer and Thorbecke (FGT) poverty index, Tobit regression model, and principal component model. The outcome shows that the average age, years of farming experience, and educational level approximate 48 years, 9 years, and 11 years respectively. The poverty line approximate 4, 172.06 Naira (1 USD = 1 104 Naira). The poverty incidence 〖(P〗_0) is approximated at 0.5298, this correspond to 52.98% of ginger women farmers are poor, this add up to the fact that 63 ginger women farmers are poor, while 57 ginger women farmers were non-poor. The poverty depth 〖(P〗_1) which express the depth of an average poor ginger women farmers from poverty line is calculated as 0.2876 this interpret that 28.76% of ginger women farmers are poor. The severity of poverty 〖(P〗_2) which express the distance of each poor ginger women farmers to one another was calculated at 0.1967, this stand for that 19.67% of the ginger women farmers were severely poor. The educational level, years of ginger farming, income from ginger farming, off- farm income and membership of cooperative were different significantly from zero in influencing poverty status among ginger women producers. The major limitations were lack of credit facilities, lack of access to land, and lack of farm inputs. Credit (finance) at single digit interest rate should be made available to ginger women producers.