Role Of Socioeconomic Status Research Articles

The effect of socio-economic status on impression management (IM) in employment interviews: The mediating effect of the sense of control

This study investigated the effect of socio-economic status (SES) on honest IM (self-promotion, honest ingratiation, honest defensive impression management) and deceptive IM (slight image creation, extensive image creation, deceptive ingratiation, image protection) in employment interview, and examined the mediating effect of sense of control. For this purpose, a survey was conducted on 253 university students with employment interview experiences. The results showed that subjective SES had a positive association with self-promotion and honest defensive IM of honest IM, and this relationship was mediated by sense of control. However, subjective SES was not associated with honest ingratiation of honest IM, nor with any tactic of deceptive IM. While objective SES was positively associated with sense of control, objective SES had no statistically significant relationship with honest and deceptive IM. The current study provided meaningful implication as it emphasized the role of SES in the employment interview by identifying behavioral differences among job applicants with varying SES, and providing basic explanation on the effect of SES by clarifying the role of sense of control.

Family doctor contract services and health-related quality of life among patients with chronic diseases in rural China: what is the role of socioeconomic status?

PurposeFew studies explored the relationship between the family doctor contract services (FDCS) and health-related quality of life (HRQOL) among patients with chronic diseases in rural China. This study aims to explore the relationship between the status of signing on FDCS and HRQOL among patients with chronic diseases and examine whether there are differences in the relationship between different socioeconomic status (SES).MethodsA total of 1,210 respondents were included in this study. HRQOL was measured by EQ-5D-3L. The contracting status was divided into uncontracted and contracted. Tobit regression and Logistic regression were employed to explore the association between contracting status and HRQOL. The interaction terms were included to explore the differences in the association among different SES.ResultsContracting with family doctors was associated with HRQOL (coefficient = 0.042; 95%CI 0.008 to 0.075). The association was different among different socioeconomic levels that the contracting status was only associated with HRQOL in sub-high-income (P < 0.01) and highly educated patients (P < 0.05). Compared with uncontracted patients, contracted patients reported higher ED-5D-3L utility value in the sub-high-income group (coefficient = 0.078; 95%CI 0.017 to 0.140) and high educational attainment (coefficient = 0.266; 95%CI 0.119 to 0.413).ConclusionsThis study found a significant association between FDCS and HRQOL among chronic patients in rural Shandong, China. This relationship varied by income levels and educational attainment. The government should take efforts to formulate a variety of measures to encourage chronic patients to contract with family doctors, with special attention to people with low SES.

Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status.

Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts may be particularly severe. We recruited Malawian adults with CD4<100 cells/ul two weeks after starting ART in the REALITY trial (NCT01825031), as well as volunteers without HIV infection. Clinical assessment, socioeconomic evaluation, blood draw for immune activation markers and carotid femoral pulse wave velocity (cfPWV) were carried out at 2- and 42-weeks post-ART initiation. Socioeconomic risk factors for immune activation and arterial stiffness were assessed using linear regression models. Of 279 PLWH, the median (IQR) age was 36 (31-43) years and 122 (44%) were female. Activated CD8 T-cells increased from 70% amongst those with no education to 88% amongst those with a tertiary education (p = 0.002); and from 71% amongst those earning less than 10 USD/month to 87% amongst those earning between 100-150 USD/month (p = 0.0001). Arterial stiffness was also associated with higher SES (car ownership p = 0.003, television ownership p = 0.012 and electricity access p = 0.029). Conversely, intermediate monocytes were higher amongst those with no education compared to a tertiary education (12.6% versus 7.3%; p = 0.01) and trended towards being higher amongst those earning less than 10 USD/month compared to 100-150 USD/month (10.5% versus 8.0%; p = 0.08). Water kiosk use showed a protective association against T cell activation (p = 0.007), as well as endothelial damage (MIP1β, sICAM1 and sVCAM1 p = 0.047, 0.026 and 0.031 respectively). Socioeconomic risk factors for persistent inflammation amongst PLWH in SSA differ depending on the type of inflammatory pathway. Understanding these pathways and their socioeconomic drivers will help identify those at risk and target interventions for NCDs. Future studies assessing drivers of inflammation in HIV should include an SES assessment.

The role of socioeconomic status and parental investment in adolescent outcomes

Using structural equation modeling on a nationally representative sample of Chinese middle school students in the China Education Panel Survey, this study examines whether the three dimensions of socioeconomic status (SES, i.e., economic status, parental education, and occupational status) are related to adolescent outcomes via different parental investment pathways, as hypothesized by the family investment model (FIM). There were two main findings. First, we found that all three components of SES significantly predicted various domains of family investments and adolescent outcomes. Second, material investments mediated the effects of SES on adolescents’ cognitive ability and behavioral problems, whereas both time investment and neighborhood quality mediated the effects of SES on adolescents’ psychological well-being and behavioral issues. Those findings expand our understanding of the effects of SES when applying the FIM and advance our knowledge of the FIM by identifying the specific mediating mechanisms that may account for family–child linkages.

A longitudinal study of suicide and suicide attempt in northwest of Iran: incidence, predictors, and socioeconomic status and the role of sociocultural status

BackgroundA detailed community-level understanding of socioeconomic status (SES) and sociocultural status (SCS) of suicides and suicide attempters (SAs) in a prospective design could have significant implications for policymakers at the local prevention and treatment levels. The effect of SCS and SES on SAs is poorly understood and investigated in Iran. The present study aimed to investigate the incidence, trend, and role of SES and SCS on suicide and SAs.MethodsA longitudinal study was conducted based on the registry for SAs in Malekan County, Iran, from 2015 to 2018. Demographic characteristics, SES, SCS, incidence rates, and predictors of suicidal behaviors were measured via structured instruments. Simple and multiple logistic regressions were used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsA total of 853 SAs (32 suicides and 821 attempts) were identified during the study. Trend analysis revealed that the suicide rate significantly decreased from 2014 (10.28) to 2018 (1.75) per 100,000. In the final multiple variable models, age (26–40), male sex, unemployment, antisocial activities, history of SA, hanging method, and season (spring) increased the suicide risk while religious commitment had protective effects on suicide.ConclusionsOur findings indicated that demographic characteristics, low SES, and SCS are associated with suicide. In this county, trend of suicide and SA were decreased from 2014 to 2018. This study findings highlight the need to consider a wide range of contextual variables, socio-demographic, SES, and SCS in suicide prevention strategies. Improving inter-sectoral collaborations and policymakers’ attitudes are imperative for SA reduction.

Association of Hospitalised Infection With Socioeconomic Status in Patients With Rheumatoid Arthritis Receiving Biologics or Tofacitinib: A Population-Based Cohort Study.

Objectives: Use of biologics or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) is associated with infection in patients with rheumatoid arthritis (RA). Socioeconomic status is substantial in infectious diseases; however, the impact of socioeconomic status on risk for infection in patients with RA receiving b/tsDMARD remains unclear.Methods: We used the 2003–2017 Taiwanese National Health Insurance Research Database to identify patients with RA receiving b/tsDMARDs. A Cox regression analysis was used to estimate the associations of covariates with the risk of hospitalised infection shown as hazard ratios (HRs) with 95% confidence interval (CIs).Results: We identified 7,647 RA patients who started their first bDMARD/tsDMARD treatment. Log-rank analyses demonstrated the association between age (p < 0.001), urbanisation (p = 0.001), the insured amount (p = 0.021), and the hospitalisation. Cox proportional regression analyses showed that age was independently associated with hospitalised infection in a dose–response manner, whereas a high-income category had an inverse association (HR 0.48, 95% CI 0.23–0.96). Hospitalisation for infection within 5 years was a strong risk factor (HR 5.63, 95% CI 1.91–16.62), and living in a rural area tended to be a risk factor (HR 1.76, 95% CI 0.98–3.14) for incident hospitalised infection.Conclusions: This study showed the crucial impacts of age, socioeconomic status, and history of infection on hospitalised infection in patients with RA receiving b/tsDMARDs. These findings highlight the largely ignored role of socioeconomic status in risk stratification among patients receiving b/tsDMARDs for RA.

Quality of Life Indicators for Adolescent with Diabetes Type1

This study aims to reveal some indicators of the quality of life of adolescents with diabetes through the four main dimensions of the quality of life, which are: health-related quality of life, psychological quality of life, social quality of life, and environmental quality of life. The study sample consisted of 10 adolescents with type 1 diabetes, 05 of whom were males and 05 were females. We relied on the descriptive analytical approach along with the method of content analysis. The results of the study concluded:&#x0D; - The presence of positive indicators in adolescents with diabetes within the four dimensions of quality of life: optimism, satisfaction, acceptance of disease, sense of activity and ability to perform duties, and access to appropriate health services.&#x0D; - The presence of negative indicators in adolescents with diabetes within the four dimensions of quality of life: a sense of anxiety and depression, low self-esteem, a sense of fatigue and poor relationships with peers&#x0D; -Kolar ,kathryn, &amp;Rassner. (1996). quality of life in youth with insulin -depandent diabetes mellitis.Dessertation abstracts international, p. 6178.&#x0D; -Krishnavathana, h., W Loar, R., J Anderson, B., &amp; A Heptulla, R. (2006). the role of socioeconomic status, depression,quality of life ,and glycemic contril in type1 diabetes mellitus. journal of pediatrics-elsevier.&#x0D; -Odell, M., &amp;Delors, A. (1997). therolatioship between social and adjustement in adolescents with diabtes. dissertation abstracts international, p. 2693.&#x0D; -Wherrett, D., Huot, C., Mitchell, B., &amp;Pacaud, D. (2013). le diabète de type1 chez les enfants et les adolescents. canadian journal of diabetes, pp. 5531-5541

An Evolutionary Perspective in Tourism: The Role of Socioeconomic Status on Extremeness Aversion in Travel Decision Making

The present research investigates a novel relationship between travelers’ childhood socioeconomic status (SES) and travel decision-making. We theorize that travelers from lower childhood SES or resource-scarce/unpredictable environments are more likely to avoid extreme options in a choice set. Five studies consistently show that childhood SES is negatively associated with extremeness aversion in diverse travel choices. We also demonstrate that the general risk tendency mediates the relationship between childhood SES and extremeness aversion in travel decision making (studies 3A and 3B). Lastly, we reveal that childhood SES is more likely to predict extremeness aversion when a choice set involves a quality–price trade-off rather than a quality–quality trade-off (study 4). This research introduces evolutionary aspects to explain pervasive behavioral tendencies in the context of travel and tourism and offers new insights to practitioners.

Lessons from the COVID-19 pandemic on the role of socioeconomic status in health outcomes

The COVID-19 pandemic has brought upon the world many challenges, both for the health and safety of citizens and in the public health system. Along with these challenges, pre-existing inequalities have been exacerbated. Vulnerable populations have struggled during these times not only due to their increased likelihood of pre-existing health conditions, but in finding access to quality care and treatment. Thus, it is important to discuss and examine the outcomes of this pandemic for those most at risk as this is telling to the current state of our healthcare system and what changes should be made. COVID-19 has again revealed the importance of prioritizing access to care for all, particularly communities from low SES, and to rethink the healthcare system, in order to combat health disparities.

Distributive Justice as a Means of Combating Systemic Racism in Healthcare

Distributive Justice as a Means of Combating Systemic Racism in Healthcare

Spatio-temporal modelling of the first Chikungunya epidemic in an intra-urban setting: The role of socioeconomic status, environment and temperature.

Three key elements are the drivers of Aedes-borne disease: mosquito infestation, virus circulating, and susceptible human population. However, information on these aspects is not easily available in low- and middle-income countries. We analysed data on factors that influence one or more of those elements to study the first chikungunya epidemic in Rio de Janeiro city in 2016. Using spatio-temporal models, under the Bayesian framework, we estimated the association of those factors with chikungunya reported cases by neighbourhood and week. To estimate the minimum temperature effect in a non-linear fashion, we used a transfer function considering an instantaneous effect and propagation of a proportion of such effect to future times. The sociodevelopment index and the proportion of green areas (areas with agriculture, swamps and shoals, tree and shrub cover, and woody-grass cover) were included in the model with time-varying coefficients, allowing us to explore how their associations with the number of cases change throughout the epidemic. There were 13627 chikungunya cases in the study period. The sociodevelopment index presented the strongest association, inversely related to the risk of cases. Such association was more pronounced in the first weeks, indicating that socioeconomically vulnerable neighbourhoods were affected first and hardest by the epidemic. The proportion of green areas effect was null for most weeks. The temperature was directly associated with the risk of chikungunya for most neighbourhoods, with different decaying patterns. The temperature effect persisted longer where the epidemic was concentrated. In such locations, interventions should be designed to be continuous and to work in the long term. We observed that the role of the covariates changes over time. Therefore, time-varying coefficients should be widely incorporated when modelling Aedes-borne diseases. Our model contributed to the understanding of the spatio-temporal dynamics of an urban Aedes-borne disease introduction in a tropical metropolitan city.

Black-White disparities in women’s physical health: The role of socioeconomic status and racism-related stressors

Black women have elevated rates of multiple physical illnesses and conditions when compared to White women – disparities that are only partially explained by socioeconomic status (SES). Consequently, scholars have called for renewed attention to the significance of racism-related stress in explaining Black-White disparities in women's physical health. Drawing on the biopsychosocial model of racism as a stressor and the intersectionality perspective, this study examines the extent to which SES and racism-related stressors – i.e., discrimination, criminalization, and adverse neighborhood conditions – account for disparities in self-rated physical health and chronic health conditions between Black and White women. Results indicate that Black women have lower SES and report greater exposure to racism-related stressors across all domains. Moreover, I find that SES and racism-related stressors jointly account for more than 90% of the Black-White disparity in women's self-rated physical health and almost 50% of the Black-White disparity in chronic health conditions. Theoretical and policy implications of these findings are discussed.

Early childhood exposure to ambient air pollution is associated with increased risk of paediatric asthma: An administrative cohort study from Stockholm, Sweden

IntroductionAsthma is a complex, heterogeneous disease and one of the most common chronic diseases among children. Exposure to ambient air pollution in early life and childhood may influence asthma aetiology, but it is uncertain which specific components of air pollution and exposure windows are of importance. The role of socio-economic status (SES) is also unclear. The aims of the present study are, therefore, to investigate how various exposure windows of different pollutants affect risk-induced asthma in early life and to explore the possible effect SES has on that relationship. MethodsThe study population was constructed using register data on all singleton births in the greater Stockholm area between 2006 and 2013. Exposure to ambient black carbon (BC), fine particulate matter (PM2.5), primary organic carbon (pOC) secondary organic aerosols (SOA), secondary inorganic aerosols, and oxidative potential at the residential address was modelled as mean values for the entire pregnancy period, the first year of life and the first three years of life. Swedish national registers were used to define the outcome: asthma diagnosis assessed at hospital during the first six years of life. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were modelled with Cox proportional hazards model with age as the underlying time-scale, adjusting for relevant potential confounding variables. ResultsAn increased risk for developing childhood asthma was observed in association with exposure to PM2.5, pOC and SOA during the first three years of life. With an interquartile range increase in exposure, the HRs were 1.06 (95% CI: 1.01–1.10), 1.05 (95% CI: 1.02–1.09) and 1.02 (95% CI: 1.00–1.04), for PM2.5, pOC and SOA, respectively, in the fully adjusted models. Exposure during foetal life or the first year of life was not associated with asthma risk, and the other pollutants were not statistically significantly associated with increased risk. Furthermore, the increase in risk associated with PM2.5 and the components BC, pOC and SOA were stronger in areas with lower SES. ConclusionOur results suggest that exposure to air pollution during the first three years of life may increase the risk for asthma in early childhood. The findings further imply a possible increased vulnerability to air pollution-attributed asthma among low SES children.

Abstract P056: The Role Of Socioeconomic Status In Racial/ethnic Disparities In Complications Of Diabetes: The Atherosclerosis Risk In Communities Study

Background: Few prospective studies have evaluated the role of socioeconomic status in explaining racial/ethnic disparities across major complications among adults with diabetes. We assessed the prospective association of race/ethnicity with long-term complications and cardiovascular mortality in persons with diabetes in a community-based cohort. Methods: We conducted a prospective analysis of 4,460 black and white participants in the ARIC Study with prevalent or incident diabetes (and no history of cardiovascular disease) followed from time of diabetes through 2018. We calculated incidence rates of major clinical outcomes (fatal coronary heart disease or myocardial infarction, heart failure, ischemic stroke, end stage renal disease, hospitalized peripheral artery disease [PAD], lower extremity amputation) using standard definitions in the ARIC Study. We used Cox regression to assess the associations of race/ethnicity with incident complications and cardiovascular mortality before and after adjustment for cardiovascular and socioeconomic factors. Results: The incidence rates (per 1,000 person-years) were higher for black vs. white adults with diabetes for heart failure (22.1 vs. 17.4), ischemic stroke (8.5 vs. 5.5), end stage renal disease (5.6 vs. 1.6), PAD (4.7 vs. 3.2), lower extremity amputation (2.9 vs. 1.0) and cardiovascular mortality (7.5 vs. 6.5). These associations remained significant after adjusting for age, sex, smoking, and hypertension (HRs 1.41 to 3.27), but - with the exception of ESRD - were largely attenuated after further adjusting for health insurance and socioeconomic variables ( Table ). Conclusions: Among adults with diabetes, the association of race/ethnicity with complications differs depending on the outcome. Socioeconomic disparities play a major role in explaining the differences between groups. Our findings suggest that eliminating economic and healthcare system disparities is important to address health equity and prevent complications in adults with diabetes.

The role of socio-economic status in the utilization of health care services in rural areas in Bauchi State

Several socio-economic factors have been indicated as factors that are responsible for the utilization and outcome of health care services. The study aims at investigating the socio-economic factors that affect the utilization of health care services by inhabitants of rural areas of Bauchi State. The study engaged the survey design. A total of 3447 respondents were sampled for the study. The procedure used is the simple random sampling procedure. A well-structured questionnaire was used to elicit data for the study. 42% of the respondents were males while 58% of them females. The result obtained shows that education (47.4%); employment status (52.5%) and house ownership status (67.7%) are the socio-economic factors that significantly necessitated the utilization of health care services by rural dwellers of Bauchi State. Education status, Occupation, Income, education, healthcare, type of house, age, marital status and insurance, do not have influence on the utilization of health care services (P> 0.05). In conclusion, the utilization of health care centers in Bauchi State is very low among the rural dwellers. The non-educated or half literate, the unemployed and those who live in rented homes should be encouraged to utilize health facilities the more. Also, the influence of other socio-economic factors on health facilities utilization should be studied.

Early literacy in Arabic: the role of SES, home literacy environment, mothers’ early literacy beliefs and estimation of their children’s literacy skills

The study focuses on the beliefs of Arabic-speaking mothers in Israel relating to early literacy, and the relations between their beliefs and their children’s actual early literacy skills. Participants included 113 mothers and their 5–6-year-old preschool children. At the families’ homes, mothers reported about the richness of the home literacy environment (HLE), their general beliefs relating to the importance of the literacy environment and their specific estimations of their child’s letter knowledge, phonological awareness, word writing and reading. In preschools, we assessed children’s letter knowledge, phonological awareness, word writing and reading. Results showed that mothers were aware of their children’s early literacy skills yet they over-estimated them. In a series of hierarchical regression analyses, we found that family socio-economic status (SES) significantly explained all of the children’s early literacy skills. Beyond SES, richness of the HLE contributed to most of the assessed literacy skills. Mothers’ general beliefs regarding the importance of the HLE and their estimation of their child’s literacy skills explained children’s skills beyond SES and HLE. The study has educational implications relating to the promotion of children’s early literacy skills in Arabic within the family.

The role of socioeconomic status in the relationship between social support and burden among cancer caregivers.

While much research has focused on the direct impact of socioeconomic status on cancer patients, what is not clear is the impact of socioeconomic status on social support and the burden of care for caregivers. In this study, a cross-sectional method, using a convenience sampling approach, was adopted to collect the data of 191 caregivers of cancer patients who were referred to the oncology clinic and cancer institute of hospitals affiliated with Tehran University of Medical Sciences, Iran. The participants completed a questionnaire on basic demographics, the short version of the Burden Scale for Family Caregivers, and Zimet Multidimensional Perceived Social Support. A maximum likelihood exploratory factor analysis with oblique rotation to assess the factor structure of the constructs and the measurement model was conducted. The two-factor model consisting of 22 items explained 65.116% of the variance. There was a significant negative relationship between social support and burden (b = -0.771, P < 0.001) and also between economic status and burden (b = -0.308, P < 0.01). Moreover, there was a significant positive association between the interaction of social support and economic status and burden (b = 0.138, P < 0.05). More specifically, the negative relationship between social support and burden was statistically stronger for participants with weak economic status (b = -0.663, P < 0.001) than those with good economic status (b = -0.356, P < 0.01). Social support and an individual's economic status are essential determinants of caregiver burden. Further studies are recommended to better inform the precise support needed by caregivers to enhance their quality of life, and ultimately, that of the patients under their care.

Stressful life events and the risk of primary progressive multiple sclerosis: A population-based case-control study

BackgroundThe onset and presentation of primary progressive multiple sclerosis (PPMS) like any other autoimmune diseases can be triggered by unexpected lifetime stressful events, which require to be assessed in order to minimize our exposure to such events as much as possible. ObjectiveThe aim of the present study was to determine the possible role of socioeconomic status (SES) and stressful events in PPMS development MethodsThe present population-based case–control study recruited PPMS cases and healthy controls from the general population during 2019–2020 in Tehran, Iran. Clinical diagnosis of cases was based on the 2017 McDonald criteria and confirmed by a neurologist. The selection of sex-matched controls from the same source population of cases was performed using the standard method of Random Digit Dialing (RDD). The study questionnaire was filled out over telephone interviews. Matched logistic regression was administered to estimate the adjusted and unadjusted odds ratio (OR) at 95% confidence intervals (CIs) adjusted for sex, age, and marital status using SPSS 23. ResultsThis study examined 146 PPMS cases and 294 controls. Mean ages (SD) for cases and controls were 46.97 (9.4) and 37.67 (6.12), respectively (P < 0.001). No stressful events over five years prior to the disease onset were associated with an increased risk of PPMS. Marriage (OR: 0.04; 95% CI (0.01– 0.37), P = 0.004), close family members’ serious disease (OR: 0.10; 95% CI (0.02–0.60), P = 0.01), and being in debt (OR: 0.03; 95% CI (0–0.37), P = 0.006) were found to have a negative association with the risk of disease occurrence. Death of a loved one, family disruption, jail term, homelessness period, Conquer(national university entrance exam), death of spouse, getting fired from a job, joblessness, divorce, migration, close family members’ suicide, and retirement were not associated with the risk of PPMS (P > 0.05). History of depression before the PPMS presentation was considerably associated with the incidence of PPMS (P < 0.001). Self-rated health status was scored noticeably lower by cases as compared with controls (P < 0.001). Participants with the paternal educational degree of guidance school showed a higher risk of PPMS by 2.83 time (OR: 2.83; 95% CI (1.02 – 7.80), P = 0.04) than participants with university educated fathers. In total, SES during adolescence did not indicate any association with the risk of PPMS (with the exception of levels 2 (P = 0.02) and 7 (P = 0.05)). ConclusionNo stressful life events were identified as possible increasing risk factors for PPMS. Marriage, close family members’ serious disease, and being in debt had a negative association with the disease risk. The history of depression may elevate the risk of PPMS. While the highest and lowest SES levels in adolescence were not remarkable determiners for PPMS, levels 2 and 7 had a positive association with the risk of PPMS. The maternal educational level was not an important factor; however, the paternal educational degree of guidance school as compared to university degree made individuals more susceptible to PPMS. Self-rated health status score was higher in controls.

How do educational inequalities develop? The role of socioeconomic status, cognitive ability, home environment, and self-efficacy along the educational path

In Western countries, children's education is strongly influenced by their social background, which cannot be fully explained by individual differences in cognitive ability between social classes. It is still an open question how, to what extent and at what point along the educational path individual and family factors shape children's educational success. In the present study, twins (N = 6174) clustered in three age cohorts (11, 17 and 23 years) were examined using multilevel analyses to test if parental socioeconomic status (SES) and children's cognitive ability, as well as family's quality of home environment and children's self-efficacy can explain the development of educational inequalities captured via school track recommendations and university attendance. Results showed educational inequalities at each critical point along the entire path of education. With increasing parental SES, individual cognitive abilities mattered significantly less, so that children from high parental SES families often received a recommendation to attend upper secondary education even with low cognitive abilities. In contrast, the association between cognitive abilities and university attendance increased with increasing parental SES in the older age cohort, whereby individuals with high cognitive abilities but low parental SES rarely attended university. Furthermore, for school track recommendations, with increasing children's self-efficacy and better home environment the educational recommendation improved, while home environment amplified the effect of SES on the development of educational inequalities. These results suggest a waste of academic potential of low SES children. Subsequent studies should examine further constructs that could contribute to the development of educational inequalities.

Looking beyond Administrative Health Care Data: The Role of Socioeconomic Status in Predicting Future High-cost Patients with Mental Health and Addiction.

Introduction:Previous research has shown that the socioeconomic status (SES)–health gradient also extends to high-cost patients; however, little work has examined high-cost patients with mental illness and/or addiction. The objective of this study was to examine associations between individual-, household- and area-level SES factors and future high-cost use among these patients.Methods:We linked survey data from adult participants (ages 18 and older) of 3 cycles of the Canadian Community Health Survey to administrative health care data from Ontario, Canada. Respondents with mental illness and/or addiction were identified based on prior mental health and addiction health care use and followed for 5 years for which we ascertained health care costs covered under the public health care system. We quantified associations between SES factors and becoming a high-cost patient (i.e., transitioning into the top 5%) using logistic regression models. For ordinal SES factors, such as income, education and marginalization variables, we measured absolute and relative inequalities using the slope and relative index of inequality.Results:Among our sample, lower personal income (odds ratio [OR] = 2.11, 95% confidence interval [CI], 1.54 to 2.88, for CAD$0 to CAD$14,999), lower household income (OR = 2.11, 95% CI, 1.49 to 2.99, for lowest income quintile), food insecurity (OR = 1.87, 95% CI, 1.38 to 2.55) and non-homeownership (OR = 1.34, 95% CI, 1.08 to 1.66), at the individual and household levels, respectively, and higher residential instability (OR = 1.72, 95% CI, 1.23 to 2.42, for most marginalized), at the area level, were associated with higher odds of becoming a high-cost patient within a 5-year period. Moreover, the inequality analysis suggested pro-high-SES gradients in high-cost transitions.Conclusions:Policies aimed at high-cost patients with mental illness and/or addiction, or those concerned with preventing individuals with these conditions from becoming high-cost patients in the health care system, should also consider non-clinical factors such as income as well as related dimensions including food security and homeownership.