Significant Differences In Socioeconomic Status Research Articles

Sex Difference and Socioeconomic Inequity in Chinese People With Hypertension: National Cross-Sectional Survey Study.

Sex differences in blood pressure (BP) levels and hypertension are important and the role of socioeconomic status (SES) in sex differences in hypertension remains unclear. This study aimed to evaluate the impact of SES on sex differences of hypertension in a nationally representative survey study. A total of 98,658 participants aged ≥18 years who have lived in their current residence for ≥6 months were recruited from 162 study sites across mainland China. Sex was self-reported. Individual-level SES included the highest level of education and annual household income. Area-level SES included economic development status, urban/rural residency, and north/south location. Outcomes included levels of systolic and diastolic BP, and hypertension. Linear and Cox regression models were used to examine the associations between sex (women vs men) and BP characteristics stratified by individual or combined SES indicators. Systolic and diastolic BP levels and the prevalence of hypertension were higher in men than in women. This sex difference was found across categories of SES with widened sex disparities in participants having more favorable SES. Significant multiplicative interaction effects of SES on the association of sex with BP characteristics were found. Women with improving SES were associated with lower BP and hypertension prevalence compared to men. For combined SES, a 9% (prevalence ratio 0.91, 95% CI 0.83-0.98) and a 30% lower probability (prevalence ratio 0.70, 95% CI 0.63-0.78) of having hypertension were found in women with an overall intermediate SES and high SES, respectively, compared to those with low SES, while no significant reduction was found in men. There are significant sex differences in BP characteristics and SES has a potent impact on the disparities. Sex-specific public health policies to alleviate socioeconomic inequalities, especially in women are important for the prevention of hypertension.

Investigating socioeconomic disparities in prescribing new diabetes medication

Abstract Background There is a concern regarding socioeconomic disparities in prescription of new medications such as SGLT-2is or GLP-1RAs in type 2 diabetes mellitus (T2DM). This study aims to analyze prescription patterns of these medications and assess socioeconomic disparities in their initiation among individuals with T2DM with very high cardiovascular risk. Methods Individuals diagnosed with T2DM and very high cardiovascular risk were identified (N = 10,768) based on general practitioner’ electronic health record data. Socioeconomic status (SES) was based on standardized disposable household income in quintiles. The association between SES and the prescription of SGLT-2is and GLP-1RAs in 2022 was investigated by logistic regression analyses, adjusting for potential confounding factors. SGLT-2is and GLP-1RAs prescription patterns were examined over 2019-2022, stratified for age-groups and sex. Results We found a positive association between SES quintile 1 (referent) and quintile 4 in SGLT-2is prescription in all models (OR 1.29 95%CI:1.08-1.54 in the fully adjusted model). For prescriptions of GLP-1RAs, we found no significant differences in SES. Proportionally, men are more frequently prescribed SGLT-2is, while there are no sex disparities in GLP-1RAs prescription. Older individuals consistently receive fewer SGLT-2is and GLP-1RAs prescriptions compared to other age categories. Conclusions We observed sex and age disparities but no profound socioeconomic differences in initiation of SGLT-2is and GLP-1RAs in the Netherlands. The latter may be due to guidelines’ clear indication of the eligible population (T2DM and very high cardiovascular risk) and GP education. Future development and potential disparities in initiation and maintenance should be monitored. Key messages • We found no disparities in prescribing new Type 2 diabetes medication based on socioeconomic status. • The adoption of prescribing new medication for Type 2 diabetes patients takes time.

Prevalence of Helminth Infections in Patients with Celiac Disease

Introduction: The aim of this study was to investigate the association between helminth infections and celiac disease (CeD), examining various demographic and clinical factors in CeD cases compared to controls. Methods: We conducted a retrospective case-control study utilizing Leumit Health Care Services’ electronic health records. The study encompassed individuals with CeD and a matched control group. We analyzed demographic and clinical characteristics, examining their association with helminth infections. Results: We observed CeD cases and controls had similar mean ages (17.8 years vs. 18.0 years, p = 0.565) and gender distributions (64.0% females in both groups, p = 0.999). There were no significant differences in socioeconomic status and ethnic distribution between the two groups. Most of the helminthiases in the CeD group were due to intestinal helminthiases, and most of the intestinal helminthiases were nematode (roundworm) infections. Enterobiasis (the pinworm Enterobius vermicularis) is involved in most cases (odds ratio 1.32, 95% confidence interval 1.20–1.45, p < 0.001). While the prevalence of ascariasis and anisakiasis was also higher in the CeD group, these differences were not statistically significant (p = 0.115 and p = 0.174, respectively). No significant differences were found in the prevalence of other specific helminth infections, such as echinococcosis, cestode infections, and strongyloidiasis. Conclusions: This study reveals an unexpected association between CeD and helminth infections, challenging prevailing hypotheses, particularly within the context of the hygiene hypothesis. These findings warrant further investigation to elucidate the mechanisms underlying this intriguing relationship.

Patterns and socioeconomic differences in secondhand exposure to cigarettes, e-cigarettes, and heated tobacco products at home in Hong Kong adolescents.

Smoke or aerosols from cigarettes, e-cigarettes (ECs), or heated tobacco products (HTPs) are harmful. Yet, there is little knowledge about the specific patterns of secondhand tobacco exposure by source within household settings and the socioeconomic status (SES) differences in adolescents. We used territory-representative student data from a cross-sectional school-based survey in 2020-2021 to calculate the weighted prevalence of secondhand exposure to cigarettes, e-cigarettes, and HTPs in the past seven days. Parental education and perceived family affluence were used as indicators of socioeconomic status. Generalized linear mixed models were used to analyze associations. Among 22039 participants, 29.8% reported any secondhand tobacco exposure (SH-Any) at home, primarily from cigarettes (27.4%), followed by e-cigarettes (4.0%) and HTPs (0.9%). Tertiary parental education level was associated with lower SH-Any exposure (Adjusted odds ratio, AOR=0.49; 95% CI: 0.45-0.53, p<0.001), fewer exposure days (β= -0.685, p<0.001), lower exposure to cigarettes (SH-CC) (AOR=0.49; 95% CI: 0.45-0.54, p<0.001) and to e-cigarettes or HTPs (SH-EC/HTP) (AOR=0.57; 95% CI: 0.45-0.71, p<0.001). 'Poor' family affluence was associated with higher exposures [AOR(SH-Any) =1.14; 95% CI: 1.06-1.22, p=0.001; β(days)=0.160, p<0.001; AOR(SH-CC) =1.15; 95% CI: 1.07-1.24, p<0.001], except for SH-EC/HTP exposure, which was higher in students in an affluent family (AOR =1.66; 95% CI: 1.25-2.21, p<0.001). Significant SES differences in SH-EC/HTP exposure were found only in groups with low parental education level. Dose-response relationships were found between lower SH-Any and SH-CC and higher SES categories (p for trend<0.001). Adolescents experienced a high prevalence of tobacco smoke exposure at home, primarily from cigarettes. Higher SES was associated with lower tobacco exposure, except for SH-EC/HTP, which was higher among adolescents from affluent families. Additionally, high parental education level was protective against exposure to SH-EC/HTP. Comprehensive control measures to reduce the use of these tobacco products are needed to protect adolescents of diverse socioeconomic backgrounds.

Quality of life and socioeconomic and educational status in patients with congenital hypothyroidism

BackgroundThe aim of this study was to investigate the influence of primary congenital hypothyroidism (CH) on quality of life, level of education and socioeconomic status (SES).MethodsTwo independent study cohorts, a national and a regional, were collected from Finnish national registers and patient records. Data on social security benefits, SES, marital status, and education were collected from Statistics Finland. Health-related quality of life (HRQoL) was studied in the regional patient cohort with the standardized 15D and 16D instruments.ResultsThere were no statistically significant differences in education level, marital status, or SES between CH patients (n = 40) and their matched controls at the age of 25 years. The mean 15D score was both statistically significantly and clinically importantly lower in CH patients (n = 29) than controls (0.904 vs. 0.953, p = 0.008). CH patients reported significantly lower scores across various dimensions of physical and mental HRQoL, including breathing, sleeping, speech, excretion, mental function, distress, and vitality. The mean 16D score was lower in CH patients compared to controls (0.917, vs. 0.947), but without statistical significance.ConclusionSES of CH patients did not differ from matched controls. Thus, most CH patients integrate well into society, but their HRQoL is impaired.ImpactMost patients with primary congenital hypothyroidism integrate well into society. In the current study, their socioeconomic and marital status did not differ from matched controls at the age of 25 years.However, health-related quality of life measured using 15D instrument was impaired.Every fourth patient reported that congenital hypothyroidism influenced everyday life.

Scientific literacy in biology and attitudes towards science in the Chilean education system

ABSTRACT Background The development of scientific literacy in young people is seen as important in several countries. In recent decades, Chile’s educational reforms aimed at performance have led to a market-oriented funding and management system, worsening social inequality and segregation. Purpose The study looked at biology literacy and science attitudes in Chilean secondary school students, considering two aims: 1) to analyse the level of scientific literacy in biology and attitudes toward science posed by secondary school students, making comparisons by gender, age, socio-economic status (SES), and type of school; and 2) to evaluate the relationship between scientific literacy in biology and attitudes towards science. Sample 612 secondary school students in a central southern region of Chile, took part in the study. Design & Methods A quantitative method was used to analyse the students’ responses on two validated and adapted instruments; A test to measure biological knowledge (TOSLS) and Likert Scale Science-related (LSSr) to measure attitude towards science. These instruments were administered to secondary students, and descriptive and inferential analyses were conducted. Results The adapted TOSLS showed significant differences in SES, school type and slight variations by gender and age, although, no illiteracy level in biology was found among the Chilean students. The adapted LSSr showed significant differences concerning attitudes toward science were found in school type, and variations by SES and age, and gender. Also, the correlation analysis shows a weak positive relationship between scientific literacy in biology and attitudes towards science, although of moderate magnitude. Conclusion This study found that scientific literacy in biology does not necessarily impact attitudes towards science. However, SES and type of school can affect understanding and views of science and its role in society, which aligns with previous findings on social inequality in Chilean education.

Impact of Socio- Economic Status on the Educational Achievement of Secondary School Students in Vadodara

With the onset of COVID-19 pandemic, most of the students and their families were affected by economic burden and became unemployed. Those who had business also suffered, unemployment in India effected the future of the students and their parents. Paying fees in schools became a problem for parents. Many students lost their father or mother. Research has shown that the effect of socio-economic status on the academic achievement of students was observed due to corona. Many parents are not educated. If the size of the family is large, then out of 4 children, one or two children are not able to get admission in the school. The present study will help us to know the importance of the situation of our country along with the academic achievement of students. The objective of this present study is to know the socio-economic status of secondary school students of Vadodara district and the problems faced by them in their academic achievement. There are many factors affecting academic achievement. psychological, social, economic and environmental etc. The objectives of the study were to identify the level educational achievement of secondary school students of Vadodara City and to examine the influence of socio-economic status on the educational achievement of secondary school students The descriptive survey method was used for the present study. 50-students and parents of the two Hindi medium schools namely Shri Krishna Hindi Vidyalaya and Adarsh Hindi Vidyalaya were selected as the sample for the present study. It has been found in the present study that the academic achievement of low-level students, average level students, high level students were investigated the level of all the students, mean scores of high-level students were 212 and the marks of average level students were 142 and the lowest low level of students is 57. To see the impact of socio-economic status on educational achievement, t-test was conducted, it was found that statistically there exists no significant difference in socioeconomic status and educational academic achievement It becomes important to be conclude that even the status of social or economic level is low but efforts can be made to attain expected educational achievement and lead to a totally developed personality for which education is aimed for.

Socioeconomic Disparities Affecting the Presentation and Outcomes in Pediatric Subdural Empyema Patients.

Pediatric subdural empyemas (SDE) carry significant morbidity and mortality, and prompt diagnosis and treatment are essential to ensure optimal outcomes. Nonclinical factors affect presentation, time to diagnosis, and outcomes in several neurosurgical conditions and are potential causes of delay in presentation and treatment for patients with SDE. To evaluate whether socioeconomic status, race, and insurance status affect presentation, time to diagnosis, and outcomes for children with subdural empyema. We conducted a retrospective cohort study with patients diagnosed with SDE between 2005 and 2020 at our institution. Information regarding demographics (age, sex, zip code, insurance status, race/ethnicity) and presentation (symptoms, number of prior visits, duration of symptoms) was collected. Outcome measures included mortality, postoperative complications, length of stay, and discharge disposition. 42 patients were diagnosed with SDE with a mean age of 9.5 years. Most (85.7%) (n = 36) were male ( P = .0004), and a majority, 28/42 (66.7%), were African American ( P < .0001). There was no significant difference in socioeconomic status based on zip codes, although a significantly higher number of patients were on public insurance ( P = .015). African American patients had a significantly longer duration of symptoms than their Caucasian counterparts (8.4 days vs 1.8 days P = .0316). In total, 41/42 underwent surgery for the SDE, most within 24 hours of initial neurosurgical evaluation. There were no significant differences in the average length of stay. The average length of antibiotic duration was 57.2 days and was similar for all patients. There were no significant differences in discharge disposition based on any of the factors identified with most of the patients (52.4%) being discharged to home. There was 1 mortality (2.4%). Although there were no differences in outcomes based on nonclinical factors, African American men on public insurance bear a disproportionately high burden of SDE. Further investigation into the causes of this is warranted.

Socioeconomic Status and Children’s English Language and Literacy Outcomes: The Mediating Role of Home Literacy Environment

ABSTRACT Research Findings: The present study examined the relation between socioeconomic status (SES) and Chinese children’s development of English as a second language in Hong Kong, and whether the home literacy environment (HLE) was an important mediator. Participants were 237 children (110 girls, Mage = 47.38 months, SDage = 3.66) and one of their caregivers. Children were assessed on phonological awareness, receptive vocabulary, expressive vocabulary, and letter knowledge. Information on HLE (i.e. shared reading, extratextual talk, direct teaching, play and media-based activities, and literacy resources) was obtained via a caregiver questionnaire. Findings revealed significant SES differences in all aspects of HLE, as well as in children’s English receptive vocabulary, expressive vocabulary, and letter knowledge. HLE was differentially related to children’s English skills, suggesting the mediating effect of HLE in the relation between SES and Chinese children’s English skills. Practice or Policy: Findings from this study highlight the features of HLE that can best support children’s second language development. The results can also inform the design of family interventions and policies aimed at reducing educational disparities.

An Epidemiological Survey of Intestinal Parasitic Infection and the Socioeconomic Status of the Ethnic Minority People of Moken and Orang Laut.

Ethnic minority groups are often subjected to exclusion, social and healthcare marginalization, and poverty. There appears to be important linkages between ethnic minority groups, poor socioeconomic status, and a high prevalence of parasitic infection. Data regarding the prevalence and health effects of IPIs are necessary in the development and implementation of targeted prevention and control strategies to eradicate intestinal parasitic infection in the high-risk population. Thus, we investigated for the first time the intestinal parasitic infection status (IPIs), the socioeconomic status, and sanitary condition in the communities of Moken and Orang Laut, the ethnic minority peoples living on the coast of southwest Thailand. A total of 691 participants participated in the present study. The information concerning socioeconomic status and sanitary condition of the study population was obtained by personal interviews using a picture questionnaire. Stool samples were collected and examined for intestinal parasitic infection using direct wet smear and formalin-ethyl acetate concentration techniques. The results revealed that 62% of the study population were infected with one or more types of intestinal parasites. The highest prevalence of intestinal parasitic infections was found in the 11-20-year-old age range group. A statistically significant difference of IPIs among the three communities were observed (p < 0.0001). There was a statistical difference concerning 44 multiple infections of soil-transmitted helminths (STHs) (p < 0.001), whereas no statistically significant difference in multiple infections of protozoa was observed (p > 0.55). The results also displayed the significant difference in socioeconomic status and sanitary condition among the Moken living in Ranong and Phang Nga and the Orang Laut living in the Satun province (p < 0.001). Our study found no direct association between parasitic infection status and ethnic/geographic features; however, socioeconomic status is the key factor associated with prevalence of intestinal parasitic infection, with the observation that the higher prevalence of IPIs is due to a low socioeconomic status, consequently leading to poor hygiene and sanitation practices. The picture questionnaire played a major role in information gathering, especially from those of low or no education. Lastly, data pertaining to the species of the parasites and the mode of transmission assisted in the identification of group-specific vulnerabilities and shortcomings that can be utilized in education and corrected to reduce the prevalence of infection in the study areas.

600P Ethnic and socio-economic status in ovarian cancer patients recruited to clinical trials

Ethnicity and deprivation affect cancer outcomes. We sought to determine whether the ovarian cancer (OC) trial population was representative of the general OC population in terms of ethnicity and socio-economic status (SES), across two London tertiary cancer centres. All OC patients treated between 2017 and 2022 were included. Any patients participating in a clinical trial during this period were included in the trial population (TP) and the remainder classified as the non-trial population (NTP). Demographic and treatment data were collected from electronic patient records. Ethnicity was classified using NHS coding, based on the UK 2021 Census. The UK Indices of Multiple Deprivation (IMD) was calculated based upon postcode, grouped into quintiles. Pearson’s chi-square test was used to evaluate differences between TP and NTP. 215 TP and 680 NTP were included. In the TP; 88, 104 and 23 entered phase II, phase III or observational trials, respectively. 11 (5.1%) TP were non-English speaking. There was a statistically significant difference in SES (p=0.0260) and ethnicity (p<0.0001) between TP and NTP cohorts (Table).Table: 600PTP (n=215; %)NTP (n=680; %)P valueSocio-Economic Status: Indices of Multiple Deprivation (Quintiles)Q1 Most Deprived30 (13.9)107 (15.7)P = 0.0260Q250 (23.3)234 (34.4)Q351 (23.7)128 (18.8)Q435 (16.3)106 (15.6)Q5 Least Deprived43 (20.0)104 (15.3)Unclassified6 (2.8)1 (0.2)EthnicityAsian or Asian British14 (6.5)86 (12.6)P <0.0001Black (African, Black British, Black Caribbean, Black Other)11 (5.1)65 (9.6)Other ethnic group11 (5.1)53 (7.8)Mixed/Multiple Ethnic Groups8 (3.7)7 (1.0)White (British, Irish, Other)157 (73.0)381 (56.0)Unclassified14 (6.5)88 (12.9)The odds ratio for clinical trial enrolment was 0.69 (95% confidence interval (CI): 0.50 - 0.94; p=0.018) and 0.51 (95% CI: 0.35 - 0.74; p=0.003) for those more vs less deprived and in non-white vs white patients, respectively. Open table in a new tab The odds ratio for clinical trial enrolment was 0.69 (95% confidence interval (CI): 0.50 - 0.94; p=0.018) and 0.51 (95% CI: 0.35 - 0.74; p=0.003) for those more vs less deprived and in non-white vs white patients, respectively. Patients with higher levels of deprivation and non-white ethnicity were under-represented in clinical trials at our centres, which may worsen health disparities. Further research is required to understand the systematic, clinician-focused and patient-focused barriers to trial recruitment in such groups.

Racial identity as a moderator of the association between socioeconomic status and quality of life

Research in social and humanitarian science has identified socioeconomic status (SES) as one of the essential determinants of quality of life (QoL). Similarly, racial identity is assumed to predict SES outcomes in multiracial settings. Therefore, understanding how racial identity moderates the association between SES and QoL may provide essential insights into the mechanisms generating socioeconomic inequalities and their implication on life outcomes. The current study employs a cross-sectional study designed to investigate the moderating effect of racial identity on the association between SES and QoL in a sample of 1,049 South Africans. A correlation matrix was computed to explore the bivariate associations between QoL, socioeconomic, and sociodemographic features. ANOVA was used to evaluate racial differences in QoL and SES. A moderator analysis was adopted to determine a possible moderating effect of racial identity on the connection between SES and QoL. Findings show a significant difference in QoL and SES based on race. While racial identity was a significant moderator of the association between QoL and SES for Black Africans, no significant moderating effect was reported for other racial groups. These results highlight the importance of racial identity for life outcomes and emphasis the unique experience associated with Black racial identity and its implications for SES, QoL, and their association in South Africa. This study explains the necessity to improve the QoL of minority groups, such as Black South Africans, and offers detailed explanations of their perceived disadvantage.

Socioeconomic status and early reading achievement: How working memory and cognitive flexibility mediate the relation in low‐achieving and typically developing K to first grade students

Studies have demonstrated significant associations between executive function (EF) and reading ability. Many of these studies have evaluated this association through composite EF skills. In this study, we evaluated the indirect effects of working memory (WM) and cognitive flexibility (CF) in the relation between kindergarten socioeconomic status (SES) and first‐grade reading achievement. Through a two‐period estimation of mediating effects, we also examined these same relationships within low‐achieving (LA) and typically developing (TD) readers. For these investigations, nationally representative data from the United States were utilised from the Early Childhood Longitudinal Study, Kindergarten Class of 2010–2011. Results revealed significant EF and SES differences between TD and LA readers. Additionally, WM mediated around 11% of the association between kindergarten SES and first‐grade reading achievement while CF mediated 2.6%. The comparison of results between LA and TD readers yielded differences in mediating effects. For LA readers, 15% of the association was mediated by WM, but for TD only, 7.8% was mediated. CF mediated a small amount in both groups. Both WM and CF mediate the relation between kindergarten SES and first‐grade reading achievement. These findings are important because they provide clear evidence that EF ability may partially account for achievement gaps in reading ability from kindergarten to first grade.

Ethnic Disparity in the Incidence of Scoliosis Among Adolescents in Tianzhu Tibetan Autonomous County, China.

ObjectivesTo determine the influence of ethnic disparities, socioeconomic status (SES) and hukou on the incidence of scoliosis.MethodsWe enrolled 2,445 junior high school students (Han: 1,153; ethnic minorities: 1,292) aged 12–16 years from two schools in Tianzhu Tibetan Autonomous County, Gansu Province from November 2020 to February 2021. We measured the angle of trunk rotation (ATR) using a scoliometer. Two-factor analysis of variance was used to comparatively analyze differences in the ATR according to ethnicity, age, sex, body mass index (BMI), and SES between the groups. Associations between risk factors and scoliosis were estimated using odds ratios and 95% confidence intervals with an unconditional multivariate logistic regression model for the two groups.ResultsAdolescents with Han ethnicity were more likely to have scoliosis than their ethnic minority counterparts (10.8% vs. 7.1%, P < 0.05). The ATR value in the Han group decreased with age whereas the minority group showed an upward trend (P < 0.05). The difference between ethnic groups was not significant, only at level 3. In particular, the ATR values among Han girls were significantly higher than those of ethnic minority girls (P < 0.05). Compared with Han adolescents, the BMI of ethnic minorities had a greater impact on the ATR. A statistically significant difference in SES was found between the two ethnic groups (P < 0.05). Hukou and parents' occupation had an important influence on the onset of scoliosis.ConclusionsHan adolescents had higher ATR values and were more likely to have scoliosis than ethnic minority adolescents in our study. Growth and development indicators (height and BMI) and differences in SES between the two groups played an important role.

Lipid control in adult Chinese patients with type 2 diabetes: a retrospective analysis of time trends and geographic regional differences.

Lipid control in adult Chinese patients with type 2 diabetes: a retrospective analysis of time trends and geographic regional differences.

Abstract P164: Risk Factors Of Undiagnosed Diabetes And Hypertension In Arkansas

Introduction: Hypertension and diabetes are issues in the US especially in the south. In Arkansas, an estimated 797,000 adults have prediabetes and are at risk for diabetes. We aimed to assess cardiometabolic risk factors and impact of nutrition-related indicators in self-identified diabetes and hypertension patients and those at risk. Method: Data were analyzed from the 2008 Arkansas Cardiovascular Health Examination Survey (n=1,383), which used probability sampling to obtain a representative sample of Arkansas residents. A self-report survey was administered on health history, socioeconomic status (SES), lifestyle, and diet. Blood biomarkers were measured and compared for those who self-reported diabetes or hypertension with those who were at risk. Results: We used t-tests for continuous variables and chi-square test for categorical variables with statistical significance at p&lt;0.05. We hypothesized that participants with undiagnosed diabetes or hypertension had less access to care (SES as a surrogate) and worse health behavior than the diagnosed groups. Significant differences in SES, behaviors, nutrients, and biomarkers were observed between healthy vs. both diagnosed and undiagnosed groups. Surprisingly, we found that undiagnosed groups had higher average food security than the diagnosed groups. Also, some of the health behaviors including alcohol consumption were 5-6 fold higher among the undiagnosed and healthy groups as compared to currently diagnosed diabetes group. Moderate physical activity was about 2 fold higher among the healthy (5.5 hours/week) as compared to undiagnosed hypertension group (3 hours/week). In addition, the currently diagnosed groups seem to have some improved dietary habits based on higher levels of vegetable and fruit consumption and lower blood cholesterol. We have also found that both the healthy and undiagnosed diabetes groups had above normal or high triglyceride levels. Conclusion: Undiagnosed diabetes and hypertension do not have serious symptoms, but are dangerous health conditions. From our findings, targeted education should be implemented among all people, especially on access to food, vegetable and fruit consumption, alcohol use, physical activity, cholesterol and triglyceride levels.

COVID-19 effect on cancer diagnosis: A retrospective comparative analysis.

e18506 Background: In response to the COVID-19 pandemic, many health systems postponed routine screening and care to conserve resources and reduce patient exposure. As a result, several studies have shown a decline in the diagnosis of new cancer cases, a process that relies heavily on the use of screening tools and modalities. The Washington D.C. area is home to a heterogeneous patient population and one of the highest income gaps in the United States. Patterns in healthcare inequality in the area mirror these disparities. This study aims to identify the impact of the COVID-19 pandemic on cancer diagnosis rates compared to prior years and analyze whether vulnerable populations in the D.C. area were disproportionately affected. Methods: Data was collected from the George Washington University (GWU) Cancer Registry. The study population included patients age 18 and up residing in D.C., Maryland or Virginia who were diagnosed with any cancer at the GWU Health System within the following date ranges: April 1 to September 30 of 2018, 2019, 2020 and September 1, 2019 to February 29, 2020. Data collected included age at diagnosis, race, ethnicity, cancer site, stage at diagnosis, and patient zip code as a proxy for socioeconomic status (SES). Median income by zip code was labeled as low, middle or high. Chi square analysis was used to compare changes in each of these demographic and SES categories between each time frame. Results: There were 372 new cancer diagnoses during the COVID-19 period, April 1 2020 to September 30 2020. During this time period in 2018 and 2019, there were 525 and 539 new cancer diagnoses, respectively. Immediately prior to the COVID-19 period, September 1 2019 to February 29 2020, there were 588 new cancer diagnoses. Patterns of cancer type, age at diagnosis, sex, clinical stage, pathological stage and SES did not significantly differ between the COVID-19 period and any other time period (p &gt; 0.05 for all categories). However, ethnicity did change significantly with a slight increase in the number of Hispanic patients diagnosed during the COVID-19 period as compared to the 2018 and 2019 time periods (p = 0.041) and the September 2019 to February 2020 time period (p = 0.0005). Conclusions: Through this retrospective analysis, we observed a decrease in new cancer diagnoses during the COVID-19 period with no significant differences in patient age, sex, cancer type, cancer stage or SES. There was a slight increase in cancer diagnoses among Hispanic patients during the COVID-19 period. These results suggest that most groups were equally impacted by the COVID-19 pandemic with respect to cancer diagnosis. However, this may be specific to the region we studied and limited by the population size and our means of collecting data about patient SES. Further studies comparing early and late impacts of COVID-19 on cancer care will be important to identify specific communities for targeted outreach and intervention.

A90 A PROPENSITY SCORE-MATCHED, STATE-LEVEL COMPARISON OF INPATIENT CIRRHOSIS OUTCOMES IN ENGLISH VS NON-ENGLISH SPEAKING PATIENTS

Abstract Background United States (US) citizens speaking a foreign language at home has increased by 192% from 1980 to 2018. Aims With the increase in multiculturalism and ongoing concerns for health disparities in the US, we sought to compare inpatient outcomes between non-English speaking and English-speaking patients with cirrhosis. Methods The 2013–14 Maryland State inpatient databases were used to compare inpatient outcomes in adult patients with cirrhosis. The analysis cohort was identified using a validated algorithm of ICD-9 codes. Cirrhosis patients were stratified based on primary language into non-English-speaking patients [NESP] vs English-speaking patients [ESP]. A 1:3 propensity score matching analysis based on possible confounders was used to finalize the analysis cohort. The primary outcome (all-cause in-hospital mortality) and secondary outcomes including 30-day all-cause readmission rates, length of stay, total hospitalization charges were then compared between groups. Results In the study period, 3,035 NESP vs 21,212 ESP discharges were identified. We matched 1,659 NESP with 4,928 ESP using a 1:3 algorithm. Table 1 highlights demographic data. In the unmatched analysis, all-cause mortality was higher in the ESP cohort compared to NESP (6.71% vs 5.73%, p=0.046). However, after propensity-matching, inpatient mortality rate became comparable between both groups (6.45% vs 6.51%, p=0.9). Thirty day all-cause readmission rates were also similar between ESP vs NESP (4.87% vs 4.28%, p=0.18). Median length of stay in the ESP group was 4 days (IQR 3–8) vs 5 days (IQR 3–7) in the NESP group, while median total charges in ESP were $55,984 (IQR $33,897-$98,679) compared to $61,262 (IQR $36,228-$$108,369) in NESP. Conclusions While significant differences in socioeconomic status and payer type exist between non-English and English speaking cirrhosis patients, these do not appear to negatively impact inpatient outcomes including all-cause inpatient mortality, 30-day readmission rates, length of stay, total hospital charges. Funding Agencies None

Consumption of ultra-processed foods and relationship between nutrient intake and obesity among participants undergoing specific health checkups provided by National Health Insurance

Objective Obesity associated with an increased consumption of ultra-processed foods (UPF) has been reported by studies abroad using the NOVA food classification system, an international framework for classifying food according to the degree of processing. However, no such study has been conducted in Japan. In this study, we evaluated the association between UPF consumption, nutrient intake, and obesity using the NOVA system.Method In September 2017, we conducted a survey using a questionnaire of patients who had attended routine health checkups in Manazuru Town, Kanagawa Prefecture and collected their three-day dietary records as well as medical examination results. The final analysis included 169 patients (66 men, 103 women). Food consumed by the respondents were classified into four groups of NOVA systems. The dietary share of UPF (UPF energy ratio) was compared to total energy intake (except alcoholic beverages and eating out). Nutrient intake and obesity risk were compared across the UPF energy ratio tertile (low, middle, and high intake). Covariance and logistic regression analysis were conducted and adjusted based on age, sex, household structure, education, income, and total energy intake (except energy-providing nutrients, macronutrients, and protein intake per body weight) to analyze the association between UPF consumption and nutrient intake. Finally, for obesity, we adjusted for physical activity and smoking status using a similar analysis of the relationship between UPF consumption and energy providing nutrients and macronutrients.Result Approximately 75% of patients investigated were older than 65 years. The average (standard deviation) UPF energy ratio was 29.7% (15.0). There were no significant differences in socioeconomic status among groups according to the UPF energy ratio. The high-UPF group had a significantly greater total energy intake. However, the protein energy ratio, protein intake per body weight, dietary fiber, and vitamins A, E, K, B1, B6, C, niacin, folic acid, potassium, magnesium, and iron intake were significantly lower in the high-UPF group. Moreover, the high-UPF group had a significantly higher BMI. The odds ratio for obesity was higher (4.51[1.50-13.57]) in the high-UPF group than in the low-UPF group (1.00).Conclusion Those who consumed more UPF had lower protein intake and suffered from multiple vitamin and mineral deficiencies. Furthermore, their energy intake was greater, and the odds ratio for obesity was significantly higher. It has been suggested that excessive UPF consumption warrants further attention.

The Neonatal Environment and Health Outcomes (NEHO) Birth Cohort Study: Behavioral and Socioeconomic Characteristics and Drop-Out Rate from a Longitudinal Birth Cohort in Three Industrially Contaminated Sites in Southern Italy.

Pregnant women living in industrially contaminated sites (ICSs) are exposed to environmental contaminants through different pathways, and thus children’s health may be affected by pollutants. We created the Neonatal Environment and Health Outcomes (NEHO) longitudinal birth cohort in three ICSs in the Mediterranean area of southern Italy, collecting comprehensive information on personal data and lifestyles by questionnaire. Through multiple correspondence analysis, we identified possible clusters of enrolled women, and a neural network classifier analysis (NNCA) was performed to identify variables capable of predicting the attrition rate of the study. NEHO recruited 845 mother–child pairs over two years. The mothers’ mean age was 31.1 ± 5.2 SD years. We found significant differences in socioeconomic status (SES) among the three evaluated ICS, and an overall 11.1% prevalence of mothers who actively smoked during pregnancy. Active smoking during pregnancy was strongly associated with the lowest socioeconomic level (p < 0.0001). By means of the NNCA, we found that smoking during pregnancy and the lowest education level characterized the cluster with the highest attrition rate (p < 0.001). Our results demonstrate that reason for public health concern still exists regarding smoking during pregnancy and that SES influences both lifestyles, producing negative pregnancy outcomes and a higher survey attrition rate.