Significant Differences In Socioeconomic Status Research Articles

Resources and Strategies Used by Young Parents in Serbia

The paper deals with resources available to young parents and the strategies they deploy as a response to various domain-related demands (housing, finance, work, family). First, the structural and cultural features of the social context in Serbia are discussed as the framework for the study. Secondly, the paper analyses young parents’ differences, by socioeconomic status (SES) and gender, regarding their resources, such as housing, finances, and employment, as well as their strategies. The analysis is based on a mixed-methods approach, which brings together the survey results of a sub-sample of 435 parents from a nationally representative survey of young adults aged 18 to 35, and a qualitative analysis of semi-structured interviews with 24 young mothers and fathers. The analyses indicate significant SES and gender differences in young parents’ resources and strategies, which are shaped by the structures and cultures of parenthood specific to the contemporary social context in Serbia.

Maternal Immune activity during pregnancy and socioeconomic disparities in children’s self-regulation

Maternal immune activity during pregnancy has been associated with risk for psychiatric disorders in offspring, but less is known about its implications for children’s emotional and behavioral development. This study examined whether concentrations of five cytokines assayed from prenatal serum were associated with socioeconomic status (SES) and racial disparities in their offspring’s self-regulation abilities. Participants included 1628 women in the Collaborative Perinatal Project (CPP). Seven behavioral items conceptually related to self-regulation were rated by CPP psychologists when children were 4 years old. Concentrations of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, and IL-10 were assessed. Covariates included child sex and mother’s age, psychiatric disorders, and medical conditions during pregnancy. There were significant SES differences in child self-regulation, with higher SES children scoring higher on self-regulation (β = 0.18, 95% CI [0.11, 0.25]), but no racial differences. The concentration of IL-8 in maternal serum was associated with higher child self-regulation, β = 0.09, 95% CI [0.02, 0.16]. In mediation analyses, variation in maternal IL-8 contributed to the association between family SES and child self-regulation (β = 0.02, 95% CI [0.003, 0.030]), explaining about one-tenth of the SES disparities. This study suggests pregnancy as an early sensitive period and maternal immune activity as an important context for child development.

Psychosocial Mediators between Socioeconomic Status and Dietary Restrictions among Patients Receiving Hemodialysis in Japan.

The generalizability of differences in dietary restrictions (DRs) as function of socioeconomic status (SES) and the pathways of the associations between SES and DRs remain unclear. Therefore, we aimed to explore SES differences in DRs and psychosocial mediators between SES and DRs in Japanese patients receiving hemodialysis. This study was a cross-sectional survey of 6,644 outpatients (average age = 66.5 years; 65% males) of hemodialysis facilities across Japan. DRs were assessed by self-reported and objective measures, and SES was assessed based on education and income. Three psychosocial mediators were used: self-efficacy, control expectancy, and social support. Indirect influences of SES through the mediators were evaluated with a multiple mediator model. Although higher education was significantly associated with higher self-reported DRs, higher income was significantly associated with lower self-reported DRs. Significant SES differences in objective DRs were not observed. The relationships between education and self-reported DRs and objective DRs were significantly mediated by self-efficacy and/or control expectancy. The influences of income were mediated by social support. It becomes possible to design interventions targeting modifiable psychosocial factors including self-efficacy, control expectancy, and social support in order to reduce SES inequalities in DRs.

Comparison of USDA Forest Service and Stakeholder Motivations and Experiences in Collaborative Federal Forest Governance in the Western United States.

In the United States, over 191 million acres of land is managed by the United States Department of Agriculture Forest Service, a federal government agency. In several western U.S. states, organized collaborative groups have become a de facto governance approach to providing sustained input on management decisions on much public land. This is most extensive in Oregon, where at least 25 "forest collaboratives" currently exist. This affords excellent opportunities for studies of many common themes in collaborative governance, including trust, shared values, and perceptions of success. We undertook a statewide survey of participants in Oregon forest collaboratives to examine differences in motivations, perceptions of success, and satisfaction among Forest Service participants ("agency participants"), who made up 31% of the sample, and other respondents ("non-agency") who represent nonfederal agencies, interest groups, citizens, and non-governmental groups. We found that agency participants differed from non-agency participants. They typically had higher annual incomes, and were primarily motivated to participate to build trust. However, a majority of all respondents were similar in not indicating any other social or economic motivations as their primary reason for collaborating. A majority also reported satisfaction with their collaborative-despite not ranking collaborative performance on a number of specific potential outcomes highly. Together, this suggests that collaboration in Oregon is currently perceived as successful despite not achieving many specific outcomes. Yet there were significant differences in socioeconomic status and motivation that could affect the ability of agency and nonagency participants to develop and achieve mutually-desired goals.

Insurance-related disparities in primary care quality among U.S. Type 2 diabetes patients.

BackgroundThis study explored insurance-related disparities in primary care quality among Americans with type 2 diabetes.MethodsData came from the household component of the 2012 Medical Expenditure Panel Survey (MEPS). Analysis focused on adult subjects with type 2 diabetes. Logistic regressions were performed to investigate the associations between insurance status and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, while controlling for confounding factors.ResultsPreliminary findings revealed differences among three insurance groups in the first contact domain of primary care quality. After controlling for confounding factors, these differences were no longer apparent, with all insurance groups reporting similar primary care quality according to the four domains of interest in the study. There were significant differences in socioeconomic status among different insurance groups.ConclusionThis study reveals equitable primary care quality for diabetes patients despite their health insurance status. In addition to insurance-related differences, the other socioeconomic stratification factors are assumed to be the root cause of disparities in care. This research emphasizes the crucial role that primary care plays in the accessibility and quality of care for chronically ill patients. Policy makers should continue their commitment to reduce gaps in insurance coverage and improve access as well as quality of diabetic care.

Are Pregnant and Postpartum Women Interested in Health-Related Apps? Implications for the Prevention of Perinatal Depression.

Recent studies have shown that women are more likely than men to use the Internet to seek health information and that the use of technology is common among perinatal women. Access to the Internet is growing through the global use of mobile phones and apps, in both developed and less developed countries. This pattern is particularly relevant for clinicians and researchers who are interested in the use of technologies to disseminate perinatal depression interventions. In a cross-sectional anonymous online survey for English and Spanish-speaking perinatal women, 509 pregnant (77.6 percent) and postpartum (22.4 percent) women provided demographic and Information and Communication Technologies data. Results indicated that the single device with greatest access was the mobile phone (47.5 percent). The majority of the sample had Internet access through mobile phones, computers, or both. Significant differences in socioeconomic status were found for Internet seeking behavior of health-related information and downloading apps between those with and without Internet access. Ninety percent of respondents (n = 267) searched for health-related information and 72.3 percent had downloaded any kind of app. More than half of respondents (57 percent, n = 188) downloaded a health-related app and 26.9 percent reported having paid for the apps. This study shows preliminary evidence to suggest the need to design, develop, and test apps that aim to disseminate prevention programs for perinatal depression.

Socioeconomic status (SES) affects means–end behavior across the first year

This study assessed the impact of SES on early means–end behavior. Sixty-one 6- to 8- and 10- to 12-month-old infants from high and low SES families were presented with two tasks requiring a two-step process to retrieve a toy. On the cloth task, overall performance improved with age, but low SES infants showed delays. Performance by the 10- to 12-month-old low SES infants was identical to that of the 6- to 8-month-old high SES infants. On the hook task, again overall performance improved with age, but significant SES differences emerged at 10 to 12months, with only 20% of low SES infants succeeding at the task, compared to 73% of high SES infants. The results suggest a divergence in means–end behavior between high and low SES infants by 6months of age, adding to the well-known documentation of gaps in cognitive skills evident between high and low SES infants.

Estado nutricional y características socioepidemiológicas de escolares chilenos, OMS 2007

IntroductionCurrent Chilean childhood obesity fi res are within the highest in the world. ObjectiveTo describe the nutritional status of Quilpué schoolchildren and its relationship with demographic and socioeconomic variables. MethodsThe nutritional status (OMS 2007) of 1091 schoolchildren was assessed using measurements of height and weight obtained in the “Pilot School Health Program” conducted in the schools of the Municipal Corporation of Quilpué, which included pupils from kindergarten to 4th grade. The program described above, as well as SINAE databases, were used for the Healthcare and School Vulnerability Index (SVI) variables, respectively, as well as the the number of hours of physical education, type of lunches, and the presence of vendors at school, were obtained using a questionnaire in schools. ResultsObesity was observed in 26.3% of students, and a further 27.7% were overweight. Obesity was more frequent in boys (32.3%) compared to girls (20.1%) (P<.01); in third grade (31.8%) (P=.01); if lunches were parental choices (26.7%) (P<.01); and with the presence of school vendors (26.3%) (P=.01). No significant differences in socioeconomic status regarding BMI were found, but the most vulnerable children (municipal schools, high SVI, Fonasa A healthcare) had lower average height and higher rates of chronic malnutrition (height <-2 SD). ConclusionsA high prevalence of obesity was found in this study, which highlights the need for monitoring and nutrtional intervention strategies at school age (which once finalized, the Healthy Child Surveillance does not carry out any more controls), taking into account the most vulnerable sectors.

Impact of “Integrated Murrah Development Scheme” (IMDS) on dairy farmers of Haryana state of India

The present study was taken up to measure the impact “Integrated Murrah Development Schemes (IMDS) on socio-economic status of the beneficiaries as well as on productive and reproductive performance of the Murrah buffaloes of the beneficiaries. ‘Z’ test analysis indicated that there was significant difference in socio-economic status of the beneficiaries and non beneficiaries viz; milk consumption, milk sale at 5 % level of probability, while; herd size, type of animal shed, material possession, milk production, annual income from dairying, annual gross income of the respondents at 1 % level of probability. Similarly, there was significant difference in productive and reproductive performance of Murrah buffaloes of the beneficiaries and non beneficiaries viz; age at first calving, calving interval, at 5 % level of probability; while, number of AIs required per conception, lactation length, dry period, average lactation milk yield, average daily milk yield and peak yield at 1 % level of probability. Most of the beneficiaries (73.75%) had medium level overall impact of IMDS on socio-economic status of the beneficiaries followed by high (17.50%) and low (8.75%). Whereas, medium level overall impact of IMDS was found on the productive and reproductive performance of Murrah buffaloes of the majority beneficiaries (89.38%) followed by high impact on few (10.63%). Such development programmes should be promoted for the improvement of socio economic status of farmers as well as improvement of milk productivity of the animals.

How important are community characteristics in influencing children׳s nutritional status? Evidence from Malawi population-based household and community surveys

Using the 2004 data from the Malawi Integrated Household Survey and the Malawi Community Survey, this study investigates the influence of community characteristics on stunting among children under five years of age in a rural context. Multilevel logistic regression modelling on 4284 children with stunting as the dependent variable shows that availability of daily markets and lineage defined in terms of patrilineal or matrilineal communities were significant community determinants of childhood stunting in Malawi. There were significant differences in socio-economic status between household heads from matrilineal and patrilineal communities. Implementation of strategies that empower communities and households economically such as supporting the establishment of community daily markets and promoting household income generating opportunities can effectively reduce the burden of childhood stunting in Malawi.

Self-perceived oral health and periodontal parameters in chronic periodontitis patients with and without rheumatoid arthritis.

It is hypothesized that self-perceived oral health and periodontal status are worse in chronic periodontitis (CP) patients with rheumatoid arthritis (RA) compared to CP patients without RA. The aim of the present study was to assess self-perceived oral health and periodontal parameters in CP patients with and without RA. Fifty CP patients with RA and 50 CP patients without RA were included. Information regarding sociodemographic characteristics and self-perceived oral symptoms were collected using a questionnaire. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, number of missing teeth, and marginal bone loss) were recorded. There was no significant difference in socioeconomic status, education status, self-perceived oral symptoms, and periodontal parameters among CP patients with and without RA. Self-perceived oral health and periodontal parameters are mainly governed by the intensity of CP, and the role of RA in this context seems to be rather secondary.

Decisional regret after robotic-assisted laparoscopic prostatectomy is higher in African American men

ObjectivesLongitudinal studies report racial disparities in prostate cancer (PCa) including greater incidence, more aggressive tumor biology, and increased cancer-specific mortality in African American (AA) men. Regret concerning primary treatment selection is underevaluated in patients with PCa. We investigated the relationships between clinicopathologic variables across racial and socioeconomic lines following robotic-assisted laparoscopic prostatectomy. Materials and methodsWe assessed treatment decisional regret using a validated questionnaire in a total of 484 white and 72 AA patients with PCa who were followed up for a median of 16.6 months post–robotic-assisted laparoscopic prostatectomy. Socioeconomic status (SES) information was aggregated from 2010 US census zip code data. Perioperative clinicopathologic characteristics and functional outcomes were compared between groups. Univariate and multivariate regression analyses were used to evaluate the influence of race, aggregate SES, and other clinical and demographic characteristics on decisional regret. ResultsThe majority (87.7%) of the population was not regretful of their decision to undergo treatment. However, a greater proportion of AA vs. white patients were regretful (20.6% vs. 11.2%, respectively; P = 0.03). AA and white men were similar on all functional, clinical, and pathologic features with the exception of younger age among AA men (56 vs. 60y, respectively; P<0.001). Although there were significant differences in SES by race (P<0.001), regret did not differ by SES (β =−1.53; P = 0.15). Race, postoperative sexual dysfunction, pad usage, and length of hospital stay, however, were significantly associated with decisional regret. ConclusionsAA men were more regretful than white men, after adjusting for clinicopathologic characteristics and postoperative functional outcomes.

Differences in the association between childhood trauma and BMI in black and white South African women

Childhood trauma has previously been associated with adult obesity. The aim of this study was to determine if ethnicity altered the relationship between childhood trauma and obesity in South African women. Forty-four normal-weight (BMI < 25kg/m(2)) and obese (BMI > 30kg/m(2)), black and white premenopausal women completed the Childhood Trauma Questionnaire (CTQ), which retrospectively assessed emotional and physical neglect, and emotional, physical and sexual abuse in childhood. Body composition did not differ by ethnicity in the normal-weight and obese groups. However,independent of BMI group, there were significant differences in socioeconomic status (SES) between black and white women (P < 0.01). Total CTQ score, as well as the sub-scales, physical and emotional neglect, and physical and sexual abuse were higher in black than white women (all P < 0.05), but these scores did not differ between BMI groups. Apart from the sexual abuse score, the differences in physical and emotional neglect and physical abuse scores were no longer significant after adjusting for ethnic differences in age and SES. For sexual abuse, there was a significant interaction between ethnicity and BMI group(P = 0.04), with scores in normal weight women being higher in black than white women, but scores in obese women not differing by ethnicity. Ethnicity alters the association between childhood sexual abuse and BMI status. Larger studies are required to verify this finding, including measures of body image and body size satisfaction that may explain these findings.

Is Nonsuicidal Self-Injury Associated With Parenting and Family Factors?

The present study investigates the association of parenting and family factors with nonsuicidal self-injury (NSSI) in preadolescents. A sample of 1,439 preadolescents and their parents were assessed by means of (a) adolescent-reported parenting behaviors (support and behavioral/psychological control), (b) parent-reported parenting behaviors (support and behavioral/psychological control) and parenting stress, and (c) parent-reported family structure, socioeconomic status (SES) of the family, family functioning, and family stressful life-events. The prevalence of NSSI was 4.82%. Preadolescents engaging in NSSI perceived more psychological and behavioral control from their parents. Logistic regression using parent-reported parenting behaviors as covariates showed a significant interaction between parent-reported support and behavioral control in relation to NSSI behaviors. No significant differences in parent-reported parenting stress and family structure emerged. Significant differences in parent-reported SES of families with and without self-injurious preadolescents were found. Finally, no significant associations appeared between the presence of NSSI and parent-reported family functioning and stressful life-events.

Comparisons of the sleep quality, daytime sleepiness, and sleep cognitions of Caucasian Australians and Zimbabwean and Ghanaian black immigrants

Studying sleep differences across different ethnic groups is not only important for our understanding of sleep but may lead to the development of new, culturally appropriate interventions. Perceptions of sleep quality, daytime sleepiness, and sleep cognitions (beliefs and attitudes) were investigated in a community sample of Caucasian Australians and Black immigrants currently resident in Australia from Zimbabwe (Black Zimbabwean) and Ghana (Black Ghanaian). A sample of a total of 176 participants including Caucasian Australian ( n = 58), Black Zimbabwean ( n = 59), and Black Ghanaian ( n = 59), aged between 18 and 60 years was surveyed. Groups were matched on age and gender, with a strong predominance of professional occupations in all groups in the final sample and no significant socio-economic status differences between groups. Participants completed the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Dysfunctional Beliefs and Attitudes about Sleep, and the Short Form-36 Health Survey. After matching participants on age, gender, and socio-economic status, no statistically significant group differences were found on sleep quality, daytime sleepiness, and physical health. However, significant group differences were found on beliefs and attitudes about sleep with Black Zimbabwean and Black Ghanaian participants, attributing sleep difficulties more to physical than psychological phenomena compared to Caucasian Australian participants.

Neural correlates of socioeconomic status in the developing human brain

Socioeconomic disparities in childhood are associated with remarkable differences in cognitive and socio-emotional development during a time when dramatic changes are occurring in the brain. Yet, the neurobiological pathways through which socioeconomic status (SES) shapes development remain poorly understood. Behavioral evidence suggests that language, memory, social-emotional processing, and cognitive control exhibit relatively large differences across SES. Here we investigated whether volumetric differences could be observed across SES in several neural regions that support these skills. In a sample of 60 socioeconomically diverse children, highly significant SES differences in regional brain volume were observed in the hippocampus and the amygdala. In addition, SES × age interactions were observed in the left superior temporal gyrus and left inferior frontal gyrus, suggesting increasing SES differences with age in these regions. These results were not explained by differences in gender, race or IQ. Likely mechanisms include differences in the home linguistic environment and exposure to stress, which may serve as targets for intervention at a time of high neural plasticity.

Socioeconomic status and the risk of colorectal cancer

AbstractBACKGROUND:No previous prospective US study has examined whether the incidence of colorectal cancer (CRC) is disproportionately high in low socioeconomic status (SES) populations of both men and women. This study examined the relationship between both individual and area‐level SES and CRC incidence, overall and by tumor location.METHODS:Data were obtained from the ongoing prospective National Institutes of Health‐AARP Diet and Health Study of persons (50‐71 years old) who resided in 6 US states and 2 metropolitan areas at baseline in 1995‐1996. Incident CRCs were ascertained from tumor registries through December 2006. SES was measured by self‐reported education and census‐tract socioeconomic deprivation. Baseline and follow‐up questionnaires collected detailed information on individual‐level CRC risk factors including family history and health behaviors.RESULTS:Among 506,488 participants analyzed, 7676 were diagnosed with primary invasive colorectal adenocarcinomas: 46.6% in the right colon, 26.7% in the left colon, and 25.9% in the rectum. The overall incidence of CRC was significantly higher among people who had low educational level or lived in low‐SES neighborhoods, relative to respective highest‐SES groups, even after accounting for other risk factors. These associations were stronger in the rectum than in left or right colon. In the right colon, there were no significant SES differences by either SES measure after accounting for covariates.CONCLUSIONS:SES, assessed by either individual‐level education or neighborhood measures, was associated with risk of CRC even after accounting for other risk factors. The relationship between SES and CRC was strongest in the rectum and weakest in the right colon. Cancer 2012;3636–3644. © 2012 American Cancer Society.

Socioeconomic Disparities in Prevalence, Treatment, and Control of Hypertension in Middle-aged Koreans

BackgroundWe investigated socioeconomic inequalities in hypertension prevalence, treatment, and control among middle-aged Koreans.MethodsWe analyzed data from 4275 adults aged between 40 and 64 years who participated in the Korean National Health and Nutrition Examination Survey, 2007 and 2008. Education, income, and occupational level were evaluated to assess the relationship of socioeconomic status with hypertension prevalence, treatment, and control.ResultsThere were significant differences in socioeconomic status among individuals with no hypertension, controlled hypertension, and uncontrolled hypertension in both sexes. In multiple logistic regression models, as compared with men who had more than 12 years of education, those with 7 to 12 years and less than 7 years of education had odds ratios (ORs) for untreated hypertension of 2.14 (95% CI: 1.18 to 3.90) and 2.98 (95% CI: 1.42 to 6.28), respectively (P for trend <0.05). As compared with women who had more than 12 years of education, those with 7 to 12 years and less than 7 years of education had ORs for hypertension prevalence of 1.75 (95% CI: 1.10 to 2.78) and 1.88 (95% CI: 1.12 to 3.16), respectively (P for trend <0.05). Women who worked as manual labors had an OR for uncontrolled hypertension of 1.50 (95% CI: 1.02 to 2.22) as compared with women in other jobs. There was no statistically significant association between income level and hypertension control.ConclusionsSocioeconomic status was independently associated with hypertension prevalence and care, which suggests a need for health policy efforts to reduce the socioeconomic disparity in hypertension management.

Immigrant status and disparities in health care delivery in patients with myocardial infarction

BackgroundWe investigated the differences in socioeconomic status and quality health care between Singapore-born citizens and immigrants presenting with ST-segment elevation myocardial infarction (STEMI). MethodsIn a prospective study, patients admitted with STEMI were recruited for a questionnaire survey. The recruited patients were categorized based on their immigration status into Singapore-born citizens (SBC), foreign-born citizens (FBC), permanent residents (PR) and non-residents (NR). ResultsAmong the 374 recruited patients, 286 (76.5%) patients were categorized as SBC, and the remaining 88 (23.5%) as immigrants. Further breakdown of the immigrants revealed that 33 were FBC (median duration of living in Singapore, 53years), 22 were PR (18years), and 33 were NR (11years). Significant differences in socioeconomic status among SBC, FBC, PR and NR were detected. NR were in the lowest, while PR in the highest, socioeconomic class based on occupation (p=0.003), education level (p<0.001), and average monthly household income (p=0.020). There were no disparities in the proportion of patients treated with primary PCI (SBC 88%, FBC 82%, PR 91%, NR 79%, p=0.555). Median door-to-balloon times were similar among the four groups (56, 52, 60, 56min, p=0.614). Compared with SBC, PR was associated with longer symptom-to-balloon times (median difference 54.1min; 95% CI 9.0 to 99.2). ConclusionThere were major differences in the socioeconomic status among SBC, FBC, PR and NR who presented with STEMI. Although there were no major disparities in access to high quality health care to these patients with different immigration status, symptom-to-balloon time differed substantially among the different migrant classes.

A study of head and neck cancer treatment and survival among indigenous and non-indigenous people in Queensland, Australia, 1998 to 2004.

BackgroundOverall, Indigenous Australians with cancer are diagnosed with more advanced disease, receive less cancer treatment and have poorer cancer survival than non-Indigenous Australians. The prognosis for Indigenous people with specific cancers varies however, and their prognosis for cancers of the head and neck is largely unknown. We therefore have compared clinical characteristics, treatment and survival between Indigenous and non-Indigenous people diagnosed with head and neck cancer in Queensland, Australia.MethodsRates were based on a cohort of Indigenous people (n = 67), treated in public hospitals between 1998 and 2004 and frequency-matched on age and location to non-Indigenous cases (n = 62) also treated in the public health system. Data were obtained from hospital records and the National Death Index. We used Pearson's Chi-squared analysis to compare categorical data (proportions) and Cox proportional hazard models to assess survival differences.ResultsThere were no significant differences in socioeconomic status, stage at diagnosis or number and severity of comorbidities between Indigenous and non-Indigenous patients, although Indigenous patients were more likely to have diabetes. Indigenous people were significantly less likely to receive any cancer treatment (75% vs. 95%, P = 0.005) and, when cancer stage, socioeconomic status, comorbidities and cancer treatment were taken into account, they experienced greater risk of death from head and neck cancer (HR 1.88, 1.10, 3.22) and from all other causes (HR 5.83, 95% CI 1.09, 31.04).ConclusionThese findings show for the first time that Indigenous Australians with head and neck cancer receive less cancer treatment and suggest survival disparity could be reduced if treatment uptake was improved. There is a need for a greater understanding of the reasons for such treatment and survival disparities, including the impact of the poorer overall health on cancer outcomes for Indigenous Australians.