Community Socioeconomic Characteristics Research Articles

The impact of a school-based tooth-brushing program on dental caries: a cross-sectional study

BackgroundPromotion of oral health in children is recognized as one of the components of health-promoting schools (HPSs). However, few studies have addressed supportive school environments for children’s oral health. This study aimed to evaluate the status of dental caries in school children at HPSs, with the objective of examining the impact of a supportive school environment for oral health, considering the lifestyles of individual children and the socioeconomic characteristics of their communities.MethodsData of 2043 5th-grade students in 21 elementary schools in Ichikawa city between 2008 and 2013 were analyzed. Children’s oral health status was evaluated using the decayed, missing, and filled permanent teeth (DMFT) index. A self-reported lifestyle questionnaire, a survey of the school environment promoting tooth-brushing, and community socioeconomic characteristics derived from the National Census data were included in the analyses. Bivariate analyses were conducted to evaluate the children’s DMFT status, and zero-inflated negative binominal (ZINB) regression was used to assess the relationships between DMFT and other variables.ResultsPrevalence of dental caries in the permanent teeth of 5th-grade children (aged 10–11 years) was 33.3%, with a mean DMFT score (± SD) of 0.83 ± 1.50. According to multilevel ZINB regression analysis, children from schools with after-lunch tooth-brushing time showed a higher odds ratio (OR) for excess zero DMFT (OR = 1.47, 95% CI = 1.00–2.15, P = 0.049) as compared to those from schools without it. Neither bivariate analysis nor ZINB model analysis revealed any significant influence of children’s gender or use of a toothpaste with fluoride.ConclusionsThe school-based environment supportive of oral health was significantly associated with a zero DMFT status in children. School-based efforts considering the socioeconomic characteristics of the area warrant attention even with declining prevalence of dental caries.

Posttraumatic Stress Disorder and Mental Distress Following the 2004 and 2005 Florida Hurricanes.

Community characteristics, such as perceived collective efficacy, a measure of community strength, can affect mental health outcomes following disasters. We examined the association of perceived collective efficacy with posttraumatic stress disorder (PTSD) and frequent mental distress (14 or more mentally unhealthy days in the past month) following exposure to the 2004 and 2005 hurricane seasons. Participants were 1486 Florida Department of Health workers who completed anonymous questionnaires that were distributed electronically 9 months after the 2005 hurricane season. Participant ages ranged from 20 to 79 years (mean, 48; SD, 10.7), and the majority were female (79%), white (75%), and currently married (64%). Fifty percent had a BA/BS degree or higher. In 2 separate logistic regression models, each adjusted for individual sociodemographics, community socioeconomic characteristics, individual injury/damage, and community storm damage, lower perceived collective efficacy was significantly associated with a greater likelihood of having PTSD (OR, 0.93; 95% CI, 0.90-0.96), and lower collective efficacy was significantly associated with frequent mental distress (OR, 0.94; 95% CI, 0.92-0.96). Programs enhancing community collective efficacy may be a significant part of prevention practices and possibly lead to a reduction in the rate of PTSD and persistent distress postdisaster. (Disaster Med Public Health Preparedness. 2019;13:44-52).

Association between community socioeconomic characteristics and access to youth flag football

BackgroundThe American Academy of Pediatrics has recommended that opportunities for non-tackling American football (e.g., flag football) be expanded, given concerns about the risks of brain trauma from tackle football. This...

Community socioeconomic status and public access defibrillators: A multilevel analysis

BackgroundAlthough current guidelines recommend that distribution of public-access defibrillators (PADs) should take into account area-level risk of out-of-hospital cardiac arrest (OHCA), community socioeconomic status (SES) can unduly influence policy implementation in positioning PADs. Using recent, complete data from Seoul Metropolitan City, Korea, this study aims to examine whether community SES is associated with distribution of PADs, in terms of per capita count and risk-grid coverage. MethodsA cross-sectional, observational study was conducted using three sources of administrative data: (1) PAD registry data (2007–2015), (2) OHCA database (2010–2014), and (3) community socioeconomic characteristics of two sub-city levels (neighborhoods nested in districts). We examined the relationship between neighborhood per capita tax, an SES proxy, with each of the two outcome variables. After examining per capita number of PADs and risk-grid coverage by neighborhood tax quartile, multilevel linear regression analysis was conducted to account for the nested nature of data and also to control for OHCA risk in the model. ResultsA total of 6609 PADs in 405 neighborhoods were included in the analysis. The average number of positioned PADs per 10,000 persons was 7.45, showing a gradient by neighborhood SES (4.92 in the lowest SES quartile vs 12.66 in the highest). Risk-grid coverage was around 10% across all neighborhood SES quartiles. These findings remained valid in the multilevel analysis: per capita number of PADs was still positively associated with neighborhood SES, while risk-grid coverage of PADs was not. ConclusionsMore affluent neighborhoods in Seoul exhibit higher per capita PADs, even accounting for OHCA risk, while risk-grid coverage is generally low regardless of community SES. Seoul’s ongoing program aimed to increase PAD coverage should also pay attention to improving community-level inequality as well as distributional efficiency.

Perceptions of community, social capital, and how they affect self-reported health: a multilevel analysis

ObjectivesThe link between social capital and self-reported health has been widely explored. On the other hand, we know less about the relationship between social capital, community socioeconomic characteristics, and non-social capital–related individual differences, and about their impact on self-reported health in community settings. MethodsCross-sectional study design with a proportional sample of 7965 individuals from 20 US communities were analyzed using multilevel linear regression models, where individuals were nested within communities. The response rates ranged from 13.5% to 25.4%. ResultsFindings suggest that perceptions of the community and individual level socioeconomic characteristics were stronger predictors of self-reported health than were social capital or community socioeconomic characteristics. ConclusionsPolicy initiatives aimed at increasing social capital should first assess community member's perceptions of their communities to uncover potential assets to help increase social capital.

Exposure assessment models for elemental components of particulate matter in an urban environment: A comparison of regression and random forest approaches

Exposure assessment for elemental components of particulate matter (PM) using land use modeling is a complex problem due to the high spatial and temporal variations in pollutant concentrations at the local scale. Land use regression (LUR) models may fail to capture complex interactions and non-linear relationships between pollutant concentrations and land use variables. The increasing availability of big spatial data and machine learning methods present an opportunity for improvement in PM exposure assessment models. In this manuscript, our objective was to develop a novel land use random forest (LURF) model and compare its accuracy and precision to a LUR model for elemental components of PM in the urban city of Cincinnati, Ohio. PM smaller than 2.5 μm (PM2.5) and eleven elemental components were measured at 24 sampling stations from the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). Over 50 different predictors associated with transportation, physical features, community socioeconomic characteristics, greenspace, land cover, and emission point sources were used to construct LUR and LURF models. Cross validation was used to quantify and compare model performance. LURF and LUR models were created for aluminum (Al), copper (Cu), iron (Fe), potassium (K), manganese (Mn), nickel (Ni), lead (Pb), sulfur (S), silicon (Si), vanadium (V), zinc (Zn), and total PM2.5 in the CCAAPS study area. LURF utilized a more diverse and greater number of predictors than LUR and LURF models for Al, K, Mn, Pb, Si, Zn, TRAP, and PM2.5 all showed a decrease in fractional predictive error of at least 5% compared to their LUR models. LURF models for Al, Cu, Fe, K, Mn, Pb, Si, Zn, TRAP, and PM2.5 all had a cross validated fractional predictive error less than 30%. Furthermore, LUR models showed a differential exposure assessment bias and had a higher prediction error variance. Random forest and other machine learning methods may provide more accurate exposure assessment.

Racial and Socioeconomic Disparities in Hip Fracture Care.

Despite declines in both the incidence of and mortality following hip fracture, there are racial and socioeconomic disparities in treatment access and outcomes. We evaluated the presence and implications of disparities in delivery of care, hypothesizing that race and community socioeconomic characteristics would influence quality of care for patients with a hip fracture. We collected data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS), which prospectively captures information on all discharges from nonfederal acute-care hospitals in New York State. Records for 197,290 New York State residents who underwent surgery for a hip fracture between 1998 and 2010 in New York State were identified from SPARCS using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Multivariable regression models were used to evaluate the association of patient characteristics, social deprivation, and hospital/surgeon volume with time from admission to surgery, in-hospital complications, readmission, and 1-year mortality. After adjusting for patient and surgery characteristics, hospital/surgeon volume, social deprivation, and other variables, black patients were at greater risk for delayed surgery (odds ratio [OR] = 1.49; 95% confidence interval [CI] = 1.42, 1.57), a reoperation (hazard ratio [HR] = 1.21; CI = 1.11, 1.32), readmission (OR = 1.17; CI = 1.11, 1.22), and 1-year mortality (HR = 1.13; CI = 1.07, 1.21) than white patients. Subgroup analyses showed a greater risk for delayed surgery for black and Asian patients compared with white patients, regardless of social deprivation. Additionally, there was a greater risk for readmission for black patients compared with white patients, regardless of social deprivation. Compared with Medicare patients, Medicaid patients were at increased risk for delayed surgery (OR = 1.17; CI = 1.10, 1.24) whereas privately insured patients were at decreased risk for delayed surgery (OR = 0.77; CI = 0.74, 0.81), readmission (OR = 0.77; CI = 0.74, 0.81), complications (OR = 0.80; CI = 0.77, 0.84), and 1-year mortality (HR = 0.80; CI = 0.75, 0.85). There are race and insurance-based disparities in delivery of care for patients with hip fracture, some of which persist after adjusting for social deprivation. In addition to investigation into reasons contributing to disparities, targeted interventions should be developed to mitigate effects of disparities on patients at greatest risk. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Residential mobility impacts exposure assessment and community socioeconomic characteristics in longitudinal epidemiology studies.

Epidemiologic studies commonly use residential locations to estimate environmental exposures or community-level characteristics. The impact of residential mobility on these characteristics, however, is rarely considered. The objective of this analysis was to examine the effect of residential mobility on estimates of traffic-related air pollution (TRAP), greenspace, and community-level characteristics. All residential addresses were reported from birth through age seven for children enrolled in the Cincinnati Childhood Allergy and Air Pollution Study. Exposure to TRAP at each address was estimated using a land use model. Greenspace was estimated using satellite imagery. Indices of neighborhood deprivation and race were created based on socioeconomic-census tract measures. Exposure estimates using the birth record address, the last known address, and the annual address history were used to determine exposure estimation error and bias in the association with asthma at age seven. Overall, 54% of the cohort moved at least once prior to age seven. Each move was separated by a median of 4 miles and associated with a median decrease of 4.4% in TRAP exposure, a 5.3% increase in greenspace, an improved deprivation index, and no change in the race index. Using the birth record address or the last known address instead of the annual address history resulted in exposure misclassification leading to a bias toward the null when associating the exposures with asthma. Using a single address to estimate environmental exposures and community-level characteristics over a time period may result in differential assessment error.

Who is Next? Identifying Communities with the Potential for Increased Implementation of Sustainability Policies and Programs

Understanding the system of connections between societal contexts and policy outcomes in municipal governments provides important insights into how community sustainability happens, and why it happens differently in various communities. A growing body of research in recent years has focused on understanding the socio-economic characteristics of communities and cities that are recognized as policy leaders in sustainability. In this paper, we expand the focus beyond the leaders in sustainability as we apply a selection of socio-demographic influences of community sustainability to a large sample of U.S. communities using community classification analytics to identity a range of community types and levels of engagement with sustainability. Our typology presents an integrated and comprehensive perspective on the structure of community sustainability in the United States, highlighting key points of comparison between human capital factors such as population size and density, affluence, home ownership, and adoption of sustainability policy. The analysis provides new insights not only about community leaders in sustainability, but also communities with the civic and social capacity to do more, and the challenges that may inhibit sustainability efforts in others.

Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes.

There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.

Differences in the Community Built Environment Influence Poor Perceived Health Among Persons With Spinal Cord Injury

ObjectiveTo assess the association between characteristics of the built environment and differences in perceived health among persons with spinal cord injury (SCI) using objective measures of the local community derived from Geographic Information Systems data. DesignSecondary analysis of cross-sectional survey data. SettingCommunity. ParticipantsPersons with chronic SCI enrolled in the Spinal Cord Injury Model Systems database (N=503). All cases were residents of New Jersey, completed an interview during the years 2000 through 2012, had a complete residential address, and were community living at the time of follow-up. InterventionsNot applicable. Main Outcome MeasurePerceived health. ResultsBivariate tests indicated that persons with SCI residing in communities with more (vs less) mixed land use and small (vs large) amounts of open space were more likely to report poor perceived health. No associations were found between perceived health and differences in the residential or destination density of the community. Adjusting for variation in demographic, impairment, quality of life, and community socioeconomic characteristics accounted for the gap in the odds of reporting poor health between persons living in areas with large versus small amounts of open space (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.28–1.02). However, even after accounting for individual background differences, persons living in communities characterized by more heterogeneous land use were twice as likely to report poor health compared with persons living in less mixed areas (OR, 2.14; 95% CI, 1.12–4.08). ConclusionsDifferences in the built characteristics of communities may be important to the long-term health and well-being of persons with SCI who may have greater exposure to the features of their local area because of limited mobility. The results of this study suggest living in a community with more heterogeneous land use was not beneficial to the perceived health of persons with chronic SCI living in New Jersey. Further investigation is needed to assess if the relationships observed in this analysis are influenced by differences in infrastructure and resources across communities. Further research is also needed to investigate the role built environment plays in the long-term health and well-being of persons with SCI in other geographic locales.

Market potential for smart growth neighbourhoods in the USA: A latent class analysis on heterogeneous preference and choice

With data from a 2011 National Association of Realtors community preference survey, we examined individuals’ preferences and the resulting market potential for smart growth neighbourhoods in the USA. Using a latent class choice model, we discovered four classes of individuals that reveal distinctive behaviours when choosing smart growth neighbourhoods, based on the interplay between aspects of community design, socioeconomic characteristics and personal attitudes. Based on these results we estimated the demand for smart growth neighbourhoods given the way they are planned and built. By linking the results of the latent class choice to a market diffusion model we were able to evaluate the effectiveness of a proposed smart growth neighbourhood design in inducing less sprawling development.

Why Do Some Women Know More? An Exploration of the Association of Community Socioeconomic Characteristics, Social Capital, and HIV/AIDS Knowledge

The objective of this study was to investigate the associations of community-level socio-economic status (SES) characteristics and social capital with women's knowledge of HIV/AIDS. We used a representative national sample of 6,771 women ages 15–49 years from the Bangladesh Demographic Health Survey of 2007. We extended the findings of prior studies by providing new evidence that both community and social capital were related to having knowledge of AIDS. The significant community characteristics associated with women's greater knowledge of AIDS were: women's higher mean age at first marriage, higher mean years of education, the higher percentage of women in the community who work, and higher mean household living standard in the community. Regardless of individual-level SES, living in a community with higher community-level SES and having greater social capital were associated with having a greater likelihood of hearing about AIDS. However, we found that once women knew about AIDS, not all of the community-SES and social capital indicators explained their advanced knowledge of AIDS prevention and transmission. Our findings underscore the importance of HIV/AIDS education campaigns in the disadvantaged communities, specifically targeting women who are not members in any non-governmental organizations, as well as greater use of media in educating women about AIDS.

What makes a “successful” marine protected area? The unique context of Hawaii′s fish replenishment areas

In 1998, in order to combat the degradation of yellow tang populations on the west coast of Hawaii Island, fish replenishment areas (FRAs) were established prohibiting aquarium fishing along more than thirty percent of the coastline. Unlike other marine management approaches in Hawaii, which have largely been controversial, fraught with confusion over regulations, inadequately enforced, and lacking public support, these FRAs have been lauded as a marine conservation success, with wide-ranging support and evidence of rapid replenishment of the yellow tang population. In order to better understand the contextual factors contributing to the success of the West Hawaii FRAs, this research explores the following questions: (1) What factors documented in the literature on marine protected areas (MPAs) have been demonstrated to contribute to or inhibit MPA success internationally; (2) which of these factors do the FRAs of West Hawaii exhibit; and (3) are there additional factors that may have contributed to their wide acceptance and success? Common factors contributing to MPA success are determined through a synthesis of the literature. These include: level of community engagement, socioeconomic characteristics, ecological factors, MPA design, governance, and enforcement. The outcomes of West Hawaii′s FRAs are examined in the context of these factors. While the common factors agreed upon in the literature were key to the success of the FRAs, additional contextual factors such as the unique nature of the aquarium fishery and its social marginalization also played a vital role.

한국성인의 건강행위와 구강건강행위가 치주조직병자율(CPI)에 미치는 영향

This study sought to explore the relationships between health behavior, oral health behavior and community periodontal index away the adult in korea. The date of 'The fifth korean national health and nutrition examination survey 2010' was analyzed for this study. The questionnaire was measured regarding health behavior, oral health behavior, community periodontal index and socio-economic characteristics. For statistical analysis, the SPSS 19.0 for Windows was used. We determined frequencies, percentage and determining statistical significance using multiple regression analysis. General characteristics showed differences in community periodontal index associated with residence, gender, age, income level, education, division of basic livelihood security. Health behavior showed differences in community periodontal index associated with smoking, AUDIT. Oral health behaviors showed differences in community periodontal index associated with dental care treatment, utilization of dental hospitals, dental check up, tooth brushing, use oral health supplies. In conclusion, in order to reduce community periodontal index of the adult, the importance and needs of periodontal status should be emphasized. periodontal status related education and program for the adult should be operated.

Vulnerability of fishery-based livelihoods to the impacts of climate variability and change: insights from coastal Bangladesh

Globally, fisheries support livelihoods of over half a billion people who are exposed to multiple climatic stresses and shocks that affect their capacity to subsist. Yet, only limited research exists on the vulnerability of fishery-based livelihood systems to climate change. We assess the vulnerability of fishery-based livelihoods to the impacts of climate variability and change in two coastal fishing communities in Bangladesh. We use a composite index approach to calculate livelihood vulnerability and qualitative methods to understand how exposure, sensitivity, and adaptive capacity measured by sub-indices produce vulnerability. Our results suggest that exposure to floods and cyclones, sensitivity (such as dependence on small-scale marine fisheries for livelihoods), and lack of adaptive capacity in terms of physical, natural, and financial capital and diverse livelihood strategies construe livelihood vulnerability in different ways depending on the context. The most exposed community is not necessarily the most sensitive or least able to adapt because livelihood vulnerability is a result of combined but unequal influences of bio-physical and socio-economic characteristics of communities and households. But within a fishing community, where households are similarly exposed, higher sensitivity and lower adaptive capacity combine to create higher vulnerability. Initiatives to reduce livelihood vulnerability should be correspondingly multifaceted.

Child maltreatment reports in Israel: The intersection between community socioeconomic characteristics and ethnicity.

The authors examined the relationship between community characteristics and child maltreatment reports in Israel, comparing Jewish and Arab localities both in terms of maltreatment reports and the responses of the social services to these reports. Administrative data were obtained from the protective services and the Central Bureau of Statistics for 231 local authorities in Israel (covering 98% of children in Israel). Jewish communities showed significantly more reports of sexual abuse and physical abuse than Arab communities. Reporting rates also showed different associations with socioeconomic and demographic variables. In Jewish localities, demographic, economic, and educational factors were all correlated with the reporting of child maltreatment, whereas in Arab localities, only median age (young) of the local population was associated with a greater rate of child maltreatment reporting. No differences in the responses of the protective services were found. Implications of the results for future policy are discussed.

Capturing Community Context of Human Response to Forest Disturbance by Insects: A Multi-Method Assessment.

The socioeconomic and environmental features of local places (community context) influence the relationship between humans and their physical environment. In times of environmental disturbance, this community context is expected to influence human perceptual and behavioral responses. Residents from nine Colorado communities experiencing a large outbreak of mountain pine beetles (Dendroctonus ponderosae) were surveyed in 2007. Multiple analytic methods including ordinary least squares regression and multilevel modeling techniques were used to evaluate a community-context conceptual model of factors influencing individual actions in response to forest disturbance by beetles. Results indicated that community biophysical and socioeconomic characteristics had important impacts on participation in beetle-related actions and influenced the relationships of individual-level variables in the conceptual model with beetle-related activities. Our findings have implications for natural resource management and policy related to forest disturbances, and for developing a methodology appropriate to measure the general community context of human-environment interactions.

Effects of Socio-Economic and Input-Related Factors on Polluting Plants' Location Decisions

Abstract Many environmental justice studies argue that firms choose to locate waste sites or polluting plants disproportionately in minority or poor communities. However, it is not uncommon for these studies to match site or plant location to contemporaneous socioeconomic characteristics instead of to characteristics at the time of siting. While this may provide important information on disproportionate impacts currently faced by these communities, it does not describe the relationship at the time of siting. Also, variables that are important to a plant's location decision – i.e., production and transportation costs – are often not included. Without controlling for such variables, it is difficult to evaluate the relative importance of socioeconomic characteristics in a firm's initial location decision. This paper examines the role of community socioeconomic characteristics at the time of siting in the location decisions of manufacturing plants while controlling for other location-relevant factors such as input costs.When plant location is matched to current socioeconomic characteristics, results are consistent with what the environmental justice literature predicts: race is significant and positively related to plant location, while income is significant and negatively related to plant location. When plant location is matched to socioeconomic characteristics at the time of siting, empirical results suggest that race is no longer significant, though income is still significant and negatively related to plant location. Poverty rates are sometimes significant but act as a deterrent to plant location. Variables traditionally considered in the firm location literature – such as land and labor costs, the quality of labor, and distance to rail – are significant. The presence of pre-existing TRI plants in a neighborhood and average plant size are also significant.

Effects of mutual health organizations on use of priority health care services in urban and rural Mali: a case-control study

To examine the effects of a community-based mutual health organization (MHO) on utilization of priority health services, financial protection of its members and inclusion of the poor and other target groups. Four MHOs were established in two districts in Mali. A case-control study was carried out in which household survey data were collected from 817 MHO member households, 787 non-member households in MHO catchment areas, and 676 control households in areas without MHOs. We compiled MHO register data by household for a 22-month period. Outcome measures included utilization of priority services, health expenditures and out-of-pocket payments. Independent variables included individual, household and community demographic, socioeconomic and access characteristics, as determined through a household survey in 2004. MHO members who were up to date on premium payments (controlling for education, distance to the nearest health facility and other factors) were 1.7 times more likely to get treated for fevers in modern facilities; three times more likely to take children with diarrhoea to a health facility and/or treat them with oral rehydration salts at home; twice as likely to make four or more prenatal visits; and twice as likely, if pregnant or younger than 5 years, to sleep under an insecticide-treated net (P < 0.10 or better in all cases). However, distance was also a significant negative predictor for the utilization of many services, particularly assisted deliveries. Household and individual enrolment in an MHO were not significantly associated with socioeconomic status (with the exception of the highest quintile), and MHOs seemed to provide some financial protection for their members. MHOs are one mechanism that countries strengthening the supply of primary care can use to increase financial access to - and equity in - priority health services.