Socioeconomic Differences Research Articles

The Effect of Racial, Ethnic, and Socioeconomic Differences on Visual Impairment before Cataract Surgery

PurposeTo compare the associations of race/ethnicity and socioeconomic status (SES) with visual impairment (VI) prior to surgical removal of cataracts across two large health systems in the U.S. Mid-Atlantic region. DesignMulti-institutional cross-sectional data study. ParticipantsPatients aged 65 and older who underwent cataract surgery at Johns Hopkins Hospital (JHH) and Kaiser Permanente (KP) between January 1, 2017 and December 31, 2019. MethodsCovariates included patient age, sex, smoking status, surgery laterality, Charlson Comorbidity Index (CCI), and ocular comorbidities. Multivariable generalized estimating equation models were used to examine the association of race/ethnicity and area deprivation index (ADI) with visual acuity. Main Outcome MeasuresVisual acuity prior to cataract surgery was assessed using Log of Minimum Angle of Resolution (logMAR). Race/ethnicity and ADI were the main exposures of interest. ResultsAt JHH, 11,509 patients (17,731 eyes) were included, while KP had 7,143 patients (10,542 eyes). After adjusting for covariates, Black (β, 0.49), Asian (β, 0.83), and Hispanic patients (β, 0.95) were more likely to have worse visual acuity secondary to cataracts at JHH (P < 0.001 for all) compared to White patients. Similarly, at KP, Black (β, 0.56), Asian (β, 0.70), and Hispanic patients (β, 0.89) were more likely to have worse visual acuity (P < 0.001 for all) compared to White patients. Compared to those living in the least disadvantaged neighborhoods (Quartile [Q]1 ADI) at JHH, higher ADI quartiles (more deprived) were more likely to have worse visual acuity (β, 0.27; P = 0.001 for Q2, β, 0.40; P = 0.001 for Q3, β, 0.95; P < 0.001 for Q4). There was no significant association found between ADI and VI secondary to cataracts at KP. ConclusionsAmong older adults, non-White race/ethnicity was independently associated with VI secondary to cataracts in two large health systems in the U.S. Mid-Atlantic region, after adjustment for ADI. Area deprivation was also associated with VI but only in the JHH system. Our study suggests that non-White patients and those with lower SES are at greater risk of VI secondary to cataracts possibly due to social, structural and institutional barriers.

Socioeconomic Differences in Patient Reported Outcome Measures 3 Months After Stroke: A Nationwide Swedish Register-Based Study.

There is a well-known association between low socioeconomic status (SES), poor survival, and clinician-reported outcomes after stroke. We aimed to assess socioeconomic differences in Patient Reported Outcome Measures 3 months after stroke. This nationwide cohort study included patients registered with acute stroke in the Swedish Stroke Register 2015-2017. Patient Reported Outcome Measures included activities of daily living (mobility, toileting, and dressing), and poststroke symptoms (low mood, fatigue, pain, and poor general health). Information on SES prestroke was retrieved from Statistics Sweden and defined by a composite measure based on education and income tertiles. Associations between SES and Patient Reported Outcome Measures were analyzed using logistic regression adjusting for confounders (sex and age) and additionally for potential mediators (stroke type, severity, cardiovascular disease risk factors, and living alone). Subgroup analyses were performed for stroke type, men and women, and younger and older patients. The study included 44 511 patients. Of these, 31.1% required assistance with mobility, 18% with toileting, and 22.2% with dressing 3 months after stroke. For poststroke symptoms, 12.3% reported low mood, 39.1% fatigue, and 22.7% pain often/constantly, while 21.4% rated their general health as poor/very poor. Adjusted for confounders, the odds of needing assistance with activities of daily living were highest for patients with low income and primary school education, for example, for mobility, odds ratio was 2.06 (95% CI, 1.89-2.24) compared with patients with high income and university education. For poststroke symptoms, odds of poor outcome were highest for patients with low income and university education (eg, odds ratio, 1.79 [95% CI, 1.49-2.15] for low mood). Adjustments for potential mediators attenuated but did not remove associations. The associations were similar in ischemic and hemorrhagic strokes and more pronounced in men and patients <65 years old. There are substantial SES-related differences in Patient Reported Outcome Measures poststroke. The more severe outcome associated with low SES is more pronounced in men and in patients of working age.

P-005 SOCIOECONOMIC DIFFERENCES IN WORKING LIFE EXPECTANCY: A SCOPING REVIEW

P-005 SOCIOECONOMIC DIFFERENCES IN WORKING LIFE EXPECTANCY: A SCOPING REVIEW

Presentation and patterns of reinterventions after revascularization in patients with premature peripheral arterial disease

ObjectivePremature peripheral arterial disease (PAD) (age ≤50 years) has been shown to negatively impact the outcomes of lower extremity revascularization (LER). Patients with premature PAD have an increased risk of major amputation compared with older patients. The primary goal of this study is to compare the frequency of reinterventions after LER in patients with premature PAD to their older counterparts with common age of presentation (ie, 60-80 years). MethodsA retrospective review of consecutive patients undergoing LER for PAD in a single center was performed. Clinical, procedural, and socioeconomic characteristics were compared between patients with premature PAD and the older group. Perioperative and long-term outcomes were captured and compared including mortality, major amputation, reintervention rate and frequency, as well as major adverse limb events. ResultsThere were 1274 patients who underwent LER (4.3% premature, 61.8% age 60-80). Patients with premature PAD were more likely to be females of racial minorities. Notably, the mean Distressed Communities Index score was significantly higher in the premature PAD group compared with the older patients. Patients with premature PAD were significantly more likely to have end-stage renal disease but less likely to have hypertension, hyperlipidemia, and coronary artery disease compared with older patients. There was no significant difference in perioperative complications. After a mean follow-up of 5 years, patients with premature PAD were significantly more likely to undergo more frequent reinterventions compared with older patients. Kaplan-Meier curves showed similar overall survival and major adverse limb event-free survival between the two groups. ConclusionsPatients with premature PAD are likely to undergo more frequent reinterventions after initial LER and have similar 5-year survival curves compared with patients at least 20 years older. Demographic and socioeconomic differences impacting patients with premature PAD, even in this relatively underpowered institutional experience, are striking and warrant further investigation.

Social Inequalities in Loneliness: Disentangling the Contributions of Education, Income, and Occupation

Loneliness represents a serious health risk. However, studies investigating social inequalities in loneliness are rare. Thus, the current study investigates which socioeconomic groups are the most affected by loneliness. Data from the population-based German Aging Survey were used ( N = 3,784), with participants being 40+ years old. Education, income, and occupational prestige were used as socioeconomic indicators. It was found that loneliness scores were descriptively higher in groups with lower educational attainment, lower income and lower occupational prestige. In a linear regression analysis, significant socioeconomic differences in loneliness emerged only for income and occupational prestige. Thus, individuals with a low occupational position and those with low income are systematically more affected by loneliness than higher status groups. Material and occupational resources are likely to constitute major socio-structural explanatory variables for loneliness and should be further investigated as such by future studies.

A Study on the Role of Constructive Journalism During Covid-19 Pandemic

An expansive proliferation of misinformation and fake news followed with the outbreak of the Covid-19 pandemic, a devastating event with lasting scars that changed the world forever. While social media may have originally helped in connecting people and sharing information, it may have also triggered a heightened accessibility in spreading misinformation and fake reports during the pandemic. The Covid-19 outbreak cannot be held as the sole reason for the mounting scepticism among people over the mainstream news reporting or the rising news avoidance observed in recent years. The role of news media organisations during pandemic situations towards disseminating scientific and verified information is indispensable. However, a shift from the normative role of mass media as a mere informant and mute spectator to one that reflexively gathers and presents socially useful news for its audience could have quelled the misinformation-induced hysteria to a certain extent during the peak of the pandemic—a constructive approach. This study critically analyses the various discourses surrounding constructive journalism and its role during the Covid-19 pandemic. It was found that most discourses vouched for the inclusion of constructive approaches in news sharing during crises and in future. However, regional, geopolitical and socioeconomic differences may allude to different understandings and contextual applications of constructive journalism that would require greater academic research.

Russia’s Regional Parliamentary Elections (2021): Cleavage Structure and Trends of Changes

Abstract The article studies the cleavage structures of Russian regions based on the results of elections to regional assemblies in 2021 and analyzes changes compared to previous elections. Factor analysis reveals factors of territorial differences in party voting (electoral cleavages), issue dimensions and sub-dimensions of political space, as well as factors of demographic and socio-economic inter-territorial differentiation. Correlation analysis and multiple regression (OLS) help determine whether electoral cleavages have a political interpretation and a social basis. It demonstrates that the regional elections of 2021 largely reproduced the cleavage structure of 2016, but with some changes. What was common was the almost identical total number of participants and the factors of territorial differences in party voting. The difference was the increase in the number of ‘complete’ electoral cleavages and political subdimensions; the emergence of new actors; expansion of the agenda. It is also noted, that the confrontation between the ‘party of power’ and other participants in domestic politics and the socio-economic sphere constituted the political content of the main electoral cleavage, while the confrontation between market liberals and protectionists in the socio-economic sphere competed for second place with the socio-cultural confrontation. The most common social background of electoral cleavages remained urbanization, which was the main predictor in most cases. At the same time, the importance of economic activity of the population has increased, displacing the factor of demographic characteristics from second place.

Исследование неоднородности социально-экономического пространства России на уровне макрорегионов

Introduction. This article examines the problem of differentiation of the economic space of Russia. This problem originates during the collapse of the Soviet Union, when, during the transition from a command economy to a market economy, the state was faced with an uneven distribution of natural, territorial, demographic and other resources across the country's regions. The destruction of industrial, financial and social ties of the regions occurred as a result of the policy pursued by Yeltsin B., who pursued a course of strengthening the sovereignty of the subjects of Russia. In the Decree of the President of the Russian Federation No. 803 dated 06/03/1996 "On the main provisions of regional policy in the Russian Federation", the task was set to smooth out significant imbalances in the socio-economic development of the regions. In this paper, the question is considered: has the task regulated by the decree of the President of the Russian Federation been achieved? The purpose of the work is to assess the differences in the socio-economic development of Russian regions grouped into federal districts.Materials and methods. The information base of this study consists of the works of domestic authors and data from the State Statistics Service (Rosstat). The Thale index, its structural decomposition, and the Atkinson index were used to analyze the socio-economic inequality of the regions.Results. The article provides a structural analysis of the socio-economic development of Russia (at the level of macro-regions) from 2000-2020 using the above indices. The results of the study showed significant intergroup differences in the macro-regions of Russia, as well as increased regional inequality in most of the considered indicators. An analysis of the regions within the federal districts showed that the regions of the Central Federal District differ significantly in terms of socio-economic development. In other federal districts, there is a low level of regional inequalityConclusions. As a result of the study, proposals were developed to reduce the socio-economic differentiation of the regions. The conclusions of this work can be used to improve the state regional policy in the field of balanced development of territories.

A Descriptive Study of Spanish and Ecuadorian Commercial Infant Cereals: Are They in Line with Current Recommendations?

Cereals are an important source of nutrients, especially used in complementary feeding. The objective of this study is to review the nutritional composition of cereal-based foods for infants from 4 months and toddlers that are offered in Spain and Ecuador, countries selected because of the opportunity to work in them, and due to their socio-economic differences (industrialized and developing countries, respectively). The number of these products was 105 cereals in Spain and 22 in Ecuador. The products were classified as gluten-free cereals, five cereals, eight cereals, multigrain cereals, and cookies. A 25 g serving was used to determine the percentage in which the samples analyzed can cover the Reference Nutrient Intake (RNI) for micronutrients in infants from 7 months and toddlers according to the European Food Safety Authority (EFSA). Nutritional information per 100 g of dry product was collected according to medium, minimum, and maximum units, and nutrient density was calculated. The age range in which these products are recommended is different in both countries. The nutritional composition presents some differences; Spanish cereals show a lower content of sodium, added sugars, hydrolyzed cereals, and maltodextrin than Ecuadorian cereals. Commercialized cereals could contribute to satisfying the nutritional needs of infants and toddlers; however, they can also be a source of non-recommended components.

Predicting human and viral protein variants affecting COVID-19 susceptibility and repurposing therapeutics

The COVID-19 disease is an ongoing global health concern. Although vaccination provides some protection, people are still susceptible to re-infection. Ostensibly, certain populations or clinical groups may be more vulnerable. Factors causing these differences are unclear and whilst socioeconomic and cultural differences are likely to be important, human genetic factors could influence susceptibility. Experimental studies indicate SARS-CoV-2 uses innate immune suppression as a strategy to speed-up entry and replication into the host cell. Therefore, it is necessary to understand the impact of variants in immunity-associated human proteins on susceptibility to COVID-19. In this work, we analysed missense coding variants in several SARS-CoV-2 proteins and their human protein interactors that could enhance binding affinity to SARS-CoV-2. We curated a dataset of 19 SARS-CoV-2: human protein 3D-complexes, from the experimentally determined structures in the Protein Data Bank and models built using AlphaFold2-multimer, and analysed the impact of missense variants occurring in the protein–protein interface region. We analysed 468 missense variants from human proteins and 212 variants from SARS-CoV-2 proteins and computationally predicted their impacts on binding affinities for the human viral protein complexes. We predicted a total of 26 affinity-enhancing variants from 13 human proteins implicated in increased binding affinity to SARS-CoV-2. These include key-immunity associated genes (TOMM70, ISG15, IFIH1, IFIT2, RPS3, PALS1, NUP98, AXL, ARF6, TRIMM, TRIM25) as well as important spike receptors (KREMEN1, AXL and ACE2). We report both common (e.g., Y13N in IFIH1) and rare variants in these proteins and discuss their likely structural and functional impact, using information on known and predicted functional sites. Potential mechanisms associated with immune suppression implicated by these variants are discussed. Occurrence of certain predicted affinity-enhancing variants should be monitored as they could lead to increased susceptibility and reduced immune response to SARS-CoV-2 infection in individuals/populations carrying them. Our analyses aid in understanding the potential impact of genetic variation in immunity-associated proteins on COVID-19 susceptibility and help guide drug-repurposing strategies.

Does social need fulfillment moderate the association between socioeconomic status and health risk behaviours during pregnancy?

Socioeconomic differences in health risk behaviours during pregnancy may be influenced by social relations. In this study, we aimed to investigate if social need fulfillment moderates the association between socioeconomic status (SES) and health risk behaviours (smoking and/or alcohol consumption) during pregnancy. We used baseline data from the Lifelines Cohort Study merged with data from the Lifelines Reproductive Origin of Adult Health and Disease (ROAHD) cohort. Education level was used to determine SES, categorized into low, middle, and high, with middle SES as the reference category. Social need fulfillment was taken as indicator for social relations and was measured with the validated Social Production Function Instrument for the Level of Well-being scale. The dependent variable was smoking and/or alcohol consumption during pregnancy. Univariable and multivariable logistic regression analysis was conducted to assess the association of SES and social need fulfillment with health risk behaviours and to test for effect modification. We included 1107 pregnant women. The results showed that women with a high SES had statistically significantly lower odds of health risk behaviours during pregnancy. The interaction effect between SES and social need fulfillment on health risk behaviours was not statistically significant, indicating that no moderation effect is present. The results indicate that social need fulfillment does not modify the effect of SES on health risk behaviours during pregnancy. However, in literature, social relations are identified as an important influence on health risk behaviours. More research is needed to identify which measure of social relations is the most relevant regarding the association with health risk behaviours.

DEI-01. CLINICAL AND SOCIOECONOMIC FACTORS ASSOCIATED WITH PARTICIPATION IN POST-MORTEM TISSUE DONATION IN PEDIATRIC BRAIN TUMORS: A RETROSPECTIVE CHART REVIEW

Abstract BACKGROUND The gift of post-mortem tissue donation is a critical resource in the discovery and interrogation of pathobiological mechanisms of pediatric brain tumors. Broad generalizability of research findings requires a representative population to participate in pre-clinical studies. As a “Center of Excellence” within the Gift from a Child initiative, our institution has a well-established post-mortem tissue donation program funded by the Swifty Foundation. Our primary objective was to determine if clinical and socioeconomic differences exist between patients that participated in and those that declined research-based autopsy. METHODS We performed a single-institution retrospective chart review of pediatric patients with central nervous system (CNS) malignancies who died from their disease between 1/1/2021 and 12/31/2022. Individual clinical, demographic, and socioeconomic data were assessed. Population-level data were estimated using Zip Code Tabulation Areas. Descriptive statistics were used to compare categorical data. RESULTS Among 26 patients who died secondary to disease in the study timeframe, 23 (88%) were approached and 8/23 (35%) consented to participation. In the consented group (C) vs. declined group (D), there was a higher percentage of White, Non-Hispanic/Latino patients by self-reported race (C: 88% vs. D: 55%) and no patients who identified as Asian or Hispanic/Latino (C: 0% &amp; 0% vs. D: 13% &amp; 27%). Of all patients approached, 2 required interpreters (9%) and both families declined participation. The rate of private insurance was higher in the consented group (C: 75% vs D: 47%) compared to Medicaid as primary insurance in the declined group (C: 13% vs D: 53%). CONCLUSIONS Patients from racial and ethnic minorities are underrepresented in tissue donation programs. Future research should aim to understand and improve identified disparities to ensure advancements benefit all children with CNS malignancies. One area we plan to address is improved communication with non-English speaking families by educating interpreter services prior to discussion.

1194-P: Racial and Socioeconomic Differences in Technology Access in Children with Type 1 Diabetes (T1D)

1194-P: Racial and Socioeconomic Differences in Technology Access in Children with Type 1 Diabetes (T1D)

Vocational education, skill training and self-employment: evidence from India’s non-farm sector

ABSTRACT Does vocational education and skill training induce self-employment remains a significant open policy question in India. A connected question is how workers from different socioeconomic, demographic and educational settings relate their vocational education and skill training with employment type. In this paper, using nationally representative household survey data, we investigate how vocational education and skill training are associated with the uptake of self-employment activities (vis-à-vis wage employment opportunities) in the non-farm sector in India. This paper shows that individuals with vocational training are more likely to engage in self-employment activities than those with wage employment in the non-farm sector in India, with stark socioeconomic and demographic differences. Our results suggest significant gender and caste inequalities in self-employment based on their vocational education and skill training status. We also find some evidence suggesting that youth with vocational training opt for wage employment vis-à-vis self-employment than their older counterparts. Examining socioeconomic and demographic complexities in connecting vocational education and skill training with self-employment in this study aligns with the recent education and labour market policy of the Indian government.

Involuntary psychiatric hospitalisation – differences and similarities between patients detained under the mental health act and according to the legal guardianship legislation

BackgroundInvoluntary psychiatric hospitalisation occurs under different legal premises. According to German law, detention under the Mental Health Act (MHA) is possible in cases of imminent danger of self-harm or harm to others, while detention according to the legal guardianship legislation (LGL) serves to prevent self-harm if there is considerable but not necessarily imminent danger. This study aims to compare clinical, sociodemographic and environmental socioeconomic differences and similarities between patients hospitalised under either the MHA or LGL.MethodsWe conducted a retrospective health records analysis of all involuntarily hospitalised cases in the four psychiatric hospitals of the city of Cologne, Germany, in 2011. Of the 1,773 cases, 87.3% were detained under the MHA of the federal state of North Rhine-Westphalia and 6.4% were hospitalised according to the federal LGL. Another 6.3% of the cases were originally admitted under the MHA, but the legal basis of detention was converted to LGL during the inpatient psychiatric stay (MHA→LGL cases). We compared sociodemographic, clinical, systemic and environmental socioeconomic (ESED) variables of the three groups by means of descriptive statistics. We also trained and tested a machine learning-based algorithm to predict class membership of the involuntary modes of psychiatric inpatient care.ResultsCases with an admission under the premises of LGL lived less often on their own, and they were more often retired compared to MHA cases. They more often had received previous outpatient or inpatient treatment than MHA cases, they were more often diagnosed with a psychotic disorder and they lived in neighbourhoods that were on average more socially advantaged. MHA→LGL cases were on average older and more often retired than MHA cases. More often, they had a main diagnosis of an organic mental disorder compared to both MHA and LGL cases. Also, they less often received previous psychiatric inpatient treatment compared to LGL cases. The reason for detention (self-harm or harm to others) did not differ between the three groups. The proportion of LGL and MHA cases differed between the four hospitals. Effect sizes were mostly small and the balanced accuracy of the Random Forest was low.ConclusionWe found some plausible differences in patient characteristics depending on the legal foundation of the involuntary psychiatric hospitalisation. The differences relate to clinical, sociodemographic and socioeconomical issues. However, the low effect sizes and the limited accuracy of the machine learning models indicate that the investigated variables do not sufficiently explain the respective choice of the legal framework. In addition, we found some indication for possibly different interpretation and handling of the premises of the law in practice. Our findings pose the need for further research in this field.

Geographical, sex, and socioeconomic differences in non-communicable disease indicators: A cross-sectional survey in Eastern Uganda.

The prevalence of non-communicable diseases (NCDs) is increasing in many low- and middle-income countries (LMICs). This study examined differences in the burden of NCDs and their risk factors according to geographic, sex, and sociodemographic characteristics in a rural and peri-urban community in Eastern Uganda. We compared the prevalence by sex, location, wealth, and education. Unadjusted and adjusted prevalence ratios (PR) were reported. Indicators related to tobacco use, alcohol use, salt consumption, fruit/vegetable consumption, physical activity, body weight, and blood pressure were assessed. Among 3220 people (53.3% males, mean age: 35.3 years), the prevalence of NCD burden differed by sex. Men had significantly higher tobacco (e.g., current smoking: 7.6% vs. 0.7%, adjusted PR (APR): 12.8, 95% CI: 7.4-22.3), alcohol use (e.g., current drinker: 11.1% vs. 4.6%, APR: 13.4, 95% CI: 7.9-22.7), and eat processed food high in salt (13.4% vs. 7.1, APR: 1.8, 95% CI: 1.8, 95% CI: 1.4-2.4) than women; however, the prevalence of overweight (23.1% vs 30.7%, APR: 0.7, 95% CI: 0.6-0.9) and obesity (4.1% vs 14.7%, APR: 0.3, 95% CI: 0.2-0.3) was lower among men than women. Comparing locations, peri-urban residents had a higher prevalence of current alcohol drinking, heavy episodic drinking, always/often adding salt while cooking, always eating processed foods high in salt, poor physical activity, obesity, prehypertension, and hypertension than rural residents (p<0.5). When comparing respondents by wealth and education, we found people who have higher wealth or education had a higher prevalence of always/often adding salt while cooking, poor physical activity, and obesity. Although the findings were inconsistent, we observed significant sociodemographic and socioeconomic differences in the burden of many NCDs, including differences in the distributions of behavioral risk factors. Considering the high burden of many risk factors, we recommend appropriate prevention programs and policies to reduce these risk factors' burden and future negative consequences.

A case study of South Korean elementary school teachers’ emergency remote teaching

COVID-19 is an unprecedented pandemic that has impacted the whole world. The pandemic made researchers and educators realize the critical need to prepare for future disasters. This study explored a context-specific case for elementary online learning where we investigated how elementary school teachers transitioned to emergency remote teaching (ERT) from face-to-face to online learning during the pandemic. A case study approach was used to explore South Korean elementary teachers’ ERT approaches and experiences during COVID-19. Using the CIPP (Context, Input, Process, and Product) framework, we sought to understand how the transition occurred from the perspectives of the teachers. The analysis uncovered several themes that fall under each category of the framework. In terms of context, limited technological aptitude and lack of training in online instructional design as well as policy issues and socio-economic differences were identified as key factors in assessing the current state of the ERT. In terms of input, instructors’ efforts as well as support from in and out of school were discussed. Student interaction and engagement were identified as key factors in understanding the process of ERT. Lastly, learning outcomes, instructional strategies, and systemic transformation emerged as products of ERT.

“Justice Vs Efficiency” dilemma in the context of russia’s regional economic policy

Deriving the necessity of regional economic policy from the market failure concept, the author, using D. Friedman’s center-periphery theory, justifies the fact of excessive socio-economic differentiation among the regions of the Russian Federation, which has a hindering rather than accelerating effect on long-term economic growth. The clear division of Russian regions as parts of the “center-periphery-semi-periphery” classification based on the classification of spatial policy theorists by G. Cameron as non-interventionists, adapters, and radical transformers raises the question of the optimal degree of intervention by the Russian government in regulating territorial structure. The centerpiece of the article is the comparative analysis of two alternative approaches within the models of “territorial justice” and “economic efficiency” outlining the tools used in each of them. By uncovering the objective regularities of cyclical development that bring to the forefront one or another model of regional regulation and linking their use to the achieved level of economic development of the country, the author proves the inevitability of relying on a leveling model in Russia’s regional policy. However, to avoid the reproduction of social dependency of subsidized territories, there is an urgent need for close coordination of regional policy with structural policy, aiming both at achieving economic development rooted in innovations as opposed to, for instance, exploitation of natural resources.

I (don’t) need to know that I can make it. Socioeconomic differences in the link between students’ academic self-efficacy and their educational aspirations and decisions

I (don’t) need to know that I can make it. Socioeconomic differences in the link between students’ academic self-efficacy and their educational aspirations and decisions

Fertility Decline in Iceland, 2013-2022: Trends and Structures

Iceland is one of the Western countries that have experienced an unexpected fertility decrease in the 2010s. In this study, the aggregate Icelandic fertility decline is dissected to explore which fertility components are the main drivers behind the decline since 2010 in order to better understand whether the development is associated with compositional changes or linked to changes such as increased propensities of childlessness and decreased propensities to have another child. As such, it contributes empirical evidence to ongoing theorisation within current fertility debates. Official administrative register data are analysed by means of event-history analysis. Findings are presented as parity-specific birth risks and in the form of Kaplan-Meier estimates of synthetic period-based cohorts of women and men progressing to parity one over calendar years. In terms of results, we find that the fertility decline was concentrated around first births, and the decline can principally be attributed to women under the age of thirty. Propensities to remain childless have increased slightly since 2013, while there were no declines in the intensities to have a second and a third child. Hence, the development in Iceland appears to be driven by clear postponement of parenthood but not altered childbearing behaviour in terms of propensities to have a second and a third child. Results do not necessary contradict theories under the umbrella of the gender-relations framework, but they highlight the importance of exploring other factors impacting the transition to parenthood, such as perceived global and welfare uncertainties. Socioeconomic differentials in first-birth fertility and factors affecting postponement and ultimate childlessness should be explored further, as well as short-term developments in higher-order birth intensities during adverse circumstances, such as the 2008 economic crisis and the Covid-19 pandemic, during which periods the third-birth intensities increased.