Socioeconomic Diversity Research Articles

Invesigate How Cultural and Socioeconomic Factors Influence Oral Cancer Prevention Behaviors, Screening Uptake, and Treatment Outcomes

ABSTRACT Background: Oral cancer is a significant global health issue, with prevention and early detection being pivotal for improved outcomes. This study investigates the impact of cultural and socioeconomic factors on oral cancer prevention behaviors, screening participation, and treatment outcomes Materials and Methods: A cross-sectional study design was employed, involving a sample size of 1,000 participants. Participants were recruited through stratified sampling to ensure cultural and socioeconomic diversity. Statistical analyses, including logistic regression, were used to explore associations between factors and outcomes. Results: The study revealed multifaceted influences of cultural and socioeconomic factors on oral cancer-related aspects. Cultural factors significantly influenced prevention behaviors, with participants from certain cultural backgrounds exhibiting higher rates of tobacco use and lower rates of dietary adherence). Socioeconomic status played a role in screening uptake, with individuals from lower income brackets less likely to undergo regular screenings Conclusion: Cultural and socioeconomic factors have a substantial influence on oral cancer prevention behaviors, screening participation, and treatment outcomes.

Predictors of planned home birth before and during the COVID-19 pandemic.

To determine how demographic and clinical predictors of home birth have changed since the onset of the COVID-19 pandemic in the US. Using National Vital Statistics birth certificate data, a retrospective population-based cohort study was performed with planned home births and hospital births among women age≥18 years during calendar years 2019 (pre-pandemic) and 2021 (pandemic-era). Birth location (planned home birth vs. hospital birth) was analyzed using univariate and multivariable logistic regression, systematically examining the interaction of each demographic and clinical covariate with study year. After exclusions, a total of 6,087,768 birth records were retained for analysis, with the proportion of home births increasing from 0.82 % in 2019 to 1.24 % in 2021 (p<0.001). In the final multivariable logistic regression model of planned home birth, five demographic variables retained a statistically significant interaction with year: race and ethnicity, age, educational attainment, parity, and WIC participation. In each case, demographic differences between those having planned home births and hospital births became smaller (odds ratios closer to 1) in 2021 compared to 2019. Planned home births increased by more than 50 % during the pandemic, with greater socioeconomic diversity in the pandemic-era home birth cohort. The presence of clinical risk factors remained a strong predictor of hospital birth, with no evidence that pandemic-era home births had a higher clinical risk profile as compared to the pre-pandemic period.

Supplemental Material for Can Selecting the Most Qualified Candidate Be Unfair? Learning About Socioeconomic Advantages and Disadvantages Reduces the Perceived Fairness of Meritocracy and Increases Support for Socioeconomic Diversity Initiatives in Organizations

Supplemental Material for Can Selecting the Most Qualified Candidate Be Unfair? Learning About Socioeconomic Advantages and Disadvantages Reduces the Perceived Fairness of Meritocracy and Increases Support for Socioeconomic Diversity Initiatives in Organizations

A review of advanced wastewater treatment technologies: USA vs. Africa

This research paper conducts a comprehensive comparative analysis of advanced wastewater treatment technologies in the USA and Africa, emphasizing infrastructure, regulatory frameworks, and socio-economic factors. The USA exhibits robust infrastructure, supportive regulations, and technological awareness, fostering the adoption of advanced solutions. In contrast, Africa faces limited resources and diverse regulatory landscapes. Affordability, accessibility, public awareness, and education are critical socio-economic factors influencing technology adoption. Prospects include innovations like AI integration and circular economy principles. Policy recommendations stress adaptive frameworks and international collaborations. The conclusion underscores the importance of inclusive strategies for global sustainable wastewater management, recognizing each region's unique socio-economic diversity. This research contributes valuable insights for policymakers, researchers, and practitioners working towards resilient and equitable wastewater treatment systems.

Running Toward Equity: Socioeconomic Diversity and Parental Perception of a Physical Activity-Based Positive Youth Development Program for Girls

The Girls on the Run (GOTR) is a national positive youth development program to promote self-confidence, resilience, and self-esteem for girls through physical activity. It also includes an opportunity for parent involvement in a 5K event at the end of the program. Given the evidence on the importance of family support and parent role modeling for children’s physical activity, the purpose of this study was to explore how parents from different socioeconomic backgrounds view their daughters’ participation in GOTR and their own attitudes toward physical activity. Parents were recruited from high and low resource sites for participation in online focus group discussions. Questions included perspective on their daughter’s participation in GOTR, their own physical activity, and participation in the GOTR 5K event. Discussions were recorded, transcribed, and thematically analyzed from two focus groups with parents from low resource sites (N=10) and two with parents from high resource sites (N= 15). A common theme across resource groups was that GOTR enhances self-confidence, communication skills, and physical activity. More parents from the high resource sites reported being physically active and having supportive environments than low resource site parents. While some parents noted intention to participate in the 5K with their daughter, more parents in the low resource group reported barriers to physical activity and participating in the 5K event. There is an opportunity to encourage and facilitate parental 5K participation to create a ripple effect for benefits of the GOTR program.

Intellectual development in young children with autism spectrum disorders: A longitudinal study.

Intelligence profiles in autism have been characterized by great variability. The questions of how autistic children's intelligence changes over time, and what factors influence these changes deserve study as part of efforts to document child autism profiles, but also because the relationship between intellectual functioning and children's background characteristics is poorly understood, particularly in a longitudinal context. A total of 39 autistic children and 39 age-matched neurotypical children (5-9 years old) completed two IQ assessments at preschool age and up to 4 years later. Repeated-measures analyses assessed longitudinal changes in the children's verbal (VIQ), performance (PIQ), and full-scale IQ (FSIQ) at group level. We further sought to identify clusters with distinct profiles in each group by adopting an unsupervised K-means clustering approach, and detect possible between-subgroup differences in terms of children's socioeconomic status and autism severity. The largest cluster in the autistic group was composed of children whose PIQ significantly dropped at follow-up, while the second largest cluster improved in all quotients; the smallest cluster, wherein children had more highly educated mothers than the rest of the clusters, was characterized by large improvement in VIQ. For the neurotypical children, there was a two-cluster division; the majority of them improved in the three quotients, while very few dropped in PIQ at follow-up. The relation between socioeconomic status and IQ changes was significant for both groups. The findings demonstrate both the complexity of intelligence changes in autism and the need to view this complexity through the lens of the children's socioeconomic diversity.

"Join the team" clinical research workforce development model: A new paradigm in healthcare career opportunities.

The University of California (UC) Davis Clinical and Translational Science Center has established the "Join the Team" model, a Clinical Research Coordinator workforce pipeline utilizing a community-based approach. The model has been extensively tested at UC Davis and demonstrated to generate a viable pathway for qualified candidates for employment in clinical research. The model combines the following elements: community outreach; professional training materials created by the Association for Clinical Research Professionals and adapted to the local environment; financial support to trainees to encourage ethnic and socioeconomic diversity; and internship/shadowing opportunities. The program is tailored for academic medical centers (AMCs) in recognition of administrative barriers specific to AMCs. UC Davis's model can be replicated at other locations using information in this article, such as key program features and barriers faced and surmounted. We also discuss innovative theories for future program iterations.

Affirmative Action and Equality of Opportunity in College Admissions

This essay critically examines the efficacy of race-based affirmative action in U.S. college admissions, arguing that it fails to adequately address the root causes of racial inequality and often does not benefit the most marginalized individuals within minority groups. By exploring affirmative action through the lens of political philosophy, particularly John Rawls' conception of social justice, the essay contends that a focus on socioeconomic status rather than race would more effectively promote equality of opportunity and align with Rawlsian principles. The analysis draws on various studies and theoretical perspectives to highlight the limitations of race-based affirmative action, including its tendency to benefit economically advantaged members of minority groups and its inadequacy in addressing the diverse and complex backgrounds of individuals within these groups. The essay proposes socioeconomic affirmative action as a more equitable alternative, supported by empirical evidence suggesting that such an approach could increase both socioeconomic and racial diversity in higher education institutions. The conclusion underscores the need for systemic reforms beyond admissions policies to truly achieve a just and equitable society.

Understanding COVID-19 vaccination decisions during pregnancy and while breastfeeding in a Canadian province

ABSTRACTBackgroundVaccination in pregnancy is important for preventing illness for mothers and babies; however, vaccine uptake in pregnant individuals is lower than non-pregnant females of fertile age. Given the devastating effects of COVID-19 and the increased morbidity and mortality risk for pregnant individuals, it is important to understand the determinants of vaccine hesitancy in pregnancy. The focus of our study was to explore COVID-19 vaccination among pregnant and breastfeeding individuals and its association with their reasons (psychological factors) for vaccination using the 5C scale and other factors.MethodsAn online survey investigating prior vaccinations, level of trust in healthcare providers, demographic information, and the 5C scale was used for, pregnant and breastfeeding individuals in a Canadian province.ResultsPrior vaccinations, higher levels of trust in medical professionals, education, confidence, and collective responsibility predicted increased vaccine uptake pregnant and breastfeeding individuals.ConclusionsThere are specific psychological and socio-demographic determinants that affect COVID-19 vaccine uptake in pregnant populations. Implications of these findings include targeting these determinants when informing and developing intervention and educational programs for both pregnant and breastfeeding individuals, as well as healthcare professionals who are making vaccine recommendations to patients. Study limitations include a small sample and lack of ethnic and socioeconomic diversity.

A STAKEHOLDER-PARTNERED APPROACH TO INEQUITIES AFFECTING HOME HEALTH CARE WORKERS, OLDER ADULTS, AND CAREGIVERS

Abstract Home health aides (HHAs) provide on-site support for homebound older adults with cognitive impairments, while lessening strain on familial caregivers. However, HHAs face structural challenges in work-related transportation. Massachusetts General Hospital (MGH) researchers partnered with community and corporate stakeholders to inform a study evaluating whether on-demand transportation for HHAs via Uber rides will: 1) Improve metrics among HHAs (total visits, total unique patients, hours/week and days/week worked, missed visit/no-show rates, work satisfaction); 2) Increase racial, ethnic, socioeconomic and geographic diversity of older adults with cognitive impairments receiving homecare. Community partner CCHERS (Center for Community Health Education Research Services) helps residents of public/publicly-assisted housing in high-need areas of Greater Boston gain training and entry-level employment in healthcare as HHAs. Through its collaborations with other groups (e.g., Mothers for Justice &amp; Equality, HomeCare Aide Council, Mass HomeCare Alliance), CCHERS identified that lack of affordable, accessible, reliable transportation was among the most-cited barriers affecting HHAs and equitable homecare delivery. Corporate partner Uber Health, through work in preliminary social-impact case studies, identified the platform’s central ride-coordination approach as preferred by Black and Hispanic women in the 18-45y age group (~80% of the local HHA workforce). MGH researchers’ study goals and metrics were informed by input of partners. With its community-engaged approach, innovative partnerships, and focus on achieving equity objectives to benefit patients and homecare workers alike, this project has potential for strong local impacts and future implications for state and/or national policies to provide high-quality, equitable homecare by directly addressing employment transportation-related barriers.

Prevalence and burden of vitiligo in Africa, the Middle East and Latin America.

Vitiligo is a common chronic autoimmune disorder characterized by skin and hair depigmentation that affects 0.5%-2.0% of the global population. Vitiligo is associated with diminished quality of life (QoL) and psychosocial burden. The burden of vitiligo may vary based on skin tone and cultural differences as well as geographical variations in disease awareness, societal stigma, healthcare systems and treatment options. Data on the burden and management of vitiligo in Africa, the Middle East and Latin America are scarce. Literature searches using terms covering vitiligo in Africa, the Middle East and Latin America were conducted using PubMed to identify relevant publications that focused on disease prevalence and burden, QoL and psychosocial impact and disease management between 2011 and 2021. Most of the reviewed studies were conducted in the Middle East, and most Latin American studies were from Brazil. Most studies involved small patient numbers and may not be generalizable. Reported prevalence of vitiligo ranged from 0.18% to 5.3% in Africa and the Middle East, and from 0.04% to 0.57% in Latin America. In several studies, prevalence was higher among female participants. Generally, non-segmental vitiligo was the dominant clinical variant identified and the age at onset varied widely across studies. Common comorbidities include autoimmune diseases such as Hashimoto's thyroiditis, alopecia areata and diabetes. Few treatment guidelines exist in these regions, with the exceptions of guidelines published by the Brazilian and Argentinian Societies of Dermatology. There is a clear unmet need for large epidemiological studies with uniform methodology to accurately ascertain the true prevalence of vitiligo in Africa, the Middle East and Latin America. Additional data on vitiligo burden and management in Africa and Latin America are also needed, along with local disease management guidelines that consider genetic variation, psychosocial burden and socioeconomic diversity in all 3 regions.

Flood Risk Assessment Focusing on Exposed Social Characteristics in Central Java, Indonesia

This study analyzes Indonesia, a country marked by significant socioeconomic diversity, to inform the development of holistic flood risk management strategies. We examine the relationship between flood-exposed populations and socioeconomic factors at the regency level, particularly in Central Java, using open data encompassing flood-prone areas, topography, population distribution, and socioeconomic indicators. Key findings include population exposure to flooding varies significantly across the 33 regencies and 7 cities, ranging from 1% to 61% in exposure rate. A notable 5.8-fold difference in average income exists among regencies, with income strongly correlating with higher education rates. Similarly, poverty rates correlate with low educational attainment; there was a very large range in the balance between the size of the exposed economy and the number of exposed poor population in each administrative division. Consequently, we propose a classification system that considers social vulnerability due to poverty, low-education, and economic impacts. The map reflecting these classifications is a risk map that facilitates the understanding of the risk characteristics and the relative risk magnitude of each administrative district. Our analysis underscores the importance of adapting flood risk management strategies to local socioeconomic characteristics and suggests the importance of the use of local wisdom.

Analyzing Socio-economic Diversity in the Population of Urban Redevelopment Areas

Analyzing Socio-economic Diversity in the Population of Urban Redevelopment Areas

Human mobility networks reveal increased segregation in large cities

A long-standing expectation is that large, dense and cosmopolitan areas support socioeconomic mixing and exposure among diverse individuals1–6. Assessing this hypothesis has been difficult because previous measures of socioeconomic mixing have relied on static residential housing data rather than real-life exposures among people at work, in places of leisure and in home neighbourhoods7,8. Here we develop a measure of exposure segregation that captures the socioeconomic diversity of these everyday encounters. Using mobile phone mobility data to represent 1.6 billion real-world exposures among 9.6 million people in the United States, we measure exposure segregation across 382 metropolitan statistical areas (MSAs) and 2,829 counties. We find that exposure segregation is 67% higher in the ten largest MSAs than in small MSAs with fewer than 100,000 residents. This means that, contrary to expectations, residents of large cosmopolitan areas have less exposure to a socioeconomically diverse range of individuals. Second, we find that the increased socioeconomic segregation in large cities arises because they offer a greater choice of differentiated spaces targeted to specific socioeconomic groups. Third, we find that this segregation-increasing effect is countered when a city’s hubs (such as shopping centres) are positioned to bridge diverse neighbourhoods and therefore attract people of all socioeconomic statuses. Our findings challenge a long-standing conjecture in human geography and highlight how urban design can both prevent and facilitate encounters among diverse individuals.

Comparison of Projected Hemophilia a Populations Residing in Hospital Referral Regions with and without Hemophilia Treatment Centers in the US

Introduction: Among the approximately 53,000 people with hemophilia A (PwHA) in the US, a majority receive care at federally supported hemophilia treatment centers (HTCs). PwHA treated at HTCs have more favorable outcomes and are more likely to receive advanced therapies than PwHA receiving care external to the HTC network. Identifying geographic, socioeconomic and racial disparities among populations residing in hospital referral regions (HRRs) with and without HTCs will support efforts to improve care access and advance health equity. The objective of this study was to evaluate geographic, socioeconomic and racial differences in modeled US populations of PwHA who reside within HRRs with and without HTCs. Methods: Characteristics of HRRs with and without HTCs were compared using the Centers for Disease Control and Prevention (CDC) HTC listings. The study cohorts included individuals who resided in HRRs with and without an HTC based on modeled US populations of projected PwHA (pPwHA). The number of males with hemophilia A in each HRR was calculated at a rate of 12 cases per 100,000 males in the region of interest based on CDC estimates, and the number of females who were carriers of hemophilia A was calculated at a rate of 0.6 female carriers per male case as defined by the International Society of Thrombosis and Haemostasis Scientific and Standardization Committee. Demographic characteristics for each HRR were derived from the 2020 5-year American Community Survey; zip code tabulation areas were crosswalked to 5-digit zip codes and aggregated to HRRs.Differences in population characteristics in HRRs with and without HTCs were evaluated for statistical significance using the Wilcoxon rank sum test. Results: In 307 HRRs in the US, 109 had an associated HTC, while 198 did not (Figure). However, larger mean (SD) populations comprised HRRs with HTCs than those without (3,183,191 [2,752,401] vs 906,047 [814,847]; P&amp;lt;0.001; Table). Findings from this modeling work indicate that 78% of pPwHA reside in HRRs with an HTC. HRRs with HTCs served populations with greater proportions of Asian (5.3% vs 3.0%) and Black (14% vs 11%) individuals than those without HTCs ( P&amp;lt;0.001 for both). Compared with those in HRRs without HTCs, individuals residing in HRRs with HTCs had a wider range of median incomes ($27,978-$184,456 vs $35,087-$138,168; P&amp;lt;0.001) and a greater likelihood of falling above the 150% federal poverty line (77.9% vs 76.3%; P=0.014). Additionally, those residing in HRRs with HTCs were less likely to drive to work (75.0% vs 79.0%) and more likely to take public transit (4.4% vs 1.7%) or walk (3.0% vs 2.1%) than people in HRRs without HTCs ( P&amp;lt;0.001 for all). Conclusions: This analysis estimated that in the US, 4 of 5 pPwHA reside in an HRR with HTC access. HRRs with HTCs served larger populations with greater racial and socioeconomic diversity than HRRs without HTCs. While it is possible that PwHA who reside in HRRs without HTCs can still receive adequate care via outreach clinics, mobile units or virtual appointments, this work highlights that geographic barriers to HTC access remain incompletely addressed. Future efforts should focus on accurately identifying US hemophilia A populations and their locations relative to HTCs and comparing the impact on care and outcomes in those who rely on outreach efforts or mobile programs.

Auditing, Revealing and Promoting Industry in the London Borough of Southwark

Renewed enthusiasm surrounds the potential for urban industry and its contribution to the socioeconomic diversity of cities, despite concerns about the loss of industrial uses, land, and buildings in high-value, post-industrial cities. Yet, industry is often hidden and undervalued, and methodologies to change the culture around nurturing industry in cities have not been well explored. As a first step in moving this agenda forward, this article proposes effective ways to reveal industrial uses and to advocate for policy protections of the land they occupy. It examines how London Metropolitan University’s School of Art, Architecture and Design (AAD) Cities action researchers applied their &lt;em&gt;Audit, Reveal and Promote &lt;/em&gt;methodology to Southwark, a London borough with a high concentration of urban industry. There are key aspects to revealing industrial economies: collecting accurate data on the ground, showcasing local businesses, building stakeholder networks through mutual trust, and creating a space of possibilities between vertical hierarchical and grassroots power networks to enable stakeholders to participate in urban change. This article presents a methodology for cultural change towards valuing a mix of uses, including industry, to transform land development towards retention and densification of industry.

The Economics Profession’s Socioeconomic Diversity Problem

It is well-documented that women and racial and ethnic minorities are underrepresented in the economics profession, relative to both the general population and other academic disciplines. Less is known about the socioeconomic diversity of the economics profession. In this paper, we use data on parental education from the Survey of Earned Doctorates to examine the socioeconomic background of US economics PhD recipients, as compared to other disciplines. We find that economics PhD recipients are substantially more likely to have highly educated parents, and less likely to have parents without a college degree, than PhD recipients in other non-economics disciplines. This is true for both US-born PhD recipients and non-US-born PhD recipients, but is particularly stark for the US-born. The gap in socioeconomic diversity between economics and other PhD disciplines has increased over the last five decades, and particularly over the last two decades.

Gifted education advances school integration and equity

Gifted and talented services have a long and tainted history. Since their inception, they have not served a student population that mirrored the racial, ethnic, or socioeconomic diversity of the nation as a whole. But this need not be the case. Contemporary approaches to gifted education can advance the goals of equity and school integration. In short, they can be a means through which schools serve a more diverse student population. This is possible by mandating access to gifted services in all schools, making sure all students are universally screened for eligibility, and using within-building comparisons to determine eligibility. Scott J. Peters, Matthew C. Makel, and James S. Carter III outline this perspective and explain why it would be effective at mitigating school segregation and popular among a broad range of constituencies.

Translating Authentic Selves into Authentic Applications: Private College Consulting and Selective College Admissions

Stratification in selective college admissions persists even as colleges’ criteria for evaluating merit have multiplied in efforts to increase socioeconomic and racial diversity. Middle-class and affluent families increasingly turn to privatized services, such as private college consulting, to navigate what they perceive to be a complicated and opaque application process. How independent educational consultants (IECs) advise students can thus serve as a lens for understanding how the rules of college admissions are interpreted and taught to students. Through 50 in-depth interviews with IECs, I find that IECs encourage students to be authentic by being true to themselves but that demonstrating authenticity requires attention to how one’s authentic self will be perceived. Translating an authentic self into an authentic application also involves class-based and racialized considerations, particularly for Asian American students who are susceptible to being stereotyped as inauthentic. These findings suggest that efforts to improve diversity must be carefully implemented, or they risk reproducing inequality.

The role of procedural utility in land market dynamics in Greater Cairo: An agent based model application

In land use analyses, procedural utility is the sense of well-being achieved by an actor while participating in a land market. Such utility has not been explored as an indicator of market preferences beyond applying exploratory Agent Based Models (ABMs) and hypothetical scenarios. This paper presents an empirical approach to procedural utility and applies it in the context of Greater Cairo (GC) – a context with different formal/informal markets that lead to different market preferences for buyers. We integrate the observed market preferences in GC in an ABM incorporating procedural utility. We explore the contribution of such utility on formal/informal urban segregation and urban expansion in GC. Our findings indicate that market preferences contribute to (1) the formulation of urban enclaves and lower socio-economic diversity and (2) making the urban system in GC more attractive, leading to higher urban growth. These findings validate the relevance of procedural utility in contexts where market regulations are distinct enough to trigger buyer market preferences – specifically formal/informal contexts of the Global South.