Socioeconomic Markers Research Articles

Individual and cumulative effects of socioeconomic factors on hypertension in low- and middle-income countries: a cross-sectional study of 1,071,070 individuals from 26 nationally representative surve

Abstract Background/Introduction Addressing current gaps in hypertension care in low- and middle-income countries (LMICs) requires better understanding of socioeconomic disparities. Variation of the effects of socioeconomic status on hypertension across geographic regions and the shape of the relationship with individual markers of socioeconomic status remains unclear. Purpose This cross-sectional study aims to determine the effect of individual and cumulative effect of socioeconomic disadvantages (poor household wealth, low or no education, and rurality) on hypertension burden across geographic regions. Methods We pooled nationally representative individual level population-based data from Demographic and Health Surveys (DHS) in 26 LMICs. We included surveys conducted after 2002, with at least 50% response rate, and those with information on BP measurement and hypertension status. We included adults aged 15 years and above with hypertension (systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg) or those who reported using BP-lowering medication. We excluded individuals with missing information on age, sex, education, hypertension information, rurality, and socioeconomic status. We examined the relationship of hypertension prevalence by education, household wealth, and rurality using regression analyses. Binary categories of household wealth, education, and rurality were summed to create composite socioeconomic disadvantages score (range: 0–3) as a measure of multiple disadvantages. Results We included 1,071,070 participants in the analysis, and majority (81%) belonged to Southeast Asia region. Positive gradients were found by household wealth, educational attainment and rurality. The odds of developing hypertension increased by per quintile increase in household wealth in Southeast Asia (aOR for poorest vs richest, 1·51; 95% CI: 1·47-1·55, P-trend <0.001) contrarily to decreasing prevalence by increasing wealth in Central Asia (aOR 0·67; 95% CI: 0·57-0·79, P-trend <0.001) and Europe (aOR 0·69; 95% CI:0·63-0·76, P-trend <0.001) (P-interaction <0·001). Having multiple socioeconomic disadvantages was associated with lower odds of hypertension in Southeast Asia (aOR for none vs three disadvantages, 0·75; 95% CI, 0·74-0·77) and Africa (aOR 0·47; 95% CI: 0·45-0·50), and higher odds in Europe (aOR 1·41; 95% CI: 1·31-1·51), and Central America (aOR 1·37; 95% CI: 1·20-1·57) (P-interaction <0·001). Household wealth and socio-economic disadvantages can be attributed to 19·4% and 36·9% of hypertension burden respectively. Conclusion This is one of the few studies examining the effect of individual as well as cumulative effect of socioeconomic status markers in hypertension. The shape of the socioeconomic gradient in hypertension varies across regions depending on demographic and epidemiological profile. This calls for context-specific interventions focusing on the most-at-risk population, redressing socioeconomic disparities in hypertension burden.Association between Hypertension and SES

Pregnancy Outcomes in Patients With Hepatitis C Virus Infection.

To evaluate the risks of adverse maternal and neonatal outcomes associated with pregnancies complicated by hepatitis C virus (HCV) infection. This is a secondary analysis of a multicenter prospective cohort study of HCV infection in pregnancy. Participants were screened for HCV infection with serum antibody tests, and each participant with a positive HCV result (case group) was matched with up to two individuals with negative HCV results (control group) prospectively by gestational age (±2 weeks) at enrollment. Maternal outcomes included gestational diabetes, abruption, preeclampsia or gestational hypertension, cholestasis, and preterm delivery. Neonatal outcomes included hyperbilirubinemia, admission to neonatal intensive care (NICU); small-for-gestational-age (SGA) birth weight; and neonatal infection, defined as sepsis or pneumonia. Models were adjusted for maternal age, body mass index, injection drug use, and maternal medical comorbidities. The 249 individuals in the case group were prospectively matched to 486 individuals in the control group who met eligibility criteria. There were significant differences in demographic characteristics between the groups, including race, socioeconomic markers, education, insurance status, and drug and tobacco use. The frequencies of maternal outcomes of gestational diabetes, preeclampsia, and abruption were similar between the case and control groups. Preterm birth was similar between groups, but neonates born to individuals in the case group were more likely to be admitted to the NICU (45.1% vs 19.0%, adjusted odds ratio [aOR] 2.6, 95% CI, 1.8-3.8) and to have SGA birth weights below the 5th percentile (10.6% vs 3.1%, aOR 2.9, 95% CI, 1.4-6.0). There were no increased odds of hyperbilirubinemia or neonatal infection. Despite no increased odds of preterm birth or other adverse maternal outcomes in adjusted analyses, maternal HCV infection was associated with twofold increased odds of NICU admission and nearly threefold increased odds of SGA birth weight below the 5th percentile.

P-719 The fertility clinic landscape in England 2012-2017: a study of the impact of clinic size and environment on success rates

Abstract Study question How are fertility clinics in England distributed and has this changed over time? Does clinic size, geography and local deprivation level influence live birth rates? Summary answer A clinic’s size, urban/rural environment and local deprivation level shows no statistically significant impact on a clinic’s live birth rates. What is known already It has been established that children born through assisted reproduction are more likely to have parents from higher socioeconomic groups compared to those conceived through natural conception. However, studies examining the relationship between socioeconomic status and fertility treatment success rates have varied outcomes and occasionally conflicting results. There has so far been little research internationally as to whether geographical, environmental and socioeconomic markers influence fertility treatment outcomes on a national scale. Study design, size, duration Publicly available HFEA data from 2012 to 2017 for all registered clinics in England was accessed. The total number of IVF/ICSI cycles for all age groups and live birth rate per embryo transferred were recorded. 56 clinics (32,091 treatment cycles) were recorded in 2012, rising to 69 clinics (36,638 treatment cycles) in 2017. Clinic postcode was used to determine Rural-Urban Classification and postcode-level and local authority-level deprivation according to the Index of Multiple Deprivation (IMD). Participants/materials, setting, methods Statistical analysis was performed using R Statistical Software and Datawrapper was used to generate map infographics. Clinic size was categorised by the number of IVF/ICSI cycles conducted per year – small (0-499), medium (500-999) and large (>1000). Clinic environment was classified as urban or rural and IMD was used to categorise clinics into deprivation quintiles. Weighted live birth rates were analysed to determine any difference in clinic success based on its size and environment. Main results and the role of chance The majority of clinics conducted between 0-499 IVF/ICSI cycles per year. There was no statistically significant difference in the live birth rate per embryo transferred based on clinic size with an average success rate of 31.8% in small clinics, 33.9% in medium clinics and 32.2% in large clinics (p-value 0.885). A large proportion of clinics were located in London (28-29% of clinics and 34-40% treatment cycles) between 2012 and 2017 despite only ∼16% of the population of England living in London. There were significantly fewer clinics (p-value 0.047) and treatment cycles (p-value <0.001) conducted in rural, compared to urban locations. There was a small, but not statistically significant, increase in success rate in clinics located in the least, compared to most deprived quintile. The difference in average live births/embryo transferred between the most and least deprived quintile across all years studied was 3.8% (31.1% in most deprived vs 34.9% in least deprived, p-value 0.227). There was also no statistical difference between the live birth rates per embryo transferred across the local-authority deprivation quintiles, although there was a trend for slightly higher success rates in the least deprived quintile compared to most deprived quintile. (30.3% compared to 33.9% (p-value 0.211)). Limitations, reasons for caution Clinic postcode only was used, therefore deprivation may not be representative of the whole population it treats. All IVF/ICSI treatments for all age groups were included, but some clinics may treat an older population of patients. Many IVF laboratories have satellite clinics in surrounding areas, whose postcodes were not included. Wider implications of the findings It is reassuring that local environment and deprivation do not significantly impact on clinic success rates. More detailed analysis of individual patient data on a nationwide level is required to understand this further either through access to primary care records or collaboration between clinics. Trial registration number not applicable

Are social determinants of health associated with an increased length of hospitalization after revision total hip and knee arthroplasty? A comparison study of social deprivation indices.

Length of stay (LOS) has been extensively assessed as a marker for healthcare utilization, functional outcomes, and cost of care for patients undergoing arthroplasty. The notable patient-to-patient variation in LOS following revision hip and knee total joint arthroplasty (TJA) suggests a potential opportunity to reduce preventable discharge delays. Previous studies investigated the impact of social determinants of health (SDoH) on orthopaedic conditions and outcomes using deprivation indices with inconsistent findings. The aim of the study is to compare the association of three publicly available national indices of social deprivation with prolonged LOS in revision TJA patients. 1,047 consecutive patients who underwent a revision TJA were included in this retrospective study. Patient demographics, comorbidities, and behavioral characteristics were extracted. Area deprivation index (ADI), social deprivation index (SDI), and social vulnerability index (SVI) were recorded for each patient, following which univariate and multivariate logistic regression analyses were performed to determine the relationship between deprivation measures and prolonged LOS (greater than five days postoperatively). 193 patients had a prolonged LOS following surgery. Categorical ADI was significantly associated with prolonged LOS following surgery (OR = 2.14; 95% CI = 1.30-3.54; p = 0.003). No association with LOS was found using SDI and SVI. When accounting for other covariates, only ASA scores (ORrange=3.43-3.45; p < 0.001) and age (ORrange=1.00-1.03; prange=0.025-0.049) were independently associated with prolonged LOS. The varying relationship observed between the length of stay and socioeconomic markers in this study indicates that the selection of a deprivation index could significantly impact the outcomes when investigating the association between socioeconomic deprivation and clinical outcomes. These results suggest that ADI is a potential metric of social determinants of health that is applicable both clinically and in future policies related to hospital stays including bundled payment plan following revision TJA.

Integrating genetic and socioeconomic data to predict the progression of nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease globally, with an estimated prevalence exceeding 25%. Variants in the PNPLA3 and HSD17B13 genes have been a focus of investigations surrounding the etiology and progression of NAFLD and are believed to contribute to a greater burden of disease experienced by Hispanic Americans. However, little is known about socioeconomic factors influencing NAFLD progression or its increased prevalence among Hispanics. We cross-sectionally analyzed 264 patients to assess the role of genetic and socioeconomic variables in the development of advanced liver fibrosis in individuals at risk for NAFLD. Adjusting for age, sex, body mass index, and PNPLA3 genotype, lacking a college degree was associated with 3.3 times higher odds of advanced fibrosis (95% confidence interval [CI]: 1.21-8.76, p = 0.019), an effect comparable to that of possessing the major PNPLA3 risk variant. Notably, the effect of PNPLA3 genotype on advanced fibrosis was attenuated to nonsignificance following adjustment for education and other socioeconomic markers. The effect of the protective HSD17B13 variant, moreover, diminished after adjustment for education (odds ratio [OR]: 0.39 [95% CI: 0.13-1.16, p = 0.092]), while lower education continued to predict advanced fibrosis following multivariable adjustment with an OR of 8.0 (95% CI: 1.91-33.86, p = 0.005). Adjusting for education attenuated the effects of genotype and Hispanic ethnicity on liver fibrosis, suggesting that social factors-rather than genes or ethnicity-may be driving disease severity within some populations. Findings reveal the importance of including socioenvironmental controls when considering the role of genetics or ethnicity in complex disease.

Environmental Levels of Volatile Organic Compounds, Race, and Socioeconomic Markers Correlate with Areas of High Colorectal Cancer Incidence.

Ambient levels of volatile organic compounds (VOCs) released from nearby industrial plants have shown positive associations with increased colorectal cancer (CRC) rates. The objective of this study is to analyze the distribution of CRC in the context of socioeconomic status and its correlation with community environmental data. A retrospective study analyzed CRC patients from 2021 to 2023. The census tracts of the patients' residential addresses were obtained, and CRC rates were calculated for each census tract. Socioeconomic data was gathered on these communities. Environmental VOC measurements were obtained from the National Scale Air Toxics Assessment. All datapoints were compared to statewide levels. Three census tracts in the county had higher CRC cases comparatively. These areas exhibited higher incidence rates and localized clusters of CRC cases, higher distribution of Black or African Americans, lower household incomes, lower home values, and lower educational attainment. VOC measurements in these census tracts had higher levels compared to county and state averages: specifically, 10.68% higher than county and 48.07% higher than state benzene levels (0.52 µg/m3 clusters vs 0.47µg/m3 county vs 0.35 µg/m3 state), 10.84% and 129.15% higher toluene (1.65 µg/m3 vs 1.49 vs 0.72 µg/m3), and 15.64% and 141.87% higher butadiene (0.048 µg/m3 vs 0.041 µg/m3 vs 0.020 µg/m3). This study illustrates a positive correlation between higher ambient exposure to VOCs with increased CRC incidence. These findings underscore the potential interplay of environmental factors, socioeconomic determinants, and environmental injustice when considering strategies to address health disparities and CRC incidence.

Factors Influencing the Consumption of Tobacco amongst the Khasi Indigenous People in Northeast India.

Tobacco use in any form is a major public health concern. It accounts for nearly 1.35 million deaths every year. Many chronic illnesses occur due to the consumption of tobacco, either smoke or smokeless form. The study aims to explore how smoking and smokeless tobacco consumption are distributed across a range of demographic and socioeconomic markers among Khasi indigenous people in Northeast India. It is a case-control study conducted in adults over 31 years of age. The study was carried out between June 2020 and August 2021. An Independent t-test was performed to determine the significant difference in age between smoking/smokeless tobacco users and non-tobacco users. Univariate and Multivariate analyses were conducted to determine the significant predictors affecting the use of smoking/smokeless tobacco in the respondents. A total of 505 respondents were included in the present study. There was a high statistically significant difference in the income level of tobacco and non-tobacco users (P value- 0.002). In Univariate analysis, it was found that the odds of consuming both forms of tobacco were significantly lower in the respondents aged between 51-60 (OR = 0.61, P value = 0.0453). The participants who studied till graduation and above had lower odds of both using forms of tobacco as compared to respondents who were illiterate/primary educated only (OR = 0.85, P value = 0.046). In conclusion, smoking and smokeless tobacco consumption are still widely prevalent in this region and strongly associated with age, gender, level of education, and place of residence. There is a need for further detailed analysis to identify risk factors that are strongly associated with the use of smoke and smokeless tobacco so that the community will be conscious about the hazardous effects of tobacco use in any form.

Subjective social status and trajectories of frailty: findings from the English Longitudinal Study of Ageing

ObjectivesSubjective social status is a known antecedent for many health outcomes, but little research has examined the association between subjective status and frailty among older people. Using longitudinal data, the...

Revisão sistemática: concepções e estratégias de mensuração da pobreza subjetiva

Abstract Objective The study analyzes the theoretical and practical perspectives that have been developed concerning the concepts and measurement strategies of subjective poverty. Method Thus, a systematic review was conducted, considering a temporal scope of ten years (2011-2021), on peer-reviewed articles in English, Portuguese, and Spanish. Following the analysis, the corpus consisted of 17 articles. Results It was identified that the concept of subjective poverty is affected by sociodemographic and analytical characteristics. This has an impact on different approaches, which can be more or less inclusive. The less inclusive ones are defined by exclusively monetary perspectives, while others consider the macrostructural issues of the analyzed realities: the effects of other socioeconomic markers and the psychosocial implications of poverty. Conclusion Thus, subjective poverty points out that, in the background of the subjects’ discourse, there are psychosocial intersections that impact their ways of life.

Energy efficiency, financial inclusion, and socio-economic outcomes: Evidence across advanced, emerging, and developing countries

This study analyzes the effects of financial inclusion and energy efficiency on socio-economic performance across advanced, emerging, and developing economies. We view financial inclusion from the lens of access to and usage of financial services, while energy intensity represents energy efficiency. The panel quantile regression model is employed to capture the nonlinear impacts of financial inclusion and energy efficiency across the conditional distributions of the socio-economic indicators. We find that financial inclusion broadly improves the socio-economic markers, except employment in developing economies. Comparatively, the effect of access to financial services is stronger than the effect of the usage of financial services. On the other hand, the impact of energy efficiency is quite heterogeneous across the country groups and the socio-economic indicators, being sensitive to the level of economic development of the countries. Overall, energy efficiency has the strongest influence in advanced economies, but a moderate influence in the emerging and developing economies. Our results provide imperative policy reflections for the policymakers in the underlying countries, particularly on properly channeling financial resources and enhancing energy efficiency to benefit the various components of their economies.

Induced vulnerability: the consequences of racialization for African women in an emergency shelter in Catalonia (Spain)

ABSTRACT The growing presence of African women (especially Moroccans) in the support services for survivors of gender-based violence in Catalonia (Spain) highlights how the perception of difference in contexts of significant cultural diversity can fuel othering processes based on racialized assumptions, which may ultimately lead these women to experience situations of additional vulnerability. Through the results of an anthropological study based on African (mainly Moroccan) women, we show how their racialized “otherness” is a cultural construct resulting from a combination of five main variables: gender, ethnicity, nationality, phenotype and religion. One of the most critical consequences of activating this reductionist mechanism is the creation of additional vulnerability for other women in the same situation. We then analyze how these women mobilize cultural, ethnic, religious and socioeconomic markers, with results that ultimately impede the formation of sisterhood and mutual support relationships, thus increasing their sense of being neglected and their vulnerability.

Abstract 15337: Study of Relationship Between Neighborhood Racial Segregation and Heart Failure Mortality

Background Upstream factors, including socioeconomic status, healthcare access, structural environment, contribute to the presence of disparities in cardiovascular outcomes. The impact of neighborhood-level racial segregation on cardiovascular outcomes is not well understood. Research Question The goal of this study was to evaluate the association between neighborhood racial segregation and heart failure mortality. Methods/ Approach This is a retrospective, cohort study performed at Kaiser Permanente Southern California that included patients hospitalized for heart failure between January 2010 and December 2017. Data regarding demographics, comorbidities, and outcomes, was linked to the diversity index from the US Census Bureau. This is a measure of racial segregation, the likelihood that any two people from an area will be from different race/ ethnicity groups. The cohort was divided into tertiles by diversity index. Mortality rates for each racial group was calculated. Multivariate logistic regression models were constructed to evaluate the association between race/ethnicity and mortality. Results/ Data There were 19,322 patients included in our analysis. After adjusting for demographics, socioeconomic markers, neighborhood characteristics, and comorbidities, higher mortality was noted for Black patients compared to White patients in the least diverse tertile (adjusted OR [95% CI]: 1.42 [1.15-1.74]). In the most diverse tertile, no significant difference between Black and White patients was observed (adjusted OR [95% CI] 1.02 [0.83-1.26]). Asian and White patients did not show a difference in mortality across tertiles. Hispanic patients had a statistically significant decreased mortality in the two more diverse tertiles. Conclusion: Heart failure mortality is lower in Black patients in more diverse neighborhoods. Further work is needed to look at the pathway that connects racial segregation to heart failure outcomes.

Omega-3 Polyunsaturated Fatty Acid Levels in Maternal and Cord Plasma Are Associated with Maternal Socioeconomic Status.

Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) play a crucial role in fetal growth and neurodevelopment, while omega-6 (n-6) PUFAs have been associated with adverse pregnancy outcomes. Previous studies have demonstrated that socioeconomic status (SES) influences dietary intake of n-3 and n-6 PUFAs, but few studies have evaluated the association between maternal and cord plasma biomarkers of PUFAs and socioeconomic markers. An IRB-approved study enrolled mother-infant pairs (n = 55) at the time of delivery. Maternal and cord plasma PUFA concentrations were analyzed using gas chromatography. Markers of SES were obtained from validated surveys and maternal medical records. Mann-Whitney U tests and linear regression models were utilized for statistical analysis. Maternal eicosapentaenoic acid (EPA) (p = 0.02), cord EPA (p = 0.04), and total cord n-3 PUFA concentrations (p = 0.04) were significantly higher in college-educated mothers vs. mothers with less than a college education after adjustment for relevant confounders. Insurance type and household income were not significantly associated with n-3 or n-6 PUFA plasma concentrations after adjustment. Our findings suggest that mothers with lower educational status may be at risk of lower plasma concentrations of n-3 PUFAs at delivery, which could confer increased susceptibility to adverse pregnancy and birth outcomes.

Trends in the long-term impact of childhood visual impairment on health and social outcomes in the UK: a cross-cohort study across three decades of disability-related legislation and policy implementation.

Childhood vision impairment (VI) can adversely impact health and social outcomes and limit life chances. We investigated whether its adverse impacts into adult life changed during a period in which legislation, policy and services to address inequalities relating to disability were implemented. Cross-cohort study comprising 14247 participants from the 1946, 1958 and 1970 British birth cohorts (BC). Participants dichotomized as VI at age 15/16 (distance visual acuity was 6/12 or worse in the better-seeing eye) or normally sighted. Associations of childhood VI with health, well-being, socioeconomic and social participation outcomes in mid-adult life were investigated using regression models adjusted for participants' early life socioeconomic markers and sex. Change in adjusted odds ratios of >10% in the same direction in successive cohorts, or a > 20% difference between 1970BC and one older cohort were considered meaningful. Trends over time in impacts of childhood onset VI into mid-adult life were complex. This included worsening of odds of poorer physical health (odds ratio 1.47; 95% confidence interval 1.02-2.14), living in unsatisfactory (1.54; 1.03-2.29) or overcrowded (2.34; 1.26-4.06) households, being unemployed (2.19; 1.19-3.97) and not gaining additional educational qualifications during mid-adult life (1.61; 1.08-2.47). By contrast the odds of not participating in some social activities (e.g. seeing friends) improved over time. Associations with other outcomes were unchanged. Many adverse impacts of childhood VI do not appear ameliorated over time by legislation, policies and provision that would have been expected to reduce inequalities. Moreover, some were increased. Childhood VI continues to cast a life-long shadow.

Early-life socioeconomic circumstances and the comorbidity of depression and overweight in adolescence and young adulthood: A prospective study

Depression and overweight both often emerge early in life and have been found to be associated, but few studies examine depression-overweight comorbidity and its social patterning early in the life course. Drawing on data from 4,948 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort from the UK (2,798 female, 2,150 male), we investigated how different aspects of early-life socioeconomic circumstances are associated with depression-overweight comorbidity from adolescence to young adulthood exploring any differences by age and sex. We estimated how parental education, social class and financial difficulties reported in pregnancy were associated with depression and overweight, and their comorbidity at approximately the ages 17 and 24 in males and females. The results from multinomial logistic regression models showed that all three socioeconomic markers were associated with depression-overweight comorbidity and results were similar across age. Lower parental education (relative risk ratio (RRR) and 95% confidence interval (CI) of low education v high education: 3.61 (2.30-5.67) in females and 1.54 (1.14-2.07) in males) and social class (class IV/V v class I: 5.67 (2.48-12.94) in females and 3.11 (0.70-13.91) in males) had strong associations with comorbidity at age 17 relative to having neither depression or overweight. Financial difficulties were also a risk factor in females, with less clear results in males. These findings highlight how early socioeconomic circumstances are linked with the accumulation of mental and physical health problems already in adolescence, which has implications for life-long health inequalities.

Pulmonary embolism and deep venous thrombosis after COVID-19: long-term risk in a population-based cohort study

BackgroundVenous thromboembolism (VTE) (pulmonary embolism [PE] or deep venous thrombosis [DVT]) is common during acute COVID-19. Long-term excess risk has not yet been established. ObjectivesTo study long-term VTE risk after COVID-19. MethodsSwedish citizens aged 18 to 84 years hospitalized and/or testing positive for COVID-19 between January 1, 2020, and September 11, 2021 (exposed), stratified by initial hospitalization, were compared to matched (1:5), nonexposed, population-derived subjects without COVID-19. Outcomes were incident VTE, PE, or DVT recorded within 60, 60 to <180, and ≥180 days. Cox regression was used for evaluation, and a model adjusted for age, sex, comorbidities, and socioeconomic markers was developed to control for confounders. ResultsAmong exposed patients, 48,861 were hospitalized for COVID-19 (mean age, 60.6 years) and 894,121 were without hospitalization (mean age, 41.4 years). Among patients hospitalized for COVID-19, fully adjusted hazard ratios during 60 to <180 days were 6.05 (95% CI, 4.80-7.62) for PE and 3.97 (CI, 2.96-5.33) for DVT compared with that for nonexposed patients with corresponding estimates among those with COVID-19 without hospitalization 1.17 (CI, 1.01-1.35) and 0.99 (CI, 0.86-1.15), based on 475 and 2311 VTE events, respectively. Long-term (≥180 days) hazard ratios in patients hospitalized for COVID-19 were 2.01 (CI, 1.51-2.68) for PE and 1.46 (CI, 1.05-2.01) for DVT, while nonhospitalized patients had similar risk as nonexposed patients, based on 467 and 2030 VTE events, respectively. ConclusionPatients hospitalized for COVID-19 retained an elevated excess risk of VTE, mainly PE, after 180 days, while long-term risk of VTE in individuals with COVID-19 without hospitalization was similar to that in the nonexposed patients.

Association between breastfeeding duration and educational achievement in England: results from the Millennium Cohort Study

ObjectiveTo evaluate the association between breastfeeding duration and educational outcomes at the end of secondary education among children from the Millennium Cohort Study.DesignCohort study comparing school results at age 16...

Socioeconomic markers of Congenital Zika Syndrome in Brazil

Socioeconomic markers of Congenital Zika Syndrome in Brazil

The IMPACT Cross-Sectional Study

Background: The COVID-19 pandemic has exacerbated socioeconomic deficiencies within Canada's immigrant populations, yet the difference between immigrants from countries with similar language and resources (such as the US) and those from a different background (non-US countries) is not well understood. Accordingly, the IMPACT study at the centre of this article included a Canadian national survey that compared key domains of life in US immigrants with non-US immigrants to provide policymakers with a research-based path toward delivering culturally targeted and socially competent services.&#x0D; Methods: Potential participants were recruited from newcomer support services centers to complete the IMPACT survey which assess participants' self-perceived impacts of COVID-19 on various socioeconomic markers. For each socioeconomic variable, we analyzed the experiential differences between US vs non-US immigrant subgroups. &#x0D; Results: On average, non-US immigrants in Canada were less likely to disclose their COVID-19 health status; this trend was correlated with reported concerns over discontinuation of one’s income. Qualitative themes within the non-US immigrant subgroup elucidated a mentality of “making it on [one’s]own”, and consequently, a reluctance to seek out external resources. Surprisingly, the US immigrant subgroup was subject to a comparatively greater post-pandemic decrease in socioeconomic well-being, resulting in proportionally greater food and financial insecurities than non-US immigrants. &#x0D; Conclusion: The study highlighted two key findings: (1) US immigrants faced a proportionally increased instability of their socioeconomic well-being; whilst (2) non-US immigrants faced greater social and intrapersonal barriers to external supports and experienced a greater incidence of COVID-19 infections, likely resulting from this cohorts reluctance to miss employment income.

Genetic propensity, socioeconomic status, and trajectories of depression over a course of 14 years in older adults

Depression is one of the leading causes of disability worldwide and is a major contributor to the global burden of disease among older adults. The study aimed to investigate the interplay between socio-economic markers (education and financial resources) and polygenic predisposition influencing individual differences in depressive symptoms and their change over time in older adults, which is of central relevance for preventative strategies. The sample encompassing n = 6202 adults aged ≥50 years old with a follow-up period of 14 years was utilised from the English Longitudinal Study of Ageing. Polygenic scores for depressive symptoms were calculated using summary statistics for (1) single-trait depressive symptoms (PGS-DSsingle), and (2) multi-trait including depressive symptoms, subjective well-being, neuroticism, loneliness, and self-rated health (PGS-DSmulti-trait). The depressive symptoms over the past week were measured using the eight-item Centre for Epidemiologic Studies Depression Scale. One standard deviation increase in each PGS was associated with a higher baseline score in depressive symptoms. Each additional year of completed schooling was associated with lower baseline depression symptoms (β = −0.06, 95%CI = −0.07 to −0.05, p < 0.001); intermediate and lower wealth were associated with a higher baseline score in depressive symptoms. Although there was a weak interaction effect between PGS-DSs and socio-economic status in association with the baseline depressive symptoms, there were no significant relationships of PGS-DSs, socio-economic factors, and rate of change in the depressive symptoms during the 14-year follow-up period. Common genetic variants for depressive symptoms are associated with a greater number of depressive symptoms onset but not with their rate of change in the following 14 years. Lower socio-economic status is an important factor influencing individual levels of depressive symptoms, independently from polygenic predisposition to depressive symptoms.