Differences In Socioeconomic Status Research Articles

The educational resources and needs of mothers of preschool children from two socioeconomic levels

AbstractObjectiveThis study aimed to investigate the educational resources and needs of mothers of children aged 60 to 72 months and the differences between those of high and low socioeconomic status (SES).BackgroundParents have a crucial impact on their children's development in the preschool years. Mothers are especially challenged by the variety of information sources available and struggle with parenting decisions.MethodThirty‐three structured interviews with mothers were carried out in one private and one public school, representing high and low SES, respectively.FindingsBetween the two SES groups, both similarities and differences were observed in terms of their educational resources and needs. The following themes emerged in the study: general sources of parenting information, challenges, the first source to consult when problems occur, topics preferred in a parent education program, and the phase of maternity in which they preferred to receive training. The two SES groups were similar in terms of their main challenges, the topics preferred in a parent education program, and the phase of maternity in which they preferred to receive education. Differences were observed in terms of the sources of parenting information, the first source to consult when problems occur, and some of the preferred topics of a parent education program.ImplicationsThese findings may be useful in revisiting existing parent education programs, or in creating new ones, for the caregivers of preschool children.

Effects of Elective Revision After Breast Reconstruction On Patient-Reported Outcomes.

There has been increasing emphasis on patient-reported satisfaction as a measure of surgical outcomes. While previous research has investigated factors influencing patient satisfaction following breast reconstruction, there are few studies on how patient satisfaction is impacted by revision procedures. The purpose of this study was to investigate whether elective revisions following breast reconstruction are significantly associated with changes in patient-reported outcomes and quality of life. A retrospective review was conducted of patients who underwent immediate autologous or alloplastic breast reconstruction at a single institution from 2015-2021. Patients were included if they had completed BREAST-Q pre-operatively, post-initial reconstruction, and post-revision procedures. Patients were excluded if they received adjuvant radiation or if they had previously undergone breast reconstruction procedures. The primary outcome measures were BREAST-Q domains. Demographic, clinical, and surgical variables were also analyzed. Of the 123 patients included for analysis, 61 underwent autologous breast reconstruction and 62 underwent alloplastic reconstruction. Mean age was 49.31 ± 11.58 years and BMI was 29.55 ± 5.63 kg/m2. 48 patients underwent no revision procedures and 75 patients underwent at least one revision. Between these two groups, there were no differences in age, BMI, complication rates, socioeconomic status, or pre-operative BREAST-Q scores. Patients reported significantly higher satisfaction with outcome after their first revision compared to after initial reconstruction alone (p=0.04). Autologous reconstruction patients who had at least one revision had significantly higher Satisfaction with Outcome (p=0.02) and Satisfaction with Surgeon (p=0.05) in the 2-year follow-up period compared to patients who had no revisions. Revision procedures following autologous breast reconstruction are associated with higher patient satisfaction with outcome. Further research should explore specific factors influencing patient decision-making regarding whether to undergo revisions.

Patterns and socioeconomic differences in secondhand exposure to cigarettes, e-cigarettes, and heated tobacco products at home in Hong Kong adolescents.

Smoke or aerosols from cigarettes, e-cigarettes (ECs), or heated tobacco products (HTPs) are harmful. Yet, there is little knowledge about the specific patterns of secondhand tobacco exposure by source within household settings and the socioeconomic status (SES) differences in adolescents. We used territory-representative student data from a cross-sectional school-based survey in 2020-2021 to calculate the weighted prevalence of secondhand exposure to cigarettes, e-cigarettes, and HTPs in the past seven days. Parental education and perceived family affluence were used as indicators of socioeconomic status. Generalized linear mixed models were used to analyze associations. Among 22039 participants, 29.8% reported any secondhand tobacco exposure (SH-Any) at home, primarily from cigarettes (27.4%), followed by e-cigarettes (4.0%) and HTPs (0.9%). Tertiary parental education level was associated with lower SH-Any exposure (Adjusted odds ratio, AOR=0.49; 95% CI: 0.45-0.53, p<0.001), fewer exposure days (β= -0.685, p<0.001), lower exposure to cigarettes (SH-CC) (AOR=0.49; 95% CI: 0.45-0.54, p<0.001) and to e-cigarettes or HTPs (SH-EC/HTP) (AOR=0.57; 95% CI: 0.45-0.71, p<0.001). 'Poor' family affluence was associated with higher exposures [AOR(SH-Any) =1.14; 95% CI: 1.06-1.22, p=0.001; β(days)=0.160, p<0.001; AOR(SH-CC) =1.15; 95% CI: 1.07-1.24, p<0.001], except for SH-EC/HTP exposure, which was higher in students in an affluent family (AOR =1.66; 95% CI: 1.25-2.21, p<0.001). Significant SES differences in SH-EC/HTP exposure were found only in groups with low parental education level. Dose-response relationships were found between lower SH-Any and SH-CC and higher SES categories (p for trend<0.001). Adolescents experienced a high prevalence of tobacco smoke exposure at home, primarily from cigarettes. Higher SES was associated with lower tobacco exposure, except for SH-EC/HTP, which was higher among adolescents from affluent families. Additionally, high parental education level was protective against exposure to SH-EC/HTP. Comprehensive control measures to reduce the use of these tobacco products are needed to protect adolescents of diverse socioeconomic backgrounds.

Fitness Levels of Elementary School Students Based on Gender and Race in Indonesia: Are There Differences?

This research aimed to determine differences in physical fitness levels based on Race and Gender in Indonesia. It used a comparative quantitative approach. The samples in this research were elementary school students in three provinces: Sumsel, DIY, and NTT. They were selected using cluster random sampling and yielded 254 people. Then, the samples were clustered to equalize numbers based on students’ gender and regional race (South Sumatra, DIY, &amp; NTT). After this process, the remaining 132 people were taken. Students’ physical fitness data were collected using the Indonesian Physical Fitness Test (TKJI). The data were then analyzed using the parametric Two-Way ANOVA statistics. The results of the Two-Way ANOVA test showed that the race factor variable had a value of Sig. 0.00 &lt; 0.05. This value indicates a significant difference in the TKJI test scores between races in the three provinces: South Sumatra, DIY, and NTT. In the gender factor variable, the Sig. 0.001 &lt; 0.05, meaning a significant difference was also found in the TKJI test scores between male and female students. Furthermore, for the combined race and gender factor variables, the Sig 0.485 &gt; 0.05. Since the Sig value was greater, there is no influence or interaction between the race and gender factors in the three provinces in determining the results of the students' TKJI scores. Differences in physical fitness in terms of race can be caused by differences in physical activity, socioeconomic status, and social factors, such as racial discrimination and interpersonal racial discrimination. These differences can manifest as emotional stress due to increased psychological stress and increased risk of unhealthy behavior, including activities. In addition, the difference in physical fitness was also found between genders. The results show that men have a better level of physical fitness than women. One of the reasons is possibly due to increased fat mass associated with growth and puberty in girls. In addition, boys are often more active than girls. Keywords: Physical fitness, Student, Race, Gender

Abstract PO1-02-14: Breast cancer in older women - long-term prognosis by age and subtype in a large population-based cohort

Abstract Background Compared to middle-aged women, older women have a higher risk of breast cancer death. Whether the increased risk of breast cancer death is present in all subgroups of older adults with breast cancer, or negligible in the subgroups receiving adequate surgical and oncological treatment, has been debated. We studied long-term prognosis by age and subtype, adjusting for stage, treatment, socioeconomic status and comorbidity, clarifying which subgroups of older patients that are at increased risk of breast cancer death. Methods In a nation-wide cohort of 45,949 women aged ≥60 years at diagnosis of breast cancer 1997-2014, we estimated crude probabilities of breast cancer death and from other causes using competing risk methods. Cox proportional hazards models were used to estimate adjusted hazard ratios (HR) with 95% confidence intervals (CI. Results In this large population-based cohort study of older women with breast cancer, we found an increasing risk of breast cancer death with increasing age at diagnosis, both at 5- and 10-year follow up. The strong association between age and breast cancer death was found for all breast cancer subtypes, being most prominent in Her2-positive breast cancer. The age effect was also significant in Luminal A breast cancer where treatment opportunities are not necessarily affected by age. High-risk tumors were equally common in all age groups above 60 years. In multivariable analysis, stage, subtype, grade and treatment were important explanatory variables to the age-related differences in survival, while comorbidity and socioeconomic status contributed minorly. After adjustments, older age remained an independent risk factor for both overall and breast cancer survival. Older women with triple-negative (60-79 years) or Her2-positive (60-84 years) tumors had a 5-year risk of breast cancer death exceeding the risk of death by other causes. Conclusions Older women had a significantly higher risk of breast cancer death irrespective of breast cancer subtype, also in Luminal A disease where treatment opportunities are not necessarily affected by age. Table 3. Crude probabilities of breast cancer specific death and death by other cause (competing cause of death) at 5, 10 and 15 years. Table 4. Multivariable analysis of prognostic factors affecting 15-year overall (OS) and breast cancer- specific survival (BCSS) Table 5. Multivariable analysis of prognostic factors affecting 15-year overall (OS) and breast cancer- specific survival (BCSS) by age at diagnosis and subtype. Citation Format: Amelia Chiorescu, Anna L V Johansson, Antonis Valachis, Alexios Matikas, Jan Frisell, Lars Holmberg, Irma Fredriksson. Breast cancer in older women - long-term prognosis by age and subtype in a large population-based cohort [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-02-14.

Abstract PO1-09-08: Mammography adherence modifies the relationship between multilevel social deprivation and tumor characteristics in the Carolina Breast Cancer Study

Abstract Objective: To describe associations of individual and community socioeconomic status (SES) with breast cancer tumor and treatment characteristics, and to assess potential modification by mammography receipt. Methods: The Carolina Breast Cancer Study is a population-based cohort of women diagnosed with breast cancer between 2008 and 2013. We restricted this analysis to participants with stage 1-3 cancer (n=2,841). Socio-demographic information was obtained during in-home study interviews, and tumor characteristics were obtained from medical records and pathology reports. Community characteristics were obtained from American Community Survey census-tract level data. SES subgroups were identified using latent class analysis, a method for identifying group membership based on multiple shared characteristics. This was done separately using individual data (e.g. household income) and census-tract level data (e.g. poverty rate). We reported prevalence differences (PDs) and 95% CIs for each outcome. Finally, analyses were repeated with stratification by race (Black/non-Black) and receipt of at least one mammogram every 2 years (yes/no), based on self-reported mammography history. Results: Based on the latent class models, participants were sorted into 4 groups based on their individual/community SES: “high/high”, “high/low”, “low/high”, and “low/low”. Black women made up 81% of the low/low group compared to 26% of the high/high. All high individual-SES participants were combined as one referent group because they had similar clinical characteristics regardless of community status. We found that participants with low/low SES had more aggressive tumor characteristics at diagnosis compared to the referent group, such as stage 3 cancer (PD = 5.7%, 2.4-9.0), grade 3 tumor (PD = 9.9%, 5.3-14.4), and triple negative breast cancer (PD = 5.8%, 2.4-9.1). Low/low participants were also more likely to have an interval of at least 30 days between diagnosis and treatment (PD = 4.6%, 0.2-9.0). However, none of these associations were significant for low/high women. When reported separately by race, Black women with low/low SES had greater frequency of stage 3 cancer (PD = 6.3, 1.9-10.8) and prolonged treatment length (PD = 7.5%, 1.1-13.8) compared to high-SES Black women. Race-stratified SES differences were non-significant for genomic subtype and other tumor characteristics like grade and tumor size. After stratifying by screening status, we found that associations of SES with stage and tumor size were only present among those with &amp;lt; 1 mammogram every 2 years. The low/low PDs were (7.9%, 1.5-14.3) for stage 3 and (7.8%, 2.2-13.3) for tumor size &amp;gt;5 cm. Low/low women also had greater frequency of lump detected cancer (PD = 12.6%, 4.0-21.2). In contrast, these associations were not present among women with biannual mammography. Finally, screening status did not modify PDs for genomic subtype (ER+/HER2-, ER-/HER2+, TNBC). Conclusions: Lower community-level SES is associated with less favorable tumor characteristics at diagnosis, mainly among those with low individual SES. Access to mammography may explain part of the disparity in stage and tumor size, suggesting public health benefit for targeted screening initiatives in disadvantaged communities. Still, screening and SES are only 2 mechanisms that contribute to racial disparities; our future work will explore additional intervention points. Demographic and clinical characteristics of CBCS participants by individual and community socioeconomic status (n=2,841) SES groups were derived from latent class models. P-values were assessed by chi-square tests. Participants with race classified as “other” includes all those not identifying as Black or White, including American Indian/Alaska Native, Asian, or another race not listed on the questionnaire. Urbanicity is defined at the census tract-level Citation Format: Matthew Dunn, Marc Emerson, Louise Henderson, Katherine Reeder-Hayes, Terry Hyslop, Melissa Troester. Mammography adherence modifies the relationship between multilevel social deprivation and tumor characteristics in the Carolina Breast Cancer Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-09-08.

Improvement of knowledge following diabetes self-management education with respect to socioeconomic status: A retrospective cohort study among type 2 diabetes in Eastern India

ABSTRACT Introduction: We assessed the baseline knowledge and the improvement and retention of knowledge after attending diabetes self-management education (DSME) programs with respect to different socioeconomic status (SES). We also looked into the change in body mass index (BMI), blood pressure, and glycemic parameters after attending the DSME sessions. Materials and Methods: This was a retrospective, cohort study carried out via chart review based on data collected from manual or electronic medical records (EMR) and questionnaire responses of 160 adult patients with type 2 diabetes (T2D) who attended two DSME sessions with a gap of at least six months. Results: Baseline knowledge on diabetes was uniform (P = 0.06), irrespective of differences in SES, and DSME sessions significantly improved the knowledge in all socioeconomic classes (P value &lt; 0.05 in each SES group). However, SES did have a significant influence on the finally acquired knowledge of diabetes as was evident from the final score after attending two DSME sessions. A significant number of patients (48.1%) from our cohort either improved or retained their knowledge of diabetes over a mean follow-up of 15.5 months. The BMI of our cohort was significantly reduced from baseline to final follow-up (P = 0.016). Conclusion: DSME sessions were effective in improving knowledge and awareness among T2D patients, irrespective of socioeconomic classes in Eastern India. The acquired knowledge from DSME sessions was retained over a long time.

Examine the Predictive Relationship between Perceived Social Support and Perceived Stress among Pregnant Women

The woman's mental and physical health will unavoidably suffer throughout her pregnancy. Extreme mood swings and, in rare occasions, mental instability can occur. These factors make pregnancy a time when a woman has to undertake bio-psycho-social modifications, such as establishing strong social support systems, in order to alleviate the stress that comes with being pregnant. Objective: To investigate the predictive relationship between perceived social support and perceived stress among pregnant women in Pakistan. Methods: The study used a correlational cross-sectional research design. The sample consisted of (N=72) pregnant females in their third trimester with an age range between 18 to 37 years (Mean age= 26.3; SD=4.4) was selected from departments of Obstetrics and Gynecology of various hospitals in Karachi, Pakistan by using purposive sampling technique. The data were collected from December 2022 till January 2023. The demographic information form, Multidimensional Scale of Perceived Social Support and Perceived Stress Scale were used, and analysis of data were done by using Regression analysis and One-way ANOVA through SPSS version 25.0. Results: The findings revealed a significant negative predictive relationship between perceived social support from friends and perceived stress of pregnant women (b= -.482, p&lt;.05). The analysis of variance reveals that significant mean differences in socioeconomic status and number of miscarriages on perceived stress are present among pregnant women. Conclusions: These results emphasize the need to develop comprehensive strategies for assisting pregnant women by taking into account the aspects of social support, and make interventions to tackle stress successfully, and enhance maternal well-being throughout the pregnancy.

Social inequality in admission chances for prestigious higher education programs in Germany: do application patterns matter?

Abstract Research has shown that admission to prestigious higher education programs varies by students' socio-economic status (SES). Access to these programs is characterized by high competition and often rather complex admission procedures. Thus, access may depend not only on students’ performance and decisions to apply but also on their application patterns: Where and how they apply, which may vary by social background due to differences in educational achievement, aspirations, and constraints. Using applications to highly prestigious medical programs in Germany, we examine whether admission chances are socially selective even among the positively selected group of applicants, and whether this is due to SES differences in application patterns or performance. Based on complete application register data, we identify application patterns through cluster analysis. We then used the resulting cluster model to predict cluster membership in the 2018 applicant cohort, for which we collected survey data with information on applicants’ SES, preferences, and motivations. We find that application patterns vary primarily by applicants’ performance (grades and test scores) and SES-specific geographic constraints. However, our multivariate analyses on admission chances show that application patterns do not mediate SES differences in admission chances. Instead, these differences are entirely due to SES differences in applicants’ performance.

The association of race, ethnicity, and socioeconomic status on the severity of menopause symptoms: a study of 68,864 women.

This study aimed to evaluate if and how race, ethnicity, and socioeconomic status (SES) are associated with the severity of menopause symptoms in a large, diverse sample of women. For this cross-sectional study conducted between March 24, 2019, and January 13, 2023, a total of 68,864 women were enrolled from the Evernow online telehealth platform. Participants underwent a clinical intake survey, which encompassed demographic information, detailed medical questionnaires, and a modified Menopause Rating Scale. The modified scale was adapted for ease of use online and is available in the supplementary material along with the full intake. Symptom severity was evaluated using a multivariate binomial generalized linear model, accounting for factors such as race, ethnicity, age, body mass index, smoking status, bilateral oophorectomy status, and SES. Odds ratios (OR) and CIs were calculated based on the linear regression coefficients. Of the participants, 67,867 (98.6%) were included in the analysis after excluding outliers and those with unknown oophorectomy status. The majority of respondents identified as White (77.4%), followed by Hispanic (9.0%), Black (6.7%), two or more races/ethnicities (4.4%), Asian (1.2%), Indigenous/First Nations (0.8%), Middle Eastern (0.3%), and South Asian (0.2%). Notably, individuals identifying as Black (hot flashes OR, 1.91; 97.5% CI, 1.75-2.09; P < 0.001), Hispanic (skin/hair changes OR, 1.58; 97.5% CI, 1.45-1.71; P < 0.001), Indigenous/First Nations (painful sex OR, 1.39; 97.5% CI, 1.19-2.75; P = 0.007), Middle Eastern (weight changes OR, 2.22; 97.5% CI, 1.25-4.37; P = 0.01), or with two or more races/ethnicities (skin/hair changes OR, 1.41; 97.5% CI, 1.26-1.58; P < 0.001) reported higher levels of symptom severity compared with their White counterparts. Conversely, Asian and South Asian participants reported lower symptom severity. Even after incorporating SES into the linear model, racial and ethnic groups with lower SES (Black, Hispanic, Indigenous, and multiple ethnicities) exhibited slight shifts in OR while maintaining high statistical significance (Black [hot flashes OR, 1.87; 97.5% CI, 1.72-2.04; P < 0.001], Hispanic [skin/hair changes OR, 1.54; 97.5% CI, 1.42-1.68; P < 0.001], Indigenous/First Nations [painful sex OR, 1.74; 97.5% CI, 1.17-2.70; P = 0.009], multiple ethnicities [skin/hair changes OR, 1.41; 97.5% CI, 1.26-1.58; P < 0.001]). Our study suggests that the relationship between race and ethnicity and the severity of menopause symptoms is not solely explained by differences in SES but is itself an independent factor. Understanding and addressing social, cultural, and economic factors are crucial to reduce disparities in menopausal symptoms.

Attentional development is altered in toddlers with congenital heart disease

AbstractBackgroundCongenital Heart Disease (CHD) is the most common congenital abnormality. Survival rates are over 90%, however infants with CHD remain at high risk of attention and executive function impairments. These abilities are difficult to assess in toddlers because clinical assessments rely on language abilities which are commonly delayed in CHD. Our aim was to characterise visual attention in toddlers with CHD compared to controls and identify associations with parent‐rated effortful control.MethodsThirty toddlers with CHD (19 male, median (IQR) age at assessment 22.2 (22–23.1) months) and 66 controls from the developing human connectome project (36 male, age at assessment 22 (21.5–23.8) months) using eye‐tracking tasks designed to assess multiple components of visual attention. Analyses of co‐variance and regressions were used to identify differences between groups and relationships between gaze behaviours and parent‐rated effortful control.ResultsToddlers with CHD were less accurate when switching behaviours (set‐shifting) [median (IQR) 79%, (28–100)] compared to controls [100% (86–100), pFDR = 0.032], with worse accuracy associated with lower parent‐rated effortful control in CHD but not controls (interaction pFDR = 0.028). Reaction times were slower during selective [CHD 1243 ms (986–1786), controls 1065 ms (0851–1397), pFDR&lt;0.001] and exogenous attention tasks [CHD 312 ms (279–358), control 289 (249–331), (pFDR = 0.032) and endogenous attention was less mature (prolonged looks at facial stimuli CHD 670 ms (518–885), control 500 ms (250–625), (pFDR = 0.006). These results were unrelated to differences in cognition or socioeconomic status. In contrast, the allocation of attentional resources was preserved in CHD.ConclusionsWe identified a profile of altered attention and early executive functioning development in CHD. Eye‐tracking may provide clinically feasible, early objective measures of attention and executive function development in CHD.

The relationship between practice ownership and follow-up of comprehensive dental care. A Swedish register study.

The aims of this register study were: 1. To study whether the type of ownership of the dental practice was correlated with the type of dental care provided, that is public versus private ownership and professional (dentist or dental hygienist) versus non-professional ownership. 2. To study the extent of follow-up of patients who have undergone two types of treatments. Material and method: Two types of dental care were defined in the two groups studied, periodontitis/peri-implantitis and comprehensive restorative/rehabilitation. All relevant treatment codes that fall under these definitions are noted when they are performed. Also, the follow-up of each treatment code is noted. Differences in dental and socioeconomic status over time and between regions were adjusted for. A drop-out analysis was performed. Results: Dental practices owned by dentists or dental hygienists schedule follow-up appointments for patients who have undergone comprehensive restorative or rehabilitation dentistry more often than practices with other types of ownership. Dental practices owned by dentists or dental hygienists follow up patients with periodontitis and peri-implantitis less frequently. Type of ownership of a dental business influences the extent to which periodontal, and comprehensive restorative or rehabilitation dentistry were followed up.

Lifestyle Factors Influencing Metabolic Syndrome after Adjusting for Socioeconomic Status and Female Reproductive Health Indicators: A National Representative Survey in Korean Pre- and Postmenopausal Women.

Metabolic syndrome (MetS) is increasing markedly among postmenopausal women. Although studies suggest multiple risk factors for its development, few have investigated changes in socioeconomic status (SES), female reproductive health indicators (menarche age, experience of pregnancy, delivery, breastfeeding, and postmenopausal status), and lifestyle factors. This study investigated lifestyle factors affecting MetS prevalence among pre- and post-menopausal women after adjusting for SES and female reproductive health indicators. Data from the Korea National Health and Nutrition Examination Survey VII (2016-2018) on 2856 pre- and postmenopausal women aged 40-59 years were analyzed. Differences in SES (e.g., age, education, and household income), female reproductive health indicators (e.g., age of menarche and menopause), and lifestyle (e.g., total calorie intake, fats, and proteins, percentage of energy from carbohydrates, fats, and proteins, smoking, physical activity, and obesity) between MetS and non-MetS groups were calculated by performing χ2 or t-tests. Consequently, current smoking, physical inactivity, overweight, and obesity were significantly associated with increased MetS after adjusting for SES and female reproductive health indicators using logistic regression analysis. Hence, health policies and programs focusing on modifiable MetS risk factors-encouraging healthy eating habits, smoking cessation, and regular exercise-must be formulated to prevent the development of MetS in pre- and postmenopausal women.

Association between the COVID-19 pandemic and childhood development aged 30 to 36 months in South Korea, based on the National health screening program for infants and children database

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on the neurodevelopment of children. However, the precise effects of the virus and the social consequences of the pandemic on pediatric neurodevelopment are not yet fully understood. We aimed to compare the neurodevelopment of children between before and during the COVID-19 pandemic, as well as examine the impact of socioeconomic status (SES) and regional differences on the development.MethodsThe study used the Korean Developmental Screening Test to compare the difference in the risk of neurodevelopmental delay between before and during the COVID-19 pandemic. Multivariable logistic regression analysis was conducted to identify the relationship between experiencing the COVID-19 pandemic and the risk of neurodevelopmental delay. Stratified analyses were performed to determine whether the developmental delays caused by the pandemic’s impact varied depending on SES or regional inequality.ResultsThis study found an association between the experience of COVID-19 and a higher risk of neurodevelopmental delay in communication (adjusted OR [aOR]: 1.21, 95% confidence interval [CI]: 1.19, 1.22; P-value: < 0.0001) and social interaction (aOR: 1.15, 95% CI: 1.13, 1.17; P-value: < 0.0001) domains among children of 30–36 months’ ages. Notably, the observed association in the Medicaid group of children indicates a higher risk of neurodevelopmental delay compared to those in the non-Medicaid group.ConclusionsThese findings highlight the need to be concerned about the neurodevelopment of children who experienced the COVID-19 pandemic. The study also calls for increased training and support for Medicaid children, parents, teachers, and healthcare practitioners. Additionally, policy programs focused on groups vulnerable to developmental delays are required.

Quality of life and socioeconomic and educational status in patients with congenital hypothyroidism.

The aim of this study was to investigate the influence of primary congenital hypothyroidism (CH) on quality of life, level of education and socioeconomic status (SES). Two independent study cohorts, a national and a regional, were collected from Finnish national registers and patient records. Data on social security benefits, SES, marital status, and education were collected from Statistics Finland. Health-related quality of life (HRQoL) was studied in the regional patient cohort with the standardized 15D and 16D instruments. There were no statistically significant differences in education level, marital status, or SES between CH patients (n = 40) and their matched controls at the age of 25 years. The mean 15D score was both statistically significantly and clinically importantly lower in CH patients (n = 29) than controls (0.904 vs. 0.953, p = 0.008). CH patients reported significantly lower scores across various dimensions of physical and mental HRQoL, including breathing, sleeping, speech, excretion, mental function, distress, and vitality. The mean 16D score was lower in CH patients compared to controls (0.917, vs. 0.947), but without statistical significance. SES of CH patients did not differ from matched controls. Thus, most CH patients integrate well into society, but their HRQoL is impaired. Most patients with primary congenital hypothyroidism integrate well into society. In the current study, their socioeconomic and marital status did not differ from matched controls at the age of 25 years. However, health-related quality of life measured using 15D instrument was impaired. Every fourth patient reported that congenital hypothyroidism influenced everyday life.

Relation to Social Determinants in Cardiovascular Disease Risk Profile: An Alarming View

Globally, Cardiovascular disease (CVD) is one of the major reasons for mortality. Cardiovascular health in children and adults is profoundly affected by the milieu of early life. Currently, CVD is taking a different turn based on social antecedents like poverty, the difference in socio-economic status, gender inequality, being a fluid person, and work life in harmony increases the risk of getting into CVD, that too in vulnerable populations like racial and ethnic minorities, women, the elderly, the chronically ill individual with disabilities, lesbian, gay, bisexual, transgender, queer and racism play a significant role in conditioning disease burden and modulating outcomes of CVD. People with low socioeconomic status increase the hypothalamic pituitary adrenal axis (HPA axis) in the body, due to stress response, and at the end, increased cortisol and sympathetic nervous system activity lead to decreased angiogenic activity. People from low socioeconomic backgrounds, loneliness, and social isolation in many cases like racism, ethnic minorities, children, women, elderly, and chronically ill individuals with disabilities, are exposed to constant stress because of a lack of their fundamental needs. The wider introduction of universal screening for social factors that impact cardiac health will help to identify children and families at risk. Hence,aggressive screening tests beginning at an early age will be beneficial for early detection and treatment. Healthcare professionals need to pay attention to promotinghealth education and awareness aids to decrease CVD-associated mortality.

“But our worlds are different!”: reflexivity as a tool to negotiate insider–outsider dilemmas

PurposeIn ethnographic research, negotiating insider–outsider perspectives is essential in order to get closer to the participants’ lives. By highlighting the importance of empathy and reflexivity, the paper attempts to trace my reflexive navigation as a novice researcher as I enter the field as an outsider. The process of co-creation between the researcher and the participant is mediated by the nuances of the researcher’s identity, thereby shaping the researcher–participant relationship.Design/methodology/approachThe current study elaborates my journey as a Ph.D. scholar in an ethnographic study of persons with spinal cord injury or amputation. The different themes organised around my personal reflections discuss the various challenges I faced and how I navigated through them.FindingsThe paper reflects on how different aspects of my identity, such as being non-disabled, a female and differences in socioeconomic status shaped the researcher–participant relationship. Additionally, it highlights how I traverse through the blurred worlds of insider–outsider and explore the role of reflexivity and empathy in creating a horizontal researcher–participant relationship.Originality/valueThis reflexive journey offers potential insights into budding researchers who often face dilemmas whether or not it is necessary for qualitative researchers to be members of the population they are studying. The paper also contributes to an understanding around practising reflexivity while working with a sensitive population. It argues researchers to look beyond the insider–outsider debate and utilise reflexivity as a tool for a nonhierarchical researcher–participant relationship.

Is the association between long-term care and subjective well-being socio-economically stratified? Evidence from Europe

ABSTRACT Informal and formal care receipt can affect the overall subjective well-being of care recipients. While much attention has been devoted to the mechanisms by which care use relates to subsequent well-being, no previous research has examined socio-economic stratification in this association. This question is important given that the proportion of disabled older adults relying exclusively on informal caregivers is expected to rise, especially among lower socio-economic status (SES) groups. This study examines SES gradients in the associations of informal and formal care use with subjective well-being, and across four care contexts (Northern, Western, Southern and Eastern Europe) using data on functionally impaired Europeans aged 50 + from the Survey of Health, Ageing & Retirement in Europe (n = 6,012). We investigate how wealth and education moderate the associations between take-up of informal and formal care and changes in subjective well-being (i.e. quality of life and depressive symptoms). We also investigate whether this relationship differs by care context. We find little evidence of SES differences in the association between the onset of care and subjective well-being regardless of the care context. We interpret our findings in light of previous theory and derive implications for future research on the relationship between care receipt and well-being.

Scientific literacy in biology and attitudes towards science in the Chilean education system

ABSTRACT Background The development of scientific literacy in young people is seen as important in several countries. In recent decades, Chile’s educational reforms aimed at performance have led to a market-oriented funding and management system, worsening social inequality and segregation. Purpose The study looked at biology literacy and science attitudes in Chilean secondary school students, considering two aims: 1) to analyse the level of scientific literacy in biology and attitudes toward science posed by secondary school students, making comparisons by gender, age, socio-economic status (SES), and type of school; and 2) to evaluate the relationship between scientific literacy in biology and attitudes towards science. Sample 612 secondary school students in a central southern region of Chile, took part in the study. Design & Methods A quantitative method was used to analyse the students’ responses on two validated and adapted instruments; A test to measure biological knowledge (TOSLS) and Likert Scale Science-related (LSSr) to measure attitude towards science. These instruments were administered to secondary students, and descriptive and inferential analyses were conducted. Results The adapted TOSLS showed significant differences in SES, school type and slight variations by gender and age, although, no illiteracy level in biology was found among the Chilean students. The adapted LSSr showed significant differences concerning attitudes toward science were found in school type, and variations by SES and age, and gender. Also, the correlation analysis shows a weak positive relationship between scientific literacy in biology and attitudes towards science, although of moderate magnitude. Conclusion This study found that scientific literacy in biology does not necessarily impact attitudes towards science. However, SES and type of school can affect understanding and views of science and its role in society, which aligns with previous findings on social inequality in Chilean education.

Abstract 6161: Investigating the relationships between race and socioeconomic status on the biology of ER+ breast cancer

Abstract Black women in the US have worse health care options, poorer educational opportunities, and decreased income quality which collectively contribute to an overall lower socioeconomic status (SES) compared to white women. Furthermore, although the incidence of estrogen receptor positive (ER+) breast cancer is similar for Black and white women in the US, Black patients have significantly worse outcomes. The field has traditionally focused on systemic factors such as SES to explain outcome disparities. Consequently, differences in the molecular biology between tumors from Black and White women remains a gap in knowledge in the field. Recent studies have found that Black cancer patients have a unique gene expression profile that may modulate treatment response. However, how SES contributes to these differences in molecular biology and whether these differences in SES alter treatment response remain unknown. One challenge to addressing these questions is that existing datasets significantly underrepresent Black women and are not sufficiently annotated to understand the complex interplay between molecular biology and SES. Here, we present analysis of RNA expression datasets from 60 ER+ patient tumors (38 Black, 22 White), with corresponding SES and patient outcome annotations which suggest that the ECM and TIME of ER+ breast cancer are influenced by race and factors of SES including BMI and community poverty burden. We further provide evidence that these alterations in the TME may also associate with worse patient outcomes. Citation Format: Jerry Tyler DeWitt, Elena Oropeza, Svasti Haricharan. Investigating the relationships between race and socioeconomic status on the biology of ER+ breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6161.