Socioeconomic Strata Research Articles

Evaluating the level of access and equity of the bus rapid transit (BRT) system: The case of Dar-Es-Salaam, Tanzania

Bus Rapid Transit (BRT) systems have witnessed significant growth worldwide, particularly in rapidly urbanizing cities in the developing world, often implemented through public-private partnerships to foster economic growth. However, the success of such ambitions relies on ensuring equitable transit access for all residents, including those living with poverty or other social disadvantages. The purpose of this study is to explore transit access, coverage, and equity of the BRT system in Dar-es-Salaam, Tanzania using infrastructure-based measures of proximity to transit stations and stops. In particular, the equitable distribution of transit access patterns is explored in relation to neighborhood socio-economic strata in the catchment areas within a 30-min walking distance. The study's findings reveal notable disparities in the level of access among various socio-economic strata, with the least deprived population benefiting the most from the Dar-es-Salaam BRT system. As more BRT phases are implemented, there is a continuous increase in the Multidimensional Poverty Index (MPI) within the areas not covered by the BRT system. This suggests that access improvements predominantly favor the wealthier population rather than effectively addressing the needs of the impoverished population. To enhance access and achieve more equitable outcomes, it is crucial to implement targeted strategies and measures. These may include improved integration of the BRT with a feeder system, continuous improvement of Non-Motorized Transport (NMT) facilities, and the promotion of equitable transit-oriented development along the BRT corridor. These initiatives play a vital role in ensuring that vulnerable populations, especially the poor, have access to and can benefit from the BRT services.

Racial Capitalism and Black-White Health Inequities in the United States: The Case of the 2008 Financial Crisis.

Scholars cite racist political-economic systems as drivers of health inequities in the United States (i.e., racial capitalism). But how does racial capitalism generate health inequities? I address this open question within the historical context of predatory lending during the 2008 financial crisis. Relevant hypotheses are tested with multiple waves of data from Black and White participants of the National Longitudinal Study of Adolescent to Adult Health (N = 8,877). Across socioeconomic strata, I find that Black participants report higher rates of foreclosure, eviction, repossession, delinquent bills, lost income, and new debts in the wake of the financial crisis. Using structural equation and quasi-experimental models, I then show that Black participants also self-report rapid health declines and increases in prescription drug abuse throughout this period, much of which is explained by chronic financial stress. I conclude that racial capitalism can generate health inequities by ensnaring Black Americans in a toxic web of financial exploitation and stress proliferation.

Revisiting the nexus between corruption and gender: does women’s political participation in parliament matter?

ABSTRACT The study aims to empirically verify the hypotheses that the increase in the share of women legislator in politics has the potential to reduce levels of corruption within the Parliament and overall political corruption levels. Using data from the Varieties of Democracy (V-Dem) platform, fixed effects, and generalised method of moments (GMM-System) models are estimated for a set of 154 countries between 1995 and 2018. The results show that when considering corruption within the legislative house, the greater share of women in politics is associated with lower levels of corruption. Even after controlling for various societal factors, the results confirm the positive effect of women’s participation in parliament on the decline of corruption. Yet, this effect does not seem to spill over into other branches of government and sectors of the public sphere. When considering the level of more general corruption, it responds much more to variations in structural aspects, as democratic maturity and equality in the distribution of political power among different socioeconomic strata, than to women’s participation in parliamentary seats.

The Influence of Socio-economic Factors on Electric Vehicle Adoption in Uttar Pradesh

Using electric vehicles (EVs) is vital to the global plan to fight climate change and cut carbon emissions. In Uttar Pradesh, one of India's most populous and economically varied states, this study investigates the impact of socioeconomic factors on the adoption of electric vehicles. Using a mixed-methods approach that includes stakeholder interviews and surveys from various socioeconomic strata, the research highlights important factors such as infrastructure availability, government incentives, education levels, and income levels. The results show that growing EV use correlates with the income of EV owners and educational achievement, mainly because of improved access to resources and information. However, significant obstacles to widespread adoption include insufficient infrastructure for charging and the meagreness of government incentives. The study also emphasizes how important it is for governments to create infrastructure, run awareness programs, and offer incentives to encourage the use of electric vehicles. These findings are essential for stakeholders and policymakers who want to increase the use of electric vehicles in Uttar Pradesh and support the larger goals of environmental preservation and sustainable development.

The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata

BackgroundIn this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association.MethodsThis study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM.ResultsThe median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods.ConclusionsHigher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.

Suicidal ideation in adolescence: an explanation from three of its associated variables in Bogotá, 2009

Objective: To determine the relationship between hopelessness, loneliness and the level of family health in school-age adolescents with and without suicidal ideation to deepen in the knowledge of this phenomenon from a nursing point of view and to pose promotion and prevention options in Bogotá, Colombia. Method: This was a cross-sectional, comparative, correlational, descriptive and quantitative study. The sample was selected in the period between February and April 2009, through mixed sampling and 482 school-attending 14-17 year-old adolescents were included. Widely recognized and highly qualified psychometric tools were used to measure the variables concerned. Univariate, bivariate and multivariate statistic analysis were used to describe the behavior of each variable, to explore the relationships and contrasts between these variables and to estimate the effect of the independent variables on the presence of suicidal thoughts. This study has followed the ethical considerations necessary for research involving human beings.Results: 20% of the sample used reported the presence of suicidal thoughts or desires. All variables studied influence the presence of suicidal thoughts except age, socioeconomic strata, borough and type of school. However, with the use of logistic regression methods, the variables that best express the presence of suicidal thoughts are: previous suicide attempt, low self-esteem, depression and belonging to an unhealthy family.Conclusions: Data on suicidal ideation and attempts made in this study support the idea of implementing greater preventive efforts within families and schools. Identifying adolescents at risk of suicide or mental health disorders, and build effective prevention and treatment programs is a priority.

A health economics perspective on behavioural responses to climate change across geographic, socio-economic and demographic strata

This perspective examines the relationship between climate change, health outcomes, and behavioural responses across the life course. It identifies three primary channels through which climate change impacts behaviours which in turn affect health: increased morbidity driving healthcare demand and accessibility, reduced productivity and income affecting health care investments, and combined health and economic risks shaping migration patterns, dietary choices and human capital investment across the life course and generations. Climate-induced changes in behaviours exacerbate existing health-related and socio-economic vulnerabilities. While climate-related shocks elevate demand for healthcare services, disruptions in infrastructure hinder access, especially for the poorest, widening health inequities. Loss of income and disrupted employment further compound health and economic risks, pushing vulnerable communities towards informal care options and impoverishment tied to health expenditures. Increased health and economic risks are associated with migration affecting healthcare access and health outcomes. They also influence dietary choices, with health consequences. Finally, deteriorating prospects of leading a long, prosperous and healthy life may induce individuals to reduce their time horizon and assign lower values to long-term survival, impacting human capital investments across the life course and generations. Again, these impacts are prone to exhibit a social gradient with vulnerable individuals being more likely to give up on striving for a healthier life. Effective policies must integrate climate, health, and socioeconomic factors, considering long-term behavioural responses and their health and socio-economic implications. Adapting health financing mechanisms to account for climate risks and incentivise resilience-building behaviours within health and social care systems is essential for protecting health across the life course, and avoiding widening inequities.

Clinical and socioeconomic pattern of infective dermatoses in pediatric population at a tertiary care center of Northeast India

Background: Cutaneous disorders are one of the most important components of any health-care system, especially which including children. Infective dermatoses are the most common skin diseases in children. The pattern of dermatoses in children varies from one country to another and within the same country from one state to another due to various climatic, cultural, and socioeconomic factors. Aims and Objectives: The aims and objectives are to study the clinical and socioeconomic profile of cutaneous infections and infestations among children. Materials and Methods: All children up to 12 years presenting with cutaneous infections and infestations were taken as study participants. A detailed history of the disease, socioeconomic status, and housing condition was taken from the patients as well as from the parents. Local, general, and systemic examinations were carried out on all the children and their examination findings were recorded in a standard pro forma for analysis and interpretation of data. Results: A total number of 1932 were children aged 0–12 years patients attended the Dermatology Outpatient Department during the study period of which 665 (34%) presented with infective dermatoses. 61.20% of patients belonged to school-aged children (5–12 years) 76.7% had a family with 4–6 members. 67.67% were from the rural areas, and 77.4% belonged to the lower class. Scabies was the leading offender (29.92%) among infective dermatoses followed by Impetigo contagiosa (20.45%). Conclusion: There is an increased incidence of cutaneous infections and infestations with increasing age among children. The incidence is associated with housing conditions, family size, socioeconomic strata, and seasonal. Most of these conditions are common and controllable with easy preventive and curative measures.

A Comparative Study of Household Water, Sanitation and Hygiene (WASH) Covariates Across Socioeconomic Strata

Background: Water, sanitation, and hygiene (WASH) are essential for a healthy and productive life. High-quality access to these services reduces disease occurrence and spread in communities. Developing countries, including Pakistan, face significant challenges in providing these facilities. This study aims to highlight WASH-related service disparities in Pakistani households based on socioeconomic strata. Methodology: A stratified random sampling strategy was used, with a sample size of 1200 households based on the PDHS 2019 special survey. Descriptive analysis and chi-square tests were conducted to assess the association between wealth quintiles and WASH access. Results: The study found that 82.4% of households had access to improved sources of drinking water. Only 4.8% of households in the lowest quintile had access to improved drinking water sources. Water unavailability for at least one day per week was 13% higher among the lower quintiles. Forty-four percent of households using improved sanitation facilities belonged to the two highest strata, while poorer households predominantly used unimproved sanitation facilities. Conclusion: Lower-quality WASH access is more prevalent among lower wealth quintiles, increasing the risk of disease and infection. Further research is needed to inform policymakers and develop plans to reduce inequalities in access to WASH services.

Drug dependence and suicide, a growing problem

Both nationally and internationally, drug dependence and suicide are problems with a high prevalence rate and in recent years have had an upward trend, bringing with them multiple social and health consequences. The relationship between drug dependence and suicide is statistically significant, with drug-dependent patients having a risk up to six times higher of attempting suicide compared to the general population. Therefore, it is important to know the risk factors associated with suicidal behavior in drug-dependent patients, in order to improve the prevention, treatment and prognosis of both problems. Although it is true that many of the risk factors associated with suicidal behavior are already known, these factors in the context of drug-dependent patients are still a subject that has not been investigated as much, and particularly at the national level, the variability of the factors according to the different regions, multiculturalism, socioeconomic strata, etc., are not taken into account. Therefore, it is recommended to increase the research budget, emphasizing on the variables and populations already mentioned, in order to have better qualified health personnel in the problem in question.

LMIC-14. MAPPING THE REFERRAL PATH - HURDLES IN PEDIATRIC BRAIN TUMOR DIAGNOSIS: A PERSPECTIVE FROM TERTIARY CANCER CARE CENTRE IN A LOW MIDDLE-INCOME COUNTRY

Abstract BACKGROUND Delayed referral remains leads to worse outcomes for children with cancer in low- and middle-income countries (LMIC), especially for patients with brain tumors. Delay in treatment could be due to the ignorance from the families to seek health care advice or lack of awareness of primary care physician. METHODS A retrospective study was conducted to delineate the referral path of children with brain tumors who presented to our institution. Patients &amp;lt;18 years with brain tumors registered from June 2022-December 2023 were included. Patients with relapsed disease, second opinion, or partially treated in an outside institute prior to referral were excluded. Data were captured using a proforma after obtaining permission from Institutional ethics committee. RESULTS Thirty-one children were enrolled with a median age of 5 years (range: 0-17) with M: F ratio of 1.58:1. The most common diagnosis in this cohort was medulloblastoma in 13(42%) followed by high grade glioma in 7(22%) and low-grade glioma in 4 patients (13%). Twenty-four (77%) belonged to low socio-economic strata defined by Modified Kuppuswamy classification, of which 22 (71%) were hailing from rural area with median distance from cancer center being 121 miles (range: 4.34 -242). Median of 3 (range: 1-6) consultations were sought prior to being referred to us and about 11 (35%) had visited alternative system of medicine before consulting us. Mean delay from symptom onset to diagnosis was 52 days (range: 2-530) with healthcare seeking delay of 5.4 days (Range: 0-30) and health system delay of 46 days (range: 1-500). The factors influencing delay included rural background (p=0.04) and lower socioeconomic strata (p=0.03). CONCLUSIONS Health system delay was a major cause of delayed referral in our study. By improving awareness of the primary care physicians about symptomatology of pediatric brain tumors, the referral pathway can be expedited thereby improving the outcomes of these children.

Pedagogical control scales of vertical jumping performance in untrained adolescents (13-16 years): research by strata.

A scale is used to establish performance ranges in different sciences, it being necessary to design specialized biological and pedagogical indicators in physical activity, sport and health. To design a scale for the pedagogical control of the vertical jumping ability in untrained adolescents (13-16 years), stratifying the sample by age range, ethnicity, urban and rural area, socioeconomic level, and gender. A representative sample of the Ecuadorian population (n = 3,705) is studied, classifying it into the aforementioned strata, controlling the vertical jump by ISAK I and II level experts, applying the Sargent Test to measure vertical jumps on a multi-force wall, establishing scales with seven percentile levels, and making comparisons related to chronological age, gender, socioeconomic, and genetic indicators. Significant differences in the vertical jumping performance were determined according to the category or age range (13-14 ≠ 15-16 years) and by gender (w = 0.000). Various levels of performance were determined, classifying the maximum level as talented in the female gender (≥40 cm; and ≥42 cm) and male gender (≥47 cm; and ≥57 cm) in the 13‒14 and 15‒16 years categories, respectively. Sampling comparisons by geographical area only determined significant differences in the male gender, with the jumping ability being higher in urban areas (13‒14 years: w = 0.046; 15‒16 years: w = 0.013). The comparison by ethnic groups showed significant differences (k = 0.030), favoring the Afro-Ecuadorian ethnic group in both genders, while there are significant differences by socioeconomic level, especially between the middle and lower classes. The present research solves the lack of a tool for making correct didactic decisions related to the vertical jumping ability, taking into account various important stratified indicators. The complementary conclusions show significant differences according to the category stratum or age range, the gender stratum, and the ethnic stratum in females and males, where the best average rank favored the Afro-Ecuadorian ethnic group in both genders. There are significant differences in the geographical area stratum in the male gender, and differences in the socioeconomic stratum in favor of the upper and middle classes.

Measuring socioeconomic inequalities in postnatal health checks for newborns in Ethiopia: a decomposition analysis.

Addressing health inequity is a top priority for achieving sustainable development goals. The existing evidences in Ethiopia have shown that there are substantial inequalities in the use of health services among various socioeconomic strata. Therefore, the present study aimed to measure socioeconomic inequalities and the contributing factors in postnatal health checks for newborns in Ethiopia. We used a secondary data from the recent 2019 Ethiopia Mini Demographic and Health Survey dataset. The study includes a weighted sample of 2,105 women who gave birth in the 2 years preceding to the survey. The study participants were selected using two stage cluster sampling techniques. The socioeconomic inequality in postnatal health checks for newborns was measured using the Erreygers Normalized Concentration Index (ECI) and illustrated by the concentration curve. A decomposition analysis was done to identify factors contributing to the socioeconomic related inequality in postnatal health checks for newborns in Ethiopia. The concentration curve of postnatal health checks for newborns lay below the line of equality, and the Erreygers normalized concentration index was 0.133, with a standard error = 0.0333, and a p value <0.001; indicating that the postnatal health check for newborns was disproportionately concentrated among newborns with higher socioeconomic status. The decomposition analysis reported that antenatal care (ANC) visit (59.22%), household wealth index (34.43%), and educational level of the mother (8.58%) were the major contributors to the pro-rich socioeconomic inequalities in postnatal health checks for newborns. The finding revealed that there is a pro-rich inequality in postnatal health checks for newborns in Ethiopia. To reduce the observed socioeconomic health inequality, the government needs to improve ANC visits, implement strategies to access health service for economically disadvantaged groups, and increase educational attainment among women.

One Thousand and One Nights’ Struggle for Survival: Tales of Child Undernourishment in Arab Countries

This study evaluates young children’s developmental opportunities and anthropometric outcomes across 16 low- and middle-income Arab countries during 2004-2015. We find that disproportionately many children become stunted and underweight, particularly in less developed countries including Mauritania, Somalia and Sudan, but also in the higher-income Iraq and Morocco. Within countries, significant dissimilarities exist in children’s opportunities across different socio-economic strata. These gaps must be tackled by a variety of measures at the local, national and international levels –with buyin from families, local organizations and authorities– including universal pre/post-natal care, immunization, and nutrient supplementation at critical points in children’s development.

Prospective assessment of AI-enabled cost savings, continuous support, and psychosocial enhancement (AI New Era Study).

e13615 Background: Cancer patients (pts) need extensive primary care across their treatment journey, yet the world's primary health systems struggle with patient volume and resource scarcity. This study aims to assess the effectiveness of Artificial Intelligence (AI) medical service model in primary care and clinical service pre-screening, as well as their potential impact on improving the quality of medical services and reducing medical costs. Methods: A total of 17,856 medical consultation inquiries from 7,522 pts with various types of cancer have been collected and categorized. The study employed a novel AI-driven medical service model (based on large language model), amalgamating clinical guidelines with a local oncology database, to prospectively field questions from 454 cancer-afflicted pts. Clinicians evaluated the accuracy and comprehensiveness of the responses to basic medical issues, while pts assessed the intelligibility and satisfaction. Results: Treatment-related inquiries constituted 34.44% (n = 6,149) of the total, with 81.53% of pts asking such questions. Basic medical issues were addressed in 65.56% (n = 11,707) of inquiries, raised by 59.78% of pts. Specific concerns within basic medical issues included test report explanations (20.45%), adverse reaction consultations (19.82%), and medication information requests (17.66%). In light of the prevalence of basic medical issues, the study prospectively explores the potential of AI technology to revolutionize medical models, driving the advent of a new era in healthcare research. As result, the AI model exhibited high performance across several metrics: accuracy (96.87 ± 10.29), comprehensiveness (97.40 ± 9.91), intelligibility (95.72 ± 12.62), and satisfaction (96.34 ± 11.03). Notably, the model demonstrated a proficiency in identifying queries necessitating physician expertise, with a 95.60% accuracy rate upon review. A survey of 50 outpatients indicated an enhancement in service speed (7.78%) and patient satisfaction (14.29%). This increase in satisfaction was primarily ascribed to pts' heightened sense of control and safety. When benchmarked against GPT-4, the AI model's overall performance was significantly superior (95.08 ± 10.05 vs 89.70 ± 12.85, p&lt;0.01), particularly in domestic drug knowledge and gene report analysis. Conclusions: Largely fueled by the advanced capabilities of large language model, AI has the potential to profoundly reshape the entire patient care journey. Our AI medical service model efficiently meets key healthcare needs, addressing over half of clinical issues and cutting costs. It also guides pts to the right specialists for timely care. Early surveys indicate better primary care and improved doctor-patient relations. Further research is needed to understand AI's effects on fairness, access, and outcomes across varied demographic and socioeconomic strata.

Effectiveness and safety of medication abortion via telemedicine versus in-person: A cohort of pregnant people in Colombia

ObjectiveTo compare the effectiveness and safety of medication abortion (MAB) via telemedicine versus in-person in pregnant people with less than 12 gestational weeks in Colombia. Study designA retrospective cohort study was conducted with 23,362 pregnant people who requested MAB service from Profamilia (a Colombian non-governmental organization) in 2021–2022. The outcomes were success and safety of MAB. We performed a descriptive and a multivariate statistical analysis using the binary regression model to obtain an adjusted Odds Ratio (aOR) to identify factors associated with abortion success. ResultsIn comparison to in-person care (n = 20,289), individuals in telemedicine (n = 3073) were predominantly from urban areas, belonged to a lower socioeconomic stratum, single and did not identify with any ethnic group. In-person users tended to have higher levels of education and accessed the service through private insurance (p < 0,05). There were no differences in the odd of a successful abortion based on the modality of care (aOR 1.18; 95% CI=0.87–1.59). The results were also the same with sensitivity analysis stratified: pregnant people who were nine weeks gestation or less (aOR 0.86; 95% CI=0.63–1.17) or more (aOR 0.87; 95% CI=0.28–2.65). ConclusionTelemedicine is an effective and safe option for MAB, as in-person care. Telemedicine has the potential to increase abortion access by extending the availability of providers and offering people a new option for obtaining care conveniently and privately, especially for women with disadvantaged socioeconomic and educational background. ImplicationsThis study demonstrates that medication abortion (MAB) administered via telemedicine produces outcomes akin to those of in-person care, providing a compelling rationale for its adoption, particularly in underserved regions. This approach can be replicated in other countries in Latin America and the Caribbean.

Feasibility and satisfaction level of caregivers with telemedicine in childhood cancer: A mixed-methods study.

1549 Background: Telemedicine has emerged as a crucial solution to addressing health care disparities, especially in countries like India where healthcare disparities are pronounced and specialist care is concentrated in urban areas. Methods: We conducted a mixed-methods study among caregivers of children with cancer who had utilised telemedicine in the past 6 months. Telephonic quantitative interviews collected information on diagnosis, current treatment status, residence and socio-economic parameters. A logistic regression model was created to assess patient and caregiver related factors associated with satisfaction with telemedicine. In-depths interviews were conducted in a sub-set of participants followed by thematic analysis. Results: Caregiver of 465 patients [median (range) age: 8 (0.1-18) years; 70.04% male; 82.54% with haematological malignancy] participated in this study. Patients had a median (range) of 2 (1-30) telemedicine in the past year, with parents being the most common care giver being involved [n=326 (70.10%)]. Telemedicine was reported to be more convenient than in-person visits and helpful in saving time and money by 90.54% (n=421) patients and 88.6% (n=421) patients reported easier follow up and access to care using telemedicine. Difficulty in explaining issues over telephones or emails was the reason for dissatisfaction for 47.53% (n=221) patients, additionally 22.37% (n=104) patients felt they received inadequate attention during telemedicine. Majority of the patients (85.38%, n=397) planned to continue teleconsultation and 88.39% (n=411) would recommend teleconsultation to others. Socioeconomic status of upper and upper-middle class upper and upper-middle socioeconomic status [OR (95%CI): 2.14 (1.38-3.32), p: &lt;0.001; aOR (95%CI): 2.11 (1.35 - 3.31), p: 0.001] was significantly associated with caregiver satisfaction with telemedicine. Qualitative interview showed themes of monetary and time savings with telemedicine, ease of consultations for minor complaints, delay in responsiveness of doctors, language barriers and difficulty in using telemedicine platforms due to low literacy levels. Conclusions: Telemedicine has emerged as a valuable tool for paediatric cancer care offering convenience and accessibility. While most caregivers expressed satisfaction, challenges remain in communication and limited access among caregiver of lower socio-economic strata. Further studies should aim at developing more patient friendly telemedicine platforms.

Micronutrient-fortified bouillon as a strategy to improve the micronutrient adequacy of diets in Burkina Faso.

Bouillon is a promising candidate for fortification to complement existing large-scale food fortification (LSFF) programs. We used household dietary data from Burkina Faso to model potential contributions of bouillon fortified with vitamin A (40-250μg/g bouillon), folic acid (20-120μg/g), vitamin B12 (0.2-2μg/g), iron (0.6-5mg/g), and zinc (0.6-5mg/g) for meeting micronutrient requirements of women of reproductive age (15-49 years; WRA) and children (6-59 months). Most households (82%) reported bouillon consumption, with higher proportions of resource-constrained (84-88%) and rural households (88%) consuming bouillon. Accounting for the contributions of existing LSFF, household diets were inadequate to meet the micronutrient requirements of many WRA and children, exceeding 90% and 60% inadequacy for vitamins A and B12, respectively. Modeling results showed bouillon fortification could reduce inadequacy by up to ∼30 percentage points (pp) for vitamin A, ∼26 pp for folate among WRA (∼11 pp among children), ∼38 pp for vitamin B12, and 11-13 pp for zinc, with comparable reductions across socioeconomic strata and urban and rural residence. Predicted reductions in iron inadequacy were <3 pp. These results suggest dietary micronutrient inadequacies are a concern in Burkina Faso, and fortified bouillon can make substantial contributions to reducing micronutrient inadequacies, including among resource-constrained and rural populations.

Final assessment of the COVID-19 pandemic impact between the different social and economic strata population of the city of Buenos Aires

BackgroundDuring the pandemic, epidemiological communications reported an estimation of excess deaths. However, the final calculation requires a detailed analysis. The study aim was to ascertain the number and distribution of COVID-19 fatalities among various socio-economic strata in a large, moderate to low-income city. Study designObservational time series analysis in a large city, treated as a natural experiment. MethodsAnalysis of death certificates, demographic data, and health system records of positive RT-PCR COVID-19 tests from 2015 to 2021, categorizing by age, sex, and place of residence. The study measured the pandemic's impact on mortality, including COVID and non-COVID deaths, using corrected Poisson regression models for different demographics and assessing socio-economic status impact via ecological community-level analysis. ResultsCompared to the pre-pandemic period (2015–2019, IRR = 1.00), the sex- and age-adjusted rate of all-cause death increased significantly during the pandemic (2020–2021) IRR = 1.109 [1.054–1.167], p < 0.0001. This was observed in both males (IRR = 1.158 [1.1–1.219], p < 0.0001) and females (IRR = 1.068 [1.016–1.124], p = 0.01). There was no observed effect of the pandemic on the historical trend in the progressive reduction of mortality in people under 35 years of age. The increase in deaths was at the expense of COVID (+11,175 deaths) and cardiovascular causes (IRR = 1.114 [1.020–1.217] p = 0.017). During the pandemic, there was a significant increase in deaths at home (IRR = 1.219 [1197–1.242], p < 0.0001), especially in people dying of cardiovascular causes (IRR = 1.391 [1.360–1.422], p < 0.0001). The increase in the adjusted mortality rate during the pandemic was socially conditioned. ConclusionsThe pandemic not only led to increased COVID-19 mortality but also heightened fatalities from non-COVID causes, reflecting a potential bias in healthcare resource allocation towards SARS-CoV-2 at the expense of chronic pathologies care.

Inequities in urban tree care based on socioeconomic status

Urban trees are key elements for livable cities because they provide ecological, social, and economic benefits. Due to their importance, tree care should assure their welfare and ecosystem service provision. Among tree care strategies, pruning is highly controversial because it can be performed poorly, risking tree and human welfare. For the first time, we investigate whether the “luxury effect”, that describes a positive effect of human wealth on plant diversity, extends to urban tree care. In the Latin American city of Santiago de Chile, we sampled trees in 120 sites located in residential areas of different socioeconomic status. At each site, a trained forester evaluated each tree recording the occurrence and quality of pruning. We used a Generalized Linear Mixed Model with logistic distribution to estimate the probability of good pruning according to socioeconomic status. We found most trees (82 % of 510 trees) were pruned and most of them had poor corrective pruning applied. Good pruning increased with socioeconomic status of neighborhoods: 15 %, 31 %, and 54 % of pruned trees in low, medium, and high socioeconomic status, respectively. There was a significantly higher probability of finding well pruned trees in residential areas of high socioeconomic stratum than in lower strata. Our study reveals that trees in poorer zones are massively affected by the extended application of poor pruning that, in turn, risk ecosystem service provision for vulnerable people. Urgent strategies need to be implemented to prevent further tree damage in Santiago de Chile, especially in lower socioeconomic zones. Due to the widespread application of poor pruning on residential trees in our city and the paucity of local and global research on the relationship between socioeconomics and urban tree care practices, we make a call to investigate these patterns, especially in cities that exhibit social, economic, and environmental segregation.