Socioeconomic Variation Research Articles

Comparative Study on Variations of Living Standard for Public and Private University Students in Sylhet City of Bangladesh

The attempt of this present research is to conduct a comparative study for estimation of socioeconomic variations in standard of living for both private and public university students in Sylhet urban area of Bangladesh. The results represent that the living standard of a private university student is significantly higher than a public university. The main reasons are that the students of private university have ability to spend more money for better university facilities including accommodation costs and for better living expenses than the public university. The amount of education costs also varies based on parent’s income and it is significantly high for private university students than public university. It founds that the engagement in extra-curricular activities of a public university student is higher than private university. It also found that the monthly expenditures of male students are significantly higher than the female students.

Gentrification and mental health in Hong Kong

This study investigates the association between gentrification and mental health in Hong Kong, where gentrification is mainly driven by government intervention and is widely supported by the public. We utilize a harmonized dataset that integrates the 2006 and 2016 Hong Kong population census data with data from Wave 4 (2017/2018) of the Hong Kong Panel Study of Social Dynamics (HKPSSD). Findings of the multilevel logistic models show that residents in gentrifying neighborhoods report a lower risk of mental distress compared to residents in non-gentrifying neighborhoods with similar socioeconomic characteristics. Furthermore, residents with higher household incomes tend to benefit more from gentrification. Results from causal mediation analysis suggest that neighborhood cohesion mediates the effect of gentrification on mental health. This study advances the literature on gentrification effects by offering empirical evidence from the relatively understudied East Asian context and examining the socioeconomic variations in these effects. We discuss potential policy implications for future interventions in neighborhood change processes.

Socioeconomic Variation in Motivations for Ritual Practice

This paper investigates socioeconomic variation in motivations for ritual practices among Mauritian Hindus. Using cultural domain analysis, we explore individuals’ reported reasons for engaging in a variety of religious rituals. Our findings demonstrate significant intra-cultural diversity driven by social stratification. Specifically, we observe that those of lower social standing appear primarily motivated by existential concerns related to material security and safety, while higher-status individuals view these practices as platforms for personal and social enrichment, as they are more preoccupied with self-actualization, spiritual connection, and social affirmation, reflecting a more abstract engagement with religious practices. Our findings reveal the adaptability of ritual practices to meet a wide range of human needs across varying life circumstances, as rituals can be differentially negotiated by individuals within the same cultural context depending on the specific socioecological niches they occupy. Moreover, they highlight the role of culture as a dynamic and distributed system with important implications for anthropological theory and practice.

Socioeconomic and geographic variation in adjuvant chemotherapy among elderly patients with stage III colon cancer in Norway - a national register-based cohort study.

About half of the patients diagnosed with colon cancer are 70 years or older. Standard treatment for stage III colon cancer is major surgical resection followed by adjuvant chemotherapy (ACT). Norwegian guidelines recommend initiation of ACT within 6 weeks after resection. This study investigated socioeconomic and geographic variation in the recommended provision of ACT to elderly patients with stage III colon cancer in Norway. This population-based retrospective cohort study included patients aged 70 years or older diagnosed with stage III colon cancer between 2011 and 2021 who underwent major surgical resection. Individual data were obtained from national registries. Multilevel logistic regression analysis was used to model variation in provision of ACT. Of 4 501 included patients, 603 (13%) and 1 182 (26%) received ACT within 6 and 8 weeks after resection, respectively. The provision of ACT decreased with increasing age and frailty. Odds of ACT within 6 weeks decreased for patients with low socioeconomic status (SES) compared to high SES (odds ratio (OR) 0.67 (95% confidence interval (CI) 0.50-0.91)), and decreased for patients living alone compared to those living with a cohabitant (OR 0.72 (95% CI 0.58-0.91)). Geographic variation was found between hospital referral areas (OR 0.41-2.58). Our study found that ACT provision to elderly stage III colon cancer patients is associated with SES and geography, indicating variation in guidelines adherence. Further research is needed to explore the impact of ACT timing among elderly patients with stage III colon cancer in Norway.

Epidemiology of asthma across the ages.

In the last three decades, the overall prevalence of asthma appears to be plateauing, although large geographical and socioeconomic variation is evident. Overall, asthma prevalence slightly decreased in most age groups, except for school-aged children. Of note, asthma mortality steadily decreased, potentially highlighting improved asthma management strategies. Several epidemiological studies indicate that a complex interplay between genetic, environmental and immunological factors predisposes individuals to asthma inception and persistence across different life stages. Established risk factors for preschool wheezing to asthma persistence comprise a combination of pre- and post-natal parameters including maternal history of asthma, prematurity, caesarian section, early- life respiratory infections, exposure to air pollution or tobacco smoke and allergic polysensitization. On the other hand, persistence into adulthood is mainly driven by disease severity, allergic multimorbidity, relevant comorbidities, severe respiratory infections and tobacco smoke exposure. It is evident that asthma prevention strategies do not fit a "one size fits all" concept and key environmental interventions should be tailored to different regions of the world. Undoubtedly, the heterogeneity of asthma as a disease is at least partly reflected in the reported epidemiological measures, and continuing, methodologically rigorous studies, will allow us to unravel some of the observed discrepancies.

Inequalities in the Quality and Safety of Post-Diagnostic Primary Care for People With Dementia: A Scoping Review.

International guidelines make recommendations for the delivery of safe, high-quality primary care for people with dementia including prescribing, personalised care planning and regular holistic reviews. It is unclear how the quality and safety of this healthcare varies with socio-economic factors. This scoping review aimed to understand the depth and breadth of existing evidence exploring socio-economic variation in the quality and safety of primary care for people with dementia. Prescribing and care planning indicators of high-quality, safe primary care were defined from guidance. Composite and proxy markers of socio-economic status (SES) were defined. EMBASE, MEDLINE, PsychInfo, The Cochrane Database of Systematic Reviews, worldcat.org and clinicaltrial.gov databases were searched. Studies in English, on human participants from 2006 onwards were eligible. Narrative synthesis was conducted. Studies explored how one or more selected indicators (anti-dementia medication and anti-psychotic prescribing, potentially inappropriate prescribing (PIP), medication review, dementia review or care planning) varied with a recognised marker of SES in people with dementia. Searches identified 1980 studies after removing duplicates. 385 full texts were reviewed, with 53 eligible for inclusion (51 quantitative, 2 reviews). Most identified studies explored prescribing processes (50 quantitative, 2 reviews), with 2 exploring annual review. There was evidence of substantial disparity in quality and safety indicators in studies exploring prescribing; 20/29 (69%) of studies exploring anti-dementia medication prescribing found those with markers of lower SES were significantly less likely to receive these. 16/28 studies exploring PIP/Anti-psychotics found significant disparities in safe prescribing for those with markers of lower SES. Neither study exploring annual reviews found any significant differences across SES. We found evidence of disparity in the quality and safety of post-diagnostic primary care for people with dementia based on SES, particularly for a range of prescribing indicators. Further work exploring inequalities in care planning and reviews for people with dementia is needed to understand existing inequalities in the quality and safety of primary care for people with dementia.

Disparities in Thyroid Cancer Mortality Across Racial and Ethnic Groups: Assessing the Impact of Socioeconomic, Clinicopathologic, and Treatment Variations.

Thyroid cancer remains a significant public health concern, with disparities in mortality rates observed across racial/ethnic groups. We quantified the extent to which socioeconomic, clinicopathologic, and treatment variations explain racial/ethnic disparities in thyroid cancer mortality. We studied a cohort of 109,981 thyroid cancer patients diagnosed from 2006 to 2018 using the United States Surveillance, Epidemiology, and End Results database. We used multivariable logistic regression to assess the association of race/ethnicity with treatment status. We also performed mediation analyses to estimate how much the racial/ethnic differences in thyroid cancer-specific mortality were explained by variations in treatment and clinicopathologic and socioeconomic factors. Non-hispanic (NH) Black patients were more likely to not receive the recommended surgical resection than NH White patients (adjusted odds ratio [aOR] 1.10, 95% confidence interval [CI] 1.02-1.20). NH Black patients had a significantly higher risk of all-cause mortality compared with NH White patients (adjusted hazards ratio [aHR] 1.19, 95% CI 1.07-1.31). Mediation analysis showed that socioeconomic status significantly explained 48.7% (indirect effect HR 1.07, 95% CI 1.01-1.14) of the difference in thyroid cancer-specific mortality between NH Black and NH White patients. This study found that race/ethnicity was associated with treatment status and the risk of mortality among patients diagnosed with thyroid cancer. Moreover, clinicopathologic and socioeconomic factors were identified as the most crucial mediators that explained the excess mortality among minority groups. These findings provide insight into the pathways through which disparities in thyroid cancer mortality in NH Black and Hispanic thyroid patients could operate.

Hierarchical individual variation and socioeconomic impact on personalized functional network topography in children

BackgroundThe spatial layout of large-scale functional brain networks exhibits considerable inter-individual variability, especially in the association cortex. Research has demonstrated a link between early socioeconomic status (SES) and variations in both brain structure and function, which are further associated with cognitive and mental health outcomes. However, the extent to which SES is associated with individual differences in personalized functional network topography during childhood remains largely unexplored.MethodsWe used a machine learning approach—spatially regularized non-negative matrix factorization (NMF)—to delineate 17 personalized functional networks in children aged 9–10 years, utilizing high-quality functional MRI data from 6001 participants in the Adolescent Brain Cognitive Development study. Partial least square regression approach with repeated random twofold cross-validation was used to evaluate the association between the multivariate pattern of functional network topography and three SES factors, including family income-to-needs ratio, parental education, and neighborhood disadvantage.ResultsWe found that individual variations in personalized functional network topography aligned with the hierarchical sensorimotor-association axis across the cortex. Furthermore, we observed that functional network topography significantly predicted the three SES factors from unseen individuals. The associations between functional topography and SES factors were also hierarchically organized along the sensorimotor-association cortical axis, exhibiting stronger positive associations in the higher-order association cortex. Additionally, we have made the personalized functional networks publicly accessible.ConclusionsThese results offer insights into how SES influences neurodevelopment through personalized functional neuroanatomy in childhood, highlighting the cortex-wide, hierarchically organized plasticity of the functional networks in response to diverse SES backgrounds.

Socioeconomic Variation in Tobacco Smoking Among the Adult Population in Ireland.

Differences in smoking prevalence across socioeconomic groups are a major driver of health inequalities. Although smoking prevalence continues to decline across most developed countries, socioeconomic inequalities in smoking still persist. While Ireland is among a small number of countries with a tobacco-endgame goal set to achieve a smoking prevalence of 5% by 2025, the challenge this presents by socioeconomic status is uncharted. We analyzed how differences in smoking status across various socioeconomic groups have changed over time in the adult population in Ireland. We used cross-sectional smoking data from the national population-based Healthy Ireland Survey for 2015-2022 (n = 52494). Educational attainment and area-based deprivation were used as socioeconomic indicators. Socioeconomic differences and changes in inequality over time were identified using the relative index of inequality (RII). Multinomial logistic regression was used to analyze the association between socioeconomic status and daily smoking, occasional smoking, former smoking, and never smoking with adjustment for sex, age, and survey year. We observed the highest daily smoking rates among the least educated (OR = 11.62; 95% CI = 9.91, 13.63) and individuals living in the most deprived areas (OR = 4.23; 95% CI = 3.55, 5.04). Additionally, we identified significant relative smoking inequalities over the observation period continued to increase, among the least educated (RII = 2.86, 95%CI = 2.63, 3.09) and individuals living in the most deprived areas (RII = 2.64, 95% CI = 2.36, 2.93). Despite generally reducing smoking prevalence, socioeconomic inequalities continue to widen among the smoking population in Ireland. As the tobacco endgame deadline of 2025 is fast approaching, this study highlights the urgent need to consider potential effects across the lowest socioeconomic status groups when implementing equity-oriented tobacco control policies.

Socioeconomic inequalities of pregnancy termination among reproductive age women in Bangladesh: a decomposition analysis using demographic and health survey

ObjectivesUndergoing women of pregnancy termination (PT) significantly faces the problem of physical and mental health. This study aims to assess the prevalence and socioeconomic disparity factors of PT in Bangladesh. This study analyzed data from the 2017–18 Bangladesh Demographic and Health Survey. Researchers employed chi-square tests to identify relationships between categorical variables and logistic regression to pinpoint factors associated with PT. To assess the socioeconomic variation of PT, the analysis utilized concentration curves, concentration indices, and decomposition techniques.ResultsThe study found that 21.0% of reproductive-aged women in Bangladesh had ever terminated a pregnancy. Our study revealed that women from Chittagong and Sylhet regions, with wealthier backgrounds, aged 30 or older, employed in business, taking short birth intervals, and whose husband/partner was 35 or older, were more likely to have had a pregnancy termination with statistical significance (p < 0.05). Besides, concentration curves showed a higher prevalence of PT among wealthier women (CCI = 0.029, p < 0.001). Decomposition of this inequality revealed that a woman’s wealth status was the largest contributor (74.98%) to the observed disparities, followed by exposure to mass media (41.82%), place of residence (34.35%), occupation (24.81%), and preceding birth interval (6.53%). Our study recommended that, in mitigating the above disparities, we should foster open discussions about underlying factors contributing to PT in Bangladesh.

Liver Cancer Etiology: Old Issues and New Perspectives.

This review aims to synthesize the old issues and current understandings of the etiology of liver cancer, focusing on the diverse causative factors influenced by geographical, socioeconomic, and lifestyle variations across different regions. We highlight significant geographic disparities in liver cancer risk factors. While hepatitis B and C viruses, aflatoxin exposure, and alcohol consumption remain globally established contributors; metabolic dysfunction-associated steatotic liver disease and metabolic syndromes are increasingly prominent in the West. Chronic HBV and aflatoxin continue to dominate as risk factors in Asia and Africa. Dietary factors, metabolic diseases like diabetes and obesity, genetic predispositions, environmental risk factors and lifestyle choices such as smoking and alcohol use play substantial roles in specific populations. Protective factors like coffee and tea consumption, along with aspirin use, vegetables and fruits have shown potential in reducing HCC risk, although findings vary by population and dietary habits. Liver cancer etiology is influenced by various factors that differ by region. Established risk factors include hepatitis B and C, aflatoxin, and alcohol. Emerging risks, such as metabolic dysfunction-associated steatotic liver disease, are more prevalent in Western countries, while aflatoxin and HBV remains significant in Asia and Africa. Diet, metabolic conditions like diabetes and obesity, genetic predispositions, and lifestyle choices also play crucial roles. Coffee, tea, aspirin, vegetables, and fruits may reduce HCC risk, but effectiveness varies. Future research should integrate epidemiology, genetics, and nutrition, with global cooperation and data sharing essential for effective cancer control strategies.

Sex differences in clinically diagnosed psychiatric disorders over the lifespan: a nationwide register-based study in Sweden

Limited studies exist on sex differences in incidence rates of psychiatric disorders across the lifespan. This study aims to analyze sex differences in the incidence rates of clinically diagnosed psychiatric disorders over the lifespan. We conducted a nationwide register-based cohort study, including all individuals who were born in Sweden and lived in Sweden between 2003 and 2019, including 4,818,071 females and 4,837,829 males. We calculated sex- and age-specific standardized incidence rates for any and 10 major types of psychiatric disorders. Multivariable-adjusted incidence rate differences (IRDs) for diagnosed psychiatric disorders between females and males were estimated. During a follow-up of 119,420,908 person-years, males showed a higher incidence rate of any diagnosed psychiatric disorder than females at age 5-9 (IRD=-8.93; 95% CI:-9.08 to-8.79; per 1000 person-years), whereas females showed a higher rate than males at age 15-19 (IRD=9.33; 95% CI: 9.12-9.54) and onwards (except age 60-69). Specifically, among females, excess rates were apparent for depressive, anxiety, eating, stress-related and bipolar disorders at age 10-54, whereas among males, excess rates were pronounced for autism and attention deficit hyperactivity disorders before age 14, drug use disorders at age 15-54, and alcohol use disorders in adulthood. For schizophrenia, the male excess at age 15-49 shifted to female excess at age 60-79. The magnitude of IRDs were greater in recent years and individuals with lower socioeconomic status. Knowledge about the lifespan and socioeconomic variations in the sex differences in rates of diagnosed psychiatric disorders may inform targeted screening/intervention strategies. Vetenskapsrådet, FORTE, Karolinska Institutet Strategic Research Area in Epidemiology and Biostatistics, and Icelandic Research Fund.

Empirical Study on Delays in Highway Projects: A Comparative Analysis of Small and Large Projects

Delays in National Highway projects, regardless of their geographical location, have exerted a substantial impact on project performance and yielded unfavourable economic consequences. The majority of these projects in India are implemented by Public-Private Partnerships (PPPs), which use a wide range of contract types, including traditional ones such as item rate contracts and bills of quantity, in addition to more modern alternatives such as build operate transfer, engineering procurement and transfer, and recently developed hybrid models. This study examines and compares the reasons of critical delays in national highway projects in Himachal Pradesh with project characteristics. This mixed-methods study gathered comprehensive data from project participants using qualitative analysis and a survey questionnaire. Interviews and document analysis identified delay factors, which were then assessed through a structured questionnaire distributed to a representative sample of project participants. The findings highlight critical delay factors in National Highway projects in Himachal Pradesh and offer insights into the unique challenges faced by large PPP projects and small traditional projects. Despite the small sample size of 134 survey responses, the findings are significant but may have limited applicability to other infrastructure projects due to socio-economic and geographic variations. This suggests a research gap indicating that further analysis is needed to understand the challenges in EPC and PPPs for large hilly road projects, along with a focused study on organizational culture to assess highway project performance. This study contributes empirical data to the literature about the steep National Highway projects in Himachal Pradesh. Policymakers, project specialists, and stakeholders may ascertain the reasons of delays and formulate targeted actions to enhance project efficiency.

Abstract C155: Differential colorectal cancer mortality across racial and ethnic groups: Impact of socioeconomic status, clinicopathology, and treatment-related factors

Abstract Introduction: Non-Hispanic Black colorectal cancer (CRC) patients have a higher risk of mortality compared to most other racial/ethnic groups. Limited studies examine the contribution of socioeconomic (SES), clinicopathologic, or treatment variations toward mortality disparities. This retrospective cohort investigation examined the extent to which SES, clinicopathologic, and treatment factors explain racial/ethnic differences in CRC mortality. Methods: We studied 146,515 individuals ,18+ years old, with a confirmed diagnosis of CRC within 2010-2017 identified from the Surveillance, Epidemiology, and End Results (SEER) database. We performed Cox regression analyses to examine the association of race/ethnicity, surgery type, and tumor site with all-cause mortality and CRC-specific mortality. We then performed mediation analysis to quantify the extent to which mortality differences were mediated by SES, clinicopathologic, and treatment factors. Results: Non-Hispanic Black patients had a significantly higher hazard of all-cause mortality than non-Hispanic White patients. The non- Hispanic White versus non-Hispanic Black patients’ comparison demonstrated that variations in SES and clinicopathologic factors significantly explained 46.63% (indirect effect HR: 0.92, 95% CI 0.91-0.93) and 10.87% (indirect effect HR: 0.98, 95% CI 0.97-99) of the excess all-cause mortality among non-Hispanic Black patients, respectively. The Hispanic vs. non-Hispanic Black comparisons identified SES as the most influential mediator, explaining 19.68% of the excess all-cause mortality. The proportions mediating for CRC-specific mortality showed comparable outcomes to all-cause mortality. Conclusions Non-Hispanic Black patients had greater risk for all-cause mortality and CRC-specific mortality attributed to SES and clinicopathologic variations compared to other racial/ethnic groups. Future studies should investigate equity in healthcare through interventions addressing SES-related disparities. Citation Format: Pierre Fwelo, Toluwani E. Adekunle, Tiwaladeoluwa B. Adekunle, Ella R. Garza, Emily S. Huang, Wayne R. Lawrence, Aldenise P. Ewing. Differential colorectal cancer mortality across racial and ethnic groups: Impact of socioeconomic status, clinicopathology, and treatment-related factors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C155.

Racial disparities in access to liver transplantation in patients with early-stage hepatocellular carcinoma

BackgroundOrthotopic liver transplantation is the recommended treatment option for patients with early-stage hepatocellular carcinoma and concomitant cirrhosis. Waitlist candidacy can be affected by social determinants of health that vary across races and ethnicities. Our study sought to evaluate whether racial/ethnic disparities exist in access to orthotopic liver transplantation in patients with hepatocellular carcinoma. MethodsThe National Cancer Database participant use file was used to analyze data between 2004 and 2020. Patients 18–70 years of age with TNM clinical stage I and II hepatocellular carcinoma who received either orthotopic liver transplantation or liver directed/nonsurgical therapies were included. Baseline demographic variables and treatment modalities were collected. Patients were assigned fixed categories on the basis of race and ethnicity. Descriptive statistics, multivariable logistical regressions, effects modification analysis, and propensity matching were used. ResultsThere were 23,313 non-Hispanic White, 5,215 non-Hispanic Black, 5,581 Hispanic, and 2,768 other patients included in this analysis. Significant socioeconomic variation was observed across races. Non-Hispanic White patients were more likely to undergo orthotopic liver transplantation than non-Hispanic Black patients. The proportion of patients insured by Medicare was the same between non-Hispanic White and non-Hispanic Black patients. There was a graeter proportion of non-Hispanic Black patients with Medicaid compared with non-Hispanic White patients, whereas a lower proportion of non-Hispanic Black patients were insured via private insurance compared with non-Hispanic White patients. Effect modification analysis showed the non-Hispanic Black patients were less likely to undergo orthotopic liver transplantation for those with private and Medicare coverage compared with non-Hispanic White patients. Propensity matching showed a significantly decreased rate of orthotopic liver transplantation in non-Hispanic Black patients compared with non-Hispanic White patients. ConclusionNon-Hispanic Black patients were less likely to undergo orthotopic liver transplantation for early-stage hepatocellular carcinoma, despite adjusting for cancer stage and socioeconomic factors, compared with non-Hispanic White patients. Social determinants of health were associated with the probability of undergoing orthotopic liver transplantation. Understanding disparities related to social determinants of health will help guide health policy changes and improved access to care.

Socioeconomic determinants of child malnutrition: Evidence from Ethiopia

In this research, I examined the role of socioeconomic variations in the prevalence of stunting and underweight among children in Ethiopia. The study aimed to identify key health factors contributing to these disparities in child malnutrition by utilizing concentration indices, concentration curves, and regression-based decomposition analysis. Despite a notable decline in the average rates of stunting and underweight prevalence, the relative and absolute gaps between different demographic and socioeconomic groups have widened in Ethiopia. The empirical analysis revealed that higher levels of maternal education and household wealth significantly benefited children from better socioeconomic backgrounds, making them less likely to experience malnutrition. The disparity in socioeconomic status is the primary driver of inequalities in child malnutrition. The findings suggest that to reduce these disparities, national health policies should focus on promoting maternal literacy and targeting interventions for underprivileged groups.

Age-Related Blood Pressure Gradients Are Associated With Blood Pressure Control and Global Population Outcomes.

The strong relationship between blood pressure (BP) and age is well known. Limited evidence suggests that a steeper age-BP slope may be associated with an increased risk of adverse outcomes. The May Measurement Month campaign enables an investigation of geographic, socioeconomic, and sex differences in age-related BP gradients and their association with public-health outcomes. Cross-sectional, annual global BP May Measurement Month screening data were analyzed. Average systolic BP and age-related BP slopes across different age groups were calculated to assess regional, socioeconomic, and sex-stratified variations. The association of BP slopes derived from adjusted linear regression models with country-level health metrics was investigated. Age-related systolic BP gradients differed distinctly across global geographic regions, income levels, and between sexes. The steepest age gradients of BP were observed in populations from Africa and Europe. Women had lower BP levels than men at younger ages (20s and 30s) but subsequently experienced more pronounced age-related BP gradients. Geographically divergent age-related BP gradients were significantly associated with major national public health indicators. Globally, steeper age-related BP slopes were associated with poor BP control, increased disability-adjusted life years, and death rates. A steeper population age-BP slope of 1 mm Hg per 10 years was associated with a decrease in life expectancy of 3.3 years in this population (95% CI, -5.1 to -1.4; P=0.0007). Age-related BP gradients vary considerably across global populations and are associated with variability in BP-related risks and adverse outcomes across regions. Effective public health strategies may require region-specific targeting of adverse BP gradients to improve health outcomes.

Understanding the cataract treatment disparities among older adults in India.

Cataract is a leading cause of global blindness, affecting around 33% of blind individuals worldwide. It significantly impacts individuals' well-being, independence, and quality of life, posing a substantial economic burden. India's rapidly ageing population necessitates an examination of cataract prevalence and treatment disparities. No attempts have been made to address socioeconomic variation in treatment disparities of effective cataract treatment coverage among older adults in India. This study utilises data from the Longitudinal Ageing Study of India (LASI) conducted in 2017-18, that covered, 73,396 individuals aged 45 and above. Logistic regression, univariate, and bivariate analyses were employed to understand the variation of cataract and their associations with various demographic factors. Visual acuity tests and self-reported cataract data were used. The prevalence of cataract among older adults in India was 14.25%, with higher rates among females and the older adult. Socioeconomic disparities werelarge, with lower prevalence among those with higher education and urban residence. Despite the effectiveness of cataract surgery, disparities in treatment access and effective coverage persisted. Approximately 27.52% of older adults did not receive cataract treatment, and those who received out of them 28% did not receive effective treatment. The effective treatment was lower among female, less educated, and poor. Cataract remains a significant public health concern in India, particularly among older adults. The study highlights the importance of addressing socioeconomic disparities in cataract treatment access and quality of care. Targeted interventions are needed to bridge these gaps, ultimately improving visual health outcomes and well-being among older adults in India.

Level of education, but not occupation, is differentially associated with asthma phenotypes in adults.

Education, but not occupation, was differentially associated with adult asthma phenotypes in the general population. Further research into socioeconomic status variation in various asthma phenotypes is warranted.

Socioeconomic and regional variations in repair modality for ruptured abdominal aortic aneurysms

BackgroundPrevious studies report that patients of racial/ethnic minorities more frequently present with ruptured abdominal aortic aneurysms (rAAAs) than their counterparts. The distribution of rAAA treatment modality, whether open aneurysm repair (OAR) or endovascular aneurysm repair (EVAR), by race/ethnicity classification remains uncertain. This study aims to investigate disparities, as represented by race/ethnic classification, median income, and insurance status, in the management of rAAA in a national cohort. MethodsWe conducted a retrospective analysis of patients admitted with rAAA managed with either OAR or EVAR from 2002 to 2020 using the National Inpatient Sample, comparing repair type by race/ethnicity group. Multilevel mixed effects logistic regression models, adjusted for patient- and system-level factors, were used to calculate difference in use of OAR or EVAR dependent on race/ethnicity classification. ResultsWe identified 10,788 admissions for rAAA repairs, of which 9506 (88.1%) were White, 605 (5.6%) were Black, 424 (3.9%) were Hispanic, and 253 (2.4%) were Asian/Native American. Asians/Native Americans underwent the highest frequency of OAR as compared with EVAR (61.7% vs 38.3%). In the adjusted model, there was no statistically significant difference in the use of OAR vs EVAR by race/ethnicity classification. In total, primary payer and median income were also not statistically significant predictors of AAA treatment modality. ConclusionsOur study found no statistical evidence of disparities with respect to race, insurance, or median income and use of OAR or EVAR for the management of rAAA.