Socioeconomic Variation Research Articles

Does Combining Antenatal Care Visits at Health Posts and Health Centers Improve Antenatal Care Quality in Rural Ethiopia?

Even though quality maternal care is crucial for the well-being of women and their newborns, the inferior quality of antenatal care in rural Ethiopia is a timely concern. This study aimed to investigate the effects of combining antenatal care visits at health posts and health centers on improving antenatal care quality in rural Ethiopia. Using the 2019 Ethiopia Health Extension Program assessment done by MERQ, we extracted and analyzed the survey responses of 2,660 women who had received at least one antenatal visit from a primary health care unit. We measured the cumulative count of quality of antenatal care using the Donabedian model. To model the differences in the quality of antenatal care at health posts and health centers, we used zero-truncated Poisson regression and reported incidence risk ratios with their 95% confidence intervals. The quality of antenatal care increased by 20% (adjusted IRR= 1.20 [1.12-1.28]) when antenatal care reception was mixed at health posts and health centers, compared to those who received all antenatal care only from health posts. Quality differences based on socioeconomic status and setting variations were observed as predictors of quality of care, even if women received antenatal care at both health posts and health centers. Combining antenatal care provision from health posts and health centers should be sustained as one of the antenatal care quality improvement strategies in rural parts of Ethiopia while ensuring the equitable provision of quality care across socioeconomic groups and between agrarian and pastoral settings.

Examining socioeconomic factors associated with wildfire occurrence and burned area in Galicia (Spain) using spatial and temporal data

BackgroundThe Spanish region of Galicia is one of the most fire-prone areas in Europe. Most wildfires are directly or indirectly related to human activities, suggesting that socioeconomic factors likely can inform wildfire management. Socioeconomic factors, for example, could help explain the causes and distribution of wildfires spatially and temporally within the region. We sought to examine how socioeconomic and biophysical variables and their fluctuations over time (2000–2015) might influence wildfire ignitions and hectares burned in Galicia using municipality-level data describing socioeconomic factors and forest land wildfires.ResultsWe used cluster analysis to characterize socioeconomic variation in our data set and regression analysis of panel data to investigate jointly the temporal and spatial dimensions of correlation between socioeconomic factors and wildfires. Using cluster analysis, we divided the region inter-territorially according to socioeconomic characteristics. Clustering divisions were found to have a similar pattern to that of Galician provinces. Our regression models for each cluster indicate that several socioeconomic factors are at least correlated with and may tend to influence wildfire occurrence and burned area in Galicia. We also found discernible patterns related to our identified clusters, confirming that differences between territories exist regarding the likely influence of socioeconomic factors on the number of wildfire ignitions and hectares burned.ConclusionsResults suggest that socioeconomic factors are as crucial as meteorological variables for understanding wildfire ignitions and burned area in Galicia (Spain). Accurate knowledge of inter-territorial socioeconomic differences could help public officials and forest managers to design wildfire prevention policies best suited to the socioeconomic, cultural, and environmental circumstances of each territory.

The spatial implications of academic achievement in Year 12: Rethinking discourses of disadvantage in rural locations

Rurality is an identified point of disadvantage in measures such as the Index of Community Socio-Educational Advantage (ICSEA) and school resourcing models. However, socioeconomic disadvantage is commonly used as an explanation for lower average student achievement in rural locations. Thus, policies are often directed towards reducing disadvantage associated with socioeconomic status, and rurality is overlooked. This research tests the validity of these assumptions using a matched study approach. We examine data on New South Wales (NSW) students, schools and courses to investigate how the English and Mathematics achievement levels of students in their final year of secondary school are associated with family and school characteristics across locations. The findings show that socioeconomic variation does not fully account for differences in achievement in rural locations. Instead, rurality appears to mediate other effects on student achievement in a complex interplay of factors contributing to lower average results. This highlights the need to consider the specificities of rurality in schooling, particularly the role of rural knowledges and perspectives in schooling and student achievement.

Socio-economic variations of breast cancer treatment and discontinuation: a study from a public tertiary cancer hospital in Mumbai, India

BackgroundThe study examined the socio-economic variation of breast cancer treatment and treatment discontinuation due to deaths and financial crisis.MethodsWe used primary data of 500 patients with breast cancer sought treatment at India’s one of the largest cancer hospital in Mumbai, between June 2019 and March 2022. This study is registered on the Clinical Trial Registry of India (CTRI/2019/07/020142). Kaplan–Meier method and Cox-hazard regression model were used to calculate the probability of treatment discontinuation.ResultsOf the 500 patients, three-fifths were under 50 years, with the median age being 46 years. More than half of the patients were from outside of the state and had travelled an average distance of 1,044 kms to get treatment. The majority of the patients were poor with an average household income of INR15,551. A total of 71 (14%) patients out of 500 had discontinued their treatment. About 5.2% of the patients died and 4.8% of them discontinued treatment due to financial crisis. Over one-fourth of all deaths were reported among stage IV patients (25%). Patients who did not have any health insurance, never attended school, cancer stage IV had a higher percentage of treatment discontinuation due to financial crisis. Hazard of discontinuation was lower for patients with secondary (HR:0.48; 95% CI: 0.27–0.84) and higher secondary education (HR: 0.42; 95% CI: 0.19–0.92), patients from rural area (HR: 0.79; 95% CI: 0.42–1.50), treated under general or non-chargeable category (HR: 0.60; 95% CI:0.22–1.60) while it was higher for the stage IV patients (HR: 3.61; 95% CI: 1.58–8.29).ConclusionIntegrating breast cancer screening in maternal and child health programme can reduce delay in diagnosis and premature mortality. Provisioning of free treatment for poor patients may reduce discontinuation of treatment.

Association of individual-socioeconomic variation in quality-of-primary care with area-level service organisation: A multilevel analysis using linked data.

Ensuring equitable access to primary care (PC) contributes to reducing differences in health related to people's socioeconomic circumstances. However, there is limited data on system-level factors associated with equitable access to high-quality PC. We examine whether individual-level socioeconomic variation in general practitioner (GP) quality-of-care varies by area-level organisation ofPC services. Baseline data (2006-2009) from the Sax Institute's 45 and Up Study, involving 267,153 adults in New South Wales, Australia, were linked to Medicare Benefits Schedule claims and death data (to December 2012).Small area-level measures of PC service organisation were GPs per capita, bulk-billing (i.e., no copayment) rates, out-of-pocket costs (OPCs), rates of after-hours and chronic disease care planning/coordination services. Using multilevel logistic regression with cross-level interaction terms we quantified the relationship between area-level PC service characteristics and individual-level socioeconomic variation in need-adjusted quality-of-care (continuity-of-care, long-consultations, and care planning), separately by remoteness. In major cities, more bulk-billing and chronic disease services and fewer OPCs within areas were associated with an increased odds of continuity-of-care-more so among people of high- than low education (e.g., bulk-billing interaction with university vs. no school certificate 1.006 [1.000, 1.011]). While more bulk-billing, after-hours services and fewer OPCs were associated with long consultations and care planning across all education levels, in regional locations alone, more after-hours services were associated with larger increases in the odds of long consultations among people with low- than high education (0.970 [0.951, 0.989]). Area GP availability was not associated with outcomes. In major cities, PC initiatives at the local level, such as bulk-billing and after-hours access, were not associated with a relative benefit for low- compared withhigh-education individuals. In regional locations, policies supporting after-hours access may improve access to long consultations, more so for people with low- compared with high-education.

Morphometric evolution of the domestic triad, in western Gallia Narbonensis (southern France, Languedoc), between the 2nd c.BC and the 4th c.AD: Preliminary and critical use of log size index for diachronic analysis

In bioarchaeology, the biometry of archaeozoological remains is an important component of studies on domestic species and size has been used for multiple purposes from identifying domestication, to track environmental changes or evolution of husbandry practices. The establishment of the Roman Empire has been accompanied by social, political and economic transformations that also reflect in farming practices and animal husbandry. In southern France, biometric variation has already been partially perceived during Roman times, particularly for cattle, but lack chronological accuracy and statistical validation.This paper presents a diachronic analysis of linear measurements of post-cranial bones belonging to the domestic triad (sheep, goat, cattle and suids) in western Gallia Narbonensis (France), between the Roman conquest and Late Antiquity, i.e. from 200 BCE to 400 AD. Biometric data from 64 archaeological sites, excavated and studied over more than 30 years of preventive archaeology, were analysed using a Log Size Index (LSI) approach using time as a continuous variable. The analysis of 5533 measurements first analysed per bone and variable, then separating length, breadth and depth dimensions, revealed different trends, highly influenced by the number of measurements, reflecting allometric differences but also cases of asynchronous evolution. However, these allometries within species are small when compared to interspecies differences. Overall, the size of the four taxa increased from the 2nd century BC to the 2nd century AD. Cattle and pig sizes then decreased from the 2nd century AD and only from the 4th century onwards for goats, while sheep size tends to increase during the 3rd-4th centuries. If the Roman conquest influences the size of the domestic animals, this does not affect the four species in the same way. This potentially reflects differentiated agropastoral strategies for each of the species in the western part of Gallia Narbonensis during the Roman period. This study, which provides a diachronic and cross-species study framework, should be seen as a first step for a more in-depth understanding of micro-regional and socio-economic variation in domestic species morphologies.

One nation one health—Preview through Ayurveda

For many years, the definition of “health” has remained untouched as a narrow concept, encircling physical well-being from a medical context. Over the past years, different healthcare experts, whether groups or individuals, have developed and defended various definitions of what a proper state of “health” actually means in the present time. Human health cannot be separated from the health of our total planetary biodiversity in today’s world. Human beings live in an interdependent existence with the totality of the living world. We now know how liable our human well-being is to the “health” of the Earth’s energy exchange systems. The sustained good health of populations, along with the holistic approach to health and diseases, also requires a proper management of our social resources, economic relations, and the natural world because today’s public health has its roots in the same socioeconomic variations. India is known for its own traditional medicine, far older than modern medicine, with a state-owned education, practice, and research system. The world has recently recognized science’s efficacy in health and wellness. Ayurveda is not limited to medicine or therapy for a target organ; instead, it implies a holistic approach to life and living in harmony with nature. Ayurveda perceives human beings as the microcosm of the macrocosm and highlights how human life is interconnected and interdependent on nature. In achieving health, it always stresses this connection and uses strategies connecting humans to nature. Ayurveda practices assist individuals in taking control of their health and increasing self-reliance, and re-begin their relationship with the environment. Thus, Ayurveda can play an essential part in the One Nation, One Health System as the whole wellness of a nation and environment rather than individual health.

Impact of Education and Socio-Economic Status on Post-Natal Body Weight using Machine Learning Approach

Background: The maternal education and socio-economic status of the mother greatly affect the growth ofthe baby. Nutritional deficiency is the major cause of motor and physiological disorders in children. Hence,predicting body weight could be used to monitor the growth of the babies. Although the prediction ofweights is standardized by World Health Organization (WHO), for babies based on their gender and age;generalizing it for all locations and socio-economic variations is not possibleMethod: Hence, in this paper, an ANN-based predictive approach to establish the relationship betweenthe factors like socioeconomic status, age, and prior weights to predict the baby’s weight using a locallyacquired dataset. This could be helpful for the health workers to properly diagnose the disease a time ahead.Conclusion: The proposed work suggests predicting the baby’s growth rate using Machine Learning (ML)techniques is both an efficient and feasible approach.

Regional variation in sudden unexpected death in infancy in New Zealand.

To estimate the relative risk of sudden unexpected death in infancy (SUDI) by district health board (DHB) in New Zealand after adjustment for socio-economic deprivation, ethnicity and other demographic factors. We conducted a population-based cohort study using data from the Integrated Data Infrastructure, a large research database containing linked data from a range of government agencies. The study population was all live births and their mothers in New Zealand from 2012 to 2018. The exposure of interest was DHB. The outcome was SUDI. There were 418 068 live births in New Zealand from 2012 to 2018, and of these 415 401 (99.4%) had valid DHB data. There was considerable variation in the proportion of infants in each DHB living in the most deprived decile varying from 4.5% in Nelson, West Coast and Canterbury to 29.7% in Counties Manukau. There were 267 SUDI cases, giving an overall rate of 0.64/1000 live births during the study period (2012-2018). The SUDI rate varied from 1.11/1000 in Northland to 0.30/1000 in Waitemata and Auckland. Counties Manukau had the largest number of deaths (n=54; rate=1.08/1000). Five DHB regions had increased risk of SUDI compared to the reference group but, after adjustment, no DHB was significantly increased. This study found that there is marked variation in SUDI risk by DHB, but this is explained by socio-economic and demographic variation within DHBs. This study emphasises the importance of the contribution of social determinants of health to SUDI.

Socio-economic and regional variation in breast and cervical cancer screening among Indian women of reproductive age: a study from National Family Health Survey, 2019-21

BackgroundIn India, breast and cervical cancers account for two-fifths of all cancers and are predominantly prevalent among women in the reproductive age group. The Government of India recommended screening of breast and cervical cancer among women aged 30 years and over. This study examines the socio-economic and regional variations of breast and cervical screening among Indian women in the reproductive age.MethodsA full sample of 707,119 women aged 15–49 and a sub-sample of 357,353 women aged 30–49 from National Family Health Survey-5 (2019-21) were used in the analysis. Self-reported ever screening for breast and cervical cancer for women aged 15–49 and women aged 30–49 were outcome variables. A set of socio-economic and risk factors associated with breast and cervical cancer screening were used as the predictors. Logistic regression was used to understand the significant correlates of cancer screening and, concentration index and concentration curve were used to assess the socio-economic inequality in breast and cervical cancer screening.ResultsThe proportion of breast and cervical cancer screening among women aged 30–49 were 877 and 1965 per 100,000 women respectively. Cancer screening was lower among women who were poor, young, had lower educational attainment and resided in rural areas. The concentration index was 0.2 for ever screening of breast cancer and 0.15 for cervical cancer among women aged 30–49 years. The concertation curve for screening of both breast and cervical cancers was pro-rich. Women with higher educational attainment [OR:1.46, 95% CI: 1.31–1.62], aged 40–49 years [OR:1.35; 95% CI: 1.28–1.43], resided in the western [OR:1.62; 95% CI:1.4–1.87] or southern [OR:6.66; 95% CI:5.93–7.49] region had significantly higher odds of up taking either of the screening. The pattern of breast and cervical cancer screening among women aged 15–49 was similar to that of women 30–49.ConclusionThe overall proportion of cancer screening among women in 30–49 age group is low in India. Early screening and treatment can reduce the burden of these cancers. Creating awareness and providing knowledge on cancer could be a key strategy for reducing the burden of breast and cervical cancers among women in the reproductive age in India.

RELASI DAN DAMPAK DESTINASI KAMPUNG WAYANG TERHADAP SOSIAL EKONOMI MASYARAKAT (Studi Pada Desa Kepuhsari Kecamatan Manyaran Kabupaten Wonogiri)

There is a tendency that nowadays tourists prefer to travel to the village because the village gives other nuances that have not been found in modern tourism. Tourism to the village then gave birth to a concept called a tourist village, a rural tourism destination. Tourist visits will have an impact on socio-economic changes in rural communities. This research was conducted with the aim of knowing the relationship and impact of Kampung Wayang Destinations on the Socio-Economic Society of Kepuhsari village, Manyaran sub-district. This research is a descriptive survey method using an instrument in the form of a questionnaire. The population is 129 people, consisting of pokdarwis members, homestay owners and people who participate in the wayang village destination activities. By setting a sample of 30% taken proportionally to 39 respondents. The sampling technique used was simple random sampling. The analytical tool used is regression-correlation using SPSS software version 21. The results show that tcount = 5,492 > ttable = 2,026, then Ho is rejected and Ha is accepted so that there is a significant effect of Kampung Wayang Destinations on the Socio-Economic Society of Kepuhsari village, Manyaran sub-district. The relationship between the two is quite strong namely R=0,67. While the contribution of the wayang village destination to the socio-economic variation of the community R2 = 0,449 is 44.9%.

Demographic Patterns and Outcomes of Multiple Myeloma Patients Received Autologous Stem Cell Transplant: A Nationwide Analysis

Introduction: Triplet or quadruplet regimens with autologous stem cell transplant(ASCT) in eligible patients has become the standard of care for multiple myeloma(MM) in recent years due to improved outcomes. Significant racial and socioeconomic variations were observed in the past in regards to treatment utilization and outcomes. We aim to explore the demographic, racial distribution and inpatient mortality trends among MM patients receiving ASCT in recent years. Methods: Cases with a diagnosis of MM that received an ASCT were identified from the National Inpatient Sample database from 2016 to 2019 using the International Classification of Disease 10th Revision Diagnosis and Procedure Codes. Cochran Armitage test of trend, Chi-square tests and ANOVA tests were used to analyze trends, inpatient deaths (IPDs), and means between different groups of interest. The results are statistically weighted. Results: A total of 477,065 MM cases were identified from 2016-2019, out of which 25,145 received ASCT. The number of patients that received ASCT from 2016-2019 were 5925, 6185, 6625, and 6410 respectively. During the same time frame, the proportion of cases aged less than 65 were 3700 (62.4%), 3815 (61.7%), 3900 (58.9%), 3820 (59.6%), P<0.001. The number of cases in the age range 65-74 were 1840 (31.1%), 1920 (24%), 2155 (27%), 2075 (26%), P = 0.039 and the proportion of patients aged 75 and above were 135 (2.3%), 175 (2.8%), 240 (3.6%), 225 (3.5%), P <0.001. Females that received ASCT were 2660 (45%), 2585 (41.8%), 2805 (42.3%), 2690 (42%), P=0.003. The mean Charlson Comorbidity Index (Standard Deviation) from 2016 to 2019 was 4.36 (1.36), 4.37 (1.54), 4.48 (1.53), 4.53 (1.62), P <0.001. From 2016-19, the proportion of Caucasians, Blacks, Hispanics and Asian/Pacific Islanders are stated in Table 1. IPDs among ages less than 65, 65-74, and 75 and above from 2016-2019 were 125 (0.8%), 45 (0.6%) and 15 (1.9%) respectively. IPDs among Blacks was 10 (0.2%) when compared to Non-blacks 185 (0.9%), P<0.001. Caucasians noted to have an IPD of 125 (0.8%) compared to non-Caucasians 70 (0.7%), P=0.364, while Hispanics had IPDs in 20 (0.9%) compared to 175 (0.8%) in Non-hispanics, P=0.369. Conclusion: From 2016 to 2019, we observed an overall increase of MM patients receiving ASCT and continued to notice the similar trend among males. Hispanics and Asian/Pacific islanders were also noted to have an increasing trend of ASCT during the same time period. Conversely, there was a decrease in the proportion of MM patients receiving ASCT among the age group less than 65, 65-74, and females. IPD was noted to be lower in blacks; and also in the 65-74 years age group but higher among age 75 and above who received ASCT. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Variations in the patterns of tobacco usage among indian females - findings from the global adult tobacco survey India

BackgroundMales dominate in tobacco usage, as well as in tobacco research, knowing that women face more severe health consequences. There is a specific lack of information on epidemiological statistics, risks, and the level of knowledge among women regarding tobacco. This study examines the Global Adult Tobacco Survey (GATS)-India dataset to estimate female tobacco usage and assess socio-economic variations in tobacco consumption, awareness regarding the adverse effects of tobacco, noticing pack health warnings (PHW), and intention to quit tobacco use well as factors influencing these domains.MethodsUsing a geographically clustered multistage sampling method, the nationally representative GATS II (2016–17) interviewed 40,265 female respondents aged 15 years and above from all Indian states and union territories. Standard operational definitions were used to estimate the primary independent variables (community, individual, and household categories) and dependent variables like awareness regarding the adverse effects of tobacco, noticing pack health warning (PHW), and intention to quit tobacco. Sampling weights were adjusted while performing the analysis. Bivariate and multivariable analysis were used to generate the estimates.ResultsOf the total female respondents, 84.2% were never-users, 13.3% ever consumed Smokeless Tobacco (SLT) products, 1.8% ever smoked tobacco, and 0.8% were dual users once in their lives. Around 16% of the women had exposure to Second Hand Smoke (SHS) either at their homes, workplaces or in public places. Overall, maximum awareness was seen among non-smoker females (64.7%) and dual users (64.7%), followed by women exposed to SHS, SLT users, and smokers. PHW was noticed more by the bidi smokers, followed by SLT users and cigarette smokers. Factors that positively affected intention to quit smoking included younger age, secondary school education, self-employed status, the habit of buying packed cigarettes/bidi, believing that smoking causes serious illness, and attempted quitting in the last 12 months.ConclusionA high proportion of women consume tobacco which is significantly influenced by socio-demographic factors. Tobacco regulators should be especially concerned about women as the tobacco marketing experts target them. Mobilizing self-help groups and organizations working for women and children could assist broader campaigns to generate awareness and motivate quitting attempts.

Spatial and socioeconomic inequities in liveability in Australia's 21 largest cities: Does city size matter?

Spatial and area-level socioeconomic variation in urban liveability (access to social infrastructure, public transport, open space, healthy food choices, local employment, street connectivity, dwelling density, and housing affordability) was examined and mapped across 39,967 residential statistical areas in Australia's metropolitan (n=7) and largest regional cities (n=14). Urban liveability varied spatially, with inner-city areas more liveable than outer suburbs. Disadvantaged areas in larger metropolitan cities were less liveable than advantaged areas, but this pattern was reversed in smaller cities. Local data could inform policies to redress inequities, including those designed to avoid disadvantage being suburbanised as cities grow and gentrify.

How Stress Is Related to Age, Education, Physical Activity, Body Mass Index, and Body Fat Percentage in Adult Polish Men?

Stressful events and chronic tension are considered a burden and a threat to physical, mental, and social health. The aim of the study was to demonstrate the associations of variation in stress exposure with social factors, physical activity, basic components of physical fitness, body mass index (BMI) and percentage of body fat (BFP). An additional objective was to identify the main BFP modifiers among those analyzed. The material consisted of data of ethnically homogeneous group 355 men (32–87 yrs), invited to the study as part of the Wroclaw Male Study research project. The analyzed features included socioeconomic status (age, educational level), elements of lifestyle (physical activity), major and most important stressful life events—Social Readjustment Rating Scale (SRRS) and basic parameters of the somatic structure of the body (BMI, BFP). Statistical analyses included: chi-square test, Mann–Whitney U test and backward stepwise regression (significance level α = 0.05). Stress exposure showed significant socioeconomic variation among the adult Poles studied. Higher levels of education were associated with higher levels of stress. Significant correlations between SRRS and physical activity were found, especially in men older than 60 years and with higher levels of education. A positive relationship was shown between SRRS and BFP, especially in men under 60 years of age. BFP appeared to depend mainly on age and stress. The main determinants of SRRS were age and education level, while BFP turned out to be more sensitive to stress than BMI. The modifying force of physical activity for SRRS appears to be age dependent.

Socioeconomic Variation in the Relationship Between Neighbourhoods' Built Environments and the Spread of COVID-19 in Toronto, Canada.

The novel coronavirus disease 2019 (COVID-19) pandemic underscores the importance of place of residence as a determinant of health. Prior work has primarily examined the relationship between neighbourhoods’ sociodemographic traits and COVID-19 infection rates. Using data from the City of Toronto, Canada, we assess how the built environments of neighbourhoods, in conjunction with their sociodemographic profiles, shape the pattern of spread of COVID-19 in low-, middle-, and high-income neighbourhoods. Our results show that COVID-19 spread faster in neighbourhoods with a higher share of overcrowded households, large commercial areas, and poor walkability. The extent to which neighbourhood walkability is associated with a slower increase in COVID-19 infections varied by neighbourhood income level, with a stronger negative association in low-income neighbourhoods. Net of the share of overcrowded households, population density is associated with a faster increase in COVID-19 infections in low-income neighbourhoods, but slower increase in high-income neighbourhoods. More green space is associated with a slower increase in COVID-19 infections in low-income, but not higher-income, neighbourhoods. Overall, our findings suggest that post-pandemic urban planning efforts cannot adopt a one-size-fits-all policy when reconstructing neighbourhoods in ways that promote health and reduce their vulnerability to infectious diseases. Instead, they should tailor the rebuilding process in ways that address the diverse needs of residents in low-, middle-, and high-income neighbourhoods.

Associations among drinking water quality, dyslipidemia, and cognitive function for older adults in China: evidence from CHARLS

BackgroundThe current study aimed to examine the association between drinking water quality and cognitive function and to identify the direct and indirect effects of drinking water quality and dyslipidemia on cognitive function among older adults in China.MethodsPrimary data for the study were selected from China Health and Retirement Longitudinal Study (CHARLS, 2015) and 4,951 respondents aged 60 and above were included. Data on drinking water quality were selected from the 2015 prefectural water quality data from the Institute of Public and Environment Affairs in China and measured by the Blue City Water Quality Index. Dyslipidemia was measured by self-reported dyslipidemia diagnosis and lipid panel. Three composite measures of cognitive function included mental status, episodic memory, and global cognition. Mixed effects models were conducted to assess the associations between drinking water quality or dyslipidemia and cognitive function. The mediation effects of dyslipidemia were examined by path analyses.ResultsExposure to high quality drinking water was significantly associated with higher scores in mental status, episodic memory, and global cognition (β = 0.34, p < 0.001 for mental status; β = 0.24, p < 0.05 for episodic memory; β = 0.58, p < 0.01 for global cognition). Respondents who reported dyslipidemia diagnosis had higher scores in the three composite measures of cognitive function (β = 0.39, p < 0.001 for mental status; β = 0.27 p < 0.05 for episodic memory; β = 0.66, p < 0.001 for global cognition). An elevated blood triglycerides was only associated with higher scores in mental status (β = 0.21, p < 0.05). Self-reported dyslipidemia diagnosis was a suppressor, which increased the magnitude of the direct effect of drinking water quality on mental status, episodic memory, and global cognition.ConclusionDrinking water quality was associated with cognitive function in older Chinese and the relationship was independent of natural or socioeconomic variations in neighborhood environments. Improving drinking water quality could be a potential public health effort to delay the onset of cognitive impairment and prevent the dementia pandemic in older people.

Neighbourhood rental market integration and private rent trajectories – evidence from the city of Vienna

ABSTRACT The urban housing regime in Vienna is often regarded as one of the last integrated rental markets once described by Kemeny. Thus, according to the theory, private landlords should be forced to charge lower rents due to direct competition from the social sector. This paper formally tests this hypothesis on a very local level by linking private rent trajectories across Viennese subdistricts to their housing market structure while controlling for possible effects of location, initial prices and socioeconomic variation. Indeed significant evidence for a price dampening effect is found, as higher shares of limited-profit housing within the local rental market substantially increase the probability of a subdistrict joining a lower rent development path. However, the magnitude of the effect increases considerably for more peripheral locations associated to less demand pressure. A similar relationship is found for municipal housing, but with much lower impact, most likely due to comparatively stronger entry barriers. Thus this paper concludes a price dampening neighbourhood effect which varies with the openness of the social housing supply and the centrality of the location.

Mortality burden due to long-term exposure to ambient PM2.5 above the new WHO air quality guideline based on 296 cities in China.

Quantifying the spatial and socioeconomic variation of mortality burden attributable to particulate matters with aerodynamic diameter ≤ 2.5 µm (PM2.5) has important implications for pollution control policy. This study aims to examine the regional and socioeconomic disparities in the mortality burden attributable to long-term exposure to ambient PM2.5 in China. Using data of 296 cities across China from 2015 to 2019, we estimated all-cause mortality (people aged ≥ 16 years) attributable to the long-term exposure to ambient PM2.5 above the new WHO air quality guideline (5 µg/m3). Attributed fraction (AF), attributed deaths (AD), attributed mortality rate (AMR) and total value of statistical life lost (VSL) by regional and socioeconomic levels were reported. Over the period of 2015-2019, 17.0% [95% confidence interval (CI): 7.4-25.2] of all-cause mortality were attributable to long-term exposure to ambient PM2.5, corresponding to 1,425.2 thousand deaths (95% CI: 622.4-2,099.6), 103.5/105 (95% CI: 44.9-153.3) AMR, and 1006.9 billion USD (95% CI: 439.8-1483.4) total VSL per year. The AMR decreased from 120.5/105 (95% CI: 52.9-176.6) to 92.7/105 (95% CI:39.9-138.5) from 2015 to 2019. The highest mortality burden was observed in the north region (annual average AF = 24.2%, 95% CI: 10.8-35.1; annual average AMR = 137.0/105, 95% CI: 60.9-198.5). The highest AD and economic loss were observed in the east region (annual average AD = 390.0 thousand persons, 95% CI: 170.3-574.6; annual total VSL = 275.6 billion USD, 95% CI: 120.3-406.0). Highest AMR was in the cities with middle level of GDP per capita (PGDP)/urbanization. The majority of the top ten cities of AF, AMR and VSL were in high and middle PGDP/urbanization regions. There were significant regional and socioeconomic disparities in PM2.5 attributed mortality burden among Chinese cities, suggesting differential mitigation policies are required for different regions in China.

Geographic and socio-economic variations in markers of household air pollution in India: prevalence, determinants, and co-exposure

Geographic and socio-economic variations in markers of household air pollution in India: prevalence, determinants, and co-exposure