Socioeconomic Status Research Articles

An Exploration of The Influences of Childhood Socioeconomic Status on Neural Development and Functioning

The review of literature examines the relationship between socioeconomic status and neurological development according to current studies. This article specifically investigates how the socioeconomic status of childhood influences the development of the brain and cognitive functioning even into adulthood. The measurements of socioeconomic status like education, household income, and neighborhood demographics are each found to independently influence neural development, thus affecting cognitive functioning. This article investigates how factors of socioeconomic status affect specific brain structures and cognitive functions. Low socioeconomic status was found to negatively impact neural development and hinder cognitive abilities and growth. High parental education specifically is linked to greater cognitive functioning and skills as it contributes to greater cognitive enrichment in the home and healthier habits like nutrition. The volume of brain structures like the amygdala, hippocampus, prefrontal cortex, overall surface area, and cortical thickness of the brain are all impacted by socioeconomic measures. Socioeconomic stressors are associated with poor behavioral outcomes, attention deficits, poor language, and weakened executive functioning. Neighborhood quality contributes greatly to socioeconomic stressors which have an impact on brain reactivity, behavioral intensity, and selective attention. Racial and ethnic minorities are often disadvantaged in neighborhood quality and overall socioeconomic status. Various studies expound upon the significant relationship between the socioeconomic status and neurological development of racial and ethnic minorities. Journal articles, empirical studies, etc. propose home, school, and policy-based interventions to bridge the developmental gaps between low and high-socioeconomic standing children and adolescents. Such studies can be applied to educational modifications and other forms of cognitive enrichment.

Antibiotic resistance and serotype distribution of Shigella strains in Bangladesh over the period of 2014–2022: evidence from a nationwide hospital-based surveillance for cholera and other diarrheal diseases

ABSTRACT The objective of this study was to assess the prevalence, antimicrobial resistance patterns, and risk factors linked to Shigella infections through a nationwide hospital-based diarrheal disease surveillance in Bangladesh. From May 2014 to May 2022, from a systematic sentinel surveillance of Shigella infections in over 10 hospitals across Bangladesh, stool specimens were collected from patients with acute watery diarrhea and tested for Shigella species by microbiological culture. The susceptibility to antibiotics was tested using the disk diffusion method. Structured questionnaires were used to collect participants’ socioeconomic status and clinical, sanitation, and food history. Out of 24,357 stool specimens, 1.8% were positive for Shigella species, with a higher prevalence among males (58%). Children in the 6–17 age group were found to be at the highest risk of Shigella infections. The most prevalent serotype was Shigella flexneri (79.5%), followed by Shigella sonnei. S. flexneri serotype 2a was the most common (63.3%) among all Shigella serotypes. Antibiotic susceptibility testing showed over 99% of isolates resistant or with intermediate susceptibility to one of the seven antibiotics tested. About 96% of S. flexneri and all S. sonnei isolates demonstrated resistance to at least one quinolone class of antibiotics, particularly ciprofloxacin or nalidixic acid. S. sonnei showed higher antibiotic resistance and multidrug resistance compared to S. flexneri . The high level of resistance to ciprofloxacin highlights the need for more prudent use of this antibiotic and improved hygiene and sanitation. The study emphasized the importance of regular monitoring of drug resistance to effectively manage Shigella infections. These findings may provide the epidemiological evidence for conducting future appropriate Shigella vaccine clinical trials in Bangladesh. IMPORTANCE This nationwide study in Bangladesh assessed Shigella infections from 2014 to 2022 from clinical samples. S. flexneri was predominant, with concerning antibiotic resistance, notably to ciprofloxacin and nalidixic acid in over 96% of isolates. This emphasizes the urgency of prudent antibiotic use and improved hygiene. The findings provide crucial antimicrobial resistance patterns of Shigella species, highlighting the need for ongoing resistance monitoring and potentially informing future vaccine trials.

Parent–child interaction frequency: associations with age, sibling presence, and child health

Abstract Objectives Parent-child interaction plays a crucial role in child development. This study investigated associations between the frequency of parent-child-interactions and sociodemographic characteristics (age, sex, socio-economic status, family structure, number and age of siblings), physical and psychological symptoms in children, and mental health of parents. Methods The frequencies of 11 different parent-child interactions (shared reading, singing, moving, painting, building, puzzle, playing ball, role games, language games, number games and talking about problems) were assessed in 739 children aged 2–6.5 years-old using a standardised parental questionnaire, within a population-based cohort study in Leipzig, Germany. Physical and psychological symptoms were investigated using the HBSC Symptom-Checklist and parental depression symptoms using the Patient Health Questionnaire. We applied regression analyses to assess associations between variables. Results Shared reading was the parent-child interaction reported most frequently, with an average occurrence of several times a week. Number games were reported least frequently, with an average occurrency of every two weeks. Fewer parent-child interactions were significantly associated with higher child age, higher number of siblings, presence of older siblings and a lower level of physical and psychological symptoms. The other variables (sex, SES, living situation, presence of younger siblings or both (younger and older), depression symptoms of parents) were not significantly associated with the frequency of parent-child interactions. Conclusion The findings show that age of children and number as well as age of siblings at home may shape the frequency of parent-child interaction in preschool children. In addition, the findings suggest that parent-child interaction might be related to the health of children rather than the (mental) health of parents. Impact This study assessed the associations between the frequency of different types of parent-child interactions and sociodemographic as well as health-related parameters in a large sample of children. There still exist sex-specific differences in the frequency of parent-child interactions related to traditional role models of girls and boys. A higher frequency of parent-child interactions is associated with more physical and psychological symptoms in children. Parent-child interactions are less frequent in families with more children, especially when older siblings are present.

Positive and negative syndromes in schizophrenia: analysis of determinants and severity of symptoms in Moroccan patients

Abstract Background Schizophrenia is a debilitating psychiatric condition distinguished by a variety of cognitive, emotional, and behavioral manifestations. It affects an individual’s cognition, emotions, and actions, resulting in challenges in discerning reality from illusion. The objective of the current study was to assess the determinants and severity of symptoms in Moroccan patients hospitalized in Ar-Razi Hospital, Rabat, Morocco using Positive and Negative Syndromes scales (PANSS). Methods One hundred sixty-one schizophrenic patients were admitted to Ar-Razi Hospital in Sale. The PANSS scale, in conjunction with a sociodemographic questionnaire, is utilized as the assessment tool for symptoms. A chi-square test at a 5% error level and a Pearson correlation test were applied to investigate possible associations. Results The findings demonstrate a significant bias towards males (9:1), with 90% being unmarried, and 96.3% originating from urban settings. The breakdown of patients based on symptoms reveals a prevalence of 14.3% for the positive scale, 18% for the negative scale, and 11.2% for the psychopathological scale. The correlation analysis demonstrates a strong relationship between the three scales. The factors that were found to have a notable impact are gender (p < 0.000), functional ability (p < 0.032), socioeconomic status (p < 0.008), living environment (p < 0.05), and use of tobacco and cannabis. Conclusion Confronted with this scenario, healthcare professionals are required to evaluate the key factors in the timely detection of schizophrenia and advocate for the consistent utilization of the PANSS scale in the management and monitoring of patients.

Social Determinants of Health and Language and Academic Outcomes in Pediatric Cochlear Implantation

ImportanceCochlear implants can restore sound and enable speech and language development for children with severe to profound sensorineural hearing loss. Long-term outcomes of pediatric cochlear implant recipients are variable. Although the association between social determinants of health (SDH) and pediatric cochlear implant outcomes has been explored, the strength of this association has not been quantitatively synthesized in the literature.ObjectiveTo determine the association of SDH with language and academic outcomes in pediatric cochlear implant recipients.Data SourcesIn August 2023, the following databases were searched: Embase.com, Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Cumulated Index to Nursing and Allied Health Literature Plus, APA PsycINFO, and ClinicalTrials.gov. Following duplicate exclusion of 8687 results, 5326 records were finalized.Study SelectionAbstract screening, full-text review, and risk of bias assessment was performed by 1 to 2 reviewers. Articles were included if an effect size for an SDH variable that was associated with measures of language, communication, reading, academics, and quality of life was reported.Main Outcomes and MeasuresA random-effects meta-analysis was performed, with standardized regression coefficients measuring the relative direction and magnitude of a variable association with the outcome of interest.ResultsOf 5326 articles, 40 articles that included a total of 3809 children were included in the systematic review; 20 articles that included a total of 1905 children were included in the meta-analysis. Parental involvement, education level, and low socioeconomic status were moderately to strongly associated with language outcomes (β = 0.30; 95% CI, 0.13-0.48; β = 0.45; 95% CI, 0.29-0.62; β = −0.47; 95% CI, −0.83 to −0.10, respectively). Known determinants of language outcomes, such as the age of cochlear implantation and duration of cochlear implant use, demonstrated moderate to no associations with language outcomes (β = −0.30; 95% CI, −0.43 to −0.17; β = 0.19; 95% CI, −0.26 to 0.63, respectively).Conclusions and RelevanceThe results of this systematic review and meta-analysis suggest that SDH are associated with childhood language development and academic achievement. In addition to efforts to expedite cochlear implant placement in eligible children, optimal outcomes may be achieved with interventions centered on the child’s home, primary medical care, and school environment.

Student Socio-Economic Status & the Type of Enrolled Programs

This research article examines the effect of students’ socio-economic status on the type of program a student enrols in Kenya’s national polytechnics. It utilises an ex-post facto research design because the researcher could not manipulate the variable under consideration. Data was collected using questionnaires for students and interview guide schedules. The data was qualitatively and quantitatively analysed. Quantitative data was analysed by using multinomial logistic regression analysis, while qualitative data was analysed thematically. Reliability was attained using internal consistency where a Cronbach Alpha coefficient of 0.8 was established. The multinomial logistic regression results indicated that the student's socio-economic status is not statistically significant in the type of program a student enrolsin national polytechnics in Kenya. Consequently, the research article recommends that, the government should increase capitation and loans based on the type of program that one enrols. This is due to the fact that different programs attract different mean costs both directly and indirectly. Key Words: Socio-economic status, Programs, Type of programs

Fine Particulate Matter, Its Constituents, and Spontaneous Preterm Birth

ImportanceThe associations of exposure to fine particulate matter (PM2.5) and its constituents with spontaneous preterm birth (sPTB) remain understudied. Identifying subpopulations at increased risk characterized by socioeconomic status and other environmental factors is critical for targeted interventions.ObjectiveTo examine associations of PM2.5 and its constituents with sPTB.Design, Setting, and ParticipantsThis population-based retrospective cohort study was conducted from 2008 to 2018 within a large integrated health care system, Kaiser Permanente Southern California. Singleton live births with recorded residential information of pregnant individuals during pregnancy were included. Data were analyzed from December 2023 to March 2024.ExposuresDaily total PM2.5 concentrations and monthly data on 5 PM2.5 constituents (sulfate, nitrate, ammonium, organic matter, and black carbon) in California were assessed, and mean exposures to these pollutants during pregnancy and by trimester were calculated. Exposures to total green space, trees, low-lying vegetation, and grass were estimated using street view images. Wildfire-related exposure was measured by the mean concentration of wildfire-specific PM2.5 during pregnancy. Additionally, the mean exposure to daily maximum temperature during pregnancy was calculated.Main Outcomes and MeasuresThe primary outcome was sPTB identified through a natural language processing algorithm. Discrete-time survival models were used to estimate associations of total PM2.5 concentration and its 5 constituents with sPTB. Interaction terms were used to examine the effect modification by race and ethnicity, educational attainment, household income, and exposures to green space, wildfire smoke, and temperature.ResultsAmong 409 037 births (mean [SD] age of mothers at delivery, 30.3 [5.8] years), there were positive associations of PM2.5, black carbon, nitrate, and sulfate with sPTB. Adjusted odds ratios (aORs) per IQR increase were 1.15 (95% CI, 1.12-1.18; P < .001) for PM2.5 (IQR, 2.76 μg/m3), 1.15 (95% CI, 1.11-1.20; P < .001) for black carbon (IQR, 1.05 μg/m3), 1.09 (95% CI, 1.06-1.13; P < .001) for nitrate (IQR, 0.93 μg/m3), and 1.06 (95% CI, 1.03-1.09; P < .001) for sulfate (IQR, 0.40 μg/m3) over the entire pregnancy. The second trimester was the most susceptible window; for example, aORs for total PM2.5 concentration were 1.07 (95% CI, 1.05-1.09; P < .001) in the first, 1.10 (95% CI, 1.08-1.12; P < .001) in the second, and 1.09 (95% CI, 1.07-1.11; P < .001) in the third trimester. Significantly higher aORs were observed among individuals with lower educational attainment (eg, less than college: aOR, 1.16; 95% CI, 1.12-1.21 vs college [≥4 years]: aOR, 1.10; 95% CI, 1.06-1.14; P = .03) or income (<50th percentile: aOR, 1.17; 95% CI, 1.14-1.21 vs ≥50th percentile: aOR, 1.12; 95% CI, 1.09-1.16; P = .02) or who were exposed to limited green space (<50th percentile: aOR, 1.19; 95% CI, 1.15-1.23 vs ≥50th percentile: aOR, 1.12; 95% CI, 1.09-1.15; P = .003), more wildfire smoke (≥50th percentile: aOR, 1.19; 95% CI, 1.16-1.23 vs <50th percentile: aOR, 1.13; 95% CI, 1.09-1.16; P = .009), or extreme heat (aOR, 1.51; 95% CI, 1.42-1.59 vs mild temperature: aOR, 1.11; 95% CI, 1.09-1.14; P < .001).Conclusions and RelevanceIn this study, exposures to PM2.5 and specific PM2.5 constituents during pregnancy were associated with increased odds of sPTB. Socioeconomic status and other environmental exposures modified this association.

Dog Acquisition in Lower-Income Communities as Consumer Behavior: An Exploratory Qualitative Study

Introduction: This qualitative research article examines the nature of the decision-making processes used by people to acquire dogs in low-income communities compared to how people in middle and upper socioeconomic communities make this decision. Methods: We explored the preferences, thoughts, and concerns that influenced decisions of a convenience sample of 40 respondents who acquired dogs or puppies within the last 2 years. Sixty-five percent of respondents (N = 26) described living in or near poverty, while 35% held middle or upper socioeconomic status. To elicit detailed accounts of their decision-making process, a semi-structured interview was administered. Results were subjected to qualitative data analysis to identify different features of the acquisition process and to compare these features by respondents’ socioeconomic status. Results: Most respondents described similar ‘stages’ in dog acquisition as consumers making other high-involvement purchases: recognizing need (mulling), information-gathering and evaluating (creating criteria sets, sourcing pragmatically, and encountering decision triggers), and adjusting to new dogs post-acquisition. Aspects of acquisition were extended or attenuated, and more complex than predicted by models built for inanimate products. Social class influenced some but not all stages of dog acquisition. Conclusion: Findings from this analysis support advertising and wide dissemination of adoptable dog information. A community engaged model of sheltering including non-judgmental adoptions, community veterinary and behavioral pet support, and building trust could increase local dog adoption.

The screening and management of skin diseases in remote African regions: a narrative review

Abstract Introduction Skin diseases in remote African regions are often exacerbated due to a lack of resources and expertise with little current research addressing the challenges that patients and healthcare systems experience. Although skin diseases in remote African regions are prevalent and pose a substantial health burden, they remain neglected and understudied. This review aims to explore current challenges in the diagnosis and management of skin diseases in African regions and focus on the need for enhanced understanding and improved healthcare strategies. Methods We reviewed papers that were retrieved from PubMed, Google Scholar, and other relevant academic search sites to analyze the prevalence, screening techniques, as well as management strategies and obstacles associated with dermatological diseases in remote African regions. Results Current literature suggests there is indeed a high prevalence of skin diseases where other infections are predominant. Further, different factors, such as socioeconomic status and environmental conditions, make it challenging for optimal screening and treatment of skin diseases in remote African regions. Common screening methods for skin diseases involve clinical examination and laboratory tests, while management includes pharmacotherapy, surgery, and counseling approaches. Overall, access to medications and adequate healthcare services remains limited. Conclusion Early diagnosis and management of skin diseases in remote African regions have significant challenges, including a lack of funding for dermatology, education, and research. Future promising strategies such as teledermatology, point-of-care diagnostic technologies, and task shifting show promise in improving access to care. However, there is a need for sustained efforts to address the underlying socioeconomic factors and improve healthcare delivery in remote African regions.

The enigma of the number of ʿAlawis in Syria: 11% indeed?

This article intends to interrogate a common figure that seems to have become accepted in research concerning the number of the ʿAlawis in Syria during the last century. A thorough examination of the dramatic shifts in Syria during the last decades, mainly from the rise of the Asad family to power in 1970, indicates that the number of the ʿAlawis in the Syrian population has diminished gradually, while the number of the Sunni majority remains relatively high. Apart from official surveys and assessments, this study takes into consideration several factors, such as religious conservatism, socio-economic status, immigration into the country, urbanization and other aspects. All the relevant factors indicate that the number of ʿAlawis in the eve of the civil war (2011) was significantly lower than accepted in research, a conclusion that sheds new light on the degree of the threat to their survival which the sect has faced during this conflict.

Spatial Distribution of Public Lower Secondary School and its Impact on Students’ Enrolment in Ogun Central Senatorial District Ogun State, Nigeria

Given the quest for universal basic education, the large enrolments in the Nigerian secondary educational institutions has resulted in the problem of over-crowded classes, shortage of teachers and shortages of classroom, which portend enormous challenges to the development of the educational sector in Ogun state. Using Ogun Central as a case study, the study identified the spatial pattern of the schools; analyzing students’ enrolment trends in the area, and identifying the factors associated with the observed pattern. Spatial analysis tool in ArcGIS was used to analyze both the spatial accessibility index and the students’ annual enrolment trend of the lower secondary school in the area. The result of the nearest neighbor analysis for the spatial pattern of lower secondary schools in the study revealed a random pattern. This pattern implies that the lower secondary schools are located far from one another, which indicates, that for students to attend the schools, most of them need to cover long distances. The spatial distribution of junior secondary school is influenced by socioeconomic status, environmental factors, demographic characteristics, transportation infrastructure, and geographic accessibility, which are key determinants of educational equity. Linear regression analysis was employed to identify trends and predict future enrollments of students. Further, the results of the trend analysis of enrolments of students in the zone from 2020 – 2023 reveal a negative trend. This implies a decrease in students’ enrolment as the year increases. The four years (2020 – 2023) annual trend of enrolments in the zone is represented by the negative trend y = -3180.3x + 99400. This result suggests that the students’ enrolments in the zone would gradually keep decreasing as time goes on if quick remedial actions are not taken. However, factors such as shortage of teachers, shortage of classrooms, COVID-19, insufficient infrastructural facilities and fuel subsidy removal could be responsible for the negative enrolment trend

Determinants of persistent malaria transmission in the Arjo-Didessa farm area in Ethiopia

Background: In tropical and subtropical areas of the world, malaria is still a serious public health concern. Activities related to agricultural development that involve irrigation schemes likely increase the risk of malaria in tropical and sub-Saharan African regions. Ethiopia is a sub-Saharan country where malaria is endemic.Objectives: The aim of the study was to investigate the determinants related to the persistence of malaria transmission in the Arjo-Didessa sugarcane farm area in southwest Ethiopia.Method: The study employed a quantitative survey design. Quantitative data were collected from 397 households using structured questionnaires. SPSS Statistics version 26 was used to analyse the data. Z- and Chi-square tests were applied, and the data were analysed using logistic regression.Results: The determinants that were identified included variation in land use, water management practices, socioeconomic status and knowledge about the use of anti-malaria treatment. These were shown to contribute to increased malaria transmission and the rise in malaria cases in agricultural areas.Conclusion: The effectiveness of malaria control in agricultural settings can be improved through free access to malaria testing and treatment as well as knowledge about anti-malaria treatment among the residents in agricultural areas.Contribution: The study revealed key determinants, including the promotion of free access to anti-malaria treatment, which should be considered for the effective management of malaria in agricultural areas.

Feasibility of recruiting young adults with low socioeconomic status for formative evaluation of a smoking cessation mobile intervention

Feasibility of recruiting young adults with low socioeconomic status for formative evaluation of a smoking cessation mobile intervention

Management of phthalates in Canada and beyond: can we do better to protect human health?

Ortho-phthalates (herein referred to as phthalates) are synthetic chemicals used in thousands of different everyday products and materials. Nearly ubiquitous environmental exposure is reflected by phthalate metabolites in the urine of almost all Canadians. However, phthalate exposure tends to be higher amongst people of low socioeconomic status and ethnic minorities. Substantial evidence shows that certain phthalates cause harm to human health, particularly developing fetuses and children. Governments vary in their approach to assessing and managing risks associated with phthalates. Canada continues to take a more permissive stance on phthalate regulations compared to the EU and some US states. We argue that the recent Canadian national risk assessment on phthalates does not appropriately reflect the growing evidence demonstrating harm to human health from phthalate exposure and does not adequately consider the evidence showing higher exposures faced by vulnerable populations. Canadians would benefit from adopting a more stringent regulatory approach to phthalates. Specifically, Canada should expand phthalate restrictions to apply to all consumer products, implement sunset dates toward eliminating the use of existing phthalates, and mandate publicly available evidence of no harm for phthalate alternatives. Canadian alignment on phthalate regulations with the EU and a growing number of US states could encourage other countries to follow suit.

Effects of COVID-19 Pandemic on Patients with Kidney Disease and Kidney Replacement Therapy: Focus on Black, Asian, and Minority Ethnic Groups: A Systematic Review

Background COVID-19 pandemic significantly affected health services globally, resulting in poorer outcomes, especially in patients with chronic long-term illnesses. For patients with chronic kidney disease (CKD), potential effects might include, among others, disruption of dialysis services, reduced kidney transplant rates, and increased incidence of severe COVID-19 infections and death. Such differences may be further exacerbated in patients from Black, Asian, and Minority Ethnic (BAME) populations with CKD. Aim To conduct a systematic review to identify the global impact of COVID-19 on kidney replacement therapy and to determine the extent of any disparities in BAME patients with CKD. Materials and Methods PubMed, Embase (OVID), and CINAHL (EBSCO) databases were searched for relevant studies published between January 1, 2019, and November 24, 2023. Predetermined inclusion/exclusion criteria were utilized to shortlist abstracts. Two reviewers independently appraised articles and systematically extracted data and assessed the quality of studies. Thematic analysis was used for evidence synthesis; no quantitative meta-analysis was conducted. The review was registered with PROSPERO (CRD42020201771). Results Two hundred and eleven abstracts were shortlisted, 52 articles were identified for full-text review, and 20 articles published worldwide were included in the final review. Themes identified included: effects of the COVID-19 pandemic on patients with CKD undergoing dialysis (six studies); impact on kidney transplant recipients and transplant programs (eight studies); and differential impact of COVID-19 on BAME patients in comparison with the general population (six studies). The presence of CKD in patients with COVID-19 was identified as a poor prognostic factor, along with obesity, lower socioeconomic status, and BAME population. Conclusion The findings of this targeted review demonstrate the global impact of COVID-19 on various aspects of kidney replacement therapy and provide evidence of important disparities for BAME patients. In case of any future pandemic, vulnerable groups undergoing hemodialysis and those with kidney allografts will require special attention and care.

Canadian Spine SocietyCPSS-01. Abstract ID 48. Is long-term follow-up required for low-grade spondylolisthesis? A prospective study of 247 children followed until skeletal maturityCPSS-02. Abstract ID 101. Major complications following anterior vertebral body tethering surgeryCPSS-03. Abstract ID 164. Late referral of adolescent idiopathic scoliosis: the impact of socioeconomic status and health care utilizationCPSS-04. Abstract ID 97. The impact of curve correction

Canadian Spine SocietyCPSS-01. Abstract ID 48. Is long-term follow-up required for low-grade spondylolisthesis? A prospective study of 247 children followed until skeletal maturityCPSS-02. Abstract ID 101. Major complications following anterior vertebral body tethering surgeryCPSS-03. Abstract ID 164. Late referral of adolescent idiopathic scoliosis: the impact of socioeconomic status and health care utilizationCPSS-04. Abstract ID 97. The impact of curve correction

Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case–control study from Thailand

IntroductionTuberculosis (TB) is a chronic lung disease caused by Mycobacterium tuberculosis. Tobacco smoking and sharing of instruments have been reported to increase TB risk. In 2022, cannabis was legalized in Thailand. To address for the potential increase in cannabis use after legalization and the reported increased TB risk associated with cannabis usage, we aimed to estimate the odds ratio and population-attributable fraction (PAF) of different types of cannabis use.Materials and methodsA matched case–control study was conducted in the Songkhla Province of Southern Thailand in 2023. Face-to-face interviews were conducted to collect information on cannabis consumption. Multivariate logistic regression was performed to estimate the odds ratios representing TB risk from the independent variables. PAF was also calculated to compare the public health impacts of the variables.ResultsAmong the 148 TB cases and 117 healthy controls, we observed lower socioeconomic status and higher proportions of tobacco and alcohol use in these cases. Eleven percent of the controls were current cannabis users, while nearly 19% had ever experienced cannabis use. The proportions of ever-used, smoked, and shared cannabis use were significantly higher in these cases. After adjusting for covariates, the best-fit model showed an odds ratio of 4.22 (95% confidence interval: 1.47–12.07) for smoking and sharing a bong of cannabis. No statistical significance was found for the other types of consumption. PAF of smoked and shared bongs of cannabis was 12.16, which was slightly lower than that found in smoking tobacco (12.62).ConclusionIncreased numbers of cannabis users, especially shared smokers, may have an impact on TB risk in lower-middle-income countries, where TB is already highly prevalent.

Socially Equitable Public Service Provision: Towards Inclusive Coproduction of Public Infrastructure

ABSTRACT The challenge of building and maintaining public infrastructure in the face of climate change and natural hazards necessitates greater citizen involvement in decision-making processes. Coproduction aims to ensure equitable service distribution by engaging a diverse range of citizens. However, the literature highlights disparities, with certain citizens having greater resources for participation. This study explores how individual socioeconomic factors and risk perceptions influence citizens’ willingness to engage in coproduction. Coproduction has been criticized for excluding marginalized populations, we analyze how multilevel factors shape willingness to participate in two modes of coproduction: co-planning and co-investing. The results indicate that risk perception is the most significant factor driving citizens’ willingness to coproduce. Furthermore, well-educated or wealthy citizens are more inclined to participate. This study proposes an inclusive approach to coproduction, aiming to ensure equitable public service delivery regardless of socioeconomic status.

Burden of Non-Communicable Disease and It’s Association with Weight Status: A Cross-Sectional Study in a Rural Community of Bangladesh

Background: Non-Communicable Diseases (NCDs) are now the leading causes of morbidity and mortality worldwide. Bangladesh has also experienced a rapid epidemiological shift from communicable diseases to non-communicable diseases due to growing urbanization and lifestyle alteration over the last few decades and this transition is also prominent in rural community of the country. Among all modifiable factors, overweight or obesity is the key risk factor for NCDs. This study aimed to determine the burden of NCD and its link to the body weight status of the rural population of Bangladesh. Materials and methods: This cross-sectional study was conducted in a village of Gomostapur Upazila under Chapainawabganj district from February to April 2024 among 135 people. The data were collected with face-to-face interview and Body Mass Index was measured. The data were compiled and tabulated according to key variables and analyzed with IBM SPSS 29.0.2. Results: Majority 44.5% of the study people belonged to age group 21-40 years. Among them 47.4% were male and 52.6% were female. Maximum respondents were of low-middle socioeconomic condition. Among them around 3/4th of the population was suffering from NCDs. Most of the respondents 24.4% had bone and joint pain followed by Hypertension, Asthma, COPD, Diabetes and Heart Disease at 20.7%, 17.0%, 14.1% and 10.4% respectively. Hypertension, Diabetes, Cardiovascular Disease, Stroke and Cancers were more prevalent in the older age group. Hypertension, Diabetes, Stroke and Bone-Joint Pain were seen more in female participants whereas male respondents had more prevalence of Asthma, COPD. Most of the study population had BMI above 25 kg/m2 and the study showed maximum NCDs were prevalent considerably in overweight and obese groups. Conclusion: The study revealed that, NCDs are highly prevalent among obese older rural population of Bangladesh while management, prevention, awareness and research are low. The integrated programs must be designed and implemented through a primary health care approach and high risk-group targeted interventions should be procurable to combat the rising burden of NCDs. IAHS Medical Journal Vol 7(1), June 2024; 74-79

Abstract 4136873: The Role of Socioeconomic Status in the Association Between Cardiovascular Polygenic Risk Score and Cardiovascular Events

Introduction: Polygenic risk scores (PRS) provide a summation of small-effect genetic variants that predict cardiovascular (CV) disease risk. Socioeconomic status (SES) can also impact CV risk, but it is unknown whether SES modifies the effects of PRS on CV events. Hypothesis: The association between CV PRS and CV events is modified by SES. Methods: Participants without CV disease at baseline from the UK Biobank prospective cohort study were followed from recruitment (2006-2010) through 2023. We included participants with genetic data (for CV PRS) and CV risk factors assessed at baseline (hemoglobin A1c, total cholesterol, blood pressure, body mass index, physical activity, tobacco use, and sleep). The CV PRS was centered at zero and standardized to one unit variance within each ancestry group. SES was defined by tertiles of index of multiple deprivation (from housing, crime, income, education, employment, health deprivation and disability, and neighborhood environment). The primary outcome was CV events (myocardial infarction, heart failure hospitalization, stroke, or death). Using Cox proportional hazard models, we estimated the total effect of PRS on CV events, tested for interaction of SES in the association between PRS and CV events, and estimated the direct effect of PRS on CV events by adjusting for age, sex, CV risk factors, and SES. Results: There were 201,374 participants (mean age 55.9 (± 8.1), 53.4% female). CV events occurred in 21,916 (10.9%) participants: 5,754 (2.9 %) myocardial infarctions, 4,061 (2.0%) strokes, 4,312 (2.1%) heart failure hospitalizations, and 12,782 (6.4%) deaths. Each unit of PRS was associated with 1.17 times the risk of CV events (HR 1.17, 95%CI 1.15 to 1.18, p-value < .001, adjusted for age and sex). People with the lowest SES had 1.22 times the risk of CV events (HR 1.22; 95%CI 1.18 to 1.26; p-value <.001) and the middle SES had 1.07 times the risk of CV events (HR 1.07; 95%CI 1.03 to 1.10; p-value <.001) compared to the highest SES, adjusted for age, sex, and CV risk factors. PRS remained associated with CV events (HR 1.15, 95%CI 1.13 to 1.16, p-value<.001) after adjusting for age, sex, CV risk factors, and SES. There was no significant multiplicative interaction between SES and PRS for CV events (interaction p-value = 0.45). Conclusions: SES is associated with CV events but does not modify the effect of PRS on CV events. Genetic risk remains independently important in CV event risk beyond traditional CV risk factors and SES.