Socioeconomic Determinants Research Articles

The level of wasting and associated factors among children aged 6-59 months in sub-Saharan African countries: multilevel ordinal logistic regression analysis.

Despite various interventions to combat child malnutrition in sub-Saharan Africa, wasting remains a critical public health concern for children aged 6-59 months. Wasting is a significant predictor of child survival and development, with a heightened risk of mortality among children. However, there is a lack of recent comprehensive data on the prevalence, severity level, and factors contributing to wasting in this age group. To identify the severity levels of wasting and its individual and community-level factors contributing to wasting among children aged 6-59 months in Sub-Saharan African countries. This research utilized Demographic and Health Survey data from 34 Sub-Saharan African countries, spanning the period from 2007 to 2022. The study included a weighted sample of 180,317 6-59-month-old children. We employed a multilevel proportional odds model to identify factors predicting the severity of wasting. Adjusted odds ratios and 95% confidence intervals were reported to demonstrate significant relationships (p < 0.05) in the final model. In Sub-Saharan Africa, 7.09% of children aged 6-59 months experience wasting (95% CI: 6.97, 7.20%). Among these children, the prevalence of moderate wasting is 4.97% (95% CI: 4.90, 5.10%), while severe wasting affects 2.12% (95% CI: 2.0, 2.20%). Factors such as term/post-term babies, wealth, frequency of feeding, improved toilet facilities, water sources, employed and educated mothers, rural residence, high community maternal education, and community media exposure are strongly associated with a lower chance of experiencing severe form of wasting. Conversely, birth order, family size, breastfeeding, diarrhea, cough, and fever, high community poverty, female household heads, and all Sub-Saharan Africa regions are linked to higher levels of wasting. The study findings underscore the persistent challenge of wasting among Sub-Saharan Africa's children, with 7.09% affected, of which 4.97% experience moderate wasting and 2.12% severe wasting. The identified predictors of wasting highlight the complex interplay of socio-economic, environmental, and health-related determinants. To address this issue improve access to healthcare and nutrition services, enhance sanitation infrastructure, promote women's empowerment, and implement community-based education programs. Additionally, prioritize early detection through routine screening and strengthen health systems' capacity to provide timely interventions.

An optimal threshold for over-indebtedness: a study on the discrepancy between subjective and objective debt burdens

PurposeThe study aims to explore the discrepancy between the subjective and objective debt burdens across various household socio-demographic and debt characteristics. Additionally, it seeks to establish an optimal debt service-to-income ratio (DSTI) threshold for identifying over-indebtedness.Design/methodology/approachThis study utilized a sample of 1,004 respondents from a nationwide survey conducted among Polish indebted households. A discrepancy ratio (DR) measure was proposed to evaluate the divergence between subjective and objective over-indebtedness. Binary logistic regression was employed to estimate the probability of being subjectively and objectively over-indebted, as well as the discrepancy between the two measures of over-indebtedness. The study also employed numerical simulations to determine the optimal DSTI threshold for identifying over-indebted households in general and based on their socio-economic characteristics.FindingsThe study established a debt service-to-income ratio (DSTI) threshold of 20% to minimize the discrepancy between subjective and objective debt burden, which is lower than thresholds found in other studies aimed at identifying over-indebted households. Age, number of loans, self-perceived needs satisfaction and type of debt were identified as significant socio-economic and debt-related determinants of over-indebtedness. Household socio-economic and debt-related characteristics significantly influence the threshold for identifying over-indebtedness using DSTI. It can vary widely, ranging from as low as 11% for well-educated women with multiple loan commitments to 43.7% for young males with vocational education, high incomes and originating from households with four or more members.Originality/valueThe paper proposes a more comprehensive approach to debt burden analysis by introducing a new methodology for determining a debt service-to-income (DSTI) threshold that could serve as a measure of over-indebtedness based on the discrepancy between subjective and objective over-indebtedness. It also emphasizes the significance of socio-economic and debt-related factors in evaluating subjective and objective over-indebtedness.

Understanding Micronutrient Access through the Lens of the Social Ecological Model: Exploring the Influence of Socioeconomic Factors-A Qualitative Exploration.

Micronutrient deficiencies disproportionately affect various populations, influenced by a complex interplay of socioeconomic factors. This study delves into the intricate relationship between socioeconomic status and micronutrient access, emphasizing the perceptions of affordability, availability, and the impact of social support networks. A qualitative research design was employed, using purposive sampling to enlist a diverse cohort of participants from varied socioeconomic backgrounds. The methodology comprised semi-structured interviews and focus groups to gather detailed insights into the participants' experiences and views on micronutrient access. The analysis framework was based on the Social Ecological Model (SEM), enabling an in-depth examination of individual, interpersonal, community, and societal influences. With 30 participants, aged 20-70, representing a range of unique characteristics such as differing health conditions, cultural backgrounds, and economic statuses, the study uncovered five key themes: Individual-Level Factors, Interpersonal Relationships, Community Environment, Societal Factors, and Intersectionality. These themes illustrate how personal dietary habits, social networks, community resources, and broader socioeconomic policies converge to shape micronutrient access, emphasizing the complex interplay of overlapping social identities and structural barriers. The findings highlight the need for holistic nutrition interventions that account for the extensive spectrum of socioeconomic determinants. This study not only enriches the theoretical underpinnings of the SEM but also provides actionable insights for crafting targeted strategies to enhance micronutrient access and ameliorate dietary inequities. It advocates for comprehensive public health initiatives attuned to the nuanced needs and hurdles faced by diverse demographic sectors.

The socioeconomic determinants of University dropouts: The case of Greece

This research paper aims to explore the issue of university dropouts in Greece, which has become a growing concern in recent years due to its impact on individuals, educational institutions, and society as a whole. One of the main contributing factors to students discontinuing their higher education in Greece is the choice of the wrong faculty. Financial challenges, unrelated to tuition fees, also significantly affect students’ ability to pursue their studies. Family background plays a crucial role, with students from families with higher educational attainment exhibiting greater persistence. The study found that gender, age, and academic performance can influence students’ perceptions of dropout factors, which can change as they progress through their educational journey. To address these challenges, the research proposes a multifaceted approach, including early intervention programs, expanded financial support, improved mental health and counseling services, flexible learning options, and strong academic advising.

Socioeconomic determinants of moderate and severe obstructive sleep apnea in children: A pre and post COVID analysis

IntroductionCOVID-19 has disproportionately affected healthcare access of certain minority groups, and thus could contribute to delay in timely evaluation and management of pediatric obstructive sleep apnea (OSA). Socioeconomic status (SES) is known to affect healthcare access in pediatric otolaryngology and may also be a risk factor for OSA and its associated co-morbidities. ObjectivesOur primary objective is to determine the impact of COVID-19 on time to diagnosis (TTD) and time to treatment (TTT) of polysomnography (PSG)-proven moderate to severe pediatric OSA in different socioeconomic classes. Secondary objectives include determining the impact of racial and demographic factors on TTD and TTT. MethodsThis is a retrospective chart review of 120 children; 60 children pre-COVID (February 2018 to February 2020), and 60 children post-COVID onset (March 2020 to March 2022). This study was performed at a pediatric teaching hospital and tertiary referral center, and involved children aged 3–17 years old with outpatient PSG-proven moderate to severe OSA. Approval was obtained from our hospital's institutional review board (IRB). ResultsThere were a total of 120 children, 60 in each group. The average age was 9.5 years old; females constituted 41.6 % of the sample. TTD increased from 53.7 days pre-covid to 103 days post-COVID onset in all children (p = 0.00), 42.5 days–151.9 days in white children (p = 0.00), 38 days–142.7 days in children with high SES (p = 0.00), 32.1 days–146.5 days in children with private insurance (p = 0.00), and 65.7 days–105.8 days in children with public insurance (p = 0.04). TTT did not change significantly. ConclusionOur results show that TTD of OSA and obesity in advantaged groups were affected to a greater degree than disadvantaged groups. This suggests children of all socioeconomic groups are susceptible to healthcare disparities and the COVID-19 pandemic has uncovered the vulnerability of such populations. Policymakers should consider providing more funding and support for all children, including continued funding for those with lower SES.

Spatial and Climatic Patterns of Intraregional Migration in the Republic of Sakha (Yakutia)

Abstract This study investigates the impact of the geographical location of uluses (municipal districts) and their climate on intraregional migration in the Republic of Sakha (Yakutia). Six of the most common indices describing the intensity of migration were used for the analysis. Despite strong outflows of population from the north, the disparities between the Arctic uluses and the rest of the Republic were statistically insignificant. Disparities between geographical parts of Yakutia and clusters by temperature were more marked, but they were not observed for all indices. This is due to a very low migration turnover in the south. The study finds that the geographical location of the uluses and their climate had some influence on intraregional migration, but socioeconomic determinants were much more important.

Evaluating the Role of Households' Food Security Status and Socioeconomic Determinants on Child Mortality in Nigeria

When addressing global development, it is imperative to recognize the relationship between food security and child mortality. Despite the targeted goals of SDGs 2 (zero hunger) and 3 (good health and well-being), Nigeria continues to grapple with relatively high rates of child malnutrition, alongside persistent challenges in child mortality and food insecurity that affect its population significantly. This study employed the Nigeria Living Standard Survey (NLSS) dataset with 11,655 households to estimate the impact of food (in)security on child mortality using the Propensity Score Matching (PSM). The study shows that food insecurity is predominant in the rural northern and urban southern part of Nigeria. Child mortality rates were found to be influenced by various factors such as maternal education, maternal age, geopolitical zones, place of residence, and access to healthcare facilities, showcasing a complex interplay of positive and negative impacts. The empirical estimates revealed that households’ food insecurity had a significant impact on child mortality in Nigeria. Hence, in order to achieve the SDG’s 2 and 3 in Nigeria, a more concerted effort should be geared towards food security and child mortality among the Nigerian rural and urban communities. The insights from this study underscore the importance of prioritizing interventions that drives food security, enhancing nutritional access, and tackling underlying social determinants to substantially reduce child mortality rates. It is imperative for policymakers, healthcare professionals, and communities to integrate complementarity approaches in developing sustainable solutions that safeguard the well-being and prospects of Nigeria's children.

An evolution of socioeconomic inequalities in self-rated health in Korea: Evidence from Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018

Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea over the past two decades and identify the contributing factors to the observed inequalities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016/2018 were utilized. The concentration index (CI) was calculated to measure health inequalities, and decomposition analysis was applied to identify and quantify the contributing factors to the observed inequalities in health. The results indicated that health inequalities exist, suggesting that poor health was consistently more concentrated among Korean adults with lower income (1998: −0.154; 2016/2018: −0.152). Gender-stratified analyses also showed that poor health was more concentrated in lower income women and men, with the degree of inequalities slightly more pronounced among women. The decomposition approach revealed that income and educational attainment were the largest contributors to the observed health inequalities as higher income and education associated with better self-rated health. These findings suggest the importance of considering socioeconomic determinants, such as income and education, in efforts to tackling health inequalities, particularly considering that self-rated health is a predictor of future mortality and morbidity. Furthermore, it is essential to implement more egalitarian social, labour market, and health policies in order to eliminate the existing socioeconomic inequalities in health in Korea.

Socio-Economic Determinants of Property Crime Across the Districts of Punjab: Highlighting the Role of Law Enforcement Agencies of Pakistan

Socio-Economic Determinants of Property Crime Across the Districts of Punjab: Highlighting the Role of Law Enforcement Agencies of Pakistan

Our Culture Is Best! Populist Engagement with Culture in the Construction of the Populist Myth

ABSTRACT The recent populist upsurge has dramatically transformed political, social and cultural realities, and the end of its success is not yet in sight. Adding to the scholarly work on the political and socio-economic determinants of populist success, this paper analyzes how populism and culture work together in constructing and propagating the populist myth. Concretely, it theorizes the interaction between populism and culture in narrating the people’s suffering of an existential crisis, and the populist leader’s identification with the people through a shared cultural narrative. As the example of French far-right populism shows, this manifests in two interconnected ways: on the one hand populism uses concrete cultural products to shape their dichotomous rhetoric, while on the other hand its articulation in society affects our understanding of who can (and cannot) culturally belong. The concept of equaliberty is introduced to further reflect on the democratic challenges posed by populist narratives, as well as consider the potential of inclusionary counter-narratives. To this end, the notion of artivism is presented as a mode of engagement that can bring the worlds of art and politics together, serving as a creative laboratory to produce equaliberal alternatives to populism.

Disparities in head and neck cancer (HNC): An insight of the National Inpatient (NIS) database.

e13730 Background: Despite the decline in tobacco use, the incidence of head and neck cancers continues to increase in part due to HPV. HNC accounts for 4% of all cancers in the United States (USA), with particularly high morbidity in oncology. There is a complex interplay of factors that contributes to the incidence and prevalence of HNC; among these, sociodemographic characteristics and net income are notably linked to poorer outcomes within African American and Latino communities. Interestingly, despite a higher incidence in the White population, disparities persist. Consequently, there is a pressing need for a more nuanced characterization to comprehensively grasp the impact of sociodemographic factors on HNC outcomes. Methods: This was a retrospective cohort analysis of adults admitted to hospitals in the USA between 2016 and 2020 with a primary diagnosis of HNC. Data was obtained from the NIS Database, the largest publicly available inpatient database in USA, with over 7 million in-hospital stays per year. The primary outcome was to describe the trends of HNC, comparing sociodemographic characteristics. Secondary outcomes included the impact of being cared for in Teaching Hospitals (TH) vs. nonteaching hospitals (NTH) and length of stay (LoS). Hypothesis testing for categorical variables was tested with Chi-Square. Continuous variables were tested with a Student's t-test. Statistical significance was defined as a two-tailed P value of &lt;0.05. Results: 191,740 patients met inclusion criteria: patients admitted between January 2016 and December 2020 under the primary diagnosis of HNC, corresponding to the billable code of the International Classification of Diseases 10th Revision, and patients 18 and older. Of all patients, 159,985 were admitted to TH and 31,755 in NTH. The most common geographic locations were the south region, 34% vs 46%, and the central region, 24% vs 20% for TH and NTH, respectively. The mean patient age was 62 in TH and 65.4 in NTH (p&lt;0.001). The most affected sex was male. Hospitalization LoS (median) was 6.3 days in TH and 5.4 days in NTH (p&lt;0.001). Furthermore, mortality was higher in NTH 7.51% vs 4.87% in TH (p&lt;0.001). Most patients had a lower income: 50% in TH vs 62% in NTH had an income under the 50 bracket (p&lt;0.001). White was the most common race among admitted patients (p&lt;0.001). Chronic kidney disease, obesity, and coronary artery disease were significantly associated comorbidities (p&lt;0.001). The two most commonly described complications during admission were AKI (p= 0.58) and mechanical ventilation (p=0.55). Conclusions: Low income is associated with higher mortality in patients with HNC. Socioeconomic determinants of health have been shown to have a predominant influence on outcomes over classic risk factors. Despite a greater LoS in teaching hospitals, this was inversely related to mortality, which could be associated with a more comprehensive diagnostic process and cancer-related care.

The Digital Divide, Wealth, and Inequality: An Examination of Socio-Economic Determinants of Collaborative Environmental Governance in Thailand through Provincial-Level Panel Data Analysis

Collaborative environmental governance (CEG) is a tripartite process that engages the government, private sector, and general public in decision-making related to environmental challenges, focusing on fostering more sustainable and efficient solutions. Understanding the specific factors influencing the degree of CEG presents a significant challenge, particularly in developing countries. This study aims to identify and assess the socio-economic determinants affecting the degree of CEG in Thailand, a representative developing country. Utilizing robust panel data models, which are well-suited to handle the complex variability of socio-economic factors, we analyzed provincial-level data from 2017 and 2019. Our findings revealed the associations between the degree of CEG and variables such as the internet access divide, economic activities, income inequality, and budget allocations for environmental activities. This research fills critical gaps in our understanding of how these determinants shape collaborative governance efforts, offering novel insights that challenge existing paradigms and providing actionable recommendations for policymakers striving to enhance environmental governance in developing regions.

Socio-Economic and Demographic Factors Affecting Adoption of Electric Vehicles in India

The purpose of this study is to analyze the diverse socio-economic and demographic determinants that impact the adoption and growth of electric vehicles (EVs) in India. Quantitative research was conducted utilizing data from the Prowess IQ database. Growth of Electric Vehicles (GEV) is represented through the proxy of total income of ten prominent Indian EV manufacturing companies for eight years from 2016 to 2023. This is analyzed against nine independent variables including GDP, Per Capita Income, Age of Company, Population Density, Average Petrol/Diesel Price, Price of Electricity Per Unit, Average Household Electricity Consumption, and Vehicle Electricity Consumption, data for which was extracted from governmental and company websites. The study employed statistical methods, such as correlation and regression analysis, to examine the associations between the dependent and independent variables. The results depict notable positive correlations with GDP, per capita income, age of company, and population density, and negative correlations with the price of electricity and diesel. Regression analysis further substantiated six variables (population density, petrol prices, per capita income, GDP, diesel prices, and average household electricity consumption) as statistically significant contributors to GEV in India These findings point towards the need to leverage the positive drivers and mitigate the effects of negative correlates. Policies offering financial support tailored to demographic and economic contexts, might help achieve accelerated and sustainable growth for EVs in India. This study highlights the unique impact of demographic elements like population density on the EV market in India.

Socioeconomic Influence on Physical Therapist Student Financial Literacy, Self-Efficacy, Stress, and Anxiety.

Doctor of Physical Therapy (DPT) students have considerable educational debt upon graduation with suspected low levels of financial literacy, limited financial self-efficacy, and elevated stress and anxiety. The purpose of this study was to determine the relationships between financial knowledge, financial anxiety, financial stress, and financial self-efficacy with socioeconomic determinants in DPT students. Five hundred seventy-eight DPT students, surveyed through a cross-sectional sample of convenience. Participants responded to a 40-item demographic questionnaire providing a self-assessment of their current financial literacy, financial self-efficacy, financial anxiety, financial stress, and level of general social support. Pairwise correlations were used to determine the relationship between independent variables and composite scores on self-assessment tools. Multiple regression analyses were conducted to predict financial knowledge, self-efficacy, anxiety, stress, and social support by socioeconomic indicators and educational debt status. While there was a moderate, positive association between presence of debt and financial self-efficacy and financial anxiety for all students (r = .55), there was no statistically significant difference in financial knowledge, self-efficacy, anxiety, stress, or social support for students based on race/ethnicity. There was a negligible to weak correlation between financial knowledge, financial self-efficacy, and level of financial anxiety based on age, race/ethnicity, gender, socioeconomic background, debt load, risk tolerance, and retirement reflection. When subjected to multiple regression analysis, the level of education-related debt could explain a large proportion of the variance in multiple measures, including financial self-efficacy, anxiety, and stress. Economic background explained a large proportion of variance in the general social support students felt. We found a strong, positive correlation between the presence of debt and financial stress and anxiety for all DPT student respondents. While there is no difference in financial literacy and self-efficacy based on race and ethnic background, there is a moderate correlation between self-efficacy and financial anxiety for all students. Education on strategies to manage debt load may reduce both factors.

Unlevel Playing Field: Socioeconomic Determinants of Early Childhood Development in Turkiye

We investigate the socioeconomic determinants of early childhood development (ECD) in Türkiye, focusing on maternal education and household wealth, using representative microdata from the 2018 Türkiye Demographic and Health Survey (TDHS), which collected data on the developmental status of young children aged 36–59 months for the first time. Using this data, we construct an ECD index based on four developmental domains (i.e., literacy-numeracy, physical development, learning readiness and socio-emotional). Our results suggest that 74 percent of children (70.3 percent of boys and 78 percent of girls) are developmentally on track. We find that while over 96 percent of children are developmentally on track in physical and learning readiness domains, only 14.5 percent and 73.6 percent are in the literacy-numeracy and socio-emotional development domains, respectively. The multivariate regression results suggest both maternal education and household wealth improve children’s ECD outcomes but the latter has a stronger effect. In fact, we find that mother’s schooling is only positively and statistically associated with ECD once mothers have at least a high school education. Kindergarten attendance, which stands at a meagre 11.3 percent, is only likely for children from well-to-do and educated households. As a result, we find large gaps in ECD and its components between children with low and high socioeconomic backgrounds. We conclude that leveling the playing field is only possible via a nationwide multisectoral initiative that can support and educate caregivers and children simultaneously.

Impact assessment of sustainable agricultural practices on smallholder households food security: evidence from Burkina Faso

ABSTRACT This study investigates the factors affecting smallholder farmers’ decisions to adopt Sustainable Agricultural Practices (SAPs) and the impacts of single and multiple SAPs adoption on household food security in the Hauts-Bassins region of Burkina Faso. Data were collected through an individual face-to-face survey with 384 farmers. The study used both the multinomial endogenous switching regression and the average treatment effect model complemented with the multivalued inverse probability weighted regression model for the analyses. Results showed that age, education, cooperative membership, farm size, and access to climate and technology information are some socio-economic determinants of farmers’ decisions to adopt SAPs. Several factors can affect the adoption of SAPs and the impact of adopted SAPs on household welfare. Therefore, adopting single or joint SAPs can’t lead to a positive impact on crop yield, income, and further food security, unless implemented in suitable conditions. Also, the adoption of SAPs may enable food diversification and availability but not cover all aspects of food security. Thus, future studies can deeply explore the impact of SAPs on the different dimensions of food security. Our findings advocate for policies that target reducing constraints faced by farmers in successfully implementing SAPs.

Correlates of adverse outcomes of adolescent pregnancy in Sidama region, Ethiopia. An unmatched case-control study

IntroductionAdolescent pregnancy has received little attention, despite being it is the leading cause of maternal mortality and morbidity in low-income countries, including Ethiopia. Sidama regional state is one of the regions in Ethiopia that has high rates of adolescent pregnancy. This study aimed to identify factors related to adverse outcomes of adolescent pregnancy, in the Sidama region, Ethiopia. MethodsA hospital-based unmatched case-control study was conducted among 120 cases and 240 controls of pregnant adolescents. Structured interviews and patient record reviews were used to examine the potential correlates and adverse outcomes of adolescent pregnancy. Using binary logistic analysis, adjusted odds ratio (AOR) with 95% confidence intervals, were computed to identify factors related to adverse outcomes of adolescent pregnancies. ResultsA monthly income below the poverty level (AOR: 3.40; 95% CI, 1.21–9.58), lack of antenatal care follow-up (AOR: 4.22; 95% CI, 1.97–9.04), experiencing gender-based violence (AOR: 2.03; 95% CI, 1.16–3.57), and referral to a specialized health facility (AOR: 2.79; 95% CI,1.39, 5.62) were associated with higher odds of adverse pregnancy outcomes. ConclusionSeveral socio-economic and health care system-related determinants are associated with adverse outcomes of adolescent pregnancy. Therefore, it is crucial to improve free and accessible maternal health care services for adolescents, focusing on education, challenging social norms that condone gender-based violence as well as enhancing the referral system to lessen the burden of adverse outcomes of adolescent pregnancy.

Determinants of echocardiographic epicardial adipose tissue in a general middle-aged population - The Cardiovascular Risk in Young Finns Study

Epicardial adipose tissue (EAT) is the cardiac visceral fat depot proposed to play a role in the etiology of various cardiovascular disease outcomes. Little is known about EAT determinants in a general population. We examined cardiometabolic, dietary, lifestyle and socioeconomic determinants of echocardiograpghically measured EAT in early adulthood. Data on cardiometabolic, dietary, lifestyle and socioeconomic factors were collected from participants of the Cardiovascular Risk in Young Finns Study (YFS; N = 1667; age 34–49 years). EAT thickness was measured from parasternal long axis echocardiograms. Multivariable regression analysis was used to study potential EAT determinants. Possible effect modification of sex was addressed. Mean EAT thickness was 4.07 mm (95% CI 4.00–4.17). Multivariable analysis [β indicating percentage of change in EAT(mm) per one unit increase in determinant variable] indicated female sex (β = 11.0, P < 0.0001), type 2 diabetes (β = 14.0, P = 0.02), waist circumference (cm) (β = 0.38, P < 0.0001), systolic blood pressure (mmHg) (β = 0.18, P = 0.02) and red meat intake (g/day) (β = 0.02, P = 0.05) as EAT determinants. Sex-specific analysis revealed age (year) (β = 0.59, P = 0.01), alcohol intake (drinks/day) (β = 4.69, P = 0.006), heavy drinking (yes/no) (β = 30.4, P < 0.0001) as EAT determinants in women and fruit intake (g/day) (β = −1.0, P = 0.04) in men. In the YFS cohort, waist circumference, systolic blood pressure and red meat intake were directly associated with EAT among all participants. In women, age, alcohol intake, heavy drinking and type 2 diabetes associated directly with EAT, while an inverse association was observed between fruit intake and EAT in men.

#365 Dialysis centers performance: socioeconomic and environmental determinants

Abstract Background and Aims Healthcare outcomes in hemodialysis centers are intricately shaped by a myriad of factors extending beyond clinical realms. This study explores the interplay of socioeconomic and environmental determinants on the performance of 7638 hemodialysis centers in the United States during 2022. Leveraging data from the Centers for Medicare &amp; Medicaid Services, the United States Census Bureau, and the National Center for Environmental Information, our analysis encompasses outcomes like mortality, hospitalization, readmission rates, and emergency department visit rates. Method A dataset comprising information from 7638 US hemodialysis centers, spanning January to December 2022, was obtained through the Centers for Medicare &amp; Medicaid Services, US Census Bureau and environmental data, and from the National Center for Environmental Information. The study assessed mortality, hospitalization, readmission, and emergency department visits within one-month post-hospitalization. Independent variables included dialysis center characteristics, state-specific socioeconomic and environmental data, analysed through descriptive statistics and a linear regression model. Results Results reveal a significant correlation between racial composition and outcomes, with states having higher Latino populations exhibiting lower ED visit rates, contrasting with elevated mortality rates in states with higher African American populations. Socioeconomic factors, such as education and insurance status, influence ED visit rates. Environmental determinants, specifically average yearly state temperature, impact mortality and hospitalization rates. Operational characteristics matter: for-profit centres and those providing higher number of hemodialysis bed correlate with decreased mortality rates, while centres offering peritoneal dialysis or late-shift services demonstrate lower emergency department visit rates. Conclusion Our study unveils a nuanced interplay of factors influencing outcomes in hemodialysis centers. Disparities rooted in race and socioeconomic status underscore the need for targeted interventions. Environmental considerations further contribute to the complexity, while operational characteristics reveal intriguing trends, challenging conventional expectations. This analysis provides a foundation for tailored strategies to enhance the performance and equity of hemodialysis centers.

Is Too Much Time on the Internet Making us Less Satisfied with Life?

The Internet’s profound impact on society, communication, and the global economy is undeniable. Despite the studies on Internet adoption and frequency of use, little attention has been given to the intensity of usage as measured by the time spent online. In highly developed countries like the European ones, bridging the access gap is nowadays less relevant, as almost everyone has Internet access. Instead, the focus should be on analysing usage intensity to uncover new digital disparities among different groups and understand potential impacts on individuals' subjective well-being (SWB).This study aims to deeply examine Internet usage time, its socioeconomic determinants, and its effects on SWB using data from the European Social Survey (ESS) spanning from 2016 to 2020–22 in 21 European countries. We seek to answer two research questions: (1) How do individuals' characteristics influence Internet usage intensity? (2) What is the impact of Internet usage intensity on individuals' SWB?Our findings show inequalities in Internet usage time driven by individuals' socioeconomic and sociodemographic characteristics. Traditionally disadvantaged groups, both offline and online, exhibit lower Internet usage time, consistent with the existing literature on the digital divide. As for the effect of intensity of Internet use on SWB, after accounting for individuals' characteristics and addressing Internet's endogeneity, we found a negative and significant relationship between Internet usage intensity and life satisfaction, especially for the most intensive internet users.