Traffic activities from a high volume of automobiles are the main cause of urban air quality deterioration that affects public health. This study focuses on the link between socioeconomic status and their perception of the causes of urban traffic pollution from motor vehicles and traffic activities in the equatorial city of Kuala Lumpur, Malaysia. Several statistical techniques, including chi-square and exploratory factor analysis, analyzed the survey data of 200 residents. The results showed more than half of the respondents perceived a basic knowledge of traffic pollution and over 70% were aware of the negative impact of air pollution on human health. However, only 58% of the residents positively identified the technical processes of the sources of traffic pollution. Instead of emissions from motor vehicles, most of the respondents perceived that environmental factors are significant contributors to urban pollution. Furthermore, the residents’ awareness and attitudes towards vehicular traffic pollution are influenced by socioeconomic aspects, such as the level of education, gender, and age. Understanding the impact of socioeconomic status differences among the residents is crucial in addressing the issue of deteriorating urban air quality and reducing the negative impacts faced by vulnerable urban low-income communities.

BackgroundSmoking poses health risks to women across the lifespan. This study aimed to examine age-related differences in smoking, quit attempts, and cessation outcomes among women in Great Britain, overall and by socioeconomic position.MethodsWe analysed cross-sectional data from 30,519 women (≥ 16 years) in Great Britain participating in a nationally representative survey between 2023 and 2025. We used logistic regression with restricted cubic splines to obtain age-specific estimates of smoking prevalence, the quit attempt rate, the success rate of quit attempts, and the overall quit rate, among all women and by socioeconomic position (indexed by occupational social grade; ABC1 = more advantaged, C2DE = less advantaged). We calculated prevalence ratios (PR; C2DE/ABC1) to illustrate the extent of socioeconomic disparities.ResultsOverall, smoking prevalence was highest among women in their 20s and 30s and declined with age. However, there were notable differences by socioeconomic position. While it declined steadily with age among more advantaged women, smoking prevalence peaked in the early 40s among less advantaged women and was more than twice that of more advantaged women in mid-life (PR range = 2.02–2.47 between ages 35 and 60). Quit attempts decreased linearly with age, with similar prevalence and trends across socioeconomic groups. The success rate of quit attempts was highest among women in their 20s and 30s, but dropped in mid-life and further in older age. Women from less advantaged backgrounds had lower success rates, particularly between ages 45 and 60 (PR range = 0.70–0.73). The overall quit rate among past-year smokers was highest at age 31 for more advantaged women (23.3%) and at age 25 for less advantaged women (22.9%). Quit rates were substantially lower between ages 40 and 60 among less advantaged women (PR range = 0.65–0.69).ConclusionsSmoking behaviours and cessation outcomes among women in Great Britain vary by both age and socioeconomic position, with particularly high smoking prevalence and low quit rates among less advantaged women in mid-life, corresponding with perimenopause and the menopausal transition. These disparities highlight the need for tailored smoking cessation strategies to improve quit success and reduce smoking prevalence across the lifespan.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04574-1.

Abstract From the Public Square to the Gas Station. Gender, Social Milieu, and Spatial Practices: What Articulations in Public Space in Morocco? Where do women go out in Béni Mellal? This paper examines women’s practices in Béni Mellal (Morocco) by exploring their use of public spaces, focusing on two contrasting examples: a public square in the city center and a gas station transformed into a leisure complex in the suburbs. Socioeconomic differences among women are clearly reflected in their choice of spaces. The public square primarily attracts women from modest backgrounds, offering them a familiar and reassuring neighborhood environment, while the gas station draws women from more affluent backgrounds, providing a space aligned with their social status and lifestyle.

BackgroundReducing health inequalities is of national importance. Total hip replacement (THR) is a commonly used elective surgical procedure. Few studies have examined area-level inequalities for a wide range of outcomes following THR. The aim of this study is to compare area-level socioeconomic differences in outcomes following primary THR surgery for osteoarthritis in England.Methods and findingsThis is a population-based prospective cohort study of the National Joint Registry (NJR). Data from the NJR were linked to national mortality, Hospital Episode Statistics and Patient Reported Outcome Measures (PROMs) databases for England from 2007 to 2017 with follow-up to 2023 for outcomes, for patients aged 50 years and over with osteoarthritis. Outcomes of 90-day mortality; 5-year revision rate; 6-month health complications; 1-year rehospitalisation and reoperation for orthopaedic indications; and patient-reported Oxford Hip Score (OHS), post-THR surgery were examined by area-level Index of Multiple Deprivation quintiles. Modified Poisson regression was adjusted for patient age, sex, body mass index, pre-operative physical state and comorbidity.Among 448,184 patients with primary THR, mean age was 70 years (standard deviation: 9 years) and 61% were women. Patients from the most deprived group were more likely to die within 90 days of the operation compared to the least deprived group (adjusted rate ratio, RR: 1.25 (95% confidence interval (CI) [1.07, 1.46]); adjusted risk difference, RD: 9 (95% CI [2, 16]) per 10,000. Similarly, those from the most deprived group were more likely to experience complications (RR: 1.26 (95% CI [1.21, 1.32]); RD: 1.14% (95% CI [0.92, 1.36])); be rehospitalised (RR: 1.16 (95% CI [1.14, 1.19]; RD: 2.78% (95% CI [2.39, 3.17])) or reoperated (RR: 1.23 (95% CI [1.13, 1.33]); RD: 0.31% (95% CI [0.19, 0.44])) and report poorer OHS (adjusted score: −2.97 (95% CI [−3.10, −2.84]) N = 200,522). There was no variation by deprivation level for THR revision rates at 5 years (RR: 1.02 (95% CI [0.94, 1.10]); RD: 0.02% (95% CI [−0.10, 0.15])). The main study limitations are the lack of complete PROMs data, and the exclusion of self-funded patients or those with private insurance for THR procedures in independent hospitals.ConclusionsInequalities in several outcomes after THR are present in England by area-level deprivation. These findings are useful to inform shared decision-making for patients deciding whether to undergo hip replacement and to benchmark the effectiveness of policies which aim to reduce health inequalities following THR.

Does pay for performance affect socioeconomic inequalities in access? Evidence from hospital specialised care in England.

Racial and socioeconomic disparities in the utilization of diabetes medication: A comprehensive analysis of NHANES 2011-2023.

BackgroundSocioeconomic status (SES) is a distal ecological factor that predicts the trajectory of human development. Exposure to low SES may have lasting effects on brain structure and function. Although prior research has identified static neural correlates of SES disparities, it remains unclear how socioeconomic contexts shape dynamic brain states. Therefore, the present study employs electroencephalography (EEG) microstate analysis to investigate how SES influences the dynamics of resting-state brain activity.MethodsBased on SES scores, participants in the top and bottom 27% were categorized as the high-SES group (n = 29), and the low-SES group (n = 29). Resting-state EEG signals were collected from all participants, and microstate analysis identified the temporal features of four canonical large-scale neural networks (microstates A, B, C, and D) to explore socioeconomic differences in brain dynamics across different SES groups.Results(1) The correlation between SES and the temporal characteristics of both microstates A (ps < 0.05) and C (ps < 0.05) was significant, suggesting that SES may be associated with neural dynamics involved in auditory-language processing and the default mode network (DMN). (2) High- and low-SES groups exhibited divergent temporal characteristics in microstate dynamics. Compared with the high-SES group, participants in the low-SES group demonstrated larger duration (p = 0.025), occurrence (p = 0.002), and time coverage (p < 0.001) in microstate A, while exhibiting reduced occurrence (p < 0.001) and time coverage (p = 0.005) in microstate C. The results indicate that the low-SES individuals may have compensatory reinforcement of the auditory-language network and a weakened DMN activity. (3) High- and low-SES groups exhibiting different microstate transition patterns may reflect distinct cognitive control mechanisms. Compared with the high-SES group, the low-SES group demonstrated that the transition probabilities between microstates A and B (ps < 0.05), A and D (ps < 0.05) were significantly higher, whereas those between microstates B and C (ps < 0.05), C and D (ps < 0.05) were significantly lower.ConclusionThese findings reveal a robust association between SES disparities and spatiotemporal EEG microstate dynamics. The reconfiguration of metastable brain states may represent the way the brain responds to challenging environments.

Abstract Vocational education and training involve several actors working together in a skills ecosystem. This paper focuses on the role of training agencies (TAs) in the transitions in this system. They interrelate with schools, workplaces, and the apprentices themselves to enhance the quality of the apprenticeship training. Using rich data from one Norwegian county, we present evidence on the transition from school to apprenticeship. Further, we analyse whether TAs contribute to apprenticeship completion as well as the variation across TAs using regression analysis, controlling for socio-economic differences across apprentices, and we distinguish between the perspectives of the workplace and the apprentice. We find that the probability of passing the final examination and achieving the trade certificate is significantly higher for apprentices in TAs than for apprentices with a contract directly with an independent private firm. In addition, there is a large variation in completion rates across TAs and across approved training establishments that are not a part of a TA.

Using large-scale national data (n = 3,845), this study employed multiple regressions to analyze U.S. adults’ reports of their relative frequencies playing informal versus formally organized sports generally, and when playing their most played sport, while growing up. As anticipated, we found generational and socioeconomic status differences such that playing more formally organized sports has become more of a hallmark of youth sports participation among the youngest generation and among those from higher socioeconomic status families. Also, more invested and passionate family, community, and individual sports contexts seemingly encouraged more formally organized sports participation for the sport one played the most. Overall, the results indicate that youth sports participation in the U.S. has generally contained a healthy mix of both informal and formal sports– but there have been increasing tilts toward more formal sports, understood to be aided by youth sports commercialization, intensive parenting pressures and cultural reproduction processes.

Discussing diversity in the classroom: do teachers address both ethnic and socioeconomic differences?

The socioeconomic patterning of Great Britain's fast-food outlets and supermarkets: A repeated cross-sectional study of area-level deprivation and food outlet density from 2011 to 2024.

Racial and ethnic disparities have been widely reported in orthopaedic surgery, but recommendations for meaningful change remain limited. This study aimed to quantify the extent to which the relative socioeconomic differences of neighborhoods contribute to health inequity. A survey assessing a wide range of social determinants of health and patient-reported outcome measures was administered to 503 patients presenting to a multi-disciplinary orthopaedic clinic. Area Deprivation Index (ADI) was used as a neighborhood disparity indicator along with patient reported demographics, social, medical, and economic characteristics. Multivariable logistic regression analyses were performed to assess factors associated with lower Knee and Hip Disability and Osteoarthritis Outcome Scores (KOOS Jr. & HOOS Jr.). Significant factors associated with lower hip and knee functional outcomes included advanced age, BMI ≥ 40.0kg/m2 (P ≤ .002), decreased functional status (P ≤ .014), increased distance traveled (P ≤ .049), and Black race (P ≤ .025). English non-fluency (P = .001) and opioid use (P = .001) were also associated with decreased HOOS Jr scores. No significant association was observed between the ADI and hip and knee osteoarthritis outcome scores in multivariable analysis (P > 0.05). The association between socioeconomic deprivation and the burden of knee and hip pain was better explained by direct patient factors such as race, advanced age, higher BMI, opioid use, non-English literacy, and longer distances traveled rather than indirect factors such as the ADI.

Rising greenhouse gas emissions have led to extreme weather events, which have become increasingly frequent in recent years. These have serious consequences for people's lives and the global economy. In 2023, the European Union was the fourth largest emitter of greenhouse gases in the world. It is against this background that the Union is proposing a European Green Deal, aiming for climate neutrality, resource efficiency and economic competitiveness by 2050. This paper studies the impact of the European LIFE program which is one of the funding mechanisms of the Green Deal on the reduction of greenhouse gas emissions, focusing on the case study of Romania and Spain. The main aim is to determine whether LIFE funding contributes significantly to emission reductions by using econometric modeling to analyze various factors influencing emissions in the two selected countries, taking into account their socio-economic differences. The results of such a comparison between an economically developed country in Western Europe and an emerging economy in Eastern Europe may provide valuable insights into the impact of the EU's efforts to transition to a green economy, as well as the factors that continue to influence emissions in these distinct economies.

This study examines diversity of religious as a factor that influences key socio-economic indicators. The purpose of the research is to identify the relationship between the level of religious diversity and such indicators of regional development as GDP per capita, the Human Development Index (HDI), unemployment rate, urbanization level, female labour force participation, and population growth. The methodology includes agglomerative hierarchical clustering (Ward’s method) of the region’s countries based on selected socio-economic indicators, as well as pairwise correlation analysis between the Religious Diversity Index (RDI) and the identified variables. The analysis reveals four stable clusters of countries with distinct socio-economic and demographic profiles. Statistically significant positive correlations between the RDI and GDP per capita, HDI, and urbanization, along with a negative correlation with unemployment, indicate that higher religious heterogeneity is associated with stronger socio-economic performance. These results are interpreted as evidence of an indirect effect of religious diversity on the socio-economic environment through institutional and cultural mechanisms shaping social behaviour and economic activity. The scientific significance of the study lies in expanding the empirical basis for analysing the role of religion in the socio-economic development of Middle Eastern countries and refining our understanding of its influence. The findings can be applied in forecasting socio-economic trajectories of the region and in designing culturally sensitive development models.

The Society for Maternal-Fetal Medicine (SMFM), the American College of Obstetricians and Gynecologists (ACOG), and the American Society of Addiction Medicine (ASAM) jointly recommend universal substance use screening in pregnancy with a validated tool. Biologic testing with urine drug screening (UDS) is not recommended unless testing would change medical management. Despite recommendations, racial and socioeconomic differences in substance use screening and biological testing exist. We evaluated the impact of an obstetric substance use screening protocol on validated screening, UDS indication documentation, pre-UDS patient assent, and UDS disparities across race, ethnicity, and payor.This retrospective cohort study used electronic health record data before (July 1, 2020-June 9, 2021) and after (June 10, 2021-May 31, 2022) implementation of an obstetric substance use screening protocol at a tertiary care center. Documented, validated screening, UDS indication, and patient assent were assessed among UDS encounters pre- and postintervention. Association of race, ethnicity, and payor with UDS was assessed using generalized estimating equations models pre- and postintervention. Categorical variables were compared using chi-square and Fisher's exact tests.UDS occurred less frequently postintervention than preintervention (1.9% [124/6,412 encounters] vs. 7.8% [441/5,658 encounters], p < 0.001). Adjusting for payor, Black individuals had higher odds of UDS (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [CI]: 1.64-2.70) than White individuals preintervention; however, there were no differences (aOR = 1.23, 95% CI: 0.81-1.87) postintervention. Privately insured individuals had lower odds of UDS preintervention (OR = 0.23, 95% CI: 0.18-0.30) and postintervention (OR = 0.08, 95% CI: 0.04-0.15) than government-insured individuals. Among those with UDS, none (0/441) underwent validated screening preintervention versus 36.3% (45/124) postintervention. Documented UDS indication occurred in 27.9% (123/441) preintervention versus 55.7% (69/124) postintervention (p < 0.001). Documented assent occurred in 0.5% (2/441) of encounters preintervention versus 47.6% (59/124) postintervention (p < 0.001).Implementation of an obstetric substance use screening protocol was associated with decreasing UDS and increasing validated screening, documented UDS indication, and patient assent. Racial disparities in UDS were reduced postintervention; however, suboptimal screening remained, with persistent disparities by payor. · Substance use screening in pregnancy with a validated tool is performed suboptimally.. · There are known disparities in biologic testing for substance use by race and socioeconomic status.. · We evaluated an obstetric substance use screening protocol pre- and postintervention.. · The protocol was associated with validated tool use, patient assent, and screening documentation.. · Racial disparities in substance use screening were reduced postintervention..

This study examined differences in access to information on health and social activities by socioeconomic position (SEP) among community-dwelling older adults in Japan. A mail survey was conducted with 4,101 adults aged ≥65 years without functional disabilities. Information-gathering frequency and sources (television, newspapers/magazines, the internet, social interactions) were assessed. Educational attainment and subjective economic status were classified into three levels. Poisson regression models with robust variance and linear regression models were used to analyse associations between SEP and information access. Older adults with higher SEP were more likely to gather information regularly, particularly through newspapers/magazines and the internet, while television and social interactions were common across all SEP levels. Those with higher education tended to use multiple information sources. These associations were more pronounced for educational attainment than for economic status. Television and social interactions may be effective channels for reaching those with lower SEP.

In this paper, the author will discuss the effects of regular physical activity on the control of aggression among adolescents on pedagogical and psychological levels. It examines the influence of the various types of exercises, exercise frequencies, and school based programs on emotional awareness, self-control, and peer conflict. The debate incorporates the data taken in experiments, longitudinal studies, and classroom interventions. The physiological regulation of stress and mood enhancement is achieved by aerobic exercise. The team sports develop social abilities and give systematic environments to handle impulses. Yoga and tai chi are mind-body practices, which make individuals more focused and less emotional. The paper includes also the practical recommendations to schools, addressing the exercise intensity in relation to age, in accordance with social-emotional learning, teacher education, and regular follow-up. The paper identify common methodological limitations in current research, including short follow-up periods, inconsistent aggression measures, and limited attention to gender and socio-economic differences. The article concludes with actionable recommendations for educators and researchers, a proposed evaluation toolkit you can adopt, and a curated reference list of 30 to 35 accessible empirical and review sources. This work aims to help you design evidence-based physical activity programs that reliably improve emotional regulation and reduce adolescent aggression, and to meet the reporting standards required by English for Specific Purposes journals.

The purpose of the study is to review the key areas of youth migration in Kazakhstan. Youth migration goes beyond the traditional understanding of mobility, reflecting not only socio-economic differences between regions and countries, but also the formation of sustainable migration trajectories that affect the structure of national human capital. Methodology: the research employed comparative analysis, descriptive statistics, and content analysis to explore current trends in youth migration. The originality of the study lies in identifying a dual structure of migration mobility, expressed in the discrepancy between declared preferences and actual migration decisions. A shift in migration preferences of young people has been revealed from traditional destinations (Russia, the USA, Turkey) to countries with stable legal mechanisms for labor and educational mobility, such as South Korea, Germany, and the United Kingdom. Similar trends can be traced in educational migration. The results of the study generally emphasize the need to move from a migration deterrence strategy to a managed mobility concept focused on return, knowledge transfer, and institutional support for youth migration trajectories. In the context of global competition for human capital, Kazakhstan needs to form a proactive migration policy based on an analysis of the motives, barriers and opportunities for youth mobility. The value of the data obtained lies in identifying the youth's demand for security in professional self-realization, stability of legal status and predictability of career trajectories. Special attention should be paid to the "revolutionary" factor of the GenZ generation, which strives for changes in the structure of work and career models, reflecting the need for rapid adaptation to new conditions. The practical significance of the work lies in the fact that the results can be used to develop measures aimed at ensuring the safety of young people's career paths, as well as creating a flexible labor relations system that takes into account the needs and demands of the new generation. Keywords: youth migration, Kazakhstan, internal and external tracks, human capital, managed mobility, return migration.

To examine differences in hearing loss etiologies and cochlear implant outcomes between Jewish and Arab pediatric populations in Israel, addressing the understudied influence of ethnic disparities. A retrospective cohort study was conducted on 120 children (53 Jewish, 67 Arab) who underwent 171 cochlear implantations at our hospital between May 2018 and December 2022. Data included demographics, socioeconomic status, etiology, and audiological outcomes. Outcomes were assessed using pure tone averages (PTA) and speech thresholds (SRT/SDT) at seven-time points over 60 months. Predictors of early and long-term outcomes were evaluated using multivariate ANCOVA models. Jewish and Arab children had comparable demographics, but significant socioeconomic differences (399.5 ± 378.7 vs. 110.3 ± 181.6, p < 0.0001). Hearing loss etiologies differed significantly: Arab children showed predominantly congenital causes (68.7%), mainly genetic (62.7%), while Jewish children had higher acquired causes (54.7%), primarily CMV-related (52.5%). PTA thresholds were significantly better in Jewish patients at 1-4, 25-36, and 49-60 months post-implantation (p < 0.05). SRT/SDT thresholds did not differ. Multivariate analysis identified ethnicity, younger age at surgery, primary implantation status, and etiology as significant predictors of outcomes. Socioeconomic rank was not independently associated with outcomes. Ethnic differences in cochlear implant outcomes persist despite Israel's universal healthcare system, reflecting the impact of unmeasured social, cultural, and behavioral factors. These findings underscore the importance of individualized treatment strategies that consider both biological and sociocultural factors to optimize outcomes for all populations.

Low socioeconomic status amplifies the perceived rarity of large rewards.