Effects Of Socioeconomic Status Research Articles

Het effect van sociaaleconomische status en politieke kansenstructuren op protestparticipatie: een multilevel analyse van 17 Europese landen

The effect of socioeconomic status and political opportunity structures on protest participation: a multilevel analysis of 17 European countries In recent years, protesting has become an increasingly pertinent form of political participation. Within the literature on political participation, both socioeconomic status (SES) and political opportunity structures (POS) have been shown to affect protest participation, but not often have these factors been studied in relation to each other. This study addresses this gap in the literature by analysing the effects of both SES and openness of POS on individual protest participation, as well as the moderating effect of POS on the effect of SES. Multilevel models were estimated using data from the European Social Survey and the Comparative Study of Electoral Systems. The results show that both SES and openness of POS positively affect individual protest participation. The moderating effect of POS openness was not significant, indicating that the positive effect of SES on protest participation remains consistent across different political opportunity structures. Thus, we have shown that political inequality based on socioeconomic status is persistent across European countries, however, it does not depend on political opportunity structures.

Association of socioeconomic status (SES) with use of specialist palliative care (SPC) among people who died with cancer before and during the COVID-19 pandemic.

e18504 Background: Access to high-quality care, including SPC, is known to vary according to SES. The effect of SES on access to SPC during the COVID-19 pandemic remains unknown. We measured the association of SES with SPC use in different care settings among people who died with cancer before and during the COVID-19 pandemic. Methods: This retrospective, population-based cohort study included 173,915 adult patients who died with cancer from 16/3/2015 to 15/3/2020 (pre-pandemic), and from 16/3/2020 to 15/3/2021 (pandemic period), in Ontario, Canada; March 16, 2020 coincided with the start of pandemic-related hospital entrance screening. The primary outcome was access to SPC in the last 30 days of life, measured as the percentage of people with at least one SPC visit and the rate of visits/patient/30 days across home, hospital inpatient, and outpatient care settings. We used an interrupted time series analysis with segmented linear regression accounting for serial correlation to examine the immediate and gradual changes due to the pandemic. Analyses were stratified by SES, defined using area-level material deprivation quintiles (Q1, least to Q5, most deprived). Results: In total, 100,462 (57.8%) people received SPC in the last 30 days of life. The access to SPC increased steadily by 0.13% per 30 days over the pre-pandemic period ( P<0.001), with a drop of 5.34% at the start of pandemic ( P<0.001) and a trend increase of 0.19% during the pandemic period ( P = 0.10). The table shows study outcomes by care setting and SES. At baseline, patients in Q5 (vs Q1) had lower rates of SPC home visits, while rates of inpatient visits and outpatient visits were similar. Pre-pandemic for Q1 and Q5, inpatient visits were decreasing, outpatient visits were increasing, and home visits were stable. For both Q1 and Q5, there was an immediate decrease in home visits and increase in outpatient visits at pandemic onset, followed by a recovery in home visits; trends for inpatient and outpatient visits were unchanged. Conclusions: The COVID-19 pandemic led to an immediate decrease in access to SPC among people who died with cancer, particularly for home visits. SES was significantly associated with access to home visits, both before and during the pandemic. [Table: see text]

The “long arm” of adverse childhood experiences on adult health depreciation in China

BackgroundThe effects of childhood adversity on health may persist into the middle and old-aged. The assessment of the long-term effect of adverse childhood experiences (ACE) on adult health depreciation promotes a paradigm shift from current factors in health to early causation shaping health life course trajectories. ObjectiveDetermine whether the direct and significant dose-response effect between childhood adversity and health depreciation holds true, and to examine whether socioeconomic status (SES) in adulthood can diminish the negative effects of ACE. MethodsA sample of 6344 nationally representative respondents (48 % were male; Mage = 64.48 years old, SD = 9.6 years old) was obtained. Adverse childhood experiences were collected from a Life History survey in China. Health depreciation was assessed by years lived with disabilities (YLDs) based on the Global Burden of Disease (GBD) disability weights. Ordinary least squares and matching methods (propensity score matching and coarsened exact matching) were used to test the relationship and treatment effect between ACEs and health depreciation. Mediating effect coefficients test and the Karlson-Holm-Breen (KHB) examined the mediating effect of socioeconomic status in adulthood. ResultsCompared to respondents without ACE, respondents who experienced 1 ACE increased YLD 15.9 % (p < 0.01); 2 ACEs by 32.8 % (p < 0.01); 3 ACEs by 47.4 % (p < 0.01), and 4+ ACEs by 71.5 % (p < 0.01) higher YLDs. The mediating effect of SES in adulthood was only between 3.9 % and 8.2 %. The interaction effect between ACE and adult socioeconomic status was not significant. ConclusionThe “long arm” of ACE on health depreciation exhibited a significant dose-response relationship. Policies and measures aimed at reducing family dysfunction and strengthening early childhood health interventions can facilitate the reduction of health depreciation in middle and old age.

The role of socioeconomic background on cardiovascular health promotion in early childhood: insights from the SI Program for preschoolers

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): 1. SHE Foundation and "la Caixa" 2. Fondo de Investigación Sanitaria - Instituto de Salud Carlos III. Background Family socioeconomic status (SES) impacts childhood health and could influence the effect of school-based health promotion interventions. Purpose This work aims to evaluate the impact of SES on the effects of the SI! Program randomized controlled trials for cardiovascular health promotion in preschoolers carried out in Colombia, Spain, and USA. Specifically, this work analyzed the effect of SES in the change of knowledge, attitudes and habits (KAH) and body mass index z-scores (zBMI) from baseline to immediately after the end of the health promotion intervention. Methods Children completed a KAH questionnaire (from 0 to 80 points) at baseline and immediate post-intervention. Families reported household income and education level through a dedicated questionnaire. Household income was categorized as low or high, and education level as low, intermediate, or high based on local census data. Adjusted baseline scores were calculated and stratified by SES using linear mixed models. The impact of the intervention was assessed by an individual participant-level meta-analysis using a random-effects model (DerSimonian-Laird method). Estimates of the difference between groups were derived from linear mixed models. Results A total of 3839 children were included in the analysis (48.9% girls, 4.0 (SD=0.8) years at baseline). Children of families with high education level and high household income tended to have a higher KAH score at baseline than those with low education level or low income (47.2 points [95%CI: 43.9; 50.5] vs. 45.7 points [95%CI: 42.4; 48.9]; 47.4 points [95%CI: 44.6; 50.2] vs. 45.8 points [95%CI: 43.0; 48.6], respectively) (Fig. 1A). Children from high education level and high income families had a lower zBMI at baseline than those from low education level and low income families (0.23 [95%CI: -0.20; 0.67] vs. 0.47 [95% CI: 0.03; 0.90]; 0.25 [95%CI: -0.15; 0.66] vs. 0.44 [95%CI: 0.04; 0.85], respectively) (Fig. 1B). The mean difference in KAH change between the intervention and control groups was 4.76 points (95%CI: 2.78; 6.74). The effect of the intervention on KAH score change was higher for children of families reporting high income or an intermediate/high education level than for those reporting low income or education level (Fig. 2A). The overall mean difference in zBMI change between groups was -0.06 (95%CI: -0.14; 0.02), and no significant differences were found in relation to SES indicators (Fig. 2B). Conclusions These results suggest that children from a low SES background benefit less from lifestyle interventions than those from high SES families. Health promotion interventions may implement strategies to counteract this effect and, consequently, avoid the potential risk of increasing health inequalities.

Disentangling the confounding effects of students’ ethnicity and socioeconomic background on preservice teachers’ judgments

Ethnic disparities in educational systems are often discussed to be a result of the low socioeconomic status (SES) of the family rather than students’ ethnicity. In Germany, it is particularly the students with a Turkish background whose families are associated with low SES. In addition, large-scale studies have consistently shown only small or no effects of ethnicity when controlling for students’ SES. However, a correlational field design does not allow researchers to draw stringent conclusions about the superordinate impact of family SES. In the current study, we experimentally varied the SES and ethnicity of a student’s family as described in a vignette, resulting in a fully crossed design. A sample of preservice teachers read one of four student descriptions and judged the students’ mathematical achievement and German language proficiency. The results showed that ethnicity had a stronger influence than family SES and that a male ethnic minority student was judged to be less competent in German language proficiency, independent of his family’s SES. Our study implies that ethnicity should not be neglected or reduced to effects of SES in research on ethnic disparities in education.

Socioeconomic deprivation and prognostic outcomes in acute coronary syndrome: A meta-analysis using multidimensional socioeconomic status indices

BackgroundLow socioeconomic status (SES) is an important prognosticator amongst patients with acute coronary syndrome (ACS). This paper analysed the effects of SES on ACS outcomes. MethodsMedline and Embase were searched for articles reporting outcomes of ACS patients stratified by SES using a multidimensional index, comprising at least 2 of the following components: Income, Education and Employment. A comparative meta-analysis was conducted using random-effects models to estimate the risk ratio of all-cause mortality in low SES vs high SES populations, stratified according to geographical region, study year, follow-up duration and SES index. ResultsA total of 29 studies comprising of 301,340 individuals were included, of whom 43.7% were classified as low SES. While patients of both SES groups had similar cardiovascular risk profiles, ACS patients of low SES had significantly higher risk of all-cause mortality (adjusted HR:1.19, 95%CI: 1.10–1.1.29, p < 0.001) compared to patients of high SES, with higher 1-year mortality (RR:1.08, 95%CI:1.03–1.13, p = 0.0057) but not 30-day mortality (RR:1.07, 95%CI:0.98–1.16, p = 0.1003). Despite having similar rates of ST-elevation myocardial infarction and non-ST-elevation ACS, individuals with low SES had lower rates of coronary revascularisation (RR:0.95, 95%CI:0.91–0.99, p = 0.0115) and had higher cerebrovascular accident risk (RR:1.25, 95%CI:1.01–1.55, p = 0.0469). Excess mortality risk was independent of region (p = 0.2636), study year (p = 0.7271) and duration of follow-up (p = 0.0604) but was dependent on the SES index used (p < 0.0001). ConclusionLow SES is associated with increased mortality post-ACS, with suboptimal coronary revascularisation rates compared to those of high SES. Concerted efforts are needed to address the global ACS-related socioeconomic inequity. Registration and protocolThe current study was registered with PROSPERO, ID: CRD42022347987.

The Effect of Welfare State Policy Spending on the Equalization of Socioeconomic Status Disparities in Mental Health.

This article examines whether and how the relationship between socioeconomic status (SES) and depression is modified by welfare state spending using the 2006, 2012, and 2014 survey rounds of the European Social Survey (ESS) merged with macroeconomic data from the World Bank, Eurostat, and SOCX database (N = 87,466). Welfare state spending effort divided between social investment and social protection spending modifies the classic inverse relationship between SES and depression. Distinguishing policy areas in both social investment and social protection spending demonstrates that policy programs devoted to education, early childhood education and care, active labor market policies, old age care, and incapacity account for differences in the effect of SES across countries. Our analysis finds that social investment policies better explain cross-national differences in the effect of SES on depression, implying policies focused earlier in the life course matter more for understanding social disparities in the mental health of populations.

Relationship between socioeconomic status and cognitive ability among Chinese older adults: the moderating role of social support

BackgroundUnderstanding the causes and pathways of cognitive decline among older populations is of great importance in China. This study aims to examine whether the discrepancy in socioeconomic status (SES) makes a difference to the cognitive ability among Chinese older adults, and to disentangle the moderating role of different types of social support in the process in which SES influences cognition.MethodsWe utilized a nationally representative sample from the 2018 Chinese Longitudinal Healthy Longevity Survey. A cumulative SES score was constructed to measure the combined effect of different socioeconomic statuses on the cognitive ability of the elderly. We further examined the moderating role of two types of social support, including emotional support, and financial support. Hierarchical regression analysis was applied to test the direct effect of SES on cognitive ability, and to investigate the moderating role of social support on the association of the SES with the dependent variables.ResultsThe results showed that the higher SES of older adults was significantly associated with better cognitive ability (β = 0.52, p < 0.001) after controlling for age, sex, marital status, living region, Hukou, health insurance, lifestyle factors, and physical health status. Emotional support and financial support were moderated the relationship between SES score and cognitive ability.ConclusionOur results reveal the importance of considering social support in buffering the effects of SES and the associated cognitive ability for aging populations. It highlights the importance of narrowing the socioeconomic gap among the elderly. Policymakers should consider promoting social support to improve the cognitive ability among older adults.

Socioeconomic Status as a Determinant of Delayed Diagnosis of Sickle Cell Disease - A Case Report of Newly Diagnosed Sickle Cell Disease in a 52-Year-Old Woman

A look into socioeconomic status (SES) associations with delayed diagnosis of sickle cell disease (SCD) is necessary to improve societal norms, governmental health policies, and strategies. A person's social standing in a society is generally governed by the combination of his education, profession, and income, which is regarded as his SES. Considerable evidence establishes the likelihood of individuals from low SES suffering from the disease, cognitive problems, and increased mortality (Lubeck et al., 2019, National Research, 2004). Sickle cell disease (SCD) is one of the most common severe genetic hemoglobinopathies recognized by the World Health Organization as a global public health problem. Socioeconomic status (SES) is an individual's social or economic standing and measures an individual's or family's financial position or rank in a social group. Current guidelines and management algorithms of SCD do not factor in the effect of SES on patients with SCD. There needs to be more literature regarding the role of SES and its impact on clinical outcomes and characteristics of SCD. Studies have shown that lower SES is linked to disproportionate access to health care in many diseases, and of all the factors that measure SES, income was the most indicative.

MP12-05 THE IMPACT OF SOCIOECONOMIC STATUS ON THE SURVIVAL OF MEN WITH EARLY-ONSET PROSTATE CANCER

You have accessJournal of UrologyCME1 Apr 2023MP12-05 THE IMPACT OF SOCIOECONOMIC STATUS ON THE SURVIVAL OF MEN WITH EARLY-ONSET PROSTATE CANCER Carlos Riveros, Victor Chalfant, Ahmed El-shafie, Allison H. Feibus, Mohammed Al-Toubat, Soroush Bazargani, SeyedBehzad Jazayeri, Mark Bandyk, and K.C. Balaji Carlos RiverosCarlos Riveros More articles by this author , Victor ChalfantVictor Chalfant More articles by this author , Ahmed El-shafieAhmed El-shafie More articles by this author , Allison H. FeibusAllison H. Feibus More articles by this author , Mohammed Al-ToubatMohammed Al-Toubat More articles by this author , Soroush BazarganiSoroush Bazargani More articles by this author , SeyedBehzad JazayeriSeyedBehzad Jazayeri More articles by this author , Mark BandykMark Bandyk More articles by this author , and K.C. BalajiK.C. Balaji More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003227.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer (PC) is considered a disease of older men; about 10% of new diagnoses in the US occur in men ≤55 years old. Socioeconomic status (SES) has shown to influence survival in patients with PC; however, the impact of SES on men with early-onset PC remains undescribed. METHODS: Using the National Cancer Database, we identified men ≤55 years of age with PC between 2004-2018. Descriptive statistics were used to characterize differences among SES groups. Kaplan-Meier (KM) and Cox regression analyses were used to assess the effect of SES on overall survival (OS). To establish the impact of SES, the quartile assignments of median income and education level were combined to create a composite SES measure. Income and education level were determined by matching each patient’s zip code at the time of diagnosis with data derived from the 2016 American Community Survey on median household income and the percentage of people aged ≥25 years old who had not earned a high school diploma, respectively. The quartile assignments (Q1, Q2, Q3, Q4) of the income and education measures were added together to form 4 composite SES categories: 2-3=Low; 4-5=Mid-Low; 6-7=Mid-High; and 8=High. RESULTS: A total of 112,563 patients with early onset PC with a median follow-up of 79.0 months were included in the study cohort. Compared to high SES patients, low SES patients were more likely to be African American (42.4% vs. 8.6%; p<0.001), Hispanic (9.5% vs. 2.7%; p<0.001), and uninsured (5.2% vs. 1.1%; p<0.001); they were also more likely to live in a rural area (3.2% vs 0.1%; p<0.001) and have stage IV disease (5.5% vs. 3.1%; p<0.001). KM analysis showed that a decreasing SES was directly associated with lower rates of OS (log-rank test p<0.001). On multivariable analysis, SES was found to have a negative effect on OS (low SES vs. high SES; hazard ratio [HR] 1.54; 95% confidence interval [CI] 1.41-1.68; p<0.001) (Figure 1). CONCLUSIONS: In patients with early-onset PC, SES was associated with overall survival. SES should be considered when implementing programs to improve the management of patients with early-onset PC Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e134 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carlos Riveros More articles by this author Victor Chalfant More articles by this author Ahmed El-shafie More articles by this author Allison H. Feibus More articles by this author Mohammed Al-Toubat More articles by this author Soroush Bazargani More articles by this author SeyedBehzad Jazayeri More articles by this author Mark Bandyk More articles by this author K.C. Balaji More articles by this author Expand All Advertisement PDF downloadLoading ...

The cumulative effect of socioeconomic status and dyslexia on linguistic, cognitive and reading skills among Arabic‐speaking children

Research has shown that children with dyslexia and children with a low socioeconomic status (SES) fall behind in terms of literacy acquisition, but a question remains regarding the cumulative effect of dyslexia and SES on linguistic, cognitive and reading skills. To examine the impact of cognition and environment on literacy development, we returned to the data set of 1,441 elementary school children (223 dyslexic readers and 1,241 typical readers) from low and medium-high SES backgrounds within Palestinian society in Israel who had participated in the development study of a comprehensive battery of tests in oral and written Arabic. The findings of this retrospective study reveal that, across grade levels, dyslexic readers from a low SES background showed similar performance to those from a medium-high SES background on most linguistic, cognitive and reading measures. As for typical readers, SES contributed to individual differences in all linguistic, cognitive and reading indices, with the exception of RAN. Finally, a cumulative effect of dyslexia and SES was found in relation to morphology, vocabulary, listening comprehension and text-reading accuracy.

Effects of early-life environment and adulthood SES on cognitive change in a multiethnic cohort.

Early-life socioeconomic status (SES) and adversity are associated with late-life cognition and risk of dementia. We examined the association between early-life SES and adversity and late-life cross-sectional cognitive outcomes as well as global cognitive decline, hypothesizing that adulthood SES would mediate these associations. Our sample (N = 837) was a racially and ethnically diverse cohort of non-Hispanic/Latino White (48%), Black (27%), and Hispanic/Latino (19%) participants from Northern California. Participant addresses were geocoded to the level of the census tract, and US Census Tract 2010 variables (e.g., percent with high school diploma) were extracted and combined to create a neighborhood SES composite. We used multilevel latent variable models to estimate early-life (e.g., parental education, whether participant ever went hungry) and adult (participant's education, main occupation) SES factors and their associations with cross-sectional and longitudinal cognitive outcomes of episodic memory, semantic memory, executive function, and spatial ability. Child and adult factors were strongly related to domain-specific cognitive intercepts (0.20-0.48 SD per SD of SES factor); in contrast, SES factors were not related to global cognitive change (0.001-0.01 SD per year per SD of SES factor). Adulthood SES mediated a large percentage (68-75%) of the total early-life effect on cognition. Early-life sociocontextual factors are more strongly associated with cross-sectional late-life cognitive performance compared to cognitive change; this effect is largely mediated through associations with adulthood SES.

Effect of socioeconomic status on patients undergoing elective abdominal aortic aneurysm repair in a publicly funded health care system.

The association between socioeconomic status (SES) and outcomes after abdominal aortic aneurysm (AAA) repair in publicly funded health care systems is poorly described. The purpose of this study was to determine the effect of SES on postoperative outcomes in patients who underwent AAA repair in Nova Scotia, Canada. We performed a retrospective analysis of all elective AAA repairs in Nova Scotia between November 2005 and March 2015 using administrative data sources. We compared postoperative 30-day outcomes and long-term survival across socio-economic quintiles, defined as the Pampalon Material Deprivation Index (MDI) and Social Deprivation Index (SDI). We also compared the relation between baseline characteristics, MDI quintile, SDI quintile and 30-day mortality. We used multivariable logistic regression and survival analysis to calculate adjusted 30-day mortality and long-term survival, respectively. A total of 1913 patients underwent AAA repair during the study period. The overall 30-day mortality rate was 2.6% (50 patients). Thirty-day outcomes including death (p = 0.8), stroke (p = 0.7), myocardial infarction (p = 0.06), length of stay (p = 0.3) and discharge disposition other than home (p = 0.8) were similar across MDI quintiles. Similarly, there was no statistically significant association between SDI quintile and postoperative outcomes. Multivariable analysis showed that age greater than 70 years (odds ratio [OR] 3.06, 95% confidence interval [CI] 1.55-6.06) and open repair (OR 3.22, 95% CI 1.59-6.52) but not MDI quintile (p = NS) or SDI quintile (p = NS) were associated with increased 30-day mortality. There was no effect of MDI or SDI quintile on long-term survival on univariable or multivariable analysis. Socioeconomic status does not appear to affect short- or long-term mortality after AAA repair in a publicly funded health care system. Further research is needed to address any existing gaps in screening and referral before repair.

Socioeconomic inequalities in paediatric metabolic syndrome: mediation by parental health literacy.

Parental health literacy may explain the relationship between parental socioeconomic status (SES) and paediatric metabolic syndrome (MetS). For this reason, we assessed to what extent parental health literacy mediates the relationships between parental SES and paediatric MetS. We used data from the prospective multigenerational Dutch Lifelines Cohort Study. Our sample consisted of 6683 children with an average follow-up of 36.2 months (SD 9.3) and a mean baseline age of 12.8 years (SD 2.6). We used natural effects models to assess the natural direct, natural indirect and total effects of parental SES on MetS. On average, an additional 4 years of parental education, e.g. university instead of secondary school, would lead to continuous MetS (cMetS) scores that were 0.499 (95% confidence interval (CI): 0.364-0.635) units lower, which is a small effect (d: 0.18). If parental income and occupational level were 1 SD higher, on average cMetS scores were 0.136 (95% CI: 0.052-0.219) and 0.196 (95% CI: 0.108-0.284) units lower, respectively; these are both small effects (d: 0.05 and 0.07, respectively). Parental health literacy partially mediated these pathways; it accounted for 6.7% (education), 11.8% (income) and 8.3% (occupation) of the total effect of parental SES on paediatric MetS. Socioeconomic differences in paediatric MetS are relatively small, the largest being by parental education. Improving parental health literacy may reduce these inequalities. Further research is needed into the mediating role of parental health literacy on other socioeconomic health inequalities in children.

The effects of SES, social support, and resilience on older adults’ well-being during COVID-19: Evidence from Singapore

The COVID-19 pandemic has rendered visible many socioeconomic inequalities and the lengthy period of disruption to everyday life had disproportionate effects on the most vulnerable groups in Singapore and across the world. Utilizing data from the Singapore Life Panel ® (SLP) collected in September 2021, this study examined a sample of 6667 older adults to assess the effects of socioeconomic status (SES) on well-being, and the mechanisms through which social support and resilience may mediate its influence. Overall, our results suggest significant direct and indirect effects of SES on well-being and provide evidence for the pivotal role that social support plays in building resilience and well-being. Affluent socioeconomic backgrounds do not intrinsically build resilience; instead, it is through the access to social resources, which SES affords and facilitates, that resilience is developed, and well-being is safeguarded. We argue that Singapore's policy response to COVID-19 has yet to fully leverage on social resources and develop a social infrastructure that can buffer the negative impacts of prolonged crises on the most vulnerable groups.

Social determinants of neurocognitive and academic performance in sickle cell disease.

Sickle cell disease (SCD) is associated with poor neurocognitive outcomes due to biomedical and psychosocial factors. The aims of this study were to investigate associations between household and neighborhood socioeconomic status (SES) with cognitive and academic outcomes in SCD and to determine if these relationships were modified by sickle genotype, fetal hemoglobin, or age. We prospectively recruited patients to complete a battery of neurocognitive and academic measures. Household SES was measured using the Barratt Simplified Measure of Social Status, a composite index of parent education and occupation. The Social Vulnerability Index was used to classify individuals based on social vulnerabilities at the neighborhood level. Overall, 299 patients between the ages of 4 and 18 (mean=11.4, standard deviation=4.3) years diagnosed with SCD (57% SS/SB0 -thalassemia) completed testing. Stepwise multivariate models demonstrated that patients with low social vulnerability (i.e., high SES) at the neighborhood level displayed intelligence and math scores that were 4.70 and 7.64 points higher than those living in areas with moderate social vulnerability, respectively (p<.05). Reading performance did not differ based on neighborhood SES; however, the effect of neighborhood SES was dependent on age, such that older participants living in neighborhoods with moderate or high levels of social vulnerability displayed poorer reading scores than those with low social vulnerability (p<.05). This study identified patients with SCD at higher risk of poor academic performance based on SES. Interventions addressing academic difficulties should be offered to all children with SCD, but should be emergently offered to this subpopulation.

Direct and Indirect Effects of Socioeconomic Status and Discrimination on Subjective Cognitive Decline: A Longitudinal Study of African American Women.

The present study builds on recent findings suggesting that the stress of institutional and interpersonal racism may contribute to African Americans' elevated risk for dementia. We investigated the extent to which 2 consequences of racism-low socioeconomic status (SES) and discrimination-predict self-reported cognitive decline (SCD) 19years later. Further, we examined potential mediating pathways that might link SES and discrimination to cognitive decline. Potential mediators included depression, accelerated biological aging, and onset of chronic illnesses. Hypotheses were tested using a sample of 293 African American women. SCD was assessed using the Everyday Cognition Scale. Structural equation modeling was used to assess the effects of SES and racial discrimination, both measured in 2002, on SCD reported in 2021. Turning to the mediators, midlife depression was assessed in 2002, accelerated aging in 2019, and chronic illness in 2019. Age and prodrome depression were included as covariates. There were direct effects of SES and discrimination on SCD. In addition, these 2 stressors showed a significant indirect effect on SCD through depression. Finally, there was evidence for a more complex pathway where SES and discrimination accelerate biological aging, with accelerated aging, in turn leading to chronic illness, which then predicted SCD. Results of the present study add to a growing literature indicating that living in a racialized society is a central factor in explaining the high risk for dementia among Black Americans. Future research should continue to emphasize the various ways that exposure to racism over the life course effects cognition.

Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016

BackgroundDiabetes is a growing epidemic worldwide and the effect of socioeconomic status (SES) is frequently acknowledged in the literature. This study aims to compare the effect of SES on diabetes prevalence in South Africa between 2003 and 2016. In addition, vulnerable groups regarding diabetes development in 2016 will be identified.MethodsUsing DHS data there were 8,006 participants (59.19% women) in 2003 and 10,292 participants (59.42% women) in 2016. Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for diabetes by age, gender, educational level and place of residence. To identify vulnerable groups with high risk of developing diabetes in 2016, the method of p-value based regression tree analysis was applied using “wealth index” and “weight perception” as additional variables.ResultsThere was an increase in diabetes prevalence from 3.86% in 2003 to 4.46% in 2016. Women had more risk of developing diabetes at both time points (27% in 2003 and 24% in 2016 more risk). Increase in age and living in urban areas were associated with more risk of developing diabetes at both time points. There was no specific pattern regarding risk of developing diabetes and educational level in case of women. However, men who completed secondary school or had a higher diploma or above had more risk of developing diabetes in 2016 (OR = 2.24 and 4.67 respectively). Vulnerable groups who have higher risk of developing diabetes in 2016 were participants aged “60 years or older” with a wealth index of “rich” or “richer”, followed by participants from the same age group who were “poor” or “poorer” and participants aged “40–59 years” with a wealth index of “rich” or “richer”. Subsequently were participants from the age group “15–39 years” with a weight perception of “overweight” or “obese”.ConclusionDiabetes prevalence increased in South Africa between 2003 and 2016. Main risk factors were age, gender and living in urban areas. Men with high educational level were more at risk of developing diabetes in 2016. Vulnerable groups in 2016 were participants 40 years and older, particularly with high SES. This was followed by younger participants who were obese or overweight.

Direct Effect of Life-Course Socioeconomic Status on Late-Life Cognition and Cognitive Decline in the Rush Memory and Aging Project.

The role of socioeconomic status (SES) across the life course in late-life cognition is unclear. We tested the hypotheses that: 1) High SES in childhood, young adulthood, midlife, and late life have independent causal effects on higher cognition level and slower cognitive decline; 2) Compared with stable low SES (referent), stable high SES has the largest estimated effect for higher cognition level and slower decline among life-course SES combinations. The Rush Memory and Aging Project enrolled 1,940 dementia-free older adults in northeastern Illinois (1997-2018). We used inverse probability-weighted marginal structural models to estimate the joint and independent effect of each life-course SES on global and domain-specific cognition. A total of 1,746 participants had, on average, 6 years of follow-up. High SES at each life-course stage starting in young adulthood had a protective estimated effect on global and domain-specific cognition intercepts. Compared with consistently low SES, consistently high SES (β= 0.64, 95% confidence interval: 0.48, 0.93) and high SES beyond childhood (β= 0.64, 95% confidence interval: 0.47, 0.83) had the largest benefit for global cognition intercepts. None of the life-course SES measures influenced rate of global or domain-specific decline. Additional understanding of life-course SES components influencing cognitive level is warranted.

The regulatory roles of socio-economic status, social and intellectual activity in the relationship between alcohol consumption and cognitive decline trajectory in middle-aged and elderly Chinese: A prospective cohort study.

To determine the relationship between alcohol consumption and cognitive decline, and to further explore the potential regulatory role of education, socio-economic status (SES), and social or intellectual activity in this relationship. 6197 participants aged 45-75years with four repeated measures data from 2011 to 2018 were included. A mixed-effect model was used to explore the relationship between alcohol consumption and the rate of change in cognitive decline, a latent class growth mixed model (LCGMM) was applied to determine the potential trajectory of cognitive decline, and finally, the mediating and moderating analyses were used to determine the regulatory effect of all four variables on the relationship between alcohol consumption and potential trajectory. Compared to never-drinkers, moderate alcohol consumption was a protective factor for overall cognitive function (β=0.13, 95% CI: 0.04-0.20, p<0.001), but there was no statistical correlation with the decline rate of cognitive function. And this protective effect was no longer significant after additional adjustments for education, SES, social and intellectual activity. The LCGMM model divided participants into two trajectories, a high-level-to-decline group including 79.75% of participants (quadratic: β [SE]: -0.90 [0.07], p<0.001), and a low-level-to-decline group including 20.25% participants (linear: β [SE]: -3.05 [0.49], p<0.001). With the latter as the reference, SES played a reverse regulation role in the harmful effect of heavy drinking on cognitive trajectories (odd ratio [OR]=0.46, 95% CI: 0.23-0.93, p<0.05). Social and intellectual activities played a negative mediating role in the harmful effect of alcohol consumption on cognitive trajectories (light: OR=0.96, p<0.001; moderate: OR=0.96, p<0.001; heavy: OR=0.97, p<0.01). Alcohol itself has no protective effect on the decline of longitudinal cognitive trajectory. But the regulatory effect of SES, social and intellectual activities slows down the harm of alcohol consumption on the decline of cognitive function. The data used in this study are from publicly available databases. They are retrospective cohort studies without any intervention. Therefore, no clinical trial registration has been conducted.