Measures Of Socioeconomic Status Research Articles

Neighborhood socioeconomic status and postpartum depression among commercial health insurance enrollees: a retrospective cohort study

BackgroundPostpartum depression (PPD) is a prevalent psychological condition. Although the effect of obstetrical and maternal complications on PPD are well described, the impact of neighborhood socioeconomic status (SES) on PPD is relatively unexplored.ObjectivesThis study examined the relationship between neighborhood SES score and PPD.MethodsA summary SES measure for each U.S. zip code was constructed using income, education, and occupational 2021 Census data and linked to national commercial claims for 2017–2023. PPD status using diagnosis codes at outpatient and inpatient visits, and prescription drug use 3, 6, 9, and 12 months postpartum, were determined. Multivariate analysis controlled for potential confounders.ResultsPPD prevalence in commercial claims was 11.48%. Patients with PPD had higher rates of obstetrical (OR: 1.555, p < .0001) and maternal complications (OR: 1.145, p < .0001), and more lifestyle risk factors (OR: 1.113, p < .0001). Comorbidity scores were higher for patients with PPD. Controlling for age and clinical factors, living in a disadvantaged neighborhood was associated with an increased incidence of PPD (OR: 1.137, p < .0001).LimitationsClaims data may include potential inaccurate coding of diagnoses/procedures. Clinical information is limited to conditions and treatments defined by ICD-10-CM codes. Area-based SES measures inevitably misclassify people on both ends of the socioeconomic spectrum (this misclassification is random; direction of bias is known).ConclusionsThe inverse and significant effect of area-based high SES on PPD rates demonstrates that preventive efforts may require interventions focusing on both the patient and the lived environment.

Association of neighborhood-level disadvantage beyond individual sociodemographic factors in patients with or at risk of knee osteoarthritis

ObjectiveLower socioeconomic status (SES) is a risk factor for poorer pain-related outcomes. Further, the neighborhood environments of disadvantaged communities can create a milieu of increased stress and deprivation that adversely affects pain-related and other health outcomes. Socioenvironmental variables such as the Area Deprivation Index, which ranks neighborhoods based on socioeconomic factors could be used to capture environmental aspects associated with poor pain outcomes. However, it is unclear whether the ADI could be used as a risk assessment tool in addition to individual-level SES.MethodsThe current study investigated whether neighborhood-level disadvantage impacts knee pain-related outcomes above sociodemographic measures. Participants were 188 community-dwelling adults who self-identified as non-Hispanic Black or non-Hispanic White and reported knee pain. Area Deprivation Index (ADI; measure of neighborhood-level disadvantage) state deciles were derived for each participant. Participants reported educational attainment and annual household income as measures of SES, and completed several measures of pain and function: Short-form McGill Pain Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, and Graded Chronic Pain Scale were completed, and movement-evoked pain was assessed following the Short Physical Performance Battery. Hierarchical linear regression analyses were used to assess whether environmental and sociodemographic measures (i.e., ADI 80/20 [80% least disadvantaged and 20% most disadvantaged]; education/income, race) were associated with pain-related clinical outcomes.ResultsLiving in the most deprived neighborhood was associated with poorer clinical knee pain-related outcomes compared to living in less deprived neighborhoods (ps < 0.05). Study site, age, BMI, education, and income explained 11.3–28.5% of the variance across all of the individual pain-related outcomes. However, the ADI accounted for 2.5–4.2% additional variance across multiple pain-related outcomes.ConclusionThe ADI accounted for a significant amount of variance in pain-related outcomes beyond the control variables including education and income. Further, the effect of ADI was similar to or higher than the effect of age and BMI. While the effect of neighborhood environment was modest, a neighborhood-level socioenvironmental variable like ADI might be used by clinicians and researchers to improve the characterization of patients’ risk profile for chronic pain outcomes.

Socioeconomic Disparities, Service Equity, and Citizen Satisfaction: Cross‐National Evidence

AbstractThe literature on citizen satisfaction has predominantly focused on the key factors of service quality, with scant attention paid to the role of equity. Furthermore, these studies often rely on a single demographic identity within a single country, limiting their scope. This study aims to address these gaps by examining how outcome disparities based on socioeconomic status (SES) affect satisfaction with service providers across countries. Using a cross‐national education database, we employ three SES measures—education, income, and occupation—to test how disparities in student performance across SES groups affect parents' satisfaction with schools. Our findings show that parents in less professional occupations express lower satisfaction with schools when their children underperform compared with students whose parents hold more professional jobs. However, this relationship does not exist for education‐ or income‐based disparities. This study advances the understanding of how outcome disparities based on SES are associated with citizen satisfaction.

What role does the environment play in language development? Exploring the associations among socioeconomic status, parent language input, and language skills in school-aged children with autism.

Language development in children with autism is influenced by proximal (e.g., parent language input) and distal (e.g., socioeconomic status) environmental constructs. Studies have found that "rich and responsive" parent language input supports autistic children's language development, and recent work has reported positive associations between measures of socioeconomic status (SES) and child language skills. However, little is known about how these proximal and distal environmental constructs interact to shape language development in autism. In a sample of 74 autistic school-aged children, the present study investigated the associations among measures of SES, the quantity and quality of language produced by parents and children during home-based dyadic parent-child interactions, and children's expressive and receptive language skills. Results showed that annual household income was positively associated with parent number of total words (NTW), parent number of different words (NDW), and parent mean length of utterance (MLU), while neither parent education level nor annual household income were significantly associated with measures of child language skills. Parent MLU was positively associated with child MLU and child expressive language skills. Findings suggest that annual household income may influence both the quantity and quality of parent language input, and that parent MLU, a qualitative measure of parent language input, may play a particularly important role in shaping autistic children's expressive language development. Future research should study longitudinal associations among SES, parent language input, and child language skills, as identifying environmental predictors of language skills in autism may facilitate the creation of more effective interventions that support language development.

Cognitive, affective and sociological predictors of school performance in mathematics

Mathematics is a key school subject for some of the most lucrative and economically important careers. Low mathematics performance in school is associated with low psychometric intelligence, family socioeconomic status (SES), specific mathematical abilities, and high mathematics anxiety. We used a sample of Hungarian schoolchildren (N = 102, mean age = 12.3 years) to directly compare the predictive power of general intelligence, specific mathematical abilities measured by the Pedagogical Examination of Dyscalculia (DPV), mathematics anxiety, and socioeconomic status for mathematics grades. Mathematics grades correlated with IQ, specific mathematic ability, mathematics anxiety, and a composite measure of family SES. The WISC-IV showcased a manifest correlation of 0.62 and a latent correlation of 0.78 with the DPV and high manifest (r=-0.53) and latent (r=-0.59) correlations with mathematics anxiety. IQ alone accounted for 52% of the variance in mathematics grades. IQ, specific mathematical ability, family SES and mathematics anxiety jointly accounted for 56% of the variance in grades, with a non-significant contribution of specific mathematical ability and family SES over IQ and a marginal contribution of mathematics anxiety. Our results show that psychometric intelligence is the most important predictor of mathematics grades, while family SES and specific mathematical abilities are only associated with grades to the extent they reflect psychometric intelligence. The results, however, confirmed a small role of mathematics anxiety over intelligence in predicting grades.

Long-Term Exposure to Nitrogen Dioxide and Ozone and Respiratory Health in Children.

Further evaluation of the impact of long-term exposure to the gaseous air pollutants nitrogen dioxide (NO2) and ozone (O3) on child lung function, and of NO2 or O3 on eosinophilic airway inflammation, is needed. To determine whether NO2 and O3 are associated with lung function and FeNO in children. We measured lung function (FEV1 and FVC) at mid-childhood (mean age 7.9 years, n=703), early teens (13.2 years, n=976), and mid-teen (17.6 years, n=624) study visits, and fractional exhaled nitric oxide (FeNO) at the early and mid-teen study visits in Project Viva, a cohort of mother-child pairs in the Boston, MA area. Long-term exposure to NO2 and O3 was estimated at home address using geospatial models. We examined associations of home address NO2 and O3 exposure and proximity to roadway with lung function and FeNO using linear regression models, adjusting for age, sex, height, weight, season, relative humidity, temperature, parental smoking, and measures of socioeconomic status. We examined for effect modification of the mid-teen associations by blood eosinophil level, physical activity, aeroallergen sensitization, and parental atopy. Median exposure to NO2 was 33.1 ppb (interquartile range [IQR] 10.4 ppb) and to O3 was 35.3 ppb (IQR 3.4) in the first year of life. Exposure to NO2 was associated with lower FEV1 and FVC across all age groups and exposure time intervals: e.g. an IQR increment of NO2 exposure from birth through the early teen visit was associated with 189.9 mL lower FEV1 (95% CI -273.3, -106.5) at the mid-teen visit. Lifetime NO2 exposure at was associated with higher FeNO at the early teen visit: e.g. 16.2% higher FeNO [95% CI 7.1-26.4%) per IQR of lifetime NO2 through the early teen visit. O3 exposure was not associated with lung function or FeNO. Aeroallergen sensitization (measured in a subset of participants) modified associations of NO2 and O3 with FeNO. Exposure to NO2 was associated with lower lung function and higher FeNO among generally healthy children and teenagers. As NO2 exposure levels were within the annual EPA standard, these findings suggest a need to reduce exposure to this pollutant to optimize child respiratory health.

Socioeconomic inequalities in cervical cancer screening in sub-Saharan Africa: Decomposition analysis

Abstract Background Cervical cancer remains prevalent in sub-Saharan Africa (SSA). Despite global efforts to eliminate this disease, its incidence continues to rise due to barriers in screening, vaccination, and treatment access. While studies address access barriers, little has explored inequality, often limited to single countries. Here, we examine socioeconomic inequalities in cervical cancer screening in SSA. Methods Data from the Demographic and Health Surveys of 10 SSA countries was used for the analysis. We stratified the study by wealth index and educational attainment as a measure of socioeconomic status. Socioeconomic status inequalities in cervical cancer screening were constructed using concentration curves. We then computed the concentration index to quantify socioeconomic inequality. To examine the factors associated with high socioeconomic inequality in cervical cancer screening, a decomposition analysis was conducted. Results Concentration curves showed screening uptake skewed towards the wealthy and educated across all countries, reflected by positive concentration indices (CIX=0.21; p-value&amp;lt;0.0001) except in Burkina Faso and Mauritius. Decomposition analysis revealed significant positive concentration indices for women with complete secondary (CIX=0.74) and higher education (CIX=0.91), those in the richest wealth index (CIX=0.35), separated women (CIX=0.08), currently working women (CIX=0.02), as well as those who were exposed to reading newspaper/magazine (CIX=0.19), listening to radio (CIX=0.10), and watching TV (CIX=0.44). Conclusions Cervical cancer screening in SSA exhibits pro-rich and pro-higher educational inequalities. Urgent interventions are needed to restructure existing screening programs to prioritize accessibility and inclusion, particularly for women from poorer households and with a lower level of education. These findings are vital for policymakers and public health practitioners to address cervical cancer screening disparities in SSA. Key messages • Addressing socioeconomic inequalities in cervical cancer screening is crucial for improving public health in sub-Saharan Africa. • Combatting socioeconomic disparities in cervical cancer screening is critical for achieving health equity in sub-Saharan Africa.

Childhood socioeconomic status and depression in adulthood: systematic review

Abstract Background Low socioeconomic status (SES) is generally associated with poorer mental health, particularly depression. We carried out a systematic review to address the question of whether childhood SES is associated with depression in adulthood and the potential pathways which may explain this association. Methods We followed a systematic search strategy in PubMed and Scopus with specific inclusion and exclusion criteria. After removing duplicates, studies were screened for eligibility and quality was assessed independently by two assessors using the Newcastle-Ottawa scale. Results After the selection process, 20 observational studies (7 cohort and 13 cross-sectional) that examine the association between SES during childhood and depression in adulthood were included in the systematic review. The most common measures of childhood SES were parental education, occupation or family income, estimated subjectively and/or objectively. In 17 of the studies an inverse relationship between childhood SES and depression was shown. In 17 studies, models were employed to demonstrate the possible pathways which explain the relationship between childhood SES and depressive symptoms. The most important mediators were adult SES, psychosocial factors, childhood trauma and physical health. Conclusions Our findings reveal the long-term association between childhood socioeconomic conditions and depression later in life. Suboptimal childhood SES seems to be an important risk factor for depression in adulthood. Improving childhood socioeconomic conditions can potentially have lasting effects well beyond childhood. Key messages • Protecting children against the effects of socioeconomic adversity could reduce depression in adult life. • Policy makers should direct resources towards alleviating childhood disadvantage for promoting health in adulthood.

Accounting for health equity in policy evaluation: a content analysis of primary research

Abstract Background Public Health researchers increasingly make use of sophisticated study designs and methods to evaluate the effects of policies on health and social outcomes. Natural experiment evaluation (NEE) conceptualises policies as ‘natural’ experiments that occur outside of the control of researchers. Often, NEE employs quasi-experimental methods (QEM) which enable researchers to rigorously evaluate the effect of population-level interventions. As for other health-related research, it is unclear to what extent such public health evaluations can and do consider the (health) equity implications of policies. We sought to investigate how health equity is addressed in NEEs and other policy evaluations that employ QEM. Methods We identified a random sample of primary research as part of a pre-registered scoping review (https://osf.io/3h6cb/). Studies that employed methods labelled as interrupted time series, difference-in-differences, controlled before and after, regression discontinuity, and synthetic control were included. Through content analysis, we examined how health equity was considered in data analysis and discussion sections. Results We analysed 59 studies, of which 25 were stratified for one or more socially-stratifying factors. Results were mainly stratified by sex (n = 15, 25.4%), age (n = 13, 22%), and diverse measures of socioeconomic status (n = 14, 23.7%), i.e. income, employment, education, or other factors. Of these, 21 studies included a discussion of health equity-related results, ranging from a few sentences to a holistic discussion including recommendations for decision-makers. Most commonly, researchers recommended monitoring of policy effects in different sub-populations, and careful policy design that conceptualises complex policy effects, including unintended and unequitable effects. Conclusions Policy evaluations have great potential for informing public health decision-making but health equity aspects were under-examined in these studies. Key messages • Health equity is assessed by evaluating policy effects in relevant sub-populations. Only 25 of 59 studies included results that were stratified for one or more socially stratifying factors. • Studies that were focused on disadvantaged populations commonly included recommendations for policymakers, calling for better policy design and improved monitoring of policy effects.

Pathways to Mobility: Using a Multidimensional Approach to Examine Postgraduation Outcomes for Promoting College Student Success

Research examining students’ socioeconomic outcomes after attaining a bachelor’s degree tends to use single measures such as income or occupation (Thomas &amp; Zhang, 2005; Torche, 2015). Yet, socioeconomic status is more complex than single measures. To capture that complexity, this study draws data from the National Center for Education Statistics Baccalaureate and Beyond Longitudinal Study (B&amp;B:08/12) to examine a multidimensional measure of socioeconomic status one and four years after graduation with a bachelor’s degree. The findings suggest that college graduates are not guaranteed benefits or low levels of time unemployed. The differences found across groups and time points highlight the importance of considering both monetary and non-monetary aspects of socioeconomic status related to higher education attendance and student success. This study contributes to exploring multidimensional measures to advance the understanding of students’ postgraduation outcomes and the continued impact of higher education on students’ outcomes beyond completion.

Delay discounting of rewards and losses, alcohol use, and the influence of socioeconomic factors: A cross-sectional online study in frequent drinkers.

Delay discounting describes the devaluation of future outcomes over time and is a popular behavioral construct in addiction research. Prior studies show modest yet consistent associations between problematic alcohol use and delayed reward discounting (DRD). However, the potential confounding influence of socioeconomic status (SES, e.g., income and education) is rarely addressed. In this study, we aimed to investigate the robustness of DRD as a predictor of alcohol use after controlling for socioeconomic and demographic variables. Additionally, we aimed to test the association between delayed loss discounting (DLD) and alcohol use in a sufficiently large sample. We collected data from 341 moderate-to-heavy-drinking participants (27.92 ± 21.12 g alcohol/day, 43.48 ± 11.90 years old, 49.9% female, UK residents) in a cross-sectional online study. DRD and DLD were measured using an intertemporal choice task. Questionnaires encompassed alcohol use (AUDIT, weekly alcohol consumption), education and income, subjective measures of past and present socioeconomic status, and impulsivity. DRD, but not DLD, was significantly associated with AUDIT scores (r = 0.15) and weekly alcohol consumption (r = 0.12). DRD remained a significant yet weak predictor of AUDIT scores when controlling for education and income, but not when controlling for education and age. We replicated a small but robust association between alcohol use and DRD, but not DLD. This association appeared to be confounded by education and age, but not by income. We conclude that socioeconomic and demographic variables should systematically be accounted for in future studies investigating DRD and alcohol use.

Social Disadvantage and Transportation Insecurity in Clubfoot Clinic.

This study aims to evaluate the association of missing clubfoot clinic visits with transportation barriers and measures of socioeconomic status including the child opportunity index (COI). An 11-question survey was administered to caregivers of patients with clubfoot seen at a single pediatric tertiary hospital between August 2020 and September 2023. A chart review was conducted to obtain zip codes used to determine COI 2.0 scores. The impact of race/ethnicity, income, persons per household, COI, and transportation methods on missing at least one clinic visit was analyzed using descriptive and nonparametric statistics. The transportation survey was completed by a total of 99 caregivers. The median travel time to the clinic was 45 minutes (IQR: 33, range: 1 to 180). Most participants reported use of a personal car (108/128, 83%), and 72% took time off work to attend the appointment. Those with lower COI had longer travel time (P=0.02) and were less likely to use personal cars (P=0.05). Missed clubfoot clinic visits were more common for families reliant on transportation other than a personal vehicle (P=0.01) and those with annual income under $30,000 (P=0.02). Transportation insecurity was associated with greater social disadvantage as indicated by COI and more missed clinic visits. Level III.

Relationship Between Socioeconomic Status and Basic Auditory Processing in Young Adults.

The current study aimed at investigating the relationship between socioeconomic status (SES) and basic auditory processing in young adults with normal hearing. Specifically, we sought to determine whether SES metrics, including parental education, parental occupation, and individual education attainment, influenced performance on tasks of basic auditory processing. Secondarily, we also aimed at understanding the interactive effects of SES and working memory on basic auditory processing. A total of 38 young adults were included in the study. Self-reported SES measures were recorded through Likert scales, and auditory processing measures included tests for temporal fine structure (TFS) and spectrotemporal sensitivity (STS). Pearson correlation analyses were conducted to probe the relationships between SES indicators and auditory processing performance. Multiple linear regressions were conducted to understand the interactive effects of SES and working memory on auditory processing performance. The analysis revealed no significant correlation between SES measures and basic auditory processing performance across TFS and STS tasks. Furthermore, analysis investigating the interaction between SES and working memory also yielded nonsignificant results. These findings indicate that, within this specific age cohort, SES information may not be indispensable for assessing basic auditory processing. Our study suggests that SES may not significantly influence basic auditory processing in young adults with normal hearing. However, further research with larger sample sizes and longitudinal designs is warranted to confirm these findings and explore potential age-related differences in the impact of SES on auditory processing across the lifespan.

Socioeconomic status differences in agentic and communal self-concepts: Insights from 6 million people across 133 nations.

Do people of different socioeconomic status (SES) differ in how they see themselves on the Big Two self-concept dimensions of agency and communion? Existent research relevant to this theoretically and socially important question has generally been indirect: It has relied on distant proxies for agentic and communal self-concepts, narrow operationalizations of SES, comparatively small samples, and data from few nations/world regions. By contrast, the present research directly examines the associations between SES and agentic and communal self-concepts, relies on well-validated measures of agency and communion, examines three complementary measures of SES, and uses data from 6 million people (years of age: M = 26.12, SD = 11.50) across 133 nations. Overall, people of higher status saw themselves as somewhat more agentic and as slightly less (or negligibly less) communal. Crucially, those associations varied considerably across nations. We sought to explain that variation with 11 national characteristics and found only three of them to be robustly relevant: National religiosity and pathogen load curbed status differences in agentic self-concepts, and income inequality amplified status differences in communal self-concepts. Our discussion develops theory to explain the importance of national religiosity, pathogen load, and income inequality for socioeconomic status differences in agentic and communal self-concepts and it also describes the substantial societal implications of those differences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Patterns of change in the association between socioeconomic status and body mass index distribution in India, 1999-2021.

Body mass index (BMI) is an important indicator of human health. However, trends in socioeconomic inequalities in BMI over time throughout India are understudied. Filling this gap will elucidate which socioeconomic groups are still at risk for adverse BMI values. This repeated cross-sectional study analysed four rounds of India's National Family Health Surveys (1998-1999, 2005-2006, 2015-2016, and 2019-2021). The outcome was BMI categories, measured in kilogram per metres squared (kg/m2), defined as severely/moderately thin (<17.0 kg/m2), mildly thin (17.0-18.4 kg/m2), normal (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). We examined the prevalence, standardised absolute change, and odds ratios estimated by multivariable regression models by household wealth and levels of education, two important measures of socioeconomic status (SES). The study population consisted of 1 244 149 women and 227 585 men. We found that those in the lowest SES categories were more likely to be severely/moderately thin or mildly thin. Conversely, those in the highest SES groups were more likely to be overweight or obese. The gradients were steepest for wealth, and this was substantiated by the results of regression models for every wave. There has been a decline in the difference in the prevalence of severely/moderately thin or mildly thin between SES groups when comparing the years 1999 and 2021. SES-based inequalities in BMI were smaller in 2021 compared to 1999. However, those in low SES groups were most likely to be severely/moderately thin or mildly thin while those in high SES groups were more likely to be overweight or obese. Future research should explore the pathways that link SES with BMI.

Population-Level Exposure to PM2.5, NO2, Greenness (NDVI), Accessible Greenspace, Road Noise, and Rail Noise in England

Air pollution, greenspace and noise are interrelated environmental factors with the potential to influence human health outcomes. Research has measured these exposures in diverse ways across the globe, but no study has yet performed a country-wide analysis of air pollution, greenspace, and noise in England. This study examined cross-sectional PM2.5, NO2, greenness, accessible greenspace, road noise, and rail noise exposure data at all residential postcodes in England (n = 1,227,681). Restricted cubic spline models were fitted between each environmental exposure and a measure of socioeconomic status, the Index of Multiple Deprivation (IMD) rank. Population-weighted exposures by IMD deciles, urbanicity, and region were subsequently estimated. Restricted cubic spline models were also fitted between greenness and each other environmental exposure in the study. The results show some evidence of inequalities in exposure to air pollutants, greenspace, and noise across England. Notably, there is a socioeconomic gradient in greenness, NO2, PM2.5, and road noise in London. In addition, NO2, PM2.5, and road noise exposure decrease as greenness increases in urban areas. Concerningly, almost all air pollution estimates in our study exceed international health guidelines. Further research is needed to elucidate the socioeconomic patterns and health impacts of air pollution, greenspace, and noise over time.

Friends, neighbors, country, and respect: Status ladders and health behaviors in the United States

Efforts to understand the relationship between socioeconomic status (SES) and health have expanded beyond traditional indicators of education, income, occupation, and wealth to individuals’ own reports of where they stand. This more contemporary approach has enjoyed considerable success, in that self-reported SES standing, often measured on a ladder representing the entire U.S. socioeconomic hierarchy, is associated strongly with health even when traditional SES indicators are controlled. However, disparities in self-rated health across ladder measures typically are not assessed with regard to health behavior disparities. Here, we draw on two US national probability samples assessing diverse ladder reference groups, as well as a new ladder asking people to report how much respect, honor, or esteem they receive from other people. Respect or honor offers a distinct potential to measure social influence across circles of recognition. We find that U.S.-based ladder status is related to smoking currently or ever and to days of exercise. While friend, neighbor, and respect-based ladders do not relate to health behaviors net of U.S. ladder standing, they show relationships to ever smoking and physical activity, and self-rated health, in their own right. Physical activity accounts for 12–18% of self-rated health disparities by friend, neighbor, or country ladder status. Smoking and drinking do not robustly contribute to ladder-based disparities in self-rated health. Contrasting what is typically found for traditional SES measures, physical activity merits further research, as does the receipt of respect or honor. That status ladder health disparities go largely unexplained by behaviors suggests the potential roles of non-behavioral pathways including inflammation, hopelessness, or classism.

Residential food environment and dietary antioxidant consumption among pregnant women: Modifying effects of socioeconomic factors and ethnic identity

BackgroundResidential food environment influences dietary patterns, however the impact of individuals' perceived social identity on the antioxidant intake, an indicator of healthy dietary patterns, remains underexplored. ObjectiveWe conducted a cross-sectional analysis using data collected in a longitudinal cohort. In the study, we aim to investigate the interactions between the food environment and two indicators of social identity, specifically a subjective ladder measure of socioeconomic status (SES) and the Multigroup Ethnic Identity Measure (MEIM) score, in relation to dietary antioxidant intake (DAI) among n = 512 Boston and NYC-resident pregnant women. MethodsThe modified Retail Food Environment Index (mRFEI) was calculated using the Centers for Disease Control and Prevention's equation, with higher scores indicating a healthier food environment. DAI was estimated by summing standardized data from six micronutrients (magnesium, selenium, zinc, and vitamins A, C, and E) obtained through the Block98 Food Frequency Questionnaires administered during pregnancy, with higher scores indicating increased intake. The mRFEI and DAI were dichotomized based on a median split. Multivariable-adjusted logistic regressions were used to analyze associations, both with and without considering women's subjective SES or MEIM levels as effect modifiers. ResultsWomen were racially/ethnically mixed (19.2 % White, 42.7 % Black, and 33.1 % Hispanic) with 32.2 % reporting more than high school education. In the main effect models, no significant association was observed between mRFEI and DAI. Women with higher MEIM scores exhibited higher DAI [Odds ratio (OR) =1.85, 95 % Confidence interval (CI) = 1.26–2.73]. Exploratory interaction models showed that subjective SES significantly modified the association (p-value for interaction = 0.03), women perceiving themselves to have a lower SES compared to their community (n = 45) exhibited a significantly positive association between mRFEI and DAI. ConclusionThese findings suggest that women perceiving their SES to be lower than their neighborhoods may benefit from better access to healthy food.

Gender, socioeconomic status, and numeracy test scores

We study the interrelationship between the gender gap in numeracy and socioeconomic status (SES) based on household income, parental education, and labor force status. A composite measure of SES confirms the well-established fact that boys from lower SES are more disadvantaged. In contrast, we find that separately the three aspects of higher SES interact uniquely with gender to drive differential outcomes in numeracy for girls and boys. Income and mother’s role in particular, are important drivers of the gender gap at the extremes of the income distribution. Mother’s education and labor force participation is associated with increasingly higher test scores for girls across the income distribution, thus leading to a double disadvantage for poor girls. But the gender gap does not disappear at the top of the income distribution, as for boys, test scores increase with stay-at-home mothers. In high-income households boys benefit from a traditional household structure; while in low-income households, the gap is driven by girls having worse numeracy scores in the traditional household structure.

Abstract B138: The association of neighborhood-level socioeconomic status and treatment outcomes in dermatofibrosarcoma protuberans: A United States cohort analysis

Abstract Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue sarcoma predominantly affecting the dermis and subcutaneous fat. There has been a lack of research on the intersection of socioeconomic status (SES) and DFSP. Therefore, this study aims to investigate the impact of SES on DFSP outcomes, specifically with differing treatments, an area previously underexplored due to the disease’s rarity. Cases of malignant DFSP from 2006-2018 in the Surveillance, Epidemiology, and End Results Census Tract-level SES and Rurality Database were identified to conduct a retrospective cohort analysis. SES was categorized into 5 groups using the Yost Index, a composite census-tract level measure of SES which incorporates factors like household income, educational level, and home value. Multivariable Cox-proportional hazards regression was conducted to assess relationships of reported characteristics with overall survival. Multivariable logistic regression was used to assess for independent predictors of receipt of Mohs surgery. The associations were also stratified by race/ethnicity. Among the 4995 DFSP cases identified, patients were mostly female (53%), white (52%), and of highest SES (Yost Index Group 5, 29%). Most patients received surgical excision, including Mohs surgery, (93%; Mohs: 9.1%). Higher SES was associated with better overall survival compared to lower SES patients (highest vs lowest SES: hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.26-0.58). Mohs surgery was also the only surgical intervention associated with better survival, compared to no surgery (HR, 0.40; 95% CI, 0.16-0.95). When stratified by race/ethnicity, the association of higher SES with better survival was present in both white (highest vs lowest SES: HR, 0.47; 95% CI, 0.24-0.90) and non-white patients (highest vs lowest SES: HR, 0.34; 95% CI, 0.20-0.58). Higher SES was associated with an increased likelihood of receiving Mohs (highest vs lowest SES: odds ratio [OR], 2.77; 95% CI, 1.80-4.25), and Black patients (23%) were less likely than white patients to receive Mohs (OR, 0.49; 95% CI, 0.33-0.72). When stratified by race/ethnicity, the association of higher SES with receipt of Mohs was present in white patients (highest vs lowest SES: OR, 5.44; 95% CI, 2.88-10.3), though it was not significant in non-white patients. This study demonstrates that higher SES and Mohs were associated with better overall survival for patients with DFSP. Higher SES also increased the likelihood of receiving Mohs, an optimal DFSP treatment. Our study emphasizes that patients with lower SES may have reduced access to more effective treatments like Mohs for DFSP, which may lead to poorer survival. This indicates a need for healthcare policies that address these disparities to improve treatment for patients of all socioeconomic statuses, including racial/ethnic minorities. *Both authors contributed equally Citation Format: Fatima N. Mirza, Megan Hoang, Hayley S Goldbach, Oliver J. Wisco, Tiffany J. Libby, Martin A. Weinstock, Abrar A. Qureshi, Eunyoung Cho. The association of neighborhood-level socioeconomic status and treatment outcomes in dermatofibrosarcoma protuberans: A United States cohort analysis [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B138.