Socioeconomic Status Variables Research Articles

Depressive symptoms and its multifaceted associated factors among young men who have sex with men facing the dual threats of COVID-19 and mpox in China

IntroductionThe COVID-19 pandemic has significantly impacted the mental health of human beings since 2020, especially the young people and the pre-existing marginalized groups such as men who have sex with men (MSM). During the COVID-19 pandemic, the multi-country outbreak of mpox in 2022 additionally posed a significant stress on the most-affected communities (i.e., MSM). This study investigated the level of depressive symptoms and its multifaceted associated factors among Chinese young men who have sex with men (YMSM) in this unique period. MethodsIn September 2022, a large-scale cross-sectional survey was conducted among YMSM aged 18–29 years across six representative provinces in China. Hierarchical regression analysis was performed to test the various types of associated factors of depressive symptoms. ResultsAmong the 2493 participants, 65·6 % (n = 1638) reported mild to severe depressive symptoms. The hierarchical regression analysis identified that depressive symptoms was significantly positively associated with unemployment, having substance use in the past 6 months, a higher level of MSM self-stigma, incompletion of COVID-19 vaccination, greater mpox risk perception, and presence of mpox related-like symptoms. LimitationsThis study used the facility-based sampling method to recruit the participants, which may lead to selection bias. ConclusionsChinese YMSM faced significant mental health challenges during the concurrent epidemics of COVID-19 and mpox, which was associated with their socio-economic status, risk behaviors, stigma, and multiple diseases-related variables. Proactive measures may hold promise as effective strategies for mitigating mental distress among marginalized groups during public health crises.

Survival benefit of autologous transplant (ASCT) for mantle cell lymphoma (MCL) in the California Cancer Registry (CCR).

e19043 Background: Extended follow up of the prospective Nordic MCL2 cohort shows ASCT in CR1 confers a median OS (mOS) of 12.7 y (Eskelund, BJH 2016). Incorporation of BTK inhibitors in 1L MCL is challenging the role of ASCT in an ongoing prospective trial (TRIANGLE, ASH 2022). The present study aims to evaluate the role of ASCT and the impact of social determinants of health (SDH) in a diverse real-world population of MCL patients. Methods: Adult MCL patients diagnosed from January 1, 2000 to December 31, 2020 in the CCR were identified with ICD-O-3 code 9673. The study was approved by UCLA IRB. OS was estimated using KM statistics, calculated from diagnosis to death/last follow-up. Univariate Cox proportional hazards modeling for lymphoma-specific survival (LSS) was performed for variables of interest; those significant at p ≤ 0.10 were incorporated in a stepwise multivariable regression excluding patients with missing data. Socioeconomic status (SES) variables were reported using census-block group data at diagnosis. Results: 5740 ethnically diverse patients were included (NH Whites, n=4038; NH Black, n=175; Hispanic, n=1057; Asian/Pacific Islanders, n=400). Median age at diagnosis was 69 y (IQR 61–68) and 71% were males. 4096 (71%) and 1346 (23%) patients received chemoimmunotherapy and were treated at an NCI/NCCN center, respectively. With a median follow-up of 33 m (IQR 9–76), mOS of the entire cohort was 4.4 y. ASCT patients (n=652, 11%) had improved mOS compared to non-ASCT (14.2 y vs 3.7 y, respectively p<0.001), and 100-day TRM was 2.5%. In the univariable model for all subjects, age, Charlson Comorbidity Index (CCI), married, chemoimmunotherapy, ASCT, NCI/NCCN center, insurance, period of diagnosis, and community SES, poverty, and education were prognostic for LSS. Race, sex, and rural residence were not associated with LSS. Multivariable analysis of 4148 subjects showed significant predictors of LSS were age ≥ 70 y (HR 1.71, p<0.001), ASCT (HR 0.54, p<0.001), diagnosis after 2013 (HR 0.78, p<0.001), CCI (Ref 0; 1-2 HR 1.22, p<0.001; 3+ HR 1.94, p<0.001), married (HR 0.86, p=0.003), NCI/NCCN treatment center (HR 0.77, p=0.001), higher education (top 40% with high school diploma vs. bottom 20%, HR 0.70, p<0.001), higher overall SES (medium vs. low SES tertile, HR 0.81, p=0.003), and increased community poverty (middle 40% vs. bottom 20%, HR 1.14, p=0.043). Conclusions: Our data represent the largest real-world cohort describing the role of ASCT and SDH in MCL. A minority of patients received ASCT and had improved OS compared to non-ASCT patients. While follow-up of ongoing prospective studies will clarify the role of ASCT using contemporary 1L regimens, the present data suggest ASCT in select patients results in durable response with low TRM. Socially disadvantaged patients should be identified and offered supportive programs early in the disease course to mitigate inferior outcomes.

The impact of socioeconomic status on gastrointestinal cancer care delivery in southeast Texas.

e15579 Background: Gastrointestinal (GI) cancers are a leading cause of cancer deaths in the US with an estimated 1,038,410 new cases and a 30.4% mortality rate in 2023. Disparities in cancer care are well documented and result from several variables, including socioeconomic status (SES), behavioral, and biological factors. We conducted a retrospective population-based cohort study aimed to investigate the relationship between various socioeconomic factors and delays in cancer treatment initiation, emphasizing the impact of gender, race, age, and geographical distance on the time to treatment initiation (TTI). Methods: We identified patients with colorectal, hepatobiliary, small intestinal, and gastroesophageal cancers, who received their cancer diagnosis and initiated treatment at Baptist Hospitals of Southeast Texas in Beaumont, Texas between January 2012, and December 2017. SES data, including age, sex, race, geographical distribution, insurance status, cancer staging, and treatment were collected. Logistic regression was performed to determine risk association by calculating odds ratios with 95% confidence intervals, as well as p-values to determine significance. The primary outcomes of interest were the overall survival (OS) rate, and TTI defined as the time interval between the confirmed cancer diagnosis and initiating the first treatment modality. Results: A total of 517 GI cancer patients were included in this study, with 359 comprising a cohort of patients with colorectal cancer. The majority of patients included were ; caucasians(%) males (%).. African American patients were significantly more likely to receive delayed treatment, Odds Ratio (OR): 5.89, 95% confidence interval (CI) 4.02-8.62, especially compared to the odds for similar Caucasian patients (OR: 0.16, CI: 0.11-0.23). When compared to younger counterparts, patients above the age of 80 were found to have poorer odds of prolonged survival (OR: 2.91, CI: 1.80-4.72). Patients who lived 30 miles away or further from our hospital had longer TTI compared to those living within 30 miles radius (OR: 1.85, CI: 1.19-2.87), a risk which remained significant within the colorectal cancer cohort (OR: 2.20, CI: 1.29-3.74). Patients with Medicare insurance showed longer TTI (OR: 1.50, CI: 1.01-2.23), and decreased OS (OR: 1.79, CI: 1.05-3.06)). No statistically significant difference was observed based on gender. Conclusions: Age, geographical location, and racial SES variables contribute to the disparities in GI cancer care in our community. Addressing these disparities and implementing targeted interventions to mitigate the impact of socioeconomic barriers is imperative to ensure equitable access to timely and effective cancer care, ultimately leading to improved patient outcomes and cancer survival rates.

Risk prediction of advanced colorectal neoplasia varies by race and neighbourhood socioeconomic status

ObjectiveNeighbourhood deprivation increases the risk of colorectal neoplasia and contributes to racial disparities observed in this disease. Developing race-specific advanced colorectal neoplasia (ACN) prediction models that include neighbourhood socioeconomic status...

Socioeconomic differences in use of antiseizure medication in pregnancies with maternal epilepsy: A population-based study from Nordic universal health care systems.

Research points to disparities in disease burden and access to medical care in epilepsy. We studied the association between socioeconomic status (SES) and antiseizure medication (ASM) use in pregnancies with maternal epilepsy. We conducted a cross-sectional study consisting of 21 130 pregnancies with maternal epilepsy identified from Nordic registers during 2006-2017. SES indicators included cohabitation status, migrant background, educational attainment, and household income. Main outcomes were the proportion and patterns of ASM use from 90 days before pregnancy to birth. We applied multiple imputation to handle SES variables with 2%-4% missingness. We estimated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) using modified Poisson regression with the highest SES category as reference. Mothers with the highest education and the highest income quintile used ASMs least frequently (56% and 53%, respectively). We observed increased risks of ASM discontinuation prior to or during the first trimester for low SES. The risk estimates varied depending on the SES indicator from aRR = 1.27 for low income (95% CI: 1.03-1.57) to aRR = 1.66 for low education (95% CI: 1.30-2.13). Migrant background was associated with ASM initiation after the first trimester (aRR 2.17; 95% CI 1.88-2.52). Low education was associated with the use of valproate during pregnancy in monotherapy (aRR 1.70; 95% CI 1.29-2.24) and in polytherapy (aRR 2.65; 95% CI 1.66-4.21). Low education was also associated with a 37% to 39% increased risk of switching from one ASM to another depending on the ASM used. For the other SES indicators, aRRs of switching varied from 1.16 (foreign origin; 95% CI 1.08-1.26) to 1.26 (not married or cohabiting; 95% CI 1.17-1.36). Low SES was associated with riskier patterns of ASM use: discontinuation, late initiation, and switching during pregnancy. These findings may reflect unplanned pregnancies, disparities in access to preconception counseling, and suboptimal care.

Healthcare disparities, screening, and molecular testing in the changing landscape of non-small cell lung cancer in the United States: a review.

Inequitable access to care continues to hinder improvements in diagnosis and treatment of lung cancer. This review describes healthcare disparities in the changing landscape of non-small cell lung cancer (NSCLC) in the United States, focusing on racial, ethnic, sex-based, and socioeconomic trends. Furthermore, strategies to address disparities, overcome challenges, and improve patient outcomes are proposed. Barriers exist across lung cancer screening, diagnosis, and treatment regimens, varying by sex, age, race and ethnicity, geography, and socioeconomic status. Incidence and mortality rates of lung cancer are higher among Black men than White men, and incidences in young women are substantially greater than in young men. Disparities may be attributed to geographic differences in screening access, with correlating higher incidence and mortality rates in rural versus urban areas. Lower socioeconomic status is also linked to lower survival rates. Several strategies could help reduce disparities and improve outcomes. Current guidelines could improve screening eligibility by incorporating sex, race, and socioeconomic status variables. Patient and clinician education on screening guidelines and patient-level barriers to care are key, and biomarker testing is critical since ~ 70% of patients with NSCLC have an actionable biomarker. Timely diagnosis, staging, and comprehensive biomarker testing, including cell-free DNA liquid biopsy, may provide valuable treatment guidance for patients with NSCLC. Efforts to improve lung cancer screening and biomarker testing access, decrease bias, and improve education about screening and testing are needed to reduce healthcare disparities in NSCLC.

Propensity score analysis for health care disparities: a deweighting approach

BackgroundPropensity score weighting is a useful tool to make causal or unconfounded comparisons between groups. According to the definition by the Institute of Medicine (IOM), estimates of health care disparities should be adjusted for health-status factors but not for socioeconomic status (SES) variables. There have been attempts to use propensity score weighting to generate estimates that are concordant with IOM’s definition. However, the existing propensity score methods do not preserve SES distributions in minority and majority groups unless SES variables are independent of health status variables.MethodsThe present study introduces a deweighting method that uses two types of propensity scores. One is a function of all covariates of health status and SES variables and is used to weight study subjects to adjust for them. The other is a function of only the SES variables and is used to deweight the subjects to preserve the original SES distributions.ResultsThe procedure of deweighting is illustrated using a dataset from a right heart catheterization (RHC) study, where it was used to examine whether there was a disparity between black and white patients in receiving RHC. The empirical example provided promising evidence that the deweighting method successfully preserved the marginal SES distributions for both racial groups but balanced the conditional distributions of health status given SES.ConclusionsDeweighting is a promising tool for implementing the IOM-definition of health care disparities. The method is expected to be broadly applied to quantitative research on health care disparities.

Effect of frailty status on mortality risk among chilean community-dwelling older adults

IntroductionThe study of frailty and its effect on the risk of mortality in older people is of utmost importance, but understanding the critical factors is still limited. Our main objective was to analyze the association of frailty with all-cause mortality in a prospective community cohort of older people. MethodsA five-year longitudinal follow-up study was conducted with 1,174 community-dwelling older adults (men and women≥65 years old) from different Family Health Centers and community groups from Chile. We evaluated the functional risk, socioeconomic status, and anthropometric variables. The frailty status was evaluated by modified Fried criteria. ResultsThe diagnosis of frailty was reached in 290 older adult participants, who had significantly increased 5-year all-cause mortality independently of age, sex, cognitive impairment, and socioeconomic status (adjusted HR 1.51, 1.06–2.15). ConclusionFrailty is a predictor of increased mortality independently of age, sex, socio-economic and cognitive factors.

Socioeconomic disparities in lumbar fusion rates were exacerbated during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic disrupted healthcare access and utilization throughout the US, with variable impact on patients of different socioeconomic status (SES) and race. We characterize pre-pandemic and pandemic demographic and SES trends of lumbar fusion patients in the US. MethodsAdults undergoing first-time lumbar fusion 1/1/2004–3/31/2021 were assessed in Clinformatics® Data Mart for patient age, geographical location, gender, race, education level, net worth, and Charlson Comorbidity Index (CCI). Multivariable regression models were used to evaluate the significance of trends over time, with a focus on pandemic trends 2020–2021 versus previous trends 2004–2019. ResultsThe total 217,204 patients underwent lumbar fusions, 1/1/2004–3/31/2021. The numbers and per capita rates of lumbar fusions increased 2004–2019 and decreased in 2020 (first year of COVID-19 pandemic), with large variation in geographic distribution. There was overall a significant decrease in proportion of White patients undergoing lumbar fusion over time (OR=0.997, p<.001), though they were more likely to undergo surgery during the pandemic (OR=1.016, p<.001). From 2004–2021, patients were more likely to be educated beyond high school. Additionally, patients in the highest (>$500k) and lowest (<$25k) net worth categories had significantly more fusions over time (p<.001). During the pandemic (2020–2021), patients in higher net worth groups were more likely to undergo lumbar fusions ($150k–249k & $250k–499k: p<.001) whereas patients in the lowest net worth group had decreased rate of surgeries (p<.001). Lastly, patients’ CCI increased significantly from 2004 to 2021 (coefficient=0.124, p<.001), and this trend held true during the pandemic (coefficient=0.179, p<.001). ConclusionsTo the best of our knowledge, our work represents the most comprehensive and recent characterization of SES variables in lumbar fusion rates. Unsurprisingly, lumbar fusions decreased overall with the onset of the COVID-19 pandemic. Importantly, disparities in fusion patients across patient race and wealth widened during the pandemic, reversing years of progress, a lesson we can learn for future public health emergencies.

Determinants of COVID-19 Prevalence Rate in Asia: A study using Spatial Analysis

This study aims at finding out the important determinants of prevalence rate of COVID-19 in the Asian continent using spatial analysis. The impact of climatic, socioeconomic, demographic, and health status variables on the prevalence rate of COVID-19 is seen through various spatial models such as Spatial lag, Spatial error, Geographically Weighted regression model, and Multiscale Geographically Weighted regression model. The performance of the models is compared under different comparison criteria. It is found that among all, Multiscale Geographically Weighted regression model outperformed other competitive models. Findings also indicate that cardiovascular health, prevalence of smoking habit, human development index, and net migration rate played significant role in defining the prevalence rate of COVID-19 in Asia.

328 Medicaid Fee-for-Service Is an Independent Predictor of Increased Hospital Length of Stay After Traumatic Brain Injury

INTRODUCTION: Hospital length of stay (HLOS) is a metric of injury severity, resource utilization, and healthcare access. Recent evidence has shown associations between Medicaid and increased HLOS after traumatic brain injury (TBI). Whether managed care organization (Medicaid-MCO) or fee-for-service (Medicaid-FFS) models affect HLOS is unknown. METHODS: The Department of Health Care Access and Information Patient Discharge Database years 2017-2019 were queried for TBI patients aged =18-years (y) using ICD-10 codes (S06.0-S06.9/A). Inclusion criteria were Medicaid-MCO/Medicaid-FFS or PI not designated as death/hospice within 5-days of hospitalization. Demographic, socioeconomic status (SES), care-related, charges, and HLOS variables were compared. Subgroup analyses were performed in severe TBI (intracranial pressure monitor/craniotomy = Yes). Multivariable negative binomial regressions assessed the relationship between insurance and HLOS, adjusting for demographic, SES, injury severity, diagnosis-related group, and major complication/comorbidity. Incidence rate ratios (IRR) were reported. RESULTS: Overall (N = 39,834), 33.2% were Medicaid-MCO, Medicaid-FFS = 24.2%, and PI = 42.6%. Significant differences (p &lt; 0.001) were observed for age (MCO = median 45y, FFS = 37y, PI = 44y), sex (male: MCO = 70.8%, FFS = 80.1%, PI = 68.8%), race (Hispanic: MCO = 35.0%, FFS = 51.6%, PI = 24.6%), lowest-quintile SES (MCO = 33.1%, FFS = 31.9%, PI = 9.0%), discharge to home (MCO = 72.1%, FFS = 76.8%, PI = 68.5%), and charges (MCO = median $100,297, FFS = $120,062, PI = $91,863). HLOS was longest in FFS (median = 4-days [IQR: 2-11], MCO = 4-days [2-9], PI = 3-days [1-7]). These differences were conserved in severe TBI (N = 1,650; MCO = 32.8%, FFS = 31.8%, PI = 35.3%) at greater magnitudes (home discharge: MCO = 15.5%, FFS = 25.6%, PI = 8.2%; charges: MCO = $629,625, FFS = $724,225, PI = $607,082; HLOS: MCO = 22-days [IQR: 13-34], FFS = 26-days [14-44], PI = 17-days [10-27]). On multivariable regression, Medicaid-FFS and MCO had significantly longer HLOS compared with PI in all TBI (IRR = 1.44 [95% CI: 1.41-1.48], IRR = 1.17 [1.15-1.20], respectively) and severe TBI (IRR = 1.52 (1.40-1.65), IRR = 1.25 [1.15-1.36], respectively). CONCLUSIONS: Medicaid-FFS had the highest likelihood of increased HLOS. Medicaid-MCO appeared to be a distinct risk stratum with shorter HLOS and lower hospital charges than Medicaid-FFS. Reasons may include different efficacies in care delivery and reimbursement, and require further investigation.

Demographics and socioeconomic determinants of health predict continued participation in a CT lung cancer screening program

PurposeWe developed machine learning (ML) models to assess demographic and socioeconomic status (SES) variables’ value in predicting continued participation in a low-dose CT lung cancer screening (LCS) program. Materials and Methods480 LCS subjects were retrospectively examined for the following outcomes: (#1) no follow-up (single LCS scan) vs. multiple follow-ups (220 and 260 subjects respectively) and (#2) absent or delayed (>1 month past the due date) follow-up vs timely follow-up (356 and 124 subjects respectively). We quantified the contributions of 14 socioeconomic, demographic, and clinical predictors to LCS adherence, and validated and compared prediction performances of multivariate logistic regression (MLR), support vector machine (SVM) and shallow neural network (NN) models. ResultsFor outcome #1, age, sex, race, insurance status, personal cancer history, and median household income were found to be associated with returning for follow-ups. For outcome #2, age, sex, race, and insurance status were significant predictor of absent/delayed LCS follow-up. Across 5-fold cross-validation, the MLR model achieved an average AUC of 0.732 (95% CI, 0.661-0.803) for outcome #1 and 0.633 (95% CI, 0.602-0.664) for outcome #2 and is the model with best predictive performance overall, whereas NN and SVM tended to overfit training data and fell short on testing data performance for either outcome. ConclusionsWe identified significant predictors of LCS adherence, and our ML models can predict which subjects are at higher risk of receiving no or delayed LCS follow-ups. Our results could inform data-driven interventions to engage vulnerable populations and extend the benefits of LCS.

Investigating Variables Predicting Environmental Awareness in the Context of Education for Sustainable Development: An Analysis Based on TIMSS 2019 Data

Trends in International Mathematics and Science Study (TIMSS) provides unique and detailed information to explore the competencies and attitudes of fourth and eighth-grade students worldwide. The "Environmental Awareness Scale" was developed for the first time in the TIMSS 2019 cycle to measure students' environmental awareness. This cognitive scale gives essential information on students' scientific understanding of some environmental problems at the national and international levels. Using this scale to assess students' environmental awareness will improve education for sustainable development (ESD) in this setting since the obtained data provide reliable information that education policymakers use to integrate the most important environmental education topics and concepts into their curricula and identify the factors that should be considered to raise students' environmental awareness. This study aims to investigate to what extent the science self-concept variable from science-related factors, as well as the gender and socioeconomic status (SES) variables from demographic characteristics, predict the environmental awareness of eighth-grade students in Türkiye participating in the TIMSS 2019. For this purpose, a theoretical model was developed and analyzed with Structural Equation Modeling (SEM) to investigate the association between students' environmental awareness and science self-concept, gender, and SES. The analysis revealed that science self-concept, SES, and gender variables together explained 36% of students' environmental awareness. Furthermore, while science self-concept appears to be the strongest predictor of students' environmental awareness, SES level was also a significant variable explaining students' environmental awareness. On the other hand, there was no significant difference in environmental awareness between male and female students. The study's findings are discussed based on the United Nations Educational, Scientific and Cultural Organization (UNESCO)'s emphasis on the periodic monitoring and evaluation of progress in implementing ESD based on data.

Phenotypes and Serum Biomarkers in Sarcoidosis.

Sarcoidosis is a multisystem disease, which is diagnosed on a compatible clinical presentation, non-necrotizing granulomatous inflammation in one or more tissue samples, and exclusion of alternative causes of granulomatous disease. Considering its heterogeneity, numerous aspects of the disease remain to be elucidated. In this context, the identification and integration of biomarkers may hold significance in clinical practice, aiding in appropriate selection of patients for targeted clinical trials. This work aims to discuss and analyze how validated biomarkers are currently integrated in disease category definitions. Future studies are mandatory to unravel the diverse contributions of genetics, socioeconomic status, environmental exposures, and other sociodemographic variables to disease severity and phenotypic presentation. Furthermore, the implementation of transcriptomics, multidisciplinary approaches, and consideration of patients' perspectives, reporting innovative insights, could be pivotal for a better understanding of disease pathogenesis and the optimization of clinical assistance.

Examining the relations between early language skills and environmental variables and literacy skills: A longitudinal study from 2 to 9 years

A 7-year longitudinal study was conducted as part of the French national cohort ELFE ( N = 1095). The aim was to identify how and why early language skills at 2 years might predict later literacy skills assessed successively at 5, 7, and 9 years (LitSk5y; 7y; 9y). Using one and the same model, we also examined the relations between literacy skills in the three sessions and the potential impact of three environmental variables: the home learning environment (HLE) and two variables related to socioeconomic status (SES), namely, parental education level (PEL) and household income (HInc). The main findings reveal that expressive vocabulary at 2 years is a significant predictor of LitSk5y. No significant link was found for HLE. The other significant links reveal that PEL is associated with LitSk5y and LitSk7y, and HInc with LitSk5y and LitSk9y. The differential impact of these two SES variables is discussed. Moreover, the restructuring lexical model is proposed to explain how the development of early expressive vocabulary is linked to the development of literacy skills via an implicit stimulation of phonemic awareness during the acquisition of new words.

“Estar Tranquilo”: Using a Life-course Approach to Explore Perceptions of Well-being among Older Adults in Curicó, Chile

This study assesses perceptions of well-being between two groups of older adults in Curicó, Chile. One group (n=12) were residents of a long-term care center (known as ELEAM), while another group (n=13) were members of two clubs for older adults – Estrellitas del Vaticano (Vatican’s Little Stars) and Club Campo Lindo (Beautiful Countryside) – who lived in their own homes. Data collection consisted of life-story narratives to explore differences in how older adults in different living situations – long-term residential care vs. independent living – define and perceive what it means to be well in older age. Both groups were paired according to the variables of age, educational level, socioeconomic status, and physical status. In this article, I explore how both groups expressed their desire to estar tranquilo or “be peaceful” in their older age; however, each group achieved this state in different ways. ELEAM residents focused on fostering good relationships with fellow residents and maintaining their autonomy. In contrast, club members focused on practicing their religion, maintaining family relationships, and engaging in activities. Although participants shared similar backgrounds and lived through the same historical events (i.e., military dictatorship), their current situations impacted their perceptions of well-being. For individuals to achieve their desired level of well-bing or to estar tranquilo required that they adapt to different living arrangements: club members had to adapt to living without their children, and ELEAM residents to living in an institution.

The Association Between Attitudes Towards Mathematics, Students’ Background and TIMSS Mathematics Achievement

The overall aim of this study is to examine the association between Swedish students’ attitudes towards mathematics, mathematics achievement as measured by the Trends in Mathematics and Science Study (TIMSS), socioeconomic status (SES), and educational background variables. A further aim is to investigate whether students’ attitudes towards mathematics have a mediating role between their mathematics achievement and their background. Several indicators of students’ SES and background, taken from both the TIMSS 2015 database and from Swedish official registers, were used. The overall results show that there were differences in attitudes towards mathematics in relation to the different SES and educational background measures. There are also associations between students’ SES and both TIMSS mathematics achievement and their attitudes towards mathematics. The students’ attitudes towards mathematics only had a small mediation role between the students’ backgrounds and TIMSS mathematics achievement. Finally, although the mediation models had a better fit when including other information, the mediation effect was lower. Practical implications of the obtained results are discussed.

Individual and school correlates of body mass index and cardiorespiratory fitness in primary school children from the REACT project: A multivariate multilevel analysis.

This paper examines the relationship between body mass index (BMI) and cardiorespiratory fitness (CRF) using a multivariate multilevel approach and investigates the links between individual and school-related correlates with children's BMI and CRF. This cross-sectional sample included 1014 children (6-10 years) from 25 Portuguese primary schools. BMI was calculated, and CRF was assessed with the PACER test. Fundamental movement skills (FMS) included five object control tasks. Moderate-to-vigorous physical activity (MVPA), sleep, and sedentary time were assessed with the ActiGraph wGT3X-BT accelerometer. Socioeconomic status (SES) and school variables were also obtained. A multivariate multilevel model was used, and alpha was set at 5%. BMI and CRF systematically increased with age. Most of the joint variance (94.4%) was explained at the child level, and BMI and CRF were correlated at this level (ρ = -.37). More active children demonstrated higher CRF levels and had lower BMI levels; sedentary and sleep time were not significantly associated with BMI or CRF. FMS were positively associated with CRF but were not significantly associated with BMI. Children at higher SES were more fit and had lower BMI than their peers of lower SES. Finally, school-level variables were not significantly related to BMI and CRF. BMI and CRF had a low but statistically significant negative correlation in this sample of children. Most of the variation in BMI and CRF was explained by child-level characteristics.

Sociobiome - Individual and neighborhood socioeconomic status influence the gut microbiome in a multi-ethnic population in the US

Lower socioeconomic status (SES) is related to increased incidence and mortality due to chronic diseases in adults. Association between SES variables and gut microbiome variation has been observed in adults at the population level, suggesting that biological mechanisms may underlie the SES associations; however, there is a need for larger studies that consider individual- and neighborhood-level measures of SES in racially diverse populations. In 825 participants from a multi-ethnic cohort, we investigated how SES shapes the gut microbiome. We determined the relationship of a range of individual- and neighborhood-level SES indicators with the gut microbiome. Individual education level and occupation were self-reported by questionnaire. Geocoding was applied to link participants’ addresses with neighborhood census tract socioeconomic indicators, including average income and social deprivation in the census tract. Gut microbiome was measured using 16SV4 region rRNA gene sequencing of stool samples. We compared α-diversity, β-diversity, and taxonomic and functional pathway abundance by SES. Lower SES was significantly associated with greater α-diversity and compositional differences among groups, as measured by β-diversity. Several taxa related to low SES were identified, especially an increasing abundance of Prevotella copri and Catenibacterium sp000437715, and decreasing abundance of Dysosmobacter welbionis in terms of their high log-fold change differences. In addition, nativity and race/ethnicity have emerged as ecosocial factors that also influence the gut microbiota. Together, these results showed that lower SES was strongly associated with compositional and taxonomic measures of the gut microbiome, and may contribute to shaping the gut microbiota.

Influence of socioeconomic status on clinical outcomes of diffuse midline glioma and diffuse intrinsic pontine glioma.

Given the lack of a definitive treatment and the poor prognosis of patients with diffuse midline glioma (DMG) and diffuse intrinsic pontine glioma (DIPG), socioeconomic status (SES) may affect treatment access and therefore survival. Therefore, this study aimed to examine the relationship between SES and treatment modalities, progression-free survival (PFS), and overall survival (OS) in children with DMG/DIPG. A retrospective, single-institution review was conducted of medical records of patients ≤ 18 years of age who had DMG or DIPG that was diagnosed between 2000 and 2022. Patient demographics, surgical interventions, chemotherapy, radiation therapy, clinical trial enrollment, and medical care-related travel were extracted. SES variables (education and mean income) for associated patient census tracts were collected and stratified. Statistical analysis using unpaired t-tests, chi-square analysis, and log-rank tests was conducted. Of the 96 patients who met the inclusion criteria, the majority were female (59%) and non-Hispanic White (57%). The median PFS, median OS, and time from diagnosis to treatment did not differ between races/ethnicities or sex. Ninety-one of 96 patients had census tract data available. Patients from higher-income census tracts (> 50% of families with annual household income greater than $50,000) had a longer median OS (480 vs 235 days, p < 0.001) and traveled significantly longer distances for medical care (1550 vs 1114 miles, p = 0.048) than families from lower-income census tracts. Patients from the highest education quartile traveled significantly farther for treatment than the lowest education quartile (mean 2964 vs 478 miles, p = 0.047). Patients who received both oral and intravenous chemotherapy were more likely to be from higher-income census tracts than those who received intravenous or no chemotherapy. Duration of PFS, rates of clinical trial enrollment, biopsy rates, H3K27 mutation status, ventriculoperitoneal shunt placement rates, and radiotherapy rates were not associated with SES variables. Patients from families from higher-income census tracts experienced longer OS and traveled farther for treatment. Patients from families from higher-education-level census tracts traveled more often for treatment. The authors' findings suggest that SES influences DMG and DIPG OS. More studies should be done to understand the role of SES in the outcomes of children with DMG/DIPG.