Women Of Low Socioeconomic Status Research Articles

The effectiveness of smoking cessation interventions for socio-economically disadvantaged women: a systematic review and meta-analysis

IntroductionThis systematic review and meta-analysis assessed the effectiveness of smoking cessation interventions among women smokers in low socio-economic status (SES) groups or women living in disadvantaged areas who are historically underserved by smoking cessation services.MethodsA systematic literature search was conducted using MEDLINE (OVID), EMBASE, Cochrane, CINAHL, PsychINFO and Web of Science databases. Eligibility criteria included randomised controlled trials of any smoking cessation intervention among women in low SES groups or living in socio-economically disadvantaged areas. A random effects meta-analysis assessed effectiveness of interventions on smoking cessation. Risk of bias was assessed with the Cochrane Risk of Bias tool. The GRADE approach established certainty of evidence.ResultsA total of 396 studies were screened for eligibility and 11 (6153 female participants) were included. Seven studies targeted women-only. 5/11 tested a form of face-to-face support. A pooled effect size was estimated in 10/11 studies. At end of treatment, two-thirds more low SES women who received a smoking cessation intervention were more likely to stop smoking than women in control groups (risk ratio (RR) 1.68, 95% CI 1.36–2.08, I2= 34%). The effect was reduced but remained significant when longest available follow-up periods were pooled (RR 1.23, 95% CI 1.04–1.48, I2 = 0%). There was moderate-to-high risk of bias in most studies. Certainty of evidence was low.ConclusionsBehavioural and behavioural + pharmacotherapy interventions for smoking cessation targeting women in low SES groups or women living in areas of disadvantage were effective in the short term. However, longer follow-up periods indicated reduced effectiveness. Future studies to explore ways to prevent smoking relapse in this population are needed.Systematic review registrationPROSPERO: CRD42019130160

Assessment of sexuality among women in Morocco

IntroductionHaving a healthy active sex life is essential to maintain good physical health and offer the possibility of establishing moments of mental well-being. Until now, not many studies have addressed this health aspect in our context, while problems related to intimate relationships remain one of the most frequent causes of consultation in psychiatry.ObjectivesThe objectives of our study are: to assess sexuality among Moroccan women, analyze their sexual behavior with an epidemiological description, determine their sources of information, and identify the potential causes that could lead to lower their libido.MethodsWe conducted a cross-sectional study with around hundreds of women in the general population using the female sexual function index (FSFI), associated with a questionnaire that includes age, place of residence, origin, marital status, number of children, profession, social status, age of first sexual experience, details of different sexual practices, sources of information related to genital life, the means of contraception and the presence of comorbidities.ResultsPreliminary results show a limited understanding of sexuality among women of low socioeconomic status. Women with a high level of education are more fulfilled and this is due to the ease of access to information and care. Depression contributes greatly to lower libido and marital conflict.ConclusionsSexuality remains today one of the most taboo subjects in our country and more among the female population. Hence the need for sex education begins with self-knowledge, understanding of different practices, and psychological support for all women from a young age toward enduring a healthy flourishing sex life.DisclosureNo significant relationships.

Socioeconomic disparities in supportive therapy use and tolerance of aromatase inhibitors in patients with early-stage, hormone-positive breast cancer.

523 Background: Socioeconomic disparities impact breast cancer survival with significantly higher mortality among women of lower socioeconomic status. Little is known about how disparities affect patients with early-stage hormone receptor positive (HR+) breast cancer (BC) and patients’ tolerance and adherence to standard of care adjuvant aromatase inhibitor (AI) therapy. AI-related adverse effects are common and can cause therapy intolerance and early discontinuation. Supportive therapies have been shown to improve symptom tolerability when utilized by patients. This study assessed socioeconomic disparities in utilization of supportive therapies and adherence to initial AI therapy. Methods: We performed a retrospective chart review of all female patients at our academic institution with early-stage, HR+, BC who were initiated on adjuvant AI between 2011-2020. We collected information on side effects, duration of first AI and use of supportive therapies. We linked median family income with zip codes based on national census data and sorted them based on the Pew Research Center categorization. Primary endpoints were the rate of discontinuation of AI at 1-year and utilization of supportive therapies in relation to income, insurance coverage and primary language. The Fisher's exact test, Pearson's Chi-squared test, and Wald test methods were used to compare rates of discontinuation of front-line AI therapy and use of supportive therapies for each group. Results: We identified 1006 patients of whom 95% (n = 954) had AI related side effects yet only 31% (n = 311) received supportive therapies in the first year of AI treatment. The majority (59%) of patients were in the middle-income range ($52,200-$156,000), followed by upper (24%) and lower (17%) income. Upper-income was associated with higher use of supportive therapies (OR 1.46, p = 0.031) but was not associated with lower 1-year discontinuation rate. Medicare was the most common insurance coverage (45%), followed by Commercial (32%) and Medicaid (23%). English was the primary language for 86% of patients. Neither insurance coverage nor primary language was associated with either endpoint. In evaluating race, Black patients had the least use of supportive therapies (p < 0.001), yet this group had the lowest 1-year discontinuation rate (p = 0.005). Conclusions: Our results demonstrate that income and race were associated with use of crucial supportive therapies that are proven to help patients mitigate AI toxicities. The etiology of these disparities is likely multifactorial and requires further study to ensure equitable care and access for all patients.

Selenium status in adults and children in Lusaka, Zambia

BackgroundSelenium (Se) is a trace element found in many foodstuffs and critical for antioxidant and immune functions. Widespread Se deficiency has been noted in populations of some sub-Saharan African countries including Ethiopia and Malawi. As a first step towards developing a fuller understanding of problems with the availability of Se in the diet in Lusaka province, Zambia, we measured plasma Se in adults and children in this geographic area. MethodsTotal plasma Se was measured using inductively coupled plasma optical emission spectrometry (ICP-OES) in several groups of adults recruited to various pre-existing studies, including those of high and low socioeconomic status (SES) and pregnant women, and children with a range of nutritional states (healthy, stunted or wasted). ResultsA total of 660 plasma samples from 391 adults and 269 children were included. Adults had a median plasma Se concentration of 0.27 μmol/l (IQR 0.14–0.43). Concentrations consistent with deficiency (<0.63 μmol/l) were found in 83% of adults. Low SES was associated with low plasma Se among adults, [OR 0.1; 95% CI 0.1–0.3, p < 0.0001]. Among the children, 24% had plasma Se less than 0.41 μmol/l. There was a statistically significant positive correlation between plasma Se and age among children, Spearman's rho 0.47, p < 0.0001. ConclusionsThese data suggest that Se deficiency is widespread in Lusaka province and could in part be related to socio-economic status. Supplementation or agronomic biofortification may therefore be needed.

Socioeconomic disparities in rates of facial fracture surgeries for women and men at a regional tertiary care centre in Australia.

BackgroundAssault is the most common mechanism of injury in patients presenting with facial trauma in Australia. For women, there is a propensity for maxillofacial injuries to stem from intimate partner violence (IPV). Those with a low socioeconomic status have higher rates of IPV. This study examines variations in the proportion of surgical procedures that are due to facial trauma for Australian women and men by employment status and residential socioeconomic status.MethodsA single centre retrospective study was conducted (2008–2018). The proportion of operative patients presenting with facial fractures was examined. Multivariable logistic regression adjusting for year and age, was performed for women and men.ResultsFacial fractures comprised 1.51% (1602) of all surgeries, patients had a mean age of 32, and 81.3% were male. Unemployed patients were more likely to require surgery for a facial fracture (OR 2.36 (2.09–2.68), P <0.001), and there were no significant variations by index of economic resources (IER). Unemployed males had higher rates of facial fractures (OR 2.09 (1.82–2.39), P <0.001). Unemployed and disadvantaged IER females had higher rates of facial fractures (OR 5.02 (3.73–6.75), P <0.001 and OR 2.31(1.63–3.29), P <0.001).ConclusionsThis study found disparities in rates of surgery for facial fractures; unemployment increased the rates for men and women, whereas disadvantaged IER increased rates for women. Studies have demonstrated higher rates of IPV for unemployed and low socioeconomic status women. Further research ascertaining the aetiology of these disparities is important both for primary prevention initiatives and to enable treating clinicians to better understand and address the role of IPV and alcohol consumption in these injuries.

Economic opportunities for Mexican women from low socioeconomic status: results from a technical and life skills training program

This study presents the outcomes of a technical and life-skills training program in Mexico aimed to help women from low socioeconomic status (SES) find formal employment in sales, retail, and/ or customer service. To determine the extent to which the program reached its target population and its impacts, researchers analyzed a national database of over sixty-eight thousand Mexican beneficiaries from 2016 to 2020 and conducted telephone surveys with a representative sample of women beneficiaries in Veracruz. Results from the national-level analysis of 5,326 women participants identified as low SES indicate that 23 % found better economic and educational opportunities. The state-level analysis of 94 low SES women in Veracruz was higher, with 40 % reporting to have found better opportunities; of those who reported salary information, roughly half improved their income. Lessons learned are discussed regarding reaching target populations and the potential of job training programs in developing countries.

Impact of Education Level of Women in Russia on the Position of Women in Society (historical summary)

Purpose: Since the 18th century, discrimination against women was part of official government policy in higher education institutions within Russia, as across the world until the beginning of the twentieth century. For many years, only men had the advantage of attending higher education. Thus, it can be said that women of lower socio-economic status had barely any rights in Czarist Russia. They had no right to divorce and extremely limited rights to own private property.&#x0D; Design/Methodology/Approach: Only women who were at least of median socio-economic level could consider leaving their husband. Effects of both the industrial revolution in the western world and the labour movement within Russia during the 19th century along with a number of socio-economic changes within society, led to a system of values which ultimately allowed women to participate in educational life.&#x0D; Findings: As it observed in most societies, a long period of awakening and raising awareness is required in order to ensure the desired level of equality of opportunity between genders in both education and work areas, as well as in other areas of society in Russia too.&#x0D; Highlights: When it comes to the historical process in Russia's women's education, it can be said that the path taken in the field of women's education, considering the changes in the political, socio-economic and value system is practical and beneficial.

Promoting Physical Activity in a Spanish-Speaking Latina Population of Low Socioeconomic Status With Chronic Neurological Disorders: Proof-of-Concept Study.

BackgroundPhysical activity (PA) is known to improve quality of life (QoL) as well as reduce mortality and disease progression in individuals with chronic neurological disorders. However, Latina women are less likely to participate in recommended levels of PA due to common socioeconomic barriers, including limited resources and access to exercise programs. Therefore, we developed a community-based intervention with activity monitoring and behavioral coaching to target these barriers and facilitate sustained participation in an exercise program promoting PA.ObjectiveThe aim of this study was to determine the feasibility and efficacy of a community-based intervention to promote PA through self-monitoring via a Fitbit and behavioral coaching among Latina participants with chronic neurological disorders. MethodsWe conducted a proof-of-concept study among 21 Spanish-speaking Latina participants recruited from the Los Angeles County and University of Southern California (LAC+USC) neurology clinic; participants enrolled in the 16-week intervention at The Wellness Center at The Historic General Hospital in Los Angeles. Demographic data were assessed at baseline. Feasibility was defined by participant attrition and Fitbit adherence. PA promotion was determined by examining change in time spent performing moderate-to-vigorous PA (MVPA) over the 16-week period. The effect of behavioral coaching was assessed by quantifying the difference in MVPA on days when coaching occurred versus on days without coaching. Change in psychometric measures (baseline vs postintervention) and medical center visits (16 weeks preintervention vs during the intervention) were also examined.ResultsParticipants were of low socioeconomic status and acculturation. A total of 19 out of 21 (90%) participants completed the study (attrition 10%), with high Fitbit wear adherence (mean 90.31%, SD 10.12%). Time performing MVPA gradually increased by a mean of 0.16 (SD 0.23) minutes per day (P<.001), which was equivalent to an increase of approximately 18 minutes in MVPA over the course of the 16-week study period. Behavioral coaching enhanced intervention effectiveness as evidenced by a higher time spent on MVPA on days when coaching occurred via phone (37 min/day, P=.02) and in person (45.5 min/day, P=.01) relative to days without coaching (24 min/day). Participants improved their illness perception (effect size g=0.30) and self-rated QoL (effect size g=0.32). Additionally, a reduction in the number of medical center visits was observed (effect size r=0.44), and this reduction was associated with a positive change in step count during the study period (P.=04).ConclusionsSelf-monitoring with behavioral coaching is a feasible community-based intervention for PA promotion among Latina women of low socioeconomic status with chronic neurological conditions. PA is known to be important for brain health in neurological conditions but remains relatively unexplored in minority populations.Trial RegistrationClinicalTrials.gov NCT04820153; https://clinicaltrials.gov/ct2/show/NCT04820153

Addressing missed opportunities for cervical cancer screening in Nigeria: a nursing workforce approach.

Cervical cancer is the commonest gynaecological cancer affecting women, especially in low and middle-income countries (LMICs). Despite the availability of evidence on multiple prevention pathways, including vaccination and screening, the cervical cancer burden continues to increase, especially in LMICs. This disease typifies health inequality as more than 85% of related morbidity and mortality occur among women of low socio-economic status residing in developing countries. In Nigeria, cervical cancer is the second leading cause of cancer morbidity and mortality. Sadly, Nigeria lacks a tailored cervical cancer control policy or population-based screening programme which is recommended. Consequently, existing screening services are opportunistic, sparsely distributed and have reached less than 9% of eligible Nigerian women. This article highlights the current status of cervical cancer screening in Nigeria, contextualises the role of female nurses and proffers novel approaches to address missed opportunities for screening by leveraging the nursing workforce.

Intersectionality in cancer care: A systematic review of current research and future directions.

The objective of the current review was to synthesize the literature on intersectionality relative to disparities across the cancer care continuum. A model to support future intersectional cancer research was proposed. Web-based discovery services and discipline-specific databases were queried for both peer-reviewed and gray literature. Study screening and data extraction were facilitated through the Covidence software platform. Among 497 screened studies, 28 met study inclusion criteria. Most articles were peer-reviewed empirical studies (n=22) that focused on pre-diagnosis/screening (n=19) and included marginalized racial/ethnic (n=22) identities. Pre-cancer diagnosis, sexual orientation and race influenced women's screening and vaccine behaviors. Sexual minority women, particularly individuals of color, were less likely to engage in cancer prevention behaviors prior to diagnosis. Race and socioeconomic status (SES) were important factors in patient care/survivorship with worse outcomes among non-white women of low SES. Emergent themes in qualitative results emphasized the importance of patient intersectional identities, as well as feelings of marginalization, fears of discrimination, and general discomfort with providers as barriers to seeking cancer care. Patients with intersectional identities often experience barriers to cancer care that adversely impact screening, diagnosis, treatment, as well as survivorship. The use of an "intersectional lens" as a future clinical and research framework will facilitate a more multidimensional and holistic approach to the care of cancer patients.

Obesity burden by socioeconomic measures between 2000 and 2018 among women in sub-Saharan Africa: A cross-sectional analysis of demographic and health surveys.

BackgroundThe increasing global burden of obesity especially in low‐and‐middle‐income countries (LMICs) accentuates the need for critical action. In the absence of evidence‐based approaches to mitigate recent obesity trends, the likelihood of reaching global obesity targets will be almost zero.ObjectiveThis study examined the obesity prevalence in Sub‐Sahara Africa and observed transitions on the burden of obesity prevalence over time.MethodsData from the Demographic and Health Survey which is based on cross sessional design was used. Most recent surveys carried out in 16 sub‐Saharan Africa (SSA) between 2000 and 2018 were included in the analysis. Equiplot by the International Centre for Equity was used to display the inequities by the following socioeconomic measures: wealth index, education, and place of residence. Age‐standardized prevalence was measured across these socioeconomic measures using the WHO standard population age distribution, examined changing trends and finally assessed transition in obesity prevalence by percentage point difference of highest and lowest prevalence within each of the three socioeconomic measures.ResultsA total of 496,482 women were included in the analysis. Obesity prevalence among women varied substantially, from 2% in Chad to 27% in Lesotho. Variation in obesity prevalence was observed across countries and by socioeconomic status measures. Among women in all the countries except Comoros, the burden was concentrated among the wealthiest. Out of the 16 countries included, the prevalence of obesity was concentrated among women with no education in eight countries (Benin, Burundi, Chad, Cote d'Ivoire, Guinea, Mali, Niger, Comoros) while it was concentrated in those with primary education in Congo and Lesotho and among those with secondary school education in DR Congo, Gabon, Namibia, Nigeria, and Zimbabwe. The burden of obesity was more concentrated in the urban across the 16 countries except in Comoros and Lesotho where they were higher in the rural (8.9 [7.2, 11.1] and 15.1 [13.0, 17.5] respectively) than in urban (6.6 [5.0, 8.8] and 6.8 [5.2, 8.8] respectively). Finally, the trend analysis with five countries indicated that the prevalence and gap in obesity among women increased between previous and most recent surveys except in Zimbabwe where it reduces across the three socioeconomic measures between 2011 and 2018.ConclusionsThis study examined transition in obesity prevalence among women across three socioeconomic measures in selected sub‐Saharan African countries. Increasing prevalence of obesity was found in SSA but transition to women in lower socioeconomic status is already taking place in some countries.

Antimicrobial Resistance Pattern in E. coli Isolated from Placental Tissues of Pregnant Women in Low-Socioeconomic Setting of Pakistan.

Infections during pregnancy can culminate in adverse pregnancy outcomes, including preterm birth (PTB). Pakistan is among the top ten nations with high PTB-associated neonatal mortality rates, where access to prenatal as well as neonatal care is only afforded by the privileged few. Societal stigma further discourages women seeking healthcare for minor infections. Microbial pathogens associated with genitourinary infections can lead to gestational complications culminating in earlier onset of labor. In this study, association of Escherichia coli (E. coli) with PTB in Pakistani women of low-socioeconomic status is examined. 57 paired vaginal swabs and placenta samples from mothers with full term and preterm deliveries were collected and processed for isolation and molecular characterization of extraintestinal pathogenic E. coli (ExPEC). ExPEC isolated from vaginal swabs and placenta showed phylotype B2 being most prevalent (Vagina n = 3 (9), 33%) (Placenta n = 4 (12), 33%) in preterm cases followed by phylotype B1 (Vagina n = 2 (9), 22%) (Placenta n = 3 (12), 25%) and untypeable strains. Antibiotic susceptibility profiling showed a large percentage of resistant isolates to multiple antibiotics, including carbapenem and included extended-spectrum beta-lactamase (ESBL) producers. Our study is the first to report different phylotypes of E. coli from placental tissues in preterm deliveries which may be a cause for concern for maternal and neonatal health. ExPEC from vaginal swabs and placental of females delivering preterm shows the pathogenic phylotype B2 dominance with a large percentage of isolates resistant to multiple antibiotics, including carbapenem and included ESBL producers. The placental isolates may indicate ascending infection from vagina or urinary tract which may lead to preterm birth.

Differences in Psychosocial Protective Factors by Race/Ethnicity and Socioeconomic Status and Their Relationship to Preterm Delivery.

Background: Non-Hispanic Black (“Black”) women in the United States deliver preterm at persistently higher rates than non-Hispanic White (“White”) women, and disparities in preterm delivery (PTD) also exist by socioeconomic factors. Research is needed to identify and understand factors that are protective against PTD for Black women and low socioeconomic status (SES) women.Methods: We examined seven potential protective factors at the individual, interpersonal, and neighborhood levels during pregnancy to determine if they (1) differed in prevalence by race/ethnicity and SES and (2) were associated with risk of PTD overall or within specific race/ethnicity and SES groups. We used prospectively collected data from n = 2474 women who were enrolled in the Pregnancy Outcomes and Community Health Study conducted in Michigan (1998–2004).Results: White women reported higher levels of self-esteem, mastery, perceived social support, instrumental social support, and reciprocity compared to Black women (all p < 0.01), while Black women reported higher levels of religiosity compared to white women (p < 0.01). High SES women reported higher levels of all protective factors compared to middle and low SES women (all p < 0.01). While protective factors were not independently associated with PTD, religiosity was associated with lower odds of PTD among low SES women (OR 0.6, 95% CI 0.4-0.9) and among Black women (OR 0.6, 95% CI 0.4–1.0), respectively.Conclusions: Our findings highlight the importance of assessing how protective factors may operate differently across race/ethnicity and SES to promote healthy pregnancy outcomes. Future studies should examine mechanisms that elucidate potential causal pathways between religiosity and PTD for Black women and low SES women.

El cuerpo cotidiano: itinerarios corporales de mujeres

This work aims to study women's body itineraries, through the interviews of women from high and low socioeconomic status (SES) who live in Santiago de Chile. The project inquiries bodies’ itineraries as a set of nutrition, exercise, and aesthetics care actions as everyday practices. This concept allowed reflecting on the body as a continuous becoming, a movement or action, and not a fixed entity. The project had a qualitative research design. Data was collected using reflexive interviews. Participants were asked to describe a typical day using magazine images. Every interview started with the question: “If your body could talk with images, how would it tell its day?”. Four women were interviewed, two of high SES and two of low SES. The data analysis was conducted the reflexive thematic analysis guidelines. The results compared high and low SES bodies itineraries organized by type of practice. Women of high SES describe their nutrition practices in terms of body awareness; how food affects their bodies. Low SES women instead talk about their nutrition from a self-control perspective. These women describe their food intake as something that must be at all times regulated. For them, nutrition becomes a constant failure because they usually lack self-control. Women of high SES describe the exercise as a pleasant activity, it is related to wellbeing. The interviewed women from this group reported exercising regularly. Women of Low SES described their lack of exercising in terms of laziness. Women of low SES report makeup as a daily aesthetic care practice. Women describe that they start applying makeup at their house, continue in the subway or bus on the way to work, and finish at the workplace. Makeup doesn’t have a delimited space or place. Women of high SES describe aesthetic care practices in terms of skincare. They emphasize that good-looking skin and body image reflect a healthy body. A significant difference between low and high SES women is that the first consider aesthetic care practices as superficial, while for the latter is an inner state that reflects exteriorly. In general terms, women of high SES refer to body itineraries in terms of awareness. Women regularly refer to how the practices of nutrition, exercise, and aesthetic care affect their bodies. Women of low SES instead describe their body itineraries as control practices that regularly fail. They don’t report body sensations. The analysis shows that the description of nutrition, exercise, and aesthetic care have moral (good/bad) and affective dimensions (how a body shall be affected in these practices). Being a caregiver emerged as a relevant issue when accounting for body itineraries. Two of the four women we interviewed were mothers, one from each SES. Caregiving was significant in nutrition and exercise practices. Women with children tend to eat when and what their children are eating. Eating tends to be a practice distributed in the routine. For example, a woman had a sandwich with her son before school and then a coffee after dropping him at school. Likewise, exercise is in function to the children’s routine. For example, a woman walks fast from the school to her house. Being a caregiver structures time and, as an effect, it is very significant in body itineraries. Finally, in the discussion the analysis was compared with other data. The different practices of women of high and low SES derive into different outcomes. Women of low SES are more obese and sedentary than women from high SES. The notion of body itineraries is an integrative concept to study nutrition, exercise, and aesthetic care. https://doi.org/10.16888/interd.2022.39.2.9

Socio-economic status and the risk of breast cancer among Nigerian women: a case control study.

Introductionan increased risk of breast cancer associated with high socio-economic status has been reported in high income countries. A few available African studies have reported inconsistent findings using different single socio-economic measures. Our aim was to investigate the association between socio-economic status and the risk of breast cancer among Nigerian women based on a range of socio-economic status measures.Methodswe conducted a hospital-based case-control study involving participants from five hospitals in Lagos and Abuja. Women were interviewed in-person between October 2016 and May 2017 using a semi-structured questionnaire. Socio-economic status was assessed based on education, occupation, income, wealth, and socio-economic index. Multivariable logistic regression was applied in data analysis using Statistical Package for Social Sciences (SPSS) version 23. Level of significance was based on 95% confidence interval or p-values less than 0.05.Resultswe recruited 379 histologically confirmed breast cancer cases and 403 controls. Following full adjustments, breast cancer risk reduced as socio-economic index increased (p for trend=0.028). Although women in the highest categories of educational attainment [Odds ratio (OR)=0.21, 95% confidence interval (CI): 0.09, 0.53], and personal income (OR=0.37, 95% CI: 0.19, 0.72) had a reduced risk of breast cancer compared to women in the lowest categories respectively after adjustments for relevant covariates, income alone exhibited a significant risk reduction following mutual adjustment for other socio-economic status measures (p for trend=0.014).Conclusionthe observed associations between high socio-economic status and lower breast cancer risk in Nigeria contrast with predominant findings in high-income countries. It suggests the need for socio-economic intervention and other preventive programmes such as improved access to screening and diagnostic services targeted at women of low socio-economic status in Nigeria.

Determinants of accessing healthcare in Sub-Saharan Africa: a mixed-effect analysis of recent Demographic and Health Surveys from 36 countries

ObjectiveThis study aimed to assess the determinants of accessing healthcare among reproductive-age women in Sub-Saharan Africa (SSA).Design, setting and analysisCross-sectional data were sourced from recent Demographic and Health Surveys in...

Abstract PO-008: Predictive analysis of demographic factors to examine disparity in gynecologic cancer

Abstract Introduction: Cancer continues to be a major cause of mortality worldwide and is the leading cause of death for women age 40-79. Gynecologic cancers (GYNC) account for 6.3% of all cancers, making it the 4th leading cause of cancer death among US women. Research has shown that cancers are linked to various demographic factors. Cancer incidence may differ among people of different race/ethnicity due to socioeconomic status; specifically, these variables can impact exposure to risk factors, access to health education, and early detection and treatment. Race/ethnicity is a known risk factor for GYNC. Due to the disparity in the US healthcare system, analysis of the association of various demographic variables with cancer diagnosis in women is imperative to better understand health outcomes for GYNC in this country. Methods: We used the female portion of the 2012 Florida State Inpatient Database of the Healthcare Cost and Utilization Project as our sample. The outcome variable was presence or absence of a cancer diagnosis identified by ICD-9 codes for the following cancers: ovary (OC), uterine (UC), and cervical (CC). Logistic regression analyses examined the patient-level factors of race/ethnicity, age, insurance type, income level, and other comorbidities as potential independent predictors of cancer diagnosis. Results: Logistic regression analysis demonstrated that the odds of CC is increased in women who are black (OR=1.4, 95% CI 1.2-1.5), middle age (OR=5.9, 95% CI 5.1-6.9), and have Medicaid (OR=2.2, 95% CI 3.5-4.9). The similar pattern observed with the OC and UC analysis suggests the presence of cancer disparity among women of lower socioeconomic status. Conclusions: In this study we found that cervical, ovarian, and uterine cancers were significantly associated with variables such as race and lack of reliable health insurance which can indicate disparity. One factor which could potentially contribute to any health disparity in this sample is the lack of ACA Medicaid expansion in Florida. Findings from this study highlight the importance of considering access to healthcare for women from various backgrounds to improve management of cancer and women's health at large. Citation Format: Zahra Bahrani-Mostafavi, Patricia Koplas. Predictive analysis of demographic factors to examine disparity in gynecologic cancer [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-008.

Personality Characteristics and Emotional Distress Among Chinese Pregnant Women: A Moderated Mediation Model.

Previous studies have suggested that certain personality characteristics are associated with emotional distress during pregnancy. However, the underlying mechanism of this association is rarely understood. The current study investigated the links between personality and pregnant women's emotional distress (depressive and anxiety symptoms), tested the chain mediating effects of two resilience factors—social support and positive coping, and explored whether socioeconomic status (SES) could moderate the effects (including direct and/or indirect effects) of personality on their emotional distress. Results of a relatively large sample of pregnant women in China (N = 1157) showed positive associations for psychoticism and neuroticism with depressive and anxiety symptoms as well as negative associations for extraversion with depression and anxiety. After controlling for four important variables (the first pregnancy or not, having adverse pregnancy experience or not, being pregnant as planned or not, and number of weeks of pregnancy), social support and positive coping acted as chain mediators on the associations of personality with depressive symptoms as well as of personality with anxiety. Overall, the association of personality and depressive symptoms demonstrated invariance across socioeconomic status (SES). However, SES moderated the relationship between personality and anxiety. Specifically, the negative association of positive coping with anxiety symptoms was weaker for low SES women than for high SES ones. Results highlight the importance of social support and positive coping to decrease personality-related depressive and anxiety symptom among pregnant women. Furthermore, identifying other resilience factors that alleviate anxiety in women with low SES is urgently called for.

Usefulness and expectations on skills development and entrepreneurship among women of low socioeconomic status in Ogun State, Nigeria.

The acquisition of vocational training skills and entrepreneurial know-how is acknowledged as an added advantage and a safety net to navigate poverty, especially in dwindling economic recession time and massive unemployment. This study examined the factors influencing the usefulness and perceived realization of skills development/empowerment to encourage more women's involvement in small scale businesses and promote its effect on poverty alleviation in households across Nigeria. Data collection involved a structured questionnaire and in-depth interviews conducted post-the vocational skill/empowerment training. The training was organized among Campus Keepers in a private university in Ogun State, Nigeria. Forty Campus Keepers were selected using the systematic sampling technique from a total population of 224, and 37 of the 40 selected voluntarily participated in this study. The Campus Keepers were women with low socioeconomic status who worked as cleaners on the university campus. Five of the Campus Keepers were purposively selected as key informants for the study. Results showed that respondents who had earlier knowledge and vocational skills training reported that it leads to self-employment. This view was higher for respondents who had more people in their household than those with fewer people (OR = 22.7 [CI= .56, 921.31]). The perception that the training can lead to additional income was lower for respondents who reported that either they or their spouses were sole breadwinners in their household than for those who reported that both/others/none were breadwinners (OR = .05 [CI=0, 1.2]). The odds that the skills development/empowerment training will result in perceived improved business was higher for respondents who gained more knowledge/information from the training than those who did not (OR=29.19 [CI = 1.1, 777.48]). Findings from the qualitative study suggest that key informants who participated in past training were yet to establish a profitable business of their dream fully. Governmental policy and program intervention that incorporates these findings will lead to increased participation of the target population in similar training in the future, leading to poverty alleviation towards achieving the SDGs for Nigeria.

Socioeconomic Status and Inflammation in Women with Early-stage Breast Cancer: Mediation by Body Mass Index

BackgroundBreast cancer is the most common cancer among women in the US, and women of low socioeconomic status (SES) show markedly poorer outcomes than those of high SES. SES may influence health through inflammation, although links between SES and inflammatory biomarkers have not been investigated in women with breast cancer. This study tested the hypothesis that breast cancer patients of lower SES would show higher levels of inflammation than those of higher SES. BMI was examined as a mediator of this association. MethodsWomen recently diagnosed with early-stage breast cancer (N = 194) were recruited before neoadjuvant or adjuvant therapy. Participants completed questionnaires and provided blood samples for immune assessment. SES was indexed by participants’ self-reported education and annual household income, BMI was determined by height and weight measurements, and blood was assayed for inflammatory biomarkers linked with cancer outcomes: IL-6, CRP, TNF-α, and sTNF-RII. General linear models tested associations between SES and inflammation, and mediation models examined indirect effects through BMI. ResultsConsistent with hypotheses, education status was associated with CRP, (F(2,185) = 4.72, p = 0.001), and sTNF-RII, (F(2,185) = 4.19, p = 0.02), such that lower education was associated with higher levels of both biomarkers. Further, BMI mediated the associations between education and CRP, (95% CIs [-0.62, −0.11; −0.76, −0.21]), sTNF-RII, (95% CIs [−0.09, −0.01; −0.10, −0.02]), and IL-6, (95% CIs [−0.32, −0.05; −0.38, −0.09]). Annual household income was not significantly associated with inflammation (ps > 0.25), and indirect effects on inflammation through BMI were not significant. ConclusionsLower education was associated with higher levels of inflammation in this sample, which may presage poor breast cancer-related and clinical outcomes. SES should inform the development of interventions targeting BMI and inflammation in breast cancer.