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Adepoju OE, Singh M, Tipton M, Peperone G, Trujillo M, Ojinnaka C. Access to technology, internet usage, and online health information-seeking behaviors in a racially diverse, lower- income population. Front Public Health 2024; 12:1328544. [PMID: 38450126 PMCID: PMC10914988 DOI: 10.3389/fpubh.2024.1328544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 03/08/2024] Open
Abstract
Background This study examined access to technology, internet usage, and online health information-seeking behaviors, in a racially diverse, lower-income population. Methods Data were obtained via a cross-sectional survey of low-income communities in Houston, Los Angeles, and New York between April and August 2023. Binary responses to the following online health information-seeking behaviors, internet and technology access, were examined: using the internet to (i) understand a medical diagnosis, (ii) fill a prescription, (iii) schedule a healthcare appointment, (iv) email communication with a healthcare provider, and (v) access electronic health records and medical notes. Results 41% of survey respondents identified as non-Hispanic Black individuals, 33% as non-Hispanic White individuals, and 22% as Hispanic individuals. 69% reported a pre-tax annual household income of less than $35,000. 97% reported ownership/access to a smart device; 97% reported access to reliable internet. In the past year, only 59% reported using the internet to better understand their medical diagnosis, 36% reported filling a prescription online, 47% scheduled a medical appointment online, 47% viewed electronic health records online, and 56% emailed healthcare providers. Female sex, higher incomes, and having at least a bachelor's degree were significantly associated with all five online health information-seeking attributes. Conclusion Despite high technology adoption rates, we observed suboptimal online health information-seeking behaviors. This underutilization has potential adverse implications for healthcare access and use given the documented advantage of HIT. Efforts to increase health information-seeking behaviors should explore the identification of HIT barriers, and patient education to increase familiarity and usage in this population.
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Affiliation(s)
- Omolola E. Adepoju
- Department of Health Systems and Population Health Sciences, University of Houston, Houston, TX, United States
- Humana Integrated Health System Sciences Institutes, University of Houston, Houston, TX, United States
| | - Maya Singh
- Humana Integrated Health System Sciences Institutes, University of Houston, Houston, TX, United States
| | - Mary Tipton
- Department of Health Systems and Population Health Sciences, University of Houston, Houston, TX, United States
- Humana Integrated Health System Sciences Institutes, University of Houston, Houston, TX, United States
| | - Gerard Peperone
- Spring Branch Community Health Center, Houston, TX, United States
| | - Marlen Trujillo
- Spring Branch Community Health Center, Houston, TX, United States
| | - Chinedum Ojinnaka
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
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202
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Astvansh V, Wang B, Chen T, Qu JC. Labor unionization and real earnings management: Evidence from labor elections. PLoS One 2024; 19:e0292889. [PMID: 38377129 PMCID: PMC10878506 DOI: 10.1371/journal.pone.0292889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/29/2023] [Indexed: 02/22/2024] Open
Abstract
By exploiting the local randomness in close-call labor elections, the authors find a negative impact of labor unionization at a firm on its real earnings management (REM). The finding suggests a managerial pressure effect of increased labor power. In a local regression discontinuity (RD) analysis, firms that narrowly pass the 50% threshold show a significant decrease in REM, relative to their peers that narrowly fail. This effect is stronger for firms headquartered in right-to-work states and when managers have less pressure to manage earnings. Evidence from a global parametric RD analysis and a multivariate OLS test using industry-level unionization measures confirms the external validity of results in local RD analysis. Overall, the research sheds new light on the economic consequence of labor unionization on employers' accounting decisions.
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Affiliation(s)
- Vivek Astvansh
- Marketing Area, Desautels Faculty of Management, McGill University, Montréal, Québec, Canada
- Department of Informatics, Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana, United States of America
- Environmental Resilience Institute, Indiana University, Bloomington, Indiana, United States of America
- Dewy Data, Inc., Stockton, California, United States of America
| | - Beibei Wang
- Post-Doctoral Station of Applied Economics, Nanjing University, Nanjing, China
- Post-Doctoral Workstation, Bank of Nanjing, Nanjing, China
| | - Tao Chen
- Divison of Banking & Finance, Nanyang Business School, Nanyang Technological University, Singapore, Singapore
| | - Jimmy Chengyuan Qu
- Divison of Banking & Finance, Nanyang Business School, Nanyang Technological University, Singapore, Singapore
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203
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Sherifali D, da Silva LP, Dewan P, Cader FA, Dakhil Z, Gyawali B, Klassen S, Yaseen IF, Jovkovic M, Khalid S, Fitzpatrick-Lewis D, Alliston P, Racey M. Peer Support for Type 2 Diabetes Management in Low- and Middle- Income Countries (LMICs): A Scoping Review. Glob Heart 2024; 19:20. [PMID: 38404615 PMCID: PMC10885823 DOI: 10.5334/gh.1299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
Background Although there is evidence of peer support in high-income countries, the use of peer support as an intervention for cardiometabolic disease management, including type 2 diabetes (T2DM), in low- and middle-income countries (LMICs), is unclear. Methods A scoping review methodology was used to search the databases MEDLINE, Embase, Emcare, PsycINFO, LILACS, CDSR, and CENTRAL. Results Twenty-eight studies were included in this scoping review. Of these, 67% were developed in Asia, 22% in Africa, and 11% in the Americas. The definition of peer support varied; however, peer support offered a social and emotional dimension to help individuals cope with negative emotions and barriers while promoting disease management. Conclusions Findings from this scopingreview highlight a lack of consistency in defining peer support as a component of CMD management in LMICs. A clear definition of peer support and ongoing program evaluation is recommended for future research.
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Affiliation(s)
- Diana Sherifali
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Lilian Pinto da Silva
- Faculty of Physical Therapy, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Pooja Dewan
- British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Scotland, UK
| | - F. Aaysha Cader
- Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh
| | - Zainab Dakhil
- Ibn Al-Bitar Cardiac Centre, Al-Kindy College of Medicine/University of Baghdad, Baghdad, Iraq
| | - Bishal Gyawali
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sheila Klassen
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Israa Fadhil Yaseen
- Baghdad Heart Center, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
| | - Milos Jovkovic
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Saira Khalid
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Donna Fitzpatrick-Lewis
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Paige Alliston
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Megan Racey
- McMaster Evidence Review and Synthesis Team, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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204
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Mocumbi AO. Cardiovascular Health Care in Low- and Middle- Income Countries. Circulation 2024; 149:557-559. [PMID: 38377254 DOI: 10.1161/circulationaha.123.065717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Ana Olga Mocumbi
- Universidade Eduardo Mondlane, Maputo, Mozambique. Instituto Nacional de Saúde, Marracuene, Mozambique
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205
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Banda A, Hoffman J, Roos V. Individual and Community-Contextual Level Factors Associated With Wellbeing Among Older Adults in Rural Zambia. Int J Public Health 2024; 69:1606571. [PMID: 38440080 PMCID: PMC10909949 DOI: 10.3389/ijph.2024.1606571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024] Open
Abstract
Objective: This article aims to identify individual and community-contextual level factors associated with the wellbeing of older adults (50 years and older) in rural Zambia. Methods: Data from the nationally representative 2015 Living Conditions Monitoring Survey (LCMS) was used. Employing multilevel mixed effects, the individual and community-contextual factors on wellbeing were determined. Results: Overall, 31.7% of rural older adults perceived their wellbeing as good. Both individual and community-contextual level factors are associated with the wellbeing of older adults in rural communities. At the individual level, wellbeing was associated with higher education attainment. Community-contextual factors significantly associated with wellbeing included improved housing, access to piped tap water within the premises, own charcoal or income to purchase firewood. Conclusion: The findings foreground the imperative to analyse both individual and community-contextual level factors of wellbeing to generate and present evidence for investments in education across the life course and for the development of infrastructure towards increasing the wellbeing of rural older adults. Additionally, the results provide a basis for planning by devising policies and programmes for older people to thrive and for no one to be left behind regardless the setting.
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Affiliation(s)
- Andrew Banda
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
- Department of Demography, Population Science, Monitoring and Evaluation, University of Zambia, Lusaka, Zambia
| | - Jaco Hoffman
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
- The Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
| | - Vera Roos
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
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206
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Ben-Aharon O, Sergienko R, Iskrov G, Greenberg D. Willingness to pay for an mRNA-based anti-cancer treatment: results from a contingent valuation study in Israel. Isr J Health Policy Res 2024; 13:9. [PMID: 38374060 PMCID: PMC10875764 DOI: 10.1186/s13584-024-00594-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND mRNA technology is currently being investigated for a range of oncology indications. We assessed the willingness to pay (WTP) of the general population in Israel for a hypothetical novel mRNA-based treatment for oncology indications. METHODS We used a contingent valuation methodology to elicit WTP using a web-based questionnaire. A sample of adult participants were presented with a hypothetical scenario in which an mRNA-based intervention increased the likelihood of a cure for various cancer types from 20% to 40% (half of the sample), or 60% (the other half of the sample). RESULTS 531 respondents completed the questionnaire. The mean, median and mode WTP for the proposed hypothetical treatment in both scenarios were ILS65,000 (± ILS114,000), ILS20,000 and ILS50,000, respectively (1USD = 3.4ILS). The WTP was skewed towards zero, and 9.6% of the respondents were not willing to pay any amount. WTP higher amounts was significantly associated with higher income (p < 0.01), self-reported good health (p < 0.05), supplementary health insurance (p < 0.05), Jews compared to other populations (p < 0.01), interest in technology (p < 0.001) and a tendency to adopt medical innovations (p < 0.001). No statistical difference between the 40% vs. the 60% potential cure scenarios was found. Logistic and OLS regressions indicated that age, religion, income, and interest in adopting medical innovations were the best predictors of respondents' WTP. CONCLUSION Despite the scientific breakthroughs in oncology treatment over the last few decades, many types of cancer are still incurable. Given the expected development of innovative mRNA-based treatments for cancer, these results should inform policymakers, the pharmaceutical industry and other stakeholders on the future coverage and reimbursement of these technologies incorporating patients' and societal views. To date, WTP considerations have not been given much weight in prioritization of drug reimbursement processes, neither in Israel nor in other countries. As a pioneer in adoption of the mRNA technology, Israel can also lead the incorporation of WTP considerations in this field.
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Affiliation(s)
- Omer Ben-Aharon
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.
| | - Ruslan Sergienko
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Georgi Iskrov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Dan Greenberg
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
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207
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Yashadhana A, Jaques K, Chaudhuri A, Pry J, Harris P. Intersectoral Partnerships Between Local Governments and Health Organisations in High- Income Contexts: A Scoping Review. Int J Health Policy Manag 2024; 13:7841. [PMID: 38618835 PMCID: PMC11016275 DOI: 10.34172/ijhpm.2024.7841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/31/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Local governments are the closest level of government to the communities they serve. Traditionally providing roads, rates and garbage services, they are also responsible for policy and regulation, particularly land use planning and community facilities and services that have direct and indirect impacts on (equitable) health and well-being. Partnerships between health agencies and local government are therefore an attractive proposition to progress actions that positively impact community health and well-being. Yet, the factors underpinning these partnerships across different contexts are underdeveloped, as mechanisms to improve population health and well-being. METHODS A scoping review was conducted to gain insight into the concepts, theories, sources, and knowledge gaps that shape partnerships between health and local governments. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was informed by a critical realist approach that identifies necessary, contingent and contextual factors in the literature. MEDLINE, Scopus, Web of Science, and ProQuest Central databases were searched for studies published between January 2005 and July 2021. RESULTS The search yielded 3472 studies, after deleting duplicates and initial title and abstract screening, 188 papers underwent full text review. Twenty-nine papers were included in the review. Key themes shaping partnerships included funding and resources; partnership qualities; governance and policy; and evaluation and measures of success. The functional, organisational and individual aspects of these themes are explored and presented in a framework. CONCLUSION Given that local government are the closest level of government to community, this paper provides a sophisticated roadmap that can underpin partnerships between local government and health agencies aiming to influence population health outcomes. By identifying key themes across contexts, we provide a framework that may assist in designing and evaluating evidence-informed health and local government partnerships.
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Affiliation(s)
- Aryati Yashadhana
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
- School of Social Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Karla Jaques
- Ingham Institute, Liverpool, NSW, Australia
- Centre for Health Equity Training, Research and Evaluation, University of New South Wales, Sydney, NSW, Australia
- South Western Sydney Local Health District, Ingham Institute, Liverpool, NSW, Australia
| | - Aulina Chaudhuri
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Jennie Pry
- Liverpool Hospital, Liverpool, NSW, Australia
- Healthy Places, Population Health, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Patrick Harris
- Ingham Institute, Liverpool, NSW, Australia
- Centre for Health Equity Training, Research and Evaluation, University of New South Wales, Sydney, NSW, Australia
- South Western Sydney Local Health District, Ingham Institute, Liverpool, NSW, Australia
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208
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Idrovo AJ. Successful local science in low- income and middle-income countries. Lancet 2024; 403:615. [PMID: 38368008 DOI: 10.1016/s0140-6736(23)01087-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/24/2023] [Indexed: 02/19/2024]
Affiliation(s)
- Alvaro J Idrovo
- Public Health Department, School of Medicine, Universidad Industrial de Santander, Bucaramanga 680006, Colombia.
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209
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Barbek R, Toussaint A, Löwe B, von dem Knesebeck O. Intersectional inequalities in somatic symptom severity in the adult population in Germany found within the SOMA.SOC study. Sci Rep 2024; 14:3820. [PMID: 38360818 PMCID: PMC10869707 DOI: 10.1038/s41598-024-54042-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/07/2024] [Indexed: 02/17/2024] Open
Abstract
Somatic symptoms are common in a wide range of medical conditions. In severe cases, they are associated with high individual and economic burden. To explore social inequalities in somatic symptom severity (SSS) and to identify social groups with highest SSS, we applied an intersectional research approach. Analyses are based on cross-sectional data of the adult population living in Germany (N = 2413). SSS was assessed with the Somatic Symptom Scale-8. A multiple linear regression model with three-way interaction of gender, income and history of migration and post-hoc pairwise comparison of estimated marginal means was conducted. Analyses revealed intersectional inequalities in SSS along the axis of gender, income, and history of migration. Highest SSS was found in males with low income whose parent(s) immigrated, females with low income who immigrated themselves, and females with low income and no history of migration. Intersectional approaches contribute to a more comprehensive understanding of health disparities. To reduce disparities in SSS, proportionate universal interventions combining universal screening and targeted treatment seem promising.
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Affiliation(s)
- Rieke Barbek
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | - Anne Toussaint
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
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210
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Huynh J, Phan TMH. Uncertainty and bank risk in an emerging market: The moderating role of business models. PLoS One 2024; 19:e0297973. [PMID: 38358987 PMCID: PMC10868748 DOI: 10.1371/journal.pone.0297973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/14/2024] [Indexed: 02/17/2024] Open
Abstract
The paper explores the role of business models in the link between uncertainty and bank risk. From the perspective of banks, given that future outcomes tend to be less predictable if banking uncertainty rises, we highlight a framework that a larger dispersion of bank shocks to bank-specific variables might mirror such decreased predictability as a consequence of increasing uncertainty. To compensate for the persistence of bank risk and address the endogeneity issue, we applied the system generalized method of moments (GMM) estimator as the main regressions. Analyzing a panel of commercial banks from Vietnam between 2007 and 2019, we find that higher levels of banking uncertainty may increase bank risk, as gauged by banks' credit risk (loan loss reverses and non-performing loans) and default risk (Z-score index). This detrimental influence of uncertainty appears to be most pronounced with banks relying on pure lending, and it decreases with more non-interest income. A deeper investigation after estimating the marginal effects with plots reveals an asymmetric pattern that bank risk is immune to uncertainty in banks with the highest level of income diversification. Interestingly, we also provide evidence that uncertainty may lower the default risk level when income diversification exceeds a sufficiently high level. Our findings demonstrate that diversified business models are an efficient buffer against higher bank risk in times of increased uncertainty.
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Affiliation(s)
- Japan Huynh
- Faculty of Finance and Banking, Ho Chi Minh City Open University, Ho Chi Minh, Vietnam
| | - Thi Minh Hue Phan
- Faculty of Finance and Banking, Ho Chi Minh City Open University, Ho Chi Minh, Vietnam
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211
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Mansouri A, Khosravi Farsani A, Mohammadifard N, Nouri F, Jozan M, Tabatabaei GA, Salehidoost R, Rafiee H. Self-rated health and its determinants in patients with hypertension in Isfahan in 2019. BMC Public Health 2024; 24:480. [PMID: 38360624 PMCID: PMC10870428 DOI: 10.1186/s12889-024-17887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Self-rated health (SRH) serves as an assessment of contentment regarding one's social, mental, and physical well-being and has been linked to both cardiovascular mortality and morbidity. Nonetheless, the relationship between SRH and medical outcomes in individuals with hypertension unsettled. This research endeavors to pinpoint the determinants that affect SRH in Iranian patients with hypertension. MATERIALS AND METHODS This cross-sectional study took place in Isfahan, Iran, from November 2018 to August 2019 and involved 886 patients with essential HTN. The data collection methods included a checklist for demographic information and risk factors, blood pressure measurements (systolic and diastolic), the Persian version of the 8-Item Morisky Medication Adherence scale, and a self-rated health questionnaire recommended by the World Health Organization. Independent sample T-test and chi squared test were used for comparison of variables between two groups of SRH. Additionally, multivariable logistic regression was used to analyze the factors influencing self-rated health status. RESULTS Among 886 participants (mean age 57.8 ± 8.8 years, 71.9% women), 89.62% reported good SRH. Comorbid conditions were significantly associated with poorer SRH (p < 0.05). Notably, higher education (odd ratio (OR) = 1.88, 95% confidence interval (CI) = 1.13-3.11, p = 0.015) and increased income (OR = 4.34, 95% CI = 1.43-13.18, p = 0.010) were identified as positive determinants of good SRH. CONCLUSION We concluded that socioeconomic factors (education and income) and comorbid conditions (diabetes, hyperlipidemia, and pulmonary diseases) are risk factors for poor SRH among hypertensive patients. These findings could help planning of health enhancement initiative.
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Affiliation(s)
- Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi Farsani
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Jozan
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghazaal Alavi Tabatabaei
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Rezvan Salehidoost
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Hamed Rafiee
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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212
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Ruan Y, Heer E, Warkentin MT, Jarada TN, O'Sullivan DE, Hao D, Ezeife D, Cheung W, Brenner DR. The association between neighborhood-level income and cancer stage at diagnosis and survival in Alberta. Cancer 2024; 130:563-575. [PMID: 37994148 DOI: 10.1002/cncr.35098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Socioeconomic status (SES) is associated with a range of health outcomes, including cancer diagnosis and survival. However, the evidence for this association is inconsistent between countries with and without single-payer health care systems. In this study, the relationships between neighborhood-level income, cancer stage at diagnosis, and cancer-specific mortality in Alberta, Canada, were evaluated. METHODS The Alberta Cancer Registry was used to identify all primary cancer diagnoses between 2010 and 2020. Average neighborhood income was determined by linking the Canadian census to postal codes and was categorized into quintiles on the basis of income distribution in Alberta. Multivariable multinomial logistic regression was used to model the association between income quintile and stage at diagnosis, and the Fine-Gray proportional subdistribution hazards model was used to estimate the association between SES and cancer-specific mortality. RESULTS Out of the 143,818 patients with cancer included in the study, those in lower income quintiles were significantly more likely to be diagnosed at stage III (odds ratio [OR], 1.07; 95% CI [confidence interval], 1.06-1.09) or IV (OR, 1.12; 95% CI, 1.11-1.14) after adjusting for age and sex. Lower income quintiles also had significantly worse cancer-specific survival for breast, colorectal, liver, lung, non-Hodgkin lymphoma, oral cavity, pancreas, and prostate cancers. CONCLUSIONS Disparities were observed in cancer outcomes across neighborhood-level income groups in Alberta, which demonstrates that health inequities by SES exist in countries with single-payer health care systems. Further research is needed to better understand the underlying causes and to develop strategies to mitigate these disparities.
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Affiliation(s)
- Yibing Ruan
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, Alberta, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Emily Heer
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matthew T Warkentin
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tamer N Jarada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Dylan E O'Sullivan
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Desiree Hao
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Doreen Ezeife
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Winson Cheung
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darren R Brenner
- Forzani & MacPhail Colon Cancer Screening Centre, University of Calgary, Calgary, Alberta, Canada
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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213
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Poirier MJP. Systematic comparison of household income, consumption, and assets to measure health inequalities in low- and middle-income countries. Sci Rep 2024; 14:3851. [PMID: 38360925 PMCID: PMC10869835 DOI: 10.1038/s41598-024-54170-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/09/2024] [Indexed: 02/17/2024] Open
Abstract
There has been no systematic comparison of how the three most common measures to quantify household SES-income, consumption, and asset indices-could impact the magnitude of health inequalities. Microdata from 22 Living Standards Measurement Study surveys were compiled and concentration indices, relative indices of inequality, and slope indices of inequality were calculated for underweight, stunting, and child deaths using income, consumption, asset indices, and hybrid predicted income. Meta-analyses of survey year subgroups (pre-1995, 1995-2004, and post-2004), outcomes (child deaths, stunting, and underweight), and World Bank country-income status (low, low-middle, and upper-middle) were then conducted. Asset indices and the related hybrid income proxy result in the largest magnitudes of health inequalities for all 12 overall outcomes, as well as most country-income and survey year subgroupings. There is no clear trend of health inequality magnitudes changing over time, but magnitudes of health inequality may increase as country-income levels increase. There is no significant difference between relative and absolute inequality measures, but the hybrid predicted income measure behaves more similarly to asset indices than the household income it is supposed to model. Health inequality magnitudes may be affected by the choice of household SES measure and should be studied in further detail.
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Affiliation(s)
- Mathieu J P Poirier
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, ON, M3J 1P3, Canada.
- School of Global Health, Faculty of Health, York University, Toronto, Canada.
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214
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Levin A, Yeung KHT, Hutubessy R. Systematic review of cost projections of new vaccine introduction. Vaccine 2024; 42:1042-1050. [PMID: 38278630 PMCID: PMC10911080 DOI: 10.1016/j.vaccine.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/23/2023] [Accepted: 01/07/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND A recent review of guidance documents on vaccine delivery costing revealed current guidance on cost projections for new vaccine introduction has gaps on methods of sampling, data collection and analysis. In preparation for updating the respective guidance, this systematic review was undertaken to qualitatively assess methodologies used in new vaccine cost projection studies. This will inform researchers and stakeholders about the methods of new vaccine introduction cost projections for strategic directions in countries where cost data are not available. METHODS We systematically searched four search engines (PubMed, Cochrane Open Access, Mendeley and Google Scholar) for articles on cost projections for new vaccines published between 1999 and 15 June 2022. We developed inclusion and exclusion criteria for the selection of articles and analyzed the results using a PRISMA 2020 flow diagram. RESULTS Out of 1,108 articles identified, 171 met the criteria for inclusion in the study. Half of the articles were from high-income countries (50%), and most cost projections were part of cost-effectiveness analysis (84%). The most common source of cost data was secondary national information (43%), followed by author's assumptions (17%), secondary international information (14%), and primary data collection (7%). 19% of studies didn't include costs to deliver vaccines in their cost estimation. Among studies that included secondary vaccine delivery costs, approximately half only calculated vaccine administration costs (50%), while 35% included incremental system costs and 15% utilized ingredients data. Two thirds of the studies were conducted to inform policymakers of the cost-effectiveness or cost-benefit of introducing the vaccine. CONCLUSIONS Half of the economic evaluations on new vaccine introductions only included partial vaccine delivery costs. Thus, total costs of vaccine introduction were often being underestimated in economic evaluations. This suggests that guidelines on economic evaluations and journals should recommend that authors include more extensive vaccine delivery costs in their studies.
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Affiliation(s)
- Ann Levin
- Levin & Morgan LLC, Bethesda, Maryland, United States
| | - Karene Hoi Ting Yeung
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 20, Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Raymond Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 20, Avenue Appia, 1211 Geneva 27, Switzerland
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215
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Yeboah Asiamah-Asare BK, Peprah P, Adu C, Ahinkorah BO, Addo IY. Associations of nuptiality perceptions, financial difficulties, and socio-demographic factors with mental health status in Australian adults: Analysis of the Household, Income and Labour Dynamics in Australia (HILDA) survey. PLoS One 2024; 19:e0296941. [PMID: 38354107 PMCID: PMC10866460 DOI: 10.1371/journal.pone.0296941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE This study examined the association of nuptial/relationship factors, financial difficulties, and socio-demographic factors with the mental health status of Australian adults. DESIGN Cross-sectional quantitative study design. SETTINGS, PARTICIPANTS, AND INTERVENTIONS Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey wave 19, 6846 adults were included in the analysis. Mental health was measured using the mental component summary (MCS) subscale of the Short-Form Health Survey SF-36. Hierarchical multiple linear regressions were used to examine the predictors of mental health status. RESULTS Overall, 7.1% of the participants reported poor mental health status. Individual financial difficulty factors explained 3.2% (p<0.001) of the variance in mental health scores. In addition, financial difficulties were negatively associated with mental health status. Nuptiality and relationship factors accounted for 9.8% (p<0.001) of the variance in mental health status. CONCLUSION The study suggests negative marital or relationship perceptions and financial difficulties are significant factors accounting for poor mental health. This finding suggests the need for more policy attention toward the social determinants of poor mental health especially nuptiality or relationship perceptions which have received less policy and research attention in Australia.
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Affiliation(s)
- Bernard Kwadwo Yeboah Asiamah-Asare
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Prince Peprah
- Social Policy Research Centre, UNSW, Sydney, Australia
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Centre for Social Research in Health; UNSW Sydney, Sydney, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, University of Technology Sydney, Sydney, Australia
- School of Clinical Medicine, UNSW Sydney, Sydney, Australia
| | - Isaac Yeboah Addo
- Centre for Social Research in Health; UNSW Sydney, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
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216
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Wooden M, Watson N, Butterworth P. Data Resource Profile: Household, Income and Labour Dynamics in Australia (HILDA) Survey. Int J Epidemiol 2024; 53:dyae043. [PMID: 38553031 DOI: 10.1093/ije/dyae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024] Open
Affiliation(s)
- Mark Wooden
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
| | - Nicole Watson
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
| | - Peter Butterworth
- SEED Lifespan, School of Psychology, Deakin University, Melbourne, Australia
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217
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Gong Z, Wang Y, Li M. Determining the drivers of global innovation under COVID-19: An FSQCA approach. PLoS One 2024; 19:e0295403. [PMID: 38354180 PMCID: PMC10866485 DOI: 10.1371/journal.pone.0295403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/20/2023] [Indexed: 02/16/2024] Open
Abstract
During the COVID-19 epidemic, national innovation faced the challenges of high-risk research and development and intensified trade competition. How to allocate resources reasonably to promote national innovation has become a problem that must be solved. Based on the global innovation index (GII) framework, this study analyzes the influence of national innovation input elements (such as human capital resources, infrastructure, business maturity, etc.) on innovation output from the perspective of configuration, combining with the necessary condition analysis (NCA) and fuzzy set/qualitative comparative analysis (FSQCA). The research results show that:(1) A single innovation input constitutes the necessary condition and serves as a bottleneck for high innovation output;(2) ITT, HCR, IFT, MS and BS are all "multiple concurrent" and form different configurations, namely, two high-innovation and four nonhigh innovation configurations, that drive national innovation governance is characterized by "different roads leading to the same goals." (3) As innovation is limited by the income levels of various countries, there are obvious differences in innovation drive paths between high- and low-income countries. Moreover, the configuration of asymmetric relationships with low-innovation output that occurs in high-income countries has unique characteristics. In this study, the influence of the coupling of national innovation input elements on innovation output is explored.
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Affiliation(s)
- Zhenxing Gong
- Business School of Liaocheng University, Liaocheng, China
- University of Wisconsin-Madison, Madison, WI, United Stats of America
| | - Yue Wang
- Business School of Liaocheng University, Liaocheng, China
| | - Miaomiao Li
- School of Economics and Management, Beijing Information Science and Technology University, Beijing, China
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218
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Galbraith ED, Barrington-Leigh C, Miñarro S, Álvarez-Fernández S, Attoh EMNAN, Benyei P, Calvet-Mir L, Carmona R, Chakauya R, Chen Z, Chengula F, Fernández-Llamazares Á, García-del-Amo D, Glauser M, Huanca T, Izquierdo AE, Junqueira AB, Lanker M, Li X, Mariel J, Miara MD, Porcher V, Porcuna-Ferrer A, Schlingmann A, Seidler R, Shrestha UB, Singh P, Torrents-Ticó M, Ulambayar T, Wu R, Reyes-García V. High life satisfaction reported among small-scale societies with low incomes. Proc Natl Acad Sci U S A 2024; 121:e2311703121. [PMID: 38315863 PMCID: PMC10873637 DOI: 10.1073/pnas.2311703121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/08/2023] [Indexed: 02/07/2024] Open
Abstract
Global polls have shown that people in high-income countries generally report being more satisfied with their lives than people in low-income countries. The persistence of this correlation, and its similarity to correlations between income and life satisfaction within countries, could lead to the impression that high levels of life satisfaction can only be achieved in wealthy societies. However, global polls have typically overlooked small-scale, nonindustrialized societies, which can provide an alternative test of the consistency of this relationship. Here, we present results from a survey of 2,966 members of Indigenous Peoples and local communities among 19 globally distributed sites. We find that high average levels of life satisfaction, comparable to those of wealthy countries, are reported for numerous populations that have very low monetary incomes. Our results are consistent with the notion that human societies can support very satisfying lives for their members without necessarily requiring high degrees of monetary wealth.
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Affiliation(s)
- Eric D. Galbraith
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
- ICREA, Barcelona08010, Spain
- Department of Earth and Planetary Science, McGill University, Montréal, QCH3A0E8, Canada
| | - Christopher Barrington-Leigh
- Department of Equity, Ethics, and Policy, School of Population and Global Health, McGill University, Montréal, QCH3A 1G1, Canada
- Bieler School of Environment, McGill University, Montréal, QCH3A 2A7, Canada
| | - Sara Miñarro
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | - Santiago Álvarez-Fernández
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | - Emmanuel M. N. A. N. Attoh
- Water Systems and Global Change Group, Wageningen University, Wageningen 6700 HB, Netherlands
- International Water Management Institute, Colombo10120, Sri Lanka
| | - Petra Benyei
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
- Instituto de Economía, Geografía y Demografía, Consejo Superior de Investigaciones Científicas, Madrid28037, Spain
| | - Laura Calvet-Mir
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
- Institut Metròpoli, Universitat Autònoma de Barcelona, Barcelona08193, Spain
| | - Rosario Carmona
- Center for Integrated Disaster Risk Management, Pontificia Universidad Católica de Chile, Santiago8331150, Chile
| | - Rumbidzayi Chakauya
- College of Agriculture and Environmental Science, University of South Africa, Florida, 1710Johannesburg, South Africa
| | - Zhuo Chen
- Faculty of Social Sciences, University of Helsinki, HelsinkiFI-00014, Finland
| | - Fasco Chengula
- Institute of Resource Assessment, University of Dar es Salaam, Dar es Salaam16103, Tanzania
| | - Álvaro Fernández-Llamazares
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
- Helsinki Institute of Sustainability Science, University of Helsinki, HelsinkiFI-00014, Finland
| | - David García-del-Amo
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | | | - Tomas Huanca
- Boliviano de Investigación y de Desarrollo Socio Integral, San Borja, Bolivia
| | - Andrea E. Izquierdo
- Instituto Multidisciplinario de Biología Vegetal, Consejo Nacional de Investigaciones Científicas y Técnicas-Universidad Nacional de Córdoba, Córdoba5000, Argentina
| | - André B. Junqueira
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | - Marisa Lanker
- The Nelson Institute for Environmental Studies, University of Wisconsin-Madison, Madison, WI53706
| | - Xiaoyue Li
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | - Juliette Mariel
- Centre de coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Unité Mixte de Recherche Savoirs-Environnement-Sociétés (UMR SENS), Montpellier34398, France
| | - Mohamed D. Miara
- Department of Nature and Life Sciences, Ibn Khaldoun University, Tiaret14000, Algeria
- Laboratory of Agro-Biotechnology and Nutrition Research in Semi-Arid Areas, Ibn Khaldoun University, Tiaret14000, Algeria
| | - Vincent Porcher
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | - Anna Porcuna-Ferrer
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
- Centre de coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Unité Mixte de Recherche Savoirs-Environnement-Sociétés (UMR SENS), Montpellier34398, France
| | - Anna Schlingmann
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
| | - Reinmar Seidler
- Department of Biology, University of Massachusetts, Boston, MA02215
| | | | - Priyatma Singh
- School of Science and Technology, University of Fiji, Saweni, Lautoka, Fiji
| | - Miquel Torrents-Ticó
- Helsinki Institute of Sustainability Science, University of Helsinki, HelsinkiFI-00014, Finland
- Global Change and Conservation, Organismal and Evolutionary Biology Research Programme, University of Helsinki, HelsinkiFI-00014, Finland
| | - Tungalag Ulambayar
- Zoological Society of London, Mongolia Representative Office, Ulaanbaatar14201, Mongolia
| | - Rihan Wu
- Department of Sociology and Anthropology, Peking University, Beijing100871, China
- Norwegian Institute for Cultural Heritage Research, Oslo0155, Norway
| | - Victoria Reyes-García
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona (ICTA-UAB), Cerdanyola del Vallès, Barcelona08193, Spain
- ICREA, Barcelona08010, Spain
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219
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Xu B, Clark WAV, Pak M. Homophily, selection, and choice in segregation models. Proc Natl Acad Sci U S A 2024; 121:e2313752121. [PMID: 38324571 PMCID: PMC10873625 DOI: 10.1073/pnas.2313752121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
Schelling's 1971 work on the dynamics of segregation showed that even a small degree of homophily, the desire to live among like neighbors, can lead to a starkly segregated population. One of the driving factors for this result is that the notion of homophily used is based on group identities that are exogenous and immutable. In contrast, we consider a homophily that arises from the desire to be with neighbors who are behaviorally similar, not necessarily those who have the same group identity. The distinction matters because behaviors are neither exogenous nor immutable but choices that can change as individuals adapt to their neighborhoods. We show that in such an environment, integration rather than segregation is the typical outcome. However, the tendency toward adaptation and integration can be impeded when economic frictions in the form of income inequality and housing cost are present.
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Affiliation(s)
- Bing Xu
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu, Sichuan610074, China
| | | | - Maxwell Pak
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu, Sichuan610074, China
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220
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Manyara AM, Mwaniki E, Gill JMR, Gray CM. Perceptions of diabetes risk and prevention in Nairobi, Kenya: A qualitative and theory of change development study. PLoS One 2024; 19:e0297779. [PMID: 38349938 PMCID: PMC10863861 DOI: 10.1371/journal.pone.0297779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/12/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Type 2 diabetes is increasing in Kenya, especially in urban settings, and prevention interventions based on local evidence and context are urgently needed. Therefore, this study aimed to explore diabetes risk and co-create a diabetes prevention theory of change in two socioeconomically distinct communities to inform future diabetes prevention interventions. METHODS In-depth interviews were conducted with middle-aged residents in two communities in Nairobi (one low-income (n = 15), one middle-income (n = 14)), and thematically analysed. The theory of change for diabetes prevention was informed by analysis of the in-depth interviews and the Behaviour Change Wheel framework, and reviewed by a sub-set (n = 13) of interviewees. RESULTS The key factors that influenced diabetes preventive practices in both communities included knowledge and skills for diabetes prevention, understanding of the benefits/consequences of (un)healthy lifestyle, social influences (e.g., upbringing, societal perceptions), and environmental contexts (e.g., access to (un)healthy foods and physical activity facilities). The proposed strategies for diabetes prevention included: increasing knowledge and understanding about diabetes risk and preventive measures particularly in the low-income community; supporting lifestyle modification (e.g., upskilling, goal setting, action planning) in both communities; identifying people at high risk of diabetes through screening in both communities; and creating social and physical environments for lifestyle modification (e.g., positive social influences on healthy living, access to healthy foods and physical activity infrastructure) particularly in the low-income community. Residents from both communities agreed that the strategies were broadly feasible for diabetes prevention but proposed the addition of door-to-door campaigns and community theatre for health education. However, residents from the low-income community were concerned about the lack of government prioritisation for implementing population-level interventions, e.g., improving access to healthy foods and physical activity facilities/infrastructure. CONCLUSION Diabetes prevention initiatives in Kenya should involve multicomponent interventions for lifestyle modification including increasing education and upskilling at individual level; promoting social and physical environments that support healthy living at population level; and are particularly needed in low-income communities.
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Affiliation(s)
- Anthony Muchai Manyara
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Department of Health Systems Management and Public Health, Technical University of Kenya, Nairobi, Kenya
- Global Health and Ageing Research Unit, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Mwaniki
- Department of Health Systems Management and Public Health, Technical University of Kenya, Nairobi, Kenya
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- School of Social and Political Sciences, University of Glasgow, Glasgow, United Kingdom
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221
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Silva AF, Dourado I, Lua I, Jesus GS, Guimarães NS, Morais GAS, Anderle RVR, Pescarini JM, Machado DB, Santos CAST, Ichihara MY, Barreto ML, Magno L, Souza LE, Macinko J, Rasella D. Income determines the impact of cash transfers on HIV/AIDS: cohort study of 22.7 million Brazilians. Nat Commun 2024; 15:1307. [PMID: 38346964 PMCID: PMC10861499 DOI: 10.1038/s41467-024-44975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Abstract
Living with extremely low-income is an important risk factor for HIV/AIDS and can be mitigated by conditional cash transfers. Using a cohort of 22.7 million low-income individuals during 9 years, we evaluated the effects of the world's largest conditional cash transfer, the Programa Bolsa Família, on HIV/AIDS-related outcomes. Exposure to Programa Bolsa Família was associated with reduced AIDS incidence by 41% (RR:0.59; 95%CI:0.57-0.61), mortality by 39% (RR:0.61; 95%CI:0.57-0.64), and case fatality rates by 25% (RR:0.75; 95%CI:0.66-0.85) in the cohort, and Programa Bolsa Família effects were considerably stronger among individuals of extremely low-income [reduction of 55% for incidence (RR:0.45, 95% CI:0.42-0.47), 54% mortality (RR:0.46, 95% CI:0.42-0.49), and 37% case-fatality (RR:0.63, 95% CI:0.51 -0.76)], decreasing gradually until having no effect in individuals with higher incomes. Similar effects were observed on HIV notification. Programa Bolsa Família impact was also stronger among women and adolescents. Several sensitivity and triangulation analyses demonstrated the robustness of the results. Conditional cash transfers can significantly reduce AIDS morbidity and mortality in extremely vulnerable populations and should be considered an essential intervention to achieve AIDS-related sustainable development goals by 2030.
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Affiliation(s)
- Andréa F Silva
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Inês Dourado
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Iracema Lua
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Gabriela S Jesus
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
- Faculty of Medicine, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Nathalia S Guimarães
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Gabriel A S Morais
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Rodrigo V R Anderle
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Julia M Pescarini
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Daiane B Machado
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Carlos A S T Santos
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Maria Y Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Mauricio L Barreto
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil
| | - Laio Magno
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
- Department of Life Sciences, State University of Bahia (UNEB), Salvador, Brazil
| | - Luis E Souza
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil
| | - James Macinko
- Departments of Health Policy and Management and Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Davide Rasella
- Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil.
- ISGlobal, Hospital Clinic - Universitat de Barcelona, Barcelona, Spain.
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He SL, Zhong Y, He WW. The impact of city size on income inclusive growth: A human capital perspective and evidence from China. PLoS One 2024; 19:e0288294. [PMID: 38346090 PMCID: PMC10861076 DOI: 10.1371/journal.pone.0288294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
This paper methodically investigates the influence of inclusive income growth on city size, examining it through the dual lenses of "income" and "distribution." The analysis leverages meticulously collected panel data encompassing 276 Chinese cities at the prefecture level and above, spanning the period from 2005 to 2019. Theoretical analysis indicates that the effect of city size expansion on per capita income adheres to a 'U'-shaped trajectory, while its influence on the urban-rural income gap manifests an 'inverted U' pattern. Moreover, the inclusive income growth stemming from city size demonstrates notable heterogeneity across various geographic locations and city hierarchies. The findings reveal that human capital serves as the primary mechanism through which city size influences inclusive income growth. After decomposing the income inclusiveness index, it becomes evident that the expansion of city size exerts a more potent direct driving effect on the income of urban residents. On the one hand, city size expansion directly increases rural residents' income levels by improving labor productivity. On the other hand, it facilitates leapfrog income development by inducing the rural labor force to move to cities.
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Affiliation(s)
- Shao-ling He
- School of Medical Humanities and Management, Hunan University of Medicine, Huaihua, Hunan, China
| | - Yuan Zhong
- School of Economics and Trade, Hunan University, Changsha, Hunan, China
| | - Wei-wei He
- School of Economics, Hunan University of Finance and Economics, Changsha, Hunan, China
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Bapolisi WA, Makelele J, Ferrari G, Kono-Tange L, Bisimwa G, Schindler C, Merten S. Engaging men in women's empowerment: impact of a complex gender transformative intervention on household socio-economic and health outcomes in the eastern democratic republic of the Congo using a longitudinal survey. BMC Public Health 2024; 24:443. [PMID: 38347559 PMCID: PMC10863082 DOI: 10.1186/s12889-024-17717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In the Democratic Republic of the Congo, women in (peri-)urban areas are commonly engaged in small trade, which allows them to meet the basic needs of their families. Microsaving approaches are a low-risk option to obtain financing for economic activities. A project combining men's sensitization on gender equity and women's empowerment through village savings and loan associations were implemented in North and South Kivu to raise the household economic level. OBJECTIVE This study assessed how involving men in gender equity affects women's health and socio-economic outcomes, including food security. METHODS A cohort study was conducted with 1812 women at the baseline; out of them 1055 were retrieved at the follow-up. Baseline data collection took place from May to December 2017 and the follow-up from July 2018 to January 2019. To identify socio-economic changes and changes of gender relations, linear and logistic regressions were run. RESULTS Results showed that the household income improved with intervention (coefficient = 0.327; p = 0.002), while the capacity to pay high bills without contracting debts decreased (coefficient = 0.927; p = 0.001). We did not find enough statistically significant evidence of the influence of the intervention on skilled birth attendance (coefficient = 0.943; p = 0.135), or family planning use (coefficient = 0.216; p = 0.435) nor women's participation in the decision-making (coefficient = 0.033; p = 0.227) nor on couple's cohesion (coefficient = 0.024; p = 0.431). Food insecurity levels decreased over time regardless of being in the intervention or control area. CONCLUSION Empowering women while sensitizing men on gender aspects improves financial well-being (income). Time, security, and strong politics of government recognizing and framing the approach are still needed to maximize the benefit of such projects on social factors such as women's participation in decision-making and social cohesion.
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Affiliation(s)
- Wyvine Ansima Bapolisi
- Université Catholique de Bukavu, Democratic Republic of the Congo, Bukavu, Sud-Kivu, Democratic Republic of the Congo.
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Jean Makelele
- CARE International, Goma, Democratic Republic of the Congo
| | - Giovanfrancesco Ferrari
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Ghislain Bisimwa
- Université Catholique de Bukavu, Democratic Republic of the Congo, Bukavu, Sud-Kivu, Democratic Republic of the Congo
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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224
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Gouveia AVDS, Carvalho REDS, Correia MEG, Silveira JACD. [Temporal trend in the prevalence of malnutrition in children under five assisted by the Brazilian Income Transfer Program (2008-2019)]. CAD SAUDE PUBLICA 2024; 40:e00180022. [PMID: 38359276 PMCID: PMC10876152 DOI: 10.1590/0102-311xpt180022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 07/15/2023] [Accepted: 09/29/2023] [Indexed: 02/17/2024] Open
Abstract
This study aimed to analyze the temporal trend of malnutrition in children aged under five years assisted by the Brazilian Income Transfer Program from 2008 to 2019, by exploring regional inequalities and seeking to determine the impact of the economic and political crises aggravated in 2014, and the government's adherence to fiscal austerity policies on the trend. The analyses were performed using aggregated data from infants (0-23 months) and preschoolers (24-59 months), extracted from the Brazilian Food and Nutritional Surveillance System (SISVAN) assisted by the Brazilian Income Transfer Program (n = 34,272,024). Trends were analyzed using generalized linear models with age-specific mixed effects (negative binomial distribution and log linkage function). The regional inequalities were analyzed based on the grouping of Federative Units according to the Social Vulnerability Index (SVI) and the influence of crises and austerity policies on the prevalence of malnutrition by the interaction between "year" and "crisis" (2008-2013 vs. 2014-2019). There was a reduction in the prevalence of child malnutrition until mid-2013, when the trends became stationary for preschoolers and upward for infants. There was also a higher risk of malnutrition in Federative Units with medium- and high-social vulnerability, when compared to those with low-social vulnerability. The inflection points in the trends corroborate the hypothesis that the political and economic crises, and the governmental responses to these crises, negatively impacted the nutritional status of children in poverty and extreme poverty in Brazil.
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225
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Birhanu F, Yitbarek K, Bobo FT, Atlantis E, Woldie M. Undernutrition in children under five associated with wealth-related inequality in 24 low- and middle- income countries from 2017 to 2022. Sci Rep 2024; 14:3326. [PMID: 38336795 PMCID: PMC10858243 DOI: 10.1038/s41598-024-53280-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Undernourishment is a persistent public health problem contributing to increased mortality in children under five in low-income countries, likely exacerbated by socio-economic disparities within communities. This paper aimed to examine the effect of wealth-related inequality on undernutrition in children under five in low, lower-middle, and upper-middle-income countries (LMICs). We analyzed cross-sectional data from the demographic and health survey program collected between 2017 and 2022 from 24 LMICs. Children born within 5 years preceding the survey were included in the analysis. Child undernutrition was the dependent variable (measured by stunting, wasting, and underweight) and country-level wealth-based inequality was the independent variable assessed by concentration index values stratified by the World Bank's income categories. Within country inequality of child undernutrition was determined by concentration index (C) values with 95% confidence intervals (95% CI) and sub-group analysis by place of residence and sex of the child. We then fit bootstrapped meta-regression to check the variation in inequality of child undernutrition across different income category countries. The analysis was controlled by potential confounding variables. From the total sample size of 334,502 children included in the study, 35% were undernourished. Wealth-related inequality in child undernutrition was observed in 11 countries, consistently across income categories. Child undernutrition was highly concentrated among the poor households of Türkiye [C: - 0.26, 95% CI - 0.31 to - 0.20], and Cameroon [C: - 0.19, 95% CI - 0.22 to - 0.17], and relatively it was less concentrated among the poor in Liberia [C: - 0.07, 95% CI - 0.11 to - 0.04], and Gambia [C: - 0.07, 95% CI - 0.11 to - 0.04]. There is no difference in undernutrition associated with inequality between the three broad LMIC categories. The wealth-related inequality in child undernutrition within many of the included countries is still very significant. However, the economic category of countries made no difference in explaining wealth-related inequality in child undernutrition. Inter-sectoral collaboration to fight poverty and render special attention to the disadvantaged population segments would potentially help to address the observed inequity.
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Affiliation(s)
- Frehiwot Birhanu
- School of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Amana, Ethiopia
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Kiddus Yitbarek
- Department of Health Policy and Management, Institute of Health, Jimma University, Jimma, Ethiopia.
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Firew Tekle Bobo
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
| | - Evan Atlantis
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Mirkuzie Woldie
- Fenot Project, School of Population and Public Health, University of British Columbia, Addis Ababa, Ethiopia
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226
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Macintyre AK, Shipton D, Sarica S, Scobie G, Craig N, McCartney G. Assessing the effects of population-level political, economic and social exposures, interventions and policies on inclusive economy outcomes for health equity in high- income countries: a systematic review of reviews. Syst Rev 2024; 13:58. [PMID: 38331910 PMCID: PMC10851517 DOI: 10.1186/s13643-023-02429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/11/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND A fairer economy is increasingly recognised as crucial for tackling widening social, economic and health inequalities within society. However, which actions have been evaluated for their impact on inclusive economy outcomes is yet unknown. OBJECTIVE Identify the effects of political, economic and social exposures, interventions and policies on inclusive economy (IE) outcomes in high-income countries, by systematically reviewing the review-level evidence. METHODS We conducted a review of reviews; searching databases (May 2020) EconLit, Web of Science, Sociological Abstracts, ASSIA, International Bibliography of the Social Sciences, Public Health Database, Embase and MEDLINE; and registries PROSPERO, Campbell Collaboration and EPPI Centre (February 2021) and grey literature (August/September 2020). We aimed to identify reviews which examined social, political and/or economic exposures, interventions and policies in relation to two IE outcome domains: (i) equitable distribution of the benefits of the economy and (ii) equitable access to the resources needed to participate in the economy. Reviews had to include primary studies which compared IE outcomes within or between groups. Quality was assessed using a modified version of AMSTAR-2 and data synthesised informed by SWiM principles. RESULTS We identified 19 reviews for inclusion, most of which were low quality, as was the underlying primary evidence. Most reviews (n = 14) had outcomes relating to the benefits of the economy (rather than access to resources) and examined a limited set of interventions, primarily active labour market programmes and social security. There was limited high-quality review evidence to draw upon to identify effects on IE outcomes. Most reviews focused on disadvantaged groups and did not consider equity impacts. CONCLUSIONS Review-level evidence is sparse and focuses on 'corrective' approaches. Future reviews should examine a diverse set of 'upstream' actions intended to be inclusive 'by design' and consider a wider range of outcomes, with particular attention to socioeconomic inequalities.
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Affiliation(s)
- Anna K Macintyre
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK.
| | - Deborah Shipton
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Shifa Sarica
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Graeme Scobie
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Neil Craig
- Place and Wellbeing, Public Health Scotland, Edinburgh, EH12 9EB, UK
| | - Gerry McCartney
- School of Social & Political Sciences, University of Glasgow, Glasgow, UK
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227
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Beltrán Ponce S, Gokun Y, Douglass F, Dawson L, Miller E, Thomas CR, Pitter K, Conteh L, Diaz DA. Disparities in outcomes and access to therapy options in hepatocellular carcinoma. J Natl Cancer Inst 2024; 116:264-274. [PMID: 37831897 DOI: 10.1093/jnci/djad213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/10/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) disproportionately impacts racial and ethnic minorities and patients with lower socioeconomic status. These social determinants of health (SDH) lead to disparities in access to care and outcomes. We aim to understand the relationship between SDH and survival and locoregional treatment options in HCC. METHODS Using the National Cancer Database, we evaluated survival and access locoregional treatments including non-transplant surgery, liver transplant (LT), and liver-directed radiation therapy (LDRT) in patients with HCC diagnosed between 2004 and 2017. Variables including clinical stage, age, sex, race, income, rurality, year of diagnosis, facility type (FT), Charlson-Deyo score (CD), and insurance were evaluated. Cox proportional hazards multivariable regression and dominance analyses were used for analyses. RESULTS In total, 140 340 patients were included. Worse survival was seen with advanced stage, older age, Black race, rurality, public insurance, treatment at a nonacademic center, and lower income. The top predictors for survival included stage, age, and income. Completion of non-transplant surgery was best predicted by stage, FT, and insurance type, whereas LT was predicted by age, year of diagnosis, and CD score. LDRT utilization was most associated with year of diagnosis, FT, and CD score. CONCLUSION For patients with HCC, survival was predicted primarily by stage, age, and income. The primary sociodemographic factors associated with access to surgical treatments, in addition to FT, were insurance and income, highlighting the financial burdens of health care. Work is needed to address disparities in access to care, including improved insurance access, addressing financial inequities and financial toxicities of treatments, and equalizing care opportunities in community centers.
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Affiliation(s)
- Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yevgeniya Gokun
- Secondary Data Core, Center for Biostatistics, The Ohio State University Wexner School of Medicine, Columbus, OH, USA
| | | | - Laura Dawson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Eric Miller
- Department of Radiation Oncology, The Ohio State University Wexner School of Medicine, The James Cancer Center, Columbus, OH, USA
| | - Charles R Thomas
- Department of Radiation Oncology, Dartmouth Geisel School of Medicine, Hanover, NH, USA
| | - Kenneth Pitter
- Department of Radiation Oncology, The Ohio State University Wexner School of Medicine, The James Cancer Center, Columbus, OH, USA
| | - Lanla Conteh
- Division of Hepatology, Department of Gastroenterology, The Ohio State University Wexner School of Medicine, Columbus, OH, USA
| | - Dayssy A Diaz
- Department of Radiation Oncology, The Ohio State University Wexner School of Medicine, The James Cancer Center, Columbus, OH, USA
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228
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Lammers N, Beese F, Hoebel J, Poethko-Müller C, Wachtler B. Social Inequalities in Long-Term Health Effects After COVID-19-A Scoping Review. Int J Public Health 2024; 69:1606739. [PMID: 38384747 PMCID: PMC10878999 DOI: 10.3389/ijph.2024.1606739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
Objectives: We aimed to map and synthesize evidence about social inequalities in long-term health effects after COVID-19 (LTHE), often referred to as "long COVID" or "post-COVID-19 conditions." Methods: We conducted a scoping review of peer-reviewed articles by searching the databases Embase and Scopus. According to predefined inclusion criteria, titles/abstracts and full texts were screened for eligibility. Additionally, reference lists of all included studies were hand-searched for eligible studies. This study followed the PRISMA guidelines for scoping reviews. Results: Nineteen articles were included. LTHE were analysed according to ethnicity, education, income, employment and deprivation indices. The studies varied significantly in their definitions of LTHE. Eighty-two analyses showed no statistically significant associations. At least 12 studies had a high risk of type II errors. Only studies associating deprivation indices and long COVID tended to show a higher prevalence of LTHE in deprived areas. Conclusion: Although some studies indicated social inequalities in LTHE, evidence was generally weak and inconclusive. Further studies with larger sample sizes specifically designed to detect social inequalities regarding LTHE are needed to inform future healthcare planning and public health policies.
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Affiliation(s)
| | | | | | | | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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229
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Perkins J, Nelson S, Birley E, Mcswiggan E, Dozier M, McCarthy A, Atkins N, Agyei-Manu E, Rostron J, Kameda K, Kelly A, Chandler C, Street A. Is qualitative social research in global health fulfilling its potential?: a systematic evidence mapping of research on point-of-care testing in low- and middle- income contexts. BMC Health Serv Res 2024; 24:172. [PMID: 38326871 PMCID: PMC10848363 DOI: 10.1186/s12913-024-10645-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Qualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs). METHODS We conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted. RESULTS One hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%). CONCLUSIONS A reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.
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Affiliation(s)
- Janet Perkins
- Department of Social Anthropology, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK.
| | - Sarah Nelson
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Emma Birley
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Emilie Mcswiggan
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Marshall Dozier
- Library Academic Support Team, Library & University Collections, and Information Services University of Edinburgh, Argyle House, 3 Lady Lawson Street, Edinburgh, EH3 9DR, Scotland, UK
| | - Anna McCarthy
- Department of Social Work, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK
| | - Nadege Atkins
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Eldad Agyei-Manu
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Jasmin Rostron
- Centre for Population Health Sciences, Old Medical School, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, UK
| | - Koichi Kameda
- Centre Population et Développement (CEPED), 45 Rue Des Saints-Pères, 75006, Paris, France
| | - Ann Kelly
- Department of Global Health and Social Medicine, King's College London, Bush House North East Wing, 30 Aldwych, London, WC2B 4BG, England, UK
| | - Clare Chandler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England, UK
| | - Alice Street
- Department of Social Anthropology, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15a George Square, Edinburgh, EH8 9LD, Scotland, UK
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Renneberg CK, Brund RBK, Heuckendorff S, Gunaseelan A, Kruse LV, Fonager K. Preschool children from lower household incomes experience inequality in asthma treatment: findings from a Danish nationwide cohort study. Eur J Public Health 2024; 34:85-90. [PMID: 37862429 PMCID: PMC10843934 DOI: 10.1093/eurpub/ckad187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The obligation to pay for asthma medication in a country with universal healthcare might lead to increased asthma exacerbations and inequitable healthcare access for children from low-income households. Thus, the aim of this study was to examine the association between household income and childhood/preschool asthma regarding hospitalization and medication receipt. METHODS In this nationwide register-based cohort study, we encompassed all 3-year-old children residing in Denmark, born between 2000 and 2014, along with their linked parents and followed them until their sixth birthday. Household income was divided into quartiles. Asthma was categorized in two mutually exclusive groups as either the redemption of two prescriptions for asthma medication or receiving a hospital diagnosis. We utilized Poisson regression to estimate the risk ratio (RR). RESULTS The analysis included 834 422 preschool children. The prevalence of asthma dependent on medication alone was 7.3%, while 1.8% of children necessitated asthma-related hospitalization. Income inequality was evident across all income quartiles. Notably, children from the lowest income quartile had a RR of 0.95 (95% CI: 0.92-0.98) of redeeming asthma medication and conversely a RR of 1.18 (95% CI: 1.14-1.23) of asthma-related hospitalization. CONCLUSIONS Despite universal healthcare, income inequality has a dual impact on children from low-income households. They face a diminished risk of redeeming asthma medication and a higher susceptibility to asthma-related hospitalizations indicating an unequal access to healthcare. Prioritizing efforts to reduce childhood health inequalities is crucial. However, further research, particularly qualitative studies, is needed to better comprehend the underlying mechanisms to address the complexities of income inequality.
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Affiliation(s)
| | | | - Signe Heuckendorff
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
- Psychiatry Region North Jutland, Aalborg, Denmark
| | - Artika Gunaseelan
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Lisbeth Venø Kruse
- Department of Paediatrics, Aalborg University Hospital, Aalborg, Denmark
| | - Kirsten Fonager
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Brown J, Hirsch JA, Tabb LP, Judd SE, Bennett A, Rundle A, Lovasi GS. A Segmented Regression Analysis of Household Income and Recurrent Falls Among Adults in a National Cohort Study. Am J Epidemiol 2024; 193:516-526. [PMID: 37939143 DOI: 10.1093/aje/kwad211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/22/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
Falls can have life-altering consequences for older adults, including extended recovery periods and compromised independence. Higher household income may mitigate the risk of falls by providing financial resources for mobility tools, remediation of environmental hazards, and needed supports, or it may buffer the impact of an initial fall on subsequent risk through improved assistance and care. Household income has not had a consistently observed association with falls in older adults; however, a segmented association may exist such that associations are attenuated above a certain income threshold. In this study, we utilized segmented negative binomial regression analysis to examine the association between household income and recurrent falls among 2,302 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study recruited between 2003 and 2007. Income-fall association segments separated by changes in slope were considered. Model results indicated a 2-segment association between household income and recurrent falls in the past year. In the range below the breakpoint, household income was negatively associated with the rate of recurrent falls across all age groups examined; in a higher income range (from $20,000-$49,999 to ≥$150,000), the association was attenuated (weaker negative trend) or reversed (positive trend). These findings point to potential benefits of ensuring that incomes for lower-income adults exceed the threshold needed to confer a reduced risk of recurrent falls.
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232
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Sturgis P, Brunton-Smith I, Allum N, Fuglsang S. Testing the cultural-invariance hypothesis: A global analysis of the relationship between scientific knowledge and attitudes to science. PLoS One 2024; 19:e0296860. [PMID: 38315694 PMCID: PMC10843117 DOI: 10.1371/journal.pone.0296860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/20/2023] [Indexed: 02/07/2024] Open
Abstract
A substantial body of research has demonstrated that science knowledge is correlated with attitudes towards science, with most studies finding a positive relationship between the two constructs; people who are more knowledgeable about science tend to be more positive about it. However, this evidence base has been almost exclusively confined to high and middle-income democracies, with poorer and less developed nations excluded from consideration. In this study, we conduct the first global investigation of the science knowledge-attitude relationship, using the 2018 Wellcome Global Monitor survey. Our results show a positive knowledge-attitude correlation in all but one of the 144 countries investigated. This robust cross-national relationship is consistent across both science literacy and self-assessed measures of science knowledge.
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Affiliation(s)
- Patrick Sturgis
- Department of Methodology, London School of Economics and Political Science, London, United Kingdom
| | - Ian Brunton-Smith
- Department of Sociology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Nick Allum
- Department of Sociology, University of Essex, Wivenhoe Park, Essex, United Kingdom
| | - Simon Fuglsang
- Department of Political Science, Aarhus University, Aarhus, Denmark
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Mudd AL, Bal M, Verra SE, Poelman MP, de Wit J, Kamphuis CBM. The current state of complex systems research on socioeconomic inequalities in health and health behavior-a systematic scoping review. Int J Behav Nutr Phys Act 2024; 21:13. [PMID: 38317165 PMCID: PMC10845451 DOI: 10.1186/s12966-024-01562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/14/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Interest in applying a complex systems approach to understanding socioeconomic inequalities in health is growing, but an overview of existing research on this topic is lacking. In this systematic scoping review, we summarize the current state of the literature, identify shared drivers of multiple health and health behavior outcomes, and highlight areas ripe for future research. METHODS SCOPUS, Web of Science, and PubMed databases were searched in April 2023 for peer-reviewed, English-language studies in high-income OECD countries containing a conceptual systems model or simulation model of socioeconomic inequalities in health or health behavior in the adult general population. Two independent reviewers screened abstracts and full texts. Data on study aim, type of model, all model elements, and all relationships were extracted. Model elements were categorized based on the Commission on Social Determinants of Health framework, and relationships between grouped elements were visualized in a summary conceptual systems map. RESULTS A total of 42 publications were included; 18 only contained a simulation model, 20 only contained a conceptual model, and 4 contained both types of models. General health outcomes (e.g., health status, well-being) were modeled more often than specific outcomes like obesity. Dietary behavior and physical activity were by far the most commonly modeled health behaviors. Intermediary determinants of health (e.g., material circumstances, social cohesion) were included in nearly all models, whereas structural determinants (e.g., policies, societal values) were included in about a third of models. Using the summary conceptual systems map, we identified 15 shared drivers of socioeconomic inequalities in multiple health and health behavior outcomes. CONCLUSIONS The interconnectedness of socioeconomic position, multiple health and health behavior outcomes, and determinants of socioeconomic inequalities in health is clear from this review. Factors central to the complex system as it is currently understood in the literature (e.g., financial strain) may be both efficient and effective policy levers, and factors less well represented in the literature (e.g., sleep, structural determinants) may warrant more research. Our systematic, comprehensive synthesis of the literature may serve as a basis for, among other things, a complex systems framework for socioeconomic inequalities in health.
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Affiliation(s)
- Andrea L Mudd
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands.
| | - Michèlle Bal
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Sanne E Verra
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN, Wageningen, the Netherlands
| | - John de Wit
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science- Public Health, Utrecht University, PO Box 80140, 3508 TC, Utrecht, The Netherlands
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234
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Huang P, Sun Z, Li L, Li J. Has the Integrated Medical Insurance System promoted return-to-hometown entrepreneurship among migrant workers? Evidence from China. Front Public Health 2024; 12:1323359. [PMID: 38371234 PMCID: PMC10870983 DOI: 10.3389/fpubh.2024.1323359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/09/2024] [Indexed: 02/20/2024] Open
Abstract
An important way to reduce urban-rural disparity lies in encouraging migrant workers to return to their hometowns for entrepreneurship. This paper examines the effect of the Integrated Medical Insurance System on the return-to-hometown entrepreneurship among migrant workers. Using microdata from the China Household Finance Survey (CHFS) spanning from 2013 to 2019, we find that the Integrated Medical Insurance System (IMIS) significantly increases the likelihood of migrant workers returning to their hometowns for entrepreneurship by 0.44%. This result remains stable after a series of robustness checks. Heterogeneity results indicate that this "pullback effect" is more pronounced for those who are male and with lower educational levels, higher income, larger social networks, and lower risk preferences. Finally, the interaction between the Mass Entrepreneurship and Innovation policy (MEI) and IMIS can create a more significant combined effect in promoting the return of migrant workers to their hometowns for entrepreneurial activities.
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Affiliation(s)
- Pengcheng Huang
- School of Finance, Anhui University of Finance and Economics, Bengbu, China
| | - Zhengxiu Sun
- School of Economics and Management, Southeast University, Nanjing, China
| | - Linfang Li
- Jinan No.1 High School in Shandong Province, Jinan, China
| | - Jia Li
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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235
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Vo DH. Does institutional quality matter for financial inclusion? International evidence. PLoS One 2024; 19:e0297431. [PMID: 38306358 PMCID: PMC10836707 DOI: 10.1371/journal.pone.0297431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 01/04/2024] [Indexed: 02/04/2024] Open
Abstract
Financial inclusion is pivotal in supporting sustainable economic growth and social transformation. It is a key enabler for reducing poverty and uplifting prosperity. Improving financial inclusion has attracted significant attention from practitioners, academics, and governments. However, the asymmetric effect of institutional quality on financial inclusion contingent upon the income level has largely been neglected in the existing literature. As such, this study examines this asymmetric effect using the panel smooth transition regression for a sample of 110 countries globally from 2004 to 2020. Our empirical findings confirm the asymmetric effect of institutional quality on financial inclusion depending on the income level. Improved institutional quality is associated with extended financial inclusion in high-income and middle-income countries. However, low-income countries may not benefit from their institutional reform. Policy implications have emerged based on these empirical findings.
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Affiliation(s)
- Duc Hong Vo
- Research Centre in Business, Economics & Resources, Ho Chi Minh City Open University Vietnam, Ho Chi Minh City, Vietnam
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236
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Huang S, Yang L, Yang C, Wang D, Li Y. Obscuring effect of income inequality and moderating role of financial literacy in the relationship between digital finance and China's household carbon emissions. J Environ Manage 2024; 351:119927. [PMID: 38176388 DOI: 10.1016/j.jenvman.2023.119927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/24/2023] [Accepted: 12/23/2023] [Indexed: 01/06/2024]
Abstract
Households have emerged as one of the primary sources for carbon emissions in China, thus posing challenges to the "dual carbon" objectives. Digital finance, an emergent form of industry that fused advanced technology with financial services, had a pronounced impact on household carbon emissions stemming from daily consumption. However, the mechanisms driving this impact have not been adequately examined. Based on micro-level household survey data across 25 Chinese provinces from 2012, 2014, 2016, and 2018, the study identified the chief channels via which digital finance affected household carbon emissions, deriving several key findings. First, digital finance augmented household carbon emissions, presenting a significant negative impact on the climate. Second, due to the existence of "digital divide" between rural and urban areas, the impact of digital finance was more subdued in rural areas. Additionally, the effects of digital finance were more pronounced in the affluent eastern provinces. Third, income mobility obscured the positive relationship between digital finance and household carbon emissions. This is primarily attributed to the urban-rural divide in China; taking into account that urban-to-rural transfers make income distribution more equitable, there is a counterintuitive drop in per capita consumption, thereby suppressing consumption-related carbon emissions. This presented the conundrum of "income distribution equality-consumption negativity". Finally, financial literacy was identified as a crucial positive moderating role, enabling households with high financial literacy to harness the dividends of digital finance, thereby engaging in more diversified consumption activities and intensifying the negative impact of digital finance on carbon emissions. The findings reinforced the pivotal role of digital finance in bolstering efforts to combat climate change and ensuring environmentally-responsible economic advancements.
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Affiliation(s)
- Simin Huang
- School of Economics and Management, Inner Mongolia University, 010021, Inner Mongolia, China; Inner Mongolia Institute for Energy and carbon neutrality strategy, Inner Mongolia University, Hohhot, 010021, China
| | - Lin Yang
- School of Economics and Management, Inner Mongolia University, 010021, Inner Mongolia, China; Inner Mongolia Institute for Energy and carbon neutrality strategy, Inner Mongolia University, Hohhot, 010021, China.
| | - Chen Yang
- School of Economics and Management, Inner Mongolia University, 010021, Inner Mongolia, China; Inner Mongolia Institute for Energy and carbon neutrality strategy, Inner Mongolia University, Hohhot, 010021, China
| | - Donghan Wang
- School of Economics and Management, Communication University of China, Beijing, 100024, China.
| | - Yiming Li
- School of Economics and Management, Inner Mongolia University, 010021, Inner Mongolia, China; Inner Mongolia Institute for Energy and carbon neutrality strategy, Inner Mongolia University, Hohhot, 010021, China
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237
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Ulucak R, Danish, Zhang Y, Chen R, Qiu Y. Income Inequality, Economic Complexity, and Renewable Energy Impacts in Controlling Consumption-Based Carbon Emissions. Eval Rev 2024; 48:119-142. [PMID: 37154303 DOI: 10.1177/0193841x231173766] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Although many studies have been conducted on the role of renewable energy in the environment, literature has ignored the potential role of socioeconomic indicators in renewable energy and pollution nexus. Also, critical questions arose with the critical factors, such as income inequality and economic complexity, have not been answered properly. This study explores the nexus between income inequality, economic complexity, renewable energy consumption, GDP per capita, and pollution and thus aims to reach efficient policy strategies by revealing empirical evidence. The study follows an environmental impact model structure and conducts the panel-corrected standard errors and fixed effect regression. BRICS countries (Brazil, Russia, India, China, and South Africa) are selected to conduct our research. Annual data covering the period 1990-2017 for the sample countries are employed. Consumption-based carbon dioxide emissions as an indicator of environmental pollution are used since income inequality makes more sense in terms of the consumption side of an economy and is more related to consumers rather than the production sector. The obtained results reveal that income inequality has a positive and significant impact on consumption-based carbon dioxide emissions. However, GDP per capita, renewable energy, and economic complexity reduce pollution. It is also observed that the interaction term of inequality and renewable energy decreases emissions. Findings confirm that socioeconomic indicators, such as economic complexity and income inequality with the interaction of renewable energy, are crucial factors in reducing emissions and designing a greener future.
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Affiliation(s)
- Recep Ulucak
- Department of Economics, Faculty of Economics and Administrative Sciences, Erciyes University, Kayseri, Turkey
| | - Danish
- School of Economics and Trade, Guangdong University of Foreign Studies, Guangzhou, China
| | - Yaoqi Zhang
- School of Forestry and Wildlife Sciences, Auburn University, Auburn, Alabama, USA
| | - Rui Chen
- Agricultural and Resource Economics College of Agriculture, Environment and Nutrition Sciences, Tuskegee University, Tuskegee, Alabama, USA
| | - Yiting Qiu
- School of Economics and Trade, Guangdong University of Foreign Studies, Guangzhou, China
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238
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Issa J, Wouterse B, Milkovska E, van Baal P. Quantifying income inequality in years of life lost to COVID-19: a prediction model approach using Dutch administrative data. Int J Epidemiol 2024; 53:dyad159. [PMID: 38081182 PMCID: PMC10859130 DOI: 10.1093/ije/dyad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/09/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Low socioeconomic status and underlying health increase the risk of fatal outcomes from COVID-19, resulting in more years of life lost (YLL) among the poor. However, using standard life expectancy overestimates YLL to COVID-19. We aimed to quantify YLL associated with COVID-19 deaths by sex and income quartile, while accounting for the impact of individual-level pre-existing health on remaining life expectancy for all Dutch adults aged 50+. METHODS Extensive administrative data were used to model probability of dying within the year for the entire 50+ population in 2019, considering age, sex, disposable income and health care use (n = 6 885 958). The model is used to predict mortality probabilities for those who died of COVID-19 (had they not died) in 2020. Combining these probabilities in life tables, we estimated YLL by sex and income quartile. The estimates are compared with YLL based on standard life expectancy and income-stratified life expectancy. RESULTS Using standard life expectancy results in 167 315 YLL (8.4 YLL per death) which is comparable to estimates using income-stratified life tables (167 916 YLL with 8.2 YLL per death). Considering pre-existing health and income, YLL decreased to 100 743, with 40% of years lost in the poorest income quartile (5.0 YLL per death). Despite individuals in the poorest quartile dying at younger ages, there were minimal differences in average YLL per COVID-19 death compared with the richest quartile. CONCLUSIONS Accounting for prior health significantly affects estimates of YLL due to COVID-19. However, inequality in YLL at the population level is primarily driven by higher COVID-19 deaths among the poor. To reduce income inequality in the health burden of future pandemics, policies should focus on limiting structural differences in underlying health and exposure of lower income groups.
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Affiliation(s)
- Jawa Issa
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Bram Wouterse
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Elena Milkovska
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter van Baal
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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239
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Pestana J, Frutuoso J, Costa E, Fonseca F. Heterogeneity in physician's job preferences in a dual practice context - Evidence from a DCE. Soc Sci Med 2024; 343:116551. [PMID: 38242030 DOI: 10.1016/j.socscimed.2023.116551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/26/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
Many countries are facing challenges in recruiting and retaining physicians, particularly in regions where the public and private sectors compete for doctors. Understanding the factors influencing physicians' job choices can help inform policies aimed at attracting and retaining this valuable workforce. This study aims to elicit the strength of physicians' preferences regarding various job-related aspects, including earnings, time flexibility, discussion of clinical cases, frequency of facilities and equipment updates, training opportunities and autonomy in decision making. To achieve this, a Discrete Choice Experiment (DCE) was administered to 697 physicians. Each participant completed a series of eight choice tasks, where they had to choose between two hypothetical jobs differing in these attributes with levels mirroring positions in the public and private sectors in Portugal. The resulting choices were analysed using mixed logit, generalized multinomial logit and latent classes models to account for diverse unobserved variations in physicians' preferences and to explore preference heterogeneity across different observable characteristics. Jobs that offered more autonomy and training opportunities were strongly preferred, as physicians would require additional compensation to work with reduced autonomy (equivalent to 28.62% of gross income) or less frequent training (equivalent to 22.75%). This study also shows that the ranking of the job characteristics is similar between physicians working exclusively in the public sector and those engaged in dual practice. Nevertheless, public sector physicians place more emphasis on the availability of frequent training possibilities and frequent updates of facilities and equipment compared to their counterparts in dual practice. These findings contribute to existing knowledge by highlighting the significance of non-monetary attributes and shedding light on the preferences of physicians across various employment scenarios. They offer valuable insights for policy development aimed at influencing physicians' allocation of time between sectors.
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Affiliation(s)
- Joana Pestana
- Nova School of Business and Economics, Lisbon, Portugal.
| | - João Frutuoso
- Serviço de Medicina Intensiva do Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Eduardo Costa
- Nova School of Business and Economics, Lisbon, Portugal
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240
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McCoy D, Kapilashrami A, Kumar R, Rhule E, Khosla R. Developing an agenda for the decolonization of global health. Bull World Health Organ 2024; 102:130-136. [PMID: 38313156 PMCID: PMC10835633 DOI: 10.2471/blt.23.289949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 02/06/2024] Open
Abstract
Colonialism, which involves the systemic domination of lands, markets, peoples, assets, cultures or political institutions to exploit, misappropriate and extract wealth and resources, affects health in many ways. In recent years, interest has grown in the decolonization of global health with a focus on correcting power imbalances between high-income and low-income countries and on challenging ideas and values of some wealthy countries that shape the practice of global health. We argue that decolonization of global health must also address the relationship between global health actors and contemporary forms of colonialism, in particular the current forms of corporate and financialized colonialism that operate through globalized systems of wealth extraction and profiteering. We present a three-part agenda for action that can be taken to decolonize global health. The first part relates to the power asymmetries that exist between global health actors from high-income and historically privileged countries and their counterparts in low-income and marginalized settings. The second part concerns the colonization of the structures and systems of global health governance itself. The third part addresses how colonialism occurs through the global health system. Addressing all forms of colonialism calls for a political and economic anticolonialism as well as social decolonization aimed at ensuring greater national, racial, cultural and knowledge diversity within the structures of global health.
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Affiliation(s)
- David McCoy
- International Institute for Global Health, United Nations University, Hospital Canselor Tuanku Muhriz UKM, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000Kuala Lumpur, Malaysia
| | - Anuj Kapilashrami
- School of Health and Social Care, Essex University, Colchester, England
| | - Ramya Kumar
- Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Emma Rhule
- International Institute for Global Health, United Nations University, Hospital Canselor Tuanku Muhriz UKM, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000Kuala Lumpur, Malaysia
| | - Rajat Khosla
- International Institute for Global Health, United Nations University, Hospital Canselor Tuanku Muhriz UKM, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000Kuala Lumpur, Malaysia
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241
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Lin K, Zhou YM, Ma HP, He F, Huang XN, Tian XB, Zheng Y, Sun J. Quality of childcare and delayed child development in left-behind children in China. Pediatr Res 2024; 95:809-818. [PMID: 37845526 PMCID: PMC10899099 DOI: 10.1038/s41390-023-02840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Inequalities in job opportunities and income prompts many Chinese parents to leave rural regions to work in urban regions. Their children are left behind in rural regions, subjected to worse quality of childcare that jeopardizes their development. This study aimed to examine the association between quality of childcare and delayed child development in under-three years children left behind in China. METHODS Cross-sectional national survey was conducted in children left behind in rural China in 2017. Exploratory and confirmatory factor analysis was used to develop a quality of childcare index. Mutlilevel analyses determined factors associated with quality of childcare and child development on a province and individual level. RESULT The largest population of at-risk children left behind were found in higher-GDP provinces. Children left behind had the lowest mean quality of childcare score. Multilevel analysis found that province level accounted for a great proportion of variance observed. CONCLUSIONS While migration to urban regions for work may improve household income, a trade-off in worse quality of childcare and developmental delays exists. With improving household income often being the greatest contributing factor for parental migration, policies to reduce inequalities in job opportunities and wealth between rural and urban regions are required. IMPACT Previous studies identified higher prevalence of developmental delays in children left behind in China. However, quality of childcare has not been examined. Based on WHO's Nurturing Care Framework, we developed a quality of childcare index to assess its association with child development in children left behind. Greatest proportion of children left behind at-risk of developmental delays resided in higher-GDP states, indicating a trade-off in worse quality of childcare and developmental delays. Since improving household income is the main factor for parental migration, policies to close inequalities in job opportunities and wealth between rural and urban regions are required.
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Affiliation(s)
- Kelly Lin
- Institute of Integrated Intelligence and Systems, and School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Yu-Ming Zhou
- Beijing Anding Hospital, Capital Medical University & The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
| | - Hai-Ping Ma
- Youfu Hospital of Binzhou City, No. 585, Changjiang 1st Road, Bincheng District, Binzhou City, Shandong Province, People's Republic of China
| | - Fan He
- Beijing Anding Hospital, Capital Medical University & The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
| | - Xiao-Na Huang
- United Nations Children's Fund (UNICEF China Office), Beijing, People's Republic of China
| | - Xiao-Bo Tian
- United Nations Children's Fund (UNICEF China Office), Beijing, People's Republic of China
| | - Yi Zheng
- Beijing Anding Hospital, Capital Medical University & The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
| | - Jing Sun
- Institute of Integrated Intelligence and Systems, and School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia.
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242
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Nilsson AH, Eichstaedt JC, Lomas T, Schwartz A, Kjell O. The Cantril Ladder elicits thoughts about power and wealth. Sci Rep 2024; 14:2642. [PMID: 38302578 PMCID: PMC10834405 DOI: 10.1038/s41598-024-52939-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/03/2024] Open
Abstract
The Cantril Ladder is among the most widely administered subjective well-being measures; every year, it is collected in 140+ countries in the Gallup World Poll and reported in the World Happiness Report. The measure asks respondents to evaluate their lives on a ladder from worst (bottom) to best (top). Prior work found Cantril Ladder scores sensitive to social comparison and to reflect one's relative position in the income distribution. To understand this, we explored how respondents interpret the Cantril Ladder. We analyzed word responses from 1581 UK adults and tested the impact of the (a) ladder imagery, (b) scale anchors of worst to best possible life, and c) bottom to top. Using three language analysis techniques (dictionary, topic, and word embeddings), we found that the Cantril Ladder framing emphasizes power and wealth over broader well-being and relationship concepts in comparison to the other study conditions. Further, altering the framings increased preferred scale levels from 8.4 to 8.9 (Cohen's d = 0.36). Introducing harmony as an anchor yielded the strongest divergence from the Cantril Ladder, reducing mentions of power and wealth topics the most (Cohen's d = -0.76). Our findings refine the understanding of historical Cantril Ladder data and may help guide the future evolution of well-being metrics and guidelines.
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Affiliation(s)
- August Håkan Nilsson
- Department of Psychology, Lund University, Lund, Sweden.
- Oslo Business School, Oslo Metropolitan University, Oslo, Norway.
| | - Johannes C Eichstaedt
- Department of Psychology, Institute for Human-Centered A.I., Stanford University, Stanford, CA, USA
| | - Tim Lomas
- Department of Epidemiology, Harvard University, Cambridge, USA
| | - Andrew Schwartz
- Department of Computer Science, Stony Brook University, Stony Brook, NY, USA
| | - Oscar Kjell
- Department of Psychology, Lund University, Lund, Sweden
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243
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Gugushvili A. The heterogeneous well-being effects of intergenerational mobility perceptions. J Health Psychol 2024; 29:99-112. [PMID: 37466150 DOI: 10.1177/13591053231187345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Individuals make comparisons with their parents which determine their intergenerational mobility perceptions, yet very little is known about the areas used for intergenerational comparison and whether these matter for individuals' well-being. In 2021 we commissioned a nationally representative survey in Georgia in which we explicitly asked 1159 individuals an open-ended question on the most important areas in their intergenerational comparisons. More than 170 types of answers were provided by respondents and many of these responses went beyond the standard indicators of intergenerational mobility. We show that the areas of intergenerational comparison significantly differ between those who perceive themselves as being downwardly and upwardly mobile or immobile using the measure of mobility previously validated in cross-national research. Using, among other statistical approaches, treatment effects estimators, we demonstrate that some areas of intergenerational comparison, particularly in terms of income attainment, are significantly and consistently associated with internationally validated measures of well-being.
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244
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Garrido MM, Dorneo A, Adelberg M, Biko D, Shafer PR, Frakt AB. Potential inequities in access to in-person SHIP counseling services. Am J Manag Care 2024; 30:e46-e51. [PMID: 38381548 DOI: 10.37765/ajmc.2024.89500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Counseling and education on Medicare coverage options are available through the federal State Health Insurance Assistance Program (SHIP), but little is known about the population that SHIP reaches. STUDY DESIGN Cross-sectional study. METHODS Using a novel data source on SHIP counseling site locations, we characterized the availability of in-person SHIP counseling by zip code tabulation area (ZCTA) and used linear regression and t tests to evaluate whether SHIP counseling sites are disproportionately located in higher-income communities. RESULTS Our sample included 1511 SHIP counseling sites. More than half (63%) of the localities in our sample have a SHIP site within the ZCTA or county. Twenty-four percent do not have a SHIP site within the county but have one in an adjacent county. The remaining 13% do not have a nearby SHIP site. There is a disproportionate number of individuals eligible for Medicare in localities without a SHIP site. Moreover, the population living in areas without in-person SHIP sites is more likely to have low income and fewer years of education than the population living in areas with a SHIP site. CONCLUSIONS These results suggest that there are areas where in-person SHIP service expansion or other additional navigation support may be warranted.
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Affiliation(s)
- Melissa M Garrido
- Boston University School of Public Health, Talbot 2W, 715 Albany St, Boston, MA 02118.
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245
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Gatto A, Chepeliev M. Global food loss and waste estimates show increasing nutritional and environmental pressures. Nat Food 2024; 5:136-147. [PMID: 38287151 DOI: 10.1038/s43016-023-00915-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024]
Abstract
Accurate global food losses and waste (FLW) quantification remains challenging owing to limited harmonized global estimates, a lack of comprehensive quantification approaches and an absence of frameworks for addressing FLW challenges. Here we compile a country-level database that assesses FLW across global value chains and quantifies the nutritional and environmental impact of FLW for 121 countries and 20 composite regions. Between 2004 and 2014, FLW increased by a quarter, especially in sub-Saharan Africa and Southeast Asia, where increasing nutritional losses of ~550 cal per capita per day impact food security. Growing food imports in high-income countries and fast-growing economies worsened FLW and related environmental footprints in exporting low-income regions. Reducing overconsumption and FLW in high-income countries may have positive effects in middle- and low-income countries, where food exports largely drive farm-level losses. Policies should focus on promoting the profitable reuse of unavoidable FLW while enhancing agricultural production efficiency to improve water use and nutritional security.
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Affiliation(s)
- Alessandro Gatto
- Department of Agricultural Economics and Rural Policy, Wageningen University and Wageningen Economic Research, Wageningen, The Netherlands.
| | - Maksym Chepeliev
- Center for Global Trade Analysis, Department of Agricultural Economics, Purdue University, West Lafayette, IN, USA.
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246
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Qamar W. Dental health in the shadows of global commitments: Addressing neglected priorities in lower middle- income countries. J PAK MED ASSOC 2024; 74:413-414. [PMID: 38419252 DOI: 10.47391/jpma.10750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
I am writing to draw your attention to a serious concern that requires our attention around global health commitments: the frequently disregarded and undervalued dental reforms. In the realm of global health commitments, dental reforms are often ignored and underestimated. (1) Despite significant advancements in many other facets of health owing to these commitments, dental health remains marginalized within its sphere creating a glaring disparity, especially in lower middle-income countries where it’s a crucial concern.(2)
Dental health has a significant impact on a person's quality of life in addition to preventing oral diseases. It has a significant impact on a person's quality of life, having an impact on their mental and physical well-being. Neglected oral health can affect speech, self-esteem, and psychosocial wellbeing as well as cause pain, infections, malnutrition, and systemic health problems.(3) The disruptive relationship between oral diseases and significant medical conditions like diabetes, cardiovascular disease, and adverse pregnancy outcomes emphasizes the complex relationship between dental health and overall health.
Despite efforts to promote understanding, such as Universal Health Coverage (UHC) and the International Health Regulations (IHR), oral health is often disregarded in global discussion. Particularly in lower middle-income countries, oral health is neglected due to a lack of tailored interventions, which decreases its significance. A significant leap forward has been made with the recent World Health Organization (WHO) resolution that declares oral health a global priority and calls for its inclusion in national strategies. The WHO has acknowledged the need to address this problem immediately.(4) The challenge, however, is recognition into concrete, commitment-backed activities and specific interventions. The resolution has potential, but its effectiveness will be judged by the concrete measures taken to bridge the gaps.
The Sustainable Development Goals (SDGs) offer a potential reference point for rectifying this gap. By integrating oral health in SDGs like Goal 3 on excellent health and well-being, a holistic approach may be taken. This integration could help bridge the gap between international commitments, raise the public's awareness of oral health, and foster tailored initiatives for dental reforms.
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Affiliation(s)
- Wajiha Qamar
- Department of Oral Biology, Bacha Khan College of Dentistry, Mardan, Pakistan
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Hernandez AE, Westrick AC, Stoler J, Kesmodel SB, Pinheiro PS, Figueroa ME, Kobetz EN, Rebbeck T, Goel N. ASO Visual Abstract: Associations Between Neighborhood-Level Income and Triple-Negative Breast Cancer in a Majority-Minority Population. Ann Surg Oncol 2024; 31:1029-1030. [PMID: 38071707 DOI: 10.1245/s10434-023-14666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Alexandra E Hernandez
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ashly C Westrick
- Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI, USA
| | - Justin Stoler
- Department of Geography and Sustainable Development, University of Miami, Coral Gables, FL, USA
- Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan B Kesmodel
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Maria E Figueroa
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biochemistry and Molecular Biology Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Erin N Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
- Division of Computational Medicine and Population Health, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Timothy Rebbeck
- Harvard T. H. Chan School of Public Health and Dana-Farber Cancer Institute, Boston, MA, USA
| | - Neha Goel
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
- Harvard T. H. Chan School of Public Health and Dana-Farber Cancer Institute, Boston, MA, USA.
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248
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Noghanibehambari H, Fletcher J. Dust to Feed, Dust to Gray: The Effect of in Utero Exposure to the Dust Bowl on Old-Age Longevity. Demography 2024; 61:87-113. [PMID: 38214503 DOI: 10.1215/00703370-11140760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Intensive agriculture and deep plowing caused topsoil erosion and dust storms during the 1930s, affecting agricultural income and land values for years. Given the growing literature on the relevance of in utero and early-life exposures, it is surprising that studies focusing on links between the Dust Bowl and later-life health have produced inconclusive and mixed results. We reevaluate this literature and study the long-term effects of in utero and early-life exposure to topsoil erosion caused by the 1930s Dust Bowl on old-age longevity. Specifically, using Social Security Administration death records linked with the full-count 1940 census, we conduct event studies with difference-in-differences designs to compare the longevity of individuals in high- versus low-topsoil-erosion counties before versus after 1930. We find intent-to-treat reductions in longevity of approximately 0.85 months for those born in high-erosion counties after 1930. We show that these effects are not an artifact of preexisting trends in longevity. Additional analyses suggest that the effects are more pronounced among children raised in farm households, females, and those whose mothers had lower education. We also provide suggestive evidence that reductions in adulthood income are a likely mechanism for the effects we document.
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Affiliation(s)
| | - Jason Fletcher
- La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA
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249
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Holland MR, Noordegraaf R, DaCosta J, Guan TH. Moving on income as a social determinant of health: free transit for social assistance recipients in Kingston, Ontario. Can J Public Health 2024; 115:111-116. [PMID: 37787928 PMCID: PMC10868560 DOI: 10.17269/s41997-023-00816-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/18/2023] [Indexed: 10/04/2023]
Abstract
SETTING The public health intervention setting is the City of Kingston, Ontario, Canada. The authors were involved in various stages of development of the intervention, including advocacy, design, implementation, and evaluation. INTERVENTION In early 2017, the City of Kingston launched a pilot program to offer all recipients of social assistance a pass that would provide unlimited access to transit. The 1-year pilot program showed promise in terms of the objectives of the two departments involved, Housing and Social Services and Kingston Transit, as it reduced barriers to transportation and increased ridership in the city. The pilot was adopted as an ongoing program, The Ontario Works Universal Transit Pass, upon completion of the pilot. The program was funded by redirecting provincial means-tested and discretionary employment benefits from the Housing and Social Services budget to the Kingston Transit budget in order to purchase transit in bulk for Ontario Works (OW) recipients. OUTCOMES The program provided greater access to essential services, increased household budgets, reduced stigma, and increased ridership. The improved social and economic opportunities that the program facilitated demonstrate the potential of addressing social determinants of health through transportation. IMPLICATIONS The program illustrates an effective model for addressing income as a social determinant of health through transportation policy. Moreover, it demonstrates the potential for creative, cooperative approaches to inter/intra-government operations-like the transfer of funds from Housing and Social Services to Kingston Transit-which simultaneously promotes both greater efficacy of public services and health equity.
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Affiliation(s)
| | - Ruth Noordegraaf
- Housing and Social Services, City of Kingston, Kingston, ON, Canada
| | - Jeremy DaCosta
- Transportation Services, City of Kingston, Kingston, ON, Canada
| | - T Hugh Guan
- Kingston, Frontenac, Lanark, and Addington (KFL&A) Public Health Unit, Kingston, ON, Canada
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250
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Chen YL, Li DJ, Chen YY, Yen CF. The impact of housing-price-related indices on suicide rates in Taiwan. Int J Soc Psychiatry 2024; 70:40-47. [PMID: 37665194 DOI: 10.1177/00207640231194484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND While certain socioeconomic factors have been studied in relation to suicide, housing-price-related indexes have rarely been investigated. AIMS This article aims to examine the impact of housing-price-related indexes on suicide rates in the general population of Taiwan, a country with high housing costs and suicide rates. METHODS The study utilized three national housing-price-related indexes from 2012 to 2019: (1) housing price index, (2) housing price to income ratio, and (3) housing rental index. Cause of Death Data was employed to calculate suicide rate. A linear regression model with autoregressive errors was used to analyze the association between housing-price-related indexes and suicide rates among different sex and age groups. RESULTS The findings revealed that higher housing rental index values were associated with increased suicide rates in young and middle-aged adults compared to the elderly population, regardless of sex. However, this association was not observed with the other two housing-price-related indexes (i.e. housing price index and housing price to income ratio). CONCLUSION These results offer valuable insights for policymakers, mental health professionals, and housing advocates to improve housing affordability and reduce the burden of suicide in the general population, particularly among younger generations.
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Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung
- Department of Healthcare Administration, Asia University, Taichung
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung
- Department of Nursing, Meiho University, Pingtung
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung
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