Physiological stress responses to inequality across income groups in a virtual society

Socioeconomic status (SES) and cognitive outcomes are predicted by resting-state EEG in school-aged children

Children's socioeconomic status (SES) is related to patterns of intrinsic resting-state brain function that subserve relevant cognitive processes over the course of development. Although infant research has demonstrated the association between children's environments, cognitive outcomes, and resting-state electroencephalography (rsEEG), it remains unknown how these aspects of their environment, tied to SES, impact neural and cognitive development throughout the school years. To address this gap, we applied a multivariate pattern analysis (MVPA) to rsEEG data to identify which neural frequencies at rest are differentially associated with unique aspects of socioeconomic status (SES; income and maternal education) and cognitive (vocabulary, working memory) outcomes among school-aged children (8-15 years). We find that the alpha frequency is associated with both income and maternal education, while lower gamma and theta fluctuations are tied to dissociable aspects of SES and cognitive outcomes. Specifically, changes in the gamma frequency are predictive of both maternal education and vocabulary outcome, while changes in the theta frequency are related to both income and working memory ability. The current findings extend our understanding of unique pathways by which SES influences cognitive and neural development in school-aged children.

The relationship between neighborhood economic deprivation and community-acquired pneumonia related admissions in Maryland

Introduction

Community-acquired pneumonia (CAP) is a major health concern in the United States (US), with its incidence, severity, and outcomes influenced by social determinants of health, including socioeconomic status. The impact of neighborhood socioeconomic status, as measured by the Distressed Communities Index (DCI), on CAP-related admissions remains understudied in the literature.

Objective

To determine the independent association between DCI and CAP-related admissions in Maryland.

Methods

We conducted a retrospective study using the Maryland State Inpatient Database (SID) to collate data on CAP-related admissions from January 2018 to December 2020. The study included adults aged 18-85 years. We explored the independent association between community-level economic deprivation based on DCI quintiles and CAP-related admissions, adjusting for significant covariates.

Results

In the study period, 61,467 cases of CAP-related admissions were identified. The patients were predominantly White (49.7%) and female (52.4%), with 48.6% being over 65 years old. A substantive association was found between the DCI and CAP-related admissions. Compared to prosperous neighborhoods, patients living in economically deprived communities had 43% increased odds of CAP-related admissions.

Conclusion

Residents of the poorest neighborhoods in Maryland have the highest risk of CAP-related admissions, emphasizing the need to develop effective public health strategies beneficial to the at-risk patient population.

Income inequality and deaths of despair risk in Canada, identifying possible mechanisms

BACKGROUND

Declines in life expectancy in developed countries have been attributed to increases in drug-related overdose, suicide, and liver cirrhosis, collectively referred to as deaths of despair. Income inequality is proposed to be partly responsible for increases in deaths of despair rates. This study investigated the associations between income inequality, deaths of despair risk in Canada, and potential mechanisms (stress, social cohesion, and access to health services).

METHODS

We obtained data from the Canadian Community Health Survey and the Canadian Vital Statistics Database from 2007 to 2017. A total of 504,825 Canadians were included in the analyses. We used multilevel survival analyses, as measured by the Gini coefficient, to examine the relationships between income inequality and mortality attributed to drug overdose, suicide, death of despair, and all-cause. We then used multilevel path analyses to investigate whether each mediator (stress, social cohesion, and access to mental health professionals), which were investigated using separate mediation models, influenced the relationship between income inequality and drug overdose, suicide, deaths of despair, and all-cause death.

RESULTS

Adjusted multilevel survival analyses demonstrated significant relationships between a one-SD increase in Gini coefficient was associated with an increased hazard for drug overdose (HRadj. = 1.28; 95 CI = 1.05, 1.55), suicide (HRadj. = 1.24; 95 CI = 1.06, 1.46), deaths of despair (HRadj. = 1.26; 95 CI = 1.12, 1.40), and all-cause death (HRadj. = 1.04; 95 CI = 1.02, 1.07). Adjusted path analyses indicated that stress, social cohesion, and access to mental health professionals significantly mediated the association between income inequality and mortality outcomes.

CONCLUSION

Income inequality is associated with deaths of despair and this relationship is mediated by stress, social cohesion, and access to mental health professionals. Findings should be applied to develop programs to address income inequality in Canada.

State level income inequality affects cardiovascular stress responses: Evidence from the Midlife in the United States (MIDUS) study

RATIONALE

The slow and insidious effects of income inequality on health means that their effects can be difficult to reveal, taking many years to become apparent. These effects can also be experienced differently according to subjective status and ethnicity making the relation between income inequality and health difficult to understand. Cardiovascular reactions to acute stress are indicative of future health outcomes.

OBJECTIVE

To examine whether short to medium term income inequality affected cardiovascular responses to acute stress whilst accounting for ethnic groups and subjective status.

METHOD

Participants state of residence was available for 1155 people who participated in the MIDUS biomarker data project. This detail was used to merge the relevant US state level inequality data 1, 5, 10 and 15 years prior to the MIDUS biomarker data project which assessed cardiovascular responses to acute stress.

RESULTS

Our analysis demonstrated an association between inequality 5, 10 and 15 year prior and cardiovascular reactions to acute stress. Subjective community status and Black and minority ethnic group membership interacted to affect the association between inequality and cardiovascular reactions.

CONCLUSIONS

In states where income inequality was high, less healthy cardiovascular responses were evident. However lower subjective community status and Black and Ethnic minority group members interacted with income inequality such that their impact was variable contingent on state level inequality. These findings extend the literature on income inequality and health and particularly highlights a psychophysiology pathway linking income inequality and health.