A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Social and economic determinants of drug overdose deaths: a systematic review of spatial relationships

PURPOSE

To synthesize the available evidence on the extent to which area-level socioeconomic conditions are associated with drug overdose deaths in the United States.

METHODS

We performed a systematic review (in MEDLINE, EMBASE, PsychINFO, Web of Science, EconLit) for papers published prior to July 2022. Eligible studies quantitatively estimated the association between an area-level measure of socioeconomic conditions and drug overdose deaths in the US, and were published in English. We assessed study quality using the Effective Public Health Practice Project Quality Assessment Tool. The protocol was preregistered at Prospero (CRD42019121317).

RESULTS

We identified 28 studies that estimated area-level effects of socioeconomic conditions on drug overdose deaths in the US. Studies were scored as having moderate to serious risk of bias attributed to both confounding and in analysis. Socioeconomic conditions and drug overdose death rates were moderately associated, and this was a consistent finding across a large number of measures and differences in study designs (e.g., cross-sectional versus longitudinal), years of data analyzed, and primary unit of analysis (e.g., ZIP code, county, state).

CONCLUSIONS

This review highlights the evidence for area-level socioeconomic conditions are an important factor underlying the geospatial distribution of drug overdose deaths in the US and the need to understand the mechanisms underlying these associations to inform future policy recommendations. The current evidence base suggests that, at least in the United States, employment, income, and poverty interventions may be effective targets for preventing drug overdose mortality rates.

Prescription opioids and economic hardship in France

This paper studies how opioid analgesic sales are empirically related to socioeconomic disparities in France, with a focus on poverty. This analysis is made possible using the OpenHealth database, which provides retail sales data for opioid analgesics available on the French market. We exploit firm-level data for each of the 94 departments in Metropolitan France between 2008 and 2017. We show that increases in the poverty rate are associated with increases in sales: a one percentage point increase in poverty is associated with approximately a 5% increase in mild opioid sales. Our analysis further shows that opioid sales are positively related to the share of middle-aged people and individuals with basic education only, while they are negatively related to population density. The granularity and longitudinal nature of these data allow us to control for a large pool of potential confounding factors. Our results suggest that additional interventions should be more intensively addressed toward the most deprived areas. We conclude that a combination of policies aimed at improving economic prospects and strictly monitoring access to opioid medications would be beneficial for reducing opioid-related harm.

Comparing the spreading characteristics of monkeypox (MPX) and COVID-19: Insights from a quantitative model

Climate change is acknowledged to directly affect not only the environment, economy, and society but also the transmission dynamics of infectious diseases, thereby impacting public health. The recent experiences with the spread of SARS-CoV-2 and Monkeypox have highlighted the complex and interconnected nature of infectious diseases, which are strongly linked to various determinants of health. Considering these challenges, adopting a new vision such as the trans-disciplinary approach appears to be imperative. This paper proposes a new theory about viruses' spread, based on a biological model, accounting for the optimisation of energy and material resources for organisms' survival and reproduction in the environment. The approach applies Kleiber's law scaling theory, originally developed in biology, to model community dynamics in cities. A simple equation can be used to model pathogen spread without accounting for each species' physiology by leveraging the superlinear scaling of variables with population size. This general theory offers several advantages, including the ability to explain the rapid and surprising spread of both SARS-CoV-2 and Monkeypox. The proposed model shows similarities in the spreading processes of both viruses, based on the resulting scaling factors, and opens new avenues for research. By fostering cooperation and integrating knowledge from different disciplines to effectively tackle the multifaceted dimensions of disease outbreaks, we can work towards preventing future health emergencies.

Linking forest ecosystem processes, functions and services under integrative social-ecological research agenda: current knowledge and perspectives

The integrity of forest ecosystems is essential to human well-being, but people's activities are causing rapid changes in forest ecosystems and environmental conditions. Forest ecosystem processes, functions and services are dissimilar concepts in biology and ecology, but they are not naturally disconnected and cannot be disconnected from people's interactions in the concepts of interdisciplinary environmental sciences. This review aims to explore how people's socioeconomic conditions and activities impact forest ecosystem processes, functions and services, and ultimately, human well-being. While there has been an increase in studies on linking forest ecosystem processes and functions in the last two decades, few have explicitly considered their links to people's activities and forest ecosystem services. The current literature on the impacts of people's activities on forest ecosystem conditions (i.e., forest area and species richness) has mostly focused on deforestation and environmental degradation. To better understand the social-ecological consequences on forest ecosystem conditions, it is essential to examine the direct and indirect impacts of people's socioeconomic conditions and activities on forest ecosystem processes, functions, services and stability which should be based on more informative social-ecological indicators. In doing so, I outline the current research knowledge, challenges, limitations and future research directions with conceptual models for linking forest ecosystem processes, functions and services with people's activities and socioeconomic conditions under integrative social-ecological research agenda. This updated social-ecological knowledge would aim to better guide policymakers and forest managers on how to manage and restore forest ecosystems sustainably to meet the needs of current and future generations.

Formulating sustainable development policies for China within the framework of socioeconomic conditions and government stability

Improvement in the environmental quality has been seen as a major concern worldwide, and a crucial agenda of the Sustainable Development Goals (SDG's). In this study, we examined the causal impacts of economic growth, financial development, nuclear energy, government stability, and socioeconomic conditions on the environmental quality of China, using quarterly data, covering the period 1984-2018. We used different proxies for environmental quality, i.e., Carbon dioxide (CO₂) emissions, ecological footprints, and load capacity factor, and a unique methodology named Fourier quantile causality, recently recommended by Cheng et al. (2021), for the first time in case of China. We find that nuclear energy, and government stability are positively causing the environmental quality, while economic growth, financial development, and socioeconomic conditions are degrading the environmental quality in China, since they are linked with increased income and energy consumption. Furthermore, all the explanatory variables are largely sensitive on different quantiles to affect the environmental quality; however, economic growth is a highly causing environmental degradation. Our study suggests that increasing nuclear energy consumption along with green financial measures that simultaneously support economic growth and socioeconomic conditions can be effective tools for improving environmental quality and realizing the SDGs in China.

Women's choices of hospital for breast cancer surgery in Italy: Quality and equity implications

This paper employs mixed logit regression to investigate the effects of providers characteristics on women's choice of hospital for breast surgery. Patient level data are used to model choices in Tuscany region, Italy. In particular, we focus on the effects of travel time and hospital quality indicators including quality standard (volumes of breast surgery), measurement of process (waiting times) and quality of surgical procedures. Variation in preferences related to individual characteristics such as age, education and travel distance from the hospital are also considered. Findings show that, on average, women prefer closer hospital with longer waiting times and higher quality (high volumes of interventions). We found preference heterogeneity associated to education: travel distance affects choice especially among less educated women (regardless of age), while among younger women (<65 years), less educated ones prefer shorter waiting times. These results could be used to optimize the allocation of resources toward breast cancer units that meet quality and efficacy standards to increase the efficiency and responsiveness of breast cancer care.

Disentangling the multigenerational transmissions of socioeconomic disadvantages and mental health problems by gender and across lineages: Findings from the Stockholm Birth Cohort Multigenerational Study

There is a paucity of research examining the patterning of socioeconomic disadvantages and mental health problems across multiple generations. The current study therefore aimed to investigate the interconnected transmissions of socioeconomic disadvantages and mental health problems from grandparents to grandchildren through the parents, as well as the extent to which these transmissions differ according to lineage (i.e., through matrilineal/patrilineal descent) and grandchild gender. Drawing on the Stockholm Birth Cohort Multigenerational Study, the sample included 21,416 unique lineages by grandchild gender centered around cohort members born in 1953 (parental generation) as well as their children (grandchild generation) and their parents (grandparental generation). Based on local and national register data, socioeconomic disadvantages were operationalized as low income, and mental health problems as psychiatric disorders. A series of path models based on structural equation modelling were applied to estimate the associations between low income and psychiatric disorders across generations and for each lineage-gender combination. We found a multigenerational transmission of low income through the patriline to grandchildren. Psychiatric disorders were transmitted through both the patriline and matriline, but only to grandsons. The patriline-grandson transmission of psychiatric disorder partially operated via low income of the fathers. Furthermore, grandparents' psychiatric disorders influenced their children's and grandchildren's income. We conclude that there is evidence of transmissions of socioeconomic disadvantages and mental health problems across three generations, although these transmissions differ by lineage and grandchild gender. Our findings further highlight that grandparents' mental health problems could cast a long shadow on their children's and grandchildren's socioeconomic outcomes, and that socioeconomic disadvantages in the intermediate generation may play an important role for the multigenerational transmission of mental health problems.

Natural hazard insurance outcomes at national, regional and local scales: A comparison between Sweden and Portugal

This study addresses the role of natural hazard insurance in two European countries with different insurance markets and socioeconomic conditions: Sweden and Portugal. The analyses were conducted at the national, regional (Southern Sweden and Lisbon Metropolitan Area - LMA), and local (Malmö and Lisbon cities) scales. Most damage caused by weather and climate-related (WCR) hazards during the 1980-2019 period was not covered by insurance companies in Sweden (71%) and Portugal (91%). An insurance affordability analysis was performed using income for the national and regional scales. Unaffordability is higher in Southern Sweden than in LMA, implying that better socioeconomic conditions do not necessarily mean a higher average capacity to pay for insurance. At the local scale, urban flooding was analysed for Malmö (1996-2019) and Lisbon (2000-2011) using insurance databases, in which the most relevant 21st century rainfall events for each city are included (2014 and 2008, respectively). The influence of terrain features on flooding claims and payouts was determined using Geographic Information Systems (GIS) spatial analyses. The flat Malmö favours ponding and extensive flooding, while the distance to the drainage network and flow accumulation are key factors to promote flooding along valley bottoms in the hilly Lisbon. Flooding hotspots tend to result from a combination of higher depths/lower velocities (accumulation of floodwaters and ponding) and not from a pattern of lower depths/higher velocities (shallow overland flow). More detailed data on insurance, flooding, and socioeconomic conditions, at regional and mainly local scales, is needed to improve affordability and urban flooding risk assessments.

Life course socioeconomic conditions and multimorbidity in old age - A scoping review

Multimorbidity disproportionally affects individuals exposed to socioeconomic disadvantage. It is, however, unclear how adverse socioeconomic conditions (SEC) at different periods of the life course predict the occurrence of multimorbidity in later life. In this scoping review, we investigate the association between life course SEC and later-life multimorbidity, and assess to which extent it supports different life course causal models (critical period, sensitive period, accumulation, pathway, or social mobility). We identified four studies (25,209 participants) with the first measure of SEC in childhood (before age 18). In these four studies, childhood SEC was associated with multimorbidity in old age, and the associations were partially or fully attenuated upon adjustment for later-life SEC. These results are consistent with the sensitive period and the pathway models. We identified five studies (91,236 participants) with the first measure of SEC in young adulthood (after age 18), and the associations with multimorbidity in old age as well as the effects of adjustment for later-life SEC differed from one study to the other. Among the nine included studies, none tested the social mobility or the accumulation models. In conclusion, SEC in early life could have an effect on multimorbidity, attenuated at least partly by SEC in adulthood.

Psychological patterns of poverty in Russia: Relationships among socioeconomic conditions, motivation, self-regulation and well-being

This article aims to extend our understanding of the link between socioeconomic conditions and psychological variables. It focuses on the effects of five distinct socioeconomic indicators on a range of psychological variables in samples of 162 individuals living below the poverty line and 188 of their more well-off counterparts in Russia. Participants completed a questionnaire containing measures of socioeconomic indicators (i.e., income, education, perceived deprivation, subjective socioeconomic status, and childhood socioeconomic status) and psychological variables representing self-regulation, motivation, and well-being. Our main findings include: (a) significant effects of socioeconomic status on all psychological variables, which are in line with other studies seeking to answer similar questions, (b) varying importance of different socioeconomic indicators for different psychological variables, and (c) centrality of all socioeconomic indicators except childhood socioeconomic status, and of values of openness to change and self-transcendence, satisfaction with life and self-esteem in the network of relationships between socioeconomic indicators and psychological variables.

A Neighborhood Analysis of Time Trends in COVID-19 Infection in NYC

To understand how observed COVID-19 diagnostic testing disparities across New York City (NYC) have impacted infection rates and COVID-19 spread, we examined neighborhood-level factors associated with, and the spatial distribution of, antibody test and infection rates, and compared changes over time by NYC ZIP code tabulation area (ZCTA). Data were obtained from 2019 American Community Survey 5-year estimates to create an SES index by ZCTA. Other predictors obtained from 2018 census data were the proportions of white residents, Hispanic residents and residents ≥ 65 years old. Multivariable Poisson regressions were performed to assess the rate of change for antibody testing and positivity, and to assess the independent associations with SES, race and age. Results: There was a significant association between the rate of antibody tests and SES quartiles (Q1: β_adj = 0.04, Q2: β_adj = 0.03 and Q3: β_adj = - 0.03, compared to Q4), and the proportion of residents who are white (β_adj = 0.004, p < .0001), Hispanic   (β_adj = 0.001, p < .0001), and ≥ 65 years (β_adj = 0.01, p < .0001). Total number of positive antibody tests was significantly inversely associated with SES quartile (Q1: β_adj = 0.50, Q2: β_adj = 0.48 and Q3: β_adj = 0.29, compared to Q4), and proportion of white residents (β = - 0.001, p < .0001) and ≥ 65 years (β = - 0.02, p < .0001), and significantly positively associated with proportion of Hispanic residents (β = 0.003, p < .0001). There are disparities in antibody testing and positivity, reflecting disproportionate impacts and undercounts of COVID-19 infection across NYC ZCTAs. Future public health response should increase testing in these vulnerable areas to diminish infection spread.

Intergenerational transmission of out-of-home care and the role of mental health problems: Findings from Stockholm birth cohort multigenerational study

Out-of-home care (OHC) experiences are associated with poor long-term outcomes throughout life. However, the continuity of OHC over generations is not fully explored, and the influence of mental health problems (MHP) and socioeconomic conditions on such transmission is still unclear. We therefore assessed the extent to which MHP affect the intergenerational transmissions of OHC as well as whether there are differential patterns depending on the socioeconomic conditions of the family of origin. We used a prospective data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen) on 11,333 cohort members (Generation 1; G1), their parents (Generation 0; G0), and 24,905 children (Generation 2; G2). Multivariate regressions and path models were used to examine the associations between OHC and MHP across generations; stratified analysis by occupational class in G0 was performed to explore potentially differential patterns. Our findings support the existence of an intergenerational transmission of OHC, particularly in the working class group (OR 4.70); MHP was only transmitted across generations in this group (OR 1.51). While the results indicated a stronger role of MHP among the middle/upper class (OR 5.59) compared to working class (OR 3.52) in part of the pathway (MHP G1→OHC G2), this patter was not consistent throughout the whole pathway (e.g. OHC G1→MHP G1). We conclude that there is a tendency for OHC and MHP experiences to continue across generations, particularly among families with more disadvantageous socioeconomic conditions. MHP seem to play an important role in the transmission of OHC irrespective of socioeconomic conditions.

Multi-dimensional community characteristics in linking particulate matter pollution and cause-specific mortality: 72 communities of South Korea

Concentration-response function for exposure to ambient particulate matter (PM) and mortality (i.e., relative risk, RR) may be inequal across communities by socioeconomic conditions. Investigation on specific mechanisms of this inequality regarding susceptibility to PM, beyond non-specific "socioeconomic conditions", would provide policy-relevant implications for tackling this inequality. However, such investigation via epidemiological studies is challenged by residual confounding by correlated mechanisms and different loss of life expectancy by PM exposures between communities. Here, we aimed to assess community characteristics including different aspects of socioeconomic deprivation, medical resources, health behaviors, air quality, and greenness in their relation to inequal RR for PM₁₀ and cause-specific mortality in 72 municipalities in South Korea, 2006-2013, considering these challenges. We found that a 10 μg/m³ increase in PM₁₀ on average across 46 days was associated with a 1.05% (95% CI: 0.24, 1.88) increase in all-cause mortality (ALL), 1.32% (95% CI: -0.29, 2.95) increase in cardiovascular mortality (CVD), and 6.47% (95% CI: 3.06, 10.00) increase in respiratory mortality (RES). The association between PM₁₀ and mortality was higher in communities with higher ratio of SO₂ to PM₁₀ (ALL and RES), higher material deprivation (ALL, CVD, and RES), lower medical resources (CVD), higher prevalence of drinking (ALL and CVD), and lower prevalence of smoking (CVD and RES). Lag-structures showed smaller loss of life expectancy by PM exposures in communities with higher prevalence of smoking. Our findings suggest that PM-related health inequalities are shaped by a variety of mechanisms relating to susceptibility to PM exposures and different loss of life expectancy. Health policies controlling community characteristics may contribute to minimizing PM₁₀-related health inequalities in those perspectives.

Associations of neighborhood socioeconomic conditions with self-rated health, mental distress, and health behaviors: A nationwide cross-sectional study in Japan

Although associations between neighborhood socioeconomic conditions and health have been well established, their geographical scope is mostly limited to Western societies, while multilevel studies in the non-Western context (e.g., Japan) are limited to specific cities/regions within countries. This consequently limits the external validity of the findings. To fill the gap, this study examined the associations between neighborhood socioeconomic conditions and health-related indicators by using nationwide cross-sectional data in Japan. Individual data was collected from a nationwide online survey conducted in 2015 (n = 4593). Self-rated health, mental distress (Kessler Psychological Distress Scale: K6), smoking, and physical activity were analyzed in relation to neighborhood conditions. Analyses of multilevel logistic regression models were done using the Areal Deprivation Index (ADI) with population density as the neighborhood-level independent variable. After adjusting for individual covariates, ADI showed significant positive associations with poor self-rated health (odds ratio for one standard deviation increase and 95% confidence interval: 1.09, 1.00–1.19), mental distress (1.09, 1.02–1.16), current smoking (1.11, 1.03–1.19), and physical inactivity (1.11, 1.04–1.18). Population density was not associated with the four dependent variables. Analyses of the nationwide survey data in Japan showed that neighborhood socioeconomic conditions were independently associated with multiple health statuses and behaviors. These analyses may contribute to generalizing existing findings. Lastly, the results indicate the importance of neighborhood socioeconomic conditions in reducing health disparities in Japan.

Spirometry: A Need for Periodic Updates of National Reference Values

The aim of the study was to assess the need for changes in spirometry reference values in the Polish population with time lapse, as the aftereffect of a radical socioeconomic overturn of the 1990. We retrospectively analyzed data files on forced expiratory volume in 1 s (FEV1), vital capacity (VC), and forced VC (FVC) in healthy, never-smoking Caucasians (731 females and 327 males) obtained in in 1993-1998. We assessed a discrepancy between the then measured values of these variables, on the one side, and the corresponding European Community for Steel and Coal (ECSC) predicted values or the current updated predicted values for the Polish population, on the other side. We found that those old measured values approximately corresponded to the ECSC reference, but they were appreciably lower than the current Polish reference values; the younger the subjects the greater the difference. The current Polish reference values of FVC were much closer to the old measured VC than to the old measured FVC values, which introduces a substantial discrepancy between the past and present FVCs. We conclude that the spirometry reference values may change with time lapse. Thus, accuracy of prediction equations should be periodically updated, which seems to particularly concern the equations elaborated for the nations that undergo rapid economic developments connected with changes in living standards.

Functional Measures of Sarcopenia: Prevalence, and Associations with Functional Disability in 10,892 Adults Aged 65 Years and Over from Six Lower- and Middle-Income Countries

Identification of sarcopenia in lower- and middle-income countries (LMICs) is limited by access to technologies that assess muscle mass. We investigated associations between two functional measures of sarcopenia, grip strength and gait speed (GS), with functional disability in adults from six LMICs. Data were extracted from the World Health Organization (WHO) Study on global AGEing and adult health Wave 1 (2007-2010) for adults (≥ 65 years) from China, Mexico, Ghana, India, Russia and South Africa (n = 10,892, 52.8% women). We calculated country-specific prevalence of low grip strength, slow GS (≤ 0.8 m/s), and both measures combined. Using multivariable negative binomial regression, we separately assessed associations between low grip strength, slow GS, and both measures combined, with the WHO Disability Assessment Schedule 2.0, accounting for selected socioeconomic factors. In women, low grip strength ranged from 7 in South Africa to 51% in India; in men, it ranged from 17 in Russia to 51% in Mexico. Country-specific proportions of slow GS ranged from 77 in Russia, to 33% in China. The concomitant presence of both was the lowest in South Africa and the highest in India (12.3% vs. 33%). Independent of age, those with both low grip strength and slow GS had between 1.2- and 1.5-fold worse functional disability scores, independent of comorbidities, low education, and low wealth (all country-dependent). Low grip strength, slow GS, and the combination of both, were all associated with higher levels of functional disability, thus indicating these objective measures offer a reasonably robust estimate for potential poor health outcomes.

Characteristics of place and the rural disadvantage in deaths from highly preventable causes

Extensive research has documented higher mortality in rural parts of the United States compared to urban areas. Much of this work focuses on aggregate rates, documenting a rural mortality penalty that has been increasing over the last three decades. Advances in place-based analyses suggest the importance of community resources for individual mortality but have largely focused on urban spaces. We advance knowledge on rural-urban mortality disparities by focusing on differences for highly preventable causes of death. Using unique geocoded mortality records from Washington state, we match individual-level attributes with area-level measures of socioeconomic conditions to examine whether characteristics of place elucidate the rural mortality penalty. We find that rural decedents have greater odds of dying from highly preventable causes compared to their urban counterparts. Place-based socioeconomic measures, meanwhile, independently associate with the odds of dying from highly preventable causes. However, we find no evidence that the relationship between socioeconomic conditions and highly preventable death varies across geographic contexts.

Surveillance of Aedes aegypti indoors and outdoors using Autocidal Gravid Ovitraps in South Texas during local transmission of Zika virus, 2016 to 2018

The yellow fever mosquito, Aedes aegypti, has facilitated the re-emergence of dengue virus (DENV) and emergence of chikungunya virus (CHIKV) and Zika virus (ZIKV) in the Americas and the Caribbean. The recent transmission of these arboviruses in the continental United States has been limited, to date, to South Florida and South Texas despite Ae. aegypti occurring over a much larger geographical region within the country. The main goal of our study was to provide the first long term longitudinal study of Ae. aegypti and enhance the knowledge about the indoor and outdoor relative abundance of Ae. aegypti as a proxy for mosquito-human contact in South Texas, a region of the United States that is at high risk for mosquito-borne virus transmission. Here, the relative abundance of indoors and outdoors mosquitoes of households in eight different communities was described. Surveillance was done weekly from September 2016 to April 2018 using the CDC Autocidal Gravid Ovitraps in low- and middle-income communities. A total of 69 houses were included in this survey among which 36 were in the low-income communities (n = 11 for Donna, n = 15 for Progresso, n = 5 for Mesquite, n = 5 for Chapa) and 33 in middle-income communities (n = 9 for La Feria, n = 8 for Weslaco, n = 11 for McAllen, and n = 5 for Rio Rico). Overall, Ae. aegypti was the dominant species (59.2% of collections, n = 7255) followed by Culex spp. mosquitoes (27.3% of collections, n = 3350). Furthermore, we demonstrated for Ae. aegypti that 1) outdoor relative abundance was higher compared to indoor relative abundance, 2) low-income communities were associated with an increase in mosquito relative abundance indoors when compared to middle-income communities, 3) no difference was observed in the number of mosquitoes collected outdoors between low-income and middle-income communities, and 4) warmer months were positively correlated with outdoor relative abundance whereas no seasonality was observed in the relative abundance of mosquitoes indoors. Additionally, Ae. aegypti mosquitoes collected in South Texas were tested using a specific ZIKV/CHIKV multiplex real-time PCR assay, however, none of the mosquitoes tested positive. Our data highlights the occurrence of mosquitoes indoors in the continental United States and that adults are collected nearly every week of the calendar year. These mosquito data, obtained concurrently with local ZIKV transmission of 10 locally acquired cases in nearby communities, represent a baseline for future studies in the Lower Rio Grande Valley (LRGV) including vector control interventions relying on the oviposition behavior to reduce mosquito populations and pathogen transmission.

Socioeconomic decline and advancement within and between generations and the risk of stroke - a case-control study

Abstract

Background

Disadvantageous socioeconomic conditions (SEC) in both childhood and adulthood increase the risk of stroke. We investigated whether intergenerational and lifetime social advancement decreases and/or social descent increases stroke risk.

Methods

In a case-control study with 466 patients with first-ever ischemic stroke and 807 controls randomly selected from the general population, we compared paternal profession to subjects’ professional education in adolescence and their last profession in adulthood. Furthermore, we constructed a socioeconomic risk score for childhood (based on paternal and maternal profession and occupation, familial, living and material conditions), adolescence (based on highest school degree and professional education), and adulthood (based on last profession, periods of unemployment, and marital status), and compared subjects´ positions at different life stages. Odds ratios were derived based on conditional logistic regression conditioning on age and sex only, after adjustment for medical and lifestyle risk factors, and after additional adjustment for socioeconomic risk score values.

Results

Intergenerational upward mobility between paternal profession and subject’s professional education was associated with lower ischemic stroke risk independent of medical and lifestyle risk factors (odds ratio (OR) 0.58; 95% confidence interval (CI) 0.41–0.81) and after additional adjustment for socioeconomic conditions in all three life stages (OR 0.67; 95% CI 0.45–0.99). Advancement between fathers´ profession and subject’s last profession was associated with reduced odds of stroke after adjustment for risk factors (OR 0.65; 95% CI 0.47–0.89), but not significantly after additional adjustment for SEC (OR 0.77; 95% CI 0.52–1.13). Social descent between adolescence and adulthood indicated by the transition into a more disadvantageous tertile of socioeconomic risk score was associated with increased odds of stroke after adjustment for all risk factor (OR 2.93; 95% CI 1.21–7.13). Analyses by sex revealed mostly similar results in men and women with only few potential differences.

Conclusions

Our study results indicate that aspects of social downward mobility during adulthood may be associated with increased risk of stroke, whereas intergenerational upward mobility may be linked to a lower stroke risk. If confirmed by future studies, such results may help to focus stroke prevention measures at high risk populations.

Measuring social inequality in health amongst indigenous peoples in the Arctic. A comparison of different indicators of social disparity among the Inuit in Greenland

The purpose of the article is to compare different indicators of social position as measures of social inequality in health in a population sample from an indigenous arctic people, the Inuit in Greenland. Data was collected during 2005-2015 and consisted of information from 3967 adult Inuit from towns and villages in all parts of Greenland. Social inequalities for smoking and central obesity were analysed in relation to seven indicators of social disparity in four dimensions, i.e. education and employment, economic status, sociocultural position, and place of residence. For each indicator we calculated age-adjusted prevalence by social group, rate ratio and the concentration index. The indicators were correlated with Pearson's r ranging from 0.24 to 0.82. Concentration indices ranged from 0.01 to 0.17. We could not conclude that one indicator was superior to others. Most of the indicators were traditional socioeconomic indicators used extensively in research in western countries and these seemed to be useful among the Inuit too, in particular household assets and job. Two sociocultural indicators developed for use among the Inuit and which included parameters specific to the indigenous peoples in the transition from a traditional to a modern life style proved to be equally useful but not superior to the traditional socioeconomic indicators. The choice of indicator must depend on what it is realistic to collect in the actual research setting and the use of more than one indicator is recommended. It is suggested to further develop culture specific indicators of social position for indigenous peoples.

Effect of childhood socioeconomic conditions on cancer onset in later life: an ambidirectional cohort study

Objectives

Living in low socioeconomic conditions during childhood is associated with poor health outcomes in later life. Whether this link also applies to cancer is unclear. We examined whether childhood socioeconomic conditions (CSCs) are associated with cancer risk in later life and whether this effect remained after adjusting for adulthood socioeconomic conditions (ASCs).

Methods

Data for 26,431 individuals ≥ 50 years old included in SHARE were analysed. CSCs were constructed by using indicators of living conditions at age 10. ASC indicators were education, main occupation, and household income. Gender-stratified associations of CSCs with cancer onset (overall and by site) were assessed by Cox regression.

Results

In total, 2852 individuals were diagnosed with cancer. For both men and women, risk of overall cancer was increased for advantaged CSCs and remained so after adjusting for ASCs (hazard ratio = 1.36, 95% CI 1.10, 1.63, and 1.70, 95% CI 1.41, 2.07).

Conclusions

Advantaged CSCs are associated with an increased risk of overall cancer at older age, but results vary by cancer sites and sex. Participation in cancer screening or exposure to risk factors may differ by social conditions.

Electronic supplementary material

The online version of this article (10.1007/s00038-018-1111-9) contains supplementary material, which is available to authorized users.

Low socioeconomic condition and the risk of dengue fever: A direct relationship

This study aimed to characterize the first dengue fever epidemic in Várzea Paulista, São Paulo, Brazil, and its spatial and spatio-temporal distribution in order to assess the association of socioeconomic factors with dengue occurrence. We used autochthonous dengue cases confirmed in a 2007 epidemic, the first reported in the city, available in the Information System on Diseases of Compulsory Declaration database. These cases where geocoded by address. We identified spatial and spatio-temporal clusters of high- and low-risk dengue areas using scan statistics. To access the risk of dengue occurrence and to evaluate its relationship with socioeconomic level we used a population-based case-control design. Firstly, we fitted a generalized additive model (GAM) to dengue cases and controls without considering the non-spatial covariates to estimate the odds ratios of the occurrence of the disease. The controls were drawn considering the spatial distribution of the household of the study area and represented the source population of the dengue cases. After that, we assessed the relationship between socioeconomic variables and dengue using the GAM and obtained the effect of these covariates in the occurrence of dengue adjusted by the spatial localization of the cases and controls. Cluster analysis and GAM indicated that northeastern area of Várzea Paulista was the most affected area during the epidemic. The study showed a positive relationship between low socioeconomic condition and increased risk of dengue. We studied the first dengue epidemic in a highly susceptible population at the beginning of the outbreak and therefore it may have allowed to identify an association between low socioeconomic conditions and increased risk of dengue. These results may be useful to predict the occurrence and to identify priority areas to develop control measures for dengue, and also for Zika and Chikungunya; diseases that recently reached Latin America, especially Brazil.

Parental population exposure to historical socioeconomic and political periods and grand-child's birth weight in the Lifeways Cross-Generation Cohort Study in the Republic of Ireland

Exposure to deprived socioeconomic conditions during the peri-conception and early childhood periods can have a negative long-term impact on individuals' health and that of their progeny. We aimed to examine whether relatives' birth period affected index-child (grand-child) birthweight status in the Lifeways Cross-Generation Cohort in the Republic of Ireland. Participants were 943 mothers and offspring, 890 fathers, 938 maternal grandmothers (MGM), 700 maternal grandfathers (MGF) 537 paternal grandmothers (PGM) and 553 paternal grandfathers (PGF). Index-child's birthweight was sex-for-gestational age standardised (UK1990 population), and then classified into low birthweight (≤10th percentile) and high-birthweight (≥90th percentile) and compared against normal-birthweight (>10th to <90th percentiles). Four adult birth periods were considered: The Free State (FS, 1916-1938); Emergency Act (EA, 1939-1946); Post-World War-II Baby-Boom (PWWII-BB, 1947-1964); and Modern Ireland (MI, 1964 onwards). Logistic regression was used to assess the crude and adjusted relationship between index-child's birthweight status and relatives' birth periods. Overall, there were 8.7% (n=82) index-children in the low-birthweight category, 77.9% (n=735) and 13.4% (n=126) within the normal and high birthweight groups respectively. Index-children whose mothers were born during the PWWII-BB had higher birthweight infants (Crude OR(COR)=1.81 (1.08-3.03) which remained the case only for male index-children when adjusted for co-variables (Adjusted OR(AOR)=4.61(1.71-12.42)). Parents' combined PWWII-BB birth period was positively associated with male index-child higher birthweight, even adjusted for maternal characteristics (AOR=4.60(1.69-12.50)). MGFs born during the EA were more likely to have grandchildren with low birthweight after adjustment for maternal characteristics (AOR=2.45(1.03-5.85)), particularly for female index-children (AOR=4.74(1.16-19.25)). Both PGMs and PGFs born during the FS period had higher birthweight grandchildren, adjusted for maternal-related co-variables (PGM, AOR=3.23(1.21-8.63); PGF, AOR=3.93(1.11-13.96)), with the effect of PGM more evident in her granddaughter (AOR=6.53(1.25-34.04)). In conclusion, there is some evidence that period of grandparental birth is associated with their grandchildren's birthweights, suggesting that transgenerational exposures may be particular to historical context, meriting further exploration.

Childhood deprivation and later-life cognitive function in a population-based study of older rural South Africans

RATIONALE

Little research has evaluated the life course drivers of cognitive aging in South Africa.

OBJECTIVES

We investigated the relationships of self-rated childhood health and father's occupation during childhood with later-life cognitive function score and whether educational attainment mediated these relationships among older South Africans living in a former region of Apartheid-era racial segregation.

METHODS

Data were from baseline assessments of "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community" (HAALSI), a population-based study of 5059 men and women aged ≥40 years in 2015 in rural Agincourt sub-district, South Africa. Childhood health, father's occupation during childhood, and years of education were self-reported in study interviews. Cognitive measures assessed time orientation, numeracy, and word recall, which were included in a z-standardized latent cognitive function score variable. Linear regression models adjusted for age, sex, and country of birth were used to estimate the total and direct effects of each childhood risk factor, and the indirect effects mediated by years of education.

RESULTS

Poor childhood health predicted lower cognitive scores (total effect = -0.28; 95% CI = -0.35, -0.21, versus good); this effect was not mediated by educational attainment. Having a father in a professional job during childhood, while rare (3% of sample), predicted better cognitive scores (total effect = 0.25; 95% CI = 0.10, 0.40, versus unskilled manual labor, 29% of sample). Half of this effect was mediated by educational attainment. Education was linearly associated with later-life cognitive function score (0.09; 95% CI = 0.09, 0.10 per year achieved).

CONCLUSION

In this post-Apartheid, rural South African context, older adults with poor self-reported childhood health or whose father worked in unskilled manual labor had relatively poor cognitive outcomes. Educational attainment strongly predicted cognitive outcomes, and appeared to be, in part, a mechanism of social stratification in later-life cognitive health in this context.

Survey data on entrepreneurs׳ subjective plan and perceptions of the likelihood of success

Entrepreneurship is an important economic process in both developed and developing worlds. Nonetheless, many of its concepts appear to be difficult to ‘operationalize’ due to lack of empirical data; and this is particularly true with emerging economy. The data set described in this paper is available in Mendeley Data׳s “Vietnamese entrepreneurs’ decisiveness and perceptions of the likelihood of success/continuity, Vuong (2015) [1]” http://dx.doi.org/10.17632/kbrtrf6hh4.2; and can enable the modeling after useful discrete data models such as BCL.

Geospatial Risk Factors of Canine American Trypanosomiasis (Chagas Disease) (42 Cases: 2000-2012)

American trypanosomiasis or Chagas disease caused by Trypanosoma cruzi affects many mammals, including humans and dogs, in all Latin American countries outside the Caribbean and increasingly also in the southern United States. Dogs are considered as reliable sentinels and have been identified as an important risk factor for the disease in humans in endemic countries. Factors that determine American trypanosomiasis in dogs may therefore have public health relevance. Associations of different environmental, locational, and pet owner socioeconomic conditions were evaluated retrospectively as potential risk factors for American trypanosomiasis status in dogs in a case-control study. Laboratory-confirmed cases received at the Texas A&M University Veterinary Medical Teaching Hospital between the years 2000 and 2012 and candidate risk factor variables extracted from publicly available environmental data and 2010 US Census Bureau were used. The sample included 42 dogs serologically positive and 82 dogs serologically negative determined by indirect immunofluorescent assay. The diagnostic titer was 1:160 (case). Univariate logistic regressions followed by stepwise multivariate logistic modeling were used for variable screening and to determine the strengths of variable associations with case status. Total Edge Contrast Index (odds ratio [OR] = 3.35, 95% confidence interval [CI] 3.10, 3.62), residing in homes that had rural addresses (OR = 2.48, 95% CI 2.43, 2.53), total number of owner occupied housing units in a neighborhood with a householder who is Hispanic or Latino (OR = 1.66, 95% CI 1.04, 2.66), and the total number of housing units in a neighborhood that were built on or prior to year 1980 (OR = 2.22, 95% CI 1.94, 2.55) were identified as risk factors. Suitable awareness campaigns and future research that considers pet owner housing and socioeconomic circumstances are necessary for effective prevention and control of this disease among dogs.

[Dietary patterns of children and socioeconomical, behavioral and maternal determinants]

Objective:

To identify dietary patterns of children and to verify their association with socio-economical, behavioral and maternal determinants.

Methods:

A cross-sectional study with a random sample of 328 children aged 8 and 9 years. Dietary intake was assessed by food records in three nonconsecutive days and measured in grams of food groups and nutrients. Factor analysis and subsequent orthogonal rotation (varimax) were used to determine dietary patterns. Ordinal logistic regression was used to assess associations between dietary patterns and the studied determinants.

Results:

Five dietary patterns were observed: “Traditional,” “Sweetened beverages and snacks,” “Monotonous,” “Healthy” and “Egg-dairy.” A higher maternal level of education was directly associated with “Sweetened beverages and snacks” and “Egg-dairy' standards. Low income children who were submitted to greater food restriction by parents/guardians followed the more “Traditional” standard, represented by the consumption of rice, beans, vegetables, cooked roots and tubers and red meat. The “Monotonous” pattern, represented by a high consumption of milk and chocolate powder, was most followed by children from the middle class. Children living in rural areas consumed more foods from the “Egg-dairy” pattern, when compared to those from the urban area.

Conclusions:

Dietary patterns of children were associated with family socioeconomic status, maternal level of education, practice of food restriction by parents/guardians and location of residence in urban or rural area. Better socioeconomic conditions contributed to a more nutritionally inadequate dietary pattern.

Regional Mortality Disparities in Germany: Long-Term Dynamics and Possible Determinants

While regional mortality inequalities in Germany tend to be relatively stable in the short run, over the course of the past century marked changes have occurred in the country's regional mortality patterns. These changes include not only the re-emergence of stark differences between eastern and western Germany after 1970, which have almost disappeared again in the decades after the reunification of Germany in 1990; but also substantial changes in the disparities between northern and southern Germany. At the beginning of the twentieth century, the northern regions in Germany had the highest life expectancy levels, while the southern regions had the lowest. Today, this mortality pattern is reversed. In this paper, we study these long-term trends in spatial mortality disparities in Germany since 1910, and link them with theoretical considerations and existing research on the possible determinants of these patterns. Our findings support the view that the factors which contributed to shape spatial mortality variation have changed substantially over time, and suggest that the link between regional socioeconomic conditions and recorded mortality levels strengthened over the last 100 years.