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Using a qualitative methodology, 14 women experiencing food insecurity were interviewed to explore their experiences with engaging in healthy eating to manage their weight. Data was collected using semi-structured interviews and evaluated using content analysis methods. Resilience factors situated throughout the social environment altered the path from exposure to risk (food insecurity) to poor outcomes (unhealthy eating behaviors/obesity). Resilience factors included social safety net programs, transportation, stretching the food budget, nutritional knowledge, and motivation. Study results can be used to develop strength-based policies and interventions to address obesity among women with low incomes. [ABSTRACT FROM AUTHOR]

Child protection systems monitoring is key to ensuring children's wellbeing. In England, monitoring is rooted in onsite inspection, culminating in judgements ranging from 'outstanding' to 'inadequate'. But inspection may carry unintended consequences where child protection systems are weak. One potential consequence is increased child welfare intervention rates. In this longitudinal ecological study of local authorities in England, we used Poisson mixed-effects regression models to assess whether child welfare intervention rates are higher in an inspection year, whether this is driven by inspection judgement, and whether more deprived areas experience different rates for a given inspection judgement. We investigated the impact of inspection on care entry, Child Protection Plan-initiation, and child-in-need status. We found that inspection was associated with a rise in rates across the spectrum of interventions. Worse judgements yielded higher rates. Inspection may also exacerbate existing inequalities. Unlike less deprived areas, more deprived areas judged inadequate did not experience an increase in the less intrusive 'child-in-need' interventions. Our findings suggest that a narrow focus on social work practice is unlikely to address weaknesses in the child protection system. Child protection systems monitoring should be guided by a holistic model of systems improvement, encompassing the socioeconomic determinants of quality. [ABSTRACT FROM AUTHOR]

Introduction: Neighbourhood effect on health outcomes is well established, but little is known about its effect on access to essential health services (EHS). Therefore, this study aimed to assess the contributing factors to access to EHS in slum versus non-slum settings. Methodology: The most recent data from 58 Demographic and Health Surveys (DHS) conducted between 2011 and 2018 were used, including a total of 157,000 pairs of currently married women aged 15–49 and their children aged 12–23 months. We used meta-analysis techniques to examine the inequality gaps in suboptimal access to EHS between mother-children pairs living in slums and non-slums. Blinder-Oaxaca decomposition technique was used to identify the factors contributing to the inequality gaps in each low- and middle-income country (LMIC) included. Result: The percentage of mother–child pairs living in slums ranged from 0.5% in Egypt to 63.7% in Congo. Meta-analysis of proportions for the pooled sample revealed that 31.2% [27.1, 35.5] of slum residents and 20.0% [15.3, 25.2] among non-slum residents had suboptimal access to EHS. We observed significant pro-slum inequalities in suboptimal access to EHS in 28 of the 52 LMICs with sufficient data. Of the 34 African countries included, 16 showed statistically significant pro-slum inequality in suboptimal access to EHS, with the highest in Egypt and Mali (2.64 [0.84–4.44] and 1.76 [1.65, 1.87] respectively). Findings from the decomposition analysis showed that, on average, household wealth, neighbourhood education level, access to media, and neighbourhood-level illiteracy contributed mostly to slum & non-slum inequality gaps in suboptimal access to EHS. Conclusion: The study showed evidence of inequality in access to EHS due to neighbourhood effects in 26 LMICs. This evidence suggests that increased focus on the urban poor might be a important for increasing access to EHS and achieving the universal health coverage (UHC) goals. [ABSTRACT FROM AUTHOR]

Objectives Data Sources Data Collection/Extraction Methods Study Design Principal Findings Conclusions To evaluate the quality of Arkansas All‐Payer Claims Database (APCD) for disparity research in persistent poverty areas by determining (1) its representativeness of Arkansas population, (2) variation by county, and (3) differences in coverage between persistent poverty and other counties.Cross‐sectional study using 2019 Arkansas APCD member enrollment data and county‐level data from various agencies.An alias identifier linked persons across insurance plans. County FIPS codes were used to extract county‐level variables.Cohort 1 included individuals with ≥1 day of medical coverage in 2019. Cohort 2 included individuals with medical coverage in June, 2019. Cohort 3 included individuals with continuous medical coverage in 2019. Sampling proportions of a county's population in the three cohorts were compared between persistent poverty and other counties. Inverse‐variance weighted linear regression was used to identify county‐level socioeconomic and demographic characteristics associated with inclusion in each cohort.In 2019, 73.6% of Arkansans had medical coverage for ≥1 day (Cohort 1), 66.3% had coverage in June (Cohort 2), and 58.8% had continuous coverage (Cohort 3) in APCD. Sampling proportions varied by county (median[range]: Cohort 1, 78% [58%–95%]; Cohort 2, 71% [51%–88%]; and Cohort 3, 64% [44%–80%]), and were higher among persistent poverty counties than others for all three cohorts (mean [SD], persistent poverty vs. other: Cohort 1: 80.9% [6.4%] vs. 77.1% [6.3%], p = 0.04; Cohort 2: 74.0% [6.4%] vs. 70.1% [6.2%], p = 0.03; Cohort 3: 66.4% [6.1%] vs. 62.7% [6.0%], p = 0.03). In the 2019 APCD, larger counties and those with higher proportions of females or persons 65+ years had higher coverage, whereas counties with higher per capita household income, median home value, or disproportionately more persons of other races (non‐White and non‐Black) had lower coverage (p < 0.05 for all three cohorts).The Arkansas APCD had good coverage of Arkansas population. Coverage was higher in persistent poverty counties than others. [ABSTRACT FROM AUTHOR]

The study examines the socioeconomic determinants of physical health among populations experiencing food insecurity and receiving free meals in soup kitchens in the Prefecture of Attica, Greece. Data were collected from the same six soup kitchens in 2012, 2017 and 2021, resulting in a dataset of 1533 observations. The study revealed that periods characterised by an economic recession are associated with deteriorated physical health of food‐insecure people. Moreover, the study found that physical health deteriorations among food‐insecure people are associated with older age, female gender, immigration status, disability and/or long‐term health conditions, LGBT status, unemployment, economic inactivity, homelessness, living below the poverty threshold, long‐term food dependency, illicit drug consumption and residing in lower‐ and middle‐class areas. The study proposes the Intersectional Model of Health Inequalities, which integrates multiple factors involved in shaping the health inequalities of people experiencing food insecurity, from macro‐level factors such as a country's economic performance to individual‐level factors like education, employment status and demographic characteristics. The model emphasises that low‐income populations should not be treated as a homogeneous entity. Its goal is to inform policymakers about the diverse health inequalities experienced by people with low incomes. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Safe drinking water and closed sanitation are fundamental to health and are assumed in the United States, however, gaps remain, disproportionately affecting marginalized communities. We sought to describe household sanitation access for children in rural Alabama and local health provider knowledge of sanitation related health concerns. METHODS: Data were collected from self-administered surveys obtained from children enrolled in a larger cross-sectional study to determine soil transmitted helminthiasis prevalence in Alabama, from a survey of health providers from local federally qualified health centers and from a baseline knowledge check of Alabama health providers enrolled in an online sanitation health course. RESULTS: Surveys completed on 771 children (approximately 10% of county pediatric population) revealed less than half lived in homes connected to centralized sewers; 12% reported "straight-pipes," a method of discharging untreated sewage to the ground outside the home, and 8% reported sewage contamination of their home property in the past year. Additionally, 15% of respondents were likely to use well water. The local health providers surveyed did not include routine screening for water and sanitation failures or associated infections. Regional healthcare providers have limited knowledge of soil transmitted helminthiasis. CONCLUSIONS: A significant number of children from rural counties of Alabama with high rates of poverty reside in homes with water and sanitation challenges that predominantly affect African American families. This is an under-recognized health risk by local health providers, and its contribution to well-documented health disparities in this region is poorly understood. [ABSTRACT FROM AUTHOR]

In slum environments, adolescents face unique challenges that can significantly impact their well-being. This study aimed to assess the personal well-being of adolescents living in Delhi- NCR (National Capital Region) slums. Cummins' homeostasis theory states that individuals have a natural tendency to maintain a certain level of well-being and that various psychological mechanisms work to maintain this well-being within a positive and stable range. The study's objectives were to evaluate the normative range of mean scores for PWI domains, examine demographic factors influencing subjective well-being, and to evaluate the psychometric properties of the Personal Well-being Index-School Children (PWI-SC) in the context of slum-dwelling adolescents. A total of 477 slum dwelling adolescents aged 10–19 years participated in the study. The findings revealed that the PWI-SC demonstrated strong internal consistency (Cronbach's α = 0.83) and was a one-factor solution, affirming its reliability and unidimensionality as a measure of subjective well-being. The results indicated that slum-dwelling adolescents reported moderate to high levels of subjective well-being across various PWI domains. Furthermore, the regression analysis demonstrated that various domains, such as standard of living, life achievement, personal relationships, personal safety, community connectedness, and future security, significantly contribute to adolescents' overall life satisfaction. However, the impact of health is unknown in this context. Moreover, Age, family income, household size, and living conditions in the slums were identified as factors influencing subjective well-being among adolescents. Despite confronting challenging circumstances, slum-dwelling adolescents exhibit remarkable well-being, suggesting the presence of homeostatically protected moods. The validated PWI-SC has emerged as a valuable tool for future research and interventions aimed at enhancing adolescent well-being in similar contexts. [ABSTRACT FROM AUTHOR]

This study examined the differences in mental health service use, barriers, and service preferences among 393 low-income housing (LIH) and market-rate housing (MRH) Harlem residents in New York City. One-third (34.6%) endorsed the need for professional support for psychological issues, 27.2% and 15.8% reported using counseling services and psychotropic medication, with no differences between housing types. LIH residents (21.6–38.8%) reported significantly higher use of all types of mental health resources (e.g., websites, anonymous hotlines, self-help tools) compared with MRH residents (16.1–26.4%). Eighty-six percent reported barriers to mental health access, with LIH residents reporting more than double the barriers. Particularly, LIH residents reported greater difficulty getting time off work (34.1% vs. 14%), lack of health insurance (18.7% vs. 9.8%), lack of trust in mental health providers (14.6% vs. 4.7%), and stigma (12.2% vs. 5.1%) compared with MRH residents. Residents most preferred places of services were health clinics and houses of worship; provided by healthcare and mental health providers; and services delivered in-person and phone-based counseling. In contrast, residents least preferred getting support at mental health clinics; from family/friends; and by the Internet. No differences were found between service preferences by housing type. LIH residents reported higher use of mental health services and resources, but they face significantly more barriers to mental health care, suggesting a need to address specific barriers. Preferences for mental health services suggest a need for expanding mental health services to different settings given the low preference for services to be delivered at mental health clinics. [ABSTRACT FROM AUTHOR]

Purpose: Poverty continues to be a pervasive social problem within the United States despite a plethora of services and government assistance programs. Currently, universal and guaranteed basic income programs are being actively promoted. Method: This review incorporated universal or guaranteed basic income primary reports open to any country and in English from four academic databases including grey literature between January 1, 2013, and April 8, 2023, using randomized controlled trials or quasi-experimental study designs with no specified outcome. Results: Out of an initial 147 articles, four of the primary studies utilized a randomized controlled trial and one used a quasi-experimental design. One study occurred in the United States. Discussion: Despite the increasing implementation of such programs throughout the United States and their associated high cost, evidence is lacking based on their long-term impact and effectiveness. Further study is recommended including stronger evaluations of current and future programs. [ABSTRACT FROM AUTHOR]

As recently as the late 20th century, Schizophrenia, a category of mental illness with widely varying phenotypic symptoms, was believed by psychobiologists to be a genetically based disorder in which the environment played a limited etiological role. Yet a growing body of evidence indicates a strong correlation between schizophrenia and environmental factors. This theoretical paper explores the relationship between highly elevated rates of schizophrenia in some low-income minority communities worldwide and trauma-related dissociative symptoms that often mimic schizophrenia. Elevated rates of schizophrenia in racially and ethnically isolated, inner-city Black populations are well documented. This paper contains evidence proposing that this amplification in the rate of schizophrenia is mediated by childhood trauma, disorganized attachment, and social defeat. Further, evidence demonstrating how these three variables combine in early childhood to incubate dissociative disorders will also be conveyed. The misdiagnosis of dissociative disorders as schizophrenia is theorized to partially mediate the increased rate of schizophrenia in communities that experience high levels of racial/ethnic discrimination. It is argued that this misdiagnosis is often attributable to cultural misunderstanding and/or a lack of knowledge about dissociative disorders [ABSTRACT FROM AUTHOR]

Simple Summary: This cross-sectional study analyzed how multilevel social factors affect patient-reported outcomes in children under 18 who survived cancer. Study participants include 293 pairs of these survivors who received survivorship care at a U.S.-based comprehensive cancer center between 2017 and 2018 and their primary caregivers. Findings indicate that higher caregiver anxiety is linked to worse depression, stress, fatigue, sleep problems, and lower positive affect in survivors of pediatric cancer. The study also found that family conflicts are associated with sleep issues in childhood cancer survivors. Furthermore, survivors living in socioeconomically deprived areas experience poorer sleep quality, and those residing in environments with high physical deprivation experience more psychological stress and fatigue, alongside reduced positivity and mobility. These results highlight the significant impact of parental, familial, and neighborhood factors on a range of patient-reported outcomes among young cancer survivors, suggesting these social factors as crucial targets for intervention. In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children's Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors' and caregivers' PROs. General linear regression tested associations of social determinants with survivors' PROs. We found that caregivers' higher anxiety was significantly associated with survivors' poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers' sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors' sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors' poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors' higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors' quality of life and well-being and represent new intervention targets. [ABSTRACT FROM AUTHOR]

Background: Existing research on the impacts of adversity on young children's psychological well‐being has largely focused on household‐level risk factors using observational methods in high‐income countries. This study leverages natural variation in the timing and location of community homicides to estimate their acute effects on the regulatory, behavioral, and developmental outcomes of Brazilian 3‐year‐olds. Methods: We compared the outcomes of children who were assessed soon after a recent neighborhood homicide to those of children from the same residential neighborhoods who had not recently experienced community violence. Our sample included 3,241 3‐year‐olds (Mage = 41.05 months; 53% female; 45% caregiver education less than middle school; 26% receiving a public assistance program) from seven neighborhoods in São Paulo, Brazil. Child outcome measures included parent reports of effortful control and behavior problems as well as direct assessments of children's developmental (cognitive, language, and motor) skills. Community homicides were measured using police records. Results: Recent exposure to community homicides was associated with lower effortful control, higher behavior problems, and lower overall developmental performance for children (d =.05–.20 standard deviations; p = ns – <.001). Effects were consistent across subgroups based on sociodemographic characteristics and environmental supports, but generally largest when community violence exposure was geographically proximal (within 600 m of home) and recent (within 2 weeks prior to assessment). Conclusions: Results highlight the pervasive effects that community violence can have on young children as well as the need to expand support to mitigate these effects and prevent inequities early in life. [ABSTRACT FROM AUTHOR]

Objective To explore the vitamin D nutritional status and influencing factors of primary and middle school students in poverty areas of Guizhou Province, and to provide scientific basis for the development of targeted nutritional improvement measures. Methods A total of 2,519 students from 4 primary and4 middle schools in 9 key monitoring counties (districts) in Guizhou Province, where the Nutrition Improvement Program for Rural Compulsory Education Students was implemented in 2023, were selected for questionnaire surveys, physical examinations, and blood biochemistry tests using multistage cluster sampling methods. Multifactorial logistic regression was used to analyze the current status of vitamin D nutrition and its influencing factors. Results The average vitamin D level of primary and middle school students in poverty areas of Guizhou Province was (22. 59 ± 6. 66) ng/ml, and the rate of low vitamin D was 37. 51%. The prevalence of low vitamin D among female students (46. 17%) was higher than that of male students (29. 11%), and the difference was statistically significant 仗2 = 78. 213, P < 0. 001). There was a significant difference in the rate of low vitamin D among students in different regions 仗2 二 23. 454, P <0. 001), and the rate of low vitamin D tended to increase with age = 44. 905, P <0. 001). The results of multifactorial logistic regression analysis showed that, compared with the corresponding reference group, ethnic minorities (OR = 0. 706, 95% CI: 0. 590 - 0. 844), physical activity M60 min/d (OR = 0. 791, 95% CI: 0. 663 - 0. 943), and living in the countryside (OR - 0. 747, 95% CI: 0. 616 -0.906) were protective factors for low vitamin D levels; obesity (OR =2. 133, 95% C/: 1.390 - 3.272), female students (OR 二2. 238, 95% CI: 1.882 -2.662), the 11-13 years old group (OR =1. 849, 95% CI: 1. 521 - 2. 248) and the 14 - 17 years old group (OR = 2. 000, 95% CI: 1. 576 - 2. 539) were risk factors for low vitamin D levels. Conclusion High rates of low vitamin D among primary and middle school students in poverty areas of Guizhou Province require the development of personalized nutritional interventions to improve vitamin D nutritional status. [ABSTRACT FROM AUTHOR]

Reducing multidimensional relative poverty is one of the important issues in the current global poverty governance field. This article takes 12 ethnic regions in China as the research object and constructs a multidimensional relative poverty measurement system. The calculated multidimensional relative poverty index is decomposed according to provinces, cities, dimensions, and indicators. Then, the Dagum Gini coefficient and convergence analysis are used to analyze spatiotemporal heterogeneity and convergence characteristics. The results show that the multi-dimensional relative poverty situation of various provinces in ethnic minority areas has improved from 2012 to 2021, among which Tibet province is the most serious and Shaanxi is the best. According to the analysis of convergence, it was observed that there is no σ-convergence of multidimensional relative poverty in ethnic areas in general, and there is absolute β-convergence in general and in the southwest and northwest regions, and there is no absolute β-convergence in the northeast region. Based on this, policy recommendations for reducing multidimensional relative poverty are proposed at the end of the article. Compared with previous studies, this article focuses on ethnic regions that are easily overlooked. Starting from the dimensions of economy, social development, and ecological environment, the poverty measurement system has been enriched. [ABSTRACT FROM AUTHOR]

BACKGROUND: Districts with federal nutrition programs must have an updated local school wellness policy (LSWP) to promote nutrition, physical activity, and student wellness. This study evaluates factors associated with LSWP quality among low‐income districts. METHODS: In 2018, we collected LSWPs from websites of 200 randomly selected, county‐stratified, low‐income‐serving California public districts. Multivariable linear regression assessed associations between district characteristics, model LSWP use (national, state, none), and adoption date on policy quality. RESULTS: On the WellSAT 3.0 scale of 0‐100, mean (95% CI) comprehensiveness was 65.0 (63.2‐66.7) and strength was 37.3 (35.3‐39.2). Nearly verbatim adoption of model LSWPs was high (68.5% state model, 13.0% a national model). Half were adopted before mandated updates. District size (≥1000 students) and national model LSWP adoption were associated with higher comprehensive scores. National model LSWP adoption was associated with higher strength scores in updated policies compared with those not updated. IMPLICATIONS: LSWPs have improved school food and activity environments, but district engagement in LSWP is low. Integration into education frameworks that reduce learning barriers could provide synergy for re‐engagement. CONCLUSIONS: High adoption of model policies and low update compliance indicate little district engagement in LSWP. Mixed methods studies of districts with high‐quality LSWP are needed. [ABSTRACT FROM AUTHOR]

Background: Economic violence prevails to be one of the unexplored domains of intimate partner violence. Objective: To explore the perceived forms of economic violence and its health impacts among married women in Puducherry. Methodology: A community-based exploratory study was conducted in urban slums in Puducherry. All married women aged 18 to 65 years belonging to low socio-economic status residing in two selected slums were included by purposive sampling. A total of seven focus group discussions were conducted till the point of saturation and manual content analysis done. Results: Four major themes emerged, namely: experiences of economic abuse, health impacts of economic abuse, perceived factors influencing economic abuse, and suggested preventive measures for economic abuse. Conclusion: Economic abuse against women in India exists in multiple dimensions. It has profound consequences on the physical and psychological health of women. [ABSTRACT FROM AUTHOR]

Background: With increasing urbanization, number of urban slums is also rising. The health facilities and indicators in urban slums are poor as compared to other urban population. The present study presents an analysis of the health problems, utilization of health services and vulnerability of urban slums. Aims & Objectives: To map the slums in urban areas and assess the vulnerability of households. Methodology: The study was conducted in all urban slums of five cities of Nainital and Udham Singh Nagar districts namely Haldwani, Ramnagar, Rudrapur, Jaspur and Kashipur. Group discussions involving community members, ward surveys by ASHA workers and household level vulnerability assessment were done using standard format according to "Guidelines and Tools for Vulnerability Mapping and Assessment of Urban Health, 2017". Results: Most urban slum dwellers are daily wage laborers with major population suffering mainly from diabetes, hypertension, respiratory infection. Lack of drugs and diagnostic facilities are the major concerns. Infrastructure needs strengthening in most of the slums. Around three fourth of population belonged to vulnerable group with remaining in highly vulnerable group. Conclusion: There are social problems in urban slums like illiteracy, lack of awareness, unemployment which worsen the health problems. So, a holistic approach is needed for the solution. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine, via testimonial data, resistance strategies used to thwart a sexual assault among slum-dwelling Kenyan adolescent girls (N = 678) following their participation in an empowerment self-defense program (IMpower). The majority (58.2%) of perpetrators were strangers; there were no differences in resistance strategies used between strangers versus known perpetrators (83.8% used verbal strategies, 33.2% used resistance strategies, 16.7% ran away, and 7.9% used distraction). Associations between resistance strategies and perpetrator tactics, number of assailants, location of the assault, and the presence of a bystander were also examined. [ABSTRACT FROM AUTHOR]

Multilevel models with nested errors are widely used in poverty estimation. An important application in this context is estimating the distribution of poverty as defined by the distribution of income within a set of domains that cover the population of interest. Since unit-level values of income are usually heteroskedastic, the standard homoskedasticity assumptions implicit in popular multilevel models may not be appropriate and can lead to bias, particularly when used to estimate domain-specific income distributions. This article addresses this problem when the income values in the population of interest can be characterized by a two-level mixed linear model with independent and identically distributed domain effects and with independent but not identically distributed individual effects. Estimation of poverty indicators that are functionals of domain-level income distributions is also addressed, and a nonparametric bootstrap procedure is used to estimate mean squared errors and confidence intervals. The proposed methodology is compared with the well-known World Bank poverty mapping methodology for this situation, using model-based simulation experiments as well as an empirical study based on Bangladesh poverty data. [ABSTRACT FROM AUTHOR]

To get a rich description of the barriers to using assistive technology (AT) among men and women ≥65 years living in poor and disadvantaged communities in Puerto Rico, an issue not well described among older people. We conducted qualitative interviews assisted by videos of AT and guided by the Matching Person and Technology Model and the Gender Analysis Framework with a purposive sample of 23 men and women. Participants were asked questions regarding reasons for not using AT, willingness for using AT, their identified gender roles and gender-related activities, and bargaining positions. They were also asked about their access to resources to acquire AT, bargaining positions, the stigma associated with AT use, and the characteristics of AT. Directed content analysis with input from a Community Advisory Board was used for the interpretation of the results. The predominant barrier (for both men and women) to using AT devices were: lack of information about AT s and access to money for their purchase, lack of availability and cost of such devices, and (self)-stigma. More women than men experienced limited access to AT services, limited access to and control of money, limited skills for using AT, and less bargaining power for making independent decisions. More men than women expressed a lack of functional need and personal preferences other than using AT devices for managing difficulties in activities. There are gender differences concerning the multilevel barriers to using AT devices among older Hispanics residing in low-income communities. Older Hispanic men and women in this study experienced different obstacles to using assistive technology (AT) they need for compensating their functional disabilities in daily living activities. Women in this study reported having less access to money and AT services, diminished skills for using AT devices, and less power to make independent decisions to access AT devices compared to men. To ensure the equitable provision of AT, cultural as well as gender-related factors concerning AT use need to be considered. Future research should focus on women's functional health, also should focus on the development of gender-sensitive and culturally competent AT interventions to improve older Hispanics from poor communities function and opportunities for ageing at their homes and in their communities. [ABSTRACT FROM AUTHOR]

By means of probabilistic graphical models, in this paper, we present a new framework for exploring relationships among indicators commonly included in the Multidimensional Poverty Index (MPI). In particular, we propose an Ising model with covariates for modeling the MPI as an undirected graph. First, we prove why Ising models are consistent with the theoretical distribution of MPI indicators. Then, a comparison between our estimates and the association measures typically used in the literature is provided. Finally, we show how undirected graphs can complement the MPI policy-relevant properties, apart from discovering further insightful patterns that can be useful for policy purposes. This novel approach is illustrated with an empirical application for the global MPI indicators of Guinea and Ecuador, taking living areas and monetary poverty as covariates, respectively. [ABSTRACT FROM AUTHOR]

Mindfulness has been shown to increase parental well-being in multi-faceted ways, yet we do not invest in broad applications of mindfulness training for those most in need. The overall aim of this qualitative study is to better understand whether and how mindful self-care instruction helps Black, low-income women assimilate the experience of birth and the transition into motherhood. Conclusions indicate that the mindfulness program impacts these women by helping them feel more connected to themselves, increasing their awareness and practice of self-care, and improving their mental health and well-being. [ABSTRACT FROM AUTHOR]

Calls for humanity to act on environmental changes are becoming increasingly critical. The growing polycrisis including the impact of ongoing conflicts in contested geopolitical spaces and the struggles for ways to sustain a livelihood in areas of precarity and poverty, are just some of the intersecting challenges which have given rise to a Code Red alarm by the United Nations surrounding issues related to climate change. Rich narratives and stories of climate actions from Africa offer examples of potential paths. This paper explores how such narratives inform local development and climate action. A key message is that stories and narratives, created by various peoples, disciplines, and systems of knowledge, can all be powerful genres and sources for agentic change that can inspire and embolden development practice and action. [ABSTRACT FROM AUTHOR]

This study aimed to (a) compute the prevalence of violence exposure types, polyvictimization, and self-reported depression, anxiety, and using substances to cope among youth ages 12–18 years living on the streets or in the slums of Kampala, Uganda, (b) examine the independent associations among orphan status, violence exposure types, and self-reported mental health concerns, and (c) explore the association between polyvictimization and mental health concerns. Data are from a 2014 cross-sectional survey of service-seeking youth ages 12–18 years (N = 1134) in Kampala, Uganda. Violence exposure types explored in this study were: witnessing family physical violence, direct physical abuse by a parent, any rape history, and physical dating violence. We used descriptive statistics and multivariable logistic regression to test study objectives. Over half of the sample (60.5%) reported experiencing at least one type of violence exposure; many youth endorsed self-reported depression (57.8%), anxiety (76.8%), and substance use to cope (37.0%). Exposure to violence was associated with higher odds for self-reported depression, anxiety, and using substances to cope. These findings underscore the urgent need to implement evidence-based interventions among this young, underserved population and their families to prevent violence, improve mental health outcomes, and promote resilience. [ABSTRACT FROM AUTHOR]

Introduction: Pregnant British Pakistani women have disproportionately poorer health than the wider population. Bradford has a strong Pakistani presence and a wide range of public health problems including high levels of gestational diabetes, high obesity rates and a high infant mortality rate, which is highest for babies of Pakistani origin. For women to be healthy, we need to know what concerns they have about their health so they can be addressed appropriately. The aim of this study, therefore, was to explore the health concerns of pregnant British Pakistani women living in deprived areas. Methods: Semi-structured qualitative interviews were conducted with 21 pregnant Pakistani women in a hospital setting. Data were analysed using thematic analysis. Results: Pakistani women identified safety issues, barriers to undertaking physical activity in the areas where they live, concerns surrounding exercising during pregnancy and cultural and religious constraints that prevented them from engaging in physical activity. They reported issues around food, concerns around a lack of culturally appropriate diet information, the cost of unhealthy food locally, and the lack of healthy food options in their residences. Women were unsure on where to obtain health promotion information and reported a lack of access in obtaining that information. Language barriers in accessing health promotion information were further reported as a concern. Discussion: Researchers, midwives, health providers, local authority and policy makers interested in improving the health of pregnant Pakistani women may use these findings to develop further research and interventions to improve the poor health of this population. Significance: What is already known on this subject? South Asian women have previously identified issues relating to safety in physical activity and cultural barriers to engaging in physical activity but there has been little investigation into the health concern of pregnant Pakistani women. What this study adds? We now have a clearer understanding of the barriers faced by pregnant Pakistani women living in deprived areas when trying to live a healthy lifestyle. This understanding will contribute to the development of strategies for promoting health and improving the outcomes for this population. [ABSTRACT FROM AUTHOR]

Background: Adolescents are vulnerable to stressors because of the rapid physical and mental changes that they go through during this life period. Young people residing in slum communities experience additional stressors due to living conditions, financial stress, and limited access to healthcare and social support services. The Adolescents' Resilience and Treatment nEeds for Mental Health in Indian Slums (ARTEMIS) study, is testing an intervention intended to improve mental health outcomes for adolescents living in urban slums in India combining an anti-stigma campaign with a digital health intervention to identify and manage depression, self-harm/suicide risk or other significant emotional complaints. Methods: In the formative phase, we developed tools and processes for the ARTEMIS intervention. The two intervention components (anti-stigma and digital health) were implemented in purposively selected slums from the two study sites of New Delhi and Vijayawada. A mixed methods formative evaluation was undertaken to improve the understanding of site-specific context, assess feasibility and acceptability of the two components and identify required improvements to be made in the intervention. In-depth interviews and focus groups with key stakeholders (adolescents, parents, community health workers, doctors, and peer leaders), along with quantitative data from the digital health platform, were analysed. Results: The anti-stigma campaign methods and materials were found to be acceptable and received overall positive feedback from adolescents. A total of 2752 adolescents were screened using the PHQ9 embedded into a digital application, 133 (4.8%) of whom were identified as at high-risk of depression and/or suicide. 57% (n = 75) of those at high risk were diagnosed and treated by primary health care (PHC) doctors, who were guided by an electronic decision support tool based on WHO's mhGAP algorithm, built into the digital health application. Conclusion: The formative evaluation of the intervention strategy led to enhanced understanding of the context, acceptability, and feasibility of the intervention. Feedback from stakeholders helped to identify key areas for improvement in the intervention; strategies to improve implementation included engaging with parents, organising health camps in the sites and formation of peer groups. Trial Registration: The trial has been registered in the Clinical Trial Registry India, which is included in the WHO list of Registries, Reference number: CTRI/2022/02/040307. Registered 18 February 2022. [ABSTRACT FROM AUTHOR]

We examine how Danish politicians articulate views on the 'parallel society agreement' (aka, the 'ghetto‐laws'), a controversial legislative intervention aiming to manage urban migration‐related diversity. Through nationwide urban redevelopment aimed at facilitating residential 'mixing', the goal of the legislation is to eliminate so‐called 'parallel societies'—socio‐economically deprived neighbourhoods characterized by high concentrations of ethnic minorities. In‐depth interviews with Danish politicians (n = 11) explored how this proposal was supported, contested or rejected in situated discourse. Following social representations theory, we focus on how 'parallel societies' were constructed in relation to differing ideas about 'mainstream society' and value‐laden oppositional meaning‐categories (i.e. themata). In particular, we highlight processes of socio‐ethical reasoning that occurred through thematization of a shared oppositional meaning‐category: 'freedom‐constraint'. Views on the intervention were articulated around this oppositional meaning‐category. Moreover, a connection was observed between the views articulated by individual politicians and sets of congruent ideas and images mobilized to represent 'parallel societies'. We discuss the theoretical value of taking a social representations approach to urban policy debates, and the practical limitations of dominant representations for successfully promoting intercultural dialogue and engagement—the stated goal of this intervention. [ABSTRACT FROM AUTHOR]

Purpose: Phonological awareness and alphabet knowledge are fundamental building blocks for literacy development. We identified preschoolers with persistent delays in these skills and evaluated the efficacy of a supplemental curriculum to remediate deficits in early literacy skills. Method: Using a cluster design, 21 classrooms were randomly assigned to early literacy versus language intervention conditions. Sixty children identified through fall semester assessments of phonological awareness and alphabet knowledge were enrolled in small-group instruction. Teachers completed eLearning modules, used a digital platform to enter data and facilitate data-based decision making, received practice-based coaching, and delivered 12 weekly units of an early literacy curriculum. Comparison teachers delivered similarly administered small-group language instruction. Results: Large effects were evident for letter sounds, phoneme segmentation, first sound, and first sound fluency measures (d = 0.92, 4.77, 1.15, and 1.50, respectively), and nonsignificant, small effects for letter naming and blending measures (d = 0.26 and 0.27). Discussion: This early literacy intervention package had practical benefits, with 90% of experimental group preschoolers exceeding the phonemic awareness benchmark for beginning kindergarten compared to 45% in the comparison group, for example. Providing preschool teachers with tools and support for implementing a tiered approach to early literacy intervention holds promise for producing impressive gains in skills required for children to succeed in later schooling. [ABSTRACT FROM AUTHOR]

This study examines factors underlying single mothers' stress in an African slum. Using survey data from 1,221 mothers in a Kenyan informal settlement, this study examines 1) whether single mothers experience more stress due to their demographic and socioeconomic characteristics; 2) whether financial and child care support from kin offsets limited support from fathers; and 3) whether variation in the type and source of support explains stress differentials across marital status. The results suggest that lower socioeconomic status does not explain single mothers' elevated stress. Rather, despite receiving greater assistance with child care and financial support from kin, single mothers receive substantially less support of either kind from the child's father. These differences in support, particularly financial assistance, account for single mothers' elevated stress. These findings highlight the comparatively weak social support available for single mothers residing in precarious urban environments and its importance for their psychological well-being. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to examine the motivations and supports of stakeholders in the slum communities, Ghana. Design/methodology/approach: Two-stage methodologies were used for data collection. Published Google News articles about the phenomenon as well as exploratory qualitative in-depth interviews with 15 participants. Findings: The evidence shows that structured and unstructured are the two main categories of stakeholders operating in the space of slums in Ghana. It shows that stakeholders are motivated by their objectives and ethical or moral obligations to provide support in the form of consumables, housing and finance to the slums. Research limitations/implications: Because of the data collection regime used in this project, findings are specific to the Ghanaian context and not generalisable. However, the results could be beneficial in other contexts with similar slum phenomena. Practical implications: The conclusions drawn serve as a springboard for urban managers responsible for slum administration and management to develop policy packages to incentivise and enlist more non-slum stakeholders in the existing stakeholders. Originality/value: To the best of the authors' knowledge, this study is one of the few that expands the frontiers of the stakeholder model within context to discover specific slum stakeholders, their motivations and support for the slums in a consolidated manner. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension, the "Silent, Invisible killer" - is a modern day's universal epidemic. The adult populations in slum area are more vulnerable for hypertension as they are so busy in the fulfilment of even day to day basic needs and care, family commitments and economic stress. Aim and objectives: To estimate the prevalence of hypertension among the adults (25-44 years) and to study the effect of sleep on blood pressure levels. Methodology: The present cross-sectional study was carried among adults aged between 25 to 44 years residing in the slums of Meerut District. 30 Cluster Sampling technique was used. The slum was selected as a cluster unit. During the visit by house-to-house survey, members of the family were listed and eligible person were interviewed and examined. Data collected on a structured and pretested questionnaire. Results: Prevalence of hypertension among those who had sleep duration of >8 hours per day was 44.8% followed by 20.1% and 17.5% among those who had 7-8 hours and less than 7 hours of sleep time respectively. It was found that 24.2% monophasic sleep pattern follower were hypertensives while the prevalence was 19.4% in biphasic pattern. Conclusion: Majority (55.4%) had a sleep duration between 7-8 hours, followed by 33.9% and 10.7% with <7 hours and >8 hours of sleep time respectively. Majority (61.3%) of the study population were having monophasic sleep pattern, while 36.3% were biphasic and 2.4% were multiphasic. [ABSTRACT FROM AUTHOR]

In this paper, we present the results of a scoping review in which we examined the scientific literature (2010–2021) on faith-based organizations (FBOs) working within the field of poverty alleviation, focusing on the way studies define and use the term FBO. Fifty-two relevant studies were identified and included. Our research shows that the term FBOs is primarily used in American studies. Moreover, there is no broad consensus on the exact definition or meaning of the term nor on its scope. Because of this lack of consensus and the inherent shortcomings of the term, we suggest to replace the term FBO by the term "religion-based solidarity initiatives" (RSIs), We define RSIs as: "Initiatives that, from a religious inspiration, aim at organizing collective action for and/or providing support or services to people in vulnerable positions." These initiatives can range from small scale ad hoc initiatives till large scale formal organizations. [ABSTRACT FROM AUTHOR]

The article focuses on a study that measured lead levels in maternal and cord blood in a convenience sample of mothers delivering at a hospital that serves women from the informal settlements of Dandora and Kariobangi in Nairobi. It describes the methods used to investigate maternal lead exposures in the settlements as well as associations between potential lead sources and blood lead levels. It discusses the implications of the discovery of high BLL found in the study participants.

The authors discuss a study by Dragan and Glied, published in the issue which highlights three important aspects of Vision Zero or Safe System programs, which can address disparities in road traffic injuries. Topics include purpose of Vision Zero, reason that the findings by Dragan and Glied are particularly challenging, and reason that the U.S. has only recently adopted Safe System approaches.

The article discusses some strategies on how to address the impacts of climate change on health in urban areas. Topics mentioned include the need of community engagement in informal settlements, the importance of government investment, and the key role of socioeconomic equity in preventing climate risks.

• COVID-19 highlighted historical and ongoing racial inequities experienced by African Americans. • Qualitative findings can inform families' needs in another extreme event. • Findings underscore the need to proactively address sociodemographic risk factors. The current study identified qualitative themes describing the impact of COVID-19 on African American families living in urban, low-income areas. A total of 22 caregivers, 15 adolescents, and 37 community partners, including service providers and organizational leaders participated in qualitative interviews. Study findings identified five qualitative themes that included: (a) the worsening of existing inequities, (b) altering the framework for public education delivery, (c) changes in the dynamics of family relationships, (d) challenges in healthcare, emotional impact, and well-being, and (e) positive changes such as learning and coping. Our findings provided a context-specific examination of COVID-19′s impact, identifying some novel qualitative aspects using multiple perspectives that have implications for policy and practice. [ABSTRACT FROM AUTHOR]

Urban children are more likely to be vaccinated than rural children, but that advantage is not evenly distributed. Children living in poor urban areas face unique challenges, living far from health facilities and with lower-quality health services, which can impact their access to life-saving vaccines. Our goal was to compare the prevalence of zero-dose children in poor and non-poor urban and rural areas of low- and middle-income countries (LMICs). Zero-dose children were those who failed to receive any dose of a diphtheria-pertussis-tetanus (DPT) containing vaccine. We used data from nationally representative household surveys of 97 LMICs to investigate 201,283 children aged 12–23 months. The pooled prevalence of zero-dose children was 6.5% among the urban non-poor, 12.6% for the urban poor, and 14.7% for the rural areas. There were significant differences between these areas in 43 countries. In most of these countries, the non-poor urban children were at an advantage compared to the urban poor, who were still better off or similar to rural children. Our results emphasize the inequalities between urban and rural areas, but also within urban areas, highlighting the challenges faced by poor urban and rural children. Outreach programs and community interventions that can reach poor urban and rural communities—along with strengthening of current vaccination programs and services—are important steps to reduce inequalities and ensure that no child is left unvaccinated. [ABSTRACT FROM AUTHOR]

The widespread use of social media (SM) platforms among adolescents has raised concerns over its role in increased adverse physical and mental health conditions. However, current research linking SM use with adolescent health relies on tenuous correlational associations, disproportionately focuses on harmful effects of its use, and seldom examines the perspectives of youth themselves (Odgers and Jensen, 2020; Schønning et al., 2020). This article examines adolescent lived experience in relation to SM platform engagement. Drawing from ethnographic fieldwork conducted in 2018–2019 and 2021–2022 among 75 middle-school adolescents living in an ethnically diverse and low-income Southern California community, we examine adolescent subjective experiences with SM platforms that illuminate adolescent concerns during this developmental stage. By attending to adolescent subjectivity, this article reveals the ways in which engagement with SM platforms is inextricable from cultural, social, political, and socio-emotional milieu. • The majority of young adolescents use SM more than previous studies suggest. • SM research requires attention to experience beyond negative health outcomes. • Ethnographic research reveals cultural and psychological themes and social dynamics. • SM is embedded within social, cultural, and political milieu of lived experience. [ABSTRACT FROM AUTHOR]

China still faces relatively serious energy poverty, and technological innovation is considered effective at alleviating this issue. This paper empirically investigates the impact of regional technological innovation on energy poverty based on panel data from 30 provinces in China from 2001 to 2020. This paper explores the effect of industrial structure distortion in the process of technological innovation on energy poverty. This paper conducts asymmetry analysis and investigates the heterogeneous impact of technological innovation on energy poverty in different areas. The research conclusions are as follows: (1) Regional technological innovation can effectively alleviate energy poverty. (2) Industrial structure distortion moderates the impact of technological innovation on energy poverty, and it weakens the effect of technological innovation in alleviating energy poverty, although the moderating effect is not significant in coal-producing regions. (3) The effect of technological innovation on alleviating energy poverty is more obvious in regions where energy poverty is prominent. (4) The role of technological innovation in alleviating energy poverty shows spatial heterogeneity, and this alleviation effect is more obvious in the western and non-coal producing regions. We also propose several policy implications for alleviating energy poverty. • Regional technological innovation can effectively alleviate energy poverty. • Industrial structure distortion moderates the impact of technological innovation on energy poverty. • Industrial structure distortion hinders the ability of technological innovation to alleviate energy poverty. • Technological innovation is more effective in alleviating energy poverty in regions where energy poverty is severe. • Technological innovation is more effective at alleviating energy poverty in the west and non-coal-producing regions. [ABSTRACT FROM AUTHOR]

The two important goals of sustainable development, affordable and clean energy, and good health and well-being have attracted global attention. This study explores the nexus and impact pathways between energy poverty and farmers' health, defining energy poverty from a multidimensional perspective that includes cooking, washing, warming, cooling, showering, traveling, entertainment, education, and communication. A mixed approach is deployed by using 1016 survey data collected from the rural mountainous areas of China, where the probit model, ordinary least squares, and conditional mixed process estimation methods are used for model estimation. Results indicate that farmers' physical and mental health is significantly negatively affected by multidimensional energy poverty. Regards to the different dimensions of energy poverty, cooking energy and traveling energy have considerable negative impacts on farmers' health. In terms of population heterogeneity, multidimensional energy poverty has a worse effect on farmers' health in the empty-nest stage and on males. To alleviate multidimensional energy poverty and improve health, this study proposes targeted policy recommendations for domestic policymakers and can shed light on other developing economies facing similar challenges. • The average incidence of multidimensional energy poverty in study area is 32.48 %. • Multidimensional energy poverty negatively affects farmers' health. • Cooking and traveling energy have significant negative impacts on farmer' health. • The negative impact on farmer' health in empty-nest stage is greater. [ABSTRACT FROM AUTHOR]