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Purpose: To evaluate the relationship between socioeconomic disadvantage using national area deprivation index (ADI) and CT-based body composition measures derived from fully automated artificial intelligence (AI) tools to identify body composition measures associated with increased risk for all-cause mortality and adverse cardiovascular events. Methods: Fully automated AI body composition tools quantifying abdominal aortic calcium, abdominal fat (visceral [VAT], visceral-to-subcutaneous ratio [VSR]), and muscle attenuation (muscle HU) were applied to non-contrast CT examinations in adults undergoing screening CT colonography (CTC). Patients were partitioned into 5 socioeconomic groups based on the national ADI rank at the census block group level. Pearson correlation analysis was performed to determine the association between national ADI and body composition measures. One-way analysis of variance was used to compare means across groups. Odds ratios (ORs) were generated using high-risk, high specificity (90% specificity) body composition thresholds with the most disadvantaged groups being compared to the least disadvantaged group (ADI < 20). Results: 7785 asymptomatic adults (mean age, 57 years; 4361:3424 F:M) underwent screening CTC from April 2004-December 2016. ADI rank data were available in 7644 patients. Median ADI was 31 (IQR 22–43). Aortic calcium, VAT, and VSR had positive correlation with ADI and muscle attenuation had a negative correlation with ADI (all p <.001). Compared with the least disadvantaged group, mean differences for the most disadvantaged group (ADI > 80) were: Aortic calcium (Agatston) = 567, VAT = 27 cm2, VSR = 0.1, and muscle HU = -6 HU (all p <.05). Compared with the least disadvantaged group, the most disadvantaged group had significantly higher odds of having high-risk body composition measures: Aortic calcium OR = 3.8, VAT OR = 2.5, VSR OR = 2.0, and muscle HU OR = 3.1(all p <.001). Conclusion: Fully automated CT body composition tools show that socioeconomic disadvantage is associated with high-risk body composition measures and can be used to identify individuals at increased risk for all-cause mortality and adverse cardiovascular events. [ABSTRACT FROM AUTHOR]

Mathematics education is seen as a right for all children, and important to ensure a prosperous future. However, in Australia and other nations, rural students and students from low socioeconomic backgrounds both perform less well in mathematics and are less likely to pursue advanced mathematics. This paper presents a case study of a low socioeconomic status, rural government school that has high engagement and achievement in senior mathematics, despite its setting. The study uses a conceptual framework informed by Appreciative Inquiry and the theory of Practice Architectures to explore the activities and facilitatory elements that have likely contributed to the school's mathematics success. Rather than being attributed to one or two key programmes, the school's mathematics success seemed associated with a collection of whole-school factors. Setting high expectations while providing proactive learning support, differentiating instruction, emphasising the value of mathematics, linking mathematics to careers, and building mathematics teacher capacity were all associated with the school's higher than expected mathematics performance. Rather than hindering the school's mathematics programme, its small size and rural context were used to enable practices that contributed to mathematics success. [ABSTRACT FROM AUTHOR]

The identification of seriously infected areas across a city, region, or country can inform policies and assist in resources allocation. Concentration of coronavirus infection can be identified through applying cluster detection methods to coronavirus cases over space. To enhance the identification of seriously infected areas by relevant studies, this study focused on coronavirus infection by small area across a city during the second wave. Specifically, we firstly explored spatiotemporal patterns of new coronavirus cases. Subsequently, we detected spatial clusters of new coronavirus cases by small area. Empirically, we used the London-wide small-area coronavirus infection data aggregately collected. Methodologically, we applied a fast Bayesian model-based detection method newly developed to new coronavirus cases by small area. As empirical evidence on the association of socioeconomic factors and coronavirus spread have been found, spatial patterns of coronavirus infection are arguably associated with socioeconomic and built environmental characteristics. Therefore, we further investigated the socioeconomic and built environmental characteristics of the clusters detected. As a result, the most significant clusters of new cases during the second wave are likely to occur around the airports. And, lower income or lower healthcare accessibility is associated with concentration of coronavirus infection across London. [ABSTRACT FROM AUTHOR]

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Background: Very little is known about self-harm in children. We describe the characteristics and outcomes of children under 13 years who presented following self-harm to five hospitals in England. Methods: We included children under 13 years who presented after self-harm to hospitals in the Multicentre Study of Self-harm in England. Information on patients' characteristics and method of self-harm was available through monitoring of self-harm in the hospitals. Area level of socioeconomic deprivation was based on the English Index of Multiple Deprivation (IMD). Results: 387 children aged 5–12 years presented to the study hospitals in 2000–2016, 39% of whom were 5–11 years. Boys outnumbered girls 2:1 at 5–10 years. The numbers of boys and girls were similar at age 11, while at 12 years there were 3.8 girls to every boy. The proportion of study children living in neighbourhoods ranked most deprived (43.4%) was twice the national average. 61.5% of children self-poisoned, 50.6% of them by ingesting analgesics. Of children who self-injured, 45.0% self-cut/stabbed, while 28.9% used hanging/asphyxiation. 32% of the children had a repeat hospital presentation for self-harm, 13.5% re-presented within a year. Conclusions: Gender patterns of self-harm until age 11 years are different to those of adolescents, with a male preponderance, especially in 5–10 years, and hanging/suffocation being more common. The frequent use of self-poisoning in this age group highlights the need for public health messages to encourage safer household storage of medicines. Self-harm in children is strongly associated with socioeconomic deprivation; understanding the mechanisms involved could be important in effective prevention. [ABSTRACT FROM AUTHOR]

Since its development, Singh's 2003 Area Deprivation Index (ADI) has been routinely used by researchers to measure a global construct of neighborhood socioeconomic deprivation and to investigate how living in neighborhoods of different levels of socioeconomic deprivation affects individuals' health. We empirically tested the ADI's dimensionality, using 2013–2017 American Community Survey tract-level estimates (N = 73,056), and the stability of its performance across time and place. Factor analysis findings illuminated three distinct dimensions, the ADI-3, consisting of neighborhood financial strength, economic hardship and inequality, and educational attainment. The prior-assumed unidimensional ADI measure fails standard tests of construct validity. Findings from multigroup structural equation modeling across 2009 and 2017 and between New York and Minnesota suggest that the ADI performs with only partial stability across time and place. In order to most precisely understand the complex role of neighborhood socioeconomic position in health, public health researchers must integrate construct-valid and regionally and temporally relevant measures. [ABSTRACT FROM AUTHOR]

Understanding of the role of objective versus subjective childhood socioeconomic disadvantage (SD) in depression onset in adulthood among women, independent of later life SD, and across birth cohorts, is limited. We examined the association between objective (i.e., household education level) and subjective (i.e., rank of family income and report of not enough food to eat) SD during childhood and diagnosis of clinical depression after age 30 among 47,055 women in the Sister Study. We used Cox proportional hazard models adjusting for women's race/ethnicity, childhood household composition, mother's age at her birth adulthood educational attainment, and calendar year of birth. Analyses were repeated stratified by 10-year birth group. A total of 8036 (17.1%) women were diagnosed with clinical depression over a mean follow-up of 24.0 (± 9.9) years. Those reporting being poor (versus well-off) or not having enough food to eat in childhood had a 1.28 (95% confidence interval (CI) 1.13, 1.44) and 1.30 (95% CI 1.21, 1.41) times higher rate of depression diagnosis, respectively, with consistent associations observed across birth year groups. An inverse association between low household education level and incident depression was observed at baseline (i.e., age 30) becoming positive over time in the total sample but only among women born between 1935–1954 in analyses stratified by 10-year birth group. Our findings suggest that subjective SD in childhood is a largely consistent predictor of depression onset among women in adulthood whereas the effects of household education level in childhood may vary across women born into different birth cohorts, and for some, across the lifecourse. [ABSTRACT FROM AUTHOR]

The racial and ethnic disproportionality and disparity in the child protective system (CPS) has been a concern for decades. Structural factors strongly influence engagement with the child welfare system and families experiencing poverty or financial hardship are at a heightened risk. The economic factors influencing child welfare involvement are further complicated by structural racism which has resulted in a greater prevalence of poverty and financial hardship for families who are Black, Native American or Alaska Native (Indigenous), or and Latino/Hispanic (Latino) and their communities. The multiple decision points within CPS are an opportunity to reify or correct for bias in child welfare outcomes. One major effort to eliminate racial disparities and disproportionalities has been to enact standardized decision-making procedures that aim to control for implicit or explicit bias in CPS. The Structured Decision-Making Model's (SDM) actuarial-based risk assessment (RA) is the gold-standard of these efforts. In this conceptual article, we ask (1) How are structural factors accounted for in assessment of risk within CPS? and (2) What are the consequences when structural factors are left out of risk assessments procedures? We posit that the exclusion of race, ethnicity, and economic factors from the RA has inflated the importance of variables that become proxies for these factors, resulting in inaccurate assessments of risk. The construction of this tool reflects how structural racism has been overlooked as an important cause of disproportionality in CPS, with interventions then focused on individual workers and cases, rather than the system at large. We suggest a new framework for thinking about risk, the structural risk perspective, and call for a revisioning of assessment of risk within child welfare that acknowledges the social determinants of CPS involvement. [ABSTRACT FROM AUTHOR]

Neighborhood greenness has been linked to better cardiovascular health, but little is known about its association with biomarkers related to cardiovascular risk. Adverse neighborhood conditions, such as disorder and socioeconomic disadvantage, are associated with higher cardiovascular biomarker levels, but these relationships may differ in neighborhoods with more greenness. This study evaluated cross-sectional associations of validated measures of neighborhood greenness, disorder, and socioeconomic disadvantage with cardiovascular biomarkers in middle-aged and older adults living in Baltimore City. The sample included 500 adults, aged 57–79 years, enrolled in the Baltimore Memory Study and living in Baltimore City during 2009–2010. Multi-level log-gamma regressions examined associations between the three neighborhood characteristics and seven cardiovascular biomarkers. Models additionally evaluated the effect modification by neighborhood greenness on associations of neighborhood disorder and socioeconomic disadvantage with the biomarkers. Adjusting for covariates and neighborhood greenness, greater neighborhood disorder was associated with higher C-reactive protein (exp β = 1.21, SE = 0.11, p = 0.035) and serum amyloid A (exp β = 1.28, SE = 0.12, p = 0.008), while greater neighborhood socioeconomic disadvantage was associated with higher tumor necrosis factor alpha (exp β = 1.24, SE = 0.12, p = 0.019). Higher neighborhood greenness was associated with lower soluble vascular cell adhesion molecule-1, accounting for disorder (exp β = 0.70, SE = 0.10, p = 0.010) and socioeconomic disadvantage (exp β = 0.73, SE = 0.10, p = 0.025). There was no evidence of effect modification among neighborhood characteristics. The findings suggest that neighborhood effects on cardiovascular health may be mediated through cardiovascular biomarker levels, and that socioeconomic disadvantage, disorder, and greenness may each be important features of neighborhoods. [ABSTRACT FROM AUTHOR]

We use a "chain of risks" model to identify risk factors for prolonged heavy drinking in a nationally representative US sample followed from adolescence to middle age, focusing on educational mediators and differential consequences of early exposure to family poverty and area-level disadvantage. Using data from the 1979 National Longitudinal Survey of Youth (civilian respondents ages 14-19 at baseline, N = 5781), longitudinal path models assessed racial/ethnic and gender differences in indirect effects of early disadvantage (duration of exposure to family poverty and area-level disadvantage during adolescence) on midlife heavy drinking. Educational mediators were high school academic performance (taking remedial coursework), high school completion, and attaining a college education. Subgroups were based on race/ethnicity (50.7% White, 30.5% Black, 18.8% Hispanic respondents) and gender (49.6% males). There was a significant indirect path from family poverty during adolescence to poor high school academic performance, lower educational attainment, and more heavy drinking in midlife. For Black respondents, there was an additional direct effect of early area-level disadvantage on greater midlife heavy drinking that was not seen for other groups. The effect of family poverty on reduced high school graduation was stronger for males than females. Enduring impacts of family poverty duration during adolescence on educational attainment have consequences for health risk behaviors in midlife. Due to differential exposure to early adversity, intersectoral interventions are needed to reduce disparities in alcohol outcomes and to promote health equity among high-risk populations. [ABSTRACT FROM AUTHOR]

We propose a household production function approach to human development that explicitly considers the role of parenting style in child rearing. Specifically, parenting style is modeled as an investment that depends not only on inputs of time and market goods, but also on attention. Our model relates socioeconomic disadvantage to parenting style and human development through the constraints that disadvantage places on cognitive capacity. We find empirical support for key features of our model. Parenting style is a construct that is distinctive to standard parental investments and is important for young-adult outcomes. Effective parenting styles are negatively correlated with disadvantage. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the association between poverty and child mental disorders, and in particular, address an important knowledge gap by examining the influence of primary carer mental health in these relationships. We extend previous research by differentiating by specific child mental disorders, age group (4–11 and 12–17 year-olds) and gender using data from a 2013/14 national survey of 4–17 year-olds in Australia, Young Minds Matter (N = 6310). Mental disorders were assessed using the Diagnostic Interview Schedule for Children – Version IV. Primary carer mental health problems were determined by three self-reported measures. We calculated a poverty line according to OECD standards. The greatest risk of any mental disorders when living in poverty was among 12–17 year-old males (unadjusted OR = 2.77; 95% CIs = 1.91–4.02), a significantly higher risk than for 4–11 year-old males, and particularly strong for Attention-Deficit/Hyperactivity Disorder (ADHD). By disorder type, poverty was most strongly related to Conduct Disorder (CD) and least strongly related to Major Depressive Disorder (unrelated in adolescent females). When adjusting for primary carer mental health problems, the associations between poverty and child mental disorders were not statistically significant, except among 12–17 year-old males, and for CD and ADHD in the whole sample. Further adjustment for family structure and area-level disadvantage accounted for these associations. Our results demonstrated the importance of paying attention to parental and child mental health, and the child's developmental stage and gender when assessing the welfare, social and health service needs of families and their children living in poverty. [ABSTRACT FROM AUTHOR]

This study investigates mechanisms through which socioeconomic disadvantage impacts family and child functioning using data from the Fragile Families and Child Wellbeing Study (FFCWS), which includes 4,898 families followed from a child’s birth through age 9 (47.6% female). Analyses explored associations between economic stress at birth and age 1 and child conduct problems at age 9 and whether associations were sequentially mediated through age 3 maternal depression and age 5 observed harsh and positive parenting. Results revealed several significant direct associations. Lower mean income at birth and age 1 was associated with higher material hardship at age 1. Hardship was associated with increased risk of maternal depression at age 3. Maternal depression was associated with higher harsh/lower positive parenting at age 5. Higher harsh/lower positive parenting were associated with higher conduct problems at age 9. While indirect effects for the full series of pathways from income to conduct problems through three sequential meditators (hardship, maternal depression, harsh/positive parenting) were not significant, several specific indirect effects were significant. The effect from income to positive parenting through hardship and depression was significant. The effects of income on conduct problems through harsh and positive parenting were significant. The effect of income on depression through hardship was significant. Results suggest that effects of socioeconomic disadvantage on conduct problems are partially mediated by compromised parenting. Further, material hardship partially explained how lower income was associated with maternal depression and less optimal parenting. Implications for future studies investigating material hardship and impacts of disadvantage are discussed. [ABSTRACT FROM AUTHOR]

Numerous theories assert that youth with externalizing symptomatology experience intensified emotion reactivity to stressful events; yet scant empirical research has assessed this notion. Using in-vivo data collected via experience sampling methodology, we assessed whether externalizing symptoms conditioned adolescents' emotion reactivity to daily stressors (i.e. change in emotion pre-post stressor) among 206 socioeconomically disadvantaged adolescents. We also assessed whether higher externalizing symptomology was associated with experiencing more stressors overall, and whether adolescents' emotional upheavals resulted in experiencing a subsequent stressor. Hierarchical linear models showed that adolescents higher in externalizing symptoms experienced stronger emotion reactivity in sadness, anger, jealously, loneliness, and (dips in) excitement. Externalizing symptomatology was not associated with more stressful events, but a stress-preventative effect was found for recent upheavals in jealousy among youth low in externalizing. Findings pinpoint intense emotion reactivity to daily stress as a risk factor for youth with externalizing symptoms living in socioeconomic disadvantage. [ABSTRACT FROM AUTHOR]

We examined whether parent engagement in parent training (PT) differed based on PT format (parent group-based with video versus mastery-based individual coaching with child) in an economically disadvantaged sample of families seeking behavioral treatment for their preschool children in an urban mental health clinic. Parents (N = 159; 76.1% mothers, 69.8% African American, 73% low-income) were randomized to one of two interventions, Chicago Parent Program (parent group + video; CPP) or Parent-Child Interaction Therapy (individualized mastery-based coaching; PCIT). Parent engagement indicators compared were PT attendance and completion rates, participation quality, and parent satisfaction. Risk factors predictive of PT attrition (parent depression, psychosocial adversity, child behavior problem severity, length of wait time to start PT) were also compared to determine whether they were more likely to affect engagement in one PT format versus the other. No significant differences were found in PT attendance or completion rates by format. Clinicians rated parents’ engagement higher in PCIT than in CPP while satisfaction with PT was rated higher by parents in CPP compared to PCIT. Never attending PT was associated with more psychosocial adversity and externalizing behavior problems for CPP and with higher baseline depression for PCIT. Parents with more psychosocial adversities and higher baseline depression were less likely to complete PCIT. None of the risk factors differentiated CPP completers from non-completers. Delay to treatment start was longer for PCIT than CPP. Strengths and limitations of each PT format are discussed as they relate to the needs and realities of families living in urban poverty. [ABSTRACT FROM AUTHOR]

Family socioeconomic status (SES) and child health are so strongly related that scholars have speculated child health to be an important pathway through which a cycle of poverty is reproduced across generations. Despite increasing recognition that SES and health work reciprocally and dynamically over the life course to produce inequality, research has yet to address how these two pathways simultaneously shape children's development. Using longitudinal data from the Fragile Families and Child Wellbeing Study and marginal structural models, we ask three questions: (1) how does the reciprocal relationship between socioeconomic disadvantage and child health affect estimates of each circumstance on children's cognitive development?; (2) how do their respective effects vary with age?; and (3) do family SES and child health have differential effects on cognitive development across population subgroups? The results show that the negative effects of socioeconomic disadvantage and poor health are insensitive to their reciprocal relationships over time. We find divergent effects of socioeconomic disadvantage and poor health on children's cognitive trajectories, with a widening pattern for family SES effects and a leveling-off pattern for child health effects. Finally, the effects of socioeconomic disadvantage are similar across all racial/ethnic groups, while the effects of child health are largely driven by white children. We discuss theoretical and policy implications of these findings for future research. [ABSTRACT FROM AUTHOR]

This systematic review examines associations between parental socioeconomic disadvantage and childhood attention deficit/hyperactivity disorder (ADHD). Socioeconomic status (SES) was measured by parental income, education, occupation and marital status. Results were mixed by measure of SES with no one aspect being differentially related to ADHD. 42 studies were included in the review, of which 35 found a significant univariate association between socioeconomic disadvantage and ADHD. Meta-analyses of dimensions of SES and their association with ADHD indicate that children in families of low SES are on average 1.85-2.21 more likely to have ADHD than their peers in high SES families. In spite of substantial between-study heterogeneity, there is evidence for an association between socioeconomic disadvantage and risk of ADHD measured in different ways. This is likely mediated by factors linked to low SES such as parental mental health and maternal smoking during pregnancy. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We assess how the support parents provide to young adults as they leave school and begin working is related to their family's socioeconomic circumstances. We do this using an innovative Australian data set which merges survey and administrative data. The survey data inform us about intergenerational co-residence and financial gifts and the administrative data about the family's welfare receipt history. We find that disadvantaged young people are more likely to be economically independent of their parents than are their more advantaged peers. This disparity is larger for financial gifts than for co-residence and increases with age. Moreover, there is a complex relationship between parental support and participation in study and work. We find no evidence, however, that a lack of parental support is the source of the socioeconomic gradient in either studying or employment. These results are important in eliminating one potential pathway through which socioeconomic disadvantage limits young people's outcomes. [ABSTRACT FROM AUTHOR]

A number of studies have consistently reported that there is a greater prevalence of mental illness among the most socioeconomically disadvantaged. At the same time, there is evidence that services are not optimally accessed by the most socioeconomically disadvantaged; the most in need of care are also the most likely to have unmet healthcare needs. Of people with mental illnesses, those with severe mental illnesses (SMI) are the most at risk of poverty and the least likely to have optimal care. In the past, specialized community mental health services have been identified as the primary provider for people with SMI. However, there is growing interest in using the primary care setting as the main source of mental health care where both medical treatment and psychotherapy can be accessed. In this paper, we examine factors related to primary care use (and in turn, pharmacologic and psychotherapies) for people who are socioeconomically disadvantaged and who have a SMI. [ABSTRACT FROM AUTHOR]

While access to postsecondary education in Canada has increased over the past decade, a number of recent studies demonstrate that youth from disadvantaged socioeconomic backgrounds are vulnerable to some degree of exclusion from postsecondary education. These studies tend to emphasize the lack of financial resources and social capital as the main sources of this vulnerability. Our paper employs multilevel framework to explore the extent of the impact of schools on access to postsecondary education, especially for youth from disadvantaged background. Our analyses revealed that: (1) for youth with similar financial constraints who attend schools with relatively similar quality, those from disadvantaged socioeconomic backgrounds who attend schools with high concentration of low SES students are particularly vulnerable to exclusion from university education, and (2) a substantial portion of the SES effect operate through the impact of high school academic achievement and postsecondary education expectation on access to postsecondary education. [ABSTRACT FROM AUTHOR]

Objectives: This paper (a) creates and validates measures for population survey data to assess functional limitation in mobility, self-care, communication, and learning ability for school-age American children; (b) calculates rates of functional limitation using these measures, and provides population estimates of the number of children with limitations; and (c) examines these limitations as a function of socioeconomic factors. Method : The study is based on data for children aged 5–17 collected in the 1994 National Health Interview Survey on Disability. Ordinal values are assigned to survey items in the four functional areas and analyzed to produce scales of high reliability. These measures are used to identify within a 95% confidence interval the number of children with these limitations. Ordered logistic regression models measure the effects of functional limitations on disability and societal limitation. Socioeconomic differences are measured with an ordered logistic regression model that predicts severity and comorbidity. Results : Limitations in learning ability (10.6%) and communication (5.5%) are the most common, with mobility (1.3%) and self-care (0.9%) occurring less often. Six percent of children have one serious functional limitation and 2.0% have two or more serious functional limitations. This corresponds to 4.0 million school-age American children with serious functional limitations. Functional limitation is strongly linked to socioeconomic disadvantage and to residence in single-mother households. Conclusions : Future population research should use multiple-item scales for four distinct areas of functional limitation, and a summary that takes into account both severity and comorbidity. The improved estimates of the number of school-age children with functional limitation in this paper may help contribute to a more informed scientific and policy discussion of functional limitation and disability among American school-age children. Future research on the disability process among children must consider the role of socioeconomic disadvantage and family structure. [ABSTRACT FROM AUTHOR]