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Background: Previous studies show a positive association between household wealth and overweight in sub-Saharan African (SSA) countries; however, the manner in which this relationship differs in the presence of educational attainment has not been well-established. This study examined the multiplicative effect modification of educational attainment on the association between middle-income and rich household wealth and overweight status among adult females in 22 SSA countries. We hypothesized that household wealth was associated with a greater likelihood of being overweight among middle income and rich women with lower levels of educational attainment compared to those with higher levels of educational attainment., Methods: Demographic and Health Survey (DHS) data from 2006 to 2016 for women aged 18-49 years in SSA countries were used for the study. Overweight was defined as a body mass index (BMI) ≥ 25 kg/m 2 . Household wealth index tertile was the exposure and educational attainment, the effect modifier. Potential confounders included age, ethnicity, place of residence, and parity. Descriptive analysis was conducted, and separate logistic regression models were fitted for each of the 22 SSA countries to compute measures of effect modification and 95% confidence intervals. Analysis of credibility (AnCred) methods were applied to assess the intrinsic credibility of the study findings and guide statistical inference., Results: The prevalence of overweight ranged from 12.6% in Chad to 56.6% in Swaziland. Eighteen of the 22 SSA countries had measures of effect modification below one in at least one wealth tertile. This included eight of the 12 low-income countries and all 10 middle income countries. This implied that the odds of overweight were greater among middle-income and rich women with lower levels of educational attainment than those with higher educational attainment. On the basis of the AnCred analysis, it was found that the majority of the study findings across the region provided some support for the study hypothesis., Conclusions: Women in higher wealth strata and with lower levels of educational attainment appear to be more vulnerable to overweight compared to those in the same wealth strata but with higher levels of educational attainment in most low- and middle- income SSA countries.

Background: Aim of this study is to describe the relationship between anthropometric traits and educational attainment among Estonian schoolchildren born between 1937 and 1962. We asked whether height, cranial volume and face width (a testosterone-dependent trait), measured in childhood predict later educational attainment independently of each other, family socioeconomic position (SEP) and sex. Associations between morphometric traits and education and their interactions with biosocial variables are of scholarly importance because higher education is nearly universally associated with low fertility in women, and often with high fertility in men. Hence, morphometric traits associated with educational attainment are targeted by natural selection and describing the exact nature of these associations is relevant for understanding the current patterns of evolution of human body size., Methods: Data on morphometric measurements and family background of 11,032 Estonian schoolchildren measured between seven and 19 years of age were obtained from the study performed by Juhan Aul between 1956 and 1969. Ordinal logistic regression was used for testing the effects of morphometric traits, biosocial variables and their interaction on the cumulative probability of obtaining education beyond primary level., Results: Of biosocial variables, family SEP was the most important determinant of educational attainment, followed by the sex, rural vs urban origin and the number of siblings. No significant interactions with morphometric traits were detected, i.e., within each category of SEP, rural vs urban origin and sex, taller children and those with larger heads and relatively narrower faces were more likely to proceed to secondary and/or tertiary education. The effect of height on education was independent of cranial volume, indicating that taller children did not obtain more educations because their brains were larger than those of shorter children; height per se was important., Conclusions: Our main finding - that adjusting for other morphometric traits and biosocial variables, morphometric traits still robustly predicted educational attainment, is relevant for understanding the current patterns of evolution of human body size. Our findings suggest that fecundity selection acting on educational attainment could be partly responsible for the concurrent selection for smaller stature and cranial volume in women and opposite trends in men.

Background: Low back pain is an important public health issue across the world. However, it is unclear whether socioeconomic status (SES) is associated with low back pain. This study determines an association between SES and low back pain among older people., Methods: We used cross-sectional data derived from the year 2013 across 30 Japanese municipalities. The survey was conducted between October 2013 to December 2013. Functionally independent community-dwelling older adults aged 65 and above (n = 26,037) were eligible for the study. Multilevel Poisson regression analysis with a robust variance estimator was used to examine the association between SES and low back pain. Self-reported low back pain in the past year was used as a dependent variable. Educational attainment, past occupation, equivalized household income, wealth, and subjective economic situation represented SES and were separately analyzed as independent variables, adjusted for covariates including age and sex., Results: The prevalence of low back pain was 63.4%. Overall, lower SES were more likely to suffer from low back pain compared with that for the highest. First, as for the educational attainment, the prevalence ratio (PR) (95% credible interval (CI)) for the lowest level was 1.07 (1.02-1.12). Second, as for the past occupation, the PR (95% CI) for the blue-collared workers compared with professionals was 1.06 (1.01-1.11). Third, as for the equalized household income, the PRs (95% CI) for lower middle and the lowest income levels were 1.08 (1.02-1.13) and 1.16 (1.10-1.23), respectively. Fourth, as for the wealth, the PRs (95% CI) for lower middle and the lowest wealth levels were 1.11 (1.04-1.19) and 1.18 (1.11-1.27), respectively. Fifth, as for the subjective economic situation, the PRs (95% CI) for lower middle and the lowest financial conditions were 1.18 (1.10-1.26) and 1.32 (1.22-1.44), respectively., Conclusions: Significant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.

Background: Lifetime educational attainment is an important predictor of health and well-being for women in the United States. In this study, we examine the roles of sociocultural factors in youth and an understudied biological life event, pubertal timing, in predicting women's lifetime educational attainment., Methods: Using data from the National Longitudinal Survey of Youth 1997 cohort (N = 3889), we conducted sequential multivariate linear regression analyses to investigate the influences of macro-level and family-level sociocultural contextual factors in youth (region of country, urbanicity, race/ethnicity, year of birth, household composition, mother's education, and mother's age at first birth) and early menarche, a marker of early pubertal development, on women's educational attainment after age 24., Results: Pubertal timing and all sociocultural factors in youth, other than year of birth, predicted women's lifetime educational attainment in bivariate models. Family factors had the strongest associations. When family factors were added to multivariate models, geographic region in youth, and pubertal timing were no longer significant., Conclusion: Our findings provide additional evidence that family factors should be considered when developing comprehensive and inclusive interventions in childhood and adolescence to promote lifetime educational attainment among girls., (© 2016, American School Health Association.)

Objectives. To examine whether, through interactions with preexisting socioeconomic status vulnerabilities, the COVID-19 pandemic exacerbated exposure to firearm violence among communities with a legacy of redlining (i.e., grading the creditworthiness of neighborhoods based on their sociodemographic composition). Methods. We used an exogenous population threshold whereby the Home Owners Loan Corporation graded neighborhoods only in US cities with populations of more than 40 000 and used a difference-in-difference strategy to examine the evolution of fatal firearm incidents between 2017 and October 2022. Results. After the COVID-19 pandemic began, fatal firearm violence increased significantly in low-graded neighborhoods that the Home Owners Loan Corporation had deemed risky for mortgage lending. The effect held consistently across various model specifications. Conclusions. Social and environmental constructs can interact in a complex manner to compound disadvantage and exacerbate the consequences of negative shocks for marginalized communities. Public Health Implications. Home Owners Loan Corporation policies contributed to widening racial disparities in firearm violence, highlighting the need for reinvestment in marginalized communities to keep future shocks from exacerbating vulnerability to adverse outcomes. (Am J Public Health. 2025;115(2):161–169. https://doi.org/10.2105/AJPH.2024.307891) [ABSTRACT FROM AUTHOR]

Aims: The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position. Methods: The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n =143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time. Results: A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83–3.84) to 5.09 (95% confidence interval 4.28–6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between −38.86 and −48.81 during the entire study period, P =0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019. Conclusions: This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate three-year follow-up among young adults who entered residential substance use disorder (SUD) treatment with regard to outcomes related to education, work and mortality. Methods: Participants who entered residential SUD treatment between 2011 and 2016 aged 16–29 years were included in the study. In this study, we used data from the electronic health records of the treatment facility of the participants and linked these with data from nationwide registries. The data included de-identified, person-level information on patient demographics, crime, treatment use and socioeconomic factors. The primary outcome was education and employment status, analyzed using logistic regression. Results: At the follow-up, two-fifths of the sample were in education or employment, half were receiving welfare benefits and the annual income level was low. 3.6% of the sample had died. Those who were in education or work were less likely to have post-treatment convictions and to use residential SUD treatment services than those who were not. Conclusion: Being in education or employment and not engaging in crime or severe substance use can create a life situation that helps to sustain recovery. There is a need to establish SUD treatment for young adults that includes education- and employment-focused interventions. [ABSTRACT FROM AUTHOR]

Background: Early childhood caries (ECC) is a highly prevalent oral disease among children worldwide, arising from multiple contributing factors. This study aimed to investigate the sociodemographic and clinical factors associated with ECC in preschool children attending a hospital in Ica, Peru. Methods: This observational cross-sectional study involved 186 children evaluated during two dental health campaigns organised by a hospital in Ica, Peru. Oral examinations were conducted by two trained paediatric dentists, while haemoglobin levels were measured by two nurses. Mothers or caregivers completed questionnaires to provide relevant sociodemographic and behavioural data. Multiple logistic regression analyses were conducted to identify variables significantly associated with ECC (p < 0.05). The maximum likelihood method was used to assess the contribution of demographic, clinical and other factors—such as oral hygiene and cariogenic diet—using odds ratios (ORs) and regression coefficients to indicate the magnitude and direction of their effects. Results: The prevalence of ECC was 76.88%. Among the children, 50.54% were male, with a mean age of 4.44 ± 0.87 years. Most participants had poor oral hygiene (63.98%), while 82.26% of children with anaemia had reduced haemoglobin levels. The mean monthly family income was USD 376.35 ± 168.96. Mothers or caregivers reported brushing their children's teeth twice daily (56.99%) and giving sweets one to two times daily (79.03%). Factors significantly associated with ECC included the child's age (OR = 3.32; 95% CI, 1.68–6.58), haemoglobin level (OR = 0.43; 95% CI, 0.25–0.72), monthly family income (OR = 0.99; 95% CI, 0.9972–0.9998) and mother/caregiver education (OR = 0.13; 95% CI, 0.03–0.52). Additionally, dental brushing frequency (OR = 0.13; 95% CI, 0.02–0.65) and sweet consumption (OR = 4.98; 95% CI, 1.05–23.56) were identified as associated behaviours. Conclusion: The findings demonstrate that ECC is associated with a child's age, monthly family income, mother/caregiver education level, haemoglobin level, brushing frequency and sweet consumption. [ABSTRACT FROM AUTHOR]

Background/Objectives: Chronic kidney disease (CKD) is a severe health problem with dire consequences for the quality of life of millions of individuals and their families around the globe. This quantitative study analyzes the factors associated with hemodialysis patients' quality of life (QoL) in Lahore City, Pakistan. Methods: Primary data from a sample of 384 patients were collected through regular visits to the hospital. We employed proportional odds models (POMs) and structural equation models to identify factors associated with the QoL. Results: The results revealed significant associations between various factors and patients' quality of life. While gender showed no association with quality of life, younger age, single marital status, higher education, higher family income, and employment status were associated with a better QoL. Clinical variables such as the absence of diabetes and hypertension and specific laboratory parameters were protective against deteriorating QoL. Physical symptoms like muscle soreness, cramps, and shortness of breath significantly impacted QoL. Social and environmental factors adversely affected patient well-being, including family distress and financial issues. Psychological variables such as anxiety, depression, and fear of death also influenced QoL. Conclusions: The findings underscore the importance of holistic, patient-centered care approaches in renal failure management, highlighting the need for tailored interventions to address the diverse needs of dialysis patients and enhance their QoL. Further longitudinal research is recommended to validate these findings and guide the development of targeted interventions for improving patient well-being in hemodialysis settings. [ABSTRACT FROM AUTHOR]

Background: The link between chronic non-communicable diseases (NCDs) and poverty in underdeveloped countries is debated. This study aims to examine socioeconomic inequalities related to NCDs and assess the contributing factors to these disparities. Methods: The study utilized data from the National Health Services Survey in Shaanxi Province for 2003, 2008, and 2013, having 71,766 respondents. The concentration index (CI) was employed to rigorously quantify the degree of socioeconomic inequality in the prevalence of non-communicable diseases (NCDs). The CI decomposition identified the contribution of each variable, while the horizontal inequity (HI) index was calculated annually to assess changes in inequality. Additionally, a Probit model was employed to examine the significant determinants contributing to the occurrence of NCDs. Results: The results show a significant increase in NCD prevalence with age, particularly for individuals aged 60 and above, who experienced a 286.55% rise from 2003 to 2013. Higher education levels are associated with decreased NCD prevalence, as evidenced by a 74.13% reduction for those with high school education or above. Additionally, wealthier individuals had a 15.31% lower prevalence of NCDs, indicating that higher socioeconomic status correlates with a reduced likelihood of chronic diseases. Conclusions: The study finds that NCD prevalence significantly increases with age, while higher education levels and greater wealth are associated with reduced prevalence. These findings highlight the need to target older populations and lower socioeconomic groups for effective NCD prevention and management. Policies should focus on improving educational opportunities and socioeconomic conditions to reduce the burden of NCDs, particularly among older and economically disadvantaged groups. [ABSTRACT FROM AUTHOR]

This study aimed to define complementary feeding trends in Guinea from 2005 to 2018 and complementary feeding risk factors at the individual, household, and community levels. Data from 2005 to 2018 demographic health surveys (DHS) and Multiple Indicator Cluster Surveys were used to describe complementary feeding trends in Guinea. The most recent DHS was used to examine complementary feeding risk factors at the individual, household, and community levels. Complementary feeding indicators including introduction to complementary foods (INTRO), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were calculated based on the 2010 World Health Organisation guidance. Multivariate logistic regressions were used to identify significant risk factors (p < 0.05). Since 2005, there has been a marginal increase in MDD and MAD, but a decrease in INTRO and MMF. The 2018 DHS survey revealed various complementary feeding risk factors. At the individual level, travelling 1–60 min to get water was associated with decreased odds of meeting INTRO, while iron supplementation and maternal education were associated with increased odds of meeting MMF and MDD, respectively. Routine vitamin A supplementation, fever in the past 2 weeks, and low birth weight were associated with increased odds of meeting MAD. At the household level, being in a lower wealth quintile was associated with decreased odds of meeting MDD and MAD. National and subnational programmes and policies designed to improve infant and young child diets may consider tailored approaches that address the specific indicators and risk factors associated with poorer diets in this Guinean context. Key messages: Between 2005 and 2018 there has been an increase in minimum dietary diversity (MDD) and minimum acceptable die (MAD), but a decrease in INTRO and minimum meal frequency (MMF).As of 2018, 49.9% of infants were introduced to complementary foods between 6 and 8 months of age, 25.0% met MMF, 15.2% met MDD, and 4.4% met MAD.Individual (child vitamin A and iron supplementation, child fever, low birth weight, maternal education, delivery with the help of birth attendant) and household (wealth quintile) level factors were identified as key risk factors for complementary feeding practices. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effectiveness of web‐based nutrition education for parents of preschool children in reducing nutritional risk. The study was conducted in a one‐group pretest–posttest quasi‐experimental design. Parents of 3–5‐year‐old children from 11 preschools in Istanbul participated. They underwent a web‐based nutrition education program. The NutriSTEP assessment tool was used to evaluate the nutritional risk score as a pretest assessment, followed by the training program. Posttests were conducted at 1‐ and 3‐month intervals. Before the intervention, 55.8% of the children exhibited high nutritional risk. After the intervention, this percentage decreased significantly at the 1‐month and 3‐month follow‐ups, with 94.2% and 93.6% of the children classified as low risk, respectively. The analysis also revealed significant associations between children's eating behaviours and factors such as maternal education, family income and family structure. As a result, web‐based nutrition education was effective in reducing nutritional risk among preschool children. The findings underscore the importance of using technology for nutrition interventions, especially in diverse populations. The training program's simple, short and understandable video increased participants' interest in the training and encouraged regular follow‐up. Key messages: Web‐based nutrition education significantly reduced the nutritional risk of preschool children, with high‐risk cases dropping from 55.8% to less than 7% at the 3‐month follow‐up.Technology‐based programmes offer flexible, accessible and effective solutions for parental involvement in child feeding, particularly in urban areas and at times when face‐to‐face access is limited.Parental education and socioeconomic factors, such as maternal education and family income, were strongly associated with child nutritional risk, highlighting the importance of tailoring interventions to different demographic groups. [ABSTRACT FROM AUTHOR]

Women of reproductive age are particularly vulnerable to low‐quality diets due to their higher micronutrients needs. The minimum dietary diversity for women (MDDW) is a proxy for micronutrient adequacy in this group of women. Its relationship with other aspects that lead to malnutrition is not fully elucidated and depends on the context. In this study, we assessed the prevalence of MDDW among women of a rural area in Chad and its association with socioeconomical, agricultural, dietary and food security data. A cross‐sectional study was conducted. Following a multistage cluster sampling, 984 women of reproductive age were randomly selected and interviewed in March 2019. We obtained food consumption data through unquantified 24 h recalls and computed MDDW as consuming at least five out of 10 predefined food groups. We constructed a Food Production Diversity Score (FPDS) with crop and livestock information. We obtained multivariable logistic regression models including different covariates. MDDW was achieved by only 33% of women in the sample. In our final model, we identified a significant association of MDDW with the FPDS and gathering of wild plants. Women in households with the highest FPDS had 70% more chances of achieving MDDW than those with the lowest FPDS. Gathering wild plants doubled these chances. Areas of cultivated land, Water, Sanitation and Hygiene resources, and a high level of food security, measured with the Household Food Insecurity Access Scale, were also significantly related to the achievement of MDDW. This illustrates the importance of nutrition‐sensitive policies, also considering biodiversity and food production diversification. Key messages: Only one in three women in a rural area of the Guerá region in Chad reach the minimum dietary diversity measured by the minimum dietary diversity for women (MDDW) indicator.Food insecurity is highly prevalent among households (HHs) of these rural areas of Chad, with more than 90% of the HHs being moderately or severely food insecure.Diverse food production and gathering of wild foods in HHs has a positive impact on MDDW.Water, Sanitation and Hygiene resources, areas of cultivated land and greater HH food security also showed this positive association. Altogether, this indicates the importance of nutrition‐sensitive policies that address malnutrition through a holistic approach. [ABSTRACT FROM AUTHOR]

Background: Children with chronic kidney disease (CKD) require comprehensive assessments, including medical and quality of life (QoL) evaluations. Few studies have been conducted in developing countries. Methods: This cross-sectional study included 2–18-year-old patients who were categorized into 4 groups: the CKD stage 2–3, stage 4–5, stage 5 with dialysis (D), and kidney transplantation (KT) groups. QoL was measured using the Pediatric Quality of Life Inventory™ (PedsQL™) version 4.0; relationships between different factors and QoL were determined using multivariable linear regression analysis. Results: Eighty-seven patients (mean age: 13.3 (4.1) years) were included. The self-reported total scores were 77.5 (12.5), 78.9 (11.2), 77.4 (16.2), and 76.1 (10.9) in the stage 2–3, stage 4–5, stage 5D and KT groups, respectively. Parent-reported scores showed a weak-to-moderate correlation with self-reported scores (r = 0.12–0.42), with total scores of 71.8 (12.7), 69.5 (14.9), 63.4 (14.8), and 70.8 (18.1) in the stage 2–3, 4–5, 5D and KT groups, respectively. Multivariable linear regression revealed that the parent-reported score in the stage 5D group was 15.92 points lower than that in the stage 2–3 group (p = 0.02); the score in the low maternal education group was 10.13 points lower than that in the high maternal education group (p = 0.04). Conclusions: Parent-reported scores showed weak-to-moderate correlation with self-reported scores. Patients with CKD stage 5D and patients with low maternal education had lower QoL. Regular QoL assessment is recommended for patients with advanced CKD and those with socioeconomic vulnerabilities. [ABSTRACT FROM AUTHOR]

Sense of community is a necessary ingredient for existing and future communities in developed and developing countries to thrive. However, there are socioeconomic factors that have the potential to influence the sense of community in developing countries. This is an aspect that is underreported in literature in developing countries like Nigeria. This study examines the influence of socioeconomic factors on the sense of community in selected public housing estates in Akure, Southwest, Nigeria. Structured questionnaire was used to collect data for the research. Single-factor descriptive Analysis, Mean Scoring and Categorical Regression Analysis were used to analyze the data. Findings showed that the sense of community in the study area was above average and that socioeconomic characteristics jointly predicted of sense of community. However, of the nine socioeconomic variables, four were significant predictors of sense of community in this context. The four significant variables were employment status, level of education, tenure status and age. The paper concludes by providing implications, considering the significant factors especially in developing strategies to enhance the sense of community in the study area. [ABSTRACT FROM AUTHOR]

Although socioeconomic inequality has been identified as a significant factor for violence against women, the connection between these two variables has not been widely recognized and addressed in many countries. This study aims to quantify the degree of socioeconomic inequalities in intimate partner violence (IPV) in Vietnam and investigate the contribution of each determinant factor that contributes to the observed inequality. We utilized the Vietnamese National Survey on Domestic Violence against Women (N = 4,019) for the analysis. Household wealth was used as a proxy for socioeconomic status. We used a concentration index to quantify the degree of socioeconomic inequality in emotional, physical, or sexual violence and a combination of these three types of violence. We further decomposed the concentration index to identify the contribution of each determinant to the observed inequality in IPV. We found that the prevalence of IPV was significantly concentrated among the worse-off across all types of IPV and that disparities in husband's occupation (48%), women's education (39%), husband's education (38%), and class (34%) were the primary factors contributing to increased inequalities in IPV. Our results indicated that higher education and engagement in skilled jobs were highly concentrated among the better-off, creating unequal distribution of these variables across wealth. Policy could mitigate the inequality in IPV by expanding women's access to education and economic opportunities. However, interventions should target both men and women and within couples because husband's characteristics also play an important role in explaining socioeconomic inequalities in IPV. [ABSTRACT FROM AUTHOR]

Black pregnant and postpartum individuals are at risk for intimate partner violence (IPV), and those with a history of childhood maltreatment and IPV are even more likely to be re-victimized during pregnancy. However, it is unknown if specific types of child maltreatment predict later IPV with and without a weapon better than others. The current study sought to (i) document the prevalence of childhood maltreatment and IPV and (ii) examine the relations among types of childhood maltreatment and later IPV with and without a weapon within a sample of Black individuals seeking prenatal care at a large public hospital in the southeastern United States. Participants (n = 186; mean age = 27.2 years, SD = 5.3) completed measures assessing childhood maltreatment and IPV with and without a weapon. Approximately 68.5% of participants (n = 124) endorsed experiencing childhood maltreatment, while 42.6% (n = 78) endorsed experiencing IPV. The bivariate relations among five childhood maltreatment types (i.e., sexual, physical, and emotional abuse, physical and emotional neglect) and IPV with and without a weapon were assessed. All childhood maltreatment subtype scores—except childhood physical neglect—were significantly higher among participants who reported a history of IPV with or without a weapon compared to participants who denied a history of IPV with or without a weapon. Logistic regression models revealed childhood sexual abuse emerged as the only significant predictor of experiencing IPV with a weapon (B = 0.10, p =.003) and IPV without a weapon (B = 0.11, p =.001). For every point increase in childhood sexual abuse subtype score, the odds of experiencing IPV with and without a weapon increased by 10% (OR = 1.10, 95%CI [1.04, 1.18]) and 12% (OR = 1.12, [1.05, 1.20]), respectively. Findings suggest that screening for childhood sexual abuse may provide a critical opportunity for maternity care providers to identify individuals at increased risk for IPV victimization with and without a weapon. [ABSTRACT FROM AUTHOR]

This article presents the first systematic review and meta-analysis of the prevalence and correlates of different forms of intimate partner violence (IPV) among women and men in Mexico. To identify studies, a comprehensive search strategy was developed and executed across 11 databases (Academic Search Complete, APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, International Bibliography of the Social Sciences, LILACS, MEDLINE, SciELO, Sociological Abstracts, Web of Science). From the 1,746 studies screened, 155 full-text articles were reviewed, and this systematic review included 27 studies involving 249,557 participants to determine the prevalence of physical, psychological, sexual, threats, and other forms of IPV, according to gender and other sociodemographic characteristics. Overall IPV prevalence was 16.4%, with significant differences across pregnant and non-pregnant women. Physical IPV prevalence was 14.7%, revealing higher rates in men (29.5%) compared to women (14.2%). Psychological IPV prevalence was 27.3% and sexual IPV was at 6.6%, with differences across evaluation periods. Threats and other IPV forms showed a prevalence rate of 14.2% and 21.5%. Meta-regression analyses included gender, education, marital status, rural residency, pregnancy, age, and evaluation period. This study demonstrates that IPV is a critical public health concern in Mexico, impacting both women and men. It shows the vulnerability of rural residents, youth, and pregnant women. However, understanding IPV complexities in Mexico requires nuanced considerations of demographic and situational contexts. Urgent initiatives from municipal, state, and federal governments are needed to combat IPV, focusing on prevention and support for affected individuals. [ABSTRACT FROM AUTHOR]

Despite its significance in determining poverty risk, family size has received little focus in recent social policy analysis. This paper provides a correction, focusing squarely on the changing poverty risk of larger families (those with three or more dependent children) in the UK over recent years. It argues that we need to pay much closer attention to how and why poverty risk differs according to family size. Our analysis of Family Resource Survey data reveals how far changes in child poverty rates since 1997 – both falling poverty risk to 2012/13 and increases since then – have been concentrated in larger families. Social security changes are identified as central: these have affected larger families most as they have greater need for support, due to both lower work intensity and higher household needs. By interrogating the way policy change has affected families of different sizes the paper seeks to increase understanding of the effects of different poverty reduction strategies, with implications for policy debates in the UK and beyond. In providing evidence about the socio-demographics of larger families and their changing poverty risk it also aims to inform contested debates about the state's role in providing financial support for children. [ABSTRACT FROM AUTHOR]

Background: Marriage promotes breastfeeding duration through economic and social supports. The COVID-19 pandemic disproportionately affected marginalized communities and impacted women's employment and interpersonal dynamics. This study examined how marriage affects breastfeeding duration across socioeconomic and racially minoritized groups during COVID-19, aiming to inform social support strategies for vulnerable families in public health crises. Methods: For this cross-sectional study, data were drawn from the 2017–2021 North Dakota Pregnancy Risk Assessment Monitoring System (weighted n = 41433). Breastfeeding duration was self-reported, and 2-, 4-, and 6-month duration variables were calculated. Marital status(married, not married) and education (< high school education, ≥high school education) were drawn from birth certificates. Income (≤ US$48,000, > US$48,000) and race/ethnicity (White, American Indian, Other) were self-reported. Infant birth date was used to identify pre-COVID (2017–2019) and COVID (2020–2021) births. Logistic regression estimated odds ratios and 95% confidence intervals for the association between marital status and breastfeeding duration outcomes. Models were fit overall, by COVID-19 era and by demographic factors. Lastly, demographic-specific models were further stratified by COVID era. Models were adjusted for maternal health and sociodemographic factors. Results: Overall, married women consistently had 2-fold higher odds of breastfeeding across all durations during both pre-COVID and COVID eras. Pre-COVID, marriage was a stronger predictor for all breastfeeding durations in low-income women (4-month duration OR 4.07, 95%CI 2.52, 6.58) than for high-income women (4-month duration OR 1.76, 95%CI 1.06, 2.91). Conversely, during COVID, marriage was a stronger predictor of breastfeeding duration for high-income women (4-month duration OR 2.89, 95%CI 1.47, 5.68) than low-income women (4-month duration OR 1.59, 95%CI 0.80, 3.15). Findings were similar among American Indian women and those with less than high school education, in that both groups lost the benefit of marriage on breastfeeding duration during the COVID-19 pandemic. Conclusion: Marriage promotes breastfeeding duration, yet the observed benefit was reduced for low-socioeconomic and racially minoritized populations during the COVID-19 pandemic. These observations highlight the disproportionate impacts low-socioeconomic and racially minoritized populations face during public health crises. Continued research examining how major societal disruptions intersect with social determinants to shape breastfeeding outcomes can inform more equitable systems of care. [ABSTRACT FROM AUTHOR]

Objective: In recent times, artificial Intelligence (AI) has gained popularity in medical as well as dental radiology. Studies have been conducted among medical and dental students and professionals about the knowledge and understanding towards AI. The aim of this study was to investigate the perceptions and acceptability of AI in dental radiology among a group of Indian patients seeking dental treatment. Methods: A cross-sectional research was planned with a validated questionnaire, containing ten close ended questions amongst 1562 patients. Their sociodemographic characters, opinions and attitudes regarding AI and feasibility of acceptance of AI-based dental radiological diagnosis among patients was evaluated. The study sample was divided in various groups on the basis of their age; group-1(16–30 years), group-2(31–45 years) and group-3(>45 years), educational status and urban/rural background. Statistical analysis was done by Chi-square test with significance value set at p< 0.005. Results-: The participants possessed impressive knowledge about AI. Patients' awareness, attitudes and acceptability towards AI for dental radiographic diagnosis were substantially influenced by age, education level and residential background. Although many of them, especially the urban and more educated participants believed that AI could be more accurate, they preferred the human judgement. Overall, a negative attitude in terms of acceptability of AI in dental radiology was observed in this study. Conclusions: Participants opined that AI should only be used as an auxiliary tool and valued clinical judgment over AI in ambiguous situations. It is recommended that this promising technological advancement can be used for initial screening in dental radiology. [ABSTRACT FROM AUTHOR]

Background/Objectives: Socio-affective relationships have garnered increasing attention in recent years as a means to enhance coexistence and well-being. Within this context, educational institutions play a pivotal role in shaping peaceful coexistence and promoting well-being among future generations. Physical Education (PE) is particularly significant, because it integrates cooperative–opposition activities, which blend collaboration and competition, fostering socio-emotional development. This systematic review aimed to investigate how PE contributes to coexistence and socio-affective well-being in adolescents aged 12 to 18. Methods: Using the PRISMA 2020 framework, 15 empirical studies were analyzed from seven databases. Studies were selected based on PICOS criteria: secondary education students (Population), cooperative–opposition activities (Intervention), control groups or pre-post designs (Comparison), relational and emotional dimensions (Outcomes), and quantitative methodologies (Study design). Results: Interventions grounded in the Motor Conduct Education and Sports Education Model significantly reduced interpersonal conflicts and improved social skills and emotional well-being. Positive emotions predominated in these activities, fostering stronger peer relationships within classroom groups. Approaches emphasizing task-oriented pedagogies were less effective than those centered on peer support in eliciting positive emotional responses. Conclusions: This review underscores the transformative potential of innovative educational strategies in PE to enhance coexistence and socio-affective well-being. Future research should explore the comparative efficacy of various pedagogical models and their long-term impact. These findings provide valuable guidance for educators and policymakers seeking to promote holistic development in adolescents through PE. [ABSTRACT FROM AUTHOR]

Objective: Duration of untreated psychosis (DUP) is considered an important factor in outcome. Individual, familial and illness factors may prolong DUP. Little data on this issue is available from the country of Nepal. The purpose of the present study was to assess DUP in patients with first-episode psychosis and identify associations with patients' sociodemographic and clinical factors. Methods: A cross-sectional, descriptive study was conducted in the department of psychiatry at Tertiary Hospital in the Eastern part of Nepal. Eighty-six patients were enrolled. ICD-10 was used to make the diagnosis. The Nottingham Onset Schedule-DUP version (NOS-DUP) was used to assess DUP. Positive and Negative Syndrome Scale (PANSS) was used to assess patients' clinical symptoms. Results: The mean (SD) DUP was 21.4 (42.1) months and median DUP was 3.0 months (IQR = 23.5). Participants from mountainous regions, those who were unemployed, having an insidious onset of illness, and patients with a diagnosis of schizophrenia had significantly longer DUP (P <.005). Duration of untreated psychosis was also positively correlated with negative symptoms (r =.42, P <.001) and total PANSS score (r =.42, P <.001). Conclusion: Duration of untreated psychosis in first-episode psychotic patients was relatively long (compared to studies in other countries) and was found to be positively associated with living in mountainous regions of Nepal, being unemployed, having an insidious onset of illness, and having a diagnosis of schizophrenia. Programs and educational efforts are needed to ensure early treatment of patients with first-episode psychosis, especially in the mountainous rural areas of Nepal. [ABSTRACT FROM AUTHOR]

Background: Health-promoting lifestyle behaviors are self-initiated behaviors that focus on life promotion through lifestyle which consists of different aspects to enhance the level of well-being. The lifestyle adopted during pregnancy has a long-term effect on the health and life quality of both mother and child. Purpose: This study aimed to assess predictors of health-promoting lifestyle behaviors among pregnant women of Siyari Rural Municipality, Rupandehi. Methods: A community-based cross-sectional analytical design was carried out in Siyari Rural Municipality, Rupandehi, Nepal. The research was conducted from March to August 2023 and the data was collected from 15th June to 15th July 2023, among 229 pregnant women. A probability proportionate sampling technique was implemented to select total participants and a pregnant was selected randomly. With ethical approval from Pokhara University, the IRC, and maintaining all ethics face-to-face interviews were conducted using a pretested structured questionnaire. Health-promoting behavior was measured using Lifestyle Profile II (HPLP-II) consisting of 6 elements health responsibility, physical activity, nutrition, spiritual growth, interpersonal relationships, and stress management. Data was entered into Epi-Data 3.1 and analyzed using IBM SPSS Statistics 26. Results: The mean score of health-promoting behavior was 123.09 ± 13.34, and 72.9% of participants had a moderate level of health-promoting lifestyle behavior. Subscale scores showed low scores in physical activity 8.79 ± 1.66 and stress management 15.13 ± 2.09. Ethnicity (AOR: 0.09; 95% CI 0.03–0.29) and education level of the participant (AOR:0.09; 95% CI 0.01–0.66) were the greatest predictors of health-promoting lifestyle behavior among pregnant women. Conclusion: Pregnant women had moderate levels of health-promoting behavior with low scores in physical activity and stress management so the government of Nepal should enhance a balanced approach that includes prenatal exercise counseling, stress management programs along with nutrition, health checkups, and social relationships that directly lead to better pregnancy outcomes. Ethnicity and education of the participant were the greatest predictors of health-promoting lifestyle behaviors so these predictors should be properly focused on individual and health system levels to improve health-promoting behaviors during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: Doctor–patient trust, especially patients' trust in doctors, represents patients' compliance with doctors' behavior and may affect patients' choice of medical treatment behavior. This paper aims to delve into the profound impact of doctor–patient trust on the hierarchical diagnosis and treatment system. Additionally, it formulates corresponding policy suggestions for reforming this system from a practical perspective, offering a useful reference for the development of both the theory and practice of China's healthcare protections. Methods: In this paper, the rank‐dependent expected utility theory was used to construct a tripartite evolutionary game model of hierarchical diagnosis and treatment system for observing the interactions and behaviors between superior hospitals, primary hospitals, and patients under different levels of doctor–patient trust. Meanwhile, descriptive statistics and binary logistic regression methods were used in empirical research for revealing the specific mechanism. Results: When the doctor–patient trust is at a high level, it is easier for each participant in the hierarchical diagnosis and treatment system to choose cooperative strategies, thus enabling the system to operate smoothly. Specifically, the medical level of healthcare institutions exerts a significantly positive impact on the level of doctor–patient trust and concurrently, an enhanced level of doctor–patient trust promotes patients' adherence to the hierarchical diagnosis and treatment system when making healthcare choices. Conclusions: Doctor–patient trust is a significant bridge connecting medical institutions and patients. It is an important factor to realize the orderly operation of hierarchical diagnosis and treatment system. To attain the objective of strengthening doctor–patient trust and fostering the smooth functioning of the hierarchical diagnosis and treatment system, it is essential to capitalize on policy mechanism to motivate healthcare service providers to enhance their medical capabilities and gradually guide patients to make healthcare choices in an orderly manner according to the system design. [ABSTRACT FROM AUTHOR]

Background: Menstruation is a universal and normal phenomenon during the reproductive age of females; adolescence is an essential period where females are preparing and adjusting themselves to manage their menstrual bleeding safely and cleanly. Menstrual hygiene management (MHM) is an issue that is insufficiently acknowledged and has not received adequate attention among visually impaired adolescent girls (VIAGs). Objectives: The purpose of this study was to determine the knowledge and practice of MHM and associated factors among VIAGs of selected institutions in Rwanda. Design: This study consisted of a cross-sectional study design using a quantitative approach. Methods: A cross-sectional study was conducted in April and May 2021 on 92 VIAGs. They were recruited from educational institutions in two Provinces in Rwanda. Voluntary participation and confidentiality were assured. Socioeconomic and demographic data, menstruation, and menstrual hygiene questionnaires were used to obtain the required information. Statistical Packages for the Social Sciences (SPSS) for Windows version 25 was used. Descriptive statistics, Chi-square test, and logistic regressions were used for data analysis. Results: The study reached 92 respondents. The majority of the respondents, 67.4% had a poor level of menstruation and menstrual hygiene knowledge while only 32.6% had a good level of menstruation and menstrual hygiene knowledge. Also, it is confirmed that the majority of respondents, 52.1% had a good level of practice, while 47.8% had a poor level of menstrual hygiene practice. The multivariable analysis revealed that factors associated with the menstrual hygiene practice were as follows: the mother's education (odds ratio (OR): 5.979; 95% CI: [1.700–21.032]; p value: 0.005) and level of knowledge of menstruation and menstrual hygiene (OR: 0.132; 95% CI: [0.028–0.622]; p value: 0.010). Conclusion: The knowledge and practice of MHM among VIAGs were poor. Recommendations included the need for mothers to assist their daughters in improving learning and practice of menstrual hygiene, as well as the integration of MHM into school curricula. Further research is suggested to better understand MHM among Rwandan adolescent girls, both visually impaired and non-blind. [ABSTRACT FROM AUTHOR]

Background: Healthy food nudges may be more, or especially, effective among groups experiencing socioeconomic disadvantage. We investigated the modifying role of socioeconomic and demographic characteristics in the effectiveness of nudge interventions targeting healthy foods in real-world grocery store settings on food purchasing patterns. Methods: We pooled individual participant data from multiple trials. Eligible trials were identified via a PubMed search and selected based on having a controlled real-world design, testing a nudging intervention promoting healthy purchases, while collecting participants' sociodemographic and purchasing data. Out of four eligible trials, three had longitudinal measurements, one consisted of a single time point, two were randomised and two were not. Applied nudges consisted of a combination of placement nudges (focussing on availability or positioning) and property nudges (presentation and/or information). Harmonised data included dichotomised socioeconomic and demographic variables and the percentage of purchased fruits and vegetables of total purchases. Multilevel meta-regression based on linear mixed-effects models were used to explore modifying effects using two approaches: longitudinal and cross-sectional analyses. Results: The analytical sample in the longitudinal analysis comprised of 638 participants, who were predominantly female (76.3%), had a lower education attainment (67.7%), and a mean age of 46.6 years (SD 13.5). These characteristics were similar in the cross-sectional analysis (n = 855). Compared to control group participants, there was no main effect of healthy food nudges on the percentage of fruit and vegetable purchases by intervention group participants in the longitudinal analysis (β = 0.00; 95%CI -0.03, 0.09). This main effect was not modified by educational attainment (βgroup*higher education = -0.06; -0.40, 0.02), sex (βgroup*females = 0.13; -0.00, 0.61) nor age (βgroup*older adults = -0.05; -0.39, 0.02). Results from the cross-sectional analysis were comparable. Conclusions: This pooled analyses of four controlled trials did not find evidence supporting the hypothesis that grocery store nudge interventions of healthy foods work more effectively among groups experiencing socioeconomic disadvantage. Future studies are needed to address the identified limitations through rigorous trial design using comprehensive interventional strategies, standardised outcome measures, while also evaluating context-specific approaches. Such insights will help to better understand the equity of nudging interventions in grocery store settings and the potential for reducing diet-related health disparities. Trial registrations: The trial of Ayala et al. (2022) was retrospectively registered at ClinicalTrials.gov (NCT01475526; at 14 November 2011, https://clinicaltrials.gov/study/NCT01475526), the of Huitink et al. (2020) was retrospectively registered in the ISRCTN registry (ISRCTN39440735; at 5 September 2018, https://doi.org/10.1186/ISRCTN39440735), the of Vogel et al. (2024) was retrospectively registered at ClinicalTrials.gov (NCT03518151; at 24 April 2018, https://clinicaltrials.gov/study/NCT03518151), and finally of Stuber et al. (2024) was registered in the Dutch Trial Register (ID NL7064, at 30 May 2018, https://www.onderzoekmetmensen.nl/en/trial/20990). [ABSTRACT FROM AUTHOR]

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Fuel taxes are seen as an important instrument in the fight against climate change, including in the European Green Deal. From a social-ecological policy perspective, it is important to understand current high levels of public opposition to fuel taxes. If social disadvantage is an important driver of opposition, this would strengthen arguments that fuel taxes need to be designed in a fairer way. However, it remains unclear how important social disadvantage – here defined as a combination of low income, fuel poverty risk, low education, low occupational status and job insecurity – is for explaining opposition compared to factors such as political trust and climate change attitudes, and how the role of social disadvantage varies with welfare regimes in Europe. In this article, we examine how strongly social disadvantage is associated with opposition to fuel taxes once political trust and climate change attitudes are controlled for, and we compare results across welfare regimes. The article uses data from the 2016 European Social Survey and employs logistic regression and decomposition analysis. We find that social disadvantage contributes nearly as much to fuel tax opposition as climate change attitudes and political trust together, with 10.9 and 16.6 percentage points respectively. However, the role of social disadvantage varies by welfare regime. It matters most in Southern and Eastern Europe, where opposition is particularly high, as are poverty and inequality. We discuss implications for social-ecological policy strategies that aim to increase public acceptability of fuel taxes in Europe. [ABSTRACT FROM AUTHOR]

Background: Health agency refers to one's capacity to form health-related goals, experience control, and possess the means to pursue them. Low socioeconomic status (SES) is linked to impaired health agency and increased risk of adverse pregnancy outcomes, potentially due to a reduced tendency to seek care. Better healthcare availability may not improve their pregnancy outcomes, and therefore improved understanding of maternal health agency is paramount. Methods: Semi-structured interviews were conducted with 15 participants who either had children or desired to have them. Low SES was determined by neighborhood median income and educational attainment. A thematic content analyses was conducted. Results: Two themes emerged: 1) Origin and development of personal goals, and 2) Awareness and competence. Participant's goals stemmed from cultural norms, personal narratives, and intuition. Integrated goals were those participants valued highly, were aware of, and strived for. Four subthemes were identified in goal-awareness and competence. Internal conflict due to discrepancies between goals and behavior resulted in the need to balance the burdens and benefits of behavior change. Conclusion: Maternal health agency is a modifiable outcome dependent on goal-awareness and various factors. Impaired agency seemed to stem from lack of goal-awareness rather than an inability to meet established pillars. [ABSTRACT FROM AUTHOR]

Abortion is a safe and common medical procedure. Roughly one in four women in the United States will have an abortion before the end of her reproductive years. Because of how common this experience is and how rapidly abortion policy is shifting, understanding the relationship between abortion and women's socioeconomic futures is well worth exploring. Extant research has demonstrated that the transition to parenthood is a critical inflection point in women's socioeconomic trajectories, often leading to poorer outcomes. In this article, we connect previous sociological work elucidating mechanisms of socioeconomic stratification and gender by considering the relationship between abortion use and access and future socioeconomic outcomes such as education, income, and financial stability—as measured by several measures, including evictions, debt, ability to pay bills, and a separate index of economic instability. We use national longitudinal survey data to assess socioeconomic outcomes associated with abortion using two statistical approaches. We find that women who lived in a location with fewer abortion restrictions in adolescence, and women who had an abortion, compared to a live birth, in adolescence, are more likely to have graduated from college, have higher incomes, and have greater financial stability at two time-points over an almost 25-year period. Our results provide evidence that policy environments allowing access to abortion, and teenagers having the option to use abortion to avoid early parenthood, are important axes along which women's economic lives are shaped. Our research implies that the widespread abortion bans and restrictions in the United States are likely to lead to lower educational attainment and adult economic stability among women living under such restrictions, as compared to women in locations with better access to abortion. [ABSTRACT FROM AUTHOR]

In the face of continued socioeconomic inheritance, the belief that the simple expansion of educational opportunities will create meritocratic societies has been met with skepticism. It is well documented that within expanding educational systems, class-advantaged families attempt to secure further advantages for their offspring. Conversely, for many, the modernist belief that educational expansion is a means to achieving a fairer society remains compelling. Studying trends in intergenerational occupational mobility in 40 countries from four continents, I examine whether educational expansion enhances occupational mobility, and whether such trends are counteracted by heightened persistence between social origin and destination within education groups. The results indicate that educational expansion over time, and the policies supporting it, are linked to improved intergenerational occupational mobility. Furthermore, this increased mobility through expanded educational opportunities is not negated by a strengthening of within-education elite persistence in occupational status, suggesting that occupational mobility patterns can genuinely change through educational expansion. The modernist ideology around educational expansion as a driver of social mobility may warrant renewed attention. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) adults in South Africa face high levels of violence and poor mental health outcomes. Interventions to prevent these negative health implications are hampered by a lack of representative data among this population. This study aims to quantify the associations between three forms of violent victimization and depressive symptoms in a sub-sample of SGM drawn from a population-based cross-sectional study in Gauteng, South Africa. Data come from the sixth Quality of Life survey conducted in South Africa's Gauteng province. Brief screeners assessed childhood sexual abuse (CSA), past-year intimate partner violence (IPV), non-partner violence, and depressive symptoms. Three survey-weighted logistic regression analyses were fit to model associations between elevated depressive symptoms and CSA, past-year IPV, and past-year non-partner violence, controlling for socio-demographics (age, race, sex, area of residence, education, socioeconomic status, and recent employment). N = 1,328 SGM respondents were included. Over 40% (n = 537) reported depressive symptoms, while 17% (n = 222) reported CSA, 5% (n = 67) reported IPV, and 16% (n = 208) reported non-partner violence. CSA and non-partner violence were associated with significantly higher odds of reporting depressive symptoms (aOR: 1.51, 95% CI [1.03, 2.23]; aOR: 1.84, [1.24, 2.73], respectively). IPV was not associated with elevated depressive symptoms (aOR: 1.17, [0.64, 2.16]). In all models, employment in the past 7 days was associated with significantly lower odds of reporting depressive symptoms. Recent and childhood violence is a major burden that is associated with elevated symptoms of depression among SGM in urban South Africa. Community-tailored interventions and policy-related advocacy related to employment and violence prevention may alleviate depressive symptoms in SGM adults in Gauteng. [ABSTRACT FROM AUTHOR]

Objectives: Compare mental health, stress, and well-being in the Swedish population as measured before and during the COVID-19 pandemic. Methods: Repeated cross-sectional design using data measured before (Jan-2019; n = 2791) and during (Oct/Nov-2020; n = 2926) COVID-19 pandemic in Swedish population-representative cohorts. Following constructs were measured: anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), stress (Perceived Stress Scale-10 items), health-related quality of life (HRQOL[Functional Assessment of Cancer Therapy–General Population]) and self-rated health (SRH) was assessed with a single-item question. Results: When adjusting for age, sex, education, and income there were significantly higher levels of anxiety (M̂ = 9.15 vs. 8.48, p < 0.01) and depression (M̂ = 3.64 vs. 3.30, p = 0.03), lower levels of stress (M̂ = 14.06 vs. 14.91, p < 0.001), but worsened HRQOL (M̂ = 76.40 vs. 77.92, p < 0.01) and SRH (M̂ = 6.91 vs. 7.20, p < 0.001), observed in 2020 compared to 2019. For the negative effects seen in anxiety, depression, HRQOL, and SRH, higher income and education had a protective effect. The decrease in stress was also correlated with higher income. Conclusions: The COVID-19 pandemic led to a small but significant worsening in mental health and well-being in the general Swedish population, where higher socioeconomic status seemed to have a protective effect. [ABSTRACT FROM AUTHOR]

Background and Aims: Heavy episodic drinking (HED) trends have not been comprehensively examined in Canada. We measured age, period and birth cohort trends in HED in Canada by sex/gender and socioeconomic position. Design and setting. We analyzed repeat cross‐sectional data from the 10 provinces in the Canadian Community Health Surveys from 2000 to 2021 using hierarchical cross‐classified random effects logistic regression. Participants: 1 167 831 respondents aged 12+. Measurements: HED was defined as 4+ standard drinks for women or 5+ for men at least monthly in the past 12 months. Socioeconomic position was measured using household income and education. Findings We observed steeper HED decreases in young adult men (aged 18–29) than women (by 14.4% and 8.7%, respectively, from 2015 to 2021) and HED increases in middle adult women (ages 50–64) (by 8.0% from 2000 to 2014). Sex/gender‐specific age‐period‐cohort models revealed strong age and birth cohort effects. In women and men, respectively, HED peaked in young adulthood (18.2% and 33.8%) and decreased with age, and HED was greatest in the 1980–1989 cohort (20.7% and 35.8%) and decreased in the most recent cohort born in 1990–2009 (15.6% and 19.8%), particularly in men. Higher household incomes had greater HED across age, periods and cohorts, while trends varied by education. Compared with lower education groups, people with a bachelor's degree or above had the lowest HED in middle adulthood. People with a bachelor's degree or above had low HED in earlier cohorts, which converged with other education groups in recent cohorts due to a pronounced HED increase, particularly in women. Conclusion: The sex/gender gap in heavy episodic drinking (HED) appears to be converging in Canada: current young adult men are reducing HED, while high‐risk cohorts of women are aging into middle adulthood with greater HED. Recent birth cohorts with a bachelor's degree or above experienced pronounced HED increases, which among women suggests greater educational attainment contributes to the converging gender gap in HED. [ABSTRACT FROM AUTHOR]

Familism is a multidimensional construct that includes familial support. However, limited research examines whether the sub-components of familism equally contribute to mental health and whether familism protects against depression beyond social support. To address these gaps, we test associations between the multidimensional components of familism (familial support, familial obligations, family as referents) and social support with depressive symptoms among immigrant Dominican women in New York City. We tested associations between the multidimensional components of familism, specifically, familial support, familial obligations, and family as referents (Sabogal et al., 1987), as well as social support, with depressive symptoms among 419 women. Multiple regression analysis indicated that whereas familial support predicted decreases in depressive symptoms (β = − 0.15), family obligations, and family as referents did not. However, only social support predicted decreased depressive symptoms (β= − 0.18) when accounting for covariates and familism subscales. Controlling for covariates, age predicted decreased depressive symptoms (β = − 0.19), whereas self-rated poor health exhibited the inverse effect (β = 0.17). These findings highlight the need for a nuanced understanding of familism, social support, and the association of cultural and demographic values on Latina mental health. These results illustrate the need for further analysis of social support and the multiple components of the familism construct. [ABSTRACT FROM AUTHOR]

Diet and physical activity guidelines for cancer survivorship are less likely to be followed by populations of minority cancer survivors, such as Latina/Hispanic women, compared to non-Hispanic White women. It is important to understand psychosocial mechanisms that may increase adherence to healthy lifestyle habits, especially in populations at risk for poorer cancer outcomes. This cross-sectional study examined the relationships between overall social support (SS) and SS from three sources (family, friends, and significant other) with diet (fruit and vegetables, fat, energy density, and diet quality), and moderate-to-vigorous physical activity (MVPA) behaviors in Latina/Hispanic women with a history of breast cancer (n = 85; M age = 55.2; SD = 9.2). Linear regression models and odds ratios were used to examine associations and adjusted for age, income, and acculturation. Family, significant other, and total SS were positively related to total fruit and vegetable intake but SS from friends was not. Higher levels of SS from all sources were each related to a low energy density diet. A higher quality diet was only related to SS from family. SS was not related to fat intake or MVPA. Higher SS from family and a significant other were associated with higher odds of meeting the fruit/vegetable guidelines; (family, OR = 3.72, 95% CI [1.21, 11.39]; significant other, OR = 3.32, 95% CI [1.08, 10.30]). Having more SS from family or a significant other may contribute to Latina/Hispanic women breast cancer survivors meeting national guidelines for a diet high in fruits and vegetables and low in energy density. [ABSTRACT FROM AUTHOR]

The purpose of this article is to examine the influence of social determinants of health on the global health problem of cardiovascular disease (CVD), particularly focused on the Americas. CVD, encompassing conditions such as coronary heart disease, heart failure, and cerebral vascular disease, is identified as the leading cause of mortality worldwide, with low- and middle-income countries bearing the brunt of its burden. The article discusses how factors such as economic status, education, physical environment, food supply, substance addiction, and health care accessibility contribute to the prevalence of CVD. Additionally, it explores current public health policies addressing CVD and provides recommendations for enhancing these policies to alleviate the burden of the disease. The recommendations include implementing tobacco control policies, raising the legal age for purchasing tobacco products, and advocating for comprehensive health care services. The article concludes by emphasizing the importance of tailored interventions, evidence-based policies, and evaluation strategies in combating CVD and improving public health outcomes. [ABSTRACT FROM AUTHOR]

Objectives: There is little data on the oral health conditions of Somali children. The aim was to assess the dental caries status and related risk factors of 12‐aged children in primary schools in Hargeisa, Somaliland. Methods: A school‐based survey was conducted in Hargeisa in December 2022. Using 2‐stage cluster sampling, 405 children (12‐aged) were randomly selected from 16 primary schools. Data collection involved WHO structured interviewer‐administered questionnaire and clinical examinations. The DMFT index was measured according to WHO criteria, and accordingly, the mean for the significant caries index (SiC) was calculated. The association between the DMFT and the relevant variables was analysed using negative binomial regression in STATA. Results: The overall prevalence of dental caries was found to be 62.7%, with a mean DMFT of 1.7 and a SiC score of 3.7. Non‐public school pupils showed significantly higher prevalence of dental caries and mean DMFT compared to public school counterparts (68.5% vs. 58.6%) and (1.91 vs. 1.48), respectively. Merely 14.7% of the participants utilized dental care services in the previous year. The multivariable analysis showed a significant positive association of the DMFT outcome with attending a non‐public school (95% CI 1.16–2.12) and having many previous dental visits (95% CI 1.22–2.83). In the adjusted model, fathers of low education had children with better dental caries status (lower mean DMFT) than their well‐educated counterparts. The mean DMFT was not significantly influenced by the factors sex, location, educational attainment (school class of the participants) and frequency of teeth cleaning. Conclusion: Although the overall mean DMFT of school children in Hargeisa could be regarded low, the high levels of untreated caries especially in the one‐third most affected are a cause for concern. Children enrolled in non‐public schools formed the high‐risk group. Preventive oral public health programs targeting Somali school children are recommended. [ABSTRACT FROM AUTHOR]

The triglyceride glucose-body mass index (TyG-BMI) is a well-established surrogate marker for insulin resistance. While an association between insulin resistance and depression has been identified, that between TyG-BMI and depression remains unclear. Therefore, we used data from the National Health and Nutrition Examination Survey (NHANES) database to investigate this. This cross-sectional study included 9673 adults (aged ≥20 years) from the NHANES in the United States from 2011 to 2020. Depressive symptoms were assessed using a nine-item version of the Patient Health Questionnaire. The covariates included age, sex, race/ethnicity, marital status, educational level, poverty-income ratio, smoking status, alcohol intake, diabetes status, cardiovascular disease, hypertension, physical activity, high-density lipoprotein, low-density lipoprotein, and total cholesterol. Multivariate logistic regression models, subgroup analyses, and threshold saturation effect analyses were conducted. After adjusting for age, sex, race/ethnicity, marital status, education level, poverty-income ratio, smoking status, drinking status, diabetes status, cardiovascular disease, hypertension, physical activity, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, the threshold saturation effect showed a TyG-BMI inflection point of 174.4. Below the inflection point, a 10-unit increase in TyG-BMI was associated with a 12 % lower prevalence of depression. Above the inflection point, each 10-unit increase in TyG-BMI was associated with a 4 % increase in prevalence of depression. TyG-BMI had a U-shaped relationship with prevalence of depression. There was a significant link between higher TyG-BMI levels and increased prevalence of depression. When the TyG-BMI value was below 174.4, any further increase in TyG-BMI was associated with a significantly lower prevalence of depression. [ABSTRACT FROM AUTHOR]

Vaccination against measles still stands as a highly impactful public health strategy for mitigating childhood morbidity and mortality. Relatively poor immunization coverage among children has been observed in low and middle-income countries (LMICs). Our study intended to determine socio-demographic factors associated with the 1st dose of measles vaccination among South Asian (SA) and SubSaharan African (SSA) countries children. This was a cross-sectional study. This study utilized demographic and health survey data from 42 low-and middle-income countries (LMICs) in SA and SSA. The children's dataset yielded 255,775 children between the ages of 12 and 59 months. The independent predictors were determined by using crude and adjusted odds ratios with 95% confidence intervals (CI). The prevalence of first-dose measles-immunized children was 55.5% for the selected LMICs. The multivariable analysis for combined regions (SA and SSA) showed that parents with a higher level of education, rich wealth quintile, mothers with media access, mothers with more than four antenatal care (ANC) visits and baby postnatal check-up (PNC) within two months were significantly associated with the first dose of measles vaccination among children. The first dose measles immunization coverage in the selected LMICs was considerably low. To boost the uptake of childhood measles vaccination, public health interventions particularly need to focus on children born to uneducated parents, poor families, and those who have not used health services (ANC and PNC). Financial funding is crucial for establishing mobile vaccination clinics to improve immunization rates among the impoverished. [ABSTRACT FROM AUTHOR]

This study aimed to identify the individual- and community-level determinants of mothers' healthcare-seeking behaviour for children under the age of 5 years with acute respiratory infection (ARI) symptoms in low-and middle-income countries (LMICs). Nationally representative Demographic and Health Survey datasets from 29 LMICs were used. The study included 16,893 children aged under 5 years with ARI symptoms in the 2 weeks prior to the survey. A multilevel logistic regression model was used to examine associations between individual- and community-level factors with health-seeking behaviour for ARIs. The adjusted odds ratio (AOR) along with 95% confidence intervals (CIs) were reported as a measure of association. The overall prevalence of healthcare-seeking behaviour for ARIs among children under 5 years in LMICs was 58.83% (95% CI: 58.08, 59.57). Findings showed that mothers with primary or higher education (AOR = 1.20; 95% CI: 1.08, 1.33), and those residing in rich households (AOR = 1.32; 95% CI: 1.18, 1.48), attending antenatal care (ANC) visits (AOR = 1.53; 95% CI: 1.31, 1.79) and delivering at a healthcare facility (AOR = 1.28; 95% CI: 1.16, 1.41) were more likely to seek healthcare for ARIs. A higher level of community maternal education (AOR = 1.44; 95% CI: 1.24, 1.68) was positively associated with seeking healthcare for ARIs, while a higher level of community poverty (AOR = 0.83; 95% CI: 0.72, 0.96) was negatively associated with healthcare seeking for ARIs. This study revealed that mothers' healthcare-seeking behaviour for ARIs was closely linked to modifiable risk factors, including maternal education, household wealth, use of maternal health services (e.g., ANC), as well as community poverty and literacy levels. Future interventions should consider these modifiable risk factors when developing strategies to improve child health outcomes in LMICs. [ABSTRACT FROM AUTHOR]

Breastfeeding improves cognitive ability in childhood, but the long-term impact on socioeconomic outcomes remains unknown. We examined associations between durations of predominant and any breastfeeding and educational attainment, income, and labor force participation in adulthood, and whether these varied by maternal education. Prospective cohort study. We followed 84,255 individuals born 1959–1967 with prospectively collected information on breastfeeding duration and intensity from the Copenhagen Infant Health Nurse Records. Socioeconomic outcome information came from national registers (1980–2020). Linear and Poisson regression were used, and models were adjusted for prenatal and postnatal variables across three levels of maternal education. Durations of being breastfed exhibited associations with all outcomes, with most being more pronounced among mothers with low education. Compared with infants breastfed <1 month, those breastfed ≥5 months had 0.68 (95% confidence interval: 0.60–0.76), 0.55 (0.45–0.65), and 0.65 (0.46–0.84) additional years of education for infants born to mothers with low, medium, or high education, respectively. Moreover, infants breastfed ≥5 months had 4047, 3713, and 1902 US$ higher annual incomes and were 23% less likely to be outside the labor force at age 50 years. These associations were stronger with longer breastfeeding durations and for predominant than any breastfeeding. Prolonged and higher breastfeeding intensity consistently exhibited dose-dependent associations with improved socioeconomic indicators in adulthood. Notably, these relationships were more pronounced among individuals whose mothers had lower educational attainment. Consequently, our findings suggest that breastfeeding may have a lasting positive influence on socioeconomic outcomes, particularly for the most disadvantaged infants. [ABSTRACT FROM AUTHOR]

To examine changes and socioeconomic patterns in indicators of a poor indoor environment in 2000 and 2021. Cross-sectional data from the Danish Health and Morbidity Survey in 2000 and 2021. The study included 27,068 participants. Indicators of indoor environment (annoyances from mould, temperature, draught, traffic and neighbour noise, and presence of water damage) were obtained from questionnaires (2021) and partly by interview (2000). Socioeconomic status included home ownership, educational level, and household income. The degree of social inequality in the indoor environment was estimated using the concentration index of inequality. The prevalence of annoyances due to draught, temperature, and noise increased significantly from 2000 to 2021 (e.g., temperature 5.9%–25.1%, odds ratio (OR) 6.72, 95% confidence interval (CI) 6.12–7.38), whereas the prevalence of water damage decreased (17.7%–13.8%, OR 0.85, 95% CI 0.76–0.96). No difference was seen in annoyances due to mould (3.1% in 2000 and 2.5% in 2021, OR 0.90, 95% CI 0.69–1.17). Social inequality was present for thermal conditions, annoyances due to noise and presence of water damage when assessed by income but not by educational level. Conditions were more prevalent among individuals with low income in both 2000 and 2021. The proportion of individuals reporting a poor indoor environment due to thermal conditions and noise increased in the period 2000–2021. Social inequality was observed in all indicators of a poor indoor environment for household income, whereas the inequality was less pronounced when assessed by educational level. [ABSTRACT FROM AUTHOR]

Based on theoretical premises of ecological systems theory and the compensatory hypothesis, a subset of data from the Family Life Project (N = 773), a population-based study of rural families with low incomes, were used to test for associations between maternal literacy in infancy and children's academic outcomes and teacher-reported problem behaviors in kindergarten. A second aim tested whether increased time in child care averaged from 6 to 36 months moderated such relations. Results indicated that maternal literacy was significantly positively related to academic outcomes (ES = 0.17–0.23) and significantly negatively related to children's problem behaviors (ES = −0.15) in kindergarten. Child care hours were not significantly related to any outcome. Significant interactions were found between maternal literacy and hours in child care on both children's academic skills and problem behaviors. Specifically, for mothers with lower literacy levels, significant dose-response relationships were detected between increased time in child care and children's higher academic scores and reduced problem behaviors (ES = 0.07–0.09). Implications for maternal literacy and child care access among rural families are discussed. Highlights: The findings from this study indicate that high maternal literacy is positively associated with children's kindergarten readiness in rural communities with low incomes. For mothers with lower literacy levels, time spent in child care may be an important promotive factor for children's development among children living in rural areas. Expanding child care access that would enable the delivery of two-generational early childhood services to children and their families may be helpful in rural communities. [ABSTRACT FROM AUTHOR]

While parental violent disciplining of children is a global concern, children living in low- and middle-income countries like Bangladesh are particularly more vulnerable to harsh disciplinary practices at home. There is limited empirical evidence on the use of disciplinary practices in Bangladesh, impeding the development of prevention practices. This study investigated the extent of violent child disciplining and parental attitudes toward physical punishment and identified their predictor using data from the 2019 Bangladesh Multiple Indicator Cluster Survey. Violent discipline includes any form of physical punishment like spanking, slapping, or hitting any part of the body, as well as psychological aggression such as shouting, screaming, or name-calling. Study participants were 44,570 mothers/caregivers of children aged 2–14 years. Multilevel mixed-effects logistic regression models were fitted to identify the predictors of violent disciplinary practices and parents' attitudes toward physical punishment. The results revealed a very high prevalence of violent disciplinary practices in Bangladesh. About 89% of the mothers/caregivers reported using at least one form of violent discipline; 39% were spanked, hit, or slapped on the bottom, 29% were hit or slapped on the face, head, or ears, and 5% were beaten up as hard as one could. Younger children, and children from urban areas, certain administrative divisions, poorer families, children with functional difficulties, less educated mothers/caregivers were more likely to experience violent discipline. About 35% of mothers/caregivers supported physical punishment, indicating a large discrepancy between attitude and the practice of violent discipline. Parents' attitudes appeared as one of the strongest predictors of violent discipline. Prevention efforts should be made to promote positive parenting and minimize the gap between parental attitudes and the practice of physical punishment. Highlights: This study documented a very high prevalence (89%) of violent physical punishment to children at home, while only 35% of mothers/caregivers supported physical punishment, indicating a big gap between attitude and practice about child discipline in Bangladesh. Mothers/caregivers' attitudes toward physical punishment appeared as a major predictor of the usage of violent physical discipline. Changes in attitudes need to be promoted by improving knowledge about the negative consequences of violent physical punishment. [ABSTRACT FROM AUTHOR]

Objective: Research links low marital quality to poor mental and physical health, but the impact of spousal infidelity on long-term chronic health, especially using longitudinal data, is understudied. The present work investigates whether infidelity predicted long-term chronic health, and whether demographic factors and support or strain from friends or family moderated this relationship. Methods: Using longitudinal data from 2579 adults from the United States (1093 males, 1486 females; M age = 57.17, Median age = 56, SD age = 12.26, age range: 33–84 years), we examined associations between partner infidelity and chronic health conditions across two timepoints (T1: 2004–2006, T2: 2013–2014). We analyzed participants' history of partner infidelity at T1 and its relationship with chronic health through mixed models as well as latent variable structural equation modelling. We also examined whether supportive relationships and demographic variables moderated these associations. Results: Controlling for demographic covariates (age, gender, education, ethnicity, employment, marital status, marital satisfaction and income level), infidelity was linked to poorer chronic health in mixed model analyses (p <.001), and this finding was also supported in latent variable analyses that controlled for baseline chronic health (p =.003). Additionally, moderation analyses found that the impact of infidelity on chronic health was larger among low-income individuals and ethnic minorities. Conclusion: Partner infidelity has lasting detrimental associations with chronic health that are not mitigated by positive relationships. The research highlights the potential long-term health implications of partner infidelity and suggests the need for interventions to mitigate such negative effects. [ABSTRACT FROM AUTHOR]

Background: The objectives of this study were to (a) assess the associations between early behavioral problems and intergenerational income mobility (i.e., the degree to which income status is transmitted from one generation to the next), (b) verify whether these associations are moderated by child sex, and (c) explore indirect effects of early behavioral problems on income mobility via high school graduation. Methods: Data were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 3,020; 49.17% girls). Participants were followed from age 6 to 37 years. Measures included parents' and teachers' ratings of behavioral problems at age 6 years as well as participants' (ages 30–35 years) and their parents' (when participants were aged 10–19 years) income data obtained from tax return records. Regression models were used to predict upward and downward mobility (i.e., increased or decreased income status from one generation to the next) from attention‐deficit/hyperactivity problems, conduct/opposition problems, depression/anxiety problems, prosociality, and the quality of children's relationship with their caregiver. Two‐way interaction effects between behavioral problems and child sex were examined and indirect effect models including high school graduation as a mediator of these associations were conducted. Results: Despite their higher educational attainment, females had lower incomes and experienced lower upward (but higher downward) income mobility than males. For both females and males, higher levels of attention‐deficit/hyperactivity and conduct/opposition problems were associated with decreased odds of upward mobility, whereas higher levels of attention‐deficit/hyperactivity were associated with increased odds of downward mobility. Attention‐deficit/hyperactivity problems, conduct/opposition problems as well as low prosociality were associated with lower educational attainment (no high school diploma), which in turn was associated with increased odds of downward mobility. Conclusions: Results highlight the importance of providing intensive support to children with early behavioral problems as a means of improving educational attainment and intergenerational income mobility. [ABSTRACT FROM AUTHOR]

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Background: Today, food insecurity is recognized as an important public health problem that can have detrimental effects on families. Aim: The aim of this study was to assess the determinants and consequences of food insecurity in families having children under the age of 2 years. Method: In this cross-sectional study, 307 mothers and their children under the age of 2 years were selected by stratified random sampling. Demographic and socioeconomic data were collected by completing questionnaires through face-to-face interview. Household food insecurity (HFI) status was determined using the United States Department of Agriculture (USDA) household food security questionnaire. Results: Based on the results, 67.4% of families were high food secure. Low and very low food security was 25.7% and 6.9%, respectively. House size (Beta = −0.019, 95% CI: −0.029, −0.009), father's job (Beta = −4.758, 95% CI:−6.777, −2.738), father education (Beta = −0.370, 95% CI: −0.717, −0.023), and economic status (Beta = −0.628, 95% CI: −0.809, −0.448) were significantly related to the USDA total food insecurity score (p < 0.05). Regression analysis showed that children birth weight, father's body mass index (BMI), and mother's waist circumference had a significant positive correlation with weight for age (Z-score) of children. Children's birth weight, father's BMI, and HFI status had significant and positive correlation with weight for length (Z-score). Moreover, the significant association between children's birth height, mother's BMI, and mother's waist circumference with length for age (Z-score) were observed (p < 0.05). Conclusion: We found the father's job was the most effective factor in food insecurity and economic status of the family was in the second place. Also, HFI had a relationship with weight status of children under the age of 2 years. [ABSTRACT FROM AUTHOR]