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• We study the link between civic sense and recycling in Italy. • We highlight theoretical results obtained using a contribution game. • We use the Italian Multipurpose Household Survey (MHS). • We use an ordered probit model for years 1998, 2012, 2018, 2019. • We find a positive, robust and stable link between civic sense and recycling. This article studies from a conceptual, theoretical and empirical point of view the link between civic sense and recycling activities in Italy related to the years 1998, 2012, 2018, 2019. It establishes a link among the concepts of civic sense, whose essential components are behaviours, attitudes and interactions, with it being a typical traditional theoretical approach with perfectly rational and perfectly informed agents, along with a standard empirical analyses on the determinants of (household) waste recycling. Starting from a game-theoretic model of contribution with particular features related to the objective function of agents and a heterogeneity in their costs, the article aims to highlight how certain theoretical results get together with empirical evidence. In the empirical analysis, using the micro-data of a "Multipurpose Survey on Households" provided by the Italian National Statistical Office and an ordered probit model, the article finds a positive, robust and stable correlation between civic sense and household recycling activities The findings show that a higher civic sense is related to an increase in household recycling activities, respectively, of 1.2 percentage points in 1998, 4.3 percentage points in 2012, and 3.8 percentage points in both 2018 and 2019. [ABSTRACT FROM AUTHOR]

Onion is a vital vegetable crop in Ethiopia, with significant economic and health benefits. However, its production trend is not consistent, with periods of increase and decrease; and its productivity in the country falls far below its potential. As a result, farmers are not yet fully benefited from onion production. Thus, this study was initiated to identify the factors influencing onion production in the Raya Kobo District of Amhara Regional State of Ethiopia. Data was collected from 189 onion-producing farmers through household surveys, and both descriptive and econometric techniques were used for analysis. The study found significant variation in onion production among farmers, with lower levels compared to national and international averages. Factors such as gender, education level, experience, labor force, land size, access to extension services, irrigation water, land plough frequency, and fertilizer availability positively impact onion production. However, excessive fertilizer use was found to have a negative effect. The study also identified challenges faced by farmers, including input shortages, high costs, diseases, labor issues, soil infertility, and storage knowledge gaps. The study recommends policymakers and stakeholders to utilize these findings to develop effective policies and interventions that can enhance onion production, benefiting farmers and improving the overall onion production. [ABSTRACT FROM AUTHOR]

Introduction: Provision of quality antenatal care (ANC) to pregnant women is essential for reducing maternal and newborn mortality. ANC provides an opportunity for early identification of conditions that increase the risk of adverse pregnancy outcomes. However, there is limited evidence regarding the quality of ANC received by women in Malawi. This study aimed to assess the quality of ANC and associated factors in Malawi. Materials and methods: National representative data from the 2019–2020 Malawi Multiple Indicator Cluster Survey was used for this cross–sectional study. A total of 6,287 weighted sample of women aged 15 to 49 years who had a live birth and received ANC at least once within two years preceding the survey were included in the analysis. Descriptive statistics were used to estimate the magnitude of quality ANC and multivariable logistic regression was computed to identify associated factors. Results: Of the 6,287 women, only 12.6% (95% CI: 11.4–13.9) received quality ANC. The likelihood of receiving quality ANC was significantly higher among women who had four to seven ANC contacts (AOR = 2.10; 95% CI: 1.79–2.49), made at least eight ANC contacts (AOR = 3.40; 95% CI: 1.90–6.09) and started ANC within the first trimester (AOR = 1.30; 95% CI: 1.10–1.53). On the other hand, women who had only primary education (AOR = 0.62; 95% CI:0.48–0.82) and had five or more births (AOR = 0.56; 95% CI: 0.40–0.78) were less likely to receive quality ANC. Conclusion: The findings reveal that quality of ANC in Malawi is low. These findings suggest the need for targeted interventions aimed at improving access to and utilization of ANC services among women with lower education and higher parity. Strengthening efforts to promote early ANC initiation and increasing the number of ANC contacts could significantly enhance the quality of ANC received by women in Malawi. [ABSTRACT FROM AUTHOR]

As the Duwamish Valley community in Seattle, Washington, U.S.A. and other environmental justice communities nationally contend with growing risks from climate change, there have been calls for a more community-centered approach to understanding impacts and priorities to inform resilience planning. To engage community members and identify climate justice and resilience priorities, a partnership of community leaders, government-based practitioners, and academics co-produced a survey instrument and collected data from the community using the Seattle Assessment for Public Health Emergency Response (SASPER), an approach adapted from the Centers for Disease Control and Prevention's Community Assessment for Public Health Emergency Response (CASPER). In addition, we conducted a process and outcome project evaluation using quantitative survey data collected from volunteers and qualitative semi-structured interviews with project team members. In October and November 2022, teams of volunteers from partner organizations collected 162 surveys from households in the Duwamish Valley. Poor air quality, extreme heat, and wildfires were among the highest reported hazards of concern. Most Duwamish Valley households agreed or strongly agreed that their neighborhood has a strong sense of community (64%) and that they have people nearby to call when they need help (69%). Forty-seven percent of households indicated willingness to get involved with resilience planning, and 62% of households said that they would use a Resilience Hub during an emergency. Survey volunteers evaluated their participation positively, with over 85% agreeing or strongly agreeing that they learned new skills, were prepared for the survey, and would participate in future assessments. The evaluation interviews underscored that while the SASPER may have demonstrated feasibility in a pre-disaster phase, CASPER may not meet all community/partner needs in the immediate disaster response phase because of its lack of focus on equity and logistical requirements. Future research should focus on identifying less resource intensive data collection approaches that maintain the rigor and reputation of CASPER while enabling a focus on equity. [ABSTRACT FROM AUTHOR]

In 2019, the Federal Deposit Insurance Corporation (FDIC) reported that 7.1 million households in the United States (5.4%) were unbanked and lacked a checking or savings account). Using three leading household surveys, this paper documents how the interaction between bank access and poverty has evolved over time. We present a historical time series of unbanked rates, showing high‐unbanked rates for those in poverty even with increases in financial access over time. In the 1980s, 49.6% of households in poverty were unbanked while 22.8% were unbanked in 2019. Unbanked rates were even higher for Black and Hispanic households that were in poverty. In the 1980s, these groups had unbanked rates of 73.6% and 66.5% which declined to 38.4% and 31.8% in 2019, respectively. To explain differences in banking rates by race, we use binary Kitagawa‐Oaxaca‐Blinder decompositions. Socio‐demographic characteristics explain less than half the difference in unbanked rates for Blacks and around half for Hispanics. [ABSTRACT FROM AUTHOR]

Obtaining representative information on hosts and displaced populations in a single survey is not straightforward. This article demonstrates the value of combining traditional and nontraditional sampling frames, geospatial information, and listing exercises to design a representative survey of hosts and Rohingya displaced populations in Cox's Bazar, Bangladesh. The article applies innovative segmentation techniques using geospatial data to delimit enumeration areas in the absence of updated cartography. The article also highlights the importance of listing exercises to inform stratification decisions and update population counts. [ABSTRACT FROM AUTHOR]

The paper reports analysis of data from a household survey concerning water conservation behaviour in Kuwait. Econometric models were used for nine conservation measures, The models were estimated for nationals and expatriates. The results revealed that households made efforts to conserve water by changing habits/practices. The results failed to support the theory of planned behaviour as water conservation campaign had no effect on households' water conservation. Awareness about environment and water conservation did not result in pro-conservation behaviour. [ABSTRACT FROM AUTHOR]

Can the expansion of a prosperous middle class help China to rebalance to consumption-led growth? We address this question through analysis of macro- and micro-level data. Using macro statistics, we examine trends in national aggregate consumption and GDP growth from 2000 through 2019. We observe growth in aggregate consumption but do not find convincing evidence of consumption-led growth. Using micro-level household survey data from 2002, 2007, 2013 and 2018, we estimate the size of China's prosperous middle class and its contribution to aggregate consumption growth. We find that the prosperous middle class expanded rapidly but contributed less to aggregate consumption growth than expected. We discuss features of this class that diminished its contribution to consumption-led growth, including its low propensity to consume out of income and its limited expansion beyond urban subgroups. We conclude that the expansion of the prosperous middle class is necessary but not sufficient to bring about rebalancing. [ABSTRACT FROM AUTHOR]

Background: Mexico has one of the world's highest rates of cesarean section (C-section). Little is known about Mexico's frequency of and risk factors for non-consented C-sections, a form of obstetric violence. We examined the prevalence of sociodemographic and obstetric-specific characteristics of Mexican women who delivered via C-section, as well as the association between the location of prenatal care services and experiencing a non-consented C-section. Methods: We conducted a secondary analysis of data collected from Mexico's 2016 National Survey on the Dynamics of Household Relationships (ENDIREH 2016) of women who reported a C-section during their latest delivery. Adjusted logistic regressions were calculated to explore the associations between the location of prenatal care services and experiencing a non-consented cesarean delivery, stratifying by Indigenous belonging. Results: The sample size for this analysis was 10,256 ENDIREH respondents, with 9.1% not consenting to a C-section. ENDIREH respondents between the ages of 26 and 35 years old, living in urban settings, living in Central or Southern Mexico, and married or living with a partner experienced a higher prevalence of non-consented C-sections. For both women who identified as Indigenous and those who did not, the odds of experiencing a non-consented C-section were higher when receiving prenatal services in private settings. Receiving more than one type of prenatal service was also associated with increased odds of non-consented C-sections, while ENDIREH 2016 respondents who did not identify as Indigenous and received prenatal care at the State Institute for Social Security and Services for State Workers facility had lower odds of experiencing a non-consented C-section. Conclusions: This analysis indicates that receiving prenatal care at a private facility or a combination of public and private services increases the risk of experiencing a non-consented C-section in Mexico. Additional research is required to further understand the factors associated with non-consented C-sections in Mexico. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has prompted countries to swiftly implement rigorous preventive measures on a population-wide scale worldwide. However, in low-income countries like Mozambique this was difficult, coupled with a generalised lack of knowledge on how the population understood and complied with these measures. This study assessed community perceptions and implementation of anti-COVID-19 measures recommended by Mozambican authorities in Manhiça and Quelimane districts, including confinement, social distancing, frequent handwashing, mask wearing, and quarantine as the key practices to evaluate. We conducted a cross-sectional quantitative survey in October 2020 and February 2021, interviewing heads of households, face-to-face. The data collected included self-evaluation of compliance and existence of handwashing facilities and face-masks in the households, aided by observations. We present descriptive statistics on perceptions and compliance at individual and household levels. Out of the 770 participants, nearly all (98.7%) were aware of Coronavirus disease, including the term COVID-19 (89.2%). Knowledge varied between districts, with Manhiça participants showing higher levels of sufficient ability to define the disease. The symptoms most mentioned were dry cough (17.8%), fever (15.7%), flu-like symptoms (14.2%), breathing difficulties (13.6%), and headache (13.1%). Participants recognized various transmission modes, including touching infected objects and inhaling infected air. Preventive measures like handwashing with soap or sanitizing hands with alcohol, wearing masks, and social distancing were acknowledged, but the understanding varied. Compliance with these measures was generally low, with fewer than half of respondents reporting adherence to them. Only 30.4% of households had handwashing facilities (of which only 41.0% had water), and masks were often limited to one per person aged 6 years or more. Community members in Manhica and Quelimane were aware of COVID-19 but had limited understanding of what the preventive measures meant, and had lower levels of compliance. Understanding and addressing the factors affecting the proper implementation of these measures is crucial for improving community adherence in preventing infectious diseases with epidemic potential. [ABSTRACT FROM AUTHOR]

Over the past decade, national statistical offices in low- and middle-income countries have increasingly transitioned to computer-assisted personal interviewing and computer-assisted telephone interviewing for the implementation of household surveys. The byproducts of these types of data collection are survey paradata, which can unlock objective, module- and question-specific, actionable insights on survey respondent burden, survey costs, and interviewer effects – all of which have been understudied in low- and middle-income contexts. This study uses paradata generated by Survey Solutions, a computer-assisted personal interviewing platform used in recent national household surveys implemented by the national statistical offices of Cambodia, Ethiopia, and Tanzania. Across countries, the average household interview, based on a socioeconomic household questionnaire, ranges from 82 to 120 minutes, while the average interview with an adult household member, based on a multi-topic individual questionnaire, takes between 13 to 25 minutes. The paper further provides guidelines on the use of paradata for module-level analysis to aid in operational survey decisions, such as using interview length to estimate unit cost for budgeting purposes as well as understanding interviewer effects using a multilevel model. Our findings, particularly by module, point to where additional interviewer training, fieldwork supervision, and data quality monitoring may be needed in future surveys. [ABSTRACT FROM AUTHOR]

Low-income populations are disadvantaged in a car-dependent society despite car ownership and could be using walking and cycling to reduce their travel costs. This study explores how low-income households with and without cars living in various geographies disproportionately use walking and cycling to save money in comparison to higher-income households. Data from the 2017 National Household Travel Survey is used to investigate the variation in walking and cycling behavior among three groups of households: (1) carless low-income households, (2) low-income households with cars, and (3) higher-income households. Generalized ordered logistic regression models are estimated to examine how the probability of using active travel to save money varies by household type, location (urban, suburban, rural) and other socioeconomic attributes. We find that low-income households are more likely to walk or cycle to save money on transportation compared to higher-income households. Carless low-income households present a higher probability to use active travel to decrease travel costs in comparison to car-owning low-income households. Our results also indicate that on average, urban residents are more likely to travel actively to reduce expenses compared to suburban and rural residents. The lowest spatial variation is found for carless low-income households, demonstrating their higher disadvantage compared to those with cars. Low-income people of color are more likely to use active travel to save money while being a female, older, or having children are attributes associated with a lower probability to use active travel to reduce travel expenses in low-income households. [ABSTRACT FROM AUTHOR]

Data on income distributions within and across countries are becoming increasingly important for informing analysis of income inequality and understanding the distributional consequences of climate change. While datasets on income distribution collected from household surveys are available for multiple countries, these datasets often do not represent the same concept of inequality (or income concept) and therefore make comparisons across countries, over time and across datasets difficult. Here, we present a consistent dataset of income distributions across 190 countries from 1958 to 2015 measured in terms of net income. We complement the observed values in this dataset with values imputed from a summary measure of the income distribution, specifically the Gini coefficient. For the imputation, we use a recently developed nonparametric principal-component-based approach that shows an excellent fit to data on income distributions compared to other approaches. We also present another version of this dataset aggregated from the country level to 32 geographical regions. Our dataset is developed for the purpose of calibrating models such as integrated human–Earth system models with detailed data on income distributions. This dataset will enable more robust analysis of income distribution at multiple scales. The latest version of our data are available on Zenodo: 10.5281/zenodo.7093997 (Narayan et al., 2022b). [ABSTRACT FROM AUTHOR]

Household expenditure data is at the core of efforts to measure living standards, inequality and financial protection against illness. Currently it is mainly derived from recall-based surveys that are time consuming and prone to measurement errors. Diaries are often used as an alternative approach, however this results in fatigue and low compliance. Smartphone- based diaries could overcome many of these challenges, but it is yet unknown how this approach could be used and its relationship with data from the household surveys. This study evaluated a smartphone-based diary application for collecting daily household expenditures and compared data with that of household surveys. Results show that smartphone-based diary applications could be used to optimize or complement the information from conventional survey-based indicators. [ABSTRACT FROM AUTHOR]

This study assessed the impact of safety nets on food insecurity in households with people with disabilities (PWD) in Nigeria. Using data from the 2019 Nigeria General Household Survey, we assessed the risk of experiencing food insecurity among households and the moderating role of safety nets using households without PWDs as a reference. PWD households were three times more likely to experience severe food insecurity compared to households without PWDs. The impact of the safety net program on the risk of food insecurity showed that receiving social benefits had little effect among households with disabled members experiencing severe food insecurity. [ABSTRACT FROM AUTHOR]

Large, unexpected shocks are becoming more frequent, making the design of robust social transfer programs more vital than ever. We evaluate the performance of the Food Friendly Program (FFP), the largest in-kind social transfer program in Bangladesh, before and during the nation-wide COVID-19 lockdown. Using two-rounds of nationally representative household surveys combined with administrative data, we document that high leakages and large welfare losses are related to corruption. This contrasts with the performance of the pre-lockdown FFP, when leakage was low and coverage high. We then compare the performance of the FFP with two initiatives launched following the pandemic: an in-kind and cash transfer program, respectively. These programs have markedly higher levels of leakage than the FFP. Our findings are relevant to other large shocks, such as those caused by climate change, and have important policy implications for the design and delivery of transfer programs in developing countries characterized by institutional weaknesses. [ABSTRACT FROM AUTHOR]

To inform policy makers concerned with food security, this paper relies on the 1–2–3 household survey (2004–2005) to provide a geographical overview of Congo's food markets and dietary status. The results of this descriptive study point to inefficient domestic food markets, with Kinshasa being a case in point: it is deficient, poorly connected to its hinterland and highly dependent on imports. Food markets in the Kasaï provinces and the northeastern region are two minor exceptions, while the most competitive food producers are found in Équateur and North Kivu. Despite differential access, five diet types can be identified, with the most energy rich (cassava/palm oil) being consumed in Maniema, Orientale, Équateur, and rural Bas-Congo. In contrast, households in South Kivu and Kinshasa suffer from large calorie deficiencies, which is due to low purchasing power for the former and relatively higher food prices and more demanding social norms for the latter. [ABSTRACT FROM AUTHOR]

Objective: To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015–2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021. Material and methods: A nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income). Results: The proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4–58.0) overall, 51.3% (95%CI: 44.9–57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0–82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95%CI 1,106–1,330) including $860.9 (95%CI 776.1–945.7) for non-medical costs, $339 (95%CI 257–421) for the indirect costs, and $18.1 (95%CI 11.9–24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type. Conclusion: Main cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels. [ABSTRACT FROM AUTHOR]

Abstract:Background: Our aim was to assess, in the general German population, the association between tobacco smoking status and self-reported SARS-CoV-2 infection, COVID-19 symptom severity, and symptom duration. Methods: Cross-sectional household survey with face-to-face interviews of representative samples of the German population conducted between 02/2021-04/2022. Associations between smoking status (current, long-term ex-, never) and three self-reported outcomes (corona infection status, symptom severity, and symptom duration) were analysed with regression models, adjusted for a range of potential confounding factors, including vaccination status in a sub-sample. We also ran sensitivity analyses. Results: 872 people reported an infection (5.4 % of 16,028). There was no relevant and statistically significant association between current smoking and long-term ex-smoking compared with never smoking regarding ever being infected with corona (aOR=1.02, 95 %CI=0.86–1.20 and aOR=1.03, 95 %CI=0.83–1.28, respectively), symptom severity (aOR=0.84, 95 %CI=0.59–1.20 and aOR=0.88, 95 %CI=0.55–1.38, respectively), and symptom duration (aβ)=-0.09 months, 95 %CI=-0.45–0.28 and aβ=0.002 months, 95 %CI=-0.48–0.48). Sensitivity analyses examining the interaction between survey wave and smoking status showed that the risk of an infection increased over time, and this increase was higher in current smokers compared with never smokers. Conclusions: In the general German population smokers appear to be as likely to acquire a corona infection as long-term ex- and never smokers. [ABSTRACT FROM AUTHOR]

Numerous studies have explored associations between bicycle network characteristics and bicycle ridership. However, the majority of these studies have been conducted in inner metropolitan regions and as such, there is limited knowledge on how various characteristics of bicycle networks relate to bicycle trips within and across entire metropolitan regions, and how the size and composition of study regions impact on the association between bicycle network characteristics and bicycle ridership. We conducted a retrospective analysis of household travel survey data and bicycle infrastructure in the Greater Melbourne region, Australia. Seven network metrics were calculated (length of the bicycle network, betweenness centrality, degree centrality, network density, network coverage, intersection density and average weighted slope) and Bayesian spatial models were used to explore associations between these network characteristics and bicycle ridership. We demonstrated that bicycle ridership was associated with several network characteristics, and that these characteristics varied according to the outcome (count of the number of trips made by bike or the proportion of trips made by bike) and the size and characteristics of the study region. These findings challenge the utility of approaches based on spatially modeling network characteristics and bicycle ridership when informing the monitoring and evaluation of bicycle networks. Further efforts are required to be able to quantify network characteristics that reflect the myriad of factors that influence comfort and safety for people of all ages and abilities. [ABSTRACT FROM AUTHOR]

Using data from the 2015 China Household Financial Survey (CHFS) this paper examines the effect of culture on the gender gap in financial literacy. We exploit geographical differences in culture in China, comparing outcomes between rural and urban areas and between areas in the east and west (Shanghai and Chongqing). Using the Blinder‐Oaxaca decomposition we show that, nationally, the gender gap in financial literacy is entirely the product of differences in the way men and women acquire financial literacy. It is a result consistent with cultural effects. When considering just women in Shanghai and Chongqing we observe a raw financial literacy differential of 13% (favoring Shanghai). This gap is also the product of differences in the way financial literacy is acquired. It provides additional evidence as to the importance of culture when it comes to understanding financial literacy. [ABSTRACT FROM AUTHOR]

In South Africa, youth (15–34 years) are the most vulnerable age group, assuming a large share of unemployment and NEET rates. This has raised concerns of their living standards, which have a great influence on their overall development. Although much has been written on poverty in South Africa, poverty specifically among the youth remains under-researched. This study analyses factors that determine poverty among youth-headed households in South Africa using the 2018 General Household Survey data from Statistics South Africa. Using a binary logistic regression, the paper provides findings and makes recommendations and imperative insights to policy-makers in advancing the socio-economic status of young people. [ABSTRACT FROM AUTHOR]

In one of the largest demand-side energy efficiency programs at the time, the Mexican government supported more than 11 million, mostly low-income households in replacing their old light bulbs and appliances with more efficient models. Previous evaluations of this program focused exclusively on appliances, which made up almost 90 per cent of the total program cost, and found modest benefits in terms of energy savings. This study compares the respective effects of replacing light bulbs and appliances simultaneously in a single econometric framework, using data from nationally representative household surveys and a difference-in-differences approach which exploits geographical variation in treatment intensities. Despite using different sources and types of data, our results for the appliances replacement intervention are largely in line with the estimates of previous studies. In addition, we find that the impact on energy consumption (proxied by the amount paid for electricity) of replacing light bulbs was of comparable magnitude as that of replacing appliances, although the average cost per participating household was much smaller. Overall, our results suggest that low-cost investments that help poor households reduce their energy consumption for lighting can have high returns on energy efficiency in the residential sector. [ABSTRACT FROM AUTHOR]

Big data has been fruitfully leveraged as a supplement for survey data—and sometimes as its replacement—and in the best of worlds, as a "force multiplier" to improve survey analytics and insight. We detail a use case, the big data classifier (BDC), as a replacement to the more traditional methods of targeting households in survey sampling for given specific household and personal attributes. Much like geographic targeting and the use of commercial vendor flags, we detail the ability of BDCs to predict the likelihood that any given household is, for example, one that contains a child or someone who is Hispanic. We specifically build 15 BDCs with the combined data from a large nationally representative probability-based panel and a range of big data from public and private sources, and then assess the effectiveness of these BDCs to successfully predict their range of predicted attributes across three large survey datasets. For each BDC and each data application, we compare the relative effectiveness of the BDCs against historical sample targeting techniques of geographic clustering and vendor flags. Overall, BDCs offer a modest improvement in their ability to target subpopulations. We find classes of predictions that are consistently more effective, and others where the BDCs are on par with vendor flagging, though always superior to geographic clustering. We present some of the relative strengths and weaknesses of BDCs as a new method to identify and subsequently sample low incidence and other populations. [ABSTRACT FROM AUTHOR]

Longitudinal evidence demonstrating the association between parental absence and depressive symptoms in adolescence is limited. The present study aimed to explore this relationship in a Chinese national representative sample. This research was based on the China Family Panel Studies and included 1481 subjects. Depressive symptoms were assessed using the self-reported Center for Epidemiologic Studies Depression questionnaire. A multiple logistic regression model with a generalized estimating equation was used to test the association between parental absence and adolescent depressive symptoms. In the baseline year, 2012, 29.03% and 43.75% of adolescents had maternal and paternal absence, respectively. The prevalence of depressive symptoms increased from 23.23% to 28.12% in subsequent years. After controlling for covariates, maternal absence was positively associated with depressive symptoms (odds ratio 1.69, 95% confidence interval 1.06–2.68). Maternal absence led to depression in adolescents. It may be beneficial for adolescents with depression to spend more time with their mothers. [ABSTRACT FROM AUTHOR]

• Population-level monitoring of children's development informs research and policy. • Caregiver-reported household surveys, such as the ECDI2030, can play this role. • Results from two national samples support the use of the ECDI2030 for monitoring. • Findings also suggest more research is needed on social and emotional development. • Recommendations are made for ensuring the quality of data from caregiver surveys. Population-level monitoring of early childhood development (ECD) can inform research and guide national policy. One approach to population-level monitoring is through the design of surveys that (a) are feasible and cost-effective to implement at scale, (b) yield well-validated summaries of children's holistic development, and (c) can ideally support comparisons across national and cultural contexts. The Early Childhood Development Index 2030 (ECDI2030) is a caregiver-reported household survey designed to achieve these goals for children aged 24-59 months. This paper describes how the ECDI2030 was developed and provides initial results on its reliability, concurrent validity, and gender equity in nationally representative samples from Mexico (N = 1641) and Palestine (N = 1099). Overall, the results support the use of the ECDI2030 for population-level monitoring, but also suggest that the conceptualization of social-emotional development warrants further attention from researchers. Recommendations are made about statistical analyses that can be undertaken to ensure the quality of data collected from ECD assessments in international settings. [ABSTRACT FROM AUTHOR]

Burn injuries pose a significant public health challenge, especially in low- and middle-income countries (LMICs). In Bangladesh, burn injuries are prevalent and often result in severe disability or death. However, knowledge regarding the causes of burn injuries, acute burn management, and barriers to seeking burn care in the riverine areas of northern Bangladesh is limited. We conducted a questionnaire-based study in eight subunits and five selected districts in northern Bangladesh to determine the prevalence, causes, and management of burn injuries in these areas. A total of 210 individuals from different households were interviewed, which represented a population of 1020 persons. Among the respondents, 55% reported that at least one member of their household suffered from a burn injury in the past. The most common causes of burn injuries were open fire (41%) and hot fluids (30%). More than 40% of burns were not rinsed with water directly after sustaining the injury. Additionally, almost 30% of respondents did not seek medical care immediately after the injury, with financial constraints being the most commonly cited reason. We found a low rate of adequate cooling and seeking medical care. The need for basic knowledge on prevention and treatment of burn injuries and improved access to affordable health care services in the region is high. • There is a high burn injury prevalence in Bangladesh, leading to severe disability and fatalities. • Open fire and scalds were the most common causes of burn injuries. • A specific household survey in the rural north of Bangladesh was conducted. • There is a concerning lack of immediate water rinsing for almost half of burn injuries. • There is an urgent need for burn injury prevention in northern Bangladesh. [ABSTRACT FROM AUTHOR]

Poverty was already a main problem in Afghanistan even before, but it has exacerbated due to the pandemic. However, the actual impact of the pandemic on households had not been investigated. This study provides such analysis using data obtained from a strictly random survey of 1060 households in the capital of Balkh, the fourth most populated province in Afghanistan. Using headcount ratio and poverty gap measures and both income and expenditure approaches, the results show that an additional 12% of households fell below the poverty line, from an already high of 75% before the pandemic. The poverty gap index rises to 34%, but the computed Gini coefficient indicates no significant change in inequality. Poor governance and corruption in Afghanistan are major impediments to address the issue of poverty. This paper suggests several measures which can be implemented to have effective policies and governance to alleviate poverty. [ABSTRACT FROM AUTHOR]

Reverse mortgage is one of the products (perhaps the main one) that is good to obtain additional income by using the habitual residence as collateral. The main objective of this paper is to analyse the effects that reverse mortgage contracting has on household finances over the lifetime of a family according to the socioeconomic group to which it belongs in Spain. Four indicators are employed to measure the immediate and long-term effects. We use a stochastic model with a double source of randomness, survival and entry into dependency, and apply it to the three socioeconomic groups obtained with cluster methodology from the 2017 Spanish Household Financial Survey data. We conclude that the effects are very different depending on the group: regarding only the effects of hiring a reverse mortgage on the income of the family, widowed women aged between 81 and 85 years, with low income and expenses as well as little net wealth, and a habitual residence that represents half of her net wealth (Cluster 1) are the most benefited; considering that the highest impact indicators are on the probability of illiquidity and on the value of lack of liquidity, the use of reverse mortgages benefits more the families in Cluster 3 (high income and expenses and really high net wealth, head of household aged between 76 and 80 years) and less the families in Cluster 2 (medium income, net wealth and expenses, head of household aged between 65 and 75 years). [ABSTRACT FROM AUTHOR]

We investigate the factors that influence the selection and productivity of informal service-oriented family enterprises in Nigeria. Using nationally representative micro-data from the Nigerian General Household Survey (2010–2015), we employed random-effect probit and selectivity-adjusted regression models to estimate and analyze the results. The findings reveal that the location of informal Non-Farm Household Enterprises (NFHEs)–whether home-based or non-home-based—significantly impacts the wholesale, retail, personal, and consultancy service sectors operated by informal NFHEs. This impact remains significant even after accounting for variations in individuals, households, or locational characteristics. Furthermore, when considering selectivity in the earnings equation, we found that home-based informal enterprises exhibit lower productivity compared to non-home-based enterprises, a difference that varies across sectors. Overall, factors such as the gender of business owners, educational levels, geopolitical zones, infrastructure, and business characteristics play a crucial role in determining the locational and productivity disparities among service-oriented enterprises in Nigeria. Key recommendations stemming from this study include addressing gender-based segregation and economic disparities, prioritising financial inclusion for small business development, bridging infrastructure gaps, and implementing policies that acknowledge and bolster the informal sector. [ABSTRACT FROM AUTHOR]

Background: Saudi Arabia is implementing a comprehensive health system transformation in health services provision, governance, and financing. Given the high burden of non-communicable diseases (NCD), a key objective of the transformation is to integrate NCD prevention and treatment into primary care. The study objectives were to assess primary care service use for treatment of NCDs, to quantify existing inequities in preventive services utilization, and to identify regional and sociodemographic factors associated with these inequities. Methods: Using the 2019 Kingdom of Saudi Arabia World Health Survey, multivariable logistic regression models were conducted to identify predictors of utilization of primary care services for NCD prevention and treatment, unmet need among those with a diagnosis of diabetes, hypertension, or dyslipidemia, and unmet need in breast and cervical cancer screening. Results: Among those with an NCD diagnosis, living in a high-income household was associated with a lower probability of having an unmet need compared to those in low-income households. Furthermore, rural residents were less likely to have an unmet need compared to urban residents (OR 0.58, p=0.029). Individuals without a perceived need for healthcare within the last 12 months had three times the probability of unmet need in comparison to those with such a perceived need (p<0.001). Women in all regions had a lower probability of ever having a mammogram compared to women in the central regions around Riyadh. Women with an education above a secondary level had five times the odds of undergoing cervical cancer screening and three times the likelihood of ever having a mammogram (P=0.012, p=0.02) than other women. Compared to women in low-income households, those in middle (OR 1.99, P=0.026), upper middle (OR 3.47, p<0.001), or high-income households (OR 2.59, p<0.001) had a higher probability of having had cervical cancer screening. Conclusions: Inequities in NCD treatment and prevention services' utilization in Saudi Arabia are strongly associated with region of living, population density, wealth, income, education and perceived need for health care. More research is needed to better understand the extent of unmet primary care needs for NCD and how to address the underlying contributing factors to access inequities. [ABSTRACT FROM AUTHOR]

This paper develops a Bayesian method to detect heterogeneity in the relationship between covariates and the outcome in models with ordered responses. To this end, we construct an efficient Markov chain Monte Carlo algorithm for a hierarchical Bayesian model that selects random coefficients in ordered models. This method extends an approach for selecting random coefficients in linear mixed models into the ordered setting by adding two enhancements that are relevant to the latter category of models. First, we construct steps to efficiently estimate cut-points by addressing identification and ordering constraints. Second, we develop a framework to evaluate marginal effects that combine the fixed and random effects of each covariate. The marginal effects additionally allow for model uncertainty by averaging across models visited by the selection algorithm. Simulation studies demonstrate that this method detects random effects when they are present, estimates parameters accurately and efficiently samples from the posterior with low autocorrelations across successive draws. On applying this method on data from the survey of consumer expectations, we find clear support for the presence of household-level heterogeneity in relationships between demographic variables, and current as well as expected financial conditions. [ABSTRACT FROM AUTHOR]

Background: Global efforts reduced incidence of polio cases from 350,000 in 1988 to 22 cases in 2022 globally. There have been no wild poliovirus (WPV) cases seen in Somalia since August 2014. However, in 2017, there was a surge in the number of cases of circulating vaccine-derived poliovirus type 2 (cVDPV2), even with different intervention responses using monovalent oral polio vaccine type 2 (mOPV2). This study aimed to assess the use of fractional inactivated polio vaccine (fIPV), a smaller dose of the polio vaccine, equal to 1/5 of a standard dose, as an innovative polio vaccination delivery model, and identify the main opportunities for and challenges to the use of fIPV in the future for vaccinations. Methods: The study used two designs: a quasi-experimental design used to pilot fIPV in five districts and a cross-sectional study using both quantitative and qualitative approaches to collect primary data. A simple random sampling method was used to select 2 out of the 5 pilot districts for household surveys to study 768 participants. Key informant interviews and focus-group discussions were used to collect data from key frontline health workers and health/immunization officials involved in the campaigns. Secondary data from the pilot campaigns were analysed, such as administrative pilot data, lot quality assurance sampling (LQAS) and post-campaign communication assessments. Results: A total of 131,789 children aged 4–59 months were included for the pilot. Among these, 126,659 (96.1%) and 126,063 (95.6%) children were vaccinated in rounds 1 and 2, respectively. Out of the 768 households assessed, 99.9% had their children vaccinated. Nearly half of the few children who were not vaccinated were reported to be due to the parent of the child not being at home (48%). Ninety-seven percent of the qualitative study interviewees were satisfied with fIPV injection and recommended its use for routine immunization. Conclusions: The study findings are promising in the use of fIPV in mass campaigns to realize better coverage and global polio eradication. fIPV will potentially be used by policymakers in the design of polio eradication campaigns that integrate the fIPV vaccine into routine or supplementary immunization. [ABSTRACT FROM AUTHOR]

Territorial inequalities have long been a subject of study and concern in Canada. In the face of large structural changes such as industrial shifts and the decarbonization of our economies, there is an urgency to understand such inequalities and design effective policy interventions for those places facing persistent economic decline. This paper shares a novel composite index that measures economic disparity across Canadian Census Subdivisions (CSDs) using Census data from 2001 through 2016 and the 2011 National Household Survey. Named the "Index of Economic Disparity," it is comprised of an equally weighted average of four sub‐indices that assign percentile rankings for all CSDs based on whether they experience persistent and substantial decline in key economic areas: population, labour force outcomes, working‐age share of population, and industrial diversity. The variation of outcomes across geographies—urban and rural—highlights the importance of place‐based policies. [ABSTRACT FROM AUTHOR]

In South Africa, households were formed at about twice the rate that the population grew be-tween census 1996 and census 2011 and the number of single-person households ballooned by 150%. Reweighted household survey data shows a surge in household formation in the late 1990s was driven by prime-aged and older women and Black African men, likely connected to new freedoms afforded to these groups after the transition to democracy. Household formation steadied in the 2000s, hiding variation in who formed what types of households. Astonishing growth in the rate at which South Africans live alone was led by Black African men, a group historically associated with circular labour migration. Women instead are heading up complex households including children. These changes connect to long-term marital decline. By 2011, most female heads were never-married and the growing majority population group of never-married adults increased their rate of household formation. [ABSTRACT FROM AUTHOR]

The practice of women eating after men is a common gender-inequitable food allocation mechanism among adults in Indian households and has been associated with poor health and nutritional outcomes for women. However, empirical evidence on whether a similar practice of girls eating after boys is prevalent among children is scarce. Using primary data from a household survey conducted in educationally backward areas of four Indian states, we provide new evidence of this practice among children. Almost 28 per cent of the sample households follow the mealtime custom of girls eating after boys. Scheduled Tribes and households with higher incomes are less likely to follow this practice. Other relevant factors include children's relative ages by sex and an interplay between family size and children's sex composition. While our findings may not be generalizable, they suggest an intersectionality between gender and other dimensions of inequality, namely social identity and economic class. [ABSTRACT FROM AUTHOR]

Household consumption surveys do not typically offer poverty estimates for refugees. We test the performance of a recently developed cross-survey imputation method to estimate poverty for a sample of refugees in Chad, combining survey and administrative data collected by the United Nations High Commissioner for Refugees (UNHCR). We find the imputed poverty rates are not statistically different from the poverty rates obtained directly from the survey consumption data. This result is robust to different model specifications, varying poverty lines, and assumptions of the error terms. Targeting results based on the imputed poverty estimates also outperform common targeting methods, such as proxy means tests and the current targeting method used by humanitarian organizations in Chad. Replicating this approach in at least some of the 122 other countries currently using UNHCR administrative data could help address data gaps and provide much-needed estimates to effectively respond to forcibly displaced crises. [ABSTRACT FROM AUTHOR]

• The changing structure of households in Africa is challenging the design of micro-level pro-poor policies. • Divorce/separation and widowhood have increased compared to data from 1987/88. • Lower incomes in female-headed households do not lower children's educational investment. • The gender mix of children plays a key role in aggregate household investments for male-headed households, with the financial inclusion of female household heads under 40 years being important for investments in children's education. • Structural changes in female leadership in communities interact with structural changes at the household level. Female headship of households has increased significantly around the world. This paper establishes a link between gender, income, and children's educational investments in an imperfect credit market. We show using a representative household survey from Ghana that, even though there is a positive correlation between income and educational investments, there are expected and unexpected heterogeneities in income and children's educational investments. We find that, whereas income levels for male-headed households with children 6 to 18 years are over 20% higher, female-headed households tend to invest 31% to 38% more on children's education than male-headed households. In imperfect credit markets, higher educational investments could be taking place at the expense of other household outcomes such as food/leisure. Our empirical results show the need for different interventions for different households. We also show how institutional changes that recognize affirmative action can interact with household-level structural changes. [ABSTRACT FROM AUTHOR]

Background Accurate estimation of diarrhea incidence from facility-based surveillance requires estimating the population at risk and accounting for case patients who do not seek care. The Enterics for Global Health (EFGH) Shigella surveillance study will characterize population denominators and healthcare-seeking behavior proportions to calculate incidence rates of Shigella diarrhea in children aged 6–35 months across 7 sites in Africa, Asia, and Latin America. Methods The Enterics for Global Health (EFGH) Shigella surveillance study will use a hybrid surveillance design, supplementing facility-based surveillance with population-based surveys to estimate population size and the proportion of children with diarrhea brought for care at EFGH health facilities. Continuous data collection over a 24 month period captures seasonality and ensures representative sampling of the population at risk during the period of facility-based enrollments. Study catchment areas are broken into randomized clusters, each sized to be feasibly enumerated by individual field teams. Conclusions The methods presented herein aim to minimize the challenges associated with hybrid surveillance, such as poor parity between survey area coverage and facility coverage, population fluctuations, seasonal variability, and adjustments to care-seeking behavior. [ABSTRACT FROM AUTHOR]

In this study, we examine the relationship between formal care provision and informal care receipt from within the household for people over 75 years old using data from the British Household Panel Survey between 1991 and 2009. To address potential concerns about endogeneity of formal care we use a 'spatial lag' instrumental variable. We find a negative and statistically significant effect of formal care provision on informal care receipt from within the household, suggesting a substantial degree of substitutability between these two modes of care. These findings provide grounds for estimates of savings in the cost of informal care enabled by spending on formal care, which is important in light of the effects of the caregiving burden and associated responsibilities on carer's labour market participation. [ABSTRACT FROM AUTHOR]

The United Nations has estimated that 2.8 billion individuals across the world will not have access to safely managed sanitation in 2030. In the accounting of global sanitation access, local inequities often are invisible to those counting, especially given that many of these counters are physically distant and often external to communities suffering from lack of access. Lowndes County, Alabama, a predominantly-Black county in rural Alabama (USA), provides a window into the social, racial, and environmental injustices that are present in the rural American South. Our survey of household sanitation access in Lowndes County, implemented by a collaboration of an academic institution, a local environmental justice organisation, and residents, shows that community members in the county are aware of the problems associated with failing septic systems. Producing data that can make publicly visible the lack of access to sanitation will, however, remain a challenge until institutional and structural barriers are overcome. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to compare differences in suicidality and self-harm between specific lesbian, gay and bisexual (LGB) groups, and investigate whether minority stress factors might contribute to any associations, addressing methodological limitations of previous research. Methods: We analysed data combined from two population-based representative household surveys of English adults (N = 10,443) sampled in 2007 and 2014. Using multivariable logistic regression models adjusted for age, gender, educational attainment, area-level deprivation, and common mental disorder, we tested the association between sexuality and three suicide-related outcomes: past-year suicidal thoughts, past-year suicide attempt, and lifetime non-suicidal self-harm (NSSH). We added bullying and discrimination (separately) to final models to explore whether these variables might mediate the associations. We tested for interactions with gender and survey year. Results: Lesbian/gay people were more likely to report past-year suicidal thoughts [adjusted odds ratio (AOR) = 2.20; 95% CI 1.08–4.50] than heterosexuals. No minority group had an increased probability of suicide attempt. Bisexual (AOR = 3.02; 95% CI = 1.78–5.11) and lesbian/gay (AOR = 3.19; 95% CI = 1.73–5.88) individuals were more likely to report lifetime NSSH than heterosexuals. There was some evidence to support a contribution of bullying in the association between lesbian/gay identity and past-year suicidal thoughts, and of each minority stress variable in the associations with NSSH. There was no interaction with gender or survey year. Conclusion: Specific LGB groups are at elevated risk of suicidal thoughts and NSSH, with a possible contribution of lifetime bullying and homophobic discrimination. These disparities show no temporal shift despite apparent increasing societal tolerance towards sexual minorities. [ABSTRACT FROM AUTHOR]

There is a paucity of official data on violence against women (VAW) in Mexico. Two-hundred and seventy-two household surveys and seven focus group discussions with 50 women were conducted to explore women's experiences of VAW in public spaces in Corregidora, Mexico. Seven semi-structured interviews with stakeholders were carried out to understand their knowledge of VAW and reduction measures through infrastructure delivery and urban planning. Results showed that the most common and recurring type of VAW was catcalling, and 39 per cent of survey participants experienced at least one type of VAW. Government stakeholders appeared either unaware of the extent of VAW or were dismissive of its impact. The disconnect between women's experiences and stakeholders' views has implications for the design and implementation of safety measures for women. [ABSTRACT FROM AUTHOR]

The distance between the birth date and the school entry cutoff has been repeatedly used as an exogenous instrument to examine the impact of several educational programmes. In this work, we analyse the validity of this instrument for the case of Argentina. Considering multiple waves of the Permanent Household Survey we detect the existence of discontinuities in the distribution of births around the school entry cutoff (30 June). These discontinuities suggest that parents act strategically. In particular, they defer birth dates to days after the cutoff. This effect is especially large considering a bandwidth of 7 days and in boys. [ABSTRACT FROM AUTHOR]

Small‐scale fisheries are vital to millions of rural people, but surprisingly little is known about the environmental and socio‐economic factors that guide rural peoples' decisions to adopt a fishery‐oriented livelihood. We analyzed data from a large‐scale household survey of 3929 households in 235 rural communities in the Peruvian Amazon to develop multi‐scalar quantitative models to explain engagement in fishing and the relationship between fishing livelihoods and poverty. Households harvested an average of 1000 kg of fish and sold 450 kg over the 12 months preceding interviews. The mean total annual income was 3119 USD per household and fishing contributed 27% to total income. Access to extensive floodplain habitat, geographical isolation, and an available workforce were important drivers of fishing activity, while poor market connectivity and limited financial capital restricted households from increasing the scale of market‐oriented fishing. Wealthier households generally harvested more fish, whereas reliance on fisheries was greatest among poorer households who harvested less fish. Fisheries management and conservation initiatives in developing regions must consider the distinct drivers of fishing specialization across the full wealth spectrum with particular attention to "high reliance‐high harvest" households. [ABSTRACT FROM AUTHOR]

Previous studies mainly focused on individual-level factors that influence the adoption and usage of mobile technology and social networking sites, with little emphasis paid to the influences of household situations. Using multilevel modelling approach, this study merges household- (n1 = 1,455) and individual-level (n2 = 2,570) data in the U.K. context to investigate (a) whether a household economic capital (HEC) can affect its members' Twitter adoption, (b) whether the influences are mediated by the member's activity variety and self-reported efficacy with mobile technology, and (c) whether the members' traits, including educational level, gross income and residential area, moderate the relationship between HEC and Twitter adoption. Significant direct and indirect associations were discovered between HEC and its members' Twitter adoption. The educational level and gross income of household members moderated the influence of HEC on individuals' Twitter adoption. [ABSTRACT FROM AUTHOR]

Background: Most injury care research in low-income contexts such as Malawi is facility centric. Community-derived data is needed to better understand actual injury incidence, health system utilisation and barriers to seeking care following injury. Methods: We administered a household survey to 2200 households in Karonga, Malawi. The primary outcome was injury incidence, with non-fatal injuries classified as major or minor (> 30 or 1–29 disability days respectively). Those seeking medical treatment were asked about time delays to seeking, reaching and receiving care at a facility, where they sought care, and whether they attended a second facility. We performed analysis for associations between injury severity and whether the patient sought care, stayed overnight in a facility, attended a second facility, or received care within 1 or 2 h. The reason for those not seeking care was asked. Results: Most households (82.7%) completed the survey, with 29.2% reporting an injury. Overall, 611 non-fatal and four fatal injuries were reported from 531 households: an incidence of 6900 per 100,000. Major injuries accounted for 26.6%. Three quarters, 76.1% (465/611), sought medical attention. Almost all, 96.3% (448/465), seeking care attended a primary facility first. Only 29.7% (138/465), attended a second place of care. Only 32.0% (142/444), received care within one hour. A further 19.1% (85/444) received care within 2 h. Major injury was associated with being more likely to have; sought care (94.4% vs 69.8% p < 0.001), stayed overnight at a facility (22.9% vs 15.4% P = 0.047), attended a second place of care (50.3% vs 19.9%, P < 0.001). For those not seeking care the most important reason was the injury not being serious enough for 52.1% (74/142), followed by transport difficulties 13.4% (19/142) and financial costs 5.6% (8/142). Conclusion: Injuries in Northern Malawi are substantial. Community-derived details are necessary to fully understand injury burden and barriers to seeking and reaching care. Key messages: • What is already known on this topic – Empirical data on injury burden from low-income country settings is lacking, particularly from community derived sources. • What this study adds – We conducted a household survey in Northern Malawi to understand incidence, health system utilisation, time delays and barriers to receiving care following injury. We found the burden of injuries was substantial with a community preference to attend primary facilities directly following injury, many not receiving care within 2 hours of injury. Almost a quarter of those injured did not seek care at all revealing important health system barriers inhibiting timely access to care. • How this study might affect research, practice, or policy – Addressing the identified barriers to seeking timely care and streamlining care to the most appropriate facilities have important policy implications for injury care system strengthening in this and similar settings. [ABSTRACT FROM AUTHOR]

The presence of comorbidities among individuals with disabilities worsens their already complex health and social circumstances. This study aims to explore prevalence and patterns of morbidities among persons with disabilities in Bangladesh and identify associated socio-demographic factors. Data from 4270 persons with disability was analysed extracted from the 2021 Bangladesh National Household Survey on Persons with Disability. Outcome variable considered was the occurrence of morbidity among persons with disabilities. Explanatory variables encompassed factors at the individual, household, and community levels. Adjusted and unadjusted multilevel mixed-effects logistic regression model was used to explore association of outcome variable with explanatory variables. We found that approximately half of individuals with disabilities experienced one or more morbidities, with chronic conditions being the most prevalent (44%). Around 42% of total persons with disability were unable to work. Specifically, hypertension (18.3%), diabetes (9.1%), and heart problems (17.1%) were prevalent chronic conditions. The likelihood of experiencing comorbidity was found to be higher among females (aOR 1.3, 95% CI 1.1, 1.7), increase year of education (aOR, 1.1, 95% CI 1.0–1.2), and those from wealthier households (aOR 1.6, 95% CI 1.2, 2.2). This underscores the need for targeted policies and interventions addressing their distinct healthcare needs. [ABSTRACT FROM AUTHOR]

When transforming from a traditional rural economy to a rapid marketization period, it is essential to consider the relationship between multiple shocks and household income in poor rural areas of China. Using two waves of a rural household surveys from six poor counties in China between 2015 and 2018, we examine the effect of multiple shocks on households' income and explore the heterogeneity of different shocks and households based on income. The multiple linear regression and quantile regression results demonstrate that multiple shocks negatively affect farm household income, and the range of impact is widening. Specifically, natural disaster shocks reduce the income of low-income households more, and unnatural disaster shocks reduce the income of middle–low-income farm households more. We conclude that illness within the family and lack of working household members are the primary shocks currently suffered by different types of farm households. In contrast to previous research, this study identifies middle–low-income farm households as most in need of attention and reveals that unnatural disaster shocks in poor rural areas of China are most in need of governance during recovery transitions. The findings enrich the existing theoretical system and provide policymakers with practical insights regarding differentiated and preemptive risk governance approaches. [ABSTRACT FROM AUTHOR]