Estimates of multidimensional poverty and its determinants among older people in rural China: evidence from a multicenter cross-sectional survey.

BACKGROUND: In 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China. METHODS: A multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people's information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty. RESULTS: A total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P < 0.05). CONCLUSIONS: China's subsidy system and financial support must be enhanced. Particular attention should be given to the re-education of rural older individuals, basic vocational education should be strengthened in rural areas, and social participation should be encouraged.

Heating or eating? The framing of food and fuel poverty in UK news media.

Amidst the cost-of-living crisis the UK news has been increasingly reporting of individuals "choosing between heating and eating," suggesting overlapping food and fuel poverty (FFP). The media plays a powerful role in establishing narratives, shaping political debates, and even influencing what societies regard as an "issue" or a "public health issue." Relying on framing theory, this media analysis seeks to better understand how FFP have been constructed relationally in the UK news and how surrounding public health messaging has been employed. Using the NexisLexis database, we searched for UK news articles about intersecting FFP published between January 2010 and April 2022. After double screening, relevant data were extracted from 185 articles and data fragments were coded and analysed. FFP-focused news largely gained momentum in late 2021 into 2022. Two frame categories - descriptive and prescriptive - of FFP were identified. Descriptive frames explained the experience of FFP as a: trade-off between goods (71% of articles), mutual cutback of goods (28%), or just poverty (income/monetary poverty) (1%). Prescriptive frames assigned blame or responsibility to: government (59% of articles), food/fuel industry (13%), community or charity organisations (12%), or individuals (3%). Relatively few (29%) articles linked FFP with health consequences, and none framed it as a health issue. The prominence of the trade-off frame in the UK news suggests that FFP is a crucial topic for the UK public that requires joint attention. Despite the prominence of the government responsibility framing, the frame lacks accompanying prescriptions of consistent, specific, targeted solutions. A public health frame in the UK news may address this gap by outlining potential evidence-based solutions and increasing capacity by appointing responsible actors to help prevent and address this issue.

Multidimensional Poverty and Risk of Atherosclerotic Cardiovascular Disease: A U.S. National Study.

Background: Poverty is associated with atherosclerotic cardiovascular disease (ASCVD). While poverty can be evaluated using income, a unidimensional poverty metric inadequately captures socioeconomic adversity. Objectives: The aim of the study was to examine the association between a multidimensional poverty measure and ASCVD. Methods: Survey data from the National Health Interview Survey was analyzed. Four poverty dimensions were used: income, education, self-reported health, and health insurance status. A weighted deprivation score (c i ) was calculated for each person. The multidimensional poverty index was computed for various cutoffs, k, for total population, and by ASCVD status. The association between multidimensional poverty and ASCVD was examined using Poisson regression. Area under receiver operator characteristics curve analysis was performed to compare the multidimensional poverty measure with the income poverty measure as a classification tool for ASCVD. Results: Among the 328,164 participants, 55.0% were females, the mean age was 46.3 years, 63.1% were non-Hispanic Whites, and 14.1% were non-Hispanic Blacks. Participants with ASCVD (7.95%) experienced greater deprivation at each multidimensional poverty cutoff, k, compared to those without ASCVD. In adjusted models, higher burden of multidimensional poverty was associated with up to 2.4-fold increased prevalence of ASCVD (c i  = 0.25, adjusted prevalence ratio [aPR] = 1.66, P < 0.001; c i  = 0.50, aPR = 1.99; c i  = 0.75, aPR = 2.29; P < 0.001; c i  = 1.00, aPR = 2.38, P < 0.001). Multidimensional poverty exhibited modestly higher discriminant validity, compared to income poverty (area under receiver operator characteristics = 0.62 vs 0.58). Conclusions: There is an association between the multidimensional poverty and ASCVD. Multidimensional poverty index demonstrates slightly better discriminatory power than income alone. Future validation studies are warranted to redefine poverty's role in health outcomes.

Pooled lagged effect of runoff on leptospirosis cases in Colombia.

Leptospirosis is a global zoonotic disease caused by spirochete bacteria of the genus Leptospira. The disease exhibits a notable incidence in tropical and developing countries, and in Colombia, environmental, economic, social, and cultural conditions favor disease transmission, directly impacting both mortality and morbidity rates. Our objective was to establish the pooled lagged effect of runoff on leptospirosis cases in Colombia. For our study, we included the top 20 Colombian municipalities with the highest number of leptospirosis cases. Monthly cases of leptospirosis, confirmed by laboratory tests and spanning from 2007 to 2022, were obtained from the National Public Health Surveillance System. Additionally, we collected monthly runoff and atmospheric and oceanic data from remote sensors. Multidimensional poverty index values for each municipality were sourced from the Terridata repository. We employed causal inference and distributed lag nonlinear models to estimate the lagged effect of runoff on leptospirosis cases. Municipality-specific estimates were combined through meta-analysis to derive a single estimate for all municipalities under study. The pooled results for the 20 municipalities suggest a lagged effect for the 0 to 2, and 0-3 months of runoff on leptospirosis when the runoff is < 120 g/m2. No effect was identified for longer lagged periods (0-1, 0 to 4, 0 to 5, and 0-6 months) or higher runoff values. Incorporation of the multidimensional poverty index into the meta-analysis of runoff contributed to the models for the lagged periods of 0-3, and 0-4 months.

Effects of guaranteed basic income interventions on poverty-related outcomes in high-income countries: A systematic review and meta-analysis.

Background: High-income countries offer social assistance (welfare) programs to help alleviate poverty for people with little or no income. These programs have become increasingly conditional and stringent in recent decades based on the premise that transitioning people from government support to paid work will improve their circumstances. However, many people end up with low-paying and precarious jobs that may cause more poverty because they lose benefits such as housing subsidies and health and dental insurance, while incurring job-related expenses. Conditional assistance programs are also expensive to administer and cause stigma. A guaranteed basic income (GBI) has been proposed as a more effective approach for alleviating poverty, and several experiments have been conducted in high-income countries to investigate whether GBI leads to improved outcomes compared to existing social programs. Objectives: The aim of this review was to conduct a synthesis of quantitative evidence on GBI interventions in high-income countries, to compare the effectiveness of various types of GBI versus "usual care" (including existing social assistance programs) in improving poverty-related outcomes. Search Methods: Searches of 16 academic databases were conducted in May 2022, using both keywords and database-specific controlled vocabulary, without limits or restrictions on language or date. Sources of gray literature (conference, governmental, and institutional websites) were searched in September 2022. We also searched reference lists of review articles, citations of included articles, and tables of contents of relevant journals in September 2022. Hand searching for recent publications was conducted until December 2022. Selection Criteria: We included all quantitative study designs except cross-sectional (at one timepoint), with or without control groups. We included studies in high income countries with any population and with interventions meeting our criteria for GBI: unconditional, with regular payments in cash (not in-kind) that were fixed or predictable in amount. Although two primary outcomes of interest were selected a priori (food insecurity, and poverty level assessed using official, national, or international measures), we did not screen studies on the basis of reported outcomes because it was not possible to define all potentially relevant poverty-related outcomes in advance. Data Collection and Analysis: We followed the Campbell Collaboration conduct and reporting guidelines to ensure a rigorous methodology. The risk of bias was assessed across seven domains: confounding, selection, attrition, motivation, implementation, measurement, and analysis/reporting. We conducted meta-analyses where results could be combined; otherwise, we presented the results in tables. We reported effect estimates as standard mean differences (SMDs) if the included studies reported them or provided sufficient data for us to calculate them. To compare the effects of different types of interventions, we developed a GBI typology based on the characteristics of experimental interventions as well as theoretical conceptualizations of GBI. Eligible poverty-related outcomes were classified into categories and sub-categories, to facilitate the synthesis of the individual findings. Because most of the included studies analyzed experiments conducted by other researchers, it was necessary to divide our analysis according to the "experiment" stage (i.e., design, recruitment, intervention, data collection) and the "study" stage (data analysis and reporting of results). Main Results: Our searches yielded 24,476 records from databases and 80 from other sources. After screening by title and abstract, the full texts of 294 potentially eligible articles were retrieved and screened, resulting in 27 included studies on 10 experiments. Eight of the experiments were RCTs, one included both an RCT site and a "saturation" site, and one used a repeated cross-sectional design. The duration ranged from one to 5 years. The control groups in all 10 experiments received "usual care" (i.e., no GBI intervention). The total number of participants was unknown because some of the studies did not report exact sample sizes. Of the studies that did, the smallest had 138 participants and the largest had 8019. The risk of bias assessments found "some concerns" for at least one domain in all 27 studies and "high risk" for at least one domain in 25 studies. The risk of bias was assessed as high in 21 studies due to attrition and in 22 studies due to analysis and reporting bias. To compare the interventions, we developed a classification framework of five GBI types, four of which were implemented in the experiments, and one that is used in new experiments now underway. The included studies reported 176 poverty-related outcomes, including one pre-defined primary outcome: food insecurity. The second primary outcome (poverty level assessed using official, national, or international measures) was not reported in any of the included studies. We classified the reported outcomes into seven categories: food insecurity (as a category), economic/material, physical health, psychological/mental health, social, educational, and individual choice/agency. Food insecurity was reported in two studies, both showing improvements (SMD = -0.57, 95% CI: -0.65 to -0.49, and SMD = -0.41, 95% CI: -0.57 to -0.26) which were not pooled because of different study designs. We conducted meta-analyses on four secondary outcomes that were reported in more than one study: subjective financial well-being, self-rated overall physical health, self-rated life satisfaction, and self-rated mental distress. Improvements were reported, except for overall physical health or if the intervention was similar to existing social assistance. The results for the remaining 170 outcomes, each reported in only one study, were summarized in tables by category and subcategory. Adverse effects were reported in some studies, but only for specific subgroups of participants, and not consistently, so these results may have been due to chance. Authors' Conclusions: The results of the included studies were difficult to synthesize because of the heterogeneity in the reported outcomes. This was due in part to poverty being multidimensional, so outcomes covered various aspects of life (economic, social, psychological, educational, agency, mental and physical health). Evidence from future studies would be easier to assess if outcomes were measured using more common, validated instruments. Based on our analysis of the included studies, a supplemental type of GBI (provided along with existing programs) may be effective in alleviating poverty-related outcomes. This approach may also be safer than a wholesale reform of existing social assistance approaches, which could have unintended consequences.

Analysis of incidence, intensity, and gender perspective of multidimensional urban poverty in Kenya.

Poverty continues to be one of the biggest challenges facing many economies worldwide, and its incidences and intensities are very high in developing economies. This paper utilized the Alkire-Foster (AF) method to compute the multidimensional poverty index (MPI) and analyze the incidence and intensity of multidimensional poverty among urban households in Kenya. The findings indicated that 8.7 % of urban households are multidimensionally deprived in 33.3 % of the selected dimensional indicators. Also, the results showed that over 50 % of urban households are deprived of drinking water and sanitation services. In addition, the findings revealed that higher poverty incidence, intensity, and urban multidimensional poverty exist among female-headed households, old household headships, and households residing in peri-urban regions. The Probit regression analysis indicated that large household size, number of children under five years, household head age, gender, marital status, urban food insecurity, health status, and residing in Malaria endemic zone are significant positive predictors of urban multidimensional poverty. On the other hand, an increase in the number of educated women, owners of insurance coverage, agricultural land, and wealthy and home-owning households is linked to a decline in urban multidimensional poverty. The paper professes that policymakers should cautiously consider household socioeconomic differences while designing poverty alleviation policies.

Incidence, intensity and drivers of multidimensional poverty among rural women in Nigeria.

Rural women are important agents of development and they are the backbone of achieving sustainable development in any society. However, rural women in Nigeria, like in most developing countries, disproportionately bear the burden of poverty due to poor access to productive resources, information and services. There is growing evidence that prioritizing measures for ending poverty among rural women represents an important gateway to the achievement of other global goals. This study therefore seeks to determine the extent of multidimensional poverty among rural women in Nigeria and to also identify its critical risk factors. Using secondary data obtained from 2018/2019 Harmonized Nigeria Living Standard Survey (HNLSS), findings from the study reveal that more than three-quarters of the rural women in Nigeria are multidimensionally poor and they experience multiple deprivations in the weighted indicators across the poverty dimensions. The living standard dimension accounted for the largest share of deprivation suffered by rural women while health dimension contributed the least. However, further analysis across the sub-indicators of poverty dimensions revealed security shocks, unemployment and time to health care services as the biggest contributors to multidimensional poverty of rural women in Nigeria. Results also show that age, household size, years of education, household expenditure, ownership of cropland, credit access and access to safety nets are the main determinants of multidimensional poverty among rural women. The study recommends the need to focus on policy options that provide more primary health care services, increase employment opportunities and strengthen shock-preventive or shock-responsive social protection systems of rural women.

Changing levels of income and multidimensional poverty among persons with disabilities in Colombia: A pseudo panel analysis.

In Colombia, more than 4 per cent of the population lives with disability and high levels of income and multidimensional poverty have been recognised within this group. However, there is no information on how the levels of poverty have changed over time or whether households with members with disabilities are more likely to be chronically poorer than households without disabilities in the country. In addition, no evidence exists on the potential effect of the Covid-19 pandemic on the socioeconomic characteristics of persons with disability. This study aims to contribute to the literature on this topic by analysing a nationally representative survey (Quality of Life Survey) from 2018 to 2022 and studying the changes in the levels of income and multidimensional poverty of persons with disabilities and their household, and identifying whether any changes associated with the Covid-19 pandemic.

Attitudes towards childcare practices in rural and urban caregivers with high rates of multidimensional poverty

Objective: To analyse the relationship between poverty and attitudes towards childcare practices in rural and urban areas of Colombia. Method: This article presents a cross-sectional correlational study conducted in the department of Atlántico, northern Colombia. Attitudes towards childcare and living conditions were assessed among 1189 caregivers of preschool children. The multidimensional poverty index and the participants' area of origin (urban or rural) were considered. Results: No direct relationship was found between attitudes towards childcare and the multidimensional poverty index. However, it was observed that urban participants from deprived areas had a higher poverty index and less positive attitudes towards childcare, especially regarding cognitive, sleep and health care. There was a moderating effect of area on attitudes towards childcare. Conclusions: The study highlights the influence of poverty and social vulnerability on attitudes towards childcare, particularly in urban areas. These findings underline the importance of considering socio-economic and geographical conditions when addressing childcare practices. It also highlights the need to implement specific strategies to promote positive childcare practices in more vulnerable contexts to improve early childhood development in Colombia.

Objetivo: Analizar la relación entre la pobreza y las actitudes hacia las prácticas de cuidado infantil en áreas rurales y urbanas de Colombia. Método: El presente artículo es un estudio transversal correlacional en el departamento del Atlántico, al norte de Colombia. Se indagó sobre las actitudes hacia el cuidado infantil y las condiciones de vida en 1189 cuidadores de niños en edad preescolar. Se tuvo en cuenta el índice de pobreza multidimensional y el área de procedencia de los participantes (urbana o rural). Resultados: No se encontró una relación directa entre las actitudes hacia el cuidado infantil y el índice de pobreza multidimensional. Sin embargo, se observó que los participantes de áreas urbanas provenientes de zonas vulnerables presentaron un mayor índice de pobreza y mostraron actitudes menos positivas hacia el cuidado infantil, especialmente en el cuidado cognitivo, del sueño y de la salud. Se evidenció un efecto moderador del área sobre las actitudes de cuidado. Conclusiones: El estudio destaca la influencia de la pobreza y la vulnerabilidad social en las actitudes de cuidado infantil, especialmente en áreas urbanas. Estos hallazgos subrayan la importancia de considerar las condiciones socioeconómicas y geográficas al abordar el cuidado infantil. Además, se resalta la necesidad de implementar estrategias específicas para promover prácticas de cuidado positivas en contextos más vulnerables, con el fin de mejorar el desarrollo de la primera infancia en Colombia.

Assessing the effect of health status on multidimensional poverty among older adults: the Chinese longitudinal healthy longevity survey.

Background: This study aimed to explore the association between health status (physical, mental, and self-rated health) and multidimensional poverty (subjective and objective poverty) in older adults. Method: A panel binary logit regression approach was applied to four waves of CLHLS data (2008, 2011, 2014, and 2018). In total,1,445 individuals were included after data cleaning. Results: The mean values and proportion of physical, mental, and self-rated health were 5.73 (87.42%), 0.93 (93.06%), and 3.46 (86.7%), respectively, and mean values and proportion of subjective and objective poverty were 0.19 (18.51%) and 0.21(21.4%). In addition, physical, mental, and self-rated health were all found to be associated with subjective poverty among older adults (r = -0.181, r = -0.630, r = -0.321, p < 0.05), that is, the better the physical, mental, and self-rated health, the lower the probability of subjective poverty. A comparable connection between self-rated health and objective poverty also exists (r = -0.157, p < 0.05). Furthermore, medical expenditure played a mediation role in the association between the health status and poverty of older adults. Conclusion: In order to effectively alleviate the poverty of older adults, strategies should be taken to improve the health level of older adults, especially the physical and mental health of high-aged older adults, and the self-rated health of middle-aged older adults. Furthermore, social security and pensions should be further developed to adequately reimburse medical expenditures.

Understanding multidimensional poverty in pakistan: implications for regional and demographic-specific policies.

This study enriches the limited literature on multidimensional poverty by focusing on household demographic characteristics as determinants of household-specific living arrangements in Pakistan. The study employs the Alkire and Foster methodology to measure the multidimensional poverty index (MPI) using data drawn from the latest available nationally representative Household Integrated Economic Survey (HIES 2018-19). The analysis investigates multidimensional poverty levels among households in Pakistan according to various criteria (such as access to education and healthcare, basic living standards, and monetary status) and how they differ across Pakistan's regions and provinces. The results indicate that 22% of Pakistanis are multidimensionally poor in terms of health, education, basic living standards, and monetary status; and that multidimensional poverty is more common in rural areas and Balochistan. Furthermore, the logistic regression results show that households with more working-age people, employed women, and employed young people are less likely to be poor, whereas households with more dependents and children are more likely to be poor. This study recommends policies for addressing poverty that consider the needs of multidimensionally poor Pakistani households in various regions and with various demographic characteristics.

Moderate Multidimensional Poverty Index: Paving the Way Out of Poverty.

Eradicating poverty in all its forms, everywhere, requires indicators that measure sustainable pathways out of poverty, and not only the absence of acute poverty. This paper introduces a trial Moderate Multidimensional Poverty Index (MMPI) that reflects moderate rather than acute levels of multidimensional poverty. The MMPI adjusts nine of the 10 indicators of the global Multidimensional Poverty Index (global MPI) to reflect moderate poverty and create a meaningful superset of the acutely poor population. Although data-constrained, the trial MMPI outlines a methodology and potential indicators for a measure that would: (i) be meaningful and comparable across populations at higher levels of development; (ii) align with higher standards defined in Agenda 2030; and (iii) provide insight into aspects of intrahousehold deprivation. The MMPI is illustrated empirically using nationally representative household surveys from Bangladesh, Guatemala, Iraq, Serbia, Tanzania and Thailand. The results confirm the added value of having three nested measures of destitution, acute, and moderate multidimensional poverty. The MMPI also complements monetary measures with informative differences in poverty levels observed. The results demonstrate that a Moderate MPI is a desirable global poverty index, which is likely to illuminate thus far hidden aspects in of multidimensional poverty, such as intrahousehold deprivations in education. Challenges remain regarding data availability, and further study across additional countries is required before the MMPI structure can be finalised.

Multidimensional Food Poverty: Evidence from Low-Income Single Mothers in Contemporary Japan.

The objective of this article is to gain an in-depth understanding of the eating lives of low-income single mothers in Japan. Semi-structured interviews were conducted with nine low-income single mothers living in the three largest urban areas (Tokyo, Hanshin [Osaka and Kobe] and Nagoya) in Japan. Framed by the capability approach and sociology of food, their dietary norms and practices, as well as underlying factors that impact the norm-practice gap were analysed across nine dimensions: meal frequency, place of eating, meal timing, duration, persons to eat with, procurement method, food quality, meal content and pleasure of eating. These mothers were deprived of various types of capabilities, extending not only from the quantity and nutritional aspects of food, but also to spatial, temporal, qualitative and affective aspects. Aside from financial constraints, eight other factors (time, maternal health, parenting difficulties, children's tastes, gendered norms, cooking abilities, food aid and local food environment) were identified as influencing their capabilities to eat well. The findings challenge the view that food poverty is the deprivation of economic resources required to ensure a sufficient amount of food. Social interventions that go beyond monetary aid and food provision need to be proposed.

Framework for inferring empirical causal graphs from binary data to support multidimensional poverty analysis.

Poverty is one of the fundamental issues that mankind faces. To solve poverty issues, one needs to know how severe the issue is. The Multidimensional Poverty Index (MPI) is a well-known approach that is used to measure a degree of poverty issues in a given area. To compute MPI, it requires information of MPI indicators, which are binary variables collecting by surveys, that represent different aspects of poverty such as lacking of education, health, living conditions, etc. Inferring impacts of MPI indicators on MPI index can be solved by using traditional regression methods. However, it is not obvious that whether solving one MPI indicator might resolve or cause more issues in other MPI indicators and there is no framework dedicating to infer empirical causal relations among MPI indicators. In this work, we propose a framework to infer causal relations on binary variables in poverty surveys. Our approach performed better than baseline methods in simulated datasets that we know ground truth as well as correctly found a causal relation in the Twin births dataset. In Thailand poverty survey dataset, the framework found a causal relation between smoking and alcohol drinking issues. We provide R CRAN package'BiCausality' that can be used in any binary variables beyond the poverty analysis context.

Catastrophic health-care payments and multidimensional poverty: Are they related?

The negative impact of health-related out-of-pocket (OOP) payments is a well-known problem in low and middle-income countries (LMICs). Cross-sectional analysis reveals that households use different coping mechanisms to mitigate or overcome the effect of OOP payments, but little is known from a longitudinal perspective. We explore this link using panel data for Colombia, Mexico, India, Malawi, Nigeria, Uganda, and Tanzania. Using a fixed-effect model, we computed the association between multidimensional poverty (MP) and facing catastrophic health payments (CHP) using a capacity-to-pay approach. We estimated different heterogeneous effects, including variables such as area of residence, facing CHP, being poor in the first wave, and facing CHP in period two. While using cross-sectional data, we found that the association between CHP and MP is present for six of the seven countries; it is not the case for the time variation in most of them. The results provide evidence that OOP induce a long-term impact on MP only in Colombia, India and Nigeria. In the last two countries, the levels of poverty and CHP were the highest of all seven, and the association between both situations was found by using different poverty cutoffs and thresholds to define CHP.

Multidimensional poverty is associated with dementia among adults in Afghanistan.

Background: Multidimensional poverty is associated with dementia, but no evidence is available for countries in conflict. Methods: A cross-sectional study was conducted in two provinces of Afghanistan between February 15th 2022 and April 20th 2022 among adults age 50 and older. Multidimensional poverty included six dimensions of well-being and 16 indicators of deprivation. The Rowland Universal Dementia Assessment Scale measured dementia. Poverty between adults with and without dementia was examined, adjusting for sex. Associations between dementia and poverty were investigated using multivariate regression model. Findings: Of the 478 adults included, 89 (52.7%) had mild, and 25 (14.8%) had moderate to severe dementia. More women than men had mild (52.7% vs 33.3%) and moderate-to-severe dementia (14.8% vs 5.8%). Approximately 33.9% adults with mild and 51.2% adults with moderate-to-severe dementia were found to be deprived in four or more dimensions compared to 21.8% without dementia. The difference in four dimensions of multidimensional poverty between adults with mild and moderate-to-severe dementia and adults without dementia was respectively 59.5% and 152.88%. Education, employment, health, and living conditions were the main contributors to the adjusted poverty head count ratio. Multidimensional poverty in four or five dimensions was strongly associated with dementia among older adults particularly over 70 years old (odds ratio [OR], 17.38; 95% CI, 2.22-135.63), with greater odds for older women overall (OR, 2.69; 95% CI, 1.76-4.11). Interpretation: Our findings suggest that early improvement in social determinants of health through targeted structural policies may lower dementia risk later in life. Specifically, better access to free, quality education, healthcare, and basic living standard together with employment opportunities could reduce risk of dementia. Funding: The present study was funded by a grant from the Alzheimer Association (AARG-NTF-21-851241).

Evolution of Multidimensional Poverty in Crisis-Ridden Mozambique.

Mozambique experienced important reductions in the poverty rate until recently, before two major natural disasters hit, an armed insurgency stroke in the northern province of Cabo Delgado, and the country started suffering from a hidden debt crisis with associated economic slowdown. As the last available national household expenditure survey is from 2014/15, just before these crises started unfolding, there is need for a poverty assessment based on alternative data sources. We study the evolution of multidimensional poverty in Mozambique using survey data from the Demographic and Health Surveys (DHS). Using both the standard Alkire-Foster multidimensional poverty index and the first-order dominance (FOD) method, we find that the multidimensional poverty reduction trend observed between 2009-11 and 2015 halted between 2015 and 2018. Meanwhile, the number of poor people increased, mainly in rural areas and in the central provinces. Importantly, the poorest provinces did not improve their rankings over time, and between 2015 and 2018, no progress took place for most areas and provinces, as measured by the FOD approach.

Socioeconomic Macro-Level Determinants of Hypertension: Ecological Analysis of 138 Low- and Middle-Income Countries.

AIM: To assess the relative importance of major socioeconomic determinants of population health on the burden of hypertension in Low-and-Middle-Income Countries (LMICs). METHODS: Country-level data from 138 countries based on World Development Indicators 2020 were used for correlation and linear regression analyses of eight socioeconomic predictors of hypertension: current health expenditure, domestic general government health expenditure per capita, GDP per capita, adult literacy rate, unemployment rate, urban population, multidimensional poverty index, and total population. RESULTS: The median prevalence of age-standardised hypertension was 25.8% across the 138 countries, ranging from 13.7% in Peru to 33.4% in Niger. For every 10% increase in the unemployment rate, the prevalence of hypertension increased by 2.70%. For every 10% increase in the percentage of people living in urban areas, hypertension was reduced by 0.63%. CONCLUSIONS: The findings revealed that countries with high GDP, more investment in health and an improved multidimensional poverty index have a lower prevalence of hypertension.

Long-term care insurance and multidimensional poverty of middle-aged and elderly: Evidence from China.

Introduction: This paper examined the impact of public long-term care insurance (LTCI) pilots in China on the multidimensional poverty status of middle-aged and older adults. Methods: Using panel data from the China Health and Retirement Longitudinal Survey, we utilized LTCI pilots conducted in different cities from 2012 to 2018 and assessed the impact of LTCI using a difference-in-differences strategy. Results: We found that the implementation of LTCI reduces the multidimensional poverty of middle-aged and older adults and their likelihood of future multidimensional poverty. LTCI coverage was also associated with a reduction in the likelihood that middle-aged and older adults in need of care fall into income poverty, living consumption poverty, health poverty, and social participation poverty. Discussion: From a policy perspective, the findings of this paper suggest that the establishment of an LTCI system can improve the poverty of middle-aged and older adults in several ways, which has important implications for the development of LTCI systems in China and other developing countries.

Multidimensional poverty of persons with disabilities in China: An analysis of poverty reduction effect of employment services.

Introduction: Disability is a global public health problem, and poverty due to illness and disability has always been a major problem and challenge for global poverty governance. In order to eradicate poverty, China has carried out a series of welfare reforms and employment interventions for people with disabilities. The purpose of this study is to examine the levels of multidimensional poverty of persons with disabilities aged 16-59 in China and the poverty reduction effect of employment services. Methods: The Alkire-Foster (AF) method is applied to measure and decompose the multidimensional poverty index (MPI) of people with disabilities in this study. In order to make the results more robust, ordinary least squares (OLS) regression and the combination of propensity score matching and difference-in-differences (PSM-DID) are used to study the effect of employment services on multidimensional poverty of the disabled. Results: The results show that among persons with disabilities aged 16-59, about 90% are deprived in at least one dimension, and about 30% are in a state of severe multidimensional poverty until 2019. The contributions of deprivation in the dimensions of education and social participation are remarkably higher than dimensions of economy, health and insurance. In addition, employment services have a significant improvement effect on multidimensional poverty, which is reflected not only in the economic dimension, but also in the dimensions of education, insurance and social participation. Conclusion: People with disabilities are generally in multidimensional poverty in China, and their abilities in learning and social integration are seriously inadequate. Employment services have played a great role in improving poverty, but the improvement has been different in different dimensions and different disability categories. These findings provide important evidence for recognizing multidimensional poverty of persons with disabilities and the poverty reduction effect of employment services, which will help to formulate more reasonable public policies to eradicate poverty.