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1.
Nature ; 608(7921): 108-121, 2022 08.
Article in English | MEDLINE | ID: mdl-35915342

ABSTRACT

Social capital-the strength of an individual's social network and community-has been identified as a potential determinant of outcomes ranging from education to health1-8. However, efforts to understand what types of social capital matter for these outcomes have been hindered by a lack of social network data. Here, in the first of a pair of papers9, we use data on 21 billion friendships from Facebook to study social capital. We measure and analyse three types of social capital by ZIP (postal) code in the United States: (1) connectedness between different types of people, such as those with low versus high socioeconomic status (SES); (2) social cohesion, such as the extent of cliques in friendship networks; and (3) civic engagement, such as rates of volunteering. These measures vary substantially across areas, but are not highly correlated with each other. We demonstrate the importance of distinguishing these forms of social capital by analysing their associations with economic mobility across areas. The share of high-SES friends among individuals with low SES-which we term economic connectedness-is among the strongest predictors of upward income mobility identified to date10,11. Other social capital measures are not strongly associated with economic mobility. If children with low-SES parents were to grow up in counties with economic connectedness comparable to that of the average child with high-SES parents, their incomes in adulthood would increase by 20% on average. Differences in economic connectedness can explain well-known relationships between upward income mobility and racial segregation, poverty rates, and inequality12-14. To support further research and policy interventions, we publicly release privacy-protected statistics on social capital by ZIP code at https://www.socialcapital.org .


Subject(s)
Economic Status , Friends , Income , Social Capital , Social Mobility , Adult , Child , Community-Institutional Relations , Datasets as Topic , Economic Status/statistics & numerical data , Geographic Mapping , Humans , Income/statistics & numerical data , Poverty/statistics & numerical data , Racism , Social Media/statistics & numerical data , Social Mobility/statistics & numerical data , Social Support , United States , Volunteers
2.
Nature ; 608(7921): 122-134, 2022 08.
Article in English | MEDLINE | ID: mdl-35915343

ABSTRACT

Low levels of social interaction across class lines have generated widespread concern1-4 and are associated with worse outcomes, such as lower rates of upward income mobility4-7. Here we analyse the determinants of cross-class interaction using data from Facebook, building on the analysis in our companion paper7. We show that about half of the social disconnection across socioeconomic lines-measured as the difference in the share of high-socioeconomic status (SES) friends between people with low and high SES-is explained by differences in exposure to people with high SES in groups such as schools and religious organizations. The other half is explained by friending bias-the tendency for people with low SES to befriend people with high SES at lower rates even conditional on exposure. Friending bias is shaped by the structure of the groups in which people interact. For example, friending bias is higher in larger and more diverse groups and lower in religious organizations than in schools and workplaces. Distinguishing exposure from friending bias is helpful for identifying interventions to increase cross-SES friendships (economic connectedness). Using fluctuations in the share of students with high SES across high school cohorts, we show that increases in high-SES exposure lead low-SES people to form more friendships with high-SES people in schools that exhibit low levels of friending bias. Thus, socioeconomic integration can increase economic connectedness in communities in which friending bias is low. By contrast, when friending bias is high, increasing cross-SES interactions among existing members may be necessary to increase economic connectedness. To support such efforts, we release privacy-protected statistics on economic connectedness, exposure and friending bias for each ZIP (postal) code, high school and college in the United States at https://www.socialcapital.org .


Subject(s)
Economic Status , Friends , Geographic Mapping , Schools , Social Capital , Social Class , Students , Datasets as Topic , Economic Status/statistics & numerical data , Humans , Income/statistics & numerical data , Prejudice/statistics & numerical data , Schools/statistics & numerical data , Social Media/statistics & numerical data , Students/statistics & numerical data , United States , Universities/statistics & numerical data
3.
Proc Natl Acad Sci U S A ; 121(2): e2308652121, 2024 Jan 09.
Article in English | MEDLINE | ID: mdl-38175866

ABSTRACT

The hypothalamic-pituitary-thyroid (HPT) axis is fundamental to human biology, exerting central control over energy expenditure and body temperature. However, the consequences of normal physiologic HPT-axis variation in populations without diagnosed thyroid disease are poorly understood. Using nationally representative data from the 2007 to 2012 National Health and Nutrition Examination Survey, we explore relationships with demographic characteristics, longevity, and socio-economic factors. We find much larger variation across age in free T3 than other HPT-axis hormones. T3 and T4 have opposite relationships to mortality: free T3 is inversely related and free T4 is positively related to the likelihood of death. Free T3 and household income are negatively related, particularly at lower incomes. Finally, free T3 among older adults is associated with labor both in terms of unemployment and hours worked. Physiologic TSH/T4 explain only 1.7% of T3 variation, and neither are appreciably correlated to socio-economic outcomes. Taken together, our data suggest an unappreciated complexity of the HPT-axis signaling cascade broadly such that TSH and T4 may not be accurate surrogates of free T3. Furthermore, we find that subclinical variation in the HPT-axis effector hormone T3 is an important and overlooked factor linking socio-economic forces, human biology, and aging.


Subject(s)
Thyroid Gland , Triiodothyronine , Humans , Aged , Longevity , Economic Status , Nutrition Surveys , Hypothalamo-Hypophyseal System/physiology , Thyrotropin , Demography , Thyroxine
4.
Proc Natl Acad Sci U S A ; 120(18): e2215262120, 2023 05 02.
Article in English | MEDLINE | ID: mdl-37094159

ABSTRACT

Land conservation efforts throughout the United States sustain ecological benefits while generating wealth in the housing market through capitalization of amenities. This paper estimates the benefits of conservation that are capitalized into proximate home values and quantifies how those benefits are distributed across demographic groups. Using detailed property and household-level data from Massachusetts, we estimate that new land conservation led to $62 million in new housing wealth equity. However, houses owned by low-income or Black or Hispanic households are less likely to be located near protected areas, and hence, these populations are less likely to benefit financially. Direct study of the distribution of this new wealth from capitalized conservation is highly unequal, with the richest quartile of households receiving 43%, White households receiving 91%, and the richest White households receiving 40%, which is nearly 140% more than would be expected under equal distribution. We extend our analysis using census data for the entire United States and observe parallel patterns. We estimate that recent land conservation generated $9.8 billion in wealth through the housing market and that wealthier and White households benefited disproportionately. These findings suggest regressive and racially disparate incidence of the wealth benefits of land conservation policy.


Subject(s)
Conservation of Natural Resources , Economic Status , Housing , Humans , Family Characteristics , Hispanic or Latino , Poverty , United States , Black or African American , White
6.
Med J Aust ; 220(2): 74-79, 2024 02 05.
Article in English | MEDLINE | ID: mdl-38149410

ABSTRACT

OBJECTIVES: To investigate the relationship between access to fluoridated drinking water and area-level socio-economic status in Queensland. STUDY DESIGN: Ecological, geospatial data linkage study. SETTING: Queensland, by statistical area level 2 (SA2), 2021. MAIN OUTCOME MEASURES: Proportion of SA2s and of residents with access to fluoridated drinking water (natural or supplemented); relationship at SA2 level between access to fluoridated water and socio-economic status (Index of Relative Socio-economic Advantage and Disadvantage, IRSAD; Index of Economic Resources, IER). RESULTS: In 2021, an estimated 4 050 168 people (79.4% of the population) and 397 SA2 regions (72.7%) in Queensland had access to fluoridated water. Access was concentrated in the southeastern corner of the state. After adjusting for SA2 population, log area, and population density, the likelihood of access to fluoridated drinking water almost doubled for each 100-rank increase in IRSAD (adjusted odds ratio [aOR], 1.93; 95% confidence interval [CI], 1.59-2.36) or IER (aOR, 1.77; 95% CI, 1.50-2.11). CONCLUSIONS: The 2012 decision to devolve responsibility for water fluoridation decisions and funding from the Queensland government to local councils means that residents in lower socio-economic areas are less likely to have access to fluoridated water than those in more advantaged areas, exacerbating their already greater risk of dental disease. Queensland water fluoridation policy should be revised so that all residents can benefit from this evidence-based public health intervention for reducing the prevalence of dental caries.


Subject(s)
Dental Caries , Drinking Water , Humans , Queensland/epidemiology , Dental Caries/epidemiology , Dental Caries/prevention & control , Economic Status , DMF Index , Fluoridation , Prevalence
7.
Public Health Nutr ; 27(1): e35, 2024 Jan 15.
Article in English | MEDLINE | ID: mdl-38224091

ABSTRACT

OBJECTIVE: The present study examined the association of BMI, fat mass, physical activity engagement (PA), maximal oxygen consumption (VO2max), screen time and academic performance (AP) with Mediterranean diet (MD) adherence in a sample of high socio-economic status (SES) children. DESIGN: A non-randomised design was used. A multilinear regression model was developed using backward elimination. Analysis included variables pertaining to age, BMI, VO2max, fat percentage, AP, PA engagement and screen time. All participants had a high SES and so this variable was not included as a predictor. Data met the assumptions required for multiple regressions in terms of linearity, homoscedasticity, normality, independence and non-multicollinearity. SETTING: Two state and three mixed funding schools in Granada, Spain. PARTICIPANTS: Data were collected from 244 children aged between 10 and 12 years. RESULTS: Better AP, higher PA engagement and lower screen time were found to be predictive of MD adherence. These variables explained 22·9 % of the variance in data measuring adolescent MD adherence. CONCLUSIONS: The present study suggests that, in addition to SES, PA, AP and screen time are important components to consider when targeting improvements in MD adherence in children. It is, therefore, concluded that interventions targeting improvements in PA, AP and screen time are needed to promote MD adherence in children, regardless of SES.


Subject(s)
Diet, Mediterranean , Child , Adolescent , Humans , Spain , Economic Status , Surveys and Questionnaires , Cross-Sectional Studies
8.
J Exp Child Psychol ; 246: 106013, 2024 Oct.
Article in English | MEDLINE | ID: mdl-38996742

ABSTRACT

Previous studies have established a negative correlation between economic deprivation and self-esteem; however, limited insights exist regarding the onset of children linking self-esteem to economic status. To investigate this, we examined 198 preschoolers (96 girls and 102 boys) and their parents (170 mothers and 28 fathers). We assessed children's implicit and explicit self-esteem, whereas parents' reported on both personal relative deprivation and the family's economic objective deprivation. In addition, we explored children's money knowledge as a moderator. Our findings reveal that preschoolers may connect their implicit self-esteem with family economic status; however, such connections require basic knowledge about money. We discuss potential explanations for the influence of family economic deprivation, specifically on the implicit-not explicit-self-esteem of preschoolers.


Subject(s)
Self Concept , Humans , Female , Male , Child, Preschool , Economic Status , Parents/psychology , Adult , Family/psychology
9.
BMC Geriatr ; 24(1): 226, 2024 Mar 05.
Article in English | MEDLINE | ID: mdl-38443843

ABSTRACT

BACKGROUND: Childhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people's life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst middle- aged and older adults in India. METHODS: The data for the study was drawn from national representative survey "Longitudinal Ageing Study in India (LASI)" Wave I, 2017-2018 in order to conduct cross-sectional study. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population. RESULTS: Poor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.56, CI: 1.19, 2.04). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.16 CI: 1.01, 1.34). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.28 CI: 1.08, 1.51) and poor childhood socioeconomic status group (AoR: 1.31 CI: 1.11, 1.55) as compared to the higher socioeconomic category. CONCLUSIONS: Childhood socioeconomic status and health have a significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life.


Subject(s)
Depression , Economic Status , Child, Preschool , Humans , Middle Aged , Aged , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Aging , India/epidemiology
10.
BMC Public Health ; 24(1): 428, 2024 Feb 10.
Article in English | MEDLINE | ID: mdl-38341573

ABSTRACT

BACKGROUND: Child marriage of girls is one example of human rights violations, and is increasingly recognized as a key obstacle to global public health. Given the importance of a comprehensive understanding of the motivations for child marriage, this study aimed to identify socio-ecological factors contributing to gills child marriage. METHODS: A comprehensive search was conducted of all English-language studies measuring causes of child marriage between 2000 and October 2022 in the Web of Science, PubMed, Scopus, PsycInfo, ProQuest, Poplin and Google Scholar databases. Girl child marriage is defined as a marriage under the age of 18. In this study, the CASP evaluation checklist was used to collect data. Two independent reviewers reviewed all articles. RESULTS: A total of 34 eligible qualitative articles were included. The most salient causes of child marriage among girls include low skills and knowledge, internal and external beliefs and motivations, and physical advantages at the individual level. Family characteristics and structure contribute to child marriage at the interpersonal level, while environmental and economic factors play a role at the community level. Social factors and cultural norms, as well as the shortcomings and weaknesses of legislation, are also contributing factors at the society level. CONCLUSION: The results showed that cultural beliefs supporting gender inequality and economic status were the most important causes of child marriage. These results can help policymakers and decision-makers implement strategies to reduce gender inequality to prevent child marriage.


Subject(s)
Family Characteristics , Human Rights , Female , Child , Humans , Qualitative Research , Socioeconomic Factors , Economic Status
11.
BMC Public Health ; 24(1): 1843, 2024 Jul 10.
Article in English | MEDLINE | ID: mdl-38987724

ABSTRACT

BACKGROUND: Being older and having a migrant feature might cause a double risk of vulnerability in poor economic, social support, and health status at the place of destination. This study examines the association of migration on the social support and economic condition of older persons in India. METHODS: Longitudinal Ageing Study in India (LASI) wave-I (2017-2018) data with total samples of 66,156 older adults aged 45 + with 30,869 and 35,287 male and female samples, respectively, used in this study. Descriptive and bivariate analyses have been performed to examine the pattern of older migrants, and multinomial logistic regression analysis has been used to establish the associations between migration, social support, and economic condition. RESULTS: Over half (57.5%) of the population aged 45 + in India had migrant characteristics; 80% migrated before 25 years. Of all migrants, about 90% migrated within one state (Intrastate), and 9% migrated to another (Interstate). The association between social support and migration by distance and the adjusted result showed that immigrants were less likely to have medium [RRR = 0.56 (CI; 0.46-0.68)] and high [RRR = 0.39 (CI; 0.30-0.50)] social support. The interstate migrants were also less likely to have high [RRR = 0.90 (CI; 0.83-0.98)] social support. The migrants with 0-9 years of duration were less likely to have high social support, and the urban to rural stream migrants were more likely to have high social support. The association between economic status and migration by distance and the adjusted result showed that more affluent immigrants were likelier to have [RRR = 1.41 (CI; 1.14-1.73)] better economic conditions than affluent non-migrants. Migrants with 0-9-year duration and urban to rural stream were found to be likelier to have better economic conditions. CONCLUSIONS: The findings of this study suggest that distance, duration, and migration stream have a significant association with social support and economic conditions in later life. In exploring migration's effect on social and economic status, policymakers should prioritize migrants in their agenda to maintain socio-economic and social support for older persons in India to achieve the sustainable goal of active and healthy ageing.


Subject(s)
Social Support , Transients and Migrants , Humans , India , Male , Female , Aged , Longitudinal Studies , Middle Aged , Transients and Migrants/statistics & numerical data , Transients and Migrants/psychology , Economic Status/statistics & numerical data , Socioeconomic Factors , Aged, 80 and over , Time Factors
12.
BMC Public Health ; 24(1): 37, 2024 01 02.
Article in English | MEDLINE | ID: mdl-38166980

ABSTRACT

BACKGROUND: In 2021, China had a population of 264·01 million individuals over the age of 60, indicating a high prevalence of chronic diseases. Among older adults, physical inactivity (PI) is a significant risk factor for chronic diseases. However, few studies have been conducted on the correlation of physical activity (PA) with the economic status, geography and chronic disease risks in Chinese elderly. The objectives of this study were to better understand the distribution of PA among older adults in China and its relationship with economic status, geography, and chronic disease risks. METHODS: This study utilized data from the China Longitudinal Aging Social Survey (CLASS) in 2020, post-COVID-19. The study employed a stratified, multistage, probabilistic sampling approach and included 11,396 adults over the age of 59 from 28 provinces in China. Data on demographics, the duration and intensity of PA, history of diseases and personalized factors influencing PA were collected via structured interviews by researchers. In this study, we conducted a comprehensive analysis, employing a range of statistical methods including descriptive analysis, Wilcoxon rank-sum tests, Bayesian networks, and chi-square tests. RESULTS: The prevalence of PI among older adults over 59 in China is 28·82%. Significant regional differences were observed in the duration of PA at different intensities. Older adults residing in more economically developed areas were more likely to engage in moderate-to-vigorous physical activity (MVPA) and exhibited longer sedentary behavior. Economic status and urban-rural disparities consistently emerged as direct influential factors across all intensity types. Chronic disease risks were significantly lower in active older adults compared to inactive ones. Lack of social guidance, family support, and personal inclination towards sedentary behavior were the main personalized factors affecting PA among older adults, and these factors could be relatively easily modified. CONCLUSIONS: Economic status, geography, and living areas (urban and rural) significantly influenced the distribution of physical activities in China. Particularly, economic status and living areas acted as direct factors. Older adults reaching the recommended standards for PA had significantly lower chronic disease risks, highlighting the importance of improving personalized factors which are crucial for promoting PA.


Subject(s)
COVID-19 , Economic Status , Humans , Aged , Cross-Sectional Studies , Bayes Theorem , COVID-19/epidemiology , Exercise , Aging , Disease Outbreaks , Chronic Disease , China/epidemiology
13.
BMC Health Serv Res ; 24(1): 733, 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38877526

ABSTRACT

BACKGROUND: Patients with fewer socioeconomic and health literacy resources are disadvantaged in their access and use of healthcare, which may give rise to worse experiences with care and thus inequalities in patient experiences. However, only a limited number of studies have examined how socioeconomic and health literacy factors shape inequalities in patients' experiences with cancer care. OBJECTIVE: To examine whether patients' experiences with cancer care differ according to their economic status and health literacy. METHODS: Secondary analysis of data on 2789 adult patients diagnosed with cancer from the Swiss Cancer Patient Experiences-2 (SCAPE-2) study, a cross-sectional survey conducted in eight hospitals across Switzerland from September 2021 to February 2022. Regression analysis was applied to examine the independent effect of patients' economic status and health literacy on various outcomes of experiences with cancer care, covering eight different dimensions of patient-centred care, controlling for confounding factors. RESULTS: Adjusted regression analysis showed that patients with lower economic status reported significantly worse experiences with cancer care in 12 out of 29 specific care experiences, especially in the dimensions of 'respect for patients' preferences' and 'physical comfort' where all items of experiences were associated with economic status. Additionally, lower health literacy was associated with worse patient experiences in 23 specific care experiences. All items in the dimensions of 'respect for patients' preferences', 'physical comfort' and 'emotional support' were associated with health literacy. DISCUSSION: This study revealed significant inequalities in experiences with cancer care shaped by the economic status and health literacy of patients across different dimensions of patient-centred care. It is essential to address the needs of more disadvantaged patients who face obstacles in their access and use of the healthcare system, not only to mitigate inequalities in cancer care but also to avoid inequalities in health outcomes.


Subject(s)
Health Literacy , Healthcare Disparities , Neoplasms , Humans , Health Literacy/statistics & numerical data , Neoplasms/therapy , Neoplasms/psychology , Female , Male , Cross-Sectional Studies , Middle Aged , Switzerland , Aged , Adult , Socioeconomic Factors , Patient Satisfaction/statistics & numerical data , Patient-Centered Care , Surveys and Questionnaires , Economic Status
14.
Proc Natl Acad Sci U S A ; 118(43)2021 10 26.
Article in English | MEDLINE | ID: mdl-34663722

ABSTRACT

Despite the ever-growing economic gap between the very wealthy and the rest of the population, support for redistributive policies tends to be low. This research tested whether people's tolerance of inequality differs when it is represented in terms of a successful individual versus a group of people at the top of the economic ladder. We propose that drawing people's attention to wealthy individuals undermines support for redistribution by leading people to believe that the rich person's wealth is well deserved. Across eight studies (n = 2,800), survey participants rated unequal distributions of resources as more fair when presented with an individual, rather than a group, at the top of the distribution. Participants also expressed lower support for redistributive policies after considering inequality represented by successful individuals compared to groups. This effect was driven by people's different attributions for individual versus group success. Participants thought that individuals at the top were more deserving of their successes and, in turn, were less likely to support redistribution when inequality was represented by individual success. These findings suggest that support for inequality, and policies to reduce it, may depend on who people are led to consider when they think about the top of the economic distribution.


Subject(s)
Economic Status , Socioeconomic Factors , Adult , Developed Countries/economics , Female , Humans , Male , Mass Media , Social Class , Social Perception , Surveys and Questionnaires , United States
15.
J Biosoc Sci ; 56(1): 36-49, 2024 01.
Article in English | MEDLINE | ID: mdl-37309019

ABSTRACT

Functional health is arguably one of the most important health indicators for older adults, because it assesses physical, cognitive and social functions in combination. However, life-course circumstances may impact this multidimensional construct. The aim of the present study was to assess the relationship between life-course socio-economic status (SES) and different dimensions of functional health in older adults. Data on 821 Portuguese adults aged 50 years and over in 2013-2015 were analysed. Life-course SES was computed using participants' paternal occupation (non-manual (nm); manual (m)) and own occupation (nm; m), resulting in four patterns: stable high (nm + nm), upward (m + nm), downward (nm + m) and stable low (m + m). Functional health included physical and mental functioning, cognitive function, handgrip strength, and walking speed. Linear (beta coefficients) and logistic regressions (odds ratios) were used to estimate the association between life-course SES and functional health.Overall, those who accumulated social disadvantage during life-course presented worse functional health than those with stable high SES (stable low - SF-36 physical functioning: ß = -9.75; 95% CI: -14.34; -5.15; SF-36 mental health: ß = -7.33; 95% CI: -11.55; -3.11; handgrip strength: ß = -1.60; 95% CI: -2.86; -0.35; walking time, highest tertile: OR = 5.28; 95% CI: 3.07; 9.09). Those with an upward SES were not statistically different from those in the stable high SES for most of the health outcomes; however, those with an upward SES trajectory tended to have higher odds of cognitive impairment (OR = 1.75; 95% CI: 0.96; 3.19). A downward SES trajectory increased the odds of slower walking speed (OR = 4.62; 95% CI: 1.78; 11.95). A disadvantaged life-course SES impacts older adults' physical and mental functioning. For some outcomes, this was attenuated by a favourable adulthood SES but those with a stable low SES consistently presented worse functional health.


Subject(s)
Economic Status , Hand Strength , Humans , Middle Aged , Aged , Adult , Socioeconomic Factors , Portugal , Social Class
16.
Popul Stud (Camb) ; 78(1): 21-42, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37161858

ABSTRACT

This paper investigates the biological, socio-economic, and institutional factors shaping the individual risk of death during a major pre-industrial epidemic. We use a micro-demographic database for an Italian city (Carmagnola) during the 1630 plague to explore in detail the survival dynamics of the population admitted to the isolation hospital (lazzaretto). We develop a theoretical model of admissions to the lazzaretto, for better interpretation of the observational data. We explore how age and sex shaped the individual risk of death, and we provide a one-of-a-kind study of the impact of socio-economic status. We report an inversion of the normal mortality gradient by status for those interned at the lazzaretto. The rich enjoyed a greater ability to make decisions about their hospitalization, but this backfired. Instead, the poor sent to the lazzaretto faced a relatively low risk of death because they enjoyed better conditions than they would have experienced outside the hospital.


Subject(s)
Economic Status , Pandemics , Humans , Italy/epidemiology , Social Class , Hospitalization , Socioeconomic Factors
17.
JAMA ; 331(8): 687-695, 2024 02 27.
Article in English | MEDLINE | ID: mdl-38411645

ABSTRACT

Importance: The extent to which changes in health sector finances impact economic outcomes among health care workers, especially lower-income workers, is not well known. Objective: To assess the association between state adoption of the Affordable Care Act's Medicaid expansion-which led to substantial improvements in health care organization finances-and health care workers' annual incomes and benefits, and whether these associations varied across low- and high-wage occupations. Design, Setting, and Participants: Difference-in-differences analysis to assess differential changes in health care workers' economic outcomes before and after Medicaid expansion among workers in 30 states that expanded Medicaid relative to workers in 16 states that did not, by examining US individuals aged 18 through 65 years employed in the health care industry surveyed in the 2010-2019 American Community Surveys. Exposure: Time-varying state-level adoption of Medicaid expansion. Main Outcomes and Measures: Primary outcome was annual earned income; secondary outcomes included receipt of employer-sponsored health insurance, Medicaid, and Supplemental Nutrition Assistance Program benefits. Results: The sample included 1 322 263 health care workers from 2010-2019. Health care workers in expansion states were similar to those in nonexpansion states in age, sex, and educational attainment, but those in expansion states were less likely to identify as non-Hispanic Black. Medicaid expansion was associated with a 2.16% increase in annual incomes (95% CI, 0.66%-3.65%; P = .005). This effect was driven by significant increases in annual incomes among the top 2 highest-earning quintiles (ß coefficient, 2.91%-3.72%), which includes registered nurses, physicians, and executives. Health care workers in lower-earning quintiles did not experience any significant changes. Medicaid expansion was associated with a 3.15 percentage point increase in the likelihood that a health care worker received Medicaid benefits (95% CI, 2.46 to 3.84; P < .001), with the largest increases among the 2 lowest-earning quintiles, which includes health aides, orderlies, and sanitation workers. There were significant decreases in employer-sponsored health insurance and increases in SNAP following Medicaid expansion. Conclusion and Relevance: Medicaid expansion was associated with increases in compensation for health care workers, but only among the highest earners. These findings suggest that improvements in health care sector finances may increase economic inequality among health care workers, with implications for worker health and well-being.


Subject(s)
Health Personnel , Income , Medicaid , Patient Protection and Affordable Care Act , Humans , Health Care Sector/economics , Health Care Sector/statistics & numerical data , Health Personnel/economics , Health Personnel/statistics & numerical data , Medicaid/economics , Medicaid/statistics & numerical data , Patient Protection and Affordable Care Act/economics , Patient Protection and Affordable Care Act/statistics & numerical data , Physicians/economics , Physicians/statistics & numerical data , United States/epidemiology , Income/statistics & numerical data , Economic Status/statistics & numerical data , Economic Factors
18.
Diabet Med ; 40(10): e15182, 2023 10.
Article in English | MEDLINE | ID: mdl-37489698

ABSTRACT

AIMS: Studies of social inequality and risk of developing type 1 diabetes are inconsistent. The present review aimed to comprehensively review relevant literature and describe what has been reported on socio-economic status or parental occupation and risk of type 1 diabetes in children. METHODS: We searched for publications between 1 January 1970 and 30 November 2021. We focused on the most recent and/or informative publication in cases of multiple publications from the same data source and referred to these as primary studies. RESULTS: Our search identified 69 publications with relevant data. We identified eight primary cohort studies with individual-level data, which we considered the highest quality of evidence. Furthermore, we identified 13 primary case-control studies and 14 semi-ecological studies with area-level socio-economic status variables which provided a weaker quality of evidence. Four of eight primary cohort studies contained data on maternal education, showing non-linear associations with type 1 diabetes that were not consistent across studies. There was no consistent pattern on the association of parental occupation and childhood-onset type 1 diabetes. CONCLUSIONS: There is a need for more high-quality studies, but the existing literature does not suggest a major and consistent role of socio-economic status in the risk of type 1 diabetes.


Subject(s)
Diabetes Mellitus, Type 1 , Child , Humans , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/etiology , Economic Status , Social Class , Socioeconomic Factors , Educational Status
19.
AIDS Care ; 35(8): 1107-1115, 2023 08.
Article in English | MEDLINE | ID: mdl-37217167

ABSTRACT

HIV/AIDS is known to have adverse effects on individual and family socio-economic status due to the loss of productive time and over-expenditure in treatment. However, empirical data on how HIV/AIDS affects households' socio-economic status are insufficient. We linked socio-economic data from a Health and Demographic Surveillance System (HDSS) that implements an HIV/AIDS Longitudinal bio-behavioural survey (LBBS) to understand the long-term impact of HIV/AIDS on households' socio-economic status between 2010 and 2018. We compared changes in socio-economic status between households headed by HIV-negative and -positive individuals. A logistic regression was used to assess factors that influence socio-economic status. The level of education and household size were not significant predictors of households' socio-economic status. Households headed by HIV-positive individuals could maintain their baseline socio-economic status (unadjusted RRR = 1.17, 95% CI: 1.01, 1.36) but improvement chances were reduced despite a non-significant association (unadjusted RRR = 0.98, 95% CI: 0.80, 1.20). While HIV/AIDS is known to disrupt economic growth, in this setting, being a male household head, old and widowed reduces chances of improved socio-economic status. The elderly people, widows and widowers are disadvantaged. Consequently, there is a need for special programmes, which seek to empower the identified vulnerable groups economically. .


Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , HIV Seropositivity , Humans , Male , Aged , HIV Infections/epidemiology , Kenya/epidemiology , Economic Status , Acquired Immunodeficiency Syndrome/epidemiology , Family Characteristics
20.
Dev Sci ; 26(4): e13351, 2023 07.
Article in English | MEDLINE | ID: mdl-36417543

ABSTRACT

Infants undergo fundamental shifts in perception that are reported to be critical for language acquisition. In particular, infants' perception of native and non-native sounds begins to align with the properties of their native sound system. Thus far, empirical evidence for this transition - perceptual narrowing - has drawn from socio-economically and linguistically narrow populations from limited world regions. In this study, infants were sampled across diverse socio-economic strata and linguistic development in Singapore. One hundred and 16 infants were tested on their ability to discriminate both a native phonetic contrast (/ba/ versus /da/) and a non-native Hindi contrast (/ta/ versus /ʈa). Infants ranged in age from 6 to 12 months. Associations between age and discrimination varied by contrast type. Results demonstrated that infants' native sensitivities were positively predicted by family SES, whereas non-native sensitivities were not. Maternal socio-economic factors uniquely predicted native language sensitivity. Findings suggest that infants' sensitivity to native sound contrasts is influenced by their family socio-economic status. RESEARCH HIGHLIGHTS: We investigated effects of socio-economic status on infant speech perception. Infants were tested on native and non-native speech discrimination. Socio-economic status predicted native speech discrimination. Maternal occupation was a key predictor of native speech discrimination.


Subject(s)
Economic Status , Speech Perception , Humans , Infant , Language Development , Language , Phonetics
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