Changes over time of fruit, vegetable and sweets consumption among European adolescents and associations with sociodemographic characteristics: an HBSC study.

BACKGROUND: European adolescents do not eat enough fruits and vegetables and have a high sweets consumption. This study aims to analyse the changes in time of dietary behaviours related to sociodemographic characteristics, among European adolescents. METHODS: Health Behaviour in School Age Children data (2013/14 to 2017/18), of European adolescents, aged 11- to15-year-old, were used. Family Affluence Scale identified socioeconomic status (SES). Changes in time of dietary behaviours and associations with sociodemographic characteristics were estimated by binary and multilevel logistic regression. RESULTS: 182 719 adolescents were included, and 10/36 European countries showed a significant increase in daily fruit and vegetable consumption and 12/36 countries a significant decrease in sweets consumption over 4 years. The multilevel analysis showed that 13- and 15-year-old adolescents consumed fewer daily fruits and vegetables (P < 0.001) and more daily sweets (P < 0.001) than 11-year-old adolescents. Also, 15-year-old adolescents' sweets consumption change over time was less favourable (P = 0.006). Girls consumed more daily fruits, vegetables and sweets than boys (P < 0.001).Low SES adolescents consumed fewer daily fruits and vegetables than medium/high SES adolescents. Additionally, the low SES adolescents' vegetable consumption change over time was less favourable (P < 0.001). CONCLUSIONS: Dietary behaviour policy recommendations should be adapted for the sex, age and SES of the population.

The school counselor's role in addressing ACEs: an intervention strategy.

Children growing up with unemployed parents may be at higher risk of adverse childhood experiences (ACEs). The role of school counselors in identifying and providing services to children at risk of ACEs is important. In addition, the intervention strategy is expected to bridge the role between schools and the government in overcoming the risks of ACEs in the community.

Is a change in economic status associated with anxiety, depression and suicide ideation during the COVID-19 pandemic in South Korean adults?

BACKGROUND: Coronavirus disease 2019 (COVID-19) affected global economic changes and mental health outcomes. However, sex differences are unclear regarding the relationship between economic status change and mental health outcomes during the pandemic. Therefore, we investigated whether change in economic status is associated with depression, anxiety and suicidal ideation, based on sex. METHODS: We used data from the COVID-19 National Mental Health Survey 2021 in South Korea. We used the Generalized Anxiety Disorder (GAD) 7-item scale for measuring anxiety, the Patient Health Questionnaire-9 scale for measuring depression and self-reported questionnaires for investigating suicidal ideation and COVID-19-related suicidal ideation. RESULTS: Among 2000 participants, those with a worse economic status change had a 2.7-fold higher risk of GAD (prevalence ratio [PR], 2.70; 95% confidence interval [CI], 2.07-3.51); 2.5-fold higher depression risk (PR, 2.55; 95%CI, 2.05-3.18); 2.1-fold higher risk of suicidal ideation (PR, 2.09; 95%CI, 1.72-2.53); and 4.0-fold higher risk of COVID-19-related suicidal ideation (PR, 4.03; 95%CI, 2.78-5.83). Women whose economic status worsened had a 3.5-fold higher risk of COVID-19-related suicidal ideation (PR, 3.49; 95%CI, 2.01-6.06). CONCLUSION: Worse economic change is associated with negative mental health outcomes during the COVID-19 pandemic; particularly, women experiencing financial hardships during the pandemic had a higher risk of COVID-19-related suicidal ideation.

Vaccination against COVID-19 in Perú: Inequalities and associated factors. / LA VACUNACIÓN CONTRA COVID-19 EN EL PERÚ: Desigualdades y factores asociados.

Objective: to search for inequalities in vaccination with two doses, and its relationship with social and economic variables, cases and deaths. Methods: Exploratory ecological study of a secondary source from the Ministry of Health of Peru and the United Nations Program, from March 2020 to January 2022. Results: We found a high positive correlation (p < 0.05) with the Regional Competitiveness Index (r = 0.72), and the State Density Index (r = 0.81); moderate with the Human Development Index, doctors per 1,000 inhabitants, cases and deaths per 100 000. In the three waves of the pandemic, the most affected were older adults; the third wave was higher. Mortality decreased during vaccination compared to before it; there was inequality with two doses between the regions. The Lorenz curve expressed inequality with the number of doses (GINI: One dose: 0,05, Two doses: 0,06, Three doses: 0,18). The concentration curve was similar to that of Lorenz through the Regional Competitiveness Index, with higher doses, inequality increased (One dose: 0,05, two doses: 0,06, three doses: 0,16); The same happened with the State Density Index (One dose: 0,05, two doses: 0.06, three doses: 0,17). Conclusion: Inequality in vaccination between regions was found, associated with socioeconomic factors in Peru.

Objetivo: buscar desigualdades en la vacunación con dos dosis, y su relación con variables sociales, económicas, casos y fallecidos. Métodos: Estudio ecológico exploratorio de fuente secundaria del Ministerio de Salud de Perú y Programa de las Naciones Unidas, de marzo 2020 a enero 2022. Resultados: Encontramos correlación positiva alta (p < 0,05) con el Índice de Competitividad Regional (r = 0,72), y el Índice de Densidad del Estado (r = 0,81); moderada con el Índice de Desarrollo Humano, médicos por 1000 habitantes, casos y fallecidos por 100 000. En las tres olas de pandemia, los más afectados fueron adultos mayores; fue más alta la tercera ola. La mortalidad disminuyó durante la vacunación en comparación con antes de ella; existió desigualdad con dos dosis entre las regiones. La curva de Lorenz expresó desigualdad con el número de dosis (GINI: Una dosis: 0,05, Dos dosis: 0,06, Tres dosis: 0,18). La curva de concentración presentó semejanza con la de Lorenz mediante el Índice de Competitividad Regional, a mayor dosis se incrementó la desigualdad (Una dosis: 0,05, dos dosis: 0,06, tres dosis: 0,16); igual sucedió con el Índice de Densidad del Estado (Una dosis: 0,05, dos dosis: 0,06, tres dosis: 0,17). Conclusión: Se encontró desigualdad en la vacunación entre las regiones, asociada con factores socioeconómicos en Perú.

Suicide and mental health during the COVID-19 pandemic in Japan.

BACKGROUND: The coronavirus disease (COVID-19) pandemic is an unprecedented public health crisis, but its effect on suicide deaths is little understood. METHODS: We analyzed data from monthly suicide statistics between January 2017 and October 2020 and from online surveys on mental health filled out by the general population in Japan. RESULTS: Compared to the 2017-19 period, the number of suicide deaths during the initial phase of the pandemic was lower than average but exceeded the past trend from July 2020. Female suicides, whose numbers increased by approximately 70% in October 2020 (incidence rate ratio: 1.695, 95% confidence interval: 1.558-1.843), were the main source of this increase. The largest increase was found among young women (less than 40 years of age). Our survey data indicated that the status of young women's mental health has been deteriorating in recent months and that young female workers were more likely to have experienced a job or income loss than any other group, suggesting adverse economic conditions surrounding them. CONCLUSIONS: Continuous monitoring of mental health, particularly that of the most vulnerable populations identified in this study, and appropriate suicide prevention efforts are necessary during the COVID-19 pandemic.

The impact of disability on employment and financial security following the outbreak of the 2020 COVID-19 pandemic in the UK.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic may have a greater impact on people with disabilities than non-disabled people. Our aim was to compare the short-term impact of the 2020 COVID-19 pandemic and first lockdown on the employment and financial security of working age adults with and without disabilities in the UK. METHODS: Secondary analysis of data collected in Wave 9 and the special April, May and June COVID-19 monthly surveys of 'Understanding Society', the UK's main annual household panel study. RESULTS: During the first 3 months of the introduction of the COVID-19 lockdown in the UK, respondents with disability were more likely than their peers to be working reduced hours and experience higher levels of financial stress. These differences were attenuated, but not eliminated, when estimates were adjusted to take account of pre-lockdown financial status. CONCLUSIONS: Working age adults with disability were particularly disadvantaged by the financial impact of the COVID-19 lockdown in the UK. The UN Secretary-General António Guterres has stated the need for a disability-inclusive COVID-19 government response. The results of our analysis suggest that these pleas have either not been heeded, or if measures have been implemented, they have so far been ineffectual in the UK.

Obesity prevalence in large US cities: association with socioeconomic indicators, race/ethnicity and physical activity.

BACKGROUND: Obesity has a complex association with socioeconomic factors. Further clarification of this association could guide population interventions. METHODS: To determine the relationship between obesity prevalence, socioeconomic indicators, race/ethnicity, and physical activity, we performed a cross-sectional, multivariable linear regression, with data from large US cities participating in the Big Cities Health Inventory. RESULTS: Increased household income was significantly associated with decreased obesity prevalence, for White (-1.97% per 10 000USD), and Black (-3.02% per 10 000USD) populations, but not Hispanic. These associations remained significant when controlling for the proportion of the population meeting physical activity guidelines. Educational attainment had a co-linear relationship with income, and only a bachelor's degree or higher was associated with a lower prevalence of obesity in White (-0.30% per percentage) and Black (-0.69% per percentage) populations. No association was found between obesity prevalence and the proportion of the population meeting physical activity guidelines for any race/ethnicity grouping. CONCLUSION: At the population level of large US cities, obesity prevalence is inversely associated with median household income in White and Black populations. Strategies to increase socioeconomic status may also decrease obesity. Targeting attainment of physical activity guidelines as an obesity intervention needs further appraisal.

Loan sharking: changing patterns in, and challenging perceptions of, an abuse of deprivation.

BACKGROUND: Illegal high interest lending or 'loan sharking' exploits the vulnerable and has profound negative impacts on individuals and communities. The 2008 UK financial crash and subsequent austerity programme coupled with changes in the consumer credit market have fuelled an increase in predatory lending. METHODS: The study is a descriptive analysis of demographic, financial, health and behavioural data on 753 victims (2011-2017). A review of the causative factors and potential political, economic and public health responses is analysed. RESULTS: Most victims were female but males were considerably more indebted. Illegal loans are largely taken out for routine living expenses and over 70% of victims reported other serious debts. Victims are disproportionately poor, unemployed and on benefits but fewer than half have had financial or benefits advice. Despite 90% reporting they would not borrow illegally again, 30% had previously done so from the same shark and over half considered them a friend. CONCLUSIONS: The increase in loan sharking has coincided with the withdrawal of traditional sub-prime lenders and local welfare assistance schemes, and the low penetration of Credit Unions in many areas. Conventional perceptions of loan sharks and their relationships with victims are largely incorrect. A range of coordinated financial, political and social interventions is required.

Factors Associated with the Health Literacy on Social Determinants of Health: A Focus on Socioeconomic Position and Work Environment.

Though impressive progress has been made in healthcare worldwide, many people still experience disproportionate health burdens and inequities in healthcare services. For establishing sustainable development goals, health literacy on social determinants of health (HL-SDH) has been recognized as a key to creating better social and physical environments. In particular, low levels of health literacy among industrial workers are considered as a major barrier to benefitting from the progress made in healthcare. This study aimed to describe levels of HL-SDH and to examine the relationships among socioeconomic status, working environment, and HL-SDH among workers in Korea. A total of 660 workers from an online panel participated in Korea from 30 May to 7 June 2018. The Korean version of HL-SDH instrument consisted of 33 items and four dimensions: access, understand, appraise, and apply. Descriptive statistics, a t-test, ANOVA, and multiple regression analysis were conducted. The mean score of HL-SDH was 2.48. Perceived mental health status, annual income, and the number of employees per worksite were found to be statistically significant factors related to HL-SDH (F = 3.64, p = <0.001). The HL-SDH score was considerably higher, indicating that nursing interventions to enhance HL-SDH are required for health promotion, especially among workers in poor social and working environments.

Racial disparities in knowledge, attitudes and practices related to COVID-19 in the USA.

BACKGROUND: Recent reports indicate racial disparities in the rates of infection and mortality from the 2019 novel coronavirus (coronavirus disease 2019 [COVID-19]). The aim of this study was to determine whether disparities exist in the levels of knowledge, attitudes and practices (KAPs) related to COVID-19. METHODS: We analyzed data from 1216 adults in the March 2020 Kaiser Family Foundation 'Coronavirus Poll', to determine levels of KAPs across different groups. Univariate and multivariate regression analysis was used to identify predictors of KAPs. RESULTS: In contrast to White respondents, Non-White respondents were more likely to have low knowledge (58% versus 30%; P < 0.001) and low attitude scores (52% versus 27%; P < 0.001), but high practice scores (81% versus 59%; P < 0.001). By multivariate regression, White race (odds ratio [OR] 3.06; 95% confidence interval [CI]: 1.70-5.50), higher level of education (OR 1.80; 95% CI: 1.46-2.23) and higher income (OR 2.06; 95% CI: 1.58-2.70) were associated with high knowledge of COVID-19. Race, sex, education, income, health insurance status and political views were all associated with KAPs. CONCLUSIONS: Racial and socioeconomic disparity exists in the levels of KAPs related to COVID-19. More work is needed to identify educational tools that tailor to specific racial and socioeconomic groups.

Influence of sociodemographic and economic factors on physical activity among university students / Influência de fatores sociodemográficos e econômicos na atividade física entre estudantes universitários / La influencia de factores sociodemográficos y económicos para la actividad física de estudiantes universitarios

Objective: To estimate the influence of socioeconomic factors on the variation of time spent by university students on the practice of physical activity after the first academic year. Methods: Longitudinal quantitative study with 348 full-time university students, between 16 and 25 years old, from capital of Mato Grosso, Brazil. Change in time spent on the practice of moderate and vigorous physical activity was evaluated in minutes per week, through the short version of IPAQ - International Physical Activity Questionnaire. The following independent variables were analyzed: sex, age, race/skin color, economic class, students' housemates and field of study. Multinomial regression analysis was used to verify the association of physical activity time variation, in tertiles, with the independent variables. Results: The overall change in median physical activity time in one year was -90.0 minutes/week, the students of higher socioeconomic status maintained the same time of practice of physical activity, while those of other classes showed a decrease in this time after the first year at university. After adjustments, the lower economic class (OR=2.85; 95%CI= 1.26-6.43) and the fact that the student lives in a house shared by students (OR=2.84; 95%CI= 1.26-6.38) were associated with reduction in time spent on physical activity. Conclusion: There was a decrease in time spent on physical activity among students from the lower economic classes who lived in a share house after the first year at university.

Objetivo: Estimar a influência de fatores socioeconômicos na variação do tempo gasto por estudantes universitários na prática de atividade física após o primeiro ano letivo. Métodos: Estudo quantitativo longitudinal, realizado em 2015 e 2016, com 348 universitários em tempo integral, com idade entre 16 e 25 anos, da capital do Mato Grosso, Brasil. Avaliou-se a mudança no tempo gasto na prática de atividade física moderada e vigorosa em minutos por semana por meio da versão curta do International Physical Activity Questionnaire (IPAQ). As variáveis independentes do estudo são sexo, idade, raça/cor da pele, classe econômica, colegas de casa dos alunos e campo de estudo. Utilizou-se a análise de regressão multinomial para verificar a associação da variação do tempo de atividade física, em tercis, com as variáveis independentes. Resultados: A mudança geral no tempo mediano de atividade física em um ano é de 90,0 minutos/semana. Os estudantes de maior nível socioeconômico mantiveram o mesmo tempo de prática de atividade física, enquanto os de outras classes apresentaram uma diminuição nesse tempo após o primeiro ano na universidade. Após os ajustes, a classe econômica mais baixa (OR=2,85; IC95%=1,26-6,43) e o fato de o aluno morar em uma casa compartilhada pelos alunos (OR=2,84; IC95%=1,26-6,38) associaram-se à redução no tempo gasto em atividade física. Conclusão: Houve diminuição do tempo gasto em atividade física entre estudantes das classes econômicas mais baixas, que viviam em uma casa compartilhada, após o primeiro ano na universidade.

Objetivo: Estimar la influencia de factores socioeconómicos en la variación del tiempo gasto por estudiantes universitarios en la práctica de actividad física después del primer año académico. Métodos: Estudio cuantitativo y longitudinal realizado entre 2015 y 2016 con 348 universitarios a jornada completa entre 16 y 25 años de la capital Mato Grosso, Brasil. El cambio del tiempo gasto con la práctica de actividad física moderada y vigorosa ha sido evaluada en minutos por semana con la versión corta del IPAQ- International Physical Activity Questionnaire. Las variables independientes fueron el sexo, la edad, la raza/el color de la piel, la clase económica, los compañeros de piso y el campo de estudio. El análisis de regresión multinomial ha sido utilizado para verificar la asociación de la variación del tiempo de actividad física en terciles y las variables independientes. Resultados: El cambio total del tiempo mediano de la actividad física en un año ha sido de -90.0 minutos/semana, los estudiantes con estatus socioeconómico más alto mantuvieron el mismo tiempo de práctica de actividad física mientras aquellos de otras clases socioeconómicas presentaron una reducción en el tiempo de actividad física después del primer año en la universidad. Tras los ajustes, la clase económica más baja (OR=2,85; 95%CI= 1,26-6,43) y el hecho de vivir en casa compartida con estudiantes (OR=2,84; 95%CI= 1,26-6,38) se asoció con la reducción del tiempo gasto con la actividad física. Conclusión: Hubo una reducción del tiempo gasto con la actividad física entre los estudiantes de clases económicas más bajas que vivían en casa compartida después del primer año en la universidad.

Health-related quality of life and its associated factors: results of a multi-center cross-sectional study among university students.

BACKGROUND: The decline of health among university students represents an important and growing public health concern. Health problems and unhealthy lifestyle habits are common among many students, but factors influencing students' health are not fully understood. METHODS: Italian university students from different study programs and curriculum years were asked to fill out a self-administered questionnaire, collecting data about age, gender, curriculum year, study program and health-related quality of life (QOL). Two latent factors were extracted: physical component summary score and mental component summary score. T-test, one-way ANOVA, multivariate and age and sex-stratified analyses were performed. RESULTS: Students scored relatively poor on health-related QOL, with an overall mental component summary score of 41,3% (± 10,0) and physical component summary score of 52,9% (±6,0), with significantly higher mental component summary score for male students (P = < 0,005). Studying economics, law (b = -2,513, P = 0,007) or engineering (b = -2,762; P = 0,001) was associated to negatively influence students' health. CONCLUSIONS: Factors such as study program are associated with health-related QOL. Further longitudinal studies assessing additional socio-demographic factors are needed to fully assess what influences students' health. Students' health should be at the top of the agenda of public health researchers, academic supervisors and policy-makers.

Man shall not live by bread alone: the role of perceived emotional support in low-income adults' health outcomes.

BACKGROUND: Adults with low income have limited access to valuable health resources thus presenting a major obstacle to improving their health. Although there are diverse health enhancement programs for low-income populations, relatively few focus on emotional support despite the positive impact of perceived emotional support on health. This study examines the interaction of perceived emotional support and income on the overall health status and psychological well-being of adults with low income. METHODS: Secondary data were collected from the Health Information National Trends Survey (Cycle 4). A total of 3677 respondents completed the survey, including 889 adults with low income, as determined by their eligibility for the Supplemental Nutrition Assistance Program (SNAP). Ordinary-least square hierarchical regression analysis was conducted to test main and interaction effects. RESULTS: Perceived emotional support moderated the relationship between SNAP eligibility and health outcomes. Lacking an emotional support network has greater detrimental effects on the overall health and psychological well-being of people with low income compared to similar persons with higher income. CONCLUSION: These findings suggest the need for health programs that enhance access to emotional support for adults with low income.

Implementing community-based health promotion in socio-economically disadvantaged areas: a qualitative study.

BACKGROUND: There is a gradient relationship between socio-economic status and health. We investigated the views and perceptions of health promotion service providers regarding factors that affect lack of engagement in public health initiatives by residents in socio-economically disadvantaged (SED) communities. METHODS: We conducted semi-structured interviews with a purposive sample of key providers (n = 15) of community-based health promotion services to elicit their views about engagement-related factors and their experiences of the provision, delivery and impact of health promotion in SED areas. Interviews were analysed using thematic analysis. RESULTS: Failure to (i) recognise within SED communities, socio-cultural norms of health-related behaviour and (ii) communicate to local residents an understanding of complex lifestyle influences appeared to affect adversely service engagement and contribute to the development of negative attitudes towards health promotion. Engagement is more likely when services are delivered within familiar settings, peer support is available, initiatives are organized within existing groups, external incentives are offered and there are options regarding times and locations. Collaborative working between providers and communities facilitates efficient, context-sensitive service delivery. CONCLUSIONS: Knowledge of a local community and its socio-environmental context alongside a collaborative, facilitative and tailored approach to delivery are required to ensure successful engagement of SED communities in health promotion.

Health inequalities and well-being in times of financial and political crisis in Brazil, a case study.

Background: Although global efforts have resulted in improvements in health and well-being across the world, economic downturns can rapidly undermine achievements in this area. Methods: Using Gallup World Poll data (n = 7,084) this study assessed the changes in health status and well-being before (2009-2013) and during (2015-2017) the current financial and political crisis in Brazil and their association with the Social Determinants of Health Inequalities. Health and well-being were measured by the Personal Life Index and the Life Evaluation Index. Descriptive analysis and logistic regression models were conducted. Results: A significant deterioration of well-being was found during the crisis, with a 29% decline (63-44%) in the prevalence of respondents classified as 'thriving' in life. Food security, age and social support were the best predictors of health status and well-being, mitigating the association of health and well-being with income and unemployment. Education and community environment also showed strong association with well-being, and satisfaction with healthcare system played an important role in health status. Conclusions: In order to protect health and well-being during such crisis, policies should pay particular attention on enhancing the access to food, healthcare system, educational system, community environment (quality of air, water and infrastructure) and fostering social support.

Needs of homeless veterans: 5 years of the CHALENG Survey 2012-16.

BACKGROUND: National surveys of homeless veterans have been conducted for over a decade, but there has been no examination of changes in the needs of homeless veterans. METHODS: Annual surveys of convenience samples of homeless veterans conducted for Project Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) from 2012 (n = 6859), 2013 (n = 7741), 2014 (n = 7126), 2015 (n = 3765) and 2016 (n = 3191) were analyzed. CHALENG surveys collected background information about respondents and their ratings of unmet needs of homeless veterans. RESULTS: Across years, the majority of respondents were males, white, 45-60 years old, Army veterans, lived in urban areas, had no dependent children, and were enrolled in VA healthcare. Over time, the proportion of respondents who were over 60, female, and white increased. There was little change in reported unmet needs with the highest rated unmet needs related to credit counseling, utility assistance, furniture and housewares, dental care and disability income. Among subsamples of veterans with specialized needs, the top three reported unmet needs were housing for registered sex offenders, legal assistance for evictions/foreclosures, and legal assistance for child support. CONCLUSIONS: Several intractable unmet needs of homeless veterans have persisted in contemporary time.