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1.
Mymensingh Med J ; 30(4): 1067-1072, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34605478

RESUMEN

The timing of milestone is influenced by many factors. Sex and socioeconomic status has significant effect to some psycomotor milestones. The study was conducted to determine the pattern of milestones of development of infants in our country and to compare it in different sex and socioeconomic condition. It was a hospital based prospective study done in Sir Sallimullah Medical College and Mitford Hospital, Dhaka, Bangladesh from October 2014 to November 2015. Healthy term newborn infants with average birth weight were included in this study and milestones of this birth cohort were assessed monthly from birth to 12 months of age by using a set of 60 milestones. Total number of 217 babies was enrolled but during follow up 0.9% developed meningitis, 43.7% was lost to follow up and 55.2% of the cohort was followed up to 12 months of age. Among 120 babies 51.7% were male, 48.3% were female babies and 51.7% belong to lower, 32.5% middle and 15.8% upper socioeconomic group. There was no significant difference between male and female infants achieving most of the milestones of development except in language development in which female infants were little bit higher than male infants.


Asunto(s)
Hospitales , Clase Social , Bangladesh/epidemiología , Peso al Nacer , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Estudios Prospectivos
2.
Braz Dent J ; 32(2): 72-79, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34614063

RESUMEN

The objective was assess the influence of untreated caries and socioeconomic status (SES) on school dropout among adolescents. A six-year cohort study was conducted with random sample of adolescents (12 years-old) who had been evaluated initially in 2012 from Santa Maria, Brazil. Sex, socioeconomic status (mother's education and household income), and untreated caries were collected at the baseline. The outcome variable was collected at the follow-up through self-report and was divided into three categories: adolescents who only studied, who studied and employed, and who school dropouts. A multinomial regression model was performed to assess the influence of oral disease and SES on school leaving, through relative risk ratio (RRR) and 95% confidence interval (95% CI). From of 1,134 adolescents evaluated at the baseline, 768 participants with a mean age of 17.5 years were re-evaluated at follow-up (67.8% response rate). Male (RRR: 2.31; 95%CI: 1.19-4.48) and adolescents with untreated caries at the baseline had an increment in school-leaving (RRR: 2.26; 95%CI: 1.12-4.56). Mothers with low education (RRR: 2.24; 95%CI: 1.09-4.61) had a higher probability of having children who leave school. Untreated caries and low SES in early adolescence can influence the tendency to school dropouts.


Asunto(s)
Susceptibilidad a Caries Dentarias , Instituciones Académicas , Adolescente , Brasil/epidemiología , Niño , Estudios de Cohortes , Humanos , Masculino , Clase Social
3.
Cent Eur J Public Health ; 29(3): 223-229, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34623123

RESUMEN

OBJECTIVES: Socioeconomic status (SES) and lifestyle have impact on recovery after ischaemic stroke (IS) and on risk of recurrent ischaemic stroke (RIS) in elderly patients. With regard to currently available limited data on young people, we aimed to assess SES and parameters of lifestyle and evaluate their relationship to stroke recovery and risk of RIS in young patients. METHODS: We analysed consecutive young IS patients < 50 years enrolled in the prospective HISTORY (Heart and Ischaemic STrOke Relationship studY) study registered on ClinicalTrials.gov (NCT01541163). Data were acquired from structured a self-evaluating multiple-choice questionnaire. Clinical outcome was assessed using the Modified Rankin Scale (MRS) after 3 months with score 0-1 for excellent outcome. RESULTS: Data were obtained from 297 (163 males, mean age 39.6 ± 7.8 years) young patients. Patients with MRS 0-1 (237, 79.8%) did not differ in SES except university education (21.1 vs. 3.3%; p = 0.001), less smoked (16.5 vs. 58.3%; p < 0.001), more of them did regular sport activities (79.1 vs. 51.6%; p = 0.02) and passed regular preventive medical checks (45.6 vs. 24.2%; p = 0.01). Twelve (4%) patients suffered from RIS during a follow-up with median of 25 months. They did not differ in SES but had higher body mass index (31.6 vs. 26.7; p = 0.007), reported less regular sport activities (16.7 vs. 73.0%; p < 0.001) and less regular medical checks (8.3 vs. 40.0%; p = 0.001). CONCLUSION: In young patients, SES had no relationship to clinical outcome after IS and to risk of RIS except education level. Some parameters of health lifestyle were presented more in patients with excellent outcome and without RIS during the follow-up.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Adolescente , Adulto , Anciano , Isquemia Encefálica/epidemiología , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Clase Social , Accidente Cerebrovascular/epidemiología
4.
BMC Public Health ; 21(1): 1765, 2021 09 27.
Artículo en Inglés | MEDLINE | ID: mdl-34579689

RESUMEN

BACKGROUND: This research estimates the effects of vulnerability on the spread of COVID-19 cases across U.S. counties. Vulnerability factors (Socioeconomic Status, Minority Status & Language, Housing type, Transportation, Household Composition & Disability, Epidemiological Factors, Healthcare system Factors, High-risk Environments, and Population density) do not only influence an individual's likelihood of getting infected but also influence the likelihood of his/her neighbors getting infected. Thus, spatial interactions occurring among individuals are likely to lead to spillover effects which may cause further virus transmission. METHODS: This research uses the COVID-19 community index (CCVI), which defines communities likely vulnerable to the impact of the pandemic and captures the multi-dimensionality of vulnerability. The spatial Durbin model was used to estimate the spillover effects of vulnerability to COVID-19 in U.S. counties, from May 1 to December 15, 2020. RESULTS: The findings confirm the existence of spatial spillover effects; with indirect effects (from neighboring counties) dominating the direct effects (from county-own vulnerability level). This not only validates social distancing as a strategy to contain the spread of the pandemic but also calls for comprehensive and coordinated approach to fight its effects. By keeping vulnerability factors constant but varying the number of reported infected cases every 2 weeks, we found that marginal effects of vulnerability vary significantly across counties. This might be the reflection of both the changing intensity of the pandemic itself but also the lack of consistency in the measures implemented to combat it. CONCLUSION: Overall, the results indicate that high vulnerability in Minority, Epidemiological factors, Healthcare System Factors, and High-Risk Environments in each county and adjacent counties leads to an increase in COVID-19 confirmed cases.


Asunto(s)
COVID-19 , Femenino , Humanos , Masculino , Grupos Minoritarios , Pandemias , SARS-CoV-2 , Clase Social
5.
BMC Public Health ; 21(1): 1614, 2021 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-34479524

RESUMEN

BACKGROUND: Adolescent multiple risk behaviour (MRB) is associated with negative outcomes such as police arrests, unemployment and premature mortality and morbidity. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. We test whether adolescent MRB is associated with socioeconomic status (SES) in young adulthood and whether it is moderated by early life SES variables. METHODS: Prospective cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991-1992, were used and two comparable MRB variables were derived. Logistic regression was used to determine the association between MRB and young adult SES. The moderating effect of three early life SES variables was assessed using logistic regression models with and without interaction parameters. Evidence to support the presence of moderation was determined by likelihood ratio tests ≤p = 0.05. Multiple imputation was used to account for missing data. RESULTS: Adolescents had a median of two risk behaviours in BCS70 and three in ALSPAC. Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response relationship, with each additional risk behaviour resulting in reduced odds of university degree attainment. MRB was associated occupational status at age 34 in BCS70 (OR 0.86 95% CI: 0.82, 0.90). In BCS70, there was evidence that maternal education (p = 0.03), parental occupational status (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES in that the negative effect of MRB is stronger for those with low socioeconomic backgrounds. No evidence of moderation was found in the ALSPAC cohort. CONCLUSIONS: Adolescence appears to be a critical time in the life course to address risk behaviours, due to the likelihood that behaviours established here may have effects in adulthood. Intervening on adolescent MRB could improve later SES outcomes and thus affect health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that more detailed measures should be investigated to capture the nuance of contemporary young adult SES.


Asunto(s)
Asunción de Riesgos , Clase Social , Adolescente , Adulto , Niño , Estudios de Cohortes , Humanos , Estudios Longitudinales , Estudios Prospectivos , Factores Socioeconómicos , Reino Unido/epidemiología , Adulto Joven
6.
BMC Public Health ; 21(1): 1636, 2021 09 07.
Artículo en Inglés | MEDLINE | ID: mdl-34493250

RESUMEN

BACKGROUND: Sepsis is a substantial health care burden. Data on regional variation in sepsis incidence in Germany and any possible associations with regional socioeconomic deprivation and health care capacity is lacking. METHODS: Ecological study based on the nationwide hospital Diagnosis-related Groups (DRG) statistics data of 2016. We identified sepsis by ICD-10-codes and calculated crude and age-standardized incidence proportions in the 401 administrative German districts. Associations between socioeconomic and health care capacity indicators and crude and age-adjusted sepsis incidence were investigated by simple and multiple negative binomial (NB) regressions. RESULTS: In 2016, sepsis incidence was 178 per 100,000 inhabitants and varied 10-fold between districts. We found that the rate of students leaving school without certificate was significantly associated with crude and age-standardized explicit sepsis incidence in the simple and multiple NB regressions. While we observed no evidence for an association to the capacity of hospital beds and general practitioners, the distance to the nearest pharmacy was associated with crude- and age-standardized sepsis incidence. In the multiple regression analyses, an increase of the mean distance + 1000 m was associated with an expected increase by 21.6 [95% CI, 10.1, 33.0] (p < 0.001), and 11.1 [95% CI, 1.0, 21.2]/100,000 population (p = .026) after adjusting for age differences between districts. CONCLUSIONS: Residence in districts with lower socioeconomic status (e.g., less education) and further distance to pharmacies are both associated with an increased sepsis incidence. This warrants further research with individual-level patient data to better model and understand such dependencies and to ultimately design public health interventions to address the burden of sepsis in Germany.


Asunto(s)
Sepsis , Atención a la Salud , Alemania/epidemiología , Humanos , Incidencia , Sepsis/epidemiología , Clase Social
7.
Reprod Health ; 18(1): 182, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34507589

RESUMEN

BACKGROUND: Adolescents face significant barriers to access and utilization of sexual and reproductive health services in many low-income settings, which in turn may be associated with adverse consequences such as early pregnancy, sexually transmitted infections, unsafe abortion and mortality. There is evidence suggesting that limited access to sexual and reproductive health information and services among adolescents contributes to these outcomes. We aimed to find out the factors that affect the fertility of adolescents aged 15 to 19 years in Zambia and to identify possible drivers of adolescents' fertility. METHODS: Secondary analysis of the ZDHS 2013/14 data was carried out to find out the factors that affect the fertility rate of adolescents aged 15 to 19 years using multivariate logistic regression (n = 3666). RESULTS: Overall, 23.1% of adolescents had given birth at least once in the 5 years leading to the survey (n = 3666, 99.4% response), and 49.8% were rural-based while 50.2% were urban-based. The median number of schooling was 8 years (IQR 6-10). About 52% of the adolescents were in the poorer, poor and medium wealth quintiles while the other 48% were in the rich and richer quintiles. Factors found to affect fertility include residence, wealth status, educational attainment, marriage and abortion. An urban-based adolescent with a lower socioeconomic status was 2.4 times more likely to give birth compared to rural-based poorer adolescents (aOR = 2.4, 95% CI: 1.5, 3.7, p < 0.001). Although odds of giving birth were much higher among rural-based married adolescents (aOR = 8.0, 95% CI: 5.4, 11.9, p < 0.001) compared to urban married adolescents (aOR = 5.5, 95% CI: 8.3, 16.0, p < 0.001), and these relationships both statistically significant, higher educational attainment (aOR = 0.7, 95% CI: 0.6, 0.8 p < 0.001) and abortion (aOR = 0.3, 95% CI: 0.1, 0.8, p = 0.020) reduced these odds, particularly for rural-based adolescents. CONCLUSION: Despite response aimed at reducing adolescent fertility, low wealth status, low educational attainment and early marriage remain significant drivers of adolescent fertility in Zambia. There is a need to address sexual and reproductive health needs of urban-based adolescents with a lower socioeconomic status.


Asunto(s)
Fertilidad , Población Rural , Adolescente , Femenino , Encuestas Epidemiológicas , Humanos , Matrimonio , Embarazo , Clase Social , Factores Socioeconómicos , Zambia/epidemiología
8.
Front Public Health ; 9: 688811, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34513782

RESUMEN

Background: Perfectionism in adolescence has received increased attention, but few studies have examined this in non-clinical samples. This study investigated perfectionism among adolescents from the general population in relation to demographic factors. Methods: The present study is cross-sectional and draws on the epidemiological youth@hordaland study. The sample consisted of 10.217 adolescents aged 16-19 years (52.9% girls). Self-reported perfectionism was assessed by the EDI-P scale from the Eating Disorder Inventory with two dimensions of perfectionism, namely self-oriented (SOP) and socially prescribed (SPP) perfectionism, and a total score. Perfectionism was analyzed in relation to age, gender, and socioeconomic status (SES) by perceived economic well-being and parental education level. Chi-squared tests, t-tests, and regression analyses were performed. Results: There were few gender differences on the mean scores on perfectionism, with similar levels on the total score of EDI-P and SOP, while girls scored slightly higher on SPP (p < 0.001). The latter gender difference represented a small effect size (Cohen's d = 0.053). Chi-square analyses with perfectionism split at the 90th percentile across gender showed that there were significantly more girls than boys among the high scorers both for EDI-P, EDI-SOP, and EDI-SPP. There were no significant differences between levels of perfectionism between the three age groups. The logistic regression analyses adjusted by age and gender showed that adolescents with a better perceived economic well-being had increased odds of high perfectionism. This was evident for overall EDI-P (OR = 1.760, 95% CI = 1.493-2.076), SOP (OR = 1.543, 95% CI = 1.292-1.843), and SPP (OR = 1.836, 95% CI = 1.559-2.163). Parental education was not significantly associated with perfectionism scores among the adolescents. Conclusions: The levels of perfectionism were relatively similar between the genders in the present study, besides slightly higher SPP among girls than boys. There were also significantly more girls than boys among the high scorers on overall perfectionism, SOP, and SPP, respectively. High perfectionism was related to SES for perceived economic well-being, but not for parental education level. Implications for further research and clinical interventions were suggested.


Asunto(s)
Perfeccionismo , Adolescente , Estudios Transversales , Escolaridad , Femenino , Humanos , Masculino , Factores Sexuales , Clase Social
10.
Sante Publique ; 33(2): 285-293, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34553873

RESUMEN

INTRODUCTION: Cessation of care for financial reasons is an indicator of the affordability of care. OBJECTIVE: The objective of this work was to identify the determinants of the renunciation of care for financial reasons among women in a peri-urban area of Abidjan. METHOD: This cross-sectional study was conducted from March to May 2019 among women aged 18 years and over in Anonkoi 3 in the north of Abidjan. The socio-demographic, economic, health status and health care abandonment characteristics were collected using a questionnaire. The associations between the renunciation of care for financial reasons and women’s characteristics were measured using logistic regression models with a 5% risk. RESULTS: The sample consisted of 423 women with a median age of 28 ± 11 years. Only 30% of them had health insurance. The rate of financial reasons for discontinuing care was 59.1%. This renunciation was more pronounced for the purchase of drugs, biological examinations, dental care, and surgical procedures. The number of dependent (P = 0.035), young age (P ≤ 0.035), low level of education (P = 0.024), low level of income (P ≤ 0.004) and the absence of an associative life (P = 0.004) and perceived poor health (P = 0.021) were identified as determinants of the renunciation of care for financial reasons. CONCLUSION: Empowerment, literacy, health education for women and adherence to universal health coverage should help to remove the financial barrier to women’s access to care.


Asunto(s)
Atención a la Salud , Clase Social , Adolescente , Adulto , Costa de Marfil , Estudios Transversales , Femenino , Humanos , Seguro de Salud , Factores Socioeconómicos , Adulto Joven
11.
Rev Med Chil ; 149(4): 533-542, 2021 Apr.
Artículo en Español | MEDLINE | ID: mdl-34479341

RESUMEN

BACKGROUND: There are marked differences associated with socio-economic factors in the prevalence of depressive symptoms (DS) in men and women. AIM: To estimate the association between socioeconomic status and DS in Chile and to estimate the gender gaps in this association. MATERIAL AND METHODS: The Patient Health Questionnaire-9 (PHQ-9) was applied as part of a socioeconomic survey carried out in a representative community sample (n = 2913). Using this information, we analyzed the influence of social status (education level, occupation, household income) and other psychosocial factors (gender, perceived social support, stressful life events) on DS. RESULTS: The prevalence of DS was 23.2% in women and 13.4% in men. A socioeconomic gradient was found in the distribution of DS. This gradient was more pronounced for women than for men. Gender, social support and stressful life events were the most important predictors of severe DS, with an estimated risk twice as high among women and almost three times as high among those with low social support. CONCLUSIONS: There is a combined effect between socio-economic and gender inequalities on DS. This partially explains the greater vulnerability of poor women and the DS gap between men and women.


Asunto(s)
Depresión , Clase Social , Chile/epidemiología , Depresión/epidemiología , Femenino , Humanos , Masculino , Factores Sexuales , Factores Socioeconómicos
12.
Hepatol Commun ; 5(10): 1791-1800, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34558861

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic created a crisis that disproportionately affected populations already disadvantaged with respect to access to health care systems and adequate medical care and treatments. Understanding how and where health care disparities are most widespread is an important starting point for exploring opportunities to mitigate such disparities, especially within our patient population with liver disease. In a webinar in LiverLearning, we discussed the impact of the pandemic on the United States, United Kingdom and Canada, highlighting the disproportionate effects on infection rates and death for certain ethnic minorities, those socioeconomically disadvantaged and living in higher density areas, and those working in health care and other essential jobs. We set forth a "call to action" for members of the American Association for the Study of Liver Diseases and the larger community of providers of liver disease care to generate viable solutions to improve access to care and vaccination rates of our patients against COVID-19, and in general help reduce health care disparities and improve the health of disadvantaged populations within their communities. Solutions will likely involve personalized interventions and messaging for communities that honor local leaders and embrace the diverse needs and different cultural sensitivities of our unique patient populations.


Asunto(s)
COVID-19/epidemiología , Grupos Étnicos , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud/etnología , Grupos Minoritarios , Factores Socioeconómicos , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Canadá/epidemiología , Gastroenterología , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Hepatopatías , SARS-CoV-2 , Clase Social , Determinantes Sociales de la Salud , Medicina Estatal , Reino Unido/epidemiología , Estados Unidos/epidemiología , Cobertura de Vacunación
13.
Am J Hum Genet ; 108(9): 1780-1791, 2021 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-34416156

RESUMEN

Similarities between parents and offspring arise from nature and nurture. Beyond this simple dichotomy, recent genomic studies have uncovered "genetic nurture" effects, whereby parental genotypes influence offspring outcomes via environmental pathways rather than genetic transmission. Such genetic nurture effects also need to be accounted for to accurately estimate "direct" genetic effects (i.e., genetic effects on a trait originating in the offspring). Empirical studies have indicated that genetic nurture effects are particularly relevant to the intergenerational transmission of risk for child educational outcomes, which are, in turn, associated with major psychological and health milestones throughout the life course. These findings have yet to be systematically appraised across contexts. We conducted a systematic review and meta-analysis to quantify genetic nurture effects on educational outcomes. A total of 12 studies comprising 38,654 distinct parent(s)-offspring pairs or trios from 8 cohorts reported 22 estimates of genetic nurture effects. Genetic nurture effects on offspring's educational outcomes (ßgenetic nurture = 0.08, 95% CI [0.07, 0.09]) were smaller than direct genetic effects (ßdirect genetic = 0.17, 95% CI [0.13, 0.20]). Findings were largely consistent across studies. Genetic nurture effects originating from mothers and fathers were of similar magnitude, highlighting the need for a greater inclusion of fathers in educational research. Genetic nurture effects were largely explained by observed parental education and socioeconomic status, pointing to their role in environmental pathways shaping child educational outcomes. Findings provide consistent evidence that environmentally mediated parental genetic influences contribute to the intergenerational transmission of educational outcomes, in addition to effects due to genetic transmission.


Asunto(s)
Escolaridad , Interacción Gen-Ambiente , Patrón de Herencia , Padres , Adulto , Niño , Estudios de Cohortes , Familia , Femenino , Genotipo , Humanos , Masculino , Padres/educación , Padres/psicología , Fenotipo , Clase Social
14.
BMC Public Health ; 21(1): 1571, 2021 08 19.
Artículo en Inglés | MEDLINE | ID: mdl-34412612

RESUMEN

BACKGROUND: Occupational class is an integral part of socioeconomic status. The studies focused on the occupational difference in ischemic stroke outcome in a Chinese population are limited. We aimed to investigate the associations between occupational class and the prognosis of patients with ischemic stroke in China. METHODS: We included 1484 ischemic stroke participants (mean age: 63.42 ± 11.26 years) from the prospective cohort study: Infectious Factors, Inflammatory Markers and Prognosis of Acute Ischemic Stroke (IIPAIS). Occupational class was categorized into white-collar workers, blue-collar workers and farmers in our study. Study outcomes were cardiovascular events and all-cause mortality within 12 months after ischemic stroke onset. We applied Cox proportional hazard model to evaluate the associations between the occupational class and study outcomes after ischemic stroke. RESULTS: Within 12 months after ischemic stroke, there were 106 (7.5%) cardiovascular events and 69 (4.9%) all-cause deaths. The Kaplan-Meier plots showed that white-collar workers had highest risk of cardiovascular events after 12-month follow-up (Log-rank P = 0.02). Multivariate adjusted hazard ratio and 95% confidence intervals (CIs) of farmers versus white-collar workers was 0.43(0.20-0.91) for cardiovascular events. No significant difference showed in blue-collar workers versus white-collar workers, with fully adjusted hazard ratio 0.62(95% CIs, 0.23-1.67). CONCLUSIONS: Compared with white-collar workers, farmers are associated with less risk of cardiovascular events at 12 months after ischemic stroke, while there are no significant differences in blue-collar workers.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Anciano , Isquemia Encefálica/epidemiología , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Clase Social , Accidente Cerebrovascular/epidemiología
15.
BMC Public Health ; 21(1): 1591, 2021 08 26.
Artículo en Inglés | MEDLINE | ID: mdl-34445996

RESUMEN

BACKGROUND: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90% of HIV positive individuals ought to know their HIV status. This study examined socio-economic status (SES) differences in HIV testing uptake and associated factors among youth and adults 15 years and older in South Africa. METHODS: This study used data from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomised into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were used to examine factors associated with the uptake of HIV testing in low and high SES households. RESULTS: HIV testing uptake was 73.8 and 76.7% among low and high SES households, respectively, both of which were below the first 90 targets. Among both low and high SES households, increased HIV testing uptake was significantly associated with females than males. The decreased likelihood was significantly associated with residing in rural formal areas than urban areas, those with no education or low levels of educational attainment and alcohol drinkers among low SES households. Whites and Indians/Asians had a decreased likelihood than Black Africans in high SES households. CONCLUSIONS: HIV testing interventions should target males, residents in rural formal areas, those with no or low education and those that consume alcohol in low SES households, including Whites and Indians/Asians from high SES households in order to bridge socio-economic disparities in the uptake of HIV testing. This should entail expanding HIV testing beyond traditional centres for voluntary counselling and testing through outreach efforts, including mobile testing and home-based testing.


Asunto(s)
Composición Familiar , Prueba de VIH , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Clase Social , Factores Socioeconómicos , Sudáfrica/epidemiología
16.
JAMA Netw Open ; 4(8): e2129041, 2021 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-34459904

RESUMEN

Importance: Housing insecurity induced by evictions may increase the risk of contracting COVID-19. Objective: To estimate the association of lifting state-level eviction moratoria, which increased housing insecurity during the COVID-19 pandemic, with the risk of being diagnosed with COVID-19. Design, Setting, and Participants: This retrospective cohort study included individuals with commercial insurance or Medicare Advantage who lived in a state that issued an eviction moratorium and were diagnosed with COVID-19 as well as a control group comprising an equal number of randomly selected individuals in these states who were not diagnosed with COVID-19. Data were collected from OptumLabs Data Warehouse, a database of deidentified administrative claims. The study used a difference-in-differences analysis among states that implemented an eviction moratorium between March 13, 2020, and September 4, 2020. Exposures: Time since state-level eviction moratoria were lifted. Main Outcomes and Measures: The primary outcome measure was a binary variable indicating whether an individual was diagnosed with COVID-19 for the first time in a given week with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code U07.1. The study analyzed changes in COVID-19 diagnosis before vs after a state lifted its moratorium compared with changes in states that did not lift it. For sensitivity analyses, models were reestimated on a 2% random sample of all individuals in the claims database during this period in these states. Results: The cohort consisted of 509 694 individuals (254 847 [50.0%] diagnosed with COVID-19; mean [SD] age, 47.0 [23.6] years; 239 056 [53.3%] men). During the study period, 43 states and the District of Columbia implemented an eviction moratorium and 7 did not. Among the states that implemented a moratorium, 26 (59.1%) lifted their moratorium before the US Centers for Disease Control and Prevention issued their national moratorium, while 18 (40.1%) maintained theirs. In a Cox difference-in-differences regression model, individuals living in a state that lifted its eviction moratorium experienced higher hazards of a COVID-19 diagnosis beginning 5 weeks after the moratorium was lifted (hazard ratio [HR], 1.39; 95% CI, 1.11-1.76; P = .004), reaching an HR of 1.83 (95% CI, 1.36-2.46; P < .001) 12 weeks after. Hazards increased in magnitude among individuals with preexisting comorbidities and those living in nonaffluent and rent-burdened areas. Individuals with a Charlson Comorbidity Index score of 3 or greater had an HR of 2.37 (95% CI, 1.67-3.36; P < .001) at the end of the study period. Those living in nonaffluent areas had an HR of 2.14 (95% CI, 1.51-3.05; P < .001), while those living in areas with a high rent burden had an HR of 2.31 (95% CI, 1.64-3.26; P < .001). Conclusions and Relevance: The findings of this difference-in-differences analysis suggest that eviction-led housing insecurity may have exacerbated the COVID-19 pandemic.


Asunto(s)
COVID-19/etiología , Estado de Salud , Vivienda , Pandemias , Pobreza , Política Pública , Clase Social , Adulto , Anciano , Comorbilidad , Femenino , Personas sin Hogar , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2 , Estados Unidos
17.
Nutrients ; 13(8)2021 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-34445059

RESUMEN

Few Australians consume a healthy, equitable and more sustainable diet consistent with the Australian Dietary Guidelines (ADGs). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health problems. However, granular information on dietary intakes and affordability of recommended diets was lacking for low SEGs. The Healthy Diets Australian Standardised Affordability and Pricing protocol was modified for low SEGs to align with relevant dietary intakes reported in the National Nutrition Survey 2011-2012(which included less healthy and more discretionary options than the broader population), household structures, food purchasing habits, and incomes. Cost and affordability of habitual and recommended diets of low SEGs were calculated using prices of 'standard brands' and 'cheapest options'. With 'standard brands', recommended diets cost less than habitual diets, but were unaffordable for low SEGs. With 'cheapest options', both diets were more affordable, but recommended diets cost more than habitual diets for some low SEGs, potentially contributing to perceptions that healthy food is unaffordable. The study confirms the need for an equity lens to better target dietary guidelines for low SEGs. It also highlights urgent policy action is needed to help improve affordability of recommended diets.


Asunto(s)
Dieta Saludable/economía , Inseguridad Alimentaria/economía , Renta , Valor Nutritivo , Clase Social , Determinantes Sociales de la Salud/economía , Adolescente , Adulto , Anciano , Australia , Niño , Preescolar , Comportamiento del Consumidor/economía , Análisis Costo-Beneficio , Encuestas sobre Dietas , Conducta Alimentaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ingesta Diaria Recomendada/economía , Medición de Riesgo , Factores de Riesgo
18.
Nutrients ; 13(8)2021 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-34444661

RESUMEN

Breakfast has a critical role in energy balance and dietary regulation. Consequently, it is considered an important component of a healthy diet, especially in adolescence, when there are great opportunities to consolidate habits and establish future patterns of healthiness in adulthood. Socioeconomic position (SEP) causes inequalities that are reflected in health behaviors, physical activity, mental health, and diet. Therefore, we conducted a cross-sectional study using data from the 2019-2020 DESKcohort project (Spain) to explore the relationships between breakfast and sociodemographic characteristics, health-related behaviors, and school performance of 7319 adolescents. Our findings showed that the prevalence of skipping breakfast every day was 19.4% in girls and 13.7% in boys and was related to students' SEP. The risk of skipping breakfast was 30% higher in girls from the most disadvantaged SEP, in comparison to those in the most advanced SEP (prevalence ratio (PR) = 1.30; 95% confidence interval (CI) = 1.11-1.54). Also, boys from the most disadvantaged SEP showed 28% higher risk of skipping breakfast than those in the most advanced SEP (PR = 1.28; 95% CI = 1.04-1.59). In conclusion, future public policies should be adapted considering a SEP and gender perspective to avoid increasing nutritional and health inequalities.


Asunto(s)
Conducta del Adolescente , Desayuno , Dieta Saludable , Conducta Alimentaria , Disparidades en el Estado de Salud , Clase Social , Determinantes Sociales de la Salud , Adolescente , Factores de Edad , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Estado Nutricional , Valor Nutritivo , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , España , Estudiantes , Factores de Tiempo
19.
BMC Infect Dis ; 21(1): 726, 2021 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-34332552

RESUMEN

BACKGROUND: Despite efforts to stop HIV epidemic in Latin America, new HIV cases continue to increase in the region especially among young MSM (YMSM). This study aims to assess if sociodemographic characteristics are associated with self-reported HIV positive status among YMSM from three Latin American countries. METHODS: Cross-sectional web-based survey advertised on dating apps (Grindr and Hornet) and Facebook in Brazil, Mexico and Peru. For this analysis, we included YMSM aged 18-24 years who self-reported their HIV status. We used multivariable logistic regression models for each country separately to verify if sociodemographic characteristics (race, education and income) were associated with HIV self-reported status after adjusting for behavior characteristics (sexual attraction and steady partner). RESULTS: Among 43,687 MSM who initiated the questionnaire, 27,318 (62.5%) reported their HIV status; 7001 (25.6%) of whom were YMSM. Most YMSM (83.4%) reported an HIV test in the past year, and 15.7% reported an HIV positive status in Peru, 8.4% in Mexico and 7.7% in Brazil. In adjusted models, low-income was associated with higher odds of self-reported HIV positive status in Brazil (aOR = 1.33, 95%CI: 1.01-1.75) and Peru (aOR = 1.56, 95%CI: 1.02-2.40), but not in Mexico. Lower education was associated with higher odds of self-reported HIV positive status only in Brazil (aOR = 1.35, 95%CI: 1.05-1.75). CONCLUSIONS: In this large, cross-country study, self-reported HIV positive status among YMSM was high. Lower socioeconomic status was associated with higher odds of self-reported HIV positive status in Brazil and Peru. There is an urgent need for HIV prevention interventions targeting YMSM, and efforts to address low-income YMSM are especially needed in Peru and Brazil.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Brasil/epidemiología , Estudios Transversales , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Humanos , Masculino , Perú/epidemiología , Autoinforme , Conducta Sexual , Clase Social
20.
Int J Equity Health ; 20(1): 191, 2021 08 26.
Artículo en Inglés | MEDLINE | ID: mdl-34445998

RESUMEN

PURPOSE: Few studies explored the relationship between the family doctor contract services (FDCS) and health-related quality of life (HRQOL) among patients with chronic diseases in rural China. This study aims to explore the relationship between the status of signing on FDCS and HRQOL among patients with chronic diseases and examine whether there are differences in the relationship between different socioeconomic status (SES). METHODS: A total of 1,210 respondents were included in this study. HRQOL was measured by EQ-5D-3L. The contracting status was divided into uncontracted and contracted. Tobit regression and Logistic regression were employed to explore the association between contracting status and HRQOL. The interaction terms were included to explore the differences in the association among different SES. RESULTS: Contracting with family doctors was associated with HRQOL (coefficient = 0.042; 95%CI 0.008 to 0.075). The association was different among different socioeconomic levels that the contracting status was only associated with HRQOL in sub-high-income (P < 0.01) and highly educated patients (P < 0.05). Compared with uncontracted patients, contracted patients reported higher ED-5D-3L utility value in the sub-high-income group (coefficient = 0.078; 95%CI 0.017 to 0.140) and high educational attainment (coefficient = 0.266; 95%CI 0.119 to 0.413). CONCLUSIONS: This study found a significant association between FDCS and HRQOL among chronic patients in rural Shandong, China. This relationship varied by income levels and educational attainment. The government should take efforts to formulate a variety of measures to encourage chronic patients to contract with family doctors, with special attention to people with low SES.


Asunto(s)
Enfermedad Crónica , Servicios Contratados , Médicos de Familia , Calidad de Vida , Anciano , China , Enfermedad Crónica/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Rural/estadística & datos numéricos , Clase Social
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