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Global polls have shown that people in high-income countries generally report being more satisfied with their lives than people in low-income countries. The persistence of this correlation, and its similarity to correlations between income and life satisfaction within countries, could lead to the impression that high levels of life satisfaction can only be achieved in wealthy societies. However, global polls have typically overlooked small-scale, nonindustrialized societies, which can provide an alternative test of the consistency of this relationship. Here, we present results from a survey of 2,966 members of Indigenous Peoples and local communities among 19 globally distributed sites. We find that high average levels of life satisfaction, comparable to those of wealthy countries, are reported for numerous populations that have very low monetary incomes. Our results are consistent with the notion that human societies can support very satisfying lives for their members without necessarily requiring high degrees of monetary wealth.
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Renda , Satisfação Pessoal , Humanos , Pobreza , Sociedades , Problemas SociaisRESUMO
How social inequality is describedas advantage or disadvantagecritically shapes individuals' responses to it [e.g., B. S. Lowery, R. M. Chow, J. R. Crosby, J. Exp. Soc. Psychol. 45, 375378, 2009]. As such, it is important to document how people, in fact, choose to describe inequality. In a corpus of 18,349 newspaper articles (study 1), in 764 hand-coded news media publications (study 2), and in a preregistered experiment of 566 lay participants (study 3), we document the presence of chronic frames of race, gender, and wealth inequality. Specifically, race and gender inequalities are more likely to be framed as subordinate groups' disadvantages than as dominant groups' advantages, and wealth inequality is more likely to be described with no frame (followed by dominant group advantage, then subordinate group disadvantage). Supplemental lexicon-based text analyses in studies 1 and 2, survey results in study 3, and a preregistered experiment (study 4; N = 578) provide evidence that the differences in chronic frames are related to the perceived legitimacy of the inequality, with race and gender inequalities perceived as less legitimate than wealth inequality. The presence of such chronic frames and their association with perceived legitimacy may be mechanisms underlying the systematic inattention to White individuals' and men's advantages, and the disadvantages of the working class.
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Identidade de Gênero , Meios de Comunicação de Massa , Grupos Raciais , Fatores Socioeconômicos , Feminino , Humanos , Masculino , Grupos Raciais/psicologia , Estados Unidos , População BrancaRESUMO
How much happiness could be gained if the world's wealth were distributed more equally? Despite decades of research investigating the relationship between money and happiness, no experimental work has quantified this effect for people across the global economic spectrum. We estimated the total gain in happiness generated when a pair of high-net-worth donors redistributed US$2 million of their wealth in $10,000 cash transfers to 200 people. Our preregistered analyses offer causal evidence that cash transfers substantially increase happiness among economically diverse individuals around the world. Recipients in lower-income countries exhibited happiness gains three times larger than those in higher-income countries. Still, the cash provided detectable benefits for people with household incomes up to $123,000.
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Felicidade , Renda , Humanos , TempoRESUMO
Lakes face threats from human activities like unsustainable development, population growth and industrial technologies. These challenges impact the ecosystem services of lakes. Research has assessed the monetary value of services from freshwater biomes annually. This article reviews these values, estimating lakes' global ecosystem services to be within the region of USD 1.3-5.1 trillion annually. Their natural asset value is estimated at USD 87-340 trillion, comparable to the monetary value of global real estate, assuming a relatively high social discount rate to account for future increased standards of living. Considering environmental degradation, future generations may experience a lower living standard. Using a 0.1% discount rate, recognizing potential harm and aligning with indigenous values raises the lakes' value to USD 1300-5100 trillion, which is at least equal to the global monetary value of wealth created. This valuation is shared by all as a collective asset, unlike the skewed distribution of created wealth.
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Ecossistema , Lagos , Humanos , Conservação dos Recursos NaturaisRESUMO
Scholars, activists, and policymakers have long called for reparations - a process of repair and restitution for harm and injustices done - to descendants of enslaved Africans in the U.S. as a structural intervention to address historic and ongoing injustices. However, there has been very limited epidemiologic work examining reparations. We explore some of the epidemiologic benefits and challenges of using causal inference frameworks to model reparations as an example of a large-scale, structural intervention that pushes the limits of what is considered "well-defined" and may violate key identification assumptions. Finally, we weigh these methodological limitations with the utility of assessing public health implications of reparations policies and conclude by discussing implications for future epidemiologic research.
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BACKGROUND: Aggregate trends can be useful for summarizing large amounts of information, but this can obscure important distributional aspects. Some population subgroups can be worse off even as averages climb, for example. Distributional information can identify health inequalities, which is essential to understanding their drivers and possible remedies. METHODS: Using publicly available Demographic and Health Survey (DHS) data from 41 sub-Saharan African countries from 1986 to 2019, we analyzed changes in coverage for eight key maternal and child health indicators: first dose of measles vaccine (MCV1); Diphtheria-Pertussis-Tetanus (DPT) first dose (DPT1); DPT third dose (DPT3); care-seeking for diarrhea, acute respiratory infections (ARI), or fever; skilled birth attendance (SBA); and having four antenatal care (ANC) visits. To evaluate whether coverage diverged or converged over time across the wealth gradient, we computed several dispersion metrics including the coefficient of variation across wealth quintiles. Slopes and 5-year moving averages were computed to identify overall long-term trends. RESULTS: Average coverage increased for all quintiles and indicators, although the range and the speed at which they increased varied widely. There were small changes in the wealth-related gap for SBA, ANC, and fever. The wealth-related gap of vaccination-related indicators (DPT1, DPT3, MCV1) decreased over time. Compared to 2017, the wealth-gap between richest and poorest quintiles in 1995 was 7 percentage points larger for ANC and 17 percentage points larger for measles vaccination. CONCLUSIONS: Maternal and child health indicators show progress, but the distributional effects show differential evolutions in inequalities. Several reasons may explain why countries had smaller wealth-related gap trends in vaccination-related indicators compared to others. In addition to service delivery differences, we hypothesize that the allocation of development assistance for health, the prioritization of vaccine-preventable diseases on the global agenda, and indirect effects of structural adjustment programs on health system-related indicators might have played a role.
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Saúde da Criança , Saúde Materna , Criança , Feminino , Humanos , Gravidez , África Subsaariana/epidemiologia , Diarreia , FebreRESUMO
BACKGROUND: The association between negative wealth shocks and depression among middle-aged and older individuals remains unclear. Our study aimed to assess the association between negative wealth shocks and depression and its trajectories, and to explore cross-national differences in these associations. METHODS: Our sample included 21 999 participants, of which 9519 were from the Health and Retirement Study (2012-2020), 4936 from the English Longitudinal Study of Ageing (2012-2020), 2520 from the China Health and Retirement Longitudinal Study (2011-2020), and 5024 from the Mexican Health and Aging Study (2012-2021). We used latent class trajectory models to identify depressive trajectories, alongside mixed-model logistic regression and multinomial logistic regression to evaluate associations. RESULTS: In the USA (OR 1.73, 95% CI 1.40-2.16), England (OR 1.71, 95% CI 1.09-2.70), and China (OR 1.38, 95% CI 1.09-1.75), negative wealth shocks were associated with subsequent depressive symptoms, but not in Mexico (OR 1.06, 95% CI 0.86-1.29). Additionally, negative wealth shocks were associated with several depressive trajectories in the USA and China. This association occurred only in increasing-decreasing trajectory in England, while no significant association was found across any trajectory in Mexico. CONCLUSIONS: Negative wealth shocks were associated with subsequent depressive symptoms, with significant associations observed in some specific depressive trajectories. These associations exhibited cross-national differences, underscoring the importance of considering country-specific contexts when addressing the mental health impacts of wealth shocks.
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BACKGROUND: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. METHODS: We used information on 109,439 women of reproductive age (15-49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. RESULTS: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15-24 (OR: 12.01, p < 0.001) and 25-34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. CONCLUSION: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country.
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Intervalo entre Nascimentos , Fatores Socioeconômicos , Humanos , Índia/epidemiologia , Feminino , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Prevalência , Inquéritos Epidemiológicos , Disparidades nos Níveis de SaúdeRESUMO
Wealth-based disparities in health care wherein the poor receive undertreatment in painful conditions are a prominent issue that requires immediate attention. Research with adults suggests that these disparities are partly rooted in stereotypes associating poor individuals with pain insensitivity. However, whether and how children consider a sufferer's wealth status in their pain perceptions remains unknown. The present work addressed this question by testing 4- to 9-year-olds from the US and China. In Study 1 (N = 108, 56 girls, 79% White), US participants saw rich and poor White children experiencing identical injuries and indicated who they thought felt more pain. Although 4- to 6-year-olds responded at chance, children aged seven and above attributed more pain to the poor than to the rich. Study 2 with a new sample of US children (N = 111, 56 girls, 69% White) extended this effect to judgments of White adults' pain. Pain judgments also informed children's prosocial behaviors, leading them to provide medical resources to the poor. Studies 3 (N = 118, 59 girls, 100% Asian) and 4 (N = 80, 40 girls, 100% Asian) found that, when evaluating White and Asian people's suffering, Chinese children began to attribute more pain to the poor than to the rich earlier than US children. Thus, unlike US adults, US children and Chinese children recognize the poor's pain from early on. These findings add to our knowledge of group-based beliefs about pain sensitivity and have broad implications on ways to promote equitable health care. RESEARCH HIGHLIGHTS: Four studies examined whether 4- to 9-year-old children's pain perceptions were influenced by sufferers' wealth status. US children attributed more pain to White individuals of low wealth status than those of high wealth status by age seven. Chinese children demonstrated an earlier tendency to attribute more pain to the poor (versus the rich) compared to US children. Children's wealth-based pain judgments underlied their tendency to provide healthcare resources to people of low wealth status.
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Alocação de Recursos para a Atenção à Saúde , Dor , Criança , Feminino , Adulto , Humanos , Pré-Escolar , Percepção da Dor , ChinaRESUMO
BACKGROUND: This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological advancement. METHODS: After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home ownership. RESULTS: The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several years. CONCLUSIONS: Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at improving income and financial wealth could be useful and effective. The methodological approach described in this paper could also be applied to other research settings or topics.
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Pobreza , Humanos , Países Baixos , Estudos Longitudinais , Análise de Classes Latentes , Feminino , Masculino , Renda , Nível de Saúde , Adulto , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Sleep disorders are common among older adults, leading to high prevalence of over-the-counter and prescription sleep medication use. Socioeconomically disadvantaged individuals have higher prevalence of sleep disorders. Frequent use of sleep medications can increase the risk of falls. Little is known about the association between wealth and sleep medication use in older adults. METHODS: We conducted a cross-sectional analysis using a nationwide sample of 7603 Medicare beneficiaries (65+ years) from Round 1 (2011) of the National Health and Aging Trends Study. We measured self-reported wealth as the sum of assets (retirement savings, stocks/bonds, checking/savings accounts, business assets, and home value) minus liabilities (mortgage, credit card, and medical debt). Self-reported sleep medication use in the past month was categorized as frequent (5-7 nights/week), sometimes (1-4 nights/week), or never (0 night/week). We estimated differences in the prevalence of sleep medication use by quintiles of wealth using crude and adjusted binomial regression models. Individuals missing sleep medication information were excluded. RESULTS: Median wealth was $152 582 (IQR: $24 023-412 992). Sixteen percent reported frequent sleep medication use, 15% reported some use, and 70% reported no use. Frequent sleep medication use was more common in lower wealth quintiles (lowest: 20%, highest: 12%). Alternatively, some use was more common in higher wealth quintiles (lowest: 11%, highest: 18%). Results were similar after adjustment for demographic factors, anxiety, depression, and sleep disorders. CONCLUSIONS: In this study, less wealthy older adults had higher prevalence of frequent sleep medication use. This may lead to dependency or increased fall risk in this vulnerable population.
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Medicamentos sob Prescrição , Transtornos do Sono-Vigília , Humanos , Idoso , Estados Unidos/epidemiologia , Medicare , Estudos Transversais , Medicamentos sem Prescrição , Medicamentos sob Prescrição/efeitos adversos , Sono , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/epidemiologiaRESUMO
Microplastics (MPs), as emerging indoor contaminants, have garnered attention due to their ubiquity and unresolved implications for human health. These tiny particles have permeated indoor air and water, leading to inevitable human exposure. Preliminary evidence suggests MP exposure could be linked to respiratory, gastrointestinal, and potentially other health issues, yet the full scope of their effects remains unclear. To map the overall landscape of this research field, a bibliometric analysis based on research articles retrieved from the Web of Science database was conducted. The study synthesizes the current state of knowledge and spotlights the innovative mitigation strategies proposed to curb indoor MP pollution. These strategies involve minimizing the MP emission from source, advancements in filtration technology, aimed at reducing the MP exposure. Furthermore, this research sheds light on cutting-edge methods for converting MP waste into value-added products. These innovative approaches not only promise to alleviate environmental burdens but also contribute to a more sustainable and circular economy by transforming waste into resources such as biofuels, construction materials, and batteries. Despite these strides, this study acknowledges the ongoing challenges, including the need for more efficient removal technologies and a deeper understanding of MPs' health impacts. Looking forward, the study underscores the necessity for further research to fill these knowledge gaps, particularly in the areas of long-term health outcomes and the development of standardized, reliable methodologies for MP detection and quantification in indoor settings. This comprehensive approach paves the way for future exploration and the development of robust solutions to the complex issue of microplastic pollution.
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Poluição do Ar em Ambientes Fechados , Bibliometria , Microplásticos , Microplásticos/análise , Poluição do Ar em Ambientes Fechados/prevenção & controle , Poluição do Ar em Ambientes Fechados/análise , Humanos , Monitoramento Ambiental/métodosRESUMO
INTRODUCTION: The United Nations report in 2021 ranks Pakistan 21st among countries with the highest infant and child mortality rate in the world. It is the fifth most populous country in the world with a growth rate of 2% annually. Therefore, understanding child mortality is crucial to reducing the child mortality burden. METHOD: The research utilized two waves of the Pakistan Demographic and Health Survey (PDHS), 2012-13 and 2017-18. The data are analyzed using logistic regression with interaction effects of household wealth status and propensity score matching techniques. RESULTS: The study reveals a positive link between polygyny and infant and child mortality. The odd ratios higher than "1" indicate increased mortality risk for infants and children belonging to polygynous families taking monogamous families as a reference category. Mortality risk is higher among children (OR 1.50 CI 0.18-12.63) as compared with infants (OR 1.28 CI 0.37-4.45). The main effect of household shows a negative association with infant and child mortality while after interacting with polygyny it turns out to be positive. The mortality risks increase with increasing wealth status. It can be translated as a positive link between household wealth status, and infant and child mortality in the context of polygyny. CONCLUSION: Infants and children belonging to polygynous families experience increased mortality risk as compared with monogamous families. The household wealth status may not help improve child mortality.
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OBJECTIVE: Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities. DESIGN: We used cross-sectional data from the 2015-2016 Tanzania Demographic and Health Survey. SETTING: A nationally representative survey. PARTICIPANTS: Totally, 2867 children (aged 6-23 months) and their mothers (aged 15-49 years). The mother-child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity. RESULTS: The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (Pfor interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother-child pairs who did not achieve minimum dietary diversity (Pfor trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (Pfor trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers). CONCLUSIONS: Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.
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Dieta , Características da Família , Desnutrição , Fatores Socioeconômicos , Humanos , Tanzânia/epidemiologia , Feminino , Estudos Transversais , Adulto , Adolescente , Masculino , Pessoa de Meia-Idade , Desnutrição/epidemiologia , Desnutrição/economia , Adulto Jovem , Dieta/estatística & dados numéricos , Dieta/economia , Lactente , Prevalência , Mães/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Abastecimento de Alimentos/economia , Inquéritos EpidemiológicosRESUMO
OBJECTIVE: Research is available on improved coverage and practices from several large-scale maternal nutrition programmes, but not much is known on change in inequalities. This study analyses wealth and education inequality using Erreygers and Concentration indices for four indicators: adequate iron and folic acid (IFA) consumption, women's dietary diversity, and counselling on IFA and dietary diversity. DESIGN: A pre-test-post-test, control group design. SETTING: Maternal nutrition intervention programmes conducted in Bangladesh, Burkina Faso and Ethiopia during 2015-2022. PARTICIPANTS: Recently delivered women (RDW) and pregnant women (PW). RESULTS: Statistically significant reductions in education inequality were observed for adequate IFA consumption, counselling on IFA and dietary diversity in intervention areas of Bangladesh and for adequate IFA consumption in intervention areas of Burkina Faso.A significant decrease in wealth inequality was observed for adequate IFA consumption in the intervention areas of Bangladesh, whereas a significant increase was observed in the non-intervention areas for counselling on IFA in Ethiopia and for dietary diversity in Burkina Faso. CONCLUSION: The results can be attributed to the extensive delivery system at community level in Bangladesh and being predominantly facility-based in Burkina Faso and Ethiopia. COVID-19 disruptions (in Burkina Faso and Ethiopia) and indicator choice also had a role in the results.The main takeaways for nutrition programmes are as follows: (a) assessing inequality issues through formative studies during designing, (b) monitoring inequality indicators during implementation, (c) diligently addressing inequality through targeted interventions, setting aside resources and motivating frontline workers to reduce disparities and (d) making inequality analysis a routine part of impact evaluations.
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Dieta , Ácido Fólico , Fenômenos Fisiológicos da Nutrição Materna , Fatores Socioeconômicos , Humanos , Feminino , Gravidez , Ácido Fólico/administração & dosagem , Etiópia , Bangladesh , Adulto , Dieta/estatística & dados numéricos , Burkina Faso , Países em Desenvolvimento , Adulto Jovem , Ferro/administração & dosagem , Gestantes , Ferro da Dieta/administração & dosagem , SARS-CoV-2RESUMO
PURPOSE: Mental health is shaped by social and economic contexts, which were altered during the COVID-19 pandemic. No study has systematically reviewed the literature on the relation between different assets and depression during the COVID-19 pandemic. METHODS: We conducted a systematic review of the literature on financial (e.g. income/savings), physical (e.g., home ownership), and social (e.g., marital status, educational attainment) assets and depression in U.S. adults. For each asset type, we created binary comparisons to report on the direction of the relationship and described if each study reported insignificant, positive, negative, or mixed associations. RESULTS: Among the 41 articles identified, we found that income was the most studied asset (n=34), followed by education (n=25), marital status (n=18), home ownership (n=5), and savings (n=4). 88%, 100%, and 100% of articles reported a significant association of higher income, home ownership, and higher savings, respectively, with less depression. The association between marital status and education with depression was more nuanced: 72% (13 of 18) studies showed that unmarried persons had greater risk of depression than married or cohabitating persons and 52% (13 of 25) of studies reported no significant difference in depression across educational groups. CONCLUSION: This work adds to the literature a deeper understanding of how different assets relate to depression. In the context of largescale traumatic events, policies that maintain and protect access to social, physical, and financial assets may help to protect mental health.
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COVID-19 , Depressão , Adulto , Humanos , Fatores Socioeconômicos , Depressão/epidemiologia , Depressão/psicologia , Pandemias , COVID-19/epidemiologia , RendaRESUMO
BACKGROUND: Ethiopia has made strides in reducing maternal mortality, but significant discrepancies in maternal health service utilization exist across socioeconomic levels. According to studies, women from higher-income households are far more likely to use essential services such as antenatal care, delivery care, and postnatal care than poorer women. This wealth disparity is a primary contributor to persistently high maternal mortality, particularly among poor populations. The study's goal was to assess wealth disparities in maternal health service uptake and identify contributing factors. METHODS AND MATERIALS: We used the Ethiopian Mini Demographic Health Survey (EMDHS), conducted in 2019 on women aged 15-49 living in selected census areas, with a weighted sample size of 3,909. The Erreygers Concentration Index (ECI) was used to measure wealth inequalities in maternal health care, and the ECI decomposition was used to identify factors contributing to inequality in maternal health services. RESULTS: Maternal health service utilization was pro-rich among women in Ethiopia. The prevalence of antenatal care service (ANC), delivery, and postnatal care (PNC) service utilization showed a pro-rich distribution among Ethiopian women, with ECI = 0.115 (95% CI: 0.091-0.137), ECI = 0.223 (95% CI: 0.191-0.276), and ECI = 0.121 (95% CI: 0.041-0.200), respectively. The ECI indices were decomposed to examine the contributing factors to disparities in maternal service utilization in Ethiopia. Mother's current age, household family size, region, birth order, and parity were contributors to maternal health service utilization. CONCLUSION: The ANC service, delivery service and PNC service utilization showed a pro-rich distribution among Ethiopian women. Mother's current age, household family size, region, birth order, and parity are important contributors of maternal health service inequality. To improve access and usage among low-income women, policymakers can develop programs including increasing the number of free or subsidized services and providing transportation.
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Disparidades em Assistência à Saúde , Serviços de Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde , Fatores Socioeconômicos , Humanos , Feminino , Etiópia , Adulto , Serviços de Saúde Materna/estatística & dados numéricos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Gravidez , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricosRESUMO
The feathers of tropical birds were one of the most significant symbols of economic, social, and sacred status in the pre-Columbian Americas. In the Andes, finely produced clothing and textiles containing multicolored feathers of tropical parrots materialized power, prestige, and distinction and were particularly prized by political and religious elites. Here we report 27 complete or partial remains of macaws and amazon parrots from five archaeological sites in the Atacama Desert of northern Chile to improve our understanding of their taxonomic identity, chronology, cultural context, and mechanisms of acquisition. We conducted a multiproxy archaeometric study that included zooarchaeological analysis, isotopic dietary reconstruction, accelerated mass spectrometry radiocarbon dating, and paleogenomic analysis. The results reveal that during the Late Intermediate Period (1100 to 1450 CE), Atacama oasis communities acquired scarlet macaws (Ara macao) and at least five additional translocated parrot species through vast exchange networks that extended more than 500 km toward the eastern Amazonian tropics. Carbon and nitrogen stable isotopes indicate that Atacama aviculturalists sustained these birds on diets rich in marine bird guano-fertilized maize-based foods. The captive rearing of these colorful, exotic, and charismatic birds served to unambiguously signal relational wealth in a context of emergent intercommunity competition.
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Amazona/fisiologia , Fósseis/anatomia & histologia , Animais de Estimação/fisiologia , Amazona/classificação , Animais , Chile , Dieta , Plumas/anatomia & histologia , Animais de Estimação/classificação , FilogeografiaRESUMO
When the first rice farmers expanded into Southeast Asia from the north about 4,000 y ago, they interacted with hunter-gatherer communities with an ancestry in the region of at least 50 millennia. Rigorously dated prehistoric sites in the upper Mun Valley of Northeast Thailand have revealed a 12-phase sequence beginning with the first farmers followed by the adoption of bronze and then iron metallurgy leading on to the rise of early states. On the basis of the burial rituals involving interment with a wide range of mortuary offerings and associated practices, we identify, by computing the values of the Gini coefficient, at least two periods of intensified social inequality. The first occurred during the initial Bronze Age that, we suggest, reflected restricted elite ownership of exotic valuables within an exchange choke point. The second occurred during the later Iron Age when increased aridity stimulated an agricultural revolution that rapidly led to the first state societies in mainland Southeast Asia.
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BACKGROUND: Globally, the increasing use of digital technologies such as mobile phones and the internet has allowed for the development of innovative mobile health interventions, particularly for reaching and engaging with youth. However, there is a risk that using such technologies may exclude those who lack access to them. OBJECTIVE: In this study, we investigated the sociodemographic factors associated with mobile phone ownership, internet use, and social media use among youth in Zimbabwe. METHODS: A population-based prevalence survey was conducted in 24 urban and periurban communities across 3 provinces of Zimbabwe (Harare, Mashonaland East, and Bulawayo). Youths aged 18 to 24 years resident in randomly selected households in the study communities completed an interviewer-administered questionnaire. The primary outcomes were mobile phone ownership and current internet and social media use. A household wealth indicator was developed using principal components analysis, based on household asset ownership. Multivariable logistic regression was used to investigate the factors associated with each primary outcome. Age, sex, and province were considered a priori confounders. Household wealth, marital status, education level, employment status, time lived at current address, and HIV status were included in the final multivariable model if there was an age-, sex-, and province-adjusted association with a primary outcome on univariable analysis at a significance level of P<.10. RESULTS: Of the 17,636 participants assessed for the primary outcome, 16,370 (92.82%) had access to a mobile phone, and 15,454 (87.63%) owned a mobile phone. Among participants with access to a mobile phone, 58.61% (9594/16,370) and 57.79% (9460/16,370), respectively, used internet and social media at least weekly. Older age (adjusted odds ratio [aOR] 1.76, 95% CI 1.55-2.00), increasing wealth (ranging from aOR 1.85, 95% CI 1.58-2.16, for wealth quintile 2 to aOR 3.80, 95% CI 3.00-4.80, for wealth quintile 5, with quintile 1 as reference), and higher education level (secondary: aOR 1.96, 95% CI 1.60-2.39; tertiary: aOR 8.36, 95% CI 5.29-13.20) were associated with mobile phone ownership. Older age, male sex, increasing wealth, having never been married, higher education level, being in education or formal employment, and having lived at the same address for ≥2 years were associated with higher levels of internet and social media use. CONCLUSIONS: While mobile phone ownership was near-universal, over one-third of youths in urban and periurban settings did not have access to the internet and social media. Access to the internet and social media use were strongly associated with household wealth and education level. Mobile health interventions must ensure that they do not amplify existing inequalities in access to health care. Such interventions must be accompanied by alternative strategies to engage and enroll individuals without internet or social media access to prevent the exclusion of young people by sex and socioeconomic status.