Examining direct and indirect flood damages in residential and business sectors through an empirical lens.

Investment to reduce flood risk for social and economic wellbeing requires quantitative evidence to guide decisions. Direct and indirect flood damages at individual household and business building levels were assessed in this study using multivariate analysis with three groups of flood damage attributes, i.e., flood characteristics, socioeconomic conditions, and building types. A total of 172 and 45 respondents from residential and commercial buildings were gathered through door-to-door interviews at areas in Peninsular Malaysia that were pre-identified to have frequently flooded. Two main findings can be drawn from this study. First, flood damage is greatly contributed by high-income households and businesses, despite them being less exposed to floods than low-income earners. This supports the current use of mean economic damage in engineering-based flood intervention analysis. Second, indirect damages increase with the increase in family size, indicating the importance of strengthening preparedness and social support to those with great social responsibility. Overall, the study highlights the importance of holistic flood management accounting for both direct and indirect losses.

Communication inequalities in the COVID-19 pandemic: socioeconomic differences and preventive behaviors in the United States and South Korea.

BACKGROUND: Communication inequalities are important mechanisms linking socioeconomic backgrounds to health outcomes. Guided by the structural influence model of communication, this study examined the intermediate role of health communication in the relationship between education, income, and preventive behavioral intentions during the COVID-19 pandemic in the United States and South Korea. METHODS: The data were collected through two online surveys conducted by two professional research firms in the US (April 1-3, 2020) and South Korea (April 9-16, 2020). To test the mediating role of health communication, as well as the hypothesized relationships in the proposed model, we performed a path analysis using Mplus 6.1. RESULTS: In analyzing survey data from 1050 American and 1175 Korean adults, we found that one's socioeconomic positions were associated with their intentions to engage in COVID-19 preventive behaviors through affecting their health communication experiences and then efficacious beliefs. Differences in education and income were associated with willingness to engage in preventive behaviors by constraining health communication among people with low levels of education and income. The findings showed notable differences and some similarities between the US and South Korea. For example, while income was positively associated with health communication in both US and South Korea, education was only significantly related to health communication in US but not in South Korea. CONCLUSIONS: This study suggests health communication strategies such as choice of communication channels and messages to promote intention for COVID-19 prevention behaviors in particular consideration of individual differences in socioeconomic positions in countries with different cultural features. Pubic policies and health campaigns can utilize the suggestions to promote efficacy and preventive behavioral intention during early pandemics.

Factors associated with adolescent birth in Indonesia: a national survey.

INTRODUCTION: Adolescent birth has many negative impacts on the development of a country. Preparing for pregnancy needs to be done from adolescence so that adolescents and women are healthy during pregnancy and give birth to healthy babies. In Indonesia, the adolescent birth rate is still high. This study aimed to identify the determinants of adolescent birth (birth at ages 15-19 years) in Indonesia. METHODS: This study was a quantitative study using secondary data from the 2019 Government Performance and Accountability Survey, the result of a collaboration between the National Population and Family Planning Board and Central Bureau of Statistics, with representative sample coverage at province and national levels (n=7786). Simple and multiple logistic regression tests were used to analyze data in this study. RESULTS: Total responses in this study were 7786, of whom 373 had had an adolescent birth (4.8%). Significant factors for adolescent birth were working, coming from a rural area, having a low level of welfare and first having sexual intercourse at ages 15-19 years. Level of education, having information on family planning, having access to print or electronic media, and age at first marriage had no significant effect on adolescent birth. CONCLUSION: This study concludes that the most influential factor for adolescent birth is the age of first having sexual intercourse. The authors suggest designing media more suitable to the needs of adolescents to prevent early sexual intercourse and reduce the high adolescent birth rate in Indonesia.

Women's barriers for contacting their general practitioner when bothered by urinary incontinence: a population-based cross-sectional study.

BACKGROUND: Urinary incontinence (UI) is a frequently occurring condition among women and increases with age. Effective treatments exist but many women hesitate to contact their general practitioner (GP) regarding UI. Therefore, it is important to generate knowledge regarding barriers for healthcare-seeking. Several factors such as age, duration and number of symptoms are associated with healthcare-seeking. How socioeconomic status (SES) is associated with experiencing barriers for healthcare-seeking for UI has not been explored. The objectives of this study were to: (1) analyze frequencies of barriers for healthcare-seeking, and (2) investigate associations between SES and barriers for contacting the GP, among women reporting bothersome UI. METHOD: A cross-sectional web-based questionnaire study of symptoms occurrence among 51,090 randomly selected women. This study investigates reported symptoms of three types of UI (stress UI, urge UI and UI without stress or urge) and reported barriers for GP contact combined with register data on SES. RESULTS: A total of 4,051 (16.4%) women reported to be bothered by either stress UI (9.1%), urge UI (4.0%) or incontinence without stress or urge (2.4%) and 76.3%, 70%, and 64% respectively, had not contacted their GP regarding the symptom(s). The most frequently reported barriers were 'being too embarrassed' (19.3%) and 'being too busy' (18.4%) for stress incontinence, and 'being too embarrassed (19.0%) or 'worried about wasting the doctor's time' (16.9%) for women with bothersome urge UI or UI without stress or urge. Younger women had higher odds of reporting barriers and the barriers embarrassment and being worried about what the doctor might find were significantly associated with lower educational level. CONCLUSION: Women with lower educational level have an increased risk of not seeking healthcare for UI symptoms. The GP should be aware of identifying women bothered by UI for whom effective treatment options to alleviate the symptoms are available.

Effect of socioeconomic characteristics and lifestyle on BMI distribution in the Chinese population: a population-based cross-sectional study.

BACKGROUND: Body mass index (BMI) is an accepted measurement that is widely used to quantify overweight and obesity at the population level. Previous studies have described the distribution variation of BMI through applying common statistical approaches, such as multiple linear or logistic regression analyses. This study proposed that associations between BMI and socioeconomic characteristics, diet, and lifestyle factors varied across the conditional BMI distribution. METHODS: This study was based on a sample of 10,023 Chinese adults who participated in the monitoring of chronic diseases and associated risk factors in Shaanxi Province, Northwest China, in 2013. Cross-quantile factors were observed in the relationships between major risk factors and BMI through quantile regression (QR) and ordinary least squares (OLS) regression. RESULTS: Participants' mean BMI was 24.19 ± 3.51 kg/m2 (range 14.33-52.82 kg/m2). The QR results showed that living in urban areas was associated with BMI in the low and central quantiles (10th-60th). Participants with 6-9 years of education were 0.23-0.38 BMI units higher in the first half of the BMI quantiles compared with those with ≤6 years of education. There was a positive association between consumption of red meat and BMI; however, the association diminished from the 10th to the 50th quantile. Intake of oil and alcohol were positively associated with all BMI quantiles. Cigarette smoking per day was negatively associated with BMI, which showed a U-shaped distribution. The above results were also observed in the OLS. CONCLUSION: This study implies that in addition to socioeconomic characteristics, limiting oil and alcohol intake may decrease BMI score. Consuming more red meat could be a strategy to increase BMI.

Socioeconomic status and barriers for contacting the general practitioner when bothered by erectile dysfunction: a population-based cross-sectional study.

BACKGROUND: Erectile dysfunction (ED) is common and impacts psychosocial wellbeing negatively. Many do not seek medical attention and several barriers for healthcare seeking with ED exist. Little is known about the association between socioeconomic characteristics of the patient and barriers for healthcare-seeking for men bothered by ED. The objectives of the study were 1) to estimate the proportion of men bothered by ED, who do not contact the GP, 2) to analyse the frequencies of selected barriers for healthcare seeking and 3) to analyse associations between socioeconomic factors and barriers for contacting the GP. METHODS: Data derive from a nationwide survey of symptom experiences among 100,000 randomly selected individuals aged 20 years and above. The questionnaire comprises, among other, questions about ED. This study focuses on men who reported bothersome ED and further reported, that they did not contact a GP regarding the symptom. Questions addressing barriers regarding GP contact included embarrassment, worrying about wasting the doctor's time, being too busy, and worrying about what the doctor might find. Information about socioeconomic characteristics was obtained from Statistics Denmark. RESULTS: A total of 4072 men (18.3%) reported that they had experienced ED within the past four weeks. Of those, 2888 (70.9%) were categorized as having bothersome ED. In the group of men with bothersome ED 1802 (62.4%) did not contact the GP and 60.5% reported barriers for GP-contact. Of the reported barriers, the most frequent was 'being too embarrassed' (29.7%). In general, respondents in the older age groups were less likely to report embarrassment, business and worrying what the doctor might find. Respondents with highest attained educational level were less likely to report embarrassment and worrying. CONCLUSION: Nearly two third of the respondents with bothersome ED had not contacted their GP. More than half of those reported barriers towards GP contact with embarrassment as the most frequent barrier. In general, respondents in the older age groups and with high educational level were less likely to report barriers.

Assessment of biosecurity level in small-scale broiler farms in the Western highlands of Cameroon (Central Africa).

The recent outbreak of avian influenza in the poultry sector of Cameroon has raised a concern about the level of implementation of biosecurity measures (BM) on poultry farms. Therefore, a study using a questionnaire on 102 randomly selected poultry farms was undertaken. Some measures with high adoption levels (> 90%) included "protection of airing openings of poultry barns by a wire mesh," "no external animal allowed to enter the farm," "respect of all-in all-out principle," "functional footbath," "rodent control," and "feedstuff protection from access to rodents." The least implemented measures (less than 20%) were "wearing of dedicated clothing (clean coveralls and boots) by workers," "disinfection of visitors," and "presence of storage room for dead animals." Only for "isolation" component of biosecurity, compliance with biosecurity measures was good, with more than 50% of farms having an adoption rate greater than 75%. The mean biosecurity score for the assessed farms was 19.29 ± 1.89 for a maximum score of 38 points. The score was significantly and positively correlated (p < 0.05) with the number of chicken and the geographic location of farms. The other results showed that the mean number of broiler per cycle was 550.82 ± 76 for a stocking density of 27.20 ± 6.64 birds per m2. In conclusion, broiler production in the Western highland is dominated by small-scale units with low level of biosecurity practices positively and significantly (p < 0.05) influenced by some production characteristics. To improve biosecurity practices in the area, efforts must focus on measures concerning "sanitation" and "traffic control" components of biosecurity.

The data not collected on community forestry.

Conservation and development practitioners increasingly promote community forestry as a way to conserve ecosystem services, consolidate resource rights, and reduce poverty. However, outcomes of community forestry have been mixed; many initiatives failed to achieve intended objectives. There is a rich literature on institutional arrangements of community forestry, but there has been little effort to examine the role of socioeconomic, market, and biophysical factors in shaping both land-cover change dynamics and individual and collective livelihood outcomes. We systematically reviewed the peer-reviewed literature on community forestry to examine and quantify existing knowledge gaps in the community-forestry literature relative to these factors. In examining 697 cases of community forest management (CFM), extracted from 267 peer-reviewed publications, we found 3 key trends that limit understanding of community forestry. First, we found substantial data gaps linking population dynamics, market forces, and biophysical characteristics to both environmental and livelihood outcomes. Second, most studies focused on environmental outcomes, and the majority of studies that assessed socioeconomic outcomes relied on qualitative data, making comparisons across cases difficult. Finally, there was a heavy bias toward studies on South Asian forests, indicating that the literature on community forestry may not be representative of decentralization policies and CFM globally.

Health inequalities by socioeconomic characteristics in Spain: the economic crisis effect.

BACKGROUND: An economic crisis can widen health inequalities between individuals. The aim of this paper is to explore differences in the effect of socioeconomic characteristics on Spaniards' self-assessed health status, depending on the Spanish economic situation. METHODS: Data from the 2006-2007 and 2011-2012 National Health Surveys were used and binary logit and probit models were estimated to approximate the effects of socioeconomic characteristics on the likelihood to report good health. RESULTS: The difference between high and low education levels leads to differences in the likelihood to report good health of 16.00-16.25 and 18.15-18.22 percentage points in 2006-07 and 2011-12, respectively. In these two periods, the difference between employees and unemployed is 5.24-5.40 and 4.60-4.90 percentage points, respectively. Additionally, the difference between people who live in households with better socioeconomic conditions and those who are in worse situation reaches 5.37-5.46 and 3.63-3.74 percentage points for the same periods, respectively. CONCLUSIONS: The magnitude of the contribution of socioeconomic characteristics to health inequalities changes with the economic cycle; but this effect is different depending on the socioeconomic characteristics indicator that is being measured. In recessive periods, health inequalities due to education level increase, but those linked to individual professional status and household living conditions are attenuated. When the joint effects of individuals' characteristics are considered, the economic crisis brings about a slight increase in the inequalities in the probability of reporting good health between the two extreme profiles of individuals. The design of public policies aimed at preventing any worsening of health inequalities during recession periods should take into account these differential effects of socioeconomic characteristics indicators on health inequalities.

Scale effects in food environment research: Implications from assessing socioeconomic dimensions of supermarket accessibility in an eight-county region of South Carolina.

Choice of neighborhood scale affects associations between environmental attributes and health-related outcomes. This phenomenon, a part of the modifiable areal unit problem, has been described fully in geography but not as it relates to food environment research. Using two administrative-based geographic boundaries (census tracts and block groups), supermarket geographic measures (density, cumulative opportunity and distance to nearest) were created to examine differences by scale and associations between three common U.S. Census-based socioeconomic status (SES) characteristics (median household income, percentage of population living below poverty and percentage of population with at least a high school education) and a summary neighborhood SES z-score in an eight-county region of South Carolina. General linear mixed-models were used. Overall, both supermarket density and cumulative opportunity were higher when using census tract boundaries compared to block groups. In analytic models, higher median household income was significantly associated with lower neighborhood supermarket density and lower cumulative opportunity using either the census tract or block group boundaries, and neighborhood poverty was positively associated with supermarket density and cumulative opportunity. Both median household income and percent high school education were positively associated with distance to nearest supermarket using either boundary definition, whereas neighborhood poverty had an inverse association. Findings from this study support the premise that supermarket measures can differ by choice of geographic scale and can influence associations between measures. Researchers should consider the most appropriate geographic scale carefully when conducting food environment studies.

Factors associated with financial risk due to health spending in Argentina.

This article aims to assess the association between household demographic and socioeconomic characteristics and catastrophic health expenditure (CHE) in Argentina during 2017-2018. CHE was estimated as the proportion of household consumption capacity (using both income and total consumption in separate estimations) allocated for Out-of-Pocket (OOP) health expenditure. For assessing the determinants, we estimated a generalized ordered logit model using different intensities of CHE (10%, 15%, 20% and 25%) as the ordinal dependent variable, and socioeconomic, demographic and geographical variables as explanatory factors. We found that having members older than 65 years and with long-term difficulties increased the likelihood of incurring CHE. Additionally, having an economically inactive household head was identified as a factor that increases this probability. However, the research did not yield consistent results regarding the relationship between public and private health insurance and consumption capacity. Our results, along with the robustness checks, suggest that the magnitude of the coefficients for the household head characteristics could be exaggerated in studies that overlook the attributes of other household members. In addition, these results emphasize the significance of accounting for long-term difficulties and indicate that omitting this factor could overestimate the impact of members aged over 65.

Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study.

BACKGROUND: Feeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences. OBJECTIVE: To examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics. DESIGN: Secondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum. PARTICIPANTS/SETTING: Participants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum. MAIN OUTCOME MEASURES: Participants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores. STATISTICAL ANALYSES PERFORMED: Multiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics. RESULTS: Lower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months. CONCLUSIONS: Infant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding.

The Association between Socioeconomic Profiles, Attitudes, and Knowledge of Dairy Farmers Regarding Somatic Cell Count and Milk Quality.

The primary objective of this study was to investigate the association between the bulk tank somatic cell count (SCC) and dairy farmers' knowledge about milk quality, mastitis control, and their socioeconomic characteristics. Additionally, we estimated the association between the bulk tank SCC and bulk tank milk hygienic quality in dairy herds. Bulk tank milk samples from 120 dairy herds enrolled in the milk quality payment program were collected for the determination of the SCC, the total bacterial count (TBC), the preliminary incubation count (PIC), the laboratory pasteurization count (PC), and the coliform count (CC). Based on the bulk tank SCC results, 63 herds were selected and categorized into three groups: (a) low SCC: ≤250,000 cells/mL (n = 16); (b) medium SCC: >250,000 ≤ 400,000 cells/mL (n = 24); and (c) high SCC: >400,000 cells/mL (n = 23). Socioeconomic profiles, attitudes, and knowledge of somatic cell count and milk quality were assessed using previously tested questionnaires, which were used to interview the herd managers of the 63 selected dairy herds. Among the findings, 87.0% of the dairy herds had an SCC < 400 × 103 cells/mL, and presented milk production as the main economic activity of the farm, whereas only 47.0% of dairy herds with an SCC > 400 × 103 cells/mL had milk production as the main economic activity of the farm (p < 0.031). In a total of 95% of the selected herds (n = 60), milking machines were used, with pipeline milking machines being more predominant, accounting for 70.8% in herds with a medium somatic cell count (SCC) and 78.3% in herds with a high SCC, as opposed to herds with a low SCC at 50% (p < 0.031). The frequency of dairy producers' awareness of the maximum legal requirements for the bulk tank SCC and TBC was higher in herds with a higher SCC than in herds with a medium SCC. In conclusion, the results of this study indicate a significant association between the bulk tank somatic cell count (SCC) and dairy farmers' knowledge about milk quality, mastitis control, and socioeconomic characteristics. These findings emphasize the importance of knowledge and the socioeconomic profiles of dairy farms in maintaining and enhancing milk quality in dairy herds.

Neighborhood Socioeconomic Characteristics Associated with the COVID-19 Incidence in Elementary School Children: An Ecological Study in Osaka City, Japan.

We aimed to determine whether neighborhood socioeconomic characteristics are associated with the coronavirus disease 2019 (COVID-19) incidence in elementary school children and, if so, the associated characteristics. We obtained data on the number of infected children from 282 public elementary schools and the socioeconomic characteristics of each school district in Osaka City, Japan. We examined associations between these variables through negative binomial regression analyses. The proportion of employment in the wholesale and retail trade industry and the college graduation rate were significantly positively and negatively associated, respectively, with the total number of COVID-19-infected children. It was discovered that percentages of employment in the accommodation and food service industries in Wave 2, wholesale and retail trade industries after Wave 3, and healthcare and social assistance industries in Wave 5 were significantly positively associated with the number of infected children; likewise, the college graduation rate in Wave 5 was significantly negatively associated with the number of infected children. Our findings provide insight into the relevant and important areas of focus for public health policymakers and practitioners to ensure reduced disparities in COVID-19 infection rates.

Variations in cognition by human capital characteristics: a cross-sectional analysis of Brazilian older adults.

Introduction: The productivity of individuals is assumed to decline upon reaching old age when cognitive ability is considered. This assumption is false, especially if the human development characteristics of people are analyzed, which highlights the need to recognize the heterogeneity among subpopulations. Methods: Using Wave two of the Brazilian Longitudinal Study on Aging, conducted from 2019 to 2021, this study explored the onset and speed of cognitive aging among older individuals aged at least 60 in Brazil, with reference to their education and income levels. Results: It was observed that although higher human capital characteristics yielded results toward later cognitive decline, women benefited more from having higher educational attainment levels. Such a pattern was similar among men and increased income levels. Disparities in cognitive performance, whether from education or income, were greatest at age 60, and this advantage diminished as age progressed. Conclusion: Viewing the older population as homogeneous in terms of health function is restrictive. It should be recognized that variations in social status affect individuals' health status into old age and therefore their respective potential for productivity should be maximized.

Relationship between Doping Prevalence and Socioeconomic Parameters: An Analysis by Sport Categories and World Areas.

Socioeconomic differences between countries, including corruption and doping scandals, have increased in the last few decades. The aims of the current investigation were to examine doping prevalence according to world areas and sport groups and its association with socioeconomic factors worldwide. The Anti-Doping Rule Violations (ADRVs) of 160 countries competing at 2016 Olympics were analyzed between 2013 and 2018. In addition, the relationship between doping prevalence and socioeconomic characteristics, including Human Development Index (HDI), Per Capita Income (PCI) and Corruption Index (CI), was investigated. Africa, Asia, and America were revealed to have a significantly lower doping prevalence than Europe and Oceania when observing the sum and the mean ADRV/10,000 inhabitants (p < 0.01). Strong to moderate correlations were identified between Corruption Index and ADRVs and HDI and ADRVs (p < 0.01). However, the number of Olympic athletes was positively associated with the ADRVs and the HDI (r = 0.663 and 0.424, respectively). In the comparison by sport groups, the Independent Recognized Sports (AIMS) showed significantly higher Adverse Analytical Findings (AAF) and ADRVs (p < 0.01) than Olympic and Recognized International Sports (ARISF). In conclusion, the results of the current study reveal doping prevalence differences between world areas and sport categories, identifying associations with socioeconomic characteristics of each country.

A systematic review examining socioeconomic factors in trials of interventions for men that report weight as an outcome.

Weight management interventions designed specifically for men have become more common, but the extent to which socioeconomic factors are considered in trials of these interventions is unclear. We synthesized study characteristics, methods, and reporting of interventions with a behavioral component for men that report weight as an outcome, to establish the extent to which socioeconomic factors are considered during intervention design, conduct, and reporting. A comprehensive search was conducted on Medline, Embase, PsycINFO, and CENTRAL for studies published from January 2000 to July 2021. Thirty-six trials were included. Educational attainment (n = 24) was the most frequently reported socioeconomic characteristic, followed by working status (n = 14) and area level deprivation (n = 12). Seven studies did not report any socioeconomic characteristics. Most studies (n = 20) did not mention the socioeconomic profile of their samples in relation to study strengths or limitations. Few (n = 4) consulted with men from lower socioeconomic groups during intervention design. One study examined potential differential intervention effects across socioeconomic groups, with most not powered to do so. Recent feasibility trials (n = 3) targeting specific socioeconomic groups suggest a potential nascent towards a greater consideration of factors related to equity. To best inform public health policy related to health inequalities, greater consideration of socioeconomic factors is required in trials of men's weight management interventions.

Nutrition Knowledge as a Driver of Adherence to the Mediterranean Diet in Italy.

Background: An optimal Nutrition knowledge (NK) among the population could result in greater Adherence to the Mediterranean Diet (AMD), a recognized dietary pattern capable of preventing chronic food-related diseases. This study aimed to evaluate the association between NK and AMD in Italy. Methods: A national representative sample of 2,869 adults took part in an assessment that was carried out through a self-administrated questionnaire including sections relating to NK and AMD. AMD was evaluated following the PREDIMED PLUS methodology. Descriptive statistics were provided, and ordinal measures of NK score and AMD were calculated based on quartiles of the quantitative scores. A contingency analysis was performed to check associations between variables. Results: In Italy, the average NK score was 50 ± 13.3, equivalent to 56.8% of correct answers. The average value of AMD was 6.8, corresponding to 40% of the maximum score with 31.4% of the population demonstrating low AMD, 31.3% in the lower-middle range, 24% in the medium-high range, and only 13.3% reporting a high AMD. A significant association between NK and AMD was found; respondents who reported the lowest AMD corresponded to those with the lowest NK (36.7%; p < 0.05) and similarly, those with the highest level of adherence to MD also achieved the highest NK scores (41.7%; p < 0.05). Conclusion: This study showed that AMD in Italy is generally low, and the strong association between NK and AMD demonstrated that there is a clear connection between a healthy dietary pattern and the nutrition literacy of the population. Those with the highest AMD corresponded to the highest NK and, conversely, those with the lowest AMD displayed the lowest NK. The study also highlighted that socioeconomic aspects were strong determinants of both AMD and NK.

On the Relative Importance of Different Factors Explaining Health Plan Choices: Evidence From Mandatory Health Insurance in Switzerland.

Many factors influence health plan choices. Classical individual-level determinants include socioeconomic and health-related characteristics, and risk attitudes. However, little is known to what extent personality traits can determine insurance choices. Using representative survey data from Switzerland, we investigate the associations between choices of health plans and traditional individual factors as well as personality traits. We employ dominance analysis to explore the relative importance of the different predictors. We find that personality traits play an at least equally important role in predicting health plan choices as common factors like age, health status, and income. Our results have implications regarding recent efforts to empower people in making better health plan choices and support theoretical models that integrate insights from behavioral sciences.