Socioeconomically Disadvantaged Groups and Metabolic Syndrome in European Adolescents: The HELENA Study

Abstract Background: Across the world, the COVID-19 pandemic has disproportionately affected economically disadvantaged groups. This differential impact has numerous possible explanations, each with significantly different policy implications. We examine, for the first time in a low- or middle-income country, which mechanisms best explain the disproportionate impact of the virus on the poor. Methods: We use primary data from the CoVIDA project, including the results of 59,770 RT-PCR tests in Bogotá, targeted on a mostly asymptomatic adult population June 2020 to March 3rd, 2021. This is combined with administrative data that covers all reported cases in Bogotá. We estimate a number of parameters that are likely to drive inequality in COVID-19 infection rates across socioeconomic groups, then use these estimates in an individual-level branching process model of the epidemic. We use counterfactual scenarios to estimate the relative importance of different channels for explaining inequality in infection rates. Findings: Total infections and inequalities in infections are largely driven by inequalities in the ability to work remotely and in within-home secondary attack rates. Inequalities in isolation behavior are less important but non-negligible, while access to testing and contract-tracing plays practically no role. Interventions that mitigate transmission are found to be more effective when targeted on socioeconomically disadvantaged groups.Interpretation: Socioeconomically disadvantaged groups are particularly vulnerable to COVID-19 infections, and this appears to be primarily driven by the need to work out of home, higher transmission within home, and to some extent, the ability to isolate when needed. Policies that can successfully reduce these channels of transmission among the poor are likely to have large benefits.

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Dehumanization of Socioeconomically Disadvantaged Groups Decreases Support for Welfare Policies via Perceived Wastefulness

International Review of Social Psychology ◽

10.5334/irsp.414 ◽

2020 ◽

Vol 33 (1) ◽

pp. 12

Author(s):

Mario Sainz ◽

Steve Loughnan ◽

Rocío Martínez ◽

Miguel Moya ◽

Rosa Rodríguez-Bailón

Keyword(s):

Socioeconomically Disadvantaged ◽

Welfare Policies ◽

Disadvantaged Groups

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Tobacco Use and Socioeconomically Disadvantaged Groups

Nicotine & Tobacco Research ◽

10.1093/ntr/ntx199 ◽

2017 ◽

Vol 19 (12) ◽

pp. 1399-1400

Author(s):

Andrea H Weinberger

Keyword(s):

Tobacco Use ◽

Socioeconomically Disadvantaged ◽

Disadvantaged Groups

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Socioeconomically disadvantaged groups and metabolic syndrome in European adolescents: The HELENA study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002062 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Isabel Iguacel ◽

Claudia Börnhorst ◽

Nathalie Michels ◽

Christina Breidenassel ◽

Jean Dallongeville ◽

...

Keyword(s):

Smoking Status ◽

Tanner Stage ◽

Female Adolescents ◽

Z Score ◽

Response Relationship ◽

Socioeconomically Disadvantaged ◽

Dose Response Relationship ◽

Disadvantaged Groups ◽

Z Scores ◽

Low Educated

AbstractIntroduction:Psychosocial stressors deriving from socioeconomic disadvantages in adolescents can result in higher metabolic syndrome (MetS) risk. We aimed to examine whether socioeconomic disadvantages were associated with MetS independent of lifestyle and whether there was a dose response relationship between the number of cumulated socioeconomic disadvantages and the risk of MetS.Materials and Methods:The present study included 1,037 European adolescents (aged 12.5–17.5) of the 3,528 total HELENA participants. Sociodemographic variables and lifestyle were assessed through self-reported questionnaires. Disadvantaged groups included adolescents with low educated parents, low family affluence, migrant origin, unemployed parents, and from non-traditional families. MetS score was calculated as the sum of sex- and age-specific z-scores of waist circumference, HOMA-IR index, mean of z-scores of diastolic and systolic blood pressure and mean of z-score of HDL-C multiplied by -1 and z-score of TG. A higher score indicates poor metabolic health. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk score. Models were adjusted for sex, age, pubertal status (Tanner stage) and lifestyle (diet quality, physical activity, alcohol consumption and smoking status).Results:Adolescents with low educated mothers showed a higher MetS score (0.54 [0.09–0.98]; β [99% confidence interval]) compared to high-educated mothers. Adolescents who accumulated more than three disadvantages (0.69 [0.08–1.31]) or with missing information on disadvantages (0.72 [0.04–1.40]) had a higher MetS risk compared to non-socioeconomically disadvantaged groups. Stronger associations between socioeconomic disadvantages and MetS were found in male in comparison with female adolescents.Discussion:Out of the studied socioeconomic disadvantages, maternal education is the most important determinant of adolescent's MetS risk independently of sex, age, Tanner stage, smoking status, alcohol consumption, diet quality and physical activity. Social vulnerabilities (migrant background, unemployment status and belonging to a non-traditional family) were not associated with a higher MetS risk in European adolescents. However, we found a dose-response relationship between the number of factors related to social disadvantage and adolescents’ MetS risk with adolescents accumulating three or more socioeconomic disadvantages showing the highest risk. Stronger associations between socioeconomic disadvantages and MetS were found in male compared to female adolescents. Policy makers should focus on low educated families to tackle health disparities.

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