Measles outbreak in Romania: understanding factors related to suboptimal vaccination uptake

Abstract Background A large measles outbreak started in Romania in 2016. Current study aimed to (i) clarify who was affected by the outbreak, (ii) identify their barriers and drivers to vaccination and (iii) explore variation by population group. Methods This was a two-component study. Outbreak surveillance data for 6743 measles cases were reviewed to identify key characteristics. A survey was administered via telephone to 704 caregivers of measles cases (520 respondents) to explore capability, opportunity and motivation barriers to vaccination. Data were summarized descriptively for respondent characteristics and statements. Differences by population group (education, household income, ethnicity, setting and mobility) were explored using χ2 tests, Fisher’s exact tests or regression models. Results Most cases were unvaccinated and lived in low coverage areas. Ethnic minorities were disproportionally affected. Most caregivers felt welcome at health facilities. Some were less satisfied with the waiting time and had found the vaccine out of stock. Not everybody knew that vaccines were free of charge. Less than half knew the child’s next vaccination date, some had not been informed and did not know where to seek this information. Some said their peers did not vaccinate. Beliefs were generally supportive of vaccination; but many were concerned about vaccine safety and found they had not received good information about this. Conclusions varied greatly between minorities and less educated groups, compared with people with higher education levels. Conclusions Identifying characteristics of the population affected and underlying factors can inform a strategy to avoid future outbreaks and further research to obtain deeper insights.

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COVID-19 Vaccination Willingness among Chinese Adults under the Free Vaccination Policy

Vaccines ◽

10.3390/vaccines9030292 ◽

2021 ◽

Vol 9 (3) ◽

pp. 292

Author(s):

Rugang Liu ◽

Yuxun Zhang ◽

Stephen Nicholas ◽

Anli Leng ◽

Elizabeth Maitland ◽

...

Keyword(s):

Regression Models ◽

Medical Insurance ◽

Vaccine Safety ◽

Decision Makers ◽

Vaccination Policy ◽

Chinese Adults ◽

Logistic Regression Models ◽

Ordered Logistic Regression ◽

Professional Workers ◽

Target Intervention

(1) Background: China will provide free coronavirus disease 2019 (COVID-19) vaccinations for the entire population. This study analyzed the COVID-19 vaccination willingness rate (VWR) and its determinants under China’s free vaccination policy compared to a paid vaccine. (2) Methods: Data on 2377 respondents were collected through a nationwide questionnaire survey. Multivariate ordered logistic regression models were specified to explore the correlation between the VWR and its determinants. (3) Results: China’s free vaccination policy for COVID-19 increased the VWR from 73.62% to 82.25% of the respondents. Concerns about the safety and side-effects were the primary reason for participants’ unwillingness to be vaccinated against COVID-19. Age, medical insurance and vaccine safety were significant determinants of the COVID-19 VWR for both the paid and free vaccine. Income, occupation and vaccine effectiveness were significant determinants of the COVID-19 VWR for the free vaccine. (4) Conclusions: Free vaccinations increased the COVID-19 VWR significantly. People over the age of 58 and without medical insurance should be treated as the target intervention population for improving the COVID-19 VWR. Contrary to previous research, high-income groups and professional workers should be intervention targets to improve the COVID-19 VWR. Strengthening nationwide publicity and education on COVID-19 vaccine safety and effectiveness are recommended policies for decision-makers.

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Association between parental socioeconomic status and offspring overweight/obesity from the China Family Panel Studies: a longitudinal survey

BMJ Open ◽

10.1136/bmjopen-2020-045433 ◽

2021 ◽

Vol 11 (4) ◽

pp. e045433

Author(s):

Suqin Ding ◽

Jingqi Chen ◽

Bin Dong ◽

Jie Hu

Keyword(s):

High School ◽

Socioeconomic Status ◽

Regression Model ◽

Household Income ◽

Parental Education ◽

Education Level ◽

Longitudinal Survey ◽

Average Household Income ◽

Education Levels ◽

Parental Socioeconomic Status

ObjectiveTo examine the association between parental socioeconomic status (SES) and the risk of offspring overweight/obesity and the changes of the association that occur as children grow older.DesignWe used data from the nationally representative longitudinal survey of the China Family Panel Studies of 2010 and its three follow-up waves in 2012, 2014 and 2016.ParticipantsA total of 6724 children aged 0–15 years old were included.Primary and secondary outcome measuresAverage household income and paternal and maternal education levels were used as SES indicators. Logistic regression model for panel data was used to examine the associations between SES indicators and child overweight/obesity. A restricted cubic spline linear regression model was used to estimate body mass index (BMI) trajectories with child growth across parental SES levels.ResultsCompared with the lowest education level (primary school or less), the ORs for fathers who had completed junior high school, senior high school and junior college or higher were 0.85 (95% CI 0.75 to 0.97), 0.77 (95% CI 0.64 to 0.92) and 0.72 (95% CI 0.55 to 0.93), respectively. The corresponding ORs for mothers were 0.76 (95% CI 0.67 to 0.86), 0.59 (95% CI 0.47 to 0.72) and 0.45 (95% CI 0.34 to 0.60), respectively. A negative association between parental education and offspring overweight/obesity was observed in the first 10 years but not in children 11–15 years old. BMI differences across parental education levels emerged from birth and widened before 6–7 years old, but decreased before adolescence. High average household income was related to a low risk of offspring overweight/obesity but not when parental education level was adjusted for.ConclusionHigh parental education levels were associated with a low risk of offspring overweight/obesity, especially before adolescence. Effective approaches need to be adopted in early childhood to reduce socioeconomic differences in overweight/obesity.

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Until Death Do Us Part. The Influence of Own and Partner’s Socioeconomic Status on the Health of Spanish Middle-Aged Population

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134644 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4644

Author(s):

Jordi Gumà ◽

Jeroen Spijker

Keyword(s):

Socioeconomic Status ◽

Regression Models ◽

Population Group ◽

Good Health ◽

The European Union ◽

Middle Aged ◽

Logistic Regression Models ◽

Health Differences ◽

Low Educated ◽

Significant Health

Objectives: To explore whether the influence of a partner’s socioeconomic status (SES) on health has an additive or a combined effect with the ego’s SES. Methods: With data on 4533 middle-aged (30–59) different-sex couples from the 2012 Spanish sample of the European Union Statistics on Income and Living Conditions (EU-SILC) survey, we apply separate sex-specific logistic regression models to calculate predicted probabilities of having less than good self-perceived health according to individual and partner’s characteristics separately and combined. Results: Both approaches led to similar results: Having a partner with better SES reduces the probabilities of not having good health. However, the combined approach is more precise in disentangling SES effects. For instance, having a higher educated partner only benefits health among Spanish low-educated men, while men’s health is worse if they have a working spouse. Conversely, women’s health is positively influenced if at least one couple member is economically active. Conclusions: There are significant health differences between individuals according to their own and their partner’s SES in an apparently advantageous population group (i.e., individuals living with a partner). The combinative approach permits obtaining more precise couple-specific SES profiles.

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Fertility Restrictions and Life-Cycle Outcomes: Evidence from the One-Child Policy in China

Review of Economics and Statistics ◽

10.1162/rest_a_00921 ◽

2020 ◽

pp. 1-41 ◽

Cited By ~ 1

Author(s):

Wei Huang ◽

Xiaoyan Lei ◽

Ang Sun

Keyword(s):

Life Cycle ◽

Household Income ◽

White Collar ◽

The Elderly ◽

Fertility Rates ◽

One Child Policy ◽

Child Policy ◽

Education Levels ◽

Lower Fertility ◽

The One

This study considers the experience of China’s one-child policy to examine how fertility restrictions affect economic and social outcomes over a lifetime. Using variations in these penalties across provinces and over time, we find that exposure to stricter fertility restrictions when young leads to higher education levels, more white-collar jobs, delayed marriage, and lower fertility rates. Further consequences include lower rates of residing with the elderly, higher household income, consumption, and savings. Finally, exposure to stricter fertility restrictions in early life increases female empowerment. Overall, fertility restrictions imposed when people are young have powerful effects throughout their life cycle.

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Parenting Stress and the Use of Formal and Informal Child Care: Associations for Fathers and Mothers

Journal of Family Issues ◽

10.1177/0192513x18776419 ◽

2018 ◽

Vol 39 (12) ◽

pp. 3203-3224 ◽

Cited By ~ 2

Author(s):

Lyn Craig ◽

Brendan Churchill

Keyword(s):

Parenting Stress ◽

Household Income ◽

Regression Models ◽

Family Care ◽

Formal Care ◽

Panel Survey ◽

Family Carers ◽

Stress Scale ◽

Using Data ◽

Employed Parents

We investigated relationships between nonparental care and psychological strains of parenthood. Using data from employed parents of children below 5 years of age ( n = 6,886 fathers and mothers) from Waves 4 to 11 of the household panel survey Household, Income and Labour Dynamics in Australia (HILDA), we constructed a parenting stress scale from the average of four items (α = .76) administered in the Self-Completion Questionnaire. We ran panel random-effects regression models testing associations between amount and type of nonparental care and parenting stress, for both mothers and fathers. We distinguished between formal care, informal and family care (mainly grandparents), and mixed care. Results showed that fathers and mothers’ parenting stress is positively associated with hours of nonparental care, but that for both genders parenting stress is significantly lower if the care is provided by informal/family carers.

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Trends in Melanoma Mortality in the Population Groups of South Africa

Dermatology ◽

10.1159/000500663 ◽

2019 ◽

Vol 235 (5) ◽

pp. 396-399 ◽

Cited By ~ 3

Author(s):

Caradee Yael Wright ◽

Thandi Kapwata ◽

Elvira Singh ◽

Adele C. Green ◽

Peter Baade ◽

...

Keyword(s):

South Africa ◽

Regression Models ◽

Population Group ◽

Mortality Rates ◽

Mortality Data ◽

African Countries ◽

South Africans ◽

Awareness Campaigns ◽

Increasing Trend ◽

Join Point

The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM (n = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 (p < 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 (p < 0.05) and of 3% from 1999 to 2014 (p < 0.01). These results may be used to inform CM awareness campaigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.

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Trends in mortality due to breast cancer among women in the state of Rio de Janeiro, Brazil, 1996-2011

Ciência & Saúde Coletiva ◽

10.1590/1413-81232015203.07982014 ◽

2015 ◽

Vol 20 (3) ◽

pp. 895-903

Author(s):

Daniele Bittencourt Ferreira ◽

Inês Echenique Mattos

Keyword(s):

Breast Cancer ◽

Rio De Janeiro ◽

Regression Models ◽

Polynomial Regression ◽

Population Group ◽

Mortality Rates ◽

The State ◽

Data Source ◽

Polynomial Regression Models ◽

Series Study

A descriptive time series study was conducted in order to analyze the mortality rates for breast cancer in two age brackets (< 60 years and ≥ 60 years), in areas of the state of Rio de Janeiro (inland, metropolitan area, capital and state). The data source was the Mortality Information System. Mortality rates were analyzed for four-year periods, between 1996 and 2011, and the ratios between the incidences for the two age brackets in each area. The trend in annual mortality rates was analyzed with the Joinpoint program and polynomial regression models. The ratios between the incidences observed were 7-8 times higher in women aged 60 years or older. Joinpoint analyses indicated a linear decline in mortality rates in the state and the capital for the whole population and for women aged 60 and over in the same areas. The polynomial regression models allowed the observation of periods of increasing and decreasing rates and a tendency to stabilization at the end of the period. Despite the declining trend, the magnitude of mortality from breast cancer is still high among women aged 60 and older, and it is important to investigate associated factors in this population group.

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Loneliness and Mental Health: Recommendations for Primary Care Intakes

Journal of Primary Care & Community Health ◽

10.1177/21501327211027104 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110271

Author(s):

Marissa Godfrey ◽

Pi-Ju Liu ◽

Aining Wang ◽

Stacey Wood

Keyword(s):

Mental Health ◽

Health Status ◽

Physical Health ◽

Social Integration ◽

Health Survey ◽

Household Income ◽

Regression Models ◽

Physical Health Status ◽

Health Measures ◽

Mental And Physical Health

Introduction/Objectives The healthcare intake process plays a significant role in informing medical personnel about patients’ demographic information, subjective health status, and health complaints. Intake forms can help providers personalize care to assist patients in getting proper referrals and treatment. Previous studies examined factors that could be included in intake forms independently, but this study analyzed loneliness, religiousness, household income, and social integration together to see how the combined effect influences mental and physical health status. This study aims to determine which of those 4 variables better inform patients’ mental versus physical health status. Methods One hundred and seventy-nine participants completed surveys, including the SF-12® Health Survey, measuring perceived physical and mental health, UCLA 3-item Loneliness Scale, and a demographics questionnaire with questions about household income and time spent dedicated to religious practice, if applicable. Additionally, individuals answered social integration questions about how often they contact close family and friends or volunteer in the community. Using loneliness, household income, religiousness, social integration as independent variables, and controlling for demographic variables such as age, gender, and race, 2 regression models were built with Mental and Physical Health Composite Scores from the the SF-12® Health Survey as dependent variables. Results Loneliness was associated with mental health measures ( b = −2.190, P < .001), while household income was associated with physical health measures ( b = 0.604, P = .019) above and beyond other variables in the regression models. Conclusions Integrating the 3 loneliness questions into intake forms can help approximate an individual’s mental health status. This would allow the provider to be able to assess mental health problems more effectively and provide needed resources.

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David Against Goliath: Predicting The Survival Of Formal Small Businesses In Soweto

International Business & Economics Research Journal (IBER) ◽

10.19030/iber.v14i3.9210 ◽

2015 ◽

Vol 14 (3) ◽

pp. 463

Author(s):

Johan Strydom

Keyword(s):

South Africa ◽

Logistic Regression ◽

Small Businesses ◽

Regression Models ◽

Quantitative Research ◽

Binary Logistic Regression ◽

Business Environment ◽

Shopping Malls ◽

Literature Study ◽

Key Characteristics

The aim of the paper is to determine empirically through quantitative research the key characteristics for survival of formal small businesses in the Soweto Township area. The focus was on the formal small businesses that have been operating in a very dynamic business environment with the introduction of modern shopping facilities during this period. Binary logistic regression was used to develop two regression models to predict the survival of formal small businesses based on the key characteristics identified in the literature study. The results indicate survival similarities between formal and informal small businesses regarding longevity of the business, better qualifications of owners/managers, greater maturity of owners/managers and being further away from the new shopping malls. Even with the drastic changes in the business environment of formal small businesses in Soweto, there were a group of small businesses that were able to survive and grow. Information regarding this group of small businesses can be of value to owners and investors in their future consideration of venturing and funding new small businesses in the township areas of South Africa.

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A 'Ghetto' of One's Own: Communal Violence, Residential Segregation and Group Education Outcomes in India

10.31235/osf.io/265r3 ◽

2021 ◽

Author(s):

Aarushi Kalra

Keyword(s):

Primary Education ◽

Residential Segregation ◽

Ethnic Violence ◽

Group Education ◽

Communal Violence ◽

Education Outcomes ◽

Education Levels

How does ethnic violence and subsequent segregation shape children's lives? Using exogenous variation in communal violence due to a Hindu nationalist campaign tour across India, I show that violence displaces Muslims to segregated neighbourhoods. Surprisingly, I find that post-event, Muslim primary education levels are higher in cities that were more susceptible to violence. For cohorts enrolling after the riots, the probability of attaining primary education decreases by 2.3% every 100 kilometres away from the campaign route. I exploit differences in the planned and actual route to show that this is due to residential segregation of communities threatened by violence.

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