Effect of Socioeconomic Status on Surgery for Pancreatic Adenocarcinoma

Survival for pancreatic cancer remains poor. Surgical resection remains the only chance for cure. The intent of this study was to investigate the role of socioeconomic status (SES) on resection rates for pancreatic adenocarcinoma. The National Cancer Institute's Surveillance, Epidemiology, and End results database was used to identify patients with pancreatic adenocarcinoma. Disease was deemed resectable or unresectable based on the extent of disease code. Median family income was used as a SES variable to compare patients who underwent resection with those who did not. Median family income was organized into three categories based on definitions from the national census: less than $34,680 (low income), $34,680 to $48,650 (middle), and greater than $48,650 (high income). A total of 5,908 patients with potentially resectable disease were included. A total of 3,331 patients did not have a surgical resection despite having resectable disease. Subgroup analysis of income status revealed that patients with a low or middle income were less likely to have a resection when compared with those with high income (33.0 vs 39.9 vs 45.8%, P = 0.0001). Multivariate analysis revealed that low and middle SES and race were significant predictors of resection. Ongoing study of access to health care may help define the means to eliminate the disparities in the care of patients with pancreatic adenocarcinoma.

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ANALISIS KESEDIAAN MASYARAKAT UNTUK MEMBAYAR (Willingness to Pay) BIAYA PENGADAAN AIR BERSIH (PDAM) DI KOTA PEKANBARU

Jurnal Teknik Sipil dan Perencanaan ◽

10.15294/jtsp.v18i2.7475 ◽

2016 ◽

Vol 18 (2) ◽

pp. 75-86 ◽

Cited By ~ 1

Author(s):

Ari Sandhyavitri ◽

Nessa Riana Putri ◽

Manyuk Fauzi ◽

Sigit Sitikno

Keyword(s):

Willingness To Pay ◽

Water Supply ◽

Low Income ◽

Water Demand ◽

Family Income ◽

Lower Class ◽

High Income ◽

Class Society ◽

Supply Capacity ◽

The Cost

This paper investigated how much the public's willingness to pay (WTP) for the cost of public water supply services (PDAM) in Pekanbaru City. This research also projected how much urban water demand of this city for period of 2014-2032. This study divided samples into two categories, namely (i) middle and high income society, and (ii) low income one. These categories were based on the type of house ownership, and the percentage of low income family in this city This research obtained two main factors affected to the WTP for public water services (Y), such as; (i) the number of family members (X1), and (ii) the amount of family income (X2). The equation formula of Y = -677.816 + 12934.502 X1 + 0.012 X2. The average publics willingness to connect to PDAM for the middle and high income society was 62.13% and for the lower class was 44.44%.There was a trend that the middle and high incomes societys water demand was relatively higher than that the lower one. The amount of water tariffs for middle and high income class society was at the average of Rp.6.615 / m3, and Rp.4.971/m3 for the lower income one. This tariff was higher than the average tariff in 2014 (Rp. 3,300 / m3). The water supply capacity in 2014 was estimated to 620 l/sec, and it was projected that water demand in 2032 will increase to 3,946 l/sec (three folds).Tulisan ini meneliti berapa besar keinginan masyarakat untuk membayar biaya pelayanan pengadaan air bersih (PDAM) di Kota Pekanbaru dan membuat proyeksi kebutuhan air bersih Kota Pekanbaru 2014-2032. Sampel calon pelanggan air bersih dalam penelitian ini dibagi atas dua kategori, yaitu (i) masyarakat kelas menengah keatas,dan (ii) kelas menengah kebawah. Penelitian ini mengidentifikasi dua faktor utama yang mepengaruhi keinginan masyarakat menengah ke atas membayar pelayanan air bersih PDAM (Y), yaitu; (i) jumlah anggota keluarga (X1), dan (ii) besarnya pendapatan keluarga (X2), dengan formula Y= -677,816 + 12934,502 X1 + 0,012 X2. Keinginan untuk menyambung pada masyarakat menengah keatas sebesar 62,13% dan di kelas menengah kebawah adalah 44,44%. Besarnya tarif air bersih yang diinginkan masyarakat menengah keatas Rp.6.615/m3 dan Rp.4.971/m3 untuk kelas menengah kebawah.Tarif ini lebih tinggi dari rata-rata tarif PDAM pada tahun 2014 yaitu Rp. 3.300/m3.Kapasitas pasokan PDAM air pada tahun 2014 adalah 620 l/detik, namun diproyeksikan kebutuhan air bersih meningkat menjadi 3.946 ll / detik untuk tahun 2032.

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Factors Influencing Recovery among Children with Moderate Acute Malnutrition Treated at Kirehe District Health Centers

Journal of Public Health International ◽

10.14302/issn.2641-4538.jphi-20-3437 ◽

2020 ◽

Vol 3 (1) ◽

pp. 20-27

Author(s):

Vianney Bihibindi Kabundi ◽

Camille Kayihura ◽

Onesmus Marete ◽

Nicodeme Habarurema ◽

Erigene Rutayisire

Keyword(s):

Low Income ◽

Family Income ◽

Health Facilities ◽

Health Centers ◽

Acute Malnutrition ◽

District Health ◽

Middle Income ◽

Factors Associated ◽

Income Status ◽

Moderate Acute Malnutrition

Acute malnutrition affects nearly 52 million of under five years children globally, 75% of them live in low to middle income countries. The treatment of acute malnutrition using supplement foods could help children recovering and could reduce the risk of sickness. The present study investigated the factors associated with recovery among children with moderate acute malnutrition (MAM) under a follow-up program at health facilities. A prospective study was conducted in 16 health centers of Kirehe District of Rwanda and included 200 children from 6 to 59 months. A semi-structured questionnaire was used for data collection. All children enrolled in the study spent three months in nutrition program at health centers. The results show that after 3 months in the program 77.5% recovered from MAM. Children aged above 36 to 59 months were recovered at 90% whereas children aged from 24-35 months were recovered at 73.5%. Micronutrients and deworming provided at health facility were contributed to the recovery as children who received them were recovered at 89.1% and for those who didn’t were recovery at 72.1%. The findings demonstrated that boys were 16 times more likely to recover from MAM in three months of intervention than girls (AOR=16.19, p<0.001, 95% CI: 5.39- 48.63). Children from moderate income families were 3 more likely to recover than those from very low income families (AOR=2.8, p=0.029, 95% CI: 1.11-7.51). Male gender, receiving micronutrients and deworming from health facilities and family income status were factors associated with MAM recovery status

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Assessing variation among the national essential medicines lists of 21 high-income countries: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-045262 ◽

2021 ◽

Vol 11 (8) ◽

pp. e045262

Author(s):

Michael Sergio Taglione ◽

Nav Persaud

Keyword(s):

Low Income ◽

Essential Medicine ◽

Cross Sectional Study ◽

High Income ◽

Essential Medicines ◽

Low Income Countries ◽

Cross Sectional ◽

Essential Medicine List ◽

Income Status ◽

Essential Medicines Lists

ObjectiveEssential medicines lists have been created and used globally in countries that range from low-income to high-income status. The aim of this paper is to compare the essential medicines list of high-income countries with each other, the WHO’s Model List of Essential Medicines and the lists of countries of other income statuses.DesignHigh-income countries were defined by World Bank classification. High-income essential medicines lists were assessed for medicine inclusion and were compared with the subset of high-income countries, the WHO’s Model List and 137 national essential medicines lists. Medicine lists were obtained from the Global Essential Medicines database. Countries were subdivided by income status, and the groups’ most common medicines were compared. Select medicines and medicine classes were assessed for inclusion among high-income country lists.ResultsThe 21 high-income countries identified were most like each other when compared with other lists. They were more like upper middle-income countries and least like low-income countries. There was significant variability in the number of medicines on each list. Less than half (48%) of high-income countries included a newer diabetes medicines in their list. Most countries (71%) included naloxone while every country including at least one opioid medicine. More than half of the lists (52%) included a medicine that has been globally withdrawn or banned.ConclusionEssential medicines lists of high-income countries are similar to each other, but significant variations in essential medicine list composition and specifically the number of medications included were noted. Effective medicines were left off several countries’ lists, and globally recalled medicines were included on over half the lists. Comparing the essential medicines lists of countries within the same income status category can provide a useful subset of lists for policymakers and essential medicine list creators to use when creating or maintaining their lists.

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Spatial distribution of roadway environment features related to child pedestrian safety by census tract income in Toronto, Canada

Injury Prevention ◽

10.1136/injuryprev-2018-043125 ◽

2019 ◽

Vol 26 (3) ◽

pp. 229-233 ◽

Cited By ~ 3

Author(s):

Linda Rothman ◽

Marie-Soleil Cloutier ◽

Kevin Manaugh ◽

Andrew William Howard ◽

Alison K Macpherson ◽

...

Keyword(s):

Low Income ◽

Census Tract ◽

Motor Vehicle ◽

Pedestrian Safety ◽

High Income ◽

Geographical Information ◽

Income Status ◽

Local Roads ◽

The Relationship ◽

Speed Humps

BackgroundInvestments in traffic calming infrastructure and other street design features can enhance pedestrian safety as well as contribute to the ‘walkability’ of neighbourhoods. Pedestrian–motor vehicle collisions (PMVCs) in urban areas, however, remain common and occur more frequently in lower income neighbourhoods. While risk and protective features of roadways related to PMVC have been identified, little research exists examining the distribution of roadway environment features. This study examined the relationship between roadway environment features related to child pedestrian safety and census tract income status in Toronto.MethodsSpatial cluster detection based on 2006 census tract data identified low-income and high-income census tract clusters in Toronto. Police-reported PMVC data involving children between the ages of 5 and 14 years were mapped using geographical information system. Also mapped were roadway environment features (densities of speed humps, crossing guards, local roads, one-way streets and missing sidewalks). Multivariate logistic regression was used to examine the relationship between roadway environment features (independent variables) and cluster income status (dependent variable), controlling for child census tract population.ResultsThere were significantly fewer speed humps and local roads in low-income versus high-income clusters. Child PMVC rates were 5.4 times higher in low-income versus high-income clusters.ConclusionSocioeconomic inequities in the distribution of roadway environment features related to child pedestrian safety have policy and process implications related to the safety of child pedestrians in urban neighbourhoods.

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Abstract 16279: Impact of Race and Socioeconomic Status on Rates of Congestive Heart Failure Admissions, Readmissions, and Length of Stay

Circulation ◽

10.1161/circ.142.suppl_3.16279 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Muhammad A Shakir ◽

Meghan E Buckley ◽

William D Surkis ◽

John M Clark

Keyword(s):

Heart Failure ◽

Socioeconomic Status ◽

Length Of Stay ◽

Low Income ◽

Household Income ◽

High Income ◽

Median Household Income ◽

Admission Rates ◽

Black Patients ◽

White Patients

Introduction: Health disparities due to race and socioeconomic status persist among congestive heart failure (CHF) patients. Our hospital in the Philadelphia area is uniquely situated to study disparities as it sits on the border of a diverse inner city and suburban population. The area west of our hospital is known to have a drastically higher median income than the area to the east. We aimed to evaluate differences in rates of CHF admissions, readmissions, and length of stay (LOS) for patients based on race and socioeconomic status. Methods: From 3/1/2018 to 3/31/2020, 6,785 total patients were admitted to our hospital due to acute decompensated CHF. To compare rates of admission, readmission and a LOS > 5 days based on race and socioeconomic status, we used the SlicerDicer function of the EPIC electronic record platform. For race, we compared data for white and black patients. For socioeconomic status, we included a 10-mile radius around our hospital and used public records to collect median household income for 11 zip codes to the east and 11 to the west. The average yearly median household income for the east and west zip codes were USD $27,171 and $134,390, respectively. Outcomes are expressed as percentages and compared using a Chi-square test of independence and 95% confidence interval (CI) for differences. Significance was assessed at the 0.05 level. Results: Admission rates were significantly higher among Black patients at 67% compared to White patients at 58% (95% CI 7-11%, p<0.05). There was no significant difference between rates of readmission (60% for Black vs. 58% for White patients, 95% CI 0-4%, p=0.11) or LOS > 5 days (56% for Black vs. 55% for White patients, 95% CI 0-3%, p=0.42). Admission rates were significantly higher among patients from low income areas at 70% compared to high income areas at 56% (95% CI 11-17%, p<0.05). Readmission rates were not significantly different, 57% for low income and 56% for high income areas (95% CI 0-4%, p=0.82). Patients from low income areas were significantly more likely to have a LOS > 5 days at 57% compared to patients from high income areas at 53% (95% CI 0.8-8%, p<0.05). Conclusions: Race and socioeconomic status continue to impact CHF patients’ health outcomes including rates of admissions, readmissions, and length of stay.

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How does socioeconomic status affect the incidence of hospital-treated poisonings? A retrospective study

European Journal of Public Health ◽

10.1093/eurpub/ckz179 ◽

2019 ◽

Vol 30 (3) ◽

pp. 568-572

Author(s):

Lauri O Koskela ◽

Lasse V Raatiniemi ◽

Janne H Liisanantti

Keyword(s):

Socioeconomic Status ◽

Low Income ◽

Regional Differences ◽

High Income ◽

University Hospital ◽

Postal Code ◽

Net Income ◽

Crude Incidence ◽

Primary Hospital

Abstract Background Hospital-treated poisonings have a good outcome in general. The role of regional differences and socioeconomic status has been established in intensive care admissions and various causes of death, but not yet in hospital-treated poisonings. We set out to determine whether the incidence of hospital-treated poisonings is affected by the annual income of the residential area. Methods All poisonings in Northern Ostrobothnia region of Finland treated in Oulu University Hospital during 2013–2016 were studied. Oulu University Hospital is the primary hospital in the area. Postal code areas of the county were categorized on the basis of their median annual net income as low-, middle- and high-income areas. Results A total of 2142 poisoning cases were studied. The number of individual patients was 1525. In the low-income areas, the crude incidence of poisonings was more than 2-fold when compared with the middle- and high-income areas. In adolescents aged 13 to 17 years, the incidence in the low-income areas was almost 3-fold compared with the other two categories at 335/100 000/year (95% CI, 236–463). Four patients (0.2%) died during the hospital stay and 50 patients (2.3%) died within 6 months from the last admission. Conclusions The incidence of hospital-treated poisoning was at least 2-fold in low-income areas when compared with middle- or high-income areas. For adolescent population from 13 to 17 years, the incidence in low-income areas was almost 3-fold when compared with other areas.

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Do Korean Young Children's Daily Routines and Their Mothers' Parenting Stress Differ According to Socioeconomic Status?

Social Behavior and Personality An International Journal ◽

10.2224/sbp.2012.40.3.481 ◽

2012 ◽

Vol 40 (3) ◽

pp. 481-499 ◽

Cited By ~ 2

Author(s):

SoJung Seo ◽

Hyukjun Moon

Keyword(s):

Socioeconomic Status ◽

Young Children ◽

Parenting Stress ◽

Low Income ◽

High Income ◽

Daily Routines ◽

Maternal Parenting ◽

Maternal Parenting Stress ◽

Low Income Mothers

We examined the differences in Korean children's daily routines and their mothers' perceived level of parenting stress according to socioeconomic status (SES). Mothers from low-income (239) and high-income (338) families with young children completed questionnaires regarding their perceived level of parenting stress and the daily routines of their children. We found significant differences between the 2 SES subgroups in terms of some of the dimensions of their children's daily routines. In addition, the low-income mothers experienced higher levels of maternal parenting stress compared to their high-income counterparts. Implications for research and parenting are discussed.

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Socioeconomic status and parent perceptions about the costs and benefits of youth sport

PLoS ONE ◽

10.1371/journal.pone.0258885 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0258885

Author(s):

Emily Kroshus ◽

Pingping Qu ◽

Sara Chrisman ◽

Stanley Herring ◽

Frederick Rivara

Keyword(s):

Decision Making ◽

Low Income ◽

Sport Participation ◽

Family Income ◽

Youth Sport ◽

High Income ◽

Costs And Benefits ◽

Cross Sectional Survey ◽

Parental Decision Making ◽

The Impact

Objectives Describe what costs and benefits parents across the socioeconomic spectrum weight most heavily when making decisions about sport participation for their children. Method Cross-sectional survey of a nationally representative online panel of parents of children between the ages of 5 and 18 (n = 1025, 52% response rate). Parents rated the importance of a series of potential costs and benefits of youth sport and these responses were compared across tertiles of per capita family income. We first examined the association between family income tertiles and cost and benefit variables. Model-based cluster analysis was then used to identity homogeneous groups of responses to costs and benefits. Results In all income tertiles, the top two benefits of sport were the same: having fun and being physically active. Sport as a means of keeping children out of trouble was very important for 64% of low-income parents as compared to 40% of high-income parents. Obtaining a college athletic scholarship was very important for 26% of low-income parents, as compared to 8% of high-income parents. Relative rankings of potential costs were similar by income tertile, with risk of concussion and other injury and the impact of sport on schoolwork prioritized across tertiles. Conclusions Parents prioritized fun and fitness in sport, and were concerned about injury and the impact of sport on academics. Lower income parents were the most likely to view keeping their child out of trouble, and the potential for a college athletics scholarship, as benefits of sport. Efforts to support parental decision making should be grounded in an understanding that family preferences are contextually constrained. While all parents should be appropriately informed about the potential costs and benefits they are weighting in their sports-related decision making, such family-focused efforts should be balanced with the recognition that structural change is needed to address income-related concerns about sport participation.

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Trends in Cancer Diseases Prevalence by Different Socioeconomic Strata in the United States

10.21203/rs.3.rs-1053429/v1 ◽

2021 ◽

Author(s):

Mingsi Wang ◽

Yi Ma ◽

Liangru Zhou ◽

Yi Cheng ◽

Yue Li ◽

...

Keyword(s):

United States ◽

Low Income ◽

Family Income ◽

Temporal Trends ◽

The United States ◽

High Income ◽

Poverty Level ◽

Middle Income ◽

Socioeconomic Strata ◽

Cancer Diseases

Abstract Background Income disparity among different socioeconomic strata in the United States has widened sharply in recent decades. Take into account the well-established link between income and health, this widening income gap may provide insight into the dynamics of the cancer disease burden in American adults. Assess the temporal trends of the 20-year predicted absolute cancer risk in American adults at different socioeconomic classes. Methods The cross-sectional analyses were carried out using data from adults aged 20 to 85 years between the 1999 and 2018 NHANES. Socioeconomic status was divided into three groups based on the family income to poverty ratio (PIR): high income (PIR ≥ 4), middle income (> 1 and <4), or at or below the federal poverty level (≤ 1). Results The analysis included 49 720 participants. The prevalence of lung cancer was lower in high-income participants than in middle-income participants (0.15% [n= 19] vs 0.35% [n= 92], p <0.001). For the low-income stratum, the prevalence of breast cancer was 1.12% [n = 117], but the number of adults in the middle (1.48% [n = 391], p = 0.009) and high-income levels (1.71% [n = 219], p <0.001) has increased. Conclusions The study found that the prevalence of cancer diseases was increasingly different among participants of different socioeconomic classes of NHANES from 1999 to 2018. Further research is required on the dynamics and health impact of income inequality, as well as public health policies and efforts to reduce these inequalities.

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The Association of Individual and Regional Socioeconomic Status on Initial Peritonitis and Outcomes in Peritoneal Dialysis Patients: A Propensity Score-Matched Cohort Study

Peritoneal Dialysis International ◽

10.3747/pdi.2015.00100 ◽

2016 ◽

Vol 36 (4) ◽

pp. 395-401 ◽

Cited By ~ 10

Author(s):

Qin Wang ◽

Ke-Jie Hu ◽

Ye-Ping Ren ◽

Jie Dong ◽

Qing-Feng Han ◽

...

Keyword(s):

Risk Factors ◽

Socioeconomic Status ◽

Cohort Study ◽

Peritoneal Dialysis ◽

Propensity Score ◽

Treatment Failure ◽

Low Income ◽

Laboratory Data ◽

High Income ◽

Kaplan Meier

BackgroundResearch indicates that the socioeconomic status (SES) of individuals and the area where they live are related to initial peritonitis and outcomes in peritoneal dialysis (PD). We conducted a retrospective, multi-center cohort study in China to examine these associations.MethodsData on 2,171 PD patients were collected from 7 centers, including baseline demographic, socioeconomic, and laboratory data. We explored the potential risk factors for initial peritonitis and outcomes using univariate Cox regression and unadjusted binary logistic regression. Then, we used propensity score matching to balance statistically significant risk factors for initial peritonitis and outcomes, and Kaplan-Meier survival analysis to compare differences in peritonitis-free rates between different groups of participants after matching.ResultsA total of 563 (25.9%) initial episodes of peritonitis occurred during the study period. The Kaplan-Meier peritonitis-free rate curve showed high-income patients had a significantly lower risk than low-income patients ( p = 0.007) after matching for age, hemoglobin, albumin, and regional SES and PD center. The risk of treatment failure was significantly lower in the high-income than the low-income group after matching for the organism causing peritonitis and PD center: odds ratio (OR) = 0.27 (0.09 – 0.80, p = 0.018). Regional SES and education were not associated with initial peritonitis and outcomes.ConclusionsOur study demonstrates low individual income is a risk factor for the initial onset of peritonitis and treatment failure after initial peritonitis.

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