scholarly journals Social Determinants of Health and Neurocognitive Functioning in Sickle Cell Disease

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2030-2030
Author(s):  
Andrew M Heitzer ◽  
Jennifer Longoria ◽  
Victoria I Okhomina ◽  
Jerlym S. Porter ◽  
Jeremie H. Estepp ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Linear Regression ◽  
Social Determinants ◽  
Academic Outcomes ◽  
Bachelor's Degree ◽  
Community Level ◽  
Cell Disease ◽  
Nutrition Services ◽  
Reading And Math ◽  
Access To Food

Abstract Sickle cell disease (SCD) is associated with significant neurocognitive risk due to a combination of disease and environmental factors. Neurological complications, including overt stroke, silent cerebral infarctions, and chronic insufficiencies in oxygen and/or glucose delivery to the brain contribute to neurocognitive decline. Environmentally, patients with SCD experience greater rates of poverty and fewer protective socioeconomic factors when compared with the Black population in the United States. Both personalized (e.g. familial education and occupation) and community measures of socioeconomic status uniquely contribute to neurocognitive outcomes. However, no studies have examined the specific community-level factors that contribute to neurocognitive performance. The primary objective of this study was to investigate associations between familial and community-level social determinants with cognitive and academic outcomes in a large prospectively recruited sample of patients with SCD ranging from childhood to young adulthood. We included 103 patients with SCD (51% HbSS/HbSβ 0-thalassemia). The mean age of participants was 12.86 (SD=4.04) years. Familial socioeconomic status was measured using the Barratt Simplified Measure of Social Status (BSMSS), a composite of parent education and occupation status. Community-level (based on census block) socioeconomic variables included: poverty rate, unemployment rate, percentage of individuals with a bachelor's degree, and access to food nutrition services. Following informed consent, patients completed gold-standard neurocognitive measures supervised by a psychologist, assessing intellectual (Wechsler Abbreviated Scale of Intelligence - Second Edition) and academic functioning (Woodcock Johnson Tests of Achievement - Third Edition). Multivariate linear regression was used to examine associations between community and familial level socioeconomic status with cognitive/academic outcomes after adjusting for age, sickle genotype, and hydroxyurea exposure. Stepwise linear regression was used to identify the independent factors associated with cognitive/academic outcomes. The False discovery rate (FDR) developed by Benjamini and Hochberg was used to control for multiple testing and FDR-adjusted p-values (pFDR) <0.05 were considered statistically significant. Otherwise, p-values <0.05 were considered significant. Patients with SCD lived in communities with high rates of poverty (26.57%) and unemployment (13.58%) and low rates of college education (13.26%). In multivariate analyses adjusting for age, sickle genotype, and hydroxyurea exposure, IQ was associated with the BSMSS (estimate = 0.31, standard error [SE] = 0.10, p=0.003) at pFDR<0.05 but measures of basic reading and math were not (all pFDR>0.05). In contrast, reduced intellectual functioning was associated with increased poverty rates (Estimate=-0.29, SE=0.09, p=0.003), increased unemployment rates (estimate=-0.43, SE=0.18, p=0.018), increased access to food nutrition services (Estimate=-0.21, SE=0.09, p=0.015), and decreased percentage of individuals with a bachelor's degree (Estimate=0.33, SE=0.10, p=0.003) at pFDR<0.05. Measures of basic reading and math were not associated with any of the community-level variables. Stepwise linear regression analysis showed that the BSMSS (Estimate=0.22, SE=0.11, p=0.04) and poverty rates (Estimate=-0.18, SE=0.09, p=0.049) are independently associated with full scale IQ after adjusting for age, sickle genotype and hydroxyurea exposure. Overall, community and familial socioeconomic factors accounted for greater variance in intellectual functioning than age, genotype, and hydroxyurea treatment exposure (see Figure 1). Social determinants at the community-level contribute to intellectual development in patients with SCD independent of familial socioeconomic status. Surprisingly, academic performance was not associated with community-level social determinants. Evaluation of community-level social determinants may provide insights into potential targets for neurodevelopmental interventions. Figure 1 Figure 1. Disclosures Estepp: Global Blood Therapeutics: Consultancy, Research Funding. Hankins: Bluebird Bio: Consultancy; UpToDate: Consultancy; Global Blood Therapeutics: Consultancy; Vindico Medical Education: Consultancy.

scholarly journals Does physiological distribution of blood parameters in children depend on socioeconomic status? Results of a German cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019143 ◽  
Author(s):  
Kristin Rieger ◽  
Mandy Vogel ◽  
Christoph Engel ◽  
Uta Ceglarek ◽  
Kristian Harms ◽  
...  
Keyword(s):  
Physical Activity ◽  
Socioeconomic Status ◽  
Linear Regression ◽  
Family Income ◽  
Blood Parameters ◽  
Research Centre ◽  
Regression Analyses ◽  
Pubertal Stage ◽  
Cross Sectional ◽  
Z Scores

ObjectivesIn the present study, we examined the relation between socioeconomic status (SES) and the physiological distribution of iron-related blood parameters.DesignThis is a cross-sectional analysis of longitudinal population-based cohort study.SettingBased on a sample of healthy participants from a German research centre, various blood parameters and values of clinical examinations and questionnaires were collected.ParticipantsA total of 1206 healthy volunteers aged 2.5 to 19 years, one child per family randomly selected, were included.Primary and secondary outcome measuresAssociations between the SES of children by Winkler-Stolzenberg Index (WSI) and its dimensions (income, education, occupation) and iron-related blood parameters (haemoglobin, ferritin and transferrin) were analysed by linear regression analyses. Gender and pubertal stage were included as covariables. Additionally, associations between SES of children by WSI and physical activity (side-to-side jumps, push-ups) as well as body mass index (BMI) were analysed by linear regression analyses.ResultsChildren with high WSI or family income showed significantly increased z-scores for haemoglobin (P=0.046; P<0.001). Children with increased WSI or family income showed significantly lower z-scores for transferrin (P<0.001). There was a significant correlation between haemoglobin and gender (P<0.001) and between transferrin and pubertal stage (P=0.024). Furthermore, physical activity was positively correlated and BMI was negatively correlated with WSI (P<0.001).DiscussionOur data show an association between SES and the distribution of iron-dependent parameters. Lower SES is correlated with lower values for haemoglobin and higher values for transferrin. Furthermore, we demonstrate that physical activity and BMI are associated with SES. Whereas higher SES is correlated with higher values for physical activity and lower BMI. Our parameters are standardised as z-scores with the advantages that the results are comparable across different age groups and present physiological courses.Trial registration numberNCT02550236; Results.

scholarly journals Individual and Community Social Determinants of Health Associated With Diabetes Management in a Mexican American Population

2021 ◽  
Vol 8 ◽  
Author(s):  
Kehe Zhang ◽  
Belinda Reininger ◽  
Miryoung Lee ◽  
Qian Xiao ◽  
Cici Bauer
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Mexican American ◽  
Diabetes Management ◽  
Spatial Models ◽  
Neighborhood Context ◽  
Community Level ◽  
Border Region ◽  
Determinants Of Health ◽  
The Individual

Background: Diabetes is a major health burden in Mexican American populations, especially among those in the Lower Rio Grande Valley (LRGV) in the border region of Texas. Understanding the roles that social determinants of health (SDOH) play in diabetes management programs, both at the individual and community level, may inform future intervention strategies.Methods: This study performed a secondary data analysis on 1,568 individuals who participated in Salud y Vida (SyV), a local diabetes and chronic disease management program, between October 2013 and September 2018 recruited from a local clinic. The primary outcome was the reduction of hemoglobin A1C (HbA1C) at the last follow-up visit compared to the baseline. In addition to age, gender, insurance status, education level and marital status, we also investigated 15 community (census tract) SDOH using the American Community Survey. Because of the high correlation in the community SDOH, we developed the community-level indices representing different domains. Using Bayesian multilevel spatial models that account for the geographic dependency, we were able to simultaneously investigate the individual- and community-level SDOH that may impact HbA1C reduction.Results: After accounting for the diabetes self-management education classes taken by the participants and their length of stay in the program, we found that older age at baseline, being married (compared to being widowed or divorced) and English speaking (compared to Spanish) were significantly associated with greater HbA1C reduction. Moreover, we found that the community level SDOH were also highly associated with HbA1C reduction. With every percentile rank decrease in the socioeconomic advantage index, we estimated an additional 0.018% reduction in HbA1C [95% CI (−0.028, −0.007)]. Besides the socioeconomic advantage index, urban core opportunity and immigrant's cohesion and accessibility indices were also statistically associated with HbA1C reduction.Conclusion: To our knowledge, our study is the first to utilize Bayesian multilevel spatial models and simultaneously investigate both individual- and community-level SDOH in the context of diabetes management. Our findings suggest that community SDOH play an important role in diabetes control and management, and the need to consider community and neighborhood context in future interventions programs to maximize their overall effectiveness.

Parenting of Divorced Mothers as a Link between Social Status and Boys' Academic Outcomes: Unpacking the Effects of Socioeconomic Status

1999 ◽  
Vol 70 (5) ◽  
pp. 1231-1245 ◽  
Author(s):  
David S. DeGarmo ◽  
Marion S. Forgatch ◽  
Charles R. Martinez, Jr.
Keyword(s):  
Socioeconomic Status ◽  
Social Status ◽  
Academic Outcomes

The Contribution of Socioeconomic Status to Children's Performance on Three Grammatical Measures in the Edmonton Narrative Norms Instrument

2021 ◽  
pp. 1-10
Author(s):  
Brian Weiler ◽  
Phyllis Schneider ◽  
Ling-Yu Guo
Keyword(s):  
Socioeconomic Status ◽  
Linear Regression ◽  
Chronological Age ◽  
Normative Sample ◽  
Verb Morphology ◽  
Link Type ◽  
Relative Contribution ◽  
Language Status ◽  
Study Offer ◽  
Child Age

Purpose The purpose of this study was to evaluate the relative contribution of socioeconomic status (SES) on three grammatical measures—finite verb morphology composite (FVMC), percent grammatical utterances (PGU), and clausal density—in children between the ages of 4 and 9 years. Method Data for this study were from the normative sample in the Edmonton Narrative Norms Instrument. For 359 children, hierarchical linear regression was performed to evaluate the amount of variance in FVMC, PGU, and clausal density that was uniquely explained by SES after accounting for child chronological age and language status (typical, impaired). Results After child age and language status were controlled, SES was a significant predictor of PGU and clausal density scores, but not of FVMC scores. SES uniquely accounted for 0.5% of variance in PGU scores and 0.8% of variance in clausal density scores. Conclusions Consistent with maturational accounts of children's development of tense markers, results of this study offer evidence that, among grammatical measures, FVMC is uniquely robust to variation in SES. Although significant, the variance of PGU and clausal density scores uniquely accounted for by SES was close to minimum. Clinicians can therefore include these three grammatical measures for assessing children of different socioeconomic backgrounds. Supplemental Material https://doi.org/10.23641/asha.14810484

Using Community-Level Mental Health Surveillance Data to Examine the Relationship of Depression Prevalence to Social Determinants of Health and Access to Mental Health Services

2013 ◽  
Vol 32 (1) ◽  
pp. 43-57 ◽  
Author(s):  
Shawn R. Currie ◽  
Kirsten Fiest ◽  
Lindsay Guyn
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Low Income ◽  
Community Level ◽  
Determinants Of Health ◽  
Treatment Access ◽  
Depression Prevalence

The effect of social determinants of health on depression prevalence and treatment access was examined using community survey and administrative data on mental health service users in the Calgary Health Region (CHR). Consistent with national prevalence data, depression was significantly associated with female gender, younger age, and health risk factors such as smoking, hypertension, and obesity. The prevalence of depression causing interference in daily functioning across 19 social districts (subregions within the CHR) was significantly related to community-level indicators of single-parent status, low-income families, and low educational achievement in each district. Disparities in treatment access were also found with persons living in the most impoverished districts having the lowest rates of accessing professional mental health services.

Socioeconomic Status and Academic Outcomes in Developing Countries: A Meta-Analysis

2019 ◽  
Vol 89 (6) ◽  
pp. 875-916 ◽  
Author(s):  
Sung won Kim ◽  
Hyunsun Cho ◽  
Lois Y. Kim
Keyword(s):  
Socioeconomic Status ◽  
Developing Countries ◽  
Academic Outcomes ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Developed Countries ◽  
Industrialized Countries ◽  
And Gender ◽  
Meta Analyses ◽  
K 12

Despite the multiple meta-analyses documenting the association between socioeconomic status (SES) and achievement, none have examined this question outside of English-speaking industrialized countries. This study is the first meta-analytic effort, to the best of our knowledge, to focus on developing countries. Based on 49 empirical studies representing 38 countries, and a sample of 2,828,216 school-age students (grades K–12) published between 1990 and 2017, we found an overall weak relation between SES and academic outcomes. Results for attainment outcomes were stronger than achievement outcomes, and the effect size was stronger in more economically developed countries. The SES-academic outcome relation was further moderated by grade level and gender. There were no differences in the strength of the relation by specific SES measures of income/consumption, education, and wealth/home resources. Our results provide evidence that educational inequalities are wider in higher income countries, creating a serious challenge for developing countries as they expand school access.

The Bannatyne Recategorization Assessment Procedure: Is it Valid for Individual Diagnosis of LD Children?

1986 ◽  
Vol 9 (3) ◽  
pp. 208-213 ◽  
Author(s):  
William D. Dundon ◽  
Trevor E. Sewell ◽  
John L. Manni ◽  
David Goldstein
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Assessment Procedure ◽  
Diagnostic Utility ◽  
Low Socioeconomic ◽  
Math Scores ◽  
Reading And Math

The WISC-R subtest scores of 159 black LD children of low socioeconomic status were recategorized into Spatial (Sp), Conceptual (C), and Sequential (Sq) scales as recommended by Bannatyne (1974). As a group, the sample displayed the classic Sp > C > Sq pattern. However, only 18 of the subjects (11.3%) were identified in accordance with the requirement that the differences between categories be statistically reliable for each individual. This subgroup was matched with LD controls not demonstrating the Bannatyne pattern. Analyses of longitudinal reading and math scores revealed no differences between groups. It was concluded that the diagnostic utility of the Bannatyne pattern is questionable.

scholarly journals Socioeconomic status dependent medical complexities in children with sickle cell disease in Saudi Arabia

2020 ◽  
Vol 27 (7) ◽  
pp. 1781-1787
Author(s):  
Shahida Aziz Khan ◽  
Fayza AlSiny ◽  
Ahmad Makki ◽  
Ashraf Ali ◽  
Ibtehal AlAnsari ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Saudi Arabia ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Cell Disease

scholarly journals Prospective cohort study on the social determinants of health: Tehran University of Medical Sciences employees` cohort (TEC) study protocol

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Saharnaz Nedjat ◽  
Ramin Mehrdad ◽  
Masud Yunesian ◽  
Hamidreza Pouragha ◽  
Vali Biagi ◽  
...  
Keyword(s):  
Social Capital ◽  
Socioeconomic Status ◽  
Cohort Study ◽  
Occupational Health ◽  
Social Determinants ◽  
Prospective Cohort ◽  
Occupational Exposures ◽  
Medical Sciences ◽  
The Social ◽  
History Of

Abstract Background In this study, the association between the social determinants of health (SDH) as well as other health risk factors and outcomes will be evaluated at different socioeconomic layers. Methods/design This is a prospective cohort study that was launched in January 2018 on Tehran University of Medical Sciences’ employees. The initial enrolment phase will continue up to March 2021, or until a sample size of 5500 is reached. In addition to annual phone-calls, the participants will be followed thrice at 5-year intervals. Data are collected through blood and urine samples, complete physical examination, anthropometric evaluation, and the completion of questionnaires related to SDH, such as socioeconomic status and social capital, history of diseases, lifestyle (including, nutrition, physical activity, cigarette and hookah smoking), occupational exposures (including psychosocial factors at work and work-family conflicts), and different aspects of physical, mental and occupational health as health outcomes. The association between independent variables and health (objective or subjective) are examined using multiple models and by controlling the confounding effects. Moreover, the trend in lifestyle changes and its impact on health are evaluated. Discussion Our study will explore the key social determinants as well as other factors including socioeconomic status and social capital, history of diseases, lifestyle and occupational exposures that affect health. This will provide social and occupational health decision-makers and stakeholders with new and valuable evidence in an era in which we are witnessing huge changes in lifestyle.

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