scholarly journals Neighborhood socioeconomic disadvantage is associated with multimorbidity in a geographically-defined community

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alanna M. Chamberlain ◽  
Lila J. Finney Rutten ◽  
Patrick M. Wilson ◽  
Chun Fan ◽  
Cynthia M. Boyd ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Chronic Conditions ◽  
The United States ◽  
Neighborhood Context ◽  
Socioeconomic Disadvantage ◽  
Area Deprivation ◽  
Level Of Education ◽  
Individual Level ◽  
Increased Risk

Abstract Background Persons with low socioeconomic status may be disproportionately at risk for multimorbidity. Methods Adults aged ≥20 years on 4/1/2015 from 7 counties in Minnesota were identified using the Rochester Epidemiology Project (population-based sample). A composite measure of neighborhood socioeconomic disadvantage, the area deprivation index (ADI), was estimated at the census block group level (n = 251). The prevalence of 21 chronic conditions was obtained to calculate the proportion of persons with multimorbidity (≥2 chronic conditions) and severe multimorbidity (≥5 chronic conditions). Hierarchical logistic regression was used to estimate the association of ADI with multimorbidity and severe multimorbidity using odds ratios (OR). Results Among 198,941 persons (46.7% male, 30.6% aged ≥60 years), the age- and sex-standardized (to the United States 2010 census) median prevalence (Q1, Q3) was 23.4% (21.3%, 25.9%) for multimorbidity and 4.8% (4.0%, 5.7%) for severe multimorbidity. Compared with persons in the lowest quintile of ADI, persons in the highest quintile had a 50% increased risk of multimorbidity (OR 1.50, 95% CI 1.39–1.62) and a 67% increased risk of severe multimorbidity (OR 1.67, 95% CI 1.51–1.86) after adjusting for age, sex, race, and ethnicity. Associations were stronger after further adjustment for individual level of education; persons in the highest quintile had a 78% increased risk of multimorbidity (OR 1.78, 95% CI 1.62–1.96) and a 92% increased risk of severe multimorbidity (OR 1.92, 95% CI 1.72–2.13). There was evidence of interactions between ADI and age, between ADI and sex, and between ADI and education. After age 70 years, no difference in the risk of multimorbidity was observed across quintiles of ADI. The pattern of increasing multimorbidity with increasing ADI was more pronounced in women. Finally, there was less variability across quintiles of ADI for the most highly educated group. Conclusions Higher ADI was associated with increased risk of multimorbidity, and the associations were strengthened after adjustment for individual level of education, suggesting that neighborhood context plays a role in health above and beyond individual measures of socioeconomic status. Furthermore, associations were more pronounced in younger persons and women, highlighting the importance of interventions to prevent chronic conditions in younger women, in particular.

Abstract 13852: Socioeconomic Status is Associated With Recurrent Cardiovascular Disease Events in People With Prevalent Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lena Mathews ◽  
Ning Ding ◽  
Yejin Mok ◽  
Matthew S Loop ◽  
Amira Collison ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Total Mortality ◽  
Income Group ◽  
High Risk Group ◽  
Area Deprivation ◽  
Established Risk Factor ◽  
Increased Risk

Introduction: While low socioeconomic status (SES) is an established risk factor for incident cardiovascular disease (CVD), there is scarce data regarding the association between SES and recurrent CVD events. Hypothesis: SES measures are associated with recurrent CVD events and mortality among those with prevalent CVD. Methods: We examined 3,031 individuals in the ARIC Study who developed CVD (either myocardial infarction [MI], heart failure [HF] or stroke) from the baseline visit (1987-1989) through 2013 to allow 5 years follow-up for recurrent CVD. SES was defined using baseline measures of income, education and area deprivation index (ADI), modeled individually and combined in a cumulative SES score. We used adjusted Cox proportional hazard regression to evaluate the associations of SES with composite and individual outcomes of first recurrent CVD and mortality. Results: Median age was 69 years, 49% were female, 29% Black. Over a median follow up of 4.6 years, 2,033 participants (67%) had a recurrent CVD event, and 2,202 (73%) died. Relative to the highest income group, being in the lowest income group was associated with higher risk for recurrent CVD (HR 1.27; 95% CI: 1.07-1.51) and mortality (HR 1.32; 95% CI: 1.12-1.56) ( Table ). Similarly, less than high school education was associated with increased risk of recurrent CVD (HR 1.25; 95% CI: 1.04-1.51) and mortality (HR 1.21; 95% CI: 1.01-1.45). No significant outcome associations were seen for ADI. Low cumulative SES was associated with approximately 20% higher risk of recurrent CVD, total mortality and the composite of recurrent CVD and mortality. Similar patterns were seen for individual subtypes of CVD, with the strongest SES-mortality associations for MI and stroke. Conclusions: In the high-risk group of individuals with existing CVD, low SES was linked to greater likelihood of recurrent CVD events and death. SES should be a focus in the design of secondary prevention efforts to improve outcomes in CVD.

scholarly journals Executive Function as a Mechanism Linking Socioeconomic Status to Internalizing and Externalizing Psychopathology in Children and Adolescents

2021 ◽  
Author(s):  
Elizabeth A. McNeilly ◽  
Matthew Peverill ◽  
Jiwon Jung ◽  
Katie A McLaughlin
Keyword(s):  
Socioeconomic Status ◽  
Children And Adolescents ◽  
Inhibitory Control ◽  
Low Socioeconomic Status ◽  
The United States ◽  
Low Ses ◽  
Cross Sectional ◽  
Externalizing Psychopathology ◽  
Internalizing Psychopathology ◽  
Increased Risk

IntroductionThe association between low socioeconomic status (SES) in childhood and increased risk for psychopathology is well established, but the mechanisms explaining this relationship are poorly understood. Here, we investigate the potential role of difficulties in executive functioning (EF) as a mechanism linking childhood and adolescent SES with externalizing and internalizing psychopathology. MethodsWe examined whether difficulties with EF mediated the association between SES and externalizing and internalizing psychopathology in two cross-sectional samples of children and adolescents (Study 1: N=94, ages 6-18, 51.1% male; Study 2: N=259, ages 8-16, 54.1% male) from diverse SES backgrounds in the United States. EF was measured through behavioral tasks and parent-reported behavioral regulation (BR). ResultsIn both samples, children and adolescents from lower SES families were more likely to experience both externalizing and internalizing psychopathology than youth from more advantaged backgrounds and exhibited greater EF difficulties – they had lower performance on a task measuring inhibitory control and lower parent-rated BR. Reduced inhibitory control and BR, in turn, were associated with higher externalizing and internalizing psychopathology. In Study 1, difficulties with BR mediated the association of low-SES with both externalizing and internalizing psychopathology. In Study 2, low inhibitory control mediated the association between low-SES and externalizing psychopathology. These findings largely persisted after adjusting for exposure to violence, a form of adversity that is common in children from low-SES backgrounds. ConclusionsThese findings suggest that reduced EF may be an underlying mechanism through which low-SES confers risk for psychopathology in children and adolescents.

Do Released Prisoners’ Perceptions of Neighborhood Condition Affect Reentry Outcomes?

2020 ◽  
pp. 088740342098080
Author(s):  
Lin Liu ◽  
Christy A. Visher ◽  
Dayu Sun
Keyword(s):  
The United States ◽  
Neighborhood Context ◽  
Contextual Effect ◽  
Neighborhood Disorder ◽  
Regression Analyses ◽  
Research Attention ◽  
Neighborhood Cohesion ◽  
Individual Level ◽  
Profound Influence ◽  
Neighborhood Condition

As the United States enters a decarceration era, the factors predicting reentry success have received a rapidly growing body of research attention. Numerous studies expand beyond individual-level attributes to assess the contextual effect of neighborhoods to which released prisoners return. However, past studies predominantly used neighborhood structural/economic characteristics as the proxies of neighborhood context, leaving the roles of community cohesion and disorder understudied in the context of reentry. Using longitudinal data, this study examines the influence of neighborhood cohesion and disorder on reentry outcomes, represented by released prisoners’ determination to desist and social isolation. The results of linear regression analyses show that net of the effects of individual-level risk factors, released prisoners’ perception of neighborhood disorder exhibit profound influence on reentry outcomes. Implications for reentry programming and interventions are presented.

scholarly journals Early Life Course Pathways of Adult Depression and Chronic Pain

2013 ◽  
Vol 54 (1) ◽  
pp. 75-91 ◽  
Author(s):  
Bridget J. Goosby
Keyword(s):  
Chronic Pain ◽  
Socioeconomic Status ◽  
Life Course ◽  
Maternal Depression ◽  
Low Socioeconomic Status ◽  
Socioeconomic Disadvantage ◽  
Physical And Mental Health ◽  
Highly Educated ◽  
Adult Depression ◽  
Cumulative Inequality

Applying cumulative inequality theory, this study examines the extent to which childhood socioeconomic disadvantage and maternal depression increase the risk of major depression and chronic pain in U.S. working-aged adults. Further, I assess whether low socioeconomic status amplifies the risk of adult depression and/or pain. Using data from the 2003 National Comorbidity Survey Replication ( N=4339), I find that socioeconomic disadvantage and maternal depression during youth increases the risk of adult depression and/or chronic pain. The probability of having chronic pain increases in magnitude over the life course for adults whose parents have lower educational attainment relative to those with more highly educated parents. Childhood socioeconomic circumstances are not completely explained by adulthood socioeconomic status indicators. These findings help illustrate the far-reaching influence of childhood context on adult physical and mental health.

Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

2021 ◽  
pp. 238008442110356
Author(s):  
D.J. Gaskin ◽  
H. Zare ◽  
R. McCleary ◽  
O. Kanwar ◽  
A.L. Davis
Keyword(s):  
Socioeconomic Status ◽  
Oral Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
The United States ◽  
Permanent Teeth ◽  
Dental Visit ◽  
Low Socioeconomic ◽  
The Past ◽  
Dental Needs

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents. Results: Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y. Conclusion: Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health. Knowledge Transfer Statement: Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

scholarly journals Relation of Sociodemographics and Personal Hygiene on Different Childhood Dermatoses

2015 ◽  
Vol 13 (1) ◽  
pp. 29-33
Author(s):  
E Gauchan ◽  
A Kumar ◽  
G BK ◽  
P Thapa ◽  
J Pun
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Skin Disease ◽  
Skin Diseases ◽  
Public Health Problem ◽  
Personal Hygiene ◽  
Cross Sectional ◽  
Dermatology Department ◽  
Low Socioeconomic ◽  
Increased Risk

Background Skin diseases in children contribute to significant morbidity and psychological distress. Infective dermatoses are one of the major dermatoses in children. Low socioeconomic status, overcrowding and poor personal hygiene has been linked to skin diseases.Objective To find out the prevalence of infectious skin disease in children, rate of transmissible skin disease and association of sociodemographic factors and personal hygiene on infective childhood dermatoses.Method This was a cross-sectional study conducted in the Pediatric and Dermatology Department, Manipal Teaching Hospital, Pokhara, Nepal. A total of 226 patients were examined over a period of one year. Relation of sociodemographics, crowding and personal hygiene on skin disease were assessed.Result The most common category was Infections and Infestations (51.3%) followed by Dermatitis (27.9%) . Transmissible skin disease was seen in 49.6%. Low socioeconomic status and overcrowding were associated with increased risk for infective dermatoses.Conclusion Skin disease in children constitutes a public health problem. Improving the socioeconomic status and personal hygiene can help to reduce the incidence of skin disease in children.Kathmandu University Medical Journal Vol.13(1) 2015; 29-33

Prolonged elevations in haemostatic and rheological responses following psychological stress in low socioeconomic status men and women

2003 ◽  
Vol 89 (01) ◽  
pp. 83-90 ◽  
Author(s):  
Sabine Kunz-Ebrecht ◽  
Ann Rumley ◽  
Gordon Lowe ◽  
Andrew Steptoe
Keyword(s):  
Socioeconomic Status ◽  
Factor Viii ◽  
Psychological Stress ◽  
Low Socioeconomic Status ◽  
Stress Responses ◽  
Blood Viscosity ◽  
Stress Reactivity ◽  
Plasma Viscosity ◽  
Low Socioeconomic ◽  
Increased Risk

SummaryLow socioeconomic status (SES) and psychological stress are associated with increased risk of coronary heart disease, and both may influence haemostatic responses. Von Willebrand factor (vWF), Factor VIII, plasma viscosity, haematocrit, blood viscosity, tissue plasminogen activator (t-PA) and fibrin D-dimer were measured at rest and following stressful tasks in 238 middle-aged British civil servants. SES was defined by grade of employment. Lower SES was associated with higher resting vWF, Factor VIII and plasma viscosity. Psychological stress stimulated increases in haemostatic and rheological factors. Initial stress responses did not vary with SES, but Factor VIII, plasma viscosity and blood viscosity remained more elevated 45 minutes post-stress in lower SES participants. High blood pressure stress reactivity was also associated with greater haemostatic responses. We conclude that lower SES is characterised by more prolonged elevations in procoagulant responses following psychological stress, and that these processes might contribute to increased cardiac risk.

Individual and Organizational Factors Associated With Hospital Readmission Rates: Evidence From a U.S. National Sample

2019 ◽  
Vol 39 (10) ◽  
pp. 1153-1158 ◽  
Author(s):  
Kyaien O. Conner ◽  
Hongdao Meng ◽  
Victoria Marino ◽  
Timothy L. Boaz
Keyword(s):  
Hospital Readmission ◽  
Chronic Conditions ◽  
Transitional Care ◽  
Hospital Readmissions ◽  
Severity Of Illness ◽  
Organizational Factors ◽  
The United States ◽  
Multiple Chronic Conditions ◽  
Important Indicator ◽  
Increased Risk

Objective: Hospital readmission rate is an important indicator for assessing quality of care in the acute and postacute settings. Identifying factors that increase risk for hospital readmissions can aid in the recognition of potential targets for quality improvement efforts. The main objective of this brief report was to examine the factors that predict increased risk of 30-day readmissions. Method: We analyzed data from the 2013 National Readmission Database (NRD). Results: The main factors that predicted increased risk of 30-day readmission were number of chronic conditions, severity of illness, mortality risk, and hospital ownership. Unexpectedly, discharge from a for-profit hospital was associated with greater risk for hospital readmission in the United States. Discussion and Conclusion: These findings suggest that patients with severe physical illness and multiple chronic conditions should be the primary targets for hospital transitional care interventions to help reduce the rate of unnecessary hospital readmissions.

scholarly journals Disentangling associations between poverty at various levels of aggregation and mental health

2007 ◽  
Vol 16 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Marjan Drukker ◽  
Nicole Gunther ◽  
Jim van Os
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Health Outcomes ◽  
Service Use ◽  
Psychiatric Morbidity ◽  
Socioeconomic Disadvantage ◽  
Mental Health Outcomes ◽  
Individual Level ◽  
Neighbourhood Socioeconomic Status ◽  
Subjective Mental Health

AbstractThe present editorial discusses whether socioeconomic status of the individual and of the neighbourhood could be important in prevalence, treatment and prevention of psychiatric morbidity. Previous research showed that patients diagnosed with mental disorders are concentrated in socioeconomically disadvantaged areas. This could be the result of (1) an association between individual socioeconomic status and mental health, (2) an association between neighbourhood socioeconomic status and mental health, or (3) social selection. Research disentangling associations between individual and neighbourhood socioeconomic status on the one hand and mental health outcomes on the other, reported that neighbourhood socioeconomic disadvantage was associated with individual mental health over and above individual-level socioeconomic status, indicating deleterious effects for all inhabitants both poor and affluent. In conclusion, subjective mental health outcomes showed stronger evidence for an effect of neighbourhood socioeconomic status than research focussing on treated incidence. Within the group of patients, however, service use was higher in patients living in disadvantaged neighbourhoods. Social capital was identified as one of the mechanisms whereby neighbourhood socioeconomic disadvantage may become associated with observed reductions in mental health. After controlling for individual socioeconomic status, there is evidence for an association between neighbourhood socioeconomic status and objective as well as subjective mental health in adults. Evidence for such an association in young children is even stronger.

Sign in / Sign up

Export Citation Format

Share Document