Proposal of a Multidimensional Poverty Index for Spanish Municipalities

There are two objectives that impel this work: first, to propose a valid, reliable, and parsimonious poverty index, named Municipal Poverty Index-Urban Audit (MPI-UA), and second, to describe the evolution of the multidimensional poverty risk of the Spanish municipalities according to C. For the construction of the MPI-UA, the information provided by the URBAN AUDIT database on Spanish municipalities with a population in excess of 20,000 inhabitants has been used. The validated data have been analyzed with the PLS technique to identify the variables that allow the establishment of the MPI-UA, although previously certain variables have had to be transformed. This chapter has valuable implications insofar as there is no known multidimensional poverty index for Spanish municipalities. Moreover, it may be of probable use for academics. In the case of local managers, the index can be useful both for the knowledge of the situation and for the design of public policies to reduce poverty.

Multidimensional Relative Poverty of Farmers in Tibetan Areas – Based on a Data Analysis on Micro Surveys

In 2020, the issue of absolute poverty has been solved, and China is building a well-off society in an all-round way. The issue of relative poverty is an important content of poverty reduction. Based on a survey data from Danba County in October 2020, this paper uses the AF method to calculate the incidence of multidimensional poverty and the multidimensional poverty index. The results showed that 44.65% of the farmers have multidimensional deprivation of any three indicators of relative poverty, and 2.79% of the farmers have serious multidimensional deprivation; the incidence of one-dimensional poverty in terms of “educational level index of head of household,” “per capita non-transfer income of households in 2019,” and “per capita household income in 2019” is the highest; at the same time, the contribution rate of the three indicators to the multidimensional poverty index is also higher than other indicators. Therefore, several suggestions have been put forward to alleviate the multidimensional relative poverty in the region from the aspects of industry development and education.

Poverty Alleviation Through Potential Zakat Collection

Morocco, is one of the many countries that still suffer from inequality and a high poverty index despite the economic growth over the last few years. Indeed, This paper aims to demonstrate the effect of Zakat on poverty alleviation and redistribution of wealth by estimating potential Zakat collection in Morocco. The results of this study indicate that potential zakat collection can fill the resources shortfall for the poverty alleviation under 1.9$ and 3.2$ a day. The total of all zakat potential in Morocco are not only sufficient to provide for the shortfall and eliminate the extreme poverty but also can generate surplus.

Migrants and non-migrants' welfare on cocoa farms in Ghana: Multidimensional poverty index approach

PurposeThe study assessed welfare of migrant and non-migrant labourers on cocoa farms in Ghana, using multidimensional poverty index (MPI) with four dimensions (education, health, dietary diversity, living standards) and 21 indicators. Specifically, we examined and compared non-monetary welfare of migrant and non-migrant labourers on cocoa farms in Ghana by adopting MPI approach. Also, we explored the factors affecting labourers' welfare.Design/methodology/approachA sample of 400 labourers was used. Qualitative and quantitative data were used. Quantile regression was used to investigate factors affecting labourers' deprivation in the different domains of non-monetary welfare.FindingsLabourers on cocoa farms are generally deprived in all the welfare indicators. Apart from having low education, labourers were underfed and lived under poor conditions. Though both migrants and non-migrants were multidimensionally poor, welfare of the later was higher than the former. Welfare of migrants and non-migrants on cocoa farms are influenced by similar factors: secondary occupation, income, credit accessibility, nature of contract and distance to social amenities.Research limitations/implicationsFor migrants, permanent status improves welfare. To improve labourers' welfare for enhanced productivity, cocoa farmers should provide permanent/long-term contracts for labourers and government should provide social amenities in cocoa-producing communities.Originality/valueMost previous welfare studies focused on farmers, with little attention paid to welfare of labourers on cocoa farms. We examined and compared the factors that affect migrant and non-migrant labourers' welfare on cocoa farms in Ghana. Moreover, we adopted the MPI (non-monetary) approach to assess labourers' welfare, instead of the expenditure and income approaches prevalent in literature.

Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania

Background Trachoma, a chronic conjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. Trachoma has been targeted for elimination as a public health problem which includes reducing trachomatous inflammation—follicular prevalence in children and reducing trachomatous trichiasis prevalence in adults. The rate of development of trachomatous trichiasis, the potentially blinding late-stage trachoma sequelae, depends on the rate of trachomatous scarring development and progression. Few studies to date have evaluated the progression of trachomatous scarring in communities that have recently transitioned to a low trachomatous inflammation—follicular prevalence. Methodology/Principal findings Women aged 15 and older were randomly selected from households in 48 communities within Kongwa district, Tanzania and followed over 3.5 years for this longitudinal study. Trachomatous inflammation—follicular prevalence was 5% at baseline and at follow-up in children aged 1–9 in Kongwa, Tanzania. 1018 women aged 15 and older had trachomatous scarring at baseline and were at risk for trachomatous scarring progression; 691 (68%) completed follow-up assessments. Photographs of the upper tarsal conjunctiva were obtained at baseline and follow-up and graded for trachomatous scarring using a previously published four-step severity scale. The overall cumulative 3.5-year progression rate of scarring was 35.3% (95% CI 31.6–39.1). The odds of TS progression increased with an increase in age in women younger than 50, (OR 1.03, 95% CI 1.01–1.05, p = 0.005) as well as an increase in the household poverty index (OR 1.29, 95% CI 1.13–1.48, p = 0.0002). Conclusions/Significance The 3.5-year progression of scarring among women in Kongwa, a formerly hyperendemic now turned hypoendemic district in central Tanzania, was high despite a low active trachoma prevalence. This suggests that the drivers of scarring progression are likely not related to on-going trachoma transmission in this district.

Disparities in Mantle Cell Lymphoma Outcomes in Hispanics: A Population Based Analysis in Texas and Florida

Introduction: Mantle cell lymphoma (MCL) is a rare, aggressive type of B-cell non-Hodgkin lymphoma (NHL) that accounts for approximately 7% of adult NHL's in the United States. (JCO PMID: 9704731)Although recent advancements in treatment have improved survival, prognosis remains poor. (Blood PMID: 30154113) There have been several recent studies demonstrating ethnic disparities in MCL, however, there is a paucity of survival outcome data in Hispanic (H) patients with MCL. (CLMLPMID: 31029647) The purpose of this study was to compare the demographics, treatment patterns, and survival outcomes of H and Non-Hispanic (NH) patients diagnosed with MCL, and to contrast Hispanic cohorts between Texas (TX) and Florida (FL). Methods: This is a retrospective cohort study of patients diagnosed with lymphoma (Hodgkin and Non-Hodgkin) from the Texas Cancer Registry (TCR) and the Florida Cancer Data System (FCDS) from 2006-2017. This particular analysis focuses on patients with diagnosis of MCL. Key variables included gender, race, ethnicity, birthplace, dates of diagnosis and death, primary payer at diagnosis, poverty index, stage at diagnosis, and type of treatment. The significance of variation in distribution of categorical outcomes with ethnicity [H, NH] was assessed with Fisher's Exact tests or Pearson's Chi-square as appropriate; age was assessed with T-test or Wilcoxon. Survival time was measured in years from date of primary diagnosis to date of death. Survival distributions were described with Kaplan-Meier curves and significance of variation in median survival with ethnicity was assessed with log rank testing. All statistical testing was two-sided with a significance level of 0.05. Results: We identified a total 4619 (2078 TX, 2541 FL) patients with MCL. 669 (15%) were H and 3950 (85%) were NH. In TX, the median age of diagnosis was 65.6 years (y) in H and 68.3 y in NH (p < 0.001). In FL, the median age of diagnosis was 67.56 in H and 70.06 in NH (p < 0.001). There was a statistically significant difference in poverty index between the cohorts in both TX and FL. The majority of H (50%) in TX were in the 20-100% bracket while the majority of NH (36%) in TX were in the 10-19.9% bracket (p < 0.001). The majority of H (39%) in FL were in the 10-19.9% bracket, and the majority of NH (35%) were also in the 10-19.9% bracket (p < 0.001). Interestingly, there were only 30% of H in FL in the 20-100% bracket. There was a statistically significant difference in insurance status with the most frequent insurance being government-sponsored insurance for H in TX (48%), NH in TX (58%), H in FL (48%), and NH in FL (62%). Patients were without insurance at time of diagnosis in 14% of H in TX and 9% of H in FL, in contrast to 4% of NH in TX and 2% NH in FL. The most common stage at diagnosis in both cohorts in TX and FL was Stage III/IV with 68% H in TX vs 65% NH in TX (p = 0.746) and 69% H in FL vs 67% NH in FL (p = 0.316). The most frequent chemotherapy regimen included multiple agents for all cohorts, 43% H in TX vs 37% NH in TX (p = 0.063), and 48% H in FL vs 42% NH in FL (p = 0.695). Median survival time was 3.4 y H in TX, 3.5 y NH in TX, 4.1 y H in FL, and 4.3 y NH in FL. The survival probability at 2 years was 0.636, 0.640, 0.707, 0.675 for H in TX, NH in TX, H in FL, and NH in FL, respectively. The survival probability at 5 years was 0.371, 0.379, 0.445, 0.459 for H in TX, NH in TX, H in FL, and NH in FL, respectively. The survival probability at 10 years was 0.147, 0.118, 0.276, 0.245 for H in TX, NH in TX, H in FL, and NH in FL, respectively. There was no statistically significant difference in survival probability at 2, 5, or 10 years between H and NH in TX (p = 0.68) and FL (p = 0.72). Conclusions: Our study of patients diagnosed with MCL demonstrated statistically significant differences between H and NH patients in median age of diagnosis, poverty index, and insurance status at diagnosis. These disparities were observed in patients between the cancer registries in both states. Although there were no statistically significant differences in median survival time or survival probability at 2, 5, and 10 years among the H cohorts within each state, we observed intriguing data when the two states were compared. Strikingly, H in TX had much lower survival probability at 2, 5, and 10 years compared to H in FL. In addition, H in TX were noted to have a shorter median survival time compared to H in FL. These disparities may be a direct reflection of the significantly higher rates of poverty and lack of insurance among H in TX compared to H in FL. Figure 1 Figure 1. Disclosures Diaz Duque: ADCT Therapeutics: Research Funding; Astra Zeneca: Research Funding; Hutchinson Pharmaceuticals: Research Funding; Epizyme: Research Funding.

Primary Central Nervous System Lymphoma: A Retrospective Study of the Population of Texas and Florida with an Emphasis on Survival Outcomes on Hispanics Vs Non-Hispanics

Introduction Primary central nervous system lymphoma (PCNSL) is a devastating subtype of extranodal non-Hodgkin's lymphoma (NHL) that accounts for ~4% of newly diagnosed central nervous system (CNS) tumors. (NeuroOncol PMID: 21915121) The age-adjusted incidence of PCNSL in the U.S. has increased since the 1970s. (ACS PMID: 19273630) despite advances in the treatment of lymphoma, and clinical outcomes remain poor with an estimated 5- year survival for immunocompetent patients at 30%. (NCBIPMID:31424729) Trends in outcomes of PCNSL have been reported, but sub-analyses for minorities like Hispanics (HI), have not been widely studied. Understanding ethnic disparities on outcomes and patterns of care in PCNSL are crucial given the rapid growth of HI in the U.S. This study aims to examine the demographics, treatment patterns, and survival outcomes of PCNSL in HI compared to Non-Hispanics (NH) in Texas (TX) and Florida (FL). Methods This is a retrospective study of a cohort of patients diagnosed with lymphoma (Hodgkin and Non-Hodgkin) from the TX Cancer Registry (TCR) and the FL Cancer Data System (FCDS) from 2006-2017. Patients with PCNSL were identified by the International Classification of Diseases for Oncology Third Edition (ICD-O-3) code list. Standard demographic variables collected include gender, ethnicity, dates at diagnosis and death, primary payer at diagnosis, type of treatment and poverty index (PI). The significance of variation in the distribution of categorical outcomes with ethnicity (HI and NH) was assessed with Fisher's Exact tests or Pearson's Chi-square tests as appropriate; age was assessed with T-tests or Wilcoxon tests as appropriate. Survival distributions were described with Kaplan-Meier curves and significance of variation in median survival with ethnicity was assessed with log rank testing. All statistical testing was two-sided with a significance level of 5%. Results The study included 1969 patients (TX: n=297 HI, n= 708 NH; FL: n=149 HI, n=415 NH). PCNSL was diagnosed at younger median age in HI (TX: 59,FL:59) compared to NH (TX: 62, FL:63),with a significant difference noted within each state (TX: p= 0.005; FL: p=0.007). HI in TX were identified primarily as Mexican, Spanish or NOS/Hispanic. There was a significant predominance of overall males (M) in TX (p=0.009). There was a non-significant predominance of M in FL. Regarding poverty index (PI), there were more HI (TX:51% and FL: 35%) in the 20-100% bracket than NH (TX: 25%; FL: 22%). Conversely there were more NH in all other PI in TX and FL. Government sponsored insurance was the most common insurance in all subgroups. This reached a significant predominance in HI (54%) and NH (54%) in TX (p<0.001). There was no significant difference in insurance types between HI and NH in FL(p=0.772). Regarding chemotherapy there was a trend to either use multiple agents [(TX: 34% in HI vs 32% in NH; p=0.68); (FL: 33% in HI vs 67% in NH; p=0.042)] or to not offer chemotherapy at all [(TX: 26% in HI vs 29% in NH; p= 0.68); (FL: 44% in HI vs 33% in NH; p=0.042)] with significant differences noted in FL only. (Table 1) The median survival (MS) for HI and NH in TX was similar in years (y) at 0.8 while the MS time in FL for HI vs NH was higher (1.3 vs 0.6 respectfully) Thus, the MS for HI in FL was higher compared to NH in FL and HI and NH in both TX and FL. (Table 2) The survival probability for HI was shorter at 2 and 5 years compared to NH in TX with a non-significant overall survival (OS) probability (p-value=0.19) seen in Figure 1. Significantly, the survival probability of HI in FL at 2, 5 and 10 years was higher compared to NH with an OS probability (p-value=0.0063) seen in Figure 2. Conclusion This retrospective study showed a statistically significant difference in OS probabilities at all years between HI and NH in FL with PCNSL. The OS probability also remained higher in HI in FL compared to both HI and NH in TX. In addition, the study demonstrated a longer MS in HI in FL compared to not only HI in TX, but also both NH in TX and FL. Sociodemographic differences like gender and insurance types were noted between HI in TX and FL. HI origin groups are also a subject of interest. The primary HI origin group in TX were Mexican and not otherwise specified (NOS). This data was missing for FL HI. Future studies should be conducted to uncover any further disparities between these two HI populations to explore the impact of access to care and disease biology on PCNSL survival outcomes. Figure 1 Figure 1. Disclosures Diaz Duque: Incyte: Consultancy; Morphosys: Speakers Bureau; Astra Zeneca: Research Funding; Hutchinson Pharmaceuticals: Research Funding; Epizyme: Consultancy; ADCT: Consultancy.

Understanding Oncological Disparities in Mycosis Fungoides within Hispanic Enriched Communities

Introduction Cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of extra-nodal non-Hodgkin's lymphomas that are characterized by a cutaneous infiltration of malignant monoclonal T lymphocytes (F1000Res. PMID 27540476). Among them, Mycosis Fungoides (MF) is the most predominant subtype, accounting for 50-65% of cases (An Bras Dermatol. PMID 30066762). Although most patients with MF are Non-Hispanic (NH), from the 1970s to 2010s there has been an increase in the percentage of HI patients (4% to 11%, respectively) (J Eur Acad Dermatol Venereol. PMID 32141115). Racial disparities in MF have been studied, but they are still poorly understood in Hispanic (HI) populations and further studies are needed to evaluate the role of ethnicity in MF outcomes. In this study, we focused on two communities, Texas (TX) and Florida (FL), which have a strong HI representation. According to the U.S 2020 Census, 39% of the population of TX and 26% of the population of FL are HI. Therefore, the purpose of this study is to compare demographics, treatment patterns, and survival outcomes of HI and NH patients diagnosed with MF, and to contrast HI cohorts between TX and FL. Methods This is a retrospective analysis of patients diagnosed and recorded in the Texas Cancer Registry and the Florida Cancer Data System from years (y) 2006-2017. Inclusion criteria was histopathologic proven MF. Patients were divided into HI and NH for comparison. Standard demographic, socioeconomic, clinical, and survival variables were reviewed. All statistical testing was determined using Fisher's Exact test, Pearson's Chi-square test, T-test or Wilcoxon test, as appropriate. Survival time was measured using the day of diagnosis to last date of follow up or death. Survival distribution were calculated based on Kaplan-Meier curves. All statistical testing was two-sided with a significance level of 5%. Results We identified a total 2566 (1373 TX, 1193 FL) patients with MF. 319 (12%) were HI and 2247 (88%) were NH. The median age of diagnosis in our TX population was 50 y in HI and 59 y in NH (p < 0.001). In FL, the median age of diagnosis was 57 y in HI and 65 y in NH (p <0.001). There was a statistically significant difference in poverty index between HI and NH in both TX and FL. The majority of HI (42%) in TX were in the 20-100% bracket while the majority of NH (28%) in TX were in the 10-19.9% bracket (p<0.001). In contrast, the majority of HI (36%) in FL were in the 10-19.9% bracket while the majority of NH (34%) in FL were also in the 10-19.9% bracket (p<0.001). In patient where insurance status was known, there was a statistically significant difference in insurance status with the most frequent insurance being private insurance for HI in TX (28%) and NH in TX (24%) (p<0.001). In FL, HI (39%) had private insurance whereas NH (30%) had government-sponsored insurance (p<0.001). The most common stage at diagnosis in both cohorts in TX and FL was Stage I with 56% HI in TX vs 56% NH in TX (p=0.526) and 54% HI in FL vs 44% NH in FL (p=0.052). In both cohorts, majority of HI (71%) in TX, and NH (72%) in TX (p=0.38), HI (73%) in FL and NH (81%) (p=0.156) did not undergo chemotherapy. In TX, median survival (MS) was 10.8 y for HI, and 9.7y for NH; whereas in FL, MS was not reached for HI, and for NH was 8.3y. The survival probability at 2 y was 0.921, 0.904, 0.875, 0.836 for HI in TX, NH in TX, HI in FL, and NH in FL, respectively. The survival probability at 5 y was 0.819, 0.775, 0.728, 0.665 for HI in TX, NH in TX, HI in FL, and NH in FL, respectively. The survival probability at 10 y was 0.714, 0.440, 0.512, 0.451 for HI in TX, NH in TX, HI in FL, and NH in FL, respectively. There was no statistically significant difference in overall survival (OS) probability between HI and NH in TX (p = 0.079) and FL (p = 0.28). Conclusions In this study, we evaluated ethnic disparities in MF, we chose to study TX and FL, two states that have a strong HI representation. In both populations, we found a statistically significant difference between HI and NH in poverty index and insurance status. Although there were no statistically significant differences in median survival time or survival probability at 2, 5, and 10 y among the HI and NH cohorts within each state, we observed that NH and HI in FL had a lower survival probability at 2, 5, and 10 y when compared to NH and HI in TX. Moreover, NH in TX had a much lower OS probability when compared to HI. These disparities may be a direct reflection of the significantly higher rates of poverty among HI in FL compared to HI in TX. Figure 1 Figure 1. Disclosures Diaz Duque: Incyte: Consultancy; Morphosys: Speakers Bureau; Astra Zeneca: Research Funding; Hutchinson Pharmaceuticals: Research Funding; Epizyme: Consultancy; ADCT: Consultancy.

Population-Based Analysis of Hispanic Vs Non-Hispanic Patients Diagnosed with Hodgkin Lymphoma in Texas and Florida

Introduction: Classical Hodgkin lymphoma (cHL) accounts for about 90% of cases of HL. (Medicine PMID 26107683) Within cHL, there are 4 main histologic subtypes; the incidence of cHL varies based on age, race/ethnicity, geography, socioeconomic factors, Epstein Barr virus status, and the prevalence of HIV/AIDS. (Adv HematologyPMID 21197477) Considerable disparities exist in the incidence and survival rates between Hispanic (H) and non-Hispanic (NH) populations with cHL. (Ann Oncol PMID 22241896) Between 2013-2017, the incidence rate of cHL in Florida (FL) was 457 per 100,00, and in Texas (TX), it was 408 per 100,000. (North American Association of Central Cancer Registries, 2020) Our study aims to determine demographics, treatment outcomes, and survival outcomes of H and NH patients diagnosed with cHL in TX and FL. Methods: This is a retrospective study of a cohort of patients diagnosed with lymphoma (Hodgkin and Non-Hodgkin) from the Texas Cancer Registry (TCR) and the Florida Cancer Data System (FCDS) between 2006-2017. The third edition of the International Classification of Diseases for Oncology (ICD-O-3) was used to identify patient with cHL. Variables include gender, race, ethnicity, birthplace, occupation, dates at diagnosis and death, primary payer at diagnosis, subtype of lymphoma, stage, type of treatment, poverty index, and vitality status. The significance of variation in the distribution of categorical outcomes with ethnicity (H, NH) was assessed with Fisher's Exact tests or Pearson's Chi-square tests as appropriate; age was assessed with T-tests or Wilcoxon tests as appropriate. Survival time was measured in years from date of primary diagnosis to the date of death. Survival distributions were described with Kaplan-Meier curves and significance of variation in median survival with ethnicity was assessed with log rank testing. At risk tables were computed based on the Kaplan-Meier estimate of the survival curve. All statistical testing was two-sided with a significance level of 5%. Corrections for multiple testing were not applied. Results: There were 6152 (1266 H, 4886 NH) patients in FL and 6241(1736 H, 4505 NH) patients in TX identified with cHL. In FL, the median age at diagnosis was 44.8 years (y) for H vs 48.3y for NH (p < 0.001) while in TX, there was no statistically significant difference (45.8y H, 44.9y NH, p = 0.102). In FL, there was no statistically significant difference among females (44% H, 46% NH, p = 0.136) and males (56% H, 53% NH, p = 0.136) while there was one in TX among females (43% H, 45% NH, p = 0.048) and males (58% H, 55% NH, p = 0.048). In FL, the majority of H (40.5%) and NH (36.6%) were in the 10-19.9% poverty index (p<0.001). In TX, the majority of H (51.2%) were in the 20-100% poverty index while the majority of NH (32.2%) were in the 10-19.9% index (p<0.001). In FL, 10.7% H and 6.4% NH were without insurance at time of diagnosis (p<0.001) while in TX, 23.8% H and 11.7% NH were in that position (p<0.001). The most common stage of diagnosis was stage III/IV with 37.8% H vs 34.2% NH in FL (p<0.001) and 44.1% H vs 34.6% NH in TX (p<0001). In FL, median survival time was 10.6y H vs 11.4y NH, while in TX, it was 10.3y H vs 10.4y NH. In FL, the survival probabilities at years 2, 5, and 10 were 0.858, 0.774, and 0.550 for H vs 0.808, 0.696, and 0.545 for NH, respectively. In TX, the survival probabilities at years 2, 5, and 10 were 0.758, 0.674, and 0.522 for H vs 0.828, 0.743, and 0.579 for NH, respectively. The survival probability at years 2, 5, and 10 were higher for H compared to NH in FL (p = 0.0018), however the survival probability at years 2, 5, and 10 were lower for H compared to NH in TX (p < 0.0001). Conclusion: Our study of patients diagnosed with cHL demonstrated several statistically significant differences among H and NH patients in both states. Importantly, H patients in TX had a statistically significant lower survival probability at 2, 5, and 10y compared to NH patients. A reason for this could be the more significant number of uninsured H as compared to NH patients. Conversely, H patients in FL had a statistically significant higher survival probability at 2 and 5y compared to NH patients, partly explained by the lower median age of diagnosis of H patients compared to NH patients. There is a need for further analysis that could help explain the disparities among the different ethnicities. Figure 1 Figure 1. Disclosures Diaz Duque: Astra Zeneca: Research Funding; Epizyme: Consultancy; Morphosys: Speakers Bureau; Incyte: Consultancy; ADCT: Consultancy; Hutchinson Pharmaceuticals: Research Funding.