The Fear of COVID-19 Pandemic in Triggering Tourists' Material Deprivation, Social Rights, Social Participation, and Cultural Integration: The Mediating Role of Bullying

The paper investigated the impact of the fear of the COVID-19 pandemic on tourists' social exclusion in terms of material deprivation, social rights, social participation, and cultural/normative integration, through the mediating role of bullying, in the early days of COVID-19 pandemic. Drawing on social exclusion theory, we adopted a quantitative approach and an integrative model to collect data from 473 tourists through a web-based survey from 5th March to 17th June 2020. The results demonstrated that the fear of COVID-19 has a significant influence on tourists’ social exclusion, and in turn, has led to bullying. Besides, bullying has a significant influence on material deprivation, social rights, social participation, and cultural/normative integration of social participation. In addition, this study determined that the effect of the fear of COVID-19 on tourists' social exclusion is partially mediated by bullying. This study also draws attention to the importance of upholding the values of humanity and positive human transactions in times of crisis and pandemics.

Solitary confinement and institutional harm

In a given year, one in five people incarcerated in the U.S. prisons is locked in solitary confinement. We study solitary confinement along three dimensions of penal harm: (1) material deprivation, (2) social isolation, and (3) psychological distress. Data from a longitudinal survey of incarcerated men who are interviewed at baseline in solitary confinement are used to contrast the most extreme form of penal custody with general prison conditions observed at a follow-up interview. Solitary confinement is associated with extreme material deprivation and social isolation that accompanies psychological distress. Distress is greatest for those with histories of mental illness. Inactivity and feelings of dehumanization revealed in qualitative interviews help explain the distress of extreme isolation, lending empirical support to legal arguments that solitary confinement threatens human dignity.

Where Are We on the Animal Welfare Map? Using GIS to Assess Stakeholder Diversity and Inclusion

Inequities exist in all facets of society, and animal welfare organizations (AWOs) and their communities are no exception. These organizations interface with multiple stakeholder groups. An active analysis of stakeholder groups to identify under-served areas and communities has not been performed. Using stakeholder data from Toronto Humane Society (THS) from 2015–2019, this study performed a retrospective spatial analysis to identify well served and under-served geographic areas for adopters, surrenders, public veterinary service (PVS) clients, volunteers and foster parents, using Hot Spot analysis. Correlation analysis was performed to determine whether the spatial distribution of the groups correlated with the four socioeconomic metrics of the 2016 Ontario Marginalization Index (residential instability, material deprivation, dependency, and ethnic concentration), and a metric representing the distribution of Indigenous residents. For each stakeholder group, there were well served areas, typically in central Toronto where THS is located, and under-served areas, typically in the north-west and north-east corners of Toronto and in the surrounding cities of the Greater Toronto Area. The area served by THS PVS extended further north than the other hot spot areas. The number of adopters increased as the residential instability metric increased, whereas the number of adopters decreased as the ethnic concentration metric increased. The rate of surrenders increased as the Indigenous metric increased. Public Veterinary Service clients increased as the residential instability, material deprivation, and Indigenous metrics increased. One of the primary limitations of this study was the confounding factor of distance from THS. Individuals living further from THS are less likely to utilize its services, particularly if there is another accessible AWO nearby, and therefore may appear to reflect an under-served population that may not truly be under-served. A regional approach would help to overcome this limitation. The results provide useful insights into stakeholder engagement and provide a foundation for analysis of more targeted areas, as well as for strategies to reach under-served demographics. Similar analyses by other AWOs would be helpful to address inequities in a larger geographic area. Animal welfare organizations can improve program effectiveness by adding data analytics skills to the more traditional skills associated with this sector.

Influence of Material Deprivation on Clinical Outcomes Among People Living with HIV in High-Income Countries: A Systematic Review and Meta-analysis

Despite developments in HIV treatment and care, disparities persist with some not fully benefiting from improvements in the HIV care continuum. We conducted a systematic review to explore associations between social determinants and HIV treatment outcomes (viral suppression and treatment adherence) in high-income countries. A random effects meta-analysis was performed where there were consistent measurements of exposures. We identified 83 observational studies eligible for inclusion. Social determinants linked to material deprivation were identified as education, employment, food security, housing, income, poverty/deprivation, socioeconomic status/position, and social class; however, their measurement and definition varied across studies. Our review suggests a social gradient of health persists in the HIV care continuum; people living with HIV who reported material deprivation were less likely to be virologically suppressed or adherent to antiretrovirals. Future research should use an ecosocial approach to explore these interactions across the lifecourse to help propose a causal pathway.

The resilience of youth delinquent. Education as a protective factor

Adolescents face difficult developmental tasks and multiple challenges and are exposed to very varied risk factors. In case the protection factors are not strong enough, they can generate many difficulties or emotional and behavioral disorders, especially due to the fragility and vulnerability of the adolescent's inner world during this period. This paper presents an analysis of the protection factors underlying the resilience of young offenders admitted in educational centers in Romania. The analysis is part of a broader research conducted in a doctoral thesis. The conclusions show us that the basic pillar of reeducating these young people relies in completing their studies at least at the level of primary school and the orientation towards learning a profession, so that those who blame material deprivation as the cause of delinquency have the possibility to earn a living through work.

Vulnerability pathways to mental health outcomes in children and parents during COVID-19

We examined pathways from pre-existing psychosocial and economic vulnerability to mental health difficulties and stress in families during the COVID-19 pandemic. Data from two time points from a multi-cohort study initiated during the COVID-19 pandemic were used. Parents of children 6–18 years completed questionnaires on pre-COVID-19 socioeconomic and demographic factors in addition to material deprivation and stress due to COVID-19 restrictions, mental health, and family functioning. Youth 10 years and older also completed their own measures of mental health and stress. Using structural equation modelling, pathways from pre-existing vulnerability to material deprivation and stress due to COVID-19 restrictions, mental health, and family functioning, including reciprocal pathways, were estimated. Pre-existing psychosocial and economic vulnerability predicted higher material deprivation due to COVID-19 restrictions which in turn was associated with parent and child stress due to restrictions and mental health difficulties. The reciprocal effects between increased child and parent stress and greater mental health difficulties at Time 1 and 2 were significant. Reciprocal effects between parent and child mental health were also significant. Finally, family functioning at Time 2 was negatively impacted by child and parent mental health and stress due to COVID-19 restrictions at Time 1. Psychosocial and economic vulnerability is a risk factor for material deprivation during COVID-19, increasing the risk of mental health difficulties and stress, and their reciprocal effects over time within families. Implications for prevention policy and parent and child mental health services are discussed.

Differential Effects of Multiple Dimensions of Poverty on Child Behavioral Problems: Results from the A-CHILD Study

The differential effects of low income and material deprivation—in particular, deprivation related to child educational needs—have not been well examined. This study aimed to examine the effects of low income and life-related and child-related deprivation on child behavioral problems. This study used data from first-grade students who participated in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in 2015, 2017, and 2019 (N = 12,367) in Japan. Material deprivation was divided into life-related deprivation (i.e., lack of items for a living) and child-related deprivation (i.e., lack of children’s books, etc.), and low income was assessed via annual household income. We assessed child behavioral problems and prosocial behavior using the Strengths and Difficulties Questionnaire. One in ten children belonged to low-income families, 15.4% of children experienced life-related deprivation, and 5.4% of children experienced child-related deprivation. While life- and child-related deprivation had significant adverse effects on behavioral problems, they had no association with prosocial behavior. The effects of low income were mediated by parental psychological distress (45.0% of the total effect) and the number of consulting sources (20.8%) on behavioral problems. The effects of life-related and child-related deprivation were mediated by parental psychological distress (29.2–35.0%) and the number of consulting sources (6.4–6.9%) on behavioral problems. Life-related and child-related deprivation, but not low income, are important for child mental health.

The Impact of Marginalization on Diffuse Large B-Cell Lymphoma Overall Survival: A Retrospective Cohort Study

Introduction: While health disparities in diffuse large B-cell lymphoma (DLBCL) have been previously noted, literature systematically describing the impact of social determinants of health (SDOH) on DLBCL overall survival (OS) is sparse. Furthermore, existing data largely examine SDOH of health in isolation, not accounting for key covariates or disease-related variables. Marginalization, which accounts for various SDOH, is a process of systemic discrimination and exclusion. Given the paucity of literature to date, we examined how marginalization influences DLBCL OS in the Canadian setting. The objectives of this study were: 1) To describe the impact of marginalization on DLBCL OS and 2) To identify which dimensions of marginalization, if any, impacted OS. Methods: We conducted a population-based retrospective cohort study of adult patients with newly diagnosed DLBCL in Ontario between January 1, 2005 to December 31, 2017 receiving a rituximab-containing chemotherapy regimen for curative intent, followed until March 1, 2020. Our primary exposure of interest was the Ontario Marginalization Index (ON-Marg), an administrative database tool which combines demographic indicators into four distinct marginalization dimensions: residential instability (% renters and % living alone), material deprivation (% low income and % lone parent families), dependency (% seniors and % employment), and ethnic concentration (% recent immigrants and % visible minority). Our primary outcome was 2-year OS, defined as time from the date of first rituximab-based treatment to date of death or completion of follow-up. Survival curves were generated using Kaplan-Meier methods, and Cox regression analyses were used to identify covariates that were independently associated with OS. Our final model adjusted for age (as increments of 10 years), sex, and comorbidity burden as measured by aggregate diagnostic groups (ADGs). Results: A total of 10,344 patients were diagnosed with DLBCL and treated with a rituximab-containing regimen in Ontario between January 1, 2005 and December 31, 2017. The median age was 67 (IQR, 55-75) and 46% were female. Of patients who had staging data (49%), 54% were advanced stage at diagnosis, and the median number of cycles of chemoimmunotherapy received was 6 (4-6). Median number of ADGs was 10 (8-12), indicating a moderate-to-high burden of comorbidities within this cohort, and 13% of patients resided in a rural area. Cohort characteristics and mortality rates per ON-Marg quintile (Q5 = most marginalized) are provided in Table 1. Overall, group characteristics were evenly distributed, except that the most marginalized group had a higher proportion of patients residing in urban settings and nearer to treatment hospitals. Two-year overall survival was 73.2%. After controlling for relevant confounders, material deprivation (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.02 - 1.10, p=0.003) and ethnic concentration (HR 1.05, 95% CI 1.01 - 1.09, p=0.013) contributed to increased risk of all-cause mortality. Residential instability and dependency had no significant effect. Increasing age (HR 1.29, 95% CI 1.25 - 1.33, p<0.0001) and increasing number of ADGs (HR 1.028, 95% CI 1.025 - 1.031, p<0.0001) were also associated with increased risk of all-cause mortality, while female sex was found to be protective (HR 0.89, 95% CI 0.83 - 0.97, p=0.005). Discussion: To our knowledge, no study has examined the impact of marginalization and collective SDOH on DLBCL outcomes. We found that increased material deprivation and ethnic concentration conferred increased mortality. While Canada's largely single-payer system and previously documented healthy immigrant effect may have been expected to attenuate effects of income and immigration, our study suggests otherwise. Possible explanations may include barriers to healthcare access for patient subsets, who may have less support for treatment. Structural factors such as systemic racism, health literacy, and caregiver burden must also be taken into account. These factors require further evaluation to inform targeted interventions and establish support for increased access to timely care amongst this patient population. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

We have been left behind, haven't we? Economic status loss, class voting and the populist radical right

A growing body of research attempts to reconcile economic and cultural explanations of populist radical right (PRR) voting by highlighting citizens' resentment against their gradual marginalisation within society. Nonetheless, widespread speculations about the deteriorating relative economic position of PRR voters are not supported by proper empirical evidence. To address this shortage, the present study first provides a theoretical discussion of the electoral consequences of economic status loss by bridging multidisciplinary literature on relative economic inequality and group deprivation; subsequently, it assesses such consequences empirically, by means of a novel measure of economic status loss. Our multilevel analysis on ESS and EU-SILC data on 19 elections (2008-2017) across 9 Western European countries demonstrates that PRR parties are most successful among social classes facing a collective decrease in economic status – rather than material deprivation per se. This result is consequential for scholarly debates on the reasons for class PRR alignment and on the electoral repercussions of economic inequalities.