Socioeconomic and Demographic Factors of household Expenditures: A Case Study of Southern Punjab (Pakistan)

Household expenditures are the main source of society's well-being and welfare. The examination of socioeconomic and demographic determinants of Household Expenditure in Southern Punjab is the major objective of the study. The primary data of 785 households is collected in Southern Punjab. The estimation analysis is based on the Ordinary Least Square (OLS) methodology. The age of household head, years of schooling, household size, Remittances, the value of assets, number of earners, distance of health center from household residence, the distance of the school from household residence have a positive effect on household monthly expenditures in Multan division, D.G Khan division, Bahawalpur division, and Southern Punjab. The households which belong to the informal sector have a negative relationship with monthly household expenditures in all three divisions and Southern Punjab. The association between the area of residence and monthly household expenditures is positive in all three divisions and Southern Punjab. The result shows that households living in urban areas of Southern Punjab have more expenditure as compared to rural areas. The presence of disease and household expenditures are negatively related to each other in Southern Punjab. Therefore, this study suggests that health facilities should provide at a large scale in various divisions of southern Punjab.

The impact of socioeconomic and demographic factors on individuals’ behaviour towards their health and general well-being in rural Sindh, Pakistan

Background: Health and general well-being might sound like a mundane concept for most developed nations; however, it is not perceived similarly in underdeveloped areas of the developing nations. In Pakistan, the concept becomes even more foreign and muddled with certain stubborn biases which needs to be accessed. Therefore, we conducted a study to identify the impact of socioeconomic and demographic factors associated with behaviors regarding health and general well-being.Methods: A cross-sectional study was conducted in rural health centers (RHCs) of five districts of Sindh, Pakistan, from October 2020 to December 2020. A survey questionnaire was designed to collect data on socio-economic and demographic factors and their impacts on behavior towards health and general well-being. Statistical analysis was performed using STATA Version 16.0. Chi-square test and logistic regression analysis were used to determine the extent of association between predictor variables and outcome variables.Results: A total of 969 respondents participated in the study. The mean age of the respondents was 35.70 (±13.17) years. Majority of the participants (82.77%) had limited access to the required health care facility and only (3.61%) of respondents reported that they regularly consult with disease specialists. Multivariable logistic regression revealed the ability to bear disease expenses (OR=0.55, p=0.009), level of education (OR=1.81, p=0.026), female gender (OR=0.30, p=0.048), access to required health facilities (OR=0.58, p=0.012) were significantly associated with positive behavior towards health and general well-being.Conclusions: The study shows that ease of access to healthcare facilities would encourage the population to seek more healthy behaviors. Resources for promoting healthy lifestyle choices in the general population should be more comprehensive for encompassing cognitive beliefs that target psychological and physical health outcomes.

Socioeconomic and demographic factors in the diagnosis and treatment of Chiari malformation type I and syringomyelia

OBJECTIVE The goal of this study was to assess the social determinants that influence access and outcomes for pediatric neurosurgical care for patients with Chiari malformation type I (CM-I) and syringomyelia (SM). METHODS The authors used retro- and prospective components of the Park-Reeves Syringomyelia Research Consortium database to identify pediatric patients with CM-I and SM who received surgical treatment and had at least 1 year of follow-up data. Race, ethnicity, and insurance status were used as comparators for preoperative, treatment, and postoperative characteristics and outcomes. RESULTS A total of 637 patients met inclusion criteria, and race or ethnicity data were available for 603 (94.7%) patients. A total of 463 (76.8%) were non-Hispanic White (NHW) and 140 (23.2%) were non-White. The non-White patients were older at diagnosis (p = 0.002) and were more likely to have an individualized education plan (p < 0.01). More non-White than NHW patients presented with cerebellar and cranial nerve deficits (i.e., gait ataxia [p = 0.028], nystagmus [p = 0.002], dysconjugate gaze [p = 0.03], hearing loss [p = 0.003], gait instability [p = 0.003], tremor [p = 0.021], or dysmetria [p < 0.001]). Non-White patients had higher rates of skull malformation (p = 0.004), platybasia (p = 0.002), and basilar invagination (p = 0.036). Non-White patients were more likely to be treated at low-volume centers than at high-volume centers (38.7% vs 15.2%; p < 0.01). Non-White patients were older at the time of surgery (p = 0.001) and had longer operative times (p < 0.001), higher estimated blood loss (p < 0.001), and a longer hospital stay (p = 0.04). There were no major group differences in terms of treatments performed or complications. The majority of subjects used private insurance (440, 71.5%), whereas 175 (28.5%) were using Medicaid or self-pay. Private insurance was used in 42.2% of non-White patients compared to 79.8% of NHW patients (p < 0.01). There were no major differences in presentation, treatment, or outcome between insurance groups. In multivariate modeling, non-White patients were more likely to present at an older age after controlling for sex and insurance status (p < 0.01). Non-White and male patients had a longer duration of symptoms before reaching diagnosis (p = 0.033 and 0.004, respectively). CONCLUSIONS Socioeconomic and demographic factors appear to influence the presentation and management of patients with CM-I and SM. Race is associated with age and timing of diagnosis as well as operating room time, estimated blood loss, and length of hospital stay. This exploration of socioeconomic and demographic barriers to care will be useful in understanding how to improve access to pediatric neurosurgical care for patients with CM-I and SM.

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.

Effects of Parental Education and Wealth on Early Childhood Stunting in Bangladesh

Background Malnutrition is considered to be a major public health challenge, which is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the effects of parental education and wealth on different specification of stunting among 17490 children below five years of age in Bangladesh. Methods Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17490 children (aged < 5 years) from 64400 households. Multiple logistic regressions were used to determine the risk factors associated with child stunting and severe stunting. Results The prevalence of stunting and severe stunting for children was 25.96% and 7.97%, respectively. Children aged 24 to <36 months [Odds Ratio (OR) = 2.65, 95% CI: 2.30, 3.05] and aged 36 to <48 months [OR = 2.33, 95% CI: 2.02, 2.69] had more risk of stunting compared to the children aged <6 months. Children from Sylhet division had the greatest risk of stunting of all the eight divisions [OR = 1.26, 95% CI: 1.09, 1.46]. Children of secondary complete or higher educated mothers were less likely to develop stunting [OR = 0.66, 95% CI: 0.56, 0.79] compared with children of mothers having no education at all. Similarly, children of secondary complete or higher educated father [OR = 0.74, 95% CI: 0.63, 0.87] were found to have lower risk of stunting compared with children whose father hadn’t any education. Substantially lower risk of stunting was observed among children whose mother and father both completed secondary education or above [OR = 0.59, 95% CI: 0.52, 0.69]. Children from richest households [OR = 0.49, 95% CI: 0.41, 0.58] had 51 % smaller odds on stunting compared to children from poorest families. Conclusions After controlling for socioeconomic and demographic factors, parental education and household position in wealth index were found as to be the most important determinants of child stunting in Bangladesh.

Under Age Five Children Survival Times in Nigeria: A Bayesian Spatial Modelling Approach

Background: Nigeria is among the top five countries in the world with the highest under-five mortality rates. In addition to the general leading causes of under-five mortality, studies have shown that disparities in sociocultural values and practices across ethnic groups in Nigeria influence child survival, thus there is a need for scientific validation. Methods: The approach commonly adopted in multilevel modeling of the under-five mortality rate in Nigeria is to consider child death status as a binary outcome variable. In this manner, information about the time localization of mortality risk is lost in the process. This study quantified the impact of socioeconomic and demographic factors, proximate and biological determinants, and environmental factors on the risk of under-five mortality in Nigeria using a Bayesian hierarchical hazard model with time to death outcomes. The Exponential, Gamma, Log-normal, Weibull, and Cox hazard models in a mixed effect framework with spatial components were considered, and the best model was selected for inference. In addition, the Kaplan Meier survival curve, Nelson Aalen hazard curve, and components survival probabilities were estimated. Results: Findings show that gender, maternal education, household wealth status, source of water and toilet facility, residence, mass media, frequency of antenatal and postnatal visits, marital status, place of delivery, multiple births, who decide healthcare use, use of bednet are significant risk factors of child mortality in Nigeria. The mortality risk is high among the maternal age group below 24 and above 44years, and birth weight below 2.5Kg and above 4.5Kg. The under-five mortality risk is severe in Kebbi, Kaduna, Jigawa, Adamawa, Gombe, Kanu, Kogi, Nasarawa, Plateau, Sokoto states in Nigeria. Conclusions: This study accentuates the need for special attention for the first two months after childbirth as it is the age group with the highest expected mortality. A practicable way to minimize death in the early life of children is to improve maternal health care service, promote maternal education, encourage delivery in healthcare facilities, positive parental attitude to support multiple births, poverty alleviation programs for the less privileged, and a prioritized intervention to Northern Nigeria.

Negative Association Between Smoking and Positive SARS-CoV-2 Testing: Results From a Swiss Outpatient Sample Population

To date, most of the evidence suggests that smoking is negatively associated with testing positive for SARS-CoV-2. However, evidence has several methodological limitations. Using an outpatient sample population, we analyzed the association of testing positive for SARS-CoV-2 and smoking considering comorbidities, socioeconomic and demographic factors. Baseline data were obtained from a cohort during the first wave of the pandemic in Geneva, Switzerland (March-April 2020). RT-PCR tests were carried out on individuals suspected of having SARS-CoV-2 according to the testing strategy at that time. Logistic regressions were performed to test the association of smoking and testing positive for SARS-CoV-2 and further adjusted for comorbidities, socioeconomic and demographic factors. The sample included 5,169 participants; 60% were women and the mean age was 41 years. The unadjusted OR for testing positive for SARS-CoV-2 was 0.46 (CI: 0.38–0.54). After adjustment for comorbidities, socioeconomic and demographic factors, smoking was still negatively associated with testing positive for SARS-CoV-2 (OR: 0.44; CI: 0.35–0.77). Women (OR: 0.79; CI: 0.69–0.91), higher postal income (OR: 0.97; CI: 0.95–0.99), having respiratory (OR: 0.68; CI: 0.55–0.84) and immunosuppressive disorders (OR: 0.63; CI: 0.44–0.88) also showed independent negative associations with a positive test for SARS-CoV-2. Smoking was negatively associated with a positive test for SARS-CoV-2 independently of comorbidities, socioeconomic and demographic factors. Since having respiratory or immunosuppressive conditions and being females and healthcare workers were similarly negatively associated with SARS-CoV-2 positive testing, we hypothesize that risk factor-related protective or testing behaviors could have induced a negative association with SARS-CoV-2.