It is well known that the size of initial loans approved by private lending agencies (banks, credit unions etc.) corresponds with the median income of the location of the individual, it also corresponds with gender. We wanted to show if it was the case with the PPP. We use standard machine learning techniques such as Lasso and found statistically significant association between gender of business owner and size of initial loan approvals for the State of Arkansas, and Least Squares Regression and Decision Tree regression to find a somewhat tenuous relationship between median income and initial loan approval amount and finally a strong association with the size of business. This has important applications for the equity of access to credit for marginalized peoples.

Lipid dysregulation is critically involved in hepatocellular carcinoma (HCC). Further, male predi-lection and Ras pathway hyperactivation are distinct characteristics of HCC. However, mecha-nisms underlying their connections remain unknown. The aim of the present study was to perform a comprehensive lipidomics analysis of a Hras12V transgenic mice (Ras-Tg) model of HCC induced by hepatocyte-specific Ras pathway activation and characterized by male predilection and a dis-rupted lipid metabolism. A total of 3437 lipids were identified in HCC (T) and peri-tumor tissues (P) of Ras-Tg mice and liver tissues of wild-type mice (W) of both sexes. Longitudinal comparisons of W, P, and T yielded 359 differentially expressed lipids (DELs) in male mice and 306 DELs in female mice. Generally, glycerolipid accumulation, glycerophospholipid reduction and monounsaturated fatty acid synthesis improvement were more frequent in T compared to P. The expression change pattern analysis revealed common and characteristic DELs positively/negatively associated with HCC or the Ras oncogene. Further lipid metabolism pathway investigations revealed that disordered lipid and fatty acid biosynthesis contributed to glycerolipid accumulation and glycerophospholipid re-duction in T. Comparisons between P and W suggests that different responses to the Ras oncogene in mice of different sexes, as well as higher amounts of aberrantly regulated lipids in males, may contribute to male-biased hepatocarcinogenesis. However, lateral comparisons between sexes showed a converging trend during hepatocarcinogenesis, explaining the poor efficacy for gen-der-specific therapies. In conclusion, the common and characteristic DELs and lipid metabolism pathways in HCC initiated by the Ras oncogene from sexually dimorphic hepatocytes provide novel insights into the clinical diagnosis and management of HCC.

The field of financial literacy is intricate and developing. This systematic review of the literature provides a thorough overview of financial literacy. It examines the sample of 3182 papers of the period 1990 to 2023 from different databases such as Scopus, Web of Science, IEEE, Science Direct, and JSTOR and identifies important publications, knowledge gaps, and rising themes. The four major topics that emerged are the degree of financial literacy among various groups of people, gender disparity in financial literacy, the influence of financial literacy on financial behavior and planning, and the impact of financial education on day-to-day decisions. Groups with lower levels of financial literacy include adults, women, people in the lower-income band, rural people, etc. Financial planning and financial behavior are positively associated with financial literacy. Financial literacy could be enhanced with financial education; however, output depends upon program design and experimental group. The review also discusses financial literacy in the context of gender disparity, including its definition, difficulties encountered, and possible solutions. This systematic study will help researchers, practitioners, and policymakers by providing insightful information on financial literacy and its ramifications.

This study analyzes the effect of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). A panel analysis was conducted by combining 21 years of data (from 2000 to 2020) from 38 OECD countries. Life expectancy and avoidable mortality were set as the dependent variables; gross domestic product and poverty gap were set as the independent variables; body mass index, consumption, smoking rate, healthcare personnel, number of beds in health service facilities, national medical expenses, and unemployment were set as control variables. First, economic growth and poverty gap significantly affect life expectancy and avoidable mortality. It has been confirmed that to resolve health inequality, growth during growth and distribution must be prioritized. Second, it has been confirmed that as the poverty gap increases, life expectancy increases and the avoidable mortality rate decreases. A mechanism different from the existence of a medical security system targeting the lowest class or an increase in the welfare of society worked. In conclusion, as a policy proposal to alleviate health inequality, this study suggests that policy intervention is necessary to block or alleviate the negative impact of income inequality in health care policies.

Background: Recent reports on the national temporal trends of sepsis-related mortality in the United States (US) suggested outcome improvement in several race and ethnicity groups. However, it is unknown whether national data reflect state-level trajectories. Methods: We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death dataset to identify all decedents with sepsis in the US during 2010-2019. Negative binomial regression models were fit to estimate national and state-level trends of age-adjusted sepsis-related mortality rates within race and ethnicity groups. Results: There were 1,852,610 sepsis-related deaths in the US during 2010-2019. Nationally, sepsis-related mortality rates decreased among Blacks and Asians, were unchanged among Hispanics and Native Americans, and rose among Whites. The percent of states with similar trends were 30.0% among Blacks, 32.1% among Asians, 74.3% among Hispanics, 75.0% among Native Americans, and 66.7%% among Whites, while trending in opposite direction from 3.6% among Asians to 15.0% among Blacks. Conclusions: National trends in sepsis-related mortality in the US did not represent state-level trajectories in race and ethnicity groups. Gains in sepsis outcomes among race and ethnicity groups at the national level were not shared equitably at the state level.

Purpose: The objective of this paper is to explore the association between insufficient lycopene intake and risk of periodontitis among older adults. Methods: Data analysis was conducted using data from the National Health and Nutritional Examination Survey 2009-2014. Overall, 1227 adults aged 65- to 79-years-old were investigated. Results: Overall, 48.7% of older adults in this study were classified with different levels of periodontitis and 49.1% of individuals with a form of periodontitis had insufficient dietary lycopene intake. Sufficient lycopene intake was found to be associated with a lower likelihood of severe periodontitis (OR: .33; 95% CI: 0.17-.65; p=0.002). Non-Hispanic Black (NHB) older adults were more likely to develop severe forms of periodontal disease in comparison to Non-Hispanic White (NHW) older adults (OR: 2.82, 95% CI: 1.46-5.45, p=0.003). Gender was also found to play a role in periodontitis status, with women being less likely to have severe periodontitis status, compared to men (OR: 0.27; 95% CI: 0.14-0.55; p=0.0007,). However, only NHW females were less likely to have severe periodontitis compared to NHW males (OR: 0.26; 95% CI: 0.12-0.56; p= 0.001). Conclusion: Dietary intake of lycopene associated with periodontitis disease for individuals over the age of 65; those who consume a sufficient amount of lycopene are less likely to develop severe periodontitis. In general, more men suffered from periodontitis in comparison to women. Such association also has been found between NHB with severe periodontitis. In addition, reduced risk of moderate periodontitis is associated with sufficient lycopene intake is explored in NHW, future targeted interventions using lycopene in dietary intake as a preventative measure to delay or prevent the onset of periodontal disease needs to be race and gender specific.

Introduction: This analysis is conducted as a part of a quality improvement project aiming at identifying racial disparity in inpatient stroke quality of care. Methods: Get With The Guidelines (GWTG) database was used to identify all patients discharged with any stroke diagnosis between January and December 2021. Additional chart review was conducted to ensure the accuracy of racial/ethnic categorization. The sample was dichotomized to White vs non-White groups and compared with univariate analysis. Results: The study sample comprised 1,408 encounters (1,347 patients). Mean age 71±15 years, 51% women, 82% White patients, 15% non-White patients, 72% acute ischemic stroke (AIS); 15% transient ischemic attack (TIA), 9% intracerebral hemorrhage (ICH), 3% subarachnoid hemorrhage (SAH), and 1% stroke not otherwise specified. Non-White patients were younger, had fewer concomitant diagnoses, lower proportion of TIA and higher proportion of ICH (p=0.004). In AIS cohort, compared to White patients, non-White patients had less frequent ambulance (p=0.009), arrived to the hospital later than White patients (7.7 hours longer ; p<0.001), had more severe stroke, and had less frequent IV thrombolysis utilization (7% vs 13%; p=0.042). Similarly in the TIA cohort, non-White patients’ utilization of EMS was lower than White patients and their hospital arrival was delayed. In the ICH cohort, non-White patients were younger, had lower frequency of atrial fibrillation, and a non-significant trend towards higher disease severity. The SAH cohort had only 8 non-White patients, 6 of which were transferred to higher level of care hospital within a few hours of arrival, therefore. Importantly, the hospital-based quality metrics such as door-to-CT time, door-to-needle time, and the Joint Commission stroke quality metrics were similar between the two groups. Conclusion: There is a racial disparity in the pre-hospital phase of the stroke chain of survival of non-White patients impacting the IV thrombolysis utilization. The younger age and worse lipid profile and hemoglobin A1C of non-White patients suggest the need for better preventative care starting at young age.

Disadvantaged groups around the world have suffered and endured higher mortality during the current COVID-19 pandemic. This contrast disparity suggests that socioeconomic and health-related factors may drive inequality in disease outcome. To identify these factors correlated with COVID-19 outcome, country aggregate data provided by the Lancet COVID-19 Commission subjected to correlation analysis. Socioeconomic and health-related variables were used to predict mortality in the top 5 most affected countries using ridge regression and extreme gradient boosting (XGBoost) models. Our data reveal that predictors related to demographics and social disadvantage correlate with COVID-19 mortality per million and that XGBoost performed better than ridge regression. Taken together, our findings suggest that the health consequence of the current pandemic is not just confined to indiscriminate impact of a viral infection but that these preventable effects are amplified based on pre-existing health and socioeconomic inequalities.

The editors of several major journals have recently asserted the importance of combating racism and sexism in science. This is especially relevant now, as the COVID-19 pandemic may have led to a widening of the gender and racial/ethnicity gaps. Implicit bias is a crucial component in this fight. Negative stereotypes that are socially constructed in a given culture are frequently associated with implicit bias (which is unconscious or not perceived). In the present article, we point to scientific evidence that shows the presence of implicit bias in the academic community, which contributes to strongly damaging unconscious evaluations and judgments of individuals or groups. Additionally, we suggest several actions aimed at (1) editors and reviewers of scientific journals, (2) people in positions of power within funding agencies and research institutions and (3) members of selection committees to mitigate this effect. These recommendations are based on the experience of a group of Latin American scientists comprising Black and Latin women, teachers and undergraduate students who participate in a women in science working group at universities in the state of Rio de Janeiro, Brazil. With this article, we hope to contribute to reflections, actions and the development of institutional policies that enable and consolidate diversity in science and reduce disparities based on gender and race/ethnicity.

The national rate of obesity in US Hispanic/Latinos exceeds all other major ethnic subgroups and represents an important health disparity. Plant-based diet interventions that emphasize whole plant foods with minimal processing and less refined grains and sugar have shown have shown great promise in control of obesity, but there is a paucity of data translating this treatment effect to disparity populations. The objective of our study was to evaluate the efficacy and scalability of the Healthy Eating Lifestyle Program (HELP) – a hospital-based, family centered, culturally tailored, plant-based diet intervention for Hispanic/Latino pediatric obesity patients and their families. Our evaluation methods included: 1) a quasi-experimental, one group, longitudinal study to measures changes in BMI at 0, 6, and 18 weeks of follow-up, and 2) A stakeholder analysis consisting of six key informant interviews of HELP program staff. We found a significant decrease in body mass index across all adults (-0.2 kg/m² p=0.0047), that was much stronger in men. For children ages 5-12 years, there was also a significant decrease in BMI Z score from pre- to post- intervention (p=0.04). Program strengths were the cultural tailoring of the plant-based diet choices, and allowing a tiered approached that did not require adherence to strict vegetarianism. Our pilot study findings from HELP raise the possibility that incorporating plant-based diet choices into the treatment of pediatric obesity patients and their families can be an effective addition to a culturally responsive care model.

Smartphone-based fundus camera and telemedicine are an opportunity for accessing ocular health inequalities in underresourced areas. The objective of this study is to evaluate the prevalence of retinal findings in a community in the Amazon and propose strategies to enhance ocular health. A cross-sectional study was conducted in a river side community. Retinal photos from the posterior pole and optic disc were captured using a portable fundus camera. All photos and data were analyzed remotely by a retina specialist. The final sample was 107 participants, aged 52±17. Retinal findings were detected in 37.4% (95%CI 28.7–46.8) of the sample, the three main retinal findings were epithelial changes (10.3%, 95%CI 5.6–17.1), chorioretinal scars (8.4%, 95%CI 4.2–14.8), and dry Age-related Macular Degeneration (7.5%, 95%CI 3.6–13.6). This study detected retinal alterations in similar prevalence of other underresourced areas. Telemedicine is an opportunity to address health inequities, especially in ophthalmology, through relatively low-cost portable devices, supporting clinical decisions in areas with low health access, however, maintaining assistance after implementation is a challenge. Enhancing medical education and training local non-specialized health professionals for risk assessment, device handling, and data base use is reasonable to ensure follow-up.

Health care in Canada is managed by provinces/territories. We investigated regional differences in survival among Canadians diagnosed with central nervous system (CNS) tumours. We identified 50,670 patients diagnosed with a first-ever primary CNS tumour between 2008 and 2017 with follow-up until December 31, 2017. We selected the four highest incidence histologies and used proportional hazards regression to estimate hazard ratios (HRs) for five regions (British Columbia, Prairie provinces, Ontario, Atlantic provinces and the Territories), adjusting for sex, tumour behaviour and patient age. Ontario had the best survival profile for all histologies investigated. The Atlantic provinces had the highest HR for glioblastoma (HR=1.26, 95% CI:1.18-1.35) and malignant glioma not otherwise specified (NOS) (Overall: HR=1.87, 95% CI:1.43-2.43; Pediatric population: HR=2.86, 95% CI:1.28-6.39). For meningioma, the Territories had the highest HR (HR=2.44, 95% CI:1.09-5.45) followed by the Prairie provinces (HR=1.52, 95% CI:1.38-1.67). For malignant unclassified tumours, the highest HRs were in British Columbia (HR=1.45, 95% CI:1.22-1.71) and the Atlantic provinces (HR=1.40, 95% CI:1.13-1.74). There are regional differences in the survival of CNS patients at the population level for all four specific histological types of CNS tumours investigated. Factors contributing to these observed regional survival differences are unknown and warrant further investigation.

We propose an approach for estimating the error in depth data provided by generic 3D sensors, which are modern devices capable of generating an image (RGB data) and a depth map (distance) or other similar 2.5D structure (e.g. stereo disparity) of the scene. Our approach starts capturing images of a checkerboard pattern devised for the method. Then proceed with the construction of a dense depth map using functions that generally comes with the device SDK (based on disparity or depth). The 2D processing of RGB data is performed next to find the checkerboard corners. Clouds of corner points are finally created (in 3D), over which an RMS error estimation is computed. We come up with a multi-platform system and its verification and evaluation has been done, using the development kit of the board nVIDIA Jetson TK1 with the MS Kinects v1/v2 and the Stereolabs ZED camera. So the main contribution is the error determination procedure that does not need any data set or benchmark, thus relying only on data acquired on-the-fly. With a simple checkerboard, our approach is able to determine the error for any device. Envisioned application is on 3D reconstruction for robotic vision, with a series of 3D vision sensors embarked in robots (UAV of type quadcopter and terrestrial robots) for high-precision map construction, which can be used for sensing and monitoring.

Purpose: To explore how race and residential zip codes' socioeconomic index (SES) influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City. The study included 16,915 individual tests from 30 residential zip codes. Results: The overall testing rate in St. Louis was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indian/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher testing rates were observed in low and middle SES zip codes compared to high SES zip codes. Adjusted for SES, testing rates were 1.68% higher among Blacks and 0.43% higher among American Indian/Alaskan Natives compared to Whites, and 0.033% lower among Asians. Geographical mapping showed higher testing rates in the inner core and lower rates in the periphery of St. Louis. Conclusion: Race and SES influence testing rates. Areas with low testing rates should be targeted for intervention in St. Louis.

Background: Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). Methods: A cross-national study was performed with different sources of data, using the administrative record linkage theory. We created a new data set using data from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. Result: The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. AM was significantly higher in economically weak countries, countries with political instability, countries with traditional religion, without achievement of UHC, and Sub-Saharan Africa (p<0.01). There was high disparity of AM between countries with and without UHC (F = male: 61.89, female: 51.85, p<0.001) and between groups with low and high income (F = male: 36.33, female: 42.39, p<0.001). UHC and political stability would significantly reduce AMR by > 0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70, in relation to countries without UHC, with political instability, and low economic status. Conclusions: Disparities in AM can be reduced after the achievement of UHC and economically productive activities for those adults affected by conflict and political unrest.

Over the last decades, an important number of regional and global Digital Elevation Models (DEMs) have been released publicly. As a consequence, researchers need to choose between several of these models to perform their studies and to use these DEMs as third-party data to compute derived products (e.g., for orthorectification). However, the comparison of DEMs is not trivial. For most quantitative comparisons, DEMs require to be expressed in the same Coordinate Reference System (CRS), sampled over the same grid (i.e., be at the same ground sampling distance with the same pixel-is-area or pixel-is-point convention), and with heights relative to the same Vertical Reference System (VRS). Thankfully, many open tools allow us to perform these transformations precisely and easily. Despite these rigorous transformations, local or global planimetric displacements may still be observed from one DEM to another. These displacements, or disparities, may lead to significant biases in comparisons of DEM elevations or derived products such as slope, aspect or curvature. Therefore, the control of DEM planimetric accuracy is certainly the most important task to perform at first before any comparison. This paper presents the disparity analysis method enhanced to achieve a sub-pixel accuracy, by interpolating the linear regression coefficients computed within an exploration window. This new method is significantly faster than oversampling the input data because it uses the correlation coefficients that have been already computed in the disparity analysis. To demonstrate the robustness of this algorithm, artificial displacements have been performed in a 11x11 grid with a 0.1-pixel step in both directions. The Copernicus DEM GLO-30 has been interpolated by a “classical” bicubic to achieve these 11x11 displacements. This validation method has been applied in four 10 km x 10 km DEMIX tiles showing different height distributions. Globally, this new sub-pixel accuracy method is robust. Artificial displacements have been retrieved with with typical errors (e_b) ranging from 12 to 20 % of the pixel size (worst case in Croatia).These errors in displacement retrievals are not constant in the 11x11 grid and the overall error E_b depends on the roughness (altimetry variations) encountered in the different tiles. The second idea of this paper is to assess the impact of the bicubic parameter (slope of the weight function at a distance d=1 of the interpolated point) on the accuracy of the displacement retrieval. By considering E_b as a quality indicator, tests have been performed in the four DEMIX tiles making the bicubic parameter vary between -1.5 and 0.0 by step of 0.1. For each DEMIX tile, the best bicubic (BBC) parameter b* is interpolated from the four E_b minimal values. This BBC parameter b* is low for flat areas (around -0.95) and higher in mountainous areas (around -0.75). The roughness indicator is the standard deviation of the slope norms computed from all the pixels of a tile. A logarithmic regression analysis performed between the roughness indicator and the BBC parameter b* computed in 67 DEMIX tiles shows a high correlation (r=0.717). The logarithmic regression formula estimating the BBC parameter from the roughness indicator is generic and may be applied to estimate the displacements between two different DEMs. This formula may also be used to set up a future Adaptative Best BiCubic (ABBC) that will estimate the local roughness in a sliding window to compute a local BBC.

Prostate cancer is driven by acquired genetic alterations, including those impacting the epigenetic machinery. With African ancestry a significant risk factor for aggressive disease, we hypothesize that dysregulation among the roughly 656 epigenetic genes may contribute to prostate cancer health disparities. Interrogating prostate tumor genomic data from 109 men of southern African and 56 men of European Australian ancestry, we found African-derived tumors to present with a longer tail of epigenetic driver gene candidates (72 versus 10). Biased towards African-specific drivers (63 versus 9 shared), many are novel to prostate cancer (18/63) including several putative therapeutic targets (CHD7, DPF3, POLR1B, SETD1B, UBTF and VPS72). Through clustering of all variant types and copy number alterations, we describe two epigenetic PCa taxonomies capable of differentiating patients by ancestry and predicted clinical outcomes. We identified top genes in African and European-derived tumors that represent a multifunctional “generic machinery”, alteration to which may be instrumental in epigenetic dysregulation and prostate tumorigenesis. In conclusion, numerous somatic alterations in the epigenetic machinery drive prostate carcinogenesis but African-derived tumors appear to achieve this with greater diversity amongst such alterations. The greater novelty observed in African-derived tumors illustrates the significant clinical benefit to be derived from a much needed African tailored approach to prostate cancer healthcare aimed at reducing prostate cancer health disparities.

Coronavirus disease 2019 (COVID-19), the emissary behind the worst global pandemic of the 21st century, is primarily a respiratory disease-causing virus called SARS-CoV-2 which is responsible for millions of new cases (incidence) and deaths (mortalities), worldwide. Many factors have played a role in the differential morbidity and mortality experienced by nations and ethnicities against SARS-CoV-2, such as the quality of primary medical health facilities or enabling economies. Nevertheless, the most important variable, i.e., the subsequent ability of individuals to be immunologically sensitive or resistant to the infection, was not properly discussed before. Therefore, an astounding issue arose when some developed countries experienced higher morbidity and mortality, compared with their relatively underdeveloped counterparts, despite having excellent medical health facilities. Hence this investigative review attempts to analyze the issue from an angle of previously undiscussed genetic, epigenetic, and molecular immune resistance mechanisms in correlation with the pathophysiology of SARS-CoV-2 and varied ethnicity-based immunological responses against it. The biological factors discussed here include the overall landscape of human microbiota, endogenous retroviral genes spliced into the human genome, copy number variation, and how they could modulate the innate and adaptive immune systems, which put a particular ethnic genetic architecture at a higher risk of SARS-CoV-2 infection than others. Considering an array of these factors in their entirety may help explain the geographic disparity of disease incidence, severity, and subsequent mortality associated with the disease while at the same time encouraging scientists to design new experimental approaches to investigation.

This study investigated the intersecting influence of socioeconomic status and cooking behavior on dietary habits using nationwide Japanese data. The study measured the frequency of balanced meals and breakfast intake as indicators of healthy eating habits and used subjective economic status, subjective spare time, and cooking behavior as the independent variables. It employed multivariate logistic regression analyses to elucidate the relationships among these variables. The results demonstrated that even among economically poor or time-constrained individuals, those preparing meals from ingredients were more likely to eat balanced meals and breakfast than those relying on commercial food or rarely cooking. This finding suggested that cooking behavior can mitigate disparity in healthful eating due to socioeconomic conditions. The study added new insights into the impact of combining socioeconomic status and cooking behavior on dietary habits, which highlights the potential of promoting cooking behaviors, such as teaching cooking skills, as a strategy for reducing socioeconomic dietary disparities.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualised lifestyle factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority children with obesity comorbidity. Families of Black, Asian and Minority Ethnicities (BAME) in the Northeast of England (n=180) were contacted, and families with a child diagnosed with obesity and comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems, respiratory disorder, or polycystic ovarian disease) were interviewed (n=11). Semi-structured interviews and qualitative thematic analysis included parents’ perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity. Parents’ perspectives and experience revealed eleven themes centred around living with a child with obesity, risks and impact of obesity diseases; access to lifestyle nutritional and physical activity, and ethnicity specific barriers. Parents revealed social disadvantage, fear of victimisation by social services, perceptions on their cultural and religious traditions when dealing with nutrition and exercise, and child’s weight racial stigmatisation. Parents reported closer bonding with their children than health authorities to protect from obesity consequences. Work pressure, time, and lack of professionals’ guidance were seen as barriers to healthy lifestyle, while support from friends and family bond in adopting healthy lifestyle behaviours were facilitators. Parents reported no awareness of health service provision of nutritional and physical activity obesity prevention programmes. Minority ethnic communities’ perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle nutrition and physical activity interventions are needed beyond those administered by the primary healthcare system.

Previous studies have shown, in the United States (U.S.), that non-White communities are exposed to significantly higher temperatures in urban environments than complementary White populations. Studies highlighting this disparity have usually been cross-sectional and are therefore “snapshots” in time. Using surface urban heat island (SUHI) intensity data, U.S. Census 2020 population counts, and a measure of residential segregation, this study performs a comparative analysis between census tracts identified as prevalent for White, Black, Hispanic and Asian populations and their thermal exposure from 2003 – 2018. The analysis concentrates on the top 200 most populous U.S. cities. SUHI intensity is shown to be increasing through time for all examined tracts. However, the increase is only statistically significant for White and Black prevalent zones. There is a 1.25K to ~2.00K higher degree of thermal exposure on average for non-White relative to White prevalent areas. When examined on an inter-city basis, White and Black prevalent tracts had the largest disparity, as measured by SUHI intensity, in New Orleans, LA, USA by &lt; 6.00K. Hispanic (&gt;7.00K) and Asian (&lt;6.75K) prevalent tracts were greatest in intensity in San Jose, CA, USA. To further explore temporal patterns, two models were developed using a Bayesian hierarchical spatial temporal framework. One models the effect of varying the percentages of each population group relative to SUHI intensity within all examined tracts. Increases in percentages of Black, Hispanic, and Asian populations contributed to statistically significant increases in SUHI intensity. White increases in population percentage lowered SUHI temperature intensity. Throughout all modeled tracts, there is a statistically significant 0.01K per year average increase in SUHI intensity. A second model tests the effect of residential segregation on thermal inequity across all examined cities. Residential segregation, indeed, has a statistically significant positive association with SUHI intensity from this portion of the analysis. Similarly, there is a statistically significant 0.01K increase in average SUHI intensity per year for all cities. Results from this study can be used to guide and prioritize intervention strategies and furthers urgency related to social, climatic, and environmental justice concerns.