Background:Lower socioeconomic status (SES) has been associated with increased mortality from coronary heart disease. This excess risk, relative to affluent patients, may be due to a combination of more adverse cardiovascular‐risk factors, inequalities in access to cardiac investigations, longer waiting times for cardiac revascularisation and lower use of secondary prevention drugs. We sought to investigate whether socio-economic status influenced long-term all-cause mortality after PCI in a large metropolitan city (London), which serves a population of 11 million people with a mixed social background over a 10-year period. Methods: We conducted an observational cohort study of 123,780 consecutive PCI procedures from the Pan-London (United Kingdom) PCI registry. This data set is collected prospectively and includes all patients treated between January 2005 to December 2015. The database includes PCI performed for stable angina and ACS (ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina). Patient socio-economic status was defined by the English Index of Multiple Deprivation (IMD) score, according to residential postcode. Patients were analysed by quintile of IMD score (Q1, least deprived; Q5, most deprived). Median follow-up was 3.7 (IQR: 2.0-5.1) years and the primary outcome was all-cause mortality. Results: The mean age of the patients was 64.3±12.1 years and 25.2% were female. 22.4% of patients were diabetic and 27.3% had a history of previous myocardial infarction. The rates of long-term all-cause mortality increased progressively across quintiles of IMD score, with patients in Q5 showing significantly higher long-term mortality rates compared with patients in Q1 (p=0.0044). This persisted following the inclusion of a propensity score in the proportional hazard model as a covariate (HR for Q5 compared to Q1: 1.15 [95% CI: 1.10-1.42]). Conclusion: This study has demonstrated that low SES is an independent predictor of adverse clinical outcomes following PCI for in a large diverse metropolitan city of London. Hence, attention to reduce the burden of cardiovascular risk factors and improve primary prevention, particularly in patients with lower SES, is required.

The variations in socioeconomic status (SES) between different social classes of a population correspond to differences in accessibility to all resources available and able to improve global health. While SES is now known as one of the main determinants for a good health and a good aging, its influence on sleep disorders (SD) is not well understood. SES is a concept, not directly observable but estimated using indicators like income, education, occupational status and area of living. This theoretical review explores some theories linking environment of people with occurrence of SD, with different patterns associated to SES. A model of interaction is proposed to summarize and conceptualizes these interactions and to promote more research on the topic.

Much has been explored in the individual health issue, and most of them adopt the objective data such as laboratory tests or health services utilization to analyze individual health assessment. However, the factors influencing individuals in self‐assessed health is still unclean. The study considers that self‐assessed health is viewed as catalyst in health management and explores various dimensions associated with self‐assessed health. Totally, 800 participants who were randomly sampled from the citizen of Porter County, Indiana completed the Needs Assessment Citizen Survey in 2007.After adjustment for age, gender, education, income, and health coverage, life quality (β=1.5538, sdandard erro of β=0.8404), and Medicaid assistance (β= -0.7715, sdandard erro of β= 0.3958) are the main determinants of individuals’ self‐assessed health. The results suggest that public health officials should consider improving citizens’ self-assessed health by providing good living and socio-economic environment.

Social media gives researchers an invaluable opportunity to gain insight into different facets of human life.Researchers put a great emphasis on categorizing the socioeconomic status (SES) of individuals to help predict various findings of interest. Forum uses, hashtags and so on are common tools of conversations grouping. On the other hand, crowdsourcing is a concept that involves gathering intelligence to group online user community based on common interest. This paper provides a mechanism to look at writings on social media and group them based on their academic background. We build upon earlier work where we analyzed online forum posts from various geographical regions in the USA and Canada and characterized the readability scores of such users. Specifically, we collected 1000 tweets from the members of the US Senate and computed the Flesch-Kincaid readability score for the Senators. Comparing the Senators’ tweets to the ones from average citizens, we note the following. 1) US Senators’ readability based on their tweets rate is much higher affirming the gap between the academic performance of US Senators and their average citizen, and 2) the immense difference among average citizen’s score compared to those of US Senators is attributed to the wide spectrum of academic attainment.

This article addresses the socioeconomic gradient in immigrant health by exploring immigration status and social capital as key considerations in measurement and development of health-promoting research and practice. This paper also seeks to draw attention to the importance of understanding how researchers approach the study of health disparities affecting minoritized and immigrant populations. A critical examination of the measures used in comparative health research challenges scholars to consider the different pathways through which socio-economic factors impact health and underscores the ethical commitment of health disparities researchers to consider the relevance and implications of their work. Given the reliance on existing data from national population health surveys to test the assumptions of the immigrant paradox, any immigrant-specific measure of SES with limited application to a large, representative sample of immigrants would likely hold little appeal to both researchers and practitioners. Understanding the mechanisms through which socioeconomic status influences immigrant health can allow scholars to address the needs of immigrant populations and advocate more effectively for programs and policies that seek to advance the health of all people.

The variations in socioeconomic status (SES) between different social classes of a population correspond to differences in accessibility to all resources available and able to improve global health. SES can influence global health trajectory for an individual or a community, depending if SES is low or high. Sleep is sensitive to environmental stimuli, as well as living conditions. Plenty of studies linked sleep complaints with mood disorders, allostatic load or circadian disruption; but very few or none investigated deeply what happened earlier to sleep depending of SES. While SES is now known as one of the main determinants for a good health and a good aging, its influence on sleep disorders (SD) is not well understood. SES is a concept, not directly observable but estimated using indicators like income, education, occupational status and area of living. Even if recent evidence suggested that few of SES indicators like occupational status are linked with sleep disturbances, the relation between SES and health in general with sleep as an outcome or a mediator is not well documented. This scoping review synthetized studies which investigated physiological and psychological mechanisms resulting from a low SES and linked them with sleep disturbances as consequences or as mediators. This review also explore a possible role played by sleep in the relation between socioeconomic status and health inequalities.

Abstract: For decades, researchers have suggested the existence of a bilingual cognitive advantage, especially in tasks involving executive functions such as inhibition, shifting, and updating. Recently, an increasing number of studies have questioned whether bilingualism results in change in executive functions, highlighting conflicting data published in the literature. The present study compared the performance of third-, fourth-, and fifth-grade bilingual and monolingual children on attentional and cognitive tasks. Participants were 61 monolingual and 74 bilingual children (M = 114.6 months; SD = 8.48 months) who were tested on two versions of the Attention Network Task (ANT), with and without social stimuli, as well as tests investigating working memory, short-term memory, narrative memory, and receptive vocabulary. Data on families’ socioeconomic status and children’s reasoning abilities were also collected. The results showed that bilingualism and socioeconomic status affected attentional networks in tasks involving social stimuli. In tasks involving non-social stimuli, socioeconomic status only affected the alerting and executive conflict networks. Consistent with the literature, a positive relationship emerged between socioeconomic status and executive control in the context of social stimuli, and a negative relationship emerged between socioeconomic status and the alerting network in the context of non-social stimuli. Interestingly, neither socioeconomic status nor social attentional networks correlated with working memory. Therefore, although more investigations are required, the results suggest that differences in social contexts mainly affect attentional functions.

Sleep disorders (SD) have a complex aetiology, and socioeconomic status (SES) as determined by social class, household income, ethnicity and education plays an important role in their development. As SD are associated with cognitive impairment and mood disorders, they in turn impact SES. Socioeconomic status also influences allostatic load caused by chronic accumulation of stress throughout life. Environmental and psychological stressors have a direct effect on SD, and they are modulated by SES, in combination with comorbidities like obesity and cardiovascular disease. This review explores the recent theories about the influence of SES on the development of SD in the general population, whether or not occurring with comorbidities, and also focusses on the interplay between socioeconomic status, circadian rhythms, aging and clinical outcomes like metabolic diseases and cancer.

(1) Background: Evidence-based policymaking requires data about the local population's socioeconomic status (SES) at detailed geographical level, however, such information is often not available, or is too expensive to acquire. Researchers have proposed solutions to estimate SES indicators by analyzing Google Street View images, however, these methods are also resource-intensive, since they require large volumes of manually labeled training data. (2) Methods: We propose a methodology for automatically computing surrogate variables of SES indicators using street images of parked cars and deep multiple instance learning. Our approach does not require any manually created labels, apart from data already available by statistical authorities, while the entire pipeline for image acquisition, parked car detection, car classification, and surrogate variable computation is fully automated. The proposed surrogate variables are then used in linear regression models to estimate the target SES indicators. (3) Results: We implement and evaluate a model based on the proposed surrogate variable at 30 municipalities of varying SES in Greece. Our model has $R^2=0.76$ and a correlation coefficient of $0.874$ with the true unemployment rate, while it achieves a mean absolute percentage error of $0.089$ and mean absolute error of $1.87$ on a held-out test set. Similar results are also obtained for other socioeconomic indicators, related to education level and occupational prestige. (4) Conclusions: The proposed methodology can be used to estimate SES indicators at the local level automatically, using images of parked cars detected via Google Street View, without the need for any manual labeling effort.

Mobile phones have become an integral part of our lives in the last two decades, leaving a digital trace of our activities and communication. This study aims to develop a data processing framework to evaluate human mobility and socioeconomic status based on call detail records. The methodology proposed first calculates radius of gyration and entropy for each user, then estimates the socioeconomic status by the price and age of the subscribers' phones. Finally, an unsupervised machine learning algorithm was used to group the cells into clusters based on their mobility and socioeconomic metrics. The research showed differences between Buda and Pest during a large scale social event using mobile phone ages and prices. Additionally, the clustering results revealed homogenous groups of cells around Budapest, with similar mobility and socioeconomic metrics. The main conclusion is that mobile network data combined with mobile phone properties offer a useful tool for characterising urban mobility and socioeconomic status.

The main objective of the study is to analyse time trends in excessive body weight (obesity, overweight) of Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents’ families and to find SES-mediated correlates of adolescents’ obesity. A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5-16.5 years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in the Czech Republic. Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of excessive body weight (overweight/obesity) in all SES categories of adolescents, which was most striking (p < 0.05) in adolescents with low SES (boys: +5.2/+7.5 percent points (p.p.); girls +6.3/+2.4 p.p.). When all the survey cycles were compared, the highest prevalence of overweight/obesity was evident in the low-SES adolescents in 2018, both in girls (14.9%/5.1%) and boys (20.4%/12.0%). The lower odds of obesity were significantly (p < 0.05) associated with regular vigorous physical activity, participation in organized sport. An unreasonable increase in the prevalence of obesity in adolescents with low SES suggests that national health-related and sports programmes have the least impact on children from low-SES families.

Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy. In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus playdate control in a group of 9-24-month-old healthy infants (N = 16). Overall, we found some intervention effects on relative reinforcing value of food (RRVfood) and the home environmental enrichment measures (i.e., increased music use at home and home language environment). Our intervention demonstrated large effects on an increased use of music at home. We did not find significant group differences on the RRVfood and home language environment, but some of the effect sizes were medium-to-large. Results also suggest that our intervention is feasible and acceptable. Parent feedback indicated the intervention was well-liked and steps we took to help reduce barriers worked. Music enrichment programs maybe a high-impact, low-cost strategy to address socioeconomic disparities.

This study investigates the socio-economic determinants correlated with Post-Traumatic Stress Disorder (PTSD) symptoms amid the 'Guardian of the Walls' operation, in the Israel-Hamas conflict. Our investigation primarily focused on assessing the effects of missile strikes on Israeli civilians. By conducting an in-depth statistical analysis of individual experiences, we sought to unravel the correlation between socioeconomic status and PTSD susceptibility.Our findings reveal a stark disparity in PTSD risks across different socio-economic groups. Individuals from lower socio-economic backgrounds exhibited a notably higher propensity for PTSD symptoms, suggesting that socio-economic adversity intensifies the psychological toll of conflict exposure. Conversely, higher education and stable family environments appeared to mitigate PTSD risks, underscoring the protective role of certain socio-economic factors.The study's implications extend far beyond the immediate context of the Israel-Hamas conflict. By elucidating the heightened vulnerability of lower socio-economic groups to PTSD, it calls for a nuanced approach to mental health intervention in conflict zones. This approach should not only address the direct psychological impact of conflict but also consider the broader socio-economic fabric that shapes individual experiences of trauma.This research contributes to a growing body of knowledge on PTSD in conflict settings, offering valuable insights for policymakers, mental health professionals, and humanitarian organizations. By highlighting the socio-economic dimensions of PTSD, it advocates for more comprehensive, context-sensitive mental health strategies. Such strategies are crucial for addressing the complex array of factors influencing mental health in conflict zones, ultimately paving the way for more resilient and supportive communities.

In times of war, civilians experience a heightened risk of exposure to traumatic experiences. This can lead to a greater risk of developing mental health conditions such as post-traumatic stress disorder (PTSD), which can impact individuals and communities. Research suggests that the severity of the reactions to traumatic events is likely to be influenced by the level of exposure to the traumatic events and personal characteristics. This paper examines the correlation between symptoms of Post-Traumatic Stress Disorder (PTSD) and various factors such as the extent of exposure to missile alarms, personal traits, and socioeconomic elements among Israeli civilians impacted by rocket attacks from Hamas. Our specific focus is on the influence of these rocket attacks on Israel's populace during the military operation conducted by the Israeli army, "Guardian of the Walls," in May 2021.Our findings suggest that, typically, individuals who have experienced less exposure to missile attacks and alarms, those belonging to larger families, and those with a higher level of education and income are less prone to experiencing post-traumatic symptoms. The study was carried out using surveys that gathered demographic information about the participants, as well as a specific questionnaire designed to evaluate the presence and extent of post-trauma symptoms.These findings could aid in devising preventative strategies to mitigate the PTSD risk among vulnerable groups. They indicate the importance of considering socio-economic elements when delivering mental health services to those impacted by violent incidents and trauma.

The flow of mapping the development and direction of research on Socioeconomic Factors in the Education Ecosystem is known through published articles with the Scopus database index. Quantitative approach is used as the article research with bibliometric data analysis techniques to explore all publications indexed in the Scopus database on Socioeconomic Factors in the Education Ecosystem from 1990 to 2023. The data obtained were analyzed using Excel and R/R-Studio. VOSViewer is used to perform visual analysis of keyword occurrence and document citations stimulantly. Researchers found 772 publications that fit the function, subject, and criteria that had been set. The annual growth rate is seen in the data obtained. The papers are analyzed in terms of publications by field of science, the number of studies published annually. The bibliometric data analysis performed was limited to Scopus data. Other national and international databases were not taken into account in the study. The limitation of this study is only taking data sets or meta data in publications indexed by Scopus. This article presents a brief overview of the literature accessible to researchers working in the field of Socioeconomic Factors in the Education Ecosystem as well as provides recommendations for future research.

MIGAL – Galilee Research Institute is a regional R&amp;D center in the northeast peripheral region of Israel. An internationally recognized applied research institute, MIGAL specializes in biotechnology and computational sciences, plant sciences, precision agriculture and environmental sciences, as well as food, nutrition and health. Most of MIGAL’s researchers serve as the core faculty at Tel Hai Academic College (TH). Despite the country’s small surface area, socioeconomic inequality in Israel is high by OECD standards, with wage differences between rich and poor regions reaching up to 400%. The aims of this study are to identify possible socioeconomic impacts of MIGAL–TH on the peripheral northeast’s development. We discuss the effects of academic research and institutions of higher education on mitigating differences between the center and periphery of the country. Data for MIGAL, TH and the northeastern peripheral region were collected from the yearly reports of the two institutions and the Israel Central Bureau of Statistics. MIGAL was found to serve as a link between research, academic teaching and socioeconomic development in the northeast periphery. Several variables related to this link and describing MIGAL–TH and northeastern periphery development were analyzed over time: MIGAL’s budget, total number of employees and number of employees with PhDs; number of TH graduate students; socioeconomic index (SEI) of the northeastern periphery and its position on the Israeli list of regional SEIs. The signs and significance levels of their trends indicate a potential socioeconomic impact of academic research and higher education on peripheral development in the northeast of the country. Research budgets and the creation of jobs for academics living in the region are just a few examples of this impact.

Background: The aim of our study was to analyze the effect of socioeconomic inequalities, both at the individual and area of residence levels, on the probability of COVID-19 confirmed infection, and its variations across three pandemic waves. Methods: Retrospective cohort study. We included data from all individuals tested by COVID-19 during the three waves of the pandemic, from March to December 2020 (357,989 individuals). We studied the effect of inequalities on the risk of having a COVID-19 confirmed diagnosis after being tested using multilevel analyses with two levels of aggregation: individuals and basic healthcare area (BHA) of residence (deprivation level and type of zone). Results: Patient profile changed through the pandemic, with a predominance of low-paid employees living in deprived BHA. Workers with low salaries, unemployed and people on minimum integration income or who no longer receive the unemployment allowance, had a higher probability of COVID-19 infection than workers with salaries ≥€18,000 per year. Inequalities were higher in women and in the second wave. The deprivation level of BHA of residence influenced the risk of COVID-19 infection, especially in the second wave. Conclusions: There are inequalities in the risk of COVID-19 confirmed infection, both at individual and area level. It is necessary to develop individual and area coordinated measures in the control, diagnosis and treatment of the epidemic, in order to avoid an increase in the already existing inequalities.

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.

Background: To examine the association between income levels and mortality rates in patients with chronic kidney disease. Methods: We analyzed data obtained from 3,172 patients with chronic kidney disease obtained from the Korean National Health Insurance claims database (2003–2009). Each patient was monitored until December 2010 or until death, whichever came first. Individual income was estimated from the national health insurance premium. Information on mortality was obtained from the Korean National Statistical Office. Cox proportional hazard models were used to compare mortality rates between different income groups after adjusting for possible confounding risk factors. Results: A low income was significantly associated with a high mortality rate after adjusting for covariates (adjusted HR 1.298 [1.082–1.556]). In addition, dialysis patients who had low incomes were more likely to have higher mortality rates compared to those in dialysis patients who had high incomes (adjusted HR 1.528 [1.122–2.082]). Conclusion: The findings of this study indicate that chronic kidney disease patients with low incomes have the highest mortality risk. Promotion of targeted policies and priority health services for patients with low incomes may help reduce the mortality rate in this vulnerable group.

Nowadays one of the issues interesting for researchers of political, social, and economic sciences is to investigate immigration from different angles. Accordingly, they use a diverse range of instruments, different types of graphs, descriptive indices and complex mathematical models. Immigration has always been one of the paths helping humans in their own efforts for getting compatible with the environment and coping with difficulties. Nevertheless, if this issue has been considered as an instrument regulating resources and species automatically, in the present era, its negative aspects have been evident and socioeconomic consequences of immigration in the framework of development economy and security has attracted scholars’ attentions. One of the countries attracting for immigrants particularly in the continent of Africa is South Africa. Statistics indicates that this country is the most attractive one for refugees. Somalis are one of the most important and largest groups seeking refuge in South Africa because they are usually merchants who earn money in the poor places. However, business in the poor places endangers their lives and properties because of high rate of crimes and xenophobia. As a result, the target countries face a lot of socioeconomic and security problems. The present study tries to investigate the issue of Somali immigration using network models.

Background and Objectives: Cancer as the second leading cause of death in the United States poses a huge healthcare burden. Barriers to access to advanced therapies influence the outcome of cancer treatment. In this study, we examined whether insurance types affect the quality of cancer clinical care regarding access to an important monoclonal antibody, ramucirumab. Materials and Methods: Data for 13,340 cancer patients with Purchased or Medicaid insurance from the All of Us Database were collected for this study. The Chi-square test of proportions was employed to determine the significance of patient cohort characteristics and ramucirumab usage between Purchased and Medicaid insurance groups. The independent t-test was utilized to assess the influences of other determinants on insurance types. Results: Cancer patients who are African American, with lower socioeconomic status, or with lower educational attainment are more likely to be insured by Medicaid. Analysis of survey questions demonstrated the relationship between income and education level with insurance type as Medicaid cancer patients were less likely to receive primary care and specialist physician access and more likely to request lower cost medications. In addition, those with Medicaid insurance were identified to have poorer access to expensive therapeutics like ramucirumab compared to those with Purchased insurance.  Conclusions: The inequities of the US healthcare system are observed for cancer patient care; access to physicians and therapeutics are highly varied and dependent on insurance types. Socioeconomic status determines insurance type, which unfortunately generates a significant impact on cancer treatment and disease outcome.

Aquaculture production is under pressure to increase its production to meet the growing demand for food from a growing population. In the Philippines, aquaculture has experienced the shift from milkfish to prawn with its attractive marketable price. Its intensification has led to negative and positive impacts making its collapse inevitable in the mid-1990s and raised a range of environmental and socioeconomic problems. This paper reviewed the environmental impacts, challenges, and disease outbreaks that overtook the industry using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. We examined gaps and changes required to revitalize the industry to properly take-off. It considers and gives details on the impacts of shrimp culture on the environment e.g. shrimp farm management, marine pollution, disease outbreaks, climate change impacts, and socioeconomic impacts. Moreover, the presence of viral diseases such as White Spot Syndrome Virus (WSSV), Monodon Baculovirus (MBV), Infectious Hypodermal and Hematopoietic Necrosis Virus (IHHNV), Hepatopancreatic Parvovirus (HPV), and Yellow Head Virus (YHV), have caused socioeconomic impacts with approximate losses of 40,080 mt in 1997 to 51,000 mt in 2014 in the shrimp industry. Recommended strategies were considered to improve the environmental management of shrimp aquaculture, including disease management, and priorities that were highlighted for future research. This management relates to adopting good aquaculture practices on shrimp culture, proper environmental monitoring and sustainable practices at the farm level.

The interest in spatial analysis has been growing in recent years, mainly due to communication technology advance, economic globalization, and the development of new statistical and econometric methods. The main aim of this article is to contribute to the dissemination of spatial econometric applications by presenting some basic theoretical aspects and a literature review of articles that address the socio-economic drivers that lead to environmental pollution. Three spatial regression models are reviewed here: the spatial lag model (SLM), the spatial error model (SEM), and the spatial Durbin model (SDM). A literature search was conducted using specific terms of interest in eight databases, from 1996 to February 2021, where 22 articles were considered for analysis. The results showed that most articles studied environmental problems in China. The most used exploratory spatial analysis model was Moran Index and the most used explanatory spatial analysis models were SDM and SLM.

The Shared Socioeconomic Pathways (SSPs) are the new global development trends that inform global and regional climate change research. They have the potential to foster the integration of socioeconomic scenarios within assessments of future climate-related health impacts. To date, such assessments have primarily superimposed climate scenarios on current socioeconomic conditions only. Until now, the few assessments of future health risks that employed the SSPs have focused on future human exposure—i.e., mainly future population patterns—neglecting future human vulnerability. This paper first explores the research gaps—mainly linked to the paucity of available projections—that explain such a lack of consideration of human vulnerability under the SSPs. It then highlights the need for projections of socioeconomic variables covering the wide range of determinants of human vulnerability, available at relevant spatial and temporal scales, and accounting for local specificities through sectoral and regional extended versions of the global SSPs. Finally, this paper presents two innovative methods of obtaining and computing such socioeconomic projections under the SSPs—namely the scenario matching approach and an approach based on experts’ elicitation and correlation analyses—and applies them to the case of Europe. They offer a variety of possibilities for practical application, producing projections at sub-national level of various drivers of human vulnerability such as demographic and social characteristics, urbanization, state of the environment, infrastructure, health status, and living arrangements. Both the innovative approaches presented in this paper and existing methods—such as the spatial disaggregation of existing projections and the use of sectoral models—show great potential to enhance the availability of relevant projections of determinants of human vulnerability. Assessments of future climate-related health impacts should thus rely on these methods to account for future human vulnerability—under varying levels of socioeconomic development—and to explore its influence on future health risks under different degrees of climate change.

Food insecurity (FI) is a persistent issue in Brazil, with significant disparities across the country's macroregions. This study investigated food acquisition locations and types of foods purchased at different levels of FI, utilizing data from 57,920 households in the 2017–2018 Brazilian Household Budget Survey. Food acquisition locations were grouped into supermarkets, small markets, fairs/farmers’ markets/public markets, and others. Foods were categorized into 12 groups: rice, beans, vegetables, fruits, red meats, fish, poultry, eggs, milk and dairy products, bread, cookies, and sugary drinks. Supermarkets are the primary source of food in Brazil. However, in the North and Northeast regions, small markets are more frequently used across all levels of FI. Nationally, most food groups are predominantly purchased at supermarkets. Nevertheless, households experiencing moderate or severe FI rely more on small markets for essential items such as rice, beans, and proteins, as well as ultra-processed foods. These findings highlight the need for public policies that improve food access for vulnerable populations and address regional inequalities. Enhancing access and ensuring food security across different regions is essential to promote equitable and healthy diets throughout the country.

The pandemic crisis of Covid-19 disturbed the social and the economic systems in which some changes happened during the pandemic and other changes extended subsequently. This paper is reflecting on the Sudan case, a country of a moderate population and large area with poor socioeconomic standard and infrastructure. The paper is based on the analysis of primary data and policy recommendations of an original research undertaken in five States in Sudan during the period Sept.2021-Sept.2022. The sample of the study selected from most five States that were affected by the Corona pandemic, namely: Khartoum State, Gezira State in the Central Region, Kassala State and Gadarif State from the Eastern Region, and Nyala State in the South Darfur Region in the west of the country. The research built on a quantitative research method, used the questionnaire as a tool for data collection from a sample size of 723 family head-households. The study is gaining a better understanding of the social, economic and health challenges that faced Sudanese households during the COVID-19 lock down and within the pandemic period. The study showed crucial results that the education of children was disturbed due to unavailability of the distance education in schools. In contrast some families maintained the education of the children as enrolled in private schools. In addition, the paper shows how the families used different approaches to educate their children and involve them into traditional informal and formal education ways. Additionally, the results explained the coping strategies with available resources that families used to manage economic crises and how this interferes with children education. Furthermore, the study proposing appropriate social policies and interventions that address the needs of the family in the current and future pandemic crisis.

Agroforestry practices evolve with the development of basic and advanced facilities, changes in natural and artificial factors of land use change. The study aims to examine the socioeconomic characteristics and compare satisfaction levels across forest products and vegetable farming of the agroforestry community in Khost Province. Data were collected from 662 farmers and was analyzed using univariate Analysis of Variances (ANOVA) and Multivariate Analysis of Variances (MANOVA). The results found that forest and vegetable products, including fruits, berries, herbs, mushrooms, wild animals, oils, wood, honey, okra, eggplant, carrot, cucumber, pine nuts, pepper, and timber has different impact in terms of satisfaction with basic and advanced facilities, knowledge about land use and impacts, natural and artificial factors of land use change, and positive and negative impact of land use change. The limitation of the study included an absence of exogenous factors in the model such as climate change, financial conditions, market fluctuations, regulatory system, an area in which the study is selected, research design, and current condition of endogenous factors. Overall, agroforestry practices can improve the socioeconomic development of agroforestry-dependent communities in Khost Province, Afghanistan. This study provided useful insights for policymakers and development practitioners to promote agroforestry practice adoption and improve the socioeconomic development of agroforestry-dependent communities. Future works could explore the implications of agroforestry practices on the socioeconomic development of other dependent communities in Afghanistan.

Extreme heat is a climate hazard that has been linked with high morbidity and mortality. The way extreme heat events are felt in the population varies depending on a variety of factors, such as age, employment status, living conditions, air-conditioning, housing conditions, habits, behaviors, and other socio-demographic parameters. To quantify and locate vulnerabilities of populations to extreme heat, we analyze socio-economic data at the NUTS3 level for the national case study of Greece and at the census tract level for the local case study of the city of Athens. The target variable for this study is defined as the average daily mortality during heatwaves per 100,000 individuals and a methodology is developed for constructing this variable, based on socio-economic data available in public databases. Independent variables were selected based on their contribution to socioeconomic vulnerability; they include the percentage of elderly, retired, unemployed, renting, living alone, residing in smaller houses, living in older houses, and immigrants from developing countries. An ensemble gradient boosted tree model was employed for this study to obtain feature importance metrics that was used to construct a composite index of socioeconomic heat vulnerability. The socioeconomic heat vulnerability index (SHVI) was calculated for each prefecture in Greece and for each census tract in the city of Athens, Greece. The unique feature of this SHVI is that it can be applied to any geographical resolution using the same methodology and produces a result that is not only quantifiable, but also allows comparison between vulnerability scores of different regions. This application aimed to map the SHVI of both prefecture and city, to examine the significance of scale, to identify vulnerability hotspots, and rank the most vulnerable areas, which are prioritized by authorities for interventions that protect public health.

Objective. It is unknown whether the public accurately estimate socioeconomic health inequality and whether they wish to see it reduced or eliminated. Methods. Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We present perceived and desired lifespan ratios for each sample and for key socio-demographic variables. Results. The UK public estimated the lifespan of professionals to be 5.9% longer than routine workers (true value of 5.8%), and 67.8% (UK) and 53.7% (US) participants correctly identified that professionals live longer than routine workers. In both populations, the median respondent expressed equal ideal lifespans for routine workers and professional workers. Conclusion. The UK public appear well-appraised on the average lifespan for professionals and routine workers. Across nationalities and most socio-demographic groups, the median respondent was aware of social class inequalities in lifespan and preferred that they be eliminated.

International migration is closely tied to demographic, socioeconomic, and environmental factors and their interaction with migration policies. Using a combination of a gravity econometric model and an overlapping generations model, we estimate the probability of bilateral migration among 160 countries in the period of 1960 to 2000 and use these findings to project international migration flows and their implication for income inequality within and between countries in the 21st century under five shared socioeconomic pathways (SSPs). Our results show that international migration not only increases the welfare in developing countries, but also closes the inequality gap within and between low-skilled and high-skilled labor in these countries. In most developed countries on the contrary, international migration increases the inequality gap and slightly reduces output. These changes are not uniform and vary significantly across countries depending on their population growth and human capital development trajectories. Overall, while migration is strongly affected by inequality between developed and developing countries, it has an ambiguous impact on inequality within and between countries.

The latest World Atlas of Desertification represents a turning point in the diagnosis of desertification. While it forgoes desertification mapping due to the intrinsic complexity of the phenomenon and the impossibility of measuring it using a single indicator, it introduces the Convergence of Evidence paradigm, which identifies socioeconomic and biophysical variables whose behavior allows pointing out those areas prone to desertification. The Spanish National Action Program Against Desertification (PAND), back to 2008, already implemented a similar approach to identify five “desertification landscapes” within Spain using both socio-economic and climatic information. The PAND was not only pioneering but also, unfortunately, accurate. Desertification in Spain has continued to worsen and the first two decades of the 21st century have consolidated an agri-food model whose dynamics have exacerbated the desertification processes identified in the PAND. Despite its scientific value, the PAND lacked a proper action plan and was completely detached from the diagnosis. As a result the diagnosis it provided was not followed by effective actions to halt desertification in Spain. The Spanish Government's recent declaration of climate and environmental emergency requires a new strategy to combat desertification. This commitment is an excellent opportunity to update the diagnosis of the situation and, more crucially, to unify the different desertification sectoral policies and actions under a single front. We provide here elements for a roadmap to be designed around the pressures, impacts, and drivers that define today's Spanish desertification landscapes to manage them effectively and avoid their further degradation.

This study estimates the negative impacts of the COVID-19 on poverty and unemployment in Indonesia. In doing so, this study develops and uses the SD model that reproduced similar patterns in terms of GDP, poverty, and unemployment. Estimated unemployment and estimated poverty under the COVID-19 are calculated for three different economic scenarios: the optimistic, the mid, and the pessimistic scenarios. This study concludes that Indonesia will experience rising unemployment and poverty in ranges (9-10) and (25-26) million people respectively by the end of this year – depending on projected economy growths. This study suggests that existing financial aids are sufficient to support rising unemployment and rising poverty level. However, if the Indonesia government cannot carefully slow the COVID-19 flow, higher financial supports are required to curb the negative impacts of the COVID-19.

We examined the relationship between living alone and the prevalence of depressive symptoms in older Korean widows and assessed the individual contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. The study was a secondary analysis using data from widows 65 years of age and older who participated in the Living Profiles of Older People Survey (LPOPS). A logistic regression analysis was used to evaluate the contributions of health, social ties, and socioeconomic factors to the development of depressive symptoms. Working status and equivalent household income were significantly associated with depressive symptoms in both those living with others and those living alone. Adjustment for health status and social ties did not change the impact of living alone on the prevalence of depressive symptoms. However, adjustment for equivalent household income eliminated the negative association between living alone and depressive symptoms. Our findings indicate that economic resources are more important than health and social ties for alleviating the negative impact of living alone on the development of depressive symptoms in older widows.

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.

Scenario analysis is a widely employed method for addressing uncertainties when assessing the physical and socio-economic impacts if climate change. Global scenarios have been extensively used in this context. However, these scenarios are in most cases not suitable for supporting local analyses. On the other hand, locally developed scenarios may lack the global context, thus having limited comparability with or transferability to other locations. The Shared Socioeconomic Pathways, which have been primarily developed for climate impact research, provide the possibility to extend the existing global narratives and adapt them to local characteristics in order to develop locally relevant scenarios. Here, we propose a methodological framework for producing harmonized scenarios across different case studies. This framework was developed in the EVOKED project and combines elements of top-down and bottom-up approaches to develop local scenarios for five regions in northern Europe. We employ the SSP as boundary conditions and, in cooperation with stakeholders from these five regions, develop local scenarios for a range of SSP. The developed sets of scenarios are consistently informed by global developments and are therefore comparable with other downscaled scenarios developed in different regions. At the same time, they have been based on local participatory processes, thus being locally credible and relevant to the needs of stakeholders. The local scenarios constitute a climate service per se as they can raise stakeholder awareness of the processes that will drive risk, exposure, and adaptive capacity in the future and inform discussions on mitigation strategies and adaptation pathways.

This study investigates the impact of the economic downturn induced by the COVID-19 pandemic on nutritional health disparities among women. The research aimed to understand how economic challenges have influenced dietary choices, access to nutritious food, and overall nutritional well-being in different socioeconomic groups of women.Utilizing a mixed-methods approach, the study combined quantitative data from national health and economic databases with qualitative insights from interviews conducted with a diverse group of women. The quantitative analysis focused on trends in nutritional health indicators and economic variables pre- and post-pandemic. Simultaneously, the qualitative component explored personal experiences and perceptions related to nutrition and economic hardships during the pandemic.The findings revealed a significant correlation between the economic downturn and worsening nutritional health among women, especially in low-income and marginalized communities. Women in these groups reported reduced access to healthy food options, increased reliance on less nutritious food due to budget constraints, and a general decline in dietary quality. This decline was less pronounced in higher-income groups, highlighting a clear disparity.Moreover, the study observed that the pandemic exacerbated pre-existing nutritional inequalities, with vulnerable groups experiencing a more pronounced impact. The research also noted that community support systems and public health interventions played a crucial role in mitigating some of these effects.In conclusion, the COVID-19 pandemic has not only posed a direct health challenge but has also indirectly affected women's nutritional health through economic strain. The study underscores the need for targeted nutritional support and economic policies that prioritize the health of women, particularly those from socioeconomically disadvantaged backgrounds.

The La Oroya metallurgical complex reveals a process of structural or power pathology, where economic and environmental social policies lead to a citizenry without systemic freedom, characterized by environmental contamination (PAMA executed on average 67%, some processes with 0%) and sanitary (plumbosis 8.39 to 10.28 μg / dL), the economic dependence of this industry is also observed, which caused the weakening of the communities to maintain autonomy over their own destinies.The Doe Run Peru, operated the metallurgical complex, creating added value to the extractive-export chain of mineral concentrate, but also took advantage of the legal loopholes, the little coordination between the State institutions and the little authority of the supervisory institutions to get the most out of it, complying with the law in some cases, but without moral quality in some others, such as health in the oroinos.Government institutions must have strong links that provide a normative framework with prospects with sustainable development, where the beneficiary is society and not only certain interest groups. The economic benefits of the metallurgical complex operation are multiple, which begin with labor, the purchase and sale of materials and services, the collection of taxes and energy.

Objective: (1) Describe the current literature on the relationship between EDS and SEP and (2) provide recommendations for consideration of SEP in sleep medicine and biomedical research. Methods: Databases Medline/Pubmed, Web of Science, Google scholar and Scopus were screened using PRISMA guidelines and 19 articles were included in the final synthesis. Results: All studies were cross-sectional. Among these studies, 21.05% (n = 4) are focused on children and adolescent and the lasting 88.95% (n = 15) focused on adults and old people. Age ranged between 8 and 17 years old for children/adolescent and ranged from 18 until 102 years old for adults. Main SEP measures presented in these studies were education, income, perceived socioeconomic status and employment. Sample size in these studies varied from N = 90 participants until N = 33865 participants. Overall, a lower educational level, a lower income and full-time employment were associated with EDS. EDS symptoms are prevalent in women, especially those with a low income or no job; and children and adolescents with difficult living conditions or people working part-time reported more sleep disturbances. Conclusions: SEP is already considered as an important determinant for many health outcomes, but if SEP is embedded in experimental design in psychosomatic research, biomedical research and clinical practice as a constant variable regardless of outcome; it will move forward future investigations.

Socioeconomically disadvantaged people are disproportionally more likely to develop obesity and obesity-related diseases. However, it remains unclear to what extent diet quality contributes to socioeconomic inequalities in obesity. We aimed to assess the role of diet quality in the association between socioeconomic status (SES) and obesity. Data originated from the national nutrition survey, a cross-sectional sample of the adult Swiss population (N=1860). We used education and income as proxies for SES; calculated the Alternate Healthy Eating Index (AHEI) as measure of diet quality; and used body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) as obesity markers. We applied counterfactual mediation modelling to generate odds ratios, 95% confidence intervals, and the proportion mediated by diet quality. Individuals with less than a tertiary education were two to three times more likely to be obese, regardless of the marker (OR; 95% CI: 3.36 (2.01, 5.66) using BMI; 2.44 (1.58, 3.75) using WC; 2.48 (1.63, 3.78) using WHR; and 2.04 (1.43, 2.96) using WHtR). The proportion of the association between educational level and obesity that was mediated by diet quality was 22.1% using BMI, 26.6% using WC, 31.4% using WHtR, and 35.8% using WHR. Similar findings were observed for income. Our findings suggest that diet quality substantially contributes to socioeconomic inequalities in obesity while it does not fully explain them. Focusing efforts on improving the diet quality of disadvantaged groups could help reduce social inequalities in obesity.

This study examines the dynamics of failure development in marginalized communities, investigating the interplay of socioeconomic, environmental, and community engagement factors. The research aims to uncover underlying causes, provide policy recommendations, and elucidate the challenges faced by these communities. However, limitations include a restricted focus on marginalized areas, data limitations, and an exclusive emphasis on socioeconomic factors. The analysis reveals gaps in addressing political influences, limited coverage of success stories, and potential biases in the methodology. The conclusion emphasizes the transformative power of community-led initiatives to address challenges, foster inclusivity, and create sustainable change. These initiatives prioritize capacity building, social cohesion, economic development, and access to education and healthcare. Implications for policy and practice underscore the need for comprehensive interventions, collaboration, empowerment, and sustainable development. Future research directions include exploring the long-term impact of historical failures, intersectionality, the role of technology, mental health implications, and comparative analysis.

In China, environmental pollution generated via industrialization as well as the profound changes in the social structure and gradual maturation of the social hierarchy have jointly contributed to the Chinese people's increased environmental consciousness and appeals for environmental justice (EJ). Because of the absence of an EJ theory and a lack of empirical research focused on China, this paper proposes a ‘Pyramid Model’ for China’s EJ research that involves the following three factors: basic demographic and socioeconomic factors, U.S.-based EJ principles, and Chinese characteristics. A nationwide pilot analysis of environmental inequity at the prefecture level is conducted by empirically studying the association of demographics and socioeconomic status with sources of industrial pollution in China. The prefecture-based results are shown to be robust and indicate that areas inhabited by ethnic minorities and western regions in China carry disproportionate environmental burdens. However, a different picture for migrants is presented, revealing that Chinese migrants are not currently exposed to greater levels of industrial pollution, and relevant interpretations of these findings are provided. The results also show that environmental inequality associated with income level, which is observed in the U.S., does not occur in China.

ABSTRACT This study focused for socio-economic benefit of Western shoreline of Lake Ziway ecosystem. The data collected from two woredas they are Adami Tulu Jidu Kombolch (ATJK) and Dugda woreda of fishermen and small scale irrigation users. Lake Ziway great importance food and water for both groups of respondents and additionally sources of raw material, energy, cultivation, organic fertilizers, genetic and medicinal plants. Lake Ziway also has a major economic benefit for both groups of respondents. The sampled fishermen cached mean amount of 2,524Kg per year with minimum and maximum amount of fish 504Kg and 16,800Kg per year respectively and with this fish catching they got average income of 51,398 Birr ($2,570) per year with range of 7,200 Birr ($360) and 288,000 Birr ($14,400) per year. As like of fishermen small scale irrigation also got economic benefit with their production of cereal crops, fruits and vegetables. They produce in average 13.47Quintal of cereal crop and 69.56Quintal of fruits and vegetables per year and they got average income of 7,727 Birr ($386) and with range of 13,714 Birr ($686) per year respectively. this incurred that wetland ecosystem has a lot of socio-economic benefit for the people live near by specially for developing countries like Ethiopia they are more dependent on natural ecosystem like of Lake Ziway. Because of its high importance, we have to protect and conserve and use sustainably of Lake Ziway and similar wetland ecosystems. Key Words: Wetland ecosystem service; Lake Ziway; Socioeconomic benefit; Fishermen; Small scale irrigation users

Substance use is a growing problem among young people in sub-Saharan Africa; tobacco use is the dominant one among these practices. The aim was to analyse prevalence rates and determinants for cigarette smoking of school-attending adolescents in the capital, Bissau, Guinea-Bissau. In June 2017, a survey questionnaire was implemented in 16 schools among adolescents aged 14–19 (52% girls). The Chi-square (p&lt;0.05) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Potential explanatory variables for the dependent variables were introduced into a multinomial logistic regression model, and p-values were transformed to LogWorth values. The prevalence of lifetime smoking experience among 1,845 participants was 14.8%; 6.5% were current users, and 2.2% were daily smokers. The most significant determinants for cigarette smoking included having friends who smoke, being a boy, attending a private school, smoking initiation at a young age, other substance use and violent behaviour. It is imperative to initiate preventive actions against smoking and other use of tobacco in Guinea-Bissau. Considering the significant impact of the peer group, policymakers need to engage young people in developing primary prevention strategies to curb the use of tobacco and other substances.

Breast cancer mortality rates vary across ethnic groups in Israel, where protective factors such as high fertility and breastfeeding rates may be moderated by socioeconomic factors and mammography rates. We aim to investigate disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel and examine how sociodemographic variables and number of children are associated with mortality. Our retrospective follow-up study uses data from the Israeli Central Bureau of Statistics and multivariable Cox regression models, adjusting for age, number of children, country of origin, locality size, and socioeconomic status. Compared to Jewish women, Muslim Arab women exhibited lower breast cancer mortality rates. However, after adjusting for multiple sociodemographic variables, no significant differences persisted between Jewish and Muslim Arab women. Having more than three children was associated with lower mortality among Muslim Arab women, but not among Jewish women. European/American origin, larger localities, and medium socioeconomic status were associated with higher mortality. Sociodemographic factors may therefore explain the disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel. Targeted intervention programs considering unique characteristics and risk factors of different ethnic groups are needed to reduce disparities and improve outcomes.

(1) Background: This paper details the development process of two assistive technology products (ATs) implemented in the PAID project, aiming to promote the social, educational, and labor inclusion of people with disabilities across 10 municipalities of Antioquia, Colombia. (2) Methods: Applying Design Thinking (DT) methodology, including stages of empathizing, defining, ideating, prototyping, and testing, alongside a demographic study where specific needs of people with disabilities (PwDs) were identified. (3) Results: As a result, the construction process of two specific cases of assistive technology products (ATs) is detailed, including finite element simulation, mechanical testing, and delivery to end-users. Additionally, workshops for assistive product fabrication conducted in select municipalities of the project are highlighted. (4) Conclusions: the information gathered guided the development of the ATs, focusing on their features on accessibility and ease of replication. The primary objective is to facilitate the participation of PwDs in educational environments, thus promoting inclusion and accessibility. This article describes the results of two of these ATs; however, it is worth noting that this process was performed for 112 ATs delivered through the duration of the project.

Building on the carbon reduction targets agreed in the Paris Agreements, many nations have renewed their efforts toward achieving carbon neutrality by the year 2050. In line with this ambitious goal, nations are seeking to understand the appropriate combination of technologies which will enable the required reductions in such a way that they are appealing to investors. Around the globe, solar and wind power lead in terms of renewable energy deployment, while carbon capture and storage (CCS) is scaling up toward making a significant contribution to deep carbon cuts. Using Japan as a case study nation, this research proposes a linear optimization modeling approach to identify the potential contributions of renewables and CCS toward maximizing carbon reduction and identifying their economic merits over time. Results identify that the combination of these three technologies could enable a carbon dioxide emission reduction of between 55 and 67 percent in the energy sector by 2050 depending on resilience levels and CCS deployment regimes. Further reductions are likely to emerge with increased carbon pricing over time. The findings provide insights for energy system design, energy policy making and investment in carbon reducing technologies which underpin significant carbon reductions, while identifying potential regional social co-benefits.

This study aimed to examine the trends in the prevalence of overweight and obesity and to determine the associated socioeconomic and household environmental factors among women in Nepal. Using nationally representative data from the 1996, 2001, 2006, 2011 and 2016 cross-sectional Nepal Demographic and Health Surveys (NDHSs) (n = 33,507), the prevalence of overweight–obesity (body mass index (BMI) ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) among women aged 15–49 years were examined. From the latest NDHS 2016, non-pregnant women with recorded anthropometric measurements (n = 6165) were included in the final analyses. Multivariate logistic regression models were used to determine the socioeconomic and household environmental factors associated with BMI ≥ 25 and BMI ≥ 30. Between 1996 and 2016, the prevalence of overweight–obesity increased from 1.8% to 19.7%, while the prevalence of obesity increased from 0.2% to 4.1%. Age, marital status, wealth index, province of residence, cooking fuel, refrigerator, and bicycle were significantly associated with having both overweight–obesity and obesity. Similarly, educational status, religion, type of toilet facility, television, and mobile phone were significantly associated with having overweight–obesity. Given the alarming increase in the prevalence of overweight and obesity among Nepalese women, there is an urgent need of interventions addressing these critical socioeconomic and household environmental factors.

Background: Low-income families often depend on fuels such as wood, coal, and animal dung for cooking. Such solid fuels are highly polluting and are a primary source of indoor air pollutants (IAP). We examined the association between solid fuel use (SFU) and acute respiratory infection (ARI) among under-five children in Afghanistan and the extent to which this association varies by socioeconomic status (SES) and gender. Materials and Methods: This is a cross-sectional study based on de-identified data from Afghanistan’s first standard Demographic and Health Survey conducted in 2015. The sample consists of ever-married mothers with under-five children in the household (n=27,565). We used mixed-effect Poisson regression models with robust error variance accounting for clustering to examine the associations between SFU and ARI among under-five children after adjusting for potential confounders. We also investigated potential effect modification by SES and sex. Additional analyses were conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking/kitchen (High Exposure, Moderate, and No Exposure). Results: Around 70% of households reported SFU, whereas the prevalence of ARI was 17.6%. The prevalence of ARI was higher in children living in households with SFU compared to children living in households with no SFU (adjusted prevalence ratio [aPR]= 1.10; 95%CI: 0.98, 1.23). We did not observe any effect modification by SES or child sex. When using the augmented measure of exposure incorporating the kitchen’s location, children highly exposed to IAP had a higher prevalence of ARI compared to unexposed children (aPR 1.17; 95% CI: 1.03, 1.32). SES modified this association with the strongest associations observed among children from the middle wealth quintile. Conclusion: The findings have significant policy implications and suggest that ARI risk in children may be reduced by ensuring clean cookstove as well as clean fuels and acting on the socio-environmental pathways.

This brief report investigates the potential correlation between manual labor and opioid addiction, focusing on contributing factors such as chronic pain, regular exercise, healthcare access, and housing stability. Although manual labor is associated with higher rates of work-related injuries and chronic pain, the review finds no strong, direct correlation between manual labor and increased opioid addiction rates. The relationship is complex and influenced by a range of socio-economic factors. The findings highlight the need for further research, particularly longitudinal studies, to explore these dynamics in depth and develop targeted interventions for at-risk populations.

Sleep disorders have become a public health problem for many reasons. The aim of this systematic review is to describe social, economic, and environmental determinants of sleep disturbances in Australia and New Zealand. A total of 22 studies, 14 from Australia and 8 from New Zealand involving children, adolescents and adults are included in the review. In summary, we found that sleep health disparities among children and adolescents in both countries are strongly associated to parental SES. Overall, lower family SES such as low parental income, low parental education, low SES area index are associated with higher sleep disturbances among children and adolescents. In adults, results revealed that SES determinants such as low income, lower education, unemployment, and night work were associated with sleep disturbances. Specifically, unemployment was associated with poor sleep quality, insomnia, and increased likelihood of suboptimal sleep efficiency. Low income and lower education were associated with high risk of OSA, longer sleep duration, insomnia, higher odds of suboptimal sleep duration and sleep onset latency.

Objective: This study aimed to examine the relationship between health structure disparities and hospitalizations and deaths among the pediatric population in different regions. Method: The study employed an ecological time series design, utilizing population-based secondary data ob-tained from DATASUS, from the Brazilian Ministry of Health. The data included in this study encompassed the population aged zero to 19 years, health establishments, physicians working in health establishments, hospitalizations, and deaths related to Morbidities listed in the Interna-tional Classification of Diseases. The focus was explicitly on individuals diagnosed with Cere-bral Palsy and other paralytic syndromes. The data for this study were gathered from January 2018 to December 2021. TABNET was used for data collection, and Excel for tabulation and anal-ysis. Results: Analysis of health structure data across regions revealed notable disparities, par-ticularly in the North and Northeast regions, compared to other regions. These discrepancies prompted a decision to conduct a comparative assessment between these regions and the rest of the country. Conclusion: In the North region, a significant 50% difference in hospitalizations based on residence versus a place of care was observed for individuals with Cerebral Palsy and other paralytic syndromes, indicating the necessity for relocation to access appropriate medical treatment.

This analysis investigates health outcomes by cause and income group across European and African countries, highlighting significant disparities tied to economic status. Low and lower-middle-income countries in Africa face a greater burden of disease, particularly in acute lower respiratory infections, diarrheal diseases, bacterial infections, HIV/AIDS, and maternal conditions. This is primarily due to limited access to clean water, sanitation, and healthcare services. In contrast, high-income African countries exhibit better health outcomes. European countries show variations: lower-middle-income nations suffer more fro4m acute respiratory infections and HIV/AIDS, while high-income countries report higher incidences of cancer and bacterial infections. These differences reflect disparities in healthcare quality and social determinants. The study emphasizes the need for targeted policy initiatives to address these disparities by focusing on socioeconomic factors and improving healthcare access and quality across all income groups.

Studies at the juncture of development economics and public health host considerable responsibility in addressing inequality and related mental health distress. Mental health care in economically marginalized populations requires depicting the linkages between socioeconomic status and psychological distress. In the present work, a sequential mixed-methods design was used to study 190 people in such communities in India. Gender-dependent psychological distress was found according to Kessler Psychological Distress Scale (K-10) with moderate distress in women (M= 26.30, SD= 9.15) and mild distress in men (M= 21.04, SD= 8.35). Regression analysis indicated that gender significantly predicted psychological distress, followed by age, marital status, and education of the head of the family. The Interpretative Phenomenological Analysis of semi-structured interviews to six women who scored the highest on the distress scale unveiled three master themes: (1) Manifestation of Psychological Distress, (2) Contextual Challenges, and (3) Sources of Strength and Resilience. Overall, participants reported lack of resources, community violence, gender discrimination, and widespread substance use as major contributors to the ongoing distress. These findings can pave the way for future studies to expand beyond independent economic indicators and curate clinical interventions for culturally competent mental health care.

This study investigated the characteristics and outcomes of drug-resistant tuberculosis patients in selected rural healthcare facilities in the Eastern Cape, South Africa. A retrospective review of clinical records from 456 patients, covering the period from January 2018 to December 2020, revealed that a statistically significant relationship between DR-TB types and age groups (Chi-square statistic: 30.74, p-value: 0.015). Younger adults (19-35 years) and middle-aged adults (36-50 years) are more frequently affected by RR-TB and MDR-TB, which are the most prevalent forms of DR-TB. Less common types, including Pre-XDR, XDR, and INH TB, were observed in smaller numbers. The study suggests that DR-TB imposes a heavy burden on the working-age population. Gender analysis shows that while the frequency of DR-TB differs between males and females, the percentage distribution of DR-TB types is relatively equal. Both genders are predominantly affected by RR-TB and MDR-TB, which together account for nearly 90% of cases. Pre-XDR, XDR, and INH-resistant TB are much less common, comprising only a small percentage of cases in both males and females. High-risk behaviors such as smoking and drinking are linked to a wider diversity of DR-TB types, while occupations like mining and prison work show higher rates of RR-TB and MDR-TB. In HIV-positive individuals, DR-TB is more common, but the distribution of DR-TB types between HIV-positive and negative groups shows no statistically significant difference. However, HIV-positive individuals have a 20% lower survival rate (65%) compared to HIV-negative patients (85%). Financial stability and comorbidities also significantly influence outcomes, with patients having stable income and fewer high-risk comorbidities experiencing better survival and treatment outcomes. The findings underscore the importance of addressing socioeconomic disparities and strengthening healthcare infrastructure to improve DR-TB treatment outcomes in rural Eastern Cape.

Building fires are preventable incidents that have proven to be both deadly and costly. Addressing their root causes will lead to safer neighbourhoods for families and businesses to live and operate in. Multiple studies have established the effect of residents’ socioeconomic compositions on an area’s building fire rates; however, the existing model based on the classical stepwise regression procedure has several limitations. This paper aims to construct a more accurate predictive model of building fire rates based on a set of explanatory socioeconomic variables. In building the socioeconomic model, a backward elimination by Robust Final Predictor Error (RFPE) criterion is proposed to enhance the forecasting capability of the model. The proposed method has been implemented on the census data and the fire incident data of the South East Queensland region in Australia. A cross-validation was then conducted to assess the model’s accuracy. In addition, comparative analyses of other elimination criteria, such as p-value, adjusted R-squared, Akaike’s Information Criterion (AIC), Bayesian Information Criterion (BIC) and predicted residual error sum of squared (PRESS), were conducted. The cross-validation analyses demonstrate that the proposed criterion is a more accurate predictive model based on a couple of goodness-of-fit measures. All in all, the RFPE equation was found to be a suitable criterion for the backward elimination procedure in the socioeconomic modelling of building fires.

Socioeconomic conditions and social attitudes are known to represent epidemiological determinants. Credible knowledge on socioeconomic driving factors of the COVID-19 epidemic is still incomplete. Based on a linear random effects regression, a predictive model is derived to estimate COVID-19 incidence in German rural districts from local socioeconomic factors and popularity of political parties in terms of their share of vote. Thereby, time series provided by Germany's public health institute (Robert Koch Institute) of weekly notified 7-day incidences per 100,000 inhabitants per district from the outset of the epidemic in 2020 up to December 1, 2021, have been used to construct the dependent variable. Local socioeconomic conditions including share of votes, retrieved from the Federal Statistical Office of Germany, have been used as potential risk factors. Popularity of the right-wing party Alternative for Germany (AfD) bears a considerable risk of increasing COVID-19 incidence both in terms of predicting the maximum incidences during three epidemic periods (alternatively, cumulative incidences over the periods are used to quantify the dependent variable) and in a time-continuous sense. Thus, districts with high AfD popularity rank on top in the time-average regarding COVID-19 incidence. The impact of the popularity of the Free Democrats (FDP) is markedly intermittent in the course of time showing two pronounced peaks in incidence but also occasional drops. A moderate risk emanates from popularities of the Green Party (GRÜNE) and the Christian Democratic Union (CDU/CSU) compared to the other parties with lowest risk level. Socioeconomic parameters like \emph{per capita} income, proportions of protection seekers and social benefit claimants, and educational level have negligible impact. To the contrary, incidence significantly increases with population density. In order to effectively combat the COVID-19 epidemic, public health policymakers are well advised to account for social attitudes and behavioural patterns reflected in local popularities of political parties, which are conceived as proper surrogates for these attitudes. Whilst causal relations between social attitudes and the presence of parties remain obscure, the political landscape in terms of share of votes constitutes at least viable predictive "markers" relevant for public health policy making.

Malaria remains a public health challenge in low- and middle-income countries (LMICs). Despite gains from strategies like Insecticide Treated Nets (ITNs) and Intermittent Preventive Treatment during pregnancy (IPTp), significant socioeconomic inequalities persist, particularly among pregnant women and children under five. This study analysed temporal and socioeconomic inequalities in malaria prevention in sub-Saharan Africa (SSA). Methods: Nationally representative Demographic Health Surveys from 10 SSA countries were used, comparing two time periods. Changes in ITN use by pregnant women and children under five, as well as IPTp coverage, were assessed. Inequalities based on socioeconomic status (SES) and residence were analysed using the Erreygers Normalized Concentration Index and Theil index.. Results: Results revealed significant variability in ITN use and IPTp coverage between and within countries. Eight countries showed improvements in ITN use during pregnancy, with Nigeria seeing a 173.9% increase over five years. Burkina Faso and Tanzania consistently reported high ITN use (~87%) in children under five. IPTp coverage increased in all countries except Kenya. Decomposition using the Theil index indicated that within-group inequalities, particularly based on SES and residence, were the primary drivers of disparities. Conclusion: To ensure progress toward universal health coverage, malaria prevention programs must prioritize vulnerable populations and be continuously evaluated.

Geographic Information Systems (GIS) played an important role in understanding the dynamics of the territorial spread of COVID-19 during the pandemic. Even today, it is important to understand such dynamics in view of the imminent risk of new epidemics and pandemics. This study aimed to identify space-time clusters of incidence and mortality due to COVID-19 during the pandemic, analyzing socioeconomic and demographic characteristics in order to highlight the priority areas for control and surveillance actions. This study was conducted in the Metropolitan Region of São Paulo (MRSP) from March 2020 to February 2022. To detect the clusters, a multidimensional punctual process was created to perform multiple tests for every geographic point using the SaTScan™ software. Socioeconomic and demographic differences were analyzed using nonparametric Mann-Whitney and Kruskal-Wallis tests. High-risk clusters of incidences were observed in May 2020 (RR=2; p-value <0.001) and March to June 2021 (RR=2.6; p-value <0.001) in the capital of São Paulo and neighboring municipalities, with statistically significant differences between the socioeconomic variables analyzed. No low-risk cluster of COVID-19 incidence was found, but low-risk clusters of mortality from COVID-19 were found in the period from July to December 2020 in the central region of the capital (RR=0.33; p-value <0.001), which concentrates the highest incomes and the lowest percentages of Black, Brown (Mixed-race), and Indigenous people in the MRSP.

Viral hepatitis caused by hepatitis B virus (HBV) and hepatitis C virus (HCV) poses a significant global health challenge, with an increasing number of deaths and a substantial burden on healthcare systems. This literature review explores the impact of socioeconomic determinants of health (SDoH) on the prevalence and outcomes of HBV and HCV infections among male prison inmates in Nigeria. By examining factors such as risky behaviors, overcrowding, inadequate healthcare access, and food insecurity, this review highlights how these determinants contribute to the high rates of hepatitis infections in Nigerian prisons. The review underscores the urgent need for a multifaceted approach involving policy changes, improved healthcare access, and enhanced preventive measures to address these health disparities. The findings aim to inform public health strategies and interventions to reduce the transmission and impact of viral hepatitis in prison settings, aligning with global health goals and promoting health equity.

With a reduction in the mortality rate of burn patients, patient length of stay (LOS) is increasingly adopted as an outcome measure. Some studies have attempted to identify factors that explain a burn patient's expected LOS. However, few have investigated the association between LOS and a patient's mental and socioeconomic status. There is anecdotal evidence for links between these factors and uncovering these will aid in better addressing the specific physical and emotional needs of burn patients, and facilitate the planning of scarce hospital resources. Here, we employ machine learning (clustering) and statistical models (regression) to investigate whether a segmentation by socioeconomic/mental status can improve the performance and interpretability of an upstream predictive model, relative to a unitary model derived for the full adult population of patients. Although we found no significant difference in the performance of the unitary model and segment-specific models, the interpretation of the segment-specific models reveals a reduced impact of burn severity in LOS prediction with increasing adverse socioeconomic and mental status. Furthermore, the models for the socioeconomic segments highlight an increased influence of living circumstances and source of injury on LOS. These findings suggest that, in addition to ensuring that the physical needs of patients are met, management of their mental status is crucial for delivering an effective care plan.

The closure of Black churches raises concerns about the socioeconomic impact on African American communities. This pilot study uses Social Capital theory to highlight the relationship between the Black church and socioeconomic outcomes within the community. Based on survey responses from approximately 60% of African American participants, it was revealed that religious communities have a positive impact on their socioeconomic status. These findings have reinforced the strong connection between faith and success, noting that active involvement in religious services or activities could lead to higher annual incomes. Individuals who earned a higher income also reported more frequent participation in weekly religious services and activities. Furthermore, a chi-square test of independence showed a significant relationship between the frequency of religious participation and the likelihood of receiving a scholarship or grant funding from religious organizations. Therefore, the study provides evidence highlighting the church's critical role in fostering positive economic outcomes and social networks within African American communities. These findings provide a framework for additional research in this field to explore further the impact of religious communities on various aspects of African American life.

Vitamin C status is known to be associated with several demographic and lifestyle factors. These include gender, age, ethnicity, pregnancy/lactation, body weight, smoking status and dietary habits. In the present study, our aim was to interrogate the National Health and Nutrition Examination Survey (NHANES) 2017-2018 datasets to assess the impact of these factors on vitamin C dose-concentration relationships to establish if there are higher requirements for vitamin C in certain subpopulations and the possible extent of these additional requirements. The relevant data were extracted from the NHANES 2017-2018 datasets, the final cohort of which comprised 2828 non-supplementing adult males and females (aged 18 – 80+ years) with both vitamin C serum concentrations and dietary intake data available. The data was subsequently stratified by gender, age tertiles (≤36, 37-58, ≥59 years), ethnicity (non-Hispanic white, non-Hispanic black, and total Hispanic), socioeconomic tertiles (poverty income ratios: &gt;3.0, 1.36 – 3.0, ≤1.35), weight tertiles (≤72, 72-91, ≥91 kg), BMI tertiles (≤26, 26-32, ≥32 kg/m2) and smoking status. Sigmoidal (four parameter logistic) curves with asymmetrical 95% confidence intervals were fitted to the dose-concentration data. We found that males required vitamin C intakes ~1.2-fold higher than females to reach ‘adequate’ serum concentrations of 50 µmol/L. Males had both higher body weight and a higher prevalence of smoking than females. Smokers required vitamin C intakes ~2.0-fold higher than non-smokers to reach adequate vitamin C concentrations. Relative to adults in the lighter weight tertile, adults in the heaver weight tertile required ~2.0-fold higher dietary intakes of vitamin C to reach adequate serum concentrations. We did not observe any impact of ethnicity or socioeconomic status on the vitamin C dose-concentration relationship, and although no significant difference between younger and older adults was observed at vitamin C intakes &gt; 75 mg/day, at intakes &lt; 75 mg/day, older adults had an attenuated serum response to vitamin C intake. In conclusion, certain demographic and lifestyle factors, specifically gender, smoking and body weight, have a significant impact on vitamin C requirements. Overall, the data indicate that the general population must consume ~110 mg/day of vitamin C to attain adequate serum concentrations, smokers require ~165 mg/day relative to non-smokers, and heavier people (100+ kg) require ~155 mg/day to reach the same vitamin C concentrations. These findings have important implications for global vitamin C dietary recommendations.

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as global infections with consequential disability adjusted life years (DALYs) and economic burden. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout Barranquilla, Colombia during 2014 and 2016 and explored the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on a suite of explanatory variables as potential risk factors and multiple options for random effects. A best fit model was used to analyse the case incidence risk for both epidemics to identify any risk factors during their epidemics. Neighbourhoods in the northern region of Barranquilla were hotspots for the outbreaks of both CHIKV and ZIKV. Additional hotspots occurred in the south-western and central regions of the CHIKV and ZIKV outbreaks, respectively. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata (SES) and residing in detached houses as risk factors for ZIKV case incidences. These novel findings challenge the belief that these infections are driven by social vulnerability and merits further study both in Barranquilla and throughout the tropical and subtropical regions of the world.

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as global infections with consequential disability adjusted life years (DALYs) and economic burden. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout Barranquilla, Colombia during 2014 and 2016 and explored the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on a suite of explanatory variables as potential risk factors and multiple options for random effects. A best fit model was used to analyse the case incidence risk for both epidemics to identify any risk factors during their epidemics. Neighbourhoods in the northern region of Barranquilla were hotspots for the outbreaks of both CHIKV and ZIKV. Additional hotspots occurred in the south-western and central regions of the CHIKV and ZIKV outbreaks, respectively. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata (SES) and residing in detached houses as risk factors for ZIKV case incidences. These novel findings challenge the belief that these infections are driven by social vulnerability and merits further study both in Barranquilla and throughout the tropical and subtropical regions of the world.

Background: The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to under-stand how these elements continue to affect young populations in the post-pandemic era. Methods: In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7–19 years, to ensure age and gender representation. The survey included par-ent ratings and adolescent (11–19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Results: Of the 4,525 valid responses, 1,831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-report tended to underestimate them. Conclusions: Persistent mental health problems and gender disparities high-light the need for a public health approach. This should include accessible support services, resili-ence building, targeted support for vulnerable families and gender-specific interventions.

Individuals residing in more deprived areas have a lower diet quality. While several studies have shown that individuals with a lower diet quality have a higher mortality risk, a low quality diet might also lead to poor health in highly deprived areas. We aimed to examine the association between deprivation within an area and all-cause mortality risk according to diet quality. Methods: We conducted a population-based prospective study on 27994 men and 33273 women aged 45–75 years. Neighborhood deprivation was assessed using the Japanese areal deprivation index (ADI). Dietary intakes were assessed using a validated 147-item food frequency questionnaire. Subsequently, Japanese Food Guide Spinning Top scores were calculated. Hazard ratios (HR) and 95% confidence intervals (CI) of mortality were calculated according to tertiles of ADI by diet quality score. Results: Individuals residing in the most deprived area had the lowest dietary scores. During the 16.7-year follow-up, compared to individuals with a high quality diet residing in the least deprived area, individuals with a low quality diet had a higher risk of mortality according to increment of ADI (P trend = 0.02); the multivariate adjusted HR (95% CI) was 1.07 (1.00-1.15), 1.15 (1.07-1.24), and 1.18 (1.08-1.29) in those residing in the lowest through the highest third of ADI, respectively. However, individuals with a high quality diet had no significant association between ADI and mortality (P trend =0.87). Conclusion: A well-balanced diet may prevent early death associated with neighborhood socioeconomic status among those residing in highly deprived areas.

As humanity confronts the existential threats of climate change, biodiversity loss, and growing socioeconomic inequalities, the need for transformative, systemic change has never been more urgent. Conventional innovation approaches, often focused on technological solutionism and market imperatives, have consistently fallen short in delivering the comprehensive, equitable, and sustainable solutions required to navigate these interconnected crises. This pioneering article explores the profound intersection between speculative fiction, sustainable innovation, and the burgeoning field of innovationology. By harnessing the transformative power of imaginative narratives, the integrated praxis of innovationology and sustainability science can challenge existing mental models, spark collective imagination, and foster agency to co-create sustainable futures. Through a rigorous examination of cutting-edge research, empirical evidence, and case studies, this article positions speculative fiction as a critical lever for catalyzing the systemic changes required for a more just, regenerative, and resilient future.

This investigation pioneers an examination of the scarcely explored terrain of social diversity in medical education, assessing the complex impacts of socioeconomic status (SES), prior working experiences, and completed apprenticeships on a spectrum of psychological and academic facets among first-year medical students (n = 336) in an urban university setting. By utilizing a systematic and detailed approach, the study illuminates prior anatomical knowledge and various psycholog-ical constructs, marking a significant stride into a domain where knowledge remains profoundly limited. Analyses indicated that SES significantly affects financial anxiety (F(4, 331) = 17.391, p < .001) and academic behavioral confidence (F(4, 331) = 4.323, p = 0.002). Students with prior working experience reported higher self-perceived clinical experience but lower A-level grades (t(279.459) = -6.690, p < .001), competence in natural sciences (t(321.045) = -3.178, p = 0.002), and online competence (t(319.429) = -2.026, p = 0.044). Those who completed an apprenticeship showed higher resilience, academic confidence, self-efficacy, and greater concerns about balancing studies and work (t values ranging from 2.020 to 3.158, p < 0.05). Correlation analysis revealed a positive relationship between resilience (RQS) and coping with academic stress (CAS) (r = 0.632, p < .001), as well as between resilience and academic behavioral confidence (ABC) (r = 0.608, p < .001). Negative correlations were observed between resilience, coping with academic stress, academic confidence, and cognitive test anxiety (CTA) (r values from -0.235 to -0.404, p < .001). The findings emphasize the need for tailored support for students from diverse SES backgrounds and with varying expe-riences. The study highlights the value of a comprehensive approach in medical education, con-sidering the diverse backgrounds and experiences of students. Future research should explore the long-term impact of these factors on professional competencies and patient care, leveraging the diversity of the student body for a holistic educational experience.