IU Indianapolis ScholarWorks :: Browsing by Subject "Socioeconomic Factors"

Browsing by Subject "Socioeconomic Factors"

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Correlation between caries prevalence and socioeconomic status in children ages 6 to 36 months
(2000) Ching, Brent Bing Yee; Weddell, James A. (James Arthur), 1949-; Sanders, Brian J.; Tomlin, Angela; Dean, Jeffrey A.; Klein, Arthur Irving, 1922-2004
The purpose of this study was to evaluate the status of a sample of children ages 6 to 36 months with regard to prevalence of tooth decay in a community with an optimum fluoridated water supply. It was determined whether a relation existed between these data and the socioeconomic level of the family. One hundred and fifty children ages 6 to 36 months born and reared in Marion County, Indiana were examined with a dental mirror, explorer and a portable light. Parents/legal guardians of these children were given a questionnaire to obtain family history. Caries prevalence for children ages 6 to 12, 13 to 18, 19 to 24, 25 to 30, and 31 to 36 months were 4%, 0%, 22%, 23%, and 26%, respectively. Age, mother's educational attainment, and Medicaid experience remained significant predictors of caries experience: the odds of caries were 1.1 times for each monthly increase in age. Gender, father's educational attainment, family household income, and single parent status remained marginally significant predictors of caries experience. Results for similar correlation studies between caries prevalence and socioeconomic status for children ages 6 to 36 months are inconsistent. Further research is needed for children ages 6 to 36 months. Caries experience begins before age one. Patients, parents, and health care professionals need to be aware that the caries process begins at an early age, and prevention should begin as early as 6 months of age.
Correlation between caries prevalence, socioeconomic status, and cultural findings in Hispanic children ages 6 months to 8 years
(2002) Kugar, Jennifer R.; Yoder, Karen S. Masbaum, 1941-; Avery, David R.; Sanders, Brian J.; Weddell, James A. (James Arthur), 1949-; Martinez Mier, Esperanza de los A. (Esperanza de los Angeles), 1967-; Mallatt, Mark E. (Mark Edward), 1950-; Dean, Jeffrey A.
There has been a tremendous influx in the number of Hispanic immigrants into the US over the past couple of decades. Many newcomers have families with small children, and dental needs in this pediatric population are disproportionately high. The purpose of this study was to determine if there was any correlation between the increased prevalence of caries and socioeconomic or cultural factors in Hispanic children ages six months to eight years old. To accomplish this, 127 children were given dental examinations by a calibrated dental examiner, and their parents completed a two-page questionnaire with questions regarding socioeconomic factors, den1ographics, and cultural issues. The bivariate relation between caries status and demographic and cultural variables was examined using chi-square tests or Fisher's exact tests for categorical variables and logistic regression for continuous variables. Bivariate relation between defs and demographic and cultural variables was examined using analysis of variance (ANOVA). The mean defs for children up to age two was 1.53; ages two to five the mean defs was 7.73, and for ages six to eight, 9.18. As the prevalence of caries increases with age, the child is more likely to access dental care, but despite this, there is an overall mean 79 percent of untreated decay (of decayed, missing and filled surfaces). In the permanent dentition, the overall mean DMFS was found to be 2.22. There were several factors found to be statistically significant to the incidence of defs. If the child had dental insurance, the child was more likely to have higher defs. If a child had more siblings, the defs score was higher. If the child was on the bottle at less than age one-and-a-half, the child was less likely to have dental caries. If the child on the bottle was older than age one-and-a-half, the child was much more likely to have dental caries. The older the child is when the child goes off the bottle, the more likely the child will have a higher caries experience. There is an extraordinarily large number of untreated caries found in Hispanic children. The reasons for this are multifactorial, but involve cost, language barriers, being new to the area, and not having seen a dentist yet. Identifying those at high risk such as single mothers, those with increased numbers of siblings, and infants that are still on the bottle, or older children that are at increased jeopardy due to prolonged use of the bottle are important factors in treating those that are underserved. Local dental and community organizations could benefit from being apprised of the unmet dental need of Hispanic children and some of the contributing factors. By further investigating and understanding some of the socioeconomic and cultural issues that present barriers to care, treatment might become more accessible and available. Adverse outcomes such as missed school and opportunities for acculturation, inadequate nutrition, pain, and infection might be avoided or diminished.
COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries
(BMC, 2021-10) Wong, Li Ping; Li Ping, Haridah; Danaee, Mahmoud; Ahmed, Jamil; Lachyan, Abhishek; Cai, Carla Zi; Lin, Yulan; Hu, Zhijian; Tan, Si Ying; Lu, Yixiao; Cai, Guoxi; Nguyen, Di Khanh; Seheli, Farhana Nishat; Alhammadi, Fatma; Madhale, Milkar D.; Atapattu, Muditha; Quazi-Bodhanya, Tasmi; Mohajer, Samira; Zimet, Gregory D.; Zhao, Qinjian; Pediatrics, School of Medicine
BACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.
Educational disparities in health behaviors among patients with diabetes: the Translating Research Into Action for Diabetes (TRIAD) Study
(2007-10) Karter, Andrew J.; Stevens, Mark R.; Brown, Arleen F.; Duru, O Kenrik; Gregg, Edward W.; Gary, Tiffany L.; Beckles, Gloria L.; Tseng, Chien-Wen; Marrero, David G.; Waitzfelder, Beth; Herman, William H.; Piette, John D.; Safford, Monika M.; Ettner, Susan L.
Background Our understanding of social disparities in diabetes-related health behaviors is incomplete. The purpose of this study was to determine if having less education is associated with poorer diabetes-related health behaviors. Methods This observational study was based on a cohort of 8,763 survey respondents drawn from ~180,000 patients with diabetes receiving care from 68 provider groups in ten managed care health plans across the United States. Self-reported survey data included individual educational attainment ("education") and five diabetes self-care behaviors among individuals for whom the behavior would clearly be indicated: foot exams (among those with symptoms of peripheral neuropathy or a history of foot ulcers); self-monitoring of blood glucose (SMBG; among insulin users only); smoking; exercise; and certain diabetes-related health seeking behaviors (use of diabetes health education, website, or support group in last 12 months). Predicted probabilities were modeled at each level of self-reported educational attainment using hierarchical logistic regression models with random effects for clustering within health plans. Results Patients with less education had significantly lower predicted probabilities of being a non-smoker and engaging in regular exercise and health-seeking behaviors, while SMBG and foot self-examination did not vary by education. Extensive adjustment for patient factors revealed no discernable confounding effect on the estimates or their significance, and most education-behavior relationships were similar across sex, race and other patient characteristics. The relationship between education and smoking varied significantly across age, with a strong inverse relationship in those aged 25–44, modest for those ages 45–64, but non-evident for those over 65. Intensity of disease management by the health plan and provider communication did not alter the examined education-behavior relationships. Other measures of socioeconomic position yielded similar findings. Conclusion The relationship between educational attainment and health behaviors was modest in strength for most behaviors. Over the life course, the cumulative effect of reduced practice of multiple self-care behaviors among less educated patients may play an important part in shaping the social health gradient.
Effects of Proximity to Supermarkets on a Randomized Trial Studying Interventions for Obesity
(American Public Health Association, 2016-03) Fiechtner, Lauren; Kleinman, Ken; Melly, Steven J.; Sharifi, Mona; Marshall, Richard; Block, Jason; Cheng, Erika R.; Taveras, Elsie M.; Department of Pediatrics, IU School of Medicine
OBJECTIVES: To determine whether proximity to a supermarket modified the effects of an obesity intervention. METHODS: We examined 498 children aged 6 to 12 years with a body mass index (BMI) at or above the 95th percentile participating in an obesity trial in Massachusetts in 2011 to 2013. The practice-based interventions included computerized clinician decision support plus family self-guided behavior change or health coaching. Outcomes were 1-year change in BMI z-score, sugar-sweetened beverage intake, and fruit and vegetable intake. We examined distance to the closest supermarket as an effect modifier. RESULTS: Distance to supermarkets was an effect modifier of 1-year change in BMI z-score and fruit and vegetable intake but not sugar-sweetened beverage intake. With each 1-mile shorter distance to a supermarket, intervention participants increased their fruit and vegetable intake by 0.29 servings per day and decreased their BMI z-score by -0.04 units relative to controls. CONCLUSIONS: Living closer to a supermarket is associated with greater improvements in fruit and vegetable intake and weight status in an obesity intervention.
Primary Language, Income and the Intensification of Anti-glycemic Medications in Managed Care: the (TRIAD) Study
(2010-12) Duru, O Kenrik; Bilik, Dori; McEwen, Laura N.; Brown, Arleen F.; Karter, Andrew J.; Curb, J David; Marrero, David G.; Lu, Shou-En; Rodriguez, Michael; Mangione, Carol M.
BACKGROUND Patients who speak Spanish and/or have low socioeconomic status are at greater risk of suboptimal glycemic control. Inadequate intensification of anti-glycemic medications may partially explain this disparity. OBJECTIVE To examine the associations between primary language, income, and medication intensification. DESIGN Cohort study with 18-month follow-up. PARTICIPANTS One thousand nine hundred and thirty-nine patients with Type 2 diabetes who were not using insulin enrolled in the Translating Research into Action for Diabetes Study (TRIAD), a study of diabetes care in managed care. MEASUREMENTS Using administrative pharmacy data, we compared the odds of medication intensification for patients with baseline A1c ≥ 8%, by primary language and annual income. Covariates included age, sex, race/ethnicity, education, Charlson score, diabetes duration, baseline A1c, type of diabetes treatment, and health plan. RESULTS Overall, 42.4% of patients were taking intensified regimens at the time of follow-up. We found no difference in the odds of intensification for English speakers versus Spanish speakers. However, compared to patients with incomes <15,000,patientswithincomesof15,000-39,999(OR1.43,1.07−1.92),40,000-74,999(OR1.62,1.16−2.26)or>75,000 (OR 2.22, 1.53-3.24) had increased odds of intensification. This latter pattern did not differ statistically by race. CONCLUSIONS Low-income patients were less likely to receive medication intensification compared to higher-income patients, but primary language (Spanish vs. English) was not associated with differences in intensification in a managed care setting. Future studies are needed to explain the reduced rate of intensification among low income patients in managed care.
Vaccinating sons against HPV: results from a U.S. national survey of parents
(PLoS, 2014-12-26) Taylor, Jaime L.; Zimet, Greg D.; Donahue, Kelly L.; Alexander, Andreia B.; Shew, Marcia L.; Stupiansky, Nathan W.; Department of Pediatrics, IU School of Medicine
PURPOSE: The quadrivalent HPV vaccination was approved for use in males ages 9 to 26 in 2009 and recommended for routine administration in 2011. The purpose of this study was to uncover predictable commonalities amongst parents who chose to vaccinate their 11-17 year old sons against HPV. METHODS: We compiled data from a U.S. national sample of 779 parents with sons 11-17 years old using a web-based survey to gather information about behavioral and sociodemographic factors which predicted receipt of 1 or more HPV vaccine doses based on parental report. Predictors were first modeled individually for univariable associations. Significant predictors (p<0.10) were combined in a multivariable model. RESULTS: In the adjusted model, independent predictors included receipt of flu vaccination, health insurance coverage and sexual health topic discussions with sons. Sons who had received a flu shot in the last two years more frequently received at least one dose of the vaccine (OR 1.82; 95% CI 1.45-2.26). Sons covered by private health insurance had decreased odds of HPV vaccination (OR 0.56 95% CI 0.37-0.83). Lastly, parents who had discussed sexual health topics with their sons were more likely to vaccinate (OR 1.61; 95% CI 1.37-1.89). CONCLUSIONS: Male vaccination rates in the U.S. have increased, but males continue to be under-immunized. Utilization of health care is an important factor in HPV vaccine uptake; therefore, health care providers should use every contact as an opportunity to vaccinate. Communication about sexual health topics may provide a forum for parents and health care providers to have conversations about HPV vaccination as those more comfortable discussing these topics may also be more comfortable discussing HPV vaccination.

Browsing by Subject "Socioeconomic Factors"

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