With an increasing aging population in many cities worldwide, promoting and maintaining the health of elderly individuals has become a pressing public health issue. Although greenspaces may deliver many health outcomes for the elderly population, existing evidence remains inconsistent, partly due to discrepancies in the measure of greenspace and health outcomes. In addition, few studies examined the effect of greenspace exposure on life expectancy at the individual level. Thus, this study comprehensively investigated the association between greenspace exposure and life expectancy among elderly adults in Guangzhou, China, based on the individual-level mortality dataset. The data were analyzed at both the individual level and aggregate level, and two types of buffers (straight-line vs. street-network buffer) were used to define individual greenspace exposure. After controlling for the random effects and multiple types of covariates, we found that 1) elderly individuals with higher greenspace exposure were associated with an increased life expectancy; 2) elderly individuals with lower socioeconomic status benefit more from greenspace (i.e., equigenesis hypothesis); 3) different greenspace measurements lead to different results; 4) greenspace had the highest effects on life expectancy and equigenesis within the street-network buffer distances of 3000 m and 2500 m, respectively. This study underscores the potential health benefits of greenspace exposure on elderly individuals and the importance of provision and upkeep of greenspace, especially among socially disadvantaged groups.

The objectives of this study were to evaluate the difference of selective attention efficiency between children with low and high socioeconomic status (SES) and the promotional effect of attention network training (an attention network test was used as the training task) on selective attention in children with the low SES. A total of 139 10- to 12-year-old children participated in two experiments (71 in Experiment 1 and 68 in Experiment 2). The results suggest that selective attention and switch ability of children with high SES are better than those of children with low SES. After attention network training, selective attention, switch ability, and working memory of low-SES children improved significantly. The findings provide evidence that attention network training could enhance selective attention in low-SES children and that the beneficial training effect could also transfer to switch ability and working memory. The research may provide a promising method to compensate cognitive delay of low-SES children.

BACKGROUND: Screening adherence is important in reducing colorectal cancer (CRC) incidence and mortality. Disparity in CRC screening adherence was observed in populations of different socioeconomic status (SES), but the direction and strength of the association remained unclear.
OBJECTIVE: We aimed to systematically review all the observational studies that have analyzed the association between SES and adherence to organized CRC screening based on fecal occult blood tests.
METHODS: We systematically reviewed the studies in PubMed, Embase, and Web of Science and reference lists of relevant reviews from the inception of the database up until June 7, 2023. Individual SES, neighborhood SES, and small-area SES were included, while any SES aggregated by geographic areas larger than neighbors were excluded. Studies assessing SES with any index or score combining indicators of income, education, deprivation, poverty, occupation, employment, marital status, cohabitation, and others were included. A random effect model meta-analysis was carried out for pooled odds ratios (ORs) and relative risks for adherence related to SES.
RESULTS: Overall, 10 studies, with a total of 3,542,379 participants and an overall adherence rate of 64.9%, were included. Compared with low SES, high SES was associated with higher adherence (unadjusted OR 1.73, 95% CI 1.42-2.10; adjusted OR 1.53, 95% CI 1.28-1.82). In the subgroup of nonindividual-level SES, the adjusted association was significant (OR 1.57, 95% CI 1.26-1.95). However, the adjusted association was insignificant in the subgroup of individual-level SES (OR 1.46, 95% CI 0.98-2.17). As for subgroups of the year of print, not only was the unadjusted association significantly stronger in the subgroup of early studies (OR 1.97, 95% CI 1.59-2.44) than in the subgroup of late studies (OR 1.43, 95% CI 1.31-1.56), but also the adjusted one was significantly stronger in the early group (OR 1.86, 95% CI 1.43-2.42) than in the late group (OR 1.26, 95% CI 1.14-1.39), which was consistent and robust. Despite being statistically insignificant, the strength of the association seemed lower in studies that did not adjust for race and ethnicity (OR 1.31, 95% CI 1.21-1.43) than the overall estimate (OR 1.53, 95% CI 1.28-1.82).
CONCLUSIONS: The higher-SES population had higher adherence to fecal occult blood test-based organized CRC screening. Neighborhood SES, or small-area SES, was more competent than individual SES to be used to assess the association between SES and adherence. The disparity in adherence between the high SES and the low SES narrowed along with the development of interventions and the improvement of organized programs. Race and ethnicity were probably important confounding factors for the association.

BACKGROUND: Social support consists of receipt and provision in the interpersonal exchange process. Many studies have explored and verified the effect of received social support. This study focuses on whether and when social support provision can benefit the providers\' positive psychological capital and subjective well-being.
METHODS: A sample of 732 Chinese undergraduates with low socioeconomic status completed questionnaires on social support provision, psychological capital, life satisfaction, positive affect, negative affect, and sense of indebtedness.
RESULTS: The correlation and regression analyses showed that impoverished college students\' social support provision was positively associated with life satisfaction, positive affect, and psychological capital and negatively associated with negative affect. The interaction between the sense of indebtedness and social support provision was negatively associated with life satisfaction, positive affect, and psychological capital, not significantly associated with negative affect.
CONCLUSIONS: The results demonstrated that giving social support can be as beneficial as receiving social support, and the sense of indebtedness can limit the benefits. Individuals with a lower sense of indebtedness are more likely to benefit from social support provision. The findings have implications for marginalized groups\' subjective well-being and positive psychological capital and show the necessity of guiding individuals to provide social support while maintaining their autonomy.

OBJECTIVE: To explore the relationship between socioeconomic status (SES) and disease mortality in patients with cecal adenocarcinoma in America through the Surveillance, Epidemiology, and End results (SEER) database.
METHODS: The SEER database was queried for patients with cecal adenocarcinoma in America diagnosed from 2011 to 2015. Factor analysis, cluster analysis, and univariate and multivariate Cox proportional hazard models were used for data analysis. Five social security factors were identified: factor 1, economic and educational disadvantage; factor 2, characteristics related to immigration (language isolation and foreign birth); factor 3, high relocation rate in the county; factor 4, high intra-state relocation rate; and factor 5, high domestic relocation rate. Five clusters defined by SES were identified.
RESULTS: The number of all-cause deaths among 17 185 patients was 5948, and the number of survivors was 11, 237. In the multivariate Cox regression analysis, with cluster 1 (low poverty rate and high education level) as the reference, the hazard ratio (HR) of cluster 3 (high intra-county mobility rate) was 1.13 (95% CI: 1.04-1.21, P < 0.05), and the risk was 13% higher than that of cluster 1. The HR of cluster 4 (low language isolation, foreign birth, housing overcrowding, and intra-country mobility rates) was 1.15 (95% CI: 1.07- 1.24, P < 0.001) with a 15% higher risk than cluster 1. The HR of cluster 5 (economic and educational disadvantages, immigration-related characteristics, and low intra-country mobility) was 1.11 (95% CI: 1.03-1.20, P < 0.01) with a 11% higher risk. The factors related to SES indicators were based on the mortality of patients with cecal adenocarcinoma, indicating that low economic and education levels are risk factors for cecal adenocarcinoma.
CONCLUSIONS: Low socioeconomic status is associated with an increased risk of death in patients with cecal adenocarcinoma in the United States and show different distribution patterns based on population. Improving health insurance policies and strengthening psychotherapy can provide guidance for improving prognosis f cecal adenocarcinoma patients.

Diabetes disproportionately affects minorities and those with low socioeconomic status (SES) in the United States, and differences in behavioral lifestyles are largely responsible for the unequal distribution of diabetes among different groups.
With data of 9,969 participants collected in the 2007-2008 and 2009-2010 cycles of the US National Health and Nutrition Examination Survey (NHANES), this study examined several mediators and their mediating effects in the connection between SES and the risk of diabetes. The SES is assessed by the income-to-poverty ratio (IPR), education level, and employment status. For the mediation analysis, we used health-related behaviors as mediators (smoking, alcohol use, consumption of green vegetables and fruits, physical activity and sedentary time, health insurance, and healthcare). In this study, the structural equation model was utilized to evaluate the mediating effects of behavioral lifestyle as a mediator in the relationship between SES and diabetes.
A total of 9,969 participants were included in this study. We found a negative nonlinear association between IPR and diabetes risk (Poverall < 0.001; Pnon-linear = 0.46), which was independent of the majority of known or suspected risk factors and confounding variables (gender, age, race). Participants with lower SES had higher risk of diabetes compared with those with higher SES. In mediating analysis, we found alcohol intake (OR = 0.996), physical activity (OR = 0.993), health insurance (OR = 0.998), and healthcare (OR = 1.002) mediated the IPR-diabetes association. But in the relationship between education status and diabetes, the mediation effect of alcohol intake (OR = 0.995), physical activity (OR = 0.991), and health care (OR = 1.008) were obvious. Likewise, alcohol intake (OR = 0.996), fruit intake (OR = 0.998), and health care (OR = 0.975) were important mediators in the association between employment status and diabetes.
This study provides critical insights on the link between SES and diabetes. Our results highlight that poor health-related behaviors and limited access to healthcare are important pathways for increased diabetes risk related to those with low SES, particularly among Mexican Americans and males. They should be top priorities for agencies and healthcare providers to develop behavior-related interventions to reduce inequalities in diabetes risk.

Difficulties in attaining employment significantly contribute to socioeconomic poverty among individuals with disabilities. However, our understanding of how socioeconomic deprivation experienced by individuals and families with disabilities influences employment opportunities remains incomplete. This study aims to explore the relationship between index of disability-related multiple deprivation (IDMD) and employment opportunities (EMPO), while also investigating the role of family socioeconomic status (FSES) in shaping this relation.
This study explores the heterogeneous effects of IDMD, FSES, and the interaction between IDMD*FSES on EMPO among four disabled population groups categorized by IDMD and FSES.
Results reveal that IDMD has a significant negative impact on EMPO, suggesting that persons with disabilities are confronted with a poverty trap resulting from the relationship between IDMD and EMPO. Furthermore, FSES demonstrates an effective moderating role in the IDMD-EMPO relationship, with the greatest impact observed among disabled population groups characterized by high IDMD and low FSES.
The findings suggest that family-level support is crucial for vulnerable groups of disabled individuals to overcome the poverty trap, surpassing the reliance on individual-level assistance alone. This study supports a paradigm shift in comprehending disability-related deprivation by acknowledging its association with families, thereby presenting opportunities to enhance the welfare of people with disabilities.

BACKGROUND: Culturally competent early mental health interventions for ethnic minorities (EMs) with no formal diagnoses are needed.
OBJECTIVE: To determine whether 8-12 weeks culturally adapted counselling (CAC) is better than waiting (waitlist (WL) group) to reduce depressive and anxiety symptoms and stress levels among EMs with elevated mental distress.
METHODS: Hong Kong EMs with mild and above-mild mental distress were randomly assigned to CAC or WL in this pragmatic, randomised, WL-controlled trial. The CAC group received the intervention after randomisation and the WL group received the intervention after 8-12 weeks (T1). The prespecified primary outcomes were depressive and anxiety symptoms and stress levels measured by the Depression, Anxiety and Stress subscales of the Depression, Anxiety and Stress Scale (DASS-D, DASS-A and DASS-S, respectively) at postintervention (T1, 8-12 weeks).
RESULTS: A total of 120 participants were randomly assigned to either CAC (n=60) or WL (n=60), of whom 110 provided primary outcome data. At T1, CAC led to significantly lower depressive and anxiety symptom severity and stress levels compared with waiting, with unstandardised regression coefficients of -8.91 DASS-D points (95% CI -12.57 to -5.25; d=-0.90),-6.33 DASS-A points (95% CI -9.81 to -2.86; d=-0.68) and -8.60 DASS-S points (95% CI -12.14 to -5.06; d=-0.90).
CONCLUSIONS: CAC clinically outperformed WL for mild and above-mild levels of mental distress in EMs.
CONCLUSIONS: Making CAC routinely available for EMs in community settings can reduce healthcare burden.
BACKGROUND: NCT04811170.

Socioeconomic status (SES) is a measurement of the sociological and economic statuses of individuals compared to others within the social and economic hierarchies. The common indicators of SES are income, education, and occupation statuses. Recently, researchers have used mixed measurements of SES, such as the MacArthur Scale. Numerous researches have proven the influence of SES on human development. Individuals who are less educated, have lower job status, and earn less or no income are at greater risk of poor health than their higher SES counterparts. SES has also been proven to influence life satisfaction, academic achievement, emotion regulation, cognitive function, and decision-making tendencies. SES has life span influence, which correlates with the level of cognition, rate of cognitive decline, and incidence of Alzheimer\'s disease among elderly individuals. Besides the individual level of SES, neighborhood SES can also affect cognitive function as an environmental factor. Low-SES individuals exhibit hypoactivation of the executive network and hyperactivation of the reward network, indicating low-SES individuals tend to focus more on monetary issues, while neglecting other non-monetary issues, which is consistent with the scarcity hypothesis.

Low socioeconomic status (SES) is an important prognosticator amongst patients with acute coronary syndrome (ACS). This paper analysed the effects of SES on ACS outcomes.
Medline and Embase were searched for articles reporting outcomes of ACS patients stratified by SES using a multidimensional index, comprising at least 2 of the following components: Income, Education and Employment. A comparative meta-analysis was conducted using random-effects models to estimate the risk ratio of all-cause mortality in low SES vs high SES populations, stratified according to geographical region, study year, follow-up duration and SES index.
A total of 29 studies comprising of 301,340 individuals were included, of whom 43.7% were classified as low SES. While patients of both SES groups had similar cardiovascular risk profiles, ACS patients of low SES had significantly higher risk of all-cause mortality (adjusted HR:1.19, 95%CI: 1.10-1.1.29, p < 0.001) compared to patients of high SES, with higher 1-year mortality (RR:1.08, 95%CI:1.03-1.13, p = 0.0057) but not 30-day mortality (RR:1.07, 95%CI:0.98-1.16, p = 0.1003). Despite having similar rates of ST-elevation myocardial infarction and non-ST-elevation ACS, individuals with low SES had lower rates of coronary revascularisation (RR:0.95, 95%CI:0.91-0.99, p = 0.0115) and had higher cerebrovascular accident risk (RR:1.25, 95%CI:1.01-1.55, p = 0.0469). Excess mortality risk was independent of region (p = 0.2636), study year (p = 0.7271) and duration of follow-up (p = 0.0604) but was dependent on the SES index used (p < 0.0001).
Low SES is associated with increased mortality post-ACS, with suboptimal coronary revascularisation rates compared to those of high SES. Concerted efforts are needed to address the global ACS-related socioeconomic inequity.
The current study was registered with PROSPERO, ID: CRD42022347987.