BACKGROUND: The glycemic control of children with type 1 diabetes (T1D) may be influenced by the economic status of their parents.
OBJECTIVE: To investigate the association between parental economic status and blood glucose levels of children with T1D using a mobile health application.
METHODS: Data from children with T1D in China\'s largest T1D online community, Tang-TangQuan®. Blood glucose levels were uploaded every three months and parental economic status was evaluated based on annual household income. Children were divided into three groups: Low-income (< 30000 Yuan), middle-income (30000-100000 Yuan), and high-income (> 100000 yuan) (1 Yuan = 0.145 United States Dollar approximately). Blood glucose levels were compared among the groups and associations were explored using Spearman\'s correlation analysis and multivariable logistic regression.
RESULTS: From September 2015 to August 2022, 1406 eligible children with T1D were included (779 female, 55.4%). Median age was 8.1 years (Q1-Q3: 4.6-11.6) and duration of T1D was 0.06 years (0.02-0.44). Participants were divided into three groups: Low-income (n = 320), middle-income (n = 724), and high-income (n = 362). Baseline hemoglobin A1c (HbA1c) levels were comparable among the three groups (P = 0.072). However, at month 36, the low-income group had the highest HbA1c levels (P = 0.036). Within three years after registration, glucose levels increased significantly in the low-income group but not in the middle-income and high-income groups. Parental economic status was negatively correlated with pre-dinner glucose (r = -0.272, P = 0.012). After adjustment for confounders, parental economic status remained a significant factor related to pre-dinner glucose levels (odds ratio = 13.02, 95%CI: 1.99 to 126.05, P = 0.002).
CONCLUSIONS: The blood glucose levels of children with T1D were negatively associated with parental economic status. It is suggested that parental economic status should be taken into consideration in the management of T1D for children.

BACKGROUND: National Health Insurance (NHI) is one of the Indonesian Government\'s policies to increase public access to health services. The study analyzed the role of socioeconomic status in NHI ownership in rural Indonesia. Study Design: A cross-sectional study.
METHODS: The study population included residents of rural Indonesia. The study examined secondary data from the survey entitled \"Abilities and Willingness to Pay, Fee, and Participant Satisfaction in Implementing National Health Insurance in Indonesia in 2019\", involving 33225 respondents representing Indonesia\'s rural areas. The study was conducted from March to December 2019. The variables analyzed included NHI, socioeconomic level, age group, gender, education level, employment status, and marital status. In the final step, the study employed binary logistic regression to explain the relationship between socioeconomic status and NHI ownership.
RESULTS: The results show that 63.8% of the population in rural Indonesia participated in the NHI. The poorer residents were 1.235 times more likely to have NHI than the most impoverished population (AOR 1.235; 95% CI 1.234-1.237). People with middle wealth status were 1.086 times more likely to have NHI than the poorest (AOR 1.086; 95% CI 1.085-1.087). The richer residents were 1.134 times more likely to have NHI than the poorest (AOR 1.134; 95% CI 1.133-1.136). The richest residents were 1.078 times more likely to have NHI than the poorest residents (AOR 1.078; 95% CI 1.077-1.079).
CONCLUSIONS: The study concluded that socioeconomic status is related to NHI ownership in rural Indonesia. The analysis indicated that all socioeconomic categories were more likely to become NHI participants than the poorest in Indonesia.

OBJECTIVE: Widowhood has been shown to decrease surviving spouses\' economic wellbeing. However, previous research has focused mostly on income-related outcomes, and has been less attentive to the importance of wealth, the processual nature of spousal death, and cross-national variation. In this study, we assessed how total, housing, and non-housing wealth changes over the process of widowhood across eleven European countries.
METHODS: Individual fixed-effects regressions and longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used to estimate how household net total wealth, housing wealth, and non-housing wealth changed three years prior and six or more years after spousal death relative to four or more years prior to widowhood in eleven European countries.
RESULTS: In all countries, household net wealth stayed relatively constant across the widowhood process, except for in Austria, the Czech Republic and Poland where wealth declines were observed especially in the years following death. However, we found declines in housing wealth over the widowhood process, including prior to spousal death, across most countries in our sample, particularly in Austria, France, Denmark, the Czech Republic, and Poland. Declines in housing wealth were generally not reflected by changes in non-housing wealth but coincided with leaving homeownership and downsizing.
CONCLUSIONS: Widowhood is associated with lower wealth, especially housing wealth, even in the years before spousal loss. Future research should focus on adjudicating the mechanisms behind country differences and exploring the implications of lost wealth following widowhood for surviving spouses\' wellbeing and intergenerational transfers.

Previous studies have established a negative correlation between economic deprivation and self-esteem; however, limited insights exist regarding the onset of children linking self-esteem to economic status. To investigate this, we examined 198 preschoolers (96 girls and 102 boys) and their parents (170 mothers and 28 fathers). We assessed children\'s implicit and explicit self-esteem, whereas parents\' reported on both personal relative deprivation and the family\'s economic objective deprivation. In addition, we explored children\'s money knowledge as a moderator. Our findings reveal that preschoolers may connect their implicit self-esteem with family economic status; however, such connections require basic knowledge about money. We discuss potential explanations for the influence of family economic deprivation, specifically on the implicit-not explicit-self-esteem of preschoolers.

BACKGROUND: Being older and having a migrant feature might cause a double risk of vulnerability in poor economic, social support, and health status at the place of destination. This study examines the association of migration on the social support and economic condition of older persons in India.
METHODS: Longitudinal Ageing Study in India (LASI) wave-I (2017-2018) data with total samples of 66,156 older adults aged 45 + with 30,869 and 35,287 male and female samples, respectively, used in this study. Descriptive and bivariate analyses have been performed to examine the pattern of older migrants, and multinomial logistic regression analysis has been used to establish the associations between migration, social support, and economic condition.
RESULTS: Over half (57.5%) of the population aged 45 + in India had migrant characteristics; 80% migrated before 25 years. Of all migrants, about 90% migrated within one state (Intrastate), and 9% migrated to another (Interstate). The association between social support and migration by distance and the adjusted result showed that immigrants were less likely to have medium [RRR = 0.56 (CI; 0.46-0.68)] and high [RRR = 0.39 (CI; 0.30-0.50)] social support. The interstate migrants were also less likely to have high [RRR = 0.90 (CI; 0.83-0.98)] social support. The migrants with 0-9 years of duration were less likely to have high social support, and the urban to rural stream migrants were more likely to have high social support. The association between economic status and migration by distance and the adjusted result showed that more affluent immigrants were likelier to have [RRR = 1.41 (CI; 1.14-1.73)] better economic conditions than affluent non-migrants. Migrants with 0-9-year duration and urban to rural stream were found to be likelier to have better economic conditions.
CONCLUSIONS: The findings of this study suggest that distance, duration, and migration stream have a significant association with social support and economic conditions in later life. In exploring migration\'s effect on social and economic status, policymakers should prioritize migrants in their agenda to maintain socio-economic and social support for older persons in India to achieve the sustainable goal of active and healthy ageing.

BACKGROUND: Patients with fewer socioeconomic and health literacy resources are disadvantaged in their access and use of healthcare, which may give rise to worse experiences with care and thus inequalities in patient experiences. However, only a limited number of studies have examined how socioeconomic and health literacy factors shape inequalities in patients\' experiences with cancer care.
OBJECTIVE: To examine whether patients\' experiences with cancer care differ according to their economic status and health literacy.
METHODS: Secondary analysis of data on 2789 adult patients diagnosed with cancer from the Swiss Cancer Patient Experiences-2 (SCAPE-2) study, a cross-sectional survey conducted in eight hospitals across Switzerland from September 2021 to February 2022. Regression analysis was applied to examine the independent effect of patients\' economic status and health literacy on various outcomes of experiences with cancer care, covering eight different dimensions of patient-centred care, controlling for confounding factors.
RESULTS: Adjusted regression analysis showed that patients with lower economic status reported significantly worse experiences with cancer care in 12 out of 29 specific care experiences, especially in the dimensions of \'respect for patients\' preferences\' and \'physical comfort\' where all items of experiences were associated with economic status. Additionally, lower health literacy was associated with worse patient experiences in 23 specific care experiences. All items in the dimensions of \'respect for patients\' preferences\', \'physical comfort\' and \'emotional support\' were associated with health literacy.
CONCLUSIONS: This study revealed significant inequalities in experiences with cancer care shaped by the economic status and health literacy of patients across different dimensions of patient-centred care. It is essential to address the needs of more disadvantaged patients who face obstacles in their access and use of the healthcare system, not only to mitigate inequalities in cancer care but also to avoid inequalities in health outcomes.

UNASSIGNED: Suboptimal health is identified as a reversible phase occurring before chronic diseases manifest, emphasizing the significance of early detection and intervention in predictive, preventive, and personalized medicine (PPPM/3PM). While the biological and genetic factors associated with suboptimal health have received considerable attention, the influence of social determinants of health (SDH) remains relatively understudied. By comprehensively understanding the SDH influencing suboptimal health, healthcare providers can tailor interventions to address individual needs, improving health outcomes and facilitating the transition to optimal well-being. This study aimed to identify distinct profiles within SDH indicators and examine their association with suboptimal health status.
UNASSIGNED: This cross-sectional study was conducted from June 16 to September 23, 2023, in five regions of China. Various SDH indicators, such as family health, economic status, eHealth literacy, mental disorder, social support, health behavior, and sleep quality, were examined in this study. Latent profile analysis was employed to identify distinct profiles based on these SDH indicators. Logistic regression analysis by profile was used to investigate the association between these profiles and suboptimal health status.
UNASSIGNED: The analysis included 4918 individuals. Latent profile analysis revealed three distinct profiles (prevalence): the Adversely Burdened Vulnerability Group (37.6%), the Adversity-Driven Struggle Group (11.7%), and the Advantaged Resilience Group (50.7%). These profiles exhibited significant differences in suboptimal health status (p < 0.001). The Adversely Burdened Vulnerability Group had the highest risk of suboptimal health, followed by the Adversity-Driven Struggle Group, while the Advantaged Resilience Group had the lowest risk.
UNASSIGNED: Distinct profiles based on SDH indicators are associated with suboptimal health status. Healthcare providers should integrate SDH assessment into routine clinical practice to customize interventions and address specific needs. This study reveals that the group with the highest risk of suboptimal health stands out as the youngest among all the groups, underscoring the critical importance of early intervention and targeted prevention strategies within the framework of 3PM. Tailored interventions for the Adversely Burdened Vulnerability Group should focus on economic opportunities, healthcare access, healthy food options, and social support. Leveraging their higher eHealth literacy and resourcefulness, interventions empower the Adversity-Driven Struggle Group. By addressing healthcare utilization, substance use, and social support, targeted interventions effectively reduce suboptimal health risks and improve well-being in vulnerable populations.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s13167-024-00365-5.

BACKGROUND: A person\'s sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC).
METHODS: A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety.
RESULTS: SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001).
CONCLUSIONS: Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.

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This study reviews the impact of eligibility policies in the early rollout of the COVID-19 vaccine on coverage and probable outcomes, with a focus on New York City. We conducted a retrospective ecological study assessing age  65+, area-level income, vaccination coverage, and COVID-19 mortality rates, using linked Census Bureau data and New York City Health administrative data aggregated at the level of modified zip code tabulation areas (MODZCTA). The population for this study was all individuals in 177 MODZCTA in New York City. Population data were obtained from Census Bureau and New York City Health administrative data. The total mortality rate was examined through an ordinary least squares (OLS) regression model, using area-level wealth, the proportion of the population aged 65 and above, and the vaccination rate among this age group as predictors. Low-income areas with high proportions of older people demonstrated lower coverage rates (mean vaccination rate 52.8%; maximum coverage 67.9%) than wealthier areas (mean vaccination rate 74.6%; maximum coverage 99% in the wealthiest quintile) in the first 3 months of vaccine rollout and higher mortality over the year. Despite vaccine shortages, many younger people accessed vaccines ahead of schedule, particularly in high-income areas (mean coverage rate 60% among those 45-64 years in the wealthiest quintile). A vaccine program that prioritized those at greatest risk of COVID-19-associated morbidity and mortality would have prevented more deaths than the strategy that was implemented. When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups. If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.