Search Results (267)

Because CKMS was only proposed by the American Heart Association in 2023, there has been a paucity of information about the distribution and determinants of the syndrome across population groups. We reviewed published studies of the prevalence of CKMS in the U.S. and other countries and obtained new estimates of the prevalence of this syndrome among U.S. adults by birth decade and sociodemographic attributes using 2019, 2021, and 2023 Behavioral Risk Factor Surveillance System (BRFSS) data. The results of this study indicate that CKMS is widespread in the general U.S. population, especially among older cohorts born before 1940 and during the 1940s, 1950s, and 1960s. Except for the three younger cohorts, born in the 1980s, 1990s, and 2000 or later, the prevalence of CKMS stage 4 was significantly higher among males than in females. Among those born between the 1950s and 1990s, the prevalence was significantly higher among non-Hispanic Blacks compared to their non-Hispanic white counterparts. Across all birth decades, prevalence of CKMS stage 4 was generally higher among those without a college degree, from a low-income household, and residing in rural areas. These prevalence rate estimates will further our understanding of the burden and unique needs of different population groups in improving cardiovascular–kidney–metabolic health across the life course. Full article

Food waste is a persistent global concern, requiring behavioral and systemic responses from consumers. The current study investigated the effect of sociodemographic factors and digital activism on food waste prevention behavior. Data from 390 respondents living in Italy (65% females, from 18 to 75 years old, grouped into four generations) were collected through an online survey covering these sections: sociodemographic variables, digital activism, knowledge, attitudes, and food waste behaviors. A Food Waste Prevention Index (FWPI) was computed to assess self-reported adherence to waste-reducing practices, and differences across three groups identified through tertiles were tested. Women displayed higher levels of digital activism; Gen Z was the most engaged generation in seeking information about food, while interest in food issues declined with age. Gender, geographical area, and dietary orientation significantly influenced food waste prevention, with women, rural residents, and individuals adopting flexitarian or vegetarian diets tending towards more virtuous behavior (higher FWPI). According to digital activism, less virtuous waste behavior (lower FWPI) was associated with a lower social media and apps usage frequency. Furthermore, higher FWPI individuals self-reported stronger sensitivity to sustainability-related topics such as circular economy, short food chains, and ethical or environmental motivations for vegetarianism. Overall, awareness and digital activism may synergistically foster more responsible food consumption, and targeted communication and digital tools can effectively support household food waste reduction strategies. Full article

In the context of China’s dual-carbon agenda and the Digital China initiative, elucidating the role of digital literacy in shaping consumption-based household carbon emissions (HCE) is essential for advancing low-carbon urban living and supporting a broader green transition. Existing research has rarely examined, at the individual level, how digital capability shapes household consumption decisions and the structure of carbon emissions. Accordingly, this study draws on matched household-individual microdata from the China Family Panel Studies (CFPS). We employ a two-way fixed effects model, kernel density analysis, and qualitative comparative analysis. We test the nonlinear effect of digital literacy on household consumption-related carbon emissions and examine its heterogeneity. We also examined the mediating role of perceived environmental pressure, social trust and income level. The research results show that: (1) The net impact of digital literacy on carbon emissions related to household consumption shows an inverted U-shaped curve, rising first and then falling. When digital literacy is low, it mainly increases emissions by expanding consumption channels, reducing transaction costs and improving convenience. Once digital literacy exceeds a certain threshold, the mechanism will gradually turn to optimize the consumption structure, so as to support the low-carbon transformation of individuals. (2) The impact of digital literacy on HCE is structurally different in different types of consumption. In terms of transportation and communication expenditure, the emission reduction effect is the most significant, and with the improvement in digital literacy, this effect will become more and more obvious. For housing-related consumption, the turning point appeared the earliest. With the improvement in digital literacy, its effect will enter the emission reduction stage faster. (3) Digital literacy can reduce carbon emissions related to household consumption by enhancing residents’ perception of environmental pressure and strengthening social trust. However, it may also increase emissions by increasing residents’ incomes, because it will expand the scale of consumption, which will lead to an increase in carbon emissions related to household consumption. (4) The heterogeneity analysis shows that as digital literacy improves, carbon emissions increase more strongly among rural residents, people with low human capital, low-income households, and women. However, the turning-point threshold for emission reduction is relatively lower for women and rural residents. (5) Low-carbon transitions in household consumption are shaped by dynamic interactions among multiple factors, and multiple pathways can coexist. Digital literacy can work with environmental responsibility to endogenously promote low-carbon consumption behavior. It can also, under well-developed infrastructure, empower households and amplify the emission-reduction effects of technology. Full article

Rural e-commerce has spurred profound changes in rural production and living patterns. Taking the policy of E-commerce Entering Rural Areas as a quasi-natural experiment, based on the data from fixed observation points in rural China, this paper examines how rural e-commerce development affects rural households’ green production practices. The results show that (1) while rural e-commerce has generally led to a 5% increase in farmers’ chemical fertilizer use, its promoting effect on farmers’ chemical fertilizer input has been gradually weakening over time. (2) Crop planting types moderate the relationship between rural e-commerce and farmers’ fertilizer input behaviors. For farmers mainly planting food crops, rural e-commerce increases their chemical fertilizer use by 6.87%, while for those mainly planting cash crops, rural e-commerce reduces their chemical fertilizer use by 4.25%. (3) Mechanism analysis reveals that service outlet construction and e-commerce training for farmers are the main channels through which rural e-commerce drives farmers to increase fertilizer input, while brand cultivation is a channel through which rural e-commerce inhibits farmers’ fertilizer input, and this influence channel only exists among farmers mainly planting cash crops. Full article

This study aims to develop a consumer typology based on attitudes and behaviors related to Household Food Waste in both urban and rural households in Greece, where data are limited. A structured questionnaire was administered to 279 residents of the Municipality of Eordaia through face-to-face interviews using stratified random sampling. A two-step cluster analysis identified four distinct consumer types: “Ecologically Conscious” (31%), “Empirical” (20%), “Modern” (28%), and “Socio-Ecologically Conscious” (21%). These clusters represent various levels of environmental awareness, consumer habits, and the influence of rural background on food-related practices. Findings highlight that rural background significantly impacts consumer behavior regarding Household Food Waste. This typology provides a valuable framework for designing targeted interventions and policy measures to reduce Household Food Waste. Future recommendations emphasize integrating educational food waste programs into primary schools, alongside institutional and policy support to ensure their effective implementation. Full article

Background/Objectives: This study aimed to determine the antimicrobial susceptibility patterns of multidrug resistant (MDR) and extensively resistant (XDR) Salmonella enterica serovar Typhi (S. Typhi) strains among children, along with the associated behavioral and environmental risk factors across different population groups in multiple districts of Punjab, Pakistan. Methods: A cross-sectional study was conducted across 20 districts in Punjab, Pakistan. Structured questionnaires were used to assess sociodemographic and behavioral determinants. Blood cultures from febrile children were obtained for the isolation and identification of S. Typhi, followed by antimicrobial susceptibility testing and screening for the resistance genes. Results: A total of 900 blood samples were collected and 41.5% were positive for S. Typhi. The proportion of culture-positive cases were higher among children aged 6–12 years (34.8%). Sociodemographic and behavioral analysis revealed that children from low-income households (PKR < 20,000 showed significantly higher infection rate (67.1%, p < 0.001). Antimicrobial susceptibility testing revealed high resistance rates against several antibiotics: Ciprofloxacin (88.8%), Trimethoprim/sulfamethoxazole (83.7%), Ampicillin (73.8%) and Chloramphenicol (72.7%). However, all isolates remained susceptible to carbapenems and azithromycin. The prevalence of MDR and XDR S. Typhi in urban areas was 28.1% and 60.8%, respectively, while rural areas showed 22.6% MDR and 20.6% XDR. In contrast, nomadic populations exhibited a higher rate of MDR (49.3%) but a lower XDR prevalence of 18.6% with significant geographic variations in resistance patterns. Molecular analysis revealed a high prevalence of resistance genes, including sul1 (83.7%), sul2 (79.7%), followed by dfrA7 (81.3%), catA1 (64.9%) and bla_TEM (60.5%), bla_CTX-M-1 (12.5%), bla_CTX-M-15 (25.9%) and qnrS (88.8%), respectively. Conclusions: The study underscores a persistent typhoid burden and widespread antimicrobial resistance among children in Punjab. Targeted vaccination, antibiotic stewardship, public health education are urgently needed, especially among the nomadic population, where healthcare access and hygiene awareness are limited. Full article

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk. Full article

Against the backdrop of growing global environmental crises, achieving sustainability in rural areas—where economic development, ecological conservation, and social equity often intersect—has become increasingly urgent. Sustainable development theory stresses the need to turn environmental awareness into concrete action, yet in practice, a puzzling gap often remains, especially in developing contexts such as China. Why do rural residents sometimes engage in pro-environment behaviors even when their expressed awareness or willingness seems limited? To explore this question, we conducted a study in Li County, China, combining field research with regression and path analysis across three spatial dimensions: production, ecological, and living spaces. Our findings reveal a notable divergence: farmers’ environmental actions frequently surpass their cognitive understanding and stated willingness to participate in governance. This suggests that the influence of environmental cognition and participation willingness on behavior varies across different spatial contexts. We also find that household demographic and geographic attributes not only directly shape involvement in environmental governance but also mediate the relationship between cognition, willingness, and action. By untangling these complex linkages, our study offers a more nuanced understanding of rural environmental governance. We argue for governance approaches that are spatially sensitive and participatory, capable of accounting for the often non-linear pathways from perception to intent to behavior. The insights from Li County provide a valuable empirical basis for designing spatially differentiated and participatory governance policies. These findings are crucial for promoting effective environmental stewardship and achieving sustainable development goals in rural communities globally. Full article

The purpose of this study is to clarify the impact of government embedment on villagers’ willingness to engage in mutual supervision of rural residential land utilization. It also examines the role of local elders’ involvement in this process, with the goal of improving the regulatory framework for rural residential land utilization. The data used in this study are sourced from a field survey of 450 rural households in Sichuan Province, China. Data analysis was conducted using Logit, Probit, and moderation effect models, among others. The results show the following: (1) Organizational Embedment significantly enhances villagers’ willingness to participate in mutual supervision, with government-established regulatory bodies and dedicated management personnel effectively incentivizing oversight participation. (2) Due to social risks in actual supervision, Ideological Embedment fails to effectively stimulate supervisory behavior. (3) The effects of Government Embedment vary significantly across villages in different geographic locations. (4) The involvement of local elders enhances the effectiveness of Government Organizational Embedment, with their role in rural residential land governance leaning more toward practical implementation than conceptual dissemination. The findings of this study are as follows: Against the backdrop of government administrative embedment in rural residential land governance, the involvement of local elders has played a significant role in enhancing effectiveness. Efforts should continue to focus on strengthening organizational oversight of rural residential land utilization, reinforcing communication between the government and villagers, and deepening collaboration with local elders to encourage active villager participation in the supervision and management of rural residential land use. Full article

This study takes the limited household participation in risky financial markets as its point of departure. Drawing on microdata from the 2019 China Household Finance Survey (CHFS), we construct a multidimensional analytical framework using machine learning methods. The results indicate that this limitation arises from the interplay of multiple dimensions, with significant nonlinear relationships observed between these factors and household investment behavior. Insufficient development of key driving factors constitutes the main barrier to participation in risky financial markets. Feature interaction analysis reveals a “reversal effect” in how urban–rural disparities, economic attention, income level, and social engagement shape participation behavior. Educational attainment and financial literacy act as “threshold conditions” that enable economic attention to translate into actual investment decisions. The heterogeneity analysis further shows that households at different life-cycle stages as well as across urban–rural settings exhibit distinct participation patterns. These findings provide data-driven insights that can inform policies to promote financial inclusion, enhance investor education, and strengthen household risk management practices. Full article

Background and Objectives: Influenza is a significant global healthcare problem. Despite the availability of influenza vaccines, vaccination rates remain low, particularly among rural populations. This study aims to investigate the impact of trust and demographic factors on influenza vaccination status among rural populations. Methods: Cross-sectional data were collected as a subgroup analysis of rural populations within a parent study assessing Coronavirus Disease 2019 (COVID-19) vaccination uptake among residents in the state of Alabama, U.S.A. Participants were at least 18 years old and recruited from a Qualtrics panel. Rurality (non-metro) was determined using the United States Rural–urban Commuting Area (RUCA) Codes of 4-10. Data were analyzed using a weighted sample to adjust for differences in sex and race distributions. Results: A little over one-third (37.8%) of the participants reported having received influenza vaccine in the 2023–2024 flu season. Less than half (48.4%) reported they previously received COVID-19 vaccines, and a greater percentage (54.5%) of them had a high understanding of health information. The multivariable logistic regression analysis indicated that prior COVID-19 vaccination, political affiliation, household income and trust in doctors’ communication competency were significantly associated (p < 0.05) with greater influenza vaccine uptake. Conclusions: Improving influenza vaccine uptake in underserved rural communities requires strengthening trust in healthcare providers, addressing access barriers and enhancing communication strategies that reflect sociopolitical influences on vaccination behavior. Full article

Climate change has profoundly impacted human development, with disasters serving as a prominent manifestation of its effects on societies. While disasters impose significant disruptions on agricultural production and rural livelihoods, they may also create a “window of opportunity” for rural development by motivating farmers to enhance their adaptive capacities through social learning and collective action. Existing research on disaster impacts predominantly focuses on individual decision-making under assumptions of full rationality, with limited systematic attention to collective action among rural households. Furthermore, studies examining collective action rarely address how external ecological systems influence such behaviors. To address these gaps, this study employs survey data from 419 households across 80 villages in Guangxi, China, revealing two critical findings: (1) disasters exert a significant positive effect on farmers’ participation in response-focused collective actions but a notable negative impact on their engagement in prevention-focused collective actions; and (2) these relationships are mediated by shifts in farmers’ risk perception levels. Building on these insights, this study proposes strategies to strengthen farmers’ collective action by enhancing risk perception and fostering collaborative governance mechanisms between governments and local communities. These measures aim to improve the effective provision and equitable allocation of disaster-response resources, thereby bolstering rural resilience. Full article

Municipal solid waste (MSW) is a rapidly escalating global challenge, with Thailand exemplifying the persistence of a policy–practice gap in zero-waste transitions. Despite national initiatives such as Zero Waste Thailand, household segregation and recycling rates remain modest, particularly in semi-rural municipalities. This study addresses this gap by introducing and validating the ARUN Model, a competency-based governance framework for community-level zero-waste management. Using a mixed-methods sequential explanatory design, quantitative data from 300 households were analyzed using exploratory factor analysis and regression modeling, complemented by focus group interviews with local leaders to interpret behavioral mechanisms. The findings revealed that Responsibility and Nurturing competencies exert the strongest positive effects on household zero-waste behavior, confirming the model’s reliability and construct validity. These results empirically demonstrate how community competencies shape sustainable waste practices and bridge the structural–behavioral divide in waste governance. This research provides the first empirical validation of a competency-based governance framework in a semi-rural Thai context, extending beyond participatory and capacity-based models. By integrating statistical rigor with community insight, the ARUN Model advances theoretical and practical understanding of competency-driven sustainability transitions. This study provides actionable insights for policymakers and supports the achievement of SDGs 11, 12, and 13, offering a locally rooted yet globally relevant pathway toward circular economy governance. Full article

Understanding how digital transformation shapes dietary behavior is essential for evaluating nutritional transitions in developing economies. However, the mechanisms through which the digital economy impacts dietary diversity remain insufficiently explored. This study provides new empirical evidence on how digitalization influences the dietary diversity of Chinese residents. Utilizing unbalanced panel data sourced from the China Nutrition and Health Survey (CHNS), we calculate provincial digital economy indices and estimate its effects through Ordinary Least Squares (OLS) and mediating effect model. Baseline results state that the digital economy significantly improves dietary diversity. Mediating effects analyses reveal that the digital economy augments dietary diversity by boosting household income, deepening dietary awareness, and facilitating industry transformation and consumption upgrading. Moreover, heterogeneity analyses indicate that the synergistic effect between the digital economy and diet patterns varies significantly across urban–rural areas, education levels, and household living conditions. These findings offer valuable insights for other emerging economies undergoing similar digital and nutritional transitions. Full article

Institutions hold a crucial influence over human behavior and economic development. Using 3791 agricultural land transfer-out households from the 2021 Chinese Social Survey (CSS) data as the research sample, this study employs Logit, IV-Probit, and Heckman models to explore the influence of social morality—a crucial informal institution—on farmers’ land transfer behavior from a cognitive perspective, examining the moderating factors and underlying mechanisms between the two. The findings indicate the following: (1) The perception of social morality level significantly influences land transfer behavior; when farmers perceive lower social morality, their land transfer behavior is inhibited. (2) The perception of the level of rule of law significantly negatively moderates the relationship between perception of social morality level and agricultural land transfer behavior. That is, the negative impact of the perception of social morality level on agricultural land transfer is effectively mitigated as the perceived level of rule of law increases. (3) The suppression of land transfer by perceptions of social morality stems primarily from the significant weakening of social trust, which is a crucial mechanism driving land transfer. By focusing on social morality and adopting a cognitive perspective, this study explores the impact of this informal institution on agricultural land transfer behavior. It holds significant theoretical value for deepening the understanding of informal institutional changes and enhancing the development of agricultural land markets in rural China. Full article