Search Results (304)

Background/Objectives: Pacifier use in infants has both beneficial and harmful implications, and dipping pacifiers in sweeteners is used by some parents to soothe infants. This study aimed to assess pacifier usage among mothers in Jeddah, Saudi Arabia, and to examine its association with child demographics, maternal socioeconomic status (SES), and maternal knowledge of the risks associated with dipping pacifiers in sweeteners. Methods: A cross-sectional study was conducted among mothers of healthy children aged 2 to 4 years during community-awareness events in Jeddah. Participants completed a validated Arabic questionnaire covering pacifier use patterns, feeding practices, SES background, and knowledge regarding the adverse effects of pacifier sweetening. Results: A total of 1438 mothers participated. The mean age of children was 34.3 ± 10.7 months, with 441 children (30.7%) reported as pacifier users. Among them, 202 (45.8%) used pacifiers both during the day and at night. Most children (35.6%) discontinued use between 4 and 6 months of age. Only 6.1% of mothers reported adding sweeteners to pacifiers. Pacifier usage was significantly higher among first-born children (37.6%, p < 0.001), those who received both bottle- and breastfeeding (65.5%, p < 0.001), and children enrolled in nursery (62.1%, p = 0.007). Most mothers (75.6%) were aware of the link between sweetened pacifiers and dental caries, and 69.4% of those who had this knowledge avoided giving their child a pacifier (p = 0.077). Conclusions: Birth order, feeding practices, and nursery attendance are key predictors of pacifier use. Enhancing parental awareness and education may support early interventions to promote healthier oral and feeding habits in young children. Full article

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

The changes in adolescents’ visions for the future are important to adolescents’ developmental trajectories, motivation, and educational outcomes, yet understudied. This study examined the change in possible selves and its association with grit during school closure and life interruption during COVID-19. We conducted a school-based longitudinal survey among 1577 students (Mage = 13.05, SD = 0.86) from 12 secondary schools at the start and end of an academic year prior to and during the COVID-19 pandemic with a 9-month interval. Demographic, grit, socioeconomic status (SES), self-control, and possible selves were measured. Paired t-tests indicated a significant decrease in academic possible selves and strategies. Hierarchical regression analysis results show that participants with higher grit scores reported higher academic and life possible selves; in particular, the effect of grit–perseverance was stronger than grit–passion after controlling self-control. SES moderated the effect of grit–passion on academic possible selves. The current longitudinal study provides important implications for education and youth social work practice for young people growing up with the influence of the pandemic. Full article

Background: Childhood hearing loss is a public health problem of critical importance associated with speech development, academic achievement, and quality of life. Parents’ awareness and knowledge about risk factors contribute to early detection and timely intervention.  Objective: This study aims to examine Jordanian mothers’ knowledge of childhood hearing loss risk factors and investigate the impact of education level and socioeconomic status (SES) on the accuracy and comprehensiveness of this knowledge with the moderating effect of health literacy. Material and Methods: The approach employed an embedded mixed-methods design with a dominant quantitative strand supported by qualitative data, utilizing quantitative surveys (n = 250), analyzed using structural equation modeling (SEM) in SmartPLS, and qualitative interviews (n = 10), analyzed thematically to expand upon the quantitative findings by exploring barriers to awareness and healthcare-seeking behaviors. Results: The accuracy and comprehensiveness of knowledge of hearing loss risk factors were also positively influenced by maternal knowledge of hearing loss risk factors. Maternal knowledge was significantly associated with both education level and socioeconomic status (SES). Furthermore, maternal knowledge and accuracy were significantly moderated by health literacy, such that mothers with higher health literacy exhibited a stronger relationship between knowledge and accuracy. Qualitative findings revealed that individuals encountered barriers to accessing reliable information and comprehending medical advice and faced financial difficulties due to limited options for healthcare services. Conclusions: These results underscore the need for maternal education programs that address specific issues, provide simplified healthcare communication, and enhance access to pediatric audiology services. Future research should explore longitudinal assessments and intervention-based strategies to enhance mothers’ awareness and detect early childhood hearing loss. Full article

Background: In rapidly aging societies like Japan, socioeconomic status (SES) plays a critical role in shaping older adults’ health behaviors. Disparities in SES influence access to healthcare, engagement in health-promoting activities, and the adoption of digital health technologies. This narrative review synthesizes current evidence on how SES affects health behaviors among older adults and highlights challenges in promoting equitable and sustainable healthcare in aging populations. Methods: A PubMed search was conducted for English-language articles published up to May 2025 using the keywords “socioeconomic status”, “older adults”, and terms related to health behaviors. Studies were included if they focused on individuals aged 65 or older and examined associations between SES and healthcare use, digital health, complementary and alternative medicine (CAM), supplements, or lifestyle behaviors. Results: A total of 24 articles were identified. Higher SES—typically measured by income, education, and occupation—was consistently associated with an increased use of preventive services, digital health tools, CAM, and healthier lifestyle behaviors such as diet, physical activity, and sleep. In contrast, lower SES was linked to healthcare underuse or overuse, digital exclusion, and less healthy behaviors. Structural and regional disparities often reinforce individual-level SES effects. Comorbidity burden and shifting health perceptions with age may also modify these associations. Conclusions: SES is a key determinant of health behavior in older adults. Policies should focus on redistributive support, digital inclusion, and SES-sensitive health system strategies to reduce disparities and promote healthy aging in super-aged societies. Full article

Background: A national study from China in 2023 predicted that the prevalence of overweight and obesity among children aged 7–18 will increase from 23.4% in 2019 to 32.7% by 2030. Objectives: This study aimed to investigate the longitudinal association between parental feeding practices and children’s body composition and weight status, and to assess the mediation effect of parental feeding practices in the relationship between socioeconomic status and childhood body composition. Methods: This longitudinal observational study was conducted between September and November 2021 in eight primary schools located in Luohu District, Shenzhen. Baseline and two follow-up surveys were administered annually during the same period from 2021 to 2023 (with one-year intervals). A total of 620 third-grade students (aged 8–10 years at baseline) and their parents were ultimately included in the study. Associations between parental feeding practices and children’s weight status and body composition were analyzed using mixed-effects models. The mediation effect of parental feeding practices on the relationship between socioeconomic status and childhood body composition was assessed through bootstrapping analysis. Results: At follow-up, a significant upward trend in the prevalence of central obesity among children was observed. Among all parental feeding dimensions, perceived child weight (PCW) demonstrated a strong association with central obesity after Bonferroni correction (OR = 1.33, 95% CI = 1.16, 1.51); similarly, monitoring (MN) and concern about child weight (CN) were both significantly associated with central obesity as risk factors for central obesity (OR = 1.14, 95% CI = 1.06, 1.23; OR = 1.16, 95% CI = 1.07, 1.27), both p < 0.001. These associations were modified by baseline child sex, parental BMI, and maternal and paternal education levels. However, restriction (RST) was not significantly associated with either body composition or weight status. The relationship between family socioeconomic status (SES) and childhood overweight and obesity was mediated by pressure to eat (PE) (p < 0.05). Conclusions: MN, PCW, and CN are associated with an increased risk of obesity in children. However, no significant association was found between parental feeding practices and changes in children’s body composition. Full article

Ensuring equitable access to higher education (HE) is not only a matter of social justice, but also a critical component to enhancing the long-term sustainability of modern societies. This study contributes to existing knowledge on socio-economic disparities in HE participation in Australia by identifying the extent to which key factors at the family, school, and individual levels mediate the relationship between socio-economic status (SES) and university enrolment. In doing so, it extends existing knowledge by simultaneously considering multiple factors at each ecological level, which enables us to disentangle their independent and joint influences on the SES differential in HE enrolment. To accomplish this, we analysed longitudinal data from the 2009 cohort of the Longitudinal Survey of Australian Youth (LSAY) using event-history models. Our findings reveal that students from lower-SES backgrounds are significantly less likely to enrol in university than their higher-SES peers, with persistent barriers emerging across multiple levels of influence. Indeed, after adjusting for cognitive skills, HE expectations, parental support, school climate, and access to learning resources, the estimated SES effect on HE participation was reduced by 68.6%. By systematically disentangling the relative contributions of these factors, this study provides critical insights into how sustainable education policies can be designed to mitigate social inequalities and promote inclusive growth. Intervention areas are discussed accordingly. Full article

Background: The present study seeks to examine how social disparities relate to the prevalence of poor glycemic control (HbA1c ≥ 7%), comorbidities such as hypertension and dyslipidemia, and diabetes-related complications (microvascular or macrovascular) among Saudi patients diagnosed with type 2 diabetes. Methods: A cross-sectional study was conducted among 574 patients with type 2 diabetes mellitus (T2DM) attending family medicine clinics at King Saud University Medical City in Riyadh. Participants were selected using a simple random sampling technique and interviewed via phone using a validated questionnaire. Data collected included demographic and clinical variables. Descriptive statistics and multivariate logistic regression analyses were performed to assess the association between socioeconomic status (SES) and cardiovascular complications, including stroke, dyslipidemia, hypertension, and acute coronary syndrome. Result: The analysis revealed that certain socioeconomic factors significantly increased the odds of cardiovascular complications among patients with T2DM. Being female was associated with higher odds of hypertension (OR = 2.29, p = 0.014), dyslipidemia (OR = 2.59, p = 0.012), acute coronary syndrome (ACS) (OR = 2.35, p = 0.001), and stroke (OR = 2.17, p = 0.003). Divorced or widowed participants had significantly increased odds of ACS (OR = 2.91, p = 0.001) and stroke (OR = 2.83, p = 0.002). A lower educational level (secondary school or less) was significantly associated with increased odds of hypertension (OR = 2.64, p = 0.031), dyslipidemia (OR = 2.22, p = 0.005), and stroke (OR = 2.88, p = 0.042). Monthly income between 3001 and 6000 SAR was significantly associated with higher odds of ACS (OR = 2.61, p = 0.003) and stroke (OR = 2.64, p = 0.012). Participants with diabetes duration >15 years had higher odds of dyslipidemia (OR = 2.86, p = 0.004) and stroke (OR = 2.89, p = 0.005). Being retired or not working increased the odds of all four cardiovascular outcomes, with stroke showing the highest risk (OR = 3.18, p < 0.001). Living outside the Riyadh region was also associated with elevated risk across outcomes, notably stroke (OR = 1.52, p = 0.046). Conclusions: The study concluded that notable social disparities exist among diabetic individuals affected by cardiovascular conditions, such as stroke and acute coronary syndrome (ACS), as well as risk factors for cardiovascular disease like dyslipidemia (DLD). These findings can inform targeted cardiovascular risk reduction strategies and address health inequities among diabetic populations in Saudi Arabia. Full article

Strong emotional bonds within families are foundational to children’s academic, psychological, and social development. While family cohesion is widely recognized as a protective factor across these domains, there remains a need to understand the specific mechanisms and interventions that foster such cohesion, particularly in diverse socioeconomic and cultural contexts. This systematic review examines global evidence on factors influencing family cohesion and evaluates intervention strategies designed to strengthen familial relationships. Drawing on 41 peer-reviewed studies published between 2015 and 2023, this review adheres to PRISMA guidelines and applies the Mixed Methods Appraisal Tool (MMAT) to assess methodological quality. The findings are organized around four core dimensions of family cohesion—emotional bonding, adaptability, communication, and support—and highlight both common patterns and culturally specific mechanisms. Studies were drawn from a range of settings including North America, sub-Saharan Africa, Latin America, East and Southeast Asia, and Europe, enabling a cross-cultural analysis of how family cohesion operates under different social, cultural, and economic conditions. Intervention strategies are reviewed separately following the synthesis of correlations, with attention to their effectiveness, cultural relevance, and contextual adaptability. Community-based programs, trauma-informed therapies, and parenting interventions emerge as key approaches, though their success has varied by regional and structural context. Studies consistently demonstrate that higher family cohesion correlates with improved academic outcomes, as supportive home environments promote motivation, reduce stress, and enhance learning. Mental health benefits are also evident, with cohesive and adaptable families mitigating risks of anxiety and depression through open communication and emotional availability. Social competence is fostered through observed and practiced interpersonal skills within family settings. Socioeconomic status emerges as both a challenge and a moderating factor, with lower-SES families facing greater barriers to cohesion but also displaying notable resilience when supported through external interventions. Effective strategies identified include family therapy, parenting education, community-based programs, culturally sensitive approaches, and socioeconomic policy supports. Family cohesion and adaptability are critical to nurturing children’s academic success, emotional well-being, and social development. This review contributes to a more culturally nuanced and policy-relevant understanding of family cohesion by integrating empirical findings across global contexts and identifying both shared and differentiated pathways to resilience. The results inform future program design and suggest priorities for cross-cultural family research and intervention development. Full article

Introduction: Gentrification, commonly defined as low-socioeconomic-status (SES) neighborhoods experiencing rapid increases in rental value, can lead to changes in the built and social neighborhood environment. Schools are an important location for pollutant exposure and child opportunities because children spend significant time in school. Given their central role in both environmental and social contexts, we examined the relationship between gentrification, pollutants, and child opportunity near schools in New York City. Methods: School locations (N_total = 1482) were classified into gentrifying (n = 624), non-gentrifying (n = 198), and higher-SES (ineligible for gentrification; n = 660) neighborhoods. Annual average pollutant levels (black carbon (BC), fine particulates (PM_2.5), nitrogen dioxide (NO₂)) were assessed near schools. Child opportunity index (COI 2.0) was used to evaluate overall opportunity and three domains: education; health/environment; social/economic. Results: On average, pollution was highest in gentrifying neighborhoods compared to non-gentrifying (5–8.6% difference) and higher-SES (4.8–14.8% difference) neighborhoods. Average air pollution levels remained consistently higher in gentrifying neighborhoods both before and after gentrification compared to non-gentrifying and higher-SES neighborhoods. Regarding childhood opportunity, education, and social/economic opportunities were better and health/environment opportunities were worse in gentrifying compared to non-gentrifying neighborhoods. Conclusions: Gentrifying neighborhoods are at risk for higher exposure to pollutants and lower health/environment childhood opportunities compared to other neighborhoods. Full article

This study explores homework practices and perceptions among Slovenian fourth-grade students and their parents, using data from PIRLS 2021 and national additions. Homework remains a contentious topic, often debated in terms of necessity and impact. The study examines the degree of parental involvement in their children’s homework, focusing on its association with family socioeconomic status (SES) and students’ reading achievement, as well as the students’ attitudes towards homework. A mixed-methods approach was employed, combining quantitative analyses from reading tests and contextual questionnaires with qualitative insights from open-ended parental responses. The results show that most Slovenian parents actively assist their children with homework, yet frequent involvement correlates with lower reading scores, potentially reflecting increased support for struggling students. Parental motivations emphasize educational purposes, such as reinforcement of knowledge and monitoring progress, and developmental goals like fostering work habits and confidence. Among students, attitudes towards homework are generally positive, with many acknowledging its instructional benefits. However, a significant portion find homework boring or excessive, which negatively correlates with achievement. The study highlights disparities linked to SES, with students from higher SES families demonstrating greater independence and more favorable attitudes. These findings underscore the need for balanced homework practices that consider quality over quantity, individualization in design, and collaborative communication with parents. Implications for policy include fostering autonomy and reducing SES-based inequalities. Full article

Background: The objective of this investigation was to assess the oral health (OH) of Bosnia and Herzegovinian adolescents in relation to differences and socioeconomic status (SES). Methods: This cross-sectional study included 306 school children from high schools located in the Tuzla Canton (Bosnia and Herzegovina). The sample consisted of 183 females and 123 males between 15 and 18 years old (mean of 16.82 years old). The study was conducted between December 2019 and March 2020, via an Annex 8 questionnaire from the World Health Organization (WHO), which collected information on OH behaviours, self-perceptions of oral health and dietary factors responsible for the OH of each subject. SES was categorized using five variables (occupation, education, income, place of residence and number of family members). Cross-tabulations were evaluated according to sex and socioeconomic status (SES) via the chi-square test. Results: Over 40% of the participants consumed sweets, cakes and biscuits on daily basis, whereas 41.5% of the participants visited a dentist only in the case of pain. The consumption of sweets (p = 0.024) and cakes and biscuits (p = 0.011) on a daily basis was significantly greater in female adolescents than in male adolescents. Compared with male adolescents, female adolescents reported occasional toothaches more frequently (p = 0.001) and were more dissatisfied with their dental appearance (p = 0.008) but presented a greater frequency of flossing (p = 0.001) and toothbrushing (3–5 times a day) (p = 0.0001). There was no association between the different levels (below average, average, above average) of SES and factors affecting OH status of adolescents. Conclusions: The study revealed significant sex differences in several factors affecting OH status and revealed no relationship between SES and OH behaviours or between perceptions and risk factors affecting OH in 15–18-year-old adolescents. Data obtained from this study might help in the creation of new OH prevention programs aimed at improving the OH status of adolescents in Bosnia and Herzegovina. Full article

Sports participation according to socioeconomic status (SES) was related to children in high-income Western countries. This study aimed to examine whether family or neighborhood-level SES is associated with current and continued organized sports participation, including the types of sports, among Japanese primary school children from preschool onward. The participants consisted of 269 girls, 255 boys, and their parents. Data on the type of sports participation at the current school or preschool, parental employment, and education were collected by questionnaire. Neighborhood-level SES was evaluated by the average annual income within 4 km of each school. The odds of sports participation was higher among children with mothers identifying as housewives or those with mothers employed part-time. Among girls, the odds of continued sports participation were lower if their mothers were junior high school or high school graduates or junior college/vocational school graduates. The odds of sports type like swimming were higher for children whose mothers had part-time jobs. Lower average community income was associated with lower participation in football and higher participation in baseball. These findings suggest that mothers’ employment and academic background are important correlates of sports participation for children, with variations observed by sport type and gender. Full article

A robust body of research examines the association between socioeconomic status (SES), particularly its economic dimension, income poverty, and child maltreatment rates. However, several key questions regarding this relationship remain underexplored. Utilizing a critical literature review, this article finds that some forms of child maltreatment (i.e., sexual abuse) do not correlate with income poverty. Moreover, evidence about the effects of other dimensions of SES, including employment and education is not monolithic. The complexity of this relationship is further influenced by the data source and unit of analysis. Studies using administrative data and analyzing SES at the family or household level frequently report a strong correlation between SES and child maltreatment. However, this relationship weakens (or in some cases disappears) when examined at the neighborhood or regional level using self-report data. Our findings also suggest that the overrepresentation of minority groups in child maltreatment statistics can be, at least in part, attributed to economic disadvantages. Furthermore, social cohesion appears to buffer the effects of income poverty and material hardship, highlighting the role of inequality in weakening social networks and exacerbating socioeconomic stressors. A developing body of literature demonstrates the link between income inequality and child maltreatment rates and indicates that policies aimed at addressing the impact of SES on child maltreatment should not only focus on alleviating poverty-related factors, such as material hardship, unemployment, and housing instability, but also target broader class disparities as the common root of many social problems. Full article

This study examines consumers’ ethical and responsible food purchasing decisions in Istanbul Province, Türkiye. These decisions are crucial for sustainable food consumption and policies. The data for this study were collected through a survey of 616 individuals who are influential in food consumption decisions within their households in Istanbul. Factor analysis was conducted to identify the factors influencing food purchasing decisions among consumers. After conducting factor analysis on food purchasing decisions, eight subgroups were identified: environmentalism, economy, conservatism, diligence, innovativeness, informativeness, caring, and transformativeness. After the factor analyses, the differences and similarities in the factors considered in food purchasing decisions were analyzed. According to the results of the analyses, the demographic characteristics and socio-economic status (SES) group were found to be different. In this study, logit analysis was also employed to identify the profiles of conscious consumers in their food purchasing decisions. It was determined that 51.00% of consumers were conscious of their food purchasing decisions, and women were more conscious of these decisions than men, with women having higher age and educational status than men. Consumers’ food purchasing decisions were analyzed, and recommendations are presented for decision-makers regarding sustainable food policy, with the aim of providing information and raising awareness. Full article