Explore the vast range of titles available.

Introduction The prevalence of diabetes and its complications is an important global health problem. Diabetic retinopathy (DR), a common and specific microvascular complication of diabetes, has seriously affected socioeconomic factors and individual quality of life. This cross-sectional study utilized data from NHANES 1999–2020 to investigate the association between family income to poverty ratio (PIR) and DR prevalence among U.S. adults aged 20 years and above. Methods Data from the National Health and Nutrition Examination Survey (NHANES) in 1999–2020, which included 39,210 participants, were utilized for this study. They were divided into two groups according to PIR < 5 or PIR ≥ 5. The baseline characteristics were described to show the distribution of each characteristic. Multiple linear regression and curve fitting were used to study the linear and nonlinear correlations between PIR and DR prevalence. Subgroup analysis and interaction tests were performed to test the stability of the relationship between PIR and DR prevalence. ROC analysis was performed to evaluate predictive performance. Results Among 39,210 adults aged 20 years and above, 31,907 (81.37%) were in Group 1 (PIR < 5), and 7,303 (18.63%) were in Group 2 (PIR ≥ 5). Compared with the prevalence of DR in Group 1 (2.7%), the prevalence of DR in Group 2 (1.5%) was lower. After adjusting for all covariates, a significant negative correlation was found between PIR and the prevalence of DR (OR: 0.91, 95% CI: [0.86 ~ 0.97], p  = 0.002). Non-Hispanic Whites showing significant benefit (OR: 0.87, 95% CI: [0.80 ~ 0.96], p  = 0.005, P for interaction = 0.017). After adjusting for age, the ROC analysis demonstrated a discriminative ability of the model with AUC of 0.747(95% CI: [0.74 ~ 0.76]). Conclusion The results of this study indicate that an increase in PIR is correlated with a decrease in the likelihood of DR occurrence, suggesting its potential application value as an indicator for predicting the likelihood of DR occurrence. More screening and attention should be provided to low-income populations to reduce preventable social burdens.

Background The Family Income-to-Poverty-Ratio (FIPR) is a recognized indicator of socioeconomic status, and influences a wide range of health and behavioral outcomes. Yet, marginalized and racialized groups, particularly Black individuals, may not reap comparable health benefits from their socioeconomic advancements as their non-Hispanic, White counterparts. This discrepancy is indicative of a phenomenon known as the minorities' diminished returns. Aims This study investigates the differential impact of the FIPR on depression, obesity, tobacco use, and e-cigarette use between Black and White adults. Methods Using data from the 2022 National Health Interview Survey (NHIS), which included 21,354 non-Hispanic adults from both White and Black racial groups, this research employed structural equation modeling to assess the relationship between the FIPR and health outcomes, including depression, obesity, and e-cigarette use. Results The analysis identified significant interactions between FIPR and race across all the examined outcomes. Contrary to expectations, the findings suggest that the protective effects of higher income levels on health and healthy behaviors are less pronounced for Black individuals compared to White individuals. Conclusion The study underscores the substantial societal and environmental barriers that hinder Black families and individuals from converting their FIPR and socioeconomic resources into concrete health benefits, such as an enhanced mental and physical well-being. To redress these racial health disparities, targeted interventions are crucial, particularly those that focus on bridging the employment and marriage rate gaps caused by educational disparities among Black communities. A comprehensive approach that extends beyond simple access to education is imperative to eliminate the societal obstacles that limit the socioeconomic benefits for Black populations.

Despite substantial progress in the adoption of health information technology (IT), researchers remain uncertain as to whether IT investments benefit hospitals. This study evaluates the effect of health information sharing on the cost of care, and whether the effect varies with context. Our results suggest that information sharing using health IT, specifically the extent (breadth) and level of detail (depth) of information sharing, helps to reduce the cost of care at the hospital level. The results also show that the effects of depth of information sharing on cost savings are salient in poor and less-concentrated regions, but not in wealthier, more-concentrated areas, whereas the the effects of breadth of information sharing on cost savings are equivalent across wealth and concentration. To realize the benefits of using health IT more effectively, policy makers’ strategies for encouraging active use of health IT should be informed by market characteristics.

Serum methylmalonic acid (MMA) arises from impaired metabolism of methylmalonyl-CoA and is exacerbated in chronic kidney disease (CKD) due to reduced renal clearance and nutritional deficiencies. The quality of diet may influence MMA levels by affecting vitamin B12 intake and mitigating inflammatory dietary components. This study aims to explore the relationship between the Healthy Eating Index-2015 (HEI-2015) and the prevalence of high MMA among low poverty/income ratio (PIR) patients with CKD. We conducted a cross-sectional study of participants aged ≥20 years using the data drawn from the NHANES 2011-2014. Individuals under low PIR suffering from CKD were included. HEI-2015 was calculated to evaluate diet quality. Multivariable logistic regression models were applied to examine the association between HEI-2015 and high MMA prevalence with covariates adjusted. Stratified and interaction analysis were also performed. A total of 582 CKD patients with low PIR were enrolled. The logistic analysis showed that higher HEI-2015 was significantly associated with a lower prevalence of high MMA. Patients in the highest quartile of HEI-2015 scores (>61.17) showed a 57.8% reduction in high MMA prevalence compared to those in the lowest quartile. Subgroup and interaction analysis revealed that alcohol consumption reduced the diet quality-related protection against high MMA. The protective role of high-quality diets, as reflected by HEI-2015, in reducing the prevalence of high MMA in low PIR CKD patients is noteworthy. Improving diet quality in this population could potentially mitigate the risks associated with high MMA in CKD patients with low PIR.

Background The triglyceride glucose index (TyG index) is a crucial marker for assessing the risk of chronic diseases, while socioeconomic status (SES), measured by poverty income ratio (PIR) and education level, reflects an individual’s social standing. Past studies have linked SES to diabetes and cardiovascular diseases, but research on its association with the TyG index is limited. This study aimed to explore the association between SES and the TyG index and assess the mediating role of BMI. Methods The cross-sectional study utilized data from the National Health and Nutrition Examination Survey 2007–2016 cycles to explore the relationship between SES and the TyG index in the adult of the USA. Multivariate logistic regression, stratified and interaction analyses were conducted to assess the association between SES and the TyG index. Additionally, parallel mediator analysis estimated the mediated effect of BMI between SES and the TyG index. Results Among the 11,358 individuals studied, averaging 49 years of age and with 48.3% males, fully adjusted models revealed negative associations between PIR and education level with the TyG index, while BMI showed a positive correlation. Stratified and interaction analysis indicated consistent findings across subgroups. Mediation analysis revealed that BMI mediated 14.4% and 8.57% of the effects of PIR/Education level on the TyG index, respectively. Conclusions SES was negatively associated with the TyG index. Additionally, BMI partially mediate the association between SES and the TyG index. These findings deepen the comprehension of the association between SES and the TyG index.

Introduction Both low family income and subclinical myocardial injury (SCMI) are risk factors for cardiovascular disease (CVD) mortality. However, the impact of their joint association on CVD mortality is unclear. Methods This analysis from the third National Health and Nutrition Examination Survey included 6805 participants (age 59.1 ± 13.4 years, 52.3% women, and 49.8% White) free of CVD at baseline. Family income was assessed using the poverty‐income ratio (PIR) and categorized into low (PIR < 1), middle (PIR = 1–4), and high (PIR > 4) income. A validated ECG‐based cardiac infarction injury score (CIIS) ≥ 10 was considered positive for SCMI. CVD mortality was determined using the National Death Index. Cox‐proportional hazard analysis was used to evaluate the associations of family income and SCMI, separately and jointly, with CVD mortality. Results A total of 1782 (26.2%) participants had SCMI at baseline. During a median follow‐up of 18.2 years, 856 (12.6%) events of CVD mortality occurred. In separate multivariable Cox models, SCMI (vs. no SCMI) and middle‐ and low‐income (vs. high‐income) were each associated with a higher risk of CVD mortality (HR [95% CI]: 1.34 [1.16–1.54], 1.44 [1.16–1.78], and 1.59 [1.22–2.07], respectively). Compared to high‐income participants without SCMI, those with low‐income and SCMI had an increased risk of CVD mortality (HR [95% CI]: 2.17 [1.53–3.08]). The multiplicative interaction between PIR and SCMI was not significant (p = 0.054). Conclusion Lower family income and SCMI are associated with CVD mortality, and their concomitant presence is associated with the highest risk. Family income and SCMI may help in the individualized assessment of CVD risk. This study evaluated the joint associations of family income and SCMI with CVD mortality in participants from NHANES III. We found that lower family income and SCMI are associated with CVD mortality; their concomitant presence is associated with the highest risk. Family income and SCMI may help assess CVD risk.

Background Previous studies have shown the interaction between age and socioeconomic status (SES) on the risk of infertility in the UK, but the association is still unclear in the United States. Therefore, the present study investigated the effect of age on the relationship between SES and the risk of infertility in American women. Methods The study included adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. The poverty income ratio (PIR) was used to represent the SES of the population. With participants stratified according to age category (< 35 years; ≥ 35 years), we further assessed differences in the relationship between PIR and infertility risk among participants of different age groups using multivariate logistic regression and interaction tests. Results Approximately 3,273 participants were enrolled in the study. There were 399 cases of infertility and 2,874 cases without infertility. In women ≥ 35 years of age, PIR levels were significantly higher in infertile participants than in non-infertile participants, but no such difference was found in those < 35 years of age. The association of PIR with the risk of infertility appeared to differ between age < 35 years and age ≥ 35 years (OR: 0.99, 95%Cl: 0.86–1.13 vs. OR: 1.24, 95%Cl: 1.12–1.39) in a fully adjusted model. Furthermore, an interaction between age and PIR increased the risk of infertility (p-value for interaction < 0.001). Conclusion Our study found that age may influence the association between PIR and infertility. It is imperative to perform further studies to provide more evidence.

Although breastfeeding provides health benefits to both mother and child, this study aimed to explore whether disparities in breastfeeding continue to exist, particularly among non-Hispanic Black (NHB) mothers and children. We performed a cross-sectional analysis among 19,830 children in the United States (US) using the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2020. Breastfeeding initiation and duration rates increased overall from 1999 to 2020. Children who were ever breastfed were more likely to have higher body weight, older mothers, mothers who did not smoke during pregnancy, a higher family poverty–income ratio (PIR), food security, mothers in excellent health, and mothers who had not seen a mental health professional in the past year. NHB children were breastfed at significantly lower rates and for shorter duration than non-Hispanic White (NHW), Mexican, Other Hispanic, and Other/Multi-Racial children. NHB children were breastfed less than other racial groups, including minority Mexican children with similar average PIR, suggesting a possible unique experience for NHB mothers and children. Strategies include impacting social norms and offering culturally tailored breastfeeding supports. The provision of structural supports to remove barriers to breastfeeding is a social justice issue. Breastfeeding confers health benefits to mother and child, and disparities exist among mothers and children, particularly among NHB mothers and children. The current study provides data on the most recent breastfeeding trends, showing that these disparities by race/ethnicity are present. Interestingly, even among Mexican participants of a similar PIR, NHB children were still breastfed less.

One out of every five Latin Americans—about 130 million people—have never known anything but poverty, subsisting on less than US$4 a day throughout their lives. These are the region's chronically poor, who have remained so despite unprecedented inroads against poverty in Latin America and the Caribbean since the turn of the century. This book takes a closer look at the region's entrenched poor, who and where they are, and how existing policies need to change to effectively assist the poor. The book shows significant variations of rates of chronic poverty across and within countries. The book posits that refinements to the existing policy toolkit —as opposed to more programs—may come a long way in helping the remaining poor. These refinements include intensifying efforts to improve coordination between different social and economic programs, which can boost the income-generation process and deal with the intergenerational transmission of chronic poverty by investing in early childhood development. In addition, there is an urgent need to adapt programs to directly address the psychological toll of chronic poverty on people's mindsets and aspirations, which currently undermines the effectiveness of existing policy efforts.

Importance: Depression is one of the leading causes of disability in the United States. Depression prevalence varies by income and sex, but more evidence is needed on the role income inequality may play in these associations. Objective: To examine the association between the Poverty to Income Ratio (PIR)—as a proxy for income—and depressive symptoms in adults ages 20 years and older, and to test how depression was concentrated among PIR. Design: Using the 2005–2016 National Health and Nutrition Examination Survey (NHANES), we employed Negative Binomial Regression (NBRG) in a sample of 24,166 adults. We used a 9-item PHQ (Public Health Questionnaire, PHQ-9) to measure the presence of depressive symptoms as an outcome variable. Additionally, we plotted a concentration curve to explain how depression is distributed among PIR. Results: In comparison with high-income, the low-income population in the study suffered more from greater than or equal to ten on the PHQ-9 by 4.5 and 3.5 times, respectively. The results of NBRG have shown that people with low-PIR (IRR: 1.30, 95% CI: 1.23–1.37) and medium-PIR (IRR: 1.55, 95% CI: 1.46–1.65) have experienced a higher relative risk ratio of having depressive symptoms. Women have a higher IRR (IRR: 1.29, 95% CI: 1.24–1.34) than men. We observed that depression was concentrated among low-PIR men and women, with a higher concentration among women. Conclusion and Relevance: Addressing depression should target low-income populations and populations with higher income inequality.