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Area-based social disadvantage, which measures the income, employment, and housing quality in one’s community, can impact an individual’s health above person-level factors. A life course approach examines how exposure to disadvantage can affect health in later life. This systematic review aimed to summarize the approaches used to assess exposure to area-based disadvantage over a life course, specifically those that define the length and timing of exposure. We reviewed the abstracts of 831 articles based on the following criteria: (1) whether the abstract described original research; (2) whether the study was longitudinal; (3) whether area-based social disadvantage was an exposure variable; (4) whether area-based social disadvantage was assessed at multiple points; and (5) whether exposure was assessed from childhood to older adulthood. Zero articles met all the above criteria, so we relaxed the fifth criterion in a secondary review. Six studies met our secondary criteria and were eligible for data extraction. The included studies followed subjects from childhood into adulthood, but none assessed disadvantages in late life. The approaches used to assess exposure included creating a cumulative disadvantage score, conducting a comparison between life course periods, and modeling the trajectory of disadvantage over time. Additional research was needed to validate the methodologies described here, specifically in terms of measuring the impact of area-based social disadvantage on health.

Racial inequality remains an objective reality in the United States and around the world, yet members of advantaged racial groups often deny or minimize its existence. Although we have well-developed theories to explain why advantaged racial groups would be motivated to deny or minimize inequality, at present we know relatively little about why Whites and other advantaged racial groups might be willing to acknowledge or care about racial inequality. In this article, we propose that contact between racial groups offers one of the most promising pathways to advance these outcomes. We review established and emerging research literature suggesting that contact contributes to these outcomes by encouraging members of advantaged racial groups to become psychologically invested in the perspectives, experiences, and welfare of members of disadvantaged racial groups. We propose that psychological processes such as building empathy, enhancing personal relevance, and humanizing other people can facilitate the extent to which contact leads to greater psychological investment in other racial groups. We conclude by discussing several factors that may serve as obstacles to psychological investment across racial lines and the relevance of contact and establishing connections between racial groups in light of current social divisions and racial tensions.

This consensus statement is the outcome of comprehensive collaboration through an international working group on the disparities in the legacies of major sporting events, specifically for communities and individuals from disadvantaged backgrounds (CIDBs). The workshop brought together scholars to discuss current challenges and develop four propositions and recommendations for event leveraging, policy stakeholders, and researchers. The propositions included (1) the nature of \"disadvantage\" needs to be recognized and the specific targeted CIDBs in each event context must be carefully identified or clearly defined; (2) CIDBs should be considered as an integral part of the whole event hosting cycle to ensure legacy inclusivity; (3) dedicated event leverage, sufficient financial backing, and resource commitments for CIDBs are needed; and (4) it is critical to establish a system of legacy governance for CIDBs. The recommendations aim to inform change in practice and ensure lasting positive legacies for the communities that need them most.

Couple relations are a key determinant of mental and physical well-being in old age. However, we do not know how the advantages and disadvantages associated with partnership histories vary between socioeconomic groups. We create relationship history typologies for the cohorts 1945-1957 using the Survey of Health, Ageing, and Retirement in Europe and examine, for the first time, how relationship histories relate to multiple indicators of well-being by educational attainment. The results show that stable marriages predict greater well-being, compared to single and less stable partnership histories. The positive outcomes are similar across all educational groups. Those with lower education who have divorced experience even lower well-being in old age. The interaction analyses suggest that individuals with fewer resources could suffer more from losing a partner. The findings underscore that current and past romantic relationships are linked to well-being in old age and help policymakers identify vulnerable subgroups among the ageing population.

Couple relations are a key determinant of mental and physical well-being in old age. However, we do not know how the advantages and disadvantages associated with partnership histories vary between socioeconomic groups. We create relationship history typologies for the cohorts 1945-1957 using the Survey of Health, Ageing, and Retirement in Europe and examine, for the first time, how relationship histories relate to multiple indicators of well-being by educational attainment. The results show that stable marriages predict greater well-being, compared to single and less stable partnership histories. The positive outcomes are similar across all educational groups. Those with lower education who have divorced experience even lower well-being in old age. The interaction analyses suggest that individuals with fewer resources could suffer more from losing a partner. The findings underscore that current and past romantic relationships are linked to well-being in old age and help policymakers identify vulnerable subgroups among the ageing population.

Class and social disadvantage have long been identified as significant factors in the etiology and epidemiology of psychosis. Few studies have explicitly examined the impact of intersecting social disadvantage on long-term employment and financial independence. We applied latent class analysis (LCA) to 20-year longitudinal data from participants with affective and non-affective psychosis ( = 256) within the Chicago Longitudinal Research. LCA groups were modeled using multiple indicators of pre-morbid disadvantage (parental social class, educational attainment, race, gender, and work and social functioning prior to psychosis onset). The comparative longitudinal work and financial functioning of LCA groups were then examined. We identified three distinct latent classes: one comprised entirely of White participants, with the highest parental class and highest levels of educational attainment; a second predominantly working-class group, with equal numbers of Black and White participants; and a third with the lowest parental social class, lowest levels of education and a mix of Black and White participants. The latter, our highest social disadvantage group experienced significantly poorer employment and financial outcomes at all time-points, controlling for diagnosis, symptoms, and hospitalizations prior to baseline. Contrary to our hypotheses, on most measures, the two less disadvantaged groups did not significantly differ from each other. Our analyses add to a growing literature on the impact of multiple forms of social disadvantage on long-term functional trajectories, underscoring the importance of proactive attention to sociostructural disadvantage early in treatment, and the development and evaluation of interventions designed to mitigate ongoing social stratification.

BackgroundThe impact of race and socioeconomic status on clinical outcomes has not been quantified in patients hospitalized with coronavirus disease 2019 (COVID-19).ObjectiveTo evaluate the association between patient sociodemographics and neighborhood disadvantage with frequencies of death, invasive mechanical ventilation (IMV), and intensive care unit (ICU) admission in patients hospitalized with COVID-19.DesignRetrospective cohort study.SettingFour hospitals in an integrated health system serving southeast Michigan.ParticipantsAdult patients admitted to the hospital with a COVID-19 diagnosis confirmed by polymerase chain reaction.Main MeasuresPatient sociodemographics, comorbidities, and clinical outcomes were collected. Neighborhood socioeconomic variables were obtained at the census tract level from the 2018 American Community Survey. Relationships between neighborhood median income and clinical outcomes were evaluated using multivariate logistic regression models, controlling for patient age, sex, race, Charlson Comorbidity Index, obesity, smoking status, and living environment.Key ResultsBlack patients lived in significantly poorer neighborhoods than White patients (median income: $34,758 (24,531–56,095) vs. $63,317 (49,850–85,776), p < 0.001) and were more likely to have Medicaid insurance (19.4% vs. 11.2%, p < 0.001). Patients from neighborhoods with lower median income were significantly more likely to require IMV (lowest quartile: 25.4%, highest quartile: 16.0%, p < 0.001) and ICU admission (35.2%, 19.9%, p < 0.001). After adjusting for age, sex, race, and comorbidities, higher neighborhood income ($10,000 increase) remained a significant negative predictor for IMV (OR: 0.95 (95% CI 0.91, 0.99), p = 0.02) and ICU admission (OR: 0.92 (95% CI 0.89, 0.96), p < 0.001).ConclusionsNeighborhood disadvantage, which is closely associated with race, is a predictor of poor clinical outcomes in COVID-19. Measures of neighborhood disadvantage should be used to inform policies that aim to reduce COVID-19 disparities in the Black community.

Purpose The purpose of this systematic review is to describe the complications and downsides of robotic systems in total knee arthroplasty (TKA). Methods A comprehensive search according to the PRISMA guidelines was performed across PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, and Google Scholar from inception until December 2021. All articles of any study design directly reporting on complications and downsides of the robotic system in TKA were considered for inclusion. Risk of bias assessment was performed for all included studies using the Cochrane risk of bias and MINORS score. Results A total of 21 studies were included, consisting of 4 randomized controlled trials, 7 prospective studies and 10 retrospective studies. Complications of the robotic system were pin-hole fracture, pin-related infection, iatrogenic soft tissue and bony injury, and excessive blood loss. While, downsides were longer operative duration, higher intraoperative cost, learning curve and aborting a robotic TKA due to different reasons. Iatrogenic injuries were more common in the active robotic system and abortion of the robotic TKA was reported only with active robotic TKA. Conclusion Robotic TKA is associated with certain advantages and disadvantages. Therefore, surgeons need to be familiar with the system to use it effectively. Widespread adoption of the robotic system should always be evidence-based. Level of evidence IV.

The double disadvantage hypothesis predicts that adults who hold more than one disadvantaged status may experience worse health than their singly disadvantaged and privileged counterparts. Research that has tested this thesis has yielded mixed findings due partly to a failure to examine the role of discrimination. This article uses data from the National Survey of Midlife Development in the United States (N = 2,647) to investigate the relationship between multiple disadvantaged statuses and health, and whether multiple forms of interpersonal discrimination contribute to this association. The results suggest that multiply disadvantaged adults are more likely to experience major depression, poor physical health, and functional limitations than their singly disadvantaged and privileged counterparts. Further, multiple forms of discrimination partially mediate the relationship between multiple stigmatized statuses and health. Taken together, these findings suggest that multiply disadvantaged adults do face a \"double disadvantage\" in health, in part, because of their disproportionate exposure to discrimination.

In this paper, a fresh multi-attribute decision-making (MADM) method is proposed for group-oriented decision analysis. For group-oriented multi-attribute decision-making (GOMADM) problems, this paper proposes local advantage–disadvantage degrees and advantage–disadvantage degrees from the perspective of a strict attribute containing relation between group members and other group members, and studies the related properties. Based on the above two degrees, a new GOMADM method is designed, and this method is locally optimized according to the related properties. Finally, an example is used to analyze the rationality of the GOMADM method, and their ranking results are comparatively analyzed and discussed.