Parenting perceptions of low-income mothers.

Science.gov (United States)

Webb, Jenny; Morris, Melanie Hall; Thomas, Sandra P; Combs-Orme, Terri

2015-01-01

The purpose of this descriptive qualitative study was to gain understanding of perceptions of low-income pregnant women and mothers about parenting. Participants were 65 low-income, primarily African American, women in their 20s and 30s who were recruited from a faith-based social service center in Memphis, Tennessee. Interviews were conducted by nursing, social work, and psychology students. The existential phenomenological method was used to analyze verbatim responses of participants to vignettes depicting parenting behaviors of hypothetical mothers. Five global themes were identified: (a) Focus on baby's development: "Because I'm the Mother, I'm the First Teacher"; (b) Focus on baby's safety/security: "The Baby Could Be Hurt"; (c) Focus on conveying love: "She Just Wants the Baby to Feel Her Love"; (d) Focus on learning the rules of good childcare: "It's Important to Know the Do's and Don'ts"; and (e) Focus on doing it differently (better) than parents did: "When You Know Better, You Do Better." Findings suggest that these mothers care deeply about providing a better life for their children than the life they have had. They desire to learn about being the best parents they can be. As nurses, we can help to provide educational opportunities for mothers through a variety of evidence-based interventions delivered across the childbearing years.

Air Quality, Energy Budget, and Offset Policy in South Africa's Low-Income Settlements

Science.gov (United States)

Hersey, S. P.; Piketh, S.; Burger, R.

2014-12-01

Urban and exurban residential populations in South Africa reside primarily in low-income settlements, including many townships remaining from Apartheid. Over 3 million free government homes have been built in the last 20 years, but the number of people living in informal settlements is the same as at the end of Apartheid in 1994 - a consequence of rapid urbanization. Despite availability of electricity to the vast majority of South Africans, ~80% of electrified homes in low-income areas also burn coal and/or wood as supplementary fuels for cooking and heating. These domestic burning activities represent 70-85% of total PM10mass during winter in South Africa's low-income settlements. Here we analyze data from observations of human-atmosphere systems in: 1) 19 ground monitoring sites in Gauteng Province (Johannesburg and Pretoria), and 2) an intensive sampling campaign in a township in Mpumalanga Province (Industrial Highveld). From ground monitoring, we quantitatively describe seasonal and diurnal trends in PM10 and PM2.5 typical in low-income settlements as compared with industrial and developed suburban areas, and demonstrate the impact of low-income settlements on regional air quality. We also explore the implications of economic development in townships (increased household income, expanded commercialization and widespread electricity usage) on local and regional air quality. Data from the intensive township sampling study provides a seasonal energy budget for domestic burning in low-income settlements and suggests that indoor and ambient air quality are independent systems requiring unique interventions. We conclude with a preview of innovative strategies being developed by industry, government, and academic stakeholders for a not-like-for-like emissions offset policy in South Africa, focused on investments directly into low-income settlements that are aimed at reducing PM exposure.

The effects of eliminating supplemental security income drug addiction and alcoholism eligibility on the mental health of low-income substance abusers.

Science.gov (United States)

Hogan, Sean R; Speiglman, Richard; Norris, Jean C

2010-09-01

On January 1, 1997, as the result of federal legislation, many low-income substance abusers lost income and healthcare benefits provided by the Supplemental Security Income (SSI) program. This study examined the effects of eliminating drug addiction and alcoholism (DAA) as qualifying impairments for SSI benefits on the mental health and mental health treatment utilization of former beneficiaries 3.5 years following the policy change. Study participants in four Northern California counties were categorized into three comparison groups based on their primary income source over the lifetime of the study. Findings indicated that overall the reported mental health status of former SSI DAA beneficiaries improved following the policy change; however, study participants who relied primarily on some other type of public assistance post-termination reported an increase in mental health treatment utilization.

Occupational Mobility of Low Income Workers.

Science.gov (United States)

Slifman, Lawrence

This dissertation is primarily concerned with assessing the impact of changes in the aggregate labor supply-demand balance on the upward occupational mobility of lower income workers. The empirical analysis indicates that the size of inter-occupational flows is cyclically sensitive, given relative wages. As the labor market tightens, the…

75 FR 80364 - Sample Income Data To Meet the Low-Income Definition

Science.gov (United States)

2010-12-22

... 701 RIN 3133-AD76 Sample Income Data To Meet the Low-Income Definition AGENCY: National Credit Union... (FCUs) that do not qualify for a low-income designation using the geo-coding software the NCUA has developed for that purpose to submit an analysis of a statistically valid sample of their member income data...

Predicting Infant Maltreatment in Low-Income Families: The Interactive Effects of Maternal Attributions and Child Status at Birth

Science.gov (United States)

Bugental, Daphne Blunt; Happaney, Keith

2004-01-01

Maternal attributions and child neonatal status at birth were assessed as predictors of infant maltreatment (harsh parenting and safety neglect). The population included low-income, low-education families who were primarily Hispanic. Child maltreatment during the 1st year of life (N = 73) was predicted by neonatal status (low Apgar scores, preterm…

Are College Faculty and First-Generation, Low-Income Students Ready for Each Other?

Science.gov (United States)

Schademan, Alfred R.; Thompson, Maris R.

2016-01-01

Utilizing current research on college readiness as well as the role of cultural agents as a conceptual framework, this qualitative study investigates student and faculty beliefs about readiness and the pedagogical practices that allow instructors to effectively serve as cultural agents for first-generation, low-income students. Three major…

Wanting better: a qualitative study of low-income parents about their children's oral health.

Science.gov (United States)

Lewis, Charlotte W; Linsenmayer, Kristi A; Williams, Alexis

2010-01-01

Using qualitative methods, the purpose of this study was to understand low-income parents' experiences and how these influenced their oral health-related behavior toward their children. Twenty-eight parents were recruited from 7 sites that serve low-income families. Interviews, which were audiotaped and transcribed, were comprised of mostly open-ended questions. Transcripts were analyzed for common themes. Parents' experiences influenced their oral health-related beliefs, intentions, and behaviors. Finding dentists who accept Medicaid was the greatest barrier to realizing intended preventive dental care. Physicians appeared to have relatively little impact on these families' oral health care, even though parents believed that oral health is part of overall health care. WIC (the Supplemental Nutrition Program for Women, Infants and Children) played an important role in facilitating oral health knowledge and access to dental care. Most low-income parents had received little attention to their own oral health, yet wanted better for their children. This motivated the high value placed on their children's preventive oral health. Parents faced challenges finding dental care for their children. Difficulty finding a regular source of dental care for low-income adults, however, was nearly universal. The authors identified strategies, which emerged from their interviews, to improve the oral health knowledge and dental care access for these low-income families.

The Role of Educational Aspirations and Expectations in the Discontinuity of Intergenerational Low-Income Status

Science.gov (United States)

Lee, Jungeun Olivia; Hill,, Karl G.; Hawkins, J. David

2012-01-01

This study investigated one potential mechanism mediating continuity and discontinuity in low-income status across generations: children's educational aspirations and expectations. Data were drawn from a community sample of 808 participants who were followed from age 10 to 30. Four trajectory groups of children's educational aspirations and expectations were identified from ages 10 to 18 (grades five through 12): “stable-high” group, “stable-low” group, “increaser” group, and “decreaser” group. Among participants from low-income families, those in the stable-high group and the increaser group were equally likely to graduate from high school. High school graduation was positively associated with level of total household income at age 30. Findings suggest that social work efforts that support the development of high educational aspirations and expectations in children might serve to reduce the intergenerational continuity of low-income status. PMID:24385713

76 FR 36976 - Sample Income Data To Meet the Low-Income Definition

Science.gov (United States)

2011-06-24

... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 701 RIN 3133-AD76 Sample Income Data To Meet the Low-Income Definition AGENCY: National Credit Union Administration (NCUA). ACTION: Final rule. SUMMARY... low-income designation using the geo-coding software the agency has developed for that purpose to...

HUD Low and Moderate Income Areas

Data.gov (United States)

Department of Housing and Urban Development — This dataset and map service provides information on the U.S. Housing and Urban Development's (HUD) low to moderate income areas. The term Low to Moderate Income,...

Increasing fresh fruit and vegetable availability in a low-income neighborhood convenience store: a pilot study.

Science.gov (United States)

Jetter, Karen M; Cassady, Diana L

2010-09-01

Changing the food environment in low-income communities may be an effective way to increase the consumption of fruits and vegetables by low-income consumers. This study examines the impacts of a pilot study that increases the availability of fresh produce in a convenience store in a low-income neighborhood not served by a supermarket. Two hypotheses based on theories of technology adoption are tested regarding the lack of fresh produce in low-income neighborhood stores: the first is that high fixed costs present a barrier for store owners in developing produce sections; the second is that there is insufficient consumer demand to cover the variable costs of a fresh produce section. The impacts of changing the food environment on store owners and the consumer response to environmental change are measured through weekly inventories of fresh produce. The results show that fixed costs are one barrier for store owners and that although the consumer response is sufficient to cover the direct costs of operating the produce case, it is not enough to cover variable management costs. Consequently, alternative management paradigms or venues may offer a better method to meet the demand for fresh produce by low-income consumers to promote better health through healthier diets in low-income communities.

Supporting and including children from low income families

OpenAIRE

Benoist, FD

2017-01-01

This chapter explores: • What we mean by low income and poverty and how poverty is defined • The families living on low income in the UK today and the impact of low income and poverty on children’s well-being, development and learning • Supporting children from low income families • The attainment gap between children from low income backgrounds and their peers • The pupil premium and how schools have used the extra funding to raise attainment • Key aspects of good practice and what schools c...

After-School Multifamily Groups: A Randomized Controlled Trial Involving Low-Income, Urban, Latino Children

Science.gov (United States)

McDonald, Lynn; Moberg, D. Paul; Brown, Roger; Rodriguez-Espiricueta, Ismael; Flores, Nydia I.; Burke, Melissa P.; Coover, Gail

2006-01-01

This randomized controlled trial evaluated a culturally representative parent engagement strategy with Latino parents of elementary school children. Ten urban schools serving low-income children from mixed cultural backgrounds participated in a large study. Classrooms were randomly assigned either either to an after-school, multifamily support…

Financing the response to HIV in low-income and middle-income countries.

Science.gov (United States)

Izazola-Licea, José Antonio; Wiegelmann, Jan; Arán, Christian; Guthrie, Teresa; De Lay, Paul; Avila-Figueroa, Carlos

2009-12-01

To describe levels of national HIV spending and examine programmatic allocations according to the type of epidemic and country income. Cross-sectional analysis of HIV expenditures from 50 low-income and middle-income countries. Sources of information included country reports of domestic spending by programmatic activity and HIV services. These HIV spending categories were cross tabulated by source of financing, stratified by type of HIV epidemic and income level of the country and reported in international dollars (I$). Fifty low-income and middle-income countries spent US $ 2.6 billion (I$ 5.8 billion) on HIV in 2006; 87% of the funding among the 17 low-income countries came from international donors. Average per capita spending was I$ 2.1 and positively correlated with Gross National Income. Per capita spending was I$ 1.5 in 9 countries with low-level HIV epidemics, I$ 1.6 in 27 countries with concentrated HIV epidemics and I$ 9.5 in 14 countries with generalized HIV epidemics. On average, spending on care and treatment represented 50% of AIDS spending across all countries. The treatment-to-prevention spending ratio was 1.5:1, 3:1, and 2:1 in countries with low-level, concentrated and generalized epidemics, respectively. Spending on prevention represented 21% of total AIDS spending. However, expenditures addressing most-at-risk populations represented less than 1% in countries with generalized epidemics and 7% in those with low-level or concentrated epidemics. The most striking finding is the mismatch between the types of HIV epidemics and the allocation of resources. The current global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency. Mapping HIV expenditures provides crucial guidance for reallocation of resources and supports evidence-based decisions. Now more than ever, countries need to know and act on their epidemics and give priority to the most effective programmatic

Legislated changes to federal pension income in Canada will adversely affect low income seniors' health.

Science.gov (United States)

Emery, J C Herbert; Fleisch, Valerie C; McIntyre, Lynn

2013-12-01

This study uses a population health intervention modeling approach to project the impact of recent legislated increases in age eligibility for Canadian federally-funded pension benefits on low income seniors' health, using food insecurity as a health indicator. Food insecurity prevalence and income source were assessed for unattached low income (seniors aged 65-69 years (population weighted n=151,485) using public use data from the Canadian Community Health Survey Cycle 4.1 (2007-2008). Seniors' benefits through federal public pension plans constituted the main source of income for the majority (79.4%) of low income seniors aged 65-69 years, in contrast to low income seniors aged 60-64 years who reported their main income from employment, employment insurance, Workers' Compensation, or welfare. The increase in income provided by federal pension benefits for low income Canadians 65 and over coincided with a pronounced (50%) decrease in food insecurity prevalence (11.6% for seniors ≥65 years versus 22.8% for seniors seniors' benefits in Canada from 65 to 67 years will negatively impact low income seniors' health, relegating those who are food insecure to continued hardship. © 2013.

A review of low income energy assistance measures adopted in other jurisdictions

International Nuclear Information System (INIS)

2008-01-01

Low-income energy assistance programs (LIEPs) have been established and implemented in many jurisdictions to help make electricity and natural gas more affordable. Low-income programs also serve many other public interest goals, such as safeguarding and protecting the public health and welfare of the citizens; augmenting incomes or standards of living for the lowest income energy customers; encouraging conservation and more efficient use of energy resources; reducing customer care costs for utilities; reducing uncollectible accounts and bad debt expense for utilities; and reducing carbon emissions and greenhouse gas levels. This report contained a summary of the policies, programs, and measures that have been implemented, mandated, or allowed by regulators in other jurisdictions to assist low-income energy consumers with electricity and natural gas costs. The report categorized the differing low income policies and programs that have been implemented and examined the effectiveness of those policies and programs as measured by the costs and benefits, as well the level of customer participation. These categories included rate discounts or waivers; modified rate designs; alternative billing methods; customer rebates; conservation and demand side management programs; budget or equal billing; payment plans for past due accounts; waivers of late payment charges; waivers or reductions of customer security deposits; limits on disconnections; and reduced or waived fees for reconnections. The report covered regulatory jurisdictions, including those in Canada, the United States, the United Kingdom, Australia, New Zealand, France, Spain, and Finland. The report also discussed the role of regulators, utilities, charitable organizations, and other interested parties in developing and implementing low-income energy assistance programs that were cost-effective and efficient. It was concluded that, in addition to rate discounts or waivers of the fixed monthly service charge, many

A framework for understanding grocery purchasing in a low-income urban environment.

Science.gov (United States)

Zachary, Drew A; Palmer, Anne M; Beckham, Sarah W; Surkan, Pamela J

2013-05-01

Research demonstrates that food desert environments limit low-income shoppers' ability to purchase healthy foods, thereby increasing their likelihood of diet-related illnesses. We sought to understand how individuals in an urban American food desert make grocery-purchasing decisions, and specifically why unhealthy purchases arise. Analysis is based on ethnographic data from participant observation, 37 in-depth interviews, and three focus groups with low-income, primarily African American shoppers with children. We found participants had detailed knowledge of and preference for healthy foods, but the obligation to consistently provide food for their families required them to apply specific decision criteria which, combined with structural qualities of the supermarket environment, increased unhealthy purchases and decreased healthy purchases. Applying situated cognition theory, we constructed an emic model explaining this widely shared grocery-purchasing decision process and its implications. This context-specific understanding of behavior suggests that multifaceted, system-level approaches to intervention are needed to increase healthy purchasing in food deserts.

The vector of the tobacco epidemic: tobacco industry practices in low and middle-income countries.

Science.gov (United States)

Lee, Sungkyu; Ling, Pamela M; Glantz, Stanton A

2012-03-01

To understand transnational tobacco companies' (TTCs) practices in low and middle-income countries which serve to block tobacco-control policies and promote tobacco use. Systematic review of published research on tobacco industry activities to promote tobacco use and oppose tobacco-control policies in low and middle-income countries. TTCs' strategies used in low and middle-income countries followed four main themes-economic activity; marketing/promotion; political activity; and deceptive/manipulative activity. Economic activity, including foreign investment and smuggling, was used to enter new markets. Political activities included lobbying, offering voluntary self-regulatory codes, and mounting corporate social responsibility campaigns. Deceptive activities included manipulation of science and use of third-party allies to oppose smoke-free policies, delay other tobacco-control policies, and maintain support of policymakers and the public for a pro-tobacco industry policy environment. TTCs used tactics for marketing, advertising, and promoting their brands that were tailored to specific market environments. These activities included direct and indirect tactis, targeting particular populations, and introducing new tobacco products designed to limit marketing restrictions and taxes, maintain the social acceptability of tobacco use, and counter tobacco-control efforts. TTCs have used similar strategies in high-income countries as these being described in low and middle-income countries. As required by FCTC Article 5.3, to counter tobacco industry pressures and to implement effective tobacco-control policies, governments and health professionals in low and middle-income countries should fully understand TTCs practices and counter them.

Availability of healthy snack foods and beverages in stores near high-income urban, low-income urban, and rural elementary and middle schools in Oregon.

Science.gov (United States)

Findholt, Nancy E; Izumi, Betty T; Nguyen, Thuan; Pickus, Hayley; Chen, Zunqiu

2014-08-01

Food stores near schools are an important source of snacks for children. However, few studies have assessed availability of healthy snacks in these settings. The aim of this study was to assess availability of healthy snack foods and beverages in stores near schools and examine how availability of healthy items varied by poverty level of the school and rural-urban location. Food stores were selected based on their proximity to elementary/middle schools in three categories: high-income urban, low-income urban, and rural. Audits were conducted within the stores to assess the presence or absence of 48 items in single-serving sizes, including healthy beverages, healthy snacks, fresh fruits, and fresh vegetables. Overall, availability of healthy snack foods and beverages was low in all stores. However, there was significant cross-site variability in availability of several snack and fruit items, with stores near high-income urban schools having higher availability, compared to stores near low-income urban and/or rural schools. Stores near rural schools generally had the lowest availability, although several fruits were found more often in rural stores than in urban stores. There were no significant differences in availability of healthy beverages and fresh vegetables across sites. Availability of healthy snack foods and beverages was limited in stores near schools, but these limitations were more severe in stores proximal to rural and low-income schools. Given that children frequent these stores to purchase snacks, efforts to increase the availability of healthy products, especially in stores near rural and low-income schools, should be a priority.

Designing Low-Income Housing Using Local Architectural Concepts

Science.gov (United States)

Trumansyahjaya, K.; Tatura, L. S.

2018-02-01

The provision of houses for low-income people who do not have a home worthy of being one of the major problems in the city of Gorontalo, because the community in establishing the house only pay attention to their wants and needs in creating a healthy environment, the beauty of the city and the planning of the home environment in accordance with the culture of the people of Gorontalo. In relation to the condition, the focus of this research is the design of housing based on local architecture as residential house so that it can be reached by a group of low income people with house and environment form determined based on family development, social and economic development of society and environment which take into account the local culture. Stages of this research includes five (5) stages, including the identification phase characteristics Gorontalo people of low income, the characteristics of the identification phase house inhabited by low-income people, the stage of identification preference low-income households, the phase formation house prototype and the environment, as well as the stage of formation model home for low-income people. Analysis of the model homes for low-income people using descriptive analysis, Hierarchical Cluster Analysis, and discrimination analysis to produce a prototype of the house and its surroundings. The prototype is then reanalyzed to obtain the model home for low-income people in the city of Gorontalo. The shape of a model home can be used as a reference for developers of housing intended for low-income people so that housing is provided to achieve the goals and the desired target group.

Gender Differences in Caregiver Emotion Socialization of Low-Income Toddlers

Science.gov (United States)

Chaplin, Tara M.; Casey, James; Sinha, Rajita; Mayes, Linda C.

2010-01-01

Low-income children are at elevated risk for emotion-related problems; however, little research has examined gender and emotion socialization in low-income families. The authors describe the ways in which emotion socialization may differ for low-income versus middle-income families. They also present empirical data on low-income caregivers'…

An Exploratory Mixed Method Assessment of Low Income, Pregnant Hispanic Women's Understanding of Gestational Diabetes and Dietary Change

Science.gov (United States)

Rhoads-Baeza, Maria Elena; Reis, Janet

2012-01-01

Objective: To describe and assess low income, healthy, pregnant Hispanic women's understanding of gestational diabetes (GDM) and willingness to change aspects of their diet. Design: One-on-one, in-person interviews conducted in Spanish with 94 women (primarily Mexican). Setting: Federal Qualified Community Health Center's prenatal clinic. Method:…

Resource handbook for low-income residential retrofits

Energy Technology Data Exchange (ETDEWEB)

Callaway, J.W.; Brenchley, D.L.; Davis, L.J.; Ivey, D.L.; Smith, S.A.; Westergard, E.J.

1987-04-01

The purpose of the handbook is to provide technical assistance to state grantees participating in the Partnerships in Low-Income Residential Retrofit (PILIRR) Program. PILIRR is a demonstration program aimed at identifying innovative, successful approaches to developing public and private support for weatherization of low-income households. The program reflects the basic concept that responsibility for financial support for conservation activities such as low-income residential retrofitting is likely to gradually shift from the DOE to the states and the private sector. In preparing the handbook, PNL staff surveyed over 50 programs that provide assistance to low-income residents. The survey provided information on factors that contribute to successful programs. PNL also studied the winning PILIRR proposals (from the states of Florida, Iowa, Kentucky, Oklahoma and Washington) and identified the approaches proposed and the type of information that would be most helpful in implementing these approaches.

Pediatric clinical drug trials in low-income countries: key ethical issues.

Science.gov (United States)

MacLeod, S M; Knoppert, D C; Stanton-Jean, M; Avard, D

2015-02-01

Potential child participants in clinical research trials in low-income countries are often vulnerable because of poverty, high morbidity and mortality, inadequate education, and varied local cultural norms. However, vulnerability by itself must not be accepted as an obstacle blocking children from the health benefits that may accrue as an outcome of sound clinical research. As greater emphasis is placed on evidence-based treatment of children, it should be anticipated that there will be a growing call for agreement on principles to guide clinical investigations in low-income countries. There is now general acceptance of the view that children must be protected from non-evidence-based interventions and from substandard treatments. The questions remaining relate to how best to stimulate clinical research activity that will serve the needs of infants, children, and youth in developing countries and how best to assign priority to ethically sound research that will meet their clinical requirements. In low-income countries, 39 % of citizens are 13 years of age or younger, and consequently it is certain that clinical investigations of some new therapeutic products will be conducted there more frequently. This review offers some suggestions for approaches that will help to achieve more effective ethical consideration, including (1) improving the quality of research ethics boards; (2) fostering collaborative partnerships among important stakeholders; (3) making concerted efforts to build capacity; (4) improving the quality of the consent and waiver process; and (5) developing improved governance for harmonized ethics platforms. Continuing support by international organizations is required to sustain the establishment and maintenance of stronger research ethics boards to protect children enrolled in clinical trials. This review underscores the importance of developing a culture of solidarity and true partnership between developed and low-income country organizations, which

Chemical exposures in recently renovated low-income housing: Influence of building materials and occupant activities.

Science.gov (United States)

Dodson, Robin E; Udesky, Julia O; Colton, Meryl D; McCauley, Martha; Camann, David E; Yau, Alice Y; Adamkiewicz, Gary; Rudel, Ruthann A

2017-12-01

Health disparities in low-income communities may be linked to residential exposures to chemicals infiltrating from the outdoors and characteristics of and sources in the home. Indoor sources comprise those introduced by the occupant as well as releases from building materials. To examine the impact of renovation on indoor pollutants levels and to classify chemicals by predominant indoor sources, we collected indoor air and surface wipes from newly renovated "green" low-income housing units in Boston before and after occupancy. We targeted nearly 100 semivolatile organic compounds (SVOCs) and volatile organic compounds (VOCs), including phthalates, flame retardants, fragrance chemicals, pesticides, antimicrobials, petroleum chemicals, chlorinated solvents, and formaldehyde, as well as particulate matter. All homes had indoor air concentrations that exceeded available risk-based screening levels for at least one chemical. We categorized chemicals as primarily influenced by the occupant or as having building-related sources. While building-related chemicals observed in this study may be specific to the particular housing development, occupant-related findings might be generalizable to similar communities. Among 58 detected chemicals, we distinguished 25 as primarily occupant-related, including fragrance chemicals 6-acetyl-1,1,2,4,4,7-hexamethyltetralin (AHTN) and 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta[g]-2-benzopyran (HHCB). The pre- to post-occupancy patterns of the remaining chemicals suggested important contributions from building materials for some, including dibutyl phthalate and xylene, whereas others, such as diethyl phthalate and formaldehyde, appeared to have both building and occupant sources. Chemical classification by source informs multi-level exposure reduction strategies in low-income housing. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

42 CFR 457.310 - Targeted low-income child.

Science.gov (United States)

2010-10-01

... family income at or below 200 percent of the Federal poverty line for a family of the size involved; (ii... 42 Public Health 4 2010-10-01 2010-10-01 false Targeted low-income child. 457.310 Section 457.310... Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

42 CFR 435.229 - Optional targeted low-income children.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 435.229... Coverage of Families and Children § 435.229 Optional targeted low-income children. The agency may provide Medicaid to— (a) All individuals under age 19 who are optional targeted low-income children as defined in...

Coping with low incomes and cold homes

International Nuclear Information System (INIS)

Anderson, Will; White, Vicki; Finney, Andrea

2012-01-01

This paper presents findings from a study of low-income households in Great Britain which explored households’ strategies for coping both with limited financial resources in the winter months, when demand for domestic energy increases, and, in some cases, with cold homes. The study combined a national survey of 699 households with an income below 60 per cent of national median income with in-depth interviews with a subsample of 50 households. The primary strategy adopted by low-income households to cope with financial constraint was to reduce spending, including spending on essentials such as food and fuel, and thereby keep up with core financial commitments. While spending on food was usually reduced by cutting the range and quality of food purchased, spending on energy was usually reduced by cutting consumption. Sixty-three per cent of low-income households had cut their energy consumption in the previous winter and 47 per cent had experienced cold homes. Improvements to the thermal performance of homes reduced but did not eliminate the risk of going cold as any heating cost could be a burden to households on the lowest incomes. Householders’ attitudes were central to their coping strategies, with most expressing a determination to ‘get by’ come what may.

Indexation of psychiatric journals from low- and middle-income countries: a survey and a case study

Science.gov (United States)

KIELING, CHRISTIAN; HERRMAN, HELEN; PATEL, VIKRAM; MARI, JAIR DE JESUS

2009-01-01

There is a marked underepresentation of low- and middle-income countries (LAMIC) in the psychiatric literature, which may reflect an overall low representation of LAMIC publications in databases of indexed journals. This paper investigates the worldwide distribution of indexed psychiatric journals. A survey in both Medline and ISI Web of Science was performed in order to identify journals in the field of psychiatry according to their country of origin. Two hundred and twenty-two indexed psychiatric journals were found. Of these, 213 originated from high-income countries and only nine (4.1%) from middle-income countries. None were found in low-income countries. We also present the experience of a LAMIC psychiatric journal, the Revista Brasileira de Psiquiatria, in its recent indexation process. This case study may serve as an example for other LAMIC journals to pursue indexation in major databases as a strategy to widen the international foundation of psychiatric research. There is an important need for the inclusion of LAMIC psychiatric publications in the major indexation databases. This process will require multiple agents to partner with journals from LAMIC to improve their quality and strengthen their chances of being indexed. PMID:19293959

Effects of low income on infant health.

Science.gov (United States)

Séguin, Louise; Xu, Qian; Potvin, Louise; Zunzunegui, Maria-Victoria; Frohlich, Katherine L

2003-06-10

Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health. We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status. Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not

Low-Income US Women Under-informed of the Specific Health Benefits of Consuming Beans.

Science.gov (United States)

Winham, Donna M; Armstrong Florian, Traci L; Thompson, Sharon V

2016-01-01

Bean consumption can reduce chronic disease risk and improve nutrition status. Consumer knowledge of bean health benefits could lead to increased intakes. Low-income women have poorer health and nutrition, but their level of knowledge about bean health benefits is unknown. Beans are a familiar food of reasonable cost in most settings and are cultural staples for Hispanics and other ethnicities. Study objectives were to assess awareness of bean health benefits among low-income women, and to evaluate any differences by acculturation status for Hispanic women in the Southwestern United States. A convenience sample of 406 primarily Mexican-origin (70%) low-income women completed a survey on knowledge of bean health benefits and general food behaviors. Principal components analysis of responses identified two summary scale constructs representing "bean health benefits" and "food behaviors." Acculturation level was the main independent variable in chi-square or ANOVA. The survey completion rate was 86% (406/471). Most women agreed or strongly agreed that beans improved nutrition (65%) and were satiating (62%). Over 50% answered 'neutral' to statements that beans could lower LDL cholesterol (52%), control blood glucose (56%) or reduce cancer risk (56%), indicating indifference or possible lack of knowledge about bean health benefits. There were significant differences by acculturation for beliefs that beans aid weight loss and intestinal health. Scores on the bean health benefits scale, but not the food behavior scale, also differed by acculturation. Limited resource women have a favorable view of the nutrition value of beans, but the majority did not agree or disagreed with statements about bean health benefits. Greater efforts to educate low-income women about bean health benefits may increase consumption and improve nutrition.

Utilizing a diabetic registry to manage diabetes in a low-income Asian American population.

Science.gov (United States)

Seto, Winnie; Turner, Barbara S; Champagne, Mary T; Liu, Lynn

2012-08-01

Racial and income disparities persist in diabetes management in America. One third of African and Hispanic Americans with diabetes receive the recommended diabetes services (hemoglobin A1c [A1c] testing, retinal and foot examinations) shown to reduce diabetes complications and mortality, compared to half of whites with diabetes. National data for Asian Americans are limited, but studies suggest that those with language and cultural barriers have difficulty accessing health services. A diabetic registry has been shown to improve process and clinical outcomes in a population with diabetes. This study examined whether a community center that serves primarily low-income Asian American immigrants in Santa Clara County, California, could improve diabetes care and outcomes by implementing a diabetic registry. The registry was built using the Access 2007 software program. A total of 580 patients with diabetes were identified by reviewing charts, the appointment database, and reimbursement records from Medicaid, Medicare, and private insurance companies. Utilizing the registry, medical assistants contacted patients for follow-up appointments, and medical providers checked and tracked the patients' A1c results. Among the 431 patients who returned for treatment, the mean A1c was reduced from 7.27% to 6.97% over 8 months (P<0.001). Although 10.8% of the patients changed from controlled to uncontrolled diabetes post intervention, 32.6% of patients with uncontrolled diabetes converted to controlled diabetes (P<0.001). The diabetes control rate improved from 47% to 59% at the end of the study. This study demonstrated that a diabetic registry is an effective tool to manage an underserved population with diabetes, thereby reducing disparities in diabetes management.

Management of severe acute malnutrition in low-income and middle-income countries

Science.gov (United States)

Kwashiorkor and marasmus, collectively termed severe acute malnutrition (SAM), account for at least 10% of all deaths among children under 5 years of age worldwide, virtually all of them in low-income and middle-income countries. A number of risk factors, including seasonal food insecurity, environm...

45 CFR 2551.43 - What income guidelines govern eligibility to serve as a stipended Senior Companion?

Science.gov (United States)

2010-10-01

... guideline for each State is 200 percent of the poverty line, as set forth in 42 U.S.C. 9902 (2). (b) For... percent of the poverty line shall be given special consideration for enrollment. (e) Once enrolled, a... 45 Public Welfare 4 2010-10-01 2010-10-01 false What income guidelines govern eligibility to serve...

45 CFR 2552.43 - What income guidelines govern eligibility to serve as a stipended Foster Grandparent?

Science.gov (United States)

2010-10-01

... guideline for each State is 200 percent of the poverty line, as set forth in 42 U.S.C. 9902 (2). (b) For... percent of the poverty line shall be given special consideration for enrollment. (e) Once enrolled, a... 45 Public Welfare 4 2010-10-01 2010-10-01 false What income guidelines govern eligibility to serve...

Siblings, Language, and False Belief in Low-Income Children

Science.gov (United States)

Tompkins, Virginia; Farrar, M. Jeffrey; Guo, Ying

2013-01-01

The authors examined the relationship between number of siblings and false belief understanding (FBU) in 94 low-income 4-5-year-olds. Previous research with middle-income children has shown a positive association between number of siblings and FBU. However, it is unclear whether having multiple siblings in low-income families is related to better…

The Use of Refundable Tax Credits to Increase Low-Income Children's After-School Physical Activity Level.

Science.gov (United States)

Dunton, Genevieve; Ebin, Vicki J; Efrat, Merav W; Efrat, Rafael; Lane, Christianne J; Plunkett, Scott

2015-06-01

The current study investigates the extent to which a refundable tax credit could be used to increase low-income children's after-school physical activity levels. An experimental study was conducted evaluating the effectiveness of an intervention offering a simulated refundable tax credit to parents of elementary-school-age children (n = 130) for enrollment in after-school physical activity programs. A randomized controlled design was used, with data collected at baseline, immediately following the 4-month intervention (postintervention), and 6 weeks after the end of the intervention (follow-up). Evaluation measures included (1) enrollment rate, time spent, weekly participation frequency, duration of enrollment, and long-term enrollment patterns in after-school physical activity programs and (2) moderate to vigorous physical activity. The simulated tax credits did not significantly influence low-income children's rates of enrollment in after-school physical activity programs, frequency of participation, time spent in after-school physical activity programs, and overall moderate-to-vigorous intensity physical activity at postintervention or follow-up. The use of refundable tax credits as incentives to increase participation in after-school physical activity programs in low-income families may have limited effectiveness. Lawmakers might consider other methods of fiscal policy to promote physical activity such as direct payment to after-school physical activity program providers for enrolling and serving a low-income child in a qualified program, or improvements to programming and infrastructure.

Faculty as Institutional Agents for Low-Income Latino Students in Science, Technology, Engineering, and Mathematics Fields at a Hispanic-Serving Institution

Science.gov (United States)

Santiago, Cecilia

2012-01-01

Despite the exponential growth of Latinos during the past decade and an increase in higher education participation, there continues to be a gap in degree attainment compared to other ethnic and racial groups in this country. This gap is even greater for low-income Latino students seeking a degree in STEM fields. A proposed solution for this gap…

Benefits Access for College Completion: Lessons Learned from a Community College Initiative to Help Low-Income Students

Science.gov (United States)

Duke-Benfield, Amy Ellen; Saunders, Katherine

2016-01-01

This report analyzes how students were served by Benefits Access for College Completion (BACC), a 2.5-year initiative designed to increase access to public benefits (such as SNAP or Medicaid) for eligible low-income students. These crucial supports reduce students' unmet financial needs and help them finish school. Launched in 2011, BACC funded…

Energy-microfinance intervention for low income households in India

Science.gov (United States)

Rao, P. Sharath Chandra

In India, limited energy access and energy inequity hamper the lives of low income households. Traditional fuels such as firewood and dung cake account for 84 percent and 32 percent of the rural and urban household cooking energy (NSSO, 2007). With 412 million people without access to electricity in 2005, India hosts the world's largest such population (IEA, 2007). But, low income households still spend 9 - 11.7 percent1 of their incomes on inefficient forms of energy while wealthy households spend less than 5 percent on better energy products (Saghir, 2005). Renewable energy technologies coupled with innovative financial products can address the energy access problem facing the low income households in India (MacLean & Siegel, 2007; REEEP, 2009). Nevertheless, the low income households continue to face low access to mainstream finance for purchasing renewable energy technology at terms that meet their monthly energy related expenditure (ESMAP, 2004a; SEEP, 2008a) and low or no access to energy services (Ailawadi & Bhattacharyya, 2006; Modi et. al., 2006). The lack of energy-finance options has left the marginalized population with little means to break the dependence on traditional fuels. This dissertation proposes an energy microfinance intervention to address the present situation. It designed a loan product dedicated to the purchase of renewable energy technologies while taking into account the low and irregular cash flows of the low income households. The arguments presented in this dissertation are based on a six-month pilot project using this product designed and developed by the author in conjunction with a microfinance institution and its low income clients and Energy Service Companies in the state of Karnataka. Finding the right stakeholders and establishing a joint agreement, obtaining grant money for conducting the technology dissemination workshops and forming a clear procedure for commissioning the project, are the key lessons learnt from this study

Concept of innovation in low-income market

Directory of Open Access Journals (Sweden)

Vitor Koki da Costa Nogami

2018-01-01

Full Text Available Purpose – Investigate the concept and the adoption of innovation in the low-income market. Design/methodology/approach – Four different studies were conducted. First, a Delphi study with 126 Marketing and Innovation professors from graduate programs. Second, interviews with 13 professionals, technical assistance professionals and retail managers. Third, two focus groups with low-income consumers. Fourth, survey with 390 respondents. Findings – The results indicate that innovations in the low-income markets are mainly characterized by adaptations and adjustments in products, with emphasis on incremental innovations, not radical. In addition, the adoption of innovation in this context is characterized as late, not initial. Originality/value – In terms of theoretical contributions, the present study reveals how the concept of innovation is built in the low-income market. From a perspective collectively constructed with information from different market agents (industry, retail and consumers, research findings become robust to understanding a phenomenon. Moreover, in addition to different market agents, different methods of data collection and analysis were also used, further enriching the results. This collective contribution, based theoretically on a literature of social construction, interviewing different market agents and using different methodological approaches, synergistically potentiated the development of this paper

A comparative analysis of avoidable causes of childhood blindness in Malaysia with low income, middle income and high income countries.

Science.gov (United States)

Koay, C L; Patel, D K; Tajunisah, I; Subrayan, V; Lansingh, V C

2015-04-01

To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

Pesticide Poisonings in Low- and Middle-Income Countries

DEFF Research Database (Denmark)

Jørs, Erik; Neupane, Dinesh; London, Leslie

2018-01-01

Aims and scope This editorial is an introduction to the papers making up the special issue on 'pesticide poisonings in low- and middle income countries'.......Aims and scope This editorial is an introduction to the papers making up the special issue on 'pesticide poisonings in low- and middle income countries'....

Low-Income US Women Under-informed of the Specific Health Benefits of Consuming Beans.

Directory of Open Access Journals (Sweden)

Donna M Winham

Full Text Available Bean consumption can reduce chronic disease risk and improve nutrition status. Consumer knowledge of bean health benefits could lead to increased intakes. Low-income women have poorer health and nutrition, but their level of knowledge about bean health benefits is unknown. Beans are a familiar food of reasonable cost in most settings and are cultural staples for Hispanics and other ethnicities. Study objectives were to assess awareness of bean health benefits among low-income women, and to evaluate any differences by acculturation status for Hispanic women in the Southwestern United States.A convenience sample of 406 primarily Mexican-origin (70% low-income women completed a survey on knowledge of bean health benefits and general food behaviors. Principal components analysis of responses identified two summary scale constructs representing "bean health benefits" and "food behaviors." Acculturation level was the main independent variable in chi-square or ANOVA.The survey completion rate was 86% (406/471. Most women agreed or strongly agreed that beans improved nutrition (65% and were satiating (62%. Over 50% answered 'neutral' to statements that beans could lower LDL cholesterol (52%, control blood glucose (56% or reduce cancer risk (56%, indicating indifference or possible lack of knowledge about bean health benefits. There were significant differences by acculturation for beliefs that beans aid weight loss and intestinal health. Scores on the bean health benefits scale, but not the food behavior scale, also differed by acculturation.Limited resource women have a favorable view of the nutrition value of beans, but the majority did not agree or disagreed with statements about bean health benefits. Greater efforts to educate low-income women about bean health benefits may increase consumption and improve nutrition.

The relationship between diet and perceived and objective access to supermarkets among low-income housing residents

Science.gov (United States)

Caspi, Caitlin E.; Kawachi, Ichiro; Subramanian, S.V.; Adamkiewicz, Gary; Sorensen, Glorian

2013-01-01

In the U.S., supermarkets serve as an important source of year-round produce (Chung & Myers, 1999), and yet access to supermarkets may be scarce in “food deserts,” or poor, urban areas that lack sources of healthy, affordable food (Cummins & Macintyre, 2002). This study examined objective distance to the nearest supermarket and participant-report of supermarket access in relation to fruit and vegetable intake. Street-network distance to the closest supermarket was calculated using GIS mapping. Perceived access was assessed by a survey question asking whether participants had a supermarket within walking distance of home. Cross-sectional survey data were collected from 828 low-income housing residents in three urban areas in greater-Boston. Generalized estimating equations were used to estimate the association between perceived and objective supermarket access and diet. Fruit and vegetable consumption was low (2.63 servings/day). Results suggest that most low-income housing residents in greater-Boston do not live in “food deserts,” as the average distance to a supermarket was 0.76 km (range 0.13–1.22 km). Distance to a supermarket was not associated with fruit and vegetable intake (p = 0.22). Perceived supermarket access was strongly associated with increased fruit and vegetable intake (0.5 servings/day) after controlling for socio-demographic covariates (p supermarket within walking distance from home despite the objective presence of a supermarket within 1 km consumed significantly fewer fruits and vegetables (0.56 servings/day) than those with a supermarket who reported one, even after controlling for socio-demographic variables (p = 0.0008). Perceived measures of the food environment may be more strongly related to dietary behaviors than objective ones, and may incorporate components of food access not captured in objective measures. PMID:22727742

Low-Income Community Solar: Utility Return Considerations for Electric Cooperatives

Energy Technology Data Exchange (ETDEWEB)

Aznar, Alexandra Y [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gagne, Douglas A [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-04-05

The objective of this short report is to identify project structures that make low-income community solar projects more cost-effective, replicable, and scalable, for electric cooperative and municipal utilities. This report explores the tradeoffs between providing energy bill savings for low-income subscribers and utility project returns, as well as some of the key lessons learned from existing successful low-income community solar pilot projects.

24 CFR 1000.142 - What is the “useful life” during which low-income rental housing and low-income homebuyer housing...

Science.gov (United States)

2010-04-01

... Activities § 1000.142 What is the “useful life” during which low-income rental housing and low-income... recipient shall describe in its IHP its determination of the useful life of each assisted housing unit in... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is the âuseful lifeâ during...

Outcome of a Food Observational Study among Low-Income Preschool Children Participating in a Family-Style Meal Setting

Science.gov (United States)

Treviño, Roberto P.; Vasquez, Liset; Shaw-Ridley, Mary; Mosley, Desiree; Jechow, Katherine; Piña, Christina

2015-01-01

Introduction: In the United States, one out of every seven low-income children between the ages of 2 and 5 years is at risk for overweight and obesity. Formative research was conducted to determine if preschool children participating in family-style meals consumed the minimum food servings according to U.S. Department of Agriculture dietary…

Portion size effects on daily energy intake in low-income Hispanic and African American children and their mothers.

Science.gov (United States)

Fisher, Jennifer O; Arreola, Angeles; Birch, Leann L; Rolls, Barbara J

2007-12-01

Portion size influences children's energy intakes at meals, but effects on daily intake are unknown. Effects of large portions on daily energy intake were tested in 5-y-old Hispanic and African American children from low-income families. Maternal food intake data were collected to evaluate familial susceptibility to portion size. A within-subjects experimental design with reference and large portion sizes was used in a study of 59 low-income Hispanic and African American preschool-aged children and their mothers. The portion size of 3 entrées (lunch, dinner, and breakfast) and an afternoon snack served during a 24-h period were of a reference size in one condition and doubled in the other condition. Portion sizes of other foods and beverages did not vary across conditions. Weighed food intake, anthropometric measures, and self-reported data were obtained. Doubling the portion size of several entrées and a snack served during a 24-h period increased energy intake from those foods by 23% (180 kcal) among children (P kcal) among mothers (P daily intakes among Hispanic and African American children.

A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries.

Science.gov (United States)

Adebayo, Esther F; Uthman, Olalekan A; Wiysonge, Charles S; Stern, Erin A; Lamont, Kim T; Ataguba, John E

2015-12-08

Low-income and middle-income countries (LMICs) have difficulties achieving universal financial protection, which is primordial for universal health coverage. A promising avenue to provide universal financial protection for the informal sector and the rural populace is community-based health insurance (CBHI). We systematically assessed and synthesised factors associated with CBHI enrolment in LMICs. We searched PubMed, Scopus, ERIC, PsychInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL, Cochrane Library, conference proceedings, and reference lists for eligible studies available by 31 October 2013; regardless of publication status. We included both quantitative and qualitative studies in the review. Both quantitative and qualitative studies demonstrated low levels of income and lack of financial resources as major factors affecting enrolment. Also, poor healthcare quality (including stock-outs of drugs and medical supplies, poor healthcare worker attitudes, and long waiting times) was found to be associated with low CBHI coverage. Trust in both the CBHI scheme and healthcare providers were also found to affect enrolment. Educational attainment (less educated are willing to pay less than highly educated), sex (men are willing to pay more than women), age (younger are willing to pay more than older individuals), and household size (larger households are willing to pay more than households with fewer members) also influenced CBHI enrolment. In LMICs, while CBHI schemes may be helpful in the short term to address the issue of improving the rural population and informal workers' access to health services, they still face challenges. Lack of funds, poor quality of care, and lack of trust are major reasons for low CBHI coverage in LMICs. If CBHI schemes are to serve as a means to providing access to health services, at least in the short term, then attention should be paid to the issues that militate against their success.

The Relations among Maternal Health Status, Parenting Stress, and Child Behavior Problems in Low-Income, Ethnic-Minority Families

Science.gov (United States)

BeLue, Rhonda; Halgunseth, Linda C.; Abiero, Beatrice; Bediako, Phylicia

2015-01-01

Objectives Minimal attention has been given to understanding parenting stress among low-income, ethnically diverse mothers of children with conduct problems. Maternal health and parenting hassles may serve as important risk factors for parenting stress. This study examined whether parenting hassles moderated the relations between maternal physical and mental health and parenting stress in a sample of low-income, ethnically diverse mothers of children with behavioral problems. Methods The sample included 177 low-income Black, Latina, and White mothers of kindergartners with behavior problems. PATH analysis was employed to assess the associations between maternal mental and physical health and parenting stress, as well as the moderating role of parenting hassles in this cross-sectional study. Results After adjusting for covariates, we found that parenting hassles mediates the relationship between social support and parenting stress as well as maternal health and parenting stress. Conclusion Findings suggest that promoting coping resources for daily parenting hassles and supporting the physical and mental health of minority mothers may have important implications for parenting children with high behavior problems. PMID:26863556

42 CFR 436.229 - Optional targeted low-income children.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

Improving Strategies for Low-Income Family Children's Information Literacy

Science.gov (United States)

Zhang, Haiyan; Washington, Rodney; Yin, Jianjun

2014-01-01

This article discussed the significance of improving low-income family children's information literacy, which could improve educational quality, enhance children's self-esteem, adapt children to the future competitive world market, as well as the problems in improving low-income family children's information literacy, such as no home computer and…

Information gathering and technology use among low-income minority men at risk for prostate cancer.

Science.gov (United States)

Song, Hayeon; Cramer, Emily M; McRoy, Susan

2015-05-01

Health communication researchers, public health workers, and health professionals must learn more about the health information-gathering behavior of low-income minority men at risk for prostate cancer in order to share information effectively with the population. In collaboration with the Milwaukee Health Department Men's Health Referral Network, a total of 90 low-income adult men were recruited to complete a survey gauging information sources, seeking behavior, use of technology, as well as prostate cancer awareness and screening behavior. Results indicated participants primarily relied on health professionals, family, and friends for information about general issues of health as well as prostate cancer. The Internet was the least relied on source of information. A hierarchical regression indicated interpersonal information sources such as family or friends to be the only significant predictor enhancing prostate cancer awareness, controlling for other sources of information. Prostate screening behaviors were predicted by reliance on not only medical professionals but also the Internet. Practical implications of the study are discussed. © The Author(s) 2014.

At a Glance: Forty Schools That Serve Low-Income Students

Science.gov (United States)

Independent School, 2016

2016-01-01

This article provides a list of low and no tuition independent schools. Profile information is accurate as of May 2016. Profiles contain student body information, how the school works, the school mission, and contact information. [Online Feature

Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance.

Science.gov (United States)

Slack, Kristen S; Font, Sarah; Maguire-Jack, Kathryn; Berger, Lawrence M

2017-10-11

This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele.

Evaluating consumer preferences for healthy eating from Community Kitchens in low-income urban areas: A discrete choice experiment of Comedores Populares in Peru.

Science.gov (United States)

Buttorff, Christine; Trujillo, Antonio J; Diez-Canseco, Francisco; Bernabe-Ortiz, Antonio; Miranda, J Jaime

2015-09-01

Many low-income individuals from around the world rely on local food vendors for daily sustenance. These small vendors quickly provide convenient, low-priced, tasty foods, however, they may be low in nutritional value. These vendors serve as an opportunity to use established delivery channels to explore the introduction of healthier products, e.g. fresh salad and fruits, to low-income populations. We sought to understand preferences for items prepared in Comedores Populares (CP), government-supported food vendors serving low-income Peruvians, to determine whether it would be feasible to introduce healthier items, specifically fruits and vegetables. We used a best-worst discrete choice experiment (DCE) that allowed participants to select their favorite and least favorite option from a series of three hypothetical menus. The characteristics were derived from a series of formative qualitative interviews conducted previously in the CPs. We examined preferences for six characteristics: price, salad, soup, sides, meat and fruit. A total of 432 individuals, from two districts in Lima, Peru responded to a discrete choice experiment and demographic survey in 2012. For the DCE, price contributed the most to individual's utility relative to the other attributes, with salad and soup following closely. Sides (e.g. rice and beans) were the least important. The willingness to pay for a meal with a large main course and salad was 2.6 Nuevos Soles, roughly a 1 Nuevo Sol increase from the average menu price, or USD $0.32 dollars. The willingness to pay for a meal with fruit was 1.6 Nuevo Soles. Overall, the perceived quality of service and food served in the CPs is high. The willingness to pay indicates that healthier additions to meals are feasible. Understanding consumer preferences can help policy makers design healthier meals in an organization with the potential to scale up to reach a considerable number of low-income families. Copyright © 2015 Elsevier Ltd. All rights

Does a low-income urban population practise healthy dietary habits?

Science.gov (United States)

Azizan, Nurul Ain; Thangiah, Nithiah; Su, Tin Tin; Majid, Hazreen Abdul

2018-03-01

The purpose of this study was to identify the unhealthy dietary habits and practices in a low-income community in an urban area and determine the associated factors. A cross-sectional survey was conducted in a low-income housing area in Kuala Lumpur, Malaysia. Data were collected using a questionnaire via face-to-face interviews by trained enumerators in order to obtain details on sociodemographic characteristics and dietary practices. Descriptive statistics showed that 86.7% of the respondents in the low-income community consumed fruit and vegetables less than five times per day, 11.7% consumed carbonated and sweetened drinks more than twice per day and about 25% consumed fast food more than four times per month. In total, 65.2% (n=945) did not have healthy dietary practices. Binary logistic regression showed that age, education and ethnicity were significant predictors of unhealthy dietary practices among the low-income community. Those in the 30-59 years age group had higher odds (odds ratio 1.65, p=0.04) of practising an unhealthy diet as compared with those older than 60 years of age. Unhealthy dietary practices were found to be common among the low-income group living in an urban area. Healthy lifestyle intervention should be highlighted so that it can be adopted in the low-income group.

Poject Managment Approach to Public Low Income Housing. | Ogbu ...

African Journals Online (AJOL)

This research assesses the impacts of project management (PM) variables on the socio-economic formation of public low-income housing (LIH) users in Abia and ... socio-economic impact of public low income housing (LIH) and the PM variables: project scope control (PS), project planning (PPC), project cost control (PC), ...

Low Income Consumer Utility Issues: A National Perspective; TOPICAL

International Nuclear Information System (INIS)

Eisenberg, J

2001-01-01

This report provides a survey of assistance programs that public utility commissions have approved in most states to assist the low-income customers of utilities within their states. Surveys find that there is no single model of low-income assistance; rather, each state has adopted a program that meets its particular circumstances. However, while the details of programs vary considerably, they all fall within four broad categories: (1) Affordability programs, which provide direct assistance in paying energy bills; (2) Consumer protections, such as collection practices and installment billing requirements, which make it easier to pay energy bills on time; (3) Education programs, which teach consumers about prudent energy use and counsel them about budgeting; and (4) Efficiency and weatherization programs, which make investments to help consumers control their energy bills by reducing their need for energy. Programs usually include more than one of these components. All programs also include outreach and evaluation components. This report describes these options, the advantages and disadvantages of each, and the economic and other benefits of utility assistance programs for low-income customers. Low-income programs help participants by lowering the fraction of their incomes devoted to energy bills (the energy burden) from a very high level. In the United States, the median household devotes only 3.8 percent of its income to electricity while a family depending on a minimum-wage earner must devote 12.1 percent to energy while facing housing cost increases all over the nation. Low-income families unable to keep up with these pressures find themselves forced to go without power at times, to move, or to forgo other necessities such as food or medicine in order to pay their electricity bills

National income inequality and ineffective health insurance in 35 low- and middle-income countries.

Science.gov (United States)

Alvarez, Francisco N; El-Sayed, Abdulrahman M

2017-05-01

Global health policy efforts to improve health and reduce financial burden of disease in low- and middle-income countries (LMIC) has fuelled interest in expanding access to health insurance coverage to all, a movement known as Universal Health Coverage (UHC). Ineffective insurance is a measure of failure to achieve the intended outcomes of health insurance among those who nominally have insurance. This study aimed to evaluate the relation between national-level income inequality and the prevalence of ineffective insurance. We used Standardized World Income Inequality Database (SWIID) Gini coefficients for 35 LMICs and World Health Survey (WHS) data about insurance from 2002 to 2004 to fit multivariable regression models of the prevalence of ineffective insurance on national Gini coefficients, adjusting for GDP per capita. Greater inequality predicted higher prevalence of ineffective insurance. When stratifying by individual-level covariates, higher inequality was associated with greater ineffective insurance among sub-groups traditionally considered more privileged: youth, men, higher education, urban residence and the wealthiest quintile. Stratifying by World Bank country income classification, higher inequality was associated with ineffective insurance among upper-middle income countries but not low- or lower-middle income countries. We hypothesize that these associations may be due to the imprint of underlying social inequalities as countries approach decreasing marginal returns on improved health insurance by income. Our findings suggest that beyond national income, income inequality may predict differences in the quality of insurance, with implications for efforts to achieve UHC. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cancer Outcomes in Low-Income Elders

Data.gov (United States)

U.S. Department of Health & Human Services — Cancer Outcomes in Low-Income Elders, Is There An Advantage to Being on Medicaid Because of reduced financial barriers, dual Medicare-Medicaid enrollment of...

Surviving spinal cord injury in low income countries

Directory of Open Access Journals (Sweden)

Tone Øderud

2014-08-01

Objectives: The aims of this study were to explore life expectancy (life expectancy is the average remaining years of life of an individual and the situation of persons living with SCI in low income settings. Method: Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals. Results: There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges. Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

Influenza vaccines in low and middle income countries

Science.gov (United States)

Ott, Jördis J.; Klein Breteler, Janna; Tam, John S.; Hutubessy, Raymond C.W.; Jit, Mark; de Boer, Michiel R.

2013-01-01

Objectives: Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries. Methods: PubMed and EMBASE were searched for economic evaluations published in any language between 1960 and 2011. Main outcome measures were costs per influenza outcome averted, costs per quality-adjusted life years gained or disability-adjusted life years averted, costs per benefit in monetary units or cost-benefit ratios. Results: Nine economic evaluations on seasonal influenza vaccine met the inclusion criteria. These were model- or randomized-controlled-trial (RCT)-based economic evaluations from middle-income countries. Influenza vaccination provided value for money for elderly, infants, adults and children with high-risk conditions. Vaccination was cost-effective and cost-saving for chronic obstructive pulmonary disease patients and in elderly above 65 y from model-based evaluations, but conclusions from RCTs on elderly varied. Conclusion: Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner. PMID:23732900

The association of childhood asthma with mental health and developmental comorbidities in low-income families.

Science.gov (United States)

Arif, Ahmed A; Korgaonkar, Purva

2016-01-01

The objective of the study was to determine the relationship of childhood asthma with mental health and developmental indicators in low-income families. Parents/guardians of approximately 400 children, aged 2-14 years, were recruited from a charity hospital serving low income neighborhoods in the outskirts of Karachi, Pakistan. Mothers of children were interviewed in their local language by a trained nurse. Eight self-reported comorbidities were grouped into two constructs based on factor analysis and conveniently labeled as mental health (anxiety, attention and behavioral problems) and developmental problems (learning, developmental delay, hearing impairment, sleep and speech problems). Data were analyzed using multiple logistic regression, adjusted for age, sex, presence of older siblings, number of people in the household, child birth weight, presence of mold, and family history of asthma or hay fever. Children with asthma had 18 times greater odds of mental health problems (adjusted OR = 18.0, 95% CI: 9.2, 35.1) as compared to children without asthma. The odds of developmental problems were more than 14 times greater for children with asthma (adjusted OR = 14.3, 95% CI: 7.8, 26.1) as compared to children without asthma. This study found mental and developmental adverse consequences of childhood asthma in low-income families. Identifying and treating asthma at an early age could reduce the burden of comorbidities in this population.

Managing anemia in low-income toddlers: barriers, challenges and context in primary care.

Science.gov (United States)

Crowell, Rebecca; Pierce, Michelle B; Ferris, Ann M; Slivka, Hilda; Joyce, Patricia; Bernstein, Bruce A; Russell-Curtis, Suzanne

2005-11-01

Iron-deficiency remains a concern among low-income toddlers in the U.S. This formative study describes how primary care providers serving high-risk 1- to 3-year-old children in an urban ambulatory care setting approach anemia. Data collection included a retrospective review of randomly selected medical records (n=264) and semi-structured interviews with clinicians (n=41). Thirty-eight percent of the children presented with anemia (Hgb variable. While providers felt clinically comfortable with anemia, they felt burdened and challenged by follow-up. Communication and system barriers weighed most heavily on perceived treatment outcomes.

Acculturation Influences Postpartum Eating, Activity, and Weight Retention in Low-Income Hispanic Women.

Science.gov (United States)

Martin, Chantel L; Tate, Deborah F; Schaffner, Andrew; Brannen, Anna; Hatley, Karen Erickson; Diamond, Molly; Munoz-Christian, Karen; Pomeroy, Jeremy; Sanchez, Teresa; Mercado, Adrian; Hagobian, Todd; Phelan, Suzanne

2017-12-01

Low-income Hispanic women experience elevated rates of high postpartum weight retention (PPWR), which is an independent risk factor for lifetime obesity. Sociocultural factors might play an important role among Hispanic women; however, very few studies have examined this association. The purpose of our study was to examine the associations between acculturation and maternal diet, physical activity, and PPWR. This is a cross-sectional study of baseline data from 282 Hispanic women participating in the FitMoms/Mamás Activas study, a randomized controlled trial examining the impact of primarily an internet-based weight control program, in reducing PPWR among low-income women. We performed multivariable linear regression to examine the association of acculturation with diet quality, physical activity, and PPWR at study entry. A total of 213 (76%) women had acculturation scores reflecting Mexican orientation or bicultural orientation, whereas 69 (24%) had scores that represented assimilation to Anglo culture. Women who were more acculturated had lower intakes of fruits and vegetables, lower HEI scores, and lower physical activity levels than women who were less acculturated (p acculturation and PPWR in that for every 1-unit increase in acculturation score, PPWR increased, on average, by 0.80 kg. Higher acculturation was associated with poorer diet and physical activity behaviors and greater PPWR.

Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

Science.gov (United States)

Gelaye, Bizu; Rondon, Marta B; Araya, Ricardo; Williams, Michelle A

2016-10-01

Maternal depression, a non-psychotic depressive episode of mild to major severity, is one of the major contributors of pregnancy-related morbidity and mortality. Maternal depression (antepartum or post partum) has been linked to negative health-related behaviours and adverse outcomes, including psychological and developmental disturbances in infants, children, and adolescents. Despite its enormous burden, maternal depression in low-income and middle-income countries remains under-recognised and undertreated. In this Series paper, we systematically review studies that focus on the epidemiology of perinatal depression (ie, during antepartum and post-partum periods) among women residing in low-income and middle-income countries. We also summarise evidence for the association of perinatal depression with infant and childhood outcomes. This review is intended to summarise findings from the existing literature, identify important knowledge gaps, and set the research agenda for creating new generalisable knowledge pertinent to increasing our understanding of the prevalence, determinants, and infant and childhood health outcomes associated with perinatal depression. This review is also intended to set the stage for subsequent work aimed at reinforcing and accelerating investments toward providing services to manage maternal depression in low-income and middle-income countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Low Income Housing Tax Credit Developments on Neighborhoods.

Science.gov (United States)

Baum-Snow, Nathaniel; Marion, Justin

2009-06-01

This paper evaluates the impacts of new housing developments funded with the Low Income Housing Tax Credit (LIHTC), the largest federal project based housing program in the U.S., on the neighborhoods in which they are built. A discontinuity in the formula determining the magnitude of tax credits as a function of neighborhood characteristics generates pseudo-random assignment in the number of low income housing units built in similar sets of census tracts. Tracts where projects are awarded 30 percent higher tax credits receive approximately six more low income housing units on a base of seven units per tract. These additional new low income developments cause homeowner turnover to rise, raise property values in declining areas and reduce incomes in gentrifying areas in neighborhoods near the 30th percentile of the income distribution. LIHTC units significantly crowd out nearby new rental construction in gentrifying areas but do not displace new construction in stable or declining areas.

Cigarette Design Features in Low-, Middle-, and High-Income Countries

Directory of Open Access Journals (Sweden)

Rosalie V. Caruso

2012-01-01

Full Text Available Previous studies have shown that country income grouping is correlated with cigarette engineering. Cigarettes (=111 brands were purchased during 2008–2010 from 11 low-, middle-, and high-income countries to assess physical dimensions and an array of cigarette design features. Mean ventilation varied significantly across low- (7.5%, middle- (15.3%, and high-income (26.2% countries (≤0.001. Differences across income groups were also seen in cigarette length (=0.001, length of the tipping paper (=0.01, filter weight (=0.017, number of vent rows (=0.003, per-cigarette tobacco weight (=0.04, and paper porosity (=0.008. Stepwise linear regression showed ventilation and tobacco length as major predictors of ISO tar yields in low-income countries (=0.909, 0.047, while tipping paper (<0.001, filter length (<0.001, number of vent rows (=0.014, and per-cigarette weight (=0.015 were predictors of tar yields in middle-income countries. Ventilation (<0.001, number of vent rows (=0.009, per-cigarette weight (<0.001, and filter diameter (=0.004 predicted tar yields in high-income countries. Health officials must be cognizant of cigarette design issues to provide effective regulation of tobacco products.

Food Group Categories of Low-Income African American Women

Science.gov (United States)

Lynch, Elizabeth B.; Holmes, Shane

2011-01-01

Objective: Describe lay food group categories of low-income African American women and assess the overlap of lay food groups and MyPyramid food groups. Design: A convenience sample of African American mothers from a low-income Chicago neighborhood performed a card-sorting task in which they grouped familiar food items into food groups. Setting:…

Developmental Trends in Self-Regulation among Low-Income Toddlers

Science.gov (United States)

Raikes, H. Abigail; Robinson, JoAnn L.; Bradley, Robert H.; Raikes, Helen H.; Ayoub, Catherine C.

2007-01-01

The attainment of self-regulatory skills during the toddler years is an understudied issue, especially among low-income children. The present study used growth modeling to examine the change over time and the final status in children's abilities to self-regulate, in a sample of 2,441 low-income children aged 14 to 36 months. Positive growth in…

Fluctuations, Uncertainty and Income Inequality in Developing Countries

OpenAIRE

Fadi Fawaz; Masha Rahnamamoghadam; Victor Valcarcel

2012-01-01

We analyze income inequality and high frequency movements in economic activity for low and high income developing countries (LIDC and HIDC). The impact of human capital, capital formation, and economic uncertainty on income inequality for LIDC and HIDC are also evaluated. We find strong evidence that business cycle fluctuations serve to exacerbate income inequality in HIDC while they help narrow the gap in LIDC. Importantly, volatility in output widens inequality across the board but to a con...

The Feasibility of an eLearning Nutrition Education Program for Low-Income Individuals.

Science.gov (United States)

Stotz, Sarah; Lee, Jung Sun; Rong, Hui; Murray, Deborah

2016-08-09

Online eLearning may be an innovative, efficient, and cost-effective method of providing nutrition education to a diverse low-income audience. The intent of this project is to examine perceptions of nutrition educators regarding the feasibility of an eLearning nutrition education program tailored to low-income Georgians. Semistructured individual interviews were conducted, guided by the constructivist theory. The interview guide focused on three themes: accessibility, literacy, and content. A prototype of the program also served as a talking point. Interviews were conducted in two urban Georgian counties in a location chosen by each participant. We recruited a convenience sample of Georgian nutrition educators (n = 10, 100% female, 50% Black). Interviews were transcribed and analyzed using constant comparative method. Motivation is considered the primary barrier to program feasibility. Neither access to the Internet nor literacy are considered significant barriers. Inclusion of skill-based, visual education methods such as cooking videos, recipes, and step-by-step teaching tools was highlighted. Nutrition educators perceived this program would be a feasible form of nutrition education for the priority audience. Findings from this study will inform the user-centered development of the program. © 2016 Society for Public Health Education.

Nation's Capital to cover low-income women's abortions.

Science.gov (United States)

1994-04-15

Sharon Pratt Kelly, the mayor of the District of Columbia, has announced that, effective May 1, 1994, the city will use its Medical Charities Fund to pay for "medically appropriate" abortions for women with annual incomes of US$13,200 who do not have health insurance that covers abortions. This income level represents 185% of the federal poverty level for single women. The determination as to whether an abortion is "appropriate" will be made by the woman's physician. From 1989-93, there was a ban on the use of District of Columbia tax monies to cover abortions for local women. In 1988, however, approximately 4000 District women received funding for their abortions. The US$1 million Medical Charities Fund was originally set up to cover emergency room bills for low-income District residents who did not qualify for Medicaid. $650,000 is expected to be added to the fund; in addition, the District's 1995 budget will allocate funding earmarked for abortion coverage for low-income women.

How many low birthweight babies in low- and middle-income countries are preterm?

Directory of Open Access Journals (Sweden)

Fernando C Barros

2011-06-01

Full Text Available OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.

Electronic Payment Adoption in the Banking Sector of Low-Income Countries

OpenAIRE

Teshome Alemu; Tridib Bandyopadhyay; Solomon Negash

2015-01-01

Banks in low-income countries are launching e-banking services such as Internet banking, SMS banking, ATM banking, card banking, point of sales (PoS) and mobile banking. Among these planned services, ATM is the most matured service in many private and state owned banks in Ethiopia. ATM is a recent phenomenon in low-income countries (; ), and is still being introduced in financial sectors in low-income countries (Angeli, 2008; ) making investigation of factors of ICT technology adoption in low...

13 CFR 108.710 - Requirement to finance Low-Income Enterprises.

Science.gov (United States)

2010-01-01

... VENTURE CAPITAL (âNMVCâ) PROGRAM Financing of Small Businesses by NMVC Companies Determining the... of your Portfolio Concerns must be Low-Income Enterprises in which you have an Equity Capital... total dollars) in Equity Capital Investments in Low-Income Enterprises. (b) Non-compliance with this...

Childhood asthma in low income countries

DEFF Research Database (Denmark)

Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K

2012-01-01

Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts...... of pneumonia and asthma/wheezing/bronchiolitis and examines whether asthma in under-5s may be confused with pneumonia. Over-diagnosing of bacterial pneumonia can be suspected from the limited association between clinical pneumonia and confirmatory test results such as chest x-ray and microbiological findings...... and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing...

Foreign Direct Investment Behaviour in Low and Middle Income ...

International Development Research Centre (IDRC) Digital Library (Canada)

Does FDI actually stimulate growth and development in low-income ... Does FDI help reduce poverty and inequality and if so, under what circumstances? ... countries that share key features such as income level or economic structure.

Social Policy Trends- Housing Affordability for Families with Low Incomes Across Canada

Directory of Open Access Journals (Sweden)

Margarita (Gres Wilkins

2017-06-01

Full Text Available HOUSING AFFORDABILITY FOR FAMILIES WITH LOW INCOMES ACROSS CANADA Percentage of income devoted to paying lowest-priced rent in a city, by low-income family type, select years, 1990-2015 Much public attention has been directed towards the issue of a Canada-wide housing crisis. The focus has typically been on the cost of housing for an average income Canadian family. Less attention has been paid to families with incomes much lower than those of the average Canadian household, for which the housing crisis is far more severe. Households and individuals with particularly low incomes are at the highest risk of experiencing the worst effects of a lack of housing affordability, including homelessness.

Social benefit payments and acute injury among low-income mothers.

Science.gov (United States)

Redelmeier, Donald A; Chan, William K; Mullainathan, Sendhil; Shafir, Eldar

2012-01-01

Human error due to risky behaviour is a common and important contributor to acute injury related to poverty. We studied whether social benefit payments mitigate or exacerbate risky behaviours that lead to emergency visits for acute injury among low-income mothers with dependent children. We analyzed total emergency department visits throughout Ontario to identify women between 15 and 55 years of age who were mothers of children younger than 18 years, who were living in the lowest socio-economic quintile and who presented with acute injury. We used universal health care databases to evaluate emergency department visits during specific days on which social benefit payments were made (child benefit distribution) relative to visits on control days over a 7-year interval (1 April 2003 to 31 March 2010). A total of 153 377 emergency department visits met the inclusion criteria. We observed fewer emergencies per day on child benefit payment days than on control days (56.4 v. 60.1, p = 0.008). The difference was primarily explained by lower values among mothers age 35 years or younger (relative reduction 7.29%, 95% confidence interval [CI] 1.69% to 12.88%), those living in urban areas (relative reduction 7.07%, 95% CI 3.05% to 11.10%) and those treated at community hospitals (relative reduction 6.83%, 95% CI 2.46% to 11.19%). No significant differences were observed for the 7 days immediately before or the 7 days immediately after the child benefit payment. Contrary to political commentary, we found that small reductions in relative poverty mitigated, rather than exacerbated, risky behaviours that contribute to acute injury among low-income mothers with dependent children.

Weekly and Twice-Weekly Yoga Classes Offer Similar Low-Back Pain Relief in Low-Income Minority Populations

Science.gov (United States)

... Weekly and Twice-Weekly Yoga Classes Offer Similar Low-Back Pain Relief in Low-Income Minority Populations Share: © Photodisc ... in minority and low-income populations with chronic low-back pain. Researchers from Boston University School of Medicine, Boston ...

75 FR 8392 - Low Income Housing Tax Credit Tenant Database

Science.gov (United States)

2010-02-24

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-11] Low Income Housing Tax Credit Tenant Database AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice. SUMMARY: The... Lists the Following Information Title Of Proposal: Low Income Housing Tax Credit Tenant Database. Omb...

Researching Entrepreneurship in Low-income Settlements

DEFF Research Database (Denmark)

Gough, Katherine V.; Langevang, Thilde; Namatovu, Rebecca

2014-01-01

of entrepreneurship conducted in a low-income settlement, which combined participatory quantitative and qualitative approaches, highlighting the strengths and challenges of using participatory methods. The paper demonstrates how drawing on a range of participatory methods can contribute to creating more engaging...

Screening and Referral for Postpartum Depression among Low-Income Women: A Qualitative Perspective from Community Health Workers

Directory of Open Access Journals (Sweden)

Rhonda C. Boyd

2011-01-01

Full Text Available Postpartum depression is a serious and common psychiatric illness. Mothers living in poverty are more likely to be depressed and have greater barriers to accessing treatment than the general population. Mental health utilization is particularly limited for women with postpartum depression and low-income, minority women. As part of an academic-community partnership, focus groups were utilized to examine staff practices, barriers, and facilitators in mental health referrals for women with depression within a community nonprofit agency serving low-income pregnant and postpartum women. The focus groups were analyzed through content analyses and NVIVO-8. Three focus groups with 16 community health workers were conducted. Six themes were identified: (1 screening and referral, (2 facilitators to referral, (3 barriers to referral, (4 culture and language, (5 life events, and (6 support. The study identified several barriers and facilitators for referring postpartum women with depression to mental health services.

Acquired heart disease in low-income and middle-income countries.

Science.gov (United States)

Curry, Chris; Zuhlke, Liesl; Mocumbi, Ana; Kennedy, Neil

2018-01-01

The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A Portrait of Low-Income Migrants in Contemporary Qatar

OpenAIRE

GARDNER, ANDREW; GARDNER, ANDREW; PESSOA, SILVIA; DIOP, ABDOULAYE; AL-GHANIM, KALTHAM; LE TRUNG, KIEN; HARKNESS, LAURA

2013-01-01

Though transnational labor migration in the Gulf States has increasingly been of scholarly interest, that scholarship has to date relied largely on qualitative ethnographic methodologies or small non-representative sampling strategies. This paper presents the findings of a large representative sample of low-income migrant laborers in Qatar. The data describe the basic characteristics of the low-income migrant population in Qatar, the process by which migrants obtain employment, the frequency ...

Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries.

OpenAIRE

Yusuf, S; Rangarajan, S; Teo, K; Islam, S; Li, W; Liu, L; Bo, J; Lou, Q; Lu, F; Liu, T; Yu, L; Zhang, S; Mony, P; Swaminathan, S; Mohan, V

2014-01-01

: More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. : We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater r...

Ambulatory Blood Pressure Monitoring: A Complementary Strategy for Hypertension Diagnosis and Management in Low-Income and Middle-Income Countries.

Science.gov (United States)

Abdalla, Marwah

2017-02-01

Ambulatory blood pressure monitoring (ABPM) can assess out-of-clinic blood pressure. ABPM is an underutilized resource in low-income and middle-income countries but should be considered a complementary strategy to clinic blood pressure measurement for the diagnosis and management of hypertension. Potential uses for ABPM in low-income and middle-income countries include screening of high-risk individuals who have concurrent communicable diseases, such as HIV, and in task-shifting health care strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

Successful schools and risky behaviors among low-income adolescents.

Science.gov (United States)

Wong, Mitchell D; Coller, Karen M; Dudovitz, Rebecca N; Kennedy, David P; Buddin, Richard; Shapiro, Martin F; Kataoka, Sheryl H; Brown, Arleen F; Tseng, Chi-Hong; Bergman, Peter; Chung, Paul J

2014-08-01

We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span. Copyright © 2014 by the American Academy of Pediatrics.

achieving improved financing for low-income producers

African Journals Online (AJOL)

KEY WORDS: Approaches, Improved Access, Finance, Low-income, Producers. INTRODUCTION .... either by setting up a dual-purpose financial institution, or by making ..... management information systems (Braverman and. Huppi, 1991).

Low Income Consumer Utility Issues: A National Perspective

Energy Technology Data Exchange (ETDEWEB)

Eisenberg, J

2001-03-26

This report has been prepared to provide low-income advocates and other stakeholders information on the energy burden faced by low-income customers and programs designed to alleviate that burden in various states. The report describes programs designed to lower payments, manage arrearages, weatherize and provide other energy efficiency measures, educate consumers, increase outreach to the target It discusses the costs and benefits of the population, and evaluate the programs. various options--to the degree this information is available--and describes attempts to quantify benefits that have heretofore not been quantified. The purpose of this report is to enable the low-income advocates and others to assess the options and design program most suitable for the citizens of their states or jurisdictions. It is not the authors' intent to recommend a particular course of action but, based on our broad experience in the field, to provide the information necessary for others to do so. We would be happy to answer any questions or provide further documentation on any of the material presented herein. The original edition of this report was prepared for the Utah Committee on Consumer Services, pursuant to a contract with the National Consumer Law Center (NCLC), to provide information to the Utah Low-Income Task Force established by the Utah Public Service, Commission. Attachment 1 is drawn from NCLC's 1998 Supplement to its Access to Utility Services; NCLC plans to update this list in 2001, and it will be available then from NCLC. This report has been updated by the authors for this edition.

EARLY CHILDHOOD PREDICTORS OF LOW-INCOME BOYS' PATHWAYS TO ANTISOCIAL BEHAVIOR IN CHILDHOOD, ADOLESCENCE, AND EARLY ADULTHOOD.

Science.gov (United States)

Shaw, Daniel S; Gilliam, Mary

2017-01-01

Guided by a bridging model of pathways leading to low-income boys' early starting and persistent trajectories of antisocial behavior, the current article reviews evidence supporting the model from early childhood through early adulthood. Using primarily a cohort of 310 low-income boys of families recruited from Women, Infants, and Children Nutrition Supplement centers in a large metropolitan area followed from infancy to early adulthood and a smaller cohort of boys and girls followed through early childhood, we provide evidence supporting the critical role of parenting, maternal depression, and other proximal family risk factors in early childhood that are prospectively linked to trajectories of parent-reported conduct problems in early and middle childhood, youth-reported antisocial behavior during adolescence and early adulthood, and court-reported violent offending in adolescence. The findings are discussed in terms of the need to identify at-risk boys in early childhood and methods and platforms for engaging families in healthcare settings not previously used to implement preventive mental health services. © 2016 Michigan Association for Infant Mental Health.

Water End-Uses in Low-Income Houses in Southern Brazil

Directory of Open Access Journals (Sweden)

Ana Kelly Marinoski

2014-07-01

Full Text Available Knowing water consumption patterns in buildings is key information for water planning. This article aims to characterize the water consumption pattern and water end-uses in low-income houses in the region of Florianópolis, Southern Brazil. Data were collected by interviewing householders, as well as by measuring the flow rate of existing water fixtures and appliances. The results indicated that the shower was the fixture with the largest water consumption in households, i.e., about 30%–36% of total water consumption on average, followed by the toilet (18%–20%. The surveyed households consumed from 111 to 152 L/capita·day on average, based on different income ranges. No correlation was found between income and water consumption. The results of this study can be used to estimate the consumption of water for new buildings, as well as to develop integrated water management strategies in low-income developments, in Florianópolis, such as water-saving plumbing fixtures, rainwater harvesting, and greywater reuse. Likely, there would be a deferral of capital investments in new water assets for enhancing water and wastewater services by saving water in low-income houses.

Food (In)Security in Rapidly Urbanising, Low-Income Contexts.

Science.gov (United States)

Tacoli, Cecilia

2017-12-11

Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

Food (InSecurity in Rapidly Urbanising, Low-Income Contexts

Directory of Open Access Journals (Sweden)

Cecilia Tacoli

2017-12-01

Full Text Available Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

The global cancer divide: Relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

Directory of Open Access Journals (Sweden)

Ali Batouli

2014-06-01

Conclusions: The analysis of this study suggested that cancer MIR is greater in middle/low-income countries. Furthermore, the WHO healthcare score was associated with improved cancer outcomes in middle/low-income countries while absolute levels of financial resources and infrastructure played a more important role in high-income countries.

Contraceptive use among low-income urban married women in India.

Science.gov (United States)

Kumar, Manisha; Meena, Jyoti; Sharma, Sumedha; Poddar, Anju; Dhalliwal, Vikas; Modi-Satish Chander Modi, S C; Singh, Kamlesh

2011-02-01

The reports of a rise in contraceptive practices have not been matched by a similar decrease in population, so there is a need to look into the causes of this discrepancy. To obtain information from low-income urban married women regarding their contraceptive knowledge, practices, and utilization of the services. Percentage of low-income urban married women using contraception, different types of contraception used, influence of education on choice of contraception. All nonpregnant married women between the ages of 18 and 45 years, belonging to low-income groups were selected for study. Statistical analysis was done using EPI Info ver-5.0. Chi square test was used to test the significance of data. Contraceptive use among these women was 52%; the most common method was tubal ligation. Educated women used spacing methods more often than uneducated women. Women had adequate awareness regarding type of contraceptives available but had no idea about the timing of starting contraception after delivery and about emergency contraception. The low-income urban population is aware of the importance of limiting the family size and has family planning facilities yet has less contraceptive usage because of low level of education, increased rate of discontinuation, and lack of proper knowledge of the use of contraception. © 2010 International Society for Sexual Medicine.

Patterns of Violence Exposure and Sexual Risk in Low-Income, Urban African American Girls

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Wilson, Helen W.; Woods, Briana A.; Emerson, Erin; Donenberg, Geri R.

2013-01-01

Objective This study examined the relationship between violence exposure and sexual risk-taking among low-income, urban African American (AA) adolescent girls, considering overlap among different types and characteristics of violence. Methods AA adolescent girls were originally recruited from outpatient mental health clinics serving urban, mostly low-SES communities in Chicago, IL as part of a two-year longitudinal investigation of HIV-risk behavior. A subsequent follow-up was completed to assess lifetime history of trauma and violence exposure. The current study (N=177) included violence exposure and sexual risk behavior reported at the most recent interview (ages 14-22). Multiple regression was used to examine combined and unique contributions of different types, ages, settings, and perpetrators or victims of violence to variance in sexual risk. Results More extensive violence exposure and cumulative exposure to different kinds of violence were associated with overall unsafe sex, more partners, and inconsistent condom use. The most significant unique predictors, accounting for overlap among different forms of violence, were physical victimization, adolescent exposure, neighborhood violence, and violence involving dating partners. Conclusions These findings put sexual risk in the context of broad traumatic experiences but also suggest that the type and characteristics of violence exposure matter in terms of sexual health outcomes. Violence exposure should be addressed in efforts to reduce STIs among low-income, urban African American girls. PMID:24563808

Depression and type 2 diabetes in low- and middle-income countries: a systematic review.

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Mendenhall, Emily; Norris, Shane A; Shidhaye, Rahul; Prabhakaran, Dorairaj

2014-02-01

Eighty percent of people with type 2 diabetes reside in low- and middle-income countries (LMICs). Yet much of the research around depression among people with diabetes has been conducted in high-income countries (HICs). In this systematic review we searched Ovid Medline, PubMed, and PsychINFO for studies that assessed depression among people with type 2 diabetes in LMICs. Our focus on quantitative studies provided a prevalence of comorbid depression among those with diabetes. We reviewed 48 studies from 1,091 references. We found that this research has been conducted primarily in middle-income countries, including India (n = 8), Mexico (n = 8), Brazil (n = 5), and China (n = 5). There was variation in prevalence of comorbid depression across studies, but these differences did not reveal regional differences and seemed to result from study sample (e.g., urban vs rural and clinical vs population-based samples). Fifteen depression inventories were administered across the studies. We concluded that despite substantial diabetes burden in LMICs, few studies have reviewed comorbid depression and diabetes. Our review suggests depression among people with diabetes in LMICs may be higher than in HICs. Evidence from these 48 studies underscores the need for comprehensive mental health care that can be integrated into diabetes care within LMIC health systems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prevalence of Hypertension in Low- and Middle-Income Countries

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Sarki, Ahmed M.; Nduka, Chidozie U.; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A.

2015-01-01

Abstract We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4–35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1–45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0–40.6) and lowest across low-income countries (23.1%, 95% CI 20.1–26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income

Arts Enrichment and Preschool Emotions for Low-Income Children at Risk

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Brown, Eleanor D.; Sax, Kacey L.

2013-01-01

No studies to date examine the impact of arts-integrated preschool programming on the emotional functioning of low-income children at risk for school problems. The present study examines observed emotion expression and teacher-rated emotion regulation for low-income children attending Settlement Music School's Kaleidoscope Preschool Arts…

Promoting food security of low income women in central Uganda

DEFF Research Database (Denmark)

Midtvåge, Runa; Hiranandani, Vanmala Sunder; Nambuanyi, Lekunze Ransom

• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014.......• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014....

The consequences of high cigarette excise taxes for low-income smokers.

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Matthew C Farrelly

Full Text Available BACKGROUND: To illustrate the burden of high cigarette excise taxes on low-income smokers. METHODOLOGY/PRINCIPAL FINDINGS: Using data from the New York and national Adult Tobacco Surveys from 2010-2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000-$59,999; and more than $60,000. The 2010-2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1% than nationally (22.2% and is strongly associated with income in New York and nationally (P<.001. Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010-2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003-2004 and 14.2% nationally. Daily cigarette consumption is not related to income. CONCLUSIONS/SIGNIFICANCE: Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers.

After-school programs for low-income children: promise and challenges.

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Halpern, R

1999-01-01

Children's out-of-school time, long a low-level source of public concern, has recently emerged as a major social issue. This, in turn, has heightened interest in the heterogeneous field of after-school programs. This article provides a profile of after-school programs for low-income children, focusing on supply and demand, program emphases, and program sponsors and support organizations. It also discusses the major challenges facing the field in the areas of facilities, staffing, and financing. Details and examples are drawn from the ongoing evaluation of a specific after-school program initiative called MOST (Making the Most of Out-of-School Time), which seeks to strengthen after-school programs in Boston, Chicago, and Seattle. Looking ahead, the article highlights the pros and cons of options for increasing coverage to reach more low-income children, strengthening programs, expanding funding, and articulating an appropriate role for after-school programs to fill in the lives of low-income children.

Federally Funded Education and Job Training Programs for Low-Income Youth

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Dworsky, Amy

2011-01-01

With the growing demand for highly skilled workers and declining wages for those who are less skilled, low-income youth with limited education and no work experience have few opportunities for gainful employment. Since the Great Depression, the federal government has been funding programs that provide low-income, out-of-school, and unemployed…

Prevalence of Food Addiction Among Low-Income Reproductive-Aged Women.

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Berenson, Abbey B; Laz, Tabassum H; Pohlmeier, Ali M; Rahman, Mahbubur; Cunningham, Kathryn A

2015-09-01

Hyperpalatable foods (i.e., high in salt, sugar, or fat) have been shown to have addictive properties that may contribute to overeating. Prior studies conducted on food addiction behaviors are mostly based on white and middle-aged women. Data are not available, however, on reproductive-aged women from other races/ethnicities or low-income women. The purpose of this study was to examine the prevalence and correlates of food addiction among multiethnic women of low socioeconomic status. We conducted a cross-sectional survey of health behaviors, including food addiction according to the Yale Food Addiction Scale (YFAS) between July 2010 and February 2011 among 18- to 40-year-old low-income women attending reproductive-health clinics (N = 1,067). Overall, 2.8% of women surveyed met the diagnosis of food addiction. The prevalence of food addiction did not differ by age group, race/ethnicity, education, income, or body mass index categories, tobacco and alcohol use, or physical activity. However, it did differ by level of depression (p addiction among low-income, reproductive-aged women. Racial differences were observed in the YFAS symptom count score, but not in the overall prevalence of food addition. Additionally, women with food addiction had higher levels of depression than women without food addiction.

Household expenditure for dental care in low and middle income countries.

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Mohd Masood

Full Text Available This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries who participated in the WHO World Health Survey (WHS were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.

Is There a Link between Low Parental Income and Childhood Obesity?

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Shackleton, Nichola

2017-01-01

The association between familial socioeconomic status and child obesity has created the expectation that low familial income increases the risk of child obesity. Yet, there is very little evidence in the United Kingdom to suggest that this is the case. This article focuses on whether low familial income and family poverty are associated with an…

Using social media to communicate child health information to low-income parents.

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Stroever, Stephanie J; Mackert, Michael S; McAlister, Alfred L; Hoelscher, Deanna M

2011-11-01

The objective of this study was to determine the value of using social media to communicate child health information to low-income parents. We evaluated qualitative data obtained through focus groups with low-income, predominantly Hispanic parents. Results were mixed; lack of time and credibility were the primary objections parents cited in using social media to obtain information about their children's health. Social media has value as part of an overall communication strategy, but more work is needed to determine the most effective way to use this channel in low-income populations.

Science for Agriculture and Rural Development in Low-Income Countries

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Barros, Vicente

2008-09-01

During recent months, another sign of the global fragility to sustain the increasing human demand for resources has appeared with merciless cruelty. Increasing food prices, paradoxically driven to a large extent by the rapid economic growth of vast regions of the emerging world, are affecting hundreds of millions of the poorest people in Africa, Asia, and Latin America. As described in Science for Agriculture and Rural Development in Low-Income Countries, most of the poorest people in these low-income countries live in rural areas and are engaged in agriculture or related activities. Because many people in these areas are engaged in subsistence agriculture, they do not share in the added income derived from higher market prices for food.

Simulated Models Suggest That Price per Calorie Is the Dominant Price Metric That Low-Income Individuals Use for Food Decision Making.

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Beheshti, Rahmatollah; Igusa, Takeru; Jones-Smith, Jessica

2016-11-01

The price of food has long been considered one of the major factors that affects food choices. However, the price metric (e.g., the price of food per calorie or the price of food per gram) that individuals predominantly use when making food choices is unclear. Understanding which price metric is used is especially important for studying individuals with severe budget constraints because food price then becomes even more important in food choice. We assessed which price metric is used by low-income individuals in deciding what to eat. With the use of data from NHANES and the USDA Food and Nutrient Database for Dietary Studies, we created an agent-based model that simulated an environment representing the US population, wherein individuals were modeled as agents with a specific weight, age, and income. In our model, agents made dietary food choices while meeting their budget limits with the use of 1 of 3 different metrics for decision making: energy cost (price per calorie), unit price (price per gram), and serving price (price per serving). The food consumption patterns generated by our model were compared to 3 independent data sets. The food choice behaviors observed in 2 of the data sets were found to be closest to the simulated dietary patterns generated by the price per calorie metric. The behaviors observed in the third data set were equidistant from the patterns generated by price per calorie and price per serving metrics, whereas results generated by the price per gram metric were further away. Our simulations suggest that dietary food choice based on price per calorie best matches actual consumption patterns and may therefore be the most salient price metric for low-income populations. © 2016 American Society for Nutrition.

Feeding practices of low-income mothers: how do they compare to current recommendations?

OpenAIRE

Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

2015-01-01

Background Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods Eighty low-income mothers and their preschool children were videotaped a...

Low-Income Urban High School Students' Use of the Internet to Access Financial Aid

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Venegas, Kristan M.

2006-01-01

This article focuses on the Web-based resources available to low-income students as they build their perceptions, make their decisions, and engage in financial aid activities. Data are gathered from the results of six focus groups with low-income high school students attending urban high schools. Findings suggest that low-income students do have…

The support gap: New teachers' early experiences in high-income and low-income schools

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Susan Moore Johnson

2004-10-01

Full Text Available In this article, the authors consider three sources of support for new teachers—hiring practices, relationships with colleagues, and curriculum—all found in earlier research to influence new teachers’ satisfaction with their work, their sense of success with students, and their eventual retention in their job. They find that a "support gap" exists: new teachers in low-income schools are less likely than their counterparts in high-income schools to experience timely and information-rich hiring, to benefit from mentoring and support by experienced colleagues, and to have a curriculum that is complete and aligned with state standards, yet flexible for use in the classroom. Such patterns of difference between high-income and lowincome schools warrant careful consideration because they reveal broad patterns of inequity, which can have severe consequences for low-income students. Survey data for this study were collected from random samples of teachers in five states. One survey, focusing on hiring practices and teachers’ relationships with colleagues, was administered to 374 first-year and secondyear teachers in Florida, Massachusetts, and Michigan. A second survey, focusing on curriculum, was administered to 295 second-year elementary school teachers in Massachusetts, North Carolina, and Washington. The inequitable patterns of support for teachers reported here have important implications for the work of state policymakers, school district administrators, and principals. The authors describe these and offer recommendations for policy and practice in the conclusion.

Travel patterns and characteristics of low-income subpopulation in New York state

Energy Technology Data Exchange (ETDEWEB)

Reuscher, Tim [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hwang, Ho-Ling [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lim, Hyeonsup [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-10-01

Studies have shown that people residing in poverty face more mobility challenges in their daily travels as compared to those living in higher income households. In many cities, the lack of a public transportation systems and investments in low-income areas are making it difficult for those living in poverty to access jobs, goods, and services (schools, groceries, health cares, etc. In this study, Oak Ridge National Laboratory was tasked by the New York State (NYS) Department of Transportation to conduct a detailed examination of the travel behaviors and identify patterns and trends of the low-income residents within NYS. The 2009 National Household Travel Survey data was used as the primary information source to analyze subjects associated with poverty and mobility, as well as to address questions such as are there differences in traveler demographics between the low-income population and those of others who live in various NYS regions (e.g., New York City, other urban areas of NYS)? How do they compare with the population at large (e.g., rest of the country) or with findings from previous years (i.e., trend)? Are there any regional differences (e.g., urban versus rural)? Do any unique travel characteristics or patterns exist within the low-income group? Through this study, various key findings on low-income population sizes, household characteristics, travel patterns, and mobility limitations were identified and summarized in this report.

An optimization algorithm for simulation-based planning of low-income housing projects

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Mohamed M. Marzouk

2010-10-01

Full Text Available Construction of low-income housing projects is a replicated process and is associated with uncertainties that arise from the unavailability of resources. Government agencies and/or contractors have to select a construction system that meets low-income housing projects constraints including project conditions, technical, financial and time constraints. This research presents a framework, using computer simulation, which aids government authorities and contractors in the planning of low-income housing projects. The proposed framework estimates the time and cost required for the construction of low-income housing using pre-cast hollow core with hollow blocks bearing walls. Five main components constitute the proposed framework: a network builder module, a construction alternative selection module, a simulation module, an optimization module and a reporting module. An optimization module utilizing a genetic algorithm enables the defining of different options and ranges of parameters associated with low-income housing projects that influence the duration and total cost of the pre-cast hollow core with hollow blocks bearing walls method. A computer prototype, named LIHouse_Sim, was developed in MS Visual Basic 6.0 as proof of concept for the proposed framework. A numerical example is presented to demonstrate the use of the developed framework and to illustrate its essential features.

Economic aspects of low labour-income farming

NARCIS (Netherlands)

Luning, H.A.

1967-01-01

Conflicting views on the relevance of economic theory, as developed in the West, to low-income peasant societies had been advanced ever since Boeke's time.

Recent literature pointed out that available economic theories did not seem to fit the behavioral motivation, assumed in economic logic. The

Cigarette smoking and food insecurity among low-income families in the United States, 2001.

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Armour, Brian S; Pitts, M Melinda; Lee, Chung-Won

2008-01-01

To quantify the association between food insecurity and smoking among low-income families. A retrospective study using data from the 2001 Panel Study of Income Dynamics (PSID), a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Low-income families. Family income was linked with U.S. poverty thresholds to identify 2099 families living near or below 200% of the federal poverty level. Food insecurity (i.e., having insufficient funds to purchase enough food to maintain an active and healthy lifestyle) was calculated from the 18-core-item food security module of the U.S. Department of Agriculture. Current smoking status was determined. Smoking prevalence was higher among low-income families who were food insecure compared with low-income families who were food secure (43.6% vs. 31.9%; p < .01). Multivariate analysis revealed that smoking was associated with an increase in food insecurity of approximately six percentage points (p < .01). Given our finding that families near the federal poverty level spend a large share of their income on cigarettes, perhaps it would be prudent for food-assistance and tobacco-control programs to work together to help low-income people quit smoking.

Preconception Health Behaviors of Low-Income Women.

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Ayoola, Adejoke B; Sneller, Krista; Ebeye, Tega D; Dykstra, Megan Jongekrijg; Ellens, Victoria L; Lee, HaEun Grace; Zandee, Gail L

2016-01-01

Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.

Food stress in Adelaide: the relationship between low income and the affordability of healthy food.

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Ward, Paul R; Verity, Fiona; Carter, Patricia; Tsourtos, George; Coveney, John; Wong, Kwan Chui

2013-01-01

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a "Healthy Food Basket" methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing "food stress." Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

77 FR 25787 - Low Income Taxpayer Clinic Grant Program; Availability of 2013 Grant Application Package

Science.gov (United States)

2012-05-01

... DEPARTMENT OF THE TREASURY Internal Revenue Service Low Income Taxpayer Clinic Grant Program... Package and Guidelines (Publication 3319) for organizations interested in applying for a Low Income... nominal fee to low income taxpayers involved in tax controversies with the IRS, or inform individuals for...

CROWDING AND SHOPPING VALUE IN LOW-INCOME RETAIL CENTERS

Directory of Open Access Journals (Sweden)

Izabelle Quezado

2014-07-01

Full Text Available Considering the great potential of low-income consumption, this research is based on the scales developed by Babin, Darden and Griffin (1994 and by Machleit, Kellaris and Eroglu (1994, aiming to investigate hedonic and utilitarian consumer behavior and its relation with low-income perception of crowding. A research was performed with 404 consumers in real store environment and the results showed that consumers revealed being prone to utilitarian behavior in both centers. About crowding phenomenon, the consumers felt more uncomfortable by crowding at the commercial center with less infrastructure. There were indices that this discomfort was less intense in hedonic consumers.

Tackling socioeconomic inequalities and non-communicable diseases in low-income and middle-income countries under the Sustainable Development agenda.

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Niessen, Louis W; Mohan, Diwakar; Akuoku, Jonathan K; Mirelman, Andrew J; Ahmed, Sayem; Koehlmoos, Tracey P; Trujillo, Antonio; Khan, Jahangir; Peters, David H

2018-05-19

Five Sustainable Development Goals (SDGs) set targets that relate to the reduction of health inequalities nationally and worldwide. These targets are poverty reduction, health and wellbeing for all, equitable education, gender equality, and reduction of inequalities within and between countries. The interaction between inequalities and health is complex: better economic and educational outcomes for households enhance health, low socioeconomic status leads to chronic ill health, and non-communicable diseases (NCDs) reduce income status of households. NCDs account for most causes of early death and disability worldwide, so it is alarming that strong scientific evidence suggests an increase in the clustering of non-communicable conditions with low socioeconomic status in low-income and middle-income countries since 2000, as previously seen in high-income settings. These conditions include tobacco use, obesity, hypertension, cancer, and diabetes. Strong evidence from 283 studies overwhelmingly supports a positive association between low-income, low socioeconomic status, or low educational status and NCDs. The associations have been differentiated by sex in only four studies. Health is a key driver in the SDGs, and reduction of health inequalities and NCDs should become key in the promotion of the overall SDG agenda. A sustained reduction of general inequalities in income status, education, and gender within and between countries would enhance worldwide equality in health. To end poverty through elimination of its causes, NCD programmes should be included in the development agenda. National programmes should mitigate social and health shocks to protect the poor from events that worsen their frail socioeconomic condition and health status. Programmes related to universal health coverage of NCDs should specifically target susceptible populations, such as elderly people, who are most at risk. Growing inequalities in access to resources for prevention and treatment need to

A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India.

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Travasso, Sandra Mary; Rajaraman, Divya; Heymann, Sally Jody

2014-02-07

Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated with negative mental health amongst

Parental Attitudes, Behaviors, and Barriers to School Readiness among Parents of Low-Income Latino Children

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Jaime Peterson

2018-01-01

Full Text Available We sought to explore parental attitudes, behaviors, and barriers regarding school readiness in a county clinic serving low income, Latino children. Between December 2013–September 2014, we conducted a cross sectional survey of parents during 3–6 years well-child appointments about school readiness (SR across: (1 attitudes/behaviors; (2 barriers; and (3 awareness; and (4 use of local resources. Most parents (n = 210, response rate 95.6% find it very important/important for their child to know specific skills prior to school: take turns and share (98.5%, use a pencil and count (97.6%, know letters (99.1%, colors (97.1%, and shapes (96.1%. Over 80% of parents find education important and engage in positive SR behaviors: singing, practicing letters, or reading. Major barriers to SR were lack of knowledge for kindergarten readiness, language barriers, access to books at home, constraints on nightly reading, difficulty completing school forms, and limited free time with child. Awareness of local resources such as preschool programs was higher than actual utilization. These low-income, Latino parents value SR but lack knowledge to prepare their child for school and underutilize community resources such as free preschool programs. Pediatricians are uniquely positioned to address these needs, but more evidence-based interventions are needed.

Family Investments in Low-Income Children's Achievement and Socioemotional Functioning

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Longo, Francesca; McPherran Lombardi, Caitlin; Dearing, Eric

2017-01-01

Family processes and parenting practices help explain developmental differences between children in low- versus higher-income households. There are, however, few studies addressing the question of: what are the key family processes and parenting practices for promoting low-income children's growth? We address this question in the present study,…

Timeliness of abnormal screening and diagnostic mammography follow-up at facilities serving vulnerable women.

Science.gov (United States)

Goldman, L Elizabeth; Walker, Rod; Hubbard, Rebecca; Kerlikowske, Karla

2013-04-01

Whether timeliness of follow-up after abnormal mammography differs at facilities serving vulnerable populations, such as women with limited education or income, in rural areas, and racial/ethnic minorities is unknown. We examined receipt of diagnostic evaluation after abnormal mammography using 1998-2006 Breast Cancer Surveillance Consortium-linked Medicare claims. We compared whether time to recommended breast imaging or biopsy depended on whether women attended facilities serving vulnerable populations. We characterized a facility by the proportion of mammograms performed on women with limited education or income, in rural areas, or racial/ethnic minorities. We analyzed 30,874 abnormal screening examinations recommended for follow-up imaging across 142 facilities and 10,049 abnormal diagnostic examinations recommended for biopsy across 114 facilities. Women at facilities serving populations with less education or more racial/ethnic minorities had lower rates of follow-up imaging (4%-5% difference, Pfacilities serving more rural and low-income populations had lower rates of biopsy (4%-5% difference, Pfacilities serving vulnerable populations had longer times until biopsy than those at facilities serving nonvulnerable populations (21.6 vs. 15.6 d; 95% confidence interval for mean difference 4.1-7.7). The proportion of women receiving recommended imaging within 11 months and biopsy within 3 months varied across facilities (interquartile range, 85.5%-96.5% for imaging and 79.4%-87.3% for biopsy). Among Medicare recipients, follow-up rates were slightly lower at facilities serving vulnerable populations, and among those women who returned for diagnostic evaluation, time to follow-up was slightly longer at facilities that served vulnerable population. Interventions should target variability in follow-up rates across facilities, and evaluate effectiveness particularly at facilities serving vulnerable populations.

Internet use among low-income persons recently diagnosed with HIV infection.

Science.gov (United States)

Mayben, J K; Giordano, T P

2007-10-01

Patients are increasingly using the Internet to obtain health-related information, communicate with providers and access research. Use of the Internet to obtain health-related information by low-income patients recently diagnosed with HIV infection has not been examined. In 2005, we surveyed 126 low-income patients diagnosed with HIV infection within the last three years. Eighty-five percent of the patients wereInternet to access information about HIV, 52% had never used the Internet, 28% had never used it to obtain health-related information and only 18% had done so at least monthly for the last six months. Two-thirds of the population studied would need instruction on how to use the Internet. In multivariable regression, 2004 income > or =$15,000 predicted monthly Internet use to obtain health-related information. Older age, heterosexual intercourse as HIV risk factor and inadequate health literacy were independent predictors of needing instruction. The low-income population with HIV infection lags behind the general population in Internet access and may not benefit from Internet-dependent advances in health communication, including HIV-related interventions.

Simulated Models Suggest That Price per Calorie Is the Dominant Price Metric That Low-Income Individuals Use for Food Decision Making123

Science.gov (United States)

2016-01-01

Background: The price of food has long been considered one of the major factors that affects food choices. However, the price metric (e.g., the price of food per calorie or the price of food per gram) that individuals predominantly use when making food choices is unclear. Understanding which price metric is used is especially important for studying individuals with severe budget constraints because food price then becomes even more important in food choice. Objective: We assessed which price metric is used by low-income individuals in deciding what to eat. Methods: With the use of data from NHANES and the USDA Food and Nutrient Database for Dietary Studies, we created an agent-based model that simulated an environment representing the US population, wherein individuals were modeled as agents with a specific weight, age, and income. In our model, agents made dietary food choices while meeting their budget limits with the use of 1 of 3 different metrics for decision making: energy cost (price per calorie), unit price (price per gram), and serving price (price per serving). The food consumption patterns generated by our model were compared to 3 independent data sets. Results: The food choice behaviors observed in 2 of the data sets were found to be closest to the simulated dietary patterns generated by the price per calorie metric. The behaviors observed in the third data set were equidistant from the patterns generated by price per calorie and price per serving metrics, whereas results generated by the price per gram metric were further away. Conclusions: Our simulations suggest that dietary food choice based on price per calorie best matches actual consumption patterns and may therefore be the most salient price metric for low-income populations. PMID:27655757

Food Stress in Adelaide: The Relationship between Low Income and the Affordability of Healthy Food

Directory of Open Access Journals (Sweden)

Paul R. Ward

2013-01-01

Full Text Available Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy Food Basket” methodology, this study costed a week’s supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability. It is argued that families that spend more than 30% of household income on food could be experiencing “food stress.” Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

Assessment of Low-Income Adults' Access to Technology: Implications for Nutrition Education

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Neuenschwander, Lauren M.; Abbott, Angela; Mobley, Amy R.

2012-01-01

Objective: The main objective of this study was to investigate access and use of technologies such as the Internet among Indiana's low-income population. The secondary objective was to determine whether access and use of computers significantly differed by age, race, and/or education level. Methods: Data were collected from low-income adult…

Effects of simplifying outreach materials for energy conservation programs that target low-income consumers

International Nuclear Information System (INIS)

Wong-Parodi, Gabrielle; Bruine de Bruin, Wändi; Canfield, Casey

2013-01-01

Critics have speculated that the limited success of energy conservation programs among low-income consumers may partly be due to recipients having insufficient literacy to understand the outreach materials. Indeed, we found outreach materials for low-income consumers to require relatively high levels of reading comprehension. We therefore improved the Flesch–Kincaid readability statistics for two outreach brochures, by using shorter words and shorter sentences to describe their content. We examined the effect of that simplification on low-income consumers′ responses. Participants from low-income communities in the greater Pittsburgh area, who varied in literacy, were randomly assigned to either original communications about energy conservation programs or our simplified versions. Our findings suggest that lowering readability statistics successfully simplified only the more straightforward brochure in our set of two, likely because its content lent itself better to simplification. Findings for this brochure showed that simplification improved understanding of its content among both low-literacy and high-literacy recipients, without adversely affecting their evaluation of the materials, or their intention to enroll in the advertised programs. We discuss strategies for improving communication materials that aim to reach out to low-income populations. - Highlights: • Brochures about energy programs for low-income consumers can be too hard to read. • We made brochures easier to read by using shorter words and shorter sentences. • Simplifying a straightforward brochure improved the understanding of all recipients. • However, simplifying a complex brochure had no effect on understanding. • We suggest strategies for improving outreach to low-income consumers

Examining the feasibility of implementing behavioural economics strategies that encourage home dinner vegetable intake among low-income children.

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Leak, Tashara M; Swenson, Alison; Rendahl, Aaron; Vickers, Zata; Mykerezi, Elton; Redden, Joseph P; Mann, Traci; Reicks, Marla

2017-06-01

To examine the feasibility of implementing nine behavioural economics-informed strategies, or 'nudges', that aimed to encourage home dinner vegetable intake among low-income children. Caregivers were assigned six of nine strategies and implemented one new strategy per week (i.e. 6 weeks) during three dinner meals. Caregivers recorded child dinner vegetable intake on the nights of strategy implementation and rated the level of difficulty for assigned strategies. Baseline data on home vegetable availability and child vegetable liking were collected to assess overall strategy feasibility. Participants' homes in a large Midwestern metropolitan area, USA. Low-income caregiver/child (aged 9-12 years) dyads (n 39). Pairwise comparisons showed that child dinner vegetable intake for the strategy 'Serve at least two vegetables with dinner meals' was greater than intake for each of two other strategies: 'Pair vegetables with other foods the child likes' and 'Eat dinner together with an adult(s) modelling vegetable consumption'. Overall, caregivers' mean rating of difficulty for implementing strategies was 2·6 (1='not difficult', 10='very difficult'). Households had a mean of ten different types of vegetables available. Children reported a rating ≥5 for seventeen types of vegetable on a labelled hedonic scale (1='hate it', 5-6='it's okay', 10='like it a lot'). Behavioural economics-informed strategies are feasible to implement during dinner meals, with some strategies differing by how much they influence vegetable intake among low-income children in the home.

Maternal Health Status and Parenting Stress in Low-Income, Ethnic-Minority Mothers of Children with Conduct Disorder Problems: the Role of Daily Parenting Hassles.

Science.gov (United States)

BeLue, Rhonda; Halgunseth, Linda C; Abiero, Beatrice; Bediako, Phylicia

2015-12-01

Minimal attention has been given to understanding parenting stress among low-income, ethnically diverse mothers of children with conduct problems. Maternal health and parenting hassles may serve as important risk factors for parenting stress. This study examined whether parenting hassles mediated the relations between maternal physical and mental health and parenting stress in a sample of low-income, ethnically diverse mothers of children with behavioral problems. The sample included 177 low-income black, Latina, and white mothers of kindergartners with behavior problems. Path analysis was employed to assess the associations between maternal mental and physical health and parenting stress, as well as the moderating role of parenting hassles in this cross-sectional study. After adjusting for covariates, we found that parenting hassles mediated the relationship between social support and parenting stress as well as maternal health and parenting stress. Findings suggest that promoting coping resources for daily parenting hassles and supporting the physical and mental health of minority mothers may have important implications for parenting children with high behavior problems.

Adverse childhood experiences of low-income urban youth.

Science.gov (United States)

Wade, Roy; Shea, Judy A; Rubin, David; Wood, Joanne

2014-07-01

Current assessments of adverse childhood experiences (ACEs) may not adequately encompass the breadth of adversity to which low-income urban children are exposed. The purpose of this study was to identify and characterize the range of adverse childhood experiences faced by young adults who grew up in a low-income urban area. Focus groups were conducted with young adults who grew up in low-income Philadelphia neighborhoods. Using the nominal group technique, participants generated a list of adverse childhood experiences and then identified the 5 most stressful experiences on the group list. The most stressful experiences identified by participants were grouped into a ranked list of domains and subdomains. Participants identified a range of experiences, grouped into 10 domains: family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, child welfare/juvenile justice, and media/technology. Included in these domains were many but not all of the experiences from the initial ACEs studies; parental divorce/separation and mental illness were absent. Additional experiences not included in the initial ACEs but endorsed by our participants included single-parent homes; exposure to violence, adult themes, and criminal behavior; personal victimization; bullying; economic hardship; and discrimination. Gathering youth perspectives on childhood adversity broadens our understanding of the experience of stress and trauma in childhood. Future work is needed to determine the significance of this broader set of adverse experiences in predisposing children to poor health outcomes as adults. Copyright © 2014 by the American Academy of Pediatrics.

Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

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Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

2017-12-01

Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

Examining the implications of dental treatment costs for low-income families.

Science.gov (United States)

Snow, Patrick; McNally, Mary E

2010-01-01

Dental disease is concentrated among those with low socioeconomic status. Dental care is not publicly funded, and many Canadians must therefore make difficult financial choices when accessing dental care. Families who live in poverty have difficulty meeting even their most basic household needs, so dental treatment may not be affordable. The objective of this study was to understand how the cost of dental treatment affects the monthly budgets of families with low incomes. A chart review was conducted for a sample of 213 new patients examined at the Dalhousie University dental clinic over a 1-year period. Costs for proposed treatment plans were averaged. The patients" ability to pay for proposed treatment was examined in the context of various income scenarios. Two hundred and one patients were included in the final analysis. Dental treatment costs per patient averaged approximately $1600 for the year, with 42% of the planned treatment completed within the first year. The estimated monthly cost of completed treatment was $55. When the cost of a healthy diet was included in the monthly budget, it was determined that families in Nova Scotia with parents working for minimum wage and those receiving income assistance would experience a 100% shortfall for dental expenses. Low-income families in Nova Scotia were unable to afford both a nutritious diet and dental care. This is disturbing, given the links between a healthy diet and both overall health and dental health. An understanding of the significance of income shortfalls for those with low incomes, especially as they affect even basic nutritional needs, will help dental professionals to appreciate the seriousness of this issue and the difficulties that many Canadians face when trying to access basic dental care.

Medicines coverage and community-based health insurance in low-income countries

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Wagner Anita K

2008-10-01

Full Text Available Abstract Objectives The 2004 International Conference on Improving Use of Medicines recommended that emerging and expanding health insurances in low-income countries focus on improving access to and use of medicines. In recent years, Community-based Health Insurance (CHI schemes have multiplied, with mounting evidence of their positive effects on financial protection and resource mobilization for healthcare in poor settings. Using literature review and qualitative interviews, this paper investigates whether and how CHI expands access to medicines in low-income countries. Methods We used three complementary data collection approaches: (1 analysis of WHO National Health Accounts (NHA and available results from the World Health Survey (WHS; (2 review of peer-reviewed articles published since 2002 and documents posted online by national insurance programs and international organizations; (3 structured interviews of CHI managers about key issues related to medicines benefit packages in Lao PDR and Rwanda. Results In low-income countries, only two percent of WHS respondents with voluntary insurance belong to the lowest income quintile, suggesting very low CHI penetration among the poor. Yet according to the WHS, medicines are the largest reported component of out-of-pocket payments for healthcare in these countries (median 41.7% and this proportion is inversely associated with income quintile. Publications have mentioned over a thousand CHI schemes in 19 low-income countries, usually without in-depth description of the type, extent, or adequacy of medicines coverage. Evidence from the literature is scarce about how coverage affects medicines utilization or how schemes use cost-containment tools like co-payments and formularies. On the other hand, interviews found that medicines may represent up to 80% of CHI expenditures. Conclusion This paper highlights the paucity of evidence about medicines coverage in CHI. Given the policy commitment to expand CHI

Social marketing nutrition education for low-income population.

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Hagues, Rachel; Stotz, Sarah; Childers, Austin; Phua, Joe; Hibbs, Judy; Murray, Deborah; Lee, Jung Sun

2018-01-01

As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.

Bucking the trend? Health care expenditures in low-income countries 1990-1995.

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Jowett, M

1999-01-01

Health care expenditures in low-income countries are analysed for the years 1990 and 1995 using four key indicators. Key findings include a substantial reduction in public spending per capita across low-income countries between 1990-95; a significant shift towards private expenditures, which appears increasingly to be substituting rather than supplementing public expenditures; a fall in total and public health spending in many countries despite growth in national income, contradicting the relationship found in other studies. Two possible explanations are put forward. First that the patterns found are a direct result of the structural adjustment policies adopted by many low-income countries, which aim to control and often cut public financing, whilst promoting private health expenditures. Secondly, that following the wave of privatization of state industries, many governments are finding problems adapting to their new role as a tax collector, and are thus not benefiting from economic growth to the extent that might be expected.

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth.

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Trude, Angela Cristina Bizzotto; Kharmats, Anna Yevgenyevna; Hurley, Kristen Marie; Anderson Steeves, Elizabeth; Talegawkar, Sameera A; Gittelsohn, Joel

2016-08-24

Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD. Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income. On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable

Pharmaceutical quality assurance of local private distributors: a secondary analysis in 13 low-income and middle-income countries

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Caudron, Jean Michel; Schiavetti, Benedetta; Pouget, Corinne; Tsoumanis, Achilleas; Meessen, Bruno; Ravinetto, Raffaella

2018-01-01

Introduction The rapid globalisation of the pharmaceutical production and distribution has not been supported by harmonisation of regulatory systems worldwide. Thus, the supply systems in low-income and middle-income countries (LMICs) remain exposed to the risk of poor-quality medicines. To contribute to estimating this risk in the private sector in LMICs, we assessed the quality assurance system of a convenient sample of local private pharmaceutical distributors. Methods This descriptive study uses secondary data derived from the audits conducted by the QUAMED group at 60 local private pharmaceutical distributors in 13 LMICs. We assessed the distributors’ compliance with good distribution practices (GDP), general quality requirements (GQR) and cold chain management (CCM), based on an evaluation tool inspired by the WHO guidelines ’Model Quality Assurance System (MQAS) for procurement agencies'. Descriptive statistics describe the compliance for the whole sample, for distributors in sub-Saharan Africa (SSA) versus those in non-SSA, and for those in low-income countries (LICs) versus middle-income countries (MICs). Results Local private pharmaceutical distributors in our sample were non-compliant, very low-compliant or low-compliant for GQR (70%), GDP (60%) and CCM (41%). Only 7/60 showed good to full compliance for at least two criteria. Observed compliance varies by geographical region and by income group: maximum values are higher in non-SSA versus SSA and in MICs versus LICs, while minimum values are the same across different groups. Conclusion The poor compliance with WHO quality standards observed in our sample indicates a concrete risk that patients in LMICs are exposed to poor-quality or degraded medicines. Significant investments are needed to strengthen the regulatory supervision, including on private pharmaceutical distributors. An adapted standardised evaluation tool inspired by the WHO MQAS would be helpful for self-evaluation, audit and inspection

Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

Directory of Open Access Journals (Sweden)

Arafat Tfayli

2010-01-01

Full Text Available Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.

Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries.

Science.gov (United States)

Engle, Patrice L; Fernald, Lia C H; Alderman, Harold; Behrman, Jere; O'Gara, Chloe; Yousafzai, Aisha; de Mello, Meena Cabral; Hidrobo, Melissa; Ulkuer, Nurper; Ertem, Ilgi; Iltus, Selim

2011-10-08

This report is the second in a Series on early child development in low-income and middle-income countries and assesses the effectiveness of early child development interventions, such as parenting support and preschool enrolment. The evidence reviewed suggests that early child development can be improved through these interventions, with effects greater for programmes of higher quality and for the most vulnerable children. Other promising interventions for the promotion of early child development include children's educational media, interventions with children at high risk, and combining the promotion of early child development with conditional cash transfer programmes. Effective investments in early child development have the potential to reduce inequalities perpetuated by poverty, poor nutrition, and restricted learning opportunities. A simulation model of the potential long-term economic effects of increasing preschool enrolment to 25% or 50% in every low-income and middle-income country showed a benefit-to-cost ratio ranging from 6·4 to 17·6, depending on preschool enrolment rate and discount rate. Copyright © 2011 Elsevier Ltd. All rights reserved.

Bringing Bike Share to a Low-Income Community

Centers for Disease Control (CDC) Podcasts

This podcast is an interview with Sarah Kretman Stewart, MPH, MEd, Healthy Living Minneapolis Project Specialist at the Minneapolis Health Department. In this program, Sarah talks about the impact a bike share program had on the low-income town of Near North, Minnesota.

26 CFR 1.42-1T - Limitation on low-income housing credit allowed with respect to qualified low-income buildings...

Science.gov (United States)

2010-04-01

... credit agencies for exclusive use in making housing credit allocations to buildings that are part of... housing credit allocations in excess of an agency's aggregate housing credit dollar amount. In the event... not perform an independent investigation of the qualified low-income building in order to certify on...

Evaluation of DOE's Partnership in Low-Income Residential Retrofit (PILIRR) Program

Energy Technology Data Exchange (ETDEWEB)

Callaway, J.W.; Lee, A.D.

1989-05-01

In July 1986, the US Department of Energy (DOE) awarded competitive grants to five states to conduct pilot projects to establish partnerships and use resource leveraging to stimulate support for low-income residential energy retrofits. The projects were conducted under DOE's Partnerships in Low-Income Residential Retrofit (PILIRR) Program. These projects have been monitored and analyzed through a concurrent process evaluation conducted by the Pacific Northwest Laboratory (PNL). This study reports the findings of that evaluation. The overriding goal of the PILIRR Program was to determine whether the states could stimulate support for low-income residential energy improvements from non-federal sources. The goal for the process evaluation was to conduct an assessment of the processes used by the states and the extent to which they successfully established partnerships and leveraged resources. Five states were selected to participate in the program: Florida, Iowa, Kentucky, Oklahoma and Washington. Each state proposed a different approach to promote non-federal support for low-income residential weatherization. Three of the five states--Florida, Iowa, and Washington--established partnerships that led to retrofits during the monitoring period (October 1986--October 1988). Kentucky established its partnership during the monitoring period, but did not accomplish its retrofits until after monitoring was complete. Oklahoma completed development of its marketing program and had begun marketing efforts by the end of the monitoring period. 16 refs., 7 figs., 1 tab.

Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis.

Science.gov (United States)

Siriwardhana, Dhammika D; Hardoon, Sarah; Rait, Greta; Weerasinghe, Manuj C; Walters, Kate R

2018-03-01

To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs. Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083. MEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017. Low-income and middle-income countries. Community-dwelling older adults aged ≥60 years. We screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I 2 =99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I 2 =97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years. The prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries. CRD42016036083. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Playing Linear Numerical Board Games Promotes Low-Income Children's Numerical Development

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Siegler, Robert S.; Ramani, Geetha B.

2008-01-01

The numerical knowledge of children from low-income backgrounds trails behind that of peers from middle-income backgrounds even before the children enter school. This gap may reflect differing prior experience with informal numerical activities, such as numerical board games. Experiment 1 indicated that the numerical magnitude knowledge of…

Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey.

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kunst, Anton; Harper, Sam; Guthold, Regina; Rekve, Dag; d'Espaignet, Edouard Tursan; Naidoo, Nirmala; Chatterji, Somnath

2012-10-28

Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different

Nutrient offerings from the meals and snacks served in four daycare centers in Guatemala City.

NARCIS (Netherlands)

Vossenaar, M.; Panday, B.; Hamelinck, V.; Soto-Méndez, M.J.; Doak, C.M.; Solomons, N.W.

2011-01-01

Objective: To assess the nutritional content and contribution to recommended nutrient intakes of the menu offerings in diverse daycare centers serving low-income urban families in Guatemala City. Methods: An observational study design was used to record all food and drink items offered to children

Narrowing the Early Mathematics Gap: A Play-Based Intervention to Promote Low-Income Preschoolers’ Number Skills

Directory of Open Access Journals (Sweden)

Nicole R. Scalise

2018-01-01

Full Text Available Preschoolers from low-income households lag behind preschoolers from middle-income households on numerical skills that underlie later mathematics achievement. However, it is unknown whether these gaps exist on parallel measures of symbolic and non-symbolic numerical skills. Experiment 1 indicated preschoolers from low-income backgrounds were less accurate than peers from middle-income backgrounds on a measure of symbolic magnitude comparison, but they performed equivalently on a measure of non-symbolic magnitude comparison. This suggests activities linking non-symbolic and symbolic number representations may be used to support children’s numerical knowledge. Experiment 2 randomly assigned low-income preschoolers (Mean Age = 4.7 years to play either a numerical magnitude comparison or a numerical matching card game across four 15 min sessions over a 3-week period. The magnitude comparison card game led to significant improvements in participants’ symbolic magnitude comparison skills in an immediate posttest assessment. Following the intervention, low-income participants performed equivalently to an age- and gender-matched sample of middle-income preschoolers in symbolic magnitude comparison. These results suggest a brief intervention that combines non-symbolic and symbolic magnitude representations can support low-income preschoolers’ early numerical knowledge.

Critical Components of a Summer Enrichment Program for Urban Low-Income Gifted Students

Science.gov (United States)

Kaul, Corina R.; Johnsen, Susan K.; Witte, Mary M.; Saxon, Terrill F.

2015-01-01

Effective program models are needed for low-income youth. This article describes one successful summer enrichment program, University for Young People's Project Promise, and outlines three key components of a Partnership for Promoting Potential in Low-Income Gifted Students (Partnership Model), which is based on Lee, Olszewski-Kubilius, and…

Access to housing subsidies, housing status, drug use and HIV risk among low-income U.S. urban residents

Directory of Open Access Journals (Sweden)

Dickson-Gomez Julia

2011-11-01

Full Text Available Abstract Background Much research has shown an association between homelessness and unstable housing and HIV risk but most has relied on relatively narrow definitions of housing status that preclude a deeper understanding of this relationship. Fewer studies have examined access to housing subsidies and supportive housing programs among low-income populations with different personal characteristics. This paper explores personal characteristics associated with access to housing subsidies and supportive housing, the relationship between personal characteristics and housing status, and the relationship between housing status and sexual risk behaviors among low-income urban residents. Methods Surveys were conducted with 392 low-income residents from Hartford and East Harford, Connecticut through a targeted sampling plan. We measured personal characteristics (income, education, use of crack, heroin, or cocaine in the last 6 months, receipt of welfare benefits, mental illness diagnosis, arrest, criminal conviction, longest prison term served, and self-reported HIV diagnosis; access to housing subsidies or supportive housing programs; current housing status; and sexual risk behaviors. To answer the aims above, we performed univariate analyses using Chi-square or 2-sided ANOVA's. Those with significance levels above (0.10 were included in multivariate analyses. We performed 2 separate multiple regressions to determine the effects of personal characteristics on access to housing subsidies and access to supportive housing respectively. We used multinomial main effects logistic regression to determine the effects of housing status on sexual risk behavior. Results Being HIV positive or having a mental illness predicted access to housing subsidies and supportive housing, while having a criminal conviction was not related to access to either housing subsidies or supportive housing. Drug use was associated with poorer housing statuses such as living on the

24 CFR 5.611 - Adjusted income.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Adjusted income. 5.611 Section 5... Serving Persons with Disabilities: Family Income and Family Payment; Occupancy Requirements for Section 8 Project-Based Assistance Family Income § 5.611 Adjusted income. Adjusted income means annual income (as...

Neurodevelopmental Disorders in Low- and Middle-Income Countries

Science.gov (United States)

Newton, Charles R.

2012-01-01

In "Global Perspective on Early Diagnosis and Intervention for Children with Developmental Delays and Disabilities" (p1079-1084, this issue), Scherzer et al. highlighted the potential increase in neurodevelopmental impairments and disabilities affecting an increasing number of children in low- and middle-income countries (LMIC). In this…

Access to and use of paid sick leave among low-income families with children.

Science.gov (United States)

Clemans-Cope, Lisa; Perry, Cynthia D; Kenney, Genevieve M; Pelletier, Jennifer E; Pantell, Matthew S

2008-08-01

The ability of employed parents to meet the health needs of their children may depend on their access to sick leave, especially for low-income workers, who may be afforded less flexibility in their work schedules to accommodate these needs yet also more likely to have children in poor health. Our goal was to provide rates of access to paid sick leave and paid vacation leave among low-income families with children and to assess whether access to these benefits is associated with parents' leave taking to care for themselves or others. We used a sample of low-income families (paid leave and characteristics of children, families, and parents' employer. Access to paid leave was lower among children in low-income families than among those in families with higher income. Within low-income families, children without >or=1 full-time worker in the household were especially likely to lack access to this benefit, as were children whose parents work for small employers. Among children whose parents had access to paid sick leave, parents were more likely to take time away from work to care for themselves or others. This relationship is even more pronounced among families with the highest need, such as children in fair or poor health and children with all parents in full-time employment. Legislation mandating paid sick leave could dramatically increase access to this benefit among low-income families. It would likely diminish gaps in parents' leave taking to care for others between families with and without the benefit. However, until the health-related consequences are better understood, the full impact of such legislation remains unknown.

Low-Income Demand for Local Telephone Service: Effects of Lifeline and Linkup

OpenAIRE

Daniel Ackerberg; Michael Riordan; Gregory Rosston; Bradley Wimmer

2008-01-01

A comprehensive data set on local telephone service prices is used to evaluate the effect of Lifeline and Linkup programs on the telephone penetration rates of low-income households in the United States. Lifeline and Linkup programs respectively subsidize the monthly subscription and initial installation charges of eligible low-income households. Telephone penetration rates are explained by an estimated nonlinear function of local service characteristics (including subsidized prices) and the ...

Health-related quality-of-life in low-income, uninsured men with prostate cancer.

Science.gov (United States)

Krupski, Tracey L; Fink, Arlene; Kwan, Lorna; Maliski, Sally; Connor, Sarah E; Clerkin, Barbara; Litwin, Mark S

2005-05-01

The objective was to describe health-related quality-of-life (HRQOL) in low-income men with prostate cancer. Subjects were drawn from a statewide public assistance prostate cancer program. Telephone and mail surveys included the RAND 12-item Health Survey and UCLA Prostate Cancer Index Short Form and were compared with normative age-matched men without cancer from the general population reported on in the literature. Of 286 eligible men, 233 (81%) agreed to participate and completed the necessary items. The sample consisted of 51% Hispanics, 23% non-Hispanic whites, and 17% African Americans. The low-income men had worse scores in every domain of prostate-specific and general HRQOL than had the age-matched general population controls. The degree of disparity indicated substantial clinical differences in almost every domain of physical and emotional functioning between the sample group and the control group. Linear regression modeling determined that among the low-income men, Hispanic race, and income level were predictive of worse physical functioning, whereas only comorbidities predicted mental health. Low-income patients with prostate cancer appear to have quality-of-life profiles that are meaningfully worse than age-matched men from the general population without cancer reported on in the literature.

Institutional Variation in Enrollment of Low-Income Students

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Monks, James

2018-01-01

Socioeconomic diversity in tertiary education has come under heightened scrutiny in the past few years. This paper estimates the relationship between prices (both sticker price and net price), financial aid policies, and selectivity on the variation of low-income students across postsecondary institutions. All three factors are significant in…

Impact of Pneumococcal Conjugate Vaccines on Pneumonia Hospitalizations in High- and Low-Income Subpopulations in Brazil

DEFF Research Database (Denmark)

Warren, Joshua L.; Shioda, Kayoko; Kürüm, Esra

2017-01-01

Background Pneumococcal conjugate vaccines (PCVs) are being used worldwide. A key question is whether the impact of PCVs on pneumonia is similar in low- and high-income populations. However, most low-income countries, where the burden of disease is greatest, lack reliable data that can be used...... to evaluate the impact. Data from middle-income countries that have both low- and high-income subpopulations can provide a proxy measure for the impact of the vaccine in low-income countries. Methods We evaluated the impact of PCV10 on hospitalizations for all-cause pneumonia in Brazil, a middle......-income country with localities that span a broad range of human development index (HDI) levels. We used complementary time series and spatiotemporal methods (synthetic controls and hierarchical Bayesian spatial regression) to test whether the decline in pneumonia hospitalizations associated with vaccine...

Consumer-led demand side financing in health and education and its relevance for low and middle income countries.

Science.gov (United States)

Ensor, Tim

2004-01-01

There is increasing awareness that supply subsidies for health and education services often fail to benefit those that are most vulnerable in a community. This recognition has led to a growing interest in and experimentation with, consumer-led demand side financing systems (CL-DSF). These mechanisms place purchasing power in the hands of consumers to spend on specific services at accredited facilities. International evidence in education and health sectors suggest a limited success of CL-DSF in raising the consumption of key services amongst priority groups. There is also some evidence that vouchers can be used to improve targeting of vulnerable groups. There is very little positive evidence on the effect of CL-DSF on service quality as a consequence of greater competition. Location of services relative to population means that areas with more provider choice, particularly in the private sector, tend to be dominated by higher and middle-income households. Extending CL-DSF in low-income countries requires the development of capacity in administering these financing schemes and also accrediting providers. Schemes could focus primarily on fixed packages of key services aimed at easily identifiable groups. Piloting and robust evaluation is required to fill the evidence gap on the impact of these mechanisms. Extending demand financing to less predictable services, such as hospital coverage for the population, is likely to require the development of a voucher scheme to purchase insurance. This suggests an already developed insurance market and is unlikely to be appropriate in most low-income countries for some time.

Postpartum Health Information Seeking Using Mobile Phones: Experiences of Low-Income Mothers.

Science.gov (United States)

Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Harris, Asia L; Siek, Katie A

2016-11-01

Objectives To assess low-income mothers' perceptions of their postpartum information needs; describe their information seeking behavior; explore their use of mobile technology to address those needs; and to contribute to the sparse literature on postpartum health and wellness. Methods Exploratory community-based qualitative approach. Interviewees were recruited among clients of community partners and had children aged 48 months and under. A survey assessing demographics was used to identify low-income mothers. 10 low-income mothers were recruited from survey participants to complete in-depth interviews regarding postpartum information needs, information seeking, and technology use. Interviews were transcribed verbatim and coded by three researchers independently. Narratives were analyzed along predetermined (etic) and emergent (emic) categories. Results Establishing breastfeeding and solving breastfeeding problems were central postpartum concerns leading to information seeking. Interviewees reported almost exclusive use of mobile phones to access the Internet. Mobile applications were widely used during pregnancy, but were not valuable postpartum. Face-to-face information from medical professionals was found to be repetitive. Online information seeking was mediated by default mobile phone search engines, and occurred over short, fragmented time periods. College graduates reported searching for authoritative knowledge sources; non-graduates preferred forums. Conclusions for Practice Low-income postpartum women rely on their smartphones to find online infant care and self-care health information. Websites replace pregnancy-related mobile applications and complement face-to-face information. Changes in searching behavior and multitasking mean information must be easily accessible and readily understood. Knowledge of page-rank systems and use of current and emergent social media will allow health-related organizations to better engage with low-income mothers online and

Energy Efficiency and Renewable Energy in Low-Income Communities

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State and local governments can provide benefits to low-income communities by investing in energy efficiency. Use the Program Finder table to identify those programs that reach the sectors and audiences of interest in your organization.

National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010

DEFF Research Database (Denmark)

Lee, Anne C C; Katz, Joanne; Blencowe, Hannah

2013-01-01

million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were......BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low...... birthweight (age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from...

Financial arrangements for health systems in low-income countries: an overview of systematic reviews.

Science.gov (United States)

Wiysonge, Charles S; Paulsen, Elizabeth; Lewin, Simon; Ciapponi, Agustín; Herrera, Cristian A; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Oxman, Andrew D

2017-09-11

is uncertain whether they improve completion of treatment for active tuberculosis. Conditional cash transfer programmes probably lead to an increase in service utilisation (moderate-certainty evidence), but their effects on health outcomes are uncertain. Vouchers may improve health service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). Introducing a restrictive cap may decrease use of medicines for symptomatic conditions and overall use of medicines, may decrease insurers' expenditures on medicines (low-certainty evidence), and has uncertain effects on emergency department use, hospitalisations, and use of outpatient care (very low-certainty evidence). Reference pricing, maximum pricing, and index pricing for drugs have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs. Provider incentives: the effects of provider incentives are uncertain (very low-certainty evidence), including: the effects of provider incentives on the quality of care provided by primary care physicians or outpatient referrals from primary to secondary care, incentives for recruiting and retaining health professionals to serve in remote areas, and the effects of pay-for-performance on provider performance, the utilisation of services, patient outcomes, or resource use in low-income countries. Research based on sound systematic review methods has evaluated numerous financial arrangements relevant to low-income countries, targeting different levels of the health systems and assessing diverse outcomes. However, included reviews rarely reported social outcomes, resource use, equity impacts, or undesirable effects. We also identified gaps in primary research because of uncertainty about applicability of the evidence to low-income countries. Financial arrangements for which the effects are uncertain include external funding (aid), caps and co-payments, pay-for-performance, and

Tailoring science education graduate programs to the needs of science educators in low-income countries

Science.gov (United States)

Lunetta, Vincent N.; van den Berg, Euwe

Science education graduate programs in high-income countries frequently enroll students from low-income countries. Upon admission these students have profiles of knowledge, skills, and experiences which can be quite different from those of students from the host high-income countries. Upon graduation, they will normally return to work in education systems with conditions which differ greatly from those in high-income countries. This article attempts to clarify some of the differences and similarities between such students. It offers suggestions for making graduate programs more responsive to the special needs of students from low-income countries and to the opportunities they offer for enhancing cross-cultural sensitivity. Many of the suggestions can be incorporated within existing programs through choices of elective courses and topics for papers, projects, and research. Many references are provided to relevant literature on cultural issues and on science education in low-income countries.

Positive Reading Attitudes of Low-Income Bilingual Latinos

Science.gov (United States)

Bussert-webb, Kathy M.; Zhang, Zhidong

2018-01-01

Many assume low-income, emergent bilingual Latinos have poor reading attitudes. To investigate this issue, we surveyed 1,503 Texas public high school students through stratified cluster sampling to determine their reading attitudes. Most represented Latinos and mixed-race Latinos/Whites who heard Spanish at home and whose mother tongue was…

Mental health interventions in schools in low-income and middle-income countries.

Science.gov (United States)

Fazel, Mina; Patel, Vikram; Thomas, Saji; Tol, Wietse

2014-10-01

Increasing enrolment rates could place schools in a crucial position to support mental health in low-income and middle-income countries. In this Review, we provide evidence for mental health interventions in schools in accordance with a public mental health approach spanning promotion, prevention, and treatment. We identified a systematic review for mental health promotion, and identified further prevention and treatment studies. Present evidence supports schools as places for promotion of positive aspects of mental health using a whole-school approach. Knowledge of effectiveness of prevention and treatment interventions is more widely available for conflict-affected children and adolescents. More evidence is needed to identify the many elements likely to be associated with effective prevention and treatment for children exposed to a range of adversity and types of mental disorders. Dissemination and implementation science is crucial to establish how proven effective interventions could be scaled up and implemented in schools. Copyright © 2014 Elsevier Ltd. All rights reserved.

Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions.

Science.gov (United States)

Sayed, Shahin; Cherniak, William; Lawler, Mark; Tan, Soo Yong; El Sadr, Wafaa; Wolf, Nicholas; Silkensen, Shannon; Brand, Nathan; Looi, Lai Meng; Pai, Sanjay A; Wilson, Michael L; Milner, Danny; Flanigan, John; Fleming, Kenneth A

2018-05-12

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan. Copyright © 2018 Elsevier Ltd. All rights reserved.

Food Stress in Adelaide: The Relationship between Low Income and the Affordability of Healthy Food

OpenAIRE

Paul R. Ward; Fiona Verity; Patricia Carter; George Tsourtos; John Coveney; Kwan Chui Wong

2013-01-01

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy ...

Prevalence study of compulsive buying in a sample with low individual monthly income.

Science.gov (United States)

Leite, Priscilla Lourenço; Silva, Adriana Cardoso

2015-01-01

Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Despite the small sample, the results of this study are important for understanding the problem in question.

How Medicaid Expansion Affected Out-of-Pocket Health Care Spending for Low-Income Families.

Science.gov (United States)

Glied, Sherry; Chakraborty, Ougni; Russo, Therese

2017-08-01

ISSUE. Prior research shows that low-income residents of states that expanded Medicaid under the Affordable Care Act are less likely to experience financial barriers to health care access, but the impact on out-of-pocket spending has not yet been measured. GOAL. Assess how the Medicaid expansion affected out-of-pocket health care spending for low-income families compared to those in states that did not expand and consider whether effects differed in states that expanded under conventional Medicaid rules vs. waiver programs. METHODS. Analysis of the Consumer Expenditure Survey 2010–2015. KEY FINDINGS AND CONCLUSIONS. Compared to families in nonexpansion states, low-income families in states that did expand Medicaid saved an average of $382 in annual spending on health care. In these states, low-income families were less like to report any out-of-pocket spending on insurance premiums or medical care than were similar families in nonexpansion states. For families that did have some out-of-pocket spending, spending levels were lower in states that expanded Medicaid. Low-income families in Medicaid expansion states were also much less likely to have catastrophically high spending levels. The form of coverage expansion — conventional Medicaid or waiver rules — did not have a statistically significant effect on these outcomes.

Population density, distance to public transportation, and health of women in low-income neighborhoods.

Science.gov (United States)

DeGuzman, Pamela B; Merwin, Elizabeth I; Bourguignon, Cheryl

2013-01-01

The purpose of this research was to determine the impact of two neighborhood walkability (the extent to which the built environment is pedestrian friendly) metrics on health outcomes of women living in low-income urban neighborhoods, both before and after accounting for individual and neighborhood factors. A cross-sectional, retrospective design was used. The sample of 1800 low-income women was drawn from Welfare, Children and Families: A Three-City Study (a study of low-income women from three U.S. cities). Using multilevel modeling and geographic information systems, the study sought to determine the effect of distance to public transportation and residential density on health status, mental health symptoms, and health-related limitations. No significant relationship was found between the two walkability metrics and health outcomes. Instead, neighborhood problems that affect crime and safety impacted health status and mental health symptoms. As cities make changes to the built environment with the hope of affecting residents' health outcomes, public health nurses need to be aware that changing walkability characteristics in a neighborhood may not affect the health of residents of high crime, low-income neighborhoods. Without first addressing neighborhood crime, efforts to improve walkability in low-income neighborhoods may fail. © 2013 Wiley Periodicals, Inc.

Associations between family food behaviors, maternal depression, and child weight among low-income children

OpenAIRE

McCurdy, Karen; Gorman, Kathleen S.; Kisler, Tiffani; Metallinos-Katsaras, Metallinos-Katsaras

2014-01-01

Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and ...

Perceptions of New Zealand nutrition labels by Māori, Pacific and low-income shoppers.

Science.gov (United States)

Signal, Louise; Lanumata, Tolotea; Robinson, Jo-Ani; Tavila, Aliitasi; Wilton, Jenny; Ni Mhurchu, Cliona

2008-07-01

In New Zealand the burden of nutrition-related disease is greatest among Māori, Pacific and low-income peoples. Nutrition labels have the potential to promote healthy food choices and eating behaviours. To date, there has been a noticeable lack of research among indigenous peoples, ethnic minorities and low-income populations regarding their perceptions, use and understanding of nutrition labels. Our aim was to evaluate perceptions of New Zealand nutrition labels by Māori, Pacific and low-income peoples and to explore improvements or alternatives to current labelling systems. Māori, Samoan and Tongan researchers recruited participants who were regular food shoppers. Six focus groups were conducted which involved 158 people in total: one Māori group, one Samoan, one Tongan, and three low-income groups. Māori, Pacific and low-income New Zealanders rarely use nutrition labels to assist them with their food purchases for a number of reasons, including lack of time to read labels, lack of understanding, shopping habits and relative absence of simple nutrition labels on the low-cost foods they purchase. Current New Zealand nutrition labels are not meeting the needs of those who need them most. Possible improvements include targeted social marketing and education campaigns, increasing the number of low-cost foods with voluntary nutrition labels, a reduction in the price of 'healthy' food, and consideration of an alternative mandatory nutrition labelling system that uses simple imagery like traffic lights.

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth

Directory of Open Access Journals (Sweden)

Angela Cristina Bizzotto Trude

2016-08-01

Full Text Available Abstract Background Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA youth in Baltimore, MD. Methods Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10–14 y dyads participating in the baseline evaluation of the B’More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake controlling for youth age, sex, BMI percentile, total calorie intake and household income. Results On average, youth consumed 1.5 ± 1.1 (M ± SD servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth’s healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06–1.41, ORvegetable 1.31; 1.15–1.51 and ORfiber 1.46; 1.23–1.74, Self-efficacy: ORfruit 1.07; 1.03–1.12, ORvegetable 1.04; 1.01–1.09, ORfiber 1.10; 1.04–1.16. Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9. In addition, youth shopping more

The role of urban agriculture for food security in low income areas in Nairobi

NARCIS (Netherlands)

Mwangi, A.M.

1995-01-01

This paper, which is based on research carried out among 210 households in Nairobi (Kenya) in 1994, examines the role of urban agriculture in household food security among low-income urban households. It determines the different strategies the low-income population of Nairobi deploys in order to

Growth faltering in low-income countries.

Science.gov (United States)

Prentice, Andrew M; Moore, Sophie E; Fulford, Anthony J

2013-01-01

Meta-analysis of growth data from over 50 low and low-middle income countries shows a consistent pattern of stunting and poor weight gain from about 3 months of age and persisting until at least 5 years. Children tend not to be wasted because their short stature offsets their underweight, leading to a rather adequately proportioned appearance. This frequently conceals the true levels of malnutrition in communities. At the macro-environmental level such growth faltering is due to the combined effects of poverty, food insecurity, low-dietary diversity, a highly infectious environment, poor washing facilities and poor understanding of the principles of nutrition and hygiene. These tend to be ameliorated as communities pass through the demographic transition with improved incomes and education. Because such changes will take generations to achieve, the global health community continues to search for effective interim solutions. Disappointingly, apart from intensive feeding programmes aimed at rehabilitating severely malnourished children, there are few examples of very successful nutrition interventions. This emphasizes the need for a better understanding of the etiology of growth failure. This paper uses anthropometric data collected over 6 decades in subsistence-farming communities from rural Gambia to illustrate the typical key features of growth faltering. Arising from this analysis, and from gaps in the published literature, the following issues are highlighted as still requiring a better resolution: (1) the pre-natal and inter-generational influences on growth failure; (2) the ontogeny of the infant immune system; (3) the exact nature of the precipitating insults that initiate gastroenteropathy; (4) the effects of both enteric and systemic infections on the hormonal regulation of growth; (5) interactions between macro- and micro-nutrient deficiencies and infections in causing growth failure, and (6) the role of the microbiome in modulating dietary influences on

Economics, Marketing and Low Income Individuals: interest after a history of indifference

Directory of Open Access Journals (Sweden)

Marcus Wilcox Hemais

2014-08-01

Full Text Available During the early years of marketing, researchers used theories and concepts from economics as base for the development of their own theories and concepts. This similarity can be seen in the way marketing viewed the low income individual and his relationship with consumption, in the first studies of the subject. Like the economists, researchers in marketing described these individuals as dependents of society and governments to better their lives. This view changes when Prahalad defends a new perspective, through which individuals in this context are seen as consumers, with desires to consume products of diverse nature. The objective of this article, therefore, is to analyze the paths trailed by economics and two moments in marketing about the low income individual. Initially, the view economics has on low income individuals is discussed, so that, afterwards, two perspectives of marketing about this segment can be presented.

Prenatal care utilization for mothers from low-income areas of New Mexico, 1989-1999.

Directory of Open Access Journals (Sweden)

Michael A Schillaci

2010-09-01

Full Text Available Prenatal care is considered to be an important component of primary health care. Our study compared prenatal care utilization and rates of adverse birth outcomes for mothers from low- and higher-income areas of New Mexico between 1989 and 1999.Prenatal care indicators included the number of prenatal care visits and the first month of prenatal care. Birth outcome indicators included low birth weight, premature birth, and births linked with death certificates. The results of our study indicated that mothers from low-income areas started their prenatal care significantly later in their pregnancies between 1989 and 1999, and had significantly fewer prenatal visits between 1989 and 1997. For the most part, there were not significant differences in birth outcome indicators between income groupings.These findings suggest that while mothers from low-income areas received lower levels of prenatal care, they did not experience a higher level of adverse birth outcomes.

[Coverage of nutritional and health programs in the low income strata].

Science.gov (United States)

Cruzat, M A; González, N; Mardones, F; Moenne, A M; Sánchez, H

1982-06-01

The extent and consequences of exclusion of low income strata from maternal and child health programs in Chile are analyzed using available data. Infant mortality has been shown by several studies to be closely associated with socioeconomic status in Chile. Babies of illiterate mothers showed the highest rate of mortality and the least improvement in rate between 1972-78. The effect of socioeconomic status on the mortality rate of infants in greatly influenced by birth weight; low birth weight infants of low income groups suffer significantly higher mortality than among higher income groups. Several national studies in Chile demonstrated a relationship between infant malnutrition and health program coverage. Infant malnutrition is greatest in groups benefiting least from health care. Based on the fact that 90.5% of births in 1980 were professionally attended, it is estimated that 9.5% of the low income population lacks access to health care. A recent survey showed that 9.9% of the population under 6 years, some 105,848 children, was not covered by the National Complementary Feeding Program. Another study showed that 12.3% of mothers had no prenatal medical attention prior to their most recent birth; mothers with little or no education, living in rural areas, and of high parity were most likely not to have received medical attention. Factors responsible for lack of access to health and nutrition programs appeared to include unsatisfactory relationships with the health workers, poor acceptability of foods offered, excessive distance and waiting times, and lack of interest or motivation on the part of the mothers.

The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007.

Science.gov (United States)

Fan, Z Joyce; Anderson, Naomi J; Foley, Michael; Rauser, Eddy; Silverstein, Barbara A

2011-01-01

We examined the disparities in health-care coverage between low- and high-income workers in Washington State (WA) to provide support for possible policy decisions for uninsured workers. We examined data from the WA Behavioral Risk Factor Surveillance System 2003-2007 and compared workers aged 18-64 years of low income (annual household income income (annual household income ≥$35,000) on proportions and sources of health-care coverage. We conducted multivariable logistic regression analyses on factors that were associated with the uninsured. Of the 54,536 survey respondents who were working-age adults in WA, 13,922 (25.5%) were low-income workers. The proportions of uninsured were 38.2% for low-income workers and 6.3% for high-income workers. While employment-based health benefits remained a dominant source of health insurance coverage, they covered only 40.2% of low-income workers relative to 81.5% of high-income workers. Besides income, workers were more likely to be uninsured if they were younger; male; Hispanic; less educated; not married; current smokers; self-employed; or employed in agriculture/forestry/fisheries, construction, and retail. More low-income workers (28.7%) reported cost as an issue in paying for health services than did their high-income counterparts (6.7%). A persistent gap in health-care coverage exists between low- and high-income workers. The identified characteristics of these workers can be used to implement policies to expand health insurance coverage.

Authorship ethics in global health research partnerships between researchers from low or middle income countries and high income countries.

Science.gov (United States)

Smith, Elise; Hunt, Matthew; Master, Zubin

2014-05-28

Over the past two decades, the promotion of collaborative partnerships involving researchers from low and middle income countries with those from high income countries has been a major development in global health research. Ideally, these partnerships would lead to more equitable collaboration including the sharing of research responsibilities and rewards. While collaborative partnership initiatives have shown promise and attracted growing interest, there has been little scholarly debate regarding the fair distribution of authorship credit within these partnerships. In this paper, we identify four key authorship issues relevant to global health research and discuss their ethical and practical implications. First, we argue that authorship guidance may not adequately apply to global health research because it requires authors to write or substantially revise the manuscript. Since most journals of international reputation in global health are written in English, this would systematically and unjustly exclude non-English speaking researchers even if they have substantially contributed to the research project. Second, current guidance on authorship order does not address or mitigate unfair practices which can occur in global health research due to power differences between researchers from high and low-middle income countries. It also provides insufficient recognition of "technical tasks" such as local participant recruitment. Third, we consider the potential for real or perceived editorial bias in medical science journals in favour of prominent western researchers, and the risk of promoting misplaced credit and/or prestige authorship. Finally, we explore how diverse cultural practices and expectations regarding authorship may create conflict between researchers from low-middle and high income countries and contribute to unethical authorship practices. To effectively deal with these issues, we suggest: 1) undertaking further empirical and conceptual research regarding

Financial arrangements for health systems in low-income countries: an overview of systematic reviews

Science.gov (United States)

Wiysonge, Charles S; Paulsen, Elizabeth; Lewin, Simon; Ciapponi, Agustín; Herrera, Cristian A; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Oxman, Andrew D

2017-01-01

completion of tuberculosis prophylaxis, and it is uncertain whether they improve completion of treatment for active tuberculosis. Conditional cash transfer programmes probably lead to an increase in service utilisation (moderate-certainty evidence), but their effects on health outcomes are uncertain. Vouchers may improve health service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). Introducing a restrictive cap may decrease use of medicines for symptomatic conditions and overall use of medicines, may decrease insurers' expenditures on medicines (low-certainty evidence), and has uncertain effects on emergency department use, hospitalisations, and use of outpatient care (very low-certainty evidence). Reference pricing, maximum pricing, and index pricing for drugs have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs. Provider incentives: the effects of provider incentives are uncertain (very low-certainty evidence), including: the effects of provider incentives on the quality of care provided by primary care physicians or outpatient referrals from primary to secondary care, incentives for recruiting and retaining health professionals to serve in remote areas, and the effects of pay-for-performance on provider performance, the utilisation of services, patient outcomes, or resource use in low-income countries. Authors' conclusions Research based on sound systematic review methods has evaluated numerous financial arrangements relevant to low-income countries, targeting different levels of the health systems and assessing diverse outcomes. However, included reviews rarely reported social outcomes, resource use, equity impacts, or undesirable effects. We also identified gaps in primary research because of uncertainty about applicability of the evidence to low-income countries. Financial arrangements for which the effects are uncertain include external

Reducing the Incidence of Low Birth Weight in Low-Income Countries Has Substantial Economic Benefits

OpenAIRE

Alderman, Harold; Behrman, Jere R.

2006-01-01

Reducing the incidence of low birth weight not only lowers infant mortality rates but also has multiple benefits over the life cycle. This study estimates the economic benefits of reducing the incidence of low birth weight in low-income countries, both through lower mortality rates and medical costs and through increased learning and productivity. The estimated economic benefits, under pla...

The impact of income inequality and national wealth on child and adolescent mortality in low and middle-income countries.

Science.gov (United States)

Ward, Joseph L; Viner, Russell M

2017-05-11

Income inequality and national wealth are strong determinants for health, but few studies have systematically investigated their influence on mortality across the early life-course, particularly outside the high-income world. We performed cross-sectional regression analyses of the relationship between income inequality (national Gini coefficient) and national wealth (Gross Domestic Product (GDP) averaged over previous decade), and all-cause and grouped cause national mortality rate amongst infants, 1-4, 5-9, 10-14, 15-19 and 20-24 year olds in low and middle-income countries (LMIC) in 2012. Gini models were adjusted for GDP. Data were available for 103 (79%) countries. Gini was positively associated with increased all-cause and communicable disease mortality in both sexes across all age groups, after adjusting for national wealth. Gini was only positively associated with increased injury mortality amongst infants and 20-24 year olds, and increased non-communicable disease mortality amongst 20-24 year old females. The strength of these associations tended to increase during adolescence. Increasing GDP was negatively associated with all-cause, communicable and non-communicable disease mortality in males and females across all age groups. GDP was also associated with decreased injury mortality in all age groups except 15-19 year old females, and 15-24 year old males. GDP became a weaker predictor of mortality during adolescence. Policies to reduce income inequality, rather than prioritising economic growth at all costs, may be needed to improve adolescent mortality in low and middle-income countries, a key development priority.

Longitudinal effects of group music instruction on literacy skills in low-income children.

Directory of Open Access Journals (Sweden)

Jessica Slater

Full Text Available Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

Longitudinal effects of group music instruction on literacy skills in low-income children.

Science.gov (United States)

Slater, Jessica; Strait, Dana L; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

2014-01-01

Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

Longitudinal Effects of Group Music Instruction on Literacy Skills in Low-Income Children

Science.gov (United States)

Slater, Jessica; Strait, Dana L.; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

2014-01-01

Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6–9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development. PMID:25409300

Exposing and addressing tobacco industry conduct in low-income and middle-income countries.

Science.gov (United States)

Gilmore, Anna B; Fooks, Gary; Drope, Jeffrey; Bialous, Stella Aguinaga; Jackson, Rachel Rose

2015-03-14

The tobacco industry's future depends on increasing tobacco use in low-income and middle-income countries (LMICs), which face a growing burden of tobacco-related disease, yet have potential to prevent full-scale escalation of this epidemic. To drive up sales the industry markets its products heavily, deliberately targeting non-smokers and keeps prices low until smoking and local economies are sufficiently established to drive prices and profits up. The industry systematically flaunts existing tobacco control legislation and works aggressively to prevent future policies using its resource advantage to present highly misleading economic arguments, rebrand political activities as corporate social responsibility, and establish and use third parties to make its arguments more palatable. Increasingly it is using domestic litigation and international arbitration to bully LMICs from implementing effective policies and hijacking the problem of tobacco smuggling for policy gain, attempting to put itself in control of an illegal trade in which there is overwhelming historical evidence of its complicity. Progress will not be realised until tobacco industry interference is actively addressed as outlined in Article 5.3 of the Framework Convention on Tobacco Control. Exemplar LMICs show this action can be achieved and indicate that exposing tobacco industry misconduct is an essential first step. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cigarette stick as valuable communicative real estate: a content analysis of cigarettes from 14 low-income and middle-income countries.

Science.gov (United States)

C Smith, Katherine; Washington, Carmen; Welding, Kevin; Kroart, Laura; Osho, Adami; Cohen, Joanna E

2016-09-01

The current cigarette market is heavily focused on low-income and middle-income countries. Branding of tobacco products is key to establishing and maintaining a customer base. Greater restrictions on marketing and advertising of tobacco products create an incentive for companies to focus more on branding via the product itself. We consider how tobacco sticks are used for communicative purposes in 14 low-income and middle-income countries with extensive tobacco markets. In 2013, we collected and coded 3232 cigarette and kretek packs that were purchased from vendors in diverse neighbourhoods in 44 cities across the 14 low-income and middle-income countries with the greatest number of smokers. A single stick from each pack was assessed for branding, decorative and communicative elements using a common coding framework. Stick communication variables included brand name, brand image/logo, brand descriptor, colour and design carried through from pack, 'capsule cigarette' symbol, and embellishment of filter end. Communication and branding on the stick is essentially ubiquitous (99.75%); 97% of sticks include explicit branding (brand name or logo present). Colour is commonly carried through from the pack (95%), and some sticks (13%) include decorative elements matching the pack. Decorative elements can be found anywhere on the stick, including the filter tip (8%), and 'convertible' cigarettes include a symbol to show where to push. Cigarette sticks are clearly valuable 'real estate' that tobacco companies are using for communicative purposes. Across all countries and brands, the stick communicates branding via text, colour and imagery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Financial hardship and self-rated health among low-income housing residents.

Science.gov (United States)

Tucker-Seeley, Reginald D; Harley, Amy E; Stoddard, Anne M; Sorensen, Glorian G

2013-08-01

Self-rated health (SRH) has been shown to be predictive of morbidity and mortality. Evidence also shows that SRH is socioeconomically patterned, although this association differs depending on the indicator of socioeconomic status used. The purpose of this study was to determine the association between SRH and financial hardship among residents of low-income housing. We analyzed cross-sectional data from the Health in Common Study (N = 828), an observational study to investigate social and physical determinants of cancer risk-related behaviors among residents of low-income housing in three cities in the Boston metropolitan area. Modified Poisson regression models were used to obtain the relative risk of low SRH (fair or poor), adjusting for demographic and socioeconomic characteristics. Unadjusted models revealed that the respondents reporting financial hardship were 53% more likely to report low SRH compared with those not reporting financial hardship. After controlling for demographic characteristics, socioeconomic characteristics, and psychological distress, the results showed that those reporting financial hardship were 44% more likely to report low SRH. Our results suggest that financial hardship is a robust predictor of SRH; and over and above the influence of demographic and traditional socioeconomic indicators, and even psychological distress, financial hardship remains strongly associated with low SRH. Additional research needs to be conducted to further elucidate this pathway and to better understand the determinants of variability in financial hardship among low-income housing residents to ensure the most appropriate policy levers (e.g., housing-related policy, food-related policy) are chosen to improve health outcomes in this population.

Low-Income Housing Tax Credit (LIHTC) Qualified Census Tract (QCT)

Data.gov (United States)

Department of Housing and Urban Development — It allows to generate tables for Low-Income Housing Tax Credit (LIHTC) Qualified Census Tracts (QCT) and for Difficult Development Areas (DDA). LIHTC Qualified...

Food purchasing selection among low-income, Spanish-speaking Latinos.

Science.gov (United States)

Cortés, Dharma E; Millán-Ferro, Andreina; Schneider, Karen; Vega, Rodolfo R; Caballero, A Enrique

2013-03-01

In the U.S., poverty has been linked to both obesity and disease burden. Latinos in the U.S. are disproportionately affected by poverty, and over the past 10 years, the percentage of overweight U.S. Latino youth has approximately doubled. Buying low-cost food that is calorie-dense and filling has been linked to obesity. Low-income individuals tend to favor energy-dense foods because of their low cost, and economic decisions made during food purchasing have physiologic repercussions. Diets based on energy-dense foods tend to be high in processed staples, such as refined grains, added sugars, and added fats. These diets have been linked to a higher risk of obesity, type 2 diabetes, and cardiovascular disease. This pilot study conducted ethnographic qualitative analyses combined with quantitative analyses to understand grocery shopping practices among 20 Spanish-speaking, low-income Latino families. The purpose was to analyze food selection practices in order to determine the effect of nutrition education on changes in shopping practices to later develop educational tools to promote selection of healthier food options. Participants received tailored, interactive, nutrition education during three to five home visits and a supermarket tour. Grocery store receipts for grocery purchases collected at baseline and at the end of the project were analyzed for each family to extract nutritional content of purchased foods. Nutritional content was measured with these factors in mind: quantity, calories, fats, carbohydrates, fiber, protein, and percentage of sugary beverages and processed food. Data were collected in 2010-2011 and analyzed in 2011-2012. After receiving between three and five home-based nutrition education sessions and a supermarket tour over a 6-month period, many families adopted instructions on buying budget-friendly, healthier alternative foods. Findings indicate that participating families decreased the total number of calories and calories per dollar

Building and Using a Social Network: Nurture for Low-Income Chinese American Adolescents' Learning

Science.gov (United States)

Li, Jin; Holloway, Susan D.; Bempechat, Janine; Loh, Elaine

2008-01-01

Little research has examined how low-income Asian American children are supported to achieve well in school. The authors used the notion of social capital to study higher versus lower achieving Chinese adolescents from low-income backgrounds. They found that families of higher-achieving adolescents built and used more effectively three kinds of…

Prevalence study of compulsive buying in a sample with low individual monthly income

Directory of Open Access Journals (Sweden)

Priscilla Lourenço Leite

2015-12-01

Full Text Available Introduction: Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. Objectives: To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. Methods: The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. Results: The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Conclusion: Despite the small sample, the results of this study are important for understanding the problem in question.

Free tax assistance and the earned income tax credit: vital resources for social workers and low-income families.

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Lim, Younghee; DeJohn, Tara V; Murray, Drew

2012-04-01

As the United States' economy continues to experience challenges, more families at or near the poverty level fall prey to predatory financial practices. Their vulnerability to these operations is increased by a lack of knowledge of asset-building resources and alternative financial services. This article focuses on Volunteer Income Tax Assistance (VITA)--a free income tax preparation program, which is a vital resource available to low-income families. Unfortunately, VITA is largely underused and often unknown to economically strained families and to the social workers and other professionals to whom these families turn for assistance. This article concludes with policy and practice implications for social workers and other professionals engaged in providing services to financially vulnerable families.

Low-income women with early-stage breast cancer: physician and patient decision-making styles.

Science.gov (United States)

McVea, K L; Minier, W C; Johnson Palensky, J E

2001-01-01

Poor women have low rates of breast conservation therapy not explained by differences in insurance status or treatment preferences. The purpose of this study was to explore how low-income women make decisions about breast cancer treatment. Twenty-five women diagnosed with early-stage breast cancer through the Nebraska Every Woman Matters program were interviewed about their experiences selecting treatment options. These interviews were transcribed and then analysed using established qualitative techniques. More than half of the women (n=16) described playing a passive role in decision making. Choice was determined by medical factors or not offered by their physicians. Intense emotional distress affected some women's ability to compare options. The women who did engage in a rational decision-making process (n=9) based their choices on concerns about body image and fear of recurrence. When presented with a choice, and when able to objectively weigh treatment options, low-income women base their treatment decisions on the same issues as those of higher income. Whether differences in income strata alter the doctor-patient power dynamic in favor of physician control over decision making, or whether low-income women are less prepared to engage in a rational deliberative process warrants further study. Copyright 2001 John Wiley & Sons, Ltd.

Low income product innovation

Directory of Open Access Journals (Sweden)

Maria Cecília Sobral

2008-10-01

Full Text Available At affluent markets, the literature on product development management tells us to aggregate value and technology, to differentiate products and to launch fast. And at the low-income markets? This exploratory research defines a popular product, characterizes and measures their markets in Brazil, and identifies innovation strategies for them. The results suggest that the effective strategic orientation differs from affluent markets. It includes: to enhance the auto service component; to identify and service the key functionalities to the targeted public; to standardize products and increase the production scale; to extend the product life cycle; to use convenient distribution and marketing channels; to build product images that have appeal in the popular market; to offer longer financing horizons with befittingly lower installments. Data came from market researches and general demographic census. General media published stories were used to identify companies and their strategies. And a few case studies allowed the authors a deeper exploration of the relevant themes.

Gender Differences in Emotion Expression in Low-Income Adolescents Under Stress.

Science.gov (United States)

Panjwani, Naaila; Chaplin, Tara M; Sinha, Rajita; Mayes, Linda C

2016-06-01

Gender roles in mainstream U.S. culture suggest that girls express more happiness, sadness, anxiety, and shame/embarrassment than boys, while boys express more anger and externalizing emotions, such as contempt. However, gender roles and emotion expression may be different in low-income and ethnically diverse families, as children and parents are often faced with greater environmental stressors and may have different gender expectations. This study examined gender differences in emotion expression in low-income adolescents, an understudied population. One hundred and seventy nine adolescents (aged 14-17) participated in the Trier Social Stress Test (TSST). Trained coders rated adolescents' expressions of happiness, sadness, anxiety, shame/embarrassment, anger, and contempt during the TSST using a micro-analytic coding system. Analyses showed that, consistent with gender roles, girls expressed higher levels of happiness and shame than boys; however, contrary to traditional gender roles, girls showed higher levels of contempt than boys. Also, in contrast to cultural stereotypes, there were no differences in anger between boys and girls. Findings suggest gender-role inconsistent displays of externalizing emotions in low-income adolescents under acute stress, and may reflect different emotion socialization experiences in this group.

Three models of community mental health services In low-income countries

Directory of Open Access Journals (Sweden)

De Silva Mary

2011-01-01

Full Text Available Abstract Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models.

Child Disinhibition, Parent Restriction, and Child Body Mass Index in Low-Income Preschool Families

Science.gov (United States)

Sparks, Martha A.; Radnitz, Cynthia L.

2013-01-01

Objective: To examine both unique and interactive effects of parent restrictive feeding and child disinhibited eating behavior on child body mass index (BMI) in low-income Latino and African American preschoolers. Methods: The sample included 229 parent-child pairs, the majority of whom were low-income and Latino (57%) or African American (25%).…

Contemporary Work and Family Issues Affecting Marriage and Cohabitation among Low-Income Single Mothers

Science.gov (United States)

Joshi, Pamela; Quane, James M.; Cherlin, Andrew J.

2009-01-01

In this paper, we advance and test an integrative model of the effects of employment status, nonstandard work schedules, male employment, and women's perceptions of economic instability on union formation among low-income single mothers. On the basis of the longitudinal data from 1,299 low-income mothers from the Three-City Welfare Study, results…

Serving low-income markets : Rethinking multinational corporations' strategies

NARCIS (Netherlands)

Sadreghazi, S.; Duijsters, G.M.; Dolfsma, W.; Duysters, G.M.; Costa, I.

2009-01-01

The global economy is changing rapidly and multinational corporations (MNCs) are at the forefront of this transformation. This book provides novel and profound analyses of how MNCs and emerging economies are related, and how this relationship affects the dynamics of the global economy. In

A corner store intervention in a low-income urban community is associated with increased availability and sales of some healthy foods.

Science.gov (United States)

Song, Hee-Jung; Gittelsohn, Joel; Kim, Miyong; Suratkar, Sonali; Sharma, Sangita; Anliker, Jean

2009-11-01

While corner store-based nutrition interventions have emerged as a potential strategy to increase healthy food availability in low-income communities, few evaluation studies exist. We present the results of a trial in Baltimore City to increase the availability and sales of healthier food options in local stores. Quasi-experimental study. Corner stores owned by Korean-Americans and supermarkets located in East and West Baltimore. Seven corner stores and two supermarkets in East Baltimore received a 10-month intervention and six corner stores and two supermarkets in West Baltimore served as comparison. During and post-intervention, stocking of healthy foods and weekly reported sales of some promoted foods increased significantly in intervention stores compared with comparison stores. Also, intervention storeowners showed significantly higher self-efficacy for stocking some healthy foods in comparison to West Baltimore storeowners. Findings of the study demonstrated that increases in the stocking and promotion of healthy foods can result in increased sales. Working in small corner stores may be a feasible means of improving the availability of healthy foods and their sales in a low-income urban community.

Outstanding challenges for rotavirus vaccine introduction in low-income countries

DEFF Research Database (Denmark)

Ustrup, Marte; Madsen, Lizell B; Bygbjerg, Ib C

2011-01-01

Rotavirus infections are the most common cause of severe diarrhoea in children worldwide. Two internationally licensed rotavirus vaccines have proven to be efficacious in middle and high-income countries and they could potentially be valuable tools for the prevention of rotavirus....... There is also a need for political commitment to prevent rotavirus infections as well as a need for an overall strengthening of the health systems in low-income countries. If these challenges were met, rotavirus vaccination could substantially improve child health and survival from rotavirus...

The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling.

Science.gov (United States)

Choi, Sunha; Lee, Sungkyu; Matejkowski, Jason

2018-06-01

This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR = 1.97, P income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage.

Learning from Low Income Market-driven Innovations and Social ...

International Development Research Centre (IDRC) Digital Library (Canada)

Learning from Low Income Market-driven Innovations and Social Entrepreneurship in India. A social enterprise is one that uses innovation, finance and business acumen in a business setting to produce social outcomes such as poverty alleviation, health benefits or social inclusion. Social enterprises generate products and ...

Occupational Engagement in Low-Income Latina Breast Cancer Survivors.

Science.gov (United States)

Sleight, Alix G

This qualitative study examined the experience of occupational engagement in low-income Latina breast cancer survivors and suggests the potential for occupational therapy practitioners to improve health outcomes in this vulnerable and underserved population. Semistructured interviews were conducted with 9 participants. Inductive analysis was used to code for themes and patterns related to occupational engagement and quality of life (QOL). Lack of occupational engagement negatively affected QOL, but participation in occupations such as religious activity and caregiving promoted well-being. Financial concerns and communication barriers decreased QOL. Breast cancer can have a negative impact on occupational engagement in low-income Latina breast cancer survivors; however, some occupations may increase QOL. Socioeconomic status and cultural values influence occupational engagement and QOL. Occupational therapy practitioners can improve health outcomes in this population through awareness of relevant sociocultural factors and attention to appropriate patient communication. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Early Math Trajectories: Low-Income Children's Mathematics Knowledge From Ages 4 to 11.

Science.gov (United States)

Rittle-Johnson, Bethany; Fyfe, Emily R; Hofer, Kerry G; Farran, Dale C

2017-09-01

Early mathematics knowledge is a strong predictor of later academic achievement, but children from low-income families enter school with weak mathematics knowledge. An early math trajectories model is proposed and evaluated within a longitudinal study of 517 low-income American children from ages 4 to 11. This model includes a broad range of math topics, as well as potential pathways from preschool to middle grades mathematics achievement. In preschool, nonsymbolic quantity, counting, and patterning knowledge predicted fifth-grade mathematics achievement. By the end of first grade, symbolic mapping, calculation, and patterning knowledge were the important predictors. Furthermore, the first-grade predictors mediated the relation between preschool math knowledge and fifth-grade mathematics achievement. Findings support the early math trajectories model among low-income children. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Reducing the Gap in Numerical Knowledge between Low- and Middle-Income Preschoolers

Science.gov (United States)

Ramani, Geetha B.; Siegler, Robert S.

2011-01-01

We compared the learning from playing a linear number board game of preschoolers from middle-income backgrounds to the learning of preschoolers from low-income backgrounds. Playing this game produced greater learning by both groups than engaging in other numerical activities for the same amount of time. The benefits were present on number line…

Educator Perceptions of Low-Income Elementary Students and Their Effects on Reading

Science.gov (United States)

Fenske, Mark S.

2013-01-01

The correlation between income level and achievement has led some educators to believe that low-income students cannot learn at the same level as can middle-class and affluent peers. This problem is significant because as more families become impoverished, more students may be at risk for failure. Many studies have identified challenges facing…

LOW INCOME CONSUMERS AND ONLINE SHOPPING: APPREHENSIONS IN CONSUMING THROUGH THE INTERNET

Directory of Open Access Journals (Sweden)

Juan Pablo da Silva Dias

2015-08-01

Full Text Available The growth in access of low income consumers to the internet has taken them to use the net in search of entertainment, education and relationships. However, consuming online is still an activity surrounded by distrust. The present study aims to discuss the reasons why low income consumers have apprehension in consuming through the internet. For this, in depth interviews were conducted with 23 low income consumers. The collected data shows that the internet is still seen by the interviewees as being, mainly, for leisure and entertainment. Online shopping still is a task they fear, because of different motives. Initially, one can point the preference to consume in physical stores, since the consumers can touch the desired product, enjoy the trip to the store as a moment of pleasure and the possibility of interacting with salesmen, who help them in their choice. The apprehensions in buying online are also influenced by the perception that sites are not safe, because they offer threats, such as viruses or theft of personal information. Furthermore, interviewees believe that online stores are not compromised with their customers, since they permit problems to occur in the delivery of merchandise, are not clear about the shopping process, and create difficulties in payment method. Another reason for them not to buy online is the perception that if a negative consuming episode of online shopping happened to someone they know, it is also bound to happen with them. Despite this reasoning, these consumers point the importance of help from a third party in their reference group as main incentive for them to face the obstacles to consuming through the internet. In conclusion, it is possible to consider that low income consumers have apprehensions that are similar to their higher income peers, but, also, show different feelings, which are seldom discussed in the literature about online shopping.

Early Language and Reading Development of Bilingual Preschoolers From Low-Income Families.

Science.gov (United States)

Hammer, Carol Scheffner; Miccio, Adele W

2006-01-01

Learning to read is a complex process and a number of factors affect a child's success in beginning reading. This complexity increases when a child's home language differs from that of the school and when the child comes from a home with limited economic resources. This article discusses factors that have been shown to contribute to children's success in early reading, namely-phonological awareness, letter-word identification, oral language, and the home literacy environment. Preliminary evidence suggests that bilingual children from low-income backgrounds initially perform poorly on phonological awareness and letter identification tasks, but appear to acquire these abilities quickly in kindergarten once these abilities are emphasized in early reading instruction. In addition, the findings show that bilingual preschoolers' receptive language abilities in English and Spanish positively impact their early letter-word identification abilities at the end of kindergarten. A positive relationship between bilingual preschoolers' home literacy environment and early reading outcomes has not been found to date. Educational implications for serving young, bilingual children from programs such as Head Start are discussed.

Parenting Practices among Low-Income Parents/Guardians of Academically Successful Fifth Grade African American Children

Science.gov (United States)

West-Olatunji, Cirecie; Sanders, Tiffany; Mehta, Sejal; Behar-Horenstein, Linda

2010-01-01

Research investigating the relationship between parenting and academic achievement has provided conflicting results, particularly for low-income, culturally-diverse parents. Using resilience theory, the researchers conducted a case study with five low-income African American mothers. Findings suggest that educators can benefit from partnering with…

How children with special health care needs affect the employment decisions of low-income parents.

Science.gov (United States)

Loprest, Pamela; Davidoff, Amy

2004-09-01

To better understand the impact of having a child with special health care needs (CSHCN), on low-income parents' employment decisions. Using data from the 1999 and 2000 National Health Interview Survey (NHIS), we estimate multivariate statistical regressions (logit and tobit models) to estimate the relationship between having a CSHCN and the likelihood of employment and hours of employment for a sample-of low-income single parents. Controlling for differences in demographic and family characteristics, we find no significant association between having a CSHCN and the probability of work or the number of hours worked among low-income single-parent families. Separate analysis of different dimensions of special health care needs shows that parents of children with activity limitations are significantly less likely to work and work fewer hours. This result does not hold true for the group of children defined based on elevated or special service use, or for the group of children with specific chronic conditions. These results indicate that only a specific subset of children with special needs present difficulties for low-income parents' work. This suggests that policies to help low-income single parents of children with disabilities move into work should target this specific subset of children with special health care needs.

Opportunities for Prevention: Assessing Where Low-Income Patients Seek Care for Preventable Coronary Artery Disease.

Science.gov (United States)

Klaiman, Tamar A; Valdmanis, Vivian G; Bernet, Patrick; Moises, James

2015-10-01

The Affordable Care Act has many aspects that are aimed at improving health care for all Americans, including mandated insurance coverage for individuals, as well as required community health needs assessments (CHNAs), and reporting of investments in community benefit by nonprofit hospitals in order to maintain tax exemptions. Although millions of Americans have gained access to health insurance, many--often the most vulnerable--remain uninsured, and will continue to depend on hospital community benefits for care. Understanding where patients go for care can assist hospitals and communities to develop their CHNA and implementation plans in order to focus resources where the need for prevention is greatest. This study evaluated patient care-seeking behavior among patients with coronary artery disease (CAD) in Florida in 2008--analyzed in 2013--to assess whether low-income patients accessed specific safety net hospitals for treatment or received care from hospitals that were geographically closer to their residence. This study found evidence that low-income patients went to hospitals that treated more low-income patients, regardless of where they lived. The findings demonstrate that hospitals-especially public safety net hospitals with a tradition of treating low-income patients suffering from CAD-should focus prevention activities where low-income patients reside.

Using Banks: Teaching Banking Skills to Low-Income Consumers.

Science.gov (United States)

Shurtz, Mary Ann; LeFlore, Ann Becker

This module, one of six on teaching consumer matters to low-income adults, discusses banking skills. Topics include banking services (savings accounts, safety deposit boxes, Christmas clubs, loans, etc.), checking accounts (deposits, checkwriting, check registers, opening an account), how to use the check register (cancelled checks, deposits),…

Financial Arrangements and Relationship Quality in Low-Income Couples

Science.gov (United States)

Addo, Fenaba R.; Sassler, Sharon

2010-01-01

This study explored the association between household financial arrangements and relationship quality using a representative sample of low-income couples with children. We detailed the banking arrangements couples utilize, assessed which factors relate to holding a joint account versus joint and separate, only separate, or no account, and analyzed…

Alienation: A Concept for Understanding Low-Income, Urban Clients

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Holcomb-McCoy, Cheryl

2004-01-01

The author examines the concept of alienation and how it can be used to understand low-income, urban clients. A description is presented of 4 dimensions of alienation: powerlessness, meaninglessness, normlessness, and social isolation. Case illustrations are provided, and recommendations are made for counseling alienated clients. This article…

Rooftop Solar Technical Potential for Low-to-Moderate Income Households in the United States

Energy Technology Data Exchange (ETDEWEB)

Sigrin, Benjamin O [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mooney, Meghan E [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-04-17

This report presents a first-of-kind assessment of the technical potential of rooftop solar for low and moderate-income households, as well as providing insight on the distribution of solar potential by tenure, income, and other building characteristics. We find that a substantial fraction of the national rooftop solar potential is located on LMI buildings and, for all incomes, a substantial fraction on multi-family and renter-occupied buildings. We also find that rooftop solar can significantly contribute to long-term penetration targets established by the U.S. DOE, though to do so requires deployment on multi-family and renter-occupied buildings. Traditional deployment models have insufficiently enabled access to solar for these income groups and building types. Without innovation either in regulatory, market, or policy factors, a large fraction of the U.S. potential is unlikely to be addressed, as well as leading to inequalities in solar access. Ironically, potential electric bill savings from rooftop solar would have the greatest material impact on the lives of low-income households as compared to their high-income counterparts.

Prenatal Care Utilization for Mothers from Low-Income Areas of New Mexico, 1989–1999

Science.gov (United States)

Schillaci, Michael A.; Waitzkin, Howard; Carson, E. Ann; Romain, Sandra J.

2010-01-01

Background Prenatal care is considered to be an important component of primary health care. Our study compared prenatal care utilization and rates of adverse birth outcomes for mothers from low- and higher-income areas of New Mexico between 1989 and 1999. Methodology/Principal Findings Prenatal care indicators included the number of prenatal care visits and the first month of prenatal care. Birth outcome indicators included low birth weight, premature birth, and births linked with death certificates. The results of our study indicated that mothers from low-income areas started their prenatal care significantly later in their pregnancies between 1989 and 1999, and had significantly fewer prenatal visits between 1989 and 1997. For the most part, there were not significant differences in birth outcome indicators between income groupings. Conclusions/Significance These findings suggest that while mothers from low-income areas received lower levels of prenatal care, they did not experience a higher level of adverse birth outcomes. PMID:20862298

Performance Pay Improves Engagement, Progress, and Satisfaction in Computer-Based Job Skills Training of Low-Income Adults

Science.gov (United States)

Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Silverman, Kenneth

2013-01-01

Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training…

Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey.

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Parker, Lucy Anne; Tursan d'Espaignet, Edouard; Chatterji, Somnath

2012-01-01

To assess the magnitude and pattern of socioeconomic inequality in current smoking in low and middle income countries. We used data from the World Health Survey [WHS] in 48 low-income and middle-income countries to estimate the crude prevalence of current smoking according to household wealth quintile. A Poisson regression model with a robust variance was used to generate the Relative Index of Inequality [RII] according to wealth within each of the countries studied. In males, smoking was disproportionately prevalent in the poor in the majority of countries. In numerous countries the poorest men were over 2.5 times more likely to smoke than the richest men. Socioeconomic inequality in women was more varied showing patterns of both pro-rich and pro-poor inequality. In 20 countries pro-rich relative socioeconomic inequality was statistically significant: the poorest women had a higher prevalence of smoking compared to the richest women. Conversely, in 9 countries women in the richest population groups had a statistically significant greater risk of smoking compared to the poorest groups. Both the pattern and magnitude of relative inequality may vary greatly between countries. Prevention measures should address the specific pattern of smoking inequality observed within a population.

Harsh, Firm, and Permissive Parenting in Low-Income Families.

Science.gov (United States)

Shumow, Lee; Vandell, Deborah Lowe; Posner, Jill K.

1998-01-01

Parents' reports of their child-rearing expectations and intentions were measured for 184 low-income urban families when children were in the third and fifth grades. Parenting strategies were stable over time. Parenting strategies were related to measures of adjustment at school, behavior problems in the home, academic achievement, and…

How Low-Income Children Use the Internet at Home

Science.gov (United States)

Jackson, Linda A.; von Eye, Alexander; Biocca, Frank; Barbatsis, Gretchen; Zhao, Yong; Fitzgerald, Hiram E.

2005-01-01

HomeNetToo is a longitudinal field study designed to examine home Internet use by low-income families in the United States. Participants were 140 children, mostly African American, whose Internet use was continuously and automatically recorded for one year. This article focuses on relationships between children's main computer activities, academic…

78 FR 33154 - Low Income Taxpayer Clinic Grant Program; Availability of 2014 Grant Application Package

Science.gov (United States)

2013-06-03

... Package and Guidelines (Publication 3319) for organizations interested in applying for a Low Income... nominal fee to low income taxpayers involved in tax disputes with the IRS, or educate individuals for whom... Grant Application Package and Guidelines, IRS Publication 3319 (Rev. 5-2013), can be downloaded from the...

The Experience of Low-Income College Students at a Selective University: An Interpretative Phenomenological Analysis

Science.gov (United States)

Dias, Paula Ribeiro

2017-01-01

Low-income students at selective institutions report feeling a sense of isolation, alienation, and marginalization. However, it is essential that the voices of low-income students that have successfully navigated the college experience be part of the conversation. Rather than approach the study from a deficit perspective, this Interpretative…

Management of Noncommunicable Disease in Low- and Middle-Income Countries

Science.gov (United States)

Checkley, William; Ghannem, Hassen; Irazola, Vilma; Kimaiyo, Sylvester; Levitt, Naomi S.; Miranda, J. Jaime; Niessen, Louis; Prabhakaran, Dorairaj; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sigamani, Alben; Smith, Richard; Tandon, Nikhil; Wu, Yangfeng; Xavier, Denis; Yan, Lijing L.

2014-01-01

Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified “best buys” it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases. PMID:25592798

Qualitative Assessment of Smoke-Free Policy Implementation in Low-Income Housing: Enhancing Resident Compliance.

Science.gov (United States)

Anthony, Jodi; Goldman, Roberta; Rees, Vaughan W; Frounfelker, Rochelle L; Davine, Jessica; Keske, Robyn R; Brooks, Daniel R; Geller, Alan C

2018-01-01

As public housing agencies and other low-income housing providers adopt smoke-free policies, data are needed to inform implementation approaches that support compliance. Focused ethnography used including qualitative interviews with staff, focus groups with residents, and property observations. Four low-income housing properties in Massachusetts, 12 months postpolicy adoption. Individual interviews (n = 17) with property staff (managers, resident service coordinators, maintenance, security, and administrators) and focus groups with resident smokers (n = 28) and nonsmokers (n = 47). Informed by the social-ecological model: intrapersonal, interpersonal, organizational, and community factors relating to compliance were assessed. Utilized MAXQDA in a theory-driven immersion/crystallization analytic process with cycles of raw data examination and pattern identification until no new themes emerged. Self-reported secondhand smoke exposure (SHSe) was reduced but not eliminated. Challenges included relying on ambivalent maintenance staff and residents to report violations, staff serving as both enforcers and smoking cessation counsellors, and inability to enforce on nights and weekends. Erroneous knowledge of the policy, perception that SHSe is not harmful to neighbors, as well as believing that smokers were losing their autonomy and being unfairly singled out when other resident violations were being unaddressed, hindered policy acceptance among resident smokers. The greatest challenge to compliance was the lack of allowable outdoor smoking areas that may have reduced the burden of the policy on smokers. Smoke-free policy implementation to support compliance could be enhanced with information about SHSe for smokers and nonsmokers, cessation support from external community partners, discussion forums for maintenance staff, resident inclusion in decision-making, and framing the policy as part of a broader wellness initiative.

Health outcomes in low-income children with current asthma in Canada.

Science.gov (United States)

To, T; Dell, S; Tassoudji, M; Wang, C

2009-01-01

Data collected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) in 1994/95 and 1996/97 were used to measure longitudinal health outcomes among children with asthma. Over 10 000 children aged 1 to 11 years with complete data on asthma status in both years were included. Outcomes included hospitalizations and health services use (HSU). Current asthma was defined as children diagnosed with asthma by a physician and who took prescribed inhalants regularly, had wheezing or an attack in the previous year, or had their activities limited by asthma. Children having asthma significantly increased their odds of hospitalization (OR = 2.52; 95% CI: 1.71, 3.70) and health services use (OR = 3.80; 95% CI: 2.69, 5.37). Low-income adequacy (LIA) in 1994/ 95 significantly predicts hospitalization and HSU in 1996/97 (OR = 2.68; 95% CI: 1.29, 5.59 and OR = 0.67; 95% CI: 0.45, 0.99, respectively). Our results confirmed that both having current asthma and living in low-income families had a significant impact on the health status of children in Canada. Programs seeking to decrease the economic burden of pediatric hospitalizations need to focus on asthma and low-income populations.

Technology transfer of hearing aids to low and middle income countries: policy and market factors.

Science.gov (United States)

Seelman, Katherine D; Werner, Roye

2014-09-01

The competitive market advantages of industry and the balancing force of international governmental organizations (IGOs) are examined to identify market and policy in support of sustainable technology transfer of hearing aids to low and middle income countries. A second purpose is to examine the usefulness of findings for other assistive technologies (AT). Searches of electronic databases, IGO documents, industry reports and journals were supplemented by informal discussions with industry and IGO staff and audiologists. The value chain is used to examine the competitive advantage of industry and the balancing tools of certain IGOs. Both industry and IGOs engage in intellectual property (IP) and competition activities and are active in each segment of the hearing aid value chain. Their market and policy objectives and strategies are different. IGOs serve as balancing forces for the competitive advantages of industry. The hearing aid market configuration and hearing aid fitting process are not representative of other AT products but IP, trade and competition policy tools used by IGOs and governments are relevant to other AT. The value chain is a useful tool to identify the location of price mark-ups and the influence of actors. Market factors and reimbursement and subsidization policies drive hearing aid innovation. UN-related international government organization activities are responsive to the needs of disability populations who cannot afford assistive technology. Policy tools used by international governmental organizations are applicable across assistive technology. A partnership model is important to distribution of hearing aids to low and middle income countries.

The association between obesity and severe disability among adults aged 50 or over in nine high-income, middle-income and low-income countries: a cross-sectional study

Science.gov (United States)

Moneta, Maria Victoria; Garin, Noe; Olaya, Beatriz; Ayuso-Mateos, Jose Luis; Chatterji, Somnath; Leonardi, Matilde; Sainio, Päivi; Galas, Aleksander; Haro, Josep Maria

2015-01-01

Objective The association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was to assess this association in nine countries using nationally-representative data from the Collaborative Research on Ageing in Europe (COURAGE) study and the WHO's Study on global AGEing and Adult Health (SAGE). Design Population-based cross-sectional study Setting The survey was conducted in China, Finland, Ghana, India, Mexico, Poland, Russia, South Africa and Spain between 2007 and 2012. Participants 42 116 individuals 50 years and older. The institutionalised and those with limited cognition were excluded. Primary outcome measure Disability was defined as severe or extreme difficulty in conducting at least one of six types of basic activities of daily living (ADL). Results The mean body mass index (BMI) ranged from 20.4 kg/m2 in India to 30.7 kg/m2 in South Africa. Compared to normal BMI (18.5–24.9 kg/m2), BMI≥35 kg/m2 was associated with significantly higher odds for ADL disability in Finland (OR 4.64), Poland (OR 2.77), South Africa (OR 2.19) and Spain (OR 2.42). Interaction analysis showed that obese individuals in high-income countries were more likely to have ADL limitations than those in low-income or middle-income countries. Conclusions The higher odds for disability among obese individuals in high-income countries may imply longer life lived with disability due to factors such as the decline in cardiovascular disease mortality. In South Africa, this may have been due to the exceptionally high prevalence of class III obesity. These findings underscore the importance of obesity prevention to reduce the disability burden among older adults. PMID:25838510

Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

Science.gov (United States)

Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda

2017-07-01

Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and

Improving Readability of an Evaluation Tool for Low-Income Clients Using Visual Information Processing Theories

Science.gov (United States)

Townsend, Marilyn S.; Sylva, Kathryn; Martin, Anna; Metz, Diane; Wooten-Swanson, Patti

2008-01-01

Literacy is an issue for many low-income audiences. Using visual information processing theories, the goal was improving readability of a food behavior checklist and ultimately improving its ability to accurately capture existing changes in dietary behaviors. Using group interviews, low-income clients (n = 18) evaluated 4 visual styles. The text…

Camouflage: The Experiences of Low-Income Business College Students

Science.gov (United States)

Ponton de Dutton, Scarlett

2011-01-01

This qualitative study shares the complex stories of two low-income business students who attend a flagship, public university as out-of-state students with the purpose of understanding, describing, giving voice to, and discovering insight from their experiences. Throughout U.S. Higher Education history, there is a pattern of limited participation…

A Marketer's Guide to Discretionary Income.

Science.gov (United States)

Linden, Fabian; And Others

Detailed information about discretionary income--how much money is available after day-to-day needs are met--is important for understanding how consumers spend their money. Business requires a precise definition of discretionary income to assess the market's size, growth, and demographic characteristics. Designed primarily for the marketing…

Measuring the bias against low-income country research: an Implicit Association Test.

Science.gov (United States)

Harris, Matthew; Macinko, James; Jimenez, Geronimo; Mullachery, Pricila

2017-11-06

With an increasing array of innovations and research emerging from low-income countries there is a growing recognition that even high-income countries could learn from these contexts. It is well known that the source of a product influences perception of that product, but little research has examined whether this applies also in evidence-based medicine and decision-making. In order to examine likely barriers to learning from low-income countries, this study uses established methods in cognitive psychology to explore whether healthcare professionals and researchers implicitly associate good research with rich countries more so than with poor countries. Computer-based Implicit Association Test (IAT) distributed to healthcare professionals and researchers. Stimuli representing Rich Countries were chosen from OECD members in the top ten (>$36,000 per capita) World Bank rankings and Poor Countries were chosen from the bottom thirty (based medicine and diffusion of innovations.

Bringing Bike Share to a Low-Income Community

Centers for Disease Control (CDC) Podcasts

2013-08-14

This podcast is an interview with Sarah Kretman Stewart, MPH, MEd, Healthy Living Minneapolis Project Specialist at the Minneapolis Health Department. In this program, Sarah talks about the impact a bike share program had on the low-income town of Near North, Minnesota.  Created: 8/14/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 8/14/2013.

76 FR 34297 - Low Income Taxpayer Clinic Grant Program; Availability of 2012 Grant Application Package

Science.gov (United States)

2011-06-13

... guidelines (Publication 3319) for organizations interested in applying for a Low Income Taxpayer Clinic (LITC... representation for free or for a nominal fee to low income taxpayers involved in tax controversies with the IRS..., IRS Publication 3319 (Rev. 5-2011), can be downloaded from the IRS Internet site at http://www.irs.gov...

Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review.

Science.gov (United States)

Mayén, Ana-Lucia; Marques-Vidal, Pedro; Paccaud, Fred; Bovet, Pascal; Stringhini, Silvia

2014-12-01

In high-income countries, high socioeconomic status (SES) is generally associated with a healthier diet, but whether social differences in dietary intake are also present in low- and middle-income countries (LMICs) remains to be established. We performed a systematic review of studies that assessed the relation between SES and dietary intake in LMICs. We carried out a systematic review of cohort and cross-sectional studies in adults in LMICs and published between 1996 and 2013. We assessed associations between markers of SES or urban and rural settings and dietary intake. A total of 33 studies from 17 LMICs were included (5 low-income countries and 12 middle-income countries; 31 cross-sectional and 2 longitudinal studies). A majority of studies were conducted in Brazil (8), China (6), and Iran (4). High SES or living in urban areas was associated with higher intakes of calories; protein; total fat; cholesterol; polyunsaturated, saturated, and monounsaturated fatty acids; iron; and vitamins A and C and with lower intakes of carbohydrates and fiber. High SES was also associated with higher fruit and/or vegetable consumption, diet quality, and diversity. Although very few studies were performed in low-income countries, similar patterns were generally observed in both LMICs except for fruit intake, which was lower in urban than in rural areas in low-income countries. In LMICs, high SES or living in urban areas is associated with overall healthier dietary patterns. However, it is also related to higher energy, cholesterol, and saturated fat intakes. Social inequalities in dietary intake should be considered in the prevention and control of noncommunicable diseases in LMICs. © 2014 American Society for Nutrition.

A randomized controlled design reveals barriers to citizenship for low-income immigrants.

Science.gov (United States)

Hainmueller, Jens; Lawrence, Duncan; Gest, Justin; Hotard, Michael; Koslowski, Rey; Laitin, David D

2018-01-30

Citizenship endows legal protections and is associated with economic and social gains for immigrants and their communities. In the United States, however, naturalization rates are relatively low. Yet we lack reliable knowledge as to what constrains immigrants from applying. Drawing on data from a public/private naturalization program in New York, this research provides a randomized controlled study of policy interventions that address these constraints. The study tested two programmatic interventions among low-income immigrants who are eligible for citizenship. The first randomly assigned a voucher that covers the naturalization application fee among immigrants who otherwise would have to pay the full cost of the fee. The second randomly assigned a set of behavioral nudges, similar to outreach efforts used by service providers, among immigrants whose incomes were low enough to qualify them for a federal waiver that eliminates the application fee. Offering the fee voucher increased naturalization application rates by about 41%, suggesting that application fees act as a barrier for low-income immigrants who want to become US citizens. The nudges to encourage the very poor to apply had no discernible effect, indicating the presence of nonfinancial barriers to naturalization. Copyright © 2018 the Author(s). Published by PNAS.

Environment and air pollution like gun and bullet for low-income countries: war for better health and wealth.

Science.gov (United States)

Zou, Xiang; Azam, Muhammad; Islam, Talat; Zaman, Khalid

2016-02-01

The objective of the study is to examine the impact of environmental indicators and air pollution on "health" and "wealth" for the low-income countries. The study used a number of promising variables including arable land, fossil fuel energy consumption, population density, and carbon dioxide emissions that simultaneously affect the health (i.e., health expenditures per capita) and wealth (i.e., GDP per capita) of the low-income countries. The general representation for low-income countries has shown by aggregate data that consist of 39 observations from the period of 1975-2013. The study decomposes the data set from different econometric tests for managing robust inferences. The study uses temporal forecasting for the health and wealth model by a vector error correction model (VECM) and an innovation accounting technique. The results show that environment and air pollution is the menace for low-income countries' health and wealth. Among environmental indicators, arable land has the largest variance to affect health and wealth for the next 10-year period, while air pollution exerts the least contribution to change health and wealth of low-income countries. These results indicate the prevalence of war situation, where environment and air pollution become visible like "gun" and "bullet" for low-income countries. There are required sound and effective macroeconomic policies to combat with the environmental evils that affect the health and wealth of the low-income countries.

Complexity of food preparation and food security status in low-income young women.

Science.gov (United States)

Engler-Stringer, Rachel; Stringer, Bernadette; Haines, Ted

2011-01-01

This study was conducted to explore whether preparing more complex meals was associated with higher food security status. This mixed-methods, community-based study involved the use of semistructured interviews to examine the cooking practices of a group of young, low-income women in Montreal. Fifty participants aged 18 to 35 were recruited at 10 locations in five low-income neighbourhoods. Food security status was the main outcome measure and the main exposure variable, "complex food preparation," combined the preparation of three specific food types (soups, sauces, and baked goods) using basic ingredients. Low-income women preparing a variety of meals using basic ingredients at least three times a week were more than twice as likely to be food secure as were women preparing more complex meals less frequently. Women who prepared more complex meals more frequently had higher food security. Whether this means that preparing more complex foods results in greater food security remains unclear, as this was an exploratory study.

Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

Science.gov (United States)

Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

2005-12-01

To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. The Household Component of the 2001 Medical Expenditure Panel Survey. Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. We aggregated annual OOP expenditures for all members of 4,531 families with a child members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. A regressive gradient was noted for financial burden across income groups, with families with incomes Poverty Level (FPL) spending a mean of 119.66 US dollars OOP per 1,000 US dollars of family income and families with incomes 100-199 percent FPL spending 66.30 US dollars OOP per 1,000 US dollars, compared with 37.75 US dollars for families with incomes >400 percent FPL. For low-income families (families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage.

Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: Associations with food-related perceptions

Science.gov (United States)

Vedovato, Gabriela M.; Surkan, Pamela J.; Jones-Smith, Jessica; Steeves, Elizabeth Anderson; Han, Eunkyung; Trude, Angela C.B.; Kharmats, Anna Y.; Gittelsohn, Joel

2016-01-01

Objective To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviors among low-income African-American (AA) families. Design Cross-sectional survey of participants in the baseline evaluation of the B’More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socioeconomic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programs, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. Setting Fourteen low-income, predominantly AA neighborhoods in Baltimore City. Subjects 298 adult caregiver-child (10–14 years old) dyads. Results 41.6% of households had some level of food insecurity, and 12.4% experienced some level of hunger. Food insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obese) among adults and children (82.8% and 37.9% food insecure without hunger; 89.2% and 45.9% with hunger, respectively), although there were no significant differences by security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. Conclusions In this setting, obesity and food insecurity are major problems. For many food insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption. PMID:26441159

Understanding Potential Changes to the Veterans Equitable Resource Allocation (VERA) System

National Research Council Canada - National Science Library

Wasserman, Jeffrey

2004-01-01

... disabilities, low incomes, and special health care needs. In contrast to earlier VHA allocation systems, which were based largely on historical costs, VERA bases its allocation of finds primarily on the number of veterans served (work- load...

Opportunities and obstacles in child and adolescent mental health services in low- and middle-income countries: a review of the literature.

Science.gov (United States)

Juengsiragulwit, Dutsadee

2015-01-01

Lower-income, less developed countries have few child and adolescent mental health professionals and a low availability of paediatric community mental health care. Child mental health professionals in low- and middle-income countries (LMICs) must therefore balance comprehensive tertiary care for the minority and provision of child and adolescent mental health services (CAMHS) within primary health care to serve the majority. This review aimed to identify the obstacles to, and opportunities for, providing CAMHS in LMICs. Articles from PsychInfo and PubMed, published up to November 2011, were retrieved using the search terms "child and adolescent", "mental health services", "child psychiatry", "low- and middle-income countries", "low-income countries" and "developing countries". Articles were then retrieved from PubMed alone, using these search terms plus the individual country names of 154 LMICs. Fifty-four articles were retrieved from PsychInfo and 632 from PubMed. Searching PubMed with 154 LMIC names retrieved seven related articles. Inclusion criteria were (i) articles relating to CAMHS or child psychiatric services; (ii) subjects included in the articles were inhabitants of LMICs or developing countries; (iii) articles reported in English. After removal of duplicates, 22 articles remained. The contents of these articles were categorized and analysed by use of the six domains of the World Health Organization assessment instrument for mental health systems (WHO-AIMS), a tool developed to collect information on available resources within mental health systems. The provision of CAMHS in LMICs clearly needs a specific strategy to maximize the potential of limited resources. Mental health-policy and awareness campaigns are powerful measures to drive CAMHS. Training in CAMH for primary health-care professionals, and integration of CAMHS into existing primary health-care services, is essential in resource-constrained settings. A wide gap in research into CAMHS still

Policy options for the split incentive: Increasing energy efficiency for low-income renters

International Nuclear Information System (INIS)

Bird, Stephen; Hernández, Diana

2012-01-01

The split incentive problem concerns the lack of appropriate incentives to implement energy efficiency measures. In particular, low income tenants face a phenomenon of energy poverty in which they allocate significantly more of their household income to energy expenditures than other renters. This problem is substantial, affecting 1.89% of all United States' energy use. If effectively addressed, it would create a range of savings between 4 and 11 billion dollars per year for many of the nation's poorest residents. We argue that a carefully designed program of incentives for participants (including landlords) in conjunction with a unique type of utility-managed on-bill financing mechanism has significant potential to solve many of the complications. We focus on three kinds of split incentives, five concerns inherent to addressing split incentive problems (scale, endurance, incentives, savings, political disfavor), and provide a detailed policy proposal designed to surpass those problems, with a particular focus on low-income tenants in a U.S. context. - Highlights: ► We demonstrate the significant impact of the split incentive on low-income tenants. ► We discuss split incentive characteristics, and policy failures. ► We described an on-bill financing model with unique features. ► This policy has protections and incentives for tenants and landlords.

Early diffusion of gene expression profiling in breast cancer patients associated with areas of high income inequality.

Science.gov (United States)

Ponce, Ninez A; Ko, Michelle; Liang, Su-Ying; Armstrong, Joanne; Toscano, Michele; Chanfreau-Coffinier, Catherine; Haas, Jennifer S

2015-04-01

With the Affordable Care Act reducing coverage disparities, social factors could prominently determine where and for whom innovations first diffuse in health care markets. Gene expression profiling is a potentially cost-effective innovation that guides chemotherapy decisions in early-stage breast cancer, but adoption has been uneven across the United States. Using a sample of commercially insured women, we evaluated whether income inequality in metropolitan areas was associated with receipt of gene expression profiling during its initial diffusion in 2006-07. In areas with high income inequality, gene expression profiling receipt was higher than elsewhere, but it was associated with a 10.6-percentage-point gap between high- and low-income women. In areas with low rates of income inequality, gene expression profiling receipt was lower, with no significant differences by income. Even among insured women, income inequality may indirectly shape diffusion of gene expression profiling, with benefits accruing to the highest-income patients in the most unequal places. Policies reducing gene expression profiling disparities should address low-inequality areas and, in unequal places, practice settings serving low-income patients. Project HOPE—The People-to-People Health Foundation, Inc.

Life After Welfare Reform: Low-Income Single Parent Families, Pre- and Post-TANF.

Science.gov (United States)

Peterson, Janice; Song, Xue; Jones-DeWeever, Avis

This study used data from the first and last waves of the 1996 U.S. Census Bureau's Survey of Income and Program Participation to compare the characteristics and wellbeing of low-income, single parent families before and after passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), noting the characteristics and…

Improving population health by reducing poverty: New York's Earned Income Tax Credit.

Science.gov (United States)

Wicks-Lim, Jeannette; Arno, Peter S

2017-12-01

Despite the established relationship between adverse health outcomes and low socioeconomic status, researchers rarely test the link between health improvements and poverty-alleviating economic policies. New research, however, links individual-level health improvements to the Earned Income Tax Credit (EITC), a broad-based income support policy. We build on these findings by examining whether the EITC has ecological, neighborhood-level health effects. We use a difference-in-difference analysis to measure child health outcomes in 90 low- and middle- income neighborhoods before and after the expansion of New York State and New York City's EITC policy between 1997-2010. Our study takes advantage of the relatively exogenous source of income variation supplied by the EITC-legislative changes to EITC policy parameters. This feature minimizes the endogeneity problem in studying the relationship between income and health. Our estimates link a 15-percentage-point increase in EITC benefit rates to a 0.45 percentage-point reduction in the low birthweight rate. We do not observe any measurable link between EITC benefits and prenatal health or asthma-related pediatric hospitalization. The magnitude of the EITC's impact on low birthweight rates suggests ecological effects, and an additional channel through which anti-poverty measures can serve as public health interventions.

The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial

Directory of Open Access Journals (Sweden)

Chen Ellen

2011-04-01

Full Text Available Abstract Background Although self-management support improves diabetes outcomes, it is not consistently provided in health care settings strained for time and resources. One proposed solution to personnel and funding shortages is to utilize peer coaches, patients trained to provide diabetes education and support to other patients. Coaches share similar experiences about living with diabetes and are able to reach patients within and beyond the health care setting. Given the limited body of evidence that demonstrates peer coaching significantly improves chronic disease care, this present study examines the impact of peer coaching delivered in a primary care setting on diabetes outcomes. Methods/Design The aim of this multicenter, randomized control trial is to evaluate the effectiveness of utilizing peer coaches to improve clinical outcomes and self-management skills in low-income patients with poorly controlled diabetes. A total of 400 patients from six primary health centers based in San Francisco that serve primarily low-income populations will be randomized to receive peer coaching (n = 200 or usual care (n = 200 over 6 months. Patients in the peer coach group receive coaching from patients with diabetes who are trained and mentored as peer coaches. The primary outcome is change in HbA1c. Secondary outcomes include change in: systolic blood pressure, body mass index (BMI, LDL cholesterol, diabetes self-care activities, medication adherence, diabetes-related quality of life, diabetes self-efficacy, and depression. Clinical values (HbA1c, LDL cholesterol and blood pressure and self-reported diabetes self-efficacy and self-care activities are measured at baseline and after 6 months for patients and coaches. Peer coaches are also assessed at 12 months. Discussion Patients with diabetes, who are trained as peer health coaches, are uniquely poised to provide diabetes self management support and education to patients. This study is designed to

Feasibility and Acceptability of Brighter Bites: A Food Co-Op in Schools to Increase Access, Continuity and Education of Fruits and Vegetables Among Low-Income Populations.

Science.gov (United States)

Sharma, Shreela; Helfman, Lisa; Albus, Katherine; Pomeroy, Mike; Chuang, Ru-Jye; Markham, Christine

2015-08-01

Intake of fruits and vegetables (F&V) continues to be low in children in the United States. The purpose of this study was to conduct a pilot feasibility evaluation of Brighter Bites, a school-based food co-op to provide access to fresh F&V and nutrition education to low-income children and their families. Brighter Bites is a 16-week school-based food co-op consisting of: (1) Weekly distribution of 50-60 servings of fresh F&V; (2) Weekly bilingual parent handouts and recipe demonstrations; and (3) implementing CATCH, a coordinated school health program in schools. Brighter Bites was pilot tested using a pre-post evaluation design in one charter school in Houston, TX, USA (n = 57 3rd grade parent-child dyads; 94.1 % Hispanic, 91 % low-income). Evaluation, at baseline, midpoint, and post-intervention, included self-reported child and parent surveys on psychosocial factors, dietary habits and mealtime practices. Pearson's Chi square test, Fisher's exact-test or paired t test were used to determine changes pre- to post-intervention (at p food, less sugary drinks with meals, more children asking for F&V as snacks. Process data showed 98 % retention rate and high parent acceptability of program components. Brighter Bites is a promising strategy to increase F&V access and education in low-income populations using existing infrastructure of schools and food banks.

Characteristics of prepared food sources in low-income neighborhoods of Baltimore City.

Science.gov (United States)

Lee, Seung Hee; Rowan, Megan T; Powell, Lisa M; Newman, Sara; Klassen, Ann Carroll; Frick, Kevin D; Anderson, Jennifer; Gittelsohn, Joel

2010-01-01

The food environment is associated with obesity risk and diet-related chronic diseases. Despite extensive research conducted on retail food stores, little is known about prepared food sources(PFSs). We conducted an observational assessment of all PFSs(N = 92) in low-income neighborhoods in Baltimore. The most common PFSs were carry-outs, which had the lowest availability of healthy food choices. Only a small proportion of these carry-outs offered healthy sides, whole wheat bread, or entrée salads (21.4%, 7.1%, and 33.9%, respectively). These findings suggest that carry-out-specific interventions are necessary to increase healthy food availability in low-income urban neighborhoods.

Experiential Cooking Programs for Low-Income Adults: Strategies for Success

Science.gov (United States)

Franck, Karen; Vineyard, Michelle; Olson, Ann; Peterson, Ashley

2012-01-01

Experiential cooking classes for low-income adults can help improve healthy nutrition behaviors. However, nutrition educators and Extension professionals can face challenges in successful implementation of these programs such as difficulties recruiting and retaining participants. Drawing upon lessons learned from a cooking intervention with…

Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review.

Science.gov (United States)

Fesenfeld, Michaela; Hutubessy, Raymond; Jit, Mark

2013-08-20

The World Health Organization recommends establishing that human papillomavirus vaccination is cost-effective before vaccine introduction. We searched Pubmed, Embase and the Cochrane Library to 1 April 2012 for economic evaluations of human papillomavirus vaccination in low and middle income countries. We found 25 articles, but almost all low income countries and many middle income countries lacked country-specific studies. Methods, assumptions and consequently results varied widely, even for studies conducted for the same country. Despite the heterogeneity, most studies conclude that vaccination is likely to be cost-effective and possibly even cost saving, particularly in settings without organized cervical screening programmes. However, study uncertainty could be reduced by clarity about vaccine prices and vaccine delivery costs. The review supports extending vaccination to low income settings where vaccine prices are competitive, donor funding is available, cervical cancer burden is high and screening options are limited. Copyright © 2013 Elsevier Ltd. All rights reserved.

The global burden of visual difficulty in low, middle, and high income countries.

Directory of Open Access Journals (Sweden)

Ellen E Freeman

Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.

Modeling condom-use stage of change in low-income, single, urban women.

Science.gov (United States)

Morrison-Beedy, Dianne; Carey, Michael P; Lewis, Brian P

2002-04-01

This study was undertaken to identify and test a model of the cognitive antecedents to condom use stage of change in low-income, single, urban women. A convenience sample of 537 women (M=30 years old) attending two urban primary health care settings in western New York State anonymously completed questionnaires based primarily on two leading social-cognitive models, the transtheoretical model and the information-motivation-behavioral skills model. We used structural equation modeling to examine the direct and indirect effects of HIV-related knowledge, social norms of discussing HIV risk and prevention, familiarity with HIV-infected persons, general readiness to change sexual behaviors, perceived vulnerability to HIV, and pros and cons of condom use on condom-use stage of change. The results indicated two models that differ by partner type. Condom-use stage of change in women with steady main partners was influenced most by social norms and the pros of condom use. Condom-use stage of change in women with "other" types (multiple, casual, or new) of sexual partners was influenced by HIV-related knowledge, general readiness to change sexual behaviors, and the pros of condom use. These findings suggest implications for developing gender-relevant HIV-prevention interventions. Copyright 2002 Wiley Periodicals, Inc.

The Effectiveness Of Rental Housing Finance For Low-Income Households In Sombo Rental Flats Surabaya

Directory of Open Access Journals (Sweden)

Annisa Nur Ramadhani

2017-07-01

Full Text Available Fullfilment for the needs of housing is a priority that cannot be suspended especially in urban areas of developing country whose population continues to increase because of the rapid urbanization. Indonesia as the developing country still has a fairly high backlog approximately at 7.6 millions unit house in 2014 most of them are low income people. The Government has several plan in striving for the scarcity of housing. One of them is the development of rental flats which have goals for the social housing fulfillment for low income people and increase their housing affordability by lowering the rental rates. The intention is to assist the low income people save their money to buy their own homes. But in facts there are several constraints related to this rental flats finance such as late payment by the residents uncontroled right transfer and the tariff adjusted to the ability of the inhabitants can not cover the cost of the physical building management and maintanance. This study aims to evaluate Sombo rental flat finance for for low income people in which the data are collected through in depth interview observation and documentation. The results of several qualitatively descriptive analysis show that the effectiveness of rental flat financing in the aspect of the purpose and goal to facilitating low income community needs of housing is quiet accomplished. Beside that the organization is also well structured and have the efficient human resources. But Sombo rental flats effectivenes is relatively low in the aspect of profit ability rental financing program and in the enforcement of rules and regulation. The main problem is in the arrears of residents rental payment and the deficiency for maintanance cost so it has to depend on the city government subsidies. The rental finance constraint are caused by several factors which are historic factors residents factors and the vision and commitment of the city government to facilitate housing for low

"The Kids Still Come First": Creating Family Stability during Partnership Instability in Rural, Low-Income Families

Science.gov (United States)

Sano, Yoshie; Manoogian, Margaret M.; Ontai, Lenna L.

2012-01-01

This qualitative study examined the nature of partnerships among 28 rural low-income mothers who experienced partnership transitions across three waves of annual interviews. Guided by "lens of uncertainty" and "boundary ambiguity theory," the authors specifically explored (a) how low-income mothers in rural communities experience partnership…

Does modifying the household food budget predict changes in the healthfulness of purchasing choices among low- and high-income women?

Science.gov (United States)

Inglis, Victoria; Ball, Kylie; Crawford, David

2009-04-01

Food cost has a strong influence on food purchases and given that persons of low income often have more limited budgets, healthier foods may be overlooked in favour of more energy-dense lower-cost options. The aim of this study was to investigate whether modifications to the available household food budget led to changes in the healthfulness of food purchasing choices among women of low and high income. A quasi-experimental design was used which included a sample of 74 women (37 low-income women and 37 high-income women) who were selected on the basis of their household income and sent an itemised shopping list in order to calculate their typical weekly household shopping expenditure. The women were also asked to indicate those foods they would add to their list if they were given an additional 25% of their budget to spend on food and those foods they would remove if they were restricted by 25% of their budget. When asked what foods they would add with a larger household food budget, low-income women chose more foods from the 'healthier' categories whereas high-income women chose more foods from the less 'healthier' categories. However, making the budgets of low- and high-income women more 'equivalent' did not eradicate income differences in overall healthfulness of food purchasing choices. This study highlights the importance of cost when making food purchasing choices among low- and high-income groups. Public health strategies aimed at reducing income inequalities in diet might focus on promoting healthy diets that are low cost.

Out-of-pocket health expenditures and antimicrobial resistance in low-income and middle-income countries: an economic analysis.

Science.gov (United States)

Alsan, Marcella; Schoemaker, Lena; Eggleston, Karen; Kammili, Nagamani; Kolli, Prasanthi; Bhattacharya, Jay

2015-10-01

The decreasing effectiveness of antimicrobial agents is a growing global public health concern. Low-income and middle-income countries are vulnerable to the loss of antimicrobial efficacy because of their high burden of infectious disease and the cost of treating resistant organisms. We aimed to assess if copayments in the public sector promoted the development of antibiotic resistance by inducing patients to purchase treatment from less well regulated private providers. We analysed data from the WHO 2014 Antibacterial Resistance Global Surveillance report. We assessed the importance of out-of-pocket spending and copayment requirements for public sector drugs on the level of bacterial resistance in low-income and middle-income countries, using linear regression to adjust for environmental factors purported to be predictors of resistance, such as sanitation, animal husbandry, and poverty, and other structural components of the health sector. Our outcome variable of interest was the proportion of bacterial isolates tested that showed resistance to a class of antimicrobial agents. In particular, we computed the average proportion of isolates that showed antibiotic resistance for a given bacteria-antibacterial combination in a given country. Our sample included 47 countries (23 in Africa, eight in the Americas, three in Europe, eight in the Middle East, three in southeast Asia, and two in the western Pacific). Out-of-pocket health expenditures were the only factor significantly associated with antimicrobial resistance. A ten point increase in the percentage of health expenditures that were out-of-pocket was associated with a 3·2 percentage point increase in resistant isolates (95% CI 1·17-5·15; p=0·002). This association was driven by countries requiring copayments for drugs in the public health sector. Of these countries, moving from the 20th to 80th percentile of out-of-pocket health expenditures was associated with an increase in resistant bacterial isolates

Food Poverty, Climate Change and Land Access in central Uganda: A focus on low-income women

DEFF Research Database (Denmark)

Nambuanyi, Lekunze Ransom

climate change impacts in Uganda have affected women’s livelihoods and food security; the constraints that exacerbate women’s vulnerability to food insecurity; and their adaptive capacity to mitigate these impacts. These findings will serve as a catalyst for the larger project that will generate......Abstract: This concept paper presents part of a work in progress on a participatory action research project that seeks to investigate the interrelated effects of climate change, agricultural practices and land tenure systems on women’s food security in central Uganda. We examine policy implications...... of food insecurity among low-income women (farmers) in central Uganda, positing the view that the agricultural and livelihood choices women farmers make are subject to the constraints they face and the policy alternatives available for them. Uganda is burdened with rising poverty, malnutrition and food...

The feasibility of a Paleolithic diet for low-income consumers

NARCIS (Netherlands)

Metzgar, Matthew; Rideout, Todd C.; Fontes-Villalba, Maelan; Kuipers, Remko S.

Many low-income consumers face a limited budget for food purchases. The United States Department of Agriculture developed the Thrifty Food Plan to address this problem of consuming a healthy diet given a budget constraint. This dietary optimization program uses common food choices to build a

Impact of Pneumococcal Conjugate Vaccines on Pneumonia Hospitalizations in High- and Low-Income Subpopulations in Brazil

DEFF Research Database (Denmark)

Warren, Joshua L.; Shioda, Kayoko; Kürüm, Esra

2017-01-01

Background: Pneumococcal conjugate vaccines (PCVs) are being used worldwide. A key question is whether the impact of PCVs on pneumonia is similar in low- and high-income populations. However, most low-income countries, where the burden of disease is greatest, lack reliable data that can be used t...

Online health consultation: examining uses of an interactive cancer communication tool by low-income women with breast cancer.

Science.gov (United States)

Lu, Hsueh-Yi; Shaw, Bret R; Gustafson, David H

2011-07-01

negative perceptions at pre-test tended to use the service more. Greater use of the service was associated with improvement in patients' perception of health self-efficacy, participation in health care and doctor-patient relationship. Moreover, use of online health consultation appears to level the differences, narrowing the gaps between those who were worse and better off at pre-test. These findings suggest that online health consultation can serve as an effective complement to other resources, which help low-income, breast cancer patients feel more confident to participate more actively in their health care, become more actively involved in making decisions about their treatments and enhance the relationship with their doctors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review

Science.gov (United States)

Islam, Rakibul M; Billah, Baki; Hossain, Md Nassif; Oldroyd, John

2017-07-27

Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs. Creative Commons Attribution License

Evaluating the co-benefits of low-income energy-efficiency programmes

Energy Technology Data Exchange (ETDEWEB)

Heffner, Grayson; Campbell, Nina

2011-06-15

The International Energy Agency's Energy Efficiency Unit (EEU) has begun a new programme of work on innovative energy-efficiency policies for mitigating fuel poverty. The IEA's current research focuses on the potential for low-income weatherisation programmes to address poor housing quality -- the main driver of fuel poverty -- as well as innovative methods for financing and evaluating such programmes. A common problem is that the energy-saving benefits accruing to fuel-poor households barely offset the investment required, suggesting a weak return on government spending. However, these investments have additional co-benefits for participants as well as for energy providers, property owners, local communities and society as a whole. This first IEA workshop focused on methods for incorporating the range of co-benefits into evaluation of low-income weatherisation programmes. The presentations given by top experts in the fuel poverty field are summarised in this report, along with conclusions and proposals for further research.

Evaluating the co-benefits of low-income energy-efficiency programmes

Energy Technology Data Exchange (ETDEWEB)

Heffner, Grayson; Campbell, Nina

2011-06-15

The International Energy Agency's Energy Efficiency Unit (EEU) has begun a new programme of work on innovative energy-efficiency policies for mitigating fuel poverty. The IEA's current research focuses on the potential for low-income weatherisation programmes to address poor housing quality -- the main driver of fuel poverty -- as well as innovative methods for financing and evaluating such programmes. A common problem is that the energy-saving benefits accruing to fuel-poor households barely offset the investment required, suggesting a weak return on government spending. However, these investments have additional co-benefits for participants as well as for energy providers, property owners, local communities and society as a whole. This first IEA workshop focused on methods for incorporating the range of co-benefits into evaluation of low-income weatherisation programmes. The presentations given by top experts in the fuel poverty field are summarised in this report, along with conclusions and proposals for further research.

Nutrition information-seeking behaviour of low-income pregnant Maghrebian women.

Science.gov (United States)

Legault, Anik; Marquis, Marie

2014-01-01

Nutrition information-seeking behaviour was explored among low-income pregnant Maghrebian women living in Montreal. Environmental factors likely to influence nutrition information-seeking behaviour during pregnancy are discussed. Data were collected in face-to-face interviews with 14 primigravid pregnant women recruited via the Montreal Diet Dispensary, a nonprofit agency with the mission of promoting health among low-income pregnant women. Data collection was part of a larger project on pregnant women's nutrition decision-making. Environmental factors likely to influence information-seeking behaviour were identified. They were grouped within two major themes: culture and interactions with individuals from the social environment. The culture theme was divided into three minor themes: eating habits, food beliefs, and religious beliefs. The interactions with individuals from the social environment theme was divided into two minor themes: interactions with health care providers and interactions with family members. Understanding the influence of these environmental factors should help registered dietitians tailor communication strategies to pregnant immigrant women's specific information needs.

Anthropometric indices for non-pregnant women of childbearing age differ widely among four low-middle income populations

Directory of Open Access Journals (Sweden)

K Michael Hambidge

2017-07-01

Full Text Available Abstract Background Maternal stature and body mass indices (BMI of non-pregnant women (NPW of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC. Methods Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m2 was calculated. Z-scores were determined using WHO reference data. Results A total of 7268 NPW participated in Equateur, DRC (n = 1741; Chimaltenango, Guatemala (n = 1695; North Karnataka, India (n = 1823; and Thatta, Sindh, Pakistan (n = 2009. Mean age was 23 y and mean parity 1.5. Median (P25-P75 height (cm ranged from 145.5 (142.2–148.9 in Guatemala to 156.0 (152.0–160.0 in DRC. Median weight (kg ranged from 44.7 (39.9–50.3 in India to 52.7 (46.9–59.8 in Guatemala. Median BMI ranged from 19.4 (17.6–21.9 in India to 24.9 (22.3–28.0 in Guatemala. Percent stunted (<−2SD height for age z-score ranged from 13.9% in DRC to 80.5% in Guatemala; % underweight (BMI <18.5 ranged from 1.2% in Guatemala to 37.1% in India; % overweight/obese (OW, BMI ≥25.0 ranged from 5.7% in DRC to 49.3% in Guatemala. For all sites, indicators for higher SES and higher age were associated with BMI. Lower SES women were underweight more frequently and higher SES women were OW more frequently at all sites. Younger women tended to be underweight, while older women tended to be OW. Conclusions Anthropometric data for NPW varied widely among low-income rural populations in four countries located on three different continents. Global comparisons of anthropometric measurements across sites using standard reference data serve to highlight major differences among populations of low-income rural NPW and assist in evaluating the rationale for and the design of optimal

The conceptual mismatch: transportation stressors and experiences for low-income adults.

Science.gov (United States)

2015-10-01

Physical access to jobs has long been identified as a barrier to employment and earnings, with prior : research identifying the spatial mismatch between suburban entry-level jobs and low-income workers. : However, existing transportation resear...

Midline versus transverse incision for cesarean delivery in low-income countries

DEFF Research Database (Denmark)

Maaløe, Nanna; Aabakke, Anna J M; Secher, Niels J

2014-01-01

While transverse incision is the recommended entry technique for cesarean delivery in high-income countries, it is our experience that midline incision is still used routinely in many low-income settings. Accordingly, international guidelines lack uniformity on this matter. Although evidence...... is limited, the literature suggests important advantages of the transverse incision, with lower risk of long-term disabilities such as wound disruption and hernia. Also, potential extra time spent on this incision appears not to impact neonatal outcome. Therefore, we suggest that it is time for a change...

Low-income DSM Programs: Methodological approach to determining the cost-effectiveness of coordinated partnerships

Energy Technology Data Exchange (ETDEWEB)

Brown, M.A.; Hill, L.J.

1994-05-01

As governments at all levels become increasingly budget-conscious, expenditures on low-income, demand-side management (DSM) programs are being evaluated more on the basis of efficiency at the expense of equity considerations. Budgetary pressures have also caused government agencies to emphasize resource leveraging and coordination with electric and gas utilities as a means of sharing the expenses of low-income programs. The increased involvement of electric and gas utilities in coordinated low-income DSM programs, in turn, has resulted in greater emphasis on estimating program cost-effectiveness. The objective of this study is to develop a methodological approach to estimate the cost- effectiveness of coordinated low-income DSM programs, given the special features that distinguish these programs from other utility-operated DSM programs. The general approach used in this study was to (1) select six coordinated low-income DSM programs from among those currently operating across the United States, (2) examine the main features of these programs, and (3) determine the conceptual and pragmatic problems associated with estimating their cost-effectiveness. Three types of coordination between government and utility cosponsors were identified. At one extreme, local agencies operate {open_quotes}parallel{close_quotes} programs, each of which is fully funded by a single sponsor (e.g., one funded by the U.S. Department of Energy and the other by a utility). At the other extreme are highly {open_quotes}coupled{close_quotes} programs that capitalize on the unique capabilities and resources offered by each cosponsor. In these programs, agencies employ a combination of utility and government funds to deliver weatherization services as part of an integrated effort. In between are {open_quotes}supplemental{close_quotes} programs that utilize resources to supplement the agency`s government-funded weatherization, with no changes to the operation of that program.

Financial management of low-income urban families

Energy Technology Data Exchange (ETDEWEB)

Schnittgrund, K.P. (Univ. of California, Riverside); Baker, G.

1983-09-01

The major focus of this research was the difference in financial-management practices used by low-income urban white, black, and Mexican-American families. A random sample of 199 interviews was completed during the spring of 1980 in Phoenix, Arizona, USA. The sample consisted of 69 white, 70 black, and 60 Mexican-American families. Differences in financial behavior did occur for each race. In addition, they were optimistic regarding their own ability to handle money and resolve financial problems but generally negative toward the ability of other families to manage money, use credit, and plan purchases. 20 references, 3 tables.

Digital Inequality and Developmental Trajectories of Low-income, Immigrant, and Minority Children.

Science.gov (United States)

Katz, Vikki S; Gonzalez, Carmen; Clark, Kevin

2017-11-01

Children growing up in the United States today are more ethnically and racially diverse than at any time in the nation's history. Because of rising income inequality, almost half of the 72 million children in the United States are also growing up in low-income families, with immigrant and children of color disproportionately likely to be within their ranks. Children in low-income households are more likely to face a number of social challenges, including constrained access to the Internet and devices that connect to it (ie, digital inequality), which can exacerbate other, more entrenched disparities between them and their more privileged counterparts. Although the American Academy of Pediatrics' new guidelines encourage clinicians to reduce children's overexposure to technology, we argue for a more nuanced approach that also considers how digital inequality can reduce low-income children's access to a range of social opportunities. We review previous research on how digital inequality affects children's learning and development and identify areas where more research is needed on how digital inequality relates to specific aspects of children's developmental trajectories, and to identify what interventions at the family, school, and community levels can mitigate the adverse effects of digital inequality as children move through their formal schooling. On the basis of the evidence to date, we conclude with guidelines for clinicians related to supporting digital connectivity and more equitable access to social opportunity for the increasingly diverse population of children growing up in the United States. Copyright © 2017 by the American Academy of Pediatrics.

Income inequality and alcohol attributable harm in Australia

Directory of Open Access Journals (Sweden)

Chikritzhs Tanya N

2009-02-01

Full Text Available Abstract Background There is little research on the relationship between key socioeconomic variables and alcohol related harms in Australia. The aim of this research was to examine the relationship between income inequality and the rates of alcohol-attributable hospitalisation and death at a local-area level in Australia. Method We conducted a cross sectional ecological analysis at a Local Government Area (LGA level of associations between data on alcohol caused harms and income inequality data after adjusting for socioeconomic disadvantage and remoteness of LGAs. The main outcome measures used were matched rate ratios for four measures of alcohol caused harm; acute (primarily related to the short term consequences of drinking and chronic (primarily related to the long term consequences of drinking alcohol-attributable hospitalisation and acute and chronic alcohol-attributable death. Matching was undertaken using control conditions (non-alcohol-attributable at an LGA level. Results A total of 885 alcohol-attributable deaths and 19467 alcohol-attributable hospitalisations across all LGAs were available for analysis. After weighting by the total number of cases in each LGA, the matched rate ratios of acute and chronic alcohol-attributable hospitalisation and chronic alcohol-attributable death were associated with the squared centred Gini coefficients of LGAs. This relationship was evident after adjusting for socioeconomic disadvantage and remoteness of LGAs. For both measures of hospitalisation the relationship was curvilinear; increases in income inequality were initially associated with declining rates of hospitalisation followed by large increases as the Gini coefficient increased beyond 0.15. The pattern for chronic alcohol-attributable death was similar, but without the initial decrease. There was no association between income inequality and acute alcohol-attributable death, probably due to the relatively small number of these types of death

Prospera Digital Phase II: Financial inclusion for low-income women ...

International Development Research Centre (IDRC) Digital Library (Canada)

Prospera Digital Phase II: Financial inclusion for low-income women in Mexico ... a research network in Latin America, to identify barriers and opportunities to scale up ... Call for new OWSD Fellowships for Early Career Women Scientists now open ... conference of McGill's Institute for the Study of International Development.

Low income Russian families adopt effective behavioral strategies to maintain dietary stability in times of economic crisis.

Science.gov (United States)

Dore, Anna R; Adair, Linda S; Popkin, Barry M

2003-11-01

The social, political and economic reforms of 1992 in Russia led to a decade of rising income inequality, unemployment and economic crises, the most severe of which occurred in 1998. This study assesses dietary trends for children in low and high income households during this politically and economically unstable period from 1994 to 2000. Several possible food-related behaviors were also assessed to evaluate coping strategies adopted in the face of decreasing economic stability. Low income children maintained a steady energy intake per kilogram weight throughout the study period (251.0-259.4 kJ/kg), whereas intake for high income children increased significantly to a per capital average of 297.1 kJ/kg by 2000. At the food group level, the trend in per capita intake for all food groups was maintained for low income children except for a 22% decrease in meat and poultry consumption (P economic crisis.

Poverty Is Low Consumption and Low Wealth, Not Just Low Income

Science.gov (United States)

Headey, Bruce

2008-01-01

The purpose of this paper is to suggest an improved measure of financial poverty, based on household consumption and wealth as well as income. Data come from the Household, Income and Labour Dynamics Australia (HILDA) Survey, which appears to be the first national socio-economic panel survey to provide longitudinal data on all three measures of…

Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting

Directory of Open Access Journals (Sweden)

Festus Njuguna

2017-10-01

Full Text Available Purpose: Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. Patients and Methods: We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Results: Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%, II (7%, III (43%, IV (40%, or V (10%. The most likely treatment outcome in patients with low-stage (I to III disease was event-free survival (67%, whereas in those with high-stage (IV to V disease, it was death (40%. No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes (P = .014 and event-free survival estimates (P < .001. Age at diagnosis, sex, duration of symptoms, distance to hospital, and health insurance status did not statistically significantly influence treatment outcomes or event-free survival estimates. Conclusion: Survival of patients with Wilms tumor in Kenya is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

Feasibility of Internet-based Parent Training for Low-income Parents of Young Children.

Science.gov (United States)

McGoron, Lucy; Hvizdos, Erica; Bocknek, Erika L; Montgomery, Erica; Ondersma, Steven J

2018-01-01

Parent training programs promote positive parenting and benefit low-income children, but are rarely used. Internet-based delivery may help expand the reach of parent training programs, although feasibility among low-income populations is still unclear. We examined the feasibility of internet-based parent training, in terms of internet access/use and engagement, through two studies. In Study 1, 160 parents recruited from Women, Infants, and Children (WIC) centers completed a brief paper survey regarding internet access and use (all parents received government aid). We found high levels of access, openness, and comfort with the internet and internet-enabled devices. In Study 2, a pilot study, we assessed use of an online parenting program in a project with a sample of 89 predominately low-income parents (75% received government aid). Parents learned about a new, online parenting program (the "5-a-Day Parenting Program") and provided ratings of level of interest and program use 2-weeks and 4-weeks later. Local website traffic was also monitored. At baseline, parents were very interested in using the web-based program, and the majority of parents (69.6%) reported visiting the website at least once. However, in-depth use was rare (only 9% of parents reported frequent use of the online program). Results support the feasibility of internet-based parent training for low-income parents, as most parent were able to use the program and were interested in doing so. However, results also suggest the need to develop strategies to promote in-depth program use.

Outpatient case management in low-income epilepsy patients.

Science.gov (United States)

Tatum, William O; Al-Saadi, Sam; Orth, Thomas L

2008-12-01

Case management (CM) has been shown to improve the medical care of patients in several paradigms of general medicine. This study was undertaken to assess the impact of CM on low-income patients with epilepsy. From 2002 to 2003, 737 epilepsy patients had CM provided by a non-profit, state-supported, epilepsy service subserving a four county region in southeastern Florida. Standardized survey forms distributed by the Florida Department of Health were completed by 159 consecutive patients at program admission. Follow-up information regarding seizure frequency, antiepileptic drugs, and quality of life self-rating was performed after 1 year of CM. The patients evaluated were composed of 58.5% men, with a mean age of 41.0 years. After CM, an increase in self-reported seizure control was seen in 40.2% of patients (preduction of ED visits per patient from 1.83 per patient per year before CM to 0.14 per patient per year after CM (p<0.0001, Wilcoxon matched-pairs test). Following CM, fewer patients reported difficulty with friends, employers, problems socializing, and feelings of anger (p<0.05, Fisher's exact test). CM of low-income patients with epilepsy resulted in self-reported improvement in seizure control, QoL, and significantly reduced ED visitation. CM in epilepsy is feasible and represents a cost-effective improvement in outpatient epilepsy management.

Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition: analysis of 179 Demographic and Health Surveys from 64 countries (1993-2015).

Science.gov (United States)

Roth, Daniel E; Krishna, Aditi; Leung, Michael; Shi, Joy; Bassani, Diego G; Barros, Aluisio J D

2017-12-01

The causes of early childhood linear growth faltering (known as stunting) in low-income and middle-income countries remain inadequately understood. We aimed to determine if the progressive postnatal decline in mean height-for-age Z score (HAZ) in low-income and middle-income countries is driven by relatively slow growth of certain high-risk children versus faltering of the entire population. Distributions of HAZ (based on WHO growth standards) were analysed in 3-month age intervals from 0 to 36 months of age in 179 Demographic and Health Surveys from 64 low-income and middle-income countries (1993-2015). Mean, standard deviation (SD), fifth percentiles, and 95th percentiles of the HAZ distribution were estimated for each age interval in each survey. Associations between mean HAZ and SD, fifth percentile, and 95th percentile were estimated using multilevel linear models. Stratified analyses were performed in consideration of potential modifiers (world region, national income, sample size, year, or mean HAZ in the 0-3 month age band). We also used Monte Carlo simulations to model the effects of subgroup versus whole-population faltering on the HAZ distribution. Declines in mean HAZ from birth to 3 years of age were accompanied by declines in both the fifth and 95th percentiles, leading to nearly symmetrical narrowing of the HAZ distributions. Thus, children with relatively low HAZ were not more likely to have faltered than taller same-age peers. Inferences were unchanged in surveys regardless of world region, national income, sample size, year, or mean HAZ in the 0-3 month age band. Simulations showed that the narrowing of the HAZ distribution as mean HAZ declined could not be explained by faltering limited to a growth-restricted subgroup of children. In low-income and middle-income countries, declines in mean HAZ with age are due to a downward shift in the entire HAZ distribution, revealing that children across the HAZ spectrum experience slower growth compared to

Interviews with low-income Pennsylvanians verify a need to enhance eating competence.

Science.gov (United States)

Stotts Krall, Jodi; Lohse, Barbara

2009-03-01

Continuation of unhealthful dietary patterns and poor diet-related health outcomes among socioeconomically disadvantaged populations underscores the need to improve diet quality for this group. Enhancing eating competence, based on the Satter model of eating competence (ecSatter), may be one effective method to reach this goal, but requires substantiation in a low-income audience. This study utilized a qualitative approach to examine the congruence of the ecSatter model with the cognitive eating behaviors of a low-income audience. Structured interviews were conducted during summer of 2006 with 70 low-income adults in Pennsylvania. Themes about decisional factors that guide food selection, nutrition/health interests, and cognitive and affective responses to eating experiences were generated through content analysis. Thematic differences among eating competence levels and food security categories were examined. Nutrition information access preferences were also obtained. Eating competence, measured with the ecSatter Inventory, was low for this sample (mean 28.8+/-8.3). Convenience, mood, family, and availability of food at home, but not nutrition, were salient factors guiding meal and snack planning for both eating competent and noneating competent participants. Nearly equal proportions of persons with eating competence and without eating competence reported that they would make changes to their food purchases if they had more money to spend on food. Interestingly, for participants without eating competence, but not for those with eating competence, weight management played an important role in meal/snack planning, food purchases, and nutrition/health interests. ecSatter provided a tenable framework for rationalizing participants' cognitive and affective responses to eating experiences. Participants without eating competence were more likely to express negative thoughts and feelings associated with eating, regardless of food security status. The Internet, which was

Books, Read-Alouds, and Voluntary Book Interactions: What Do We Know about Centers Serving Three-Year-Olds?

Science.gov (United States)

Mesmer, Heidi Anne

2018-01-01

This study examined the quality of books, the quality of read-alouds, and children's voluntary interactions with books in childcare centers serving low-income 3-year-olds (N = 30). Although a large percentage of centers had book areas, the features of book areas differed. The highest percentage of books was highly recommended and appropriate (39%)…

Cell Phone Ownership and Service Plans Among Low-Income Smokers: The Hidden Cost of Quitlines.

Science.gov (United States)

Bernstein, Steven L; Rosner, June-Marie; Toll, Benjamin

2016-08-01

Quitlines (QLs) are free, effective sources of treatment for tobacco dependence. Although the QL number is toll-free, the use of cell phones as the sole source of telephony may impose an unintended cost, in terms of cell minutes. To quantify the use of cell-only telephony among self-pay or Medicaid smokers, assess their calling plans, and estimate the impact of a typical course of QL counseling. A survey of smokers age at least 18 years visiting an American urban emergency department from April to July, 2013. Seven-hundred seventy-three smokers were surveyed, of whom 563 (72.8%) were low-income, defined as having Medicaid or no insurance. All low-income smokers had at least one phone: 48 (8.5%) reported land-lines only, 159 (28.2%) land-lines and cells, and 356 (63.2%) cells only. Of the cell phone owners, monthly calling plans provided unlimited minutes for 339/515 (65.8%), at most 250 minutes for 124 (24.1%), and more than 250 minutes for 52 (10.0%). Another recent trial found that QL users make a median of 1 call lasting 28 minutes, with the 75th and 90th percentiles of calls and minutes at 3 and 4 calls, and 48 and 73.6 minutes, respectively. Thus, robust use of QL services could consume 11%-29% of a low-income smoker's typical 250 monthly cell minutes. Among low-income smokers, cell phones are often the sole telephone. Robust use of the QL may impose a substantial burden on low-income smokers' calling plans, and therefore deter use of the QL. Exempting calls to QLs from counting against smokers' plans may help promote QL utilization. Low-income individuals have high rates of smoking, and are more likely to own only cell phones, not landlines, for telephone access. Because cell phone calling plans often have limited numbers of monthly minutes, cell-only individuals may have to spend a substantial proportion of their monthly minutes on QL services. This may act as a deterrent to using an otherwise free, effective means of treatment for tobacco dependence

Satellite-aided survey sampling and implementation in low- and middle-income contexts: a low-cost/low-tech alternative.

Science.gov (United States)

Haenssgen, Marco J

2015-01-01

The increasing availability of online maps, satellite imagery, and digital technology can ease common constraints of survey sampling in low- and middle-income countries. However, existing approaches require specialised software and user skills, professional GPS equipment, and/or commercial data sources; they tend to neglect spatial sampling considerations when using satellite maps; and they continue to face implementation challenges analogous to conventional survey implementation methods. This paper presents an alternative way of utilising satellite maps and digital aides that aims to address these challenges. The case studies of two rural household surveys in Rajasthan (India) and Gansu (China) compare conventional survey sampling and implementation techniques with the use of online map services such as Google, Bing, and HERE maps. Modern yet basic digital technology can be integrated into the processes of preparing, implementing, and monitoring a rural household survey. Satellite-aided systematic random sampling enhanced the spatial representativeness of the village samples and entailed savings of approximately £4000 compared to conventional household listing, while reducing the duration of the main survey by at least 25 %. This low-cost/low-tech satellite-aided survey sampling approach can be useful for student researchers and resource-constrained research projects operating in low- and middle-income contexts with high survey implementation costs. While achieving transparent and efficient survey implementation at low costs, researchers aiming to adopt a similar process should be aware of the locational, technical, and logistical requirements as well as the methodological challenges of this strategy.

Quantifying fine particle emission events from time-resolved measurements: Method description and application to 18 California low-income apartments.

Science.gov (United States)

Chan, W R; Logue, J M; Wu, X; Klepeis, N E; Fisk, W J; Noris, F; Singer, B C

2018-01-01

PM 2.5 exposure is associated with significant health risk. Exposures in homes derive from both outdoor and indoor sources, with emissions occurring primarily in discrete events. Data on emission event magnitudes and schedules are needed to support simulation-based studies of exposures and mitigations. This study applied an identification and characterization algorithm to quantify time-resolved PM 2.5 emission events from data collected during 224 days of monitoring in 18 California apartments with low-income residents. We identified and characterized 836 distinct events with median and mean values of 12 and 30 mg emitted mass, 16 and 23 minutes emission duration, 37 and 103 mg/h emission rates, and pseudo-first-order decay rates of 1.3 and 2.0/h. Mean event-averaged concentrations calculated using the determined event characteristics agreed to within 6% of measured values for 14 of the apartments. There were variations in event schedules and emitted mass across homes, with few events overnight and most emissions occurring during late afternoons and evenings. Event characteristics were similar during weekdays and weekends. Emitted mass was positively correlated with number of residents (Spearman coefficient, ρ=.10), bedrooms (ρ=.08), house volume (ρ=.29), and indoor-outdoor CO 2 difference (ρ=.27). The event schedules can be used in probabilistic modeling of PM 2.5 in low-income apartments. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

78 FR 63993 - ``Low-Income Levels'' Used for Various Health Professions and Nursing Programs

Science.gov (United States)

2013-10-25

... changes in the Consumer Price Index. The Secretary annually adjusts the low-income levels based on the... applicable programs. The income figures below have been updated to reflect increases in the Consumer Price... recognition of same-sex spouses and same-sex marriages, was unconstitutional. In light of this decision...

Interconnected microbiomes and resistomes in low-income human habitats

OpenAIRE

Pehrsson, Erica C.; Tsukayama, Pablo; Patel, Sanket; Mej?a-Bautista, Melissa; Sosa-Soto, Giordano; Navarrete, Karla M.; Calderon, Maritza; Cabrera, Lilia; Hoyos-Arango, William; Bertoli, M. Teresita; Berg, Douglas E.; Gilman, Robert H.; Dantas, Gautam

2016-01-01

Summary Antibiotic-resistant infections annually claim hundreds of thousands of lives worldwide. This problem is exacerbated by resistance gene exchange between pathogens and benign microbes from diverse habitats. Mapping resistance gene dissemination between humans and their environment is a public health priority. We characterized the bacterial community structure and resistance exchange networks of hundreds of interconnected human fecal and environmental samples from two low-income Latin A...

Comparison the effects of poor health and low income on early retirement: a systematic review and meta-analysis.

Science.gov (United States)

Homaie Rad, Enayatollah; Rashidian, Arash; Arab, Mohamad; Souri, Ali

2017-08-08

The main aim of this study was to estimate the effects of poor health and low income on early retirement. For this purpose systematic review and meta-analysis were conducted. Web of Science, PUBMED and Scopus databases were searched systematically. Finally 17 surveys were added in meta-analysis. These studies were conducted in 13 countries. At the end a Meta regression was done to show the effects of welfare system type on effect sizes of poor health and low income. The results of this study showed that poor health had effect on the risk of early retirement. (Poor health pooled effect sizes: 1.279 CI: (1.15 1.41), low income pooled effect sizes: 1.042 CI: (0.92 1.17), (poor health pooled marginal effects: 0.046 CI: (-0.03 0.12), low income pooled marginal effects: -0.002 CI: (-0.003 0.000). The results of this study showed that association between poor health and early retirement was stronger in comparison with low income and early retirement.

A New Majority: Low Income Students Now a Majority in the Nation's Public Schools. Research Bulletin

Science.gov (United States)

Southern Education Foundation, 2015

2015-01-01

For the first time in recent history, a majority of the schoolchildren attending the nation's public schools come from low income families. The latest data collected from the states by the National Center for Education Statistics (NCES), evidence that 51 percent of the students across the nation's public schools were low income in 2013. The…

Empowerment in the process of health messaging for rural low-income mothers: an exploratory message design project.

Science.gov (United States)

Aldoory, Linda; Braun, Bonnie; Maring, Elisabeth Fost; Duggal, Mili; Briones, Rowena Lynn

2015-01-01

Rural, low-income mothers face challenges to their health equal to or greater than those of low-income mothers from urban areas. This study put health message design into the hands of low-income rural mothers. The current study filled a research gap by analyzing a participatory process used to design health messages tailored to the everyday lives of rural low-income mothers. A total of forty-three mothers participated in nine focus groups, which were held from 2012 to 2013, in eight states. The mothers were from different racial and ethnic backgrounds. Participants discussed food security, physical activity, and oral health information. They created messages by considering several elements: visuals, length of message, voice/perspective, self-efficacy and personal control, emotional appeals, positive and negative reinforcements, and steps to health behavior change. This study was innovative in its focus on empowerment as a key process to health message design.

Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions.

Science.gov (United States)

Vedovato, Gabriela M; Surkan, Pamela J; Jones-Smith, Jessica; Steeves, Elizabeth Anderson; Han, Eunkyung; Trude, Angela Cb; Kharmats, Anna Y; Gittelsohn, Joel

2016-06-01

To examine associations between food insecurity, excess body weight, psychosocial factors and food behaviours among low-income African-American families. Cross-sectional survey of participants in the baseline evaluation of the B'More Healthy Communities for Kids (BHCK) obesity prevention trial. We collected data on socio-economic factors, food source destinations, acquiring food, preparation methods, psychosocial factors, beliefs and attitudes, participation in food assistance programmes, anthropometry and food security. We used principal component analysis to identify patterns of food source destinations and logistic regression to examine associations. Fourteen low-income, predominantly African-American neighbourhoods in Baltimore City, MD, USA. Two hundred and ninety-eight adult caregiver-child (10-14 years old) dyads. Of households, 41·6 % had some level of food insecurity and 12·4 % experienced some level of hunger. Food-insecure participants with hunger were significantly more likely to be unemployed and to have lower incomes. We found high rates of excess body weight (overweight and obesity) among adults and children (82·8 % and 37·9 % among food insecure without hunger, 89·2 % and 45·9 % among food insecure with hunger, respectively), although there were no significant differences by food security status. Food source usage patterns, food acquisition, preparation, knowledge, self-efficacy and intentions did not differ by food security. Food security was associated with perceptions that healthy foods are affordable and convenient. Greater caregiver body satisfaction was associated with food insecurity and excess body weight. In this setting, obesity and food insecurity are major problems. For many food-insecure families, perceptions of healthy foods may serve as additional barriers to their purchase and consumption.

Stakeholder perspectives on barriers for healthy living for low-income african american families.

Science.gov (United States)

Jones, Veronnie Faye; Rowland, Michael L; Young, Linda; Atwood, Katherine; Thompson, Kirsten; Sterrett, Emma; Honaker, Sarah Morsbach; Williams, Joel E; Johnson, Knowlton; Davis, Deborah Winders

2014-01-01

Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI ≥ 85) and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. Child and parent focus group analysis revealed 11 barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities. Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family informed interventions are needed to support low-income African American families in dealing with childhood obesity.

Upgrade energy building standards and develop rating system for existing low-income housing

International Nuclear Information System (INIS)

Muller, D.; Norville, C.

1993-07-01

The city of Memphis Division of Housing and Community Development (HCD) receives grant funding each year from the U.S. Department of Housing and Urban Development (HUD) to provide local housing assistance to low-income residents. Through the years, HCD has found that many of the program recipients have had difficulty in managing their households, particularly in meeting monthly financial obligations. One of the major operating costs to low-income households is the utility bill. Furthermore, HCD's experience has revealed that many low-income residents are simply unaware of ways to reduce their utility bill. Most of the HCD funds are distributed to low-income persons as grants or no/low interest loans for the construction or rehabilitation of single-family dwellings. With these funds, HCD builds 80 to 100 new houses and renovates about 500 homes each year. Houses constructed or renovated by HCD must meet HUD's minimum energy efficiency standards. While these minimum standards are more than adequate to meet local building codes, they are not as aggressive as the energy efficiency standards being promoted by the national utility organizations and the home building industry. Memphis Light, Gas and Water (MLGW), a city-owned utility, has developed an award-winning program named Comfort Plus which promotes energy efficiency open-quote in new residential construction. Under Comfort Plus, MLGW models house plans on computer for a fee and recommends cost-effective alterations which improve the energy efficiency of the house. If the builder agrees to include these recommendations, MLGW will certify the house and guarantee a maximum annual heating/cooling bill for two years. While the Comfort Plus program has received recognition in the new construction market, it does not address the existing housing stock

Upgrade energy building standards and develop rating system for existing low-income housing

Energy Technology Data Exchange (ETDEWEB)

Muller, D.; Norville, C. [Memphis and Shelby County Div. of Planning and Development, TN (United States)

1993-07-01

The city of Memphis Division of Housing and Community Development (HCD) receives grant funding each year from the U.S. Department of Housing and Urban Development (HUD) to provide local housing assistance to low-income residents. Through the years, HCD has found that many of the program recipients have had difficulty in managing their households, particularly in meeting monthly financial obligations. One of the major operating costs to low-income households is the utility bill. Furthermore, HCD`s experience has revealed that many low-income residents are simply unaware of ways to reduce their utility bill. Most of the HCD funds are distributed to low-income persons as grants or no/low interest loans for the construction or rehabilitation of single-family dwellings. With these funds, HCD builds 80 to 100 new houses and renovates about 500 homes each year. Houses constructed or renovated by HCD must meet HUD`s minimum energy efficiency standards. While these minimum standards are more than adequate to meet local building codes, they are not as aggressive as the energy efficiency standards being promoted by the national utility organizations and the home building industry. Memphis Light, Gas and Water (MLGW), a city-owned utility, has developed an award-winning program named Comfort Plus which promotes energy efficiency{open_quote} in new residential construction. Under Comfort Plus, MLGW models house plans on computer for a fee and recommends cost-effective alterations which improve the energy efficiency of the house. If the builder agrees to include these recommendations, MLGW will certify the house and guarantee a maximum annual heating/cooling bill for two years. While the Comfort Plus program has received recognition in the new construction market, it does not address the existing housing stock.

The Role of Racial Discrimination in the Economic Value of Education Among Urban, Low-Income Latina/o Youth: Ethnic Identity and Gender as Moderators.

Science.gov (United States)

Mroczkowski, Alison L; Sánchez, Bernadette

2015-09-01

The present study used resilience theory to explore relationships among perceived racial discrimination, ethnic identity, gender, and economic value of education (EVE) among urban, low-income, Latina/o youth. It was expected that racial discrimination would predict poorer perceptions of the EVE among Latina/o adolescents. Ethnic identity was hypothesized to buffer the negative effect of racial discrimination on Latina/o students' EVE. The participants in this study were 396 urban, low-income Latina/o high school students from a large, Midwestern city who completed surveys in both 9th- and 10th-grade. Structural equation modeling was used to test the relationships among racial discrimination, ethnic identity, and EVE. Results supported a protective model of resilience. Specifically, ethnic identity served as a protective factor by buffering the negative effect of perceived racial discrimination on EVE for male participants. The present study is the first to examine ethnic identity as a buffer of racial discrimination on EVE among Latina/o high school students. Future directions and implications are discussed.

Parental Mathematics Homework Involvement of Low-Income Families with Middle School Students

Science.gov (United States)

O'Sullivan, Robyn Hackford; Chen, Yung-Chi; Fish, Marian C.

2014-01-01

This study explores the relationships between methods of parental assistance (i.e., provision of structure, direct assistance, and autonomy support) with mathematics homework for high-achieving and low-achieving students and children's achievement in mathematics in low-income families and examines the impact of parental efficacy on these…

Perceptions of low-income African-American mothers about excessive gestational weight gain.

Science.gov (United States)

Herring, Sharon J; Henry, Tasmia Q; Klotz, Alicia A; Foster, Gary D; Whitaker, Robert C

2012-12-01

A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. In 2010-2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies' health. Family members, especially participants own mothers, strongly reinforced the need to "eat for two" to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Overall, low-income African-American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers' physical symptoms may be most effective for weight control.

75 FR 9609 - Low-Income Housing Tax Credit (LIHTC) Tenant Data Collection: Responses To Advance Solicitation...

Science.gov (United States)

2010-03-03

... comment on methodology for the collection of data on low-income housing tax credit housing, as required by... 36 (to be codified as 42 U.S.C. 1437z-8) that requires each State agency administering tax credits under section 42 of the Internal Revenue Code of 1986 (low-income housing tax credits or LIHTC) to...

Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients

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Bhattacharya Shelley B

2009-09-01

Full Text Available Abstract Background Completion of colorectal cancer (CRC screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT among a low-income, minority primary care population in an urban setting. Methods We recruited a convenience sample of adults over age 40 (n = 282 from a federally qualified community health center (70% African American. Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening. Results Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p Conclusion Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.

Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia.

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Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Bulgiba, Awang; Majid, Hazreen Abdul

2015-01-01

We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

Prediction of Cardiovascular Disease Risk among Low-Income Urban Dwellers in Metropolitan Kuala Lumpur, Malaysia

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Tin Tin Su

2015-01-01

Full Text Available We aimed to predict the ten-year cardiovascular disease (CVD risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM. Altogether 882 adults (≥30 years old with no CVD history were randomly selected. The classic FRS model (figures in parentheses are from the modified model revealed that 20.5% (21.8% and 38.46% (38.9% of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

Patient-provider communication and low-income adults: age, race, literacy, and optimism predict communication satisfaction.

Science.gov (United States)

Jensen, Jakob D; King, Andy J; Guntzviller, Lisa M; Davis, LaShara A

2010-04-01

To assess whether literacy, numeracy, and optimism are related to low-income adults' satisfaction with their healthcare provider's communication skills. Low-income adults (N=131) were recruited from seven counties in Indiana through University extension programs. To achieve research triangulation, participants were surveyed and interviewed about their communication satisfaction with health providers. Survey data revealed that four variables significantly predicted satisfaction: age, race, literacy, and optimism. Low-income adults in the current study were more critical of their healthcare provider's communication skills if they were younger, White, functionally literate, and pessimistic. Follow-up interviews confirmed this pattern and suggested it was a byproduct of patient activism. In low-income populations, communication satisfaction may be lower for groups that are traditionally active in doctor-patient interactions (e.g., younger patients, patients with higher literacy skills). Healthcare providers should be aware that older, non-White, optimistic, and literacy deficient patients report greater communication satisfaction than their younger, White, pessimistic, and functionally literate peers. Both groups may be coping with their situation, the former by withdrawing and the latter by actively pushing for a higher standard of care. Healthcare providers should continue to seek out ways to facilitate dialogue with these underserved groups. 2009 Elsevier Ireland Ltd. All rights reserved.

Sustainable performance of microinsurance in low-income markets

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Last Mazambani

2018-06-01

Full Text Available Sustainable performance in microinsurance offering in low-income markets is important to ensure that the service simultaneously achieves corporate profitability and poverty alleviation. Sustainable performance requires a balanced integration of supply and demand factors in the offering of the service. Microinsurance is still supply driven thereby creating a lopsided mismatch between demand and supply that leads to oversupply and low uptake. On the basis of extant literature, the paper aims to propose and discuss factors critical to demand and supply of microinsurance. A conceptual framework for sustainable microinsurance is presented with individual metrics that can be addressed as managerial tools for driving and controlling sustained superior performance. While this is a theoretical paper, microinsurance practitioners may benefit from the application of the presented theory

What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries

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Cumming, Oliver; Hunter, Paul R

2018-01-01

Patient satisfaction with healthcare has clear implications on service use and health outcomes. Barriers to care seeking are complex and multiple and delays in seeking care are associated with significant morbidity and mortality. We sought to assess the relationship between water, sanitation and hygiene (WASH) provision in healthcare facilities (HCF) and patient satisfaction/care seeking behaviour in low-income and middle-income countries. Pubmed and Medline Ovid were searched using a combination of search terms. 984 papers were retrieved and only 21 had a WASH component warranting inclusion. WASH was not identified as a driver of patient satisfaction but poor WASH provision was associated with significant patient dissatisfaction with infrastructure and quality of care. However, this dissatisfaction was not sufficient to stop patients from seeking care in these poorly served facilities. With specific regard to maternal health services, poor WASH provision was the reason for women choosing home delivery, although providers’ attitudes and interpersonal behaviours were the main drivers of patient dissatisfaction with maternal health services. Patient satisfaction was mainly assessed via questionnaires and studies reported a high risk of courtesy bias, potentially leading to an overestimation of patient satisfaction. Patient satisfaction was also found to be significantly affected by expectation, which was strongly influenced by patients’ socioeconomic status and education. This systematic review also highlighted a paucity of research to describe and evaluate interventions to improve WASH conditions in HCF in low-income setting with a high burden of healthcare-associated infections. Our review suggests that improving WASH conditions will decrease patience dissatisfaction, which may increase care seeking behaviour and improve health outcomes but that more rigorous research is needed. PMID:29765776

Staffing remote rural areas in middle- and low-income countries : a literature review of attraction and retention

NARCIS (Netherlands)

Lehmann, Uta; Dieleman, Marjolein; Martineau, Tim

2008-01-01

BACKGROUND: Many countries in middle- and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the

Hong Kong men with low incomes have worse health-related quality of life as judged by SF-36 scores.

Science.gov (United States)

Ko, G T C; Wai, H P S; Tsang, P C C; Chan, H C K

2006-10-01

To analyse the association between income and health-related quality of life using the Medical Outcome Study Short Form 36 (SF-36) Chinese version in Hong Kong Chinese working population. Cross-sectional observation study. A commercial company in Hong Kong. All clerical and administrative staff of a commercial company was invited to participate; 876 of the 1003 staff agreed. The subjects were categorised into three income groups according to monthly income in Hong Kong dollars (low, 10,000-25,000; high, >25,000). The mean age of the 288 men and 588 women was 34.9 (standard deviation, 7.9; median, 34.0; range, 18-71) years. SF-36 scores on health-related quality of life. The distribution of income was 30% in high-, 54.8% in middle-, and 15.2% in low-income groups. Women had similar SF-36 scores among different income groups. In men, for most variables there was a significant positive linear correlation between income and SF-36 scores. Low income is associated with a worse health-related quality of life in Hong Kong Chinese men.

From Marginalized to Validated: An In-Depth Case Study of an Asian American, Native American and Pacific Islander Serving Institution

Science.gov (United States)

Nguyen, Thai-Huy; Nguyen, Mike Hoa; Nguyen, Bach Mai Dolly; Gasman, Marybeth; Conrad, Clifton

2018-01-01

This article highlights the capacity of an Asian American, Native American and Pacific Islander Institution (AANAPISI) to serve as an institutional convertor--by addressing challenges commonly associated with marginalized students--for low-income, Asian American and Pacific Islander students entering college. Through an in-depth case study, we…

Estimating costs of care for meningitis infections in low- and middle-income countries.

Science.gov (United States)

Portnoy, Allison; Jit, Mark; Lauer, Jeremy; Blommaert, Adriaan; Ozawa, Sachiko; Stack, Meghan; Murray, Jillian; Hutubessy, Raymond

2015-05-07

Meningitis infections are often associated with high mortality and risk of sequelae. The costs of treatment and care for meningitis are a great burden on health care systems, particularly in resource-limited settings. The objective of this study is to review data on the costs of care for meningitis in low- and middle-income countries, as well as to show how results could be extrapolated to countries without sound data. We conducted a systematic review of the literature from six databases to identify studies examining the cost of care in low- and middle-income countries for all age groups with suspected, probable, or confirmed meningitis. We extracted data on treatment costs and sequelae by infectious agent and/or pathogen, where possible. Using multiple regression analysis, a relationship between hospital costs and associated determinants was investigated in order to predict costs in countries with missing data. This relationship was used to predict treatment costs for all 144 low- and middle-income countries. The methodology of conducting a systematic review, extrapolating, and setting up a standard database can be used as a tool to inform cost-effectiveness analyses in situations where cost of care data are poor. Both acute and long-term costs of meningitis could be extrapolated to countries without reliable data. Although only bacterial causes of meningitis can be vaccine-preventable, a better understanding of the treatment costs for meningitis is crucial for low- and middle-income countries to assess the cost-effectiveness of proposed interventions in their country. This cost information will be important as inputs in future cost-effectiveness studies, particularly for vaccines. Copyright © 2014 Elsevier Ltd. All rights reserved.

Pattern and levels of spending allocated to HIV prevention programs in low- and middle-income countries

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Amico Peter

2012-03-01

Full Text Available Abstract Background AIDS continues to spread at an estimated 2.6 new million infections per year, making the prevention of HIV transmission a critical public health issue. The dramatic growth in global resources for AIDS has produced a steady scale-up in treatment and care that has not been equally matched by preventive services. This paper is a detailed analysis of how countries are choosing to spend these more limited prevention funds. Methods We analyzed prevention spending in 69 low- and middle-income countries with a variety of epidemic types, using data from national domestic spending reports. Spending information was from public and international sources and was analyzed based on the National AIDS Spending Assessment (NASA methods and classifications. Results Overall, prevention received 21% of HIV resources compared to 53% of funding allocated to treatment and care. Prevention relies primarily on international donors, who accounted for 65% of all prevention resources and 93% of funding in low-income countries. For the subset of 53 countries that provided detailed spending information, we found that 60% of prevention resources were spent in five areas: communication for social and behavioral change (16%, voluntary counselling and testing (14%, prevention of mother-to-child transmission (13%, blood safety (10% and condom programs (7%. Only 7% of funding was spent on most-at-risk populations and less than 1% on male circumcision. Spending patterns did not consistently reflect current evidence and the HIV specific transmission context of each country. Conclusions Despite recognition of its importance, countries are not allocating resources in ways that are likely to achieve the greatest impact on prevention across all epidemic types. Within prevention spending itself, a greater share of resources need to be matched with interventions that approximate the specific needs and drivers of each country's epidemic.

Biking practices and preferences in a lower income, primarily minority neighborhood: Learning what residents want.

Science.gov (United States)

Lusk, Anne C; Anastasio, Albert; Shaffer, Nicholas; Wu, Juan; Li, Yanping

2017-09-01

This paper examines if, in a lower-income minority neighborhood, bicycling practices and bicycle-environment preferences of Blacks and Hispanics were different from Whites. During the summer of 2014, surveys were mailed to 1537 households near a proposed cycle track on Malcolm X Boulevard in Roxbury, MA. On the Boulevard, intercept surveys were distributed to cyclists and observations noted about passing cyclist's characteristics. Data were analyzed from 252 returned-mailed surveys, 120 intercept surveys, and 709 bicyclists. White (100%), Hispanic (79%), and Black (76%) bicyclists shown pictures of 6 bicycle facility types in intercept surveys perceived the cycle track as safest. More White mailed-survey respondents thought bikes would not be stolen which may explain why more Hispanics (52%) and Blacks (47%) preferred to park their bikes inside their home compared with Whites (28%), with H/W B/W differences statistically significant ( p  bike compared with Whites (75%). Minority populations are biking on roads but prefer cycle tracks. They also prefer to park bikes inside their homes and bicycle with family and friends. Wide cycle tracks (bicycling with family/friends) and home bike parking should be targeted as capital investments in lower-income minority neighborhoods.

Estimating the Impact of Low-Income Universal Service Programs

OpenAIRE

Daniel A. Ackerberg; David R. DeRemer; Michael H. Riordan; Gregory L. Rosston; Bradley S. Wimmer

2013-01-01

This policy study uses U.S. Census microdata to evaluate how subsidies for universal telephone service vary in their impact across low-income racial groups, gender, age, and home ownership. Our demand specification includes both the subsidized monthly price (Lifeline program) and the subsidized initial connection price (Linkup program) for local telephone service. Our quasi-maximum likelihood estimation controls for location differences and instruments for price endogeneity. The microdata all...

Gauging the Impact of Various Definitions of Low- and Moderate-Income Communities on Possible Electricity Savings From Weatherization

Energy Technology Data Exchange (ETDEWEB)

Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2017-06-20

With rising interest in lowering energy costs for low- and moderate-income households, the U.S. Department of Energy (DOE) asked Lawrence Berkeley National Laboratory (LBNL) to assess the implications of pursuing energy efficiency neighborhood-by-neighborhood where those households are most prevalent. DOE provided certain scenarios for qualifying geographic areas as “low- and moderate-income communities,” and LBNL used data on demographics, housing types and recent savings from low-income retrofits or weatherization to provide rough electricity savings estimates under those scenarios.

Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting.

Science.gov (United States)

Njuguna, Festus; Martijn, Hugo A; Kuremu, Robert Tenge; Saula, Peter; Kirtika, Patel; Olbara, Gilbert; Langat, Sandra; Martin, Steve; Skiles, Jodi; Vik, Terry; Kaspers, Gertjan J L; Mostert, Saskia

2017-10-01

Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%), II (7%), III (43%), IV (40%), or V (10%). The most likely treatment outcome in patients with low-stage (I to III) disease was event-free survival (67%), whereas in those with high-stage (IV to V) disease, it was death (40%). No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes ( P = .014) and event-free survival estimates ( P abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

The dynamic implications of debt relief for low-income countries

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Alma Lucía Romero-Barrutieta

2015-06-01

Full Text Available Debt relief provides low-income countries with an incentive to accumulate debt, boost consumption, and reduce investment over time. We quantify this incentive effect employing a dynamic stochastic general equilibrium model, calibrated to 1982–2006 Ugandan data, and find that long-run debt and consumption-to-GDP ratios are about twice as high with debt relief than without it, while the investment-to-GDP ratio is sixty percent lower. Our simulations show that debt-relief episodes are likely to have only a temporary impact on debt levels but may have a lasting effect over the size of the economy, lowering GDP growth up to twenty percent over time. These results fill a gap in the debt relief literature since, to the best of our knowledge, the quantification of incentive effects is rather scarce. The paper further contributes to the literature by constructing a tractable structural model that is able to replicate the data well and captures key features of low-income countries facing the possibility of debt relief.

Financial incentives for smoking cessation in low-income smokers: study protocol for a randomized controlled trial

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Etter Jean-François

2012-06-01

Full Text Available Abstract Background Tobacco smoking is the leading avoidable cause of death in high-income countries. The smoking-related disease burden is borne primarily by the least educated and least affluent groups. Thus, there is a need for effective smoking cessation interventions that reach to, and are effective in this group. Research suggests that modest financial incentives are not very effective in helping smokers quit. What is not known is whether large financial incentives can enhance longer-term (1 year smoking cessation rates, outside clinical and workplace settings. Trial design A randomized, parallel groups, controlled trial. Methods Participants: Eight hundred low-income smokers in Switzerland (the less affluent third of the population, based on fiscal taxation. Intervention: A smoking cessation program including: (a financial incentives given during 6 months; and (b Internet-based counseling. Financial rewards will be offered for biochemically verified smoking abstinence after 1, 2, and 3 weeks and 1, 3, and 6 months, for a maximum of 1,500 CHF (1,250 EUR, 1,500 USD for those abstinent at all time-points. All participants, including controls, will receive Internet-based, individually-tailored, smoking cessation counseling and self-help booklets, but there will be no in-person or telephone counseling, and participants will not receive medications. The control group will not receive financial incentives. Objective: To increase smoking cessation rates. Outcome: Smoking abstinence after 6 and 18 months, not contradicted by biochemical tests. We will assess relapse after the end of the intervention, to test whether 6-month effects translate into sustained abstinence 12 months after the incentives are withdrawn. Randomization: Will be done using sealed envelopes drawn by participants. Blinding: Is not possible in this context. Discussion Smoking prevention policies and interventions have been least effective in the least educated, low-income

Adherence to hysterosalpingogram appointments following hysteroscopic sterilization among low income women

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Leyser-Whalen, Ophra; Berenson, Abbey B.

2013-01-01

Background The few studies on post-Essure hysterosalpingogram (HSG) adherence rates show inconsistent results. This study examined associations between sociodemographic variables not examined in prior studies and HSG adherence among low income women. Study Design Medical records of 286 women who underwent sterilization between August 31, 2005 and September 30, 2011 were reviewed. Chi-square and Mann-Whitney tests were used to determine variable associations with HSG adherence. Results The adherence rate for the first HSG was 85.0% (243/286). Variables associated with adherence were: lower education level (p=.01), not working outside the home (p=.04), being married (pEssure placement is feasible among low income populations. Furthermore, not speaking English or having to commute a far distance to the clinic do not appear to be barriers. This is encouraging considering the importance of this test to confirm tubal occlusion. PMID:24012097

Cigarette smoking and food insecurity among low-income families in the United States, 2001

OpenAIRE

Armour, Brian S.; Pitts, M. Melinda; Lee, Chung-won

2007-01-01

The goal of this research is to quantify the association between food insecurity and smoking among low-income families. This analysis is a retrospective study using data from the 2001 Panel Study of Income Dynamics, a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Family income is linked with U.S. poverty thresholds to identify 2,099 families living near or below 200 percent of the federal poverty level. Food insecurit...

Changes in Hypertension Prevalence, Awareness, Treatment, and Control in High-, Middle-, and Low-Income Countries: An Update.

Science.gov (United States)

Cifkova, Renata; Fodor, George; Wohlfahrt, Peter

2016-08-01

The aim of this paper was to critically evaluate recent publications on hypertension treatment and control in regions by income. Prevalence of hypertension is increasing worldwide, most prominently in low-income countries. Awareness, treatment, and control are most successful in North America while remaining a challenge in middle- and low-income countries. Easy access to medical care and aggressive use of pharmacotherapy are the key strategies which have proved to be successful in reducing the burden of hypertension on the population level.

Boosting Low-Income Children's Opportunities to Succeed Through Direct Income Support.

Science.gov (United States)

Sherman, Arloc; DeBot, Brandon; Huang, Chye-Ching

2016-04-01

Direct income supports have long been known to substantially reduce the extent and depth of poverty. Evidence suggests that they can also bolster children's opportunities to succeed and enhance long-term mobility. A growing body of research, for example, links income from 2 related tax credits for working families-the Earned Income Tax Credit and the Child Tax Credit-to benefits for children in those families, such as improved birth weight, better school outcomes, and increased rates of employment in adulthood. Similarly, the introduction of food stamps has been found to improve not only the birth weight of infants given access to the program but also their educational achievement, as well as indicators of health, well-being, and self-sufficiency decades later. These are striking research results for income support that is not typically thought of as improving children's health or education. The mechanisms through which these income supports lead to such benefits are likely varied and complex, but emerging research suggests that helping families with children afford basic necessities can reduce the added stress of financial difficulties, preventing downstream neuroendocrine and biochemical changes that affect children's longer-term outcomes. These findings have important implications for policy makers. Research suggests that potential weakening of the safety net would not only substantially increase poverty, but also have damaging long-term effects on children. Policy makers should reject funding cuts and instead strengthen the safety net, which this analysis suggests could reduce poverty further and also enhance children's opportunities to succeed. Copyright © 2016. Published by Elsevier Inc.

Integrating Photovoltaic Systems into Low-Income Housing Developments: A Case Study on the Creation of a New Residential Financing Model and Low-Income Resident Job Training Program, September 2011 (Brochure)

Energy Technology Data Exchange (ETDEWEB)

Dean, J.; Smith-Dreier, C.; Mekonnen, G.; Hawthorne, W.

2011-09-01

This case study covers the process of successfully integrating photovoltaic (PV) systems into a low-income housing development in northeast Denver, Colorado, focusing specifically on a new financing model and job training. The Northeast Denver Housing Center (NDHC), working in cooperation with Del Norte Neighborhood Development Corporation, Groundwork Denver, and the National Renewable Energy Laboratory (NREL), was able to finance the PV system installations by blending private equity funding with utility rebates, federal tax credits, and public sector funding. A grant provided by the Governor's Energy Office allowed for the creation of the new financing model. In addition, the program incorporated an innovative low-income job training program and an energy conservation incentive program.

Breastfeeding support - the importance of self-efficacy for low-income women.

Science.gov (United States)

Entwistle, Francesca; Kendall, Sally; Mead, Marianne

2010-07-01

Breastfeeding is a key determinant in promoting public health and reducing health inequality. Low-income women have a significantly lower level of breastfeeding. Midwives in the UK have been encouraged to implement the World Health Organization/United Nations Children's Fund's Ten Steps to Successful Breastfeeding, but to date, there has been no evaluation of the impact of the training initiative on the breastfeeding behaviours of low-income women. As part of a wider study, this qualitative component was designed to answer the question - what are the views and experiences of low-income women (defined by Jarman scores) in relation to their breastfeeding support received in the post-natal period? A sample of seven women was interviewed. The in-depth interviews were analysed using a qualitative, thematic approach based on the self-efficacy theory. The four themes that emerged from the data were the following: breastfeeding related to the woman's self-confidence, the social environment in which the woman lived, knowledge of breastfeeding and the influence of maternity services on breastfeeding outcomes. These themes were interpreted in relation to the self-efficacy theory. The findings suggest that the components that inform self-efficacy are consistent with the themes from the data, suggesting that midwives and other health professionals should take the psychosocial aspects of breastfeeding support into account. As this important feature of breastfeeding support is not explicitly part of the current Ten Steps to Successful Breastfeeding, we suggest that further research and debate could inform expansion of these minimum standards to include the psychosocial aspects.

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements

Directory of Open Access Journals (Sweden)

John Twigg

2017-02-01

Full Text Available Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements.

Science.gov (United States)

Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

2017-02-01

Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

Systematic Review of Factors Influencing Farmers' Market Use Overall and among Low-Income Populations.

Science.gov (United States)

Freedman, Darcy A; Vaudrin, Nicole; Schneider, Christine; Trapl, Erika; Ohri-Vachaspati, Punam; Taggart, Morgan; Ariel Cascio, M; Walsh, Colleen; Flocke, Susan

2016-07-01

Recent evidence indicates a widening gap in fruit and vegetable (F/V) consumption between high- and low-income Americans. This gap is related, in part, to decreased access to food retailers that sell fresh F/V in low-income communities. Farmers' markets are identified as a strategy for improving F/V consumption by increasing access to these foods. The aim of this systematic review was to examine literature published from 1994 to 2014 to identify facilitators and barriers of farmers' markets use, particularly among low-income consumers. Peer-reviewed literature was identified in Ebsco Host (Academic Search Complete). Inclusion criteria for abstract review was primary research focused on farmers' market use identifying 87 studies for full-text review. Full-text review identified articles focused on facilitators and/or barriers of farmers' market use resulting in 49 articles. At least two reviewers completed review of all articles. Of the 49 articles, 39% specified inclusion of low-income consumers and fewer than 15% focused on racial and ethnic minorities. Few studies were guided by theory and/or used standardized metrics. Results indicate farmers' market use is influenced by multiple economic, service delivery, spatial-temporal, social, and personal factors. Among studies that included low-income populations (n=19), key barriers to farmers' market use were perceptions that food assistance benefits were not accepted, belief that food variety at farmers' markets was limited, lack of access to transportation, lack of racial/ethnic diversity in the market space, and mismatch between markets and personal lifestyles. There is wide variation in study design and reporting standards and infrequent use of standardized measures limiting comparisons across studies. There is a need to establish valid and reliable metrics and reporting standards for evaluating farmers' markets. Findings may inform interventions, programs, and policies to promote farmers' market use. Copyright �

Financial barriers and pricing strategies related to participation in sports activities: the perceptions of people of low income.

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Steenhuis, Ingrid H M; Nooy, Steffie B C; Moes, Machiel J G; Schuit, Albertine J

2009-11-01

Physical activity levels in most affluent countries are low and many people do not meet the current recommendations. Particularly for people with a low income, economic strategies seem promising to stimulate taking part in sports activities. This study investigated the importance of economic restraints for taking part in sports activities as well as perceptions of low-income people toward different pricing interventions. A qualitative study was conducted, using semistructured, individual interviews with 27 low-income men and women. The framework approach was used to analyze the transcripts of the interviews. The respondents considered finances to be an important barrier for participating in sports activities, together with some individual barriers. Promising pricing strategies are a discount on the subscription to the fitness or sports club, a 1 month free trial, and free entrance to the swimming pool once a week. Pricing strategies may be a promising intervention to increase physical activity levels of low-income people. However, this study indicates that this should be coupled with an intervention directed at individual barriers. Some pricing strategies will be used and appreciated more by low-income people than other pricing strategies. In addition, pricing strategies should be tailored to individual needs and preferences.

Barriers to obstetric fistula treatment in low-income countries: a systematic review.

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Baker, Zoë; Bellows, Ben; Bach, Rachel; Warren, Charlotte

2017-08-01

To identify the barriers faced by women living with obstetric fistula in low-income countries that prevent them from seeking care, reaching medical centres and receiving appropriate care. Bibliographic databases, grey literature, journals, and network and organisation websites were searched in English and French from June to July 2014 and again from August to November 2016 using key search terms and specific inclusion and exclusion criteria for discussion of barriers to fistula treatment. Experts provided recommendations for additional sources. Of 5829 articles screened, 139 were included in the review. Nine groups of barriers to treatment were identified: psychosocial, cultural, awareness, social, financial, transportation, facility shortages, quality of care and political leadership. Interventions to address barriers primarily focused on awareness, facility shortages, transportation, financial and social barriers. At present, outcome data, though promising, are sparse and the success of interventions in providing long-term alleviation of barriers is unclear. Results from the review indicate that there are many barriers to fistula treatment, which operate at the individual, community and national levels. The successful treatment of obstetric fistula may thus require targeting several barriers, including depression, stigma and shame, lack of community-based referral mechanisms, financial cost of the procedure, transportation difficulties, gender power imbalances, the availability of facilities that offer fistula repair, community reintegration and the competing priorities of political leadership. © 2017 John Wiley & Sons Ltd.

Family and Cultural Influences on Low-Income Latino Children's Adjustment

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Santiago, Catherine DeCarlo; Wadsworth, Martha E.

2011-01-01

This study examined family and cultural influences on adjustment among 90 low-income Latino middle school children (46% girls; average age = 11.38, SD = 0.66) and their primary caregivers (93% female; average age = 36.12, SD = 6.13). All participants identified as Hispanic/Latino, with 75% of families identifying as Mexican-origin Latino, and 77%…

Understanding Barriers and Solutions Affecting Preschool Attendance in Low-Income Families

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Susman-Stillman, Amy; Englund, Michelle M.; Storm, Karen J.; Bailey, Ann E.

2018-01-01

Preschool attendance problems negatively impact children's school readiness skills and future school attendance. Parents are critical to preschoolers' attendance. This study explored parental barriers and solutions to preschool attendance in low-income families. School-district administrative data from a racially/ethnically diverse sample of…

Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial.

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Phelan, Suzanne; Hagobian, Todd; Brannen, Anna; Hatley, Karen E; Schaffner, Andrew; Muñoz-Christian, Karen; Tate, Deborah F

2017-06-20

Postpartum weight retention increases lifetime risk of obesity and related morbidity. Few effective interventions exist for multicultural, low-income women. To test whether an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) for low-income postpartum women could produce greater weight loss than the WIC program alone over 12 months. A 12-month, cluster randomized, assessor-blind, clinical trial enrolling 371 adult postpartum women at 12 clinics in WIC programs from the California central coast between July 2011 and May 2015 with data collection completed in May 2016. Clinics were randomized to the WIC program (standard care group) or the WIC program plus a 12-month primarily internet-based weight loss program (intervention group), including a website with weekly lessons, web diary, instructional videos, computerized feedback, text messages, and monthly face-to-face groups at the WIC clinics. The primary outcome was weight change over 12 months, based on measurements at baseline, 6 months, and 12 months. Secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet. Participants included 371 women (mean age, 28.1 years; Hispanic, 81.6%; mean weight above prepregnancy weight, 7.8 kg; mean months post partum, 5.2 months) randomized to the intervention group (n = 174) or standard care group (n = 197); 89.2% of participants completed the study. The intervention group produced greater mean 12-month weight loss compared with the standard care group (3.2 kg in the intervention group vs 0.9 kg in standard care group, P income postpartum women, an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) compared with the WIC program alone resulted in a statistically significant greater weight loss over 12 months. Further research is needed to

Access and Mobilization: How Social Capital Relates to Low-Income Youth's Postsecondary Educational (PSE) Attainment

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Ashtiani, Mariam; Feliciano, Cynthia

2018-01-01

Youth from advantaged backgrounds have more social relationships that provide access to resources facilitating their educational success than those from low-income families. Does access to and mobilization of social capital also relate to success among the few low-income youth who "overcome the odds" and persist in higher education?…

24 CFR 1000.110 - Under what conditions may non low-income Indian families participate in the program?

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Under what conditions may non low-income Indian families participate in the program? 1000.110 Section 1000.110 Housing and Urban... ACTIVITIES Affordable Housing Activities § 1000.110 Under what conditions may non low-income Indian families...

Role of expendable income and price in food choice by low income families.

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Burns, Cate; Cook, Kay; Mavoa, Helen

2013-12-01

The public health literature suggests that the cheapness of energy-dense foods is driving the obesity epidemic. We examined food purchases in low-income families and its relationship to the price of food and availability of funds. In-depth interviews were conducted with 22 parents with children less than 15 years of age whose major source of income was a government pension. A photo taxonomy, where participants sorted 50 photos of commonly purchased foods, was used to explore food choice. The most common food groupings used by the participants were: basic, emergency, treat and comfort. The process of food purchase was described by participants as weighing up the attributes of a food in relation to price and money available. Shoppers nominated the basic unit of measurement as quantity per unit price and the heuristic for food choice when shopping as determining "value for money" in a process of triage relating to food purchase decisions. Participants stated satiation of hunger to be the most common "value" relative to price. Given that the foods nominated as filling tended to be carbohydrate-rich staples, we suggest that public health initiatives need to acknowledge this triage process and shape interventions to promote nutrition over satiation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Growth in Means-Tested Programs and Tax Credits for Low-Income Households

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Carrington, William; Dahl, Molly; Falk, Justin

2013-01-01

The federal government devotes roughly one-sixth of its spending to 10 major means-tested programs and tax credits, which provide cash payments or assistance in obtaining health care, food, housing, or education to people with relatively low income or few assets. Those programs and credits consist of the following: (1) Medicaid; (2) the low-income…

Stakeholder Perspectives on Barriers for Healthy Living for Low-income African American Families

Directory of Open Access Journals (Sweden)

Veronnie Faye Jones

2014-12-01

Full Text Available Background: Childhood obesity is a growing problem for children in the United States, especially for children from low-income, African American families. Objective: The purpose of this qualitative study was to understand facilitators and barriers to engaging in healthy lifestyles faced by low-income African American children and their families. Methods: This qualitative study used semi-structured focus group interviews with eight African American children clinically identified as overweight or obese (BMI > 85 and their parents. An expert panel provided insights in developing culturally appropriate intervention strategies. Results: Child and parent focus group analysis revealed eleven barriers and no definitive facilitators for healthy eating and lifestyles. Parents reported confusion regarding what constitutes nutritional eating, varying needs of family members in terms of issues with weight, and difficulty in engaging the family in appropriate and safe physical activities; to name a few themes. Community experts independently suggested that nutritional information is confusing and, often, contradictory. Additionally, they recommended simple messaging and practical interventions such as helping with shopping lists, meal planning, and identifying simple and inexpensive physical activities.Conclusions: Childhood obesity in the context of low-resource families is a complex problem with no simple solutions. Culturally sensitive and family-informed interventions are needed to support low-income African American families in dealing with childhood obesity.

The potential of low-intensity and online interventions for depression in low- and middle-income countries

NARCIS (Netherlands)

Bockting, C. L. H.; Williams, A. D.; Carswell, K.; Grech, A. E.

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care

Factors contributing to background television exposure in low-income Mexican American preschoolers

Science.gov (United States)

Thompson, Darcy A.; Tschann, Jeanne M.

2016-01-01

Objective Background television (TV) exposure is harmful to young children, yet few studies have focused on predictors of exposure. This study’s objectives were to elucidate demographic, environmental, and behavioral correlates of background TV exposure in low-income Mexican American preschoolers and to explore caregiver beliefs about the impact of such exposure. Methods A convenience sample of low-income Mexican American female primary caregivers of preschoolers (3–5 years old, n=309), recruited in safety-net clinics, were surveyed by phone. Caregivers reported the frequency of their child’s exposure to background TV and responded to questions on the home media environment, TV use, and whether they had thought about background TV exposure and its impact on their child. Results Background TV exposure was common; 43% reported that their child was often, very often, or always exposed to background TV. More hours of TV viewing by the caregiver and greater frequency of TV viewing during meals were associated with an increased frequency of exposure to background TV. Only 49% of participants had ever thought about the impact of background TV. Believing that background TV is not harmful was associated with higher levels of background TV exposure. Conclusions Findings suggest that background TV exposure is frequent and caregiver awareness of its potential impact is low in low-income Mexican American families. Beliefs that background TV is not harmful may predict risk of exposure. Potential targets for interventions focused on reducing background TV exposure in this population include increasing caregiver awareness of the potential negative impact of such TV exposure. PMID:27007983

Poverty and disability in low- and middle-income countries: A systematic review.

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Banks, Lena Morgon; Kuper, Hannah; Polack, Sarah

2017-01-01

Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs). Ten electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics. From the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

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Rosa, William

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

BARRIERS AND OPPORTUNITIES IN DEVELOPING 'DO-IT-YOURSELF' (DIY PRODUCTS FOR LOW-INCOME HOUSING

Directory of Open Access Journals (Sweden)

Priscilla Lepre

2010-06-01

Full Text Available Direct involvement of the user in the assembling process of his/her own products or even entire house is a reality among low-income populations in developing countries. Nevertheless, there are a limited number of products that have actually been designed from a do-it-yourself (DIY perspective, which results in several problems, such as poor user safety while the product is being assembled or inadequate results from an improvised assembling. Hence, the main goal of this paper is to analyse barriers to and opportunities for developing DIY products for low-income housing in developing countries. The research method utilises a case study of a DIY product consisting of a hybrid solution that acted as both a partition wall and a wardrobe. The identified opportunities included more systematic use of existing craft competencies among low-income families and the possibility of cost reduction through DIY concepts. Major barriers included the perception of the DIY product as inferior and the difficulty of communicating the DIY assembly process to users who quite often are illiterate.

Correlates of healthy life expectancy in low- and lower-middle-income countries.

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Islam, Md Shariful; Mondal, Md Nazrul Islam; Tareque, Md Ismail; Rahman, Md Aminur; Hoque, Md Nazrul; Ahmed, Md Munsur; Khan, Hafiz T A

2018-04-11

Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries. In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives. The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors. To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Associations between family food behaviors, maternal depression, and child weight among low-income children.

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McCurdy, Karen; Gorman, Kathleen S; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

2014-08-01

Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and depression while trained assistants collected anthropometric data from children at seven day care centers and a Supplemental Nutrition Assistance Program outreach project. Multivariate analysis of covariance revealed that higher maternal depression scores were associated with lower scores on maternal presence when child eats (P maternal control of child's eating routines (P maternal presence whenever the child ate was significantly associated with lower child BMI z scores (β = .166, P Maternal depression did not modify the relationship between family food behaviors and child weight. Overall, caregiver presence whenever a child eats, not just at meals, and better parental food resource management skills may promote healthier weights in low-income preschoolers. Further research is needed to identify the mechanisms that connect caregiver presence and food resource management skills to healthier weights for this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

Energy consumption and economic growth relationship: Evidence from panel data for low and middle income countries

International Nuclear Information System (INIS)

Ozturk, Ilhan; Aslan, Alper; Kalyoncu, Huseyin

2010-01-01

This paper uses the panel data of energy consumption (EC) and economic growth (GDP) for 51 countries from 1971 to 2005. These countries are divided into three groups: low income group, lower middle income group and upper middle income group countries. Firstly, a relationship between energy consumption and economic growth is investigated by employing panel cointegration method. Secondly, panel causality test is applied to investigate the way of causality between the energy consumption and economic growth. Finally, we test whether there is a strong or weak relationship between these variables by using method. The empirical results of this study are as follows: i) Energy consumption and GDP are cointegrated for all three income group countries. ii) The panel causality test results reveal that there is long-run Granger causality running from GDP to EC for low income countries and there is bidirectional causality between EC and GDP for middle income countries. iii) The estimated cointegration factor, β, is not close to 1. In other words, no strong relation is found between energy consumption and economic growth for all income groups considered in this study. The findings of this study have important policy implications and it shows that this issue still deserves further attention in future research.

Children's Effects on Parenting Stress in a Low Income, Minority Population.

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Bendell, R. Debra; And Others

1989-01-01

Relationships between parenting stress and other maternal and child characteristics were investigated with 66 low income mothers and their five- to eight-year-old children at risk for educational disabilities. Child characteristics (self esteem, behavior conduct, and spelling achievement) and maternal characteristics (self esteem and crowding…

Socioeconomic status and COPD among low- and middle-income countries.

Science.gov (United States)

Grigsby, Matthew; Siddharthan, Trishul; Chowdhury, Muhammad Ah; Siddiquee, Ali; Rubinstein, Adolfo; Sobrino, Edgardo; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Checkley, William

2016-01-01

Socioeconomic status (SES) is a strong social determinant of health. There remains a limited understanding of the association between SES and COPD prevalence among low- and middle-income countries where the majority of COPD-related morbidity and mortality occurs. We examined the association between SES and COPD prevalence using data collected in Argentina, Bangladesh, Chile, Peru, and Uruguay. We compiled lung function, demographic, and SES data from three population-based studies for 11,042 participants aged 35-95 years. We used multivariable alternating logistic regressions to study the association between COPD prevalence and SES indicators adjusted for age, sex, self-reported daily smoking, and biomass fuel smoke exposure. Principal component analysis was performed on monthly household income, household size, and education to create a composite SES index. Overall COPD prevalence was 9.2%, ranging from 1.7% to 15.4% across sites. The adjusted odds ratio of having COPD was lower for people who completed secondary school (odds ratio [OR] =0.73, 95% CI 0.55-0.98) and lower with higher monthly household income (OR =0.96 per category, 95% CI 0.93-0.99). When combining SES factors into a composite index, we found that the odds of having COPD was greater with lower SES (interquartile OR =1.23, 95% CI 1.05-1.43) even after controlling for subject-specific factors and environmental exposures. In this analysis of multiple population-based studies, lower education, lower household income, and lower composite SES index were associated with COPD. Since household income may be underestimated in population studies, adding household size and education into a composite index may provide a better surrogate for SES.

Immigration and income inequality

DEFF Research Database (Denmark)

Deding, Mette; Jakobsen, Vibeke; Azhar, Hussain

Four income inequality measures (Gini-coefficient, 90/10-decile ratio, and two generalized entropy indices) are applied to analyse immigrants’ income position relative to natives in a comparative perspective. Administrative data is used for Denmark, while survey data is used for Germany. We find...... higher inequality among immigrants than natives in Denmark, but vice versa for Germany. Over the period 1984-2003, this inequality gap has narrowed in both countries. At the same time, the contribution of immigrants to overall inequality has increased systematically, primarily caused by the increased...... share of immigrants in the population....

Smoking, cessation and expenditure in low income Chinese: cross sectional survey.

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Hesketh, Therese; Lu, Li; Jun, Ye Xue; Mei, Wang Hong

2007-03-04

This study was carried-out to explore smoking behaviour and smoking expenditure among low income workers in Eastern China to inform tobacco control policy. A self-completion questionnaire was administered to 1958 urban workers, 1909 rural workers and 3248 migrant workers in Zhejiang Province, Eastern China in 2004. Overall 54% of the men and 1.8% of all women were current smokers (at least 1 cigarette per day). Smoking was least common in migrant men (51%), compared with 58% of urban workers and 64% rural inhabitants (P opportunity costs, including in terms of healthcare access. The prevalence of smoking and successful quitting suggest that smoking prevalence in low income groups in Eastern China may have peaked. Tobacco control should focus on support for quitters, on workplace/public place smoking restrictions and should develop specific programmes in rural areas. Health education messages should emphasise the opportunity costs of smoking and the dangers of passive smoking.

Smoking, cessation and expenditure in low income Chinese: cross sectional survey

Directory of Open Access Journals (Sweden)

Jun Ye

2007-03-01

Full Text Available Abstract Background This study was carried-out to explore smoking behaviour and smoking expenditure among low income workers in Eastern China to inform tobacco control policy. Methods A self-completion questionnaire was administered to 1958 urban workers, 1909 rural workers and 3248 migrant workers in Zhejiang Province, Eastern China in 2004. Results Overall 54% of the men and 1.8% of all women were current smokers (at least 1 cigarette per day. Smoking was least common in migrant men (51%, compared with 58% of urban workers and 64% rural inhabitants (P Conclusion The prevalence of smoking and successful quitting suggest that smoking prevalence in low income groups in Eastern China may have peaked. Tobacco control should focus on support for quitters, on workplace/public place smoking restrictions and should develop specific programmes in rural areas. Health education messages should emphasise the opportunity costs of smoking and the dangers of passive smoking.

LESS SPACE, MORE SPATIALITY FOR LOW-INCOME HOUSING UNITS IN EGYPT: IDEAS FROM JAPAN

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Nermine Abdel Gelil

2011-07-01

Full Text Available In 1996, the Egyptian government launched a national housing project for low-income families. To minimize cost, it has progressively reduced units’ sizes. Numerous surveys indicate that unit specifications were based on political and economic criteria, rather than on users’ needs, which resulted in the recurrence of the persistent phenomenon of individual modifications. A number of scholars and architects concerned with this phenomenon are advocating the revival of the social design principles of traditional Cairene houses (16th –19th century after adapting them to contemporary needs. However, they provide no concrete solutions as to how to achieve this in small-scale units located in multi-storey buildings. During my research in Japan, I was introduced to traditional middle class urban houses. Their practical designs used to resolve issues of privacy, internal flexibility, storage, and family growth can be beneficially applied to housing units in Egypt. This paper first explains why relying solely on traditional housing designs to resolve social issues associated with low-income units in Egypt is both fanciful and incomplete, then discusses why ideas from Japanese homes can be beneficially applied to low-income housing units in Egypt. Third, this paper examines issues in these units and the resultant modifications by Egyptian households. Next, it analyzes concepts of spatial organization, modular systems, partitioning, and storage in traditional middle class urban houses in Japan. Finally, this paper formulates proposals for fulfilling the social needs of occupants in Egypt by integrating these ideas into low-income housing units.

78 FR 16277 - Notice of Submission of Proposed Information Collection to OMB: Low Income Housing Tax Credit...

Science.gov (United States)

2013-03-14

... Proposed Information Collection to OMB: Low Income Housing Tax Credit Database AGENCY: Office of the Chief... codified as 42 U.S.C. 1437z-8) that requires each state agency administering tax credits under section 42 of the Internal Revenue Code of 1986 (low-income housing tax credits or LIHTC) to furnish HUD, not...

Factors That Contribute to Transfer and Bachelor's Degree Attainment of Low-Income Community College Beginners

Science.gov (United States)

Felder, Andrea Darlene

2016-01-01

Transfer and bachelor's degree attainment rates of low-income community college beginners lag behind their middle- and high-income peers. As community college continues to be an affordable and accessible route to higher education, consideration should be given to how to close the gap in transfer and bachelor's degree attainment rates of low-income…

Low income homebuyers, low housing infrastructure quality, and disaster threat (Case study: Landslide in Trangkil Sejahtera and Trangkil Baru Residential Area, Semarang)

Science.gov (United States)

Indrianingrum, Lulut; Andiyarto, Hanggoro Tri Cahyo

2018-03-01

The Housing of Trangkil Sejahtera and Trangkil Baru are two housing areas located in the Village of Sukorejo, Gunungpati District, Semarang Municipality. In 2014, these housing areas were experienced landslide triggered by heavy rains that continued to fall across Semarang for several days. Successive landslides occurred on January 23, 2014 early in the morning until 07.30 am. Seven houses in Trangkil Sejahtera Housing were damaged by landslide, while in Trangkil Baru Housing there were 32 homes that severely damaged. The housing was located in a zone with high degree of susceptibility to landslide and stated as landslide prone areas by the Directorate of Environmental Geology. The objective of this article is to analyze the facts that the low income homebuyers basically do not understand the importance of accessing the information of land, infrastructure quality and specifications of the house. The analysis is conducted by comparing the landslide background and the homebuyer's condition background at the time the housing was purchased. The results showed that people who occupied the housing were victims of evictions and in low-income condition. A low-income homeowner has a low bargaining position in obtaining adequate housing infrastructure quality. Developers did not prepare proper infrastructure system to anticipate landslides and fulfill legal aspects of the real estate development. Low income homeowners should be educated about legal aspect of land purchased as well as their rights when buying a home.

Maternal and child undernutrition and overweight in low-income and middle-income countries.

Science.gov (United States)

Black, Robert E; Victora, Cesar G; Walker, Susan P; Bhutta, Zulfiqar A; Christian, Parul; de Onis, Mercedes; Ezzati, Majid; Grantham-McGregor, Sally; Katz, Joanne; Martorell, Reynaldo; Uauy, Ricardo

2013-08-03

Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

Exploring identity and aging: auto-photography and narratives of low income older adults.

Science.gov (United States)

Kohon, Jacklyn; Carder, Paula

2014-08-01

This study focused on meanings of health, housing, independence and aging among low-income adults age 55 and older who live in, or are on a waiting list for, publicly subsidized rental housing. The purpose was to learn how low-income older adults perceive their independence and health, and how their place of residence contributes to these perceptions, as well as related perceptions of self. Qualitative data were collected using in-person narrative interviews with 45 individuals and a second photo elicitation interview with 31 of these persons. Themes describe how disrupted identities influence subjective thoughts about the aging process, housing, health, and finances, the process of clinicalization, and place identities. These findings highlight the relationship between housing status, dignity, and shifting identities as older adults experience the aging process in a low-income context. This study expands the current scholarship on the relationship between environment and aging as well as our understanding of poverty among older persons. These topics are relevant for new policies and programs to support the aging in place of older persons in subsidized housing. Understanding the life worlds of those who live in or have applied to this form of housing will be instrumental in developing such strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

Healthy and comfortable dwellings for the low-income settlements in Surakarta

NARCIS (Netherlands)

Arsandrie, Y.; Bokel, R.M.J.; Van der Linden, A.C.; Kurvers, S.R.; Cauberg, J.J.M.

2012-01-01

Technology for the low-income group of people should be as simple as their daily life. Giving recommendations for simple dwelling design and changing people’s behaviour for a better living are the concerns of this research. A field-survey was conducted in November-December 2010 involving 426

Characterizing Air Pollution in Two Low-Income Neighborhoods in Accra, Ghana

Science.gov (United States)

Sub-Saharan Africa has the highest rate of urban population growth in the world, with a large number of urban residents living in low-income “slum” neighborhoods. We conducted a study for an initial assessment of the levels and spatial and/or temporal patterns of multiple polluta...

Fruit and vegetable attitudes, norms, and intake in low-income youth

Science.gov (United States)

Fruit and vegetable (FV) attitudes and norms have been shown to influence intake in youth; yet research with low-income youth and studies supplementing self-report with objective measures of intake are lacking. Cross-sectional survey data on self-rated FV intake, FV attitudes, and FV norms were coll...

Multidisciplinary Perspectives towards the Education of Young Low-Income Immigrant Children

Science.gov (United States)

Isik-Ercan, Zeynep; Demir-Dagdas, Tuba; Cakmakci, Huzeyfe; Cava-Tadik, Yasemin; Intepe-Tingir, Seyma

2017-01-01

This paper examines the issues surrounding low-income immigrants in the U.S. and the ways they shape the educational experiences of their young children. Using a multidisciplinary lens including sociology, family studies, education, and mental health, the authors analyse multiple perspectives towards the educational experiences of children in…

Food (In)Security in Rapidly Urbanising, Low-Income Contexts

OpenAIRE

Cecilia Tacoli

2017-01-01

Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure he...

Costs of vaccine programs across 94 low- and middle-income countries.

Science.gov (United States)

Portnoy, Allison; Ozawa, Sachiko; Grewal, Simrun; Norman, Bryan A; Rajgopal, Jayant; Gorham, Katrin M; Haidari, Leila A; Brown, Shawn T; Lee, Bruce Y

2015-05-07

While new mechanisms such as advance market commitments and co-financing policies of the GAVI Alliance are allowing low- and middle-income countries to gain access to vaccines faster than ever, understanding the full scope of vaccine program costs is essential to ensure adequate resource mobilization. This costing analysis examines the vaccine costs, supply chain costs, and service delivery costs of immunization programs for routine immunization and for supplemental immunization activities (SIAs) for vaccines related to 18 antigens in 94 countries across the decade, 2011-2020. Vaccine costs were calculated using GAVI price forecasts for GAVI-eligible countries, and assumptions from the PAHO Revolving Fund and UNICEF for middle-income countries not supported by the GAVI Alliance. Vaccine introductions and coverage levels were projected primarily based on GAVI's Adjusted Demand Forecast. Supply chain costs including costs of transportation, storage, and labor were estimated by developing a mechanistic model using data generated by the HERMES discrete event simulation models. Service delivery costs were abstracted from comprehensive multi-year plans for the majority of GAVI-eligible countries and regression analysis was conducted to extrapolate costs to additional countries. The analysis shows that the delivery of the full vaccination program across 94 countries would cost a total of $62 billion (95% uncertainty range: $43-$87 billion) over the decade, including $51 billion ($34-$73 billion) for routine immunization and $11 billion ($7-$17 billion) for SIAs. More than half of these costs stem from service delivery at $34 billion ($21-$51 billion)-with an additional $24 billion ($13-$41 billion) in vaccine costs and $4 billion ($3-$5 billion) in supply chain costs. The findings present the global costs to attain the goals envisioned during the Decade of Vaccines to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all

HIV prevention and low-income Chilean women: machismo, marianismo and HIV misconceptions.

Science.gov (United States)

Cianelli, Rosina; Ferrer, Lilian; McElmurry, Beverly J

2008-04-01

Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV.

Performance pay improves engagement, progress, and satisfaction in computer-based job skills training of low-income adults.

Science.gov (United States)

Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Silverman, Kenneth

2013-01-01

Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training program for low-income, unemployed adults. Participants worked on typing and keypad programs for 7 months. Participants randomly assigned to Group A (n = 23) earned hourly and productivity pay on the typing program (productivity pay), but earned only equalized hourly pay on the keypad program (hourly pay). Group B (n = 19) participants had the opposite contingencies. Participants worked more on, advanced further on, and preferred their productivity pay program. These results show that monetary incentives can increase performance in a job-skills training program, and indicate that payment in adult education programs should be delivered contingent on performance in the training program instead of simply on attendance. © Society for the Experimental Analysis of Behavior.

Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Sarki, Ahmed M; Nduka, Chidozie U; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A

2015-12-01

We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income countries.

A realist synthesis of cross-border patient movement from low and middle income countries to similar or higher income countries.

Science.gov (United States)

Durham, Jo; Blondell, Sarah J

2017-08-29

Patient travel across borders to access healthcare is becoming increasingly common and widespread. Patients moving from high income to middle income countries for healthcare is well documented, with patients seeking treatments that are cheaper or more readily available than at home. Less well understood is when patients move from one low income country to another or from a low income country to a higher income country. In this paper, a realist review was undertaken to explore why, in what contexts and how patients from lower income countries travel to countries with the same, or more advanced, economies for planned healthcare. Based on an initial scoping of the literature and discussions with key informants, we generated an initial theory and set of propositions about why, how, who and in what contexts people cross international borders for planned healthcare. We then systematically located and synthesized (1) peer-reviewed studies from the Scopus, Embase, Web of Science and Econlit databases; (2) non-indexed reports using key informants and Google; and (3) papers from the reference lists of included documents, to glean supportive or contradictory evidence for our initial propositions. As we reviewed the literature and extracted our data, we drew on the work of Pierre Bourdieu to understand the interplay between material and non-material capital and cognitive processes in decisions to cross borders for healthcare. Patient travel was largely undertaken due to a lack of services in the home country and/or unacceptability of local services, with decisions on when, and where, to travel, usually made within the patient's social networks. They were able to travel via use of multiple resources, including social networks, economic and cultural capital, and habitus. Those patients with greater volumes of the aforementioned factors had greater healthcare options; however, even those with limited resources engaged in patient travel. Patient movement challenges traditional

Postgraduate Education in Radiation Oncology in Low- and Middle-income Countries

DEFF Research Database (Denmark)

Eriksen, J. G.

2017-01-01

Radiation therapy is one of the most cost-effective ways to treat cancer patients on both a curative and palliative basis in low- and middle-income countries (LMICs). Despite this, the gap in radiation oncology capacity is enormous and is even increasing due to a rapid rise in the incidence...

A Postsecondary Transition Model for Low-Income, Minority Youth in Philadelphia

Science.gov (United States)

Brown, Alexis Tolbert

2016-01-01

School administrators are in the best position, but often lack the knowledge, to help low-income, minority youth transition to college. Consequently, some youth are not meeting their full potential and there are long-term, deleterious consequences on local economies as wage earning potential stagnates. Using Aslanargun's, Farmer-Hinton's, and…

Overweight and obesity among children at risk of intellectual disability in 20 low and middle income countries.

Science.gov (United States)

Savage, A; Emerson, E

2016-11-01

Children with intellectual disability (ID) in high income countries are at significantly greater risk of obesity than their non-disabled peers. We aimed to estimate the prevalence of overweight and obesity in 3 to 4-year-old children who are/are not at risk of ID in low and middle income countries. Secondary analysis of Round 4 and 5 UNICEF Multiple Indicator Cluster Surveys (MICS) from 20 low and middle income countries that included a total of 83 597 3 to 4-year-old children. Few differences in risk of overweight or obesity were apparent between 3 and 4-year-old children identified as being at risk/not at risk of ID in 20 low and middle income countries. In the two countries where statistically significant differences were observed, prevalence of overweight/obesity was lower among children at risk of ID. These results stand in stark contrast to evidence from high income countries which suggest that children with ID are at significantly increased risk of obesity when compared to their non-intellectually disabled peers. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Financing universal health coverage—effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries

Science.gov (United States)

Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

2015-01-01

Summary Background How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. Methods We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011. Findings Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9·86 (95% CI 3·92–15·8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16·7, 9·16 to 24·3), but not for consumption taxes on goods and services (−$4·37, −12·9 to 4·11). In countries with low tax revenues (tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6·74 percentage points (95% CI 0·87–12·6) and the extent of financial coverage by 11·4 percentage points (5·51–17·2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Interpretation Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax

Financing universal health coverage--effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries.

Science.gov (United States)

Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

2015-07-18

How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995-2011. Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9.86 (95% CI 3.92-15.8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16.7, 9.16 to 24.3), but not for consumption taxes on goods and services (-$4.37, -12.9 to 4.11). In countries with low tax revenues (tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6.74 percentage points (95% CI 0.87-12.6) and the extent of financial coverage by 11.4 percentage points (5.51-17.2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax policies within a pro-poor framework might accelerate progress toward achieving major

Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review.

Science.gov (United States)

Allen, Luke; Williams, Julianne; Townsend, Nick; Mikkelsen, Bente; Roberts, Nia; Foster, Charlie; Wickramasinghe, Kremlin

2017-03-01

Non-communicable diseases are the leading global cause of death and disproportionately afflict those living in low-income and lower-middle-income countries (LLMICs). The association between socioeconomic status and non-communicable disease behavioural risk factors is well established in high-income countries, but it is not clear how behavioural risk factors are distributed within LLMICs. We aimed to systematically review evidence on the association between socioeconomic status and harmful use of alcohol, tobacco use, unhealthy diets, and physical inactivity within LLMICs. We searched 13 electronic databases, including Embase and MEDLINE, grey literature, and reference lists for primary research published between Jan 1, 1990, and June 30, 2015. We included studies from LLMICs presenting data on multiple measures of socioeconomic status and tobacco use, alcohol use, diet, and physical activity. No age or language restrictions were applied. We excluded studies that did not allow comparison between more or less advantaged groups. We used a piloted version of the Cochrane Effective Practice and Organisation of Care Group data collection checklist to extract relevant data at the household and individual level from the included full text studies including study type, methods, outcomes, and results. Due to high heterogeneity, we used a narrative approach for data synthesis. We used descriptive statistics to assess whether the prevalence of each risk factor varied significantly between members of different socioeconomic groups. The study protocol is registered with PROSPERO, number CRD42015026604. After reviewing 4242 records, 75 studies met our inclusion criteria, representing 2 135 314 individuals older than 10 years from 39 LLMICs. Low socioeconomic groups were found to have a significantly higher prevalence of tobacco and alcohol use than did high socioeconomic groups. These groups also consumed less fruit, vegetables, fish, and fibre than those of high

Excess mortality in women of reproductive age from low-income countries: a Swedish national register study.

Science.gov (United States)

Esscher, Annika; Haglund, Bengt; Högberg, Ulf; Essén, Birgitta

2013-04-01

Cause-of-death statistics is widely used to monitor the health of a population. African immigrants have, in several European studies, shown to be at an increased risk of maternal death, but few studies have investigated cause-specific mortality rates in female immigrants. In this national study, based on the Swedish Cause of Death Register, we studied 27,957 women of reproductive age (aged 15-49 years) who died between 1988 and 2007. Age-standardized mortality rates per 100,000 person years and relative risks for death and underlying causes of death, grouped according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, were calculated and compared between women born in Sweden and in low-, middle- and high-income countries. The total age-standardized mortality rate per 100,000 person years was significantly higher for women born in low-income (84.4) and high-income countries (83.7), but lower for women born in middle-income countries (57.5), as compared with Swedish-born women (68.1). The relative risk of dying from infectious disease was 15.0 (95% confidence interval 10.8-20.7) and diseases related to pregnancy was 6.6 (95% confidence interval 2.6-16.5) for women born in low-income countries, as compared to Swedish-born women. Women born in low-income countries are at the highest risk of dying during reproductive age in Sweden, with the largest discrepancy in mortality rates seen for infectious diseases and diseases related to pregnancy, a cause of death pattern similar to the one in their countries of birth. The World Bank classification of economies may be a useful tool in migration research.

An evaluation of college and low-income youth writing together: self-discovery and cultural connection.

Science.gov (United States)

Chandler, Genevieve E

2002-01-01

Although the health and healing effects of writing have been documented in the literature, most of the studies have focused primarily on individuals writing alone. This formative evaluation is a component of an intervention reported elsewhere. The evaluation describes the experience of low-income youth and college students (n = 7) writing in a group during a 10-week workshop. The results revealed the development of protective processes of self-esteem, self-efficacy, coping strategies, social support, and cultural connections. In the weekly 2-hr writing sessions, using the Amherst Writers and Artists method, participants were encouraged to write their stories in their own voices in response to prompts, followed by reading aloud and positive feedback. At the end of the 10 weeks participants were interviewed about their experience within the group and outside the group. Analysis of interviews revealed two themes that emerged from the experience of writing together: connection to self through feelings, reflection, and behaviors; and connection to others through learning and empathy. The results suggest that writing in a group using a specific approach facilitated emotional catharsis, increased self knowledge, coping strategies, and understanding and appreciating of others.

Effectiveness of Collaborative Care for Depression in Public-Sector Primary Care Clinics Serving Latinos.

Science.gov (United States)

Lagomasino, Isabel T; Dwight-Johnson, Megan; Green, Jennifer M; Tang, Lingqi; Zhang, Lily; Duan, Naihua; Miranda, Jeanne

2017-04-01

Quality improvement interventions for depression care have been shown to be effective for improving quality of care and depression outcomes in settings with primarily insured patients. The aim of this study was to determine the impact of a collaborative care intervention for depression that was tailored for low-income Latino patients seen in public-sector clinics. A total of 400 depressed patients from three public-sector primary care clinics were enrolled in a randomized controlled trial of a tailored collaborative care intervention versus enhanced usual care. Social workers without previous mental health experience served as depression care specialists for the intervention patients (N=196). Depending on patient preference, they delivered a cognitive-behavioral therapy (CBT) intervention or facilitated antidepressant medication given by primary care providers or both. In enhanced usual care, patients (N=204) received a pamphlet about depression, a letter for their primary care provider stating that they had a positive depression screen, and a list of local mental health resources. Intent-to-treat analyses examined clinical and process-of-care outcomes at 16 weeks. Compared with patients in the enhanced usual care group, patients in the intervention group had significantly improved depression, quality of life, and satisfaction outcomes (ppublic-sector clinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

45 CFR 2551.81 - What type of clients are eligible to be served?

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false What type of clients are eligible to be served... FOR NATIONAL AND COMMUNITY SERVICE SENIOR COMPANION PROGRAM Clients Served § 2551.81 What type of clients are eligible to be served? Senior Companions serve only adults, primarily older adults, who have...

Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries.

Science.gov (United States)

Singla, Daisy R; Kohrt, Brandon A; Murray, Laura K; Anand, Arpita; Chorpita, Bruce F; Patel, Vikram

2017-05-08

Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2-3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36-0.62), favoring intervention conditions. Our review demonstrates that psychological treatments-comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource-have moderate to strong effects in reducing the burden of common mental disorders.

Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial.

Science.gov (United States)

Nakamura, Saki; Inayama, Takayo; Harada, Kazuhiro; Arao, Takashi

2017-11-24

No existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan. The aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults. In this randomized controlled trial, participants were assessed at three time points-baseline, postintervention (5 weeks later), and a follow-up after 3 months-from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g). Out of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, Pincome participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046). This Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to

Talking about Corporal Punishment: Nine Low-Income African American Mothers' Perspectives

Science.gov (United States)

Ispa, J.M.; Halgunseth, L.C.

2004-01-01

Qualitative interviews conducted over the course of 5 years with nine young low-income African American mothers were analyzed in order to gain understanding of their perspectives on corporal punishment. All used corporal punishment with their children. Results pertain to the vocabulary mothers used to describe corporal punishment (pop, tap, whup,…

Therapeutic hypothermia for neonatal encephalopathy in low- and middle-income countries: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

Shreela S Pauliah

Full Text Available Although selective or whole body cooling combined with optimal intensive care improves outcomes following neonatal encephalopathy in high-income countries, the safety and efficacy of cooling in low-and middle-income countries is not known.We performed a systematic review and meta-analysis of all published randomised or quasi-randomised controlled trials of cooling therapy for neonatal encephalopathy in low-and middle-income countries.Seven trials, comprising a total of 567 infants were included in the meta-analysis. Most study infants had mild (15% or moderate encephalopathy (48% and did not receive invasive ventilation (88%. Cooling devices included water-circulating cooling caps, frozen gel packs, ice, water bottles, and phase-changing material. No statistically significant reduction in neonatal mortality was seen with cooling (risk ratio: 0.74, 95% confidence intervals: 0.44 to 1.25. Data on other neonatal morbidities and long-term neurological outcomes were insufficient.Cooling therapy was not associated with a statistically significant reduction in neonatal mortality in low-and middle-income countries although the confidence intervals were wide and not incompatible with results seen in high-income countries. The apparent lack of treatment effect may be due to the heterogeneity and poor quality of the included studies, inefficiency of the low technology cooling devices, lack of optimal neonatal intensive care, sedation and ventilatory support, overuse of oxygen, or may be due to the intrinsic difference in the population, for example higher rates of perinatal infection, obstructed labor, intrauterine growth retardation and maternal malnutrition. Evaluation of the safety and efficacy of cooling in adequately powered randomised controlled trials is required before cooling is offered in routine clinical practice in low-and middle-income countries.

Role of the private sector in the provision of immunization services in low- and middle-income countries.

Science.gov (United States)

Levin, Ann; Kaddar, Miloud

2011-07-01

The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization

Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA

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Fernandez Maria E.

1998-01-01

Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomes<=$15,000. All women were Spanish speakers and had low acculturation levels. Ninety six percent had reported having a Pap smear, but 24% were not in compliance with recommended screening (Pap test within the last 3 years. Among women 40 and older, 62% had received a mammogram, but only 33% were compliant with age appropriate recommended mammography screening guidelines. Women in this study had more misconceptions about cancer than Hispanics in other studies. Multivariate logistic models for correlates of Pap test and mammography screening behavior indicate that factors such as fear of the screening test, embarrassment, and lack of knowledge influenced screening behavior. In conclusion, women in this study had lower rates of mammography screening than non-Hispanic women and lower rates of compliance with recommended Mammography and Pap test screening guidelines.

Higher food prices may threaten food security status among American low-income households with children.

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Zhang, Qi; Jones, Sonya; Ruhm, Christopher J; Andrews, Margaret

2013-10-01

Children in food-insecure households are more likely to experience poorer health function and worse academic achievement. To investigate the relation between economic environmental factors and food insecurity among children, we examined the relation between general and specific food prices (fast food, fruits and vegetables, beverages) and risk of low (LFS) and very low food security (VLFS) status among low-income American households with children. Using information for 27,900 child-year observations from the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999 linked with food prices obtained from the Cost of Living Data of the Council for Community and Economic Research, formerly known as the American Chamber of Commerce Researchers' Association, fixed effects models were estimated within stratified income groups. Higher overall food prices were associated with increased risk of LFS and VLFS (coefficient = 0.617; P security status, even when controlling for general food prices. Thus, although food price changes were strongly related to food security status among low-income American households with children, the effects were not uniform across types of food. These relations should be accounted for when implementing policies that change specific food prices.

An Investigation Into the Social Context of Low-Income, Urban Black and Latina Women

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Shelton, Rachel C.; Goldman, Roberta E.; Emmons, Karen M.; Sorensen, Glorian; Allen, Jennifer D.

2011-01-01

Understanding factors that promote or prevent adherence to recommended health behaviors is essential for developing effective health programs, particularly among lower-income populations who carry a disproportionate burden of disease. We conducted in-depth qualitative interviews (n=64) with low-income Black and Latina women who shared the experience of requiring diagnostic follow-up after having an abnormal screening mammogram. In addition to holding negative and fatalistic cancer-related bel...

Tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years: data from 68 low-income and middle-income countries.

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Xi, Bo; Liang, Yajun; Liu, Yunxia; Yan, Yinkun; Zhao, Min; Ma, Chuanwei; Bovet, Pascal

2016-11-01

Tobacco use is an important risk factor for non-communicable diseases worldwide. However, the global extent and prevalence of tobacco use in adolescents is poorly described. Using previously collected survey data, we aimed to assess tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years in 68 low-income and middle-income countries. We used data from the Global School-based Student Health Survey (2006-13) and the China Global Tobacco Youth Survey (2013), which are school-based surveys of young adolescents aged 12-15 years that assess health behaviours using a standardised, anonymous, self-reported questionnaire. We calculated the prevalence of current tobacco use and exposure to second-hand smoke in young adolescents from 68 low-income and middle-income countries that collected these data in the surveys. We used a multilevel model to estimate the association between parental tobacco use, second-hand smoke, and adolescent tobacco use, adjusting for sex, age, school, school class, country's purchasing power parity, smoking initiation age, national prevalence of tobacco use among adults, year the WHO FCTC was ratified for each country, proxy of socioeconomic status, and survey year. The mean prevalence of current tobacco use was 13·6%, ranging from 2·8% in Tajikistan to 44·7% in Samoa. In most countries, the prevalence of tobacco use was higher for boys than girls, and higher for adolescents aged 14-15 years than for those aged 12-13 years. The overall prevalence of second-hand smoke exposure was 55·9%, ranging from 16·4% in Tajikistan to 85·4% in Indonesia. Parental tobacco use (as reported by the young adolescents), especially maternal use, was associated with tobacco use in young adolescents (odds ratio 2·06, 95% CI 1·93-2·19, for maternal and 1·29, 1·23-1·35 for paternal use). Second-hand smoke exposure was also a risk factor for young adolescents' tobacco use (2·56, 2·43-2·69). However, the prevalence of tobacco use was not

Poverty Levels and Debt Indicators among Low-Income Households before and after the Great Recession

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Kim, Kyoung Tae; Wilmarth, Melissa J.; Henager, Robin

2017-01-01

This study analyzed the debt profile of low-income households before and after the Great Recession using the 2007, 2010, and 2013 Survey of Consumer Finances (SCF). We used Heckman selection models to investigate three debt characteristics: (a) the amount of debt, (b) debt-to-income ratio, and (c) debt delinquency. Before and after the Great…

Economic Stress and Cortisol Among Postpartum Low-Income Mexican American Women: Buffering Influence of Family Support.

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Jewell, Shannon L; Luecken, Linda J; Gress-Smith, Jenna; Crnic, Keith A; Gonzales, Nancy A

2015-01-01

Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 18-42; 82% Spanish-speaking; modal family income $10,000-$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6-week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress.

Factors contributing to the psychological well-being for Hong Kong Chinese children from low-income families: a qualitative study.

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Ho, Ka Yan; Li, William H C; Chung, Joyce Oi Kwan; Lam, Katherine Ka Wai; Chan, Sophia S C; Xia, Wei

2016-01-01

Despite compelling evidence demonstrating the negative impact of poverty and income disparity on children's psychological well-being, there has been a lack of qualitative information which addresses its contributing factors. This study aimed to shed light on this area by comparing the experiences toward daily life between children living in low- and high-income families. A qualitative study using a phenomenological approach was conducted from May 2012 to January 2013. A random sample of 42 children aged 10-13, with 25 from low- and 17 from high-income families were asked to voluntarily response to a demographic sheet and undergo individual semi-structured interviews which lasted about 25-30 min. Content analysis was used to analyze the data. Approval for the study was obtained from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (reference UW 12-237). The findings of this study revealed that the living environment, physical health, social life and ability to function at school of children from low-income families are severely impaired. It fills a gap in the literature by showing how poverty and income disparity affect the daily lives of children from low-income families on different levels. Also, adopting a sedentary lifestyle and unhealthy eating habits are possible factors mediating the effects of poverty and income disparity on the psychological well-being of children from low-income families. It is vital for healthcare professionals going beyond their normal roles to give advice on healthy lifestyles and behaviors by building multidisciplinary partnerships with schools and the community. Additionally, healthcare professionals should also target on these two possible factors to develop and implement appropriate interventions for promoting the psychological well-being among children living in poverty. Trial registration NCT02877719. 19 August 2016 retrospectively registered.

Parenting in low-income families from the perspective of social work

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Banovcinova A.

2018-01-01

The goal of the study was to find how poverty affects parenting. For the data collection was used questionnaire Alabama Parenting Questionnaire (APQ, which measures parenthood through five dimensions (1 positive involvement with children, (2 Supervision and monitoring, (3 use of positive discipline techniques, (4 consistency in Theus of discipline chniques, (5 use of corporal punishment. The sample was divided into two groups, with the first group consisted of 188 parents living in poverty The reference group consisted of parents living in households with income standard (N−188.Analysis of the results showed differences between parents living in poverty and between parents with a standard rate of income especially in monitoring and supervision, and also in the use of positive disciplinary techniques. On the contrary, there were no significant differences in cooperation between the parents or the use of corporal punishment. Based on the results it is clear that poverty is one of the factors affecting parenting. Therefore, social worker who works with low-income families should focus attention on this area of family functioning.

The family context of low-income parents who restrict child screen time.

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Lampard, Amy M; Jurkowski, Janine M; Davison, Kirsten K

2013-10-01

The American Academy of Pediatrics recommends that parents restrict child screen time to two hours per day, but many preschool-aged children exceed this viewing recommendation. Modifying children's viewing habits will require collaborating with parents, but little is known about the factors that influence parents' capacity for effective screen-related parenting. This study aimed to identify the demographic, family and community contextual factors associated with low-income parents' restriction of child screen time. Parents (N=146) of children (age 2-5 years) attending Head Start centers in the United States completed a self-report survey in 2010 assessing parent and child screen use (television, DVD, video, video games, and leisure-time computer use), parent restriction of child screen time, and family (parent stress, social support, and life pressures) and community (neighborhood safety and social capital) factors. Children were more likely to meet the American Academy of Pediatrics screen time recommendation if their parent reported high restriction of child screen time. Parent and child demographic characteristics were not associated with parents' restriction of child screen time. In multivariate analysis, less parent screen time, fewer parent life pressures, and greater social support were associated with parents' high restriction of screen time. Family contextual factors may play an important role in enabling low-income parents to restrict their children's screen time. When counseling low-income parents about the importance of restricting child screen time, practitioners should be sensitive to family contextual factors that may influence parents' capacity to implement this behavior change.

The Relationship between Media Influence and Ethnic Identity Development among Low-Income African American and White Adolescent Girls

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Byrd, Kenycia

2013-01-01

The purpose of this study was to examine the relationship between media influence and ethnic identity among low-income African American and White adolescent girls. According to the U.S. Census (2008), 98% of Americans have a television in their home. Prior research suggests that low-income African American adolescents are exposed to more media…

Obesity risk in children: The role of acculturation in the feeding practices and styles of low-income Hispanic families

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Parent feeding has been associated with child overweight/obesity in low-income families. Because acculturation to the United States has been associated with increased adult obesity, our study aim was to determine whether acculturation was associated with feeding in these populations. Low-income Hisp...

Promoting health and advancing development through improved housing in low-income settings

NARCIS (Netherlands)

Haines, A.; Bruce, N.; Cairncross, S.; Davies, M.; Greenland, K.; Hiscox, A.F.; Lindsay, S.; Lindsay, T.; Satterthwaite, D.; Wilkinson, P.

2013-01-01

There is major untapped potential to improve health in low-income communities through improved housing design, fittings, materials and construction. Adverse effects on health from inadequate housing can occur through a range of mechanisms, both direct and indirect, including as a result of extreme

Socioeconomic Inequalities in Overweight and Obesity in Low- and Middle-Income Countries

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S.L. López Arana (Sandra Liliana)

2016-01-01

markdownabstractMany low- and middle-income countries are experiencing a rapid increase of overweight and obesity rates. Nonetheless, there are some concerns not only about the pace of the increase in overweight and obesity, but also about inequalities in their distribution across social groups. The

Assisted Housing - Low Income Housing Tax Credit Properties - National Geospatial Data Asset (NGDA)

Data.gov (United States)

Department of Housing and Urban Development — The Low-Income Housing Tax Credit (LIHTC) is the primary Federal program for creating affordable housing in the United States. The LIHTC database, created by HUD and...

Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: results from the World Health Survey.

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Hosseinpoor, Ahmad Reza; Bergen, Nicole; Mendis, Shanthi; Harper, Sam; Verdes, Emese; Kunst, Anton; Chatterji, Somnath

2012-06-22

Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups. Using 2002-04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality. Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality. Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators.

Differences in perceptions and fast food eating behaviours between Indians living in high- and low-income neighbourhoods of Chandigarh, India.

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Aloia, Christopher Robert; Gasevic, Danijela; Yusuf, Salim; Teo, Koon; Chockalingam, Arun; Patro, Binod Kumar; Kumar, Rajesh; Lear, Scott Alexander

2013-01-07

Increased density of fast food restaurants is associated with increased prevalence of obesity in developed countries. However, less is known about this relationship in developing countries undergoing rapid urbanization and how differences in neighbourhood income affect the patronage of fast food outlets. The purpose of the study is to explore the differences in fast food preferences, perceptions, and patronage between Indians living in high- and low-income neighbourhoods. This cross-sectional study recruited 204 men and women (35 to 65 years in age) from high- and low-income neighbourhoods who completed a questionnaire on fast food consumption. The questionnaire asked participants to define fast food and to provide reasons for and frequency of visits to fast food restaurants. The differences were analyzed using Chi square and t-tests for categorical and continuous variables, respectively. Participants from a high-income neighbourhood were more likely to perceive Western -style fast food as fast food, while people from the low-income neighbourhood were more likely to identify food sold by street vendors as fast food (p food from street vendors while less likely to dine out at both fast food and non-fast food restaurants (pfood restaurants than their low-income neighbourhood counterparts, there were no significant differences in the reasons for visiting fast food restaurants (convenience, price, social enjoyment, and quality of meals) between the two groups. Both groups preferred home cooked over restaurant meals, and they recognized that home cooked food was healthier. Overall, consumption of fast food was low. People from a high-income neighbourhood dined out more frequently and were more likely to perceive Western-style food as fast food compared to their counterparts from the low-income neighbourhood.

Employment and the Risk of Domestic Abuse among Low-Income Women

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Gibson-Davis, Christina M.; Magnuson, Katherine; Gennetian, Lisa A.; Duncan, Greg J.

2005-01-01

This paper uses data from 2 randomized evaluations of welfare-to-work programs--the Minnesota Family Investment Program and the National Evaluation of Welfare-to-Work Strategies--to estimate the effect of employment on domestic abuse among low-income single mothers. Unique to our analysis is the application of a 2-stage least squares method, in…

Lower education among low-income Brazilian adolescent females is associated with planned pregnancies

Directory of Open Access Journals (Sweden)

Faisal-Cury A

2017-01-01

Full Text Available Alexandre Faisal-Cury,1 Karen M Tabb,2 Guilherme Niciunovas,3 Carrie Cunningham,4 Paulo R Menezes,1 Hsiang Huang4,5 1Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; 2School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 3School of Medicine, Federal University of São Paulo, São Paulo, Brazil; 4Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA; 5Department of Psychiatry, Laboratory of Psychopathology and Psychiatric Therapeutics (LIM-23, Faculty of Medicine, University of São Paulo, São Paulo, Brazil Abstract: Adolescent pregnancy has social, economic, and educational consequences and is also linked to adverse perinatal outcomes. However, studies show a positive relationship between pregnancy and increased social status among low-income adolescents. This study aims to assess the association between planned pregnancy and years of schooling among low-income Brazilian adolescents. This is a secondary analysis of a cohort study conducted from May 2005 to March 2007 in public primary care clinics in São Paulo, Brazil. Participants (n=168 completed a detailed structured questionnaire. Logistic regression was used to examine the association between years of schooling and planned pregnancy. After adjusting for the covariates income, wealth score, crowding, age, marital status, and race, planned pregnancy was independently associated with lower years of education (odds ratio: 1.82; 95% confidence interval: 1.02–3.23. Although this finding may be related to these adolescents having less access to information and health services, another possible explanation is that they have a greater desire to have children during adolescence. Keywords: adolescent pregnancy, planned pregnancy, Brazil, low-income population, women

A critical analysis of UK public health policies in relation to diet and nutrition in low-income households.

Science.gov (United States)

Attree, Pamela

2006-04-01

Diet and nutrition, particularly among low-income groups, is a key public health concern in the UK. Low levels of fruit and vegetable consumption, and obesity, especially among children, have potentially severe consequences for the future health of the nation. From a public health perspective, the UK government's role is to help poorer families make informed choices within healthy frameworks for living. However, the question is - to what extent are such policies in accordance with lay experiences of managing diet and nutrition on a low-income? This paper critically examines contemporary public health policies aimed at improving diet and nutrition, identifying the underlying theories about the influences on healthy eating in poor families, and exploring the extent to which these assumptions are based on experiential accounts. It draws on two qualitative systematic reviews - one prioritizing low-income mothers' accounts of 'managing' in poverty; and the other focusing on children's perspectives. The paper finds some common ground between policies and lay experiences, but also key divergencies. Arguably, the emphasis of public health policy on individual behaviour, coupled with an ethos of empowered consumerism, underplays material limitations on 'healthy eating' for low-income mothers and children. Health policies fail to take into account the full impact of structural influences on food choices, or recognize the social and emotional factors that influence diet and nutrition. In conclusion, it is argued that while health promotion campaigns to improve low-income families' diets do have advantages, these are insufficient to outweigh the negative effects of poverty on nutrition.

An Analysis of Arizona Individual Income Tax-Credit Scholarship Recipients' Family Income, 2009-10 School Year. Program on Education Policy and Governance Working Paper. PEPG 10-18

Science.gov (United States)

Murray, Vicki E.

2010-01-01

In 2009, the "East Valley Tribune and the Arizona Republic" alleged that Arizona's individual income tax-credit scholarship program disproportionately serves privileged students from higher-income families over those from lower-income backgrounds. Yet neither paper collected the student-level, scholarship recipient family income data…

Assets among low-income families in the Great Recession.

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Valentina Duque

Full Text Available This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898, we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents and by race/ethnicity (White, Black, and Hispanic mothers. Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty.

Assets among low-income families in the Great Recession.

Science.gov (United States)

Duque, Valentina; Pilkauskas, Natasha V; Garfinkel, Irwin

2018-01-01

This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898), we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents) and by race/ethnicity (White, Black, and Hispanic mothers). Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty.

Assets among low-income families in the Great Recession

Science.gov (United States)

Garfinkel, Irwin

2018-01-01

This paper examines the association between the Great Recession and real assets among families with young children. Real assets such as homes and cars are key indicators of economic well-being that may be especially valuable to low-income families. Using longitudinal data from the Fragile Families and Child Wellbeing Study (N = 4,898), we investigate the association between the city unemployment rate and home and car ownership and how the relationship varies by family structure (married, cohabiting, and single parents) and by race/ethnicity (White, Black, and Hispanic mothers). Using mother fixed-effects models, we find that a one percentage point increase in the unemployment rate is associated with a -0.5 percentage point decline in the probability of home ownership and a -0.7 percentage point decline in the probability of car ownership. We also find that the recession was associated with lower levels of home ownership for cohabiting families and for Hispanic families, as well as lower car ownership among single mothers and among Black mothers, whereas no change was observed among married families or White households. Considering that homes and cars are the most important assets among middle and low-income households in the U.S., these results suggest that the rise in the unemployment rate during the Great Recession may have increased household asset inequality across family structures and race/ethnicities, limiting economic mobility, and exacerbating the cycle of poverty. PMID:29401482

Factors that influence a career choice in primary care among medical students from high-, middle-, and low-income countries: a systematic review.

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Puertas, E Benjamín; Arósquipa, Carlos; Gutiérrez, Daniela

2013-11-01

To determine which factors influence a medical student's decision to choose a career in primary care; and to establish if these factors are similar or different among students in high-, middle- and low-income countries. An extensive search was done of PubMed, Google Scholar, and Virtual Library of Health for articles on primary care careers published in 2003-2013 in English, Spanish, and/or Portuguese. Initially, 600 records were identified; 74 full-text articles were assessed for eligibility and 55 were selected (42 from high-income countries; 13 from middle- and low-income). These were assessed to identify intrinsic and extrinsic factors that influence career choice among medical students from high-, middle-, and low-income countries. A comparison framework with common and specific factors that influence career choice in primary care among medical students from high-, middle- and low-income was developed. Factors were classified as extrinsic or intrinsic, and as facilitators or barriers. Several factors common to all countries were identified: facilitators were exposure to rural location, role models, working conditions; barriers were low income, prestige, and medical school environment. Some factors specific to middle- and low-income countries were: understanding of rural needs and intellectual challenge. Other factors specific to high-income countries were: attitude towards social problems, voluntary work, influence of family, and length of residency. Further studies on the subject are needed, especially in low- and middle-income countries. Identifying factors as barriers or facilitators for career choice will promote a better understanding of the reasons behind the shortage of primary care professionals and will contribute to policy building, improved training, and recruitment and retention of these professionals.

Child development assessment tools in low-income and middle-income countries: how can we use them more appropriately?

Science.gov (United States)

Sabanathan, Saraswathy; Wills, Bridget; Gladstone, Melissa

2015-05-01

Global emphasis has shifted beyond reducing child survival rates to improving health and developmental trajectories in childhood. Optimum early childhood experience is believed to allow children to benefit fully from educational opportunities resulting in improved human capital. Investment in early childhood initiatives in low-income and middle-income countries (LMICs) is increasing. These initiatives use early childhood developmental assessment tools (CDATs) as outcome measures. CDATs are also key measures in the evaluation of programmatic health initiatives in LMICs, influencing public health policy. Interpretation of CDAT outcomes requires understanding of their structure and psychometric properties. This article reviews the structure and main methods of CDAT development with specific considerations when applied in LMICs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Improving Outcomes from Breast Cancer in a Low-Income Country: Lessons from Bangladesh

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H. L. Story

2012-01-01

Full Text Available Women in low- and middle-income countries (LMICs have yet to benefit from recent advances in breast cancer diagnosis and treatment now experienced in high-income countries. Their unique sociocultural and health system circumstances warrant a different approach to breast cancer management than that applied to women in high-income countries. Here, we present experience from the last five years working in rural Bangladesh. Case and consecutive series data, focus group and individual interviews, and clinical care experience provide the basis for this paper. These data illustrate a complex web of sociocultural, economic, and health system conditions which affect womens’ choices to seek and accept care and successful treatment. We conclude that health system, human rights, and governance issues underlie high mortality from this relatively rare disease in Bangladesh.

Improving outcomes from breast cancer in a low-income country: lessons from bangladesh.

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Story, H L; Love, R R; Salim, R; Roberto, A J; Krieger, J L; Ginsburg, O M

2012-01-01

Women in low- and middle-income countries (LMICs) have yet to benefit from recent advances in breast cancer diagnosis and treatment now experienced in high-income countries. Their unique sociocultural and health system circumstances warrant a different approach to breast cancer management than that applied to women in high-income countries. Here, we present experience from the last five years working in rural Bangladesh. Case and consecutive series data, focus group and individual interviews, and clinical care experience provide the basis for this paper. These data illustrate a complex web of sociocultural, economic, and health system conditions which affect womens' choices to seek and accept care and successful treatment. We conclude that health system, human rights, and governance issues underlie high mortality from this relatively rare disease in Bangladesh.

Improving Outcomes from Breast Cancer in a Low-Income Country: Lessons from Bangladesh

International Nuclear Information System (INIS)

Story, H.L.; Love, R.R.; Ginsburg, O.M.; Story, H.L.; Salim, R.; Roberto, A.J.; Krieger, J.L.; Ginsburg, O.M.

2012-01-01

Women in low- and middle-income countries (LMICs) have yet to benefit from recent advances in breast cancer diagnosis and treatment now experienced in high-income countries. Their unique socio cultural and health system circumstances warrant a different approach to breast cancer management than that applied to women in high-income countries. Here, we present experience from the last five years working in rural Bangladesh. Case and consecutive series data, focus group and individual interviews, and clinical care experience provide the basis for this paper. These data illustrate a complex web of socio cultural, economic, and health system conditions which affect women's choices to seek and accept care and successful treatment. We conclude that health system, human rights, and governance issues underlie high mortality from this relatively rare disease in Bangladesh

How a North Carolina program boosted preventive oral health services for low-income children.

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Rozier, R Gary; Stearns, Sally C; Pahel, Bhavna T; Quinonez, Rocio B; Park, Jeongyoung

2010-12-01

Dental caries (tooth decay), the most common chronic disease affecting young children, is exacerbated by limited access to preventive dental services for low-income children. To address this problem, North Carolina implemented a program to reimburse physicians for up to six preventive oral health visits for Medicaid-enrolled children younger than age three. Analysis of physician and dentist Medicaid claims from the period 2000-2006 shows that the program greatly increased preventive oral health services. By 2006 approximately 30 percent of well-child visits for children ages six months up to three years included these services. However, additional strategies are needed to ensure preventive oral health care for more low-income children.

Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.

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Danis, Marion; Kotwani, Namrata; Garrett, Joanne; Rivera, Ivonne; Davies-Cole, John; Carter-Nolan, Pamela

2010-11-01

To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.

Approaches to Electric Utility Energy Efficiency for Low Income Customers in a Changing Regulatory Environment

Energy Technology Data Exchange (ETDEWEB)

Brockway, N.

2001-05-21

As the electric industry goes through a transformation to a more market-driven model, traditional grounds for utility energy efficiency have come under fire, undermining the existing mechanisms to fund and deliver such services. The challenge, then, is to understand why the electric industry should sustain investments in helping low-income Americans use electricity efficiently, how such investments should be made, and how these policies can become part of the new electric industry structure. This report analyzes the opportunities and barriers to leveraging electric utility energy efficiency assistance to low-income customers during the transition of the electric industry to greater competition.

Management of undernutrition and failure to thrive in children with congenital heart disease in low- and middle-income countries.

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Argent, Andrew C; Balachandran, Rakhi; Vaidyanathan, Balu; Khan, Amina; Kumar, R Krishna

2017-12-01

Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low- and middle-income countries. Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible. Close attention should be paid to nutritional support - primarily enteral feeding, with particular use of breast milk in infancy - in the perioperative period and in the paediatric ICU. This nutritional support requires specific attention and allocation of resources, including appropriately skilled personnel. Thereafter, it is essential to monitor growth and development and to identify causes for failure to catch-up or grow appropriately.

Prenatal Care Initiation in Low-Income Hispanic Women: Risk and Protective Factors

Science.gov (United States)

Luecken, Linda J.; Purdom, Catherine L.; Howe, Rose

2009-01-01

Objectives: To examine the psychosocial risk (distress, stress, unintended pregnancy) and protective factors (social support, mastery, familism) associated with entry into prenatal care among low-income Hispanic women. Methods: Between April and September 2005, 483 postpartum Medicaid-eligible Hispanic women completed a survey at the hospital.…

Depression in Low-Income Elementary School Children in South Korea: Gender Differences

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Lee, Gyungjoo; McCreary, Linda; Kim, Mi Ja; Park, Chang Gi; Jun, Won Hee; Yang, Soo

2013-01-01

This study examined depression in low-income elementary school children and identified gender differences in factors that influence depression from an ecological perspective. Participants were 262 first- to sixth-grade children recruited from six Korean community centers. Personal factors were anxiety and self-concept. Environmental factors…

Multilevel Perspectives on Female Sterilization in Low-Income Communities in Mumbai, India.

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Brault, Marie A; Schensul, Stephen L; Singh, Rajendra; Verma, Ravi K; Jadhav, Kalpita

2016-09-01

Surgical sterilization is the primary method of contraception among low-income women in India. This article, using qualitative analysis of key informant, in-depth interviews, and quantitative analyses, examines the antecedents, process, and outcomes of sterilization for women in a low-income area in Mumbai, India. Family planning policies, socioeconomic factors, and gender roles constrain women's reproductive choices. Procedures for sterilization rarely follow protocol, particularly during pre-procedure counseling and consent. Women who choose sterilization often marry early, begin conceiving soon after marriage, and reach or exceed ideal family size early due to problems in accessing reversible contraceptives. Despite these constraints, this study indicates that from the perspective of women, the decision to undergo sterilization is empowering, as they have fulfilled their reproductive duties and can effectively exercise control over their fertility and sexuality. This empowerment results in little post-sterilization regret, improved emotional health, and improved sexual relationships following sterilization. © The Author(s) 2015.

HIV-1 drug resistance before initiation or re-initiation of first-line antiretroviral therapy in low-income and middle-income countries: a systematic review and meta-regression analysis

NARCIS (Netherlands)

Gupta, Ravindra K.; Gregson, John; Parkin, Neil; Haile-Selassie, Hiwot; Tanuri, Amilcar; Andrade Forero, Liliana; Kaleebu, Pontiano; Watera, Christine; Aghokeng, Avelin; Mutenda, Nicholus; Dzangare, Janet; Hone, San; Hang, Zaw Zaw; Garcia, Judith; Garcia, Zully; Marchorro, Paola; Beteta, Enrique; Giron, Amalia; Hamers, Raph; Inzaule, Seth; Frenkel, Lisa M.; Chung, Michael H.; de Oliveira, Tulio; Pillay, Deenan; Naidoo, Kogie; Kharsany, Ayesha; Kugathasan, Ruthiran; Cutino, Teresa; Hunt, Gillian; Avila Rios, Santiago; Doherty, Meg; Jordan, Michael R.; Bertagnolio, Silvia

2018-01-01

Pretreatment drug resistance in people initiating or re-initiating antiretroviral therapy (ART) containing non-nucleoside reverse transcriptase inhibitors (NNRTIs) might compromise HIV control in low-income and middle-income countries (LMICs). We aimed to assess the scale of this problem and whether

Cohabitating Partners and Domestic Labor in Low-Income Black Families

OpenAIRE

Reid, Megan; Golub, Andrew; Vazan, Peter

2014-01-01

This article examines the division of domestic labor in low-income cohabiting Black stepfamilies. We analyze survey data collected from 136 such families in order to understand how stepparent gender and relationship length impact the distribution of domestic labor. We hypothesize that women do more domestic work than men across all three family types, and that stepfathers are more involved in domestic labor in established relationships compared to new relationships. Findings indicate that coh...

"I'm Happy with My Mommy": Low-Income Preschoolers' Causal Attributions for Emotions.

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Curenton, Stephanie M.; Wilson, Melvin N.

2003-01-01

This study examined low-income African American and European American preschoolers' socioemotional causal attributions. Results indicate that younger preschoolers, particularly young African Americans, may need help articulating emotions. Adults can support children's emotional reasoning through scaffolding. (Author)

What's Being Served for Dinner? An Exploratory Investigation of the Associations between the Healthfulness of Family Meals and Child Dietary Intake.

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Trofholz, Amanda C; Tate, Allan D; Draxten, Michelle L; Rowley, Seth S; Schulte, Anna K; Neumark-Sztainer, Dianne; MacLehose, Richard F; Berge, Jerica M

2017-01-01

Little is known about the healthfulness of foods offered at family meals or the relationship between the food's healthfulness and child overall dietary intake. This exploratory study uses a newly developed Healthfulness of Meal Index to examine the association between the healthfulness of foods served at family dinners and child dietary intake. Direct observational, cross-sectional study. Primarily low-income, minority families (n=120) video recorded 8 days of family dinners and completed a corresponding meal screener. Dietary recalls were completed on the target child (6 to 12 years old). The Healthfulness of Meal Index was used to measure meal healthfulness and included component scores for whole fruit, 100% juice, vegetables, dark green vegetables, dairy, protein, added sugars, and high-sodium foods. Child dietary intake measured by three 24-hour dietary recalls. Linear regression models estimated the association between the healthfulness of foods served at dinner meals and overall child HEI. The majority of coded meals included foods from protein and high-sodium components; more than half included foods from dairy and vegetable components. Nearly half of the meals had an added-sugar component food (eg, soda or dessert). Few meals served foods from fruit, 100% juice, or dark green vegetable components. Many components served at family dinner meals were significantly associated with child daily intake of those same foods (ie, dark green vegetable, non-dark green vegetables, dairy, and added sugars). The Healthfulness of Meal Index total score was significantly associated with child HEI score. This study represents the first report of a new methodology to collect data of foods served at family dinners. Results indicated a significant association between the majority of components served at family dinner meals and child overall dietary intake. Validation of the Healthfulness of Meal Index and video-recorded family meal methodology is needed to strengthen these

What’s Being Served for Dinner?: An Exploratory Investigation of the Associations between the Healthfulness of Family Meals and Child Dietary Intake

Science.gov (United States)

Trofholz, Amanda C.; Tate, Allan D.; Draxten, Michelle L.; Rowley, Seth S.; Schulte, Anna K.; Neumark-Sztainer, Dianne; MacLehose, Richard F.; Berge, Jerica M.

2016-01-01

Background Little is known about the healthfulness of foods offered at family meals or the relationship between the food’s healthfulness and child overall dietary intake. Objective This exploratory study uses a newly-developed Healthfulness of Meal (HOM) index to examine the association between the healthfulness of foods served at family dinners and child dietary intake. Design Direct observational, cross-sectional study. Participants/setting Primarily low-income, minority families (n=120) video-recorded 8 days of family dinners and completed a corresponding meal screener. Dietary recalls were completed on the target child (6–12 years old). The HOM index was used to measure meal healthfulness and included component scores for whole fruit, 100% juice, vegetables, dark green vegetables, dairy, protein, added sugars, and high sodium foods. Main outcome measures Child dietary intake measured by three 24-hour dietary recalls. Statistical analyses performed Linear regression models estimated the association between the foods served at dinner meals and overall child dietary intake. Results The majority of coded meals included foods from protein and high sodium components; over half included foods from dairy and vegetable components. Nearly half of the meals had an added sugar component food (e.g., soda, dessert). Few meals served foods from fruit, 100% juice, or dark green vegetable components. Many components served at family dinner meals were significantly associated with child daily intake of those same foods (i.e., dark green, non-dark green vegetables, dairy, and added sugars). The HOM index total score was significantly associated with child HEI score. Conclusions This study represents the first report of a new methodology to collect data of foods served at family dinners. Results indicated a significant association between the majority of components served at family dinner meals and child overall dietary intake. Validation of the HOM index and video

Efficacy and safety of bubble CPAP in neonatal care in low and middle income countries: a systematic review.

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Martin, Simone; Duke, Trevor; Davis, Peter

2014-11-01

Forty per cent of global child deaths occur in the neonatal period. Low and middle income countries need effective and simple methods to improve hospital-based neonatal care. Bubble continuous positive airway pressure (CPAP) may have a role in improving the quality of respiratory support in hospitals in low and middle income countries. To examine the evidence for the efficacy and safety of bubble CPAP in neonates with respiratory distress in low and middle income settings. A systematic search (1946-March 2014) was performed of Pubmed, Ovid MEDLINE, Web of Science, Google Scholar and the references of relevant articles. Articles meeting inclusion criteria (CPAP for respiratory distress in infants CPAP compared with oxygen therapy, followed by mechanical ventilation if required, reduced the need for mechanical ventilation by 30%-50%. In another three trials comparing bubble CPAP with ventilator CPAP, mortality and complication rates were similar, while meta-analysis of CPAP failure in these same trials showed a lower failure rate in the bubble CPAP groups (p CPAP is safe and reduces the need for mechanical ventilation. Further research into the efficacy of bubble CPAP in low-income and middle-income countries is needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Food Insecurity and Perceived Diet Quality Among Low-Income Older Americans with Functional Limitations.

Science.gov (United States)

Chang, Yunhee; Hickman, Haley

2018-05-01

To evaluate how functional limitations are associated with food insecurity and perceived diet quality in low-income older Americans. Nationwide repeated cross-sectional surveys regarding health and nutritional status. The National Health and Nutrition Examination Surveys, 2007-2008, 2009-2010, and 2011-2012. Individuals aged ≥65 years with household incomes ≤130% of the federal poverty level (n = 1,323). Dependent variables included dichotomous indicators of food insecurity and poor-quality diet, measured with the household food security survey module and respondents' own ratings, respectively. Independent variable was presence of limitations in physical functioning. Weighted logistic regressions with nested controls and interaction terms. Functional limitations in low-income older adults were associated with 1.69 times higher odds of food insecurity (P food insecurity; 3.07 for poor-quality diet; P functional limitations are exposed to significant nutritional risk. Resources should be directed to facilitating their physical access to healthful foods. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Trajectories of psychopathology and risky behaviors associated with childhood abuse and neglect in low-income urban African American girls.

Science.gov (United States)

Wilson, Helen W; Samuelson, Sarah L; Staudenmeyer, Anna H; Widom, Cathy Spatz

2015-07-01

The current study examined patterns of psychopathology, drug and alcohol use, and sexual behavior associated with childhood abuse and neglect in a high-risk sample of low-income African American girls seeking mental health treatment. Participants (N=177) were African American girls recruited from mental health clinics serving low-income communities in Chicago, IL and followed over six waves of data collection (T1-T6) reflecting early (mean age 14) to late (mean age 17) adolescence. Child abuse and neglect history was determined from adolescent and caregiver reports. Latent curve modeling examined patterns of internalizing and externalizing psychopathology, drug and alcohol use, sexual experience, and risky sexual behavior reported by girls and associations with reported child abuse and neglect. Overall, these trajectories indicated a decrease in internalizing and externalizing symptoms, stability of drug and alcohol use, and an increase in sexual experience and risky sexual behaviors over time. Child abuse and neglect was associated with increased internalizing symptoms and sexual experience at baseline and with externalizing symptoms and risky sexual behavior both at baseline and the final point. Child abuse and neglect was not significantly associated with alcohol or drug use. This study adds to the literature on the long-term consequences of child abuse and neglect by demonstrating patterns of psychopathology and risky behavior that persist over time in a high-risk group of girls with self or parent reported histories of abuse and neglect. Interventions that address externalizing problems and health risk behaviors may be of particular importance for this population. Copyright © 2015. Published by Elsevier Ltd.

Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models

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Praditsitthikorn Naiyana

2011-05-01

Full Text Available Abstract Background The World Health Organization (WHO recommends that the cost effectiveness of introducing human papillomavirus (HPV vaccination is considered before such a strategy is implemented. However, developing countries often lack the technical capacity to perform and interpret results of economic appraisals of vaccines. To provide information about the feasibility of using such models in a developing country setting, we evaluated models of HPV vaccination in terms of their capacity, requirements, limitations and comparability. Methods A literature review identified six HPV vaccination models suitable for low-income and middle-income country use and representative of the literature in terms of provenance and model structure. Each model was adapted by its developers using standardised data sets representative of two hypothetical developing countries (a low-income country with no screening and a middle-income country with limited screening. Model predictions before and after vaccination of adolescent girls were compared in terms of HPV prevalence and cervical cancer incidence, as was the incremental cost-effectiveness ratio of vaccination under different scenarios. Results None of the models perfectly reproduced the standardised data set provided to the model developers. However, they agreed that large decreases in type 16/18 HPV prevalence and cervical cancer incidence are likely to occur following vaccination. Apart from the Thai model (in which vaccine and non-vaccine HPV types were combined, vaccine-type HPV prevalence dropped by 75% to 100%, and vaccine-type cervical cancer incidence dropped by 80% to 100% across the models (averaging over age groups. The most influential factors affecting cost effectiveness were the discount rate, duration of vaccine protection, vaccine price and HPV prevalence. Demographic change, access to treatment and data resolution were found to be key issues to consider for models in developing countries

Human papillomavirus vaccine introduction in low-income and middle-income countries: guidance on the use of cost-effectiveness models.

Science.gov (United States)

Jit, Mark; Demarteau, Nadia; Elbasha, Elamin; Ginsberg, Gary; Kim, Jane; Praditsitthikorn, Naiyana; Sinanovic, Edina; Hutubessy, Raymond

2011-05-12

The World Health Organization (WHO) recommends that the cost effectiveness of introducing human papillomavirus (HPV) vaccination is considered before such a strategy is implemented. However, developing countries often lack the technical capacity to perform and interpret results of economic appraisals of vaccines. To provide information about the feasibility of using such models in a developing country setting, we evaluated models of HPV vaccination in terms of their capacity, requirements, limitations and comparability. A literature review identified six HPV vaccination models suitable for low-income and middle-income country use and representative of the literature in terms of provenance and model structure. Each model was adapted by its developers using standardised data sets representative of two hypothetical developing countries (a low-income country with no screening and a middle-income country with limited screening). Model predictions before and after vaccination of adolescent girls were compared in terms of HPV prevalence and cervical cancer incidence, as was the incremental cost-effectiveness ratio of vaccination under different scenarios. None of the models perfectly reproduced the standardised data set provided to the model developers. However, they agreed that large decreases in type 16/18 HPV prevalence and cervical cancer incidence are likely to occur following vaccination. Apart from the Thai model (in which vaccine and non-vaccine HPV types were combined), vaccine-type HPV prevalence dropped by 75% to 100%, and vaccine-type cervical cancer incidence dropped by 80% to 100% across the models (averaging over age groups). The most influential factors affecting cost effectiveness were the discount rate, duration of vaccine protection, vaccine price and HPV prevalence. Demographic change, access to treatment and data resolution were found to be key issues to consider for models in developing countries. The results indicated the usefulness of considering

Maternal Characteristics Associated with Television Viewing Habits of Low-Income Preschool Children

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Conners, Nicola A.; Tripathi, Shanti P.; Clubb, Richard; Bradley, Robert H.

2007-01-01

Few studies have examined maternal characteristics associated with heavy or inappropriate television viewing on the part of their children. We investigated the relationship between children's television viewing habits and maternal depressive symptoms and parenting beliefs. The participants were 175 low income children (mean age = 62.1 months) and…

Social Support and Low-Income, Urban Mothers: Longitudinal Associations with Adolescent Delinquency

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Ghazarian, Sharon R.; Roche, Kathleen M.

2010-01-01

The current study examined the role of engaged parenting in explaining longitudinal associations between maternal perceptions of social network support and whether youth engage in delinquent behaviors during the transition into adolescence. The sample included 432 low-income, African American and Latino youth (49% female) and their mothers…

Low-Income Mothers' Food Practices with Young Children: A Qualitative Longitudinal Study

Science.gov (United States)

Harden, Jeni; Dickson, Adele

2015-01-01

Objective: Young children living in socioeconomically deprived areas of Scotland have an increased risk of becoming overweight or obese. To enhance understanding of the wider contexts within which family food practices are developed, this study examined the experiences of low-income mothers with young children. Design: Qualitative longitudinal…

Does Early Paternal Parenting Promote Low-Income Children's Long-Term Cognitive Skills?

Science.gov (United States)

Coley, Rebekah Levine; Lewin-Bizan, Selva; Carrano, Jennifer

2011-01-01

Although scholars and policy makers herald the promotive influence of fathers' parenting involvement, limited research has carefully delineated effects of fathers' parenting on low-income children's development and whether early contributions from fathers confer long-term protective effects. Using data from the Three-City Study (N = 261), analyses…

Measurement of social capital in relation to health in low and middle income countries (LMIC): a systematic review.

Science.gov (United States)

Agampodi, Thilini Chanchala; Agampodi, Suneth Buddhika; Glozier, Nicholas; Siribaddana, Sisira

2015-03-01

Social capital is a neglected determinant of health in low and middle income countries. To date, majority of evidence syntheses on social capital and health are based upon high income countries. We conducted this systematic review to identify the methods used to measure social capital in low and middle-income countries and to evaluate their relative strengths and weaknesses. An electronic search was conducted using Pubmed, Science citation index expanded, Social science citation index expanded, Web of knowledge, Cochrane, Trip, Google scholar and selected grey literature sources. We aimed to include all studies conducted in low and middle-income countries, published in English that have measured any aspect of social capital in relation to health in the study, from 1980 to January 2013. We extracted data using a data extraction form and performed narrative synthesis as the measures were heterogeneous. Of the 472 articles retrieved, 46 articles were selected for the review. The review included 32 studies from middle income countries and seven studies from low income countries. Seven were cross national studies. Most studies were descriptive cross sectional in design (n = 39). Only two randomized controlled trials were included. Among the studies conducted using primary data (n = 32), we identified18 purposely built tools that measured various dimensions of social capital. Validity (n = 11) and reliability (n = 8) of the tools were assessed only in very few studies. Cognitive constructs of social capital, namely trust, social cohesion and sense of belonging had a positive association towards measured health outcome in majority of the studies. While most studies measured social capital at individual/micro level (n = 32), group level measurements were obtained by aggregation of individual measures. As many tools originate in high income contexts, cultural adaptation, validation and reliability assessment is mandatory in adapting the tool to the study setting. Evidence

EARLY HEAD START FAMILIES' EXPERIENCES WITH STRESS: UNDERSTANDING VARIATIONS WITHIN A HIGH-RISK, LOW-INCOME SAMPLE.

Science.gov (United States)

Hustedt, Jason T; Vu, Jennifer A; Bargreen, Kaitlin N; Hallam, Rena A; Han, Myae

2017-09-01

The federal Early Head Start program provides a relevant context to examine families' experiences with stress since participants qualify on the basis of poverty and risk. Building on previous research that has shown variations in demographic and economic risks even among qualifying families, we examined possible variations in families' perceptions of stress. Family, parent, and child data were collected to measure stressors and risk across a variety of domains in families' everyday lives, primarily from self-report measures, but also including assay results from child cortisol samples. A cluster analysis was employed to examine potential differences among groups of Early Head Start families. Results showed that there were three distinct subgroups of families, with some families perceiving that they experienced very high levels of stress while others perceived much lower levels of stress despite also experiencing poverty and heightened risk. These findings have important implications in that they provide an initial step toward distinguishing differences in low-income families' experiences with stress, thereby informing interventions focused on promoting responsive caregiving as a possible mechanism to buffer the effects of family and social stressors on young children. © 2017 Michigan Association for Infant Mental Health.

Acute Kidney Injury Recognition in Low- and Middle-Income Countries

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Jorge Cerdá

2017-07-01

Full Text Available Acute kidney injury (AKI is increasingly common around the world. Because of the low availability of effective therapies and resource limitations, early preventive and therapeutic measures are essential to decrease morbidity, mortality, and cost. Timely recognition and diagnosis of AKI requires a heightened degree of suspicion in the appropriate clinical and environmental context. In low- and middle-income countries (LMICs, early detection is impaired by limited resources and low awareness. In this article, we report the consensus recommendations of the 18th Acute Dialysis Quality Initiative meeting in Hyderabad, India, on how to improve recognition of AKI. We expect these recommendations will lead to an earlier and more accurate diagnosis of AKI, and improved research to promote a better understanding of the epidemiology, etiology, and histopathology of AKI in LMICs.

"So we would all help pitch in:" The family literacy practices of low-income African American mothers of preschoolers.

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Jarrett, Robin L; Hamilton, Megan-Brette; Coba-Rodriguez, Sarai

2015-01-01

The development of emergent literacy skills are important for the development of later literacy competencies and affect school readiness. Quantitative researchers document race- and social class-based disparities in emergent literacy competence between low-income African American and middle-income White children. Some researchers suggest that deficits in parenting practices account for limited literacy skills among low-income African American children. A small body of qualitative research on low-income African American families finds that despite economic challenges, some African American families were actively engaged in promoting child literacy development. Using qualitative interviews that emphasize family strengths, we add to this small body of research to highlight positive family practices obscured in many quantitative analyses that concentrate on family shortcomings. Specifically, we examine in-home literacy practices and child literacy development with a sample of low-income African American mothers (families) of preschoolers. Key findings include identification of various literacy activities promoting child literacy development and inclusion of multiple family members assisting in literacy activities. These findings add to substantive discussions of emergent literacy and resilience. Insights from the qualitative interviews also provide culturally-sensitive recommendations to childhood educators and speech-language pathologists (SLP) who work with low-income African American families and children. Reader should recognize that (1) there is not a 'right' phenotype and therefore not a right form of environmental input and (2) that context matters (at both the level of the cell and the individual organism). Copyright © 2015 Elsevier Inc. All rights reserved.

Maternal mental health, and child growth and development, in four low-income and middle-income countries.

Science.gov (United States)

Bennett, Ian M; Schott, Whitney; Krutikova, Sofya; Behrman, Jere R

2016-02-01

Extend analyses of maternal mental health and infant growth in low- and middle-income countries (LMICs) to children through age eight years, and broaden analyses to cognitive and psychosocial outcomes. Community-based longitudinal cohort study in four LMICs (Ethiopia, India, Peru and Vietnam). Surveys and anthropometric assessments were carried out when the children were approximately ages 1, 5 and 8 years. Risk of maternal common mental disorders (rCMDs) was assessed with the Self-Reporting Questionnaire (SRQ)-20 (score ≥8). Rural and urban as well as low- and middle-income communities. 7722 mothers and their children. Child stunting and underweight (Z score ≤2 of height and weight for age), and development (Peabody Picture Vocabulary Test), and the psychosocial outcomes self pride and life satisfaction. A high rate of rCMD, stunting and underweight was seen in the cohorts. After adjusting for confounders, significant associations were found between maternal rCMDs and growth variables in the first year of life, with persistence to age 8 years in India and Vietnam, but not in the other countries. India and Vietnam also showed significant associations between rCMDs and lower cognitive development. After adjustment, rCMD was associated with low life satisfaction in Ethiopia but not in the other cohorts. Associations of maternal rCMD in the first year of life with child outcomes varied across the study cohorts and, in some cases, persisted across the first 8 years of life of the child, and included growth, cognitive development and psychosocial domains. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Factors that influence a career choice in primary care among medical students from high-, middle-, and low-income countries: a systematic review

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E. Benjamín Puertas

2013-11-01

Full Text Available OBJECTIVE: To determine which factors influence a medical student's decision to choose a career in primary care; and to establish if these factors are similar or different among students in high-, middle- and low-income countries. METHODS: An extensive search was done of PubMed, Google Scholar, and Virtual Library of Health for articles on primary care careers published in 2003-2013 in English, Spanish, and/or Portuguese. Initially, 600 records were identified; 74 full-text articles were assessed for eligibility and 55 were selected (42 from high-income countries; 13 from middle- and low-income. These were assessed to identify intrinsic and extrinsic factors that influence career choice among medical students from high-, middle-, and low-income countries. RESULTS: A comparison framework with common and specific factors that influence career choice in primary care among medical students from high-, middle- and low-income was developed. Factors were classified as extrinsic or intrinsic, and as facilitators or barriers. Several factors common to all countries were identified: facilitators were exposure to rural location, role models, working conditions; barriers were low income, prestige, and medical school environment. Some factors specific to middle- and low-income countries were: understanding of rural needs and intellectual challenge. Other factors specific to high-income countries were: attitude towards social problems, voluntary work, influence of family, and length of residency. CONCLUSIONS: Further studies on the subject are needed, especially in low- and middle-income countries. Identifying factors as barriers or facilitators for career choice will promote a better understanding of the reasons behind the shortage of primary care professionals and will contribute to policy building, improved training, and recruitment and retention of these professionals.

Using qualitative methods to design a culturally appropriate child feeding questionnaire for low-income, Latina mothers.

Science.gov (United States)

Lindsay, Ana Cristina; Sussner, Katrina Mucha; Greaney, Mary; Wang, Monica L; Davis, Rachel; Peterson, Karen E

2012-05-01

Obesity rates remain high among children in the United States (US), but children of low-income, minority families are at particularly high risk. Latinos are the largest and most rapidly growing US population group. Effective strategies will require attention to a wide array of culturally mediated variables that influence child feeding practices through the social contexts in which behaviors take place. This paper presents the design and implementation of a qualitative study examining low-income, Latina mothers' perceptions of child weight status and feeding practices, and their associations with the development of overweight in children. Guided by the social ecologic model and social contextual model on the role of the family in mediating health behavior, the Latina Mother Child Feeding Practices (LMCFP) study provided a systematic exploration of the influence of social class, culture, and environmental factors associated with mothers' perceptions of child overweight on feeding practices and behaviors. The design for this qualitative study consisted of three sequential phases: focus groups, in-depth interviews and cognitive interviews with Latina mothers conducted by Spanish-speaking researchers. Results showed the important role of socio-cultural factors in influencing Latina mothers' child feeding practices. In the short-term, this research yielded information to develop a child-feeding questionnaire appropriate for low-income, Latina mothers. Findings have important implications in developing nutrition education strategies for child health promotion that account for the social and cultural context of minority, low-income caregivers.

Determinants of electricity demand for newly electrified low-income African households

International Nuclear Information System (INIS)

Louw, Kate; Conradie, Beatrice; Howells, Mark; Dekenah, Marcus

2008-01-01

Access to clean, affordable and appropriate energy is an important enabler of development. Energy allows households to meet their most basic subsistence needs; it is a central feature of all the millennium development goals (MDGs) and, while a lack of access to energy may not be a cause of poverty, addressing the energy needs of the impoverished lets them access services which in turn address the causes of poverty. While much is known about the factors affecting the decisions made when choosing between fuel types within a household, few quantitative studies have been carried out in South Africa to determine the extent to which these factors affect energy choice decisions. It is assumed that the factors traditionally included in economic demand such as price and income of the household affect choice; tastes and preferences as well as external factors such as distance to fuel suppliers are expected to influence preferences. This study follows two typical low-income rural sites in South Africa, Antioch and Garagapola, where the Electricity Basic Services Support Tariff (EBSST) was piloted in 2002. The EBSST is set at 50 kWh/month per household for low domestic consumers; this is worth approximately R20 (±US$3). This subsidy is a lifeline tariff, where households receive the set amount of units per month, free of charge irrespective of whether more units are purchased. These data (collected in 2001 and 2002), recently collated with detailed electricity consumption data, allow us to determine the drivers of electricity consumption within these households. The sample analysed is taken from the initial phase of the study, when no FBE had been introduced to the households. This enabled the study presented here to make use of the well-populated datasets to assess what affects the electricity use decision in these households. This paper attempts to assess which factors affected the decision-making process for electricity consumption within these households. A brief history

Comparison of motives underlying food choice and barriers to healthy eating among low medium income consumers in Uruguay

Directory of Open Access Journals (Sweden)

Gastón Ares

Full Text Available Abstract: Interventions aimed at changing dietary patterns should be designed based on the main motives underlying the food choices of specific target populations. The aim of the present study was to identify motives underlying food choice and barriers to healthy eating among consumers in two socioeconomic levels in Uruguay. Eleven focus groups were carried out with a total of 76 participants. Six of the groups involved low income participants and the others were conducted with middle income participants. Discussions were held around frequently consumed products, motives underlying food choices and barriers to healthy eating. Results confirmed the strong influence of income level on motives underlying food choice and barriers to the adoption of healthy eating. Low income participants described their choices as mainly driven by economic factors and satiety, whereas convenience was the main determinant of food selection for middle income participants. Implications for the design of public policies targeted at each group are discussed.

Comparison of motives underlying food choice and barriers to healthy eating among low medium income consumers in Uruguay.

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Ares, Gastón; Machín, Leandro; Girona, Alejandra; Curutchet, María Rosa; Giménez, Ana

2017-05-18

Interventions aimed at changing dietary patterns should be designed based on the main motives underlying the food choices of specific target populations. The aim of the present study was to identify motives underlying food choice and barriers to healthy eating among consumers in two socioeconomic levels in Uruguay. Eleven focus groups were carried out with a total of 76 participants. Six of the groups involved low income participants and the others were conducted with middle income participants. Discussions were held around frequently consumed products, motives underlying food choices and barriers to healthy eating. Results confirmed the strong influence of income level on motives underlying food choice and barriers to the adoption of healthy eating. Low income participants described their choices as mainly driven by economic factors and satiety, whereas convenience was the main determinant of food selection for middle income participants. Implications for the design of public policies targeted at each group are discussed.

Simulation in Pre-departure Training for Residents Planning Clinical Work in a Low-Income Country

Directory of Open Access Journals (Sweden)

Kevin R. Schwartz

2015-12-01

Full Text Available Introduction: Increasingly, pediatric and emergency medicine (EM residents are pursuing clinical rotations in low-income countries. Optimal pre-departure preparation for such rotations has not yet been established. High-fidelity simulation represents a potentially effective modality for such preparation. This study was designed to assess whether a pre-departure high-fidelity medical simulation curriculum is effective in helping to prepare residents for clinical rotations in a low-income country. Methods: 43 pediatric and EM residents planning clinical rotations in Liberia, West Africa, participated in a simulation-based curriculum focused on severe pediatric malaria and malnutrition and were then assessed by survey at three time points: pre-simulation, post-simulation, and after returning from work abroad. Results: Prior to simulation, 1/43 (2% participants reported they were comfortable with the diagnosis and management of severe malnutrition; this increased to 30/42 (71% after simulation and 24/31 (77% after working abroad. Prior to simulation, 1/43 (2% of residents reported comfort with the diagnosis and management of severe malaria; this increased to 26/42 (62% after simulation and 28/31 (90% after working abroad; 36/42 (86% of residents agreed that a simulation-based global health curriculum is more useful than a didactic curriculum alone, and 41/42 (98% felt a simulator-based curriculum should be offered to all residents planning a clinical trip to a low-income country. Conclusion: High-fidelity simulation is effective in increasing residents’ self-rated comfort in management of pediatric malaria and malnutrition and a majority of participating residents feel it should be included as a component of pre-departure training for all residents rotating clinically to low-income countries.

Maternal employment and the health of low-income young children.

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Gennetian, Lisa A; Hill, Heather D; London, Andrew S; Lopoo, Leonard M

2010-05-01

This study examines whether maternal employment affects the health status of low-income, elementary-school-aged children using instrumental variables estimation and experimental data from a welfare-to-work program implemented in the early 1990s. Maternal report of child health status is predicted as a function of exogenous variation in maternal employment associated with random assignment to the experimental group. IV estimates show a modest adverse effect of maternal employment on children's health. Making use of data from another welfare-to-work program we propose that any adverse effect on child health may be tempered by increased family income and access to public health insurance coverage, findings with direct relevance to a number of current policy discussions. In a secondary analysis using fixed effects techniques on longitudinal survey data collected in 1998 and 2001, we find a comparable adverse effect of maternal employment on child health that supports the external validity of our primary result.

Factors Influencing the General Well-Being of Low-Income Korean Immigrant Elders

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Lee, Kyoung Hag; Yoon, Dong Pil

2011-01-01

This study explores factors that influence the general well-being (anxiety, depression, positive well-being, self-control, vitality, and general health) of low-income Korean immigrant elders by interviewing 206 older adults living in Los Angeles County and Orange County, California. Ordinary least squares regression results reveal that lack of…

Maternal Correlates of Growth in Toddler Vocabulary Production in Low-Income Families

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Pan, Barbara Alexander; Rowe, Meredith L.; Singer, Judith D.; Snow, Catherine E.

2005-01-01

This study investigated predictors of growth in toddlers' vocabulary production between the ages of 1 and 3 years by analyzing mother-child communication in 108 low-income families. Individual growth modeling was used to describe patterns of growth in children's observed vocabulary production and predictors of initial status and between-person…

Reading and Comprehension Levels in a Sample of Urban, Low-Income Persons

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Delgado, Cheryl; Weitzel, Marilyn

2013-01-01

Objective: Because health literacy is related to healthcare outcomes, this study looked at reading and comprehension levels in a sample of urban, low-income persons. Design: This was a descriptive exploration of reading comprehension levels, controlled for medical problems that could impact on vision and therefore ability to read. Setting: Ninety…

Uncommon social trajectories: Chilean low-income adolescents with reading skills

Directory of Open Access Journals (Sweden)

Iván Ortiz

2013-07-01

Full Text Available It is generally believed that students from low-income families are less successful at school, as indicated by theories of social reproduction. This article focuses on Chilean students that, in spite of their social background, have performed well in the Programme for International Student Assessment (PISA 2009. Using logistic regression analysis we identify factors associated with academic achievement in reading. Results show that student variables have a greater explanatory value than family and school variables.

"Broken windows": Relationship between neighborhood conditions and behavioral health among low-income African American adolescents.

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Voisin, Dexter R; Kim, Dong Ha

2018-03-01

This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.

Social Competence among Low-Income Preschoolers: Emotion Socialization Practices and Social Cognitive Correlates.

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Garner, Pamela W.; And Others

1994-01-01

Two studies investigated the relationship between emotion socialization variables, social cognitive knowledge, and children's social competence in preschoolers from low-income families. Found that mothers' self-reported emotion socialization practices were related to children's emotional knowledge and sibling caregiving behavior. (MDM)

Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

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Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

2014-01-01

Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

Acceptability of the integral solar water heater by householders in the low income urban community

CSIR Research Space (South Africa)

Basson, FA