Search Results (995)

This study investigated relationships between low-income children’s food insecurity and five factors: social disorganization, social structural factors, social relationships, health/mental health, and access to services. A sample of 12,215 low-income children and parents was extracted from the 2021 National Survey of Children’s Health. Logistic regression results showed the likelihood of such children’s food insecurity to be associated positively with several factors: racial discrimination, child aged 6–10 years, child aged 11–13 years, child aged 14–17 years, Black child, child’s chronic health condition, family member mental health problem, Supplemental Nutrition Assistance Program participation, receipt of Special Supplemental Nutrition Program for Women, Infants, and Children, and lunch program participation. As well, children’s food insecurity likelihood was associated negatively with parents’ age and education, neighbor support, parents’ general health and mental health, and receipt of Temporary Assistance for Needy Families. Research implications include interventions at the individual level (e.g., screening for food insecurity, treatment of sick or mentally ill family members), community level (e.g., food pantries, neighbor support network), and macro level (e.g., advocating for racial/ethnic minorities, expanding cash and food benefits). Full article

Newborn screening (NBS) is an established public health intervention capable of preventing death, disability, and lifelong disease through early identification and treatment of affected newborns. However, equitable access to NBS remains limited, particularly in low- and middle-income countries (LMICs), where most serious birth defects occur. The 2024 World Health Assembly resolution WHA77.5 and the newly published World Health Organization (WHO) newborn screening framework provide an important global mandate and practical roadmap for expanding NBS, diagnosis, treatment, and long-term care. The framework reviewed by De Costa et al. emphasizes that NBS is a continuum of care encompassing screening, diagnostic confirmation, treatment, follow-up, rehabilitation, developmental services, and family support. Successful implementation requires quality assurance across the entire pathway, including specimen collection, laboratory testing, reporting, tracking, diagnostic services, and treatment, with external proficiency testing where appropriate. Programs should begin with condition(s) for which disease burden, effective treatment, screening feasibility, and health system capacity are aligned, and should expand progressively as capacity develops. Sustainable financing, trained personnel, information systems, referral networks, and national government stewardship are essential. Rather than replicating high-income-country models, LMICs should develop locally appropriate, scalable programs based on quality, equity, effectiveness, and continuity of care. The challenge now is to translate the WHO framework into sustainable national action. Full article

Reducing relative poverty among rural households is important for inclusive and sustainable development. Using balanced panel data from the China Family Panel Studies (CFPS) for 2016–2022, this study draws on the Sustainable Livelihoods Framework and resilience theory to examine the relationships among natural risk, health risk, livelihood resilience, and relative poverty depth. A two-way fixed-effects model is used to estimate the association between livelihood resilience and relative poverty depth and the moderating role of resilience in the risk–poverty relationship. In the baseline specifications, both natural and health risks are positively and significantly associated with greater relative poverty depth, whereas livelihood resilience is associated with lower poverty depth. The interaction estimates indicate weaker positive associations between both risks and relative poverty at higher levels of resilience, with more stable results for health risk across specifications. The findings are broadly robust to alternative measures, samples, and estimation methods, and controls for other risks and policy environments. Subgroup estimates are generally larger among low-income households, and the negative health-risk interaction is marginally significant among households with elderly members. The association of natural risk with relative poverty is more evident in the short term, whereas the association with health risk is more persistent. Analysis of indirect associations supports a liquidity-constraint pathway for the natural-risk interaction. Evidence for the corresponding health-risk indirect association depends on the confidence-interval procedure, while indirect associations through debt pressure are not supported at the 5% level. The health-risk findings are comparatively stable, whereas the statistical significance of the natural-risk estimates, particularly the interaction term, is sensitive to spatial clustering. Full article

As infectious causes of child mortality decline, birth defects represent a growing relative proportion of neonatal and under-five deaths (as well as unmeasured morbidity) in low- and middle-income countries (LMICs), underscoring the need to integrate their prevention, detection and care into child health agendas. In response to World Health Assembly resolution WHA77.5, the World Health Organization (WHO) convened global consultations with LMIC programme leaders, experts, academics, civil society, affected persons and families to develop a framework for integrating newborn screening, diagnosis and management of birth defects into national health systems. This communication summarizes key lessons from country experience and sets out the core principles for implementation captured in the framework: start with one or a few feasible, high-impact conditions; link screening to diagnosis, management and long-term follow-up; assess health-system readiness before scale-up; secure sustainable financing; strengthen data systems; and provide family-centred support. The recent WHO report ‘Strengthening Newborn Screening, Diagnosis and Management of Birth Defects’ focused on LMICs and offers a pragmatic pathway for countries to expand newborn screening equitably while building the services needed to improve survival, functioning and quality of life for children with congenital conditions. Full article

Parenting practices involving violent discipline are a global health concern, particularly among low-income families. While the current literature offers general prevalence data, it lacks a comprehensive global perspective evaluating how diverse sociodemographic, cultural, and historical contexts intersect within disadvantaged households. This scoping review protocol aims to map the global evidence on parenting practices related to physical and psychological violence used as disciplinary practices against children within low-income contexts. Following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines, we will conduct a comprehensive search across databases, including MEDLINE/PubMed (via the National Library of Medicine), CINAHL (EBSCO), APA PsycINFO (APA), Embase (Elsevier), ERIC, IBECS (via the VHL) and the WHO Global Index Medicus to capture global evidence published in recent years. Studies published in English, Portuguese, and Spanish between January 2015 and June 2026 that report violent disciplinary practices by parents or caregivers of children aged 1–8 years will be included. Rayyan software will assist with study selection. Mapping these practices across diverse socioeconomic settings may clarify current research gaps and synthesize the characteristics of families globally, shifting the interpretation of violent discipline from isolated parental choices to broader understanding of its social determinants and providing a clearer baseline to support future child protection research. Full article

Background: Breastfeeding myths held by healthcare professionals may affect the accuracy and consistency of counseling provided to women and families. This study evaluated nursing and midwifery students’ breastfeeding myths and associated factors. Methods: This descriptive, cross-sectional study included 218 nursing and midwifery students at a university in Türkiye. Data were collected using a Personal Information Form and the Breastfeeding Myths Scale (BMS). Descriptive statistics, nonparametric tests, Spearman correlation, and a multivariable generalized linear model with robust covariance estimates were used. Results: The mean age was 21.24 ± 1.80 years, and 196 participants (89.9%) were female. The mean BMS score was 67.43 ± 16.39; 214 students (98.2%) had low myth levels and 4 (1.8%) had high levels. In unadjusted analyses, scores differed by gender, department, academic year, family breastfeeding experience, perceived knowledge, and age. In the adjusted model, female students had lower scores than male students (B = −9.481, 95% CI: −18.261 to −0.700, p = 0.034), nursing students had lower scores than midwifery students (B = −4.557, 95% CI: −8.321 to −0.793, p = 0.018), and each one-year increase in age was associated with a 1.52-point decrease in BMS scores (B = −1.524, 95% CI: −2.884 to −0.163, p = 0.028). Academic year, parental education, family income, family breastfeeding experience, and perceived knowledge were not independently associated with BMS scores. Conclusions: Most students had low levels of breastfeeding myths. Female gender, nursing enrollment, and older age were associated with lower BMS scores; however, the gender finding should be interpreted cautiously because all male participants were nursing students. Full article

As a market-based and cost-effective policy instrument for steering economies toward a more sustainable and low-carbon future, carbon tax has gained widespread attention globally. Nevertheless, introducing carbon tax in developing economies remains highly controversial due to potential adverse impacts on microeconomic agents, particularly concerning poverty and income inequality. Using data from the China Family Panel Studies, this paper characterizes the behavioral responses of micro-level agents and adopts a Computable General Equilibrium (CGE) model combined with Micro Simulation (MS) approach to dynamically simulate the behavioral reactions of individuals and households after the implementation of carbon tax in China from 2025 to 2035. The results show that: (1) Implementing an industry-differentiated carbon tax in China will not be regressive, and the public need not be concerned about the resurgence of poverty; (2) Carbon tax exerts stronger adverse impacts on high-income groups than on low-income households, thereby facilitating income equity; (3) Although allocating carbon tax revenue to subsidize the clean power generation sector can further narrow income gap, it concurrently leads to a reduction in resource allocation efficiency. By combining targeted social protection policies such as energy assistance and benefit compensation, government can minimize the negative impacts of carbon tax on vulnerable groups. Full article

Introduction: India’s immunization initiatives are among the largest globally, characterized by a substantial birth cohort of 27 million children annually, and have achieved significant progress in increasing coverage through the UIP. However, there are still challenges that persist, and multiple determinants contribute to the existing challenges; migration is one of them. Migration has always been a key driver of socio-economic and demographic changes, particularly in low and middle-income countries (LMICs). Specifically, there is a need to better understand the vulnerabilities of immunization among recent migrants. To examine this, the study explores the association between a mother’s recent migration and the full immunization coverage of children aged 12–23 months in India. Data & Methods: Our study utilized data from the National Family Health Survey-5 (2019–21). The outcome variable of interest in this study is the full immunization among children aged 12–23 months (receipt of all basic vaccinations). The primary predictor variable in this study was recent maternal migration, defined as the mother’s duration of residence at the current place of residence. We used a series of multivariate logistic regression models to examine the relationship between full Immunization among children and maternal migration status, with some data restrictions in the models. Results: The results show a 17 percentage-point difference in full immunization between children of migrant and non-migrant mothers. The adjusted odds ratios of children of mothers who had recently migrated had significantly lower odds of full immunization (aOR: 0.39, 95% CI: 0.35–0.43) compared to children whose mothers had not recently migrated. Even across the household wealth quintile and social groups, the recent migration of the mother was associated with being less likely to be fully immunized among children 12–23 months. Conclusions: The findings of this study provide significant quantitative evidence that recent migration (less than 3 years) of mother is a key factor influencing Immunization coverage and is a predictor of full immunization among children aged 12–23 months in India. The recent migration was consistently linked with lower odds of full immunization coverage across different household wealth levels and social groups. This study suggests that children of recently migrated mother are a vulnerable subgroup of the population at risk of not receiving full immunization among children aged 12–23 months. Full article

Background: Loneliness in older adults is a global public health problem. Although robust evidence exists regarding its consequences, the evidence base is marked by a bias towards high-income countries and urban contexts. The rural Peruvian Amazon is a territory virtually absent from the scientific literature on ageing and loneliness. Methods: We conducted a descriptive–interpretive qualitative study based on 34 semi-structured interviews with adults aged 60 years and over, recruited through Cáritas-Requena. Analysis followed the reflexive thematic analysis framework. Purposive sampling with maximum variation criteria was employed. The study was complemented by a quantitative characterisation using the Barthel Index, the LSNS-6 scale, and the DUKE-UNC-11 questionnaire. Results: Four themes emerged: (1) structural and functional conditions as the substrate of loneliness; (2) family reconfiguration driven by internal migration, with notable prominence of skipped-generation households (grandparents caring for grandchildren); (3) lived experiences of emotional and social loneliness, including a contextual pattern of feeling lonely despite the physical presence of others, which we descriptively label “paradoxical loneliness”; and (4) coping resources, including faith, work, neighbourhood networks, non-human companionship, and habituation. The descriptive relational measures showed different distributions: objective social isolation (LSNS-6 < 12) was observed in 12.5% of participants, whereas low perceived functional social support (DUKE-UNC-11 < 32) was observed in 68.8%; these measures assess distinct constructs and were used solely to contextualise the qualitative findings. Conclusions: Among the service-connected older adults included in this study, loneliness was shaped by the interaction of family reconfiguration, material and health-related conditions, and locally available coping resources. The experience of feeling lonely despite the physical presence of others was compatible with Perlman and Peplau’s cognitive discrepancy model and is presented here as a context-specific interpretive pattern rather than as an independent dimension of loneliness. Full article

Smallholder and family farms underpin Mediterranean horticulture, yet their incomes are exposed to price risk because they sell as price-takers in opaque channels. In Ierapetra, Crete, greenhouse vegetables are traded at several independent physical auctions. This study quantifies within-venue price risk using 6281 product-day observations (daily minimum, maximum and mean prices) for six greenhouse products, November 2019–May 2026. Four indicators are computed per product-day: within-day relative spread, daily price change, coefficient of variation and a downside income-at-risk gap. Dispersion is compared across products against a reference band built from the within-day spreads of the three higher-priced products (p25–p75), a common descriptive yardstick drawn from the data themselves. On the same day, the highest price exceeds the lowest by 23% on average, and by above 100% on extreme days. A low-end seller earns 16–19% below the daily mean for commodities. The contrasts survive restriction to actively traded days and comparison at equal price levels. All series come from a single operator: the analysis therefore documents dispersion within one venue, and the contribution of fragmentation across venues remains open. Price risk is treated as a determinant of farm resilience rather than a measure of it; a unified, transparent digital auction is assessed as a design-conditional adaptation, its effect hinging on buyer participation, product representation and grading. Full article

In the context of global climate change, understanding how extreme heat affects energy poverty is critical for both policy and household welfare. This study investigates the association between heat shocks and energy poverty among rural households in China, using data from the China Family Panel Studies (CFPS) and NASA climate records. We find that heat shocks are positively and significantly associated with greater energy poverty, with northern households and those farther from provincial capitals being most vulnerable. Income heterogeneity is also important: low-income households exhibit weaker increases in energy expenditures under heat shocks, indicating that affordability constraints can mask their energy deprivation. This reveals the presence of hidden energy poverty, which conventional objective measures may underestimate. Moreover, the dynamic inter-wave cumulative estimates indicate persistent associations between heat shocks and household energy poverty, suggesting limited adaptive capacity among some rural households. Our results are robust across multiple heat-shock indicators. These findings provide household-level evidence on the pathways through which climate shocks shape energy poverty and underscore the need for targeted interventions to enhance adaptive capacity and protect vulnerable populations in rural China. Full article

Autism is a prevalent neurodevelopmental disability among children in the United States. Enhanced Milieu Teaching (EMT) en Español Para Autismo is a caregiver-implemented language-focused naturalistic developmental behavioral intervention specifically for young children on the autism spectrum whose families are Latino and Spanish-speaking. The current study tested a reduced intensity adaptation of EMT en Español Para Autismo using a single-case experimental design study with four caregiver–child dyads. All children demonstrated characteristics of autism and lived in low-income Spanish-speaking households. Caregivers were taught to use EMT en Español Para Autismo strategies during play with their child using a cyclical teach–model–coach–review approach. Home visits occurred once each week. Three out of four dyads completed the study. None of the caregivers demonstrated functional relations between the cyclical teach–model–coach–review approach and their use of strategies; however, caregivers did increase their use of contingent language models and time delays when intervention began. Caregiver impressions of the intervention were positive, but they varied in their perceptions of some of the strategies (e.g., limiting instructions), consistent with participants in prior studies. Overall, the reduced intensity of the intervention and long gaps between visits may have limited the effectiveness of this intervention compared to findings in prior studies. More research is needed to tailor language interventions for Latino Spanish-speaking families with autistic children, especially those with limited resources. Full article

Ecuadorian aquaculture plays an increasingly important role in food security, providing a sustainable complement to capture fisheries. Manabí constitutes a key economic sector that contributes to employment generation, income diversification, and supply of high-quality protein. However, the sector’s heterogeneity and limited legal registration of enterprises hinder the development of policies and targeted interventions. This study characterizes aquaculture enterprises in Manabí, integrating productive, technological, and socio-economic variables obtained from field surveys. Three distinct entrepreneurship patterns were identified: small-scale, informal farms cultivating native species with low technology but characteristics that may contribute to socio-ecological resilience; semi-formal producers operating with intermediate technology and mixed species; and freshwater shrimp farms operating at the largest relative scale within the sample, though still small-scale and family-based, with moderate technological development and market integration limited mainly to local and regional markets. The typology focused on a gradient in formalization, technological sophistication, and market orientation among enterprises. These findings provide a comprehensive understanding of aquaculture diversity in Manabí and offer a practical framework for differentiated policy design using a Strategic Producer Positioning Map. Strengthening formalization, technological innovation, environmental management, and social inclusion is essential to enhance the sector’s sustainability and competitiveness, contributing to sustainable blue economy development in coastal Ecuador. Full article

Background: Child sexual abuse is a major public health concern, particularly for children from socioeconomically disadvantaged families. This study examined the effect of a body safety training (BST) program on the self-protection skills of preschool children from low-income families. Methods: This one-group pretest–posttest quasi-experimental study was conducted with 32 children aged 4–6 years attending a public kindergarten located in a low-income neighborhood in Türkiye. The children participated in a seven-session BST program. Data were collected via the What If Situations Test (WIST), with assessments conducted before and after the intervention. Differences between the pretest and posttest scores were analyzed via the Wilcoxon signed-rank test, and effect sizes (r) were calculated. Results: Statistically significant improvements were observed in the WIST subscales of appropriate touching recognition, inappropriate touching recognition, Saying skill, Doing skill, Telling skill, and Reporting skill, as well as in the Personal Safety Questionnaire scores (all p < 0.05). A significant increase with a large effect size was observed in the WIST total skill scores following the intervention (Z = −4.756, p < 0.001, r = 0.84; mean change = 6.34, 95% CI: 4.63–8.13). Conclusions: Participation in the BST Program was associated with significant improvements in the self-protection skills of preschool children from low-income families. These findings suggest that structured body safety education may be a promising approach for supporting personal safety skills among socioeconomically disadvantaged preschool children. Full article

Background/Objectives: The aim of this study is to determine the extent to which early breast cancer detection behaviors in Türkiye are associated with age, education, income, and chronic disease status, and to evaluate the relationship of healthcare service utilization (contact with family physicians/general practitioners and specialists) with these behaviors. Methods: A cross-sectional secondary data analysis was conducted using nationally representative microdata from the Turkish Statistical Institute’s (TUIK) 2022 Turkiye Health Survey. The analysis included 5554 women aged 40–69. Descriptive statistics were calculated using the FERTFACTOR sample weight. Fully adjusted modified Poisson regression models were constructed for recent mammography (within the last 2 years) and monthly breast self-examination (BSE) (adjusted prevalence ratio, aPR), while Classification and Regression Tree (CART) analysis with five-fold cross-validation was applied to identify targetable risk profiles. (The maximum tree depth was set at 3, and the minimum terminal node size at 250 individuals.) Results: The rates of undergoing a recent mammogram and performing monthly BSE were 23.5% and 25.0%, respectively. Both early detection behaviors were more frequent among women who had contact with both a family physician/general practitioner and a specialist physician within the past 12 months. While contact with a specialist physician was independently associated with both behaviors, education level was positively associated with them, whereas the presence of a chronic disease was associated only with having a recent mammogram. In the CART analysis, the initial split occurred based on BSE behavior, and the prevalence of recent mammography varied approximately eightfold across the terminal nodes (cross-validated AUC = 0.681). Conclusions: In Türkiye, behaviors related to the early detection of breast cancer are associated with age, education, and contact with healthcare services. Fewer than one in four women were up to date with mammography, underscoring a substantial early detection gap. Contact with a specialist physician showed the strongest association; however, given the cross-sectional design, causality cannot be inferred and reverse causation cannot be excluded. Systematizing early detection recommendations within primary care and implementing targeted strategies for low-socioeconomic groups may help increase participation in screening. Full article