Socioeconomic status (SES) is a key predictor of a multitude of health and functional outcomes, and growing up in low SES contexts is associated with poor neurocognitive outcomes and mental health problems across the lifespan. Recent studies of the links between SES and brain development suggest that associations between low SES and poor neurocognitive and health outcomes are likely accounted for by impacts on neurodevelopment. Low SES is associated with structural brain development, including reduced cortical thickness in frontal regions relevant to higher-level cognitive functions. However, understanding of how the impacts of SES on neurodevelopment contribute to developing psychopathology is limited. The study of how neurodevelopmental processes may contribute to depression is of particular interest given numerous neural correlates of depression, including reduced cortical thickness in frontal regions. Whereas both SES and depression independently have demonstrated associations with grey matter maturation, no studies to date have examined how the associations between SES, depression, and cortical structure interrelate. The current study addresses this gap in the literature by examining associations between SES at both household and neighborhood levels, depression symptoms, and cortical structure in adolescence. Furthermore, exploratory analyses investigated specific pathways of SES effects on depression symptoms and cortical structure through exposure to psychosocial stress. Data were drawn from an ongoing prospective longitudinal study of reward function development. Participants included 232 youth ages 9-13 (57.03% female; 46.59% White, 39.36% African American, 11.24% Multiracial, 2.81% Other; 11.24% Hispanic) and their primary caregivers who completed assessments of depression symptoms and stress at baseline and a 9-month follow-up, as well as an MRI assessment between baseline and follow up. Regression analyses examined associations between 1) SES to cortical structure, 2) SES to depression symptoms, 3) baseline depression symptoms and cortical structure, and 4) cortical structure to depression symptoms at follow-up. Structural equation models examined indirect effects of 1) SES on depression symptoms through cortical structure, 2) SES on cortical structure through depression symptoms, and 3) SES on cortical structure and depression symptoms through experiences of psychosocial stress. Neighborhood SES was positively associated with mean cortical thickness, and household SES was inversely associated with depression symptoms at follow up, controlling for baseline symptoms. No indirect effects were identified. Findings suggest that different aspects of SES may confer unique risks for neural and psychosocial development in early adolescence, such that SES of the neighborhood appears to have global effects on neurodevelopment that are not mediated by mood or proximal stress, whereas SES of the household appears to be associated with increasing mood symptoms and heightened stress experiences in early adolescence. / Psychology

The Mississippi State Department of Education (MDE) adopted a state assessment in 2014 to measure early literacy skills for incoming kindergarten students (Mississippi Joint Legislature Committee on Performance Evaluation and Expenditure Review [PEER], 2015). The purpose of this study was to determine the effects of early childhood education (ECE) programs in a selected school district in the state. A quantitative research design was used to conduct the study. Specifically, this study sought to determine if there were differences in the mean scores on the Star Early Literacy baseline assessment for students who attended an ECE program and those who did not. In addition, this study sought to determine if there were differences in the mean scores on the Star Early Literacy baseline assessment for four literacy classifications (early emergent reader, late emergent reader, transitional reader, and probable reader), as well as differences for gender, race, and socioeconomic status (SES) among students who attended an ECE program and those who did not. Lastly, the study determined if there were significant differences in the mean scores on the Star Reading and Star Math end-of-year (EOY) assessments as well as differences by gender, race, and SES for students who attended an ECE program and those who did not. Existing data included Star Early Literacy baseline scores, Star Early Literacy four literacy classifications, Star Reading EOY scores and Star Math EOY scores, gender, race, and SES. The results of the study showed that students who participated in an ECE program scored statistically higher on all student academic outcomes when compared to students who did not participate in an ECE program. The results showed there were no statistically significant differences in the mean scores based on gender, race, or SES for student academic outcomes when comparing students who did and did not participate in an ECE program.

Disease burden and lifestyle patterns have changed rapidly worldwide, especially in some Asian countries over the past 2 decades. However, cross-country comparative research is limited. This study investigated the nutritional status of preschool children and childbearing women in China, India, Nepal, and Pakistan selected based on their socioeconomic status, population size, and urbanization. Nationally representative data were used from the China National Nutrition and Health Surveillance Report, India National Family Health Survey, Nepal Demographic and Health Survey, Pakistan Demographic and Health Survey, the WHO repository, and the World Bank. The prevalence of underweight, overweight, and obesity and some ratios were compared. These rates varied across these 4 countries and were associated with their economic development levels. China's economic status and prevalence of childhood overweight/obesity (11.5%) were highest; India's economic status was higher than that of Nepal and Pakistan, but had higher rates of stunting, wasting, and underweight (38.4%, 21.0%, and 35.7%, respectively) in preschool children. Pakistan had the highest prevalence of overweight/obesity among childbearing women (52.4% in all, 63.0% in urban areas). Nepal had the lowest economic status and overweight/obesity rate in preschool children (1.2%). In general, the prevalence of overweight/obesity was higher in urban than in rural areas, except among childbearing women in China. Nutritional status and health burden are heavily influenced by economic development. The double burden of malnutrition poses prioritization challenges for policymakers and public health efforts. Prevention of obesity is urgently needed, at least in higher-income countries in Asia.

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<p>Smoking/tobacco use is the leading preventable cause of death worldwide. Despite understanding the health consequences of smoking, less is known as to how and why the effects of smoking emerge differently between countries and within populations both over time and across socioeconomic groups and geographic locales. In this thesis, we examined socioeconomic status (SES) and geography as two potential causes of variability in current rates of tobacco use and cessation in Canada and India, countries at diverse levels of economic development and epidemiological transition. The major findings were: (i) low SES, defined by education, income, and occupation, was associated with increased risk of tobacco consumption in both Canada and India, although there was variability in the strength of this association by form of tobacco use in India; (ii) in a 60-year longitudinal study, rates of smoking have fallen over time in Canada but socioeconomic gaps have widened; (iii) smoking quit rates were higher in Canada than India; although in both countries there was a positive association between SES and quitting; (iv) geographic variation in tobacco use and quit rates remained after accounting for individual socioeconomic and demographic characteristics, suggesting the importance of place in shaping patterns of tobacco use in Canada and India. Taken together, these findings indicate that tobacco use in populations is strongly patterned along socioeconomic and geographic dimensions. Future prevention and cessation programs will need explicit consideration of socioeconomic and geographic aspects of the tobacco use distribution to effectively improve the situation across all areas and groups.</p> / Doctor of Philosophy (PhD)

BACKGROUND. Frailty is a syndrome characterized by a decreased resistance to stressors, leading to increased vulnerability to adverse outcomes, including mortality. Multi-morbidity refers to the presence of two or more chronic diseases, and is associated with increased risk of adverse health outcomes. Most of the literature in frailty is based on older people (65+ years) living in high income countries. OBJECTIVE. To compare the predictive ability of three frailty indices for all-cause and one-year mortality among high- (HIC), middle- (MIC), and low- income country (LIC) participants; and to assess the mortality risk associated with multi-morbidity. METHODS. Using data from the Prospective Urban and Rural Epidemiological (PURE) study, we developed three indices using different definitions of frailty (one phenotypic frailty index; two cumulative deficit indices). All indices were tested for predictive ability for mortality both individually and with multi-morbidity. RESULTS. Prevalence of phenotypic frailty was greatest in LIC (8%), intermediate in MIC (7%), and lowest in HIC (4%). Multi-morbidity was most prevalent in HIC (20%), intermediate in MIC (15%), and lowest in LIC (13%). Increased frailty was associated with greater mortality risk using all frailty indices (e.g. HR (95% CI) of 2.63 (2.35-2.95) for the phenotypically frail relative to the robust). At each frailty level, mortality risk was higher within one year of baseline measurement than afterwards, and increased if it was accompanied by concurrent multi-morbidity (e.g. HR of phenotypic frailty increases from 2.27 (1.96-2.62) to 5.08 (4.34-5.95) if accompanied by multi-morbidity). CONCLUSION. All frailty indices predicted mortality. This study is unique in evaluating the prognostic ability of frailty indices in middle-aged adults across HIC, MIC, and LICs. / Thesis / Master of Science (MSc)