Asthma is a chronic lung inflammatory disease that causes inflammation and narrowing of the airways. Swelling of the airways can be caused by the activation of cytokines that lead to an inflammatory or allergenic-like response. Environmental factors, both indoors and outdoors, have been found to increase the likelihood of asthma in children. Among those found to impact disease are air pollutants such as ozone, nitric dioxide, and particulate matter, as well as home exposures, like cockroaches and rodents. Those who have multiple or increased exposure to these pollutants are more likely to experience exacerbated symptoms and uncontrolled asthma. There currently is no cure for asthma, but effective therapies have been found to treat the symptoms associated with asthmatic episodes. During an asthma attack, due to narrowing of the airways, individuals experience wheezing, chest tightness, and even shortness of breath. To combat these occurrences, physicians use inhaled corticosteroids (ICS), Beta-agonist, or a combination of both to relieve symptoms. In the United States asthma affects 25.8 million people. This number is projected to increase as the US continuously becomes more industrialized and as environmental conditions deteriorate. Research conducted by the Center for Disease Control concluded that the prevalence of asthma increased amongst the general population, however, once the data were disaggregated by race, age, gender, and SES significant increases were noted amongst some groups but not others. Most notably, on average, children, women, Puerto Ricans, and people living in poverty as defined by federal guidelines had the highest asthma prevalence. Chronic diseases like asthma also produce substantial burdens on the healthcare system. Asthmatics on average require three-times as many prescriptions, twice as many emergency room visits and four-times as many hospitalizations as individuals without asthma in the same demographic population. Additionally, when an expenditure analysis was carried out, it revealed that children with asthma cost approximately three-times more per capita per child than adolescents without asthma. Chronic disease occurs over the duration of individual lives. Thus, poorly managed, they will cause preventable increases in disability-adjusted-life years, premature death, and health care expenditure for both the individual and the broader healthcare system. The observed increases will predominantly impact the indicated high-risk populations. The prevalence of asthma in urban settings was anticipated by researchers based on known environmental influences. However, the discovery of a higher prevalence and mortality rate of asthma within impoverished communities, in comparison to other urban communities, is not yet fully understood. Through this research an association between high-risk populations with uncontrolled asthma and a lack of patient education, low socioeconomic status, and utilization of Medicaid insurance was found, which indicates the influence of these factors on asthma control. Improving current asthma interventions by remodeling them to take a broader stance on asthma prevention, treatment and maintenance and through acknowledgement of the impact disparities, asthma will likely be better controlled for all individuals in the Unites States.

Bakgrund: I Sverige är tumörsjukdomar det, som efter sjukdomar i cirkulationsorganen, orsakar flest dödsfall. Det är sedan tidigare känt att människor som lever under sämre socioekonomiska förhållanden löper större risk att insjukna och avlida till följd av cancersjukdom. Likaså visar forskning att det finns skillnader i vårdkvaliteten inom cancervården till lägre utbildades nackdel. Men hur ser det ut gällande sjukdomsupptäckt, väntetider och behandlingsinsatser? Får alla cancerpatienter en jämlik vård och behandling oberoende av socioekonomisk status i Skandinavien?  Syfte: Att sammanställa befintlig litteratur om skillnader i sjukdomsupptäckt, väntetider och behandlingsinsatser för cancerpatienter med olika socioekonomisk status inom cancervården i Skandinavien.   Metod: Litteraturöversikt med 13 kvantitativa artiklar avseende skandinaviska förhållanden. Vid datainsamlingen användes databaserna PubMed och CINAHL. Katie Erikssons omvårdnadsteori om lidande användes som vårdvetenskaplig utgångspunkt, och deduktiv metod valdes för genomförande av resultatanalysen.     Resultat: Resultaten presenteras under tre huvudkategorier; socioekonomiska skillnader i sjukdomsupptäckt, väntetider och behandlingsinsatser, och visar tydliga skillnader. I Skandinavien upptäcks cancer bland individer med hög utbildning och/eller hög inkomst tidigare än bland individer med lägre socioekonomisk status. Individer med hög socioekonomisk status har även avsevärt lägre risk att befinna sig i ett avancerat sjukdomsstadie vid tiden för diagnos, och erhåller oftare, och mer avancerade behandlingsinsatser.   Slutsats: Den skandinaviska, skattefinansierade cancervården är inte jämlik. Alla patienter får inte lika vård och behandling oberoende av socioekonomisk status. Individer med hög utbildning och hög inkomst gynnas, cancer upptäcks i tidigare stadie och de erhåller mer behandlingsinsatser i jämförelse med individer med lägre socioekonomisk status som får stå tillbaka. / Background: After diseases of the circulatory organs, cancer causes most deaths in Sweden. Previous studies indicate an effect of socioeconomic factors on the risk for being diagnosed with, as well as on survival of cancer in general. Furthermore, disparities in the quality of cancer care, related to socioeconomic status, has been exposed. But what is the current situation regarding disease detection, waiting times and treatment within the Scandinavian cancer care? Do all patients receive equal cancer care and treatment, regardless of socioeconomic status?  Aim: To compile existing literature on disparities in disease detection, waiting times and treatment for patients with different socioeconomic status within the Scandinavian cancer care.  Method: A literature review, including 13 articles of quantitative methodology, reflecting Scandinavian conditions. PubMed and CINAHL were used for data collection. The review is based on the nursing theory by Katie Eriksson. Deductive method was used for the implementation of the results analysis.  Results: The results are presented within three main categories; socioeconomic disparities in disease detection, waiting times and treatment. Cancer is detected earlier among patients with higher education and/or income. These patients also have considerably lower risk of being in an advanced stage of disease at the time of diagnosis. Patients with high socioeconomic status also receive more, and more advanced treatment, compared with patients with lower socioeconomic status.   Conclusion: The Scandinavian tax-funded cancer care is not equal. Not all patients receive equal care and treatment regardless of socioeconomic status. Cancer is detected at an earlier stage among patients with high education or high income, and they receive more treatment, in comparison to individuals with lower socioeconomic status, who are being disadvantaged.

Schools that implement a school uniform policy are on the rise (Musu-Gillette, Zhang, Wang, Zhang & Oudekerk, 2017). About 74% of these schools have a high population of low socioeconomic status students (Musu-Gillette et al., 2017) with about 75% or more qualifying for free or reduced lunch. The purpose of this study was to examine any relationships between students' perceptions of the effects of school uniforms and student socioeconomic status. In a charter school, a survey was completed by students to gather perception information and a separate survey by parents to gather socioeconomic status information. Hypotheses were tested using descriptive statistics and multiple regression models. Data were gathered from 184 students in grades 3 through 8. Examining individual survey items revealed older students were more likely to report that school uniforms help to reduce bullying and teasing. Another statistically significant difference was that some students of high socioeconomic status reported that uniforms help reduce arguments with parents about clothing (t(182) = 2.66, p<.01). Student responses on 10 survey items were grouped into one factor called School Climate, reflecting student perceptions on how uniforms affect the school's climate. Analyses revealed no significant relationships between the School Climate factor and socioeconomic status. However, Hispanic students reported a significantly more positive response overall than non-Hispanic students. These findings suggest students of various socioeconomic status perceive school uniforms similarly, but older students could be more likely to associate uniforms with a reduction in bullying. More research needs to be done in charter schools as little research has been done on school uniforms in charter schools, and among Hispanic students because the participation of Hispanic students was relatively low.

In the era of accountability in our nation‘s public schools, high-stakes standardized testing is the primary methodology for determining academic achievement; results from end-of-grade standardized testing are published annually in state and national report cards that are used as an instrument for determining school and teacher quality. What standardized tests do not take into consideration, however, are external environmental factors that have an impact on academic achievement; this research project focuses upon the effects of socioeconomic status on academic achievement on the middle grade student in North Carolina in 2012 and 2013. These years were chosen to comparatively analyze student achievement during the transition from the North Carolina Standard Course of Study to the Common Core curriculum. Only public schools configured in grades 6-8 that operate on a traditional school calendar were considered for this study. One way analyses of variance and paired samples t tests were performed to determine whether significant differences exist between student achievement in each grade level, academic year, and tested subject area (mathematics and reading) based on various levels of socioeconomic status levels within the school. Socioeconomic status levels were determined by the percentage of student population within the middle school that received free or reduced cost lunch during that school year. Significant differences existed between every socioeconomic level, subject area, and grade level, and significant differences also existed between each academic year as well as the number of economically disadvantaged students passing both the reading and mathematics assessments in each academic year. Schools with higher poverty levels scored significantly lower on both subject areas in both academic years than their wealthier counterparts. Test scores were also significantly lower in 2013 than in 2012, and fewer economically disadvantaged students passed both reading and mathematics in 2013 than in 2012. Further research is suggested to determine whether the trend of higher poverty schools performing significantly lower on standardized assessments than wealthier schools will continue with the ongoing implementation of the Common Core curriculum.

Obesity among children is a public health concern. Preschool-­‐aged children, especially those from low-­‐income families, are no exception to the obesity epidemic. During the RD Parent Empowerment Program, parents of Head Start children in Johnson City, TN completed a structured education program over the course of 4 workshops related to healthy habits of families. The goal was to empower parents to shop smart, cook healthy, and eat right. The Family Nutrition and Physical Activity (FNPA) screening tool was used as an assessment tool to evaluate behavior change over the course of the program. Improvement in overall FNPA score was seen at the conclusion of the program. Individual assessment of breakfast consumption, family meal patterns, fruit and vegetable intake, beverage choices, and restriction occurred. Participation in the RD Parent Empowerment Program resulted in maintaining healthy behaviors or improved behaviors for many participants. A larger sample may provide more conclusive results.

The purpose of this study was to determine if there was a difference between a student’s reading/language arts TCAP scale score and his or her lunch status for students in grades three, four, & five within two school systems in Tennessee. The population consisted of 2,442 students who were in grades three, four, and five during the 2014-2015 school year in a city school system in east Tennessee and a county school system in middle Tennessee. The Kruskal-Wallis H, a non-parametric test, was used to identify statistically significant differences in the medians of the reading/language arts TCAP scores across the three types of lunch payment status. The independent variable was the type of student lunch status (free, reduced, and full pay). The dependent variable was the reading/language arts TCAP scale score of students in grade three, four, and five. The quantitative findings revealed the relationship between student lunch status group and reading/language arts TCAP scale score was significant for all four research questions. In all analyses, the difference in the reading/language arts TCAP scale scores of students in the free lunch status group and the full pay lunch status group was significant. When the data from both school systems were combined, there was a significant difference in the scale scores between the free and full pay lunch status groups, the free and reduced lunch status groups, and the reduced and full pay lunch status groups.

The design method for this study was non-experimental quantitative. The survey was distributed via email to Kindergarten teachers in two Northeastern Tennessee school districts. There were 69 Kindergarten teachers who responded to the survey. The study revealed that Kindergarten teachers perceive that gender, socioeconomic status, and preschool experience have a significant impact on student readiness for school. Chronological age was not perceived to have an impact on student readiness for school to a significant extent. Kindergarten teachers perceived that preschool experience has the greatest impact on student readiness for school when asked to rank the order of impact from greatest to least. Chronological age was perceived to have a greater impact on student readiness for school than either socioeconomic status or gender.

This study investigated the association of race, age, and census tract area poverty level on breast cancer stage at diagnosis. The study was limited to women residing in Missouri, aged 18 years and older, diagnosed with breast cancer, and whose cases were reported to the Cancer Registry between 2003 and 2008. The risk, relative risk, and increased risk of late-stage at diagnosis by race, age, and census tract area poverty level were computed. We found that the odds of late-stage breast cancer among African-American women were higher when compared with their white counterpart (OR 1.433; 95% CI, 1.316, 1.560). In addition, the odds of advanced stage disease for women residing in high-poverty areas were greater than those living in low-poverty areas (OR 1.319; 95% CI 1.08; 1.201). To close the widening cancer disparities gap in Missouri, there is the need for effective and programmatic strategies to enable interventions to reach areas and populations most vulnerable to advanced stage breast cancer diagnosis.

Abstract is available to download.

Background and Objectives: It is estimated that over 40% of children in Ecuador are anemic. Anemia in children can influence physical and cognitive development and have lasting effects on adulthood productivity and quality of life. The objectives of this study were to: (1) evaluate the relationship of anemia and cognitive function, and (2) determine the influence of demographic factors on cognitive function. Population and Setting: The sample consisted of 175 school-aged children between 5 to 11 years old attending a school in a poverty stricken area of Guayaquil, Ecuador. Methods: A descriptive correlational cross sectional design was used to study the relationship between the level of anemia and the level of cognitive function. Other demographic factors were evaluated to determine their influence on cognitive function. Data were collected at the school using the Raven's Coloured Progressive Matrices to measure cognitive function and the STAT-Site MHgb Meter to measure hemoglobin levels. Results: No significant correlation was found between the level of anemia and cognitive function. Multiple regression analysis of demographic variables and cognitive function found age (Beta=0.56, t=8.6, p=0.000) and income (Beta=0.16, t=2.5, p=0.01) to be significant predictors of cognitive function. Interpretation and Conclusion: Many factors influence cognitive function and development. Additional research is needed to determine the effect of income level and related factors, such as parental time spent with the child doing homework, value placed on education in the home, education level of the parents, and quality of nutrition. Interventions to improve socioeconomic level, enhance parenting styles that foster cognitive development, and improve nutrition should be implemented.