Articles

<b>Objective:</b> The knowledge, attitudes, and practices of SUA students about the use of plastics containing endocrine disruptors were investigated in this study. <b>Methodology:</b> A study with 150 participants was conducted to assess individuals' knowledge about endocrine disruptors, attitudes, and plastic use practices. <b>Results:</b> The findings indicate that the participants possessed an average degree of knowledge 50.2 ± 3.85 with the main emphasis of awareness being generic concepts rather than specific substances. Regarding the potential health impacts of endocrine-disrupting chemicals present in plastics, respondents' attitudes ranged from fair to positive, with a mean score of 3.5 ±0.09 indicating a fair attitude overall. Conclusion: It is important to practice polite behavior and increase public awareness of safe plastic disposal methods. Surprising only 38.0% of the participants mentioned that they refrain from heating their food in plastic containers to reduce their exposure to plastics. Students' practices revealed a notable dependence on plastic products despite their awareness of the concerns surrounding endocrine disruptors, as most of them reported using plastic water bottles, plastic cups, and plastic bags almost always. Additionally, only 20.7% of the respondents consistently implemented strategies to prevent exposure to endocrine-disrupting chemicals. <b>Recommendation:</b> The study recommended increasing the use of cleaner plastic substitutes and improving educational programs to convert information into practical actions. Policies that encourage environmentally friendly behavior and raise public awareness of safe plastic disposal techniques should be put into practice.

<b>Background: </b>Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and their associated risks. However, it remains unclear why a group with more knowledge about e-cigarette risks would also hold more positive attitudes toward vaping and exhibit higher usage rates — a phenomenon that may represent a knowledge-behavior paradox. Understanding this paradox, along with the complex relationships between e-cigarette knowledge, attitudes, and behaviors, is critical for informing effective public health interventions, campaigns, social media messaging, and regulatory policies. <b>Objectives: </b>This study aimed to evaluate the complex relationship between SES, e-cigarette knowledge, pro-vaping attitudes, and e-cigarette use. <b>Methods: </b>The SMOKES Study (Study of Measurement of Knowledge and Examination of Support for Tobacco Control Policies) used a multi-center, cross-sectional design, collecting data from 2,403 college and university students across 15 provinces in Iran (covering nearly half of the country's provinces). The survey measured family income, age, sex, ethnicity, e-cigarette use, knowledge, and attitudes. Structural Equation Modeling (SEM) was employed to examine the interrelations between SES, knowledge, attitudes, and behavior, while adjusting for age, sex, and ethnic minority status. <b>Results</b>: SEM analysis confirmed the hypothesized paradox. Although greater knowledge about e-cigarettes was linked to less favorable attitudes toward vaping and lower use, pro-vaping attitudes emerged as the strongest predictor of vaping behavior, while knowledge played a weaker protective role. Notably, individuals with higher SES simultaneously showed higher knowledge and, paradoxically, more pro-e-cigarette attitudes and greater usage. Female students and ethnic minority students reported higher correct knowledge and lower pro-vaping attitudes and use. Although age and higher family income were associated with more favorable attitudes, they did not directly predict vaping behavior. These results suggest that for higher SES individuals, poor knowledge is not the main driver of e-cigarette use; rather, their pro-e-cigarette attitudes, which seem to outweigh the influence of knowledge, play a key role. <b>Conclusions: </b>Although individuals from higher SES backgrounds report greater correct knowledge about e-cigarettes, this knowledge does not necessarily translate into reduced positive attitudes or lower usage. This study highlights the complexity of these paradoxical effects and suggests that public health strategies need to go beyond simple education and knowledge-based interventions. Targeted approaches should address industry messaging, challenge misconceptions, and strengthen regulatory efforts to reduce e-cigarette use among young adults, including those from higher SES backgrounds.

<b>Background: </b>Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. <b>Aims: </b>This study aimed to examine whether college students who use tobacco exhibit lower support for tobacco control policies compared to their non-user counterparts. <b>Methods: </b>We conducted a multi-center, cross-sectional study involving 2403 college students from various provinces in Iran. Tobacco use was ascertained based on self-reported consumption of cigarettes, electronic cigarettes, and hookah. Attitudes toward tobacco control policies were evaluated using a structured survey instrument, and comparative analyses were performed to assess differences in policy support between tobacco users and non-users. <b>Results: </b>The analysis revealed that tobacco users demonstrated significantly lower support for tobacco control policies compared to non-users. This association was consistently observed across users of cigarettes, electronic cigarettes, and hookah, suggesting a systematic pattern irrespective of the type of tobacco product used. <b>Conclusion: </b>These findings indicated a clear association between tobacco use and reduced endorsement of tobacco control policies among Iranian college students. These results have potential implications for public health policy, emphasizing the importance of addressing individual tobacco use behaviors in the development and implementation of tobacco control strategies. Further research is needed to elucidate the underlying mechanisms of this relationship.

<b>Background</b><b>:</b> Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). <b>Methods</b><b>:</b> This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. <b>Results</b><b>:</b> Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. <b>Conclusion</b><b>:</b> The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.

<b>Background: </b>Educational attainment is often regarded as a pathway to economic stability and social mobility. However, the Minorities’ Diminished Returns (MDRs) framework has demonstrated that the effects of educational attainment on various economic, behavioral, and health outcomes are weaker for marginalized populations, including racial/ethnic minorities, immigrants, LGBTQ+ individuals, and those living in disadvantaged areas. While MDRs have been documented for various marginalized demographic groups, the role of trauma in moderating socioeconomic outcomes remains underexplored. <b>Objective:</b> This study examines whether lifetime trauma exposure diminishes the positive association between educational attainment and poverty-to-income ratio (PIR), a key indicator of economic well-being. <b>Methods:</b> Using data from the National Survey of American Life (NSAL), we analyzed a nationally representative sample of 6,008 adults, including Black, White, Latino, and Other racial/ethnic groups. We employed linear regression models to evaluate the association between the independent variable educational attainment and the outcome PIR. We then tested lifetime trauma as a moderator of this association. Models controlled for age, gender, employment, and race/ethnicity. <b>Results:</b> Educational attainment was positively associated with PIR across all groups, but the strength of this association was significantly attenuated for individuals with a history of lifetime trauma. These effects were independent of covariates. <b>Conclusions:</b> These findings extend the MDRs framework by highlighting trauma as a potential contributor to diminished returns of education on socioeconomic wellbeing. Structural inequities that increase trauma exposure in minoritized populations may also limit the economic benefits of education, particularly for groups with multiple trauma exposures. Policies aimed at addressing economic inequality must integrate social policies that reduce trauma and stress.

<b>Background: </b>Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns of education among minoritized groups. However, few studies have tested the relevance of MDRs in American Indian and Alaska Native (AIAN) populations compared to non-Hispanic White adults. <b>Objectives:</b> This study aimed to examine the strength of the inverse association between educational attainment and hypertension prevalence, hypothesizing that the protective effect of education on hypertension risk is reduced among AIAN adults relative to non-Hispanic Whites. <b>Methods:</b> Using data from the 2023 National Health Interview Survey (NHIS), we analyzed a nationally representative sample of adults aged 18 and older. Logistic regression models examined the association between educational attainment and self-reported hypertension diagnosis, stratified by racial/ethnic group (AIAN vs. non-Hispanic White). Models were adjusted for key covariates, including age, gender, income, and insurance status. <b>Results:</b> Higher educational attainment was associated with a lower prevalence of hypertension in the combined sample of AIAN and non-Hispanic White adults. However, this protective association was significantly weaker among AIAN adults compared to non-Hispanic White adults, as evidenced by a significant interaction between race and education. <b>Conclusion:</b> AIAN adults exhibit a higher prevalence of hypertension even at higher levels of educational attainment compared to non-Hispanic White adults, supporting the relevance of MDRs for AIAN populations. This finding underscores the need for public health interventions that address structural barriers and contextual factors unique to AIAN populations. Policies focused solely on educational access may be insufficient to reduce hypertension risk among AIAN adults without addressing broader social and structural inequities.

<b>Objective:</b> Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental education, and their interaction are associated with perceived school discrimination, which in turn reduces their cognitive, academic, and emotional wellbeing. We also hypothesize that Black children with high socioeconomic status (SES) report high perceived school discrimination in high-COI settings. <b>Methods</b><b>: </b>Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which measures a wide range of educational, cognitive, and emotional outcomes. At the same time, the ABCD children are sampled across areas with vast differences in COI rankings, that can be classified into these five categories: very high, high, average, low, and very low educational COIs. Our structural equation models (SEM) tested the additive and interactive effects of race and educational attainment on perceived school discrimination, and the effects of school discrimination on various cognitive abilities (reading proficiency, picture vocabulary, and list sorting working memory), school suspension, as well as depressed mood. Our multi-group SEM assessed how these relationships vary across educational COI levels. <b>Results</b><b>: </b>Our findings showed that high SES Black children report highest school discrimination in residential areas with highest COIs. This is based on the observation that the interaction between race and parental education on experiences of school discrimination were only significant in areas with highest COI. Across residential areas with different COI levels, students who experienced higher school discrimination had higher suspension, worse depression, and worse cognitive performance. <b>Conclusion</b><b>: </b>While higher COIs are associated with better academic outcomes, Black-White gaps exist in the role of increased COI through increased racial bias that children perceive. These findings underscore the complexity of educational equity, suggesting that improving COI alone is insufficient for eliminating racial disparities in school experiences. Policies should be in place to reduce school-based discrimination against Black students in high COI settings.

<b>Background</b>: Educational attainment is known to improve self-rated health; however, research suggests that these benefits may be less pronounced for racial and ethnic minority groups. The Minorities' Diminished Returns (MDRs) theory posits that the protective effects of resources such as education are weaker for marginalized populations, such as Black and Latino individuals, compared to their White counterparts. <b>Objective</b>: This study aims to investigate racial and ethnic disparities in the association between years of schooling and self-rated health among U.S. adults, with a focus on understanding the reduced health benefits of education for Black and Latino individuals. <b>Methods</b>: Using data from the Understanding America Study (UAS; 2014), we conducted a cross-sectional analysis of adults aged 18 and older (N = 6,785). Self-rated health was the outcome, and years of schooling was the primary independent variable. We controlled for sociodemographic factors including age, gender, employment status, immigration status, and marital status. Stratified analyses were conducted by race/ethnicity (Non-Latino White, Non-Latino Black, and Latino). Linear regression models were used to examine the association between years of schooling and self-rated health, and interaction terms were included to assess variation in this relationship across racial/ethnic groups. <b>Results</b>: While years of schooling was positively associated with better self-rated health overall, the magnitude of this effect was weaker for Black and Latino individuals compared to White individuals. After adjusting for sociodemographic factors, Black and Latino adults reported worse self-rated health for each additional year of schooling, compared to their White counterparts, supporting the MDRs hypothesis. <b>Conclusion</b>: The findings suggest that while higher educational attainment is protective against worse self-rated health, this protection is not equally distributed across racial and ethnic groups. Black and Latino individuals experience diminished returns from their years of schooling in terms of self-rated health, likely due to structural barriers and social inequalities. Policies addressing health disparities must consider these diminished returns and aim to reduce structural racism and discrimination that undermine the benefits of education for minoritized populations.

Background: </b>Social determinants of health (SDOH) significantly influence health behaviors, including tobacco use among youth. Adversities such as perceived discrimination, perceived neighborhood stress, life trauma, and financial strain are stressors that may mediate the relationship between various SDOH and youth tobacco use. This study aims to investigate whether multidimensional adversities mediate the effects of SDOH on tobacco use among youth. <b>Methods:</b> Data from the Adolescent Brain Cognitive Development (ABCD) study were used to test our hypotheses. The sample included a diverse cohort of youth aged 9-10 years old followed until they were 15-16 years old. We examined the effects of baseline parental education, household income, neighborhood income, and family structure on subsequent youth tobacco use. Structural equation models were used to test if adversities (perceived discrimination, life trauma, financial strain) operate as potential mediators. <b>Results:</b> All ABCD participants were eligible for our analysis, regardless of race, ethnicity, or SDOHs (n = 11,878). The findings indicated that the effects of parental education, household income, neighborhood income, and family structure on youth tobacco use were partially mediated by adversities. Higher levels of parental education and household income were associated with lower tobacco use, and this relationship was weakened when accounting for adversities. Similarly, stable family structures and higher neighborhood income were linked to reduced tobacco use, with adversities playing a mediating role. <b>Conclusions:</b> Multidimensional adversities partially mediate the relationship between SDOH at baseline and subsequent youth tobacco use. Interventions aimed at reducing youth tobacco use should address both the social determinants and multiple adversities experienced by adolescents. Policies to improve the educational and economic situations of families, enhance neighborhood environments, and support stable family structures all reduce youth tobacco use, with lower exposure to adversities explaining this effect.

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.

<b>Background: </b>High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities’ diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. <b>Methods: </b>Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. <b>Results: </b>The study confirmed the role of our proposed serial mediators for Blacks’ weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. <b>Conclusions: </b>The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.

The purpose of this study was to examine the effectiveness of environmental solid waste management policies and practices for sustainable development in Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana. The case study research design was adopted for the study. Using the simple random sampling procedure, 425 respondents comprising of 380 residents and 45 Zoomlion staff were involved in the study. The data were analysed through the computation of frequencies, percentages, as well as means and standard deviations. On the waste management strategic action plan for sustainable development, it can be concluded that, regular monitoring system should be in place to ensure that households adhere to the solid waste management practices; and education/training programmes on solid waste management should be provided for employees so that they can appreciate the need for sustainable development practices. It can also be concluded that, most of the environmental management policies and practices of solid waste management were not effective in the KEEA Municipality because the residents were uncertain about the effectiveness of the environmental policies that have been put in place. Perhaps, the Assembly does not conduct regular monitoring to find out solid waste management practices of the various households. It could be that the Assembly does not enforce bye-laws on sanitation on appropriate solid waste management practices. It is recommended that, the Environmental Protection Agency (EPA), and the Assembly should conduct regular monitoring system in order to ensure that residents adhere to the solid waste management practices. Again, the Assembly should make available a reliable data on solid waste generation for households in the Municipality. It is also recommended that, the Environmental Protection Agency (EPA) and the Assembly should ensure proper enforcement of the bye-laws on sanitation on appropriate solid waste management practices. Residents of the KEEA Municipality should be encouraged by the Environmental Protection Agency (EPA) to consider reuse and recycling as important activities.

The paper analyses the extent to which crude oil price shocks impact GDP growth, exchange rate, interest rate and inflation of an emerging oil exporting economy, Ghana. The Structural Vector Autoregressive model is used to analyse the quarterly data from 2009q1 – 2020q4. The results showed that exchange rate and GDP growth respond positively but temporal to the impulse of crude oil price. In contrast, inflation and interest rate respond negatively to crude oil price shock. Specifically, the exchange rate appreciates in the initial quarter and begins to depreciate, whereas GDP growth experiences an increase in the first two quarters and also reduces afterwards. Crude oil price shocks to the Ghanaian economy follow the conventional behaviour of the impact of crude oil on macroeconomic indicators. The positive impact of the price shock on GDP growth and exchange rate is not much reflecting the fact that Ghana is an emerging oil-producing country with low production and export level. Ghana’s prospects in the oil and gas sector should not just be a mere hoax. Policies should be directed toward petroleum exploration and production efforts since the energy transition endanger benefits for future exploitation. Policies should be implemented to attract competitive players locally and internationally in the oil industry. The shock of crude oil prices is beginning to show evidence based on this study. Therefore government must consider recognising the importance of other economic sectors in order not be become heavily dependent on oil.

Scalable architecture principles for data warehousing are introduced to support population health management and predictive analytics. These principles are validated through the design of an accompanying Data Pipeline that allows the integration of non-traditional data sources, the use of real-time data for descriptive analytics dashboards, and support for the generation of supervised Machine Learning models. Several analytical capabilities have been implemented to exemplify the practical application of the principles, including predictive models for Risk Stratification in health care. Optimal cost-effectiveness and performance considerations ensure the practical relevance of the architectural principles and associated Data Pipeline. In recent years, the availability of Low-Cost Data Storage services and the increasing popularity of Streaming technologies opened new possibilities for the storage and processing of Streaming data on a near-real-time basis. These technologies can help Developing Countries in tackling many relevant issues such as Urban Planning, Environmental Management, Migration Policies, etc. A multi-tier approach combining Cloud-based Storage with Data Warehousing and Data Mining technologies can offer an interesting architecture to exploit Big Data related to populations.