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      Impact of Socio-economic Status on Low Birthweight: Decomposing the Differences Between Natives and Immigrants in Spain

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          Abstract

          In this population-based study, we explored the relationships between immigration, socio-economic status (SES), and perinatal outcomes. We quantified the effects of SES on birthweight disparities between native and immigrant mothers in Spain. We obtained birth and SES data from the 2011 census and administrative registers for years 2011–2015. The associations between origin, statuses, and the likelihood of low birthweight were estimated using logistic regressions. Fairlie’s nonlinear extension of the Oaxaca–Blinder decomposition method was applied to identify the extent to which the differences in birthweight between groups corresponded to socio-economic composition or to rates. Our results showed that African and Latin American mothers exhibited advantage in the perinatal outcomes over native mothers [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.63–0.90 and OR 0.73; 95% CI 0.65–0.82, respectively]. Decomposition analyses revealed that such advantage was not affected by the lower positions within the socio-economic structure that African and Latin American populations occupied.

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          Theories for social epidemiology in the 21st century: an ecosocial perspective.

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            Measurement of socioeconomic status in health disparities research.

            Socioeconomic status (SES) is frequently implicated as a contributor to the disparate health observed among racial/ ethnic minorities, women and elderly populations. Findings from studies that examine the role of SES and health disparities, however, have provided inconsistent results. This is due in part to the: 1) lack of precision and reliability of measures; 2) difficulty with the collection of individual SES data; 3) the dynamic nature of SES over a lifetime; 4) the classification of women, children, retired and unemployed persons; 5) lack of or poor correlation between individual SES measures; and 6) and inaccurate or misleading interpretation of study results. Choosing the best variable or approach for measuring SES is dependent in part on its relevance to the population and outcomes under study. Many of the commonly used compositional and contextual SES measures are limited in terms of their usefulness for examining the effect of SES on outcomes in analyses of data that include population subgroups known to experience health disparities. This article describes SES measures, strengths and limitations of specific approaches and methodological issues related to the analysis and interpretation of studies that examine SES and health disparities.
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              “We have to clean ourselves to ensure that our children are healthy and beautiful”: findings from a qualitative assessment of a hand hygiene poster in rural Uganda

              Background Neonatal sepsis is a major cause of mortality worldwide, with most deaths occurring in low-income countries. The World Health Organisation (WHO) ‘5 Moments for Hand Hygiene’ poster has been used to reduce hospital-acquired infections, but there is no similar tool to prevent community-acquired newborn infections in low-resource settings. This assessment, part of the BabyGel Pilot study, evaluated the acceptability of the ‘Newborn Moments for Hand Hygiene in the Home’ poster. This was an educational tool which aimed to remind mothers in rural Uganda to clean their hands to prevent neonatal infection. Methods The BabyGel pilot was a cluster randomised trial that assessed the post-partum use of alcohol-based hand rub (ABHR) to prevent neonatal infections in Mbale, Uganda. Fifty-five women in 5 village clusters received the ABHR and used it from birth to 3 months postnatally, with use guided by the new poster. Following the study, 5 focus group discussions (FGDs) were conducted consisting of 6–8 purposively sampled participants from intervention villages. FGDs were audio-recorded, transcribed then translated into English. Transcripts were inductively coded using ATLAS.ti® and qualitatively analysed using thematic content analysis. Results Most mothers reported that they understood the message in the poster (“The picture shows me you must use these drugs to keep your baby healthy”) and that they could adhere to the moments from the poster. Some participants used the information from the poster to encourage other caregivers to use the ABHR (“after explaining to them, they liked it”). Other potential moments for hand hygiene were introduced by participants, such as after tending to domestic animals and gardening. Conclusion The poster was well-received, and participants reported compliance with the moments for hand hygiene (although the full body wipe of the baby has since been removed). The poster will be adapted into a sticker format on the ABHR bottle. More focus could be put into an education tool for other caregivers who wish to hold the baby. Overall, the study demonstrated the acceptability of an adapted version of the WHO Moments for Hand Hygiene poster in the introduction of an intervention in the community. Trial registration ISRCTN67852437, registered 02/03/2015. Trial funding Medical Research Council/ Wellcome Trust/ DfID (Global Health Trials Scheme).
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                Author and article information

                Contributors
                mstanek@usal.es
                mrequena@poli.uned.es
                adelrey@usal.es
                Journal
                J Immigr Minor Health
                J Immigr Minor Health
                Journal of Immigrant and Minority Health
                Springer US (New York )
                1557-1912
                1557-1920
                14 May 2020
                14 May 2020
                2021
                : 23
                : 1
                : 71-78
                Affiliations
                [1 ]GRID grid.11762.33, ISNI 0000 0001 2180 1817, Department of Sociology and Communication, , University of Salamanca, ; Edificio FES, Campus Miguel de Unamuno, 37007 Salamanca, Spain
                [2 ]GRID grid.10702.34, ISNI 0000 0001 2308 8920, Department of Social Structure, , UNED, ; Madrid, Spain
                Author information
                http://orcid.org/0000-0001-6878-2086
                Article
                1027
                10.1007/s10903-020-01027-0
                7847452
                32410013
                64908d25-050e-49c5-8f88-685137498eca
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100014440, Ministerio de Ciencia, Innovación y Universidades;
                Award ID: RTI2018-098455-A-C22
                Award ID: RTI2018-098455-B-C21
                Award Recipient :
                Funded by: Consejería de Educación, Junta de Castilla y León (ES)
                Award ID: SA047G19
                Award Recipient :
                Categories
                Original Paper
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2021

                Health & Social care
                birthweight,spain,healthy immigrant,socio-economic status
                Health & Social care
                birthweight, spain, healthy immigrant, socio-economic status

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