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Kim SH, Lee H, Kim Y, Rhee CK, Min KH, Hwang YI, Kim DK, Park YB, Yoo KH, Moon JY. Recent Prevalence of and Factors Associated With Chronic Obstructive Pulmonary Disease in a Rapidly Aging Society: Korea National Health and Nutrition Examination Survey 2015-2019. J Korean Med Sci 2023; 38:e108. [PMID: 37038644 PMCID: PMC10086381 DOI: 10.3346/jkms.2023.38.e108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/03/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND The prevalence of chronic obstructive pulmonary disease (COPD) increases with age, and aging is an important risk factor for COPD development. In the era of global aging, demographic information about the prevalence of and factors associated with COPD are important to establish COPD care plans. However, limited information is available in rapidly aging societies, including Korea. METHODS We conducted a cross-sectional observational study using Korea National Health and Nutrition Examination Survey data from 2015-2019. We included 15,613 participants and analyzed trends of and factors associated with COPD. RESULTS During the study period, the overall prevalence of COPD was 12.9%. Over five years, the yearly prevalence of COPD was fairly constant, ranging from 11.5% to 13.6%. Among individuals aged ≥ 70 years, nearly one-third met COPD diagnostic criteria. In the multivariable analysis, age 70 years or older was the most strong factor associated with COPD (adjusted odds ratio [aOR], 17.86; 95% confidence interval [CI], 14.16-22.52; compared with age 40-49), followed by asthma (aOR, 3.39; 95% CI, 2.44-4.71), male sex (aOR, 2.64; 95% CI, 2.18-3.19), and current smokers (aOR, 2.60; 95% CI, 2.08-3.25). Additionally, ex-smokers, low income, decreased forced expiratory volume in 1 second %pred, and a history of pulmonary tuberculosis were associated with COPD. On the other hand, body mass index (BMI) ≥ 25 kg/m² (aOR, 0.62; 95% CI, 0.54-0.71; compared with BMI 18.5-24.9 kg/m²) had an inverse association with COPD. CONCLUSION Recent trends in the prevalence of COPD in South Korea are relatively stable. Approximately one-third of participants aged 70 years and older had COPD. Aging was the most important factor associated with COPD.
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Affiliation(s)
- Sang Hyuk Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Youlim Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Yong Il Hwang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yong Bum Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
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Jarvis I, Sbihi H, Davis Z, Brauer M, Czekajlo A, Davies HW, Gergel SE, Guhn M, Jerrett M, Koehoorn M, Nesbitt L, Oberlander TF, Su J, van den Bosch M. The influence of early-life residential exposure to different vegetation types and paved surfaces on early childhood development: A population-based birth cohort study. ENVIRONMENT INTERNATIONAL 2022; 163:107196. [PMID: 35339041 DOI: 10.1016/j.envint.2022.107196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/23/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Growing evidence suggests that exposure to green space is associated with improved childhood health and development, but the influence of different green space types remains relatively unexplored. In the present study, we investigated the association between early-life residential exposure to vegetation and early childhood development and evaluated whether associations differed according to land cover types, including paved land. METHODS Early childhood development was assessed via kindergarten teacher-ratings on the Early Development Instrument (EDI) in a large population-based birth cohort (n = 27,539) in Metro Vancouver, Canada. The residential surrounding environment was characterized using a high spatial resolution land cover map that was linked to children by six-digit residential postal codes. Early-life residential exposure (from birth to time of EDI assessment, mean age = 5.6 years) was calculated as the mean of annual percentage values of different land cover classes (i.e., total vegetation, tree cover, grass cover, paved surfaces) within a 250 m buffer zone of postal code centroids. Multilevel models were used to analyze associations between respective land cover classes and early childhood development. RESULTS In adjusted models, one interquartile range increase in total vegetation percentage was associated with a 0.33 increase in total EDI score (95% CI: 0.21, 0.45). Similar positive associations were observed for tree cover (β-coefficient: 0.26, 95% CI: 0.15, 0.37) and grass cover (β-coefficient: 0.12, 95% CI: 0.02, 0.22), while negative associations were observed for paved surfaces (β-coefficient: -0.35, 95% CI: -0.47, -0.23). CONCLUSIONS Our findings indicate that increased early-life residential exposure to vegetation is positively associated with early childhood developmental outcomes, and that associations may be stronger for residential exposure to tree cover relative to grass cover. Our results further indicate that childhood development may be negatively associated with residential exposure to paved surfaces. These findings can inform urban planning to support early childhood developmental health.
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Affiliation(s)
- Ingrid Jarvis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada
| | - Hind Sbihi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; BC Centre for Disease Control, 655 West 12(th) Avenue, Vancouver, British Columbia, Canada
| | - Zoë Davis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Agatha Czekajlo
- Department of Forest Resources Management, Faculty of Forestry, The University of British Columbia, 2424 Mail Mall, Vancouver, British Columbia, Canada
| | - Hugh W Davies
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Sarah E Gergel
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States; Center for Occupational and Environmental Health, Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States
| | - Mieke Koehoorn
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Lorien Nesbitt
- Department of Forest Resources Management, Faculty of Forestry, The University of British Columbia, 2424 Mail Mall, Vancouver, British Columbia, Canada
| | - Tim F Oberlander
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Pediatrics, Faculty of Medicine, The University of British Columbia, 4480 Oak Street, Vancouver, British Columbia, Canada
| | - Jason Su
- Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, 2121 Berkeley Way West, Berkeley, CA, the United States
| | - Matilda van den Bosch
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, British Columbia, Canada; School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88 08003 Barcelona, Spain; Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos III, Calle de Melchor, Fernández Almagro, 3, 28029 Madrid, Spain.
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Singer L, Green M, Rowe F, Ben-Shlomo Y, Morrissey K. Social determinants of multimorbidity and multiple functional limitations among the ageing population of England, 2002-2015. SSM Popul Health 2019; 8:100413. [PMID: 31194123 PMCID: PMC6551564 DOI: 10.1016/j.ssmph.2019.100413] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/29/2019] [Accepted: 05/14/2019] [Indexed: 12/29/2022] Open
Abstract
This study explores longitudinal relationships between material, psycho-social and behavioural social determinants of health and multimorbidity of people aged 50 years or older in England. We used data from the English Longitudinal Study of Ageing collected biannually between 2002 and 2015. Apart from the basic measure of multimorbidity (two or more diseases within a person) we constructed two distinct measures of health in order to take into account the biology of ageing (complex multimorbidity and multiple functional limitations). We found that the likelihood of multimorbidity and multiple functional limitations was consistently associated with the levels of household wealth, sense of control over one's life, physical activity and loneliness. Larger health inequalities were observed when health was measured as complex multimorbidity and multiple functional limitations than basic multimorbidity. Compared to the population group with the highest wealth, those with the lowest wealth had 47% higher odds of basic multimorbidity (95% C.I. 1.34-1.61), 73% higher odds of complex multimorbidity (95% C.I. 1.52-1.96) and 90% higher odds of having 10 or more functional limitations (95% C.I. 1.59-2.26). We did not find a dose-response relationship between alcohol consumption, smoking and multimorbidity but rather evidence of people in ill health actively moderating their health behaviour. We suggest that materialist models of multimorbidity and functional limitation at older age can not, on their own, explain the health inequalities as the behavioural and psycho-social factors play an important role. Policies aiming to reduce the risk of multimorbidity and functional limitation should address the issue at these three levels simultaneously, using the existing national infrastructure of General Practices. Multimorbidity and functional limitation were associated with household wealth, sense of control over life, physical activity, loneliness. We observed larger health inequalities for complex multimorbidity and multiple functional limitation than basic multimorbidity. Materialist models of multimorbidity do not explain inequalities. Behavioural and psycho-social factors play an important role.
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Affiliation(s)
- Leo Singer
- University of Liverpool, Department of Geography and Planning, Liverpool, United Kingdom
| | - Mark Green
- University of Liverpool, Department of Geography and Planning, Liverpool, United Kingdom
| | - Francisco Rowe
- University of Liverpool, Department of Geography and Planning, Liverpool, United Kingdom
| | - Yoav Ben-Shlomo
- University of Bristol, Bristol Medical School: Population Health Sciences, United Kingdom
| | - Karyn Morrissey
- University of Exeter, College of Medicine and Health, United Kingdom
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Clarke ABM, Daneman D, Curtis JR, Mahmud FH. Impact of neighbourhood-level inequity on paediatric diabetes care. Diabet Med 2017; 34:794-799. [PMID: 28164370 DOI: 10.1111/dme.13326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the association between neighbourhood-level inequity and glycaemic control in paediatric participants with Type 1 diabetes using the Neighbourhood Equity Index (NEI). METHODS The NEI was linked to the clinical data of 519 children with diabetes followed at the Hospital for Sick Children (Toronto, Canada). The NEI is a composite measure of inequity developed using the World Health Organization's Urban Health Equity Assessment and Response Tool (HEART), which encompasses 15 weighted indicators evaluating economic, social, environmental and lifestyle factors. The geographic distribution of participants was determined using postal codes, and the relationship between HbA1c and NEI was evaluated using regression and spatial analysis techniques. RESULTS Participants' mean HbA1c was significantly correlated with NEI (R = -0.24, P < 0.0001). Regression analysis demonstrated that NEI was a strong predictor of mean HbA1c (P < 0.0001), accounting for differences in HbA1c as large as 1.0% (11 mmol/mol) when controlled for age, sex, diabetes duration, insulin pump therapy and number of annual clinic visits. Geo-mapping using spatial scan testing revealed the presence of two clusters of low-equity neighbourhoods containing 3.22 (P = 0.001) and 2.83 (P = 0.02) times more participants with HbA1c ≥ 9.5% (80 mmol/mol) than expected. CONCLUSIONS Our findings demonstrated that NEI was a significant predictor of HbA1c in our clinic population and a useful tool for investigating spatial trends related to inequities in health, providing evidence that a composite, area-based measure of overall inequity is well suited to the study of glycaemic control in urban paediatric Type 1 diabetes populations.
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Affiliation(s)
- A B M Clarke
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - D Daneman
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - J R Curtis
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - F H Mahmud
- Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Pavela G, Latham K. Childhood Conditions and Multimorbidity Among Older Adults. J Gerontol B Psychol Sci Soc Sci 2015; 71:889-901. [PMID: 25975290 DOI: 10.1093/geronb/gbv028] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/25/2015] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES This research tests whether childhood conditions are associated with trajectories of chronic conditions among older adults. METHODS Using data from the Health and Retirement Study (1992-2008), a series of hierarchical linear models are used to estimate number of chronic conditions at survey midpoint and the rate of increase in chronic conditions across 18 years of data. RESULTS Results suggest that lower childhood socioeconomic status (SES) and poor childhood health are associated with increased number of chronic conditions; however, childhood SES is no longer associated with chronic conditions after adjustment for adult SES and adult health. Poor childhood health continues to be associated with total number of chronic conditions after adjustment for adult SES and health. Rate of change in chronic conditions was not associated with childhood conditions. Results from a multinomial logistic regression model further indicated that the association between childhood conditions and adult multimorbidity increased at higher levels of multimorbidity. DISCUSSION This research adds to the evidence that early life conditions have a lasting influence on adult health, and that their influence may be independent of adult health and SES.
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Affiliation(s)
- Gregory Pavela
- Office of Energetics, Nutrition Obesity Research Centre, University of Alabama at Birmingham.
| | - Kenzie Latham
- Department of Sociology, Indiana University-Purdue University of Indianapolis
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Matheson FI, Smith KLW, Fazli GS, Moineddin R, Dunn JR, Glazier RH. Physical health and gender as risk factors for usage of services for mental illness. J Epidemiol Community Health 2014; 68:971-8. [PMID: 24970764 PMCID: PMC4174114 DOI: 10.1136/jech-2014-203844] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background People with comorbid mental and physical illness (PI) experience worse health, inadequate care and increased mortality relative to those without mental illness (MI). The role of gender in this relationship is not fully understood. This study examined gender differences in onset of mental health service usage among people with physical illness (COPD, asthma, hypertension and type II diabetes) compared with a control cohort. Methods We used a unique linked dataset consisting of the 2000–2001 Canadian Community Health Survey and medical records (n=17 050) to examine risk of onset of MI among those with and without PI among Ontario residents (18–74 years old) over a 10-year period (2002–2011). Adjusted COX proportional survival analysis was conducted. Results Unadjusted use of MI medical services in the PI cohort was 55.6% among women and 44.7% (p=0.0001) among men; among controls 48.1% of the women and 36.7% of the men used MI medical services (p=0.0001). The relative risk of usage among women in the PI group relative to controls was 1.16. Among men, the relative risk was 1.22. Women were 1.45 times more likely to use MI medical services relative to men (HR=1.45, CI 1.35 to 1.55). Respondents in the PI cohort were 1.32 times more likely to use MI medical services (HR=1.32, CI 1.23 to 1.42) relative to controls. Women in the PI cohort used MI medical services 6.4 months earlier than PI males (p=0.0059). In the adjusted model, women with PI were most likely to use MI medical services, followed by women controls, men with PI and men controls. There was no significant interaction between gender and PI cohort. Conclusions Further, gender-based research focusing on onset of usage of MI services among those with and without chronic health problems will enable better understanding of gender-based health disparities to improve healthcare quality, delivery and public health policy.
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Affiliation(s)
- Flora I Matheson
- Centre for Research on Inner City Health at The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Katherine L W Smith
- Centre for Research on Inner City Health at The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Ghazal S Fazli
- Centre for Research on Inner City Health at The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - James R Dunn
- Centre for Research on Inner City Health at The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada Department of Health, Aging and Society, McMaster University, Ontario, Canada
| | - Richard H Glazier
- Centre for Research on Inner City Health at The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
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Matheson FI, Smith KLW, Moineddin R, Dunn JR, Glazier RH. Mental health status and gender as risk factors for onset of physical illness over 10 years. J Epidemiol Community Health 2013; 68:64-70. [PMID: 24014840 PMCID: PMC3888625 DOI: 10.1136/jech-2013-202838] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background There is a growing interest in understanding the connection between mental illness (MI) and the onset of new physical illnesses among previously physically healthy individuals. Yet the role of gender is often forgotten in research focused on comorbidity of health problems. The objective of this study was to examine gender differences in the onset of physical illness in a cohort of respondents who met criteria for MI compared with a control cohort without mental health problems. Methods This cohort study, conducted in Ontario, Canada, used a unique linked dataset with information from the 2000–2001 Canadian Community Health Survey and medical records (n=15 902). We used adjusted Cox proportional survival analysis to examine risk of onset of four physical health problems (chronic obstructive pulmonary disorder, asthma, hypertension and diabetes) for those with and without baseline MI across a 10-year period (2002–2011) among respondents aged 18–74 years. We controlled for socioeconomic and health indicators associated with health. Results The incidence of physical illness in the MI cohort was 28.5% among women and 29.9% among men (p=0.85) relative to controls (23.8% and 24%, respectively; p=0.48). Women in the MI cohort developed secondary physical health problems a year earlier than their male counterparts (p=0.002). Findings from the Cox proportional survival regression showed that women were at 14% reduced risk of developing physical illness, meaning that men were more disadvantaged (HR=0.89, CI 0.80 to 0.98). Those in the MI cohort were at 10 times greater risk of developing a secondary physical illness over the 10-year period (HR=1.10, CI 0.98 to 1.21). There was no significant interaction between gender and MI cohort (HR=1.05, CI 0.85 to 1.27). Conclusions Policy and clinical practice have to be sensitive to these complex-needs patients. Gender-specific treatment and prevention practices can be developed to target those at higher risk of multiple health conditions.
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Affiliation(s)
- Flora I Matheson
- Centre for Research on Inner City Health at The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, , Toronto, Ontario, Canada
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