1
|
Schwalbe N, Nunes MC, Cutland C, Wahl B, Reidpath D. Assessing New York City's COVID-19 Vaccine Rollout Strategy: A Case for Risk-Informed Distribution. J Urban Health 2024:10.1007/s11524-024-00853-z. [PMID: 38578336 DOI: 10.1007/s11524-024-00853-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
This study reviews the impact of eligibility policies in the early rollout of the COVID-19 vaccine on coverage and probable outcomes, with a focus on New York City. We conducted a retrospective ecological study assessing age 65+, area-level income, vaccination coverage, and COVID-19 mortality rates, using linked Census Bureau data and New York City Health administrative data aggregated at the level of modified zip code tabulation areas (MODZCTA). The population for this study was all individuals in 177 MODZCTA in New York City. Population data were obtained from Census Bureau and New York City Health administrative data. The total mortality rate was examined through an ordinary least squares (OLS) regression model, using area-level wealth, the proportion of the population aged 65 and above, and the vaccination rate among this age group as predictors. Low-income areas with high proportions of older people demonstrated lower coverage rates (mean vaccination rate 52.8%; maximum coverage 67.9%) than wealthier areas (mean vaccination rate 74.6%; maximum coverage 99% in the wealthiest quintile) in the first 3 months of vaccine rollout and higher mortality over the year. Despite vaccine shortages, many younger people accessed vaccines ahead of schedule, particularly in high-income areas (mean coverage rate 60% among those 45-64 years in the wealthiest quintile). A vaccine program that prioritized those at greatest risk of COVID-19-associated morbidity and mortality would have prevented more deaths than the strategy that was implemented. When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups. If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.
Collapse
Affiliation(s)
- Nina Schwalbe
- School of Pathology, Faculty of Health Science, University of the Witwatersrand, January 1 Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.
- Heilbrunn Department of Population and Family Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA.
| | - Marta C Nunes
- Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2000, South Africa
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL), and Centre International de Recherche en Infectiologie (CIRI), Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard Lyon 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Clare Cutland
- Wits African Leadership in Vaccinology Expertise (Wits-Alive), School of Pathology, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Brian Wahl
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU, UK
- School of Social Sciences, Monash University, Clayton, VIC, 3125, Australia
| |
Collapse
|
2
|
Sigaux J, Semerano L, Boissier MC. Integrating social and economic status in rheumatoid arthritis exposure studies. Joint Bone Spine 2023; 91:105677. [PMID: 38135176 DOI: 10.1016/j.jbspin.2023.105677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/24/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Johanna Sigaux
- Li2P Inserm UMR 1125, 1, rue Chablis, 93017 Bobigny cedex, France; University Sorbonne Paris Nord, 1, rue Chablis, 93017 Bobigny cedex, France; Rheumatology Department, Avicenne Hospital (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France.
| | - Luca Semerano
- Li2P Inserm UMR 1125, 1, rue Chablis, 93017 Bobigny cedex, France; University Sorbonne Paris Nord, 1, rue Chablis, 93017 Bobigny cedex, France; Rheumatology Department, Avicenne Hospital (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
| | - Marie-Christophe Boissier
- Li2P Inserm UMR 1125, 1, rue Chablis, 93017 Bobigny cedex, France; University Sorbonne Paris Nord, 1, rue Chablis, 93017 Bobigny cedex, France; Rheumatology Department, Avicenne Hospital (AP-HP), 125, rue de Stalingrad, 93017 Bobigny, France
| |
Collapse
|
3
|
Silva Júnior AE, de Oliveira ADS, Praxedes DRS, da Costa Paula DT, de Lima Macena M, de Menezes Toledo Florêncio TM, Clemente APG, Bueno NB. Social and Racial Disparities in Food Consumption Among Brazilian College Students: a Nationwide Study. J Racial Ethn Health Disparities 2023; 10:2630-2640. [PMID: 36344748 DOI: 10.1007/s40615-022-01441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
This study aims to assess the association between economic class, race/skin color, and food consumption among Brazilian college students. A cross-sectional web-based survey was conducted with college students from all over Brazil. Demographic data, economic class, self-reported race/skin color, anthropometry, and food consumption markers from the Brazilian Food and Nutrition Surveillance System were collected. The final sample comprised 5843 participants with a mean age of 24.1 (SD: 6.3) years, 4292 (73.5%) were female, and 810 (13.9%) in the highest economic stratum. We observed a progressive decrease in the frequency of fresh fruits and vegetables consumption from higher to lower economic classes (p < 0.01 for both). Contrarily, there was a progressive increase in the frequency of consumption of beans from higher to lower economic classes (p < 0.01). The frequency consumption of vegetables was also associated with race/skin color (p < 0.01), being lower in brown (PR: 0.94; CI 95%: 0.90; 0.98), and black (PR: 0.91; 95% CI: 0.85; 0.98) individuals, compared to white individuals. Brown individuals showed higher frequency consumption of beans (PR: 1.10; 95% CI: 1.05; 1.15) than whites. When compared to individuals of white race/skin color, brown (PR: 1.07; 95% CI: 1.01; 1.13) and black (PR: 1.15; 95% CI: 1.07; 1.23) individuals showed higher frequency consumption of sweetened beverages. Economic class and race/skin color were independent factors associated with the food consumption of Brazilian college students.
Collapse
Affiliation(s)
- André Eduardo Silva Júnior
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Ana Debora Santos de Oliveira
- Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival de Melo Mota S/N, Maceió-AL, 57072-970, Brazil
| | - Dafiny Rodrigues Silva Praxedes
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Mateus de Lima Macena
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Ana Paula Grotti Clemente
- Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival de Melo Mota S/N, Maceió-AL, 57072-970, Brazil
| | - Nassib Bezerra Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Avenida Lourival de Melo Mota S/N, Maceió-AL, 57072-970, Brazil.
| |
Collapse
|
4
|
Posel D, Oyenubi A. Heterogeneous gender gaps in mental wellbeing: Do women with low economic status face the biggest gender gaps? Soc Sci Med 2023; 332:116133. [PMID: 37535987 DOI: 10.1016/j.socscimed.2023.116133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/18/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
Gender differences in depression are globally documented across a wide range of studies that analyse self-reports of depressive symptoms or clinical diagnoses. Extensive research fails to identify any single reason for this finding but given systematic variation in depressive symptomatology across social groups, gender differences must derive at least partly from environmental or social factors. Among the social factors that are considered most important are those relating to gender differences in socio-economic status and the underlying gender division of labor. In this study, we add to existing research by interrogating heterogeneity in gender differences in mental health. Studies that investigate environmental factors typically consider these only in relation to the average gender gap in depression. We use a novel sorting and classification method (Chernozhukov et al., 2018) that makes it possible to map the full distribution of gender differences in depressive symptomatology among comparable women and men. Although we cannot attribute causality, the method allows us to isolate those social factors that are distinctive to women who experience the largest gender gap in depressive symptoms compared to those who exhibit the smallest. The study analyses detailed nationally representative micro-data from South Africa, a country with high rates of poverty, which are higher still among women. As is common elsewhere, women report significantly more depressive symptoms than men, and low socio-economic status is correlated with poor mental health. However, women with low socio-economic status are not relatively more concentrated among women who face the largest gender gap in depressive symptomatology. These findings would not be consistent with the hypothesis that women have a greater tendency than men to ruminate over economic hardship and could rather point to resilience and a "steeling effect" among poor women.
Collapse
Affiliation(s)
- Dorrit Posel
- School of Economics and Finance, University of the Witwatersrand, Johannesburg, South Africa.
| | - Adeola Oyenubi
- School of Economics and Finance, University of the Witwatersrand, Johannesburg, South Africa.
| |
Collapse
|
5
|
Zhang W, Silverstein M. Does the Economic Status of Adult Children Influence Self-Rated Health Among Older Adults in China? J Gerontol B Psychol Sci Soc Sci 2023; 78:1604-1616. [PMID: 37210663 DOI: 10.1093/geronb/gbad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Indexed: 05/22/2023] Open
Abstract
OBJECTIVES We aim to investigate the association between children's economic status and parents' self-rated health and examine the potential mediating mechanisms for this relationship. METHODS Utilizing nationally representative data in China in 2014, this study predicted parent's self-rated health from children's economic status using inverse probability of treatment weighting to account for selection and endogeneity bias. We further examined depressive symptoms, kin and nonkin social support networks, emotional closeness to children, and economic support from children, as potential mediators of this relationship. RESULTS The study reveals that parents whose children had greater economic success tended to have better self-rated health. For both rural and urban older adults, depressive symptoms served as the most influential mediator. However, only among rural older adults did the size of their support networks mediate the relationship between children's economic status and perceived health. DISCUSSION The results from this study suggest that children's economic success contributes to better self-rated health among older adults. In part, this relationship was explained by better emotional well-being and greater availability of support resources among parents in rural areas with successful children. This quasi-causal analysis demonstrates that adult children remain important for the well-being of their older parents in China, but also suggests that health inequalities in later life are exacerbated by the chance of having economically successful offspring.
Collapse
Affiliation(s)
- Wencheng Zhang
- Department of Sociology, Syracuse University, Syracuse, New York, USA
| | - Merril Silverstein
- Department of Sociology, Syracuse University, Syracuse, New York, USA
- Department of Human Development and Family Science, Syracuse University, Syracuse, New York, USA
| |
Collapse
|
6
|
Lin L, Cao B, Chen W, Li J, Zhang Y, Guo VY. Association of childhood threat and deprivation with depressive symptoms and the moderating role of current economic status among middle-aged and older adults in China. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1227-1236. [PMID: 36418644 DOI: 10.1007/s00127-022-02384-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the independent impact of threat-related and deprivation-related adverse childhood experiences (ACEs) on depressive symptoms among middle-aged and older adults, and to evaluate the moderating role of current economic status in these associations. METHODS This cross-sectional study included 11,048 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study. We captured five threat-related ACEs and five deprivation-related ACEs by questionnaires. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale. Current economic status was reflected by annual per capita household consumption expenditure. We performed logistic regression analyses to evaluate the independent association of childhood threat and deprivation with depressive symptoms, and conducted stratified analyses and tests for interaction to explore the moderation effect of current economic status in such associations. RESULTS Compared with the nonexposed group, the experience of both childhood threat and deprivation were independently associated with greater risks of depressive symptoms later in life (odds ratio [OR] 1.75, 95% CI 1.49-2.05 for ≥ 2 threat-related ACEs; OR 2.02, 95% CI 1.67-2.43 for ≥ 2 deprivation-related ACEs). High current economic status significantly ameliorated the impact of childhood deprivation, but not threat, on depressive symptoms (P value for interaction 0.038). CONCLUSIONS Both threat-related and deprivation-related ACEs were associated with the risk of depressive symptoms among middle-aged and older adults, while current economic status was a significant moderator in such risks only for childhood deprivation. The findings implied that prioritising targeted interventions for individuals with ACEs, especially for childhood deprivation victims who were economically disadvantaged in adulthood, may help mitigate depressive symptoms in later life.
Collapse
Affiliation(s)
- Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Bing Cao
- Department of Neurosurgery, Wu Tsai Neuroscience Institute, Stanford University School of Medicine, Stanford, CA, USA.
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080, Guangdong, China
| | - Jinghua Li
- Department of Biostatistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yuying Zhang
- Department of Child Healthcare, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Second Road, Guangzhou, 510080, Guangdong, China.
| |
Collapse
|
7
|
Jing H, Cui P, Luan WJ, Wu Y, Ma L, Wang WX. [Investigation on medical security and quality of life of migrant workers with pneumoconiosis]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:439-442. [PMID: 37400405 DOI: 10.3760/cma.j.cn121094-20220622-00334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Objective: To investigate and understand the medical security and quality of life of migrant workers with pneumoconiosis, so as to provide scientific basis for the prevention and control countermeasures of migrant workers with pneumoconiosis and targeted poverty alleviation. Methods: Using a stratified random sampling method, 200 migrant workers diagnosed with pneumoconiosis at the Shandong Academy of Occupational Health and Occupational Medicine from January 2016 to December 2021 were selected as the observation group, while 200 non migrant workers diagnosed with pneumoconiosis were selected as the control group. St. George's Respiratory Questionnaire (SGRQ) and Pneumoconiosis Questionnaire were used to collect and compare information on the age, working age of dust exposure, economic sources, employment status, income, medical security and quality of life of two groups of patients. Results: The age of migrant worker pneumoconiosis patients in the observation group was (58.1±8.1) years old, and the working age of dust exposure was (19.3±10.1) years. The main source of income was children support (85.5%, 171/200), employment status was mainly wait for employment or unemployed (69.0%, 138/200), personal monthly income was mainly non income (90.0%, 180/200), and family annual income was mainly less than 10000 yuan (48.0%, 96/200). The average personal annual medical expenditure of 5000-<10000 yuan accounted for 42.0% (84/200). The age of pneumoconiosis patients in the control group was (59.2±8.9) years old, and the working age of dust exposure was (20.2±10.5) years. The main source of income was retirement pension or salary (99.0%, 198/200), with retirement as the main employment status (66.0%, 132/200), the main personal monthly income was 2000-<4000 yuan (61.5%, 123/200), the main family annual income was 20000-<40000 yuan (44.0%, 88/200), and the average personal annual medical expenditure was mostly non-expenditure (92.0%, 184/200). There were statistically significant differences in the distribution of economic sources, employment status, personal monthly income, family annual income and average personal annual medical expenditure between the two groups (P<0.001). The main type of insurance for the observation group was rural cooperative medical care (68.5%, 137/200), and 87.0% (174/200) had no medical reimbursement and a proportion less than 50%. There were statistically significant differences in insurance type and medical reimbursement proportion between the two groups (P<0.001). The respiratory symptoms, activity ability, daily life influence and total quality of life scores of pneumoconiosis patients in the observation group were significantly higher than those in the control group, the differences were statistically significant (P<0.001) . Conclusion: Migrant workers with pneumoconiosis have low income, high medical expenditure, low medical reimbursement proportion and poor quality of life. Therefore, it is necessary to draw high attention from relevant departments and provide timely attention and assistance to improve the quality of life of migrant workers with pneumoconiosis.
Collapse
Affiliation(s)
- H Jing
- Drug Clinical Research Center of Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250002, China
| | - P Cui
- Drug Clinical Research Center of Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250002, China
| | - W J Luan
- Leadership Office of Laizhou Chronic Disease Prevention and Treatment Hospital, Laizhou 261400, China
| | - Y Wu
- Drug Clinical Research Center of Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250002, China
| | - L Ma
- Drug Clinical Research Center of Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250002, China
| | - W X Wang
- Drug Clinical Research Center of Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250002, China
| |
Collapse
|
8
|
Ayesh W, Ibrahim Hassan AA, Jaafar H, Khorshid O, Laviano A, Lovey J, Mahrous M, Mogawer E, Molla H, Morsy A, Ouaijan K. Unmet needs in cancer patients: Creating recommendations to overcome geographical disparities in economic growth. Clin Nutr ESPEN 2023; 55:267-276. [PMID: 37202056 DOI: 10.1016/j.clnesp.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 05/20/2023]
Abstract
Cancer is a major clinical, economic and societal challenge across different world regions. Effective anticancer therapies are now available, yet the impact of these treatments on the needs of patients with cancer remains questionable, since improved survival is not frequently associated with improved quality of life. In an effort to raise patients' needs at the core of anticancer therapies, the importance of nutritional support has become recognized by international scientific societies. It is recognized that the needs of patients with cancer are universal, yet the economic and societal status of any country influence the availability and implementation of nutritional care. The Middle East is a geographic area in which major differences in economic growth coexist. Consequently, it appears reasonable that international guidelines on nutritional care in oncology are reviewed to highlight those recommendations which could be universally adopted and those which may need a progressive implementation. To this end, a group of Middle East healthcare professionals working in cancer centers across the region gathered to develop a list of recommendations to be implemented in daily practice. This would translate in a likely better acceptance and delivery of nutritional care, aligning all Middle East cancer centers to the quality standards now available only in selected hospital across the region.
Collapse
|
9
|
Kim AY, Seo MS, Kang HY. Health disparity and healthcare utilization inequity among older adults living in poverty in South Korea: a cross-sectional study. BMC Geriatr 2022; 22:999. [PMID: 36575382 PMCID: PMC9795656 DOI: 10.1186/s12877-022-03686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/07/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Korea has a two-tiered universal health security system: the wage-based National Health Insurance (NHI) program and government-subsidized Medical Aid (MA) program. Beneficiaries of the MA program belong to the lowest economic class. This study aims to investigate the association between economic status-defined as NHI or MA enrollment-and health disparity of older people aged ≥ 65 years in South Korea. METHODS The claims records of 672,525 older age population from the 2017 Health Insurance Review and Assessment Service-Adult Patient Sample were used to estimate adjusted odds ratios (aORs) of MA vs. NHI beneficiaries for prevalence for common geriatric diseases. Logistic regression and negative binomial regression were used to investigate the association between economic status and prevalence or healthcare utilization for each disease. RESULTS MA beneficiaries showed significantly higher prevalence than NHI beneficiaries for seven out of nine diseases (aORs ranging from 1.18 to 1.95). The discrepancy in the prevalence between the two groups was highest among those aged 65-69 years (aORs: 1.34-2.94), and diminished as they got older (aORs: 1.05-1.67). MA beneficiaries had significantly more outpatient visits to treat six diseases (aORs: 1.07-1.28), and more hospitalization to treat seven diseases (aORs:1.08-1.73) than NHI beneficiaries. CONCLUSION The higher prevalence of common geriatric diseases among MA than NHI beneficiaries confirms unfavorable health disparity in the elderly living in extreme poverty. Similar or higher healthcare utilization in treating the same conditions among MA beneficiaries suggests a low possibility of inequity for access to healthcare resources covered by the universal health security system due to poor economic status. Greater excess use of inpatient than outpatient care by MA beneficiaries implies that the condition of poor older adults might be more severe when diagnosed with the same disease.
Collapse
Affiliation(s)
- Ah-Young Kim
- grid.15444.300000 0004 0470 5454Department of Pharmaceutical Medicine and Regulatory Sciences, College of Medicine, College of Pharmacy, Yonsei University, Seoul, South Korea ,grid.15444.300000 0004 0470 5454College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 85 Songdogwahak-ro, Incheon , 21983 Incheon, South Korea
| | - Moon Sil Seo
- grid.15444.300000 0004 0470 5454College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 85 Songdogwahak-ro, Incheon , 21983 Incheon, South Korea ,grid.15444.300000 0004 0470 5454Graduate Program of Industrial Pharmaceutical Science, Yonsei University, Incheon, South Korea
| | - Hye-Young Kang
- grid.15444.300000 0004 0470 5454College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 85 Songdogwahak-ro, Incheon , 21983 Incheon, South Korea
| |
Collapse
|
10
|
Shao S, Liu L, Tian Z. Does the environmental inequality matter? A literature review. Environ Geochem Health 2022; 44:3133-3156. [PMID: 33847864 DOI: 10.1007/s10653-021-00921-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
The environmental inequality theory reveals that the risk of environmental pollution exposure varies among regions and groups and that particular groups face a higher threat of environmental pollution. In recent years, studies on the environmental inequality issue in developed countries have been increasing, while related literature on developing countries is very scarce. It has been found that some factors, such as race and economic status, have a close relationship with the risk of environmental pollution exposure faced by individuals. For the first time, this paper provides an extensive review of existing theoretical and empirical studies on environmental inequality. We review, in detail, the evolution of the environmental inequality theory, including the definition and measurement of environmental inequality. Further, we provide a systematic refresher on the main performance of environmental inequality, including health, education, labor productivity, and real estate prices. We also identify several causes of environmental inequality, such as ethnic differences, economic status, human capital, and household registration systems. Finally, we discuss prospects for the future research on this issue.
Collapse
Affiliation(s)
- Shuai Shao
- School of Business, East China University of Science and Technology, Shanghai, 200237, China
- School of Urban and Regional Science, Institute of Finance and Economics Research, Shanghai University of Finance and Economics, Shanghai, 200433, China
| | - Liwen Liu
- School of Urban and Regional Science, Institute of Finance and Economics Research, Shanghai University of Finance and Economics, Shanghai, 200433, China
| | - Zhihua Tian
- School of Economics, Zhejiang University of Technology, Hangzhou, 310023, China.
| |
Collapse
|
11
|
Gullett LR, Alhasan DM, Gaston SA, Jackson WB, Kawachi I, Jackson CL. Neighborhood social cohesion and serious psychological distress among Asian, Black, Hispanic/Latinx, and White adults in the United States: a cross-sectional study. BMC Public Health 2022; 22:1191. [PMID: 35705933 PMCID: PMC9199195 DOI: 10.1186/s12889-022-13572-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Serious psychological distress (SPD) is common and more prevalent in women, older adults, and individuals with a low-income. Prior studies have highlighted the role of low neighborhood social cohesion (nSC) in potentially contributing to SPD; however, few have investigated this association in a large, nationally representative sample of the United States. Therefore, our objective was to investigate the overall and racial/ethnic-, sex/gender-, self-rated health status-, age-, and household income-specific relationships between nSC and SPD. METHODS We used data from survey years 2013 to 2018 of the National Health Interview Survey to investigate nSC and SPD among Asian, Non-Hispanic (NH)-Black, Hispanic/Latinx, and NH-White men as well as women in the United States (N = 168,573) and to determine modification by race/ethnicity, sex/gender, self-rated health status, age, and annual household income. nSC was measured by asking participants four questions related to the trustworthiness and dependability of their neighbors. nSC scores were trichotomized into low (< 12), medium (12-14), and high (15-16). SPD was measured using the Kessler 6 psychological distress scale with scores ≥ 13 indicating SPD. After adjusting for sociodemographic, health behavior, and clinical confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS Among 168,573 participants, most were Non-Hispanic (NH)-White (69%), and mean age was 47 ± 0.01 years. After adjustment, low vs. high nSC was associated with a 75% higher prevalence of SPD overall (PR = 1.75 [1.59-1.92]), 4 times the prevalence of SPD among Asian men (PR = 4.06 [1.57-10.50]), 2 times the prevalence of SPD among participants in at least good health (PR = 2.02 [95% CI: 1.74-2.35]), 92% higher prevalence of SPD among participants ≥ 50 years old (PR = 1.92 [1.70-2.18]), and approximately 3 times the prevalence of SPD among Hispanic/Latinx participants with household incomes ≥ $75,000 (PR = 2.97 [1.45-6.08]). CONCLUSIONS Low nSC was associated with higher SPD in the overall population and the magnitude of the association was higher in Asian men, participants who reported good health, older participants, and Hispanic/Latinx adults with higher household incomes. Future research should continue to examine how neighborhood contexts can affect health across various sociodemographic groups, especially among groups with multiple marginalized social identities.
Collapse
Affiliation(s)
- Lauren R Gullett
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - W Braxton Jackson
- Social and Scientific Systems, Inc., a DLH Holdings Company, NC, Durham, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA. .,Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| |
Collapse
|
12
|
Khayyam U, Munir R. Flood in mountainous communities of Pakistan: how does it shape the livelihood and economic status and government support? Environ Sci Pollut Res Int 2022; 29:40921-40940. [PMID: 35088281 DOI: 10.1007/s11356-022-18709-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/12/2022] [Indexed: 05/21/2023]
Abstract
The agriculture sector remains under attack by the consistent flooding events in Pakistan as flooding water is sweeping away crops and livelihood opportunities, thus dragging the already vulnerable communities into poverty. This research has studied the adverse impacts of consistent floods (2010 to 2018) on the rural mountainous agriculture, agrarian occupation, economic system, and rise in poverty in ten districts of Hazara and Malakand divisions, Khyber-Pakhtunkhwa province, Pakistan. In total, 1000 self-administered questionnaires were deployed at the household level through judgment sampling studying the flood-affected households. Primary data for the impacts of floods on the livelihood, economic status, and poverty and correlation among them was estimated through three parallel logistic regression equations based on indexes for three separate models for the study variable to describe the flood-induced vulnerability at HH level. The results of the interrelationship of the selected variables declared Malakand division more prone to loss of livelihood, degradation of low-economic status, and increased in poverty due to flooding than Hazara division. It is concluded that floods have curtailed the agricultural livelihood on damaging crop production that has degraded locals' economic system by reducing household's income and savings, ending up in borrowing of money and leading to debt due to non-repayment. Households' vulnerability has increased due to increased poverty as being more exposed to natural disasters. It calls for government intervention to safeguard poor mountainous communities of Pakistan through financial help, seeds, livestock, and technical help in times of disaster.
Collapse
Affiliation(s)
- Umer Khayyam
- Department of Development Studies, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology (NUST), Sector H-12, Islamabad, Pakistan.
| | - Ramsha Munir
- Department of Development Studies, School of Social Sciences and Humanities (S3H), National University of Sciences and Technology (NUST), Sector H-12, Islamabad, Pakistan
| |
Collapse
|
13
|
Yabe Y, Hagiwara Y, Sekiguchi T, Sugawara Y, Tsuchiya M, Yoshida S, Tsuji I. Sleep disturbance is associated with neck pain: a 3-year longitudinal study after the Great East Japan Earthquake. BMC Musculoskelet Disord 2022; 23:459. [PMID: 35578231 PMCID: PMC9109362 DOI: 10.1186/s12891-022-05410-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/09/2022] [Indexed: 11/11/2022] Open
Abstract
Background Neck pain is a common health problem in the general population as well as in people after natural disasters. Sleep disturbances are gaining attention as risk factors for musculoskeletal pain; however, the association between sleep disturbance and neck pain has not been clarified. The present study aimed to clarify the association between sleep disturbance and neck pain, especially focusing on the effect of the duration of sleep disturbance, after the Great East Japan Earthquake. Methods This study used 3-year longitudinal data obtained from individuals (n = 2,059) living in disaster-affected areas after the Great East Japan Earthquake. Sleep disturbance and neck pain were investigated at 4, 5, 6, and 7 years after the disaster. Multivariate logistic regression analyses were used for the assessment. Results Sleep disturbance was significantly associated with neck pain, and the association was stronger as the duration of sleep disturbance increased (adjusted odds ratios [95% confidence intervals]: 1.84 [1.23–2.75] for “ < 1 year”; 2.41 [1.53–3.81] for “ ≥ 1 year and < 2 years”; 2.80 [2.09–3.76] for “ ≥ 2 years”). Furthermore, preceding sleep disturbance was significantly associated with the onset of neck pain, and the association was stronger as the duration of sleep disturbance increased (adjusted odds ratios [95% confidence intervals]: 1.86 [1.08–3.20] for “ < 1 year”; 2.39 [1.22–4.70] for “ ≥ 1 year and < 2 years”; 3.00 [1.94–4.65] for “ ≥ 2 years”). Conclusions Sleep disturbance is associated with neck pain, and long-lasting sleep disturbance strengthens the association. Clinicians should consider this association to effectively treat patients with neck pain, especially those affected by natural disasters.
Collapse
Affiliation(s)
- Yutaka Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Yoshihiro Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Takuya Sekiguchi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, Miyagi, 981-8522, Japan
| | - Shinichirou Yoshida
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Public Health, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| |
Collapse
|
14
|
Zazoly AZ, Bigdeli S, Sohrabi Z. The viewpoints of medical sciences wealth creators regarding the wealth creation strategies and path in medical sciences universities. J Educ Health Promot 2022; 11:131. [PMID: 35677280 PMCID: PMC9170211 DOI: 10.4103/jehp.jehp_978_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/04/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND In the recent years, the wealth creation of educational institutions has attracted an enormous attention in different countries. Exploring experiences of these institutes help to improve the wealth creation of universities. In this regard, this study was an attempt to explain the viewpoints of the wealth creators of medical sciences regarding wealth creation strategies and define the general path of wealth creation in medical sciences universities. MATERIALS AND METHODS This qualitative study was conducted at Iran University of Medical Sciences, Tehran, Iran, in 2021. Participants were the experienced knowledgeable wealth creation experts. Fourteen semi-structured interviews were conducted to reach data saturation. Interview guided questions were about strategies and paths of wealth creation followed by probing questions. Data were analyzed using conventional qualitative content analysis. RESULTS Data analysis showed that the most important strategies were related to nine extracted categories of "the productions", "contracts and relations", revising, predicting and foresight" -, "education", "research", "healthcare services", " interdisciplinary fields between Information Technology (IT) and health-care", " saving and maintenance", and "altering the procedure of the wealth accelerator centers." In general, wealth creation path in medical sciences includes six main categories. CONCLUSIONS The result of this study provide an opportunity for educational policy-makers and authorities to improve wealth creation in medical universities. Especially, accentuated by the COVID-19 pandemic, to consider the interdisciplinary fields between IT and health-care and integrating technology to the various categories of medical sciences are absolute needs.
Collapse
Affiliation(s)
- Atefeh Zabihi Zazoly
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shoaleh Bigdeli
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Sohrabi
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Imam T, Uddin S. How do economic and public finance statuses affect policy responses during a pandemic? - learning from the COVID-19 first wave. BMC Public Health 2022; 22:785. [PMID: 35440081 PMCID: PMC9016378 DOI: 10.1186/s12889-022-13209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the time of a pandemic, it is typical for public health bodies to collaborate with epidemiologists to design health policies both at national and international levels for controlling the spread. A point largely overlooked in literature is the extent economic capability and public finance status can influence the policy responses of countries during a pandemic situation. This article fills this gap by considering 12 public health and 7 economic measures (i.e., policies) in 200 countries during the COVID-19 first wave, with countries grouped across income categories. METHODS We apply statistical analysis, inclusive of regression models, to assess the impact of economic capability and public finance status on policy responses. Multiple open-access datasets are used in this research, and information from the hybrid sources are cumulated as samples. In our analysis, we consider variables including population characteristics (population size, density) and economic and public finance status (GDR, current account balance, government surplus/deficit) further to policy responses across public health and economic measures. Additionally, we consider infection rates across countries and the institution of the measures relative to infection rate. RESULTS Results suggest that countries from all income groups have favoured public health measures like school closures and travel bans, and economic measures like influencing interest rates. However, strong economy countries have more adopted technological monitoring than low-income countries. Contrarily, low-income countries have preferred traditional measures like curfew and obligatory mask-wearing. GDP per capita was a statistically significant factor influencing the institution of both public health and economic measures. Government finance statuses like current account balance and surplus/deficit were also significant factors influencing economic measures. CONCLUSIONS Overall, the research reveals that, further to biological characteristics, policymakers and epidemiologists can consider the economic and public finance contexts when suggesting health responses to a pandemic. This, in turn, calls for more international cooperation on economic terms further to public health terms.
Collapse
Affiliation(s)
- Tasadduq Imam
- School of Business and Law, CQUniversity (Melbourne Campus), Melbourne, VIC, 3000, Australia.
| | - Shahadat Uddin
- School of Project Management, Faculty of Engineering, The University of Sydney, Forest Lodge, NSW, 2037, Australia
| |
Collapse
|
16
|
Han KT, Kim W, Kim S. Disparities in healthcare expenditures according to economic status in cancer patients undergoing end-of-life care. BMC Cancer 2022; 22:303. [PMID: 35317774 PMCID: PMC8939210 DOI: 10.1186/s12885-022-09373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 03/02/2022] [Indexed: 11/25/2022] Open
Abstract
Backgrounds A desire for better outcome influences cancer patients’ willingness to pay. Whilst cancer-related costs are known to have a u-shaped distribution, the actual level of healthcare utilized by patients may vary depending on income and ability to pay. This study examined patterns of healthcare expenditures in the last year of life in patients with gastric, colorectal, lung, and liver cancer and analyzed whether differences exist in the level of end-of-life costs for cancer care according to economic status. Methods This study is a retrospective cohort study which used data from the Korean National Elderly Sampled Cohort, 2002 to 2015. End-of-life was defined as 1 year before death. Economic status was classified into three categorical variables according to the level of insurance premium (quantiles). The relationship between the dependent and independent variables were analyzed using multiple gamma regression based on the generalized estimated equation (GEE) model. Results This study included 3083 cancer patients, in which total healthcare expenditure was highest in the high-income group. End-of-life costs increased the most in the last 3 months of life. Compared to individuals in the ‘middle’ economic status group, those in the ‘high’ economic status group (RR 1.095, 95% CI 1.044–1.149) were likely to spend higher amounts. The percentage of individuals visiting a general hospital was highest in the ‘high’ economic status group, followed by the ‘middle’ and ‘low’ economic status groups. Conclusion Healthcare costs for cancer care increased at end-of-life in Korea. Patients of higher economic status tended to spender higher amounts of end-of-life costs for cancer care. Further in-depth studies are needed considering that end-of-life medical costs constitute a large proportion of overall expenditures. This study offers insight by showing that expenditures for cancer care tend to increase noticeably in the last 3 months of life and that differences exist in the amount spent according economic status. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09373-y.
Collapse
Affiliation(s)
- Kyu-Tae Han
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Woorim Kim
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Seungju Kim
- Department of Nursing, College of Nursing, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Seongnam, Republic of Korea.
| |
Collapse
|
17
|
Neves PA, Barros AJ, Baker P, Piwoz E, Santos TM, Gatica-Domínguez G, Vaz JS, Rollins N, Victora CG. Consumption of breast milk, formula and other non-human milk by children aged under 2 years: analysis of eighty-six low- and middle-income countries. Public Health Nutr 2022; 25:680-8. [PMID: 33059789 DOI: 10.1017/S1368980020004061] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC). DESIGN We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities. SETTING Nationally representative surveys from 2010 onwards from eighty-six LMIC. PARTICIPANTS 394 977 children aged under 2 years. RESULTS Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding. CONCLUSIONS Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.
Collapse
|
18
|
He J, Xie Y. The sociocultural mechanism of obesity: The influence of gender role attitudes on obesity and the gender gap. Soc Sci Med 2021; 293:114655. [PMID: 34942576 DOI: 10.1016/j.socscimed.2021.114655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 11/22/2022]
Abstract
Worldwide, women are more likely to be obese than men, but research on the mechanism of the gender gap in obesity is relatively lacking. This article uses five rounds of Chinese General Social Survey (CGSS) data from 2010 to 2017 to empirically test the impact of gender role attitudes on obesity and the gender gap and to explore the mechanism. The main results show that the traditional gender role attitude will improve the probability of obesity in women, but it will not positively impact obesity in men. Using the proportion of "March 8th red flag bearer" at the provincial level as an instrumental variable to alleviate the possible estimation errors caused by omitted variables, the results show that the lower the proportion of red flag bearers, the higher the probability of obesity of women, and still will not improve the probability of obesity of men. The robustness test based on the generalized propensity score method (GPSM) supports the above results. The mechanism analysis shows that economic status and market participation are two essential mechanisms of gender role attitudes and female obesity. Traditional gender role attitudes increase the risk of women's obesity by reducing their economic status and labour market participation.
Collapse
|
19
|
Saydam FN, Erdem H, Ankarali H, El-Arab Ramadan ME, El-Sayed NM, Civljak R, Pshenichnaya N, Moroti RV, Mahmuodabad FM, Maduka AV, Mahboob A, Prakash Kumari PH, Stebel R, Cernat R, Fasanekova L, Uysal S, Tasbakan M, Arapović J, Magdalena DI, Angamuthu K, Ghanem-Zoubi N, Meric-Koc M, Ruch Y, Marino A, Sadykova A, Batirel A, Khan EA, Kulzhanova S, Al-Moghazi S, Yegemberdiyeva R, Nicastri E, Pandak N, Akhtar N, Ozer-Balin S, Cascio A, Dimzova M, Evren H, Puca E, Tokayeva A, Vecchi M, Bozkurt I, Dogan M, Dirani N, Duisenova A, Khan MA, Kotsev S, Obradovic Z, Del Vecchio RF, Almajid F, Barac A, Dragovac G, Pishmisheva-Peleva M, Rahman MT, Rahman T, Le Marechal M, Cag Y, Ikram A, Rodriguez-Morales AJ. Vector-borne and zoonotic infections and their relationships with regional and socio economic statuses: An ID-IRI survey in 24 countries of Europe, Africa and Asia. Travel Med Infect Dis 2021; 44:102174. [PMID: 34699956 DOI: 10.1016/j.tmaid.2021.102174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In this cross-sectional, international study, we aimed to analyze vector-borne and zoonotic infections (VBZI), which are significant global threats. METHOD VBZIs' data between May 20-28, 2018 was collected. The 24 Participatingcountries were classified as lower-middle, upper-middle, and high-income. RESULTS 382 patients were included. 175(45.8%) were hospitalized, most commonly in Croatia, Egypt, and Romania(P = 0.001). There was a significant difference between distributions of VBZIs according to geographical regions(P < 0.001). Amebiasis, Ancylostomiasis, Blastocystosis, Cryptosporidiosis, Giardiasis, Toxoplasmosis were significantly more common in the Middle-East while Bartonellosis, Borreliosis, Cat Scratch Disease, Hantavirus syndrome, Rickettsiosis, Campylobacteriosis, Salmonellosis in Central/East/South-East Europe; Brucellosis and Echinococcosis in Central/West Asia; Campylobacteriosis, Chikungunya, Tick-borne encephalitis, Visceral Leishmaniasis, Salmonellosis, Toxoplasmosis in the North-Mediterranean; CCHF, Cutaneous Leishmaniasis, Dengue, Malaria, Taeniasis, Salmonellosis in Indian Subcontinent; Lassa Fever in West Africa. There were significant regional differences for viral hemorrhagic fevers(P < 0.001) and tick-borne infections(P < 0.001), and according to economic status for VBZIs(P < 0.001). The prevalences of VBZIs were significantly higher in lower-middle income countries(P = 0.001). The most similar regions were the Indian Subcontinent and the Middle-East, the Indian Subcontinent and the North-Mediterranean, and the Middle-East and North-Mediterranean regions. CONCLUSIONS Regional and socioeconomic heterogeneity still exists for VBZIs. Control and eradication of VBZIs require evidence-based surveillance data, and multidisciplinary efforts.
Collapse
Affiliation(s)
- Fatma Nurhayat Saydam
- Department of Infectious Diseases and Clinical Microbiology, Yuksek Ihtisas University, Faculty of Medicine, Batikent Medical Park Hospital, Ankara, Turkey
| | - Hakan Erdem
- ID-IRI Lead Coordinator, Ankara, Turkey; Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, 24343, Bahrain.
| | - Handan Ankarali
- Istanbul Medeniyet University, School of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
| | | | | | - Rok Civljak
- "Dr. Fran Mihaljevic" University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ruxandra Valentina Moroti
- National Institute for Infectious Diseases 'Matei Bals', and 'Carol Davila' University of Medicine and Pharmacy', Bucharest, Romania
| | | | | | - Amjad Mahboob
- Gajju Khan Medical College/Bacha Khan Medical Complex, Swabi, Khyber Pakhtunkhwa, Pakistan
| | | | - Roman Stebel
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Roxana Cernat
- Clinical Infectious Disease Hospital Constanta, Ovidius University of Constanta, Romania
| | - Lenka Fasanekova
- Department of Infectious Diseases, University Hospital Brno and Faculty of Medicine, Masaryk University, Czech Republic
| | - Serhat Uysal
- Department of Infectious Diseases and Clinical Microbiology, Firat University Faculty of Medicine, Elazig, Turkey
| | - Meltem Tasbakan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Medical School, Izmir, Turkey
| | - Jurica Arapović
- Department of Infectious Diseases, Mostar University Clinical Hospital, Mostar, Bosnia and Herzegovina
| | | | | | | | - Meliha Meric-Koc
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Hospital of Medical Faculty, Istanbul, Turkey
| | - Yvon Ruch
- Strasbourg University Hospital (Nouvel Hôpital Civil - Centre Hospitalo-Universitaire de Strasbourg), Strasbourg, France
| | - Andrea Marino
- Department of Infectious Diseases, Garibaldi Nesima Hospital, Italy
| | - Ainur Sadykova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Ayse Batirel
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ejaz Ahmed Khan
- Shifa Tameer-E-Millat University, Shifa International Hospital, Islamabad, Pakistan
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Samir Al-Moghazi
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | - Ravilya Yegemberdiyeva
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Emanuele Nicastri
- National Institute for Infectious Diseases L. Spallanzani IRCCS, Italy
| | | | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, G-8/3, Islamabad, Pakistan
| | - Safak Ozer-Balin
- Department of Infectious Diseases and Clinical Microbiology, Firat University, Faculty of Medicine, Elazıg, Turkey
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico "P. Giaccone", University of Palermo, Italy
| | - Marija Dimzova
- Clinic for Infectious Diseases and Febrile Conditions, Medical University, Skopje, Macedonia
| | - Hakan Evren
- Department of Infectious Diseases and Clinical Microbiology, University of Kyrenia, Kyrenia, Cyprus
| | | | - Alma Tokayeva
- Department of Infectious Diseases, Semey Medical University, Semey, Kazakhstan
| | | | - Ilkay Bozkurt
- Department of Infectious Diseases, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
| | - Mustafa Dogan
- Namik Kemal University, Faculty of Medicine, Tekirdag, Turkey
| | - Natalia Dirani
- Department of Infectious Diseases, Dar Al Amal University Hospital, Douris, Baalbak, Lebanon
| | - Amangul Duisenova
- Department of Infectious and Tropical Diseases, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Stanislav Kotsev
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Zarema Obradovic
- Faculty for Health Studies University of Sarajevo, Bosnia and Herzegovina
| | | | | | - Aleksandra Barac
- Clinic for Infectious and Tropical Diseases, University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Gorana Dragovac
- Centre of Disease Prevention and Control, Institute of Public Health of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - Maria Pishmisheva-Peleva
- Pazardzhik Multiprofile Hospital for Active Treatment, Department of Infectious Diseases, Bulgaria
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | | | - Marion Le Marechal
- Grenoble Alpes University, CHUGA, Infectious Diseases Department, 38043, Grenoble, France
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Perú
| |
Collapse
|
20
|
Ono R, Uchida K, Nakatsuka K, Megumi M, Fukuda H. Economic Status and Mortality in Patients with Alzheimer's Disease in Japan: The Longevity Improvement and Fair Evidence Study. J Am Med Dir Assoc 2021:S1525-8610(21)00764-7. [PMID: 34534490 DOI: 10.1016/j.jamda.2021.08.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/28/2021] [Accepted: 08/15/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES As more countries are implementing measures to address Alzheimer's disease (AD), it is essential to update the available knowledge on the relationship between economic status and mortality in patients with AD. This study examined the influence of economic status on mortality in Japanese individuals with AD using a medical claims dataset. DESIGN This was a retrospective cohort study. SETTING AND PARTICIPANTS Medical claims data from April 2014 to March 2019 were obtained from 13 local cities participating in the Longevity Improvement and Fair Evidence study. The inclusion criteria were patients aged 65 years and older who were newly diagnosed with AD during the study period. METHODS The outcome was death during the follow-up period. We assessed economic status by household income (middle to high income and low income); data were obtained from the use of the Medical Expenditure Ceiling Application and Standard Copayment Reduction Card (fee reduction card) when receiving an AD diagnosis, as an indicator of low-income status. We performed multivariate Cox proportional hazards analyses to examine the relationship between economic status and mortality; the model was adjusted for age, sex, the Charlson comorbidity index, and antidementia drug use. RESULTS We identified 39,081 newly diagnosed patients with AD from the Longevity Improvement and Fair Evidence study database (mean age, 83.6 years; female, 67.1%). Of these, 3189 individuals were identified as having a low-income status. After adjusting for possible confounders, low-income status was associated with mortality (hazard ratio, 1.95; 95% confidence interval, 1.84-2.07). CONCLUSIONS AND IMPLICATIONS Low-income status was associated with substantially poorer prognoses in new AD cases, indicating a need for a thorough examination of medical and nursing care services utilized by low-income individuals with AD and to explore improvement strategies.
Collapse
|
21
|
Yuan Q, Wu Y, Li F, Yang M, Chen D, Zou K. Economic status and catastrophic health expenditures in China in the last decade of health reform: a systematic review and meta-analysis. BMC Health Serv Res 2021; 21:600. [PMID: 34167527 PMCID: PMC8229446 DOI: 10.1186/s12913-021-06408-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/16/2021] [Indexed: 02/08/2023] Open
Abstract
Background In order to solve the problem of “expensive medical treatment and difficult medical treatment” for patients and improve the equity of medical services, China started the health-care reform in 2009, and proposed ambitious goals of providing fair and high-quality basic medical and health services to all citizens and reducing economic burden of diseases. This study was to systematically explore the association between population economic status and incidence of catastrophic health expenditures (CHE) in mainland China in the last decade since 2009 health reform. Methods This systematic review was reported according to the standard of preferred reporting items for systematic reviews and meta-analyses (PRISMA). We systematically searched Chinese Electronic literature Database of China Journal Full Text Database, Chinese Biomedical Journal Database, Wan fang Data Resource System, VIP Database, and English literature databases of PubMed, SCI, EMbase and Cochrane Library from January 2000 to June 2020, and references of included studies. Two reviewers independently selected all reports from 2000 to 2020 for empirical studies of CHE in mainland China, extracted data and evaluated the quality of the study. We conducted meta-analysis of the incidence of CHE and subgroup analysis according to the time of the study and the economic characteristics of residents. Results Four thousand eight hundred seventy-four records were retrieved and eventually 47 studies with 151,911 participants were included. The quality scores of most of studies were beyond 4 points (91.49%). The pooled incidence of CHE of Chinese residents in the last two decades was 23.3% (95% CI: 21.1 to 25.6%). The CHE incidence increased from 2000 to 2017, then decreased over time from 2017 to 2020. From 2000 to 2020, the CHE incidence in rural areas was 25.0% (95% CI: 20.9 to 29.1%) compared to urban 20.9% (95% CI: 18.3 to 23.4%); the CHE incidence in eastern, central and western China was 25.0% (95% CI: 19.2 to 30.8%), 25.4% (95% CI: 18.4 to 32.3%), and 23.1% (95% CI: 17.9 to 28.2%), respectively; the CHE incidence was 30.9% (95% CI: 22.4 to 39.5%), 20.3% (95% CI: 17.0 to 23.6%), 19.9% (95% CI: 15.6 to 24.1%), and 23.7% (95% CI: 18.0 to 29.3%) in poverty group, low-income group, middle-income group, and high-income group, respectively. Conclusions In the past two decade, the incidence of CHE in rural areas is higher than that of urban residents; higher in central areas than in eastern, western and other regions; in poverty households than in low-income, middle-income and high-income regions. Further measures should be taken to reduce the incidence of CHE in susceptible people. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06408-1.
Collapse
Affiliation(s)
- Qingqing Yuan
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuxuan Wu
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Furong Li
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Yang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.,West China Research Centre for Rural Health Development, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Dandi Chen
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Kun Zou
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China. .,West China Research Centre for Rural Health Development, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
22
|
Gao C, Sun Y, Zhang F, Zhou F, Dong C, Ke Z, Wang Q, Yang Y, Sun H. Prevalence and correlates of lifestyle behavior, anxiety and depression in Chinese college freshman: A cross-sectional survey. Int J Nurs Sci 2021; 8:347-353. [PMID: 34307785 PMCID: PMC8283720 DOI: 10.1016/j.ijnss.2021.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/19/2021] [Accepted: 05/31/2021] [Indexed: 10/26/2022] Open
Abstract
Objectives First-year college students had exposure to unhealthy lifestyle behaviors that correlate with a high prevalence of anxiety and depression. Regarding to the modifiable lifestyle behaviors factors, this study investigated the prevalence and correlation of multiple lifestyle behaviors, anxiety and depression in a sample of Chinese first-year college students. Methods Cross-sectional data were extracted from Residents eHealth app of health lifestyle behaviors survey from September to October 2019. Anxiety, depression, eating regular meals, consumption of snacks in-between meals, consumption of fruit, dessert and sugar-sweetened beverages, smoking and secondhand smoke exposure, consuming alcohol, physical activity, sedentary time were assessed by self-report. Socio-demographic including age, gender, education, family income, religion, and health condition were captured. Logistic regression was used to explore the association of multiple lifestyle behaviors, anxiety and depression. Results Totally 1,017 participants were included in the study. The prevalence of anxiety and depression (from mild to severe) were 40.3% and 45.3%, respectively. In multivariable analyses, religion (believe in Buddhism, OR = 2.438, 95%CI: 1.097-5.421; believe in Christian, OR = 5.886, 95%CI: 1.604-21.597), gender (Female, OR = 1.405, 95%CI: 1.001-1.971), secondhand smoke exposure (OR = 1.089, 95%CI: 1.001-1.184), and eating regular meals (OR = 0.513, 95%CI: 0.346-0.759) were associated with anxiety. Family income (OR = 0.732, 95%CI: 0.596-0.898), eating regular meals (OR = 0.641, 95%CI: 0.415-0.990), frequency of breakfast (OR = 0.813, 95%CI: 0.690-0.959), with a chronic disease (OR = 1.902, 95%CI: 1.335-2.712), and consumption of nocturnal snack (OR = 1.337, 95%CI: 1.108-1.612) were associated with depression. Conclusions These results highlighted the need for early lifestyle behavior intervention, especially modifying diet patterns considering the background of religion, health condition, and social-economic status in first-year college students to improve their mental health.
Collapse
Affiliation(s)
- Chenchen Gao
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yumei Sun
- Division of Humanity & Social Sciences, School of Nursing, Peking University, Beijing, China
| | - Feifei Zhang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Ziwei Ke
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Qingyan Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yeqin Yang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hongyu Sun
- Division of Humanity & Social Sciences, School of Nursing, Peking University, Beijing, China
| |
Collapse
|
23
|
Ouyang H, Yu J, Duan J, Zheng L, Li L, Guo X. Empathy-based tolerance towards poor norm violators in third-party punishment. Exp Brain Res 2021; 239:2171-2180. [PMID: 33978785 DOI: 10.1007/s00221-021-06128-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
Third-party punishment (TPP) plays an important role in fairness norm enforcement. This study investigated how the economic status of proposers could modulate third parties' behavioural and neural responses to unfairness. Participants played a TPP game as third parties deciding whether to punish proposers after observing the offers from proposers while behavioural and electroencephalogram (EEG) data were recorded. The proposers were of either high economic status or low economic status, and the recipients were middle class. The behavioural results indicated that participants reported decreased punishment for poor-proposed unfair offers compared to rich-proposed unfair offers, and this effect was stronger for highly unfair offers. Neurally, greater P200, a component involved in empathy processing, was observed in response to highly unfair offers (i.e. 90:10 and 80:20) proposed by the poor, suggesting that when the targets of severe punishments were poor proposers, participants showed greater empathy for poor norm violators in highly unfair trials. Taken together, these findings help to elucidate that the third-parties tend to tolerate the norm-violating behaviours conducted by the poor and provided further neuroscience evidence for the influence of economic status of proposers on TPP.
Collapse
Affiliation(s)
- Hui Ouyang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | | | - Jipeng Duan
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Li Zheng
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China. .,Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China. .,Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai, China. .,National Demonstration Center for Experimental Psychology Education, East China Normal University, Shanghai, China.
| | - Lin Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China. .,National Demonstration Center for Experimental Psychology Education, East China Normal University, Shanghai, China.
| | - Xiuyan Guo
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.,Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China.,Key Laboratory of Brain Functional Genomics, Ministry of Education, Shanghai Key Laboratory of Brain Functional Genomics, East China Normal University, Shanghai, China.,National Demonstration Center for Experimental Psychology Education, East China Normal University, Shanghai, China
| |
Collapse
|
24
|
Pangaribuan IK, Simanullang E, Poddar S. The analyze toddler growth and development according to family's economic status in Village Limau Manis, Districts Tanjung Morawa. Enferm Clin 2021. [PMID: 32713594 DOI: 10.1016/j.enfcli.2019.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The toddler stage is a golden period and at the same time a critical period for a child, since he / she will experience rapid brain growth and development so that he/ she need sufficient nutrition intake. Toddler's abnormal growth and development are usually found in low economic community because they cannot afford to provide their need for basic food for their toddler's growth and development. The objective of the research was to analyze toddler's growth and development according to family's economic status. The research used descriptive analytic method with cross-sectional design. It was conducted at Limau Manis Village, Tanjung Morawa Subdistrict, Deli Serdang Regency, from January to June 2016. The population was 1899 toddlers, and 113 of them were used as the samples, taken by using simple random sampling technique. The data were gathered by using questionnaires to find out toddler's growth and development according to family's economic status. The result of univariate analysis showed that 57 toddlers (50.4%) had abnormal growth and development. The result of bivariate analysis with chi-square test showed that there was the correlation of toddler's growth and development with economic status (p value=0.004), women's care pattern (p value=0.028), and environmental sanitation (p value=0.01). Therefore, empowerment of family's economy through the development of family's nutrition portfolio is necessary.
Collapse
|
25
|
Silveira MF, Tonial CT, Goretti K Maranhão A, Teixeira AMS, Hallal PC, Maria B Menezes A, Horta BL, Hartwig FP, Barros AJD, Victora CG. Missed childhood immunizations during the COVID-19 pandemic in Brazil: Analyses of routine statistics and of a national household survey. Vaccine 2021; 39:3404-3409. [PMID: 33941406 DOI: 10.1016/j.vaccine.2021.04.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/07/2021] [Accepted: 04/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There is widespread concern that disruption to health services during the COVID-19 pandemic has led to declines in immunization coverage among young children, but there is limited information on the magnitude of such impact. High immunization coverage is essential for reducing the risk of vaccine preventable diseases. METHODS We used data from two nationwide sources covering the whole of Brazil. Data from the Information System of the National Immunization Program (SIPNI) on the monthly number of vaccine doses administered to young children were analyzed. The second source was a survey in 133 large cities in the 27 states in the country, carried out from August 24-27. Respondents answered a question on whether children under the age of three years had missed any scheduled vaccinations during the pandemic, and available vaccination cards were photographed for later examination. RESULTS SIPNI data showed that, relative to January and February 2020, there was a decline of about 20% in vaccines administered to children aged two months or older during March and April, when social distancing was at the highest level in the country. After May, vaccination levels returned to pre-pandemic values. Survey data, based on the interviews and on examination of the vaccine cards, showed that 19.0% (95% CI 17.0;21.1%) and 20.6% (95% CI 19.0;23.1%) of children, respectively, had missed immunizations. Missed doses were most common in the North (Amazon) region and least common in the South and Southeast, and also more common among children from poor than from wealthy families. INTERPRETATION Our results show that the pandemic was associated with a reduction of about 20% in child vaccinations, but this was reverted in recent months. Children from poor families and from the least developed regions of the country were most affected. There is an urgent need to booster immunization activities in the country to compensate for missed doses, and to reduce geographic and socioeconomic inequalities.
Collapse
Affiliation(s)
- Mariangela F Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Cristian T Tonial
- Hospital São Lucas, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Antonia M S Teixeira
- Avenida Abel Cabral, 577, Condomínio Residencial SunHappy 1404 D, Nova Paranamirirm, Parnamirim/ RN CEP 59151-250, Brazil
| | - Pedro C Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Ana Maria B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernando P Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Aluisio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Cesar G Victora
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
26
|
Huang F, Fu P. Intergenerational support and subjective wellbeing among oldest-old in China: the moderating role of economic status. BMC Geriatr 2021; 21:252. [PMID: 33858343 PMCID: PMC8051050 DOI: 10.1186/s12877-021-02204-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/05/2021] [Indexed: 12/02/2022] Open
Abstract
Backgrounds The oldest-old population is increasing sharply in China, and intergenerational support has been their primary source of caregiving. Although intergenerational support has been found to be associated with wellbeing of older people in previous study, most analysis were from the perspective of children’s characteristics and exchange patterns. This study aims to investigate the impact of different types of intergenerational support on subjective wellbeing among Chinese oldest-old and the variation across groups of different economic status, based on their five-tier of needs (physiological needs, safety needs, love/belonging needs, esteem needs, and self-actualization needs). Methods We included older adults aged ≥ 80 years from the 2018 Chinese longitudinal Healthy Longevity Survey (CLHLS). We assessed older people’s subjective wellbeing by their life satisfaction and psychological health. We evaluated four types of intergenerational support: parents provide financial support, receive financial, instrumental and emotional support. We applied binary logistic regression analysis to analyze the association between different intergenerational support and older people’s subjective wellbeing and the moderating effect of self-rated economic status on this relationship. Results A total of 8.794 participants were included, with a mean age of 91,46 years (standard deviation:7.60). Older adults who provide financial support (OR: 1.37, 95% CI: 1.01, 1.85) and receive emotional support (OR: 1.99, 95% CI: 1.40, 2.83) report better subjective wellbeing. However, receiving instrumental support depressed psychological health (OR: 0.67, 95% CI: 0.56, 0.79) while improved life satisfaction (OR: 1.42, 95% CI: 1.04, 1.55). Receiving emotional support promoted parents’ psychological health among all combinations of support, and receiving all the three types together raised their subjective wellbeing most. Conclusions Our study recognizes that higher level of subjective wellbeing for oldest-old is related to providing financial support, receiving emotional and certain instrumental support. In addition, higher economic status can moderate these associations. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02204-y.
Collapse
Affiliation(s)
- Fanghong Huang
- School of Economics, Shandong University, Jinan, 250100, China
| | - Peipei Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
| |
Collapse
|
27
|
Piltch-Loeb R, Merdjanoff A, Meltzer G. Anticipated mental health consequences of COVID-19 in a nationally-representative sample: Context, coverage, and economic consequences. Prev Med 2021; 145:106441. [PMID: 33515588 PMCID: PMC7838571 DOI: 10.1016/j.ypmed.2021.106441] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic will have long-term consequences due to social and economic disruption. This study aimed to understand the contextual, media, and economic factors associated with anticipated mental health consequences from the COVID-19 pandemic among Americans. A nationally representative survey of 1001 respondents was conducted in April 2020. Chi-square tests and logistic regressions examined anticipated emotional or psychological effects on respondents or members of their households should social distancing measures continue. Specific analyses focused on: 1) COVID-19 experience - knowing someone or being infected; living in a state with a high death rate; or state social distancing policies; 2) media exposure - source of coronavirus information and time spent on coronavirus news; and 3) economics - current economic effects; and anticipated long-term financial effects. 41% of respondents anticipated mental health consequences. Living in a state with a greater COVID-19 death rate (OR 1.73; 95% CI 1.10, 2.72) and anticipating long-term financial difficulties (OR 2.98; 95% CI 1.93, 4.60) were both associated with greater likelihood of anticipated mental health consequences. Those whose primary news source was television, as opposed to print or online, were almost 50% less likely to anticipate mental health challenges (OR 0.52 CI 0.33, 0.81), while those who reported spending two or more hours daily on COVID-19 news were 90% more likely (OR 1.90; 95% CI 1.27, 2.85). Aspects of community health, media consumption, and economic impacts influence anticipated poor mental health from the COVID-19 pandemic, suggesting each domain is relevant to interventions to address the consequences.
Collapse
Affiliation(s)
- Rachael Piltch-Loeb
- Department of Social and Behavioral Sciences, New York University, School of Global Public Health, New York, NY, United States of America; Emergency Preparedness Research, Evaluation, & Practice (EPREP) Program, Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, United States of America.
| | - Alexis Merdjanoff
- Department of Social and Behavioral Sciences, New York University, School of Global Public Health, New York, NY, United States of America
| | - Gabriella Meltzer
- Department of Social and Behavioral Sciences, New York University, School of Global Public Health, New York, NY, United States of America
| |
Collapse
|
28
|
Zhang M, Liu Y. Does environmental pollution influence household asset allocation? Evidence from China. Environ Sci Pollut Res Int 2021; 28:15406-15423. [PMID: 33237562 DOI: 10.1007/s11356-020-11710-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/16/2020] [Indexed: 06/11/2023]
Abstract
This paper establishes a causal relation between households' decision of asset allocation and environmental pollution based on urban PM2.5 concentration data and a nationally representative survey in China. We find a significantly negative effect of environmental pollution on households' demand for housing assets but an inverted U-shaped effect on the demand for risky assets. The effects are remarkably robust to correcting the endogenous issue and a battery of robustness checks. Social interaction can partly explain such an effect of pollution. Furthermore, we also find that because households with lower economic status are at greater risk of exposure to environmental pollution and lack of economic capabilities, their holdings of financial assets decrease more than that of the households with higher economic status when faced with pollution; however, their holdings of low liquid assets declining less.
Collapse
Affiliation(s)
- Min Zhang
- School of Economics and Business Administration, Campus B, Chongqing University, Shapingba District, Chongqing, China
| | - Yulin Liu
- School of Public Affairs, Campus A, Chongqing University, Shapingba District, Chongqing, China.
| |
Collapse
|
29
|
Chinweuba AU, Chinweuba IS, Diorgu FC, Ubochi NE, Ezeruigbo CS, Wasini KB, Nnabuenyi AI. Economic burden of moderate to severe burns and its association with health-related quality of life of Nigerian women. BMC Womens Health 2021; 21:85. [PMID: 33639915 PMCID: PMC7916273 DOI: 10.1186/s12905-021-01232-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 02/21/2021] [Indexed: 11/25/2022]
Abstract
Background Burns cases are frequent in Nigeria hospitals, however, literature on its economic burden and the association with health-related quality of life (HRQOL) of women in Nigeria is scarce. This study determined the burden of hospitalization after burns on women’s economic status and its associated HRQOL. Methods This was a three-month cross-sectional study of female patients ≥ 25 years, treated of mixed or full thickness burns in four teaching hospitals in south-east Nigeria, discharged between September–November, 2018. Study instruments were participants’ case notes for socio-demographic and disease history, interviewer-administered questionnaires, namely-economic-burden-of-burns questionnaire and English version of the EuroQol Five-Dimensions-Three-Level Health Questionnaire for Nigeria. Data were collected on second- or third-day post-discharge through home visits or phone calls. This lasted for 13 weeks. Results A total of seventy-three female patients with burn were successfully enrolled. Most participants were married, fairly educated, mainly traders or housewives. Thirty-four (46.6%) had subjective estimated family monthly income below NGN 50,000 (low economic status). Participants’ average monthly income reduced drastically after hospitalization. Their average family monthly income was NGN110,439 (USD307), while their average total expenses incurred during hospitalization was NGN691,093 (USD1,920). Almost all (93.2%) had at least one surgical intervention during management. Their average length of hospital stay was 35.4 days; eleven consequently lost their job. Many had moderate to severe economic burden of treatment; only eleven could bear all the treatment expenses independently. Anxiety/depression and pain/discomfort were common problems reported, However, these Euroqol dimensions varied according to their SES, education and occupation. Women in the low economic class were more inclined to poor HRQOL (Mean ± SD VAS = 53.33 ± 17.619) than women in high economic class (Mean ± SD VAS = 76.67 ± 21.794). Conclusion Burns places high level of economic burden on women and unfortunately, Nigerian government’s commitment to healthcare of burns patients is low. The long course of hospitalization and economic depletion impact negatively on the women’s HRQOL. Based on these findings, we recommend that government parastatals create special trust fund for burns treatment and the National Health Insurance Scheme be restructured for more accessibility.
Collapse
Affiliation(s)
- Anthonia U Chinweuba
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.
| | - Ifunanya S Chinweuba
- Department of Medicine and Surgery, College of Medicine, Chukwuemeka Odumegwu Ojukwu University, Awka, Anambra State, Nigeria
| | - Faith C Diorgu
- Department of Nursing Sciences, University of Port Harcourt, Rivers State, Port Harcourt, Nigeria
| | - Nneka E Ubochi
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Chinwe S Ezeruigbo
- Department of Nursing Science, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Kenneth B Wasini
- Faculty of Nursing Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria
| | - Anthonia I Nnabuenyi
- School of Nursing, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria
| |
Collapse
|
30
|
Alaie I, Ssegonja R, Philipson A, von Knorring AL, Möller M, von Knorring L, Ramklint M, Bohman H, Feldman I, Hagberg L, Jonsson U. Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden: a 25-year longitudinal cohort study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1993-2004. [PMID: 33715045 PMCID: PMC8519903 DOI: 10.1007/s00127-021-02056-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/24/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE Depression at all ages is recognized as a global public health concern, but less is known about the welfare burden following early-life depression. This study aimed to (1) estimate the magnitude of associations between depression in adolescence and social transfer payments in adulthood; and (2) address the impact of major comorbid psychopathology on these associations. METHODS This is a longitudinal cohort study of 539 participants assessed at age 16-17 using structured diagnostic interviews. An ongoing 25-year follow-up linked the cohort (n = 321 depressed; n = 218 nondepressed) to nationwide population-based registries. Outcomes included consecutive annual data on social transfer payments due to unemployment, work disability, and public assistance, spanning from age 18 to 40. Parameter estimations used the generalized estimating equations approach. RESULTS Adolescent depression was associated with all forms of social transfer payments. The estimated overall payment per person and year was 938 USD (95% CI 551-1326) over and above the amount received by nondepressed controls. Persistent depressive disorder was associated with higher recipiency across all outcomes, whereas the pattern of findings was less clear for subthreshold and episodic major depression. Moreover, depressed adolescents presenting with comorbid anxiety and disruptive behavior disorders evidenced particularly high recipiency, exceeding the nondepressed controls with an estimated 1753 USD (95% CI 887-2620). CONCLUSION Adolescent depression is associated with considerable public expenditures across early-to-middle adulthood, especially for those exposed to chronic/persistent depression and psychiatric comorbidities. This finding suggests that the clinical heterogeneity of early-life depression needs to be considered from a longer-term societal perspective.
Collapse
Affiliation(s)
- Iman Alaie
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.
| | - Richard Ssegonja
- grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden
| | - Anna Philipson
- grid.15895.300000 0001 0738 8966Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Anne-Liis von Knorring
- grid.8993.b0000 0004 1936 9457Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Margareta Möller
- grid.15895.300000 0001 0738 8966Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Lars von Knorring
- grid.8993.b0000 0004 1936 9457Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- grid.8993.b0000 0004 1936 9457Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Hannes Bohman
- grid.8993.b0000 0004 1936 9457Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Inna Feldman
- grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden
| | - Lars Hagberg
- grid.15895.300000 0001 0738 8966Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Ulf Jonsson
- grid.8993.b0000 0004 1936 9457Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden ,grid.4714.60000 0004 1937 0626Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
31
|
Guo H, Li W, Yao F, Wu J, Zhou X, Yue Y, Yeh AGO. Who are more exposed to PM2.5 pollution: A mobile phone data approach. Environ Int 2020; 143:105821. [PMID: 32702593 DOI: 10.1016/j.envint.2020.105821] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Few studies have examined exposure disparity to ambient air pollution outside North America and Europe. Moreover, very few studies have investigated exposure disparity in terms of individual-level data or at multi-temporal scales. OBJECTIVES This work aims to examine the associations between individual- and neighbourhood-level economic statuses and individual exposure to PM2.5 across multi-temporal scales. METHODS The study population included 742,220 mobile phone users on a weekday in Shenzhen, China. A geo-informed backward propagation neural network model was developed to estimate hourly PM2.5 concentrations by the use of remote sensing and geospatial big data, which were then combined with individual trajectories to estimate individual total exposure during weekdays at multi-temporal scales. Coupling the estimated PM2.5 exposure with housing price, we examined the associations between individual- and neighbourhood-level economic statuses and individual exposure using linear regression and two-level hierarchical linear models. Furthermore, we performed five sensitivity analyses to test the robustness of the two-level effects. RESULTS We found positive associations between individual- and neighbourhood-level economic statuses and individual PM2.5 exposure at a daytime, daily, weekly, monthly, seasonal or annual scale. Findings on the effects of the two-level economic statuses were generally robust in the five sensitivity analyses. In particular, despite the insignificant effects observed in three of newly selected time periods in the sensitivity analysis, individual- and neighbourhood-level economic statuses were still positively associated with individual total exposure during each of other newly selected periods (including three other seasons). CONCLUSIONS There are statistically positive associations of individual PM2.5 exposure with individual- and neighbourhood-level economic statuses. That is, people living in areas with higher residential property prices are more exposed to PM2.5 pollution. Findings emphasize the need for public health intervention and urban planning initiatives targeting socio-economic disparity in ambient air pollution exposure, thus alleviating health disparities across socioeconomic groups.
Collapse
Affiliation(s)
- Huagui Guo
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, PR China.
| | - Weifeng Li
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, PR China.
| | - Fei Yao
- School of GeoSciences, The University of Edinburgh, Edinburgh EH9 3FF, United Kingdom.
| | - Jiansheng Wu
- Key Laboratory for Urban Habitat Environmental Science and Technology, Shenzhen Graduate School, Peking University, Shenzhen 518055, PR China; Key Laboratory for Earth Surface Processes, Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, PR China.
| | - Xingang Zhou
- College of Architecture and Urban Planning, Tongji University, Shanghai 200092, PR China.
| | - Yang Yue
- Department of Urban Informatics, School of Architecture and Urban Planning, Shenzhen University, Shenzhen 518052, PR China.
| | - Anthony G O Yeh
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, PR China.
| |
Collapse
|
32
|
Lee HJ, Lee DW, Choi DW, Oh SS, Kwon J, Park EC. Association between changes in economic activity and catastrophic health expenditure: findings from the Korea Health Panel Survey, 2014-2016. Cost Eff Resour Alloc 2020; 18:36. [PMID: 32973406 PMCID: PMC7493960 DOI: 10.1186/s12962-020-00233-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022] Open
Abstract
Background The rate of catastrophic health expenditure (CHE) continues to rise in South Korea. This study examined the association between changes in economic activity and CHE experiences in South Korea. Methods This study analyzed the Korea Health Panel Survey data using a logistic regression analysis to study the association between changes in economic activity in 2014–2015 and the participants’ CHE experiences in 2015. The study included a total of 12,454 individuals over the age of 19. The subgroup analyses were organized by sex, age, health-related variables, and household level variables, and the reasons for leaving economic activity. Results Those who quit economic activities were more likely to experience CHE than those who continued to engage in economic activities (OR [odds ratio] = 2.10; 95% CI [confidence interval]: 1.31–3.36). The subgroup analysis results, according to health-related variables, showed that there is a tendency to a higher Charlson comorbidity index, a higher OR, and, in groups that quit their economic activities, people with disabilities were more likely to experience CHE than people without disabilities (OR = 5.63; 95% CI 1.71–18.59, OR = 1.82; 95% CI 1.08–3.08, respectively). Another subgroup analysis found that if the reason for not participating in economic activity was a health-related issue, the participant was more likely to experience CHE (active → inactive: OR = 2.40; 95% CI 0.61–9.43, inactive → inactive OR = 1.65; 95% CI 1.01–2.68). Conclusions Those individuals who became unemployed were more likely to experience CHE, especially if health problems precipitated the job loss. Therefore, efforts are needed to expand coverage for those people who suffer from high medical expenses.
Collapse
Affiliation(s)
- Hyeon Ji Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Doo Woong Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Dong-Woo Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Sarah Soyeon Oh
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea.,Department of Obstetrics & Gynecology, Ewha Womans University, Seoul, Republic of Korea
| | - Junhyun Kwon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| |
Collapse
|
33
|
Malhotra C, Krishnan A, Yong JR, Teo I, Ozdemir S, Ning XH, Hapuarachchi T, Palat G, Bhatnagar S, Joad AK, Tuong PN, Ssu WM, Finkelstein E. Socio-economic inequalities in suffering at the end of life among advanced cancer patients: results from the APPROACH study in five Asian countries. Int J Equity Health 2020; 19:158. [PMID: 32912232 PMCID: PMC7488341 DOI: 10.1186/s12939-020-01274-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/02/2020] [Indexed: 12/16/2022] Open
Abstract
Background A systematic understanding of socio-economic inequalities in end-of-life (EOL) suffering among advanced cancer patients is required to inform efforts to reduce these inequalities as part of Universal Health Coverage goals. Aims To assess inequalities in multiple domains of EOL suffering among advanced cancer patients – physical, functional, psychological, social, and spiritual –, using two socio-economic status (SES) indicators, education and perceived economic status of the household. Methods We used cross-sectional data from surveys of stage IV cancer patients (n = 1378) from seven hospitals across five countries (China, Sri Lanka, India, Vietnam and Myanmar). We conducted separate multivariable linear regression models for each EOL suffering domain. We also tested interactions between the two SES indicators and between each SES indicator and patient age. Results Patients living in low economic status households /with fewer years of education reported greater suffering in several domains. We also found significant interaction effects between economic status of the household and years of education for all EOL suffering outcomes. Age significantly moderated the association between economic status of the household and social suffering and between years of education and psychological, social, and spiritual suffering (p < 0.05 for all). Conclusion Results highlight that SES inequalities in EOL suffering vary depending on the suffering domain, the SES indicator assessed, and by patient age. Greater palliative care resources for patients with low SES may help reduce these inequalities.
Collapse
Affiliation(s)
- Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore. .,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
| | - Anirudh Krishnan
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore
| | - Jing Rong Yong
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Xiao Hong Ning
- Geriatric Department, Peking Union Medical College Hospital, Beijing, China
| | | | - Gayatri Palat
- Department of Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Center, Hyderabad, India
| | - Sushma Bhatnagar
- Unit of Anesthesiology, Pain and Palliative Care, All India Institute of Medical Sciences, Delhi, India
| | - Anjum Khan Joad
- Department of Anesthesiology and Palliative Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India
| | - Pham Nguyen Tuong
- Oncology Center, Hue Central Hospital, 16 Le Loi, Hue City, Hue, Vietnam
| | - Wynn Mon Ssu
- Clinical Research Division, Yangon General Hospital, Yangon, Myanmar
| | - Eric Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Level 4, Singapore, 169857, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| |
Collapse
|
34
|
Tsuchiya-Ito R, Ishizaki T, Mitsutake S, Hamada S, Yoshie S, Iijima K, Tamiya N. Association of household income with home-based rehabilitation and home help service utilization among long-term home care service users. BMC Geriatr 2020; 20:314. [PMID: 32859158 PMCID: PMC7456048 DOI: 10.1186/s12877-020-01704-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine the association of household income with home-based rehabilitation and home help services in terms of service utilization and expenditures. METHODS A secondary data analysis of cross-sectional design was conducted using long-term care (LTC) insurance claims data, medical claims data, and three types of administrative data. The subjects comprised LTC insurance beneficiaries in Kashiwa city, Japan, who used long-term home care services in the month following care needs certification. Household income was the independent variable of interest, and beneficiaries were categorized into low-income or middle/high-income groups based on their insurance premiums. Using a two-part model, the odds ratios (ORs) and 95% confidence intervals (CIs) for the utilization of home-based rehabilitation and home help services in the month following care needs certification were estimated using logistic regression analysis, and the risk ratios (RRs) of service expenditures were estimated using a generalized linear model for gamma-distributed data with a log-link function. RESULTS Among 3770 subjects, 681 (18.1%) used home-based rehabilitation and 1163 (30.8%) used home help services. There were 1419 (37.6%) low-income subjects, who were significantly less likely to use (OR: 0.813; 95%CI: 0.670-0.987) and spend on (RR: 0.910; 95%CI: 0.829-0.999) home-based rehabilitation services than middle/high-income subjects. Conversely, low-income subjects were significantly more likely to use (OR: 1.432; 95%CI: 1.232-1.664) but less likely to spend on (RR: 0.888; 95%CI: 0.799-0.986) home help services than middle/high-income subjects. CONCLUSION Household income was associated with the utilization of long-term home care services. To improve access to these services, the LTC insurance system should examine ways to decrease the financial burden of low-income beneficiaries and encourage service utilization.
Collapse
Affiliation(s)
- Rumiko Tsuchiya-Ito
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. .,Dia Foundation for Research on Ageing Societies, Tokyo, Japan.
| | - Tatsuro Ishizaki
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Seigo Mitsutake
- Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Shota Hamada
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan.,Health Services Research & Development Center, University of Tsukuba, Ibaraki, Japan
| | - Satoru Yoshie
- Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan.,Health Services Research & Development Center, University of Tsukuba, Ibaraki, Japan.,Institute of Gerontology, University of Tokyo, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Ibaraki, Japan
| | - Katsuya Iijima
- Institute of Gerontology, University of Tokyo, Tokyo, Japan.,Institute for Future Initiatives, The University of Tokyo, Ibaraki, Japan
| | - Nanako Tamiya
- Health Services Research & Development Center, University of Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| |
Collapse
|
35
|
Schorn L, Lommen J, Sproll C, Krüskemper G, Handschel J, Nitschke J, Prokein B, Gellrich NC, Holtmann H. Evaluation of patient specific care needs during treatment for head and neck cancer. Oral Oncol 2020; 110:104898. [PMID: 32674039 DOI: 10.1016/j.oraloncology.2020.104898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/19/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tumorous diseases of the head and neck region annually occur in more than 550.000 cases worldwide. Little is known about patient specific care needs and potential relationships between non-fulfillment of those following therapeutic and especially surgical treatment of head and neck cancer (HNC). OBJECTIVES This study aimed to evaluate potential correlations between patient specific care needs, regarding physiological rehabilitation, family/social support, economic needs, and their impact on health-related quality of life (HRQoL). METHODS A total of 1359 patients were included in this retrospective analysis. Data derived from the exploratory international multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK), including 43 oral and maxillofacial departments in Germany, Austria, and Switzerland using the Bochum patient questionnaire on rehabilitation and a questionnaire on tumor and treatment related data. RESULTS Results showed a significant correlation of a patient's social bonds and depression, coping with depression, and anxiety. Patients' needs for speech therapy, physiotherapy or respiratory training were hardly ever met and patients had to compensate for financial losses during hospitalization for acute treatment. CONCLUSION In conclusion, this study describes social, physical, and socio-economic care needs. A multidisciplinary approach managing cancer and treatment related side effects is necessary, as well as enhanced awareness of care needs of practitioners during early recovery after surgery.
Collapse
Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Julian Lommen
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany.
| | - Christoph Sproll
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780 Bochum, Germany
| | - Jörg Handschel
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Kaiserteich Medical Center, Reichstr. 59, 40217 Duesseldorf, Germany; Medical School, Heinrich-Heine-University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Julia Nitschke
- Department of Neurosurgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Benjamin Prokein
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Nils-Claudius Gellrich
- Department for Oral-, Maxillo- and Plastic Facial Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Henrik Holtmann
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Malteser Clinic St. Johannes, Johannisstraße 21, 47198 Duisburg, Germany
| |
Collapse
|
36
|
Rehnberg J. What Levels the Association Between Income and Mortality in Later Life: Age or Health Decline? J Gerontol B Psychol Sci Soc Sci 2020; 75:426-435. [PMID: 31241751 DOI: 10.1093/geronb/gbz082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Researchers frequently use the "age-as-leveler" hypothesis to explain decreasing inequality and a weakened relationship between socioeconomic position and health in old age. This study examined whether health status can explain the age pattern in the association between income and mortality as predicted by the age-as-leveler hypothesis. METHOD This study used longitudinal (1991-2002) data from the SWEOLD and LNU surveys. The analytical sample consisted of 2,619 people aged 54-92 in 2003. Mortality (2003-2014) and income (1991-2000) was collected from Swedish national registers. Poisson regression was used to estimate associations between mortality, income, age, and health status. Average marginal effects were used to visualize interaction effects between income and age. RESULTS The association between income and mortality weakened in those aged 84 and older. However, health status explained a large part of the effect that age had on the association between income and mortality. Analyses done after stratifying the sample by health status showed that the association between income and mortality was strong in people who reported good health and weak or nonexistent in those who reported poor health. DISCUSSION Age leveled the income-mortality association; however, health status, not age, explained most of the leveling.
Collapse
Affiliation(s)
- Johan Rehnberg
- Aging Research Center, Karolinska Institutet, Solna, Sweden.,Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Sweden
| |
Collapse
|
37
|
Alsolami FJ, Azzeh FS, Ghafouri KJ, Ghaith MM, Almaimani RA, Almasmoum HA, Abdulal RH, Abdulaal WH, Jazar AS, Tashtoush SH. Determinants of breast cancer in Saudi women from Makkah region: a case-control study (breast cancer risk factors among Saudi women). BMC Public Health 2019; 19:1554. [PMID: 31752790 PMCID: PMC6873398 DOI: 10.1186/s12889-019-7942-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 11/12/2019] [Indexed: 12/24/2022] Open
Abstract
Background There are various factors that play a major role in influencing the overall health conditions of women diagnosed with breast cancer. The population of women in Makkah region are diverse, therefore it is significant to highlight the possible determinants of breast cancer in this population. This is a case-control study that assessed determinants of breast cancer including socioeconomic factors, health-related characteristics, menstrual histories and breastfeeding among postmenopausal women in Makkah region in Saudi Arabia. Methods A total of 432 female participants (214 cases and 218 controls) were recruited for this study. A validated questionnaire was completed by trained dietitians at King Abdullah Medical City Hospital in the Makkah region of Saudi Arabia. Results Results displayed that determinants of breast cancer were associated significantly (P < 0.05) with unemployment, large family size, lack of knowledge and awareness about breast cancer, obesity, sedentary lifestyle, smoking, starting menarche at an early age, as well as hormonal and non-hormonal contraceptive use. There was no effect of diabetes, hypertension, hyperlipidemia, and duration of breastfeeding on the incidence of breast cancer. Conclusion In summary, the results of this study accentuate the possible effect of socioeconomic factors, health-related characteristics and menstrual history on the incidence of breast cancer in postmenopausal women in the Makkah region. Education programs should be applied to increase breast cancer awareness and possibly decrease its incidence.
Collapse
Affiliation(s)
- Fatmah J Alsolami
- Faculty of Nursing, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Firas S Azzeh
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, P.O. Box: 7067, Makkah, 21955, Kingdom of Saudi Arabia.
| | - Khloud J Ghafouri
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, P.O. Box: 7067, Makkah, 21955, Kingdom of Saudi Arabia
| | - Mazen M Ghaith
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Riyad A Almaimani
- Collage of Medicine, Department of Biochemistry, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Hussain A Almasmoum
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Rwaa H Abdulal
- Department of Medical Laboratory Science, Faculty of Medical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Wesam H Abdulaal
- Cancer Metabolism and Epigenetic Unit, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdelelah S Jazar
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, P.O. Box: 7067, Makkah, 21955, Kingdom of Saudi Arabia
| | | |
Collapse
|
38
|
Houdek P, Dvouletý O, Pažitka M. Biological, environmental and socioeconomic determinants of the human birth sex ratio in the Czech Republic. J Biosoc Sci 2020; 52:37-56. [PMID: 31196227 DOI: 10.1017/S0021932019000233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Trivers-Willard Hypothesis (TWH) states that parents in good conditions bias the sex ratio towards sons and parents in poor conditions bias the sex ratio towards daughters. This study used data from a large nationwide population dataset (N=1,401,851) from the Czech Republic - a modern contemporary society. The study included air pollution and property prices in the TWH estimation, and had a more detailed focus on stillbirths than previous studies. Using official natality microdata from the Czech Statistical Office for years between 1992 and 2010 and data on levels of air pollution in the country over the same period, the study assessed whether the biological and socioeconomic status of mothers and environmental factors affected the sex of children. The results were largely insignificant and not robust across specifications. The presented epidemiological evidence suggests that stillbirths are randomly distributed in the Czech Republic and that the sex ratio is not affected by the socioeconomic status of mothers or by environmental characteristics.
Collapse
|
39
|
Poh BK, Lee ST, Yeo GS, Tang KC, Noor Afifah AR, Siti Hanisa A, Parikh P, Wong JE, Ng ALO. Low socio economic status and severe obesity are linked to poor cognitive performance in Malaysian children. BMC Public Health 2019; 19:541. [PMID: 31196019 PMCID: PMC6565598 DOI: 10.1186/s12889-019-6856-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. Methods A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven’s Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. Results Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110–119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. Conclusions Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.
Collapse
Affiliation(s)
- Bee Koon Poh
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Shoo Thien Lee
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Giin Shang Yeo
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Kean Choon Tang
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Ab Rahim Noor Afifah
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Awal Siti Hanisa
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Panam Parikh
- FrieslandCampina, Amersfoort, LE 3818, The Netherlands
| | - Jyh Eiin Wong
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Alvin Lai Oon Ng
- Department of Psychology, School of Science and Technology, Sunway University, 47500, Petaling Jaya, Malaysia
| | | |
Collapse
|
40
|
He Y, Wu W, Wu S, Zheng HM, Li P, Sheng HF, Chen MX, Chen ZH, Ji GY, Zheng ZDX, Mujagond P, Chen XJ, Rong ZH, Chen P, Lyu LY, Wang X, Xu JB, Wu CB, Yu N, Xu YJ, Yin J, Raes J, Ma WJ, Zhou HW. Linking gut microbiota, metabolic syndrome and economic status based on a population-level analysis. Microbiome 2018; 6:172. [PMID: 30249275 PMCID: PMC6154942 DOI: 10.1186/s40168-018-0557-6] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/07/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The metabolic syndrome (MetS) epidemic is associated with economic development, lifestyle transition and dysbiosis of gut microbiota, but these associations are rarely studied at the population scale. Here, we utilised the Guangdong Gut Microbiome Project (GGMP), the largest Eastern population-based gut microbiome dataset covering individuals with different economic statuses, to investigate the relationships between the gut microbiome and host physiology, diet, geography, physical activity and socioeconomic status. RESULTS At the population level, 529 OTUs were significantly associated with MetS. OTUs from Proteobacteria and Firmicutes (other than Ruminococcaceae) were mainly positively associated with MetS, whereas those from Bacteroidetes and Ruminococcaceae were negatively associated with MetS. Two hundred fourteen OTUs were significantly associated with host economic status (140 positive and 74 negative associations), and 157 of these OTUs were also MetS associated. A microbial MetS index was formulated to represent the overall gut dysbiosis of MetS. The values of this index were significantly higher in MetS subjects regardless of their economic status or geographical location. The index values did not increase with increasing personal economic status, although the prevalence of MetS was significantly higher in people of higher economic status. With increased economic status, the study population tended to consume more fruits and vegetables and fewer grains, whereas meat consumption was unchanged. Sedentary time was significantly and positively associated with higher economic status. The MetS index showed an additive effect with sedentary lifestyle, as the prevalence of MetS in individuals with high MetS index values and unhealthy lifestyles was significantly higher than that in the rest of the population. CONCLUSIONS The gut microbiome is associated with MetS and economic status. A prolonged sedentary lifestyle, rather than Westernised dietary patterns, was the most notable lifestyle change in our Eastern population along with economic development. Moreover, gut dysbiosis and a Western lifestyle had an additive effect on increasing MetS prevalence.
Collapse
Affiliation(s)
- Yan He
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| | - Wei Wu
- Department of Environmental Health, School of Public Health, Southern Medical University, Guangzhou, 510515 China
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Shan Wu
- Department of Environmental Health, School of Public Health, Southern Medical University, Guangzhou, 510515 China
| | - Hui-Min Zheng
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
- Department of Environmental Health, School of Public Health, Southern Medical University, Guangzhou, 510515 China
| | - Pan Li
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
- Department of Environmental Health, School of Public Health, Southern Medical University, Guangzhou, 510515 China
| | - Hua-Fang Sheng
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| | - Mu-Xuan Chen
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| | - Zi-Hui Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Gui-Yuan Ji
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Zhong-Dai-Xi Zheng
- Department of Environmental Health, School of Public Health, Southern Medical University, Guangzhou, 510515 China
| | - Prabhakar Mujagond
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| | - Xiao-Jiao Chen
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| | - Zu-Hua Rong
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
- Department of Environmental Health, School of Public Health, Southern Medical University, Guangzhou, 510515 China
| | - Peng Chen
- Department of Pathophysiology, Southern Medical University, Guangzhou, 510515 China
| | - Li-Yi Lyu
- Shenzhen Fun-Poo Biotech Co., Ltd., Shenzhen, 518000 China
| | - Xian Wang
- Shenzhen Fun-Poo Biotech Co., Ltd., Shenzhen, 518000 China
| | - Jia-Bao Xu
- Department of Pathogen Biology, School of Public Health, Southern Medical University, Guangzhou, 510515 China
| | - Chong-Bin Wu
- Shenzhen Fun-Poo Biotech Co., Ltd., Shenzhen, 518000 China
| | - Nan Yu
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| | - Yan-Jun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Jia Yin
- Department of Neurology, NanFang Hospital, Southern Medical University, Guangzhou, 510515 China
| | - Jeroen Raes
- Department of Microbiology and Immunology, KU Leuven–University of Leuven, Leuven, Belgium
- VIB, Center for the Biology of Disease, Leuven, Belgium
- Vrije Universiteit Brussel, Faculty of Sciences and Bioengineering Sciences, Microbiology Unit, Brussels, Belgium
| | - Wen-Jun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430 China
| | - Hong-Wei Zhou
- State Key Laboratory of Organ Failure Research, Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 China
| |
Collapse
|
41
|
Rent PD, Kumar S, Dmello MK, Purushotham J. Psychosocial Status and Economic Dependence for Healthcare and Nonhealthcare among Elderly Population in Rural Coastal Karnataka. J Midlife Health 2018; 8:174-178. [PMID: 29307979 PMCID: PMC5753498 DOI: 10.4103/jmh.jmh_46_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS) among elderly patients. Materials and Methods: The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September–December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent. Results: Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%), whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them. Conclusion: The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.
Collapse
Affiliation(s)
- Priyanka Dsouza Rent
- Department of Public Health, K. S. Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India
| | - Sudeep Kumar
- Department of Public Health, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | | | - Jagannath Purushotham
- Department of Public Health, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| |
Collapse
|
42
|
Mizuta A, Fujiwara T, Ojima T. Association between economic status and body mass index among adolescents: a community-based cross-sectional study in Japan. BMC Obes 2016; 3:47. [PMID: 27843560 PMCID: PMC5103506 DOI: 10.1186/s40608-016-0127-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/29/2016] [Indexed: 12/05/2022]
Abstract
BACKGROUND Childhood overweight and obesity is a growing health challenge in Japan and might be associated with childhood poverty. We aimed to investigate the association between low economic status and body mass index (BMI) and to reveal the mediators of this association among junior high school students in Japan. METHODS Junior high school students (N = 2968) from two cities in Shizuoka, Japan, were surveyed. Questionnaires assessed subjective economic status, weight, and height. Economic status was categorized into low and non-low, and BMI z-scores were calculated using the WHO Growth Reference. Multivariate regression analyses were conducted to determine the association between economic status and BMI z-scores, adjusted for covariates and stratified by gender. RESULTS Among girls, low economic status was significantly positively associated with BMI z-scores in the crude model (coefficient: 0.35; p = 0.001). In a model adjusted for breakfast skipping, the coefficient of economic status decreased by 28.57 % but remained significant (coefficient: 0.25; p = 0.017). In the final model adjusted for other possible covariates, low economic status remained significantly positively associated with BMI z-score (coefficient: 0.22; p = 0.044). The same association was not found for boys. CONCLUSIONS Low economic status was positively associated with higher BMI among girls in junior high school in Japan, but this was not true for boys. Childhood poverty might be associated with overweight and obesity among adolescent girls in Japan. Health policies at junior high schools to discourage breakfast skipping might be effective for countering the association between childhood poverty and overweight in adolescent girls.
Collapse
Affiliation(s)
- Akiko Mizuta
- Department of Community Health Nursing, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192 Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192 Japan
| |
Collapse
|
43
|
Moradzadeh R, Nadrian H, Golboni F, Kazemi-Galougahi MH, Moghimi N. Economic inequalities amongst women with osteoporosis-related fractures: an application of concentration index decomposition. Health Promot Perspect 2016; 6:190-195. [PMID: 27766236 PMCID: PMC5071786 DOI: 10.15171/hpp.2016.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/08/2016] [Indexed: 11/15/2022] Open
Abstract
Background: Considering the renewed emphasis on women’s health, attention to the new aspects of their health, such as equity, among different groups is warranted. The aim of this study was to investigate the economic inequalities among women with osteoporosis-related bone fractures (ORBFs) in Sanandaj, Iran.
Methods: In this cross-sectional study, convenient sampling was employed to recruit 220 women with osteoporosis referring to the only rheumatology clinic in Sanandaj (the center of Kurdistan province in Iran) from January to April 2013. Main outcome was the history of fractures due to osteoporosis. Concentration index decomposition (CID) and logistic regression were used for data analysis. Results: In multivariate logistic analysis, the fourth and fifth quintiles of family economic status were found to be significantly associated with ORBFs. Risk difference and confidence interval (CI) for the relation between the history of bone fracture and family economic status was -0.115 (95% CI: -0.209, -0.021; P = 0.016), which reflected the higher prevalence of bone fractures among women with the lower economic levels. About 25% out of all ORBFs were happened among 20% of the women with low economic status. Conclusion: It was concluded that economic status plays an important role in happening ORBFs among underprivileged women. A reorientation on women’s health care services in Iran with a focus on underprivileged postmenopausal women seems to be necessary. There is a need for inter-sectoral coalition between the policymakers of the health system and those of other organizations to reduce the economic inequalities among osteoporotic women.
Collapse
Affiliation(s)
- Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Haidar Nadrian
- Department of Health Education & Promotion, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzaneh Golboni
- Department of Midwifery, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hasan Kazemi-Galougahi
- Department of Epidemiology and Biostatistics, School of Health and Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Moghimi
- Department of Rheumatology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
44
|
Sakhelashvili I, Eliozishvili M, Basishvili T, Datunashvili M, Oniani N, Cervena K, Darchia N. Sleep-wake patterns and sleep quality in urban Georgia. Transl Neurosci 2016; 7:62-70. [PMID: 28123823 PMCID: PMC5234514 DOI: 10.1515/tnsci-2016-0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/23/2016] [Indexed: 11/20/2022] Open
Abstract
Objectives Sleep problems represent a worldwide health concern but their prevalence and impacts are unknown in most non-European/North American countries. This study aimed to evaluate sleep-wake patterns, sleep quality and potential correlates of poor sleep in a sample of the urban Georgian population. Methods Analyses are based on 395 volunteers (267 females, 128 males, aged 20-60 years) of the Georgia Somnus Study. Subjects completed the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory-Short Form. Sociodemographic information and self-reported height and weight were collected. Results 43% of subjects had poor sleep quality (PSQI > 5). Further, 41% had low sleep efficiency, 27.6% slept 6 hours or less, 32.4% went to bed after midnight, 27.6% snored, 10.6% were taking sleep medication, and 26.8% had sleep maintenance problems as occurring three or more times a week. The latest bedtime, rise time, and gender effect on these variables were found in the age group 20-29 years. PSQI global score showed a significant age but not gender difference. The economic status and the depression score were two significant predictors of sleep quality. Conclusions Poor sleep quality has a high prevalence and is strongly linked to the economic status. Study findings call for a global assessment of sleep problems in countries where sleep disturbances represent an insufficiently recognized public health issue.
Collapse
Affiliation(s)
- Irine Sakhelashvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Marine Eliozishvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Tamar Basishvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Maia Datunashvili
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Nikoloz Oniani
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| | - Katerina Cervena
- Sleep Medicine Center, Division of Pneumology, University Hospital of Geneva, Geneva, Switzerland
| | - Nato Darchia
- Research center - T. Oniani Laboratory of Sleep-Wakefulness Cycle Studies, Ilia State University, Tbilisi, Georgia
| |
Collapse
|
45
|
Hafeez A, Hussain Shah SM. Impact Of Socio- Economic Status On Determinants Of Medical Career. J Ayub Med Coll Abbottabad 2016; 28:562-567. [PMID: 28712236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Research on determinants of Medical profession has established some constant factors with universal impact and appeal. However, the dramatic changes in the dynamics of medical profession and medical education over the past years have necessitated a revisiting of the established conclusions. The knowledge of impact of economic status on these determinants would pave way to greater interest and research on the subject, especially in Hazara Division where it is practically nonexistent. METHODS This exploratory research followed deductive-inductive approach and was conducted upon 550 respondents from four public and private colleges in Hazara Division. Extensive study of related literature yielded 20 broad determinants of medical career. Pre-research pilot testing verified the reliability of a self-designed instrument. The data collection method adopted was a single shot survey. Personal data of respondents was collected during administration of the instrument. The sample was extracted through systematic random sampling technique giving due weight to proportional representation of each college as well as to the gender distribution. RESULTS The results revealed a significant difference in the impact of reassuring social perceptions and social status and prestige of medical profession between upper middle class and lower middle class. The results also showed that the students of upper middle class faced significantly greater domestic and familial pressure to enter the medical profession than those from lower middle class. CONCLUSIONS The findings showed that the upper middle class is under greater influence of societal forces and wider impressions about the medical profession. The students hailing from upper middle class enter the Medical career motivated by urge for social status and prestige and are most compelled by domestic and familial pressures to enter medicine.
Collapse
Affiliation(s)
- Aamir Hafeez
- Department of Education, Hazara University, Mansehra, Pakistan
| | | |
Collapse
|
46
|
Prince MJ, Lloyd-Sherlock P, Guerra M, Huang Y, Sosa AL, Uwakwe R, Acosta I, Liu Z, Gallardo S, Guerchet M, Mayston R, de Oca VM, Wang H, Ezeah P. The economic status of older people's households in urban and rural settings in Peru, Mexico and China: a 10/66 INDEP study cross-sectional survey. Springerplus 2016; 5:258. [PMID: 27006867 PMCID: PMC4775717 DOI: 10.1186/s40064-016-1913-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/17/2016] [Indexed: 11/24/2022]
Abstract
Few data are available from middle income countries regarding economic circumstances of households in which older people live. Many such settings have experienced rapid demographic, social and economic change, alongside increasing pension coverage. Population-based household surveys in rural and urban catchment areas in Peru, Mexico and China. Participating households were selected from all households with older residents. Descriptive analyses were weighted back for sampling fractions and non-response. Household income and consumption were estimated from a household key informant interview. 877 Household interviews (3177 residents). Response rate 68 %. Household income and consumption correlated plausibly with other economic wellbeing indicators. Household Incomes varied considerably within and between sites. While multigenerational households were the norm, older resident’s incomes accounted for a high proportion of household income, and older people were particularly likely to pool income. Differences in the coverage and value of pensions were a major source of variation in household income among sites. There was a small, consistent inverse association between household pension income and labour force participation of younger adult co-residents. The effect of pension income on older adults’ labour force participation was less clear-cut. Historical linkage of social protection to formal employment may have contributed to profound late-life socioeconomic inequalities. Strategies to formalise the informal economy, alongside increases in the coverage and value of non-contributory pensions and transfers would help to address this problem.
Collapse
Affiliation(s)
- Martin J Prince
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, P060, De Crespigny Park, London, SE5 8AF UK
| | | | - Mariella Guerra
- Psychogeriatric Unit, National Institute of Mental Health "Honorio Delgado Hideyo Noguchi", Jr. Eloy Espinoza 709, Urb. Palao, San Martin de Porres, Lima, Peru
| | - Yueqin Huang
- Peking University, Institute of Mental Health, No. 51 Hua Yuan Bei Road, Haidian District, Beijing, 100191 People's Republic of China
| | - Ana Luisa Sosa
- National Institute of Neurology and Neurosurgery of Mexico, Universidad Nacional Autónoma de México, Insurgentes Sur 3877, 14269 Mexico City, Mexico
| | - Richard Uwakwe
- Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State Nigeria
| | - Isaac Acosta
- National Institute of Neurology and Neurosurgery of Mexico, Universidad Nacional Autónoma de México, Insurgentes Sur 3877, 14269 Mexico City, Mexico
| | - Zhaorui Liu
- Peking University, Institute of Mental Health, No. 51 Hua Yuan Bei Road, Haidian District, Beijing, 100191 People's Republic of China
| | - Sara Gallardo
- Instituto de la Memoria, Depresión y Enfermedades de Riesgo (IMEDER), Av. Constructores 1230, La Molina, Lima Peru
| | - Maelenn Guerchet
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, P060, De Crespigny Park, London, SE5 8AF UK
| | - Rosie Mayston
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, P060, De Crespigny Park, London, SE5 8AF UK
| | - Veronica Montes de Oca
- Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Hong Wang
- Peking University, Institute of Mental Health, No. 51 Hua Yuan Bei Road, Haidian District, Beijing, 100191 People's Republic of China
| | - Peter Ezeah
- Department of Sociology/Anthropology, Nnamdi Azikiwe University Awka, PMB 5025, Awka, Anambra State Nigeria
| |
Collapse
|
47
|
Bu Q, Wang B, Huang J, Liu K, Deng S, Wang Y, Yu G. Estimating the use of antibiotics for humans across China. Chemosphere 2016; 144:1384-1390. [PMID: 26492425 DOI: 10.1016/j.chemosphere.2015.10.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 09/29/2015] [Accepted: 10/02/2015] [Indexed: 06/05/2023]
Abstract
The present study aimed to propose a method to estimate the spatially resolved dataset for human-use antibiotics, which are highly needed in exposure models dealing with regions of various environmental characteristics. In this study, a regression model describing the relationship between the use of antibiotics and a set of socio-economic determinants was developed. It has been demonstrated that economic status (expressed using per capita gross domestic production) dominates the antibiotic use at least in China. Linear regression analysis was used to build the model, resulting in high goodness-of-fit, R(2) (>0.75). Internal and external validations along with residue plot indicated that the model was robust and predictive. The model was successfully applied to allocate the use of antibiotics in China in 2011 at national-, provincial-, prefectural-, and county-level, which are comparable to that back-calculated from the available data of wastewater analysis in some cities. Antibiotic uses were higher in East China than other regions and it was found that uses of total antibiotics vary among Chinese counties on four orders of magnitude (0.186-1645 t antibiotics per year per county). Also management practice could be worked out according to our exploration of the impact transition of social-economic factors on antibiotic uses. To our knowledge, this is the first endeavor to explore this economic dominated relationship for estimating spatially resolved use map of antibiotics in China.
Collapse
Affiliation(s)
- Qingwei Bu
- School of Chemical & Environmental Engineering, China University of Mining & Technology-Beijing, Beijing 100083, PR China.
| | - Bin Wang
- School of Environment, State Key Joint Laboratory of Environmental Simulation and Pollution Control, Beijing Key Laboratory for Emerging Organic Contaminants Control, Tsinghua University, Beijing 100084, PR China.
| | - Jun Huang
- School of Environment, State Key Joint Laboratory of Environmental Simulation and Pollution Control, Beijing Key Laboratory for Emerging Organic Contaminants Control, Tsinghua University, Beijing 100084, PR China.
| | - Kai Liu
- School of Environment, State Key Joint Laboratory of Environmental Simulation and Pollution Control, Beijing Key Laboratory for Emerging Organic Contaminants Control, Tsinghua University, Beijing 100084, PR China.
| | - Shubo Deng
- School of Environment, State Key Joint Laboratory of Environmental Simulation and Pollution Control, Beijing Key Laboratory for Emerging Organic Contaminants Control, Tsinghua University, Beijing 100084, PR China.
| | - Yujue Wang
- School of Environment, State Key Joint Laboratory of Environmental Simulation and Pollution Control, Beijing Key Laboratory for Emerging Organic Contaminants Control, Tsinghua University, Beijing 100084, PR China.
| | - Gang Yu
- School of Environment, State Key Joint Laboratory of Environmental Simulation and Pollution Control, Beijing Key Laboratory for Emerging Organic Contaminants Control, Tsinghua University, Beijing 100084, PR China.
| |
Collapse
|
48
|
Shin D, Kim JM, Tandi TE, Park EC. Impact of change in job status on mortality for newly onset type II diabetes patients: 7 years follow-up using cohort data of National Health Insurance, Korea. Diabetes Metab Syndr 2016; 10:S1-S6. [PMID: 26341929 DOI: 10.1016/j.dsx.2015.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study investigates the relationship between change in job status and mortality of newly diagnosed type II diabetes patients by gender. METHODS Newly onset of individuals diagnosed with type II diabetes in the years 2003 and 2004, had 7 years follow-up using National Health Insurance Corporation (NHIC) sample cohort data. The individuals diagnosed with type II diabetes within this period were 14,861. After adjusting for age, initial income group, insulin treatment and medical service utilization, hazard ratio was analyzed using Cox's proportional hazard model. RESULTS Mortality hazard ratio of continuously unemployed individuals is 3.78 times higher in males and 9.78 times higher in females than in those who keep their jobs. Also, individuals with a change in job status (e.g. from industrial worker to unemployed or self-employed), the mortality hazard ratio is 2.24 times higher in males and 5.23 times higher in females than in those who keep their jobs. The impact of change in job status change is largest for the middle class males. The middle class males has the higher mortality hazard ratio, 6.14 times in maintain unemployed and 4.12 times in change his job (industrial worker to unemployed or self-employer) than maintain one's job. CONCLUSIONS The continuous unemployment and the loss of job are related to risk of death in diabetic patients. The impact of unemployed is stronger than job change (loss or change). The impact of job status change is largest for the middle class man.
Collapse
Affiliation(s)
- Donggyo Shin
- NHIC Ilsan Hospital, Ilsan, Korea; School of Medicine, Graduate school of public health, Korea University, Seoul, Korea
| | - Ji Man Kim
- Department of Health Business Administration, Woosong University, Daejeon, Korea
| | - Tinyami Erick Tandi
- School of Medicine, Graduate school of public health, Korea University, Seoul, Korea; Institute for Occupational & Environmental Health, Korea University, Seoul, Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
49
|
Karalexi MA, Papathoma P, Thomopoulos TP, Ryzhov A, Zborovskaya A, Dimitrova N, Zivkovic S, Eser S, Antunes L, Sekerija M, Zagar T, Bastos J, Demetriou A, Agius D, Cozma R, Coza D, Bouka E, Dessypris N, Belechri M, Dana H, Hatzipantelis E, Papakonstantinou E, Polychronopoulou S, Pourtsidis A, Stiakaki E, Chatziioannou A, Manolitsi K, Orphanidis G, Papadopoulos S, Papathanasiou M, Patsouris E, Sgouros S, Zountsas B, Moschovi M, Steliarova-Foucher E, Petridou ET. Childhood central nervous system tumour mortality and survival in Southern and Eastern Europe (1983-2014): Gaps persist across 14 cancer registries. Eur J Cancer 2015; 51:2665-77. [PMID: 26343313 DOI: 10.1016/j.ejca.2015.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/11/2015] [Accepted: 08/17/2015] [Indexed: 01/29/2023]
Abstract
AIM Childhood central nervous system (CNS) tumour registration and control programs in Southern and Eastern Europe remain thin, despite the lethal nature of the disease. Mortality/survival data were assembled to estimate the burden of malignant CNS tumours, as well as the potential role of sociodemographic survival determinants across 14 cancer registries of this region. METHODS Average age-adjusted mortality rates were calculated, whereas time trends were quantified through Poisson and Joinpoint regressions. Kaplan-Meier curves were derived for the maximum and the more recent (10 and 5 year) registration periods. Multivariate Cox regression models were used to assess demographic and disease-related determinants. RESULTS Variations in mortality (8-16 per million) and survival (5-year: 35-69%) were substantial among the participating registries; in most registries mortality trend was stable, whereas Bulgaria, having the highest starting rate, experienced decreasing annual mortality (-2.4%, p=0.001). A steep decrease in survival rates was evident before the second year of follow-up. After controlling for diagnostic subgroup, age, gender and diagnostic year, Greece seemed to present higher survival compared with the other contributing registries, although the follow-up period was short. Irrespective of country, however, rural residence was found to impose substantial adverse repercussions on survival (hazard ratio (HR): 1.2, 95% confidence interval (CI): 1.1-1.4). CONCLUSION Cross-country mortality and survival variations possibly reflect suboptimal levels of health care delivery and cancer control in some regions of Southern and Eastern Europe, notwithstanding questionable death certification patterns or follow-up procedures. Continuous childhood cancer registration and linkage with clinical data are prerequisite for the reduction of survival inequalities across Europe.
Collapse
Affiliation(s)
- Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Paraskevi Papathoma
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Thomas P Thomopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Anton Ryzhov
- National Cancer Registry of Ukraine, National Institute of Cancer, Kyiv, Ukraine
| | - Anna Zborovskaya
- Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Childhood Cancer Subregistry of Belarus, Minsk, Belarus
| | - Nadya Dimitrova
- Bulgarian National Cancer Registry, National Oncology Hospital, Sofia, Bulgaria
| | | | - Sultan Eser
- Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Ankara, Turkey
| | - Luís Antunes
- North Region Cancer Registry of Portugal (NORTH), Portuguese Oncology Institute of Porto, Portugal
| | - Mario Sekerija
- Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb, Croatia
| | - Tina Zagar
- Cancer Registry of Republic of Slovenia, Institute of Oncology, Ljubljana, Slovenia
| | - Joana Bastos
- Registo Oncológico Regional do Centro, Instituto Português de Oncologia de Coimbra Francisco Gentil E.P.E, Coimbra, Portugal
| | - Anna Demetriou
- Cyprus Cancer Registry-Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | - Domenic Agius
- Malta National Cancer Registry, Department of Health Information and Research, Malta
| | - Raluca Cozma
- Epidemiology, Institute of Public Health, 16-18 Victor Babes Street, Timisoara 300226, Romania
| | - Daniela Coza
- Regional Cancer Registry of Cluj, Oncological Institute "Ion Chiricuta", Cluj-Napoca, Romania
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Maria Belechri
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Helen Dana
- Oncology Department, "Mitera" Childrens Hospital, Erythrou Stavrou 6 Marousi, Athens, Greece
| | - Emmanuel Hatzipantelis
- 2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece
| | | | - Sophia Polychronopoulou
- Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Apostolos Pourtsidis
- Department of Pediatric Hematology-Oncology, "Pan. & Agl. Kyriakou" Children's Hospital, Athens, Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Achilles Chatziioannou
- First Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, Athens, Greece
| | - Katerina Manolitsi
- Department of Neurosurgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | | | - Mathilda Papathanasiou
- 2nd Department of Radiology, Radiotherapy Unit, Medical School, National Kapodistrian University of Athens, Athens, Greece
| | - Eustratios Patsouris
- Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Spyros Sgouros
- Department of Neurosurgery, "Mitera" Childrens Hospital, Erythrou Stavrou 6 Marousi, Athens, Greece
| | - Basilios Zountsas
- Department of Neurosurgery, St. Luke's Hospital, Panorama, Thessaloniki
| | - Maria Moschovi
- Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
| |
Collapse
|
50
|
Lim YH, Bell ML, Kan H, Honda Y, Guo YLL, Kim H. Economic status and temperature-related mortality in Asia. Int J Biometeorol 2015; 59:1405-12. [PMID: 25597032 DOI: 10.1007/s00484-014-0950-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 09/16/2014] [Accepted: 12/23/2014] [Indexed: 05/24/2023]
Abstract
In developed countries, low latitude and high temperature are positively associated with the population's ability to adapt to heat. However, few studies have examined the effect of economic status on the relationship between long-term exposure to high temperature and health. We compared heterogeneous temperature-related mortality effects relative to the average summer temperature in high-socioeconomic-status (SES) cities to temperature-related effects in low-SES cities. In the first stage of the research, we conducted a linear regression analysis to quantify the mortality effects of high temperature (at or above the 95th percentile) in 32 cities in Taiwan, China, Japan, and Korea. In the second stage, we used a meta-regression to examine the association between mortality risk with average summer temperature and gross domestic product (GDP) per capita. In cities with a low GDP per capita (less than 20,000 USD), the effects of temperature were detrimental to the population if the long-term average summer temperature was high. In contrast, in cities with a high GDP per capita, temperature-related mortality risk was not significantly related to average summer temperature. The relationship between long-term average summer temperature and the short-term effects of high temperatures differed based on the city-level economic status.
Collapse
Affiliation(s)
- Youn-Hee Lim
- Institute of Environmental Medicine, Seoul National University of Medical Research Center, Seoul, Korea
- Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Yasushi Honda
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, National Taiwan University, Taipei, Taiwan
| | - Ho Kim
- Department of Epidemiology and Biostatistics, Graduate School of Public Health, Seoul National University, Seoul, Korea.
- Institute of Health and Environment, Seoul National University, Seoul, Korea.
| |
Collapse
|