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Tao Y, Zhao J, Cui H, Liu L, He L. Exploring the impact of socioeconomic and natural factors on pulmonary tuberculosis incidence in China (2013-2019) using explainable machine learning: A nationwide study. Acta Trop 2024; 253:107176. [PMID: 38460829 DOI: 10.1016/j.actatropica.2024.107176] [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: 12/06/2023] [Revised: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
Pulmonary tuberculosis (PTB) stands as a significant and prevalent infectious disease in China. Integrating 13 natural and socioeconomic factors, we conduct nine machine learning (ML) models alongside the Tree-Structured Parzen Estimator to predict the monthly PTB incidence rate from 2013 to 2019 in mainland China. With explainable ML techniques, our research highlights that population size, per capita GDP, and PM10 concentration emerge as the primary determinants influencing the PTB incidence rate. We delineate both the independent and interactive impacts of these factors on the PTB incidence rate. Furthermore, crucial thresholds associated with factors influencing the PTB incidence rate are identified. Taking factors that have a positive effect on reducing the incidence rate of PTB as an example, the thresholds at which the effects of factors PM2.5, PM10, O3, and RH on the incidence rate change from increase to decrease are 105.5 µg/m3, 75.5 µg/m3, 90.8 µg/m3, and 72.3 % respectively. Our work will contribute valuable insights for public health interventions.
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Affiliation(s)
- Yiwen Tao
- School of Mathematics and Statistics, Zhengzhou University, Zhengzhou 450001, China
| | - Jiaxin Zhao
- School of Mathematics and Statistics, Zhengzhou University, Zhengzhou 450001, China
| | - Hao Cui
- School of the Geoscience and Technology, Zhengzhou University, Zhengzhou 450001, China.
| | - Lili Liu
- Shanxi Key Laboratory of Mathematical Techniques and Big Data Analysis on Disease Control and Prevention, Complex Systems Research Center, Shanxi University, Taiyuan 030006, China
| | - Long He
- College of Mechanical and Electrical Engineering, Shaanxi University of Science and Technology, Xi'an 710021, China
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2
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Molcho M, Thomas AA, Sharp L. Reply to: Comments on "Social inequalities in treatment receipt for childhood cancers in Ireland: A population-based analysis". Int J Cancer 2024; 154:1675-1676. [PMID: 38205875 DOI: 10.1002/ijc.34837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Michal Molcho
- School of Education, University of Galway, Galway, Ireland
| | - Audrey A Thomas
- Division of Undergraduate Education, UC Berkeley, Berkeley, California, USA
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
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3
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Li K, Li H, Wang Y, Yang Z, Liang S. Household carbon footprints of age groups in China and socioeconomic influencing factors. Sci Total Environ 2024; 923:171402. [PMID: 38431176 DOI: 10.1016/j.scitotenv.2024.171402] [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: 09/21/2023] [Revised: 02/04/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
China has a large fastest-aging population, which would reshape household consumption patterns and influence global CO2 emissions. This study examines global CO2 emissions driven by household consumption (i.e., household carbon footprints, HCFs) of 34 age groups in China's 30 provinces and uncovers relevant socioeconomic influencing factors. Results show that China's population aging (i.e., the proportion of the elderly population) is conducive to global CO2 emission reduction during 2011-2014. This trend is mainly due to the relatively lower per capita HCFs of the elderly (1.7 t in 2014). In contrast, the per capita HCFs of the youth group are higher (3.3 t in 2014), mainly affected by the large expenditure on residence and transportation & communication. In addition, the HCFs of all age groups have increased during 2011-2014. Per capita expenditure is the most significant driver of this increase. The decline in CO2 emission intensity makes the largest contribution to reducing the HCFs of the youth group. For the aged group, expenditure structure change is the largest contributor to HCFs reduction. These findings reveal the differentiated impacts of China's household consumption by age on global CO2 emissions. This study lays the scientific foundation for deriving amelioration policies and achieving emission reduction targets in the process of population aging.
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Affiliation(s)
- Ke Li
- Guangdong Basic Research Center of Excellence for Ecological Security and Green Development in Guangdong-Hong Kong-Marco Greater Bay Area (GBA), Key Laboratory for City Cluster Environmental Safety and Green Development of the Ministry of Education, School of Ecology, Environment and Resources, Guangdong University of Technology, Guangzhou 510006, China
| | - Hui Li
- School of Environment, Beijing Normal University, Beijing 100875, China
| | - Yafei Wang
- School of Statistics, Beijing Normal University, Beijing 100875, China
| | - Zhifeng Yang
- Guangdong Basic Research Center of Excellence for Ecological Security and Green Development in Guangdong-Hong Kong-Marco Greater Bay Area (GBA), Key Laboratory for City Cluster Environmental Safety and Green Development of the Ministry of Education, School of Ecology, Environment and Resources, Guangdong University of Technology, Guangzhou 510006, China
| | - Sai Liang
- Guangdong Basic Research Center of Excellence for Ecological Security and Green Development in Guangdong-Hong Kong-Marco Greater Bay Area (GBA), Key Laboratory for City Cluster Environmental Safety and Green Development of the Ministry of Education, School of Ecology, Environment and Resources, Guangdong University of Technology, Guangzhou 510006, China.
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4
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Plass C. Alert regarding "Social inequalities in treatment receipt for childhood cancers in Ireland: A population-based analysis. Michal Molcho, Audrey A. Thomas, Paul M. Walsh, Roderick Skinner, Linda Sharp. Int J Cancer 2022 Mar 15;150(6):941-951. https://doi.org/10.1002/ijc.33856". Int J Cancer 2024; 154:1521. [PMID: 38205858 DOI: 10.1002/ijc.34840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
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5
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Grover S, Varadharajan N, Venu S. Urbanization and psychosis: an update of recent evidence. Curr Opin Psychiatry 2024; 37:191-201. [PMID: 38441163 DOI: 10.1097/yco.0000000000000931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE OF REVIEW Urbanization, a complex global phenomenon, has a significant bearing on schizophrenia/psychosis burden through various socioeconomic and environmental factors. This review focuses on recent evidence (2019-2023) linking urbanization, schizophrenia, and the role of green space. RECENT FINDINGS This review analyzed 43 articles that examined the correlation between urban birth or upbringing, urban living (urbanicity), and various schizophrenia/psychosis-related outcomes such as incidence, psychotic experiences, etc. The studies showed differing results across geographical locations. Socioeconomic factors like area deprivation, migrant status (ethnic density) and social fragmentation were independently associated with the risk of schizophrenia/psychosis irrespective of urbanicity. More recently, environmental factors such as green space reduction and air pollution have been explored in urban living conditions and were positively associated with an increased risk of schizophrenia/psychosis. SUMMARY There is a need for further investigation in low and middle-income countries. The impact of urbanization-related factors and green space on the risk of schizophrenia/psychosis calls for appropriate governmental commitments toward structured and healthy urban planning.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, Punjab
| | - Natarajan Varadharajan
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)
| | - Sandesh Venu
- Department of Psychiatry, Pondicherry Institute of Medical Sciences (PIMS), Kalapet, Puducherry, India
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6
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Barrett N, Tucker-Kellogg G, Smith OP. Comments on "Social inequalities in treatment receipt for childhood cancers in Ireland: A population-based analysis". Int J Cancer 2024; 154:1669-1674. [PMID: 38205859 DOI: 10.1002/ijc.34838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Neil Barrett
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Greg Tucker-Kellogg
- Department of Biological Sciences, National University of Singapore, Singapore
| | - Owen P Smith
- National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland
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Brzobohatá H, Bejdová Š, Černíková A, Velímský F, Frolík J, Velemínský P. Dental health status of the medieval silver-mining community from Kutná Hora (Czech Republic, 13th-16th c.): Impact of socioeconomic changes and mortality crises. Arch Oral Biol 2024; 161:105913. [PMID: 38382163 DOI: 10.1016/j.archoralbio.2024.105913] [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: 09/29/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The aim of the study was to evaluate the pathological conditions in teeth from skeletal remains found in the medieval burial ground at Kutná Hora (13th-16th centuries, Czech Republic). We focused on the effect on dental health of socioeconomic changes associated with the boom in silver mining at the site. DESIGN In this study, dental caries and antemortem tooth loss were recorded for 469 sexed adults (10,558 permanent teeth). Pathologies were analysed and presented by teeth and alveoli, and the differences between their frequencies were tested in sex-, age-, and burial context-separated groups (mass vs. individual graves). RESULTS The oral conditions were characterised by a low frequency of caries and moderate frequency of antemortem tooth loss (AMTL). For caries, males and females showed the same frequencies while AMTL comparisons indicated a higher rate in females. Most differences emerged between age-separated and burial context-separated groups. The age progression of the pathologies was confirmed for both caries and AMTL. Skeletons from mass burials had higher caries and AMTL frequencies than those buried in individual graves. CONCLUSIONS The dataset exhibited low caries and below average AMTL rates compared to other medieval European skeletal series. We think that life in this mining centre had a positive effect on the dental health of its inhabitants. The relatively poorer dental health of those buried in mass graves reflected either the specific composition of the population in the first half of the 14th century or the lower resilience of these individuals when facing mortality crises.
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Affiliation(s)
- Hana Brzobohatá
- Institute of Archaeology of the Czech Academy of Sciences, Letenská 4, 118 01 Prague, Czech Republic.
| | - Šárka Bejdová
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Viničná 7, 128 44 Prague, Czech Republic
| | - Alena Černíková
- Institute of Applied Mathematics and Information Technologies, Faculty of Science, Charles University, Albertov 6, 128 43 Prague, Czech Republic
| | - Filip Velímský
- Institute of Archaeology of the Czech Academy of Sciences, Letenská 4, 118 01 Prague, Czech Republic
| | - Jan Frolík
- Institute of Archaeology of the Czech Academy of Sciences, Letenská 4, 118 01 Prague, Czech Republic
| | - Petr Velemínský
- Department of Anthropology, National Museum Prague, Václavské náměstí 68, 115 79 Prague, Czech Republic
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8
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Dang X, Yang R, Jing Q, Niu Y, Li H, Zhang J, Liu Y. Association between high or low-quality carbohydrate with depressive symptoms and socioeconomic-dietary factors model based on XGboost algorithm: From NHANES 2007-2018. J Affect Disord 2024; 351:507-517. [PMID: 38307135 DOI: 10.1016/j.jad.2024.01.220] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Depressive symptoms are a serious public mental health problem, and dietary intake is often considered to be associated with depressive symptoms. However, the relationship between the quality of dietary carbohydrates and depressive symptoms remains unclear. Therefore, this study aimed to investigate the relationship between high and low-quality carbohydrates and depressive symptoms and to attempt to construct an integrated model using machine learning to predict depressive symptoms. METHODS A total of 4982 samples from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Carbohydrate intake was assessed by a 24-h dietary review, and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ9). Variance inflation factor (VIF) and Relief-F algorithms were used for variable feature selection. RESULTS The results of multivariate linear regression showed a negative association between high-quality carbohydrates and depressive symptoms (β: -0.147, 95 % CI: -0.239, -0.056, p = 0.002) and a positive association between low-quality carbohydrates and depressive symptoms (β: 0.018, 95 % CI: 0.007, 0.280, p = 0.001). Subsequently, we used the XGboost model to produce a comprehensive depressive symptom evaluation model and developed a corresponding online tool (http://8.130.128.194:5000/) to evaluate depressive symptoms clinically. LIMITATIONS The cross-sectional study could not yield any conclusions regarding causality, and the model has not been validated with external data. CONCLUSIONS Carbohydrate quality is associated with depressive symptoms, and machine learning models that combine diet with socioeconomic factors can be a tool for predicting depression severity.
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Affiliation(s)
- Xiangji Dang
- Department of Pharmaceutical, Lanzhou University Second Hospital, Cui Ying Men No.80, Lanzhou 730030, Gansu Province, PR China
| | - Ruifeng Yang
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Qi Jing
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Yingdi Niu
- Science and Technology Museum, Gansu, Yin'an Road No.568, Lanzhou 730070, PR China
| | - Hongjie Li
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Jingxuan Zhang
- School of Second Clinical Medical, Lanzhou University, Donggang West Road No. 199, Lanzhou 730020, PR China
| | - Yan Liu
- School of Pharmacy, Lanzhou University, Donggang West Road No. 199, Gansu 730020, P.R. China.
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9
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Zeng P, Shi D, Helbich M, Sun F, Zhao H, Liu Y, Che Y. Gender disparities in summer outdoor heat risk across China: Findings from a national county-level assessment during 1991-2020. Sci Total Environ 2024; 921:171120. [PMID: 38382599 DOI: 10.1016/j.scitotenv.2024.171120] [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: 11/07/2023] [Revised: 01/21/2024] [Accepted: 02/18/2024] [Indexed: 02/23/2024]
Abstract
Increasing anthropogenic global warming has emerged as a significant challenge to human health in China, as extreme heat hazards increasingly threaten outdoor-exposed populations. Differences in thermal comfort, outdoor activity duration, and social vulnerability between females and males may exacerbate gender inequalities in heat-related health risks, which have been overlooked by previous studies. Here, we combine three heat hazards and outdoor activity duration to identify the spatiotemporal variation in gender-specific heat risk in China during 1991-2020. We found that females' heat risk tends to be higher than that of males. Gender disparities in heat risk decrease in southern regions, while those in northern regions remain severe. Males are prone to overheating in highly urbanized areas, while females in low urbanized areas. Males' overheating risk is mainly attributed to population clustering associated with prolonged outdoor activity time and skewed social resource allocation. In contrast, females' overheating risk is primarily affected by social inequalities. Our findings suggest that China needs to further diminish gender disparities and accelerate climate adaptation planning.
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Affiliation(s)
- Peng Zeng
- School of Ecological and Environmental Sciences, Shanghai Key Lab for Urban Ecological Processes and Eco-Restoration, Institute of Eco-Chongming (IEC), East China Normal University, Shanghai 200241, China; Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht CS 3584, the Netherlands
| | - Dachuan Shi
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht CS 3584, the Netherlands
| | - Fengyun Sun
- School of Environmental and Geographical Sciences, Shanghai Normal University, Shanghai 200234, China
| | - Hongyu Zhao
- School of Architecture and Planning, Jilin Jianzhu University, No.5088, Xincheng Road, Nanguan District, Changchun 130118, China
| | - Yaoyi Liu
- School of Ecological and Environmental Sciences, Shanghai Key Lab for Urban Ecological Processes and Eco-Restoration, Institute of Eco-Chongming (IEC), East China Normal University, Shanghai 200241, China
| | - Yue Che
- School of Ecological and Environmental Sciences, Shanghai Key Lab for Urban Ecological Processes and Eco-Restoration, Institute of Eco-Chongming (IEC), East China Normal University, Shanghai 200241, China.
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10
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Ankara HG, Degerli H, Degerli H. Freebie Seekers or Desperate Buyers? An Analysis of Willingness to Pay for COVID-19 Vaccine in Türkiye. Soc Work Public Health 2024; 39:276-283. [PMID: 38436269 DOI: 10.1080/19371918.2024.2323140] [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] [Indexed: 03/05/2024]
Abstract
The aim of the study is to determine the level of price that individuals living in Türkiye are willing to pay (WTP) for a hypothetical COVID-19 vaccine. In addition, the study also aims to identify the socioeconomic factors affecting that level of WTP. The data is collected via a virtually applied questionnaire. Probit estimations are employed to determine the level of price that is willing to be paid. Further, the socioeconomic factors affecting the revealed WTP level are identified with an ordered-probit estimation strategy. The average price level that the participants are willing to pay for two doses of a hypothetical COVID-19 vaccine which immunes for 12 months is ₺316.93 ($42.66). Higher education groups, public employees, married people, and urban individuals are more likely to pay at higher price levels of hypothetical COVID-19 vaccine. Interestingly, the individuals living with a pregnant woman or a baby, the ones who experienced severe COVID-19 disease and the ones who already decided to be vaccinated are more likely to pay at relatively low-price levels. This study may contribute to broader literature as it will provide evidence from Türkiye for international comparisons.
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Affiliation(s)
- Hasan Giray Ankara
- Department of Health Management, The University of Health Sciences, Istanbul, Türkiye
- Faculty of Health Sciences, Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Hakan Degerli
- Vocational School of Health Services, Bilecik Şeyh Edebali University, Bilecik, Türkiye
| | - Havvana Degerli
- Department of Health Management, The University of Health Sciences, Istanbul, Türkiye
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11
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Xu KQ, Aw JYH, Payne CF. Inequalities in Mortality in the Asia-Pacific: A Cross-National Comparison of Socioeconomic Gradients. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad193. [PMID: 38195098 PMCID: PMC10948962 DOI: 10.1093/geronb/gbad193] [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: 02/09/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES Social inequalities in mortality are poorly studied in much of the Asia-Pacific. Using data from harmonized nationally representative longitudinal health and aging surveys our study systematically assesses mortality disparities across 3 standardized measures of socioeconomic status in 7 Asia-Pacific countries. METHODS We used data from multiple waves of 7 representative sample surveys: the Health, Income and Labour Dynamics in Australia survey, China Health and Retirement Longitudinal Study, the Indonesian Family Life Survey, the New Zealand Health, Work and Retirement survey, the Korean Longitudinal Study on Ageing and the Health, Aging and Retirement in Thailand survey, and the Japanese Study of Aging and Retirement. We use Cox proportional hazards modeling to examine how the hazard of mortality differs across domains of social stratification including educational attainment, wealth, and occupational status across countries. RESULTS We found consistent and pervasive gradients in mortality risk in the high-income countries by all available measures of social stratification. In contrast, patterns of inequality in adult mortality in middle-income and recently transitioned high-income countries investigated varied depending on the measure of social stratification, with strong gradients by wealth but mixed gradients by education. DISCUSSION Analyzing social gradients in mortality in the Asia-Pacific shows that inequalities, especially wealth-based inequalities, in later-life health are present across the region, and that the magnitude of social gradients in mortality is overall larger in high-income countries as compared to middle-income countries.
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Affiliation(s)
- Kim Qinzi Xu
- School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jessica Yi Han Aw
- School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australian Capital Territory, Australia
- School of Medicine and Psychology, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Collin F Payne
- School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australian Capital Territory, Australia
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, Massachusetts, USA
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12
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Liao JM, Anzai Y, Sadigh G, Fendrick AM, Lee CI. JACR Health Policy Expert Panel: Health Equity and Out-of-Pocket Payments for Imaging Studies. J Am Coll Radiol 2024; 21:688-690. [PMID: 37517773 DOI: 10.1016/j.jacr.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Joshua M Liao
- Director of the Value and Systems Science Lab and Associate Chair for Health Systems, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
| | - Yoshimi Anzai
- Director of Value and Safety for Enterprise Imaging, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah. https://twitter.com/yoshimianzai
| | - Gelareh Sadigh
- Director of Radiology Health Services and Comparative Outcomes Research, Department of Radiological Sciences, University of California at Irvine, Irvine, California. https://twitter.com/GelarehSadigh
| | - A Mark Fendrick
- Director, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan. https://twitter.com/FendrickVBID
| | - Christoph I Lee
- Director of the Northwest Screening and Cancer Outcomes Research Enterprise, Department of Radiology, University of Washington School of Medicine, Seattle, Washington; Deputy Editor of JACR. https://twitter.com/christophleemd
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Donohue JK, Jarosinski M, Reitz KM, Khamzina Y, Ledyard J, Liang NL, Chaer RA, Sridharan ND. Socioeconomic factors predict successful supervised exercise therapy completion. J Vasc Surg 2024; 79:904-910. [PMID: 38092308 PMCID: PMC10960665 DOI: 10.1016/j.jvs.2023.12.008] [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: 09/21/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 01/04/2024]
Abstract
OBJECTIVE Supervised exercise therapy (SET) for patients with intermittent claudication (IC) can lower the risk of progression to chronic limb-threatening ischemia and amputation, while preserving and restoring functional status. Despite supporting evidence, it remains underutilized, and among those who initiate programs, attrition rates are extremely high. We hypothesize that socioeconomic factors may represent significant barriers to SET completion. METHODS Patients with IC referred to SET at a multi-hospital, single-institution health care system (2018-2022) from a prospectively maintained database were retrospectively analyzed. Our primary endpoint was SET program completion and graduation, defined as completion of 36 sessions. Our secondary endpoints were vascular intervention within 1 year of referral and change in ankle-brachial index (ABI). Baseline demographics were assessed using standard statistical methods. Predictors of SET graduation were analyzed using multivariable logistic regression generating adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Change in ABI was analyzed using t-test between subgroups. Reasons for attrition were tabulated. Patient Health Questionnaire-9 (PHQ-9), metabolic equivalent level, Vascular QOL, Duke Activity Status, and ABI were analyzed using paired t-tests across the entire cohort. RESULTS Fifty-two patients met inclusion criteria: mean age 67.85 ± 10.69 years, 19 females (36.54%), mean baseline ABI of 0.77 ± 0.16. The co-pays for 100% of patients were fully covered by primary and secondary insurance plans. Twenty-one patients (40.38%) completed SET. On multivariable analysis, residence in a ZIP code with median household income <$47,000 (aOR, 0.10; 95% CI, 0.01-0.76; P = .03) and higher body mass index (aOR, 0.81; 95% CI, 0.67-0.99; P = .04) were significant barriers to SET graduation. There were no differences in ABI change or vascular intervention within 1 year between graduates and non-graduates. Non-graduates reported transportation challenges (25.00%), lack of motivation (20.83%), and illness/functional limitation (20.83%) as primary reasons for SET attrition. Metabolic Equivalent Level (P ≤ .01) and Duke Activity Status scores (P = .04) were significantly greater after participating in a SET program. CONCLUSIONS Although SET participation improves lower extremity and functionality outcomes, only 40% of referred patients completed therapy in our cohort. Our findings suggest that both socioeconomic and functional factors influence the odds of completing SET programs, indicating a need for holistic pre-referral assessment to facilitate enhanced program accessibility for these populations.
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Affiliation(s)
- Jack K Donohue
- University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | | | - Katherine M Reitz
- Division of Vascular Surgery, University of Pittsburgh, Pittsburgh, PA
| | | | - Jonathan Ledyard
- Cardiopulmonary Rehabilitation, University of Pittsburgh, Pittsburgh, PA
| | - Nathan L Liang
- Division of Vascular Surgery, University of Pittsburgh, Pittsburgh, PA
| | - Rabih A Chaer
- Division of Vascular Surgery, University of Pittsburgh, Pittsburgh, PA
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Fonseca AL, Ahmad R, Amin K, Tripathi M, Vobbilisetty V, Richman JS, Hearld L, Bhatia S, Heslin MJ. Time Kills: Impact of Socioeconomic Deprivation on Timely Access to Guideline-Concordant Treatment in Foregut Cancer. J Am Coll Surg 2024; 238:720-730. [PMID: 38205919 DOI: 10.1097/xcs.0000000000000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Receipt of guideline-concordant treatment (GCT) is associated with improved prognosis in foregut cancers. Studies show that patients living in areas of high neighborhood deprivation have worse healthcare outcomes; however, its effect on GCT in foregut cancers has not been evaluated. We studied the impact of the area deprivation index (ADI) as a barrier to GCT. STUDY DESIGN A single-institution retrospective review of 498 foregut cancer patients (gastric, pancreatic, and hepatobiliary adenocarcinoma) from 2018 to 2022 was performed. GCT was defined based on National Comprehensive Cancer Network guidelines. ADI, a validated measure of neighborhood disadvantage was divided into terciles (low, medium, and high) with high ADI indicating the most disadvantage. RESULTS Of 498 patients, 328 (66%) received GCT: 66%, 72%, and 59% in pancreatic, gastric, and hepatobiliary cancers, respectively. Median (interquartile range) time from symptoms to workup was 6 (3 to 13) weeks, from diagnosis to oncology appointment was 4 (1 to 10) weeks, and from oncology appointment to treatment was 4 (2 to 10) weeks. Forty-six percent were diagnosed in the emergency department. On multivariable analyses, age 75 years or older (odds ratio [OR] 0.39 [95% CI 0.18 to 0.87]), Black race (OR 0.52 [95% CI 0.31 to 0.86]), high ADI (OR 0.25 (95% CI 0.14 to 0.48]), 6 weeks or more from symptoms to workup (OR 0.44 [95% CI 0.27 to 0.73]), 4 weeks or more from diagnosis to oncology appointment (OR 0.76 [95% CI 0.46 to 0.93]), and 4 weeks or more from oncology appointment to treatment (OR 0.63 [95% CI 0.36 to 0.98]) were independently associated with nonreceipt of GCT. CONCLUSIONS Residence in an area of high deprivation predicts nonreceipt of GCT. This is due to multiple individual- and system-level barriers. Identifying these barriers and developing effective interventions, including community outreach and collaboration, leveraging telehealth, and increasing oncologic expertise in underserved areas, may improve access to GCT.
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Affiliation(s)
- Annabelle L Fonseca
- From the Departments of Surgery (Fonseca, Richman)
- Institute for Cancer Outcomes and Survivorship (Fonseca, Richman, Bhatia), The University of Alabama at Birmingham, Birmingham, AL
| | - Rida Ahmad
- Department of Surgery, The University of South Alabama, Mobile, AL (Ahmad, Amin, Vobbilisetty, Heslin)
| | - Krisha Amin
- Department of Surgery, The University of South Alabama, Mobile, AL (Ahmad, Amin, Vobbilisetty, Heslin)
| | - Manish Tripathi
- Kellogg School of Management, Northwestern University, Chicago, IL (Tripathi)
| | - Vijay Vobbilisetty
- Department of Surgery, The University of South Alabama, Mobile, AL (Ahmad, Amin, Vobbilisetty, Heslin)
| | - Joshua S Richman
- From the Departments of Surgery (Fonseca, Richman)
- Institute for Cancer Outcomes and Survivorship (Fonseca, Richman, Bhatia), The University of Alabama at Birmingham, Birmingham, AL
| | | | - Smita Bhatia
- From the Departments of Surgery (Fonseca, Richman)
- Institute for Cancer Outcomes and Survivorship (Fonseca, Richman, Bhatia), The University of Alabama at Birmingham, Birmingham, AL
| | - Martin J Heslin
- Department of Surgery, The University of South Alabama, Mobile, AL (Ahmad, Amin, Vobbilisetty, Heslin)
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15
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Jacobs SR, Ramsey N, Bagnato M, Pitt T, Davis CM. Health disparities in allergic diseases. Curr Opin Allergy Clin Immunol 2024; 24:94-101. [PMID: 38295102 PMCID: PMC10923006 DOI: 10.1097/aci.0000000000000972] [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] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Healthcare disparities impact prevalence, diagnosis, and management of allergic disease. The purpose of this review is to highlight the most recent evidence of healthcare disparities in allergic conditions to provide healthcare providers with better understanding of the factors contributing to disparities and to provide potential management approaches to address them. This review comes at a time in medicine where it is well documented that disparities exist, but we seek to answer the Why , How and What to do next? RECENT FINDINGS The literature highlights the socioeconomic factors at play including race/ ethnicity, neighborhood, insurance status and income. Management strategies have been implemented with the hopes of mitigating the disparate health outcomes including utilization of school-based health, distribution of educational tools and more inclusive research recruitment. SUMMARY The studies included describe the associations between upstream structural and social factors with downstream outcomes and provide ideas that can be recreated at other institutions of how to address them. Focus on research and strategies to mitigate healthcare disparities and improve diverse research participant pools are necessary to improve patient outcomes in the future.
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Affiliation(s)
- Samantha R. Jacobs
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Nicole Ramsey
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mariangela Bagnato
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Tracy Pitt
- Department of Pediatrics, Humber Hospital, Toronto, Ontario, Canada
| | - Carla M. Davis
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, United States
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, United States
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16
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Discussion to: Association of socioeconomic factors with the receipt of neoadjuvant therapy for patients with non-small cell lung cancer. J Thorac Cardiovasc Surg 2023; 167:1467-8. [PMID: 37978957 DOI: 10.1016/j.jtcvs.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Indexed: 11/19/2023]
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17
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Moujahid C, Turman JE, Houradi H, Amahdar L. Scoping Review to Identify Social Determinants of Maternal Health in Morocco. Int J Soc Determinants Health Health Serv 2024; 54:151-162. [PMID: 38037291 DOI: 10.1177/27551938231217589] [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] [Indexed: 12/02/2023]
Abstract
To understand the mechanism of health inequities and their influence on maternal health, the Commission on Social Determinants of Health (CSDH) provides a framework to identify structural and intermediate causes of health inequity. This review maps and describes the current socioeconomic determinants of maternal health in Morocco according to the CSDH framework. A scoping study was carried out from six databases (Springer, Web of Science, Pubmed, Science Direct, Jstor, and Cochrane library) based on quantitative and qualitative research done since 1990. Structural factors such as women's employment and economic status, education level, culture, and gender equity were influenced by intermediary factors such as place of residence, age at marriage, maternal age at childbirth, and parity (either alone or in conjunction with other variables). Together these factors worked to influence maternal health service usage or affected maternal health outcomes. Power dynamics were identified in a variety of social situations that impacted access to health care for women across socioeconomic categories. Studies reveal how social determinants impact maternal health in Morocco. Addressing these determinants is required for sustainably improving maternal and infant health in Morocco.
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Affiliation(s)
- Chaimae Moujahid
- Biomedical Technologies, Sciences and Technologies of Health, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Jack E Turman
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Hiba Houradi
- Biomedical Technologies, Sciences and Technologies of Health, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Loubna Amahdar
- Biomedical Technologies, Sciences and Technologies of Health, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
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18
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Smith MD, Wesselbaum D. Well-Being Inequality Among Adolescents and Young Adults. J Adolesc Health 2024; 74:703-712. [PMID: 38069931 DOI: 10.1016/j.jadohealth.2023.10.015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/07/2023] [Accepted: 10/16/2023] [Indexed: 03/24/2024]
Abstract
PURPOSE This study aimed to examine patterns of well-being across developmental stages and patterns of inequality in well-being among young adults and adolescents. Well-being exists when adolescents and young adults thrive and can achieve their full potential. METHODS We used individual-level survey data from the Gallup World Poll from 164 countries between 2009 and 2017 (N = 446,934). Regression analyses were used to determine associations. RESULTS We documented substantial inequality in well-being across three developmental stages (adolescence, early adulthood, young adulthood). Health, education, income, and social relations are strongly associated with mean well-being and well-being inequality. We showed, for mean well-being, the relative importance of these factors varies over life-cycle stages. For inequality, most factors were consistent across developmental groups; however, we identified certain characteristics that were only relevant at certain developmental stages. DISCUSSION Given the policy importance of well-being at all stages of life and the significance of adolescence and early adulthood in developing positive health-related behaviors, policies and programs targeting the highlighted characteristics are likely to be effective but require a multisectoral approach.
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Affiliation(s)
- Michael D Smith
- National Oceanic and Atmospheric Administration, Economics and Social Sciences Research, Alaska Fisheries Science Center, Seattle, Washington
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19
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Moore JE, Millar BC. Incidence of tuberculosis in Europe 2001-2021 and relationship to gross domestic product (GDP)-the continued need for levelling-up between European nations. Clin Microbiol Infect 2024; 30:561-563. [PMID: 38272179 DOI: 10.1016/j.cmi.2024.01.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Affiliation(s)
- John E Moore
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, Northern Ireland, UK; School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, Northern Ireland, UK; School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK.
| | - Beverley C Millar
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Belfast City Hospital, Belfast, Northern Ireland, UK; School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, Northern Ireland, UK; School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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20
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Benes G, Ghanem D, Badin D, Greenberg M, Honcharuk E. The Effect of Socioeconomic Deprivation on Radiographic Deformities in Children With Blount Disease. J Pediatr Orthop 2024; 44:254-259. [PMID: 38158726 DOI: 10.1097/bpo.0000000000002608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Blount disease can occur at any time during the growth process, primarily with a bimodal distribution in children younger than 4 years old and adolescents. The disease process most commonly presents in Black adolescents, with disease severity positively correlated with obesity. Given the known associations among race, obesity, and socioeconomic status, we investigated the relationship between the degree of social deprivation and severity of lower extremity deformities among a community-based cohort with Blount disease. METHODS A retrospective review of hospital records and radiographs of patients with previously untreated Blount disease was conducted. Patients were classified as having early-onset or late-onset Blount disease based on whether the lower limb deformity was noted before or after the age of 4 years. The area deprivation index (ADI), a nationally validated measure that assesses socioeconomic deprivation by residential neighborhood, was calculated for each patient as a surrogate for socioeconomic status. Higher state (range: 1 to 10) or national (range: 1 to 100) ADI corresponds to increased social deprivation. Full-length standing radiographs from index clinic visits were evaluated by 2 reviewers to measure frontal plane deformity. The association of ADI with various demographic and radiographic parameters was then analyzed. RESULTS Of the 65 patients with Blount disease, 48 (74%) children were Black and 17 (26%) were non-black children. Nineteen children (32 limbs) had early-onset and 46 children (62 limbs) had late-onset disease. Black patients had significantly higher mean state (7.6 vs. 5.4, P =0.009) and national (55.1 vs. 37.4, P =0.002) ADI values than non-black patients. Patients with severe socioeconomic deprivation had significantly greater mechanical axis deviation (66 mm vs. 51 mm, P =0.008). After controlling demographic and socioeconomic factors, the results of multivariate linear regression showed that only increased body mass index (β=0.19, 95% CI: 0.12-0.26, P <.001) and state ADI (β=0.021, 95% CI: 0.01-0.53, P =.043) were independently associated with greater varus deformity. CONCLUSIONS Socioeconomic deprivation was strongly associated with increased severity of varus deformity in children with late-onset Blount disease. Our analysis suggests that obesity and socioeconomic factors are the most influential with regard to disease progression. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Gregory Benes
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
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21
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Moreno A, Lostao L, Sperlich S, Beller J, Ronda E, Geyer S, Regidor E. Socioeconomic Patterns in the Frequency of Doctor Visits in Germany and Spain in Subjects With and Without Chronic Diseases. Int J Soc Determinants Health Health Serv 2024; 54:121-130. [PMID: 38166504 DOI: 10.1177/27551938231224708] [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] [Indexed: 01/04/2024]
Abstract
The objective of universal health care systems is to achieve equality in the use of health services at the same level of care need. This study evaluates the relationship of socioeconomic position with the frequency of doctor visits in subjects with and without chronic diseases in Germany and Spain. The dependent variables included number of consultations and if a medical consultation occurred. The socioeconomic factors were income and education. The magnitude of the relationship between socioeconomic position and medical consultation frequency was estimated by calculating the percentage ratio using binomial regression and by calculating the difference in consultations by analysis of the covariance, in the case of number of visits. Statistically significant findings according to education were not observed. The percentage ratio in the medical consultations among those with lower and higher income was 1.03 (95% confidence interval [CI] 1.01-2.88) in Germany and 1.11 (95% CI 1.03-1.20) in Spain among subjects with any of the studied chronic conditions. Also, in Germany the difference in the average number of consultations comparing lower income subjects with higher was 3.98 (95% CI 2.40-5.57) in those with chronic conditions. In both countries, there were no differences in the frequency of doctor visits according to education. However, a pro-inequality trend exists in favor of subjects with lower income.
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Affiliation(s)
- Almudena Moreno
- Department of Sociology. Medical Sociology, Universidad Pública de Navarra, Pamplona, Spain
- I-COMMUNITAS - Institute for Advanced Social Research, Universidad Pública de Navarra, Pamplona, Spain
| | - Lourdes Lostao
- Department of Sociology. Medical Sociology, Universidad Pública de Navarra, Pamplona, Spain
- I-COMMUNITAS - Institute for Advanced Social Research, Universidad Pública de Navarra, Pamplona, Spain
| | | | - Johannes Beller
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | - Elena Ronda
- Preventive Medicine and Public Health Unit, Universidad de Alicante, Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | - Enrique Regidor
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Rahman H, Karim R, Habib TZ, Swahnberg K. Women's Social Mobility and Attitudinal Acceptance of Wife Abuse: A Cross-Sectional Study Among Bengali, Santal, and Garo Ethnic Communities in Rural Bangladesh. J Interpers Violence 2024; 39:1676-1703. [PMID: 37937750 DOI: 10.1177/08862605231209994] [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] [Indexed: 11/09/2023]
Abstract
Previous studies exploring the influential factors associated with attitudinal acceptance of wife abuse (AAWA) did not widely focus on the relation between women's social mobility (WSM) and different dimensions of AAWA in rural Bangladesh. This current study examined the association between WSM and different dimensions of AAWA in the context of socio-cultural differences among the Bengali, the Santal, and the Garo ethnic communities in rural Bangladesh. Adopting a cross-sectional design, 1,929 married men and women were randomly included in the study from 8 Bengali, 8 Santal, and 8 Garo villages where 50.2% were women and 49.8% were men. Of the sample, 33.2% Garo, 33.2% Santal, and 33.6% Bengali participants were included in this study. Data revealed that 45.5% of women had low social mobility and the prevalence of different dimensions of AAWA was high and varied among the study communities. We used descriptive statistics, chi-square, and binary logistic regression analysis to estimate the association. The multivariate binary logistic regression analysis results revealed that the likelihood of attitudinal acceptance of overall abuse, psychological abuse, physical abuse, abuse on disobeying family obligation, and abuse on challenging male authority were significantly lower for the respondents who belonged to families where women enjoyed high mobility compared to those who belonged to families where WSM was low. This study also showed that the Bengali and the Santal participants were more likely to accept different dimensions of AAWA compared to the Garos. This study suggests that WSM should be considered in policy-making and implementing interventions to reduce the different dimensions of AAWA in rural Bangladesh.
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Affiliation(s)
- Hafijur Rahman
- University of Rajshahi, Bangladesh
- Linnaeus University, Kalmar, Sweden
| | - Rabiul Karim
- University of Rajshahi, Bangladesh
- Linnaeus University, Kalmar, Sweden
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Cogollos-de-la-Peña R, Álvarez-Vargas A, Domínguez-Navarro F, Espelt A, Fuentes-Aparicio L, Puigpinós-Riera R. Social inequalities in the use of physiotherapy in women diagnosed with breast cancer in Barcelona: DAMA cohort. Breast Cancer Res Treat 2024; 204:377-387. [PMID: 38155271 PMCID: PMC10948522 DOI: 10.1007/s10549-023-07191-9] [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: 05/18/2023] [Accepted: 11/19/2023] [Indexed: 12/30/2023]
Abstract
PURPOSE This study aimed to analyze social inequalities in the use and access of physiotherapy service and its clinical and socio-economic determinants in women diagnosed with breast cancer in the hospital network of Barcelona. METHODS Data from 2235 women belonging to the mixed (prospective and retrospective) DAMA Cohort were analyzed, including demographic, socio-economic, clinical, and breast cancer treatment outcomes. To determine the influence of such variables on access to physiotherapy, different Poisson regression models with robust variance (obtaining Prevalence Ratios and confidence intervals) were estimated. RESULTS Although when experiencing different chronic and acute symptoms, only between 20 and 35% of women visited physiotherapist. Two out of 3 women reported to have received insufficient information about medical care and rehabilitation. Age of women, job occupation, education level, having a mutual or private insurance, as well as outcomes related to breast cancer, appear to be factors influencing the access to physiotherapy. CONCLUSIONS Social and economic inequalities exist on the access to physiotherapy by women diagnosed with breast cancer, which is generally low, and may clearly impact on their functional recovery. Promoting strategies to reduce social bias, as well as improve communication and patient information regarding physiotherapy may be of interest for a better health care in breast cancer diagnosed women.
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Affiliation(s)
| | - Anaís Álvarez-Vargas
- Departament d'Epidemiologia i Metodologia de Les Ciències Socials I de La Salut d'Umanresa, Universitat de Vic-Universitat Central de Catalunya, Manresa, Catalonia, Spain
| | - Fernando Domínguez-Navarro
- Faculty of Health Science, Universidad Europea de Valencia, Valencia, Spain.
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag 5. 46010, Valencia, Spain.
| | - Albert Espelt
- Departament de Psicobiologia i Metodologia de Les Ciències de La Salut, Bellaterra, Catalonia, Spain
- Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura Fuentes-Aparicio
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag 5. 46010, Valencia, Spain
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rosa Puigpinós-Riera
- Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Agència de Salut Pública de Barcelona, Plaça Lesseps, Barcelona, Catalonia, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Catalonia, Spain
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Zhou L, Zhang R, Yang H, Zhang S, Zhang Y, Li H, Chen Y, Maimaitiyiming M, Lin J, Ma Y, Wang Y, Zhou X, Liu T, Yang Q, Wang Y. Association of plant-based diets with total and cause-specific mortality across socioeconomic deprivation level: a large prospective cohort. Eur J Nutr 2024; 63:835-846. [PMID: 38194192 DOI: 10.1007/s00394-023-03317-3] [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: 07/04/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Current evidence on the association between plant-based diet indices (PDIs) and mortality is inconsistent. We aimed to investigate the association of PDIs with all-cause and cause-specific mortality and to examine whether such associations were modified by socioeconomic deprivation level. METHODS A total of 189,003 UK Biobank participants with at least one 24-h dietary assessment were included. All food items were categorised into three groups, including healthy plant foods, less healthy plant foods, and animal foods. Three PDIs, including the overall PDI (positive scores for all plant-based food intake and inverse scores for animal-based foods), the healthful PDI (hPDI) (positive scores only for healthy plant food intake and inverse scores for others), and the unhealthful PDI (uPDI) (positive scores only for less healthy plant food intake and inverse scores for others), were calculated according to the quantities of each food subgroup in three categories. The Townsend deprivation index was used as the indicator of socioeconomic deprivation level. Cox proportional hazard models were used to estimate the hazard ratios (HRs) of PDIs for all-cause and cause-specific mortality. The modification effects of socioeconomic deprivation levels on these associations were evaluated. RESULTS During a median follow-up of 9.6 years, 9335 deaths were documented. Compared with the lowest quintile, the highest quintile of overall PDI was associated with adjusted HRs of 0.87 (95% CI 0.81-0.93) for all-cause mortality and 0.77 (0.66-0.91) for cardiovascular mortality. Compared with the lowest quintile, the highest quintile of hPDI was associated with lower risks of all-cause mortality (0.92, 0.86-0.98), and death caused by respiratory disease (0.63, 0.47-0.86), neurological disease (0.65, 0.48-0.88), and cancer (0.90, 0.82-0.99). Compared with the lowest quintile, the highest quintile of uPDI was associated with an HR of 1.29 (1.20-1.38) for all-cause mortality, 1.95 (1.40-2.73) for neurological mortality, 1.54 (1.13-2.09) for respiratory mortality, and 1.16 (1.06-1.27) for cancer mortality. The magnitudes of associations of hPDI and uPDI with mortality were larger in the most socioeconomically deprived participants (the highest tertile) than in the less deprived ones (p-values for interaction were 0.039 and 0.001, respectively). CONCLUSIONS This study showed that having a high overall PDI and hPDI were related to a reduced risk of death, while the uPDI was linked to a higher risk of death. Sticking to a healthy plant-based diet may help decrease mortality risks across socioeconomic deprivation levels, especially for those who are the most socioeconomically deprived.
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Affiliation(s)
- Lihui Zhou
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Ran Zhang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yuan Zhang
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Huiping Li
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yanchun Chen
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Maiwulamujiang Maimaitiyiming
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Jing Lin
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yue Ma
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yuan Wang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Xin Zhou
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tong Liu
- Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qing Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, No. 22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Bann D, Wright L, Hughes A, Chaturvedi N. Socioeconomic inequalities in cardiovascular disease: a causal perspective. Nat Rev Cardiol 2024; 21:238-249. [PMID: 37821646 DOI: 10.1038/s41569-023-00941-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/13/2023]
Abstract
Socioeconomic inequalities in cardiovascular disease (CVD) persist in high-income countries despite marked overall declines in CVD-related morbidity and mortality. After decades of research, the field has struggled to unequivocally answer a crucial question: is the association between low socioeconomic position (SEP) and the development of CVD causal? We review relevant evidence from various study designs and disciplinary perspectives. Traditional observational, family-based and Mendelian randomization studies support the widely accepted view that low SEP causally influences CVD. However, results from quasi-experimental and experimental studies are both limited and equivocal. While more experimental and quasi-experimental studies are needed to aid causal understanding and inform policy, high-quality descriptive studies are also required to document inequalities, investigate their contextual dependence and consider SEP throughout the lifespan; no simple hierarchy of evidence exists for an exposure as complex as SEP. The COVID-19 pandemic illustrates the context-dependent nature of CVD inequalities, with the generation of potentially new causal pathways linking SEP and CVD. The linked goals of understanding the causal nature of SEP and CVD associations, their contextual dependence, and their remediation by policy interventions necessitate a detailed understanding of society, its change over time and the phenotypes of CVD. Interdisciplinary research is therefore key to advancing both causal understanding and policy translation.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, Social Research Institute, IOE, UCL's Faculty of Education and Society, University College London, London, UK.
| | - Liam Wright
- Centre for Longitudinal Studies, Social Research Institute, IOE, UCL's Faculty of Education and Society, University College London, London, UK
| | - Alun Hughes
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, Faculty of Population Health Science, University College London, London, UK
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Chen C, Zhao Y, Wu Y, Zhong P, Su B, Zheng X. Socioeconomic, Health Services, and Multimorbidity Disparities in Chinese Older Adults. Am J Prev Med 2024; 66:735-743. [PMID: 38123028 DOI: 10.1016/j.amepre.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION As one of the world's most populous countries, China persistently confronts a significant multimorbidity burden. This study aimed to elucidate the multimorbidity burden experienced by Chinese older adults, explore its interplay with socioeconomic disparity, and investigate potential correlations between these provincial disparities and health services availability. METHODS The fourth wave of China's national Urban and Rural Elderly Population study, conducted in 2015, was used to construct a multimorbidity index and elucidate the geographic differences in the multimorbidity burden. Incorporating macrolevel indicators about socioeconomic and health services availability, quantile regression and Spearman correlation analyses were employed to investigate the relationship between multimorbidity and socioeconomic disparities and examine the potential linkages between these provincial disparities and health services availability. Analyses were performed in 2023. RESULTS The final analysis included a total of 213,857 older adults. At the provincial level, significant geographic disparities in multimorbidity burden were identified. After adjusting for individual social determinants of health, an independent association was found between the human development index and a higher multimorbidity index (coefficient= -0.22; 95% CI= -0.24, -0.19). Furthermore, a significant positive correlation emerged between human development index and both population and geographic densities of health services availability. Notably, geographic density displayed greater inequality (Gini coefficients=0.45-0.48) than population density (Gini coefficients=0.03-0.10). CONCLUSIONS This study demonstrates that multimorbidity burden in China is linked to provincial socioeconomic disparities and that inequality in health services availability may account for this, which would advocate for a need to reduce disparities in health services availability.
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Affiliation(s)
- Chen Chen
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Yihao Zhao
- Department of Chronic Diseases and Multimorbidity, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Yu Wu
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Panliang Zhong
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Binbin Su
- Department of Health Economics, School of Population Medicine and Public Health, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
| | - Xiaoying Zheng
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; APEC Health Science Academy, Peking University, Beijing, China.
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Guo X, Zhang P, Yue Y. Prediction of global wheat cultivation distribution under climate change and socioeconomic development. Sci Total Environ 2024; 919:170481. [PMID: 38307262 DOI: 10.1016/j.scitotenv.2024.170481] [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: 09/24/2023] [Revised: 12/30/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024]
Abstract
Socioeconomic and climate change are both essential factors affecting the global cultivation distributions of crops. However, the role of socioeconomic factors in the prediction of future crop cultivation distribution under climate change has been rarely explored. Motivated by revealing the future global wheat cultivation distribution that coupling socioeconomic factors and climate change, the MaxEnt-SPAM approach was proposed by the present study. Furthermore, the spatial and temporal patterns of global wheat cultivation in the near-term (2011-2040), the mid-term (2041-2070), and long-term (2071-2100) under the scenarios of RCP2.6-SSP1, RCP4.5-SSP2, and RCP8.5-SSP3 were predicted. It indicated that the predictive accuracy of the proposed approach could be over 80 %, with a significant positive correlation (p < 0.01) between the predicted global wheat cultivation and multiple known datasets. Socioeconomic development significantly altered the potential distribution of global wheat cultivation driven by climate change. Socioeconomic development seems to benefit wheat cultivation in the Southern Hemisphere especially central and east Africa, while the Northern Hemisphere may have witnessed a decline in future cultivation areas. It was noteworthy that heightened profitability stimulated interest in expanding wheat cultivation efforts within pivotal countries/regions positioned in the Southern Hemisphere. In the long-term period, the potential wheat cultivation area was reduced by 7 % under the RCP2.6-SSP1 scenario, while it expanded by 8 % and 2 % under the RCP4.5-SSP2 and RCP8.5-SSP3 scenarios, respectively. A global decline in wheat production of 16 %, 3 %, and 3 % was observed in the long-term under the RCP2.6-SSP1, RCP4.5-SSP2, and RCP8.5-SSP3 scenarios respectively. The present study emphasized the importance of integrating socioeconomic factors into crop distribution predictions under climate change. Our findings indicated significant temporal adjustments in the future global distribution of wheat cultivation and offered a comprehensive perspective on how socioeconomic factors interacted with climate change to influence global wheat cultivation.
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Affiliation(s)
- Xi Guo
- Key Laboratory of Environmental Change and Natural Disaster of Chinese Ministry of Education, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
| | - Puying Zhang
- Key Laboratory of Environmental Change and Natural Disaster of Chinese Ministry of Education, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China
| | - Yaojie Yue
- Key Laboratory of Environmental Change and Natural Disaster of Chinese Ministry of Education, Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
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Goldman AW, Bea MD. Banking on the Neighborhood? Inequalities in Older Adults' Access to Local Banking and Neighborhood Perceptions. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad194. [PMID: 38155541 PMCID: PMC10923209 DOI: 10.1093/geronb/gbad194] [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: 07/03/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES Access to local banking represents an understudied dimension of neighborhood-based inequalities that could significantly influence older adults' perceptions of their neighborhood spaces in ways that matter for disparities in well-being. We evaluate disparities in banking access and then examine how local banking access informs older adults' perceptions of neighborhood collective efficacy and danger, above and beyond other neighborhood socioeconomic characteristics. METHODS We use nationally representative data from older adults in the United States who were interviewed at Round 3 of the National Social Life, Health, and Aging Project, linked with data on banks in respondents' residential and surrounding census tracts from the National Establishment Time-Series database, in a series of bivariate and multivariable regression analyses. RESULTS White older adults and those with higher levels of education have significantly greater local banking access than Black and Hispanic older adults and those with lower levels of education. Higher rates of local banking institutions are associated with significantly lower perceptions of neighborhood danger, but not with perceived collective efficacy. This finding emerges when accounting for neighborhood concentrated disadvantage and physical disorder. DISCUSSION Local banks may represent neighborhood investment and the broader economic vitality of a community, as well as the ability of communities to meet older adults' everyday needs in ways that enhance older residents' feelings of safety. Increasing access to local financial institutions may help attenuate neighborhood-based contributors to inequalities in health and well-being among the older adult population.
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Affiliation(s)
- Alyssa W Goldman
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
| | - Megan Doherty Bea
- Department of Consumer Science, University of Wisconsin—Madison, Madison, Wisconsin, USA
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Fadel MA, McCoy JL, Shaffer AD, Kurland KS, Simons JP. Socioeconomic Barriers to Care for Pediatric Airways Utilizing Geographic Information Systems. Laryngoscope 2024; 134:1919-1925. [PMID: 37622670 DOI: 10.1002/lary.30982] [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: 04/15/2023] [Revised: 06/30/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Geographic information systems (GIS) provide a unique set of tools to spatially analyze health care and identify patterns of health outcomes to help optimize delivery. Our goal is to create maps of pediatric tracheostomy patients using GIS to assess socioeconomic and other factors that impact postoperative care after discharge to home. METHODS A retrospective study was performed on patients (≤21 years old) who underwent tracheostomy at a tertiary care pediatric hospital from January 1, 2015 to December 31, 2020. Using GIS, we geocoded patient addresses and conducted spatial analyses of the relationship between patients and access to health care providers as well as vulnerable population factors including poverty, educational attainment, and single-parent households. RESULTS A total of 156 patients were included. Patients initially discharged to transitional care (108/156, 69.2%) had significantly higher likelihood of presenting to the ED regardless of socioeconomic status (OR: 2.28, 95% CI: 1.03-5.05; p = 0.042). There was no relationship between ED visit rate and median household income, poverty level, and percentage of uneducated adults (p = 0.490; p = 0.424; p = 0.752). Median distance to the tertiary care pediatric hospital was significantly longer for patients with no ED visit (median = 61.28 miles; SD = 50.90) compared with those with an ED visit (median = 37.75 miles; SD = 35.92) (p = 0.002). CONCLUSION The application of GIS could provide geo-localized data to better understand the healthcare barriers to access for children with tracheostomies. This study uniquely integrates medical record data with socioeconomic factors and social determinants of health. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1919-1925, 2024.
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Affiliation(s)
- Mark A Fadel
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Jennifer L McCoy
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Amber D Shaffer
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | - Kristen S Kurland
- H. John Heinz III College and School of Architecture, Carnegie Mellon University, Pittsburgh, Pennsylvania, U.S.A
| | - Jeffrey P Simons
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
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de Vries SAG, Sas TCJ, Bak JCG, Mul D, Nieuwdorp M, Wouters MWJM, Verheugt CL. Socio-economic disparities in hospital care among Dutch patients with diabetes mellitus. Diabetes Obes Metab 2024; 26:1386-1394. [PMID: 38229451 DOI: 10.1111/dom.15440] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024]
Abstract
AIM Socio-economic status (SES) influences diabetes onset, progression and treatment. In this study, the associations between SES and use of hospital care were assessed, focusing on hospitalizations, technology and cardiovascular complications. MATERIALS AND METHODS This was an observational cohort study comprising 196 695 patients with diabetes (all types and ages) treated in 65 hospitals across the Netherlands from 2019 to 2020 using reimbursement data. Patients were stratified in low, middle, or high SES based on residential areas derived from four-digit zip codes. RESULTS Children and adults with low SES were hospitalized more often than patients with middle or high SES (children: 22%, 19% and 15%, respectively; p < .001, adults: 28%, 25% and 23%; p < .001). Patients with low SES used the least technology: no technology in 48% of children with low SES versus 40% with middle SES and 38% with high SES. In children, continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (rtCGM) use was higher in high SES {CSII: odds ratio (OR) 1.54 [95% confidence interval (CI) 1.35-1.76]; p < .001; rtCGM OR 1.39 [95% CI 1.20-1.61]; p < .001} and middle SES [CSII: OR 1.41 (95% CI 1.24-1.62); p < .001; rtCGM: OR 1.27 (95% CI 1.09-1.47); p = .002] compared with low SES. Macrovascular (OR 0.78 (95% CI 0.75-0.80); p < .001) and microvascular complications [OR 0.95 (95% CI 0.93-0.98); p < .001] occurred less in high than in low SES. CONCLUSIONS Socio-economic disparities were observed in patients with diabetes treated in Dutch hospitals, where basic health care is covered. Patients with low SES were hospitalized more often, used less technology, and adults with high SES showed fewer cardiovascular complications. These inequities warrant attention to guarantee equal outcomes for all.
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Affiliation(s)
- Silvia A G de Vries
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Scientific bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | - Theo C J Sas
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Pediatric Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jessica C G Bak
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Scientific bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | - Dick Mul
- Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, The Netherlands
| | - Max Nieuwdorp
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Michel W J M Wouters
- Scientific bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Carianne L Verheugt
- Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Zhou X, Gui H, Xin Q, Dai Y. Divergent trajectories of future global gross primary productivity and evapotranspiration of terrestrial vegetation in Shared Socioeconomic Pathways. Sci Total Environ 2024; 919:170580. [PMID: 38309360 DOI: 10.1016/j.scitotenv.2024.170580] [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: 11/27/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
Understanding the future trends of carbon and water fluxes between terrestrial ecosystems and the atmosphere is crucial for predicting Earth's climate dynamics. This study employs an advanced numerical approach to project global gross primary productivity (GPP) and evapotranspiration (ET) from 2001 to 2100 under various climate scenarios based on Shared Socioeconomic Pathways (SSPs). To improve predictions of vegetation dynamics, we introduce a novel model (CoLM-PVPM), an enhancement of the Common Land Model version 2014 (CoLM2014), incorporating a prognostic vegetation phenology model (PVPM). Compared to CoLM2014 that relies on satellite-based leaf area index (LAI) inputs, CoLM-PVPM predicts LAI time series using climate variables. Model validation using historical data from 2001 to 2010 demonstrates PVPM in capturing spatiotemporal variations in satellite LAI. Our modeling results indicate that annual averaged LAI and total GPP increase under SSP1-2.6 but decrease under SSP2-4.5, SSP3-7.0, and SSP5-8.5 by 2100. By comparison, annual total ET consistently increases under all SSP scenarios by 2100. Global annual averaged LAI is highly correlated with annual total GPP in all scenarios, while its correlation with annual total ET weakens in SSP2-4.5, SSP3-7.0, and SSP5-8.5. Global annual total vapor pressure deficit (VPD) and precipitation are highly correlated with annual total ET in all scenarios. As emission levels increase, the negative correlation between annual total VPD and GPP strengthens, while the correlation between annual total precipitation and GPP weakens. This research presents an improved model for predicting terrestrial vegetation processes and underscores the importance of low carbon emission scenarios in maintaining carbon-water balances in specific regions.
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Affiliation(s)
- Xuewen Zhou
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China; School of Atmospheric Sciences, Sun Yat-sen University, Zhuhai 519082, China
| | - Hanliang Gui
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
| | - Qinchuan Xin
- School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China.
| | - Yongjiu Dai
- School of Atmospheric Sciences, Sun Yat-sen University, Zhuhai 519082, China.
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Cochran ED, Jacobson JC, Nehrubabu M, Qiao J, McCreery S, Chung DH. Social Determinants of Outcomes Disparity among Pediatric Patients with Solid Tumor. J Am Coll Surg 2024; 238:463-478. [PMID: 38258890 DOI: 10.1097/xcs.0000000000001010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Socioeconomic factors have a significant impact on healthcare outcomes. Metrics such as area deprivation index (ADI) are used to quantify the anticipated influence of these factors. Here, we sought to assess the impact of socioeconomic factors on clinical outcomes among pediatric patients with solid tumor in our region. STUDY DESIGN We identified 3,863 pediatric patients who were diagnosed with a malignant solid tumor in the Texas Cancer Registry between 1995 and 2019. ADI was used to quantify socioeconomic determinants of health. These outcome variables were determined: stage of disease at diagnosis, time between diagnosis and treatment initiation, and overall mortality. Statistical analysis was performed using logistic regression, linear regression, Cox proportional hazards regression, and Kaplan-Meier survival curves. RESULTS A total of 53.5% of patients were male and the average age at diagnosis was 4.5 years. Forty-seven percent of patients were White, 13.3% were Black, 36.2% were Hispanic, 1.7% were Asian, and other rare minority groups made up 1.8%. On multivariable analysis, increased risk of death was associated with Black race, rare minority race, residence in a border county, and increasing ADI score, with the risk of death at 5 years rising 4% with each increasing ADI point. CONCLUSIONS Social determinants of health are associated with disparate outcomes among pediatric patients with solid tumor. Our results suggest that patients who are part of racial minority groups and those who reside in socioeconomically disadvantaged neighborhoods or regions near the Texas-Mexico border are at an increased risk of death. This information may be useful in strategizing outreach and expanding resources to improve outcomes in at-risk communities.
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Affiliation(s)
- Elizabeth D Cochran
- From the Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX (Cochran, Jacobson, Qiao, McCreery, Chung)
| | - Jillian C Jacobson
- From the Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX (Cochran, Jacobson, Qiao, McCreery, Chung)
| | - Mithin Nehrubabu
- Department of Mathematical Sciences, University of Dallas, Dallas, TX (Nehrubabu)
| | - Jingbo Qiao
- From the Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX (Cochran, Jacobson, Qiao, McCreery, Chung)
| | - Sullivan McCreery
- From the Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX (Cochran, Jacobson, Qiao, McCreery, Chung)
| | - Dai H Chung
- From the Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX (Cochran, Jacobson, Qiao, McCreery, Chung)
- Children's Health, Dallas, TX (Chung)
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Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Gaidhane AM, Rustagi S, Serhan HA, Padhi BK. Association of neighborhood deprivation and hypertension: A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102438. [PMID: 38301916 DOI: 10.1016/j.cpcardiol.2024.102438] [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: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Hypertension impacts nearly one billion individuals and is a primary health challenge. While traditional perspectives have focused on individual behavior and genetics as principal risk factors, recent research underscores the profound influence of socioeconomic factors within neighborhoods on the risk of hypertension. This systematic review and meta-analysis is aimed to elucidate the association between neighborhood deprivation and the risk of hypertension. METHODS A comprehensive literature search was conducted across PubMed, Embase, and Web of Science from inception until December 25, 2023. Observational studies defining neighborhood deprivation and reporting hypertension incidence were included. Nested Knowledge software was used for screening and data extraction, with study quality assessed using the Newcastle-Ottawa Scale. Statistical analysis was performed with R software (V 4.3), using a random-effects model to calculate the pooled relative risk (RR). RESULTS Twenty-six studies were included in the qualitative analysis and 22 in the meta-analysis, covering over 62 million participants. The pooled RR was 1.139 (95% CI: 1.006 - 1.290), p=0.04, indicating a higher hypertension risk in deprived neighborhoods. Subgroup analyses showed variability by country and deprivation assessment methods. RR varied from 1.00 in Japan (95% CI: 0.93-1.08) to 1.60 (95% CI: 1.07-2.39) in France and 1.57 (95% CI: 0.67-3.70) in Germany, with significant heterogeneity observed in measures of neighborhood deprivation. CONCLUSION Our analysis confirms a significant association between neighborhood deprivation and hypertension, underscoring the importance of socioeconomic factors in public health. It highlights the need for targeted local assessments and interventions. Future research should explore the causal mechanisms and effectiveness of interventions addressing neighborhood deprivation.
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Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; School of Pharmacy, Graphic Era Hill University, Dehradun, India; Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil 51001, Iraq
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Abhay M Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.
| | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Burns SD, Baker EH, Sheehan CM, Markides KS. Disability Among Older Immigrants in the United States: Exploring Differences by Region of Origin and Gender. Int J Aging Hum Dev 2024; 98:329-351. [PMID: 37593800 DOI: 10.1177/00914150231196093] [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] [Indexed: 08/19/2023]
Abstract
Rapid aging in American society will be disproportionately concentrated among the foreign-born. Immigrants in the United States (U.S.) are a heterogeneous population, yet little is known regarding their differences in disability later in life by region of origin. We use data from the National Health Interview Survey on respondents ages 60+ (n = 313,072) and employ gender-specific logistic models to predict reports of any activity of daily living (ADL) disability. After accounting for socioeconomic factors, compared to their U.S.-born non-Hispanic (NH) White counterparts, the odds of reporting ADL disability were higher among U.S.-born respondents that are Hispanic, NH Black, and NH Multiracial as well as respondents with Mexican, Puerto Rican, Cuban, Russian/former Soviet, Middle Eastern, East Asian, and South Asian origins. Also, Dominican, African, and Southeast Asian women-and European men-reported high odds of ADL disability. Our results highlight heterogeneity in the disability profiles of foreign-born older adults in the U.S..
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Affiliation(s)
- Shane D Burns
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth H Baker
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Connor M Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Kyriakos S Markides
- Department of Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston, TX, USA
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Sagastume D, Peñalvo JL, Ramírez-Zea M, Polman K, Beňová L. Dynamics of the double burden of malnutrition in Guatemala: a secondary data analysis of the demographic and health surveys from 1998-2015. Public Health 2024; 229:135-143. [PMID: 38442595 DOI: 10.1016/j.puhe.2024.01.035] [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: 09/15/2023] [Revised: 01/08/2024] [Accepted: 01/31/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE We estimated the prevalence and time trends of the double burden of malnutrition (DBM) in Guatemala and explored its occurrence based on socio-demographic factors. STUDY DESIGN This was a secondary data analysis using information from four Demographic and Health Surveys covering the period 1998-2015. METHODS The unit of analysis was the household within which information was gathered from women 18-49 years and their children, 6-59 months. The main outcome was the prevalence of any DBM in the household (co-existence of undernutrition and overnutrition in a woman, her children or both). We estimated the prevalence of any DBM by survey and analysed time trends. Stepwise logistic regression was used to explore the occurrence of DBM and socio-demographic factors. RESULTS We analysed 39,749 households across all surveys. The prevalence of any DBM was 25.3% (95%CI: 22.1-28.7) in 1998-99, 23.8% (22.0-25.8) in 2002, 25.9% (24.3-27.5) in 2008-09 and 24.2% (22.9-25.5) in 2014-15, with no significant change over time (P = 0.782). Characteristics associated with lower odds of any DBM were rural residence, female-headed household, wealth and women's secondary education. Higher odds were seen for households with electricity, women >25y, indigenous and with >2 children. CONCLUSION Our findings revealed that a quarter of Guatemala's households suffer from DBM, which has remained unchanged for 17 years. Interventions should prioritise urban areas, households of lower socio-economic status and those less educated. To increase awareness of policymakers of this pressing public health concern, further research on DBM could be strengthened by prospective study designs, integrating all household members and expanding the types of malnutrition.
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Affiliation(s)
- D Sagastume
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Global Health Institute, University of Antwerp, Wilrijk, Belgium.
| | - J L Peñalvo
- Global Health Institute, University of Antwerp, Wilrijk, Belgium; National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
| | - M Ramírez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - K Polman
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Department of Health Sciences, Vrije Universiteit (VU) Amsterdam, the Netherlands
| | - L Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Kouba I, Del Pozzo J, Lesser ML, Shahani D, Gulersen M, Bracero LA, Blitz MJ. Socioeconomic and clinical factors associated with excessive gestational weight gain. Arch Gynecol Obstet 2024; 309:1295-1303. [PMID: 36930325 PMCID: PMC10021048 DOI: 10.1007/s00404-023-07000-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/12/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Excessive gestational weight gain (EGWG) is associated with adverse maternal and offspring outcomes but efforts to identify women at high risk for EGWG have been limited. The objective of this study is to identify socioeconomic and clinical factors associated with EGWG. METHODS This retrospective cohort included pregnant patients who delivered live, term, singleton newborns between January 2018 and February 2020 at seven hospitals within a large health system in New York. Patients were stratified by pre-pregnancy body mass index and then classified based on whether they exceeded the Institute of Medicine guidelines for gestational weight gain (GWG) and whether they gained more than 50 pounds in pregnancy. RESULTS A total of 44,872 subjects were included for analysis: 48% had EGWG and 17% had GWG exceeding 50 pounds. Patients with EGWG were more likely to be Black race, English speakers, overweight or obese pre-pregnancy, and have a mood disorder diagnosis. Patients who were underweight, multiparous, and those with gestational diabetes were less likely to have EGWG. CONCLUSION Sociodemographic and clinical findings associated with GWG > 50 pounds were similar but only overweight and not obese patients were at increased risk. Patients at risk for EGWG may benefit from early nutrition counseling and education on lifestyle changes.
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Affiliation(s)
- Insaf Kouba
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
- Division of Maternal-Fetal Medicine, South Shore University Hospital, 376 E Main St, Suite 202, Bay Shore, NY, 11706, USA.
| | - Jaclyn Del Pozzo
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Martin L Lesser
- Biostatistics Unit, Office of Academic Affairs, New Hyde Park, NY, USA
| | - Disha Shahani
- Biostatistics Unit, Office of Academic Affairs, New Hyde Park, NY, USA
| | - Moti Gulersen
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Luis A Bracero
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Matthew J Blitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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Elbahrawy MM, Kamel MK, Rodriguez-Quintero JH, Vimolratana M, Chudgar NP, Stiles BM. Association of socioeconomic factors with the receipt of neoadjuvant therapy for patients with non-small cell lung cancer. J Thorac Cardiovasc Surg 2024; 167:1458-1466.e4. [PMID: 37741315 DOI: 10.1016/j.jtcvs.2023.09.033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/29/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Neoadjuvant therapy (NT) will be increasingly used for patients with non-small cell lung cancer (NSCLC), particularly given the recent approval of neoadjuvant chemoimmunotherapy. Several barriers may prevent the uptake of NT and should be identified and addressed. We queried the National Cancer Database (NCDB) to determine predictors of the use of NT. METHODS Using the NCDB (2006-2019), we identified 80,707 patients who underwent surgery for clinical stage II and III NSCLC. Sociodemographic and clinical factors were reviewed, and univariable and multivariable analyses were performed to identify associations with the uptake of NT. In propensity score-matched groups, survival was determined using the Kaplan-Meier method. RESULTS Among 80,707 eligible patients, 17,262 (21.4%) received NT. Clinical stage and node positivity were associated with receipt of NT. On multivariable analysis, factors associated with lower rates of NT included black race (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.67-0.90), Charlson Comorbidity Index ≥2 (OR, 0.75; 95% CI, 0.67-0.85), Medicaid/Medicare insurance (OR, 0.82; 95% CI, 0.75-0.90), lower income level (OR, 0.79; 95% CI, 0.71-0.87), and treatment at a community center (OR, 0.81; 95% CI, 0.67-0.96). In an exploratory analysis, those patients who received NT had longer 5-year overall survival compared with those who did not (48.3% vs 46.0%; P < .001). CONCLUSIONS Rates of NT are relatively low for patients with clinical stage II/III NSCLC treated prior to recent chemoimmunotherapy trials. Socioeconomic barriers to the uptake of NT include race, insurance status, income, and area of residence. As NT becomes more widely offered, accessibility for vulnerable populations must be assured.
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Affiliation(s)
- Mostafa M Elbahrawy
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Mohamed K Kamel
- Division of Thoracic and Foregut Surgery, University of Rochester Medical Center, Rochester, NY
| | - J Humberto Rodriguez-Quintero
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Marc Vimolratana
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Neel P Chudgar
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Brendon M Stiles
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
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Sanchez-Vaznaugh EV, Matsuzaki M, Acosta ME, Vasanth S, Dugay ER, Sánchez BN. "Competitive" food and beverage policies and weight status: A systematic review of the evidence among sociodemographic subgroups. Obes Rev 2024; 25:e13678. [PMID: 38151337 PMCID: PMC10947922 DOI: 10.1111/obr.13678] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/30/2023] [Accepted: 11/13/2023] [Indexed: 12/29/2023]
Abstract
Prior studies identified variable associations between competitive food and beverage policies (CF&B) and youth obesity, potentially due to differences across population subgroups. This review summarizes the evidence on associations between CF&B policies and childhood obesity within gender, grade level/ age, race/ethnicity, and/or socioeconomic levels. PubMed, EMBASE, CINAHL, and ERIC database searches identified studies published in English in Canada and the United States between January 1, 2000, and February 28, 2022. Of the 18 selected studies, six were cross-sectional, two correlational, nine were before/after designs, and one study utilized both a cross-sectional and pre-post design. Twelve studies reported findings stratified by a single sociodemographic factor, with grade level/age as the most frequently reported. Although the evidence varied, greater consistency in direction of associations and strengths of evidence were seen among middle school students. Six studies reported findings jointly by multiple sociodemographic subgroups with evidence suggesting CF&B associations with slower rate of increase or plateaus or declines in obesity among multiple subgroups, though the strengths of evidence varied. Over the past two decades, there have been relatively limited subgroup analyses on studies about CF&B policies and childhood obesity. Studies are needed with stronger designs and analyses disaggregated, particularly by race/ethnicities and socioeconomic factors, across places and time.
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Affiliation(s)
- Emma V Sanchez-Vaznaugh
- Department of Public Health, Health Equity Institute, San Francisco State University and Center for Health Equity, University of California, San Francisco, California, USA
| | - Mika Matsuzaki
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Maria Elena Acosta
- Department of Public Health, San Francisco State University, San Francisco, California, USA
| | - Sahana Vasanth
- Department of Public Health, San Francisco State University, San Francisco, California, USA
| | - Erika Rachelle Dugay
- Department of Public Health, San Francisco State University, San Francisco, California, USA
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Ettman CK, Subramanian M, Fan AY, Adam GP, Abdalla SM, Galea S, Stuart EA. Assets and depression in U.S. adults during the COVID-19 pandemic: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2024; 59:571-583. [PMID: 37838630 DOI: 10.1007/s00127-023-02565-2] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Mental health is shaped by social and economic contexts, which were altered during the COVID-19 pandemic. No study has systematically reviewed the literature on the relation between different assets and depression during the COVID-19 pandemic. METHODS We conducted a systematic review of the literature on financial (e.g. income/savings), physical (e.g., home ownership), and social (e.g., marital status, educational attainment) assets and depression in U.S. adults. For each asset type, we created binary comparisons to report on the direction of the relationship and described if each study reported insignificant, positive, negative, or mixed associations. RESULTS Among the 41 articles identified, we found that income was the most studied asset (n=34), followed by education (n=25), marital status (n=18), home ownership (n=5), and savings (n=4). 88%, 100%, and 100% of articles reported a significant association of higher income, home ownership, and higher savings, respectively, with less depression. The association between marital status and education with depression was more nuanced: 72% (13 of 18) studies showed that unmarried persons had greater risk of depression than married or cohabitating persons and 52% (13 of 25) of studies reported no significant difference in depression across educational groups. CONCLUSION This work adds to the literature a deeper understanding of how different assets relate to depression. In the context of largescale traumatic events, policies that maintain and protect access to social, physical, and financial assets may help to protect mental health.
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Affiliation(s)
- Catherine K Ettman
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
- Boston University School of Public Health, Boston, USA.
| | | | - Alice Y Fan
- Boston University School of Public Health, Boston, USA
| | - Gaelen P Adam
- Brown University School of Public Health, Providence, USA
| | | | - Sandro Galea
- Boston University School of Public Health, Boston, USA
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Joseph S, Van den Bulke F, Mathew J, Trappeniers M, Van Hoecke K, Van Cauwenberghe A, Pradeep KI. Toward a Socioeconomic Equity in Combating Adolescent Substance Abuse: An Outreach and Drop-In Centre to Bridge the Gap. Community Ment Health J 2024; 60:470-481. [PMID: 37787886 DOI: 10.1007/s10597-023-01193-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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023]
Abstract
This paper describes a case study of an Outreach and Drop-in Centre (ODIC) established under the National Action Plan for Drug Demand Reduction, Ministry of Social Justice and Empowerment, Government of India. In the quantitative part, data were gathered from the ODIC office documents and analysed using MS Excel. Linear regression analysis demonstrated a relationship between the number of in-centre clients and the number of Community Outreach Programmes (COPs). Similarly, this study examined the relationship between the number of networks established and the number of participants in COPs. Hence, two regression lines were derived accordingly. In addition, qualitative data collected through key informant interviews corroborated the quantitative results. This case study highlights the importance of networks and COPs in increasing the reach of ODIC and ensuring the quality of services. Finally, in partnership with other government agencies, this ODIC sets a model for engaging marginalised adolescents in reducing substance abuse.
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Affiliation(s)
- Shinto Joseph
- Rajagiri College of Social Sciences (Autonomous), Kalamassery, Kochi, India
| | | | - Jasmine Mathew
- Rajagiri College of Social Sciences (Autonomous), Kalamassery, Kochi, India.
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Aravena-Rivas Y, Venturelli R, Stennett M, Tsakos G. Inequalities in dental services use by older adults in Chile according to eligibility for a national dental programme. Community Dent Oral Epidemiol 2024; 52:161-170. [PMID: 37691001 DOI: 10.1111/cdoe.12909] [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: 09/09/2022] [Revised: 07/20/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES The objectives of this study were to determine the prevalence and trends in dental service use among Chilean older adults (60+ years) between 2006 and 2017; to assess the association between socioeconomic factors and dental service use and type (public/private) in 2017 and whether these differ by eligibility to a national dental programme (GES-60). METHODS This study involved secondary data analysis of five nationally representative cross-sectional surveys between 2006 and 2017. Trends were assessed for use of dental services and types of services used among 60-79-year-olds. Logistic regression models examined the association between use of dental services in 2017 and socioeconomic variables (income and education), accounting for covariates (age, gender, residence, ethnicity, cohabiting status, employment and disability). Estimated marginal means and odds ratios (ORs) were calculated to assess the association between socioeconomic variables and the outcomes by GES-60 eligibility. RESULTS Across surveys, the average prevalence of use of dental services in the last 3 months was 5.0%. There was a slight increase in dental visits between 2006 and 2017. This trend was higher among GES-60 eligible individuals using public dental services. Inequalities were observed in regression analyses. Compared to the poorest quintile and those with no formal education respectively, the ORs were 2.36 (95% confidence interval (CI) 1.79-5.68) for the richest quintile and ranged from 2.91 (95% CI 1.49-5.68) to 6.43 (3.26-12.68) for each higher level of educational attainment. Inequalities were wider among GES-60 non-eligible than GES-60 eligible older adults for both outcomes. CONCLUSIONS Socioeconomic inequalities were present among older adults regardless of GES-60 eligibility. However, these inequalities were more pronounced among non-eligible individuals. Our findings suggest a limited impact of GES-60 only among eligible older adults. Policies considering the needs of the whole older adult population are likely to have a stronger impact.
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Affiliation(s)
- Yanela Aravena-Rivas
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Renato Venturelli
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Michelle Stennett
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
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Park GR. Socioeconomic inequalities in deaths of despair: Age heterogeneity in Canada's working age population. Prev Med 2024; 181:107920. [PMID: 38423303 DOI: 10.1016/j.ypmed.2024.107920] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Although prior literature documented socioeconomic inequalities in deaths of despair among working age population, it is unclear whether and how (a) the link between socioeconomic status and deaths of despair differs by age (b) each measure of socioeconomic status has independent effects on deaths of despair. This study aims to reduce these knowledge gaps. METHODS Using data from a large scale nationally representative linked dataset (2011 Canadian Census Health and Environment Cohorts), this study employed Fine-Gray subdistribution hazard models to estimate the link between socioeconomic status and deaths of despair due to suicide, drug overdose, and alcoholic liver disease among working age population (N = 4,076,530). Age stratified analysis was conducted to examine age heterogeneity. RESULTS Socioeconomic status, such as housing tenure, employment status, household income, and education level, was associated with deaths of despair among working age population. Age differences in the association between socioeconomic status and deaths of despair were found. While education level was pronounced for deaths of despair for younger adults, a combination of socioeconomic status was significantly associated with deaths of despair for those in late adulthood. CONCLUSIONS Socioeconomic inequalities in deaths of despair are manifest among Canadian working age population. This study lends support the social and health policies aimed at reducing gaps in mortalities.
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Affiliation(s)
- Gum-Ryeong Park
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada.
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Kaddoura R, Elbejjani M, Tamim H, Mahfoud ZR, Salameh P, Mirza F, Charafeddine L. Building a maternal and child cohort amidst Lebanon's socioeconomic collapse: preliminary results and navigating research challenges. Popul Health Metr 2024; 22:5. [PMID: 38528603 DOI: 10.1186/s12963-024-00325-1] [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: 10/02/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024] Open
Abstract
The impact of conflict and crisis on maternal and child health underscores the need for reliable research in vulnerable populations. Lebanon, amidst ongoing economic collapse, political instability, and healthcare system strain, offers a case study for exploring these impacts, particularly on preterm babies and their development. This study aims to assess the feasibility of establishing a prospective cohort of mothers and their full-term and preterm babies in Lebanon, examining the association between social determinants, preterm birth, and developmental outcomes amidst the nation's multifaceted crises. The planned cohort involves 50 full-term and 50 preterm mother-baby pairs recruited at birth and followed up to 9-12 months post-birth. Data collection spans social determinants, perceived stress, social support, quality of life, and developmental assessments. Challenges in recruitment, follow-up, and data collection in the context of Lebanon's socio-political and economic turmoil are evaluated, alongside ethical considerations for research in vulnerable populations. Preliminary findings highlight substantial recruitment and follow-up challenges, notably due to population mobility, economic instability, and healthcare access issues. Despite these obstacles, 113 mother-baby pairs have been recruited. Early analysis reveals significant stress and reduced quality of life among mothers, particularly those with preterm infants, against a backdrop of declining birth rates and healthcare worker exodus. Conducting research in crisis settings like Lebanon presents unique methodological and ethical challenges but remains crucial for understanding and improving health outcomes in vulnerable populations. The study underscores the importance of adaptable research designs and ethical diligence in crisis research, highlighting the need for interventions tailored to these contexts. Establishing a mother and child cohort in Lebanon's crisis-ridden setting is faced with many challenges but is essential for guiding future interventions. Research in such contexts is needed to address health disparities and supporting vulnerable populations, emphasizing the need for dedicated funding and innovative research approaches in times of crisis.
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Affiliation(s)
- Rima Kaddoura
- American University of Beirut (AUB), Beirut, Lebanon
| | | | - Hani Tamim
- American University of Beirut (AUB), Beirut, Lebanon
- Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus
| | - Fadi Mirza
- Latifa Hospital & Private Practice, Dubai, United Arab Emirates
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Biswas B, Kumar N, Rahaman MM, Das S, Hoque MA. Socioeconomic inequality and urban-rural disparity of antenatal care visits in Bangladesh: A trend and decomposition analysis. PLoS One 2024; 19:e0301106. [PMID: 38527067 PMCID: PMC10962795 DOI: 10.1371/journal.pone.0301106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/11/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Socioeconomic inequality in antenatal care visits is a great concern in developing countries including Bangladesh; however, there is a scarcity of investigation to assess the factors of inequality and these changes over time. In this study, we investigated the trend of socioeconomic inequalities (2004-2017) in 1+ANC and 4+ANC visits, and extracted determinants contributions to the observed inequalities and urban-rural disparities in Bangladesh over the period from 2011 to 2017. METHODS The data from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 2004, 2007, 2011 and 2017 were analyzed in this study. The analysis began with exploratory and bivariate analysis, followed by the application of logistic regression models. To measure the inequalities, the Erreygers concentration index was used, and regression-based decomposition analyses were utilized to unravel the determinant's contribution to the observed inequalities. The Blinder-Oaxaca type decomposition is also used to decompose the urban-rural disparity into the factors. RESULTS Our analysis results showed that the prevalence of 1+ANC and 4+ANC visits has increased across all the determinants, although the rate of 4+ANC visits remains notably low. The magnitudes of socioeconomic inequality in 4+ANC visits represented an irregular pattern at both the national and urban levels, whereas it increased gradually in rural Bangladesh. However, inequalities in 1+ANC visits declined substantially after 2011 across the national, rural and urban areas of Bangladesh. Decomposition analyses have suggested that wealth status, women's education, place of residence (only for 4+ANC visits), caesarean delivery, husband education, and watching television (TV) are the main determinants to attribute and changes in the level of inequality and urban-rural disparity between the years 2011 and 2017. CONCLUSIONS According to the findings of our study, it is imperative for authorities to ensure antenatal care visits are more accessible for rural and underprivileged women. Additionally, should focus on delivering high-quality education, ensuring the completion of education, reducing income disparity as well as launching a program to enhance awareness about health facilities, and the impact of caesarean delivery.
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Affiliation(s)
- Biplab Biswas
- Faculty of Science, Department of Statistics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
- Faculty of Science, Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
| | - Nishith Kumar
- Faculty of Science, Department of Statistics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Md. Matiur Rahaman
- Faculty of Science, Department of Statistics, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | - Sukanta Das
- Faculty of Science, Department of Statistics, Begum Rokeya University, Rangpur, Bangladesh
| | - Md. Aminul Hoque
- Faculty of Science, Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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Weidner J, Glauche I, Manuwald U, Kern I, Reinecke I, Bathelt F, Amin M, Dong F, Rothe U, Kugler J. Correlation of Socioeconomic and Environmental Factors With Incidence of Crohn Disease in Children and Adolescents: Systematic Review and Meta-Regression. JMIR Public Health Surveill 2024; 10:e48682. [PMID: 38526534 DOI: 10.2196/48682] [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: 05/03/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND The worldwide incidence of Crohn disease (CD) in childhood and adolescence has an increasing trend, with significant differences between different geographic regions and individual countries. This includes an increase in the incidence of CD in countries and geographic regions where CD was not previously prevalent. In response to the increasing incidence, the pediatric care landscape is facing growing challenges. OBJECTIVE This systematic review and meta-analysis were undertaken to comprehensively delineate the incidence rates of CD in pediatric populations across different countries and to explore potential influencing factors. METHODS We performed a systematic review of PubMed and Embase (via Ovid) for studies from January 1, 1970, to December 31, 2019. In addition, a manual search was performed in relevant and previously published reviews. The results were evaluated quantitatively. For this purpose, random effects meta-analyses and meta-regressions were performed to investigate the overall incidence rate and possible factors influencing the incidence. RESULTS A qualitative synthesis of 74 studies was performed, with 72 studies included in the meta-analyses and 52 in the meta-regressions. The results of our meta-analysis showed significant heterogeneity between the individual studies, which cannot be explained by a sample effect alone. Our findings showed geographical differences in incidence rates, which increased with increasing distance from the equator, although no global temporal trend was apparent. The meta-regression analysis also identified geographic location, UV index, and Human Development Index as significant moderators associated with CD incidence. CONCLUSIONS Our results suggest that pediatric CD incidence has increased in many countries since 1970 but varies widely with geographic location, which may pose challenges to the respective health care systems. We identified geographic, environmental, and socioeconomic factors that contribute to the observed heterogeneity in incidence rates. These results can serve as a basis for future research. To this end, implementations of internationally standardized and interoperable registries combined with the dissemination of health data through federated networks based on a common data model, such as the Observational Medical Outcomes Partnership, would be beneficial. This would deepen the understanding of CD and promote evidence-based approaches to preventive and interventional strategies as well as inform public health policies aimed at addressing the increasing burden of CD in children and adolescents. TRIAL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42020168644; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168644. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-037669.
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Affiliation(s)
- Jens Weidner
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ingmar Glauche
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ulf Manuwald
- Faculty of Applied Social Sciences, University of Applied Sciences (FHD), Dresden, Germany
| | - Ivana Kern
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Ines Reinecke
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Franziska Bathelt
- Institute for Medical Informatics and Biometry, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Thiem-Research GmbH, Cottbus, Germany
| | - Makan Amin
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Department for Trauma Surgery and Orthopaedics, Park-Klinik Weissensee, Berlin, Germany
| | - Fan Dong
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | | | - Joachim Kugler
- Institute and Policlinic for Occupational and Social Medicine, Department of Health Sciences/Public Health, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Huang Q, Yang J, Liu GX, Zi H, Tang SD, Jia HC, Li W, Xu XF, Zeng XT. Changes in disease burden and global inequalities in bladder, kidney and prostate cancers from 1990 to 2019: a comparative analysis based on the global burden of disease study 2019. BMC Public Health 2024; 24:891. [PMID: 38528465 DOI: 10.1186/s12889-024-18353-9] [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: 01/02/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Bladder, kidney and prostate cancers make significant contributors to cancer burdens. Exploring their cross-country inequalities may inform equitable strategies to meet the 17 sustainable development goals before 2030. METHODS We analyzed age-standardized disability-adjusted life-years (ASDALY) rates for the three cancers based on Global Burden of Diseases Study 2019. We quantified the inequalities using slope index of inequality (SII, absolute measure) and concentration index (relative measure) associated with national sociodemographic index. RESULTS Varied ASDALY rates were observed in the three cancers across 204 regions. The SII decreased from 35.15 (95% confidence interval, CI: 29.34 to 39.17) in 1990 to 15.81 (95% CI: 7.99 to 21.79) in 2019 for bladder cancers, from 78.94 (95% CI: 75.97 to 81.31) in 1990 to 59.79 (95% CI: 55.32 to 63.83) in 2019 for kidney cancer, and from 192.27 (95% CI: 137.00 to 241.05) in 1990 to - 103.99 (95% CI: - 183.82 to 51.75) in 2019 for prostate cancer. Moreover, the concentration index changed from 12.44 (95% CI, 11.86 to 12.74) in 1990 to 15.72 (95% CI, 15.14 to 16.01) in 2019 for bladder cancer, from 33.88 (95% CI: 33.35 to 34.17) in 1990 to 31.13 (95% CI: 30.36 to 31.43) in 2019 for kidney cancer, and from 14.61 (95% CI: 13.89 to 14.84) in 1990 to 5.89 (95% CI: 5.16 to 6.26) in 2019 for prostate cancer. Notably, the males presented higher inequality than females in both bladder and kidney cancer from 1990 to 2019. CONCLUSIONS Different patterns of inequality were observed in the three cancers, necessitating tailored national cancer control strategies to mitigate disparities. Priority interventions for bladder and kidney cancer should target higher socioeconomic regions, whereas interventions for prostate cancer should prioritize the lowest socioeconomic regions. Additionally, addressing higher inequality in males requires more intensive interventions among males from higher socioeconomic regions.
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Affiliation(s)
- Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jun Yang
- Department of Urology, The First People's Hospital of Tianmen in Hubei Province, The Affiliated Hospital of Hubei University of Science and Technology, Tianmen, China
| | - Guo-Xiong Liu
- Department of Urology, Xianyang Central Hospital, Xianyang, China
| | - Hao Zi
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shi-Di Tang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hai-Chang Jia
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Li
- Department of Oncology, The First People's Hospital of Tianmen in Hubei Province, The Affiliated Hospital of Hubei University of Science and Technology, Tianmen, China.
| | - Xiao-Feng Xu
- Department of Urology, Xianyang Central Hospital, Xianyang, China.
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.
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Gashaw A, Mitku H. Pre-lacteal feeding practice and associated factors among mothers having children aged less than six months in Dilla town, Southern Ethiopia. BMC Pediatr 2024; 24:208. [PMID: 38521938 PMCID: PMC10960386 DOI: 10.1186/s12887-024-04660-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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 02/21/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Pre-lacteal feeding, the introduction of liquids or non-breast milk foods before establishing regular breastfeeding, poses significant risks to newborns, depriving them of vital nutrients and the protective benefits of colostrum while exposing them to infection hazards. Despite breast milk being a renewable and comprehensive source of infant nutrition for the first six months of life, prevalent in many low income country are pre-lacteal feeds such as honey, sugar-water, jiggery water, castor oil, and goat's milk. These practices, widespread in such regions, carry potential risks of infection and aspiration. The objective of this study is to assess the prevalence of pre-lacteal feeding and identify associated factors among mothers with children under six months in Dilla Town, Southern Ethiopia. METHOD A community-based cross-sectional study took place in Dilla town, southern Ethiopia, spanning from June 20 to August 20, 2022. The study included a total of 372 participants, selected through simple random sampling for kebele and systematic random sampling for individual participants. Data was collected using interviewer-administered structured questionnaires and subsequently coded, entered, cleaned, and edited using SPSS version 23.0 software. The presentation of data utilized tables and figures, followed by a logistic regression analysis to identify potential factors associated with pre-lacteal feeding. The significance level was set at a p-value less than 0.05 for the final model. RESULT The prevalence of pre-lacteal feeding practice was 176 (47.3%) in the study area and having no maternal education (AOR = 3.68, 95% CI; [1.01-5.84] colostrum avoidance (AOR = 4.20, 95% CI; [2.03-6.86] and lack of breast feeding counseling (AOR = 2.00, 95% CI; 1.40-2.57), were factors associated with pre-lacteal feeding practices. CONCLUSION AND RECOMMENDATION Pre-lacteal feeding practice among mothers of children aged less than 6 months in Dilla town was found to be higher than the national prevalence. No formal education, colostrum avoidance, lack of breastfeeding counseling, were factors associated with pre-lacteal feeding practices. So awareness creation activities on the risks of PLF (pre-lacteal feeding) and improving breastfeeding counseling targeted to all mothers and care givers including their families within the study area is vital.
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Affiliation(s)
- Anteneh Gashaw
- Department of Midwifery, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Haymanot Mitku
- Department of Midwifery, College of Medicine & Health Sciences, Dilla University, Dilla, Ethiopia
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Gamba R, Toosi N, Wood L, Alexandra C, Medina N, Pritchard M, Jhamon V, Lee M, Santillan JKA. Racial discrimination is associated with food insecurity, stress, and worse physical health among college students. BMC Public Health 2024; 24:883. [PMID: 38519967 PMCID: PMC10958967 DOI: 10.1186/s12889-024-18240-3] [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: 05/16/2023] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Students of color disproportionately experience racial discrimination and food insecurity, which both lead to poor academic and health outcomes. This study explores the extent to which the location of racial discrimination experienced is associated with food insecurity, stress, physical health and grade point average among college students METHODS: A cross sectional study design was implemented to survey 143 students from a racially diverse public university. Logistic regression models assessed if discrimination at various locations was associated with food insecurity and linear models assessed how racial discrimination was associated with physical health, stress and grade point average RESULTS: Student's experiencing food security had an average discrimination score of 2.3 (1.23, 3.37), while those experiencing food insecurity had a statistically significant (P < 0.001) higher average discrimination score 7.3 (5.4, 9.21). Experiencing any racial discrimination was associated with increased odds of experiencing food insecurity when experienced from the police (OR 11.76, 95% CI: 1.41, 97.86), in the housing process (OR 7.9, 95% CI: 1.93, 32.34) and in the hiring process (OR 6.81, 95% CI: 1.98, 23.48) compared to those experiencing no racial discrimination after adjusting for race, gender, age and income. CONCLUSION The location in which a student experienced racial discrimination impacted the extent to which the racial discrimination was associated with food security status. Further research is needed to explore potential mechanisms for how racial discrimination may lead to food insecurity.
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Affiliation(s)
- Ryan Gamba
- Department of Public Health, California State University, East Bay. SF 102. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA.
| | - Negin Toosi
- Department of Psychology, California State University, East Bay. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
| | - Lana Wood
- University Libraries, California State University, East Bay, 94542, Hayward, CA, USA
| | - Correia Alexandra
- Department of Psychology, California State University, East Bay. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
| | - Nomar Medina
- Department of Psychology, California State University, East Bay. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
| | - Maria Pritchard
- Department of Public Health, California State University, East Bay. SF 102. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
| | - Venerable Jhamon
- Department of Psychology, California State University, East Bay. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
| | - Mikayla Lee
- Department of Public Health, California State University, East Bay. SF 102. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
| | - Joshua Kier Adrian Santillan
- Department of Public Health, California State University, East Bay. SF 102. 25800 Carlos Bee Boulevard, 94542, Hayward, CA, USA
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Lanza-León P, Cantarero-Prieto D, Pascual-Sáez M. Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years. PLoS One 2024; 19:e0300404. [PMID: 38512892 PMCID: PMC10956826 DOI: 10.1371/journal.pone.0300404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.
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Affiliation(s)
- Paloma Lanza-León
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
| | - David Cantarero-Prieto
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
| | - Marta Pascual-Sáez
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
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Mikou M, Vallet A, Guivarch C. Harmonized disposable income dataset for Europe at subnational level. Sci Data 2024; 11:308. [PMID: 38514683 PMCID: PMC10957931 DOI: 10.1038/s41597-024-03138-x] [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: 08/02/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
In recent decades, detailed country-level estimates of income and wealth have become widely available and inform us about the evolution of inequality between and within countries. But a substantial portion of these available datasets lack sub-national geographical information, precluding the exploration of the spatial distribution and evolution of inequalities within countries. We present here a new dataset of disposable income for Europe at the subnational level. It has been compiled from existing income data (gross income, gross earnings, equivalised income, etc.) published by national statistical institutes at different geographical levels. We used linear regressions and numerical operations to estimate disposable income from other available socio-economic statistics (e.g. household size, tax rates). We developed a harmonization and adjustment procedures to ensure of the consistency of statistical units, income indicators, costs of living and inflation. The dataset covers 42 European countries distributed over more than 120,000 geographical entities on the 1995 to 2021 period (most of the data being available for the 2010-2020 decade). This new dataset opens avenues for investigating the links between income inequality and other socio-economic or ecological processes.
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Affiliation(s)
- Mehdi Mikou
- Université Paris-Saclay, AgroParisTech, CNRS, Ecole des Ponts ParisTech, Cirad, EHESS, UMR CIRED, 94130, Nogent-sur-Marne, France.
- Université Paris-Saclay, CNRS, AgroParisTech, Ecologie Systématique et Evolution, 91190, Gif-sur-Yvette, France.
| | - Améline Vallet
- Université Paris-Saclay, AgroParisTech, CNRS, Ecole des Ponts ParisTech, Cirad, EHESS, UMR CIRED, 94130, Nogent-sur-Marne, France
- Université Paris-Saclay, CNRS, AgroParisTech, Ecologie Systématique et Evolution, 91190, Gif-sur-Yvette, France
| | - Céline Guivarch
- Université Paris-Saclay, AgroParisTech, CNRS, Ecole des Ponts ParisTech, Cirad, EHESS, UMR CIRED, 94130, Nogent-sur-Marne, France
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