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Selvamani Y, Elgar F. Food insecurity and its association with health and well-being in middle-aged and older adults in India. J Epidemiol Community Health 2023; 77:252-257. [PMID: 36754599 DOI: 10.1136/jech-2022-219721] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
AIM Food insecurity is a global public health concern; however, there is limited knowledge about its health impacts in India. We examined the associations of food insecurity with socioeconomic conditions, chronic disease and various domains of health and well-being in a community sample of middle-aged and older adults (45+ years) in India. METHODS Cross-sectional nationally representative data were collected in wave 1 (2017-2018) of the Longitudinal Ageing Study in India. Food insecurity was measured by questions of access and availability of food. We used logistic regression analyses to examine associations of food insecurity with poor self-rated health, limitations in activities of daily living (ADLs), instrumental ADLs, low life satisfaction, depression, sleep problems and low body mass. RESULTS Food insecurity related to all seven indicators of poor health and well-being, even after controlling for material wealth and the presence of multimorbidity (which food insecurity also predicted). Associations with mental health were stronger for those for physical health. For instance, food insecurity related to a threefold increase in probable depression (OR=2.9, 95% CI=2.4 to 3.4) and low life satisfaction (OR=3.4, 95% CI=2.9 to 3.8). CONCLUSIONS Food insecurity is a powerful social determinant of poor health among older adults in India. Policy measures to improve population health and well-being should closely follow trends in food insecurity, particularly among those living in poverty and with multiple health conditions.
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Affiliation(s)
- Y Selvamani
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Frank Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Québec, Canada
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Min J, Song J. Spousal loss and cognitive function: the importance of gender and multiple dimensions of marital quality. Aging Ment Health 2023; 27:755-764. [PMID: 35696361 PMCID: PMC10041968 DOI: 10.1080/13607863.2022.2084715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/28/2022] [Indexed: 11/01/2022]
Abstract
Objectives: Research suggests that the death of a spouse has an adverse effect on a widow(er)'s cognition. However, little research has examined how the marital context before widowhood and gender influence this association. Guided by the social ambivalence and disease (SAD) model, this study examined the associations between spousal loss and cognition , with moderating effects of gender and pre-loss marital quality.Method: We analyzed a national longitudinal data, Midlife in the United States (MIDUS), specifically MIDUS 2 (2004-2005) and MIDUS 3 (2013-2014). The analytic sample consisted of (1) 146 participants who experienced the death of their spouse between MIDUS 2 and MIDUS 3 and (2) 144 age- and gender-matched comparison participants who did not lose their spouse during the period.Results: Adverse influence of widowhood on cognition was more pronounced among bereaved men than bereaved women. Widowed individuals whose relationships with their deceased spouse were ambivalent had poorer cognition than widowed individuals who had aversive relationships with their deceased spouse.Conclusion: Findings suggest that the influence of spousal death on cognitive functioning depends on gender and pre-loss marital quality, emphasizing the importance of considering pre-loss marital relationship and gender dynamics in developing efficient interventions for the widowed.
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Affiliation(s)
- Joohong Min
- Faculty of Human Ecology and Welfare, Faculty of Data
Science for Sustainable Growth, Jeju National University, Jeju, South Korea
| | - Jieun Song
- institute on Aging, University of Wisconsin-Madison, WI,
USA
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Dosbaba F, Hartman M, Batalik L, Senkyr V, Radkovcova I, Richter S, Brat K, Cahalin LP, Formiga MF. A comprehensive examination of inspiratory muscle performance from the intensive care unit to hospital discharge in patients with COVID-19. Heart Lung 2023; 60:95-101. [PMID: 36934476 PMCID: PMC10008810 DOI: 10.1016/j.hrtlng.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND The two most common symptoms associated with COVID-19 are dyspnea and fatigue. One possible cause of such symptoms may be inspiratory muscle weakness. OBJECTIVES The purpose of this study was to examine inspiratory muscle performance (IMP) from intensive care unit discharge (ICUD) to hospital discharge (HD) in patients with COVID-19 hypothesizing that IMP would be markedly depressed at both ICUD and HD. METHODS IMP was examined at ICUD and HD via the PrO2 device (PrO2 Health, Smithfield, RI) which provided the maximal inspiratory pressure (MIP), sustained MIP (SMIP), inspiratory duration (ID), and fatigue index test (FIT). Patient symptoms were assessed at ICUD, HD, and 1-month post-HD. RESULTS 30 patients (19 men, 11 women) with COVID-19 were included. The mean±SD age, BMI, and length of ICU and hospital stay was 71±11 yrs, 27.9 ± 6.3 kg/m, 9 ± 6 days, and 26±16 days, respectively. The mean±SD MIP, SMIP, ID, and FIT of the entire cohort at ICUD vs HD were 36±21 vs 40±20 cm H2O, 231±157 vs 297±182 PTU, 8.8 ± 4.2 vs 9.5 ± 4.6 s, and 9.0 ± 9.4 vs 13.1 ± 12.3, respectively, with only SMIP and FIT significantly greater at HD (p=.006 and 0.03, respectively). SMIP at HD was significantly related to resting dyspnea at HD (r=-0.40; p=.02). The SMIP and FIT of men were found to increase significantly from ICUD to HD, but no measure of IMP in the women increased significantly from ICUD to HD. At least one COVID-19-related symptom was present 1 month after HD with the most persistent symptoms being fatigue, cough, and dyspnea in 47%, 40%, and 37% of the patients, respectively. CONCLUSIONS A significant reduction in IMP exists in patients with COVID-19 at both ICUD and HD and no measure of IMP in women was observed to increase significantly from ICUD to HD. Impaired inspiratory muscle endurance rather than strength was associated with greater dyspnea at HD.
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Affiliation(s)
- Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic.
| | - Martin Hartman
- Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic; Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University Brno, Brno 62500, Czech Republic
| | - Vojtech Senkyr
- Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic
| | - Ivana Radkovcova
- Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic
| | - Svatopluk Richter
- Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno 62500, Czech Republic
| | - Kristian Brat
- Department of Respiratory Diseases, University Hospital Brno, Brno 62500, Czech Republic
| | - Lawrence P Cahalin
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, United States
| | - Magno F Formiga
- Faculdade de Medicina, Departamento de Fisioterapia, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
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Bartig S, Koschollek C, Bug M, Blume M, Kajikhina K, Geerlings J, Starker A, Hapke U, Rommel A, Hövener C. Health of people with selected citizenships: results of the study GEDA Fokus. JOURNAL OF HEALTH MONITORING 2023; 8:7-33. [PMID: 37064418 PMCID: PMC10091045 DOI: 10.25646/11143] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/14/2022] [Indexed: 04/18/2023]
Abstract
Background The health situation of people with a history of migration is influenced by a variety of factors. This article provides an overview of the health of people with selected citizenships using various indicators. Methods The analyses are based on the survey 'German Health Update: Fokus (GEDA Fokus)', which was conducted from November 2021 to May 2022 among people with Croatian, Italian, Polish, Syrian and Turkish citizenship. The prevalence for each health outcome is presented and differentiated by sociodemographic and migration-related characteristics. Poisson regressions were performed to identify relevant factors influencing health situation. Results Self-assessed general health, the presence of depressive symptoms, prevalence of current smoking and the utilisation of general and specialist healthcare differed according to various factors considered here. In addition to sociodemographic determinants, the sense of belonging to society in Germany and self-reported experiences of discrimination were particularly associated with health outcomes. Conclusions This article highlights the heterogeneity of the health situation of people with a history of migration and points to the need for further analyses to identify the reasons for health inequalities.
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Affiliation(s)
- Susanne Bartig
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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Stelander LT, Lorem GF, Høye A, Bramness JG, Wynn R, Grønli OK. The effects of exceeding low-risk drinking thresholds on self-rated health and all-cause mortality in older adults: the Tromsø study 1994-2020. Arch Public Health 2023; 81:25. [PMID: 36797780 PMCID: PMC9933408 DOI: 10.1186/s13690-023-01035-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Based on findings of increasing alcohol consumption in older adults, it is important to clarify the health consequences. Using data from the Tromsø study, we aimed to investigate the relationship between different levels of alcohol consumption in old adulthood and self-rated health trajectories and all-cause mortality. METHODS This is an epidemiological study utilizing repeated measures from the Tromsø study cohort. It allows follow-up of participants from 1994 to 2020. A total of 24,590 observations of alcohol consumption were made in older adults aged 60-99 (53% women). PRIMARY OUTCOME MEASURES Self-rated health (SRH) and all-cause mortality. SRH was reported when attending the Tromsø study. Time of death was retrieved from the Norwegian Cause of Death Registry. The follow-up time extended from the age of study entry to the age of death or end of follow-up on November 25, 2020. PREDICTOR Average weekly alcohol consumption (non-drinker, < 100 g/week, ≥100 g/week). We fitted two-level logistic random effects models to examine how alcohol consumption was related to SRH, and Cox proportional hazards models to examine its relation to all-cause mortality. Both models were stratified by sex and adjusted for sociodemographic factors, pathology, biometrics, smoking and physical activity. In addition, all the confounders were examined for whether they moderate the relationship between alcohol and the health-related outcomes through interaction analyses. RESULTS We found that women who consumed ≥100 g/week had better SRH than those who consumed < 100 g/week; OR 1.85 (1.46-2.34). This pattern was not found in men OR 1.18 (0.99-1.42). We identified an equal mortality risk in both women and men who exceeded 100 g/week compared with those who consumed less than 100 g/week; HR 0.95 (0.73-1.22) and HR 0.89 (0.77-1.03), respectively. CONCLUSIONS There was no clear evidence of an independent negative effect on either self-rated health trajectories or all-cause mortality for exceeding an average of 100 g/week compared to lower drinking levels in this study with up to 25 years follow-up. However, some sex-specific risk factors in combination with the highest level of alcohol consumption led to adverse effects on self-rated health. In men it was the use of sleeping pills or tranquilisers and ≥ 20 years of smoking, in women it was physical illness and older age.
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Affiliation(s)
- Line Tegner Stelander
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291, Tromsø, Norway. .,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Geir Fagerjord Lorem
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Høye
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jørgen G. Bramness
- grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.418193.60000 0001 1541 4204Norwegian Institute of Public Health, Oslo, Norway ,Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Hamar, Norway
| | - Rolf Wynn
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Kristian Grønli
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, P.O. Box 6124, 9291 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Le Grande M, Balmford J, Borland R, McNeill A. Perceived Health and Capacity to Cope With Stress in Recent Ex-smokers: Impact of Vaping Versus Quitting All Nicotine. Nicotine Tob Res 2023; 25:553-562. [PMID: 36318814 PMCID: PMC9910145 DOI: 10.1093/ntr/ntac252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 10/06/2022] [Accepted: 10/31/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Little is known about the continued use of nicotine following smoking cessation on perceived well-being in comparison to complete cessation of nicotine use. AIMS AND METHODS To explore aspects of perceived well-being and coping among recent ex-smokers as a function of vaping status. Ever-daily smokers in the International Tobacco Control 4 country smoking and vaping surveys in 2016 (w1 N = 883) and 2018 (w2 N = 1088). Cross-sectional associations and longitudinal samples for those who quit between waves and those who quit at w1 and maintained abstinence to w2. Main outcome measures were: Past 30 days of depression symptoms, perceived stress, stress management since quitting, and change in perceived day-to-day health. RESULTS In the cross-sectional analyses vapers were more likely to report both improved stress management (aOR = 1.71, 95% CI 1.23-2.36) and perceived day-to-day health (aOR = 1.65, 95% CI 1.26-2.16) than nicotine abstainers. In the longitudinal analyses, smokers who switched to vaping between waves (n = 372) were more likely to report depression symptoms at w2 (aOR = 2.00, 95% CI 1.09-3.65) but reported improved perceived health (aOR = 1.92, 95% CI 1.16-3.20). For the past daily smokers who remained quit between waves (n = 382), vapers were more likely to report improved stress management relative to abstainers (RRR = 5.05. 95% CI 1.19-21.40). There were no other significant differences between vapers and nicotine abstainers. CONCLUSIONS There is little evidence to support the view that perceptions of well-being deteriorate in vapers compared to complete nicotine abstainers in the immediate years after smoking cessation. IMPLICATIONS This study could find no conclusive evidence that the continued use of nicotine via e-cigarettes was detrimental to health compared to completely stopping nicotine intake altogether. Our results would suggest that continuing to use nicotine may even result in some benefits in the short term such as improved stress management, however further longitudinal studies are required to examine if these effects are restricted to the early post-quitting phase and whether other positive or negative effects on psychosocial health emerge in the future.
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Affiliation(s)
- Michael Le Grande
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Grattan Street, Parkville, Vic 3010, Australia
| | - James Balmford
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Grattan Street, Parkville, Vic 3010, Australia
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Morais ÉAHD, Abreu MNS, Assunção AÁ. [Self-rated health and factors related to the work of basic education's teachers in Brazil]. CIENCIA & SAUDE COLETIVA 2023; 28:209-222. [PMID: 36629565 DOI: 10.1590/1413-81232023281.07022022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 07/08/2022] [Indexed: 01/11/2023] Open
Abstract
The scope of this article is to analyze the association between teachers' self-rated health and the conditions in which they work in Basic Education schools in Brazil. It involved a cross-sectional study, carried out between 2015 and 2016, representative of Basic Education teachers in the country, the outcome variable of which was self-rated health (SRH). The explanatory variables were the work-related characteristics. To assess the factors associated with SRH, the Proportional Odds Logistic Regression Model was used. The prevalence of poor SRH was 27%. The probability of poor SRH was significantly higher for the group that reported episodes of verbal violence (OR=1.26; 95%CI 1.09-1.44), work pressure (OR=1.18; 95%CI 1, 04-1.33), and a commute to school of more than 50 minutes (OR=1.19; 95%CI 1.03-1.38). The probability of poor SRH was significantly better for those who reported having enough time to complete their tasks (OR=0.77; 95%CI 0.64-0.92), social support (OR=0.79; 95%CI 0.69-0.89) and satisfaction with their workload (OR=0.79; 95%CI 0.69-0.91). Actions on the school environment and organization and improvements in the transport of teachers to work are desirable.
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Affiliation(s)
- Évelin Angélica Herculano de Morais
- Departamento de Enfermagem Aplicada, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). R. Alfredo Balena 190, sala 510, Bairro Santa Efigênia. 30150-331 Belo Horizonte MG Brasil.
| | | | - Ada Ávila Assunção
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, UFMG. Belo Horizonte MG Brasil
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Roth L, Seematter-Bagnoud L, Le Pogam MA, Dupraz J, Blanco JM, Henchoz Y, Peytremann-Bridevaux I. Identifying common patterns of health services use: a longitudinal study of older Swiss adults' care trajectories. BMC Health Serv Res 2022; 22:1586. [PMID: 36572888 PMCID: PMC9793504 DOI: 10.1186/s12913-022-08987-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Population ageing puts pressure on health systems initially designed to handle acute and episodic illnesses. Segmenting an ageing population based on its healthcare utilization may enable policymakers to undertake evidence-based resource planning. We aimed to derive a typology of healthcare utilization trajectories in Swiss older adults. METHODS Our work used data from the Lc65 + study, a population-based cohort of individuals aged 65 to 70 years at enrolment. The dimensions of healthcare utilization considered were ambulatory care, emergency care, hospitalizations, professional home care and nursing home stay. We applied the Sequence Analysis framework, within which we quantified the variation between each multidimensional pair of sequences, implemented a clustering procedure that grouped together older persons with similar profiles of health services use, and characterized clusters of individuals using selected baseline covariates. RESULTS Healthcare utilization trajectories were analysed for 2271 community-dwelling older adults over a period of 11 years. Six homogeneous subgroups were identified: constant low utilization (83.3% of participants), increased utilization (4.9%), late health deterioration (4.4%), ambulatory care to nursing home (1.5%), early fatal event (3.8%) and high ambulatory care (2.1%). Associations were found between cluster membership and age, sex, household composition, self-perceived health, grip strength measurement, comorbidities, and functional dependency. CONCLUSIONS The heterogeneous healthcare utilization profiles can be clustered into six common patterns. Different manifestations of functional decline were apparent in two distinct trajectory groups featuring regular home care use. Furthermore, a small proportion of individuals with a unique set of characteristics was related to the highest levels of ambulatory and emergency care use. New research avenues are outlined to investigate time-varying effects of health factors inside the clusters containing most unfavourable outcomes.
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Affiliation(s)
- Leonard Roth
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
| | - Laurence Seematter-Bagnoud
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
| | - Marie-Annick Le Pogam
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
| | - Julien Dupraz
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
| | - Juan-Manuel Blanco
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
| | - Yves Henchoz
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- grid.9851.50000 0001 2165 4204Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 10 Route de La Corniche, 1010 Lausanne, Switzerland
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Ko HL, Min HK, Lee SW. Self-rated health and the risk of incident chronic kidney disease: a community‐based Korean study. J Nephrol 2022; 36:745-753. [PMID: 36477693 DOI: 10.1007/s40620-022-01518-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The relationship between self-rated health (SRH) and the development of incident chronic kidney disease (CKD) has not been explored in the general population. METHODS We reviewed the data of 7027 participants in the Ansung-Ansan cohort study. SRH was categorized as poor, fair, or good, and the outcome was the development of CKD, defined as the first event of an estimated glomerular filtration rate < 60 mL/min/1.73 m2, at least twice during the follow-up period. Hazard ratios (HRs) and confidence intervals (CIs) were calculated using Cox proportional hazards regression analysis. RESULTS Over a mean follow-up duration of 11.9 years, 951 participants (13.5%) developed CKD. Compared with poor self-rated health, the HR (95% CI) of fair self-rated health for incident CKD development was 0.771 (0.657-0.905; P = 0.001), whereas that of good self-rated health was 0.795 (0.676-0.935; P = 0.006). However, the renal hazard of good self-rated health did not differ from that of fair self-rated health. In the fully adjusted model, the HR (95% CI) of poor self-rated health compared to non-poor self-rated health for incident CKD was 1.278 (1.114-1.465, P < 0.001). Old age, smoking, cardiovascular disease, diabetes, hypertension, impaired sleep, and high levels of C-reactive protein and white blood cell counts were associated with increased odds of poor self-rated health, whereas male sex, college graduate level of education, and alcohol consumption were associated with decreased odds of poor self-rated health. CONCLUSION Poor self-rated health is independently associated with CKD development. Therefore, the early detection of potential CKD patients through a brief questionnaire assessment may help control the incidence of CKD.
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Affiliation(s)
- Hyun-Lee Ko
- Department of Internal Medicine, Uijeongbu Eulji University Medical Center, Gyeonggi-Do, Korea
| | - Hyang-Ki Min
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Sung-Woo Lee
- Department of Internal Medicine, Uijeongbu Eulji University Medical Center, Gyeonggi-Do, Korea.
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Svalestuen S. Is the mediating effect of psychosocial stress on the income-health relationship moderated by income inequality? SSM Popul Health 2022; 20:101302. [PMID: 36479320 PMCID: PMC9720100 DOI: 10.1016/j.ssmph.2022.101302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background There now exists a rich body of literature on the relationship between income, income inequality, and health. The discussion about the impact of income and income inequality on health includes psychosocial mechanisms, such as long-term perceptions of inferiority and social positioning, material advantage from income, and the structural conditions that define what people can do with their material resources. Aims This study investigated the extent to which income's effects on health are mediated by psychosocial stress, and to what extent those effects are moderated by country-level income inequality and economic development. Methods Data were collected from The European Social Survey, round 7. Multilevel moderated mediation analysis was applied to estimate the extent of psychosocial stress mediation of the effects of income on self-rated health. Moderated parameters were estimated over country-level income inequality and economic development. Results Significant full or partial meditation by psychosocial stress was found in all 20 countries studied. Effects moderated by income inequality and GDP per capita showed expected relationships but failed to reach conventional levels of statistical significance. Conclusions Individual-level income remains important for explaining the income-health gradient in self-rated health in Europe. The income-health relationship and the extent to which it is mediated by psychosocial stress varies among countries but is not significantly moderated by contextual income or income inequality. Policies should be aimed at allowing a greater proportion of people to live in material comfort and reduced sense of financial precarity, and protecting individuals from harmful consequences of low income.
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Affiliation(s)
- Sigbjørn Svalestuen
- Department of Social Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Jung JH, Choi KW, Kim HHS. Examining the Complex (Curvilinear and Contingent) Associations between Social Distancing Compliance and Subjective Health during a Global Health Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16058. [PMID: 36498132 PMCID: PMC9738174 DOI: 10.3390/ijerph192316058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This study investigated a potential curvilinear link between social distancing behavior and subjective health in later life. It also evaluated whether food insecurity and community social capital moderated the focal relationship. METHODS Data were drawn from three waves of the COVID Impact Survey (N = 19,234). Mixed-effects models were fitted. RESULTS Social distancing has a non-monotonic (U-shaped) relationship with subjective health, i.e., individuals with low and high levels of social distancing show relatively better health. Moreover, the negative linear relationship between social distancing and health is weaker among people suffering from food insecurity as well as those living in communities with lower stocks of social capital. DISCUSSION This study sheds new light on the health implications of social distancing during the pandemic. Our findings dovetail with the steeling hypothesis, i.e., that social distancing is less harmful for U.S. older adults exposed to prior stressful or vulnerable conditions.
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Affiliation(s)
- Jong Hyun Jung
- Department of Sociology, Sungkyunkwan University, Seoul 03063, Republic of Korea
| | - Kyung Won Choi
- Department of Sociology, University of Chicago, Chicago, IL 60637, USA
| | - Harris Hyun-soo Kim
- Department of Sociology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea
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Rañó-Santamaría O, Fernandez-Merino C, Castaño-Carou AI, Lado-Baleato Ó, Fernández-Domínguez MJ, Sanchez-Castro JJ, Gude F. Health self-perception is associated with life-styles and comorbidities and its effect on mortality is confounded by age. A population based study. Front Med (Lausanne) 2022; 9:1015195. [PMID: 36507495 PMCID: PMC9726913 DOI: 10.3389/fmed.2022.1015195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background Health self-perception (HSP) is the individual and subjective concept that a person has of their state of health. Despite its simplicity, HSP is considered a valid and relevant indicator employed in epidemiological research and in professional practice as an overall measure of health. Objectives (1) To describe and analyze the associations between HSP and demographic variables, lifestyle and diseases prevalent in a population and (2) to investigate the relationship between HSP and mortality. Materials and methods In a primary care setting, we conducted a longitudinal study of a random populational sample of a Galician municipality, stratified by decade of life. A total of 1,516 adults older than 18 years, recruited by the 2013-2015 AEGIS study, were followed-up for more than 5 years. During the clinical interview, data were collected on lifestyle and prevalent diseases. The HSP was grouped into 2 categories (good/poor). The statistical analysis consisted of a logistic regression, Kaplan-Meier curves and Cox regression. Results A total of 540 (35.6%) participants reported poor HSP. At the end of the follow-up, 78 participants had died (5.1%). The participants with increased age and body mass index and chronic diseases (anxiety, depression, ischemic heart disease, diabetes, and cancer) presented a poorer subjective health. A high level of physical activity and moderate alcohol consumption were associated with better HSP. A poorer HSP was associated with increased mortality, an association that disappeared after adjusting for the rest of the covariates (HR, 0.82; 95% CI 0.50-1.33). Conclusion (1) Health self-perception is associated with age, lifestyle, and certain prevalent diseases. (2) A poorer HSP is associated with increased mortality, but this predictive capacity disappeared after adjusting for potential confounders such as age, lifestyle, and prevalent diseases.
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Affiliation(s)
| | | | | | - Óscar Lado-Baleato
- Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain,*Correspondence: Óscar Lado-Baleato,
| | | | | | - Francisco Gude
- Health Research Institute (IDIS), Santiago de Compostela, Spain,Clinical Epidemiology Unit, University Clinic Hospital, Santiago de Compostela, Spain
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Kim MJ, Hur HJ, Jang DJ, Kim MS, Park S, Yang HJ. Inverse association of a traditional Korean diet composed of a multigrain rice-containing meal with fruits and nuts with metabolic syndrome risk: The KoGES. Front Nutr 2022; 9:1051637. [PMID: 36438748 PMCID: PMC9684706 DOI: 10.3389/fnut.2022.1051637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hansik, a traditional Korean diet, may have a beneficial impact on metabolic syndrome (MetS) risk as dietary westernization increases its prevalence. We examined the hypothesis that adherence to the hansik diet may be inversely associated with the risk of MetS and its components and sought to understand the gender differences in 58,701 men and women aged over 40. Materials and methods Hansik was defined using 14 components from which the Korean dietary pattern index (Kdiet-index) was generated by summing their scores. Low-hansik intake was defined as the Kdiet-index with <8. MetS was categorized based on the 2005 revised NCEP-ATP III criteria modified for Asians. Results The Kdiet-index score was negatively associated with the dietary inflammation index and showed that the high intake of a meal with multigrain rice, fruits, and their products, and nuts, and low intake of fried foods were inversely associated with MetS by 0.707, 0.864, 0.769, and 0.918 times, respectively, after adjusting for covariates. More women and participants with more educated and lower income belonged to the high-hansik group, and participants with high self-rated health scores consumed more hansik. All participants on a high-hansik diet were associated with a 0.87 time lower risk of MetS. Specifically, the association between hansik intake and MetS risk was not significant among men following stratification by gender. Body composition, including the body mass index, waist circumference, and fat mass, was inversely associated with hansik intake, while the skeletal muscle mass index was positively associated with the hansik intake in each gender and all participants. In all the participants in the high-hansik group, no significant changes were seen in the serum glucose and HDL concentration. However, a high-hansik intake showed lower blood pressure and serum LDL and triglyceride concentrations only in men and a higher glomerular filtration rate in both genders. Conclusions Hansik intake might improve MetS risk, with its primary beneficial effects on body composition, dyslipidemia, and blood pressure gender-dependently.
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Affiliation(s)
- Min Jung Kim
- Food Functionality Research Division, Korea Food Research Institute, Seongnam-si, South Korea
| | - Haeng Jeon Hur
- Food Functionality Research Division, Korea Food Research Institute, Seongnam-si, South Korea
| | - Dai Ja Jang
- Food Functionality Research Division, Korea Food Research Institute, Seongnam-si, South Korea
| | - Myung-Sunny Kim
- Food Functionality Research Division, Korea Food Research Institute, Seongnam-si, South Korea
- Department of Food Biotechnology, University of Science and Technology, Wanju, South Korea
| | - Sunmin Park
- Department of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan-si, South Korea
- R&D, Yejunbio, Asan-si, South Korea
- Sunmin Park
| | - Hye Jeong Yang
- Food Functionality Research Division, Korea Food Research Institute, Seongnam-si, South Korea
- *Correspondence: Hye Jeong Yang
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Moon D, Sohn M, Kim J. The Gendered Pathways Through Which Intimate Partner Violence Affects Health: Exploring the Role of Unmet Healthcare Needs. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP21366-NP21385. [PMID: 36065603 DOI: 10.1177/08862605221120907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study was to examine the relationships between intimate partner violence (IPV), gender, unmet healthcare needs, and health. Specifically, this study identified how unmet healthcare needs mediate the relationship between IPV and health, and how this mediation is moderated by gender. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N = 15,425), we first estimated ordinary least squares regression models to investigate the association between IPV and self-rated health. Then, we used structural equation models to examine how unmet healthcare needs mediate this relationship. Lastly, we conducted a moderated mediation model to investigate whether gender moderates these mediation patterns. The results of this study showed that experiencing IPV was associated with a decrease in self-rated health and an increase in the unmet need for medical care (but not in unmet need for routine health check-ups). Unmet need for medical care explained about one-quarter of the negative association between IPV and self-rated health. A moderated mediation model revealed that indirect effects of IPV on health via unmet medical care needs were more pronounced among victimized women than victimized men. This study filled knowledge gaps about the mechanisms underlying the association between IPV and poor health status. Unmet healthcare needs partially mediated the relationship between IPV victimization and health. This mechanism was more salient for the health of victimized women than victimized men. Interventions designed to improve the health of IPV victims may focus on addressing unmet healthcare needs and could be tailored according to the gender of patients.
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Affiliation(s)
- Daseul Moon
- People's Health Institute, Seoul, Republic of Korea
| | - Minsung Sohn
- The Cyber University of Korea, Seoul, Republic of Korea
| | - Jinho Kim
- Korea University, Seoul, Republic of Korea
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Li W, Frydman JL, Li Y, Liu B. Characterizing delayed care among US older adults by self-rated health during the COVID-19 pandemic. Prev Med 2022; 164:107308. [PMID: 36243228 PMCID: PMC9556801 DOI: 10.1016/j.ypmed.2022.107308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Previous studies showed that older adults with fair or poor self-rated health (SRH) were more likely to experience delayed care during the COVID-19 pandemic. We aim to understand delayed care patterns by SRH during the COVID-19 pandemic among US older adults. METHODS Using a nationally representative sample of older adults (≥ 70 years old) from the National Health and Aging Trends Study (NHATS), we assessed the patterns of delayed care by good, fair, or poor SRH. RESULTS Nearly one in five of the survey-weighted population of 9,465,117 older adults who experienced delayed care during the pandemic reported fair or poor SRH. The overall distributions of the numbers of types of delayed care (p = 0.16) and the numbers of reasons for delayed care (p = 0.12) did not differ significantly by SRH status. Older adults with good, fair, or poor SRH shared the four most common types of delayed care and three most common reasons for delayed care but differed in ranking. Older adults with poor SRH mostly delayed seeing a specialist (good vs. fair vs. poor SRH: 40.1%, 46.7%, 73%, p = 0.01). CONCLUSIONS The results suggest that utilizing SRH as a simple indicator may help researchers and clinicians understand similarities and differences in care needs for older adults during the pandemic. Targeted interventions that address differences in healthcare needs among older adults by SRH during the evolving pandemic may mitigate the negative impacts of delayed care.
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Affiliation(s)
- Weixin Li
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julia L Frydman
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Moreira JS, Melo A, Santos R, Sousa ASP. Indicators and Instruments to Assess Components of Disability in Community-Dwelling Older Adults: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:8270. [PMID: 36365968 PMCID: PMC9653663 DOI: 10.3390/s22218270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the indicators (instruments) identifying different components of disability as a result of aging exposition in community-dwelling older adults, considering the International Classification of Functioning, Disability, and Health framework. Taking the PRISMA 2020 recommendations as a reference, studies with community-dwelling older adults, reporting the development and/or age disability modifications were included. Two reviewers analyzed the observational studies searched in the MEDLINE, CINAHL, Web of Science, Scopus, and Embase databases. Of the 137 potentially eligible studies, 49 were included in this review. Several indicators (instruments) demonstrated older adults' disabilities according to the different domains of the ICF. Objective measures assessed Body Structures, Body Functions, and Environmental Factors and included handgrip strength (dynamometry, n = 8), cognitive function (Mini-Mental State examination, n = 7), gait speed (walk test, n = 6), and endurance (Chair stand-test, n = 4). Self-reported measures assessed Activities and Participation, but not the Body Structures, and included the basic and instrumental activities of daily living (ADL) (the Katz Index of ADL, n = 4 studies, the Lawton and Brody Instrumental ADL, n = 4 studies). The summary of the measures gathered can guide researchers and health professionals to select indicators (instruments) to assess and monitor older adults' disabilities resulting from aging exposition, to support the development of new wearables, and to provide improvements to the existing ones, allowing the tailored assessment of different health and disability dimensions.
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Affiliation(s)
- Juliana Santos Moreira
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
| | - Ana Melo
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
| | - Rubim Santos
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physics, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research—Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
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Tjulin Å, Vinberg S, Landstad BJ, Hedlund M, Nordenmark M. The disappointment of financial support measures during the COVID-19 pandemic among small business managers' in Sweden. SN BUSINESS & ECONOMICS 2022; 2:166. [PMID: 36246097 PMCID: PMC9548304 DOI: 10.1007/s43546-022-00347-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic is viewed as an emergent social phenomenon with several negative effects, e.g., financial decline of small businesses, as well as worsened sense of well-being. The aim of this article is to explore small business managers' perceptions of governmental financial support measures and relate them to how they experienced their own health and consequences on their work environment. This mixed-method study was performed during the COVID-19 pandemic in Sweden. A survey was conducted during the period from October 2020 to February 2021 and answered by 729 small business managers, followed by ten interviews in March 2021. The key result shows that the managers were dissatisfied with the governmental financial support measures implemented. The results show that the attitudes of the small business managers towards the financial support measures may have had a negative impact on their subjective health. The study indicates a mismatch between the needs of small businesses during the COVID-19 pandemic and how society provides resources through support systems. This in turn may have meant a limitation on the government's ability to assist small business owners with financial support during the pandemic.
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Affiliation(s)
- Åsa Tjulin
- Department of Health Sciences, Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
| | - Stig Vinberg
- Department of Health Sciences, Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
| | - Bodil J Landstad
- Department of Health Sciences, Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Marianne Hedlund
- Department of Social Work and Health Sciences, Norwegian University of Science and Technology Trondheim, Trondheim, Norway
| | - Mikael Nordenmark
- Department of Health Sciences, Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
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Versteegh M, van der Helm I, Mokri H, Oerlemans S, Blommestein H, van Baal P. Estimating Quality of Life Decrements in Oncology Using Time to Death. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1673-1677. [PMID: 35803844 DOI: 10.1016/j.jval.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The estimation of lifetime quality-adjusted life-years (QALYs) requires the extrapolation of both length and quality of life (QoL). The extrapolation of QoL has received little attention in the literature. Here we explore the predictive value of "time to death" (TTD) for extrapolating QoL in oncology. METHODS We used QoL and survival data from the Patient Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship registry, which is linked to The Netherlands Cancer Registry. QoL was assessed with EQ-5D and SF-6D. We tested the relationship between TTD and QoL using linear, 2-part, and beta regression models. Incremental QALYs were compared using the TTD approach and an annual age-related disutility approach using artificial survival data with varying mortality rates. RESULTS A total of 6 samples with >100 patients each were used for the analysis. A declining pattern in QoL was observed when patients were closer to death, confirming the predictive value of TTD for QoL. The declining pattern in QoL was most pronounced when QoL was measured with SF-6D. Proximity to death had a larger impact on QoL than age. Incremental QALYs were higher using the TTD approach than annual age-related disutility, ranging from +0.139 to +0.00003 depending on mortality rates. CONCLUSIONS TTD is a predictor variable for QoL. Using TTD allows cost-effectiveness models that lack QoL data to extrapolate morbidity using overall survival estimates. The TTD approach generates more incremental QALYs than an annual age-related disutility, most notably for longer survival periods.
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Affiliation(s)
- Matthijs Versteegh
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Ide van der Helm
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hamraz Mokri
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Simone Oerlemans
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Hedwig Blommestein
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter van Baal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Hossain B, James KS. Association between poor self-reported health and unmarried status among adults: examining the hypothesis of marriage protection and marriage selection in the Indian context. BMC Public Health 2022; 22:1797. [PMID: 36138371 PMCID: PMC9494833 DOI: 10.1186/s12889-022-14170-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background The link between marital status and health differences has long been a topic of debate. The substantial research on marriage and health has been conducted under two important hypotheses: marital protection and marriage selection. While the majority of evidence on the marriage-health relationship using these hypotheses comes from developed countries, there is a lack of evidence from Asia, particularly from India. Objectives The current study examines theoretical frameworks of marriage i.e., marital protection and marriage selection in the Indian setting concurrently, bringing substantial empirical evidence to explore the link between marriage and health, considering this subject in the context of self-reported health (SRH). Secondly, this study will aid in investigating age and gender differences in marriage and health. Methods Using the Study on Global AGEing and Adult Health (SAGE), a cohort study of individuals aged 50 years and older with a small section of individuals aged 18 to 49 for comparative reasons, the present study population was 25 years and above individuals with complete marital information. Logistic regressions were employed to explore the connection between marital status and self-reported health. In the marriage protection hypothesis, the follow-up poor SRH was the dependent variable, whereas the initial unmarried status was the independent variable. For the marriage selection effects, initial poor SRH as the independent variable and follow-up unmarried status as the dependent variable had considered. Results Examining the marital protection hypothesis, the initial unmarried status (OR: 2.14; CI at 95%: 1.17, 3.92) was associated with the followed-up SRH transition from good to poor between 2007 and 2015 for young men, while initial unmarried status was linked with a lower likelihood of stable good SRH and a higher likelihood of stable poor SRH status across all age categories among women. Focusing on the marriage selection hypothesis, among young men, a significant association exists between the initial poor SRH and departure in marital status from married to unmarried. Young women with initial poor SRH (OR: 0.68; CI at 95%: 0.40, 1.00) had lower odds of stable married. In comparison, women with initially poor SRH, irrespective of age, were more likely to have higher odds of being stably unmarried. Conclusion Marriage indeed protects health. There are also shreds of evidence on health-selected marital status in India. Taken together, the aspect of marital protection or marriage selection is gender and age-specific in India. The findings contribute to a more comprehensive understanding of the relationship between marriage and health, which may have significant implications for health-related public policies aimed at unmarried women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14170-0.
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Affiliation(s)
- Babul Hossain
- International Institute for Population Sciences, Mumbai, 400088, India.
| | - K S James
- International Institute for Population Sciences, Mumbai, 400088, India
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Rockler BE, Grutzmacher SK, Garcia J, Smit E. The role of SNAP and WIC participation and racialized legal status in U.S. farmworker health. PLoS One 2022; 17:e0272911. [PMID: 35976916 PMCID: PMC9385050 DOI: 10.1371/journal.pone.0272911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Policies that restrict access to and use of the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) by legal status may disproportionately disadvantage particular racial and ethnic groups. While immigrant legal status, race, and ethnicity are recognized as independent social determinants of health, studies examining the extent to which legal status structures racial and ethnic health disparities are limited. Research is needed to identify factors that mitigate disparate health outcomes, such as SNAP and WIC. Methods Cross-sectional data from the 2009/2010 National Agricultural Workers Survey (N = 3,961) were analyzed. Chi-square tests and logistic regressions examined associations among self-reported health, race, ethnicity, legal status, and SNAP/WIC participation. Results Farmworkers reporting excellent or good health were more likely to be non-Hispanic White, U.S. citizen, aged 18–25, single, male, educated beyond primary school, living above the poverty level, without chronic health conditions, and located in the Midwest. Hispanic farmworkers had lower odds of reporting excellent or good health (OR 0.27, 95% CI 0.12–0.62). Among SNAP/WIC participants, Hispanic farmworkers had higher odds of reporting excellent or good health (OR 6.74, 95% CI 1.54–29.57) compared to non-Hispanic White farmworkers. There was no significant association between self-reported health and legal status. Discussion This study complements the extant literature showing racial and ethnic health disparities among the U.S. farmworker population. Results provide valuable insight on the health-protective potential of programs like SNAP and WIC, particularly among Hispanic farmworkers, who may be both less likely to be eligible and more hesitant to participate. These findings underscore the need to expand U.S. farmworkers’ eligibility and participation in SNAP and WIC.
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Affiliation(s)
- Briana E. Rockler
- Department of Public Health and Environmental Studies, College of Arts and Sciences, University of Wisconsin–Eau Claire, Eau Claire, Wisconsin, United States of America
- * E-mail:
| | - Stephanie K. Grutzmacher
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Jonathan Garcia
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Ellen Smit
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
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Association between fat-soluble vitamins and self-reported health status: a cross-sectional analysis of the MARK-AGE cohort. Br J Nutr 2022; 128:433-443. [PMID: 34794520 PMCID: PMC9340855 DOI: 10.1017/s0007114521004633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Self-rated health (SRH) is associated with higher risk of death. Since low plasma levels of fat-soluble vitamins are related to mortality, we aimed to assess whether plasma concentrations of vitamins A, D and E were associated with SRH in the MARK-AGE study. We included 3158 participants (52 % female) aged between 35 and 75 years. Cross-sectional data were collected via questionnaires. An enzyme immunoassay quantified 25-hydroxyvitamin D and HPLC determined α-tocopherol and retinol plasma concentrations. The median 25-hydroxyvitamin D and retinol concentrations differed significantly (P < 0·001) between SRH categories and were lower in the combined fair/poor category v. the excellent, very good and good categories (25-hydroxvitamin D: 40·8 v. 51·9, 49·3, 46·7 nmol/l, respectively; retinol: 1·67 v. 1·75, 1·74, 1·70 µmol/l, respectively). Both vitamin D and retinol status were independently associated with fair/poor SRH in multiple regression analyses: adjusted OR (95 % CI) for the vitamin D insufficiency, deficiency and severe deficiency categories were 1·33 (1·06-1·68), 1·50 (1·17-1·93) and 1·83 (1·34-2·50), respectively; P = 0·015, P = 0·001 and P < 0·001, and for the second/third/fourth retinol quartiles: 1·44 (1·18-1·75), 1·57 (1·28-1·93) and 1·49 (1·20-1·84); all P < 0·001. No significant associations were reported for α-tocopherol quartiles. Lower vitamin A and D status emerged as independent markers for fair/poor SRH. Further insights into the long-term implications of these modifiable nutrients on health status are warranted.
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Selvamani Y, Sangani P, Muhammad T. Association of back pain with major depressive disorder among older adults in six low- and middle-income countries: A cross-sectional study. Exp Gerontol 2022; 167:111909. [PMID: 35931302 DOI: 10.1016/j.exger.2022.111909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/18/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Back pain is one of the leading causes of disability and decreased quality of life. In this study, we examined the association between back pain and major depressive disorder (MDD) in six low- and middle-income countries. We also examined the association of back pain duration and severity with MDD among middle-aged and older adults in these countries. METHODS Nationally representative data from the World Health Organization's Study on global AGEing and adult health (WHO-SAGE) consisting of 33,878 middle-aged and older adults aged 50 years or above were analysed. The linkages of back pain, pain duration and severity with MDD were examined using multivariable logistic regression analyses. RESULTS Across six countries, the prevalence of MDD was higher among middle-aged and older adults who reported back pain than those who did not report back pain (14.5 % vs 4.5 %). In the pooled data, middle-aged and older adults who suffered from back pain had higher odds of depression [adjusted odds ratio (aOR): 2.41, confidence interval (CI): 2.19-2.64] compared to those with no back pain. Particularly, the association was stronger in Ghana [aOR: 4.78] and South Africa [aOR: 2.42]. Further, the association was stronger for those who experienced back pain for >2 weeks as well as those who reported severe and extreme back pain than those with no back pain across all the countries. CONCLUSION In this study, the association of back pain and its duration and severity with MDD is consistent and significant among middle-aged and older adults in six countries. Government policies should consider the role of back pain in improving the mental health of middle-aged and older adults.
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Affiliation(s)
- Y Selvamani
- International Institute for Population Sciences, Govandi Station Road, Deonar, Maharashtra 400088 Mumbai, India.
| | - Purvi Sangani
- International Institute for Population Sciences, Govandi Station Road, Deonar, Maharashtra 400088 Mumbai, India
| | - T Muhammad
- International Institute for Population Sciences, Govandi Station Road, Deonar, Maharashtra 400088 Mumbai, India
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Ahmad FS, Jackson KL, Yount SE, Rothrock NE, Kallen MA, Lacson L, Bilimoria KY, Kho AN, Mutharasan RK, McCullough PA, Bruckel J, Fedson S, Kimmel SE, Eton DT, Grady KL, Yancy CW, Cella D. The development and initial validation of the PROMIS®+HF-27 and PROMIS+HF-10 profiles. ESC Heart Fail 2022; 9:3380-3392. [PMID: 35841128 DOI: 10.1002/ehf2.14061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/11/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022] Open
Abstract
AIMS Heart failure (HF) is a common and morbid condition impacting multiple health domains. We previously reported the development of the PROMIS®-Plus-HF (PROMIS+HF) profile measure, including universal and HF-specific items. To facilitate use, we developed shorter, PROMIS+HF profiles intended for research and clinical use. METHODS AND RESULTS Candidate items were selected based on psychometric properties and symptom range coverage. HF clinicians (n = 43) rated item importance and clinical actionability. Based on these results, we developed the PROMIS+HF-27 and PROMIS+HF-10 profiles with summary scores (0-100) for overall, physical, mental, and social health. In a cross-sectional sample (n = 600), we measured internal consistency reliability (Cronbach's alpha and Spearman-Brown), test-retest reliability (intraclass coefficient; n = 100), known-groups validity via New York Heart Association (NYHA) class, and convergent validity with Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. In a longitudinal sample (n = 75), we evaluated responsiveness of baseline/follow-up scores by calculating mean differences and Cohen's d and comparing with paired t-tests. Internal consistency was good to excellent (α 0.82-0.94) for all PROMIS+HF-27 scores and acceptable to good (α/Spearman-Brown 0.60-0.85) for PROMIS+HF-10 scores. Test-retest intraclass coefficients were acceptable to excellent (0.75-0.97). Both profiles demonstrated known-groups validity for the overall and physical health summary scores based on NYHA class, and convergent validity for nearly all scores compared with KCCQ scores. In the longitudinal sample, we demonstrated responsiveness for PROMIS+HF-27 and PROMIS+HF-10 overall and physical summary scores. For the PROMIS+HF overall summary scores, a group-based increase of 7.6-8.3 points represented a small to medium change (Cohen's d = 0.40-0.42). For the PROMIS+HF physical summary scores, a group-based increase of 5.0-5.9 points represented a small to medium change (Cohen's d = 0.29-0.35). CONCLUSIONS The PROMIS+HF-27 and PROMIS+HF-10 profiles demonstrated good psychometric characteristics with evidence of responsiveness for overall and physical health. These new measures can facilitate patient-centred research and clinical care, such as improving care quality through symptom monitoring, facilitating shared decision-making, evaluating quality of care, assessing new interventions, and monitoring during the initiation and titration of guideline-directed medical therapy.
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Affiliation(s)
- Faraz S Ahmad
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA.,The Center for Health Information Partnerships (CHIP), Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kathryn L Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susan E Yount
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nan E Rothrock
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leilani Lacson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Abel N Kho
- The Center for Health Information Partnerships (CHIP), Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Raja Kannan Mutharasan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA
| | | | - Jeffrey Bruckel
- Division of Cardiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Savitri Fedson
- Section of Cardiology, Michael E DeBakey Veterans Administration Medical Center, Houston, TX, USA.,Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Stephen E Kimmel
- Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL, USA
| | - David T Eton
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.,Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Kathleen L Grady
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA.,Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Clyde W Yancy
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 600, Chicago, IL, 60611, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Patient Centered Outcomes, Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Balasooriya NN, Bandara JS, Rohde N. Air pollution and health outcomes: Evidence from Black Saturday Bushfires in Australia. Soc Sci Med 2022; 306:115165. [PMID: 35767903 DOI: 10.1016/j.socscimed.2022.115165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 04/30/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
This paper presents new evidence of the causal effect of air pollution on Australian health outcomes, using the Black Saturday bushfires (BSB) in 2009 as a natural experiment. This event was one of the largest bushfires in Australian history and emitted approximately four million tonnes of CO2 into the atmosphere. We use data from the Household Income and Labour Dynamic Australia (HILDA) panel and compare the health status of individuals who were living in affected and unaffected regions before and after the event. Using a triple differences procedure, we further examine whether a difference in vulnerability to bushfire smoke exists comparing people living in urban or regional areas. We find that ambient air pollution had significant negative effects on health and that the magnitudes were actually larger for individuals residing in urban areas.
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Affiliation(s)
- Namal N Balasooriya
- Department of Accounting, Finance and Economics, Griffith University, Brisbane, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland; Department of Social Statistics, University of Kelaniya, Kelaniya, Sri Lanka.
| | - Jayatilleke S Bandara
- Department of Accounting, Finance and Economics, Griffith University, Brisbane, Australia.
| | - Nicholas Rohde
- Department of Accounting, Finance and Economics, Griffith University, Gold Coast, Australia.
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75
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Predicting mortality in The Irish Longitudinal Study on Ageing (TILDA): development of a four-year index and comparison with international measures. BMC Geriatr 2022; 22:510. [PMID: 35729488 PMCID: PMC9211047 DOI: 10.1186/s12877-022-03196-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/03/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives We aimed to replicate existing international (US and UK) mortality indices using Irish data. We developed and validated a four-year mortality index for adults aged 50 + in Ireland and compared performance with these international indices. We then extended this model by including additional predictors (self-report and healthcare utilization) and compared its performance to our replication model. Methods Eight thousand one hundred seventy-four participants in The Irish Longitudinal Study on Ageing were split for development (n = 4,121) and validation (n = 4,053). Six baseline predictor categories were examined (67 variables total): demographics; cardiovascular-related illness; non-cardiovascular illness; health and lifestyle variables; functional variables; self-report (wellbeing and social connectedness) and healthcare utilization. We identified variables independently associated with four-year mortality in the development cohort and attached these variables a weight according to strength of association. We summed the weights to calculate a single index score for each participant and evaluated predicted accuracy in the validation cohort. Results Our final 14-predictor (extended) model assigned risk points for: male (1pt); age (65–69: 2pts; 70–74: 4 pts; 75–79: 4pts; 80–84: 6pts; 85 + : 7pts); heart attack (1pt); cancer (3pts); smoked past age 30 (2pts); difficulty walking 100 m (2pts); difficulty using the toilet (3pts); difficulty lifting 10lbs (1pts); poor self-reported health (1pt); and hospital admission in previous year (1pt). Index discrimination was strong (ROC area = 0.78). Discussion Our index is predictive of four-year mortality in community-dwelling older Irish adults. Comparisons with the international indices show that our 12-predictor (replication) model performed well and suggests that generalisability is high. Our 14-predictor (extended) model showed modest improvements compared to the 12-predictor model. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03196-z.
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Sampasa-Kanyinga H, Lien A, Hamilton HA, Chaput JP. The Canadian 24-hour movement guidelines and self-rated physical and mental health among adolescents. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:312-321. [PMID: 34580829 PMCID: PMC8975895 DOI: 10.17269/s41997-021-00568-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The Canadian 24-hour movement guidelines for children and youth recommend a minimum of 60 min/day of moderate-to-vigorous physical activity, no more than 2 h/day of recreational screen time, and 8-11 h/night of sleep depending on age. The objective of this study was to examine the associations of meeting combinations of these recommendations with self-rated physical and mental health. METHODS This study used data from the 2017 (n = 5739) and 2019 (n = 6960) cycles of the Ontario Student Drug Use and Health Survey (OSDUHS), a biennially repeated cross-sectional study of Ontario students in grades 7 through 12. Multivariable ordered logistic regression models were adjusted for age, gender, ethnoracial background, subjective socio-economic status, and body mass index z-scores. RESULTS Similar patterns were seen in the 2017 and 2019 samples. Compared with meeting none of the recommendations, meeting different combinations of recommendations in the 2019 sample was associated with positive self-rated physical and mental health. A dose-response gradient between the number of recommendations met and self-rated physical (p < 0.001) and mental (p < 0.001) health was observed, with meeting one (AOR: 1.82; 95% CI: 1.58-2.09), two (AOR: 3.54; 95% CI: 2.98-4.22), or three recommendations (AOR: 6.34; 95% CI: 4.46-9.02) being increasingly associated with positive self-rated physical health compared with meeting none; and meeting one (AOR: 1.51; 95% CI: 1.33-1.71), two (AOR: 2.70; 95% CI: 2.31-3.17), or three recommendations (AOR: 3.58; 95% CI: 2.57-4.98) being increasingly associated with positive self-rated mental health compared with meeting none. CONCLUSION Meeting the 24-hour movement guidelines is associated with better self-rated physical and mental health among adolescents.
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Affiliation(s)
- Hugues Sampasa-Kanyinga
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Amanda Lien
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hayley A Hamilton
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jean-Philippe Chaput
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada.
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77
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Miller AC, O'Reilly D, Kee F, Cruise S, Young I. Multimorbidity, activity limitation and self-reported health all predict mortality risk, but better measures were required. J Clin Epidemiol 2022; 144:144-162. [PMID: 34910980 DOI: 10.1016/j.jclinepi.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/02/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE With an ageing population, morbidity and multiple health conditions are an increasing public health concern. This study aimed to investigate how morbidity as measured by the Charlson comorbidity index and two morbidity measures; activity limitation and self-reported health, individually and collectively explain the increased risk of mortality with age. METHODS We used the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) wave one, dataset, a national representative sample of people over 50 years of age, with follow-up until May 31, 2020. Cox proportional hazard regression models were used to assess the associations between a modified Charlson comorbidity index (m-Charlson), self-reported health, activity limitation, and mortality in the Northern Irish cohort. RESULTS m-Charlson showed a steeper relationship with age, the proportion of participants with a Charlson of two or more increase from 15.2% (aged 50-59) to 32.0% (aged 80+). All measures of morbidity exhibited a strong relationship with socio-economic status, though the gradients were more marked for self-reported health than for activity limitation or Charlson index. All three morbidity measures were independently related to mortality risk though the associations attenuated with age. However, even in models with all three measures of morbidity, most of the age-related increase in mortality risk remained unexplained. CONCLUSION All three morbidity measures carry separate and independent information about the health status of older people and therefore about mortality risk; it is apparent that it is still worth asking patients how they feel and how their health is affecting their activity. Further research should aim to dissect health trajectories in dynamic prediction models in addition to other measures of health status.
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Affiliation(s)
| | - Dermot O'Reilly
- Centre for Public Health, Queens University Belfast, Belfast, UK; Administrative Data Research Centre-Northern Ireland, Belfast, UK
| | - Frank Kee
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Sharon Cruise
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Ian Young
- Centre for Public Health, Queens University Belfast, Belfast, UK
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Wilson D, Driller M, Johnston B, Gill N. The prevalence and distribution of health risk factors in airline pilots: a cross-sectional comparison with the general population. Aust N Z J Public Health 2022; 46:572-580. [PMID: 35298070 DOI: 10.1111/1753-6405.13231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/01/2022] [Accepted: 02/01/2022] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To explore the prevalence and distribution of health risk factors in airline pilots and compare these with the general population. METHODS Health risk measures: age, sex, weight, height, body mass index (BMI), blood pressure, sleep, physical activity (PA) and fruit and vegetable intake (FV) were analysed to determine the prevalence and distribution of health risk. RESULTS Obesity prevalence and BMI was lower in pilots (p=<0.001, -17.5%, d=-0.41, and p=<0.05, -1.8, d=-0.37, respectively), yet overall overweight and obesity prevalence did not differ between groups (p=0.20). No difference was observed between groups for hypertension (p=0.79, h=-0.01), yet a higher proportion of pilots were 'at risk' for hypertension (p=<0.001, h=-0.34). The general population had longer sleep duration (p=<0.001, d=0.12), achieved more total PA minutes (p=<0.001, d=0.75), and had a higher prevalence of positive self-rated health (p=<0.001, h=0.31). More pilots achieved >5 servings of FV daily (p=0.002, h=0.16). CONCLUSION Pilots had lower obesity prevalence, higher FV, yet lower positive self-health ratings and total PA minutes, and shorter sleep duration overall. IMPLICATIONS FOR PUBLIC HEALTH The results indicate notable health risk factor prevalence in airline pilots and the general population. Based on present findings, aviation health researchers should further examine targeted, cost-effective intervention methods for promoting healthy bodyweight, managing blood pressure, and enhancing health behaviours to mitigate the risks of occupational morbidity, medical conditions causing loss of licence, medical incapacity, and to support flight safety.
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Affiliation(s)
- Daniel Wilson
- Te Huataki Waiora School of Health, The University of Waikato, New Zealand.,Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, New Zealand
| | - Matthew Driller
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Victoria
| | - Ben Johnston
- Aviation and Occupational Health Unit, Air New Zealand, New Zealand
| | - Nicholas Gill
- Te Huataki Waiora School of Health, The University of Waikato, New Zealand.,New Zealand Rugby, New Zealand
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Determining the association of perceived health status among united states older adults with self-reported pain. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2021.100051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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80
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Kallio H, Kangasniemi M, Hult M. Registered nurses' perceptions of having a calling to nursing: A mixed‐method study. J Adv Nurs 2022; 78:1473-1482. [PMID: 35188282 PMCID: PMC9306482 DOI: 10.1111/jan.15157] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/30/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
Aim To explore how nurses perceived having a calling to nursing. Design A mixed‐method study. Methods Survey data collected in autumn 2020 and semi‐structured individual interview data collected in spring 2021. The 7925 survey respondents were care professionals and 414 of them were registered nurses. The 23 interview participants were registered nurses who responded to the survey. We examined the survey results using analysis of variance and t‐tests and the interview data with qualitative thematic analysis. Results Registered nurses had a lower calling than other care professionals. Based on the interviews, having a calling to nursing produce four key findings. Nurses with a calling experienced their work as meaningful. They also adopted a humane and holistic approach to their work. However, their calling could change during their professional career. Due to its historical roots, having a calling was seen as a risk for the nursing profession, as it meant nurses had an oppressed position in society and nurses associated it with poor working conditions and low pay. Conclusion Our study showed that having a calling to nursing had multidimensional benefits for the individual nurse, their patient, colleagues, organization and society, but showed strong association between calling and nurses' poor working conditions and low pay. Impact We found that nurses had a lower calling than other care professionals. Calling still exists, but it can produce tension in modern nursing. Organizations and society need to focus on how calling can be seen as a more positive attribute of nursing and improve nurses' working conditions and pay.
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Affiliation(s)
- Hanna Kallio
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine University of Turku Turku Finland
| | - Marja Hult
- Department of Nursing Science, Faculty of Health Sciences University of Eastern Finland Kuopio Finland
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Poor worker’s long working hours paradox: evidence from the Korea National Health and Nutrition Examination Survey, 2013-2018. Ann Occup Environ Med 2022; 34:e2. [PMID: 35425616 PMCID: PMC8980752 DOI: 10.35371/aoem.2022.34.e2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 01/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background Because income and working hours are closely related, the health impact of working hours can vary according to economic status. This study aimed to investigate the relationship between working hours and the risk of poor self-rated health according to household income level. Methods We used the data from the Korea National Health and Nutrition Examination Survey VI and VII. The information on working hours and self-rated health was obtained from the questionnaire. After stratifying by household income level, the risk of poor self-rated health for long working hour group (≥ 52 hours a week), compared to the 35–51 working hour group as a reference, were calculated using multiple logistic regression. Results Long working hours increased the risk of poor self-rated health in the group with the highest income, but not in the group with the lowest income. On the other hand, the overall weighted prevalence of poor self-rated health was higher in the low-income group. Conclusions The relationship between long working hours and the risk of poor self-rated health varied by household income level. This phenomenon, in which the health effects of long working hours appear to diminish in low-income households can be referred to as the ‘poor worker’s long working hours paradox’. Our findings suggest that the recent working hour restriction policy implemented by the Korean government should be promoted, together with a basic wage preservation to improve workers’ general health and well-being.
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Wu B, Toseef MU, Stickel AM, González HM, Tarraf W. Associations Between Midlife Functional Limitations and Self-Reported Health and Cognitive Status: Results from the 1998-2016 Health and Retirement Study. J Alzheimers Dis 2022; 85:1621-1637. [PMID: 34958028 PMCID: PMC9116387 DOI: 10.3233/jad-215192] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Life-course approaches to identify and help improve modifiable risk factors, particularly in midlife, may mitigate cognitive aging. OBJECTIVE We examined how midlife self-rated physical functioning and health may predict cognitive health in older age. METHODS We used data from the Health and Retirement Study (1998-2016; unweighted-N = 4,685). We used survey multinomial logistic regression and latent growth curve models to examine how midlife (age 50-64 years) activities of daily living (ADL), physical function, and self-reported health affect cognitive trajectories and cognitive impairment not dementia (CIND) and dementia status 18 years later. Then, we tested for sex and racial/ethnic modifications. RESULTS After covariates-adjustment, worse instrumental ADL (IADL) functioning, mobility, and self-reported health were associated with both CIND and dementia. Hispanics were more likely to meet criteria for dementia than non-Hispanic Whites given increasing IADL impairment. CONCLUSION Midlife health, activities limitations, and difficulties with mobility are predictive of dementia in later life. Hispanics may be more susceptible to dementia in the presence of midlife IADLs. Assessing midlife physical function and general health with brief questionnaires may be useful for predicting cognitive impairment and dementia in later life.
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Affiliation(s)
- Benson Wu
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Mohammad Usama Toseef
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI
| | - Ariana M. Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI
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He C, Chen H, Guo L, Xu L, Liu Q, Zhang J, Hu X. Prevalence and factors associated with comorbid depressive symptoms among people with low back pain in China: A cross-sectional study. Front Psychiatry 2022; 13:922733. [PMID: 35958630 PMCID: PMC9357880 DOI: 10.3389/fpsyt.2022.922733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low back pain is a common medical condition among the general population that is associated with many adverse health effects when comorbid with depressive symptoms. However, little is known about depressive symptoms in the population with low back pain in China. Our study evaluated the prevalence of depressive symptoms and analyzed the factors associated with this condition in the Chinese population with low back pain. METHODS We conducted a cross-sectional analysis of data from the 2018 China Health and Retirement Longitudinal Study. We collected low back pain information for each participant and identified depressive symptoms using the brief version of the Center for Epidemiologic Studies Depression Scale. A wide range of sociodemographic and health-related characteristics of the subjects were extracted. We measured the prevalence of depressive symptoms comorbid with low back pain and analyzed the associated factors by multiple logistic regression. RESULTS A total of 5,779 respondents aged 45 and over with low back pain formed the sample, 41.8% of whom reported depressive symptoms. Multiple logistic regression analysis indicated greater vulnerability to depressive symptoms among females (OR = 1.41, 95% CI, 1.16-1.73), relatively younger persons (60-74 years: OR = 0.72, 95% CI, 0.63-0.83; ≥ 75 years: OR = 0.62, 95% CI, 0.49-0.79, reference: 45-59 years), those from the central and western regions (central: OR = 1.39, 95% CI, 1.18-1.64; western: OR = 1.56, 95% CI, 1.33-1.83), participants with extremely short sleep duration (OR = 2.74, 95% CI, 2.33-3.23), those with poor self-perceived health status (OR = 2.91, 95% CI, 2.34-3.63,), multisite pain (OR = 1.54, 95% CI, 1.20-1.98) and disability in activities of daily living (Basic: OR = 1.70, 95% CI, 1.47-1.98; Instrumental: OR = 1.95, 95% CI, 1.70-2.24). CONCLUSION Depressive symptoms were highly prevalent in the Chinese population ≥ 45 years with low back pain. More attention should be paid to the individuals at high-risk confirmed by this study to facilitate early identification and intervention against depressive symptoms.
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Affiliation(s)
- Chunxia He
- West China School of Nursing, Sichuan University/Institute for Disaster Management and Reconstruction, and Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China.,Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.,Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hongxiu Chen
- West China School of Nursing, Sichuan University/Institute for Disaster Management and Reconstruction, and Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Guo
- West China School of Nursing, Sichuan University/Institute for Disaster Management and Reconstruction, and Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Lisheng Xu
- West China School of Nursing, Sichuan University/Institute for Disaster Management and Reconstruction, and Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Qingquan Liu
- West China School of Nursing, Sichuan University/Institute for Disaster Management and Reconstruction, and Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Jiali Zhang
- Cheng Du Shang Jin Nan Fu Hospital, Chengdu, China
| | - Xiuying Hu
- West China School of Nursing, Sichuan University/Institute for Disaster Management and Reconstruction, and Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China.,Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
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84
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Steele BJ, Kemp K, Fairie P, Santana MJ. Family-Rated Pediatric Health Status Is Associated With Unplanned Health Services Use. Hosp Pediatr 2022; 12:61-70. [PMID: 34873628 DOI: 10.1542/hpeds.2020-005728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Self-rated health is a common self-reported health measure associated with morbidity, mortality, and health care use. The objective was to investigate the association of family-rated health status (FRH) in pediatric care with administrative indicators, patient and respondent features, and unplanned health services use. PATIENTS AND METHODS Data were taken from Child-Hospital Consumer Assessment of Healthcare Providers and Systems surveys collected between 2015 and 2019 in Alberta, Canada and linked with administrative health records. Three analyses were performed: correlation to assess association between administrative indicators of health status and FRH, logistic regression to assess respondent and patient characteristics associated with FRH, and automated logistic regression to assess the association between FRH and unplanned health services use within 90 days of discharge. RESULTS A total of 6236 linked surveys were analyzed. FRH had small but significant associations with administrative indicators. Models of FRH had better fit with patient and respondent features. Respondent relationship to child, child age, previous hospitalizations, and number of comorbidities were significantly associated with ratings of FRH. Automated models of unplanned services use included FRH as a feature, and poor ratings of health were associated with increased odds of emergency department visits (adjusted odds ratio: 2.15, 95% confidence interval: 1.62-2.85) and readmission (adjusted odds ratio: 2.48, 95% confidence interval: 1.62-2.85). CONCLUSION FRH is a simple, single-item global rating of health for pediatric populations that provides accessible and useful information about pediatric health care needs. The results of this article serve as a reminder that family members are valuable sources of information that can improve care and potentially prevent unplanned health services use.
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Affiliation(s)
- Brian J Steele
- Departments of Community Health Sciences.,Pediatrics, University of Calgary, Alberta, Canada
| | - Kyle Kemp
- Departments of Community Health Sciences.,Alberta Strategy for Patient-Oriented Research Patient Engagement Platform, Alberta, Canada
| | - Paul Fairie
- Departments of Community Health Sciences.,Alberta Strategy for Patient-Oriented Research Patient Engagement Platform, Alberta, Canada
| | - Maria J Santana
- Departments of Community Health Sciences.,Pediatrics, University of Calgary, Alberta, Canada.,Alberta Strategy for Patient-Oriented Research Patient Engagement Platform, Alberta, Canada
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85
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Shimatani K, Komada MT, Sato J. Impact of the Changes in the Frequency of Social Participation on All-Cause Mortality in Japanese Older Adults: A Nationwide Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:270. [PMID: 35010529 PMCID: PMC8751209 DOI: 10.3390/ijerph19010270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/18/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
Previous studies have shown that more frequent social participation was associated with a reduced risk of mortality. However, limited studies have explored the changes in the frequency of social participation in older adults. We investigated the impact of the changes in the frequency of social participation on all-cause mortality in Japanese older adults aged 60 years and older. The current study, conducted as a secondary analysis, was a retrospective cohort study using open available data. The participants were 2240 older adults (45.4% male and 54.6% female) sampled nationwide from Japan who responded to the interview survey. Changes in the frequency of social participation were categorized into four groups (none, initiated, decreased, and continued pattern) based on the responses in the baseline and last surveys. The Cox proportional-hazards model showed a decreased risk of all-cause mortality in decreased and continued patterns of social participation. Stratified analysis by sex showed a decreased risk of mortality in the continued pattern only among males. The results of the current study suggest that the initiation of social participation at an earlier phase of life transition, such as retirement, may be beneficial for individuals.
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86
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Vinberg S, Danielsson P. Managers of micro-sized enterprises and Covid-19: impact on business operations, work-life balance and well-being. Int J Circumpolar Health 2021; 80:1959700. [PMID: 34378496 PMCID: PMC8366643 DOI: 10.1080/22423982.2021.1959700] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/04/2021] [Accepted: 07/20/2021] [Indexed: 10/25/2022] Open
Abstract
The aim of this study is to identify how managers of micro-sized enterprises experience the impact of the Covid-19 pandemic on their business operations, work-life balance and well-being. Further, the study aims to make comparisons between managers of micro-sized businesses and managers of small-sized businesses. This mixed-method study is based on qualitative interviews with ten managers of micro-sized enterprises and a questionnaire answered by 95 managers of micro-sized and small-sized enterprises in regions in the north of Sweden. Managers of micro-sized enterprises reported significantly worse scores for mental well-being, job satisfaction and life satisfaction in comparison with managers of small-sized enterprises. Three themes emerged from the qualitative analysis: Changed leadership role, Impact on private life and Impact on well-being. In the interviews, the managers of micro-sized enterprises reported that the pandemic had increased their workload and forced them to mobilise strategies for enterprise survival. This study indicates that managers of micro-sized enterprises had changed their leadership role and increased their workload and number of work tasks, including supporting the employees, developing strategies for business survival and applying for governmental support. However, the managers demonstrated creativity in finding new solutions for their enterprises.
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Affiliation(s)
- Stig Vinberg
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Peter Danielsson
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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87
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Bagherzadeh M, Salehi L, Mahmoodi Z. Investigating preventive health behaviors against COVID-19 in elementary school students' parents: A cross-sectional study from Tehran - Capital of Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:435. [PMID: 35071641 PMCID: PMC8719560 DOI: 10.4103/jehp.jehp_58_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Parents act as a role model for children in showing health behaviors. This study investigated factors affecting the preventive behavior in elementary school students' parents based on protection motivation theory (PMT). MATERIALS AND METHODS This cross-sectional study was conducted in Tehran (Iran) in 2020. Multistage sampling was used to choose 660 elementary school students' parents. The data collection instrument was a multi-sectional questionnaire, including sections on demographic characteristics, PMT constructs, self-reported health, and information sources related to COVID-19. In this study, descriptive statistics (mean and standard deviation) and analytical statistical methods (Pearson correlation and path analysis) were used to analyze the data. The range of Cronbach's alpha of the study instrument varied from 0.71 to 0.97. RESULTS The results of the current study revealed significant association between all PMT constructs and preventive behaviors. Knowledge from both direct and indirect paths was related to preventive behaviors (B = 0.76). Preventive behaviors had the strongest, direct relationship with age (B = 0.76). Based on the final fitted model, knowledge had the greatest impact on preventive behaviors through indirect and direct routes. CONCLUSION Knowledge was the most important variable which influenced preventive behavior, and it should be noticed in prevention programs.
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Affiliation(s)
- Maryam Bagherzadeh
- Department of Health Education and Promotion, Alborz University of Medical Sciences, Karaj, Iran
| | - Leili Salehi
- Research Center for Health, Safety and Environment, Department of Health Education and Promotion, Alborz University of Medical Sciences, Karaj, Iran
| | - Zohreh Mahmoodi
- Department of Midwifery, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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88
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Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. Self-rated health and incident dementia over two decades: Replication across two cohorts. J Psychiatr Res 2021; 143:462-466. [PMID: 34311955 DOI: 10.1016/j.jpsychires.2021.06.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 11/25/2022]
Abstract
This prospective study examined the association between self-rated health and incident dementia in two large cohorts of middle-aged and older adults. Participants were drawn from the Health and Retirement Study (HRS, N = 13,839, Mean Age = 64.32, SD = 9.04) and the English Longitudinal Study of Ageing (ELSA, N = 4649, Mean Age = 64.44, SD = 9.97). Self-rated health and covariates were assessed at baseline in 1998 and 2002, and cognitive status was tracked for up to 21 years in HRS and 17 years in ELSA, respectively. Controlling for demographic factors, poorer self-rated health was associated with higher risk of incident dementia in HRS (HR: 1.18, 95%CI: 1.12-1.24, p < .001) and ELSA (HR: 1.38, 95%CI: 1.23-1.55, p < .001). These associations remained significant when diabetes, hypertension, smoking, physical inactivity, depressive symptoms, personality, and polygenic risk for Alzheimer's Disease were included as additional covariates or when cases occurring within the first ten years of follow-up were excluded from the analyses. There was no replicable evidence that age, sex, education, race or ethnicity moderated the association. Self-rated health is a long-term, replicable predictor of incident dementia that is independent of genetic, clinical, and behavioral risk factors.
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89
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Li W, Sun N, Kondracki AJ, Kiplagat S, Osibogun O, Kalan ME, Jebai R, Sun W, Wei Z. Exposure to famine in early life and self-rated health status among Chinese adults: a cross-sectional study from the Chinese Health and Retirement Longitudinal Study (CHARLS). BMJ Open 2021; 11:e048214. [PMID: 34642191 PMCID: PMC8513269 DOI: 10.1136/bmjopen-2020-048214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE China's Great Famine between 1959 and 1961 has contributed to numerous adverse health outcomes in Chinese. This study aimed to examine the association between exposure to famine in early life and self-rated health (SRH) in adulthood. METHODS 4418 Chinese adults from the 2011 China Health and Retirement Longitudinal Study were included in the analysis. Multivariable logistic regression was conducted to estimate adjusted ORs (aORs) and 95% CIs of the association between exposure to famine in early life and SRH, stratified by sex. RESULTS Participants exposed to famine during infancy were more likely to report poor SRH (aOR 1.33; 95% CI 1.04 to 1.70) compared with the non-exposed group, adjusting for confounders. Males were 32% less likely than females to report poor SRH (aOR 0.68; 95% CI 0.54 to 0.86). Participants diagnosed with chronic diseases (aOR 3.11; 95% CI 2.68 to 3.61), disability (aOR 1.82; 95% CI 1.38 to 2.38) and vision impairment (aOR 2.07; 95% CI 1.72 to 2.49) were more likely to report poor SRH. Participants who were current alcohol users and with abnormal weight were less likely to report poor SRH. Stratification by sex showed no significant association between famine and SRH among males, but a consistently significant association was observed among females (aOR 1.46; 95% CI 1.02 to 2.12). CONCLUSIONS Findings from this study indicated that females exposed to famine in China during infancy were more likely to report poor SRH in their adulthood. Implementing interventions to those who were exposed to famine in early life, especially for females, may improve their long-term consequences.
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Affiliation(s)
- Wei Li
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Ning Sun
- Department of Biostatistics, Florida International University, Miami, Florida, USA
| | - Anthony J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia, USA
| | - Sandra Kiplagat
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Mohammad Ebrahimi Kalan
- Department of Health Behavior, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Rime Jebai
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - Wenjie Sun
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Zhen Wei
- Department of Anesthesiology, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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90
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Simoes M, Huss A, Janssen N, Vermeulen R. Self-reported psychological distress and self-perceived health in residents living near pesticide-treated agricultural land: a cross-sectional study in The Netherlands. Occup Environ Med 2021; 79:127-133. [PMID: 34625506 DOI: 10.1136/oemed-2021-107544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/22/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES There is rising concern regarding possible health effects from exposure to pesticides in residents living near agricultural land. Some studies indicated increased risks of reporting symptoms of anxiety and depression among agricultural workers but less is known about the mental and perceived health of rural residents. We aimed to study possible associations between self-reported psychological distress (SPD) and self-perceived health (SPH) in residents near pesticide-treated agricultural land. METHODS Using the Public Health Monitor national survey from 2012, we selected 216 932 participants who lived in rural and semi-urban areas of the Netherlands and changed addresses at most once in the period 2009-2012. Psychological distress (PD) was assessed via the Kessler Psychological Distress scale (K10) and participants were asked to assess their own health. We estimated the area of specific crop groups cultivated within buffers of 50 m, 100 m, 250 m and 500 m around each individual's residence for the period 2009-2012. Association between these exposure proxies and the outcomes was investigated using logistic regression, adjusting for individual, lifestyle and area-level confounders. RESULTS Overall, results showed statistically non-significant OR across all buffer sizes for both SPD and SPH, except for the association between SPH and 'all crops' (total area of all considered crop groups) with OR (95% CI) ranging from 0.77 (0.63 to 0.93) in 50 m to 1.00 (1.00 to 1.00) in 500 m. We observed that most ORs were below unity for SPH. CONCLUSIONS This study provides no evidence that residential proximity to pesticide treated-crops is associated with PD or poorer perceived health.
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Affiliation(s)
- Mariana Simoes
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Anke Huss
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Nicole Janssen
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Roel Vermeulen
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.,Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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91
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Pedram P, Patten SB, Bulloch AGM, Williams JVA, Dimitropoulos G. Self-Reported Lifetime History of Eating Disorders and Mortality in the General Population: A Canadian Population Survey with Record Linkage. Nutrients 2021; 13:3333. [PMID: 34684334 PMCID: PMC8538567 DOI: 10.3390/nu13103333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 02/04/2023] Open
Abstract
Eating disorders (EDs) are often reported to have the highest mortality of any mental health disorder. However, this assertion is based on clinical samples, which may provide an inaccurate view of the actual risks in the population. Hence, in the current retrospective cohort study, mortality of self-reported lifetime history of EDs in the general population was explored. The data source was the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), linked to a national mortality database. The survey sample was representative of the Canadian household population (mean age = 43.95 years, 50.9% female). The survey inquired about the history of professionally diagnosed chronic conditions, including EDs. Subsequently, the survey dataset was linked to the national mortality dataset (for the date of death) up to 2017. Cox proportional hazards models were used to explore the effect of EDs on mortality. The unadjusted-hazard ratio (HR) for the lifetime history of an ED was 1.35 (95% CI 0.70-2.58). However, the age/sex-adjusted HR increased to 4.5 (95% CI 2.33-8.84), which was over two times higher than age/sex-adjusted HRs for other mental disorders (schizophrenia/psychosis, mood-disorders, and post-traumatic stress disorder). In conclusion, all-cause mortality of self-reported lifetime history of EDs in the household population was markedly elevated and considerably higher than that of other self-reported disorders. This finding replicates prior findings in a population-representative sample and provides a definitive quantification of increased risk of mortality in EDs, which was previously lacking. Furthermore, it highlights the seriousness of EDs and an urgent need for strategies that may help to improve long-term outcomes.
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Affiliation(s)
- Pardis Pedram
- Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- Mathison Centre for Mental Health Research & Education, Foothills Medical Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (S.B.P.); (A.G.M.B.)
- Hotchkiss Brain Institute, University of Calgary Foothills, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
| | - Scott B. Patten
- Mathison Centre for Mental Health Research & Education, Foothills Medical Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (S.B.P.); (A.G.M.B.)
- Hotchkiss Brain Institute, University of Calgary Foothills, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- O’Brien Institute for Public Health, University of Calgary Foothills, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
- Cuthbertson & Fischer Chair in Pediatric Mental Health, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Andrew G. M. Bulloch
- Mathison Centre for Mental Health Research & Education, Foothills Medical Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (S.B.P.); (A.G.M.B.)
- Hotchkiss Brain Institute, University of Calgary Foothills, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- O’Brien Institute for Public Health, University of Calgary Foothills, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
| | - Jeanne V. A. Williams
- Department of Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - Gina Dimitropoulos
- Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
- Mathison Centre for Mental Health Research & Education, Foothills Medical Centre, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada; (S.B.P.); (A.G.M.B.)
- Hotchkiss Brain Institute, University of Calgary Foothills, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
- O’Brien Institute for Public Health, University of Calgary Foothills, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6, Canada
- Faculty of Social Work, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
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92
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2021; 6:3-25. [PMID: 35146314 PMCID: PMC8734117 DOI: 10.25646/8459] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/09/2021] [Indexed: 01/20/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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93
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Heidemann C, Scheidt-Nave C, Beyer AK, Baumert J, Thamm R, Maier B, Neuhauser H, Fuchs J, Kuhnert R, Hapke U. Health situation of adults in Germany - Results for selected indicators from GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2021. [PMID: 35146314 DOI: 10.25646/8456:3-27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In this article, we examine selected health indicators for the adult population aged 18 years and older in Germany (n=22,708) from the German Health Update (GEDA 2019/2020-EHIS) conducted between April 2019 and September 2020. These indicators include those of self-assessed health and depressive symptoms as well as chronic physical diseases and conditions. In young adulthood (18 to 44 years), over 80% of participants report good or very good subjective health. During this phase of life, most chronic diseases and conditions are rare, although allergies are frequent, and bronchial asthma and depressive symptoms are not uncommon. From mid adulthood (45 years and older), there is a gradual increase in the prevalence of chronic diseases such as cardiovascular disease, diabetes, chronic obstructive pulmonary disease and osteoarthritis. Over 60% of older adults (65 years and older) report a chronic disease or long-term health problem, while only half continue to report good or very good subjective health. During this stage of life, allergies and depressive symptoms become less prevalent. For some diseases, there are also differences according to gender and level of education. This article demonstrates the high public health relevance of age-associated chronic physical diseases and health related limitations in everyday life in an ageing society as well as the need to provide care for certain health conditions already in young adulthood.
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Affiliation(s)
- Christin Heidemann
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | | | - Ann-Kristin Beyer
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Jens Baumert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Roma Thamm
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Birga Maier
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Hannelore Neuhauser
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Judith Fuchs
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ronny Kuhnert
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
| | - Ulfert Hapke
- Robert Koch Institute, Berlin Department of Epidemiology and Health Monitoring
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94
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Paitan-Quispe EN, Pérez-Castillo KH, Camacho-Caballero K, Rodriguez-Cuba MA, Runzer-Colmenares FM, Parodi JF. Association Between Tobacco Consumption and Self-Reported Visual Impairment in Adults of High-Altitude Andean Communities of Peru. Gerontol Geriatr Med 2021; 7:23337214211036256. [PMID: 34423076 PMCID: PMC8377305 DOI: 10.1177/23337214211036256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/18/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
To determine the association between tobacco consumption and self-reported visual impairment. We performed a cross-sectional study based on an original cohort study. A non-probabilistic sampling was performed to invite 413 patients of 60 years or more from 11 high-altitude Andean communities (altitude higher than 1500 m above sea level) of Peru between 2013 and 2017. Demographic data and information on tobacco consumption were collected. Associations were determined using a Poisson regression model with 95% confidence intervals (CI). Of the 413 participants, 141 (34.14%) were men and 49 (11.86%) were tobacco users. In the adjusted model, tobacco users presented a high probability of visual impairment with a prevalence ratio of 1.32 (95% CI: 1.18–1.97). We also found that having two or more comorbidities 2.19 (95% CI: 1.53–3.15), receiving health assistance in a pharmacy 3.75 (95% CI: 1.97–7.16), and coffee consumption 1.67 (95% CI: 1.26–2.21) were factors significantly associated with self-reported visual impairment. We determined that in Peruvian high-altitude Andean communities, visual impairment was more frequent in individuals reporting tobacco consumption, taking alternative medicine, going directly to a drug store without primary care physician consultation, having more than one comorbidity, and coffee consumption.
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Affiliation(s)
- Emilyn N Paitan-Quispe
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Miraflores, Lima, Perú
| | | | - Kiara Camacho-Caballero
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Miraflores, Lima, Perú.,CHANGE Research Working Group, Carrera de Medicina Humana, Universidad Científica del Sur, Miraflores, Lima, Perú
| | - Maria Alejandra Rodriguez-Cuba
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Miraflores, Lima, Perú.,CHANGE Research Working Group, Carrera de Medicina Humana, Universidad Científica del Sur, Miraflores, Lima, Perú
| | - Fernando M Runzer-Colmenares
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Miraflores, Lima, Perú.,CHANGE Research Working Group, Carrera de Medicina Humana, Universidad Científica del Sur, Miraflores, Lima, Perú
| | - Jose F Parodi
- Universidad San Martin de Porres Facultad de Medicina Humana Centro de Investigación del Envejecimiento (CIEN), Universidad San Martín de Porres, La Molina, Lima, Perú
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95
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Han Y, Chung RYN. Are both individual-level and county-level social capital associated with individual health? A serial cross-sectional analysis in China, 2010-2015. BMJ Open 2021; 11:e044616. [PMID: 34380714 PMCID: PMC8359472 DOI: 10.1136/bmjopen-2020-044616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES We aimed to examine the associations of both individual-level and county-level social capital with individual health in China during a period of rapid economic growth. DESIGN AND SETTING A serial cross-sectional study in China. PARTICIPANTS AND METHODS The participants were 42 829 Chinese adults (aged ≥18 years) from the 2010, 2012, 2013 and 2015 Chinese General Social Survey. The outcomes were self-rated physical and mental health in all time points. We assessed social capital by the individual-level and county-level indicators, including frequency of socialising, civic participation and trust. We conducted multilevel binary logistic regression models to examine the associations of individual-level and county-level social capital with self-rated physical and mental health. RESULTS At the individual level, high frequency of socialising (2010-OR: 1.49, 95% CI: 1.33 to 1.66; 2012-OR: 1.39, 95% CI: 1.26 to 1.54; 2013-OR: 1.28, 95% CI: 1.15 to 1.42; 2015-OR: 1.36, 95% CI: 1.23 to 1.50) and high trust (2010-OR: 1.34, 95% CI: 1.22 to 1.47; 2012-OR: 1.30, 95% CI: 1.18 to 1.42; 2013-OR: 1.21, 95% CI: 1.10 to 1.33; 2015-OR: 1.41, 95% CI: 1.28 to 1.55) was significantly associated with good physical health in all years. At the individual level, high frequency of socialising (2010-OR: 1.27, 95% CI: 1.14 to 1.42; 2012-OR: 1.21, 95% CI: 1.09 to 1.34; 2013-OR: 1.30, 95% CI: 1.17 to 1.45; 2015-OR: 1.35, 95% CI: 1.22 to 1.50) and high trust (2010-OR: 1.47, 95% CI: 1.34 to 1.61; 2012-OR: 1.42, 95% CI: 1.30 to 1.56; 2013-OR: 1.36, 95% CI: 1.24 to 1.49; 2015-OR: 1.43, 95% CI: 1.30 to 1.57) was also significantly associated with good mental health in all years. No evidence showed that the associations of individual-level frequency of socialising and trust with physical and mental health changed over time. There were no consistent associations of individual-level civic participation or any county-level social capital indicators with physical or mental health. CONCLUSION The positive associations of individual-level social capital in terms of socialising and trust with physical and mental health were robust during a period of rapid economic growth. Improving individual-level socialising and trust for health promotion could be a long-term strategy even within a rapidly developing society.
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Affiliation(s)
- Yang Han
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roger Yat-Nork Chung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China
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96
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Gugushvili A, Bulczak G, Zelinska O, Koltai J. Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States. PLoS One 2021; 16:e0254414. [PMID: 34347798 PMCID: PMC8336836 DOI: 10.1371/journal.pone.0254414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/25/2021] [Indexed: 11/18/2022] Open
Abstract
The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility-moving into a different socioeconomic position than one's parents-among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis.
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Affiliation(s)
- Alexi Gugushvili
- Deparment of Sociology and Human Geography, University of Oslo, Oslo, Norway
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Warsaw, Poland
- Nuffield College, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Grzegorz Bulczak
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Warsaw, Poland
| | - Olga Zelinska
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Warsaw, Poland
| | - Jonathan Koltai
- Department of Sociology, University of New Hampshire, Durham, New Hampshire, United States of America
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97
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Schneider A, Riedlinger D, Pigorsch M, Holzinger F, Deutschbein J, Keil T, Möckel M, Schenk L. Self-reported health and life satisfaction in older emergency department patients: sociodemographic, disease-related and care-specific associated factors. BMC Public Health 2021; 21:1440. [PMID: 34289829 PMCID: PMC8296655 DOI: 10.1186/s12889-021-11439-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/30/2021] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Self-reported health (SRH) and life satisfaction (LS) are patient-reported outcomes (PROs) that independently predict mortality and morbidity in older adults. Emergency department (ED) visits due to serious health problems or accidents might pose critical life events for patients. This study aimed (a) to characterize older patients' SRH and LS during the distinct event of an ED stay, and (b) to analyze concomitant associations of PROs with ED patients' sociodemographic, disease-specific and care-related variables. METHODS Study personnel recruited mostly older ED patients from three disease groups during a two-year period (2017-2019) in eight EDs in central Berlin, Germany, in the context of the health services research network EMANet. Cross-sectional data from the baseline patient survey and associated secondary data from hospital information systems were analyzed. Multilevel linear regression models with random intercept were applied to assess concomitant associations with SRH (scale: 0 (worst) to 100 (best)) and LS (scale: 0 (not at all satisfied) to 10 (completely satisfied)) as outcomes, including sensitivity analyses. RESULTS The final sample comprised N = 1435 participants. Mean age was 65.18 (SD: 16.72) and 50.9% were male. Mean ratings of SRH were 50.10 (SD: 23.62) while mean LS scores amounted to 7.15 (SD: 2.50). Better SRH and higher LS were found in patients with cardiac symptoms (SRH: β = 4.35, p = .036; LS: β = 0.53, p = .006). Worse SRH and lower LS were associated with being in need of nursing care (SRH: β = - 7.52, p < .001; LS: β = - 0.59, p = .003) and being unemployed (SRH: β = - 8.54, p = .002; LS: β = - 1.27, p < .001). Sex, age, number of close social contacts, and hospital stays in the previous 6 months were additionally related to the outcomes. Sensitivity analyses largely supported results of the main sample. CONCLUSIONS SRH and LS were associated with different sociodemographic and disease-related variables in older ED patients. Nursing care dependency and unemployment emerged as significant factors relating to both outcomes. Being able to identify especially vulnerable patients in the ED setting might facilitate patient-centered care and prevent negative health outcomes. However, further longitudinal research needs to analyze trajectories in both outcomes and suitable intervention possibilities in the ED setting. TRIAL REGISTRATION EMANet sub-studies were registered separately: German Clinical Trials Register (EMAAge: DRKS00014273, registration date: May 16, 2018; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014273; EMACROSS: DRKS00011930, registration date: April 25, 2017; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011930); ClinicalTrials.gov (EMASPOT: NCT03188861, registration date: June 16, 2017; https://clinicaltrials.gov/ct2/show/NCT03188861?term=NCT03188861&draw=2&rank=1).
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Affiliation(s)
- Anna Schneider
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany.
| | - Dorothee Riedlinger
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Emergency Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
| | - Mareen Pigorsch
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Felix Holzinger
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of General Practice, Berlin, Germany
| | - Johannes Deutschbein
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Thomas Keil
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany.,University of Wuerzburg, Institute of Clinical Epidemiology and Biometry, Wuerzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Martin Möckel
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Emergency Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
| | - Liane Schenk
- Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
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98
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O’Regan AC, Hunter RF, Nyhan MM. "Biophilic Cities": Quantifying the Impact of Google Street View-Derived Greenspace Exposures on Socioeconomic Factors and Self-Reported Health. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:9063-9073. [PMID: 34159777 PMCID: PMC8277136 DOI: 10.1021/acs.est.1c01326] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 05/30/2023]
Abstract
According to the biophilia hypothesis, humans have evolved to prefer natural environments that are essential to their thriving. With urbanization occurring at an unprecedented rate globally, urban greenspace has gained increased attention due to its environmental, health, and socioeconomic benefits. To unlock its full potential, an increased understanding of greenspace metrics is urgently required. In this first-of-a-kind study, we quantified street-level greenspace using 751 644 Google Street View images and computer vision methods for 125 274 locations in Ireland's major cities. We quantified population-weighted exposure to greenspace and investigated the impact of greenspace on health and socioeconomic determinants. To investigate the association between greenspace and self-reported health, a negative binomial regression analysis was applied. While controlling for other factors, an interquartile range increase in street-level greenspace was associated with a 2.78% increase in self-reported "good or very good" health [95% confidence interval: 2.25-3.31]. Additionally, we observed that populations in upper quartiles of greenspace exposure had higher levels of income and education than those in lower quartiles. This study provides groundbreaking insights into how urban greenspace can be quantified in unprecedented resolution, accuracy, and scale while also having important implications for urban planning and environmental health research and policy.
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Affiliation(s)
- Anna C. O’Regan
- Discipline of Civil, Structural &
Environmental Engineering, School of Engineering & Architecture, University College Cork, Cork, Ireland
- MaREI
Centre for Energy, Climate & Marine and Environmental Research
Institute, University College Cork, Cork, Ireland
| | - Ruth F. Hunter
- Centre
for Public Health, Queen’s University
Belfast, Belfast BT12 6BA, Northern Ireland, United Kingdom
| | - Marguerite M. Nyhan
- Discipline of Civil, Structural &
Environmental Engineering, School of Engineering & Architecture, University College Cork, Cork, Ireland
- MaREI
Centre for Energy, Climate & Marine and Environmental Research
Institute, University College Cork, Cork, Ireland
- Harvard
T.H. Chan School of Public Health, Harvard
University, Boston, Massachusetts 02215, United States
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99
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Humes LE, Weinstein BE. The Need for a Universal Hearing Metric-Is Pure-Tone Average the Answer? JAMA Otolaryngol Head Neck Surg 2021; 147:588-589. [PMID: 33856420 DOI: 10.1001/jamaoto.2021.0417] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington
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100
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Gugushvili A, Reeves A. How democracy alters our view of inequality - and what it means for our health. Soc Sci Med 2021; 283:114190. [PMID: 34242889 DOI: 10.1016/j.socscimed.2021.114190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Income inequality is associated with poor health when economic disparities are especially salient. Yet, political institutions may alter this relationship because democracies (as opposed to autocracies) may be more inclined to frame inequalities in negative rather than positive ways. Living in a particular political system potentially alters the messages individuals receive about whether inequality is large or small, good or bad, and this, in turn, might affect whether beliefs about inequality influence health. Further, media coverage of economic inequality may negatively affect health if it contributes toward the general perception that the gap between rich and poor has gone up, even if there has been no change in income differentials. METHODS In this study, we explore the relationship between democracy, perceptions of inequality, and self-rated health across 28 post-communist countries using survey and macro-level data, multilevel regression models, and inverse probability weighting to estimate the average treatment effect on the treated. RESULTS We find that self-rated health is higher in more democratic countries and lower among people who believe that inequality has risen in the last few years. Moreover, we observe that people in democracies are more likely to learn about rising inequality through watching television and that when they do it has a more harmful effect on their health than when people in autocracies learn about rising inequality through the same channel, suggesting that in countries where there is less trust in the television media learning about rising inequality is not as harmful for health. CONCLUSIONS Our results indicate that while democracies are generally good for well-being, they may not be unambiguously positive for health. This does not mean, of course, that inequality is good for health nor that, on average, autocracies have better health than democracies; but rather that being more aware of inequality can negatively affect self-rated health.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo, Postboks 1096 Blindern, 0317, Oslo, Norway.
| | - Aaron Reeves
- Department of Social Policy and Intervention, University of Oxford, 32 Wellington Square, OX1 2ER, Oxford, United Kingdom.
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