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Stroope J, Garn AC, Morin AJS. A cross-cultural investigation of active transportation and community participation: Results from the WHO survey of Global Ageing and Adult Health. Health Place 2024; 89:103285. [PMID: 38875962 DOI: 10.1016/j.healthplace.2024.103285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/16/2024]
Abstract
Little is known about how the associations between active transportation and community participation may vary across national contexts. Using representative datasets from China, Ghana, India, Mexico, Russia, and South Africa collected in the Study on Global Ageing and Adult Health (N = 33,535), we estimated multi-group confirmatory factor analyses, tests of measurement invariance, and predictive models. Standardized coefficients were equivalent across countries and showed a modest positive association between active transportation and community participation (the variance explained by active transportation ranged from 1.3% to 7.5% across countries). These results suggest that supporting active transportation can help mitigate negative environmental and health changes associated with increased vehicular travel and support social capital via community participation.
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Affiliation(s)
- Jessica Stroope
- Louisiana State University AgCenter, School of Nutrition & Food Sciences, 202N Knapp Hall, Baton Rouge, LA, 70803, USA.
| | - Alex C Garn
- University of Minnesota, School of Kinesiology, Cooke Hall 111, 1900 University Ave SE, Minneapolis, MN 55455, USA.
| | - Alexandre J S Morin
- Concordia University, Substantive Methodological Synergy Research Laboratory, Department of Psychology, 7141 Sherbrooke W, Montreal, QC, H4B1R6, Canada.
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Magro-Montañés B, Pabón-Carrasco M, Romero-Castillo R, Ponce-Blandón JA, Jiménez-Picón N. The relationship between neighborhood social capital and health from a biopsychosocial perspective: A systematic review. Public Health Nurs 2024; 41:845-861. [PMID: 38639208 DOI: 10.1111/phn.13323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/21/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The Social Determinants of Health (SDH) influence the health of people throughout their lives, and can be positive, protective or risk factors for the population and, in turn, biological, psychological, or social. The social environment conditions the health status of the neighborhood, population, and social group, which can be a health asset due to its strong psychosocial and socio-cultural influence. Social capital is a community asset of the healthy neighborhood that must be known in order to promote community health. OBJECTIVES The objective is to determine the relationship between social capital and neighborhood biopsychosocial health. METHODS A systematic review was conducted based on PRISMA: PubMed, Wos, Scopus, Embase, and Cochrane databases. The search was conducted from January to March 2023. Three authors independently extracted data using a structured form. RESULTS Out of 527 records, 17 results passed the inclusion and exclusion criteria. The positive and statistically significant relationship between neighborhood social capital (NSC) and the physical and mental health of neighbors is confirmed, that is, the higher the NSC, the more exercise, better oral health in children and physical health in pregnant women, lower tobacco consumption and lower prevalence of human immunodeficiency virus. At the psychological level, greater NSC leads to better mental health, mental well-being, life satisfaction, quality of life, self-perceived health, higher cognitive function, and less depression. CONCLUSIONS In conclusion, social capital is an important SDH and health asset that influences neighborhood biopsychosocial health and should be known and researched for health promotion in community settings. More evidence is needed to support the results obtained.
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Affiliation(s)
- Beatriz Magro-Montañés
- Hospital de Cruces, Bilbao, Spain
- Red Cross Nursing University Centre, University of Seville, Seville, Spain
| | - Manuel Pabón-Carrasco
- Faculty of Nursing, Physiotherapy and Podiatry, Department of Nursing, University of Seville, Seville, Spain
| | - Rocío Romero-Castillo
- Faculty of Nursing, Physiotherapy and Podiatry, Department of Nursing, University of Seville, Seville, Spain
| | - José Antonio Ponce-Blandón
- Faculty of Nursing, Physiotherapy and Podiatry, Department of Nursing, University of Seville, Seville, Spain
| | - Nerea Jiménez-Picón
- Faculty of Nursing, Physiotherapy and Podiatry, Department of Nursing, University of Seville, Seville, Spain
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Puspitasari MD, Rahardja MB, Herartri R, Surbakti IM. Managing Age-Related Disability in Indonesia: An Issue That Extends Beyond the Concept of Active Aging. J Aging Soc Policy 2023; 35:842-858. [PMID: 37337435 DOI: 10.1080/08959420.2023.2226313] [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: 04/12/2022] [Accepted: 03/22/2023] [Indexed: 06/21/2023]
Abstract
This study evaluates how various village services help older Indonesians perform daily activities and reduce age-related disability. Individual-level data from the 2020 National Socio-Economic Survey (SUSENAS) (N = 121,961 older people) and community-level data from the 2018 Village Potential Data Census Collection (PODES) (N = 83,931 villages in a data aggregation across 514 municipalities) were used in a multilevel binary logistic regression model. The interclass coefficient correlation (ICC) was calculated to determine the variation in characteristics across 514 municipalities to explain the differences in functional status. The ICC was approximately 16.2%, indicating that creating an age-friendly environment would help to delay the onset of disability. Older populations in Indonesia have a high percentage of informal employment, a low educational level, low percentages of affluent households, and few leisure activities. The findings highlight that the development of age-friendly services in the village should consider employment status and leisure activities. Participation in employment is a well-acknowledged concept for promoting active aging in developed nations but is secondary in managing age-related disability in Indonesia. The municipal government must develop an aging-friendly community (AFC) to create a supportive environment to meet the basic health and social needs of older people with age-related disability.
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Affiliation(s)
- Mardiana Dwi Puspitasari
- Research Center for Population, National Research and Innovation Agency, Republic of Indonesia (BRIN RI), Jakarta, Indonesia
| | - Mugia Bayu Rahardja
- Research Center for Population, National Research and Innovation Agency, Republic of Indonesia (BRIN RI), Jakarta, Indonesia
| | - Rina Herartri
- Research Center for Population, National Research and Innovation Agency, Republic of Indonesia (BRIN RI), Jakarta, Indonesia
| | - Indra Murty Surbakti
- Population Research and Development Center, National Population and Family Planning Board (BKKBN), Jakarta, Indonesia
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Liu H, Hu T. Correlation between air pollution and cognitive impairment among older individuals: empirical evidence from China. BMC Geriatr 2023; 23:366. [PMID: 37710153 PMCID: PMC10503026 DOI: 10.1186/s12877-023-03932-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 03/25/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Little information is available regarding the impact of air pollution on cognitive impairment in older individuals in developing countries. This study empirically tested the impacts of the air quality index (AQI), air pollution intensity (quantified by the number of days of extreme air pollution in a year), and different pollutants on the cognitive abilities of older Chinese individuals. METHODS A panel of 28,395 participants spanning 122 cities in 2015 and 2018 was used, based on 3-year follow-up survey data from the China Health and Retirement Longitudinal Study (CHARLS) database. Data from the two phases of the CHARLS microsurvey were combined with relevant statistical data on air pollution in each region in the current year. These two surveys were used to investigate changes in basic health and macro-environmental indicators in older individuals in China, and a mean difference test was conducted. We then reduced the sample selection error by controlling for environmental migration and used two-way fixed and instrumental variable methods for endogenous treatment to avoid the estimation error caused by missing variables. RESULTS Air pollution had a significantly negative effect on the cognitive abilities of older individuals (odds ratio [OR]: 1.4633; 95% confidence interval [95% CI]: 1.20899-1.77116). Different pollution intensities(only AQI value is greater than 200 or more) had apparent effects on cognitive impairment, with an OR of approximately 1.0. Sulfur dioxide had significantly negative effects on cognitive ability, with OR of 1.3802 (95% CI: 1.25779-1.51451). Furthermore, air pollution impact analysis showed heterogeneous results in terms of age, sex, education, and regional economic development level. In addition, social adaptability (calculated using social participation, learning, adaptability, and social support) not only had a significant positive effect on the cognitive abilities of older individuals, but also regulated the cognitive decline caused by air pollution. CONCLUSIONS Air pollution affects cognitive impairment in older individuals, especially in those with lower education levels, and living in economically underdeveloped areas. This effect is synchronous and has a peak at an AQI of > 200.
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Affiliation(s)
- Huan Liu
- School of Society, Soochow University, No. 199, Ren’ai Road, Suzhou Industrial Park, Su Zhou, Jiangsu 215123 China
| | - Tiantian Hu
- Shenzhen Futian District Economic Development Promotion Association, Shenzhen, China
- Qiaocheng Consulting (Shenzhen) Co., Ltd, Shenzhen, China
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Cao C, Cao W, Zheng X, Ji K, Wu Y, Hu Z, Chen R, Bai Z. Association of social capital with self-perceived eHealth literacy among community-dwelling older people: Age and gender differences. Front Public Health 2023; 11:1088863. [PMID: 37124820 PMCID: PMC10140563 DOI: 10.3389/fpubh.2023.1088863] [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: 11/03/2022] [Accepted: 03/07/2023] [Indexed: 05/02/2023] Open
Abstract
Background Studies have confirmed that social factors, including social capital and eHealth literacy, are important in later life. Currently, few studies are available for determining the relationship between social capital and eHealth literacy, and whether such a relationship exists among older people and there are age and gender differences in the relationship remain unclear. Consequently, this study aimed to investigate the association between social capital and eHealth literacy, specifically examing its variations in age and gender. Methods A cross-sectional study of 4,257 residents aged ≥ 60 years and dwelling in the community was conducted across four cities in China. A structured questionnaire was used to collect data on general characteristics, socioeconomic status, social capital, and eHealth literacy. Generalized linear models were employed to assess these associations. Results There were 4,218 respondents (age 71.9 ± 7.2 years; 64.8% women). Overall, social participation, social connection, trust, cohesion, and reciprocity were all statistically associated with eHealth literacy (p < 0.05), while such an association was not observed for social support (p > 0.05). Specifically, a higher level of social participation was associated with better eHealth literacy scores among participants aged 70-79 years (p < 0.001), and a higher level of social connection was associated with better eHealth literacy scores for those aged 60-69 and 70-79 years (p < 0.001). Meanwhile, no gender differences in the associations were found. Conclusion There is an association between social capital and eHealth literacy in older men and women. The association varis with age. The findings provide a reference for developing targeted measures to improve self-perceived eHealth literacy among older people. It is essential for achieving active and healthy aging and developing the knowledge and understanding of relevant theories, concepts, and evidence within the field of health and social capital.
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Affiliation(s)
- Chenglin Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Wenwen Cao
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Xin Zheng
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Kai Ji
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Yunwei Wu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
| | - Zhi Hu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
- *Correspondence: Zhi Hu,
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Ruoling Chen,
| | - Zhongliang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, China
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- Zhongliang Bai,
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Hirsch JA, Michael YL, Moore KA, Melly S, Hughes TM, Hayden K, Luchsinger JA, Jimenez MP, James P, Besser LM, Sánchez B, Diez Roux AV. Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study. BMJ Open 2022; 12:e066971. [PMID: 36368762 PMCID: PMC9660618 DOI: 10.1136/bmjopen-2022-066971] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The burden of Alzheimer's disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of-and disparities in-cognitive decline and dementia. METHODS AND ANALYSES We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing. ETHICS AND DISSEMINATION This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.
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Affiliation(s)
- Jana A Hirsch
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Steven Melly
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Medical Center Boulevard, Winston-Salem, Carolina, USA
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Bowman Gray Center for Medical Education, Winston-Salem, Carolina, USA
| | - Jose A Luchsinger
- Department of Medicine, Columbia University, New York, New York, USA
| | - Marcia P Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Lilah M Besser
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brisa Sánchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
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Association between social capital and oral health among adults aged 50 years and over in China: a cross-sectional study. BMC Oral Health 2022; 22:68. [PMID: 35279136 PMCID: PMC8918312 DOI: 10.1186/s12903-022-02102-8] [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: 06/22/2021] [Accepted: 03/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Social capital has a potential effect in protecting oral health among population. However, no study has explored the association between social capital and oral health in the Chinese context. Due to the unique culture, political, social context in China, it is important to understand their association in the Chinese context. The study aims to investigate the association between cognitive and structural dimensions of social capital with edentulism among adults aged 50 years and over in China. Method The study used data from the WHO SAGE (Study on Global AGEing and Adult Health) wave 1 China component. Structural social capital was operationalized as social participation. Cognitive social capital was operationalized as perceived community trust and perceived community safety. Community-level social capital was measured by aggregating individual-level social capital into community level. Oral health was measured using a final marker of oral health status, self-reported edentulism. A 2-level multilevel logistic regression was used to evaluate the association between different dimensions of social capital and oral health. Results In total, 12,856 individuals were included in the study, the overall prevalence of edentulism was 9.1% (95% CI 8.3–10.0). Multilevel logistic analysis revealed that individual-level social capital and community-level social capital are independently associated with edentulism. Individuals with low structural social capital and living in areas with low structural social capital have, respectively, 1.54 (95% CI 1.18–2.01) and 2.14 (95% CI 1.47–3.12) times higher odds for edentulism, after adjustment for potential confounders (age, sex, marital status, residence locality, wealth, education level, chronic conditions) and a potential mediator(smoking). Conclusions Living in a community with lower structural social capital and individual with low structural social capital is associated with higher risk for edentulism among adults aged 50 years and over in China.
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Han Y, Chung RYN. The role of neighborhood social capital on health and health inequality in rural and urban China. Prev Med 2022; 156:106989. [PMID: 35150751 DOI: 10.1016/j.ypmed.2022.106989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/15/2021] [Accepted: 02/06/2022] [Indexed: 10/19/2022]
Abstract
Given the "community lost" vs. "community saved" debate on how neighborhood solidarity changes with urbanization, we compared the rural-urban difference in the association of individuals' neighborhood social capital with health and the interaction effect between neighborhood social capital and income-poverty on health in China, where huge rural-urban disparities existed. Participants were 5014 Chinese adults (≥ 18 years) (rural: 2034; urban: 2980) from the 2012 cross-sectional Chinese General Social Survey. Health outcome was a factor score constructed by three items. Neighborhood social capital was divided into structural (neighborhood network size, frequency of socializing with neighbors, voting in neighborhood committee election, and participation in neighborhood voluntary activities) and cognitive (perceived neighborhood social cohesion) dimensions. Multivariable linear regression models showed positive associations between perceived neighborhood social cohesion and health in rural (β = 0.08, 95% CI: 0.03,0.14) and urban (β = 0.09, 95% CI: 0.05,0.12) areas. Only in rural but not urban areas was a neighborhood network of 10 or more persons (ref.: none) associated with better health (β = 0.25, 95% CI: 0.05,0.46). Interaction analysis showed that only in rural but not urban areas, with the increase of neighborhood network size, the health gap between the income-poor and the non-income-poor decreased generally. Our study suggested that cohesive neighborhoods benefit both rural and urban residents' health. Health interventions to improve neighborhood social cohesion should be designed to cope with the challenge of urbanization. Policymakers should avoid damaging neighborhood social capital when implementing other public policies, especially in rural areas where neighborhood network seems to matter more for health.
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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; Center for Bioethics, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Jiang J, Song J. Health Consequences of Online Social Capital among Middle-Aged and Older Adults in China. APPLIED RESEARCH IN QUALITY OF LIFE 2022; 17:2277-2297. [PMID: 35035602 PMCID: PMC8741545 DOI: 10.1007/s11482-021-10033-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/22/2021] [Indexed: 05/04/2023]
Abstract
With the rapid development of Internet techniques in China, more and more Chinese middle-aged and older adults have begun to use the Internet for their daily social interactions, and the resulting online social capital may affect their health. Using data from the Chinese General Social Survey of 2017 (n = 7733, aged 45-90 years old), this study investigated the influence of online social capital on the health of middle-aged and older adults in China, and the Heckman sample selection model was used to address potential sample selection bias in Internet use. The results show that number of online contacts significantly improved the physical health of middle-aged and older adults, while the level of depression was significantly reduced by online closeness of non-specific relationships, but more online interactions may slightly increase their depression. Furthermore, more online contacts were associated with elevated physical health among male, rural, less-educated and middle-aged adults, while more online closeness of non-specific relationships was associated with less depression in almost all subgroups. Online social capital can improve the health of middle-aged and older adults in China, so we should help increase older adults' access to the Internet and improve their Internet skills to give full play to the positive health effect of online social capital. However, it should be alert to the negative health consequences caused by excessive Internet use.
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Affiliation(s)
- Junfeng Jiang
- School of Sociology, Central China Normal University, No.152 Luoyu Road, Wuhan, 430079 China
| | - Jiang Song
- Business School, Yangzhou University, Yangzhou, China
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Lu N, Lou VWQ. Community social capital and cognitive function among older adults in rural north-east China: The moderator role of income. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:225-234. [PMID: 33852751 DOI: 10.1111/hsc.13395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/18/2021] [Accepted: 03/21/2021] [Indexed: 06/12/2023]
Abstract
This study investigated the moderating role of income in the relationship between community social capital and cognitive function among community-dwelling older adults in rural China. Data were derived from a community survey conducted in Dongliao county, Jilin province, China, in 2019. Trained interviewers completed face-to-face interviews with 458 respondents. Multiple group analysis was applied to examine the proposed model. The latent constructs of cognitive social capital and structural social capital were established in low-income and high-income groups in rural Chinese contexts. Factor loading invariance of social capital constructs was established across the two income groups. The results showed that income has moderating effects on the relationship between social capital constructs and cognitive function. Social capital that was significantly associated with cognitive function was statistically significant in low-income group only. The findings highlight the important role of income in understanding the mechanism linking social capital to cognitive function in a rural Chinese context. Social policies and interventions should pay particular attention to older adults with low economic status. Policy and intervention implications are discussed.
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Affiliation(s)
- Nan Lu
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
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Belessiotis-Richards C, Livingston G, Marston L, Mukadam N. A cross-sectional study of potentially modifiable risk factors for dementia and cognitive function in India: A secondary analysis of 10/66, LASI, and SAGE data. Int J Geriatr Psychiatry 2021; 37. [PMID: 34808698 DOI: 10.1002/gps.5661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/18/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Dementia is rising globally, particularly in low-and-middle-income countries. India has almost four million people living with dementia, set to double by 2050. Targeting nine potentially modifiable risk factors (less education, hearing impairment, depression, physical inactivity, hypertension, obesity, smoking, diabetes, and social isolation) could possibly prevent or delay many dementias. We aimed for the first time to examine risk factors for dementia in India and their link with cognitive status and dementia, to inform prioritisation of public health interventions that could prevent or delay dementia. METHODS We conducted a cross-sectional analysis using three studies: 10/66 Dementia Study (n = 2004), Longitudinal Aging Study of India (n = 386), and Study of Global Ageing (n = 2441). Our exposures were the nine risk factors above. We calculated a cognitive z-score within each study and used dementia diagnosis in 10/66. We adjusted for socioeconomic factors, age, and sex using multivariable linear for cognition and logistic regression for dementia. RESULTS Less education, hearing impairment, depression, and physical inactivity were associated with lower z-scores and increased odds of dementia. Obesity was associated with higher z-score and lower odds of dementia. Social isolation was associated with lower z-scores and decreased odds of dementia. Results for smoking, diabetes, and hypertension were inconsistent. CONCLUSION Our risk estimates were larger for less education, hearing impairment and physical inactivity compared to global estimates and should be intervention priorities. This study highlights the need for longitudinal studies to clarify the relationship between these potentially modifiable risk factors and dementia in India.
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Affiliation(s)
| | - Gill Livingston
- Department of Psychiatry, University College London, London, UK
| | - Louise Marston
- Department of Primary Care and Population Health, University College London, London, UK
| | - Naaheed Mukadam
- Department of Psychiatry, University College London, London, UK
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12
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Zhang K, Wu B, Zhang W. Perceived Neighborhood Conditions, Self-Management Abilities, and Psychological Well-Being Among Chinese Older Adults in Hawai'i. J Appl Gerontol 2021; 41:1111-1119. [PMID: 34291698 DOI: 10.1177/07334648211030072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Using survey data collected from January to September 2018 (N = 430), this study examined how neighborhood physical conditions and social cohesion were associated with psychological well-being via pathway of self-management abilities among Chinese older adults living in Honolulu, Hawai'i. Results showed that, for the whole sample, neighborhood physical conditions and social cohesion were significantly associated with psychological well-being, and the main associations were mediated by self-management abilities in the amount of 34% and 60%, respectively. Similar results were found for the foreign-born, whereas for the U.S.-born, psychological well-being was significantly related to neighborhood physical conditions only. Our findings reveal the importance of neighborhood conditions and individual psychological resources on psychological well-being of Chinese older adults.
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Affiliation(s)
| | | | - Wei Zhang
- University of Hawai'i at Mānoa, Honolulu, USA
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Peterson RL, George KM, Tran D, Malladi P, Gilsanz P, Kind AJH, Whitmer RA, Besser LM, Meyer OL. Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7166. [PMID: 34281103 PMCID: PMC8296955 DOI: 10.3390/ijerph18137166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Social environments are a contributing determinant of health and disparities. This scoping review details how social environments have been operationalized in observational studies of cognitive aging and dementia. METHODS A systematic search in PubMed and Web of Science identified studies of social environment exposures and late-life cognition/dementia outcomes. Data were extracted on (1) study design; (2) population; (3) social environment(s); (4) cognitive outcome(s); (5) analytic approach; and (6) theorized causal pathways. Studies were organized using a 3-tiered social ecological model at interpersonal, community, or policy levels. RESULTS Of 7802 non-duplicated articles, 123 studies met inclusion criteria. Eighty-four studies were longitudinal (range 1-28 years) and 16 examined time-varying social environments. When sorted into social ecological levels, 91 studies examined the interpersonal level; 37 examined the community/neighborhood level; 3 examined policy level social environments; and 7 studies examined more than one level. CONCLUSIONS Most studies of social environments and cognitive aging and dementia examined interpersonal factors measured at a single point in time. Few assessed time-varying social environmental factors or considered multiple social ecological levels. Future studies can help clarify opportunities for intervention by delineating if, when, and how social environments shape late-life cognitive aging and dementia outcomes.
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Affiliation(s)
- Rachel L. Peterson
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Kristen M. George
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
| | - Duyen Tran
- Department of Psychology, University of California Davis, Davis, CA 95616, USA;
| | - Pallavi Malladi
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA 95616, USA;
| | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Amy J. H. Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA;
- Health Services and Care Research Program, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA
- Geriatrics Research Education and Clinical Center, Department of Veterans Affairs, Madison, WI 53726, USA
| | - Rachel A. Whitmer
- Public Health Sciences, Division of Epidemiology, University of California Davis, Davis, CA 95616, USA;
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
| | - Lilah M. Besser
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL 33431, USA;
| | - Oanh L. Meyer
- Department of Neurology, University of California Davis, Sacramento, CA 95817, USA; (K.M.G.); (O.L.M.)
- Alzheimer’s Disease Research Center, University of California Davis, Sacramento, CA 95817, USA
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14
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Xiong P, Liang X, Chen H, Chen L, Zuo L, Jing C, Hao G. Association Between Childhood Neighborhood Quality and the Risk of Cognitive Dysfunction in Chinese Middle-Aged and Elderly Population: The Moderation Effect of Body Mass Index. Front Aging Neurosci 2021; 13:645189. [PMID: 34054503 PMCID: PMC8155274 DOI: 10.3389/fnagi.2021.645189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Identification of early modifiable factors is crucial to delay or prevent the development of cognitive impairment and reduce the social and economic burden. Objective: This study aimed to examine the longitudinal associations of childhood neighborhood quality (CNQ) with the risk of later-life cognitive dysfunction and the role of body mass index (BMI) in this association. Methods: A total of 8,289 community-dwelling middle-aged and elderly population from wave 2011, wave 2013, and wave 2015 of the China Health and Retirement Longitudinal Study (CHARLS) were included. Cognitive function and CNQ were measured by standardized questionnaires. Multilevel linear regression models were used to estimate the associations of CNQ and cognitive function. The interactions of BMI with CNQ in the progress of cognitive function were also estimated. Results: The participants with higher CNQ had a significantly low risk of cognitive impairment than those with lower CNQ score (β = 0.067, 95% CI: 0.031, 0.103), and the results remained similar (β = 0.039, 95% CI: 0.004, 0.075) after controlling other confounding variables. Furthermore, there was an interaction between BMI with CNQ score (P < 0.001) for the risk of cognitive impairment. In BMI-stratified analysis, we found that the association of CNQ and cognitive function was not statistically significant in overweight or obese population (β = 0.019, 95% CI: -0.032, 0.070), but was statistically significant in people with lower BMI (β = 0.059, 95% CI: 0.010, 0.107). Conclusions: Higher CNQ score is significantly associated with the lower risk of cognitive dysfunction in adulthood. BMI may moderate the associations of CNQ with the risk of cognitive function.
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Affiliation(s)
- Peng Xiong
- Division of Medical Psychology and Behavioral Sciences, Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Haiyan Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Li Chen
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Lei Zuo
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Chunxia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China
| | - Guang Hao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
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15
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Yang Z, Jiang CH. Impact of social capital, sex and education on the utilization of public health services: a cross sectional study based on the China migrant dynamic survey. BMC Public Health 2021; 21:751. [PMID: 33874933 PMCID: PMC8054364 DOI: 10.1186/s12889-021-10803-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background China is making efforts to promote the equalization of National Essential Public Health Services (NEPHS) for internal migrants. Studies have demonstrated that the impacts of social capital on health services are different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of NEPHS for the internal migrants and provide reference for other countries. Methods Data from the China Migrant Dynamic Survey of 2017, involving 130,642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of NEPHS. Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such impacts are moderated by sex and education. Results (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different sexs and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by sex. However, a high education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclusion Social capital plays an important role in the access of migrants to NEPHS. Governments should vigorously promote the construction of regional social capital, encourage migrants to actively participate in community activities, especially pay attention to the enhancement of the migrants with low SES to the destination identity.
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Affiliation(s)
- Zhen Yang
- School of Medicine, Tongji University, No 1239 Siping Road, Yangpu District, Shanghai, 200092, China.,School of Medicine, Jinggangshan University, Jianan, 343009, Jiangxi, China
| | - Cheng-Hua Jiang
- School of Medicine, Tongji University, No 1239 Siping Road, Yangpu District, Shanghai, 200092, China.
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16
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Does Education Moderate the Relationship between Social Capital and Cognitive Function among Older Adults? Evidence from Suzhou City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186560. [PMID: 32916917 PMCID: PMC7558176 DOI: 10.3390/ijerph17186560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 01/11/2023]
Abstract
While social capital is recognized as an important protective determinant of cognitive function in later life, there is a lack of research examining the potential moderators and mediators in the mechanisms linking social capital to cognitive function. This study investigated the moderating role of education on the relationship between social capital and cognitive function among older adults in urban Chinese communities. Data were derived from a community survey conducted in Suzhou, Jiangsu Province, China, in late 2015. A quota sampling method was applied to recruit respondents aged 60 years or older from 16 communities in the Gusu district. The final analytic sample size was 446. Multiple group analysis was applied to test the proposed model. The results show that cognitive social capital was significantly associated with cognitive function in the high education group only. Structural social capital was not significantly associated with cognitive function. The findings highlight the important role of social capital in influencing cognitive function in later life. Social capital interventions could be particularly useful as a preventive approach to help older adults sustain their cognitive function levels. Policy and intervention implications are discussed.
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17
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Wu YT, Brayne C, Liu Z, Huang Y, Sosa AL, Acosta D, Prina M. Neighbourhood environment and dementia in older people from high-, middle- and low-income countries: results from two population-based cohort studies. BMC Public Health 2020; 20:1330. [PMID: 32873275 PMCID: PMC7465327 DOI: 10.1186/s12889-020-09435-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A growing number of studies have explored how features of the neighbourhood environment can be related to cognitive health in later life. Yet few have focused on low- and middle-income countries and compared the results across different settings. The aim of this study is to investigate the cross-sectional associations between neighbourhood amenities and dementia in older people from high-, middle- and low-income countries. METHODS This study was based on two population-based cohort studies of people aged≥65: the Cognitive Function and Ageing Study II (CFAS II) in UK (N = 4955) and a subset of the 10/66 study in China, Dominican Republic and Mexico (N = 3386). In both cohorts, dementia was assessed using the Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) algorithm. The 10/66 dementia diagnostic algorithm was also used as an additional criterion in the 10/66 study. Publicly accessible databases, Google Maps and Open Street Map, were used to obtain geographic information system data on distance to neighbourhood amenities, including lifestyle (cafés, libraries, movie theatres, parks), daily life (post offices, convenience stores), healthcare (hospitals, pharmacies) and percentages of local green and blue spaces within 400 and 800 m of participants' residences. Multilevel logistic regression was used to investigate the associations between these environmental features and dementia adjusting for sociodemographic factors and self-rated health. RESULTS Living far from daily life amenities was associated with higher odds of dementia in both CFAS II (1.47; 95% CI: 0.96, 2.24) and the 10/66 study (1.53; 95% CI: 1.15, 2.04), while living far from lifestyle (1.50; 95% CI: 1.13, 1.99) and healthcare amenities (1.32; 95% CI: 0.93, 1.87) was associated with higher odds of dementia only in the 10/66 study. A high availability of local green and blue spaces was not associated with dementia in either cohort yet living far from public parks was associated with lower odds of dementia in CFAS II (0.64; 95% CI: 0.41, 1.00). CONCLUSIONS The different relationships across cohorts may indicate a varying role for local amenities in diverse settings. Future research may investigate mechanisms related to these differences and social, cultural and historical influences on the interaction between neighbourhood amenities and older people.
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Affiliation(s)
- Yu-Tzu Wu
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK.
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Zhaorui Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yueqin Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ana Luisa Sosa
- National Institute of Neurology and Neurosurgery of Mexico, National Autonomous University of Mexico, Mexico City, Mexico
| | - Daisy Acosta
- Internal Medicine Department, Geriatric Section, Universidad Nacional Pedro Henriquez Ureña (UNPHU), Santo Domingo, Dominican Republic
| | - Matthew Prina
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Centre, De Crespigny Park, London, SE5 8AF, UK.,King's Global Health Institute, King's College London, London, SE5 8AF, UK
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18
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Hollingworth SA, Downey L, Ruiz FJ, Odame E, Dsane-Selby L, Gyansa-Lutterodt M, Nonvignon J, Chalkidou K. What do we need to know? Data sources to support evidence-based decisions using health technology assessment in Ghana. Health Res Policy Syst 2020; 18:41. [PMID: 32345297 PMCID: PMC7189587 DOI: 10.1186/s12961-020-00550-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/17/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Evidence-based decision-making for prioritising health is assisted by health technology assessment (HTA) to integrate data on effectiveness, costs and equity to support transparent decisions. Ghana is moving towards universal health coverage, facilitated mainly by the National Health Insurance Scheme (NHIS) established in 2003. The Government of Ghana is committed to institutionalising HTA for priority-setting. We aimed to identify and describe the sources of accessible data to support HTA in Ghana. METHODS We identified and described data sources encompassing six main domains using an existing framework. The domains were epidemiology, clinical efficacy, costs, health service use and consumption, quality of life, and equity. We used existing knowledge, views of stakeholders, and searches of the literature and internet. RESULTS The data sources for each of the six domains vary in extent and quality. Ghana has several large data sources to support HTA (e.g. Demographic Health Surveys) that have rigorous quality assurance processes. Few accessible data sources were available for costs and resource utilisation. The NHIS is a potentially rich source of data on resource use and costs but there are some limits on access. There are some data on equity but data on quality of life are limited. CONCLUSIONS A small number of quality data sources are available in Ghana but there are some gaps with respect to HTA based on greater use of local and contextualised information. Although more data are becoming available for monitoring, challenges remain in terms of their usefulness for HTA, and some information may not be available in disaggregated form to enable specific analyses. We support recent initiatives for the routine collection of comprehensive and reliable data that is easily accessible for HTA users. A commitment to HTA will require concerted efforts to leverage existing data sources, for example, from the NHIS, and develop and maintain new data (e.g. local health utility estimates). It will be critical that an overarching strategic and mandatory approach to the collection and use of health information is developed for Ghana in parallel to, and informed by, the development of HTA approaches to support resource allocation decisions. The key to HTA is to use the best available data while being open about its limitations and the impact on uncertainty.
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Affiliation(s)
| | - Laura Downey
- School of Public Health, Imperial College London, London, United Kingdom
| | | | - Emmanuel Odame
- Policy Planning, Monitoring and Evaluation, Ministry of Health, Accra, Ghana
| | | | | | | | - Kalipso Chalkidou
- iDSI, Imperial College London, London, United Kingdom
- Center for Global Development, London, United Kingdom
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19
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Leroi I. "Losing my glasses…losing my mind": Perspectives on sensory impairment, loneliness, social isolation and dementia. Int J Geriatr Psychiatry 2020; 35:335-337. [PMID: 31943355 DOI: 10.1002/gps.5265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Iracema Leroi
- Global Brain Health Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
- University of Manchester, Manchester, UK
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