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Li J, Xu M, Liu T, Zhang C. Regional Differences, Dynamic Evolution and Convergence of Public Health Level in China. Healthcare (Basel) 2023; 11:healthcare11101459. [PMID: 37239745 DOI: 10.3390/healthcare11101459] [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: 03/31/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
People's health is a necessary condition for the country's prosperity. Under the background of the COVID-19 pandemic and frequent natural disasters, exploring the spatial and temporal distribution, regional differences and convergence of China's provincial public health level is of great significance to promoting the coordinated development of China's regional public health and achieving the strategic goal of a "healthy China". Based on China's provincial panel data from 2009 to 2020, this paper constructs an evaluation index system for China's public health level from five dimensions: the popularization of a healthy life, optimization of health services, improvement of health insurance, construction of a healthy environment, and development of a health industry. In this paper, the entropy method, Dagum Gini coefficient, Kernel density function and spatial econometric model are used to analyze the spatiotemporal distribution, regional differences, dynamic evolution and convergence of China's public health level since the new medical reform. The study found that, first, China's public health level is generally low, structural contradictions are prominent and the construction of a healthy environment has become a shortcoming hindering the improvement of China's public health level since the new medical reform. The public health level of the four major regions showed a spatial distribution pattern of "high in the eastern, low in the northeastern, central and western" areas. Second, the overall Gini coefficient of China's public health level showed a "V-shaped" trend of first decreasing and then rising, but the overall decrease was greater than the increase, among which the regional difference was the main source of regional differences in China's public health level, but its contribution rate showed a downward trend. Third, except for the basic maintenance of a healthy environment, the Kernel density curves of China's public health level and its sub-dimensions have shifted to the right to a certain extent, and there is no polarization phenomenon. Finally, the level of public health in China has a significant spatial correlation. Except for the northeast region, the growth rate of low-level public health provinces in China and the other three major regions is higher than that of high-level public health provinces, showing a certain convergence trend. In addition, the impact of economic development, financial pressure, and urbanization on the convergence of public health levels in the four major regions is significantly heterogeneous.
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Affiliation(s)
- Jixia Li
- School of Government, Beijing Normal University, Beijing 100875, China
| | - Mengzhi Xu
- School of Government, Beijing Normal University, Beijing 100875, China
| | - Tengfei Liu
- School of Business Administration, The Open University of China, Beijing 100039, China
| | - Can Zhang
- School of Government, Beijing Normal University, Beijing 100875, China
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Fu L, Fang Y, Dong Y. The healthcare inequality among middle-aged and older adults in China: a comparative analysis between the full samples and the homogeneous population. HEALTH ECONOMICS REVIEW 2022; 12:34. [PMID: 35761111 PMCID: PMC9238267 DOI: 10.1186/s13561-022-00383-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In the Chinese population, the middle-aged and older adults are the two main segments that utilize a large portion of healthcare. With the fast growth of the two segments, the demands of healthcare services increases significantly. The issue related to inequality in utilization of healthcare emerges with the growth and it deserves more attention. Most existing studies discuss overall inequality. Less attention is paid to inequality among subdivisions, that is, relative inequality. This study focuses on the inequality of healthcare utilization among the homogeneous population and the inequality of the full samples in China. METHODS Data were obtained from four waves of the China Health and Retirement Longitudinal Study (CHARLS): 2011, 2013, 2015 and 2018. First, the Concentration Index (CI) was used to measure the inequality of outpatient, inpatient and preventive care for the samples, and regression analysis was applied to decompose the contributing factors of inequality. Then SOM is introduced to identify homogeneous population through clustering and measure the inequality in three types of healthcare utilization among homogeneous population. Based on this, the difference between absolute inequalities and relative inequalities was discussed. RESULTS The preventive care is shown to have the highest degree of inequality inclined to the rich and has the largest increase (CI: 0.048 in 2011 ~ 0.086 in 2018); The inequality degree in outpatient care appears to be the smallest (CI: -0.028 in 2011 ~ 0.014 in 2018). The decomposition results show that age, education, income, chronic disease and self-reported health issues help explain a large portion of inequality in outpatient and inpatient care. And the contribution of socioeconomic factors and education to the inequality of preventive care is the largest. In regards to three types of healthcare among the homogeneous population, the degree of inequality seems to be higher among group with high socioeconomic status than those with lower socioeconomic status. In particular, for the people who are in the high socioeconomic group, the degree of inequality in preventive care is consistently higher than in outpatient and inpatient care. The inequality degree of preventive care in the low socioeconomic status group varies significantly with the flexibility of their response to policies. CONCLUSIONS Key policy recommendations include establishing a health examination card and continuously improving the fit of free preventive care with the needs of the middle-aged and older adults; developing CCB activities to avoid people's excessive utilization in the high socioeconomic status group or insufficient utilization in the low socioeconomic status group; reasonable control of reimbursement and out-of-pocket payments.
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Affiliation(s)
- Liping Fu
- College of Management and Economics, Tianjin University; Center for Social Science Survey and Data, Tianjin University, Tianjin, 300072, China
- College of Politics and Public Administration, Qinghai Minzu University, Qinghai, 810007, China
| | - Ya'nan Fang
- College of Management and Economics, Tianjin University; Center for Social Science Survey and Data, Tianjin University, Tianjin, 300072, China.
| | - Yongqing Dong
- College of Management and Economics, Tianjin University; Center for Social Science Survey and Data, Tianjin University, Tianjin, 300072, China
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Aluja A, Sorrel MA, García LF, García O, Gutierrez F. Factor Convergence and Predictive Analysis of the Five Factor and Alternative Five Factor Personality Models with the Five-Factor Personality Inventory for ICD-11 (FFICD). J Pers Disord 2022; 36:296-319. [PMID: 35647769 DOI: 10.1521/pedi_2021_35_542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors analyze and compare the factor convergence and predictive power of the Revised NEO Personality Inventory (NEO-PI-R) and the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ/SF) with respect to the Five-Factor Personality Inventory for ICD-11 (FFiCD). A total of 803 White Spanish subjects were analyzed. All the personality domains had significant predictive power with regard to the FFiCD except NEO Openness. The explained variance of the personality domains with respect to FFiCD Negative Affectivity (71% and 77%) and Detachment (56% and 56%) were similar for NEO-PI-R and ZKA-PQ/SF, respectively, but the NEO-PI-R accounted for greater variance for FFiCD Anankastia, Dissociality, and Disinhibition. The FFiCD facets of Rashness, Thrill- Seeking (Disinhibition), and Unassertiveness (Detachment) were located in factors other than those theoretically expected. The authors conclude that normal personality measured by the NEO-PI-R and the ZKA-PQ/SF contribute, in a differential but complementary way, to knowledge of the maladaptive personality measured by the FFiCD.
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Affiliation(s)
- Anton Aluja
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Catalonia, Spain.,University of Lleida, Lleida, Catalonia, Spain
| | | | - Luis F García
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Catalonia, Spain.,Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | | | - Fernando Gutierrez
- Personality Disorder Unit, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
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4
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Aluja A, Sorrel MA, García LF, García O, Gutierrez F, Gutierrez F. Factor Convergence and Predictive Analysis of the Five Factor and Alternative Five Factor Personality Models With the Five-Factor Personality Inventory for ICD-11 (FFiCD). J Pers Disord 2022; 36:296-319. [PMID: 34985333 DOI: 10.1521/pedi_2012_35_542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors analyze and compare the factor convergence and predictive power of the Revised NEO Personality Inventory (NEO-PI-R) and the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ/SF) with respect to the Five-Factor Personality Inventory for ICD-11 (FFiCD). A total of 803 White Spanish subjects were analyzed. All the personality domains had significant predictive power with regard to the FFiCD except NEO Openness. The explained variance of the personality domains with respect to FFiCD Negative Affectivity (71% and 77%) and Detachment (56% and 56%) were similar for NEO-PI-R and ZKA-PQ/SF, respectively, but the NEO-PI-R accounted for greater variance for FFiCD Anankastia, Dissociality, and Disinhibition. The FFiCD facets of Rashness, Thrill- Seeking (Disinhibition), and Unassertiveness (Detachment) were located in factors other than those theoretically expected. The authors conclude that normal personality measured by the NEO-PI-R and the ZKA-PQ/SF contribute, in a differential but complementary way, to knowledge of the maladaptive personality measured by the FFiCD.
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Affiliation(s)
- Anton Aluja
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Catalonia, Spain.,University of Lleida, Lleida, Catalonia, Spain
| | | | - Luis F García
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Catalonia, Spain.,Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | | | - Fernando Gutierrez
- Personality Disorder Unit, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Fernando Gutierrez
- Personality Disorder Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
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Aluja A, García LF, Rossier J, Ostendorf F, Glicksohn J, Oumar B, Bellaj T, Ruch W, Wang W, Suranyi Z, Ścigała D, Čekrlija Đ, Stivers AW, Blas LD, Valdivia M, Ben Jemaa S, Atitsogbe KA, Hansenne M. Dark Triad Traits, Social Position, and Personality: A Cross-Cultural Study. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2022. [DOI: 10.1177/00220221211072816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research explores the Dark Triad traits in 18 cultures from Europe, America, Africa, and Asia. We examined the relationships among Dark Triad traits, as measured by the SD3, with gender, age, social status, and two personality models, HEXACO and Zuckerman’s alternative five factor model (AFFM). There were 10,298 participants (5,410 women and 4,888 men) with a mean age of 40.31 ( SD = 17.32) years old. Between 6% and 16% of the variance in the Dark Triad traits was accounted by culture. Men scored higher than women on all three traits in most cultures, but gender differences were generally larger in European countries. The relationship between the Dark Triad traits dimensions and age is negative, but the largest effect size is small (Psychopathy; η2 = .018). Psychopathy is associated with low Social Position, and Narcissism with high Social Position. In regard to Personality traits, Narcissism is positively related to Extraversion, and Psychopathy is negatively related to Conscientiousness for the HEXACO, and Narcissism is positively related to Activity and Sensation Seeking, and Machiavellianism and Psychopathy are positively related to Aggressiveness and Sensation Seeking for the AFFM.
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Affiliation(s)
- Anton Aluja
- Lleida Institute for Biomedical Research, IRBLleida. University of Lleida, Catalonia, Spain
| | | | | | | | | | | | | | | | - Wei Wang
- Zhejiang University School of Medicine, China
- Norwegian University of Science and Technology, Hangzhou, Zhejiang, China
| | | | - Dawid Ścigała
- The Maria Grzegorzewska University in Warsaw, Poland
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Inequality in dental care expenditure in Iranian households: analysis of income quintiles and educational levels. BMC Oral Health 2021; 21:550. [PMID: 34702242 PMCID: PMC8549140 DOI: 10.1186/s12903-021-01912-6] [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: 07/28/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background Oral health is a major public health issue which affects the human life. Access to dental care is one of the important factors in maintaining oral health. This study was aimed to investigate inequality in dental care expenditure in Iranian households. Methods The present study is a secondary analysis of a national cross-sectional survey. The data collected from the Households Income and Expenditure Survey in 2016 and 2017. The final sample consisted of 54,354 households living in rural and urban regions of all the provinces. Inequalities in household’s dental care expenditure per capita in respect to income quintiles and educational level were measured based on the Gini coefficient and concentration index. Results The results showed that about 8% of households had paid for dental care during the month before sampling. The Gini coefficient value was estimated to be 0.97 and 0.96 for dental care expenditure per capita respectively in absolute and relative measure. It indicated a significant inequality in the dental expenditure among the sample households. The values of concentration index were positive and significant for all dental care subcategories in respect to the provincial and national income quintiles as well as the educational level of the head of the household. Conclusions Income and educational inequality in the both absolute and relative dental services expenditure of the Iranian households were in favor of higher income groups as well as higher educational level of household heads. Income inequality was higher in total dental care expenditure per capita and all its subcategories than the educational inequalities of dental expenditure. In order to reduce these inequalities, the policymakers need to pay special attention to low-income households, particularly those with low-educated heads.
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Guideline compliance for bridging anticoagulation use in vitamin-K antagonist patients; practice variation and factors associated with non-compliance. Thromb J 2019; 17:15. [PMID: 31391790 PMCID: PMC6681479 DOI: 10.1186/s12959-019-0204-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/26/2019] [Indexed: 12/18/2022] Open
Abstract
Background Bridging anticoagulation is used in vitamin-K antagonist (VKA) patients undergoing invasive procedures and involves complex risk assessment in order to prevent thromboembolic and bleeding outcomes. Objectives Our aim was to assess guideline compliance and identify factors associated with bridging and especially, non-compliant bridging. Methods A retrospective review of 256 patient records in 13 Dutch hospitals was performed. Demographic, clinical, surgical and care delivery characteristics were collected. Compliance to the American College of Chest Physicians ninth edition guideline (AT9) was assessed. Multilevel regression models were built to explain bridging use and predict non-compliance. Results Bridging use varied from 15.0 to 83.3% (mean = 41.8%) of patients per hospital, whereas guideline compliance varied from 20.0 to 88.2% (mean = 68.5%) per hospital. Both established thromboembolic risk factors and characteristics outside thromboembolic risk assessment were associated with bridging use. Predictors for overuse were gastrointestinal surgery (OR 14.85, 95% CI 2.69-81.99), vascular surgery (OR 13.01, 95% CI 1.83-92.30), non-elective surgery (OR 8.67, 95% CI 1.67-45.14), lowest 25th percentile socioeconomic status (OR 0.33, 95% CI 0.11-1.02) and use of VKA reversal agents (OR 0.22, 95% CI 0.04-1.16). Conclusion Bridging anticoagulation practice was not compliant with the AT9 in 31.5% of patients. The aggregated AT9 thromboembolic risk was inferior to individual thromboembolic risk factors and other characteristics in explaining bridging use. Therefor the AT9 risk seems less important for the decision making in everyday practice. Additionally, a heterogeneous implementation of the guideline between hospitals was found. Further research and interventions are needed to improve bridging anticoagulation practice in VKA patients.
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Kong F, Xu L, Kong M, Li S, Zhou C, Zhang J, Ai B. Association between Socioeconomic Status, Physical Health and Need for Long-term Care among the Chinese Elderly. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122124. [PMID: 31208088 PMCID: PMC6617196 DOI: 10.3390/ijerph16122124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/11/2019] [Accepted: 06/14/2019] [Indexed: 12/12/2022]
Abstract
The aim of this study was to explore the relationship between socioeconomic status (SES), physical health and the need for long-term care (NLTC) of the Chinese elderly, and further, to provide evidence-based advice for establishing an LTC system in China. A cross-sectional survey was conducted in Shandong Province, China in 2017 by using multi-stage random sampling method. Data were collected from elderly individuals aged 60 years and older by self-designed questionnaires through face-to face interviews. A total of 7070 participants were finally included in the database (40.3% male, 59.7% female). Chi-square test analysis and structural equation modeling (SEM) were conducted to clarify the association between SES, physical health and NLTC among the Chinese elderly men and women in Shandong Province. The results of the SEM analysis showed that physical health exerted a strong and negative effect on the NLTC for both genders, with a slightly stronger effect found among the elderly men. SES was found to be significantly and negatively related to the NLTC among the elderly women, while no statistical significance was found for the association between SES and NLTC for elderly men. A significant and positive association between SES and physical health was observed among the elderly men and women, with a slightly stronger effect among the elderly women. Implications for lowering the NLTC and developing an LTC system were addressed based on the findings above.
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Affiliation(s)
- Fanlei Kong
- NHC Key Laboratory of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Lingzhong Xu
- NHC Key Laboratory of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public health, Fudan University, Shanghai 200032, China.
| | - Mei Kong
- Research Center of Economics and Resource Management, Beijing Normal University, Beijing 100875, China.
| | - Shixue Li
- NHC Key Laboratory of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Chengchao Zhou
- NHC Key Laboratory of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Jianghua Zhang
- School of Management, Shandong University, Jinan 250100, China.
| | - Bin Ai
- School of Ethnology and Sociology, Minzu University of China, Beijing 100081, China.
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Kong F, Xu L, Kong M, Li S, Zhou C, Li J, Sun L, Qin W. The Relationship between Socioeconomic Status, Mental Health, and Need for Long-Term Services and Supports among the Chinese Elderly in Shandong Province-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040526. [PMID: 30781757 PMCID: PMC6406556 DOI: 10.3390/ijerph16040526] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/05/2019] [Accepted: 02/11/2019] [Indexed: 12/23/2022]
Abstract
This study aims to clarify the association between socioeconomic status (SES), mental health, and the need for long-term services and support (NLTSS) of the Chinese elderly, and further, to provide evidence-based suggestions for the development of the long-term services and support (LTSS) system in China. A cross-sectional survey using a multi-stage random sampling method was conducted in Shandong Province, China, in 2017. Data were collected from seniors aged over 60 years old through questionnaires by face-to face interviews. A total of 7070 subjects were included in the final database (40.3% male and 59.7% female). A chi-square test analysis and structural equation modeling (SEM) were employed to explore the relationship between SES, mental health, and NLTSS for both male and female elderly people. The SEM analysis showed that mental health was significantly and negatively associated with NLTSS for both male elderly and female elderly, and it was slightly stronger among the male elderly. A significant and negative relationship was observed between SES and NLTSS for both genders, and the association was stronger among the female elderly. SES exerted a positive effect on mental health for both male and female elderly people, and a slightly stronger effect was found among the male elderly. Advice for the development of a LTSS system in China was given based on the above results.
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Affiliation(s)
- Fanlei Kong
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Lingzhong Xu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public health, Fudan University, Shanghai 200032, China.
| | - Mei Kong
- Research Center of Economics and Resource Management, Beijing Normal University, Beijing 100875, China.
| | - Shixue Li
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Chengchao Zhou
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Jiajia Li
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Long Sun
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
| | - Wenzhe Qin
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
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Park JE, Park JH, Chang SJ, Lee JH, Kim SY. The Determinants of and Barriers to Awareness and Treatment of Hypertension in the Korean Population. Asia Pac J Public Health 2019; 31:121-135. [PMID: 30678483 DOI: 10.1177/1010539518825006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated whether sociodemographic, health behavioral, biomedical, and health status factors are associated with the awareness and treatment status of hypertension. Data were analyzed from 13 180 adults with hypertension in a nationally representative sample collected from 2007 to 2015 through the Korean National Health and Nutrition Examination Survey. Among hypertensive Korean adults, only 65.2% were aware of their condition and being treated with antihypertensive medications. Younger age was identified as an important barrier to diagnosis and treatment of hypertension. Although there were slight differences between participants aged <65 and ≥65 years, higher risks of being untreated or being unaware of having hypertension were also associated with male gender, lower education levels, unhealthy behaviors, and a better health conditions. We suggest that aggressive interventions to improve the awareness, treatment, and/or control of hypertension should be applied to young and middle-aged people who are vulnerable to hypertension management.
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Affiliation(s)
- Jong Eun Park
- 1 Department of Medicine, Chungbuk National University Graduate School, Cheongju, Republic of Korea
| | - Jong-Hyock Park
- 2 College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Sun Ju Chang
- 3 College of Nursing & the Research Institute of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ju Hee Lee
- 4 Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - So Young Kim
- 5 Chungbuk Regional Cardiocerebrovascular Center, Chungbuk National University Hospital, Cheongju, Republic of Korea
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Rarani MA, Nosratabadi M, Moeeni M. Early childhood development in Iran and its provinces: Inequality versus average. Int J Health Plann Manage 2018; 33:1136-1145. [PMID: 30074273 DOI: 10.1002/hpm.2594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/02/2018] [Accepted: 06/29/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Early childhood development is influenced by family socioeconomic status in such a way that socioeconomic deprivation might be accompanied with adverse outcomes in early development of a child. This study aimed to assess early childhood development based on average and also based on the distribution of socioeconomic inequality in Iran and its provinces. METHODS Using data from provincially representative Multiple Indicator Demographic and Health Survey (2010), we developed a suitable latent class approach to construct a proxy of socioeconomic status. A composite index of early childhood development was used. We assessed inequality in early childhood development using the concentration index method. RESULTS At province level (n = 30), the highest and lowest averages of early childhood development were 13.60 (SD = 2.99) and 5.81 (SD = 3.29), respectively. Concentration indices indicated pro-rich inequality in early childhood development at national and provincial level. The concentration index of early childhood development was 0.087 (95% CI = 0.085-0.0098) in Iran. Moreover, the consistent positive values of the concentration indices revealed that early childhood development inequality favored best-off children in all provinces. However, early childhood development was disproportionally distributed among provinces and rated 0.016 to 0.149. CONCLUSIONS Iranian children in more prosperous households reported higher early childhood development compared with those in poor households at national and provincial level. It is vital to consider inequality in addition to average level of childhood development across Iranian provinces to reach a more comprehensive understanding of childhood development for public policy action in the country.
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Affiliation(s)
- Mostafa Amini Rarani
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Nosratabadi
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Moeeni
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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García-Díaz R, Sosa-Rubí SG, Serván-Mori E, Nigenda G. Welfare effects of health insurance in Mexico: The case of Seguro Popular de Salud. PLoS One 2018; 13:e0199876. [PMID: 29965976 PMCID: PMC6028097 DOI: 10.1371/journal.pone.0199876] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 06/18/2018] [Indexed: 11/19/2022] Open
Abstract
This study contributes with original empirical evidence on the distributional and welfare effects of one of the most important health policies implemented by the Mexican government in the last decade, the Seguro Popular de Salud (SPS). We analyze the effect of SPS on households' welfare using a decomposable index that considers insured and uninsured households' response to out-of-pocket (OOP) payments using both social welfare weights and inequality aversion. The disaggregation of the welfare index allows us to explore the heterogeneity of the SPS impact on households' welfare. We applied propensity score matching to reduce the self-selection bias of being SPS insured. Overall results suggest non-conclusive results of the impact of SPS on households' welfare. When we disaggregated the welfare index by different sub-population groups, our results suggest that households' beneficiaries of SPS with older adults or living in larger cities are better protected against OOP health care payments than their uninsured counterparts. However, no effect was found among SPS-insured households living in rural and smaller cities, which is a result that could be attributed to limited access to health resources in these regions. Scaling up health insurance coverage is a necessary but not sufficient condition to ensure the protection of SPS coverage against financial risks among the poor.
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Affiliation(s)
- Rocío García-Díaz
- Department of Economics, Monterrey Institute of Technology and Higher Education, Nuevo León, México
| | - Sandra G. Sosa-Rubí
- Center for Health Systems Research, National Institute of Public Health, Morelos, México
| | - Edson Serván-Mori
- Center for Health Systems Research, National Institute of Public Health, Morelos, México
| | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of México, México City, México
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Erreygers G, Kessels R. Socioeconomic Status and Health: A New Approach to the Measurement of Bivariate Inequality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E673. [PMID: 28644405 PMCID: PMC5551111 DOI: 10.3390/ijerph14070673] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 11/24/2022]
Abstract
We suggest an alternative way to construct a family of indices of socioeconomic inequality of health. Our indices belong to the broad category of linear indices. In contrast to rank-dependent indices, which are defined in terms of the ranks of the socioeconomic variable and the levels of the health variable, our indices are based on the levels of both the socioeconomic and the health variable. We also indicate how the indices can be modified in order to introduce sensitivity to inequality in the socioeconomic distribution and to inequality in the health distribution. As an empirical illustration, we make a comparative study of the relation between income and well-being in 16 European countries using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 4.
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Affiliation(s)
- Guido Erreygers
- Department of Economics, University of Antwerp, 2000 Antwerp, Belgium.
- Centre for Health Policy, University of Melbourne, Melbourne 3010, Australia.
| | - Roselinde Kessels
- Department of Economics, University of Antwerp & Flemish Research Foundation (FWO), 2000 Antwerp, Belgium.
- Department of Operations Management & Institute for Business and Industrial Statistics, University of Amsterdam, 1018 TV Amsterdam, The Netherlands.
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Makdissi P, Yazbeck M. Avoiding blindness to health status in health achievement and health inequality measurement. Soc Sci Med 2016; 171:39-47. [DOI: 10.1016/j.socscimed.2016.10.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 09/30/2016] [Accepted: 10/22/2016] [Indexed: 11/25/2022]
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