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Wu W, Liao H, Yang X. Education disrupts the intergenerational transmission of health disadvantage across three generations in China. PLoS One 2024; 19:e0302963. [PMID: 38848425 PMCID: PMC11161082 DOI: 10.1371/journal.pone.0302963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 04/17/2024] [Indexed: 06/09/2024] Open
Abstract
This article utilizes survey data from the China Family Panel Studies (CFPS) to examine whether grandparents' health disadvantage have both direct and indirect effects on the health disadvantage of their grandchildren, and whether the completion of compulsory education by parents disrupts these intergenerational transmissions in China. The findings suggest that grandparents' health disadvantage significantly increases the probability of grandchildren's health disadvantage with and without controlling parental health disadvantage and other characteristics. Moreover, the study identifies a disruptive influence of parental education on this transmission process. Rigorous robustness tests, including the use of the Compulsory Education Law as an instrumental variable to control for unobserved factors, validate these results. Mechanism analysis shows that parents completing compulsory education contribute to improving their nutritional balance and adopting healthy behaviors, attaining higher social status, earning higher income, which ultimately reduce the probability of health disadvantage for both themselves and their children. These findings highlight the persistent intergenerational transmission of health disparities within families and emphasize the importance of enhancing individuals' education levels to disrupt this transmission. By doing so, it may be possible to mitigate health inequalities and disparities across the population.
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Affiliation(s)
- Weijuan Wu
- School of Economics and Management, South China Normal University, Panyu District, Guangzhou City, Guangdong Province, China
| | - Haokai Liao
- College of Humanities and Arts, Heyuan Polytechnic, Yuancheng District, Heyuan City, Guangdong Province, China
| | - Xuelin Yang
- The School of Marxism, Jiangxi University of Technology, Gaoxin District, Nanchang City, Jiangxi Province, China
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Zhong M, Qiang D, Wang J, Sun W. Improving health and reducing health inequality: An innovation of digitalization? Soc Sci Med 2024; 348:116847. [PMID: 38569285 DOI: 10.1016/j.socscimed.2024.116847] [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: 01/15/2024] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/05/2024]
Abstract
RATIONALE The association between digitalization and individual health has attracted increasing attention from both scholars and policymakers. Existing research, however, has not agreed on whether digitization can improve health or reduce health inequality. OBJECTIVE The purpose of this study is to clarify whether and how the development of digitalization may be related to health and health disparities. METHODS We rely on China Family Panel Studies (CFPS) surveys from 2012 to 2018 to obtain a sample of 82,471 observations to explore the impact of digitalization on self-rated health and health inequality and its transmission mechanisms. The hypotheses are tested by Ordinary Least Squares Modeling. RESULTS As expected, digitalization is significantly and positively correlated with self-rated health. Furthermore, the development of digitalization has led to a notable decrease in health inequality. The influencing mechanisms of digitalization include income, healthcare consumption and health behaviors. Both dimensions of digitalization-internet development and digital finance-generate significant effects and the effects of internet development are greater. CONCLUSIONS This study is the first to systematically investigate the impact of digitalization development on health and health inequality. Our findings provide evidence for the health promotion theory by clarifying the benefits of digitalization in improving residents' health and reducing health inequality. Therefore, utilizing the tools of digitalization efficiently could be a focus of policymakers aiming to accomplish the SDGs' health targets.
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Affiliation(s)
- Meirui Zhong
- Business School, Central South University, 410083, Changsha, China
| | - Dan Qiang
- Business School, Central South University, 410083, Changsha, China
| | - Jinxian Wang
- Business School, Central South University, 410083, Changsha, China.
| | - Weizeng Sun
- School of Economics, Central University of Finance and Economics, 100081, Beijing, China
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Mussone L, Changizi F. The relationship between subjective well-being and individual characteristics, personality traits, and choice of transport mode during the first lock-down in Milan, Italy. JOURNAL OF TRANSPORT & HEALTH 2023; 30:101600. [PMID: 36937248 PMCID: PMC10014291 DOI: 10.1016/j.jth.2023.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/28/2022] [Accepted: 03/07/2023] [Indexed: 06/04/2023]
Abstract
Introduction Concerning the adverse effect of COVID-19 virus pandemic on subjective well-being and daily travel, this research sought to analyse which personal characteristics, personality traits, and transport modes are related to positive and negative affect, and satisfaction with life during the first lock-down in Milan, Italy. Method In the spring of 2020, an online survey was conducted in Milan, and 1025 responses were collected. Then, three Multinomial Ordinal Regression models (MNOR) are carried out to examine the relationship between the data. Results Results show that women were more likely to feel fewer positive emotions than men. More physical activity, and income were positively associated with the models. Significant relevance of personality traits with subjective well-being is reported Regarding daily mobility during the pandemic, transport mode after lock-down, satisfaction with public transport, and worry about using public transport were found relevant to subjective wellbeing. Conclusions Whereas the feeling of worry about using public transport increased the negative affect. Transport mode during lock-down was not related to subjective well-being, though the preferred mode of transport after lock-down was related to satisfaction with life. Respondents who chose to use private cars more than other modes of transport were more likely to have higher satisfaction with life. Findings are discussed to improve transport and mobility planning during pandemics.
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Affiliation(s)
- Lorenzo Mussone
- Politecnico di Milano, Department of Architecture, Building Environment and Civil Constructions, Piazza L. da Vinci 32, Milano, Italy
| | - Farzaneh Changizi
- Politecnico di Milano, Department of Architecture, Building Environment and Civil Constructions, Piazza L. da Vinci 32, Milano, Italy
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Zhang J, Gong X, Zhang H. ICT diffusion and health outcome: Effects and transmission channels. TELEMATICS AND INFORMATICS 2022. [DOI: 10.1016/j.tele.2021.101755] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Fracso D, Bourrel G, Jorgensen C, Fanton H, Raat H, Pilotto A, Baker G, Pisano MM, Ferreira R, Valsecchi V, Pers YM, Engberink AO. The chronic disease Self-Management Programme: A phenomenological study for empowering vulnerable patients with chronic diseases included in the EFFICHRONIC project. Health Expect 2022; 25:947-958. [PMID: 35014112 PMCID: PMC9122418 DOI: 10.1111/hex.13430] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/14/2021] [Accepted: 12/24/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction The Chronic Disease Self‐Management Programme (CDSMP) has resulted in improved health outcomes for patients. However, research has focused mainly on those with chronic conditions and has not extensively explored prevention programmes targeting individuals with specific vulnerability profiles. Aim This study aimed to understand the effects of the CDSMP on the lived experience of vulnerable patients included in the EFFICHRONIC project in France, based on their needs and expectations before and after participation. Methods We conducted a qualitative phenomenological semio‐pragmatic study based on 37 in‐depth interviews with 20 patients (20 before/17 after CDSMP). Results By transforming existential dimensions (identity, relationship with others and bodily experience), chronic illness generates new needs in the vulnerable person. By resonating with the expectations and needs of participants, the CDSMP induces motivation and a sense of belonging to a community of peers. It has enabled the participants to become actors of their own health until empowerment. Although some limitations are reported, the programme has awakened a desire in the participants to take better care of their health and to develop personal skills with, for some, a desire to become involved in health education. Conclusion Our phenomenological approach highlighted the resonance between the programme (its design and implementation) and the lived experience of patients, as an effective element of empowerment. This necessitates training the facilitators to elicit the lived experience of patients. Furthermore, as a patient‐centred approach is required, the facilitators need to learn how to adapt the design of the programme to the singularity of the patient. Patient or Public Contribution Patients provided the data that were collected through in‐depth interviews, and their experiences before and after the programme were analysed.
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Affiliation(s)
- Dallal Fracso
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France.,Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France
| | - Gérard Bourrel
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France.,Institut Desbrest d'Epidémiologie et de Santé Public, UMR UA11 INSERM, Université de Montpellier, Montpellier, France
| | - Christian Jorgensen
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Hélène Fanton
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Graham Baker
- Quality Institute for Self Management Education and Training, Portsmouth, UK
| | - Marta M Pisano
- General Direction of Care, Humanization and Social and Health Care, Ministry of Health, Biosanitary Research Institute of the Principality of Asturias, Asturias, Spain
| | - Rosanna Ferreira
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Verushka Valsecchi
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Yves-Marie Pers
- IRMB, INSERM, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Agnes Oude Engberink
- Department of Primary Care, School of Medicine, University of Montpellier, Montpellier, France.,Institut Desbrest d'Epidémiologie et de Santé Public, UMR UA11 INSERM, Université de Montpellier, Montpellier, France
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Neumann‐Böhme S, Attema AE, Brouwer WBF, van Exel JNJA. Life satisfaction: The role of domain-specific reference points. HEALTH ECONOMICS 2021; 30:2766-2779. [PMID: 34414631 PMCID: PMC9291216 DOI: 10.1002/hec.4412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 07/05/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
In the evaluation of well-being, it is not only important what people have in absolute terms, but also how this compares to reference points in relative terms. We explore the relevance of relative comparisons by testing the effect of people's self-rated position on potential reference points for income and health on their subjective well-being. We used Multiple Discrepancies Theory as a framework to identify seven potentially relevant reference points for income and health. A representative sample (N = 550) of the Netherlands assessed their income and health relative to these reference points. In addition, we elicited monthly household income, health status (EQ-5D-5L), and subjective well-being (SWLS). In line with the literature, we found a negative convex relationship between subjective well-being and age and a positive relationship with being employed, income, and health. For income, subjective well-being was also associated with how current income compared to respondents' needs and progression over time, and for health especially with how current health compared to what they felt they deserved. Our findings suggest that income and health are important for subjective well-being both in absolute and relative terms. We found negative effects on life satisfaction if some of the domain specific reference points were not met.
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Affiliation(s)
- Sebastian Neumann‐Böhme
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamNetherlands
| | - Arthur E. Attema
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamNetherlands
| | - Werner B. F. Brouwer
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamNetherlands
| | - Job N. J. A. van Exel
- Erasmus School of Health Policy & ManagementErasmus University RotterdamRotterdamNetherlands
- Erasmus School of EconomicsErasmus University RotterdamRotterdamNetherlands
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de Corte K, Cairns J, Grieve R. Stated versus revealed preferences: An approach to reduce bias. HEALTH ECONOMICS 2021; 30:1095-1123. [PMID: 33690931 DOI: 10.1002/hec.4246] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 12/17/2020] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Stated preference (SP) survey responses may not predict actual behavior, leading to hypothetical bias. We developed an approach that harnesses large-scale routine data to help SP surveys provide more accurate estimates of revealed preferences (RPs), within a study which elicited preferences for alternative changes to the blood service in England. The SP survey responses were used to predict the mean number of annual whole blood donations. Ex ante, the iterative survey design estimated hypothetical bias by contrasting pilot SP survey responses (N = 1254), with individually linked data on RPs, to inform the main SP survey design (N = 25,187). Ex post, the analysis recognized mediation of the relationship between SP and RP when blood donation is deferred. The pilot survey reported that donors' intended donation frequency of 3.2 (men) and 2.6 (women) times per year, exceeded their actual frequency by 41% and 30% respectively. Choice scenario attributes for the main SP survey were then modified, and over-prediction subsequently decreased to 34% for men and 16% for women. The mediating effect of deferrals explained 29% (men) and 86% (women) of the residual discrepancy between SP and RP. Future studies can use this approach to reduce hypothetical bias, and provide more accurate predictions for decision-making.
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Affiliation(s)
- Kaat de Corte
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - John Cairns
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Grieve
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Olsen JA, Misajon R. A conceptual map of health-related quality of life dimensions: key lessons for a new instrument. Qual Life Res 2019; 29:733-743. [PMID: 31676970 PMCID: PMC7028807 DOI: 10.1007/s11136-019-02341-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 11/13/2022]
Abstract
Purpose Quality-adjusted life years (QALYs) represent a critical metric in economic evaluations impacting key healthcare decisions in many countries. However, there is widespread disagreement as to which is the best of the health state utility (HSU) instruments that are designed to measure the Q in the QALY. Instruments differ in their descriptive systems as well as their valuation methodologies; that is, they simply measure different things. We propose a visual framework that can be utilized to make meaningful comparisons across HSU instruments. Methods The framework expands on existing HRQoL models, by incorporating four distinctive continua, and by putting HRQoL within the broader notion of subjective well-being (SWB). Using this conceptual map, we locate the five most widely used HSU-instruments (EQ-5D, SF-6D, HUI, 15D, AQoL). Results By individually mapping dimensions onto this visual framework, we provide a clear picture of the significant conceptual and operational differences between instruments. Moreover, the conceptual map demonstrates the varying extent to which each instrument moves outside the traditional biomedical focus of physical health, to also incorporate indicators of mental health and social well-being. Conclusion
Our visual comparison provides useful insights to assess the suitability of different instruments for particular purposes. Following on from this comparative analyses, we extract some important lessons for a new instrument that cover the domains of physical, mental and social aspects of health, i.e. it is in alignment with the seminal 1948 WHO definition of health.
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Affiliation(s)
- Jan Abel Olsen
- Department of Community Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, 9037, Norway. .,Norwegian Institute of Public Health, Oslo, Norway.
| | - RoseAnne Misajon
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,The Cairnmillar Institute, Melbourne, Australia
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Maguire R, Hanly P, Maguire P. Living well with chronic illness: How social support, loneliness and psychological appraisals relate to well-being in a population-based European sample. J Health Psychol 2019; 26:1494-1507. [PMID: 31647344 DOI: 10.1177/1359105319883923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Positive social and psychological appraisals may help maintain well-being in illness, but few studies have systematically investigated this in a European context. After controlling for sociodemographic, health and objective social factors, we employed multilevel regression modelling to establish if appraisals predict well-being in three illness groups (n = 10,577). In addition to health and financial status, positive appraisals were consistent predictors of well-being. Social appraisals had stronger associations with well-being than extent of social contact. Optimism and resilience appeared more important in those limited by health than those who were not. Findings may inform interventions aimed at supporting people coping with illness.
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Affiliation(s)
| | - Paul Hanly
- School of Business, National College of Ireland, Ireland
| | - Phil Maguire
- Department of Computer Science, Maynooth University, Ireland
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Cantarero-Prieto D, Pascual-Sáez M, Blázquez-Fernández C. Social isolation and multiple chronic diseases after age 50: A European macro-regional analysis. PLoS One 2018; 13:e0205062. [PMID: 30356322 PMCID: PMC6200202 DOI: 10.1371/journal.pone.0205062] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/19/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Different studies have found that socioeconomic determinants influence the prevalence of chronic diseases in older people. However, there has been relatively little research on the incidence of how social isolation may affect them. We suggest that social isolation is a serious concern for people living with chronic illnesses. METHOD In this paper, we examine whether there is an increase in the propensity of being diagnosed with chronic illnesses because of a decrease in social relations for elderly Europeans. We have used a panel data for Waves 1-6 (2004-2015) of Survey on Health, Ageing and Retirement in Europe (SHARE) and logistic regressions. Besides, we have studied three geographic macro-areas (Nordic, Continental and Southern). Being diagnosed with three or more chronic diseases is considered as a dependent variable, and as social control variables we have used three isolation proxies (living alone, providing help to family, friends or neighbours and participation-club activities). Other socio-demographic variables are included (gender, age, educational level, job situation, area of location and quality of life). RESULTS Our results for the full sample indicate that people who participate in social activities have fewer probability of suffering from chronic diseases (OR = 0.70, 95% CI 0.54, 0.92). For people who live alone the reverse effect is observed (OR = 1.20, 95% CI 1.04, 1.39). Differences are shown by macro-areas, e.g. providing help (OR = 0.58, 95% CI 0.34, 0.97) isolation proxy is significant for the Nordic macro-area. Club-participation activities and living alone are significant for Continental and Southern macro-areas, respectively (OR = 0.65, 95% CI 0.55, 0.82; OR = 1.46, 95% CI 1.21, 1.77). CONCLUSIONS Social isolation increases the risk of being diagnosed with chronic illnesses. That is, people with greater social participation have lower risk of suffering from multiple chronic diseases. This risk linked to isolation, together with the traditional one associated with lifestyles, should be considered in the development of new public policies.
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Affiliation(s)
- David Cantarero-Prieto
- Group of Health Economics and Health Service Management, Department of Economics, The University of Cantabria–IDIVAL, Santander, CP, Spain
| | - Marta Pascual-Sáez
- Group of Health Economics and Health Service Management, Department of Economics, The University of Cantabria–IDIVAL, Santander, CP, Spain
| | - Carla Blázquez-Fernández
- Group of Health Economics and Health Service Management, Department of Economics, The University of Cantabria–IDIVAL, Santander, CP, Spain
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