1
|
Zhao B, Liu Z, Fu Y, Zhang H, Wu J, Lai C, Xue E, Gao Q, Shao J. Social Determinants of Intrinsic Capacity: A National Cohort Study. Am J Prev Med 2024; 66:559-567. [PMID: 37844711 DOI: 10.1016/j.amepre.2023.10.008] [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: 04/07/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Intrinsic capacity (IC), a composite of physical and mental capacities, is a marker of healthy aging. Social determinants of health (SDOH), namely the economic and social environments across a lifespan, are the most fundamental factors influencing health outcomes and health disparities. However, there is limited evidence on the influence of the individual and combined burden of the SDOH on IC. METHODS Data were obtained from the China Health and Retirement Longitudinal Study (2011-2015), and data analysis was conducted in 2023. Linear mixed-effect regression was employed to investigate the association between SDOH and IC in a longitudinal analysis. RESULTS This study comprised 7,669 participants (mean [SD] age, 68.5 [7.1] years; 49.8% female; mean [SD] IC, 7.2 [1.6]). In the longitudinal analysis, all five SDOH domains were independently and significantly associated with IC. The absence of social association within the social and community context domain exhibited the weakest association with IC (β: -0.11 [95% CI -0.20, -0.02]), while illiteracy within the education access and quality domain demonstrated the strongest association with IC (β: -0.51 [95% CI -0.60, -0.42]). Furthermore, the adverse effects of SDOH on IC became more distinguishable with the cumulative number of SDOH variables (coefficient for 2 SDOH, -0.41 [-0.64, -0.19]; 3 SDOH, -0.70 [-0.93, -0.48]; ≥4 SDOH, -1.10 [-1.33, -0.88]) compared with those without any SDOH. CONCLUSIONS Certain SDOH levels were significantly and negatively associated with IC. Targeted interventions may be needed to improve SDOH in individuals at high risk of poor IC.
Collapse
Affiliation(s)
- Binyu Zhao
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China; Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zuyun Liu
- Department of Big Data in Health Science School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yujia Fu
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China; Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huafang Zhang
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China
| | - Jingjie Wu
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chuyang Lai
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Erxu Xue
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qisheng Gao
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jing Shao
- Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China; Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| |
Collapse
|
2
|
Ekadinata N, Hsu HC, Chen YM, Chuang KY. Effects of social capital on healthcare utilization among older adults in Indonesia. Health Promot Int 2023; 38:daad104. [PMID: 37715938 DOI: 10.1093/heapro/daad104] [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: 09/18/2023] Open
Abstract
Social capital potentially affects older adults' access to healthcare services. However, the effects of social capital on the use of various types of healthcare services using longitudinal data have yet to be explored. This study aimed to examine the effects of structural and cognitive social capital on different types of healthcare utilization by older adults in Indonesia. Data were from the Indonesian Family Life Survey (waves 4 and 5) in 2007 and 2014. The sample consisted of participants aged 60 years and older who completed both waves (n = 1374). Healthcare utilization by older adults assessed health posts (posyandu), health checkups, outpatient care and hospital admissions. Social capital consisted of neighborhood trust and community participation. Generalized estimating equation models were used for the analysis. Older adults with high community participation had a higher likelihood of using preventive care in posyandu (OR = 5.848, 95% CI = 2.585-13.232) and health checkup visits (OR = 1.621, 95% CI = 1.116-2.356). Meanwhile, neighborhood trust was related to a higher probability of hospital admissions (OR = 1.255, 95% CI = 1.046-1.505). Social capital significantly affects older adults' preventive and treatment healthcare utilization. Maximizing the availability of social participation and removing barriers to access to preventive and medical care in an age-friendly environment are suggested.
Collapse
Affiliation(s)
- Nopryan Ekadinata
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan
- School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Hui-Chuan Hsu
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan
- Research Center of Health Equity, College of Public Health, Taipei Medical University, New Taipei, Taiwan
| | - Ya-Mei Chen
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kun-Yang Chuang
- School of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan
| |
Collapse
|
3
|
Vicerra PMM. Optimism bias regarding COVID-19: a cross-sectional study of lower-income older adults in Thailand. Ann Med 2023; 55:2258893. [PMID: 37725941 PMCID: PMC10512749 DOI: 10.1080/07853890.2023.2258893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/10/2023] [Indexed: 09/21/2023] Open
Abstract
Objective: Understanding the discernment of individuals about their health is crucial during public health situations such as the COVID-19 pandemic. Within this theme of study is how older adults perceive their vulnerabilities because it can relate to subsequent disease preventing behaviour.Materials and methods: The analysis explored optimism bias, or the perception of infection avoidance, regarding COVID-19 among lower-income Thais aged 60 and over. The study utilized an analytic sample of 2,139 individuals from the 2021 Survey on Housing and Support Services for Poor Older Adults. Logit regression model analysis was conducted, using optimistic bias as the outcome variable.Results: Increasing age and residing in urban areas were associated with a higher likelihood of bias. On the other hand, higher educational attainment was found to decrease the association with optimistic bias, indicating higher perception of risks. Adherence of older individuals to the residence-in-place policy might have contributed to perception of lower infection risks. Urban residents had better access to welfare benefits and medical facilities, which led to reduced worry and greater optimistic bias.Conclusion: Greater understanding of the disease and preventive strategies offer insights on how higher education levels lead to perceiving possible risks surrounding COVID-19.
Collapse
|
4
|
Pengpid S, Peltzer K. Prevalence and associated factors of incident and persistent loneliness among middle-aged and older adults in Thailand. BMC Psychol 2023; 11:70. [PMID: 36918991 PMCID: PMC10015912 DOI: 10.1186/s40359-023-01115-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The aim of the study was to assess the prevalence and associated factors of incident and persistent loneliness in a prospective cohort study among middle-aged and older adults (≥ 45 years) in Thailand. METHODS Longitudinal data from the Health, Aging, and Retirement in Thailand (HART) study in 2015 and 2017 were analysed. Loneliness was assessed with one item from the Center for Epidemiological Studies Depression scale. Logistic regression was used to calculate predictors of incident and persistent loneliness. RESULTS In total, at baseline 21.7% had loneliness, 633 of 3696 participants without loneliness in 2015 had incident loneliness in 2017 (22.2%), and 239 of 790 adults had persistent loneliness (in both 2015 and 2017) (30.3%). In adjusted logistic regression analysis, low income (aOR: 1.27, 95% CI: 1.03 to 1.57), poor self-rated physical health status (aOR: 1.64, 95% CI: 1.27 to 2.12), hypertension (aOR: 1.34, 95% CI: 1.09 to 1.65), depressive symptoms (aOR: 1.97, 95% CI: 1.11 to 3.49), and having three or chronic conditions (aOR: 1.76, 95% CI: 1.19 to 2.60) were positively associated and a higher education (aOR: 0.74, 95% CI: 0.55 to 0.98) and living in the southern region of Thailand (aOR: 0.43, 95% CI: 0.30 to 0.61) were inversely associated with incident loneliness. Poor self-rated physical health status (aOR: 1.91, 95% CI: 1.26 to 2.88), and having three or more chronic diseases (aOR: 1.78, 95% CI: 1.07 to 2.98), were positively associated, and living in the southern region (aOR: 0.40, 95% CI: 0.25 to 0.65) was inversely associated with persistent loneliness. CONCLUSION More than one in five ageing adults had incident loneliness in 2 years of follow-up. The prevalence of incident and/or persistent loneliness was higher in people with a lower socioeconomic status, residing in the central region, poor self-rated physical health status, depressive symptoms, hypertension, and a higher number of chronic diseases.
Collapse
Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand. .,Department of Psychology, University of the Free State, PO Box 339 (40), 9300, Bloemfontein, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| |
Collapse
|
5
|
The Health-Seeking Behavior of the Elderly with Non-Communicable Diseases in Coastal Areas of Vietnam. Healthcare (Basel) 2023; 11:healthcare11040465. [PMID: 36832999 PMCID: PMC9957095 DOI: 10.3390/healthcare11040465] [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: 12/18/2022] [Revised: 01/16/2023] [Accepted: 01/28/2023] [Indexed: 02/08/2023] Open
Abstract
This study aimed to analyze the utilization of health care facilities and the health-seeking behavior of elderly people with non-communicable diseases and find the factors that affect them. A cross-sectional study was conducted in seven coastal areas of the Thua Thien Hue province, Vietnam, using a sample of 370 elderly people aged over 60 years. Chi-square and multiple logistic regression analyses were used to examine the factors associated with the utilization of health care services. The participants' average age was 69.70 (SD), and 18% of them reported having ≥ two non-communicable diseases (NCDs). The results of the study showed that 69.8% of the total participants exhibited health-seeking behaviors. The findings also revealed that elderly people living alone, and those with an average or above-average income, had higher utilization of health care services. Participants with multiple NCDs exhibited more health-seeking behaviors than those with only one (OR: 9.24, 95% CI: 2.66-32.15, p = <0.001). The presence of health insurance and the need for health care counseling were also relevant ([OR: 4.16, 95% CI: 1.30-13.31, p = 0.016], [OR: 3.91, 95% CI: 2.04-7.49, p < 0.001], respectively). Health-seeking behavior is one of the most important positive implications for the aged population, as it encompasses one's physical, mental, and psychological wellbeing. Future studies can aim at gaining an in-depth understanding of the same results, helping improve the health-seeking behavior of elderly people, and enhancing their quality of life.
Collapse
|
6
|
Mohd Rosnu NS, Singh DKA, Mat Ludin AF, Ishak WS, Abd Rahman MH, Shahar S. Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127351. [PMID: 35742597 PMCID: PMC9223544 DOI: 10.3390/ijerph19127351] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/26/2022] [Accepted: 06/13/2022] [Indexed: 11/20/2022]
Abstract
South-East Asia (SEA) is the home of the largest number of the world’s older population. In this scoping review, we aimed to map the existing enablers and barriers of accessing healthcare services among older adults in SEA countries. Articles that were published from January 2001 until November 2021 were searched in four data sources (PubMed, Web of Science, EBSCO Host and The Cochrane Library). Studies pertaining to the factors which assist or obstruct older Southeast Asian adults from assessing healthcare services were chosen for this scoping review. First, two reviewers screened the titles and abstracts of articles in the data sources. After identifying appropriate articles, the reviewers read them. Data extracted by one reviewer were verified by the other reviewer. The findings were then classified according to Penchansky and Thomas’s five domains of access. A total of 19 studies were included in the final scoping review. Accessibility and acceptability were the two factors most often identified as enablers or barriers to older adults from accessing healthcare. Other often mentioned factors were finances, transportation and social/family support. Older adults living in rural areas were especially impacted by these factors. To promote healthy ageing, optimum healthcare and wellbeing among older adults in Southeast Asia, it is extremely important to consider accessibility and acceptability when planning healthcare services.
Collapse
Affiliation(s)
- Nurul Syuhada Mohd Rosnu
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (N.S.M.R.); (A.F.M.L.); (W.S.I.); (S.S.)
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (N.S.M.R.); (A.F.M.L.); (W.S.I.); (S.S.)
- Correspondence: ; Tel.: +60-3-9289-7159
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (N.S.M.R.); (A.F.M.L.); (W.S.I.); (S.S.)
| | - Wan Syafira Ishak
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (N.S.M.R.); (A.F.M.L.); (W.S.I.); (S.S.)
| | - Mohd Harimi Abd Rahman
- Optometry and Vision Sciences Programme, Center for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (N.S.M.R.); (A.F.M.L.); (W.S.I.); (S.S.)
| |
Collapse
|
7
|
Pothisiri W, Vicerra PMM, Buathong T. Poverty, noncommunicable diseases, and perceived health risks among older adults during the COVID-19 pandemic in urban Thailand. ASIAN SOCIAL WORK AND POLICY REVIEW 2022; 16:126-135. [PMID: 35664838 PMCID: PMC9111441 DOI: 10.1111/aswp.12253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/17/2022] [Accepted: 03/27/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has had negative impacts on vulnerable populations worldwide. This study aimed to examine the association between the health worries of urban older people in Thailand and covariates related to income and non-income poverty, noncommunicable diseases (NCDs), and metabolic risk factors (MRFs). The study utilized the 2021 Survey on Housing and Support Services for Poor Older Adults, which sampled lower-income urban adults aged at least 55 years from five national regions. Bivariate analyses were performed to determine the relationships of NCDs and MRFs with the covariates. Then, binary logistic regression was used to analyze outcomes of perceived health risks including becoming infected with COVID-19, declining health status, and being unable to access health care. Higher educational attainment and income levels were observed to be negatively correlated with worse health status and the inability to access health care. Subjective household crowding consistently had a positive association with the three health concerns. Having MRFs was related only to concerns about health status and access to health care during the pandemic. Welfare and health policies need to improve their responsiveness to the needs of the older population, especially for protection from socioeconomic shocks such as those seen with the current pandemic.
Collapse
Affiliation(s)
| | | | - Thananon Buathong
- Faculty of Sociology and AnthropologyThammasat UniversityBangkokThailand
| |
Collapse
|
8
|
Yun J, Lee Y, Lee HJ. A comparison of health-related quality of life and personal, social, and environmental factors of older adults according to a residential area: a propensity score matching analysis. Qual Life Res 2022; 31:2631-2643. [PMID: 35366760 DOI: 10.1007/s11136-022-03131-0] [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] [Accepted: 03/20/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study identified individual, social, and environmental factors affecting the health-related quality of life (HRQoL) of older individuals living in urban and non-urban areas of the Republic of Korea and investigated their effects on HRQoL. METHODS A secondary data analysis study was conducted using raw data from Korea's 2017 Community Health Survey. Propensity score matching (PSM) was performed to compare the individual, social, and environmental characteristics of older individuals living in urban and non-urban areas (16,695 and 29,106 individuals, respectively). Statistical analyses were performed using R program 4.0.5. The differences between variables were analyzed using chi-squared and t-tests, whereas factors influencing HRQoL were analyzed using multiple regression analysis. RESULTS Among the individual factors, the living arrangement (p = 0.001, confidence interval [CI] = 0.00-0.02) was an influencing factor in urban areas, whereas it showed no statistical significance in non-urban areas. Moreover, Helping their neighbors (p = 0.001, CI = 0.00-0.01) among the social factors and satisfaction with the living environment (p = 0.011, CI = 0.00-0.02) and with healthcare services (p = 0.047, CI = 0.00-0.01) among the environmental factors were influencing factors in urban areas, whereas they showed no statistical significance in non-urban areas. CONCLUSION Satisfaction with the living environment and with healthcare services was positively associated with HRQoL among older individuals living in urban areas. Therefore, factors associated with regional health inequality should be identified, and health equality sought through the development of local government policies that consider diversity in population composition and health indicators by region.
Collapse
Affiliation(s)
- Jungmi Yun
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| | - Yeongsuk Lee
- College of Nursing, Catholic University of Pusan, Busan, Republic of Korea
| | - Hyun-Ju Lee
- College of Nursing, Catholic University of Pusan, Busan, Republic of Korea.
| |
Collapse
|
9
|
Jeamjitvibool T, Tankumpuan T, Lukkahatai N, Davidson PM. Noncommunicable diseases and social determinants of health in Buddhist monks: An integrative review. Res Nurs Health 2022; 45:249-260. [DOI: 10.1002/nur.22215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 01/01/2022] [Accepted: 01/22/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Thanakrit Jeamjitvibool
- Department of Adult and Geriatric Nursing, Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science Chulabhorn Royal Academy Bangkok Thailand
| | - Thitipong Tankumpuan
- Department of Surgical Nursing, Faculty of Nursing Mahidol University Bangkok Thailand
| | - Nada Lukkahatai
- The Johns Hopkins University School of Nursing Baltimore Maryland USA
| | | |
Collapse
|
10
|
Ssensamba JT, Nakafeero M, Musana H, Amollo M, Ssennyonjo A, Kiwanuka SN. Primary care provider notions on instituting community-based geriatric support in Uganda. BMC Geriatr 2022; 22:258. [PMID: 35351013 PMCID: PMC8962536 DOI: 10.1186/s12877-022-02897-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Understanding of the most economical and sustainable models of providing geriatric care to Africa’s rising ageing population is critical. In Uganda, the number of old adults (60 years and above) continues to rise against absence of policies and guidelines, and models for providing care to this critical population. Our study explored public primary health care provider views on how best community-based geriatric support (CBGS) could be instituted as an adaptable model for delivering geriatric care in Uganda’s resource-limited primary public health care settings. Methods We interviewed 20 key informants from four districts of Bukomansimbi, Kalungu, Rakai, and Lwengo in Southern Central Uganda. Respondents were leads (in-charges) of public primary health units that had spent at least 6 months at the fore said facilities. All interviews were audio-recorded, transcribed verbatim, and analysed based on Hsieh and Shannon’s approach to conventional manifest content analysis. Results During analysis, four themes emerged: 1) Structures to leverage for CBGS, 2) How to promote CBGS, 3) Who should be involved in CBGS, and 4) What activities need to be leveraged to advance CBGS? The majority of the respondents viewed using the existing village health team and local leadership structures as key to the successful institutionalization of CBGS; leveraging community education and sensitization using radio, television, and engaging health workers, family relatives, and neighbors. Health outreach activities were mentioned as one of the avenues that could be leveraged to provide CBGS. Conclusion Provider notions pointed to CBGS as a viable model for instituting geriatric care in Uganda’s public primary healthcare system. However, this requires policymakers to leverage existing village health team and local governance structures, conduct community education and sensitization about CBGS, and bring onboard health workers, family relatives, and neighbors. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02897-9.
Collapse
Affiliation(s)
- Jude Thaddeus Ssensamba
- Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda. .,Health Care Programmes, VIVES University of Applied Sciences, Kortrijk, Belgium. .,School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Mary Nakafeero
- Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda.,School of Public Health, Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Hellen Musana
- Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda.,School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mathew Amollo
- School of Public Health, Department of Epidemiology and Biostatistics, Makerere University College of Health Sciences, Kampala, Uganda
| | - Aloysius Ssennyonjo
- School of Public Health, Department of Health Policy and Planning, Makerere University College of Health Sciences, Kampala, Uganda
| | - Suzanne N Kiwanuka
- School of Public Health, Department of Health Policy and Planning, Makerere University College of Health Sciences, Kampala, Uganda
| |
Collapse
|
11
|
Sritart H, Tuntiwong K, Miyazaki H, Taertulakarn S. Disparities in Healthcare Services and Spatial Assessments of Mobile Health Clinics in the Border Regions of Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10782. [PMID: 34682527 PMCID: PMC8535297 DOI: 10.3390/ijerph182010782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/21/2023]
Abstract
Reducing the disparities in healthcare access is one of the important goals in healthcare services and is significant for national health. However, measuring the complexity of access in truly underserved areas is the critical step in designing and implementing healthcare policy to improve those services and to provide additional support. Even though there are methods and tools for modeling healthcare accessibility, the context of data is challenging to interpret at the local level for targeted program implementation due to its complexity. Therefore, the purpose of this study is to develop a concise and context-specific methodology for assessing disparities for a remote province in Thailand to assist in the development and expansion of the efficient use of additional mobile health clinics. We applied the geographic information system (GIS) methodology with the travel time-based approach to visualize and analyze the concealed information of spatial data in the finer analysis resolution of the study area, which was located in the border region of the country, Ubon Ratchathani, to identify the regional differences in healthcare allocation. Our results highlight the significantly inadequate level of accessibility to healthcare services in the regions. We found that over 253,000 of the population lived more than half an hour away from a hospital. Moreover, the relationships of the vulnerable residents and underserved regions across the province are underlined in the study and substantially discussed in terms of expansion of mobile health delivery to embrace the barrier of travel duration to reach healthcare facilities. Accordingly, this research study addresses regional disparities and provides valuable references for governmental authorities and health planners in healthcare strategy design and intervention to minimize the inequalities in healthcare services.
Collapse
Affiliation(s)
- Hiranya Sritart
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand;
| | - Kuson Tuntiwong
- School of Dentistry, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
| | - Hiroyuki Miyazaki
- Center for Spatial Information Science, Tokyo University, Chiba 277-8568, Japan;
| | - Somchat Taertulakarn
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand;
| |
Collapse
|
12
|
Mou C, Xu M, Lyu J. Predictors of Undiagnosed Diabetes among Middle-Aged and Seniors in China: Application of Andersen's Behavioral Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168396. [PMID: 34444146 PMCID: PMC8392191 DOI: 10.3390/ijerph18168396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 12/17/2022]
Abstract
Undiagnosed diabetes is a threat to public health. This study aims to identify potential variables related to undiagnosed diabetes using Andersen’s behavioral model. Baseline data including blood test data from the China Health and Retirement Longitudinal Study (CHARLS) were adopted. First, we constructed health service related variables based on Andersen model. Second, univariate analysis and multiple logistic regression were used to analyze the relations of variables to undiagnosed diabetes. The strength of relationships was presented by odds ratios (ORs) and 95% confidence intervals (CIs). Finally, the prediction of multiple logistic regression model was assessed using the Receiver Operating Characteristic (ROC) curve and the area under the ROC curve (AUC). According to diagnosis standards, 1234 respondents had diabetes, among which 560 were undiagnosed and 674 were previously diagnosed. Further analysis showed that the following variables were significantly associated with undiagnosed diabetes: age as the predisposing factor; medical insurance, residential places and geographical regions as enabling factors; having other chronic diseases and self-perceived health status as need factors. Moreover, the prediction of regression model was assessed well in the form of ROC and AUC. Andersen model provided a theoretical framework for detecting variables of health service utilization, which may not only explain the undiagnosed reasons but also provide clues for policy-makers to balance health services among diverse social groups in China.
Collapse
Affiliation(s)
- Chaozhou Mou
- Department of Mathematics Statistics, Shandong University, Weihai 264209, China;
| | - Minlan Xu
- Department of Social Work, Shandong University, Weihai 264209, China
- Correspondence:
| | - Juncheng Lyu
- Department of Public Health, Weifang Medical University, Weifang 261000, China;
| |
Collapse
|
13
|
Vicerra PMM. Knowledge-Behavior Gap on COVID-19 among Older People in Rural Thailand. Gerontol Geriatr Med 2021; 7:2333721421997207. [PMID: 33718521 PMCID: PMC7917830 DOI: 10.1177/2333721421997207] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/29/2022] Open
Abstract
This study analyzed the difference between rural and urban older adults in
Thailand regarding the relationship between the knowledge and behavior toward
the prevention of contracting COVID-19. Path analysis was used to observe if the
performance of protective behaviors was affected by the level of knowledge that
older people have about the disease. This study used the Impact of COVID-19 on
Older Persons in Thailand survey collected across the five regions of the
country. Rural residents benefited from community network of village health volunteers who
provided information during the pandemic but, they had disadvantages on
accessing newer media sources, mainly the internet, for the latest developments
on COVID-19. Rural older adults had a higher level of knowledge about COVID-19
than those in urban areas; no difference was observed regarding their behavior
to prevent themselves from being infected. The knowledge-behavior gap was viewed
as a mechanism of cognitive avoidance because of overwhelming unprecedented
information.
Collapse
|
14
|
Impact of Economic Accessibility on Realized Utilization of Home-Based Healthcare Services for the Older Adults in China. Healthcare (Basel) 2021; 9:healthcare9020218. [PMID: 33671377 PMCID: PMC7922163 DOI: 10.3390/healthcare9020218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Home-based healthcare service has gradually become the most important model to cope with aging in China. However, the contradiction between oversupply and insufficient demand of healthcare services is becoming increasingly serious. How to effectively improve the realized utilization of healthcare resources has become a key issue in the development of healthcare services. Based on the social background of “getting old before getting rich”, this article explores the relationship between economic accessibility and realized utilization, and finds that the impact of economic accessibility on realized utilization is inverted U-shaped, not a linear positive effect. In addition, considering the moderating role of family support, it is found that family support can strengthen the inverted U-shaped effect of economic accessibility on realized utilization. Therefore, exerting the role of family and improving economic accessibility can effectively solve the dilemma of low utilization of healthcare services.
Collapse
|
15
|
Suntai Z. Creation of a Living Will in Older Adulthood: Differences by Race and Ethnicity. OMEGA-JOURNAL OF DEATH AND DYING 2021; 86:721-737. [PMID: 33504288 DOI: 10.1177/0030222821991321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine racial differences in the creation of a living will among older adults, guided by the Andersen model of healthcare utilization. Data from the 2018 National Health and Aging Trends Study were used to examine differences between Black and Hispanic older adults compared to Whites. Weighted bivariate analysis and a weighted logistic regression model were used to determine the presence of a living will. After accounting for predisposing, enabling and need factors, Black and Hispanic older adults were significantly less likely to have a living compared to White older adults. Results indicate the need to examine cultural, historical, and systemic factors that could affect engagement in advance care planning among Black and Hispanic older adults.
Collapse
Affiliation(s)
- Zainab Suntai
- School of Social Work, University of Alabama, Tuscaloosa, United States
| |
Collapse
|
16
|
Personality, Health Care Use, and Costs: A Study Protocol for a Systematic Review. Healthcare (Basel) 2020; 8:healthcare8030263. [PMID: 32806553 PMCID: PMC7551013 DOI: 10.3390/healthcare8030263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 11/17/2022] Open
Abstract
Recent empirical studies have shown that personality factors are associated with health care use (HCU). However, to date, a systematic review is lacking summarizing evidence regarding the link between personality factors and health care use or costs (i.e., monetarily valued health care use). Therefore, the objective of this systematic review is to provide an overview of evidence from observational studies investigating the link between personality characteristics and health care use or costs. Electronic databases (PubMed, PsycINFO, NHS EED) will be searched using predefined search terms. In an additional step, the reference lists of included studies will be searched (manually). No restrictions will be applied regarding the time of publication. Observational studies (both cross-sectional and longitudinal) assessing the link between personality characteristics and health care use/costs across all age categories will be included. Only studies using validated tools to quantify personality characteristics will be included. Among others, studies only focusing on mental HCU or studies only analyzing samples with a specific disorder (e.g., individuals with personality disorders) will be excluded. Mainly, data on methods (study design, measures, and statistical analysis), sample characteristics, and results regarding the link between personality and HCU/costs will be extracted. A quality assessment will be conducted. Two reviewers will perform the study selection, data extraction, and assessment of the study quality. If disagreements occur, they will be resolved through discussion to reach a consensus or by inclusion of a third party. Results will be presented narratively (text and tables). Depending on the number and heterogeneity of the studies included, a meta-analysis will be conducted. Results will be disseminated through publication in a peer-reviewed, scientific journal.
Collapse
|
17
|
Teerawichitchainan B. Older persons in Thailand: an update from a recent national survey. ASIAN POPULATION STUDIES 2020. [DOI: 10.1080/17441730.2020.1794311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Bussarawan Teerawichitchainan
- Department of Sociology/Centre for Family and Population Research, National University of Singapore, Singapore, Singapore
| |
Collapse
|
18
|
Chu CL, Chu YH, Lin CY, Hsieh YP, Ho CS, Su YY, Liu CN. Inequality in outpatient resource utilization among older adults during the 2007-2008 financial crisis: findings from Taiwan. BMC Health Serv Res 2019; 19:621. [PMID: 31477104 PMCID: PMC6721238 DOI: 10.1186/s12913-019-4466-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/26/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Equity in medical resource utilization is a crucial concern in countries with national health insurance systems. From the perspective of an active aging framework, public health insurance is one of the pillars of economic security, as suggested by the World Bank, to achieve the goal of social security for older adults. This study thus sought to quantify income-related inequality in national health insurance systems, especially during the global economic crisis of 2007-2008. METHODS By employing the Taiwan National Health Interview Surveys (2005 and 2009) datasets, we analyzed the socioeconomic inequality of outpatient service utilization for older Taiwanese adults during the financial crisis of 2007-2008. We used corrected concentration indices (CCIs) to examine inequalities over time. Furthermore, we decomposed socioeconomic inequalities to reveal the contributions of determinant factors. The dependent variables related to whether participants had used outpatient services in the previous month, and the independent factors included individual's needs, enabling, predisposing, and environmental factors proposed by Andersen model. RESULTS The sample consisted of 2415 observations in 2005 and 2554 observations in 2009. The income-related health care inequality was minor from pro-rich to pro-poor across the study duration, although the difference was insignificant (women: from a concentration index [CI] of 0.0256 in 2005 to a CI of - 0.0098 in 2009; men: from a CI of 0.0379 in 2005 to a CI of 0.0310 in 2009). We used a probit model to analyze the effect of explanatory factors on outpatient resource utilization by men and women. After other factors were controlled for, we found that that the income variable had a positive and significant effect on outpatient service utilization in 2009 and the absolute contribution of income to inequality notably increased from 0.0480 in 2005 to 0.3247 in 2009 for older women. CONCLUSIONS In conclusion, Taiwan's National Health Insurance system guarantees the accessibility of health care services to older adults, but slight income-related inequality was maintained in the outpatient resource utilization of women during the 2007-2008 financial crisis. Close attention should be paid to the vulnerability of women during times of economic insecurity.
Collapse
Affiliation(s)
- Chiao-Lee Chu
- Department of Long Term Care, National Quemoy University, No. 1, University Rd., Jinning township, Kinmen County, 89250 Taiwan, Republic of China
| | - Yu-Hua Chu
- School of Dentistry, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City, 11490 Taiwan, Republic of China
- Department of Dental Technology and Materials Science, Central Taiwan University of Science and Technology, No.666, Buzih Road, Beitun District, Taichung City, 40601 Taiwan, Republic of China
| | - Chih-Yuan Lin
- Department of Senior Citizen Welfare and Long-term Care Business (master program), Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Shalu District, Taichung City, 43302 Taiwan, Republic of China
| | - Yen-Ping Hsieh
- Department of Long Term Care, National Quemoy University, No. 1, University Rd., Jinning township, Kinmen County, 89250 Taiwan, Republic of China
| | - Ching-Sung Ho
- Department of Long Term Care, National Quemoy University, No. 1, University Rd., Jinning township, Kinmen County, 89250 Taiwan, Republic of China
| | - Yung-Yu Su
- Department of Long Term Care, National Quemoy University, No. 1, University Rd., Jinning township, Kinmen County, 89250 Taiwan, Republic of China
| | - Chia-Nien Liu
- Department of Living Science, National Open University, No.172, Zhongzheng Rd., Luzhou Dist.,, New Taipei City, 247 Taiwan, Republic of China
| |
Collapse
|