1
|
Lin TY, Yu HW. Spatial Analysis of Home and Community-Based Services and Number of Deaths Among Older Adults in Taiwan. J Appl Gerontol 2024; 43:261-275. [PMID: 38086745 DOI: 10.1177/07334648231214911] [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: 01/25/2024] Open
Abstract
This study examined the geographical distribution of home- and community-based services (HCBS) resources in Taiwan's Long-Term Care 2.0 policy and explored its association with the number of deaths among older adults. The main outcome of the study was determination of the number of deaths among older adults in townships (N = 346) in 2021. The results showed that home-based HCBS had a significant positive association with mortality among older adults; moreover, community-based and complementary services, which are highly clustered within a township and among its neighbors, exert a significant protective effect on mortality among older adults. Stratified analyses showed a significantly lower mortality among older adults using adult foster care and transportation services, but a significantly higher mortality among older adults using home-based professional care and respite care services, after considering the sociodemographic characteristics of older adults, urbanization, and the number of long-term care resources in the spatial analysis.
Collapse
Affiliation(s)
- Tzu-Yu Lin
- Master Program of Long-Term Care in Aging, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsiao-Wei Yu
- Geriatric and Long-term Care Research Center, Chang Gung University of Science and Technology, Taoyuan , Taiwan
- Department of Gerontological Care and Management, College of Nursing, Chang Gung University of Science and Technology, Taoyuan , Taiwan
- Department of Family Medicine, Keelung Chang Gung Memorial Hospital, Keelung , Taiwan
| |
Collapse
|
2
|
Baranyi G, Williamson L, Feng Z, Carnell E, Vieno M, Dibben C. Higher air pollution exposure in early life is associated with worse health among older adults: A 72-year follow-up study from Scotland. Health Place 2024; 86:103208. [PMID: 38367322 DOI: 10.1016/j.healthplace.2024.103208] [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: 07/19/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/19/2024]
Abstract
Air pollution increases the risk of mortality and morbidity. However, limited evidence exists on the very long-term associations between early life air pollution exposure and health, as well as on potential pathways. This study explored the relationship between fine particle (PM2.5) exposure at age 3 and limiting long-term illness (LLTI) at ages 55, 65 and 75 using data from the Scottish Longitudinal Study Birth Cohort 1936, a representative administrative cohort study. We found that early life PM2.5 exposure was associated with higher odds of LLTI in mid-to-late adulthood (OR = 1.10, 95% CI: 1.06, 1.14 per 10 μg m-3 increment) among the 2085 participants, with stronger associations among those growing up in disadvantaged families. Path analyses suggested that 15-21% of the association between early life PM2.5 concentrations and LLTI at age 65 (n = 1406) was mediated through childhood cognitive ability, educational qualifications, and adult social position. Future research should capitalise on linked administrative and health data, and explore causal mechanisms between environment and specific health conditions across the life course.
Collapse
Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom.
| | - Lee Williamson
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom; Longitudinal Studies Centre - Scotland, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Zhiqiang Feng
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Edward Carnell
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, United Kingdom
| | - Massimo Vieno
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, United Kingdom
| | - Chris Dibben
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
3
|
Laroze D, Neumayer E, Plümper T. COVID-19 does not stop at open borders: Spatial contagion among local authority districts during England's first wave. Soc Sci Med 2020; 270:113655. [PMID: 33388620 PMCID: PMC7759448 DOI: 10.1016/j.socscimed.2020.113655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/31/2020] [Accepted: 12/22/2020] [Indexed: 01/16/2023]
Abstract
Infectious diseases generate spatial dependence or contagion not only between individuals but also between geographical units. New infections in one local district do not just depend on properties of the district, but also on the strength of social ties of its population with populations in other districts and their own degree of infectiousness. We show that SARS-CoV-2 infections during the first wave of the pandemic spread across district borders in England as a function of pre-crisis commute to work streams between districts. Crucially, the strength of this spatial contagion depends on the phase of the epidemic. In the first pre-lockdown phase, the spread of the virus across district borders is high. During the lockdown period, the cross-border spread of new infections slows down significantly. Spatial contagion increases again after the lockdown is eased but not statistically significantly so.
Collapse
Affiliation(s)
- Denise Laroze
- Centre for Experimental Social Sciences and Department of Management, Universidad de Santiago de Chile, Santiago, Chile.
| | - Eric Neumayer
- Department of Geography & Environment, London School of Economics and Political Science (LSE), London, UK.
| | - Thomas Plümper
- Department of Socioeconomics, Vienna University of Economics and Business, Vienna, Austria.
| |
Collapse
|
4
|
Smith L, Downing A, Norman P, Wright P, Hounsome L, Watson E, Wagland R, Selby P, Kind P, Donnelly DW, Butcher H, Huws D, McNair E, Gavin A, Glaser AW. Influence of deprivation and rurality on patient-reported outcomes of men living with and beyond prostate cancer diagnosis in the UK: A population-based study. Cancer Epidemiol 2020; 69:101830. [PMID: 33002843 DOI: 10.1016/j.canep.2020.101830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/14/2020] [Accepted: 09/19/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND In the UK, inequalities exist in prostate cancer incidence, survival and treatment by area deprivation and rurality. This work aimed to identify variation in patient-reported outcomes of men with prostate cancer by area type. METHODS A population-based survey of men 18-42 months after prostate cancer diagnosis (N = 35608) measured self-assessed health (SAH) using the EQ-5D and five functional domains using the Expanded Prostate Cancer Index Composite (EPIC-26). RESULTS Mean SAH was higher for men in least deprived areas compared to most deprived (difference 6.3 (95 %CI 5.6-7.2)). SAH scores were lower for men in most urban areas compared to most rural (difference 2.4 (95 %CI 1.8-3.0)). Equivalent estimates in the general population reported a 13 point difference by deprivation and a 4 point difference by rurality. For each EPIC-26 domain, functional outcomes were better for men in the least deprived areas, with clinically meaningful differences observed for urinary incontinence and hormonal function. There were no clinically meaningful differences in EPIC-26 outcomes by rurality with less than a three point difference in scores for each domain between urban and rural areas. CONCLUSION In men 18-42 months post diagnosis of prostate cancer in the UK, impacts of area deprivation and rurality on self-assessed health related quality of life were not greater than would be expected in the general population. However, clinically meaningful differences were identified for some prostate functional outcomes (urinary and hormonal function) by deprivation. No impact by rurality of residence was identified.
Collapse
Affiliation(s)
- Lesley Smith
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK; Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.
| | - Amy Downing
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Paul Norman
- School of Geography, University of Leeds, Leeds, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Luke Hounsome
- National Cancer Registration and Analysis Service, Public Health England, Bristol, UK
| | - Eila Watson
- Department of Midwifery, Community and Public Health, School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Peter Selby
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Paul Kind
- Academic Unit of Health Economics, University of Leeds, Leeds, UK
| | - David W Donnelly
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Hugh Butcher
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Dyfed Huws
- Welsh Cancer Intelligence and Surveillance Unit, Public Health Wales, Cardiff, UK
| | - Emma McNair
- Information Services Division, NHS National Services Scotland, Edinburgh, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Adam W Glaser
- Leeds Institute of Data Analytics, University of Leeds, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| |
Collapse
|
5
|
Seaman R, Riffe T, Leyland AH, Popham F, van Raalte A. The increasing lifespan variation gradient by area-level deprivation: A decomposition analysis of Scotland 1981-2011. Soc Sci Med 2019; 230:147-157. [PMID: 31009881 PMCID: PMC6711767 DOI: 10.1016/j.socscimed.2019.04.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/23/2019] [Accepted: 04/07/2019] [Indexed: 12/31/2022]
Abstract
Life expectancy inequalities are an established indicator of health inequalities. More recent attention has been given to lifespan variation, which measures the amount of heterogeneity in age at death across all individuals in a population. International studies have documented diverging socioeconomic trends in lifespan variation using individual level measures of income, education and occupation. Despite using different socioeconomic indicators and different indices of lifespan variation, studies reached the same conclusion: the most deprived experience the lowest life expectancy and highest lifespan variation, a double burden of mortality inequality. A finding of even greater concern is that relative differences in lifespan variation between socioeconomic group were growing at a faster rate than life expectancy differences. The magnitude of lifespan variation inequalities by area-level deprivation has received limited attention. Area-level measures of deprivation are actively used by governments for allocating resources to tackle health inequalities. Establishing if the same lifespan variation inequalities emerge for area-level deprivation will help to better inform governments about which dimension of mortality inequality should be targeted. We measure lifespan variation trends (1981-2011) stratified by an area-level measure of socioeconomic deprivation that is applicable to the entire population of Scotland, the country with the highest level of variation and one of the longest, sustained stagnating trends in Western Europe. We measure the gradient in variation using the slope and relative indices of inequality. The deprivation, age and cause specific components driving the increasing gradient are identified by decomposing the change in the slope index between 1981 and 2011. Our results support the finding that the most advantaged are dying within an ever narrower age range while the most deprived are facing greater and increasing uncertainty. The least deprived group show an increasing advantage, over the national average, in terms of deaths from circulatory disease and external causes.
Collapse
Affiliation(s)
- Rosie Seaman
- Max Planck Institute for Demographic Research, Rostock, Germany; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK.
| | - Tim Riffe
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Alastair H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - Frank Popham
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | | |
Collapse
|
6
|
Liu L. China's dusty lung crisis: Rural-urban health inequity as social and spatial injustice. Soc Sci Med 2019; 233:218-228. [PMID: 31229908 DOI: 10.1016/j.socscimed.2019.05.033] [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] [Received: 09/07/2018] [Revised: 04/20/2019] [Accepted: 05/20/2019] [Indexed: 01/05/2023]
Abstract
This paper examines rural-urban inequities in dusty lung (pneumoconiosis) deaths in China from 2002 to 2016 and possible causes for such inequities in the framework of social and spatial justice. The research reveals alarming results that have not been reported before. Dusty lung death rates for rural men increased twice as fast as those among urban men. The rural rates were particularly higher among middle-aged men, but lower in older age groups, as compared to urban rates. There were dramatic increases in death rates from 2011 to 2016 particularly among rural men aged 40-49 years old, who were many times more likely to die from dusty lung than urban men of a similar age. Chinese rural male victims also die at a younger age, compared to men in any of the seven countries or regions included in the study. For example, rural Chinese men aged 35-59 years old were many times more likely to die from dusty lung than their American, German, Polish, and Spanish counterparts. A possible explanation for the high death rates among middle-aged rural Chinese men is the tendency for rural migrant workers to be employed in unhealthy and unsafe working conditions in decent decades. Other explanations for the severe spatial injustice include the Hukou (household registration) system and the development policies that prioritize economic growth and urban development over occupational health and safety. The paper demonstrates the usefulness and weakness of the social and spatial justice concepts in understanding health inequity. Therefore, it proposes new definitions and models of social justice and spatial justice that combine the competing distribution and capabilities approaches and highlight interactions among multiple attributes.
Collapse
Affiliation(s)
- Lee Liu
- School of Geoscience, Physics, and Safety, College of Health, Science, and Technology, University of Central Missouri, Humphreys 225, Warrensburg, MO, 64093, USA.
| |
Collapse
|