1
|
Chen BK, Yang YT, Yang CY. Trends in amenable deaths based on township income quartiles in Taiwan, 1971-2008: did universal health insurance close the gap? J Public Health (Oxf) 2016; 38:e524-e536. [PMID: 28158683 DOI: 10.1093/pubmed/fdv156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Brian K Chen
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street Suite 354, Columbia, SC 29208, USA
| | - Y Tony Yang
- College of Health and Human Services, George Mason University, 4400 University Dr, Fairfax, VA 22030-4444, USA
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan
| |
Collapse
|
2
|
Regidor E, Kunst AE, Rodríguez-Artalejo F, Mackenbach JP. Small socio-economic differences in mortality in Spanish older people. Eur J Public Health 2011; 22:80-5. [DOI: 10.1093/eurpub/ckr051] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
3
|
Socioeconomic variation in the magnitude of the association between self-rated health and mortality. Ann Epidemiol 2010; 20:395-400. [PMID: 20382341 DOI: 10.1016/j.annepidem.2010.01.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 12/21/2009] [Accepted: 01/30/2010] [Indexed: 11/24/2022]
Abstract
PURPOSE To assess socioeconomic variation in the association between self-rated health (SRH) and mortality and to determine whether socioeconomic inequalities in SRH and socioeconomic inequalities in mortality differ in magnitude. METHODS We used data from a cohort of Spanish people 60 years of age and older with an 8-year follow-up of mortality. The association between SRH at baseline and mortality was estimated by the age-adjusted relative risk of mortality in people with low, medium, and high education. The measures of health inequalities were the prevalence ratio of poor SRH and the age-adjusted relative risk of mortality according to educational level. The validity of SRH to reflect life-threatening and non-life-threatening health conditions was summarized with the likelihood ratio for poor SRH in each educational category. RESULTS The relative risk of mortality according to SRH in subjects with high and low education was 3.24 and 1.62 in men and 2.25 and 1.50 in women, respectively. Inequalities in poor self-rated health were larger than inequalities in mortality: -1.63 versus 1.07 in men and 1.45 versus 1.30 in women. The highest likelihood ratio for SRH was seen in persons with high education in the case of life-threatening conditions, and for those with low education, in the case of non-life-threatening conditions. CONCLUSIONS Socioeconomic variation in the validity of SRH to reflect life-threatening and non-life-threatening conditions could explain the greater ability of SRH to predict mortality in persons with high education and why inequalities in poor SRH are larger than inequalities in mortality.
Collapse
|
4
|
Puigpinós R, Borrell C, Antunes JLF, Azlor E, Pasarín MI, Serral G, Pons-Vigués M, Rodríguez-Sanz M, Fernández E. Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992-2003. BMC Public Health 2009; 9:35. [PMID: 19166582 PMCID: PMC2640474 DOI: 10.1186/1471-2458-9-35] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Accepted: 01/23/2009] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The objective of this study was to assess trends in cancer mortality by educational level in Barcelona from 1992 to 2003. METHODS The study population comprised Barcelona inhabitants aged 20 years or older. Data on cancer deaths were supplied by the system of information on mortality. Educational level was obtained from the municipal census. Age-standardized rates by educational level were calculated. We also fitted Poisson regression models to estimate the relative index of inequality (RII) and the Slope Index of Inequalities (SII). All were calculated for each sex and period (1992-1994, 1995-1997, 1998-2000, and 2001-2003). RESULTS Cancer mortality was higher in men and women with lower educational level throughout the study period. Less-schooled men had higher mortality by stomach, mouth and pharynx, oesophagus, larynx and lung cancer. In women, there were educational inequalities for cervix uteri, liver and colon cancer. Inequalities of overall and specific types of cancer mortality remained stable in Barcelona; although a slight reduction was observed for some cancers. CONCLUSION This study has identified those cancer types presenting the greatest inequalities between men and women in recent years and shown that in Barcelona there is a stable trend in inequalities in the burden of cancer.
Collapse
Affiliation(s)
- Rosa Puigpinós
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
- Departament de Salut Pública, Facultat de Medicina. Universitat de Barcelona, Barcelona, Spain
| | - Carme Borrell
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra., Barcelona, Spain
| | | | - Enric Azlor
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - M Isabel Pasarín
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra., Barcelona, Spain
| | - Gemma Serral
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Mariona Pons-Vigués
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Maica Rodríguez-Sanz
- Servei de Sistemes d'Informació Sanitaria, Agència de Salut Pública de Barcelona, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control and Research Unit, Institut6 Català d'Oncologia (ICO-IDIBELL), l'Hospitalet de lobregat (Barcelona), Spain
- Department of Clinical Sciences, Campus of Bellvitge, Universitat de Barcelona, l'Hospitalet de Llobregat (Barcelona), Spain
| |
Collapse
|
5
|
Menvielle G, Luce D, Geoffroy-Perez B, Chastang JF, Leclerc A. Social inequalities and cancer mortality in France, 1975-1990. Cancer Causes Control 2005; 16:501-13. [PMID: 15986105 DOI: 10.1007/s10552-004-7114-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2004] [Accepted: 12/02/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to investigate social inequalities in cancer mortality from 1975 through 1990 among men and women in France. METHODS A sample, that included census data for approximately 1% of the French population, has been followed for mortality from 1975 to 1990. Causes of death were obtained through a record-linkage with the French national cause-of-death file. The analysis was restricted to those aged 35:59 in 1975 and included 61,876 men and 65,291 women. Occupational class, coded according to the social class scheme of Erikson, Goldthorpe and Portecarero in 7 categories, and educational level (in 4 categories) in 1975 have been studied. The analysis has been conducted for 15 cancer sites among men and 13 among women. Analysis used a Cox proportional hazards model. RESULTS For educational level, inequalities among men were more pronounced for cancers of the pharynx Relative Risk (RR) lowest versus highest educational level=9.2, 95% Confidence Interval (CI) 2.9-29.1, larynx (RR=6.2, CI=3.0:12.6), oral cavity (RR=2.7, CI=1.3-5.3), lung (RR=3.5, CI=2.5-4.8), esophagus (RR=3.1, CI=1.9-5.2), stomach (RR=2.5, CI=1.2-5.3) and rectum (RR=3.4, CI=1.2-9.6). No association between educational level and cancer mortality was observed for cancers of either the colon or lymphatic and hematopoietic tissue. Social inequalities were less pronounced among women but nevertheless observed for cancer of the uterus (RR=1.9, CI=1.0-3.6), stomach (RR=4.1, CI=1.0-17.1) and lung (RR=1.6, CI=0.7-3.7). No associations were found for mortality from breast or ovarian cancers. Results were similar when socioeconomic status was measured by occupational class. CONCLUSION The analysis showed substantial inequalities in cancer mortality in France, with large differences according to cancer site.
Collapse
Affiliation(s)
- Gwenn Menvielle
- INSERM U88-IFR69, HNSM, 14 rue du Val d'Osne, 94415, Saint-Maurice Cedex, France.
| | | | | | | | | |
Collapse
|
6
|
Hommerson P, Nedeljkovic SI, Klungel OH, de Boer A, Ostojic MC, Grujic MZ, Vojvodic NM, Bloemberg BPM, Kromhout D. Cardiovascular drug use and differences in the incidence of cardiovascular mortality in elderly Serbian men. PHARMACY WORLD & SCIENCE : PWS 2005; 27:124-8. [PMID: 15999924 DOI: 10.1007/s11096-004-1559-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess whether the difference in risk of cardiovascular mortality between urban and rural areas of Serbia could be explained by differences in the use of cardiovascular medication. METHODS The Serbian cohorts of the Seven Countries Study, Velika Krsna (VK), Zrenjanin (ZR) and Belgrade (BG), were enrolled in 1962-1964 and were followed up for 25 years. The survivors of these cohorts were re-examined in 1987, 1988 and 1989, respectively. This second examination of elderly men aged 65 to 84 years included a questionnaire about current use of cardiovascular medication, risk factors and diseases and a physical examination. All subjects were followed until death or the predefined censor date (10 years after baseline). The Cox proportional hazards model was used to calculate the risk of cardiovascular mortality in the rural cohorts compared to the urban cohort and to adjust for confounding. MAIN OUTCOME MEASURE Cardiovascular death. RESULTS A total of 227 men from VK, 184 men from ZR and 287 men from BG were followed for a mean duration of 7.4 years and was complete for all subjects. After exclusion of 13 subjects with missing medication data, the incidences of cardiovascular mortality in VK, ZR, and BG were 60, 74, and 26 per 1,000 person-years, respectively. The prevalence of cardiovascular medication use was 38% in VK, 52% in ZR, and 59% in BG. The greatest difference in use of specific medication was observed for betablockers (0% in VK and ZR, 13% in BG). After adjustment for cardiovascular risk factors, diseases and age, the relative risks (RRs) of cardiovascular mortality were 2.12 [95% CI: 1.44-3.12], and 2.27 [95% CI: 1.56-3.30] in VK, and ZR compared to BG. Additional adjustment for the use of cardiovascular medication increased these RRs to 2.40 [95% CI: 1.61-3.60] and 2.55 [95% CI: 1.72-3.78], respectively. CONCLUSION The variation in cardiovascular medication use could not explain the excess risk of mortality in the rural Serbian cohorts compared to urban Belgrade.
Collapse
Affiliation(s)
- Paul Hommerson
- Department of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, P.O. Box 80082, 3508 TB Utrecht, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Villeneuve PJ, Burnett RT, Shi Y, Krewski D, Goldberg MS, Hertzman C, Chen Y, Brook J. A time-series study of air pollution, socioeconomic status, and mortality in Vancouver, Canada. JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY 2003; 13:427-35. [PMID: 14603343 DOI: 10.1038/sj.jea.7500292] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
We evaluated the relationship between daily levels of particulate and gaseous phase pollutants and mortality within a dynamic cohort of approximately 550,000 individuals whose vital status was ascertained between 1986 and 1999. Time-series methods were applied to evaluate whether there were differential pollutant effects on daily aggregated numbers of deaths in the cohort that was stratified into quintiles of income as defined by the 1991 and 1996 Canadian censuses. The percent change in all-cause, cardiovascular, respiratory, and cancer daily mortality was calculated in relation to short-term changes in levels of a number of particulate (PM(2.5), PM(10-2.5), total suspended particle co-efficient of haze PM(10), SO(4)) and gaseous (O(3), CO, SO(2), NO(2)) pollutants. The estimated effects of air pollution on mortality were adjusted for day of week effects, and several meteorologic variables including temperature, change in barometric pressure, and relative humidity. Several gaseous pollutants were associated with an increased risk of mortality. Specifically for an increase equivalent to the difference between the 90th and 10th percentiles, the estimated percent change in daily mortality based on the 3-day average of NO(2), and SO(2) was 4.0% and 1.3%, respectively. The corresponding changes in mortality associated with SO(2) were much higher when analyses were restricted to death from respiratory disease. Specifically, a difference between the 90th and 10th percentiles was associated with a 5.6% (95% CI= -0.7% to 12.3%). The daily mean coarse fraction (PM(10-2.5)) was associated with increased cardiovascular mortality (estimated change=5.9%, 95% CI=1.1-10.8%). PM(2.5) was not found to be an important predictor of mortality. For NO(2), CO, and SO(2), there was some suggestion of increased risk of all-cause and cardiovascular mortality at lower levels of socioeconomic status. However, these results should be interpreted cautiously due to the small number of deaths observed within each stratum of socioeconomic status.
Collapse
Affiliation(s)
- Paul J Villeneuve
- Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada M5S 1A8.
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Puigpinós R, Pasarín MI, Borrell C. [Obtaining educational level through a survey of relatives of the deceased. Are responses reliable?]. GACETA SANITARIA 2001; 15:370-1. [PMID: 11578573 DOI: 10.1016/s0213-9111(01)71587-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- R Puigpinós
- Institut Municipal de Salut Pública. Barcelona
| | | | | |
Collapse
|