1
|
Wang Y, Leng S, Jin Y, Tang X, Zhu X, An L. Successful ageing is associated with falls among older adults in India: a large population based across-sectional study based on LASI. BMC Public Health 2024; 24:1682. [PMID: 38914970 PMCID: PMC11197243 DOI: 10.1186/s12889-024-19181-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to assess physical, psychological and social status of older adults. This study is conducted to explore the association between them in a large Indian community-dwelling population. METHODS Data were based on the wave 1 survey of the Longitudinal Ageing Study in India (LASI). People aged 60 and above with complete information were included. The elderly met five standards including absence of chronic diseases, freedom from disability, high cognitive ability, free from depressive symptoms and active social engagement, were classified into successful agers. The assessment of falls, fall-related injuries and multiple falls depended on interview. Multivariate logistic regression was conducted to find the associations between falls, fall-injury, multiple falls and successful ageing after adjusting both socio-demographic and biological covariates. The log-likelihood ratio test was calculated interactions in subgroups. RESULTS 31,345 participants in LASI were finally included in our study. Of them, 20.25% reported fall, and 25% were classified into successful agers. After full adjustment, successful ageing was negatively associated with falls (OR 0.70; 95%CI 0.65-0.76) and multiple falls (OR 0.70; 95%CI 0.63-0.78). And the association did not show the significance in older adults with fall-related injuries (OR 0.86; 95%CI 0.72-1.04). CONCLUSIONS Successful ageing was negatively associated with falls and multiple falls, but not fall-related injuries in older people in India. Future studies are demanded to explore the causal relationship and to reveal the underlying mechanism.
Collapse
Affiliation(s)
- Yujing Wang
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siqi Leng
- Sleep Medicine Center, Mental Health Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Yuming Jin
- Department of Urology, Institute of Urology and National clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Xian Zhu
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lina An
- Department of Geriatrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
2
|
Xiao Y. Mental health inequality between urban and rural youth under COVID-19 from survey data from China. Front Public Health 2024; 12:1389765. [PMID: 38827617 PMCID: PMC11140009 DOI: 10.3389/fpubh.2024.1389765] [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: 02/22/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Background While health inequality has been the focus of past scholarly discussions, COVID-19's outbreak and spread have provided a new arena for discussing health inequality, particularly in the context of urban-rural disparities in China. This paper explores the impact of COVID-19 on urban-rural health inequality, and the roles played by socioeconomic status and social capital. Methods A cross-sectional observational collected data on demographics, mental health, socioeconomic status, and social capital. An online survey was administered from August 27 to August 30, 2020, and, 1936 valid samples were received. Mental health was measured using the Brief Symptom Inventory (BSI-18). This study applied the ordinary least squares regression (OLS) model, and data analysis was performed using STATA. Results There were 1936 participants, with an equal distribution of genders. Multiple regression analysis showed that the mental health levels of rural youth were superior to those of urban youth (p = 0.049), especially when the epidemic was not severe (p = 0.013). Socioeconomic status had a significant positive promotion effect on mental health (p = 0.008), but the interaction effect between socioeconomic status and the urban-rural divide indicated that the promotion effect of socioeconomic status on the mental health of urban youth was greater than that of rural youth (p = 0.04). Social capital had a significant positive promotion effect on mental health (p = 0.000), and the interaction effect indicated that this promoting effect did not differ between urban and rural areas (p > 0.05).
Collapse
Affiliation(s)
- Yang Xiao
- School of Philosophy, Shaanxi Normal University, Xi’an, China
| |
Collapse
|
3
|
Martinez-Perez N, Torheim LE, Arroyo-Izaga M. Availability and properties of commercially produced food products offered in European public universities: A North-South comparison. J Food Sci 2024; 89:2494-2511. [PMID: 38488725 DOI: 10.1111/1750-3841.17022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 04/12/2024]
Abstract
To date, there are no studies that have compared university food environments (FEs) with different sociocultural contexts. Therefore, we analyzed differences in the availability and properties of commercially produced foods, in a northern and a southern European university (located in Norway and Spain, respectively). A cross-sectional observational study was conducted at OsloMet-Oslo Metropolitan University and at the University of the Basque Country UPV/EHU. The nutritional quality of food products was estimated through the following nutrient profiling models (NPMs): those proposed by the Spanish Agency for Consumer Affairs, Food Safety and Nutrition (AECOSAN), the UK nutrient profiling model (UK NPM), the Norwegian Food and Drink Industry Professional Practices Committee (Matbransjens Fagligle Utvalg [MFU]), and a combination of them. In addition, food items were classified using the NOVA system. A total of 251 and 1051 products were identified at OsloMet and the UPV/EHU, respectively. The percentage categorized as low nutritional quality (LNQ) was higher at the UPV/EHU (almost 54.5% of the total products) compared with at OsloMet (almost 40%) (p < 0.001). Most of the products were categorized as ultra-processed, and there were no differences in the percentage of ultra-processed foods between the two universities (OsloMet 86.1%, UPV/EHU 83.3%, p > 0.05). A higher proportion of LNQ products was found at the UPV/EHU than at OsloMet, probably due to the government policies and actions for creating healthy FEs. Consequently, there is a need to develop interventions to improve the FE at the UPV/EHU, adapted to its sociocultural context. PRACTICAL APPLICATION: This study reveals north-south differences in terms of the availability of low nutritional quality food products. In particular, a higher proportion of this type of product was found at the University of the Basque Country UPV/EHU than at OsloMet-Oslo Metropolitan University. Our exploratory hypothesis is that this phenomenon is a consequence of the Nordic government policies that have great potential to create healthy FEs.
Collapse
Affiliation(s)
- Naiara Martinez-Perez
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain
- BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | - Marta Arroyo-Izaga
- BIOMICs Research Group, Microfluidics & BIOMICs Cluster, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Department of Pharmacy and Food Sciences, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
- Bioaraba, BA04.03, Vitoria-Gasteiz, Spain
| |
Collapse
|
4
|
Ling-Hu T, Rios-Guzman E, Lorenzo-Redondo R, Ozer EA, Hultquist JF. Challenges and Opportunities for Global Genomic Surveillance Strategies in the COVID-19 Era. Viruses 2022; 14:2532. [PMID: 36423141 PMCID: PMC9698389 DOI: 10.3390/v14112532] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Global SARS-CoV-2 genomic surveillance efforts have provided critical data on the ongoing evolution of the virus to inform best practices in clinical care and public health throughout the pandemic. Impactful genomic surveillance strategies generally follow a multi-disciplinary pipeline involving clinical sample collection, viral genotyping, metadata linkage, data reporting, and public health responses. Unfortunately, current limitations in each of these steps have compromised the overall effectiveness of these strategies. Biases from convenience-based sampling methods can obfuscate the true distribution of circulating variants. The lack of standardization in genotyping strategies and bioinformatic expertise can create bottlenecks in data processing and complicate interpretation. Limitations and inconsistencies in clinical and demographic data collection and sharing can slow the compilation and limit the utility of comprehensive datasets. This likewise can complicate data reporting, restricting the availability of timely data. Finally, gaps and delays in the implementation of genomic surveillance data in the public health sphere can prevent officials from formulating effective mitigation strategies to prevent outbreaks. In this review, we outline current SARS-CoV-2 global genomic surveillance methods and assess roadblocks at each step of the pipeline to identify potential solutions. Evaluating the current obstacles that impede effective surveillance can improve both global coordination efforts and pandemic preparedness for future outbreaks.
Collapse
Affiliation(s)
- Ted Ling-Hu
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Estefany Rios-Guzman
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Ramon Lorenzo-Redondo
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Egon A. Ozer
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| | - Judd F. Hultquist
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Center for Pathogen Genomics and Microbial Evolution, Robert J. Havey, MD Institute for Global Health, Northwestern University, Chicago, IL 60611, USA
| |
Collapse
|
5
|
Zhang Z, Zhao Y, Bian Y. A Role of Socioeconomic Status in Cognitive Impairment Among Older Adults in Macau: A Decomposition Approach. Front Aging Neurosci 2022; 14:804307. [PMID: 35211006 PMCID: PMC8862725 DOI: 10.3389/fnagi.2022.804307] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/13/2022] [Indexed: 12/25/2022] Open
Abstract
Background To explore the prevalence and inequality of cognitive impairment among older adults in Macau and the contributions of influencing factors to inequality in cognitive impairment. Methods The Montreal Cognitive Assessment (MoCA) was used to measure the prevalence of cognitive impairment. Socioeconomic status scores were used to describe economic level of the subjects. The concentration index was applied to measure the inequality of cognitive impairment associated with socioeconomic status (SES) and decomposed into its influencing factors. Results The prevalence of cognitive impairment was 44.35% in Macau. The concentration index of cognitive impairment among the elderly was −0.165 (95% CI: −0.232 to −0.098), indicating that the prevalence of cognitive impairment was concentrated in households with poor SES. Older age, poor SES, long or short sleep duration, other marital status, poor appetite, no tea/coffee drinking, no religious belief, and depression contributed positively to the inequality of cognitive impairment. Among these factors, SES made the largest contribution to inequality, accounting for 76.74%. Conclusion In Macau, the prevalence of cognitive impairment among people aged 65 years and older is concentrated among those who are in poor economic conditions. Reducing the gap between the rich and the poor at the source, increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.
Collapse
Affiliation(s)
- Zhuo Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- School of Health Services Management, Xi’an Medical University, Xi’an, China
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- Yonghua Zhao,
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China
- *Correspondence: Ying Bian,
| |
Collapse
|
6
|
Liu Y, Diao L, Wang W, Xu L, Su Y, Yin Y. Negative childhood experiences and health inequalities among adults over 45: Evidence from China. INFANT AND CHILD DEVELOPMENT 2021. [DOI: 10.1002/icd.2224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Yiwei Liu
- School of Government Central University of Finance and Economics Beijing China
| | - Li Diao
- Center for Social Security Studies Wuhan University Wuhan China
| | - Wenjing Wang
- School of Statistics and Mathematics Central University of Finance and Economics Beijing China
| | - Ling Xu
- School of Social Work University of Texas at Arlington Arlington Texas USA
| | - Yuting Su
- School of Government Central University of Finance and Economics Beijing China
| | - Yuru Yin
- College of Literature and Law Henan Agricultural University Zhengzhou China
| |
Collapse
|
7
|
Okui T. Socioeconomic Disparities in All-Cause and Cause-Specific Mortality Rates among Municipalities in Japan, 1999-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9213. [PMID: 33317152 PMCID: PMC7763490 DOI: 10.3390/ijerph17249213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022]
Abstract
Differences in all-cause and cause-specific mortality rates depending on municipal socioeconomic status (SES) in Japan have not been revealed over the last 20 years. This study exposes the difference in 1999 and 2019 using the Vital Statistics. All of the municipalities were grouped into five quintiles based on their SES, and standardized mortality ratio (SMR) of each municipal quintile compared with all of Japan was calculated for all-cause mortality and representative cause of deaths. As a result, although SMR for all-cause mortality for women tended to be lower in low SES quintiles in 1999, the reverse phenomenon was observed in 2019. Additionally, although SMR for all-cause of mortality for men was the lowest in the highest SES quintiles already in 1999, the difference in the SMR for all-cause mortality rates between the lowest and highest SES quintiles increased in 2019. The improvement of the SMR in the highest SES quintile and the deterioration in the lowest was also observed in representative types of cancer, heart disease, stroke, pneumonia, liver disease, and renal failure for men and women. Therefore, this study indicates a disparity in mortality depending on municipal SES enlarged in the last 20 years.
Collapse
Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka City 812-8582, Japan
| |
Collapse
|
8
|
Lin ST, Meng DF, Yang Q, Wang W, Peng LX, Zheng LS, Qiang YY, Mei Y, Xu L, Li CZ, Peng XS, Hu H, Lang YH, Liu ZJ, Wang MD, Li HF, Huang BJ, Qian CN, Sun R. Geographical disparities in the prognosis of patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: a large institution-based cohort study from an endemic area. BMJ Open 2020; 10:e037150. [PMID: 33172940 PMCID: PMC7656946 DOI: 10.1136/bmjopen-2020-037150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/28/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Geographical disparities have been identified as a specific barrier to cancer screening and a cause of worse outcomes for patients with cancer. In the present study, our aim was to assess the influence of geographical disparities on the survival outcomes of patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). DESIGN Cohort study. SETTING Guangzhou, China. PARTICIPANTS A total of 1002 adult patients with NPC (724 males and 278 females) who were classified by area of residence (rural or urban) received IMRT from 1 January 2010 to 31 December 2014, at Sun Yat-sen University Cancer Center. Following propensity score matching (PSM), 812 patients remained in the analysis. MAIN OUTCOME MEASURES We used PSM to reduce the bias of variables associated with treatment effects and outcome prediction. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Multivariate Cox regression was used to identify independent prognostic factors. RESULTS In the matched cohort, 812 patients remained in the analysis. Kaplan-Meier survival analysis revealed that the rural group was significantly associated with worse overall survival (OS, p<0.001), disease-free survival (DFS, p<0.001), locoregional relapse-free survival (LRRFS, p=0.003) and distant metastasis-free survival (DMFS, p<0.001). Multivariate Cox regression showed worse OS (HR=3.126; 95% CI 1.902 to 5.138; p<0.001), DFS (HR=2.579; 95% CI 1.815 to 3.665; p<0.001), LRRFS (HR=2.742; 95% CI 1.359 to 5.533; p=0.005) and DMFS (HR=2.461; 95% CI 1.574 to 3.850; p<0.001) for patients residing in rural areas. CONCLUSIONS The survival outcomes of patients with NPC who received the same standardised treatment were significantly better in urban regions than in rural regions. By analysing the geographic disparities in outcomes for NPC, we can guide the formulation of healthcare policies.
Collapse
Affiliation(s)
- Si-Ting Lin
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Dong-Fang Meng
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Qi Yang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Wei Wang
- Department of Oncology, The First People's Hospital of Kashi, Kashi, China
| | - Li-Xia Peng
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Li-Sheng Zheng
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Yuan-Yuan Qiang
- Ningxia Key Laboratory for Cerebrocranical Disease, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Yan Mei
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Liang Xu
- Institute of Gastroenterology, Sun Yat-sen University Sixth Affiliated Hospital, Guangzhou, Guangdong, China
| | - Chang-Zhi Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Xing-Si Peng
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Hao Hu
- Department of Traditional Chinese Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Yan-Hong Lang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Zhi-Jie Liu
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Ming-Dian Wang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Hai-Feng Li
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Bi-Jun Huang
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Chao-Nan Qian
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
| | - Rui Sun
- State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine; Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guang Zhou, China
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, China
| |
Collapse
|
9
|
Inequalities in health by regime of affiliation to the health system in events of obligatory notification, Colombia, 2015. ACTA ACUST UNITED AC 2019; 39:737-747. [PMID: 31860184 PMCID: PMC7363355 DOI: 10.7705/biomedica.4453] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Indexed: 11/21/2022]
Abstract
Introduction: Inequalities in the health field are caused by the differences in the social and economic conditions, that influence the disease risk and the measures taken to treat the disease.
Objective: We aimed to estimate the social inequalities in health in Colombia, according to the type of affiliation to the health system as a proxy of socioeconomic status.
Materials and methods: We conducted a retrospective descriptive analysis calculating incidence rates age and sex adjusted for all mandatory reporting events using the affiliation regime (subsidized and contributory) as a socioeconomic proxy. Estimates were made at departmental level for 2015. Social inequalities were calculated in terms of absolute and relative gaps.
Results: We found social inequalities in the occurrence of mandatory reporting events in population affiliated to the Colombian subsidized regime (poor population).
In this population, 82.31 cases of Plasmodium falciparum malaria per 100,000 affiliates were reported more than those reported in the contributory regime. Regarding the relative gap, belonging to the subsidized regime increased by 31.74 times the risk of dying from malnutrition in children under 5 years of age.
Other events such as those related to sexual and reproductive health (maternal mortality, gestational syphilis and congenital syphilis); neglected diseases and communicable diseases related to poverty (leprosy and tuberculosis), also showed profound inequalities.
Conclusion: In Colombia there are inequalities by regime of affiliation to the health system. Measured socioeconomic status was a predictor of increased morbidity and premature mortality.
Collapse
|
10
|
Uccheddu D, Gauthier AH, Steverink N, Emery T. Gender and Socioeconomic Inequalities in Health at Older Ages Across Different European Welfare Clusters: Evidence from SHARE Data, 2004-2015. EUROPEAN SOCIOLOGICAL REVIEW 2019; 35:346-362. [PMID: 31205378 PMCID: PMC6561324 DOI: 10.1093/esr/jcz007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Indexed: 06/09/2023]
Abstract
This study takes a comparative approach to assess whether the association between socioeconomic status (SES) and health in later life differs by gender in a sample of individuals aged 50 and above living in nine European countries (Austria, Belgium, Denmark, France, Germany, Italy, Spain, Sweden, and Switzerland). We apply linear hybrid (between-within) regression models using panel data (50,459 observations from 13,955 respondents) from five waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) between the years 2004-2015. SES measures included education, income, and wealth. A 40- item Frailty Index (FI) of accumulated deficits, an important indicator of health in older populations, was used as dependent variable. Considering between-effects estimates, our results show that the positive impact of education and wealth on health is stronger for women living in countries where the welfare arrangements are less decommodifying and defamilializing. No such interaction is found for income and for fixed-effects estimates. This study could advance the understanding of gender inequalities in health. Also, such findings can guide future policies devoted at reducing gender and socioeconomic inequalities in health in later life.
Collapse
Affiliation(s)
- Damiano Uccheddu
- Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), Lange Houtstraat 19, 2511 CV, The Hague, The Netherlands
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| | - Anne H Gauthier
- Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), Lange Houtstraat 19, 2511 CV, The Hague, The Netherlands
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| | - Nardi Steverink
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
- Department of Health Psychology, Faculty of Medical Sciences, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Tom Emery
- Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW), Lange Houtstraat 19, 2511 CV, The Hague, The Netherlands
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 31, 9712 TG, Groningen, The Netherlands
| |
Collapse
|
11
|
Song X, Wei Y, Deng W, Zhang S, Zhou P, Liu Y, Wan J. Spatio-Temporal Distribution, Spillover Effects and Influences of China's Two Levels of Public Healthcare Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E582. [PMID: 30781583 PMCID: PMC6407009 DOI: 10.3390/ijerph16040582] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/22/2019] [Accepted: 02/14/2019] [Indexed: 01/03/2023]
Abstract
In China, upper-level healthcare (ULHC) and lower-level healthcare (LLHC) provide different public medical and health services. Only when these two levels of healthcare resources are distributed equally and synergistically can the public's demands for healthcare be met fairly. Despite a number of previous studies having analysed the spatial distribution of healthcare and its determinants, few have evaluated the differences in spatial equity between ULHC and LLHC and investigated their institutional, geographical and socioeconomic influences and spillover effects. This study aims to bridge this gap by analysing panel data on the two levels of healthcare resources in 31 Chinese provinces covering the period 2003⁻2015 using Moran's I models and dynamic spatial Durbin panel models (DSDMs). The results indicate that, over the study period, although both levels of healthcare resources improved considerably in all regions, spatial disparities were large. The spatio-temporal characteristics of ULHC and LLHC differed, although both levels were relatively low to the north-west of the Hu Huanyong Line. DSDM analysis revealed direct and indirect effects at both short-and long-term scales for both levels of healthcare resources. Meanwhile, the influencing factors had different impacts on the different levels of healthcare resources. In general, long-term effects were greater for ULHC and short-term effects were greater for LLHC. The spillover effects of ULHC were more significant than those of LLHC. More specifically, industrial structure, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of ULHC, while industrial structure, urbanisation, topography, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of LLHC. These findings have important implications for policymakers seeking to optimize the availability of the two levels of healthcare resources.
Collapse
Affiliation(s)
- Xueqian Song
- School of Management, Chengdu University of Information Technology, Chengdu 610225, China.
| | - Yongping Wei
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, QLD 4067, Australia.
| | - Wei Deng
- Research Center for Mountain Development, Institute of Mountain Hazards and Environment, Chinese Academy of Sciences, Chengdu 610041, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Shaoyao Zhang
- Research Center for Mountain Development, Institute of Mountain Hazards and Environment, Chinese Academy of Sciences, Chengdu 610041, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Peng Zhou
- Research Center for Mountain Development, Institute of Mountain Hazards and Environment, Chinese Academy of Sciences, Chengdu 610041, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Ying Liu
- Research Center for Mountain Development, Institute of Mountain Hazards and Environment, Chinese Academy of Sciences, Chengdu 610041, China.
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Jiangjun Wan
- Department of Urban and Rural Planning, School of Architecture and Urban-Rural Planning, Sichuan Agricultural University, Chengdu 610041, China.
| |
Collapse
|
12
|
Abstract
Introduction Paediatric stabbings are on the increase across the United Kingdom, especially in large urban centres. Many London trauma centres are reporting a significant annual rise in the cases of penetrating trauma. Studies have shown victims with a lower socioeconomic status have an increased risk of paediatric penetrating trauma. This study aims to determine whether high depravity of an area increases the risk of paediatric stabbings in West London. We hypothesise that more deprived areas are likely to have a higher incidence of paediatric stabbings. Methods A retrospective review of data from the emergency department at a major trauma centre in West London was conducted using patient <18 years with a stabbing injury between March 2015 and July 2017. Gender, age, incident postcode and home postcode were collected. Socioeconomic status was measured using the 2015 English index of multiple deprivation. Incident postcode and home postcode were matched to an index of multiple deprivation decile, with 1 being the most deprived. Data were analysed using SPSS© Statistics 24. Results One hundred seventy-four cases were included; 97.7% of the cases were male and the mean age was 16 years. The location of the stabbings had a median index of multiple deprivation score of 3 (interquartile range = 3) with 61% of the cases occurring in areas with an index of multiple deprivation decile of 3 or less. Index of multiple deprivation decile from incident location and frequency of stabbing were strongly negatively associated (r = −0.85, p = 0.002). The victim’s home location had a median index of multiple deprivation score of 3 (interquartile range = 3) and 59.3% of victims living in areas with an index of multiple deprivation decile of less than 3. Again, they were strongly negatively associated (r = −0.85, p = 0.002). Conclusion The location of paediatric stabbings is associated with areas of high depravity and with victims from a more deprived background. To prevent paediatric stabbings, a multifactorial approach is required to increase the socioeconomic status of these areas.
Collapse
Affiliation(s)
- Christine Lam
- Major Trauma, St Mary’s Hospital, Paddington, London, UK
| | | | - Mansoor Khan
- Major Trauma, St Mary’s Hospital, Paddington, London, UK
| |
Collapse
|
13
|
Behzadifar M, Sohrabi R, Mohammadibakhsh R, Salemi M, Moghadam ST, Taheri Mirghaedm M, Behzadifar M, Baradaran HR, Bragazzi NL. General health status in Iranian diabetic patients assessed by short-form-36 questionnaire: a systematic review and meta-analysis. BMC Endocr Disord 2018; 18:34. [PMID: 29855368 PMCID: PMC5984362 DOI: 10.1186/s12902-018-0262-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/22/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Diabetes mellitus is one of the most prevalent diseases worldwide. Diabetes is a chronic disease associated with micro- and macro-vascular complications and deterioration in general health status. Therefore, the aim of this study was to estimate general health status among Iranian diabetic patients through a systematic review and meta-analysis of study utilizing the Short-Form-36 questionnaire. METHODS Searching the EMBASE, PubMed, ISI/Web of Sciences (WOS), MEDLINE via Ovid, PsycoINFO, as well as Iranian databases (MagIran, Iranmedex, and SID) from January 2000 to December 2017. The methodological quality of the studies was evaluated using the "A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions" (ACROBAT-NRSI). Random-effect model was used and the means were reported with their 95% confidence interval (CI). To evaluate the heterogeneity between studies, I2 test was used. Egger's regression test was used to assess the publication bias. RESULTS Fourteen studies were retained in the final analysis. The mean general health status using SF-36 in diabetic patients of Iran was 51.9 (95% CI: 48.64 to 53.54). The mean physical component summary was 52.92 [95% CI: 49.46-56.38], while the mean mental component summary was 51.02 [95% CI: 46.87-55.16]. CONCLUSION The findings of this study showed that general health status in Iranian diabetic patients is low. Health policymakers should work to improve the health status in these patients and take appropriate interventions.
Collapse
Affiliation(s)
- Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Rahim Sohrabi
- Iranian Social Security Organization, Zanjan Province Health Administration, Zanjan, Iran
| | - Roghayeh Mohammadibakhsh
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Salemi
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sharare Taheri Moghadam
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masood Taheri Mirghaedm
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Meysam Behzadifar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| |
Collapse
|
14
|
Vanthomme K, Vandenheede H, Hagedoorn P, Gadeyne S. Evolution of socioeconomic inequalities in site-specific cancer mortality among Belgian women between 1991 and 2008 using a fundamental cause approach. Cancer Causes Control 2017; 28:829-840. [DOI: 10.1007/s10552-017-0921-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 06/27/2017] [Indexed: 10/19/2022]
|
15
|
Denton EJ, Hart D, Russell PA, Wright G, Conron M. Lung cancer and socio-economic status: inextricably linked to place of residence. Intern Med J 2017; 47:563-569. [DOI: 10.1111/imj.13376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/06/2017] [Accepted: 01/09/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Eve J. Denton
- School of Public Health and Preventative Medicine; Monash University; Melbourne Victoria Australia
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
| | - David Hart
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
| | - Prue A. Russell
- Department of Anatomical Pathology; St Vincent's Hospital; Melbourne Victoria Australia
| | - Gavin Wright
- Department of Surgery; Melbourne University, St Vincent's Hospital; Melbourne Victoria Australia
| | - Matthew Conron
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
| |
Collapse
|
16
|
The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis. Qual Life Res 2016; 25:2711-2723. [PMID: 27324038 DOI: 10.1007/s11136-016-1345-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE The main purpose of this meta-analysis was to evaluate the impact of ankylosing spondylitis on the health-related quality of life assessed by the Medical Outcomes Short-Form-36 questionnaire (SF-36). METHODS A systematic literature search was performed on PubMed and Web of Science until January 22, 2016 to obtain eligible studies. Random effect model was performed to summarize the scores of each domain. The radar chart was used to compare the scores of AS patients with other health conditions. Spearman's correlation analysis and meta-regression were used to explore the related factors. STATA (version 11.0) and SPSS (version 13.0) were adopted in this meta-analysis. RESULTS Thirty-eight studies were included in this study, which were all reliable to summarize the scores of the SF-36. Pooled mean scores of the physical health domains ranged from 45.93 to 58.17, with the RP and PF domains being the lowest and the highest, respectively. Pooled mean scores of the mental health domains ranged from 47.49 to 62.52, with the VT and SF domains being the lowest and the highest, respectively. Besides, the physical component summary was lower than the mental component summary. BASDAI and BASFI were negatively associated with some domains of the SF-36 significantly. Patients with AS had a substantial impaired HRQoL in comparison with the general population. CONCLUSIONS AS could adversely affect the HRQoL of patients. Measuring HRQoL should be considered as an essential part of the overall assessment of health status of AS patients, which would provide valuable clues for improving the management of disease and making decisions regarding treatment.
Collapse
|
17
|
Regidor E, Reques L, Belza MJ, Kunst AE, Mackenbach JP, de la Fuente L. Education and mortality in Spain: a national study supports local findings. Int J Public Health 2015; 61:139-145. [PMID: 26572139 DOI: 10.1007/s00038-015-0762-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 10/29/2015] [Accepted: 11/04/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To estimate educational inequalities in mortality in Spain and in three Spanish areas: Madrid, Barcelona, and the Basque country. METHODS A national prospective study was carried out including all persons aged 25-74 years living in Spain in 2001 and followed up for mortality over 7 years. The mortality rate ratio and difference from all causes and from leading causes of death were estimated for the entire Spanish population and for the above three geographical areas. RESULTS With respect to people with the highest education, the mortality rate ratios in the entire population of Spain in people with the second highest, second lowest and lowest education were, respectively, 1.09, 1.10, 1.39 in women and 1.19, 1.27 and 1.54 in men. The mortality rate differences per 100,000 person-years were, respectively, 24.8, 28.3, 108.2 in women and 116.7, 162.5 and 319.1 in men. These estimates were intermediate in magnitude compared to those seen in the three geographical areas. CONCLUSIONS The results provide further evidence that educational inequalities in mortality are smaller in the south of Europe than in other European countries.
Collapse
Affiliation(s)
- Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Ciudad Universitaria, 28040, Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Laura Reques
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - María J Belza
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Anton E Kunst
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Luis de la Fuente
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,National Epidemiology Center, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
18
|
Hurtado JL, Bacigalupe A, Calvo M, Esnaola S, Mendizabal N, Portillo I, Idigoras I, Millán E, Arana-Arri E. Social inequalities in a population based colorectal cancer screening programme in the Basque Country. BMC Public Health 2015; 15:1021. [PMID: 26438240 PMCID: PMC4594998 DOI: 10.1186/s12889-015-2370-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 09/29/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND While it is known that a variety of factors (biological, behavioural and interventional) play a major role in the health of individuals and populations, the importance of the role of social determinants is less clear. The effect of social inequality on population-based screening for colorectal cancer (CRC) could limit the value of such programmes. The present study aims to determine whether such inequalities exist. METHODS Data was obtained from the population-based screening programme administered in the Autonomous Community of the Basque Country, Spain, with a target population aged 50 to 69, first invited to participate between 2009 and 2011. The magnitude of inequality was analysed using the odds ratio (taking the least disadvantaged socioeconomic quintile as the reference population), the population attributable risk and the relative index of inequality, based on the regression, which is the ratio of the rates in the most and least disadvantaged socioeconomic groups. RESULTS The target population comprised 242,394 people, with the test kit successfully sent to 95.1 % (230,510). The overall response rate was 64.3 % (67.1 in women and 61.4 % men). Among women, the highest participation was in the third quintile (71.5 %) and the lowest in the first - the least disadvantaged (65.7 %). The lowest and highest rates of people with identified lesions were in the second and fourth quintiles (14.7/1000 and 17.0/1000 respectively). Among men, the response rate was lowest in the fifth - most disadvantaged - quintile (60.2 %). The highest rate of identified lesions was in the fifth quintile; 38 % higher than the first (55.7/1000 compared to 41.0/1000). CONCLUSIONS Sex and socioeconomic group influence the rate of participation in the CRC programme and the rate of lesions found in the participants. Any public health programme is morally and ethically obliged to strive for equity and effectiveness. Improving participation of men and socially disadvantaged groups should be taken in account.
Collapse
Affiliation(s)
| | - Amaia Bacigalupe
- Department of Sociology 2, University of the Basque Country (UPV/EHU), Bizkaia, Spain.
| | - Montse Calvo
- Directorate of Health Planning, Department of Health, Basque Government, Araba, Spain.
| | - Santi Esnaola
- Directorate of Health Planning, Department of Health, Basque Government, Araba, Spain.
| | | | - Isabel Portillo
- Colorectal Cancer Screening Programme Coordinating Centre, Basque Health Service, Bizkaia, Spain.
| | - Isabel Idigoras
- Colorectal Cancer Screening Programme Coordinating Centre, Basque Health Service, Bizkaia, Spain.
| | - Eduardo Millán
- Healthcare Services Sub-directorate, Osakidetza-Basque Health Service, Araba, Spain.
| | - Eunate Arana-Arri
- Clinical Epidemiology Unit, Cruces University Hospital, BioCruces Health Research Institute, 48903, Barakaldo-Bizkaia, Spain.
| |
Collapse
|
19
|
Pinto JM, Schumm LP, Wroblewski KE, Kern DW, McClintock MK. Racial disparities in olfactory loss among older adults in the United States. J Gerontol A Biol Sci Med Sci 2013; 69:323-9. [PMID: 23689829 DOI: 10.1093/gerona/glt063] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Age-related olfactory loss (presbyosmia) substantially decreases quality of life, presages neurodegenerative disease, impairs nutrition, and predicts mortality. We sought to determine how race is associated with olfactory loss in older American adults in order to inform both health care and policy. METHODS The National Social Life, Health and Aging Project interviewed a cross-sectional nationally representative probability sample of older adults in the United States. African Americans and Hispanics were oversampled, providing power to detect disparities for these subgroups. As part of an omnibus survey of demographic, social, psychological, and biological measures, National Social Life, Health and Aging Project assessed the ability to verbally identify odors by presenting five odor pens. Multivariate ordinal logistic regression quantified racial differences in odor identification, and then tested potential confounders. RESULTS African Americans and Hispanics had markedly worse olfactory function (controlling for gender and age) compared with whites (p < .001), twice the magnitude of gender differences, and comparable to aging 9 years. Cognition, household assets, and education accounted for the disparity found among Hispanics but not among African Americans. Moreover, other potential confounders, such as physical or mental health, including tobacco and alcohol use, did not account for the African American health disparity, which remained significant (p = .001) after including these factors. CONCLUSIONS African Americans are more likely to suffer from presbyosmia, a health disparity not explained by gender, education, cognition, physical or mental health, and health behaviors. This novel health disparity may result from lifetime environmental exposures, diet, or genetic susceptibility. Dissecting the interactions among these putative mechanisms will provide insight into ameliorating this decline in critical human sensory function.
Collapse
Affiliation(s)
- Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine and Biological Sciences, 5841 South Maryland Avenue, MC1035, Chicago, IL 60637.
| | | | | | | | | |
Collapse
|
20
|
Federico B, Mackenbach JP, Eikemo TA, Sebastiani G, Marinacci C, Costa G, Kunst AE. Educational inequalities in mortality in northern, mid and southern Italy and the contribution of smoking. J Epidemiol Community Health 2013; 67:603-9. [PMID: 23596251 DOI: 10.1136/jech-2012-201716] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have shown that mortality inequalities are smaller in Italy than in most European countries. This may be due to the weak association between socioeconomic status and smoking in Italy. However, most published studies were based on data from a single city in northern Italy (Turin). In this study, we aimed to assess the size of mortality inequalities in Italy as a whole, their geographical pattern of variation within Italy, and the contribution of smoking to these inequalities. METHODS Participants in the National Health Interview Survey 1999-2000 were followed up for mortality until 31 December 2007. Using Cox regression, we computed the age-adjusted relative index of inequality (RII) for all-cause mortality with and without controlling for smoking status and intensity. Education was used as an indicator of socioeconomic status. RESULTS Among 72,762 individuals aged 30-74 years at baseline, 4092 died during the follow-up. The age-adjusted RII of mortality was 1.69 (95% CI 1.44 to 2.00) among men and 1.43 (95% CI 1.13 to 1.82) among women. Among men, inequalities were larger in both northern and southern regions than in the middle of the country, whereas among women they were larger in the south. After controlling for smoking RII decreased to 1.63 (95% CI 1.38 to 1.92) among men and increased to 1.54 (95% CI 1.21 to 1.96) among women. The geographical variation in mortality inequalities was not affected by smoking adjustment. CONCLUSIONS Mortality inequalities in Italy are smaller than in most European countries. This is due, among other factors, to the weak socioeconomic pattern of smoking over the past decades in Italy.
Collapse
Affiliation(s)
- Bruno Federico
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Italy.
| | | | | | | | | | | | | |
Collapse
|
21
|
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
|
22
|
Tsimbos C. An assessment of socio-economic inequalities in health among elderly in Greece, Italy and Spain. Int J Public Health 2009; 55:5-15. [PMID: 19806317 DOI: 10.1007/s00038-009-0083-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Revised: 01/15/2009] [Accepted: 06/23/2009] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study explores socio-economic inequalities in health among Mediterranean people aged 50 or higher. METHODS The data used in the analysis come from the Survey of Health, Ageing and Retirement in Europe, wave 1, release 2; the sample includes 2,671 Greek, 2,502 Italian and 2,343 Spanish persons. Seven health indicators are examined using age-sex standardized prevalence rates and logistic regression models. Concentration indices are also computed for self-rated health (SRH). RESULTS Socio-economic position of individuals declines with age. Persons of lower socio-economic position experience worse health in all instances. Independently of education and gender, Greek persons display the lowest prevalence rates for SRH and physical and depressive symptoms, Spanish exhibit the highest rates for chronic conditions, and Italians perform better regarding functional limitations. Within-country analysis shows that the magnitude of socio-economic inequalities in SRH is greatest in Greece, followed by Spain and lastly by Italy. CONCLUSIONS The analysis reconfirms the advantage of high over low socio-economic position for all countries and health indicators and proves education as an important correlate compared to wealth and income among the elderly.
Collapse
Affiliation(s)
- Cleon Tsimbos
- Department of Statistics and Insurance Science, University of Piraeus, 80, Karaoli & Dimitriou Str, Piraeus, 185 34 Athens, Greece.
| |
Collapse
|