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Kim M, Khang YH. Why Do Japan and South Korea Record Very Low Levels of Perceived Health Despite Having Very High Life Expectancies? Yonsei Med J 2019; 60:998-1003. [PMID: 31538436 PMCID: PMC6753344 DOI: 10.3349/ymj.2019.60.10.998] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/25/2019] [Accepted: 08/07/2019] [Indexed: 11/27/2022] Open
Abstract
Japan and Korea follow a unique trend in which, despite reporting two of the highest life expectancies (LEs) among the Organization for Economic Co-operation and Development (OECD) countries, the proportion of people with good self-rated health (SRH) is disproportionately low. We sought to explain this high-LE-low-SRH paradox by examining associations among LE, the prevalence of good SRH, and healthcare utilization. Our hypothesis was that countries with more frequent healthcare use would demonstrate poorer SRH and that SRH would not show a meaningful association with LE among developed countries. This study extracted data from Health at a Glance 2017 by the OECD for 26 countries with valid and comparable information on LE, SRH, and the number of doctor consultations per capita. Correlations among LE, good SRH, and number of doctor consultations per capita were analyzed. The number of annual doctor consultations per capita and the prevalence of good SRH were closely correlated (correlation coefficient=-0.610); excluding outliers produced a higher correlation coefficient (-0.839). Similar patterns were observed when we replaced good SRH with poor SRH. Meanwhile, the correlation coefficient between annual per capita doctor consultations and LE was quite low (-0.216). Although good SRH is closely related to better LE at the individual level, this was not true at the national level. Frequent use of healthcare in Japan and Korea was strongly correlated with poorer SRH, without any meaningful correlation with LE.
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Affiliation(s)
- Minhye Kim
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Young Ho Khang
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.
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Odoh C, Vidrine JI, Businelle MS, Kendzor DE, Agrawal P, Reitzel LR. Health Literacy and Self-Rated Health among Homeless Adults. HEALTH BEHAVIOR RESEARCH 2019; 2:13. [PMID: 34164607 PMCID: PMC8218643 DOI: 10.4148/2572-1836.1055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Poor health literacy reduces the efficacy of behavior change interventions, hampers management of health conditions, and attenuates understanding of the prevention and treatment of diseases. Poor health literacy has also been linked to fair/poor self-rated health in domiciled samples; however, there is a paucity of studies on the relation amongst homeless adults, who bear a disproportionate burden of disease and disability and require high level of care and access to health services. Here, we examined the association between health literacy and self-rated health among a convenience sample of homeless adults. Participants were recruited from six homeless-serving agencies in Oklahoma City (N = 575; 63% men, Mage = 43.6±12.3). Logistic regression was used to assess the association between health literacy (confidence completing medical forms: extremely/quite a bit vs somewhat/little bit/not at all) and self-rated health (poor/fair vs good/very good/excellent) controlling for age, subjective social status, education, race, sex, income, health insurance, employment, social security recipient status, diabetes diagnosis, high blood pressure diagnosis, and high cholesterol diagnosis. In the adjusted model, health literate homeless individuals had greater odds of endorsing good/very good/excellent self-rated health compared to those somewhat/a little bit/not at all confident completing medical forms (AOR = 2.02, [CI95% = 1.35-3.02]). Interventions targeted at adjusting reading level and comprehensibility of health information are needed for homeless individuals with poor/limited health literacy, which may ultimately impact their self-rated health. Shelters and homeless-serving agencies could host classes focused on practical skills for enhancing health literacy and/or provide navigation services.
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Affiliation(s)
- Chisom Odoh
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, and The University of Houston, HEALTH Research Institute, Houston TX
| | - Jennifer I Vidrine
- The University of Oklahoma Health Sciences Center, Department of Family & Preventive Medicine, Oklahoma City, OK, and Stephenson Cancer Center, Oklahoma Tobacco Research Center Oklahoma City, OK
| | - Michael S Businelle
- The University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, Oklahoma City, OK, and Stephenson Cancer Center, Oklahoma Tobacco Research Center, Oklahoma City, OK
| | - Darla E Kendzor
- The University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, Oklahoma City, OK, and Stephenson Cancer Center, Oklahoma Tobacco Research Center, Oklahoma City, OK
| | - Pooja Agrawal
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, and The University of Houston, HEALTH Research Institute, Houston TX
| | - Lorraine R Reitzel
- The University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, TX, and The University of Houston, HEALTH Research Institute, Houston TX
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Ryu J, Yoon Y, Kim H, Kang CW, Jung-Choi K. The Change of Self-Rated Health According to Working Hours for Two Years by Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1984. [PMID: 30208666 PMCID: PMC6164647 DOI: 10.3390/ijerph15091984] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to confirm the association between working hours and self-rated health, and to find the degree of changes in health level by working hours according to gender. METHODS This study was based on the 929 workers (571 men and 358 women) from the Korean Labor and Income Panel Study during 2004⁻2006. To minimize the healthy worker effects, the study subjects included only those who did not have any chronic diseases, and who answered their health status as "moderate" or above in the baseline. Logistic regression analysis was used to confirm the associations between working hours and self-rated health. RESULTS In men, working hours per week of 47⁻52 h, 53⁻68 h, and >68 h were associated with 1.2, 1.3, and 1.1 times increases, respectively, in the odds ratio on worsened self-rated health, compared with the reference group (40⁻46 h). On the other hand, the risks were 1.0, 2.2, and 2.6 times increases in women. However, the results were different according to gender in the group with less than 40 h. The men with less than 40 h had a 0.9 times odds ratio on worsened self-rated health. For the women with less than 40 h, the odds ratio on self-rated health was 5.4 times higher than the reference group. CONCLUSIONS Working more than 52 h per week had a negative effect on health, regardless of gender. However, in the group with less than 40 h, the negative association between working hours and self-rated health were shown only in women. Health outcomes due to working hours may differ by gender. Therefore, further studies are needed to explore the causes of these results.
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Affiliation(s)
- Jia Ryu
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Yeogyeong Yoon
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyunjoo Kim
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea.
| | - Chung Won Kang
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea.
| | - Kyunghee Jung-Choi
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Korea.
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Dutheil F, Duclos M, Naughton G, Dewavrin S, Cornet T, Huguet P, Chatard JC, Pereira B. WittyFit-Live Your Work Differently: Study Protocol for a Workplace-Delivered Health Promotion. JMIR Res Protoc 2017; 6:e58. [PMID: 28408363 PMCID: PMC5408138 DOI: 10.2196/resprot.6267] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 12/04/2016] [Accepted: 02/27/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Morbidity before retirement has a huge cost, burdening both public health and workplace finances. Multiple factors increase morbidity such as stress at work, sedentary behavior or low physical activity, and poor nutrition practices. Nowadays, the digital world offers infinite opportunities to interact with workers. The WittyFit software was designed to understand holistic issues of workers by promoting individualized behavior changes at the workplace. OBJECTIVE The shorter term feasibility objective is to demonstrate that effective use of WittyFit will increase well-being and improve health-related behaviors. The mid-term objective is to demonstrate that WittyFit improves economic data of the companies such as productivity and benefits. The ultimate objective is to increase life expectancy of workers. METHODS This is an exploratory interventional cohort study in an ecological situation. Three groups of participants will be purposefully sampled: employees, middle managers, and executive managers. Four levels of engagement are planned for employees: commencing with baseline health profiling from validated questionnaires; individualized feedback based on evidence-based medicine; support for behavioral change; and formal evaluation of changes in knowledge, practices, and health outcomes over time. Middle managers will also receive anonymous feedback on problems encountered by employees, and executive top managers will have indicators by division, location, department, age, seniority, gender and occupational position. Managers will be able to introduce specific initiatives in the workplace. WittyFit is based on two databases: behavioral data (WittyFit) and medical data (WittyFit Research). Statistical analyses will incorporate morbidity and well-being data. When a worker leaves a workplace, the company documents one of three major explanations: retirement, relocation to another company, or premature death. Therefore, WittyFit will have the ability to include mortality as an outcome. WittyFit will evolve with the waves of connected objects further increasing its data accuracy. Ethical approval was obtained from the ethics committee of the University Hospital of Clermont-Ferrand, France. RESULTS WittyFit recruitment and enrollment started in January 2016. First publications are expected to be available at the beginning of 2017. CONCLUSIONS The name WittyFit came from Witty and Fitness. The concept of WittyFit reflects the concept of health from the World Health Organization: being spiritually and physically healthy. WittyFit is a health-monitoring, health-promoting tool that may improve the health of workers and health of companies. WittyFit will evolve with the waves of connected objects further increasing its data accuracy with objective measures. WittyFit may constitute a powerful epidemiological database. Finally, the WittyFit concept may extend healthy living into the general population. TRIAL REGISTRATION Clinicaltrials.gov: NCT02596737; https://www.clinicaltrials.gov/ct2/show/NCT02596737 (Archived by WebCite at http://www.webcitation.org/6pM5toQ7Y).
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Affiliation(s)
- Frédéric Dutheil
- Centre Hospitalier Universitaire de Clermont-Ferrand, Service Santé Travail Environnement, Clermont-Ferrand, France
- Université Clermont Auvergne, Centre National de la Recherche Scientifique, Laboratoire de Psychologie Sociale et Cognitive, équipe Stress physiologique et psychosocial, Clermont-Ferrand, France
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
| | - Martine Duclos
- Centre Hospitalier Universitaire de Clermont-Ferrand, Service de Médecine du Sport, Clermont-Ferrand, France
- Université Clermont Auvergne, Institut National de la Recherche Agronomique, Unité de Nutrition Humaine, Centre de Recherche en Nutrition Humaine Auvergne, Clermont-Ferrand, France
| | - Geraldine Naughton
- Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia
| | | | | | - Pascal Huguet
- Université Clermont Auvergne, Centre National de la Recherche Scientifique, Laboratoire de Psychologie Sociale et Cognitive, équipe Stress physiologique et psychosocial, Clermont-Ferrand, France
| | - Jean-Claude Chatard
- Centre Hospitalier Universitaire de Saint-Etienne, Physiologie de l'Exercice, Laboratoire Interuniversitaire de Biologie de la Motricité Equipe d'Accueil 7424, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Bruno Pereira
- Centre Hospitalier Universitaire de Clermont-Ferrand, Direction de la Recherche Clinique et de l'Innovation, Clermont-Ferrand, France
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Kim I, Bahk J, Yun SC, Khang YH. Income gaps in self-rated poor health and its association with life expectancy in 245 districts of Korea. Epidemiol Health 2017; 39:e2017011. [PMID: 28330335 PMCID: PMC5543297 DOI: 10.4178/epih.e2017011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 03/15/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To examine the income gaps associated with self-rated poor health at the district level in Korea and to identify the geographical correlations between self-rated poor health, life expectancy, and the associated income gaps. METHODS We analyzed data for 1,578,189 participants from the Community Health Survey of Korea collected between 2008 and 2014. The age-standardized prevalence of self-rated poor health and the associated income gaps were calculated. Previously released data on life expectancy and the associated income gaps were also used. We performed correlation and regression analyses for self-rated poor health, life expectancy, and associated income gaps. RESULTS Across 245 districts, the median prevalence of self-rated poor health was 15.7% (95% confidence interval [CI], 14.6 to 16.8%), with interquartile range (IQR) of 3.1 percentage points (%p). The median interquintile gaps in the prevalence of self-rated poor health was 11.1%p (95% CI, 8.1 to 14.5%p), with IQR of 3.6%p. Pro-rich inequalities in self-rated health were observed across all 245 districts of Korea. The correlation coefficients for the association between self-rated poor health and the associated income gaps, self-rated poor health and life expectancy, and income gaps associated with self-rated poor health and life expectancy were 0.59, 0.78 and 0.55 respectively. CONCLUSIONS Income gaps associated with self-rated poor health were evident across all districts in Korea. The magnitude of income gaps associated with self-rated poor health was larger in the districts with greater prevalence of self-rated poor health. A strong correlation between self-rated poor health and life expectancy was also observed.
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Affiliation(s)
- Ikhan Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Jinwook Bahk
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.,Department of Public Health, Keimyung University, Daegu, Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea.,Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea
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최요한. Is Subjective Health Reliable as a Proxy Variable for True Health? A Comparison of Self-rated Health and Self-assessed Change in Health among Middle-aged and Older South Koreans. ACTA ACUST UNITED AC 2016. [DOI: 10.15709/hswr.2016.36.4.431] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Pet Ownership and the Risk of Dying from Cardiovascular Disease Among Adults Without Major Chronic Medical Conditions. High Blood Press Cardiovasc Prev 2016; 23:245-53. [PMID: 27174431 DOI: 10.1007/s40292-016-0156-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 04/25/2016] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION In a recent statement, the American Heart Association stated "There are scant data on pet ownership and survival in people without established cardiovascular disease (CVD)". This study sought to fill this gap. METHODS We analyzed nationally representative data of 3964 adults aged ≥50 who were free from major physical illnesses. Pet ownership was assessed at baseline between 1988 and 1994. Vital status was followed through December 31st 2006. RESULTS With dogs being most popular pets owned by 22.0 (standard error 0.34) % of the participants, 34.6 % of the study population owned a pet. Pet ownership was associated with low rates of CVD deaths [hazard ratio (HR) = 0.69 (95 % CI 0.45-1.07)] and stroke [0.54 (0.28-1.01)] at borderline significant levels among women. These associations were adjusted for physical activity and largely attributed to having a cat rather than a dog. Among cat owners, the HR of all CVD deaths was 0.62 (0.36-1.05) and the HR of dying from stroke was 0.22 (0.07-0.68) compared with non-cat owners. The corresponding HRs among dog owners were 0.82 (0.51-1.34) and 0.76 (0.34-1.71) respectively. No similar associations were observed among men. The hazard of dying from hypertension was not associated with pet ownership for both men and women. CONCLUSIONS Owning a cat rather than a dog was significantly associated with a reduced hazard of dying from CVD events, in particular, stroke. The protection pets confer may not be from physical activities, but possibly due to personality of the pet owners or stress-relieving effects of animal companionship.
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Lee HW, Song M, Yang JJ, Kang D. Determinants of Poor Self-rated Health in Korean Adults With Diabetes. J Prev Med Public Health 2015; 48:287-300. [PMID: 26639743 PMCID: PMC4676642 DOI: 10.3961/jpmph.15.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/21/2015] [Indexed: 01/15/2023] Open
Abstract
Objectives: Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes. Methods: A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance. Results: We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR]Frequent stress events, 5.40; 95% confidence interval [CI], 4.63 to 6.29; ORSevere distress, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants’ medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A1clevels of 6.5% or more, and comorbidities, were other correlates of poor reported health. Conclusions: Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.
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Affiliation(s)
- Hwi-Won Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Minkyo Song
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Jae Jeong Yang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
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Wang W, Obi JC, Engida S, Carter ER, Yan F, Zhang J. The relationship between excess body weight and the risk of death from unnatural causes. ACCIDENT; ANALYSIS AND PREVENTION 2015; 80:229-235. [PMID: 25931423 DOI: 10.1016/j.aap.2015.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 04/02/2015] [Accepted: 04/19/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The purpose is to exam whether excess body weight is associated with an increased risk of death from unnatural causes, particularly, injury. METHOD We analyzed nationally representative data of 14,453 adults (19 and older) who participated in the third National Health and Nutrition Examination Survey, 1988-1994, and were followed up with vital statuses through December 31, 2006. We used Cox proportional hazard regression to estimate the hazard ratio (HR) of death from all unnatural causes combined and specific ones. Gray's test was performed to assess the equality of cumulative incidence functions between body mass index (BMI) levels. RESULTS A total of 128 unnatural deaths were recorded during an 18-year follow-up with 193,019 person-years accumulated. Compared with healthy weight participants, a person with excess body weight had a low hazard of death from unnatural causes [HR=1.00 (reference), 0.58 (0.39-0.87), and 0.50 (0.30-0.82) for healthy weight, overweight and obese participants, respectively]. Injuries, including motor vehicle accidents and falls, were the major types of unnatural deaths (n=91, 71% of all unnatural deaths), and the risk of death from injuries was linearly and reversely associated with BMI. The HRs of injury were 1.00 (reference), 0.57 (0.36-0.91), and 0.36 (0.19-0.69) for healthy weight, overweight and obese participants, respectively. All these estimates were obtained after adjustment of socio-demographic variables. DISCUSSION Excess body weight appears to be associated with a low risk of death from unnatural causes, particularly, injuries. Additional investigations on the mechanism underlying the relationship between BMI and unnatural deaths are warranted.
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Affiliation(s)
- Wei Wang
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jane C Obi
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
| | - Selam Engida
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
| | - Elizabeth R Carter
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
| | - Fei Yan
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jian Zhang
- Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA.
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Van der Heyden J, Berger N, Van Oyen H. Comparison of self-rated health and activity limitation as predictors of short term mortality in the older population. Public Health 2015; 129:283-5. [DOI: 10.1016/j.puhe.2014.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/02/2014] [Accepted: 12/05/2014] [Indexed: 11/26/2022]
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Smith D, Wilkie R, Uthman O, Jordan JL, McBeth J. Chronic pain and mortality: a systematic review. PLoS One 2014; 9:e99048. [PMID: 24901358 PMCID: PMC4047043 DOI: 10.1371/journal.pone.0099048] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 05/10/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Chronic pain is common, often widespread and has a substantial impact on health and quality of life. The relationship between chronic pain and mortality is unclear. This systematic review aimed to identify and evaluate evidence for a relationship between chronic pain and mortality. METHODS A search of ten electronic databases including EMBASE and MEDLINE was conducted in March 2012, and updated until March 2014. Observational studies investigating the association between chronic or widespread pain (including fibromyalgia) and mortality were included. Risk of bias was assessed and a meta-analysis was undertaken to quantify heterogeneity and pool results. A narrative review was undertaken to explore similarities and differences between the included studies. RESULTS Ten studies were included in the review. Three reported significant associations between chronic or widespread pain and mortality in unadjusted results. In adjusted analyses, four studies reported a significant association. The remaining studies reported no statistically significant association. A meta-analysis showed statistically significant heterogeneity of results from studies using comparable outcome measures (n = 7)(I2 = 78.8%) and a modest but non-significant pooled estimate (MRR1.14,95%CI 0.95-1.37) for the relationship between chronic pain and all-cause mortality. This association was stronger when analysis was restricted to studies of widespread pain (n = 5,I2 = 82.3%) MRR1.22(95%CI 0.93-1.60). The same pattern was observed with deaths from cancer and cardiovascular diseases. Heterogeneity is likely to be due to differences in study populations, follow-up time, pain phenotype, methods of analysis and use of confounding factors. CONCLUSION This review showed a mildly increased risk of death in people with chronic pain, particularly from cancer. However, the small number of studies and methodological differences prevented clear conclusions from being drawn. Consistently applied definitions of chronic pain and further investigation of the role of health, lifestyle, social and psychological factors in future studies will improve understanding of the relationship between chronic pain and mortality.
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Affiliation(s)
- Diane Smith
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom
| | - Ross Wilkie
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom
| | - Olalekan Uthman
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Joanne L. Jordan
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom
| | - John McBeth
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, United Kingdom
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Chun H, Cho SI, Khang YH, Kang M, Kim IH. Trends in gender-based health inequality in a transitional society: a historical analysis of South Korea. J Prev Med Public Health 2012; 45:113-21. [PMID: 22509452 PMCID: PMC3324714 DOI: 10.3961/jpmph.2012.45.2.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 02/09/2012] [Indexed: 11/18/2022] Open
Abstract
Objectives This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality. Methods Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010. Results The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women's educational attainment levels and to their higher status in the labor market. Conclusions The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.
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Affiliation(s)
- Heeran Chun
- Department of Public Administration, Ewha Womans University, Seoul, Korea
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Sex/gender and socioeconomic differences in the predictive ability of self-rated health for mortality. PLoS One 2012; 7:e30179. [PMID: 22276157 PMCID: PMC3261899 DOI: 10.1371/journal.pone.0030179] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 12/14/2011] [Indexed: 11/18/2022] Open
Abstract
Background Studies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups. Methodology/Principal Findings The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14–2.80]) than in women (HR = 1.88 [95% CI: 1.44–2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74–3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83–2.50]; p for education interaction = 0.549). Conclusions The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.
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Mitchell MD, Mannino DM, Steinke DT, Kryscio RJ, Bush HM, Crofford LJ. Association of smoking and chronic pain syndromes in Kentucky women. THE JOURNAL OF PAIN 2012; 12:892-9. [PMID: 21816352 DOI: 10.1016/j.jpain.2011.02.350] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 01/18/2011] [Accepted: 02/15/2011] [Indexed: 10/17/2022]
Abstract
UNLABELLED The objective of this project was to determine the relationship between cigarette smoking and the reporting of chronic pain syndromes among participants in the Kentucky Women's Health Registry. Data was analyzed on 6,092 women over 18 years of age who responded to survey questions on pain and smoking. The chronic pain syndromes included in the analysis were fibromyalgia, sciatica, chronic neck pain, chronic back pain, joint pain, chronic head pain, nerve problems, and pain all over the body. Analyses controlled for age, body mass index, and Appalachian versus non-Appalachian county of residence. Results showed that women who were daily smokers reported more chronic pain (defined as the presence of any reported chronic pain syndromes) than women who were never smokers (adjusted odds ratio [aOR] = 2.04 and 95% confidence interval [CI] 1.67, 2.49). An increased risk was also seen for "some-day" smokers (aOR 1.68, 95% CI 1.24, 2.27), and former smokers (aOR 1.20, 95% CI 1.06, 1.37), though with less of an association in the latter group. This study provides evidence of an association between chronic pain and cigarette smoking that is reduced in former smokers. PERSPECTIVE This paper presents the association between smoking and musculoskeletal pain syndromes among Kentucky women. This finding may provide additional opportunities for intervention in patients with chronic pain.
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Affiliation(s)
- Michael D Mitchell
- University of Kentucky College of Public Health, 121 Washington Avenue, Lexington, KY 40536, USA.
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