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Rice CT, Barnett S, O'Connell SP, Akowuah E, Appleby CE, Chambers JB, Shah BN, Blackman DJ. Impact of gender, ethnicity and social deprivation on access to surgical or transcatheter aortic valve replacement in aortic stenosis: a retrospective database study in England. Open Heart 2023; 10:e002373. [PMID: 37788920 PMCID: PMC10565153 DOI: 10.1136/openhrt-2023-002373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVE To assess gender, ethnicity, and deprivation-based differences in provision of aortic valve replacement (AVR) in England for adults with aortic stenosis (AS). METHODS We retrospectively identified adults with AS from the English Hospital Episode Statistics (HES) between April 2016 and March 2019 and those who subsequently had an AVR. We separately used HES-linked Clinical Practice Research Datalink (CPRD) to identify people with AVR and evaluate the timeliness of their procedure (CPRD-AVR cohort). ORs for AVR in people with an AS diagnosis were estimated using multivariable logistic regression adjusted for age, region and comorbidity. AVR was considered timely if performed electively and without evidence of cardiac decompensation before AVR. RESULTS 183 591 adults with AS were identified in HES; of these, 31 436 underwent AVR. The CPRD-AVR cohort comprised 10 069 adults. Women had lower odds of receiving AVR compared with men (OR 0.65; 95% CI 0.63 to 0.66); as did people of black (OR 0.70; 95% CI 0.60 to 0.82) or South Asian (OR 0.75; 95% CI 0.69 to 0.82) compared with people of white ethnicities. People in the most deprived areas were less likely to receive AVR than the least deprived areas (OR 0.8; 95% CI 0.75 to 0.86). Timely AVR occurred in 65% of those of white ethnicities compared with 55% of both those of black and South Asian ethnicities. 77% of the least deprived had a timely procedure compared with 58% of the most deprived; there was no gender difference. CONCLUSIONS In this large, national dataset, female gender, black or South Asian ethnicities and high deprivation were associated with significantly reduced odds of receiving AVR in England. A lower proportion of people of minority ethnicities or high deprivation had a timely procedure. Public health initiatives may be required to increase clinician and public awareness of unconscious biases towards minority and vulnerable populations to ensure timely AVR for everyone.
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Affiliation(s)
| | - Sophie Barnett
- Medtronic International Trading Sarl, Tolochenaz, Switzerland
| | | | - Enoch Akowuah
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Clare E Appleby
- Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UK
| | | | - Benoy N Shah
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Daniel J Blackman
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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2
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Bengoa Terrero C, Bas Villalobos M, Rodríguez-Moñino AP, Lasheras Carbajo MD, Pérez-Villacastín J, García Torrent MJ, Sánchez-Del-Hoyo R, Bengoa San Sebastian E, García Lledó A. Effect of Primary Care Center Characteristics, Healthcare Worker Vaccination Status and Patient Economic Setting on Patient Influenza Vaccination Coverage Rates. Vaccines (Basel) 2023; 11:1025. [PMID: 37376414 DOI: 10.3390/vaccines11061025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/13/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Reaching the public health organizations targets of influenza vaccination in at-risk patient groups remains a challenge worldwide. Recognizing the relationship between the healthcare system characteristics and the economic environment of the population with vaccination uptake can be of great importance to improve. METHODS Several characteristics were correlated in this retrospective ecological study with data from 6.8 million citizens, 15,812 healthcare workers across 258 primary care health centers, and average income by area of the care center in Spain. RESULTS No correlation between HCW vaccination status and patient vaccination was found. A weak negative significant correlation between the size of the population the care center covers and their vaccination status did exist (6 mo.-59 yr., r = 0.19, p = 0.002; 60-64 yr., r = 0.23, p < 0.001; ≥65 yr., r = 0.23, p ≥ 0.001). The primary care centers with fewer HCWs had better uptake in the at-risk groups in the age groups of 60-64 yr. (r = 0.20, p = 0.002) and ≥65 (r = 0.023, p ≥ 0.001). A negative correlation was found regarding workload in the 6 mo.-59 yr. age group (r = 0.18, p = 0.004), which showed the at-risk groups that lived in the most economically deprived areas were more likely to be vaccinated. CONCLUSIONS This study reveals that the confounding variables that determine influenza vaccination in a population and in HCWs are complex. Future influenza campaigns should address these especially considering the possibility of combining influenza and SARS-CoV-2 vaccines each year.
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Affiliation(s)
| | | | | | | | | | | | - Rafael Sánchez-Del-Hoyo
- Unidad de Apoyo Metodológico a la Investigación, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
| | | | - Alberto García Lledó
- Servicio de Cardiología, Hospital Príncipe de Asturias, Alcalá de Henares, 28805 Madrid, Spain
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3
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Singh SS, Stranges S, Wilk P, Tang ASL, Frisbee SJ. Influence of the Social Environment on Ideal Cardiovascular Health. J Am Heart Assoc 2023; 12:e026790. [PMID: 36789849 PMCID: PMC10111502 DOI: 10.1161/jaha.122.026790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Background The environment plays a large role in the health of individuals; however, more research is needed to better understand aspects of the environment that most influence health. Specifically, our study examines how the social environment influences cardiovascular health (CVH). Methods and Results The social environment was characterized using measures of belonging and life and work stress in individuals, as well as nationally derived measures of marginalization, deprivation, economic status, and community well-being in neighborhoods. CVH was defined by the American Heart Association's Cardiovascular Health Index-a summed score of 7 clinical and behavioral components known to have the greatest impact on CVH. Data were obtained from the Canadian Community Health Survey 2015 to 2016 and multiple national data sources. Multilevel regression models were used to analyze the associations between CVH and the social environment. Overall, 27% of Canadians reported ideal CVH (6-7 score points), 68% reported intermediate CVH (3-5 score points), and 5% reported poor CVH (0-2 score points). The neighborhood environment contributed up to 7% of the differences in CVH between individuals. Findings indicated that residing in a neighborhood with greater community well-being (odds ratio [OR], 1.33 [95% CI, 1.26-1.41]) was associated with achieving higher odds of ideal CVH, while weaker community belonging (OR, 0.67 [95% CI, 0.62-0.72]) and residing in a neighborhood with greater marginalization (OR, 0.87 [95% CI, 0.82-0.91]) and deprivation (OR, 0.67 [95% CI, 0.64-0.69]) were associated with achieving lower odds of ideal CVH. Conclusions Aspects of individual-level social environment and residing in a neighborhood with a more favorable social environment were both independently and significantly associated with achieving ideal CVH.
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Affiliation(s)
- Sarah S Singh
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Medicine, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada.,Department of Family Medicine, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada.,Department of Precision Medicine Luxembourg Institute of Health Strassen Luxembourg
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Paediatrics, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada
| | - Anthony S L Tang
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Medicine, Division of Cardiology, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada
| | - Stephanie J Frisbee
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry University of Western Ontario London Ontario Canada.,Department of Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry University of Western Ontario London Ontario Canada.,Lawson Health Research Institute London Ontario Canada
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4
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Qureshi F, Bousquet-Santos K, Okuzono SS, Tsao E, Delaney S, Guimond AJ, Boehm JK, Kubzansky LD. The social determinants of ideal cardiovascular health: A global systematic review. Ann Epidemiol 2022; 76:20-38. [PMID: 36191736 PMCID: PMC9930100 DOI: 10.1016/j.annepidem.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022]
Abstract
This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth.
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Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Kelb Bousquet-Santos
- Department of Biological and Health Sciences, University of Brasilia, Campus Universitario - Centro Metropolitano, Ceilandia Campus, Brasilia, FD, Brazil
| | - Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Elaine Tsao
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Scott Delaney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Anne-Josee Guimond
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
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5
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Hergault H, Hauguel-Moreau M, Pépin M, Beauchet A, Josseran L, Rodon C, Gaye B, Dubourg O, Mansencal N. Impact of neighbourhood socio-economic status on cardiovascular risk factors in a French urban population. Eur J Prev Cardiol 2022; 29:2142-2144. [PMID: 35894217 DOI: 10.1093/eurjpc/zwac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Hélène Hergault
- Assistance Publique des Hôpitaux de Paris (AP-HP), Ambroise Paré Hospital, Cardiology Department, Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.,INSERM U-1018, Centre de recherche en Epidémiologie et Santé des Populations (CESP), Equipe Epidémiologie Clinique, UVSQ, Villejuif, France
| | - Marie Hauguel-Moreau
- Assistance Publique des Hôpitaux de Paris (AP-HP), Ambroise Paré Hospital, Cardiology Department, Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.,INSERM U-1018, Centre de recherche en Epidémiologie et Santé des Populations (CESP), Equipe Epidémiologie Clinique, UVSQ, Villejuif, France
| | - Marion Pépin
- INSERM U-1018, Centre de recherche en Epidémiologie et Santé des Populations (CESP), Equipe Epidémiologie Clinique, UVSQ, Villejuif, France.,AP-HP, Ambroise Paré Hospital, Department of Geriatrics, UVSQ, Boulogne-Billancourt, France
| | - Alain Beauchet
- AP-HP, Ambroise Paré Hospital, Public health Department, Boulogne-Billancourt, France
| | - Loïc Josseran
- AP-HP, GHU Paris Saclay, Hôpital Raymond-Poincaré, Département Hospitalier d'Epidémiologie et de Santé Publique, Garches, France
| | | | - Bamba Gaye
- INSERM, U-970, Centre de recherche cardiovasculaire, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Olivier Dubourg
- Assistance Publique des Hôpitaux de Paris (AP-HP), Ambroise Paré Hospital, Cardiology Department, Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.,AP-HP, Ambroise Paré Hospital, Department of Geriatrics, UVSQ, Boulogne-Billancourt, France
| | - Nicolas Mansencal
- Assistance Publique des Hôpitaux de Paris (AP-HP), Ambroise Paré Hospital, Cardiology Department, Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France.,AP-HP, Ambroise Paré Hospital, Department of Geriatrics, UVSQ, Boulogne-Billancourt, France
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6
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Freitas RS, Santos IDS, Matos SMAD, Aquino EMLD, Amorim LDAF. Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions. CAD SAUDE PUBLICA 2022; 38:e00266221. [PMID: 35946616 DOI: 10.1590/0102-311xen266221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/13/2022] [Indexed: 11/22/2022] Open
Abstract
This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.
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7
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McKenzie JA, Younger NO, Tulloch-Reid MK, Govia I, Bennett NR, McFarlane S, Walters R, Francis DK, Webster-Kerr K, Grant A, Davidson T, Wilks R, Williams DR, Ferguson TS. Ideal cardiovascular health in urban Jamaica: prevalence estimates and relationship to community property value, household assets and educational attainment: a cross-sectional study. BMJ Open 2020; 10:e040664. [PMID: 33323436 PMCID: PMC7745314 DOI: 10.1136/bmjopen-2020-040664] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Ideal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES). DESIGN Cross-sectional study. SETTING Urban communities in Jamaica. PARTICIPANTS 360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016-2017. EXPOSURES Community SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level. PRIMARY OUTCOME The main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations. RESULTS The prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women. CONCLUSION Living in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.
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Affiliation(s)
- Joette A McKenzie
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Novie O Younger
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Marshall Kerr Tulloch-Reid
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Nadia R Bennett
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Shelly McFarlane
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, University of the West Indies at Mona, Kingston, Saint Andrew, Jamaica
| | - Renee Walters
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Damian K Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, Georgia, USA
| | - Karen Webster-Kerr
- Office of the Prinicpal Medical Officer, National Epidemiology Unit and Non-Communicable Diseases and Injuries Prevention Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Andriene Grant
- Office of the Prinicpal Medical Officer, National Epidemiology Unit and Non-Communicable Diseases and Injuries Prevention Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Tamu Davidson
- Office of the Prinicpal Medical Officer, National Epidemiology Unit and Non-Communicable Diseases and Injuries Prevention Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Rainford Wilks
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Trevor S Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
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8
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Chewing capacity and ideal cardiovascular health in adulthood: A cross-sectional analysis of a population-based cohort study. Clin Nutr 2020; 39:1440-1446. [DOI: 10.1016/j.clnu.2019.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 11/18/2022]
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9
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Guilloteau A, Binquet C, Bourredjem A, Fournel I, Lalanne-Mistrih ML, Nacher M, Rochemont D, Cabie A, Mimeau E, Mislin-Tritsch C, Joux J, Lannuzel A, Bonithon-Kopp C, Béjot Y, Devilliers H. Social deprivation among socio-economic contrasted french areas: Using item response theory analysis to assess differential item functioning of the EPICES questionnaire in stroke patients. PLoS One 2020; 15:e0230661. [PMID: 32240217 PMCID: PMC7117693 DOI: 10.1371/journal.pone.0230661] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 03/05/2020] [Indexed: 11/19/2022] Open
Abstract
Background Multiple approaches have been proposed to measure low socio-economic status. In France the concept of precariousness, akin to social deprivation, was developed and is widely used. EPICES is a short questionnaire that was developed to measure this concept. This study aimed to evaluate Differential Item Functioning (DIF) in the EPICES questionnaire between contrasted areas: mainland France, French West Indies (FWI) and French Guiana (FG). Methods The population was taken from the INDIA study, which aimed to evaluate the impact of social inequalities on stroke characteristics and prognosis. Eligible people were patients referred to neurology or emergency departments for a suspicion of stroke. We assessed the DIF using hybrid ordinal logistic regression method, derived from item response theory. Results We analysed 1 553 stroke patients, including 768 from FWI (49.5%), 289 from FG (18.6%) and 496 from mainland (31.9%). We identified five items with a moderate to large DIF in area comparisons: “meeting with a social worker”, “complementary health insurance”, “home-owning”, “financial difficulties” and “sport activities”. Correlation between EPICES score and the latent variable was strong (r = 0.84). Conclusion This is the first attempt to assess the DIF of the EPICES score between different French populations. We found several items with DIF, which can be explained by individual interpretation or local context. However, the DIFs did not lead to a large difference between the latent variable and the EPICES score, which indicates that it can be used to assess precariousness and social deprivation between contrasted areas.
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Affiliation(s)
- Adrien Guilloteau
- Clinical Epidemiology Unit, INSERM, CIC 1432, University Hospital of Dijon, Epidemiology and infection control unit, Bourgogne-Franche-Comté University, Dijon, France
- * E-mail:
| | - Christine Binquet
- Clinical Epidemiology Unit, INSERM, CIC 1432, University Hospital of Dijon, Epidemiology and infection control unit, Bourgogne-Franche-Comté University, Dijon, France
| | - Abderrahmane Bourredjem
- Clinical Epidemiology Unit, INSERM, CIC 1432, University Hospital of Dijon, Epidemiology and infection control unit, Bourgogne-Franche-Comté University, Dijon, France
| | - Isabelle Fournel
- Clinical Epidemiology Unit, INSERM, CIC 1432, University Hospital of Dijon, Epidemiology and infection control unit, Bourgogne-Franche-Comté University, Dijon, France
| | - Marie Laure Lalanne-Mistrih
- INSERM, CIC 1424, Clinical Epidemiology Unit – Pointe-à-Pitre, University Hospital of Pointe-à-Pitre – Pointe-à-Pitre, University of West Indies – Pointe-à-Pitre, Guadeloupe, France
| | - Mathieu Nacher
- INSERM, CIC 1424, Clinical Epidemiology Unit, Hospital Andrée Rosemon, CIC 1424, Clinical Epidemiology Unit, University of French Guiana – Cayenne, Guyane, France
| | - Devi Rochemont
- INSERM, CIC 1424, Clinical Epidemiology Unit, Hospital Andrée Rosemon, CIC 1424, Clinical Epidemiology Unit, University of French Guiana – Cayenne, Guyane, France
| | - André Cabie
- INSERM, CIC 1424, Clinical Epidemiology Unit – Fort-de-France, University of West Indies, EA4537 – Fort-de-France, University Hospital of Martinique – Fort-de-France, Martinique, France
| | | | | | - Julien Joux
- University Hospital of Martinique – Fort-de-France, Martinique, France
| | - Annie Lannuzel
- INSERM, CIC 1424, Clinical Epidemiology Unit – Pointe-à-Pitre, University Hospital of Pointe-à-Pitre – Pointe-à-Pitre, University of West Indies – Pointe-à-Pitre, Institute for Brain and Spinal Cord Disorders, ICM, UMR 1127, Paris, France
| | - Claire Bonithon-Kopp
- Clinical Epidemiology Unit, INSERM, CIC 1432, University Hospital of Dijon, Epidemiology and infection control unit, Bourgogne-Franche-Comté University, Dijon, France
| | - Yannick Béjot
- Neurology Department and Dijon Stroke Registry, University Hospital of Dijon, Dijon, France
| | - Hervé Devilliers
- Clinical Epidemiology Unit, INSERM, CIC 1432, University Hospital of Dijon, Epidemiology and infection control unit, Bourgogne-Franche-Comté University, Dijon, France
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10
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Poirat L, Gaye B, Perier MC, Thomas F, Guibout C, Climie RE, Offredo L, Tafflet M, Lemogne C, Pannier B, Boutouyrie P, Jouven X, Empana JP. Perceived stress is inversely related to ideal cardiovascular health: The Paris Prospective Study III. Int J Cardiol 2018; 270:312-318. [PMID: 29936046 DOI: 10.1016/j.ijcard.2018.06.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/26/2018] [Accepted: 06/11/2018] [Indexed: 02/04/2023]
Affiliation(s)
- L Poirat
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
| | - B Gaye
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M C Perier
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - C Guibout
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - R E Climie
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Baker Heart and Diabetes Institute, Melbourne, Australia; Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia
| | - L Offredo
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M Tafflet
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - C Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Psychiatry Department, Paris, France; INSERM, U894, Psychiatry and Neuroscience Center, Paris, France
| | - B Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Pharmacology Department, Paris, France
| | - X Jouven
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Cardiology Department, Paris, France
| | - J P Empana
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
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Association between individual and neighbourhood socioeconomic factors and masticatory efficiency: a cross-sectional analysis of the Paris Prospective Study 3. J Epidemiol Community Health 2017; 72:132-139. [DOI: 10.1136/jech-2017-209593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/13/2017] [Accepted: 11/21/2017] [Indexed: 01/21/2023]
Abstract
BackgroundThere is a lack of evidence on the impact of socioeconomic factors on masticatory efficiency. The present study investigates the relationship between individual and neighbourhood socioeconomic factors (main exposure) and the number of masticatory units (MUs) used as surrogate of the masticatory efficiency (main outcome).MethodsIn this cross-sectional study nested in the Paris Prospective Study 3, 4270 adults aged 50–75 and recruited from 13 June 2008 to 31 May 2012 underwent a full-mouth examination. Number of MUs defined as pairs of opposing teeth or dental prostheses allowing mastication, number of missing teeth and gingival inflammation were documented. The individual component of the socioeconomic status was evaluated with an individual multidimensional deprivation score and education level. The neighbourhood component of the socioeconomic status was evaluated with the FDep99 deprivation index. Associations were quantified using marginal models.ResultsIn multivariate analyses, having less than 5 MUs was associated with (1) the most deprived neighbourhoods (OR=2.27 (95% CI 1.63 to 3.17)), (2) less than 12 years of educational attainment (OR=2.20 (95% CI 1.66 to 2.92)) and (3) the highest individual score of deprivation (OR=3.23 (95% CI 2.24 to 4.65)). Associations with education and individual score of deprivation were consistent across the level of neighbourhood deprivation. Comparable associations were observed with the number of missing teeth. Associations with gingival inflammation were of lower magnitude; the relationship was present for deprivation markers but not for education.ConclusionPoor masticatory efficiency is associated with low educational attainment and high deprivation scores.
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Simon M, Boutouyrie P, Narayanan K, Gaye B, Tafflet M, Thomas F, Guibout C, Périer MC, Pannier B, Jouven X, Empana JP. Sex disparities in ideal cardiovascular health. Heart 2017; 103:1595-1601. [PMID: 28754808 DOI: 10.1136/heartjnl-2017-311311] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To quantify the gap in the distribution of ideal cardiovascular health (CVH) between men and women accounting for comorbidities, socioeconomic and psychological confounding factors. METHODS A cross-sectional analysis was conducted among 9012 French men and women aged 50-75 years who were participants of the Paris Prospective Study 3. Each of the seven metrics was defined according to the American Heart Association criteria, and the CVH was considered as poor (0 or 1 ideal health metric), intermediate (2, 3 or 4 ideal health metrics) and ideal (5-7 ideal health metrics). The odds of intermediate and ideal CVH in women compared with men were estimated by multivariate polytomous logistic regression analysis using poor CVH as the reference category. RESULTS The mean age was 59.49 year (SD 6.25) and there were 38.54% of women. Though women were slightly older, less educated, more deprived, more often depressed, they were twice more often in ideal CVH than men (14.77% vs 6.84%, p<0.0001). After adjustment for age, deprivation score, education and depression, women were four times more often in ideal CVH (OR 4.01, 95% CI 3.42 to 4.69) and two times more often in intermediate CVH (OR 2.07, 95% CI 1.88 to 2.28) than men. CONCLUSION The sex disparities in the prevalence of ideal CVH have the potential to guide sex-specific strategies for improving CVH status in the general population. CLINICAL TRIAL REGISTRATION NCT00741728;Pre-results.
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Affiliation(s)
- Marie Simon
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France
| | - Pierre Boutouyrie
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Department of Pharmacology, Georges Pompidou European Hospital, Paris, France
| | - Kumar Narayanan
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Maxcure Hospitals, Hyderabad, India
| | - Bamba Gaye
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Muriel Tafflet
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | | | - Catherine Guibout
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Marie-Cécile Périer
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Bruno Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - Xavier Jouven
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Department of Cardiology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Jean-Philippe Empana
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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