1
|
Moon D, Pabayo R, Hwang J. An evolution of socioeconomic inequalities in self-rated health in Korea: Evidence from Korea National Health and Nutrition Examination Survey (KNHANES) 1998-2018. SSM Popul Health 2024; 26:101689. [PMID: 38952742 PMCID: PMC11215416 DOI: 10.1016/j.ssmph.2024.101689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 05/30/2024] [Accepted: 06/06/2024] [Indexed: 07/03/2024] Open
Abstract
Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea over the past two decades and identify the contributing factors to the observed inequalities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016/2018 were utilized. The concentration index (CI) was calculated to measure health inequalities, and decomposition analysis was applied to identify and quantify the contributing factors to the observed inequalities in health. The results indicated that health inequalities exist, suggesting that poor health was consistently more concentrated among Korean adults with lower income (1998: -0.154; 2016/2018: -0.152). Gender-stratified analyses also showed that poor health was more concentrated in lower income women and men, with the degree of inequalities slightly more pronounced among women. The decomposition approach revealed that income and educational attainment were the largest contributors to the observed health inequalities as higher income and education associated with better self-rated health. These findings suggest the importance of considering socioeconomic determinants, such as income and education, in efforts to tackling health inequalities, particularly considering that self-rated health is a predictor of future mortality and morbidity. Furthermore, it is essential to implement more egalitarian social, labour market, and health policies in order to eliminate the existing socioeconomic inequalities in health in Korea.
Collapse
Affiliation(s)
- Daseul Moon
- Centre for Labour Health, People's Health Institute, Seoul, South Korea
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jongnam Hwang
- Division of Social Welfare & Health Administration, Wonkwang University, Iksan, South Korea
| |
Collapse
|
2
|
Wu B, Li Y, Shi B, Zhang X, Lai Y, Cui F, Bai X, Xiang W, Geng G, Liu B, Jiao M, Wu Q, Yang H, Zhang C, Liu X, Tian Y, Li H. Temporal trends of breast cancer burden in the Western Pacific Region from 1990 to 2044: Implications from the Global Burden of Disease Study 2019. J Adv Res 2024; 59:189-199. [PMID: 37422280 PMCID: PMC11082062 DOI: 10.1016/j.jare.2023.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/07/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023] Open
Abstract
INTRODUCTION Breast cancer (BC) is a malignant disease that occurs worldwide and poses serious health burden. OBJECTIVES To assess the prevalence of BC burden in the Western Pacific region (WPR) from 1990 to 2019, and to predict trends from 2020 to 2044. To analyze the driving factors and put forward the region-oriented improvement. METHODS Based on the Global Burden of Disease Study 2019, BC cases, deaths, disability-adjusted life years (DALYs) cases, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate in WPR from 1990 to 2019 was obtained and analysed. Age-period-cohort (APC) model was used to analyze age, period, and cohort effects in BC, and Bayesian APC (BAPC) was used to predict trends over the next 25 years. RESULTS In conclusion, BC incidence and deaths in the WPR have increased rapidly over the past 30 years and are expected to continue to increase between 2020 and 2044. Among behavioral and metabolic factors, high body-mass index was the main risk factor for BC mortality in middle-income countries, whereas alcohol use was the main risk factor in Japan. Age is a key factor in the development of BC, with 40 years being the critical point. Incidence trends coincide with the course of economic development. CONCLUSIONS The BC burden remains an essential public health issue in the WPR and will increase substantially in the future. More efforts should be made in middle-income countries to prompt the health behavior and minimize the burden of BC because these nations accounts for the majority of BC burden in the WPR.
Collapse
Affiliation(s)
- Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China.
| | - Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China; Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bei Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Mingli Jiao
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huiying Yang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Chenxi Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yulu Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyu Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| |
Collapse
|
3
|
Dehghan G, Malekpour F, Jafari-Koshki T, Mohammadian Y, Rostami H. The status of work-related COVID-19 prevention measures and risk factors in hospitals. Work 2024; 77:445-453. [PMID: 37742681 DOI: 10.3233/wor-230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Health care workers (HCWs) in hospitals are at risk of infection with coronavirus disease 2019 (COVID-19). Prevention measures are necessary to protect HCWs against COVID-19. OBJECTIVE This study aimed to determine the status of occupational risk factors and prevention measures for COVID-19 in hospitals. METHODS This cross-sectional study was conducted in Iranian hospitals. Based on the results of reviewing the literature and guidelines, two checklists on occupational risk factors and prevention measures for COVID-19 in hospitals were designed and validated. The status of occupational risk factors and prevention measures against COVID-19 in governmental, non-governmental public, private, and military hospitals were determined using designed checklists. RESULTS Results confirmed the validity of checklists for assessing the status of COVID-19 prevention measures in hospitals. The military hospitals had the lowest mean risk factors compared to other hospitals, but there was no significant difference in occupational risk factors of infection with COVID-19 among governmental, non-governmental public, private, and military hospitals (P-value > 0.05). In the checklist of occupational risk factors of Covid-19, the type of hospital had a significant relationship with the provision and use of personal protective equipment (P-value<0.05). The mean of implementation of prevention measures among all hospitals were not statistically significant difference (P-value > 0.05). CONCLUSION The provided checklists could be a suitable tool for monitoring of status of prevention measures for COVID-19 in hospitals. Improving ventilation systems is necessary in most of the hospitals.
Collapse
Affiliation(s)
- Golnoush Dehghan
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Malekpour
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Jafari-Koshki
- Department of Statistics and Epidemiology, Molecular Medicine Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Mohammadian
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Rostami
- Research Center for Cognitive and Behavioral Sciences in Police, Directorate of Health, Rescue and Treatment, Police Headquarter, Tehran, Iran
- FARAJA Institute of Law Enforcement Sciences and Social Studies, Tehran, Iran
| |
Collapse
|
4
|
Struik L, Christianson K, Khan S, Yang Y, Werstuik ST, Dow-Fleisner S, Ben-David S. Factors that influence decision-making among youth who vape and youth who don't vape. Addict Behav Rep 2023; 18:100509. [PMID: 37519860 PMCID: PMC10382621 DOI: 10.1016/j.abrep.2023.100509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Vaping rates among Canadian youth are significantly higher compared to adults. While it is acknowledged that various personal and socio-environmental factors influence the risk of school-aged youth for vaping uptake, we don't know which known behavior change factors are most influential, for whom, and how. The Unified Theory of Behavior (UTB) brings together theoretically-based behavior change factors that influence health risk decision making. We aimed to use this framework to study the factors that influence decision making around vaping among school-aged youth. Qualitative interviews were conducted with 25 youth aged 12 to 18 who were either vaped or didn't vape. We employed a collaborative and directed content analysis approach and the UTB constructs served as the coding framework for analysis. Gender differences were explored in the analysis. We found that multiple intersecting factors play a significant role in youth decision making to vape. Youth who vaped and those who did not vape reported similar mediating determinants that either reinforced or challenged their decision-making, such as easy access to vaping, constant exposure to vaping, and the temptation of flavors. Youth who didn't vape reported individual determinants that strengthened their intentions to not vape, including more negative behavioral beliefs (e.g., vaping is harmful) and normative beliefs (e.g., family disapproves), and strong self-efficacy (e.g. self-confidence). Youth who did vape, however, reported individual determinants that supported their intentions to vape, such as social identity, coolness, and peer endorsement. The findings revealed cohesion across multiple determinants, suggesting that consideration of multiple determinents when developing prevention messages would be beneficial for reaching youth.
Collapse
Affiliation(s)
- Laura Struik
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Kyla Christianson
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Shaheer Khan
- Interdisciplinary Studies, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Youjin Yang
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Saige-Taylor Werstuik
- Interdisciplinary Studies, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Sarah Dow-Fleisner
- School of Social Work, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Shelly Ben-David
- School of Social Work, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| |
Collapse
|
5
|
Muralidharan S, Gore M, Katkuri S. Cancer care and economic burden-A narrative review. J Family Med Prim Care 2023; 12:3042-3047. [PMID: 38361876 PMCID: PMC10866236 DOI: 10.4103/jfmpc.jfmpc_1037_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/05/2023] [Accepted: 08/09/2023] [Indexed: 02/17/2024] Open
Abstract
Cancer care poses a significant economic burden in India, where noncommunicable diseases contribute to a large number of deaths and disability-adjusted life-years. Despite economic growth, equitable wealth distribution remains a challenge, leading to inequalities in healthcare access. India's healthcare system is primarily privatized, financed through out-of-pocket expenditure (OOPE), and lacks coverage for a majority of the population. As a result, individuals without financial means face catastrophic health consequences when seeking necessary healthcare. OOPE in India's healthcare system is a major concern, with medicines accounting for a significant portion of expenses, followed by diagnostic tests and consultation fees. Nonmedical expenses also contribute to the financial burden. Cancer care specifically faces substantial financial challenges, with high treatment costs, reduced workforce participation, and the need for distress financing. Cancer-related OOPE is predominantly borne by patients and their families, leading to significant financial strain. The lack of comprehensive health insurance coverage and limited access to publicly funded healthcare services exacerbate the problem. Catastrophic health expenditure (CHE) in cancer care is prevalent, pushing households into financial distress and potentially impoverishment. Efforts have been made to address this issue, such as increasing public spending on healthcare and implementing health insurance schemes. However, challenges remain in ensuring their effectiveness and reach. The role of family care physicians is crucial in supporting patients and their families during catastrophic health expenditures related to cancer-related palliative care. They coordinate care, provide advocacy, emotional support, symptom management, and facilitate end-of-life discussions. Comprehensive measures are needed to strengthen healthcare infrastructure, improve access to affordable cancer care, enhance health insurance coverage, and implement supportive measures for cancer patients. Additionally, promoting preventive measures and early detection can help reduce the need for expensive treatments and decrease the risk of catastrophic health expenditures.
Collapse
Affiliation(s)
- Shrikanth Muralidharan
- PhD Scholar, Faculty of Medical and Health Sciences, Symbiosis Community Outreach Programme and Extension, Symbiosis International (Deemed University), Lavale, Tal: Mulshi, Pune, Maharashtra, India
| | - Manisha Gore
- Assistant Professor, Faculty of Medical and Health Sciences, Symbiosis Community Outreach Programme and Extension, Symbiosis International (Deemed University), Lavale, Tal: Mulshi, Pune, Maharashtra, India
| | - Sushma Katkuri
- Professor and PG Guide, Department of Community Medicine, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India
| |
Collapse
|
6
|
He J, Hu Q. Ovarian cancer disease burden decreased in the United States from 1975 to 2018: A joinpoint and age-period-cohort analysis. Medicine (Baltimore) 2023; 102:e36029. [PMID: 38050303 PMCID: PMC10695534 DOI: 10.1097/md.0000000000036029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/18/2023] [Indexed: 12/06/2023] Open
Abstract
Ovarian cancer (OC) is the leading cause of gynecological cancer-related deaths in the United States. The purpose of this study was to evaluate long-term trends in OC incidence and incidence-based mortality rates (IBM) in the U.S. from 1975 to 2018 and to assess the effects of age, period, and cohort factors on OC incidence and mortality using an age-period-cohort model. We obtained data from the U.S. OC incidence/mortality data from the Surveillance, Epidemiology, and End Results database from 1975 to 2018. Joinpoint regression analysis was used to determine long-term trends and transitions, and an age-period-cohort model was used to quantify the effects of age, period, and cohort parameters on incidence and mortality. In addition, 1990 to 2019 U.S. OC data obtained from the Global Burden of Disease study served as a potential validation set. Between 1975 and 2018, 80,622 new cases of OC and 60,218 deaths from OC were reported in the U.S. The average annual percent change for OC incidence was -1.33 (95% CI: -1.64 to -1.02, P < .001), with a significant decrease in incidence at a rate of 7.80% (95% CI: -11.52 to -3.92) per year from to 2015-2018. IBM reached its peak for the U.S. population in 1994, with an age-standardized mortality rate of 6.38 (per 100,000 people). IBM rose first, peaked in 1986, and then declined at a rate of 0.39% (95% CI: -0.66 to -0.12) and 2.48% (95% CI: -3.09 to -1.85) per year from to 1986-2007 and 2007-2018, respectively. In addition, age-period-cohort model analysis showed the highest risk of OC incidence in 1980 to 1984 and the highest risk of OC death in 1985-1989. This study reported a significant decline in OC morbidity and mortality in the U.S. since 1986. In addition, this study analyzed the changes in trends in OC incidence and mortality by race/ethnicity in the U.S. Monitoring trends in OC incidence and mortality by race/ethnicity can help in the development of targeted prevention and treatment measures.
Collapse
Affiliation(s)
- Jiahui He
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qinyong Hu
- Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
7
|
Mac-Seing M, Gidey M, Di Ruggiero E. COVID-19-related global health governance and population health priorities for health equity in G20 countries: a scoping review. Int J Equity Health 2023; 22:232. [PMID: 37924074 PMCID: PMC10625304 DOI: 10.1186/s12939-023-02045-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023] Open
Abstract
Since the declaration of the COVID-19 pandemic, the promotion of health equity including the health of various population sub-groups has been compromised, human rights jeopardised, and social inequities further exacerbated. Citizens worldwide, including in the Group of 20 (G20) countries, were affected by both global health governance (GHG) processes and decisions and public health measures taken by governments to respond to COVID-19. While it is critical to swiftly respond to COVID-19, little is known about how and to what extent the GHG is affecting population health priorities for health equity in global economies such as the G20 countries. This scoping review synthesised and identified knowledge gaps on how the COVID-19-related GHG is affecting population health priorities for policy, programme, and research in G20 countries. We followed the five-stage scoping review methodology promoted by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews guidelines. We searched four bibliographic databases for references conducted in G20 countries and regions and published in English and French, between January 2020 and April 2023. Out of 4,625 references and after two phases of screening, 14 studies met the inclusion criteria. G20 countries included in the review were Australia, Brazil, Canada, China, France, India, Italy, Japan, Russia, South Africa, the United Kingdom, the United States of America, and the European Union. We found insufficient collaboration and coordination and misalignment among governance actors at multiple levels. In most cases, equity considerations were not prioritised while unequal consequences of COVID-19 public health measures on population groups were widely reported. COVID-19-related population health priorities mainly focused on upstream and midstream determinants of health. Our scoping review showed the stark inequities of COVID-19 public health outcomes, coupled with a prevalent lack of coherent collaboration and coordination among governance actors. Moreover, governance as an object of empirical study is still emerging when examining its intersection with global health and population health policy, programme, and research. An urgent shift is required to effectively act upon structural health determinants that include transformative and comprehensive policies for prevention, equity, resilience, and sustainable health.
Collapse
Affiliation(s)
- Muriel Mac-Seing
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Québec, Canada.
- Social and Behavioural Health Sciences Division & Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
- Centre de recherche en santé publique, Université de Montréal, Montréal, Canada.
| | - Meron Gidey
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Erica Di Ruggiero
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Social and Behavioural Health Sciences Division, Institute of Health Policy, Management and Evaluation & Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
8
|
Gui C, Shan X, Liu C, He L, Zhao H, Luo B. Disease burden of chronic kidney disease attributable to lead exposure: A global analysis of 30 years since 1990. CHEMOSPHERE 2023; 341:140029. [PMID: 37669716 DOI: 10.1016/j.chemosphere.2023.140029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Exposure to lead (Pb) is associated with an increased risk of chronic kidney disease (CKD). However, limited studies explored the global burden of CKD attributable to Pb exposure, especially in countries with different development levels. This study aimed to comprehensively evaluate the temporal and spatial trend in the disease burden of CKD attributable to Pb exposure in 204 countries and territories from 1990 to 2019. METHODS We used the data from Global Burden of Disease Study (GBD) 2019 to estimate annual deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALYs rate (ASDR) of CKD attributable to Pb exposure. The annual average percentage change (AAPCs) was calculated using the Joinpoint model to evaluate the changing trend of CKD ASMR and ASDR attributable to Pb exposure from 1990 to 2019. Meanwhile, age-period-cohort (APC) model was used to assess changes in the mortality of CKD attributable to Pb exposure from 1990 to 2019. RESULTS Global ASMR for CKD attributable to Pb exposure trended upward from 1990 to 2019. ASMR and ASDR were the highest in low and low-middle SDI regions. With the APC model, we found that global mortality rates for CKD attributable to Pb exposure increased with age. The global period rate ratio showed the highest value in 2000-2004 and the lowest in 2015-2019, while the global cohort rate ratio showed the highest value in 1941-1949 and the lowest during 1986-1994. CONCLUSIONS From 1990 to 2019, the global burden of CKD attributable to Pb exposure increased globally, especially in low and low-middle SDI regions, as well as the elderly. Pb exposure is still a great threat to the global burden of CKD, and the implementation of effective prevention measures to reduce Pb exposure in the environment should be continually strengthened.
Collapse
Affiliation(s)
- Chunyan Gui
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Hao Zhao
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, People's Republic of China.
| |
Collapse
|
9
|
Nugroho ST, Ahsan A, Kusuma D, Adani N, Irawaty DK, Amalia N, Hati SRH. Income Disparity and Healthcare Utilization: Lessons from Indonesia's National Health Insurance Claim Data. Asian Pac J Cancer Prev 2023; 24:3397-3402. [PMID: 37898843 PMCID: PMC10770668 DOI: 10.31557/apjcp.2023.24.10.3397] [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: 02/11/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Indonesia's National Health Insurance Program, known as Jaminan Kesehatan Nasional (JKN), has a variety of membership pathways for those wishing to gain access. Claim data from JKN offers a cost-effective way of observing who is accessing healthcare services and what types of services are being used. This study is a novel attempt to measure disparities amongst JKN users in their engagement with services, providing an opportunity to reflect on patterns of use. METHODS Using claims data collected from JKN users between 2015-2016, we used the Ordinary Least Square estimation model to compare health services utilization among subsidized and non-subsidized users. We focused primarily on the individual use of the hospital for outpatient and inpatient treatment. RESULTS Analysis reveals that subsidized users access primary healthcare services more frequently than non-subsidized users. Conversely, non-subsidized users access secondary and tertiary health care services more frequently than other users. Subsidized users who utilize secondary and tertiary health care tend to suffer more severe health illnesses than non-subsidized members. CONCLUSIONS This study concludes that income disparity affects healthcare utilization. Non-subsidized members are more likely than subsidized members to access secondary and tertiary health care services. Our study offers evidence of the potential underutilization of secondary and tertiary healthcare (STHC) by subsidized members, which could lead to inefficiency since subsidized members seeking STHC treatment had severe health conditions, thus needing to be treated longer and requiring higher healthcare expenditures.
Collapse
Affiliation(s)
- Sony Tito Nugroho
- Department of Economics, Faculty of Economics and Business, University of Indonesia, Depok, Indonesia.
| | - Abdillah Ahsan
- Department of Economics, Faculty of Economics and Business, University of Indonesia, Depok, Indonesia.
| | - Dian Kusuma
- Department of Health Services Research and Management, School of Health & Psychological Sciences, City University of London, London EC1V 0HB, UK.
| | - Nadhila Adani
- Department of Economics, Faculty of Economics and Business, University of Indonesia, Depok, Indonesia.
| | | | - Nadira Amalia
- Department of Economics, Faculty of Economics and Business, University of Indonesia, Depok, Indonesia.
| | - Sri Rahayu Hijrah Hati
- Department of Management Faculty of Economics and Business, University of Indonesia, Depok, Indonesia.
| |
Collapse
|
10
|
Birie B, Niguse W. Experience of respectful maternity care during childbirth and associated factors in public hospitals of the South West Region of Ethiopia: an institution-based, cross-sectional study. BMJ Open 2023; 13:e066849. [PMID: 37433724 DOI: 10.1136/bmjopen-2022-066849] [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: 07/13/2023] Open
Abstract
OBJECTIVE To determine women's level of experience of respectful maternity care during childbirth and associated factors in public hospitals in the South West Region of Ethiopia. DESIGN Institution-based, cross-sectional study. SETTING The study was conducted at secondary-level healthcare institutions in the South West Region of Ethiopia from 1 June to 30 July 2021. PARTICIPANTS 384 postpartum women were sampled from four hospitals using a systematic random sampling technique, allocating a proportion to each health facility. Pretested structured questionnaires were used to collect data from the postnatal mothers through a face-to-face exit interview. OUTCOME MEASURES The level of respectful maternity care was measured according to the Mothers on Respect Index. P values of <0.05 and 95% CIs were used to determine statistical significance. RESULTS Of the 384 sampled women, 370 postnatal mothers participated in the study (response rate 96.3%). 11.6% (95% CI 8.4% to 15.1%), 39.7% (95% CI 34.3% to 44.6%), 20.8% (95% CI 17.3% to 25.1%), and 27.8% (95% CI 23.5% to 32.4%) of women experienced very low, low, moderate, and high levels of respectful maternal care during childbirth, respectively. Having no formal education was negatively associated with experience of respectful maternal care (adjusted OR (AOR)=0.51, 95% CI 0.294 to 0.899), while daytime delivery (AOR 8.53, 95% CI 5.032 to 14.47), giving birth through caesarean section (AOR 2.19, 95% CI 1.410 to 3.404) and future intention to give birth within the health facility (AOR 5.18, 95% CI 3.019 to 8.899) were positively associated with respectful maternal care. CONCLUSION In this study, only one-fourth of women experienced high-level respectful maternal care during childbirth. Responsible stakeholders must develop guidelines and strategies to monitor and harmonise respectful maternal care practices at all institutions.
Collapse
Affiliation(s)
- Bamlaku Birie
- Midwifery, Mizan Tepi University, Mizan-Aman, Ethiopia
| | | |
Collapse
|
11
|
Paudel S, Ahmadi M, Phongsavan P, Hamer M, Stamatakis E. Do associations of physical activity and sedentary behaviour with cardiovascular disease and mortality differ across socioeconomic groups? A prospective analysis of device-measured and self-reported UK Biobank data. Br J Sports Med 2023; 57:921-929. [PMID: 36754587 PMCID: PMC10359566 DOI: 10.1136/bjsports-2022-105435] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To examine if individual-level and area-level socioeconomic status (SES) modifies the association of moderate-to-vigorous physical activity (MVPA), domain-specific physical activity and sedentary behaviour with all-cause mortality (ACM) and incident cardiovascular disease (CVD). METHODS We used self-reported (International Physical Activity Questionnaire short form) and accelerometer-measured physical activity and sedentary behaviour data from the UK Biobank. We created an individual-level composite SES index using latent class analysis of household income, education and employment status. The Townsend Index was the measure of area-level SES. Cox proportional hazards regression models stratified across SES were used. RESULTS In 328 228 participants (mean age 55.9 (SD 8.1) years, 45% men) with an average follow-up of 12.1 (1.4) years, 18 033 deaths and 98 922 incident CVD events occurred. We found an increased ACM risk of low physical activity and high sedentary behaviour and an increased incident CVD risk of low accelerometer-measured moderate-to-vigorous physical activity (ACCEL_MVPA) and high sitting time. We observed statistically significant interactions for all exposures in ACM analyses by individual-level SES (p<0.05) but only for screen time in area-level SES-ACM analysis (p<0.001). Compared with high self-reported moderate-to-vigorous physical activity (IPAQ_MVPA), adjusted ACM HRs for low IPAQ_MVPA were 1.14 (95% CI 1.05 to .25), 1.15 (95% CI 1.06 to 1.24) and 1.22 (95% CI 1.13 to 1.31) in high, medium and low individual-level SES, respectively. There were higher detrimental associations of low ACCEL_MVPA with decreasing area-level SES for both outcomes and of high screen time with ACM in low area-level SES. CONCLUSION We found modest evidence suggesting that the detrimental associations of low MVPA and high screen time with ACM and incident CVD are accentuated in low SES groups.
Collapse
Affiliation(s)
- Susan Paudel
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew Ahmadi
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, Prevention Research Collaboration, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Hamer
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, UK
| | - Emmanuel Stamatakis
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
12
|
Mehralian G, Yusefi AR, Davarani ER, Ahmadidarrehsima S, Nikmanesh P. Examining the relationship between health literacy and quality of life: evidence from older people admitted to the hospital. BMC Geriatr 2023; 23:147. [PMID: 36932343 PMCID: PMC10024369 DOI: 10.1186/s12877-023-03838-w] [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: 08/30/2022] [Accepted: 02/21/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION Literacy has become an increasingly serious problem, especially as it relates to health care. In this regard, health literacy (HL), as a cognitive skill, has proven to be an influential factor to improve of the quality of life (QOL). This study aimed to examine the level of HL and its relationship with the QOL of older people at the time of discharge from the hospital in the south of Iran. METHODS This descriptive-analytical cross-sectional study included 300 older people admitted and treated in 10 teaching-therapeutic hospitals affiliated with the Shiraz University of Medical Sciences in 2021. The standard Health Literacy for Iranian Adults (HELIA) questionnaire and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) were used to collect the required data. Data were analyzed with SPSS software version 23 software using descriptive and inferential statistics, Pearson's correlation coefficient, T-test, ANOVA, and multiple linear regression at p = 0.05. RESULTS The mean scores of Hl and QOL for older people were 48.22 ± 9.63 (out of 100) and 61.59 ± 12.43 (out of 120), respectively. Moreover, there was a significant direct correlation between the participants' HL and their QOL (r=0.388, p<0.001). All dimensions of HL, including comprehension (β=0.461, p<0.001), decision-making and behavior (β=0.434, p<0.001), access (β=0.397, p<0.001), reading skill (β=0.362, p=0.002), and assessment (β=0.278, p=0.004), were significant relationship with QOL. A statistically significant difference was revealed between the mean scores of HL regarding the participants' gender (p=0.04) and level of education (p=0.001). Furthermore, the mean scores of QOL were significantly different with regard to older people's gender (p=0.02), marital status (p=0.03), level of education (p=0.002), and income (p=0.01). CONCLUSION The findings revealed the participants' inadequate HL and average QOL. Considering the relationship of HL with QOL, it is recommended to develop comprehensive programs and effective interventions to develop HL skills and subsequently improve QOL among older people.
Collapse
Affiliation(s)
| | - Ali Reza Yusefi
- grid.510408.80000 0004 4912 3036Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
- grid.510408.80000 0004 4912 3036School of Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Esmat Rezabeigi Davarani
- grid.412105.30000 0001 2092 9755Health in Disasters and Emergencies Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sudabeh Ahmadidarrehsima
- grid.510408.80000 0004 4912 3036Department of Midwifery, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Parnian Nikmanesh
- grid.411746.10000 0004 4911 7066Healthcare Services Management, School of Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Li J, Guo B, Huang X, Wang H, Zuo G, Lu W. Study of the medical service efficiency of county-level public general hospitals based on medical quality constraints: a cross-sectional study. BMJ Open 2023; 13:e059013. [PMID: 36690403 PMCID: PMC9872475 DOI: 10.1136/bmjopen-2021-059013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/08/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Since the new medical reform in 2009, county-level hospitals in China have achieved rapid development, but health resource waste and shortage issues still exist. DESIGN We applied the meta-frontier and slacks-based measurement-undesirable data envelopment analysis model to measure the medical service efficiency with or without medical quality constraints of the county-level public general hospitals (CPGHs). The assessment includes four inputs, three desirable outputs and one undesirable output. We conducted the assessment via Max-DEA V.8.19 software. Moreover, we analyse the factors affecting CPGHs' medical service efficiency based on the fractional response model. SETTING A total of 77 sample CPGHs were selected from Shanxi province in China from 2013 to 2018. RESULTS The results of this study showed that the efficiency level of county-level public hospitals in Shanxi Province is relatively low overall (the mean value of efficiency is 0.61 without quality constraints and 0.63 under quality constraints). This showed that ignoring medical quality constraints will result in lower efficiency and lower health resource usage for high medical quality hospitals. The medical service efficiency of CPGHs differs greatly among different regions. Under the meta-frontier, the hospitals in the central region had the highest efficiency (efficiency score 0.70), followed by those in the south (efficiency score 0.63) and the hospitals in the north had the lowest efficiency (efficiency score 0.54). Factors that have larger impacts on the service efficiency of county public hospitals are the average length of hospital stay, per capita disposable income and financial subsidy income. CONCLUSIONS To improve CPGHs' medical service efficiency, the government should increase investment in the northern region, and hospitals should improve the management level and allocate human resources rationally.
Collapse
Affiliation(s)
- Jing Li
- School of Economics, Hefei University of Technology, Hefei, China
| | - Binbin Guo
- School of Economics, Hefei University of Technology, Hefei, China
| | - Xiaojun Huang
- School of Management, Hainan Medical University, Haikou, Hainan, China
| | - Huakang Wang
- School of Management, Hainan Medical University, Haikou, Hainan, China
| | - Guangyan Zuo
- School of Management, Hainan Medical University, Haikou, Hainan, China
| | - Wei Lu
- School of Management, Hainan Medical University, Haikou, Hainan, China
| |
Collapse
|
14
|
Askarzade E, Nabizade Z, Goharinezhad S, Mostaghim S. Universal Health Coverage in Iran: A Review of Strengths, Weaknesses, Opportunities, and Threats. Med J Islam Repub Iran 2023; 37:6. [PMID: 37123342 PMCID: PMC10134088 DOI: 10.47176/mjiri.37.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Indexed: 05/02/2023] Open
Abstract
Background Universal health coverage (UHC) aims to provide access to basic health services with no financial constraints. In Iran, the major challenges to the implementation of the UHC plan include aggregation and augmentation of resources, something which could threaten the dimension of population coverage and health service delivery. Therefore, this study reviews the strengths and weaknesses of the internal environment as well as the opportunities and threats of the external environment in the UHC plan to help policymakers and decision-makers of the health system. Methods In this review study, reputable databases were searched for all the relevant papers on UHC to collect data. After that, the strengths, weaknesses, opportunities and threats (SWOT) analysis was conducted to organize, collect, and analyze data. The SWOT analysis is a process that has 4 components and 2 dimensions. The 4 components are strengths, weaknesses, opportunities, and threats. In fact, strengths and weaknesses are considered internal factors and organizational features, whereas opportunities and threats are considered external factors and environmental features. The listed items were then categorized for clarification and transparency within the framework of the 6 building blocks of the World Health Organization (WHO). Results The relevant studies were reviewed to analyze the strengths and weaknesses of internal environments as well as the opportunities and threats of external environments. The necessary points for better planning and policymaking were then presented. Conclusion The success of Iran's UHC plan can be guaranteed by regular capacity building, ongoing education, and empowerment of society in addition to improving intersectoral collaboration and acquiring political commitment to develop more effective and more accountable systems matching variable and dynamic health requirements.
Collapse
Affiliation(s)
- Elahe Askarzade
- Department of Health Care Management, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Nabizade
- Department of Health Management and Economics, School of Public Health, Tehran
University of Medical Sciences, Tehran, Iran
| | - Salime Goharinezhad
- Pereventive Medicine and Public Health Research Center, Psychosocial Health
Research Insttitute, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Mostaghim
- Department of Health Care Management, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Corresponding author:Somayeh Mostaghim,
| |
Collapse
|
15
|
Impact of the COVID-19 pandemic lockdown on hospitalizations for cerebrovascular disease and related in-hospital mortality in China: A nationwide observational study. Arch Gerontol Geriatr 2023; 104:104832. [PMID: 36219895 PMCID: PMC9531358 DOI: 10.1016/j.archger.2022.104832] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this nationwide study was to assess the impact of the COVID-19 pandemic on cerebrovascular disease hospitalization rates, out-of-pocket rates, and in-hospital case fatality rates. METHODS All hospitalizations for cerebrovascular disease from 1599 hospitals from 2019 to 2020 were selected using the International Classification of Diseases, 10th revision, in the Hospital Quality Monitoring System (HQMS). We defined 2019 as the pre-pandemic group and 2020 as the post-pandemic group. Multivariate analyses were done to assess the association between the pandemic and patient outcomes and out-of-pocket rate with odds ratios (OR) and 95% CIs presented. RESULTS In total, 9 640 788 patients with the cerebrovascular disease were recruited (mean age was 65.7[SE.0.004] years, and 55.7% were male), and data is available for 5145358 patients in 2019 (pre-epidemic) and 4495430 patients in 2020(post-pandemic), indicating a 12.6% decrease. Out-of-pocket rate increase of 9.3% (2020 vs 2019: 34.1%% vs 31.2% [absolute difference, 2.9% {95% CI, 1.3% to 4.5%}, odd ratio {OR}, 1.1{95% CI, 1.0 to 1.1}]. The epidemic has led to an 18.0% increase in in-hospital mortality (2020 vs 2019: 1.1%% vs 0.9% [absolute difference, 0.2% {95% CI, 0.1% to 0.2%}, odd ratio {OR}, 1.1{95% CI, 1.1 to 1.2}]. The epidemic has led to significantly increased in-hospital mortality for patients with stroke but had no significant impact on other cerebrovascular diseases. CONCLUSIONS During the COVID-19 pandemic lockdown, patients hospitalized for stroke fell by 12.6%, and there were substantial increases in out-of-pocket rates (9.3%) and in-hospital case fatality rates (18.0%).
Collapse
|
16
|
Li H, Zeng Y, Gan L, Tuersun Y, Yang J, Liu J, Chen J. Urban-rural disparities in the healthy ageing trajectory in China: a population-based study. BMC Public Health 2022; 22:1406. [PMID: 35870914 PMCID: PMC9308310 DOI: 10.1186/s12889-022-13757-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
The aim of this study is to measure the trajectory of healthy ageing among Chinese middle-aged and older population, and explore the disparity of the trajectory, as well as contributing factors, between urban and rural areas in China.
Methods
A total of 9402 respondents aged 45 years and older interviewed in four waves (2011, 2013, 2015 and 2018) were selected from the China Health and Retirement Longitudinal Study. Healthy ageing score was calculated through item response theory. A latent growth mixture model (LGMM) was applied to distinguish the trajectory of healthy aging. A multinomial logistics regression model (MLRM) was used to explore the relationship between urban-rural areas and healthy aging trajectories, and further to explore associated factors in rural and urban areas separately.
Results
The healthy ageing score was lower in rural areas than urban areas in each survey wave. Five classes (“continuing-low”, “continuing-middle”, “continuing-middle-to-high”, “significantly-declining”, “continuing-high”) were grouped through LGMM. The MLRM results showed that urban living was significantly associated with a higher likelihood of being healthy (for [continuing-low/continuing-high]: β = − 1.17, RRR = 0.31, P < 0.001, 95% CI = 0.18–0.53; and for [continuing-middle/continuing-high]: β = − 0.53, RRR = 0.59, P < 0.001, 95% CI = 0.49–0.71).
Conclusion
Healthy ageing is a prominent objective in the development of a country, and rural-urban disparities are an essential obstacle to overcome, with the rural population more likely to develop a low level of healthy ageing trajectory. Prevention and standardized management of chronic diseases should be enhanced, and social participation should be encouraged to promote healthy ageing. The policy inclination and resource investment should be enhanced to reduce disparity in healthy ageing between urban and rural areas in China.
Collapse
|
17
|
Ajayi KV, Panjwani S, Garney W, McCord CE. Sociodemographic factors and perceived patient-provider communication associated with healthcare avoidance among women with psychological distress. PEC INNOVATION 2022; 1:100027. [PMID: 37213787 PMCID: PMC10194386 DOI: 10.1016/j.pecinn.2022.100027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 05/23/2023]
Abstract
Objective To establish the extent to which psychological distress influences health avoidance behavior among women, controlling for patient provider communication and sociodemographic characteristics. Methods Data from the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3) was analyzed to obtain healthcare avoidance behavior among women aged 18 and older (n = 2788). Weighted descriptive, bivariate, and multivariable logistic regression models were conducted. Results Approximately 649 women or 1 in 4 women (26.7% weighted prevalence; 95% Confidence Interval [CI] 0.23%-0.29%) avoided healthcare in the past 12 months. Non-Hispanic white (62.8%) and married (55.4%) women represented a higher proportion of the sample. Bivariate analysis revealed that the odds of reporting healthcare avoidance among women with mild, moderate, and severe psychological distress (Odds Ratio [OR]: 2.26, 95% CI: 1.45-3.53, p = 0.001; OR: 3.88, 95% CI: 2.29-6.56, p < 0.001; OR: 3.08, 95% CI: 1.81-5.23, p < 0.001) was significantly higher compared to those with none-minimal psychological distress. In the adjusted model, women with moderate and severe psychological distress (Adjusted OR [AOR]:3.15, 95% CI: 1.55-6.38, p = 0.002; AOR: 2.24, 95% CI: 1.10-4.92, p = 0.044) were more likely to report healthcare avoidance than those experiencing none-minimal psychological distress. Furthermore, increasing patient-provider communication score (AOR: 0.91, 95% CI: 0.87-0.96, p < 0.001) reduced the likelihood of healthcare avoidance. Among the sociodemographic variables assessed, being younger (18-49 years) and having less than a high school degree significantly increased the chances of avoiding healthcare. Conclusion A high proportion of women with psychological distress avoid necessary healthcare. Patient-provider communication quality, increasing age, and being a high school student contribute to healthcare avoidance in women. Innovation Strategies to improve health service utilization must address healthcare avoidance by developing effective health communication targeted at women with psychological distress.
Collapse
Affiliation(s)
- Kobi V. Ajayi
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, TX, United States
- Educating, Directing, Empowerment & Nurturing (EDEN) Foundation, Abuja, Nigeria
| | - Sonya Panjwani
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, TX, United States
| | - Whitney Garney
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
- Laboratory of Community Health Evaluation Science and Systems (CHESS), Texas A&M University, College Station, TX, United States
| | - Carly E. McCord
- Department of Psychiatry, College of Medicine, Texas A&M University, Bryan, TX, United States
- Department of Educational Psychology, College of Education, Texas A&M University, College Station, TX, United States
- Corresponding author at: Department of Psychiatry, Department of Educational Psychology, Texas A&M University, 8441 Riverside Parkway, Clinical Building 1, Suite 2580, Bryan, TX 77807, United States.
| |
Collapse
|
18
|
Miles A, Tanenbaum B, Thompson-Ricci S. Transforming injury prevention for youth (TrIPY): an intersectionality model for youth injury prevention. Inj Prev 2022; 28:564-569. [DOI: 10.1136/ip-2022-044619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/04/2022] [Indexed: 11/05/2022]
Abstract
Injury is deadly and expensive, and rates are increasing. The cost of injury is not only a financial burden; individuals, families and communities suffer the human costs of physical and emotional injury. For children and youth in Canada, injuries are the leading cause of death and disability. However, the risk of preventable injury is not equal for all youth. The transforming injury prevention for youth (TrIPY) model aims to recognise and remediate these inequities by applying an intersectionality lens to injury prevention programming. TrIPY conceptualises injury prevention programming through an intersectionality lens. The model was developed with diverse youth in mind, and the intended users include injury prevention practitioners, partners, stakeholders, communities and decision-makers. TrIPY was designed using a transformative perspective and built on core concepts within public health, injury prevention, intersectionality, gender analysis, youth risk, health equity, and systems of privilege and oppression. TrIPY helps to analyse intersecting inequities along multiple dimensions, to improve injury prevention programmes for diverse youth with unique identities, skills and lived experiences. The end goal of implementing an intersectionality model within injury prevention is to find out who is being missed in order to address existing inequities concerning youth injury. No matter what a person’s unique social location or lived experience, they will have the opportunity to be included in prevention programming. Developing injury prevention programmes through an intersectionality lens is needed to better understand the factors that interact to influence an individual’s risk for injury. There is a need to explore the unique experiences of youth at the intersection of various identity factors, including gender, race and ethnicity, and socioeconomic status. With this knowledge, prevention programmes can be more culturally responsive, gender transformative, inclusive, accessible and engaging for diverse groups of youth.
Collapse
|
19
|
Guo Y, Bai J, Zhang X, Jin Q, Liu Y, Yu C. Secular Trends of Mortality and Years of Life Lost Due to Chronic Obstructive Pulmonary Disease in Wuhan, China from 2010 to 2019: Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10685. [PMID: 36078400 PMCID: PMC9518558 DOI: 10.3390/ijerph191710685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has been an important public health issue in China. This study aimed to analyze the temporal trends in mortality and years of life lost (YLL) from COPD, and explore the effects of age, period, and cohort in Wuhan, China from 2010 to 2019. METHODS Data were collected from the cause of death surveillance system in Wuhan. Age-standardized mortality rate (ASMR), age-standardized YLL rate (ASYR) and the estimated annual percent changes (EAPC) were calculated to evaluate the temporal trends. The age-period-cohort (APC) model was adopted to estimate the age, period, and cohort effects. RESULTS From 2010 to 2019, COPD accounted for 26,051.15 deaths and 394,659.58 person years YLL in Wuhan. Recently, the death burden of COPD in Wuhan has somewhat improved, especially after 2015, with declining trends in ASMR and ASYR. Additionally, the ASMR and ASYR of COPD was higher in males. And these of males showed the overall upward trends, with EAPCs of 1.06 (0.13, 2.00) and 1.21 (0.12, 2.31), respectively, while females showed downward trends since 2010. According to APC model, the age effect of COPD increased with age, and the cohort risk ratios (RRs) followed the overall downward trends. Period RRs for the Wuhan population generally tended to rise and then fall, with females showing a clear downward trend after 2015, while period RRs for males maintained an upward trend throughout the study period. CONCLUSIONS Recently, the death burden from COPD in Wuhan has improved, especially after 2015, with improvements in ASMR, ASYR and period RRs. Sex differences still exist. COPD posed a greater threat to the elderly, especially males. Public health managers should continue to execute more targeted programs to lessen the death burden of COPD in Wuhan.
Collapse
Affiliation(s)
- Yan Guo
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Jianjun Bai
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xiaoxia Zhang
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Qiman Jin
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Yijun Liu
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Chuanhua Yu
- School of Public Health, Wuhan University, Wuhan 430071, China
| |
Collapse
|
20
|
Rahman T, Gasbarro D, Alam K. Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature. Health Res Policy Syst 2022; 20:83. [PMID: 35906591 PMCID: PMC9336110 DOI: 10.1186/s12961-022-00886-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022] Open
Abstract
Background Financial risk protection (FRP), defined as households’ access to needed healthcare services without experiencing undue financial hardship, is a critical health systems target, particularly in low- and middle-income countries (LMICs). Given the remarkable growth in FRP literature in recent times, we conducted a scoping review of the literature on FRP from out-of-pocket (OOP) health spending in LMICs. The objective was to review current knowledge, identify evidence gaps and propose future research directions. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines to conduct this scoping review. We systematically searched PubMed, Scopus, ProQuest and Web of Science in July 2021 for literature published since 1 January 2015. We included empirical studies that used nationally representative data from household surveys to measure the incidence of at least one of the following indicators: catastrophic health expenditure (CHE), impoverishment, adoption of strategies to cope with OOP expenses, and forgone care for financial reasons. Our review covered 155 studies and analysed the geographical focus, data sources, methods and analytical rigour of the studies. We also examined the level of FRP by disease categories (all diseases, chronic illnesses, communicable diseases) and the effect of health insurance on FRP. Results The extant literature primarily focused on India and China as research settings. Notably, no FRP study was available on chronic illness in any low-income country (LIC) or on communicable diseases in an upper-middle-income country (UMIC). Only one study comprehensively measured FRP by examining all four indicators. Most studies assessed (lack of) FRP as CHE incidence alone (37.4%) or as CHE and impoverishment incidence (39.4%). However, the LMIC literature did not incorporate the recent methodological advances to measure CHE and impoverishment that address the limitations of conventional methods. There were also gaps in utilizing available panel data to determine the length of the lack of FRP (e.g. duration of poverty caused by OOP expenses). The current estimates of FRP varied substantially among the LMICs, with some of the poorest countries in the world experiencing similar or even lower rates of CHE and impoverishment compared with the UMICs. Also, health insurance in LMICs did not consistently offer a higher degree of FRP. Conclusion The literature to date is unable to provide a reliable representation of the actual level of protection enjoyed by the LMIC population because of the lack of comprehensive measurement of FRP indicators coupled with the use of dated methodologies. Future research in LMICs should address the shortcomings identified in this review. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00886-3.
Collapse
Affiliation(s)
- Taslima Rahman
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia. .,Institute of Health Economics, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Dominic Gasbarro
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia
| | - Khurshid Alam
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia
| |
Collapse
|
21
|
Dheresa M, Daraje G, Fekadu G, Ayana GM, Balis B, Negash B, Raru TB, Dessie Y, Alemu A, Merga BT. Perinatal mortality and its predictors in Kersa Health and Demographic Surveillance System, Eastern Ethiopia: population-based prospective study from 2015 to 2020. BMJ Open 2022; 12:e054975. [PMID: 35584868 PMCID: PMC9119174 DOI: 10.1136/bmjopen-2021-054975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Perinatal mortality is an important outcome indicator for newborn care and directly mirrors the quality of prenatal, intra partum and newborn care. Therefore, this study was aimed at estimating perinatal mortality and its predictors in Eastern Ethiopia using data from Kersa Health and Demographic Surveillance System (KHDSS). DESIGN, SETTINGS AND PARTICIPANTS An open dynamic cohort design was employed among pregnant women from 2015 to 2020 at KHDSS. A total of 19 687 women were observed over the period of 6 years, and 29 719 birth outcomes were registered. OUTCOME MEASURES Perinatal mortality rate was estimated for each year of cohort and the cumulative of 6 years. Predictors of perinatal mortality are identified. RESULTS From a total of 29 306 births 783 (26.72 deaths per 1000 births; 95% CI 24.88 to 28.66) deaths were occurred during perinatal period. Rural residence (adjusted OR (AOR)=3.43; 95% CI 2.04 to 5.76), birth weight (low birth weight, AOR=3.98; 95% CI 3.04 to 5.20; big birth weight, AOR=2.51; 95% CI 1.76 to 3.57), not having antenatal care (ANC) (AOR=1.67; 95% CI 1.29 to 2.17) were associated with higher odds of perinatal mortality whereas the parity (multipara, AOR=0.46; 95% CI 0.34 to 0.62; grand multipara, AOR=0.31; 95% CI 0.21 to 0.47) was associated with lower odds of perinatal mortality. CONCLUSIONS The study revealed relatively high perinatal mortality rate. Place of residence, ANC, parity and birth weight were identified as predictors of perinatal mortality. Devising strategies that enhance access to and utilisations of ANC services with due emphasis for rural residents, primipara mothers and newborn with low and big birth weights may be crucial for reducing perinatal mortality.
Collapse
Affiliation(s)
- Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gamachis Daraje
- Department of Statistics, Haramaya University, Haramaya, Ethiopia
| | - Gelana Fekadu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
22
|
Gebremeskel AT, Omonaiye O, Yaya S. Sex differences in HIV testing among elders in Sub-Saharan Africa: a systematic review protocol. Syst Rev 2022; 11:95. [PMID: 35578357 PMCID: PMC9109370 DOI: 10.1186/s13643-022-01968-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elders (age 50+) HIV demographic (age and sex) data are essential to better understand their HIV service utilization and develop appropriate evidence-based responses and policies. Despite a significant prevalence rate of HIV and growing numbers of this population group, data are still scarce, and studies have neglected them in Sub-Saharan Africa. The aim of this protocol is to outline the methodological process of a systematic review that will gather qualitative and quantitative data to critically examine sex differences in HIV testing among elders (age 50+) in Sub-Saharan Africa. METHODS This protocol adheres to the PRISMA-P reporting guidelines. We will conduct a systematic database search to retrieve all observational and qualitative studies. Electronic search strategies will be developed for MEDLINE, EMBASE, Web of Science, Global Health, and CINAHL for studies reporting HIV data. Two reviewers will independently screen all citations, full-text articles, and abstract data. The search strategy will consist of free-text and Medical Subject Headings (MeSH) terms. Search terms for elders (50+) will include the following: "elders", "older adults", "aged", "geriatric" and "seniors". The primary outcome of interest is sex differences in the uptake of HIV counselling and testing (HCT). The study methodological quality (or bias) will be appraised using appropriate tools. Screening, data extraction, and assessments of risk of bias will be performed independently by two reviewers. Narrative synthesis will be conducted with studies that are compatible based on population and outcome. As it will be a systematic review, without human participants' involvement, there will be no requirement for ethical approval. DISCUSSION The systematic review will present key evidence on sex differences in HIV testing among elders in Sub-Saharan Africa. The findings will be used to inform program developers, policymakers, and other stakeholders to enhance sex disaggregated HIV data to improve access to HIV counselling and testing service for elders in Sub-Saharan Africa. The final manuscript will be disseminated through a peer-reviewed journal and scientific conferences. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42020172737 .
Collapse
Affiliation(s)
- Akalewold T Gebremeskel
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Olumuyiwa Omonaiye
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Burwood, Melbourne, Victoria, Australia.,Centre for Nursing and Midwifery Research, James Cook University, Townsville, Queensland, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
| |
Collapse
|
23
|
Allen LN, Mackinnon S, Gordon I, Blane D, Marques AP, Gichuhi S, Mwangi A, Burton MJ, Bolster N, Macleod D, Kim M, Ramke J, Bastawrous A. Performance and resource requirements of in-person versus voice call versus automated telephone-based socioeconomic data collection modalities for community-based health programmes: a systematic review protocol. BMJ Open 2022; 12:e057410. [PMID: 35428640 PMCID: PMC9014069 DOI: 10.1136/bmjopen-2021-057410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Gathering data on socioeconomic status (SES) is a prerequisite for any health programme that aims to assess and improve the equitable distribution of its outcomes. Many different modalities can be used to collect SES data, ranging from (1) face-to-face elicitation, to (2) telephone-administered questionnaires, to (3) automated text message-based systems. The relative costs and perceived benefits to patients and providers of these different data collection approaches is unknown. This protocol is for a systematic review that aims to compare the resource requirements, performance characteristics, and acceptability to participants and service providers of these three approaches to collect SES data from those enrolled in health programmes. METHODS AND ANALYSIS An information specialist will conduct searches on the Cochrane Library, MEDLINE, Embase, Global Health, ClinicalTrials.gov, the WHO ICTRP and OpenGrey. All databases will be searched from 1999 to present with no language limits used. We will also search Google Scholar and check the reference lists of relevant articles for further potentially eligible studies. Any empirical study design will be eligible if it compares two or more modalities to elicit SES data from the following three; in-person, voice call, or automated phone-based systems. Two reviewers will independently screen titles, abstracts and full-text articles; and complete data extraction. For each study, we will extract data on the modality characteristics, primary outcomes (response rate and equivalence) and secondary outcomes (time, costs and acceptability to patients and providers). We will synthesise findings thematically without meta-analysis. ETHICS AND DISSEMINATION Ethical approval is not required, as our review will include published and publicly accessible data. This review is part of a project to improve equitable access to eye care services in low-ioncome and middle-income countries. However, the findings will be useful to policy-makers and programme managers in a range of health settings and non-health settings. We will publish our findings in a peer-reviewed journal and develop an accessible summary of results for website posting and stakeholder meetings. PROSPERO REGISTRATION NUMBER CRD42021251959.
Collapse
Affiliation(s)
- Luke Nelson Allen
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Shona Mackinnon
- Institute of health and wellbeing, University of Glasgow, Glasgow, UK
| | - Iris Gordon
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - David Blane
- Institute of health and wellbeing, University of Glasgow, Glasgow, UK
| | - Ana Patricia Marques
- London School of Hygiene and Tropical Medicine International Centre for Eye Health, London, UK
| | - Stephen Gichuhi
- Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
| | | | - Matthew J Burton
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Nigel Bolster
- London School of Hygiene and Tropical Medicine International Centre for Eye Health, London, UK
- Peek Vision, London, UK
| | - David Macleod
- London School of Hygiene and Tropical Medicine International Centre for Eye Health, London, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | - Min Kim
- London School of Hygiene and Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK
| | - Jacqueline Ramke
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew Bastawrous
- London School of Hygiene and Tropical Medicine International Centre for Eye Health, London, UK
- London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
24
|
Salami B, Olukotun M, Vastani M, Amodu O, Tetreault B, Obegu PO, Plaquin J, Sanni O. Immigrant child health in Canada: a scoping review. BMJ Glob Health 2022; 7:e008189. [PMID: 35428681 PMCID: PMC9014022 DOI: 10.1136/bmjgh-2021-008189] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/05/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Understanding the health of immigrant children from birth to 18 years of age is important given the significance of the early childhood years and complexity of factors that may influence the health status of immigrant populations. Thus, the purpose of this review was to understand the extent and nature of the literature on the health of immigrant children in Canada. METHODS We conducted a scoping review of the literature. The review was focused on studies of first-generation and second-generation immigrant children aged 0-18 years. We completed standardised data extraction of immigration status, immigration route, age of children, data source, health or clinical focus, country of origin and major findings. RESULTS In total, 250 published papers representing data from 237 studies met the inclusion criteria for this study. A total of 178 articles used quantitative methodologies (mostly survey and cross-sectional study designs), 54 used qualitative methodologies and 18 used mixed methodologies. The articles considered in this review included 147 (59%) focusing on physical health, 76 (30%) focusing on mental health and 37 (15%) focusing on the social aspects of health for refugee and first-generation and second-generation immigrant children across the provinces and territories of Canada. CONCLUSIONS Several literature gaps exist with respect to child immigrant health in Canada. For instance, there are no exclusive studies on immigrant boys and limited studies on children of international students.
Collapse
Affiliation(s)
- Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Mary Olukotun
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Muneerah Vastani
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Oluwakemi Amodu
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Jennifer Plaquin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Omolara Sanni
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
25
|
Kapiriri L, Razavi SD. Equity, justice, and social values in priority setting: a qualitative study of resource allocation criteria for global donor organizations working in low-income countries. Int J Equity Health 2022; 21:17. [PMID: 35135553 PMCID: PMC8822856 DOI: 10.1186/s12939-021-01565-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/03/2021] [Indexed: 12/02/2022] Open
Abstract
Background There is increasing acceptance of the importance of social values such as equity and fairness in health care priority setting (PS). However, equity is difficult to define: the term means different things to different people, and the ways it is understood in theory often may not align with how it is operationalized. There is limited literature on how development assistance partner organizations (DAP) conceptualize and operationalize equity in their health care prioritization decisions that affect low-income countries (LIC). This paper explores whether and how equity is a consideration in DAP priority setting processes. Methods This was a qualitative study involving 38 in-depth interviews with DAPs involved in health-system PS for LICs and a review of their respective webpages. Results While several PS criteria were identified, direct articulation of equity as an explicit criterion was lacking. However, the criterion was implied in some of the responses in terms of prioritizing vulnerable populations. Where mentioned, respondents discussed the difficulties of operationalizing equity as a PS criterion since vulnerability is associated with several varying and competing factors including gender, age, geography, and income. Some respondents also suggested that equity could be operationalized in terms of an organization not supporting the pre-existing inequities. Although several organizations’ webpages identify addressing inequities as a guiding principle, there were variations in how they spoke about its operationalization. While intersectionalities in vulnerabilities complicate its operationalization, if organizations explicitly articulate their equity focus the other organizations who also have equity as a guiding principle may, instead of focusing on the same aspect, concentrate on other dimensions of vulnerability. That way, all organizations will contribute to achieving equity in all the relevant dimensions. Conclusions Since most development organizations support some form of equity, this paper highlights a need for an internationally recognized framework that recognizes the intersectionalities of vulnerability, for mainstreaming and operationalizing equity in DAP priority setting and resource allocation. Such a framework will support consistency in the conceptualization of and operationalization of equity in global health programs. There is a need for studies which to assess the degree to which equity is actually integrated in these programs. Equity has become an increasingly important focus in the health and social science literature, however, equity is a contested concept. While development assistance partners supporting health development subscribe to equity as a guiding principle, they struggle with its operationalization. There is need for a general framework that explicitly conceptualizes the operationalization of equity in health development.
Collapse
Affiliation(s)
- Lydia Kapiriri
- Department of Health, Aging and Society, McMaster University, 1280 Main street West, Hamilton, Ontario, Canada.
| | - S Donya Razavi
- Department of Health, Aging and Society, McMaster University, 1280 Main street West, Hamilton, Ontario, Canada
| |
Collapse
|
26
|
Tounkara M, Sangho O, Beebe M, Whiting-Collins LJ, Goins RR, Marker HC, Winch PJ, Doumbia S. Geographic Access and Maternal Health Services Utilization in Sélingué Health District, Mali. Matern Child Health J 2022; 26:649-657. [PMID: 35064429 PMCID: PMC8782685 DOI: 10.1007/s10995-021-03364-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/29/2022]
Abstract
Introduction Maternal mortality is one of the main causes of death for women of childbearing age in Mali, and improving this outcome is slow, even in regions with relatively good geographic access to care. Disparities in maternal health services utilization can constitute a major obstacle in the reduction of maternal mortality in Mali and indicates a lack of equity in the Malian health system. Literature on maternal health inequity has explored structural and individual factors influencing outcomes but has not examined inequities in health facility distribution within districts with moderate geographic access. The purpose of this article is to examine disparities in education and geographic distance and how they affect utilization of maternal care within the Sélingué health district, a district with moderate geographic access to care, near Bamako, Mali. Methods We conducted a cross sectional survey with cluster sampling in the Sélingué health district. Maternal health services characteristics and indicators were described. Association between dependent and independent variables was verified using Kendall’s tau-b correlation, Chi square, logistic regression with odds ratio and 95% confidence interval. Gini index and concentration curve were used to measure inequity. Results Most respondents were 20 to 24 years old. Over 31% of our sample had some education, 65% completed at least four ANC visits, and 60.8% delivered at a health facility. Despite this evidence of healthcare access in Sélingué, disparities within the health district contribute to inadequate utilization among approximately 40% of the women in our sample. The concentration index demonstrated the impact of inequity in geographic access, comparing women residing near and far from the referral care facility. Conclusion Maternal health services underutilization, within a district with moderate geographic access, indicates that deliberate attention should be paid to addressing geographic access even in such a district.
Collapse
Affiliation(s)
- Moctar Tounkara
- Department of Public Health, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Oumar Sangho
- Department of Public Health, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.,Agence Nationale de Télémédecine et d'Informatique Médicale, Bamako, Mali
| | | | | | | | | | - Peter J Winch
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Seydou Doumbia
- Department of Public Health, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.,University Clinical Research Center, Bamako, Mali
| |
Collapse
|
27
|
Bai J, Zhao Y, Yang D, Ma Y, Yu C. Secular trends in chronic respiratory diseases mortality in Brazil, Russia, China, and South Africa: a comparative study across main BRICS countries from 1990 to 2019. BMC Public Health 2022; 22:91. [PMID: 35027030 PMCID: PMC8759233 DOI: 10.1186/s12889-021-12484-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background As the emerging economies, the BRICS (Brazil, Russia, India, China, and South Africa) shared 61.58% of the global chronic respiratory diseases (CRD) deaths in 2017. This study aimed to assess the secular trends in CRD mortality and explore the effects of age, period, and cohort across main BRICS countries. Methods Data were obtained from the Global Burden of Disease Study (GBD) 2019 and analyzed using the age-period-cohort (APC) model to estimate period and cohort effects between 1990 and 2019. The net drifts, local drifts, longitudinal age curves, period/cohort rate ratios (RRs) were obtained through the APC model. Results In 2019, the CRD deaths across the BRICS were 2.39 (95%UI 1.95 to 2.84) million, accounting for 60.07% of global CRD deaths. Chronic obstructive pulmonary disease (COPD) and asthma remained the leading causes of CRD deaths. The age-standardized mortality rates (ASMR) have declined across the BRICS since 1990, with the most apparent decline in China. Meanwhile, the downward trends in CRD death counts were observed in China and Russia. The overall net drifts per year were obvious in China (-5.89%; -6.06% to -5.71%), and the local drift values were all below zero in all age groups for both sexes. The age effect of CRD presented increase with age, and the period and cohort RRs were following downward trends over time across countries. Similar trends were observed in COPD and asthma. The improvement of CRD mortality was the most obvious in China, especially in period and cohort effects. While South Africa showed the most rapid increase with age across all CRD categories, and the period and cohort effects were flat. Conclusions BRICS accounted for a large proportion of CRD deaths, with China and India alone contributing more than half of the global CRD deaths. However, the declines in ASMR and improvements of period and cohort effects have been observed in both sexes and all age groups across main BRICS countries. China stands out for its remarkable reduction in CRD mortality and its experience may help reduce the burden of CRD in developing countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12484-z.
Collapse
Affiliation(s)
- Jianjun Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, 430072, Wuhan, China
| | - Yudi Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, 430072, Wuhan, China
| | - Donghui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, 430072, Wuhan, China
| | - Yudiyang Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, 430072, Wuhan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, 430072, Wuhan, China. .,Global Health Institute, Wuhan University, 185# Donghu Road, 430072, Wuhan, China.
| |
Collapse
|
28
|
Perea LME, Antunes JLF, Peres MA. Approaches to the problem of nonidentifiability in the age-period-cohort models in the analysis of cancer mortality: a scoping review. Eur J Cancer Prev 2022; 31:93-103. [PMID: 34723867 DOI: 10.1097/cej.0000000000000713] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Aiming to detect age, period and cohort effects in cancer mortality, age-period-cohort models (APC) can be applied to distinguish these effects. The main difficulty with adjusting an APC model involving age, period and cohort factors is the linear relationship between them, leading to a condition known as the 'nonidentifiability problem'. Many methods have been developed by statisticians to solve it, but there is not a consensus. All these existing methods, with their advantages and disadvantages, create confusion when choosing which one of them should be implemented. In this context, the present scoping review intends not to show all methods developed to avoid the nonidentifiability problem on APC models but to show which of them are, in fact, applied in the literature, especially in the cancer mortality studies. A search strategy was made to identify evidence on MEDLINE (PubMed), Scopus, EMBASE, Science Direct and Web of Science. A total of 46 papers were analyzed. The main methods found were: Holford's method (n = 14; 30%), ntrinsic estimator (n = 10; 22%), Osmond & Gardner method n = 8; 17%), Carstensen (n = 6;13%), Bayesian approach (n = 6;13%) and others (n = 2; 5%). Even with their limitations, all methods have beneficial applications. However, the decision to use one or another method seemed to be more related to an observed geographic pattern.
Collapse
Affiliation(s)
| | | | - Marco A Peres
- Senior Principal Investigator, National Dental Research Institute Singapore, National Dental Centre Singapore; Director, Oral Health ACP, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| |
Collapse
|
29
|
Impact of information framing and vaccination characteristics on parental COVID-19 vaccine acceptance for children: a discrete choice experiment. Eur J Pediatr 2022; 181:3839-3849. [PMID: 36056176 PMCID: PMC9439717 DOI: 10.1007/s00431-022-04586-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/20/2022] [Accepted: 08/04/2022] [Indexed: 02/08/2023]
Abstract
UNLABELLED This study aimed to test the influence of vaccination characteristics and gain/loss-framing of information, on parental acceptance of the coronavirus disease 2019 (COVID-19) vaccination for their minor children. A discrete choice experiment was conducted among parents of children aged 0-17 years from September to October 2021 in Hong Kong. Respondents were randomly assigned to four groups with different framing of information and asked to choose hypothetical vaccination alternatives, described by seven attributes that were derived from prior qualitative interviews. A mixed logit model was adopted to analyze the effect of attributes and information framing on parental vaccination acceptance. The vaccine acceptance rates under different scenarios were also estimated. A total of 298 valid responses were obtained. It was found that the BioNTech brand, higher efficacy, less serious adverse events and more vaccination coverage in children significantly improved parental acceptance. Additionally, loss-framing increased parental acceptance compared with gain-framing, while the presentation of mortality information did not make a difference. Acceptance was also associated with parental uptake of the COVID-19 vaccine and the children's age. CONCLUSION The findings imply that factors including gain/loss information framing, importance of vaccine characteristics, and peer influence have a significant effect on parents' decisions to get their children vaccinated. Parents with younger children had greater vaccine hesitancy, and information framing techniques should be considered in vaccination promotion for combating such vaccine hesitancy. Future studies could be conducted to identify the moderators and mediators of information framing to facilitate its implementation. WHAT IS KNOWN • Parental acceptance of COVID-19 vaccine was found to be associated with various socio-economic and psychosocial factors, while the evidence on impact of vaccination characteristics was limited. • Behavioral interventions, including information framing, have been used to promote various health behaviors. WHAT IS NEW • Loss-framing of information on vaccine effectiveness improves vaccine acceptance, while additional information on how the vaccine reduces death does not make a difference, which can be used to inform communication with the public in vaccination promotion. • The social norm (i.e., the vaccine uptake amongst other people) is important for increasing the parental vaccine acceptance rate.
Collapse
|
30
|
Piubello Orsini L, Leardini C, Vernizzi S, Campedelli B. Inefficiency of public hospitals: a multistage data envelopment analysis in an Italian region. BMC Health Serv Res 2021; 21:1281. [PMID: 34838006 PMCID: PMC8627633 DOI: 10.1186/s12913-021-07276-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background The objective of this study was to assess public hospital efficiency, including quality outputs, inefficiency determinants, and changes to efficiency over time, in an Italian region. To achieve this aim, the study used secondary data from the Veneto region for the years 2018 and 2019. Methods A nonparametric approach—that is, multistage data envelopment analysis (DEA)—was applied to a sample of 43 hospitals. We identified three categories of input: capital investments (Beds), labor (FTE), operating expenses. We selected five efficiency outputs (outpatient visits, inpatients, outpatient visit revenue, inpatient revenue, bed occupancy rate) and two quality outputs (mortality rate and inappropriate admission rate). Efficiency scores were estimated and decomposed into two components. Slack analysis was then conducted. Further, DEA efficiency scores were regressed on internal and external variables using a Tobit model. Finally, the Malmquist Productivity Index was applied. Results On average, the hospitals in the Veneto region operated at more than 95% efficiency. Technical and scale inefficiencies often occurred jointly, with 77% of inefficient hospitals needing a downsizing strategy to gain efficiency. The inputs identified as needing significant reductions were full-time employee (FTE) administrative staff and technicians. The size of the hospital in relation to the size of the population served and the length of patient stay were important factors for the efficiency score. The major cause of decreased efficiency over time was technical change (0.908) rather than efficiency change (0.974). Conclusions The study reveals improvements that should be made from both the policy and managerial perspectives. Hospital size is an important feature of inefficiency. On average, the results show that it is advisable for hospitals to reorganize nonmedical staff to enhance efficiency. Further, increasing technology investment could enable higher efficiency levels.
Collapse
Affiliation(s)
- Luca Piubello Orsini
- Department of Business Administration, University of Verona, Via Cantarane 24, 37129, Verona, Italy.
| | - Chiara Leardini
- Department of Business Administration, University of Verona, Via Cantarane 24, 37129, Verona, Italy
| | - Silvia Vernizzi
- Department of Business Administration, University of Verona, Via Cantarane 24, 37129, Verona, Italy
| | - Bettina Campedelli
- Department of Business Administration, University of Verona, Via Cantarane 24, 37129, Verona, Italy
| |
Collapse
|
31
|
Fares H, Puig-Junoy J. Inequity and benefit incidence analysis in healthcare use among Syrian refugees in Egypt. Confl Health 2021; 15:78. [PMID: 34727960 PMCID: PMC8561984 DOI: 10.1186/s13031-021-00416-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Syrian conflict has created the worst humanitarian refugee crisis of our time, with the largest number of people displaced. Many have sought refuge in Egypt, where they are provided with the same access to healthcare services as Egyptian citizens. Nevertheless, in addition to the existing shortcomings of the Egyptian health system, many obstacles specifically limit refugees' access to healthcare. This study looks to assess equity across levels of care after observing services utilization among the Syrian refugees, and look at the humanitarian dilemma when facing resource allocation and the protection of the most vulnerable. METHODS A cross-sectional survey was used and collected information related to access and utilization of outpatient and inpatient health services by Syrian refugees living in Egypt. We used concentration index (CI), horizontal inequity (HI) and benefit incidence analysis (BIA) to measure the inequity in the use of healthcare services and distribution of funding. We decomposed inequalities in utilization, using a linear approximation of a probit model to measure the contribution of need, non-need and consumption influential factors. RESULTS We found pro-rich inequality and horizontal inequity in the probability of refugees' outpatient and inpatient health services utilization. Overall, poorer population groups have greater healthcare needs, while richer groups use the services more extensively. Decomposition analysis showed that the main contributor to inequality is socioeconomic status, with other elements such as large families, the presence of chronic disease and duration of asylum in Egypt further contributing to inequality. Benefit incidence analysis showed that the net benefit distribution of subsidies of UNHCR for outpatient and inpatient care is also pro-rich, after accounting for out-of-pocket expenditures. CONCLUSION Our results show that without equitable subsidies, poor refugees cannot afford healthcare services. To tackle health inequities, UNHCR and organisations will need to adapt programmes to address the social determinants of health, through interventions within many sectors. Our findings contribute to assessments of different levels of accessibility to healthcare services and uncover related sources of inequities that require further attention and advocacy by policymakers.
Collapse
Affiliation(s)
- Hani Fares
- United Nations High Commissioner for Refugees (UNHCR), 1202, Geneva, Switzerland.
- Universitat Pompeu Fabra-Barcelona School of Management (UPF-BSM), C. Balmes 132-134, 08007, Barcelona, Catalonia, Spain.
| | - Jaume Puig-Junoy
- Universitat Pompeu Fabra-Barcelona School of Management (UPF-BSM), C. Balmes 132-134, 08007, Barcelona, Catalonia, Spain
| |
Collapse
|
32
|
Samuel O, Zewotir T, North D. Decomposing the urban-rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa. Reprod Health 2021; 18:216. [PMID: 34717668 PMCID: PMC8557532 DOI: 10.1186/s12978-021-01268-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background There has been a substantial improvement in reducing maternal mortality in the Sub-Saharan African region. The vast rural-urban gap in maternal health outcomes, however, is obscured by this average achievement. This study attempts to measure the contribution of identified risk factors to describe the average rural-urban difference in the use of antenatal care, health facilities for delivery, and health professional assistance at delivery. Method To achieve this objective, we used descriptive analysis and Fairlie non-linear decomposition method to quantify covariates’ contribution in explaining the urban–rural difference in maternal healthcare services utilisation. Result The study’s finding shows much difference between urban and rural areas in the use of maternal healthcare services. Socio-economic factors such as household wealth index, exposure to media, and educational level of women and their husbands/partners contributed the most in explaining the gap between urban and rural areas in healthcare services utilisation. Conclusions Interventions to bridge the gap between urban and rural areas in maternal healthcare services utilisation in Sub-Saharan Africa should be centred towards socio-economic empowerment. Government can enforce targeted awareness campaigns to encourage women in rural communities in Sub-Sharan Africa to take the opportunity and use the available maternal health care services to be at par with their counterparts in urban areas. Maternal health refers to the health of women throughout pregnancy, delivery, and the postnatal period. Each step should be a good experience that ensures mothers, and their infants realize their maximum health and well-being potential. In this study, we used individual, demographic, and socio-economic characteristics to measure the urban–rural discrepancies in maternal health care services in Sub-Saharan Africa. We used Information of 220 164 women of child-bearing age (15–49) gathered from National Demographic Health Surveys from 27 countries in the Sub-Sahara African region. We found 46.1% of women in rural areas had no education, 39.7% of the women in rural areas have husbands/partners with no education, and 60.1% of the women in rural areas are from households with poor wealth indexes. The use of maternal health care services found to be predominant in the urban areas than rural areas, and the measure of this difference can inform policymakers on the level of effort that needed to be put in place to balance the discrepancies and improve maternal health in general.
Collapse
Affiliation(s)
- Oduse Samuel
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, 4001, South Africa.
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, 4001, South Africa
| | - Delia North
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, 4001, South Africa
| |
Collapse
|
33
|
Zhang S, Song X, Zhou J. An equity and efficiency integrated grid-to-level 2SFCA approach: spatial accessibility of multilevel healthcare. Int J Equity Health 2021; 20:229. [PMID: 34666773 PMCID: PMC8524218 DOI: 10.1186/s12939-021-01553-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/18/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Equity of healthcare spatial access is essential for the health outcomes of medical investments and the welfare of populations, and efficiency of medical resource allocation is important for obtaining a supply-demand equilibrium with lower cost and higher outputs with limited inputs. However, the literature that involves both equity and efficiency in its analysis of healthcare spatial allocation is rare, and the spatial accessibility of multilevel healthcare is difficult to measure by traditional methods in a large region with diversified population distribution. METHODS To assist in solving these issues, this paper aims to build an equity and efficiency integrated analytical framework by proposing a new "GTL-2SFCA" approach to analyze the spatial accessibility of multilevel healthcare; maximum and minimum floating catchments of different levels of healthcare were assigned to ensure a combination of universal search coverage and efficient hospitalization behavior simulation. RESULTS The analytical framework was applied and tested in Hubei, China. Almost half of the residents (47.95%) and townships (44.98%) have access to both public general hospitals (PGHs) and primary healthcare centers (PHCs) services, 36.89% of the residents enjoy only one sufficient service, either PGHs or PHCs, and the remaining residents (15.16%) are faced with the risk of lacking access to both services. The results reveal that there are core-periphery effects of multilevel healthcare throughout Hubei and isolate clusters that have adequate access in the western region. The polarization effect of higher-level healthcare and the polycentric pattern of lower-level healthcare coexist. The multilevel healthcare shortage was identified in some areas in boundary and peripheral regions. CONCLUSIONS This study integrates equity and efficiency into the GTL-2SFCA framework, enriches the FCA series methodologies and provides a more operational solution for evaluating the access of residents in more sophisticated spatial units to each level of healthcare. By more significantly differing and quantifying the catchment area and distance decay effect, this methodology avoids overestimating or underestimating accessibility and discovers some imperceptible spatial inequities. This study has application value for researchers and decision-makers in other scenarios and regions with significant heterogeneity in medical resources and where the population has greater mobility.
Collapse
Affiliation(s)
- Shaoyao Zhang
- College of Geography and Resources Science, Sichuan Normal University, Chengdu, 610066, China
| | - Xueqian Song
- School of Management, Chengdu University of Information Technology, Chengdu, 610225, China.
| | - Jie Zhou
- School of Foreign Languages, Chengdu University of Information Technology, Chengdu, 610225, China
| |
Collapse
|
34
|
Wang K, Wong ELY, Ho KF, Cheung AWL, Chan EYY, Wong SYS, Yeoh EK. Unequal availability of workplace policy for prevention of coronavirus disease 2019 across occupations and its relationship with personal protection behaviours: a cross-sectional survey. Int J Equity Health 2021; 20:200. [PMID: 34493292 PMCID: PMC8422060 DOI: 10.1186/s12939-021-01527-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 08/10/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The evolving pandemic of coronavirus disease 2019 (COVID-19) has become a severe threat to public health, and the workplace presents high risks in terms of spreading the disease. Few studies have focused on the relationship between workplace policy and individual behaviours. This study aimed to identify inequalities of workplace policy across occupation groups, examine the relationship of workplace guidelines and measures with employees' behaviours regarding COVID-19 prevention. METHODS A cross-sectional online survey using a structured questionnaire was conducted to gather employees' access to workplace guidelines and measures as well as their personal protection behaviours. Statistical associations between these two factors in different occupations were examined using multiple ordinal logistic regressions. RESULTS A total of 1048 valid responses across five occupational groups were analysed. Manual labourers reported lower availability of workplace guidelines and measures (76.9% vs. 89.9% for all, P = 0.003). Employees with available workplace guidelines and measures had higher compliance of hand hygiene, wearing masks, and social distancing, and this association was more significant among managers/administrators and manual labourers. CONCLUSIONS Protection of the quantity and quality of employment is important. Awareness about the disease and its prevention among employers and administrators should be promoted, and resources should be allocated to publish guidelines and implement measures in the workplace during the pandemic. Both work-from-home arrangement and other policies and responses for those who cannot work from home including guidelines encouraging the health behaviours, information transparency, and provision of infection control materials by employers should be established to reduce inequality. Manual labourers may require specific attention regarding accessibility of relevant information and availability of medical benefits and compensation for income loss due to the sickness, given their poorer experience of workplace policy and the nature of their work. Further studies are needed to test the effectiveness of specific workplace policies on COVID-19 prevention.
Collapse
Affiliation(s)
- Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kin Fai Ho
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Annie Wai Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Ying Yang Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
35
|
Cao N, Li X, Chen H, Li X, Li W. Decisional Balance of Smoking and Planning to Quit Smoking: A Moderated Mediation Model among Chinese Male Smokers. J Psychoactive Drugs 2021; 54:158-166. [PMID: 34423746 DOI: 10.1080/02791072.2021.1942339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Decisional balance in quitting smoking involves positive and negative attitudes toward smoking. This study explored the relationship between the decisional balance of smoking and planning to quit smoking, and examined the mediating role of willingness to quit smoking and the moderating role of social support. A questionnaire survey was conducted among 326 daily male smokers from China in 2016, including the decisional balance of smoking, willingness to quit smoking, social support, planning to quit, and nicotine dependence. The results showed: (1) willingness to quit smoking mediated the relationship between the decisional balance of smoking and planning to quit smoking; (2) the relationship between the decisional balance of smoking and planning to quit smoking was moderated by emotional support rather than instrumental support. Smokers with a higher level of emotional support for quitting smoking were more likely to progress to planning to quit smoking, while this relationship was not found among smokers with a lower level of emotional support. These findings suggested that smokers' willingness to quit smoking would be key to promoting their planning to quit. Meanwhile, the dynamic process of planning to quit smoking was moderated by emotional support from others.
Collapse
Affiliation(s)
- Ningmeng Cao
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Xinwei Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Haide Chen
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Xinyu Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Weijian Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| |
Collapse
|
36
|
Liang W, Shi J, Xia H, Wei X. A Novel Ruthenium-Fluvastatin Complex Downregulates SNCG Expression to Modulate Breast Carcinoma Cell Proliferation and Apoptosis via Activating the PI3K/Akt/mTOR/VEGF/MMP9 Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5537737. [PMID: 34221232 PMCID: PMC8221895 DOI: 10.1155/2021/5537737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/16/2021] [Accepted: 05/07/2021] [Indexed: 12/19/2022]
Abstract
Breast cancer is the most common cause of malignancy and cancer-related morbidity and death worldwide that requests effective and safe chemotherapy. Evaluation of metallodrug-based anticancer agents and statins as chemotherapeutics with fewer side effects is a largely unexplored research field. Synthesis and characterization of the ruthenium-fluvastatin complex were achieved using multiple spectroscopic techniques and thus further examined to evaluate its chemotherapeutic prospects in both MDA-MB-231 and MCF-7 cancer lines and eventually in vivo models of DMBA-induced mammary carcinogenesis in rodents. Our studies indicate that the metal and ligand chelation was materialized by the ligand's functional groups of carbonyl (=O) oxygen and hydroxyl (-OH), and the complex has been observed to be crystalline and able to chelate with CT-DNA. The complex was able to reduce cell proliferation and activate apoptotic events in breast carcinoma cell lines MCF-7 and MDA-MB-231. In addition, the complex was able to modify p53 expressions to interfere with apoptosis in the carcinoma of the breast, stimulated by the intrinsic apoptotic path assisted by Bcl2 and Bax in vivo, yet at the same point, controlling the PI3K/Akt/mTOR/VEGF pathway, as obtained from western blotting, correlates with the MMP9-regulated tumor mechanisms. Our research reveals that ruthenium-fluvastatin chemotherapy may disrupt, rescind, or interrupt breast carcinoma progression by modifying intrinsic apoptosis as well as the antiangiogenic cascade, thereby taking the role of a potential candidate in cancer therapy for the immediate future.
Collapse
Affiliation(s)
- Wei Liang
- Department of Oncology, Nanjing First Hospital Nanjing Medical University, Nanjing 210006, China
| | - Junfeng Shi
- Department of Oncology, Nanjing First Hospital Nanjing Medical University, Nanjing 210006, China
| | - Haiyan Xia
- Department of Oncology, Nanjing First Hospital Nanjing Medical University, Nanjing 210006, China
| | - Xiaowei Wei
- Department of Oncology, Nanjing First Hospital Nanjing Medical University, Nanjing 210006, China
| |
Collapse
|
37
|
Yuan S, Shi Y, Li M, Hu X, Bai R. Trends in Incidence of Urinary Tract Infection in Mainland China from 1990 to 2019. Int J Gen Med 2021; 14:1413-1420. [PMID: 33907445 PMCID: PMC8068484 DOI: 10.2147/ijgm.s305358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/22/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose Urinary tract infection (UTI) is the second-most-common type of infection in China. This study aimed to determine the long-term trends in the incidence of UTI in Mainland China between 1990 and 2019. Materials and Methods Data were extracted from the Global Burden of Disease Study 2019 and were analyzed with the age–period–cohort framework. Results The net drift in the incidence of UTI was –0.37% (95% CI: –0.40%, –0.35%) in males and –0.25% (95% CI: –0.29%, –0.20%) in females. For males, the local drift was lower than 0 (P<0.05) among those younger than 90 years. For females, the local drift was lower than 0 (P<0.05) among those younger than 60 years and higher than 0 (P<0.05) in those aged 65–79 years. In the same birth cohort, the incidence of UTI was higher in females than in males in all age groups (P<0.05). The period relative risk (RR) showed a decreasing pattern after 2005 in both sexes. The cohort RR showed a downward trend of the birth cohort after 1905 for males and 1960 for females. Conclusion The incidence has increased significantly among older females over the past 30 years. It is necessary to develop a comprehensive intervention plan for reproductive health services covering females and males of all ages.
Collapse
Affiliation(s)
- Sheng Yuan
- Department of New Medicine and Needle Pricking, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China.,Department of Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ying Shi
- School of Public Health, Shaanxi University of Chinese Medicine, Xi'an, Shaanxi, People's Republic of China
| | - Minmin Li
- Department of Infection Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, People's Republic of China
| | - Xiaojun Hu
- Department of Hepatobiliary Surgery, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Ruhai Bai
- School of Public Affair, Nanjing University of Science and Technology, Nanjing, Jiangsu, People's Republic of China
| |
Collapse
|
38
|
Gharibi F, Imani A, Dalal K. The catastrophic out-of-pocket health expenditure of multiple sclerosis patients in Iran. BMC Health Serv Res 2021; 21:257. [PMID: 33743679 PMCID: PMC7981983 DOI: 10.1186/s12913-021-06251-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 03/08/2021] [Indexed: 11/27/2022] Open
Abstract
Background The present study was designed and conducted to evaluate multiple sclerosis (MS) treatment costs and the resulting economic impact imposed on MS patients in Iran. Methods This was a cross-sectional study, among randomly selected 300 MS patients, registered in the MS Association of East Azerbaijan Province, Iran (1 year after their treatment began). The regression analysis, ANOVA, T-test, and chi-square were used. Results The average amount of out-of-pocket payments (OOPs) by MS patients during the previous year was 1669.20 USD, most of which was spent on medication, rehabilitation care, and physician visits. Their mean annual income was 5182.84 USD. Fifty four percent of families with an MS patient suffer from catastrophic health expenditure (CHE) and 44% experience poverty caused by the OOPs. Occupational status, having supplemental health insurance, and being residents of Tabriz significantly affect OOPs, CHE, and the resulting poverty (P < 0.05). Conclusion The catastrophic financial burden of health care costs on MS patients and their families justifies health policymakers to promote pre-payment systems and provide subsidies to less well-off patients to protect them from the unfairness of OOPs and its resulting CHE and poverty.
Collapse
Affiliation(s)
- Farid Gharibi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Ali Imani
- Health Economics Department, Tabriz Health Service Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Koustuv Dalal
- School of Health Sciences, Mid Sweden University, Sweden and Faculty of Medicine and Healthcare, al-Farabi Kazakh National University, Almaty, Kazakhstan.
| |
Collapse
|
39
|
Iqbal S, Barolia R, Ladak L, Petrucka P. Smoking cessation interventions in South Asian countries: protocol for scoping review. BMJ Open 2021; 11:e038818. [PMID: 33563618 PMCID: PMC7875297 DOI: 10.1136/bmjopen-2020-038818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 12/28/2020] [Accepted: 01/07/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Unfortunately, like many other health risks, smoking rate has been on the rise in developing countries. Half of current smokers in the world reside in only three countries of Asia that include India. Many smoking cessation interventions that were developed and successfully implemented in the context of developed countries have not been equally successful in South Asia. Hence, there is a dire need of culturally relevant smoking cessation interventions. We propose a scoping review with objectives to explore the extent and nature of interventions for smoking cessation and its associated factors in South Asian Region by systematically reviewing the available published and unpublished literature. METHODS AND ANALYSIS The review has been registered in Joanna Briggs Institute (JBI) systematic reviews register and details are given in the Methodology section. The updated framework of JBI for scoping review methodology will be used as guide for conduct of this scoping review. Electronic databases (PubMed, CINAHL plus, Proquest Theses and Dissertations, EBSCO Dentistry and Oral Sciences, and Wiley Cochrane Library), reference lists of selected studies and grey literature will be considered for inclusion in this review. The literature search is anticipated to be carried out in December-January 2020. Initially, two reviewers in consultation with a librarian will develop search syntax followed by search from the selected sources. Consequently, the reviewers will screen all the titles, abstracts and full articles to establish relevance of each study for inclusion. Factors associated with smoking cessation will be coded and categorised applying qualitative content analysis, while interventions extracted from the literature will be described with the stated level of effectiveness.
Collapse
Affiliation(s)
- Sajid Iqbal
- Aga Khan University School of Nursing and Midwifery, Karachi, Pakistan
| | - Rubina Barolia
- Aga Khan University School of Nursing and Midwifery, Karachi, Pakistan
| | - Laila Ladak
- Aga Khan University School of Nursing and Midwifery, Karachi, Pakistan
| | - Pammla Petrucka
- Aga Khan University School of Nursing and Midwifery, Karachi, Pakistan
| |
Collapse
|
40
|
He R, Liu J, Zhang WH, Zhu B, Zhang N, Mao Y. Turnover intention among primary health workers in China: a systematic review and meta-analysis. BMJ Open 2020; 10:e037117. [PMID: 33067275 PMCID: PMC7569945 DOI: 10.1136/bmjopen-2020-037117] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To analyse the prevalence and determinants of turnover intention (TI) among primary health workers (PHWs) in China to provide evidence for improving retention measures. DESIGN Systemic review and meta-analysis. DATA SOURCES Four English-language databases (PubMed, EMBASE, Cochrane Library, PsycINFO) and three Chinese databases (CNKI, CSPD, CBM) were searched up to October 2019. ELIGIBILITY CRITERIA Eligible studies were observational or descriptive studies conducted in mainland China. The prevalence of TI among health workers and related factors had to be explicitly reported in each included study. DATA EXTRACTION AND SYNTHESIS Data were extracted by one author and reviewed independently by two other authors. For each factor analysed by a meta-analysis, the factor was required to be the same across different studies, and at least three studies had to include it. The quality of studies was assessed using the Newcastle-Ottawa Scale and heterogeneity was evaluated using the I2 statistic. RESULTS We identified 16 cross-sectional studies investigating a total of 37 672 PHWs. The prevalence of TI was 30.4%. Subgroup analysis revealed that the highest prevalence was observed in the community primary healthcare institutions and the eastern provinces of China. Meta-analyses indicated that 21 factors were significantly associated with TI, including demographic factors (gender, age, education, marital status), job characteristic factors (title, work seniority, remuneration, social status, organisational affiliation, work stress) and job satisfaction factors (learning and training opportunity, interpersonal relationship, work condition and environment, and so on). CONCLUSION This study highlights the problem of TI among PHWs in China. Efforts should be made to improve conditions in both work-related areas and areas outside of work. Policymakers should continue to improve reward systems, the construction of infrastructure and promotion systems, and pay more attention to PHWs' lives outside of work and meet their living needs.
Collapse
Affiliation(s)
- Rongxin He
- Department of Social Security, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an, China
| | - Jinlin Liu
- Department of Social Security, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an, China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Bin Zhu
- Department of Social Security, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an, China
| | - Ning Zhang
- Department of Social Security, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an, China
| | - Ying Mao
- Department of Social Security, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
41
|
Cao J, Eshak ES, Liu K, Yang J, Gero K, Liu Z, Yu C. An Age-Period-Cohort Analysis of Stroke Mortality Attributable to Low Physical Activity in China and Japan: Data from the GBD Study 1990-2016. Sci Rep 2020; 10:6525. [PMID: 32300134 PMCID: PMC7162896 DOI: 10.1038/s41598-020-63307-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/17/2020] [Indexed: 12/03/2022] Open
Abstract
Stroke is the first and fourth leading cause of death in China and Japan, respectively. Physical inactivity was suggested to be one of the most important risk factors for stroke mortality. Therefore, this study aimed to assess long-term trends in stroke mortality attributable to low physical activity (LPA) in China and Japan during the period 1990–2016. Mortality data were obtained from the Global Burden of Disease Study 2016 (GBD 2016) and were analyzed with an age-period-cohort method. The age-standardized mortality rates (ASMRs) showed declining trends for LPA-attributable stroke mortality. The overall net drift per year was −1.3% for Chinese men, −2.9% for Chinese women, −3.9% for Japanese men, and −5.6% for Japanese women. In both countries, the local drift values were below zero in all age groups. The longitudinal age curves of LPA-attributable stroke mortality were higher in men than in women in all age groups. The period and cohort rate ratios showed similar downward patterns for both sexes, with a faster decline for women than for men. However, the physically active population is still small in both countries. Therefore, policymakers should further promote physical activity as one of the most recommended effective strategies in stroke prevention.
Collapse
Affiliation(s)
- Jinhong Cao
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Ehab S Eshak
- Department of Public Health, Community and Preventive Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jin Yang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Krisztina Gero
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | | | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China.
| |
Collapse
|
42
|
Mubarik S, Wang F, Fawad M, Wang Y, Ahmad I, Yu C. Trends and Projections in Breast Cancer Mortality among four Asian countries (1990-2017): Evidence from five Stochastic Mortality Models. Sci Rep 2020; 10:5480. [PMID: 32214176 PMCID: PMC7096499 DOI: 10.1038/s41598-020-62393-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/12/2020] [Indexed: 11/24/2022] Open
Abstract
The current study aimed to explore some important insights into the breast cancer mortality (BCM) trends and projections among four Asian countries by using five advanced stochastic mortality models. BCM data over 28 years from 1990-2017 with ages 20-84 were retrieved from the Global Burden of Disease (GBD) Study 2017 for four Asian countries, namely, China, India, Pakistan, and Thailand. Five stochastic mortality models with the family of generalized age-period-cohort were implemented to find the present and future BCM trends in these four Asian countries. Based on Cairns-Blake-Dowd (CBD) model and Lee-Carter model (LCM), overall, results revealed that BCM increased with the passage of time. Aging factor was the most influential factor of elevated BCM in each Asian country under consideration. Projection of BCM showed that mortality rates might continue to grow with time, especially in older ages in each Asian country under study. The highest forecasted BCM rates were observed in Pakistan as compared to other countries. The obvious increase in BCM suggested that earlier tactics should be implemented to reduce the subsequent morbidity and mortality due to breast cancer. The last but not least, some additional tactics to mitigate the BCM in older ages must be adopted.
Collapse
Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China
| | - Fang Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China
| | - Muhammad Fawad
- Henan Academy of Big Data, Zhengzhou University, Zhengzhou, 450052, China
- School of Mathematics and Statistics, Zhengzhou University, Zhengzhou, 450001, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China
| | - Ishfaq Ahmad
- Department of Mathematics and Statistics, Faculty of Basic and Applied Sciences, International Islamic University, Islamabad, Pakistan
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, 430071, China.
- Global Health Institute, Wuhan University, Wuhan, Hubei, 430071, China.
| |
Collapse
|
43
|
Mubarik S, Malik SS, Wang Z, Li C, Fawad M, Yu C. Recent insights into breast cancer incidence trends among four Asian countries using age-period-cohort model. Cancer Manag Res 2019; 11:8145-8155. [PMID: 31564974 PMCID: PMC6731990 DOI: 10.2147/cmar.s208323] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/26/2019] [Indexed: 01/07/2023] Open
Abstract
Purpose Breast cancer is one of the rapidly increasing cancers among women and a significant cause of cancer-related morbidity and mortality worldwide. Therefore, the current study was designed to examine and compare trends of breast cancer incidence (BCI) during the observed period (1990–2015) in specific age groups and investigate age-specific, time period, and birth cohort-related effects on BCI in China, India, Pakistan, and Thailand. Patients and method Data related to BCI were retrieved from the Institute for Health Metrics and Evaluation. Age–period–cohort model joint with intrinsic estimator algorithm was used to estimate the effect of age, period, and birth cohort on BCI. BCI rates were analyzed among different age groups ranging from 20 to 84 years in specified periods. Result Overall, results showed an increasing trend of BCI among four Asian countries during the study period especially in age groups 50 to 84 years. Higher incidence rates were observed in 2015 in the age group 70–74, 65–69, 50–54, and 60–64 in Pakistan, China, India, and Thailand, respectively. Age period cohort analysis revealed significantly raised effect of age and period and declined effect of the cohort on incidence rates. Conclusion The current study reported increased BCI with time in selected four Asian countries. Overall, BCI remained high in Pakistan as compared to China, India, and Thailand. Although proper registries are not available in most of the developing Asian countries, the current study highlighted the increased incidence and may play an essential role in registries development or spreading awareness against this disease. Therefore, maintaining proper records to build registries at the national level along with advancements in breast cancer screening and treatment are highly recommended to deal with the increasing burden of this disease. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/7yX8RwLIBXc
Collapse
Affiliation(s)
- Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, People's Republic of China
| | - Saima Shakil Malik
- Microbiology and Biotechnology Research Lab., Fatima Jinnah Women University, The Mall Rawalpindi 46000, Pakistan
| | - Zhenkun Wang
- Human Resource Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430071, People's Republic of China
| | - Chunhui Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430071, Hubei, People's Republic of China
| | - Muhammad Fawad
- School of Mathematics and Statistics, Central China Normal University, Wuhan 430072, Hubei, People's Republic of China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, Hubei, People's Republic of China.,Global Health Institute, Wuhan University, Wuhan 430071, Hubei, People's Republic of China
| |
Collapse
|
44
|
van der Wal JM, Bodewes A, Agyemang C, Kunst A. A population-based retrospective study comparing cancer mortality between Moluccan migrants and the general Dutch population: equal risk 65 years after immigration? BMJ Open 2019; 9:e029288. [PMID: 31420390 PMCID: PMC6701674 DOI: 10.1136/bmjopen-2019-029288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To test the hypothesis that cancer mortality rates among the Moluccan-Dutch, the oldest non-Western migrant group to arrive in the Netherlands after the Second World War, are similar to those in the general Dutch population. DESIGN Population-based retrospective study. SETTING Data from the national cause of death registry in the Netherlands and municipal registries. PARTICIPANTS Using historic records containing family names of all Moluccan-Dutch who arrived in the Netherlands in 1951, we identified 81 591 Moluccan-Dutch persons in the national cause of death registry of the Netherlands. The reference group consisted of 15 866 538 persons of the general Dutch population. OUTCOME MEASURES Mortality data were linked to demographic data from municipal registries. We calculated all-cancer and cancer-specific mortality and measured differences between the two groups using Poisson regression, adjusting for sex, age and area socioeconomic status. We conducted a sub-analysis for the first-generation and second-generation Moluccan-Dutch. RESULTS There was no difference in all-cancer mortality between Moluccan-Dutch and the general Dutch population. Mortality was higher among Moluccan-Dutch for liver, cervix and corpus uteri cancers, but lower for stomach, oesophagus, kidney and nervous system cancers. For most cancers, mortality risk as compared with the general Dutch population varied between different generations of Moluccan-Dutch. CONCLUSIONS Several decades after migration, the Moluccan-Dutch show similar all-cancer mortality, but different cancer-specific mortality rates, when compared with the general Dutch population.
Collapse
Affiliation(s)
- Junus M van der Wal
- Department of Public Health, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Adee Bodewes
- Department of Public Health, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Anton Kunst
- Department of Public Health, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
45
|
Cao J, Eshak ES, Liu K, Gero K, Liu Z, Yu C. Age-Period-Cohort Analysis of Stroke Mortality Attributable to High Sodium Intake in China and Japan. Stroke 2019; 50:1648-1654. [PMID: 31195942 PMCID: PMC6594775 DOI: 10.1161/strokeaha.118.024617] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background and Purpose- The aim of this study is to assess the long-term trends in stroke mortality attributable to high sodium intake in China and Japan during the period 1990 to 2016. Methods- The mortality data were obtained from the GBD study (Global Burden of Disease) 2016 and were analyzed using an age-period-cohort method. Results- The age-standardized mortality rates showed declining trends for high sodium intake-related stroke mortality. The overall net drifts per year were -3.1% for Chinese men and -5.0% for Chinese women; and -4.6% for Japanese men and -5.7% for Japanese women. The local drift values were below zero in all age groups for both sexes in both countries, and all local drift values of female participants were below their counterparts of male participants. The longitudinal age curves of high sodium intake-attributable stroke mortality increased rapidly for both sexes in China, whereas those of Japanese were slowly rising. The period and cohort rate ratios were found to have similar downward patterns for both sexes in both countries, with a quicker decline for women than for men (significantly with P<0.05 for all). Conclusions- The age-standardized mortality rates, the period effect and the cohort effect of stroke mortality attributable to high sodium intake in China and Japan have been declining in both sexes and all age groups from 1990 to 2016. Consequently, sodium-reduction strategies are of low cost and effective for the prevention of stroke. It is necessary to educate the nation with the correct knowledge on healthy diet and techniques to reduce salt consumption.
Collapse
Affiliation(s)
- Jinhong Cao
- From the Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, China (J.C. and C.Y.)
| | - Ehab S Eshak
- Department of Public Health, Community and Preventive Medicine, Faculty of Medicine, Minia University, Egypt (E.S.E).,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan (E.S.E., K.L.)
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Japan (E.S.E., K.L.)
| | - Krisztina Gero
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA (K.G.)
| | | | - Chuanhua Yu
- From the Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, China (J.C. and C.Y.)
| |
Collapse
|
46
|
Clements C, Hawton K, Geulayov G, Waters K, Ness J, Rehman M, Townsend E, Appleby L, Kapur N. Self-harm in midlife: analysis using data from the Multicentre Study of Self-harm in England. Br J Psychiatry 2019; 215:1-8. [PMID: 31142393 DOI: 10.1192/bjp.2019.90] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND In England suicide rates are highest in midlife (defined as age 40-59). Despite a strong link with suicide there has been little focus on self-harm in this age group.AimTo describe characteristics and treatment needs of people in midlife who present to hospital following self-harm. METHOD Data from the Multicentre Study of Self-harm in England were used to examine rates over time and characteristics of men and women who self-harm in midlife. Data (2000-2013) were collected via specialist assessments or hospital records. Trends were assessed by negative binomial regression models. Comparative analysis used logistic regression models for binary outcomes. Repetition and suicide mortality were assessed by Cox proportional hazards models. RESULTS A quarter of self-harm presentations were made by people in midlife (n = 24 599, 26%). Incidence rates increased over time in men, especially after 2008 (incidence rate ratio [IRR] 1.07, 95% CI 1.02-1.12, P < 0.01), and were positively correlated with national suicide incidence rates (r = 0.52, P = 0.05). Rates in women remained relatively stable (IRR 1.00, 95% CI 1.00-1.02, P = 0.39) and were not correlated with suicide. Alcohol use, unemployment, housing and financial factors were more common in men; whereas indicators of poor mental health were more common in women. In men and women 12-month repetition was 25%, and during follow-up 2.8% of men and 1.2% of women died by suicide. CONCLUSION Self-harm in midlife represents a key target for intervention. Addressing underlying issues, alcohol use and economic factors may help prevent further self-harm and suicide.Declaration of interestK.H. and N.K. are members of the Department of Health's National Suicide Prevention Advisory Group. N.K. chaired the National Institute for Health and Care Excellence (NICE) guideline development group for the longer-term management of self-harm and the NICE Topic Expert Group which developed the quality standards for self-harm services. N.K. also chairs the NICE guideline committee for the management of depression. All other authors declare no conflict of interest.
Collapse
Affiliation(s)
- Caroline Clements
- Research Associate,Centre for Mental Health and Safety,Manchester Academic Health Sciences Centre,The University of Manchester,UK
| | - Keith Hawton
- Professor of Psychiatry,Centre for Suicide Research,Department of Psychiatry,University of Oxford,UK
| | - Galit Geulayov
- Study Coordinator,Centre for Suicide Research,Department of Psychiatry,University of Oxford,UK
| | - Keith Waters
- Director,Centre for Self-harm and Suicide Prevention Research,Derbyshire Healthcare National Health Service Foundation Trust,UK
| | - Jennifer Ness
- Lead Health Services Researcher,Centre for Self-harm and Suicide Prevention Research,Derbyshire Healthcare National Health Service Foundation Trust,UK
| | - Muzamal Rehman
- Research Assistant,Centre for Self-harm and Suicide Prevention Research,Derbyshire Healthcare National Health Service Foundation Trust,UK
| | - Ellen Townsend
- Professor of Psychology,Self-Harm Research Group,School of Psychology,University of Nottingham,UK
| | - Louis Appleby
- Professor of Psychiatry,Centre for Mental Health and Safety,Manchester Academic Health Sciences Centre,The University of Manchester,UK
| | - Nav Kapur
- Professor of Psychiatry and Population Health,Centre for Mental Health and Safety,Manchester Academic Health Sciences Centre,The University of Manchester; and Honorary Consultant in Psychiatry,Greater Manchester Mental Health National Health Service Foundation Trust,UK
| |
Collapse
|
47
|
Wei M, Zhou W, Bi Y, Wang H, Liu Y, Zhang ZJ. Rising Mortality Rate of Cervical Cancer in Younger Women in Urban China. J Gen Intern Med 2019; 34:281-284. [PMID: 30484099 PMCID: PMC6374275 DOI: 10.1007/s11606-018-4732-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 09/11/2018] [Accepted: 10/25/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND In recent decades, much effort has been made in China to reduce the burden of cervical cancer. OBJECTIVE Our study's purpose was to examine trends of cervical cancer mortality in each 5-year age group for urban and rural Chinese women, respectively. DESIGNS Retrospective analysis of cervical cancer mortality from 1987 to 2015 from the World Health Organization Cancer Mortality Database and China Health Statistical Yearbooks. PARTICIPANTS Chinese women. MAIN MEASURES Trends were examined using annual percent change (APC) and average annual percent change (AAPC) via Joinpoint regression models for each 5-year age group in urban and rural areas, respectively. RESULTS In urban China, mortality rate of cervical cancer increased significantly among urban women aged 25-54 years (AAPC 2.12~5.49%), in contrast to a decline trend among urban women older than 60 years (AAPC - 3.61~- 5.35%). In rural China, cervical cancer rates declined in all age groups, but the magnitude was smaller in women aged 30-54 years (AAPC - 0.59~- 2.20%) compared to women older than 55 years (AAPC - 3.06~- 4.33%). CONCLUSION Mortality rate of cervical cancer is rising at an alarming rate in younger women in urban China. Timely intervention is required for these vulnerable populations.
Collapse
Affiliation(s)
- Min Wei
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Wei Zhou
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yongyi Bi
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Hong Wang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yu Liu
- Department of Statistics and Management, School of Management, Wuhan Institute of Technology, Wuhan, 430205, China
| | - Zhi-Jiang Zhang
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| |
Collapse
|
48
|
Jiang J, Wang P. Health status in a transitional society: urban-rural disparities from a dynamic perspective in China. Popul Health Metr 2018; 16:22. [PMID: 30591053 PMCID: PMC6307183 DOI: 10.1186/s12963-018-0179-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/09/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The phenomenon of urban-rural segmentation has emerged and is remarkable, and the health disparities between rural and urban China should be stressed. METHODS Based on data from the Chinese General Social Survey from 2005 to 2013, this study not only explored the net age, period, and cohort effects of self-rated health, but compared these effects between rural and urban China from a dynamic perspective through hierarchical age-period-cohort-cross-classified random effects model. RESULTS Urban-rural disparities, as well as work status and gender disparities in health increased with age, in line with the cumulative advantage/disadvantage effects theory, while marital status disparities in health declining with age was in line with the age-as-leveler effects theory. The war cohort, famine cohort, later cultural revolution cohort, and early reform cohort had poorer health than did those in the early China cohort, economic recovery cohort, and later reform cohort. The economic crisis period, war cohort, baby boomer, and early cultural revolution cohort encountered larger urban-rural health disparities, while the early China cohort and early reform cohort experienced smaller urban-rural disparities in health. CONCLUSIONS Population health is closely related to social context and health care development. It is necessary to keep economic development stable and boost medical technology improvements and the construction of the health care system.
Collapse
Affiliation(s)
- Junfeng Jiang
- School of Health Sciences, Wuhan University, Wuhan, China, No.115 Donghu Road, Wuhan City, 430071, China
| | - Peigang Wang
- School of Health Sciences, Wuhan University, Wuhan, China, No.115 Donghu Road, Wuhan City, 430071, China. .,Academy of Humanities and Social Sciences, Wuhan University, Wuhan, China, No.299 Bayi Road, Wuhan City, 430072, China.
| |
Collapse
|
49
|
Yu W, Jiang J, Xie L, Li B, Luo H, Fu Y, Chen S, Wu C, Xiang H, Tang S. Mortality Trends in Colorectal Cancer in China During 2000-2015: A Joinpoint Regression and Age-Period-Cohort Analysis. Prev Chronic Dis 2018; 15:E156. [PMID: 30576278 PMCID: PMC6307832 DOI: 10.5888/pcd15.180329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION As lifestyles have increasingly become westernized in China, public health strategies have increasingly focused on cancer prevention. The objective of this study was to describe trends in colorectal cancer (CRC) mortality and the age, period, and cohort effects of CRC mortality in urban and rural China from 2000 to 2015. METHODS We collected CRC mortality data from the China Health Statistics Yearbook. We used joinpoint regression analysis to estimate the slope of mortality trends. We then used the age-period-cohort (APC) model with intrinsic estimator to estimate the age, period, and cohort effects of CRC mortality. RESULTS CRC mortality was higher in urban areas than in rural areas, and the average annual percentage change was also larger in urban areas (4.1%) than in rural areas (3.7%). CRC mortality risk was higher among older adults than among adults aged 20 to 24: the relative risk among adults aged 60 to 64 was 31.09 times higher in urban China and 11.46 times higher in rural China. CRC mortality risk increased with period: compared with period 2000, the relative risk was 1.01 in period 2005, 1.36 in period 2010, and 1.42 in period 2015 in urban China and 1.12 in period 2005, 1.24 in period 2010, and 1.69 in period 2015 in rural China. More recent cohorts had lower CRC mortality risk: compared with the cohort born during 1920-1924, the relative risk of cohort 1950-1954 was 0.70 in urban China and 0.69 in rural China. CONCLUSION More interventions to reduce the burden of CRC should be conducted, and it is more necessary for older people and urban residents to adopt a healthy lifestyle in China.
Collapse
Affiliation(s)
- Wenyuan Yu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China.,Global Health Institute, Wuhan University, Wuhan, China
| | - Junfeng Jiang
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Lingling Xie
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Baojing Li
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Huijuan Luo
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yuanshan Fu
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Shu Chen
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Rd, Wuhan, 430071, China. .,Global Health Institute, Wuhan University, Wuhan, China
| | - Shenglan Tang
- Duke Global Health Institute, Duke University, Durham, North Carolina
| |
Collapse
|
50
|
Li C, Hu S, Yu C. All-Cause and Cancer Mortality Trends in Macheng, China (1984⁻2013): An Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102068. [PMID: 30241353 PMCID: PMC6210680 DOI: 10.3390/ijerph15102068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/16/2018] [Accepted: 09/18/2018] [Indexed: 12/28/2022]
Abstract
The aim was to study the variation trends of all-cause and cancer mortality during 1984⁻2013 in Macheng City, China. The mortality data were collected from Macheng City disease surveillance points system and Hubei Center for Disease Control and Prevention. The model life table system was used to adjust mortality rates due to an under-reporting problem. An age-period-cohort model and intrinsic estimator algorithm were used to estimate the age effect, period effect, and cohort effect of all-cause mortality and cancer mortality for males and females. Age effect of all-cause mortality for both sexes increased with age, while the age effect of cancer mortality for both sexes reached a peak at the age group of 55⁻59 years old and then decreased. The relative risks (RRs) of all-cause mortality for males and females declined with the period and decreased by 51.13% and 63.27% during the whole study period, respectively. Furthermore, the period effect of cancer mortality in both sexes decreased at first and then increased. The cohort effect of all-cause and cancer mortality for both sexes born after 1904 presented the pattern of "rise first and then fall," and decreased by 82.18% and 90.77% from cohort 1904⁻1908 to 1989⁻1993, respectively; especially, the risk of all-cause and cancer mortality for both sexes born before 1949 was much higher than that for those born after 1949.
Collapse
Affiliation(s)
- Chunhui Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
- School of Health Sciences, Global Health Institute, Wuhan University, Wuhan 430071, China.
| | - Songbo Hu
- School of Health Sciences, Global Health Institute, Wuhan University, Wuhan 430071, China.
- School of Public Health, Nanchang University, Nanchang 330019, China.
| | - Chuanhua Yu
- School of Health Sciences, Global Health Institute, Wuhan University, Wuhan 430071, China.
| |
Collapse
|