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Osadnik K, Osadnik T, Gierlotka M, Windak A, Tomasik T, Mastej M, Kuras A, Jóźwiak K, Penson PE, Lip GYH, Mikhailidis DP, Toth PP, Catapano AL, Ray KK, Howard G, Tomaszewski M, Charchar FJ, Sattar N, Williams B, MacDonald TM, Banach M, Jóźwiak J. Metabolic syndrome is associated with similar long-term prognosis in those living with and without obesity: an analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 studies. Eur J Prev Cardiol 2023; 30:1195-1204. [PMID: 37039119 DOI: 10.1093/eurjpc/zwad101] [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: 02/08/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/12/2023]
Abstract
AIMS We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. METHODS AND RESULTS The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006, and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III), and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS, and obese patients with MetS. Differences in all-cause mortality were analysed using Kaplan-Meier and Cox regression analyses. A total of 45 615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14 202 (31%) by NCEP/ATP III criteria and 17 216 (37.7%) by JIS criteria. Follow-up was available for 44 620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese {hazard ratio, HR: 1.88 [95% confidence interval (CI) 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively} and non-obese individuals [HR: 2.11 (95% CI 1.85-2.40) and 1.7 (95% CI 1.56-1.85) according to NCEP/ATP III and JIS criteria, respectively]. Obese patients without MetS had a higher mortality risk than non-obese patients without MetS [HR: 1.16 (95% CI 1.10-1.23) and HR: 1.22 (95% CI 1.15-1.30), respectively in subgroups with NCEP/ATP III and JIS criteria applied]. CONCLUSIONS MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS, obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised.
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Affiliation(s)
- Kamila Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland, Jordana 38 st., 41-808 Zabrze, Poland
| | - Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland, Jordana 38 st., 41-808 Zabrze, Poland
| | - Marek Gierlotka
- Department of Cardiology, Institute of Medical Sciences, University of Opole, Al. W. Witosa 26, 45-401 Opole, Poland
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, Bochenska 4 Street, 31-061 Krakow, Poland
| | - Tomasz Tomasik
- Department of Family Medicine, Jagiellonian University Medical College, Bochenska 4 Street, 31-061 Krakow, Poland
| | - Mirosław Mastej
- Mastej Medical Center, Staszica 17A St., 38-200 Jasło, Poland
| | - Agnieszka Kuras
- Multiprofile Medical Simulation Center, University of Opole, Oleska 48 St., 45-052 Opole, Poland
| | - Kacper Jóźwiak
- Faculty of Health Sciences, Jagiellonian University Collegium Medicum, ul/street: Piotra Michałowskiego 12, 31-126 Kraków, Poland
| | - Peter E Penson
- Clinical Pharmacy & Therapeutics Research Group, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, James Parsons Building, Byrom Street, Liverpool L3 3AF, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Brownlow Hill, Liverpool L69 7TX, UK
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, 6 West Derby St., Liverpool L7 8TX, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK
- Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), Pond St., London NW3 2QG, UK
| | - Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- CGH Medical Center, Department of Preventive Cardiology, 101 East Miller Road, Sterling, IL 61081, USA
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via G. Balzaretti 9, 10136 Milan, Italy
- IRCCS MultiMedica, Sesto S. Giovanni, Via Milanese, 300, 20099 Milan, Italy
| | - Kausik K Ray
- Imperial Centre for Cardiovascular Disease Prevention, Department of Primary Care and Public Health, 320 St Dunstan's Road (Reynolds Building) Imperial College London, London W68RP, UK
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, 1665 University Blvd, AL 35294-0022, USA
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester, 46 Grafton St., Manchester M13 9NT, UK
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Nelson St, Manchester M13 9NQ, UK
| | - Fadi J Charchar
- Health Innovation and Transformation Centre, Federation University Australia, University Drive, Ballarat, Victoria 3350, Australia
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
| | - Bryan Williams
- NIHR University College London Biomedical Research Centre, University College London and University College London Hospitals NHS Foundation Trust, 149 Tottenham Court Road, London W1T 7DN, UK
| | - Thomas M MacDonald
- MEMO Research, School of Medicine, University of Dundee, Ninewells Hospital & Medical School, Ninewells Avenue, Dundee DD1 9SY, UK
| | - Maciej Banach
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Rzgowska 281/289, 93-338 Lodz, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Rzgowska 281/289, 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zyty 28, 65-046 Zielona Gora, Poland
| | - Jacek Jóźwiak
- Department of Family Medicine and Public Health, University of Opole, Oleska 48 Street, 45-052 Opole, Poland
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Cayuela A, Cayuela L, Ortega Belmonte MJ, Rodríguez-Domínguez S, Escudero-Martínez I, González A. Has stroke mortality stopped declining in Spain? Neurologia 2022; 37:550-556. [PMID: 31780318 DOI: 10.1016/j.nrl.2019.06.001] [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: 05/02/2018] [Revised: 05/06/2019] [Accepted: 06/20/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models. METHODS Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend. RESULTS Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from -3.4% in Catalonia and Extremadura, to -6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from -3.1% in Catalonia to -6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands. CONCLUSIONS Current data show that stroke mortality rates have decreased (in women in Andalusia), stabilised (in both sexes in Murcia, in men in Castile-La Mancha, and in women in Extremadura), and have even reversed (in both sexes in the Canary Islands). Further study is needed to identify the causes of these trends.
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Affiliation(s)
- A Cayuela
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España.
| | - L Cayuela
- Departamento de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, España
| | - M J Ortega Belmonte
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España
| | | | - I Escudero-Martínez
- Unidad de Ictus, Unidad de Gestión Clínica de Neurociencias, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - A González
- Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, España
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Cayuela A, Cayuela L, Ortega Belmonte MJ, Rodríguez-Domínguez S, Escudero-Martínez I, González A. Has stroke mortality stopped declining in Spain? NEUROLOGÍA (ENGLISH EDITION) 2021; 37:550-556. [PMID: 34521606 DOI: 10.1016/j.nrleng.2019.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/20/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To analyse the changes in stroke mortality trends in Spain by autonomous community and by sex during the period 1980-2016, using joinpoint regression models. METHODS Mortality data were obtained from the Spanish National Statistics Institute. Crude and standardised rates were calculated for each Spanish autonomous community, and for each sex. Joinpoint analysis was used to identify the best-fitting points showing a statistically significant change in the trend. RESULTS Joinpoint analysis enabled us to differentiate between communities in which mortality rates showed a continuous decline throughout the study period in both sexes (Asturias, Cantabria, Castile and Leon, Ceuta, and Melilla) or in men only (Extremadura). In men, in all those communities in which changes in the trend were observed (all but Aragon, the Balearic Islands, and Murcia, where rates remained stable), we observed an initial period of decline (ranging from -3.4% in Catalonia and Extremadura, to -6.0% in Madrid) and a final period where the trends diverged: mortality rates continued to fall in Andalusia, Aragon, the Balearic Islands, and Madrid, but began to stabilise in Castile-La Mancha and Murcia and to increase in the Canary Islands. In women, in those communities where changes were observed (all but Aragon, Murcia, and the Basque Country, where rates remained stable), we observed an initial period of decline (ranging from -3.1% in Catalonia to -6.4% in Navarre) and a final period where divergent trends were observed: rates continued to decline in Andalusia, Aragon, Catalonia, Galicia, Madrid, and the Basque Country, but began to stabilise in Extremadura and Murcia and to increase in the Canary Islands. CONCLUSIONS Current data show that stroke mortality rates have decreased (in women in Andalusia), stabilised (in both sexes in Murcia, in men in Castile-La Mancha, and in women in Extremadura), and have even reversed (in both sexes in the Canary Islands). Further study is needed to identify the causes of these trends.
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Affiliation(s)
- A Cayuela
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.
| | - L Cayuela
- Departamento de Medicina Interna, Hospital Severo Ochoa, Leganés, Madrid, Spain
| | - M J Ortega Belmonte
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain
| | | | - I Escudero-Martínez
- Unidad de Ictus, Unidad de Gestión Clínica de Neurociencias, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A González
- Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Hirokawa K, Ohira T, Nagao M, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Associations Between Occupational Status, Support at Work, and Salivary Cortisol Levels. Int J Behav Med 2021; 29:299-307. [PMID: 34462898 DOI: 10.1007/s12529-021-10020-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study investigated associations between occupation, job stress, and salivary cortisol levels after psychological tasks. METHODS We examined 766 (273 men and 493 women) healthy employed Japanese participants aged 21 to 68 years (mean age = 46.4 years, standard deviation = 8.5) with three types of occupation: manager, teacher, and general worker. The Brief Job Stress Questionnaire was used to evaluate participants' job stress levels, including job demand, job control, support from supervisors, and support from coworkers. Salivary cortisol levels were measured at pre-session, post-stressful tasks, and post-relaxation. All samples were assayed using an enzyme-linked immunosorbent assay test. Natural log transformation was applied before statistical analyses. A multiple regression analysis and a repeated measures analysis of covariance were conducted to test associations between occupation and salivary cortisol levels, adjusting for confounding factors. Statistical analyses were conducted separately for men and women. RESULTS Among both men and women, general workers had higher cortisol levels than managers throughout the experimental session (men 0.6 μg/dL and 0.4 μg/dL, respectively; women 0.5 μg/dL and 0.4 μg/dL, respectively). Job control was positively associated with cortisol levels measured in all sessions, after adjusting for confounding factors (standardized beta 0.15, 0.21, and 0.18 for pre-session, post-stressful-tasks, and post-relaxation, respectively, all p < 0.05). Men with low support from coworkers had higher cortisol levels than those with high support through the sessions (0.6 μg/dL and 0.4 μg/dL, respectively). CONCLUSION Socioeconomic disparity according to occupational status was related to cortisol levels in Japanese workers. Support from coworkers may be effective for reducing cortisol secretion in men.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka, 567-8578, Japan. .,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan. .,Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan.
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey Office of Epidemiology, Fukushima Medical University, 1 Hikariga-oka, Fukushima City Fukushima, Fukushima, 960-1295, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Akihiko Kitamura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
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Velhinho A, Perelman J. Socioeconomic Inequalities in Food Consumption: A Cross-Sectional Study in Portuguese Adults. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2021. [DOI: 10.1159/000515937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> Food is a major determinant of chronic noncommunicable diseases. Because of this, social inequalities in food consumption will likely produce social inequalities in disease and life expectancy. <b><i>Objectives:</i></b> This study analyses the social inequalities in food consumption in Portugal and whether they differ between men and women and between younger and older people. <b><i>Methods:</i></b> Following a cross-sectional observational study, we analyzed data from 11,085 individuals aged 25–64 years who participated in the 2014 National Health Interview Survey (NHIS). Logistic regression models were used to measure the association between socioeconomic conditions, i.e., education and income, and food consumption. The analysis was then stratified by sex and age. <b><i>Results:</i></b> A positive gradient for income and education was observed in the consumption of fish, cakes, natural juices, and dairy products. The consumption of legumes and soft drinks was inversely related to income and education. A socioeconomic gradient for fruits and vegetables was observed only among women and older people. Worse-off people consumed less soup, and underprivileged women consumed fewer fast-food products. <b><i>Conclusion:</i></b> The food consumption patterns of Portuguese adults are related to their socioeconomic condition, with few variations across demographic categories.
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Banerjee S, Bhattacharya A, Patra S. Prevalence of cardiovascular risk factors among executive and nonexecutive workers in an urban public sector office setting: A cross-sectional epidemiological study from Eastern India. Indian J Community Med 2021; 46:723-726. [PMID: 35068743 PMCID: PMC8729269 DOI: 10.4103/ijcm.ijcm_52_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 09/17/2021] [Indexed: 11/04/2022] Open
Abstract
Aim: Methods: Results: Conclusion:
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Dhungel B, Murakami T, Wada K, Gilmour S. Mortality risks among blue- and white-collar workers: A time series study among Japanese men aged 25-64 years from 1980 to 2015. J Occup Health 2021; 63:e12215. [PMID: 33837627 PMCID: PMC8035635 DOI: 10.1002/1348-9585.12215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/16/2021] [Accepted: 02/25/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We aimed to analyse age-standardised mortality trends in Japan among blue- and white-collar male workers aged 25-64 years, by major causes of mortality from 1980 to 2015. METHODS Five-yearly mortality data were extracted from occupation-specific vital statistics maintained by the Japanese Ministry of Health, Labour and Welfare. A time series study was conducted among employed men aged 25-64 years. Age-standardised mortality trends by occupational category were calculated separately for all cancers, ischaemic heart disease, cerebrovascular disease and suicide. Poisson regression analysis was performed to analyse mortality trends by occupational category for each cause. RESULTS Mortality rates for all cancers and ischaemic heart disease were higher among white-collar workers than blue-collar workers throughout the 35-year study period. The gap in the mortality rates for all four causes of death among blue- and white-collar workers widened in 2000 after Japan's economic bubble burst in the late 1990s. Simultaneously, suicide mortality rates among white-collar workers increased sharply and have remained higher than among blue-collar workers. CONCLUSIONS White-collar male workers in Japan have a higher risk of mortality than male blue-collar workers. However, despite substantial differences, significant progress has been made in recent years in reducing mortality across all occupations in Japan.
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Affiliation(s)
- Bibha Dhungel
- Graduate School of Public HealthSt. Luke's International UniversityTokyoJapan
- Department of Health PolicyNational Centre for Child Health and DevelopmentTokyoJapan
| | - Tomoe Murakami
- Graduate School of Public HealthInternational University of Health and WelfareTokyoJapan
| | - Koji Wada
- Graduate School of Public HealthInternational University of Health and WelfareTokyoJapan
| | - Stuart Gilmour
- Graduate School of Public HealthSt. Luke's International UniversityTokyoJapan
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Hessel P, Rodríguez-Lesmes P, Torres D. Socio-economic inequalities in high blood pressure and additional risk factors for cardiovascular disease among older individuals in Colombia: Results from a nationally representative study. PLoS One 2020; 15:e0234326. [PMID: 32516351 PMCID: PMC7282633 DOI: 10.1371/journal.pone.0234326] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Studies in high-income countries have documented a consistent gradient between socio-economic status (SES) and high blood pressure (HBP), a key risk factor for cardiovascular disease (CVD). However, evidence from Latin American countries (LA) remains comparatively scarce and inconclusive. Data Data for 3,984 individuals came from a nationally representative survey of individuals aged 60 years or above in Colombia (Encuesta de Salud, Bienestar y Envejecimiento) (SABE) conducted in 2015. SES was measured by educational achievement and household assets. CVD risk factors included objectively measured HBP and body mass index (BMI), as well as behaviors (smoking, alcohol consumption, fruit and vegetables intake, and physical activity). Methods Bivariate methods and multivariate regression models were used to assess associations between SES with HBP as well as additional risk factors for CVD. Results Individuals with lower SES have significantly higher risk of suffering from HBP. Compared to those with no formal education, individuals with secondary or post-secondary education have a 37% lower risk of HBP (odds ratio [OR] = 0.63, P-value<0.001). Being in the highest asset quartile (most affluent) is associated with a 44% lower risk (OR = 56, P-value = 0.001) of HBP compared to those in the lowest asset quartile (most deprived). Individuals with lower SES are more likely to smoke, not engage in regular physical activity and not regularly consume fruits or vegetables. In contrast, individuals with higher SES are more likely to consume alcohol and, those with more assets, more likely to be obese. Conclusions Among older Colombians there exists a marked SES gradient in HBP as well as several additional risk factors for CVD. The results highlight the importance of a public health approach towards HBP and additional CVD risk factors that takes into account the specific conditions of older individuals, especially among disadvantaged groups.
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Affiliation(s)
- Philipp Hessel
- University of the Andes, Alberto Lleras Camargo School of Government, Bogotá, Colombia
- * E-mail:
| | | | - David Torres
- University of the Andes, Alberto Lleras Camargo School of Government, Bogotá, Colombia
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Mosquera PA, San Sebastian M, Ivarsson A, Gustafsson PE. Decomposition of gendered income-related inequalities in multiple biological cardiovascular risk factors in a middle-aged population. Int J Equity Health 2018; 17:102. [PMID: 30005665 PMCID: PMC6045866 DOI: 10.1186/s12939-018-0804-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/19/2018] [Indexed: 01/22/2023] Open
Abstract
Background Socioeconomic inequalities in cardiovascular disease seem to widen or endure in Sweden. However, research on inequalities in antecedent cardiovascular risk factors (CVRFs), and particularly what underpins them, is scarce. The present study aimed 1) to estimate income-related inequalities in eight biological cardiovascular risk factors in Swedish middle-aged women and men; and 2) to examine the contribution of demographic, socioeconomic, behavioural and psychosocial determinants to the observed inequalities. Methods Participants (N = 12,481) comprised all 40- and 50-years old women and men who participated in the regional Västerbotten Intervention Programme in Northern Sweden during 2008, 2009 and 2010. All participants completed a questionnaire on behavioural and psychosocial conditions, and underwent measurements with respect to eight CVRFs (body mass index; waist circumference; total cholesterol; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol; triglycerides; systolic/diastolic blood pressure; glucose tolerance). Data on cardiovascular risk, psychosocial and health behaviours were linked to national register data on income and other socioeconomic and demographic factors. To estimate income inequalities in each CVRF concentration indexes were calculated, and to examine the contribution of the underlying determinants to the observed inequalities a Wagstaff-type decomposition analysis was performed separately for women and men. Results Health inequalities ranged from small to substantial with generally greater magnitude in women. The highest inequalities among women were seen in BMI, triglycerides and HDL-cholesterol (Concentration index = − 0.1850; − 0.1683 and − 0.1479 respectively). Among men the largest inequalities were seen in glucose regulation, BMI and abdominal obesity (Concentration index = − 0.1661; − 0.1259 and − 0.1172). The main explanatory factors were, for both women and men socioeconomic conditions (contributions ranging from 54.8 to 76.7% in women and 34.0–72.6% in men) and health behaviours (contributions ranging from 6.9 to 20.5% in women and 9.2 to 26.9% in men). However, the patterns of specific dominant explanatory factors differed between CVRFs and genders. Conclusion Taken together, the results suggest that the magnitude of income-related inequalities in CVRFs and their determinants differ importantly between the risk factors and genders, a variation that should be taken into consideration in population interventions aiming to prevent inequalities in manifest cardiovascular disease.
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Affiliation(s)
- Paola A Mosquera
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87, Umeå, Sweden.
| | - Miguel San Sebastian
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87, Umeå, Sweden
| | - Anneli Ivarsson
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87, Umeå, Sweden
| | - Per E Gustafsson
- Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87, Umeå, Sweden
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Pérez-Hernández B, García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Desigualdades sociales en los factores de riesgo cardiovascular de los adultos mayores de España: estudio ENRICA-Seniors. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Costa D, Hatzidimitriadou E, Ioannidi-Kapolou E, Lindert J, Soares J, Sundin Ö, Toth O, Barros H. Male and female physical intimate partner violence and socio-economic position: a cross-sectional international multicentre study in Europe. Public Health 2016; 139:44-52. [DOI: 10.1016/j.puhe.2016.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 04/18/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
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Kyrou I, Kollia N, Panagiotakos D, Georgousopoulou E, Chrysohoou C, Tsigos C, Randeva HS, Yannakoulia M, Stefanadis C, Papageorgiou C, Pitsavos C. Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: The ATTICA Study. Eur J Prev Cardiol 2016; 24:145-152. [DOI: 10.1177/2047487316670918] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ioannis Kyrou
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
- Aston Medical Research Institute, Aston University, UK
- Translational and Experimental Medicine, Division of Biomedical Sciences, University of Warwick, UK
- WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Natasa Kollia
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
| | | | | | | | - Constantine Tsigos
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
| | - Harpal S Randeva
- Aston Medical Research Institute, Aston University, UK
- Translational and Experimental Medicine, Division of Biomedical Sciences, University of Warwick, UK
- WISDEM, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Mary Yannakoulia
- Department of Science of Dietetics and Nutrition, Harokopio University, Greece
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Pérez-Hernández B, García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Social Inequalities in Cardiovascular Risk Factors Among Older Adults in Spain: The Seniors-ENRICA Study. ACTA ACUST UNITED AC 2016; 70:145-154. [PMID: 27519455 DOI: 10.1016/j.rec.2016.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/27/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES To examine the distribution of the main cardiovascular risk factors (CVRF) according to socioeconomic level (SEL) among older adults in Spain. METHODS A cross-sectional study conducted in 2008-2010 with 2699 individuals representative of the noninstitutionalized Spanish population aged ≥ 60 years. Socioeconomic level was assessed using educational level, occupation, and father's occupation. The CVRF included behavioral and biological factors and were measured under standardized conditions. RESULTS In age- and sex-adjusted analyses, higher educational level was associated with a higher frequency of moderate alcohol consumption and leisure time physical activity, and less time spent watching television. An inverse educational gradient was observed for frequency of obesity (odds ratio [OR] in university vs primary level or below education, 0.44; 95% confidence interval [95%CI], 0.33-0.57; P-trend < .01), metabolic syndrome (OR = 0.56; 95%CI, 0.43-0.71; P-trend < .01), diabetes (OR = 0.68; 95%CI, 0.49-0.95; P-trend < .05), and cardiovascular disease (OR = 0.52; 95%CI, 0.29-0.91; P-trend < .05). Compared with a nonmanual occupation, having a manual occupation was associated with a higher frequency of several CVRF; this association was stronger than that observed for father's occupation. Differences in CVRF across SELs were generally greater in women than in men. CONCLUSIONS There are significant social inequalities in CVRF among older adults in Spain. Reducing these inequalities, bringing the levels of CVRF in those from lower SEL in line with the levels seen in higher SEL, could substantially reduce the prevalence of CVRF in the older adult population.
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Affiliation(s)
- Bibiana Pérez-Hernández
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther García-Esquinas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
| | - Auxiliadora Graciani
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Pilar Guallar-Castillón
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther López-García
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Luz M León-Muñoz
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
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Moradi G, Majdzadeh R, Mohammad K, Malekafzali H, Jafari S, Holakouie-Naieni K. Is the status of diabetes socioeconomic inequality changing in Kurdistan province, west of Iran? A comparison of two surveys. Med J Islam Repub Iran 2016; 30:375. [PMID: 27493919 PMCID: PMC4972065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 10/20/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND About 80% of deaths in 350 million cases of diabetes in the world occur in low and middle income countries. The aim of this study was to determine the status of diabetes socioeconomic inequality and the share of determinants of inequalities in Kurdistan Province, West of Iran, using two surveys in 2005 and 2009. METHODS Data were collected from non-communicable disease surveillance surveys in Kurdistan in 2005 and 2009. In this study, the socioeconomic status (SES) of the participants was determined based on the residential area and assets using principal component analysis statistical method. We used concentration index and logistic regression to determine inequality. Decomposition analysis was used to determine the share of each determinant of inequality. RESULTS The prevalence of diabetes expressed by individuals changed from 0.9% (95% CI: 0.6-1.3) in 2005 to 3.1% (95% CI: 2-4) in 2009. Diabetes Concentration Index changed from -0.163 (95% CI: -0.301- -0.024) in 2005 to 0.273 (95% CI: 0.101-0.445) in 2009. The results of decomposition analysis revealed that in 2009, 67% of the inequality was due to low socioeconomic status and 16% to area of residence; i.e., living in rural areas. CONCLUSION The prevalence of diabetes significantly increased, and the diabetes inequality shifted from the poor people to groups with better SES. Increased prevalence of diabetes among the high SES individuals may be due to their better responses to diabetes control and awareness programs or due to the type of services they were provided during these years.
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Affiliation(s)
- Ghobad Moradi
- 1 MD, PhD, Assistant Professor of Epidemiology, Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Reza Majdzadeh
- 2 PhD, Professor of Epidemiology, Knowledge Utilization Research Center (KURC), Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Mohammad
- 3 PhD, Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hossein Malekafzali
- 4 MD, PhD, Professor of Biostatistics, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Saeede Jafari
- 5 MSc Student of Epidemiology, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Kourosh Holakouie-Naieni
- 6 PhD, Professor of Epidemiology, Iranian Epidemiological Association, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. ,(Corresponding author) PhD, Professor of Epidemiology, Iranian Epidemiological Association, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Hirokawa K, Ohira T, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Occupational status and job stress in relation to cardiovascular stress reactivity in Japanese workers. Prev Med Rep 2016; 4:61-7. [PMID: 27413662 PMCID: PMC4929058 DOI: 10.1016/j.pmedr.2016.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/11/2016] [Accepted: 05/16/2016] [Indexed: 12/02/2022] Open
Abstract
This study aimed to investigate the effects of occupational status and job stress factors on cardiovascular stress reactivity in Japanese workers. In this baseline assessment between 2001 and 2009 in Osaka, Japan, we examined 928 healthy Japanese employees (330 men, 598 women) from two occupational statuses: managers/professionals and general workers. A brief job stress questionnaire was used to evaluate job stress levels. Systolic and diastolic blood pressure (SBP, DBP), heart rate, heart rate variability (high-frequency [HF], low-frequency [LF], LF/HF], and peripheral blood flow were measured at rest and during two stressful tasks. Changes in stress reactivity were calculated as the difference between the measured variables during the tasks and the rest period. Men showed inverse associations between quantitative job overload and DBP, heart rate, and LF/HF, between physical demands and blood pressure (SBP, DBP), and between a poor physical environment and HF. Men also had positive associations between qualitative job overload and heart rate, and between physical demands and peripheral blood flow (all p < 0.05). Women showed inverse associations between qualitative job overload and SBP, and showed positive associations between qualitative job overload and peripheral blood flow, and between a poor physical environment and SBP (all p < 0.05). When stratified by occupational status, significant associations between job stress and changes in stress reactivity were observed in male managers/professionals and female general workers (p < 0.05). Job stress levels are associated with changes in cardiovascular stress reactivity in men and women. Occupational status may modify these associations. Job stressors are associated with changes in stress reactivity in men and women. Job stressors associated with stress reactivity in male managers/professionals. Job stressors associated with stress reactivity in female general workers. Occupational status and gender differences should be considered.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka 567-8578, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Epidemiology, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Mako Nagayoshi
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science 1-12-4 Sakamoto, Nagasaki 852-8523 JAPAN
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Akihiko Kitamura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
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Gupta N, Heiden M, Aadahl M, Korshøj M, Jørgensen MB, Holtermann A. What Is the Effect on Obesity Indicators from Replacing Prolonged Sedentary Time with Brief Sedentary Bouts, Standing and Different Types of Physical Activity during Working Days? A Cross-Sectional Accelerometer-Based Study among Blue-Collar Workers. PLoS One 2016; 11:e0154935. [PMID: 27187777 PMCID: PMC4871331 DOI: 10.1371/journal.pone.0154935] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/21/2016] [Indexed: 01/22/2023] Open
Abstract
Introduction The aim of the study was to investigate if (a) substituting total sedentary time or long sedentary bouts with standing or various types of physical activity and (b) substituting long sedentary bouts with brief sedentary bouts; is associated with obesity indicators using a cross sectional isotemporal substitution approach among blue-collar workers. Methods A total of 692 workers from transportation, manufacturing and cleaning sectors wore an Actigraph GT3X+ accelerometer on the thigh for 1–4 working days. The sedentary (sit and lie), standing, walking, and moderate to vigorous physical activity (MVPA) time on working days was computed using validated Acti4 software. The total sedentary time and uninterrupted sedentary time spent in brief (≤5 mins), moderate (>5 and ≤30 mins), and long (>30mins) bouts, were determined for the whole day and during work and non-work time separately. The obesity indicators, BMI (kg/m2), waist circumference (cm) and fat percentage were objectively measured. Isotemporal substitution modelling was utilized to determine the linear association with obesity indicators of replacing 30 min of total sedentary time or long sedentary bouts with standing, walking or MVPA and separately replacing 30 min of long sedentary bouts with brief sedentary bouts. Results Workers [mean (standard deviation, SD); age = 45.1 (9.9) years, BMI = 27.5 (4.9) kg/m2, %BF = 29.6 (9.5), waist circumference = 94.4 (13.0) cm] sat for 2.4 hours (~32% of the measured time, SD = 1.8 hours) across the day during work period and 5.5 hours (~62% of the measured time, SD = 1.5 hours) during non-work period. Most of the sedentary time was accrued in moderate bouts [work = 1.40 (SD = 1.09) hours] during work and in long bouts during non-work [2.7 (SD = 1.4) hours], while least in long sedentary bouts during work [work = 0.5 (SD = 0.9)] and in brief sedentary bouts [0.5 hours (SD = 0.3)] during non-work. Significant associations with all obesity indicators were found when 30 min of total sedentary time or long sedentary bouts were replaced with standing time (~1–2% lower) or MVPA (~4–9% lower) during whole day, work, and non-work periods. The exception was that a statistically significant association was not observed with any obesity indicator when replacing total sedentary time or long sedentary bouts with standing time during the work period. Significant beneficial associations were found when replacing the long sedentary bouts with brief sedentary bouts (~3–5% lower) during all domains. Conclusion Replacing total sedentary time and long sedentary bouts, respectively, not only with MVPA but also standing time appears to be beneficially associated with obesity indicators among blue-collar workers. Additionally, replacing long sedentary bouts with brief sedentary bouts was also beneficially associated with obesity indicators. Studies using prospective design are needed to confirm the findings.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
- * E-mail:
| | - Marina Heiden
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
| | - Mette Aadahl
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Suliga E, Kozieł D, Cieśla E, Rębak D, Głuszek S. Factors Associated with Adiposity, Lipid Profile Disorders and the Metabolic Syndrome Occurrence in Premenopausal and Postmenopausal Women. PLoS One 2016; 11:e0154511. [PMID: 27128677 PMCID: PMC4851395 DOI: 10.1371/journal.pone.0154511] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/14/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the study was the assessment of the dependencies between a woman’s menopausal status and adiposity, lipid profile and metabolic syndrome occurrence, as well as finding out whether the correlations between the socio-demographic profile and lifestyle elements and adiposity, lipid profile and the risk of MetS are the same before and after menopause. A cross-sectional study was carried out on 3636 women, aged between 40–59, which involved a questionnaire interview, anthropometric measurements and fasting blood samples, on the basis of which the concentration of triglycerides, cholesterol and glucose was estimated. Before menopause, a greater adiposity (BMIβ = 0.08; %BFβ = 0.07; WCβ = 0.06) was characteristic for women living in a stable relationship than for single women. Women who smoked in the past were characterized by a higher BMI (β = 0.09) and WC (β = 0.06) in comparison with women who have never smoked, while after menopause a greater adiposity (%BFβ = 0.12) and a worse lipid profile (TCβ = 0.08; LDLβ = 0.07; HDLβ = -0.05; TGβ = 0.14) were present in women currently smoking, in comparison to women who have never smoked. After menopause, in women who had two or more children, a greater adiposity (BMIβ = 0.07 and 0.09; %BFβ = 0.05 and 0.07) and a higher risk of MetS (OR = 1.22, 95%CI: 1.03–1.44) was observed compared to nulliparous women, than before menopause. In women with a higher level of education, the risk of MetS after menopause was significantly lower compared with women with a lower level of education (OR = 0.74, 95%CI: 0.61–0.90). Physical activity after menopause had a higher influence on the decrease in the women’s adiposity (BMIβ = -0.11 v. -0.06; %BFβ = -0.11 v. -0.06; WCβ = -0.14 v. -0.08), than before menopause. In women not undergoing hormone replacement therapy, some of the socio-demographic factors and lifestyle elements affected adiposity, lipid profile and the risk of MetS differently before and after menopause, which requires verification through long-term research.
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Affiliation(s)
- Edyta Suliga
- Department of the Prevention of Alimentary Tract Diseases, The Institute of Nursing and Midwifery, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
- * E-mail:
| | - Dorota Kozieł
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Elżbieta Cieśla
- Department of Developmental Age Research, Institute of Public Health, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Dorota Rębak
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Głuszek
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
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Tracey ML, Fitzgerald S, Geaney F, Perry IJ, Greiner B. Socioeconomic inequalities of cardiovascular risk factors among manufacturing employees in the Republic of Ireland: A cross-sectional study. Prev Med Rep 2015; 2:699-703. [PMID: 26844139 PMCID: PMC4721305 DOI: 10.1016/j.pmedr.2015.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: To explore socioeconomic differences in four cardiovascular disease risk factors (overweight/obesity, smoking, hypertension, height) among manufacturing employees in the Republic of Ireland (ROI). Methods: Cross-sectional analysis of 850 manufacturing employees aged 18–64 years. Education and job position served as socioeconomic indicators. Group-specific differences in prevalence were assessed with the Chi-squared test. Multivariate regression models were explored if education and job position were independent predictors of the CVD risk factors. Cochran–Armitage test for trend was used to assess the presence of a social gradient. Results: A social gradient was found across educational levels for smoking and height. Employees with the highest education were less likely to smoke compared to the least educated employees (OR 0.2, [95% CI 0.1–0.4]; p < 0.001). Lower educational attainment was associated with a reduction in mean height. Non-linear differences were found in both educational level and job position for obesity/overweight. Managers were more than twice as likely to be overweight or obese relative to those employees in the lowest job position (OR 2.4 [95% CI 1.3–4.6]; p = 0.008). Conclusion: Socioeconomic inequalities in height, smoking and overweight/obesity were highlighted within a sub-section of the working population in ROI. Exploring socioeconomic differences in four cardiovascular disease risk factors among manufacturing workers in Ireland. Cross-sectional study with 850 randomly selected employees aged 18–64 years. A social gradient was found across education levels for smoking and height. Employees with a higher education attainment were less likely to be hypertensive. Managers were more likely to be overweight or obese relative to the general working population.
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Affiliation(s)
- Marsha L. Tracey
- Corresponding author at: Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
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Lourenço S, Carnide F, Benavides FG, Lucas R. Psychosocial Work Environment and Musculoskeletal Symptoms among 21-Year-Old Workers: A Population-Based Investigation (2011-2013). PLoS One 2015; 10:e0130010. [PMID: 26076365 PMCID: PMC4468175 DOI: 10.1371/journal.pone.0130010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/16/2015] [Indexed: 11/18/2022] Open
Abstract
Background The current labour market is becoming more flexible and informal, with job insecurity selectively affecting young workers. However, the role of these increasing adverse psychosocial working conditions on health outcomes remains little known among newly employed workers. Objective To estimate the associations between psychosocial work environment and musculoskeletal outcomes (widespread pain syndrome features and regional pain) in a population-based sample of young workers. Methods Cross-sectional data from workers aged 21 years were collected during the third wave of the EPITeen cohort study (2011-2013; n=650). The Job Content Questionnaire was used to characterize the psychosocial work environment according to the demand-control-support model. Data on pain and non-pain dimensions of the widespread pain syndrome (Fibromyalgia Survey Questionnaire) as well as on regional musculoskeletal pain (Nordic Musculoskeletal Questionnaire) were also collected. Crude and adjusted odds ratios (OR) with 95% confidence intervals (95% CI) were computed using logistic regression and all estimates were adjusted for sex, education and occupational biomechanical demands. Results Job insecurity was significantly associated to the non-pain dimension of the widespread pain syndrome (adjusted OR [95% CI]=1.51 [1.08, 2.12]). Young workers with strain jobs were significantly more likely to report high levels of non-pain symptoms when compared with those with no-strain jobs and this effect was even stronger when social support was added to the main exposure: workers with strain jobs and low social support had twice the odds of reporting high levels of non-pain features than those with high strain but high social support jobs (adjusted OR=1.86, 95% CI: 1.04, 3.31). These significant associations were not observed when widespread pain or multisite regional pain were the outcomes. Conclusion In the beginning of professional life, high strain jobs were associated to non-pain complaints, especially when the work environment provided also low social support.
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Affiliation(s)
- Sara Lourenço
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
- * E-mail:
| | - Filomena Carnide
- Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada—Dafundo, Portugal
| | | | - Raquel Lucas
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
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López-González ÁA, Bennasar-Veny M, Tauler P, Aguilo A, Tomàs-Salvà M, Yáñez A. Desigualdades socioeconómicas y diferencias según sexo y edad en los factores de riesgo cardiovascular. GACETA SANITARIA 2015; 29:27-36. [DOI: 10.1016/j.gaceta.2014.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 08/17/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
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21
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Social inequalities in abdominal obesity in Brazilian women: a nationwide study. J Public Health (Oxf) 2014. [DOI: 10.1007/s10389-014-0647-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Araújo F, Lucas R, Alegrete N, Azevedo A, Barros H. Individual and contextual characteristics as determinants of sagittal standing posture: a population-based study of adults. Spine J 2014; 14:2373-83. [PMID: 24486474 DOI: 10.1016/j.spinee.2014.01.040] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/29/2013] [Accepted: 01/17/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Sagittal standing posture is associated with musculoskeletal symptoms and quality of life. However, the frequency and determinants of suboptimal sagittal alignment outside the clinical context remain to be clarified. PURPOSE To estimate the association of sociodemographic, anthropometric, and behavioral characteristics with sagittal standing posture among adults from the general population. STUDY DESIGN Cross-sectional evaluation of a population-based sample. PATIENT SAMPLE As part of the EPIPorto study, 489 adults were assessed during 2005 to 2008. OUTCOME MEASURES Individual spinopelvic parameters were measured. Additionally, participants were classified into one of four types of sagittal postural patterns (Roussouly classification: Types 1, 2, and 4 corresponding to nonneutral postures and Type 3 to a neutral posture). METHODS Spinopelvic parameters were recorded from 36-inch sagittal radiographs obtained in free-standing posture. Age, sex, education, occupation, body mass index (BMI), waist circumference, total physical activity, leisure time physical activity, time spent in sitting position, smoking status, and tobacco cumulative exposure were collected. Individual parameters and patterns of sagittal posture were compared across categories of participants' characteristics. RESULTS Older age, lower educational level, blue collar occupation, and overall and central obesity were associated with increased sagittal vertical axis and pelvic tilt/pelvic incidence ratio. Taking the neutral postural pattern (Type 3) as reference for the outcome in a multinomial regression model, independently of age, sex, education, total physical activity, and smoking status, overweight adults had higher odds of Type 2 (odds ratio [OR]=1.92; 95% confidence interval [CI]: 1.13-3.27) and Type 4 (OR=2.13; 95% CI: 1.16-3.91) postural patterns in comparison with normal weight subjects. Overall and central obesity were positively related with Type 1 postural pattern (OR=6.10, 95% CI: 1.52-24.57 and OR=3.54, 95% CI: 1.13-11.11, respectively). There was also a weak direct association between female sex and Type 1 postural pattern. Regarding behavioral factors, subjects with total physical activity above the first third exhibited all nonneutral postural patterns less frequently, and current smokers were more likely to present a Type 4 postural pattern. CONCLUSIONS Higher BMI and central obesity were important potential determinants of nonneutral posture among adults from the general population. Future research should investigate the potential effectiveness of overweight prevention and management in avoiding sagittal misalignment conditions.
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Affiliation(s)
- Fábio Araújo
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Raquel Lucas
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Nuno Alegrete
- Centro Hospitalar São João, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Department of Surgery, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ana Azevedo
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Centro Hospitalar São João, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Henrique Barros
- Institute of Public Health - University of Porto (ISPUP), Rua das Taipas, 135-139, 4050-600 Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
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Lazzarino AI, Yiengprugsawan V, Seubsman SA, Steptoe A, Sleigh AC. The associations between unhealthy behaviours, mental stress, and low socio-economic status in an international comparison of representative samples from Thailand and England. Global Health 2014; 10:10. [PMID: 24555674 PMCID: PMC3933467 DOI: 10.1186/1744-8603-10-10] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 02/02/2014] [Indexed: 12/21/2022] Open
Abstract
Background Socioeconomic status is a recognised determinant of health status, and the association may be mediated by unhealthy behaviours and psychosocial adversities, which, in developed countries, both aggregate in low socioeconomic sectors of the population. We explored the hypothesis that unhealthy behavioural choices and psychological distress do not both aggregate in low socioeconomic status groups in developing countries. Methods Our study is based on a cross-sectional comparison between national population samples of adults in England and Thailand. Psychological distress was assessed using the General Health Questionnaire (GHQ-12) or three anxiety-oriented items from the Kessler scale (K6). Socioeconomic status was assessed on the basis of occupational status. We computed a health-behaviour score using information about smoking, alcohol consumption, fruit and vegetable consumption, and physical activity. Results The final sample comprised 40,679 participants. In both countries and in both genders separately, there was a positive association between poor health-behaviour and high psychological distress, and between high psychological distress and low socioeconomic status. In contrast, the association between low socioeconomic status and poor health-behaviour was positive in both English men and women, flat in Thai men, and was negative in Thai women (likelihood ratio test P <0.001). Conclusion The associations between socioeconomic status, behavioural choices, and psychological distress are different at the international level. Psychological distress may be consistently associated with low socioeconomic status, whereas poor health-behaviour is not. Future analyses will test whether psychological distress is a more consistent determinant of socioeconomic differences in health across countries.
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Affiliation(s)
- Antonio Ivan Lazzarino
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
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Rosenbach F, Richter M, Pförtner TK. Sozioökonomischer Status und inflammatorische Biomarker für Herz-Kreislauf-Erkrankungen. Herz 2014; 40 Suppl 3:298-304. [DOI: 10.1007/s00059-013-4040-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 11/28/2013] [Accepted: 12/11/2013] [Indexed: 01/20/2023]
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Bastos J, Peleteiro B, Barros R, Alves L, Severo M, de Fátima Pina M, Pinto H, Carvalho S, Marinho A, Guimarães JT, Azevedo A, La Vecchia C, Barros H, Lunet N. Sociodemographic determinants of prevalence and incidence of Helicobacter pylori infection in Portuguese adults. Helicobacter 2013; 18:413-22. [PMID: 23725608 DOI: 10.1111/hel.12061] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Understanding the determinants of Helicobacter pylori infection in adults is essential to predict the burden of H. pylori-related diseases. We aimed to estimate the prevalence and incidence of H. pylori infection and to identify its major sociodemographic correlates in an urban population from the North of Portugal. MATERIAL AND METHODS A representative sample of noninstitutionalized adult inhabitants of Porto (n = 2067) was evaluated by ELISA (IgG) and a subsample (n = 412) was tested by Western Blot to assess infection with CagA-positive strains. Modified Poisson and Poisson regression models were used to estimate crude and sex-, age-, and education-adjusted prevalence ratios (PR) and incidence rate ratios (RR), respectively. RESULTS The prevalence of H. pylori infection was 84.2% [95% confidence interval (95%CI): 82.4-86.1]. It increased across age-groups in the more educated subjects, (18-30 years: 72.6%; ≥71 years: 88.1%; p for trend <0.001) and decreased with education in the younger (≤4 schooling years: 100.0%; ≥10 schooling years: 72.6%; p for trend <0.001). Living in a more deprived neighborhood was associated with a higher prevalence of infection, only in the younger (PR = 1.20, 95%CI: 1.03-1.38) and more educated participants (PR = 1.15, 95%CI: 1.03-1.29). Among the infected, the proportion with CagA-positive strains was 61.7% (95%CI: 56.6-66.9). The incidence rate was 3.6/100 person-years (median follow-up: 3 years; 95%CI: 2.1-6.2), lower among the more educated (≥10 vs ≤9: RR = 0.25, 95%CI: 0.06-0.96). The seroreversion rate was 1.0/100 person-years (95%CI: 0.6-1.7). CONCLUSIONS The prevalence of infection among adults is still very high in Portugal, suggesting that stomach cancer rates will remain high over the next few decades.
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Affiliation(s)
- Joana Bastos
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
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Alves L, Silva S, Severo M, Costa D, Pina MF, Barros H, Azevedo A. Association between neighborhood deprivation and fruits and vegetables consumption and leisure-time physical activity: a cross-sectional multilevel analysis. BMC Public Health 2013; 13:1103. [PMID: 24289151 PMCID: PMC3879067 DOI: 10.1186/1471-2458-13-1103] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/26/2013] [Indexed: 11/10/2022] Open
Abstract
Background Most studies of the association between neighborhood socioeconomic deprivation and individual lifestyles leading to cardiovascular disease focused on a single cardiovascular risk factor. The concomitant assessment of more than one risk factor may provide clues to specific mechanisms linking neighborhood disadvantage to individual lifestyles. We investigated the association of neighborhood deprivation with fruits and vegetables consumption and leisure-time physical activity in adults living in an urban center in Portugal. Methods In 1999–2003, we assembled a random sample of 2081 adult residents in the city of Porto. Data on sociodemographic characteristics were collected by trained interviewers using structured questionnaires. Fruits and vegetables consumption was estimated using a validated 82-item semiquantitative food frequency questionnaire covering the previous year and expressed in portions per day. Physical activity was evaluated using a questionnaire exploring leisure-time activities over the previous year and expressed in metabolic equivalents (MET).minute/day. Self-reported address was used to place individuals in neighborhoods. Neighborhoods’ socioeconomic characterization was based on aggregated data at the census block level provided by the 2001 National Census. Latent class analysis models were used to identify three discrete socioeconomic classes of neighborhoods. Random effects models with random intercepts at the neighborhood level were used to explore clustering and contextual effects of neighborhood deprivation on each of the outcomes. Results We found evidence of neighborhood clustering of fruits and vegetables consumption and leisure-time physical activity that persisted after adjustment for neighborhood deprivation only among women. Women living in the most deprived neighborhoods presented a consumption increase of 0.43 (95% CI: -0.033 to 0.89) portions of fruits and vegetables per day and a decrease in leisure-time physical activity of 47.8 (95% CI: -91.8 to 1.41) MET.minute/day, when compared to those living in the most affluent neighborhoods. Among men, no contextual neighborhood deprivation effects were observed. Conclusion Overall, neighborhood deprivation had a small effect on the consumption of fruits and vegetables and leisure-time physical activity. Neighborhood factors other than socioeconomic deprivation may still impact on the studied outcomes among women. This study provides relevant information for the design of interventions directed to neighborhood characteristics in the prevention of cardiovascular diseases.
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Affiliation(s)
- Luís Alves
- Institute of Public Health, University of Porto, Rua das Taipas, 135-139, 4050-600 Porto, Portugal.
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Silva DAS. Socioeconomic inequalities in abdominal obesity in Brazilian female adolescents: a national-based study. Eur J Pediatr 2013; 172:1665-70. [PMID: 23903562 DOI: 10.1007/s00431-013-2106-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022]
Abstract
The aim of the present study was to identify the prevalence of abdominal obesity and verify the socioeconomic inequities in abdominal obesity among female adolescents from all regions of Brazil. A cross sectional nationwide study was carried out on abdominal obesity with 2,488 women aged 15 to 19 years in the National Survey on Demography and Health of Women and Children (PNDS), 2006. Abdominal obesity was identified based on waist circumference (WC). Demographic and socioeconomic data (age, skin color, schooling level, socioeconomic status, area of residence, geographic region, marital status, and private health insurance) were collected. Poisson regression was used for multivariate analysis. The prevalence of abdominal obesity was 24.7 % (95 % confidence intervals; 20.9, 28.3). The mean WC value was 74.1 cm (SD=9.3). Adolescents who studied fewer years, those living in a socially and economically more developed region and those who had a partner, showed higher prevalence of abdominal obesity. Effective actions to reduce abdominal obesity include equitable early childhood development programs and education and interventions within the health systems should be complemented with population-based policies specifically designed to reduce socioeconomic inequalities.
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Affiliation(s)
- Diego Augusto Santos Silva
- Centro de Desportos, Programa de Pós Graduação em Educação Física, Campus Universitário Trindade, Universidade Federal de Santa Catarina, Florianópolis, SC, 88010-970, Brazil,
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Rustad C, Smith C. Nutrition knowledge and associated behavior changes in a holistic, short-term nutrition education intervention with low-income women. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2013; 45:490-498. [PMID: 24206584 DOI: 10.1016/j.jneb.2013.06.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 06/25/2013] [Accepted: 06/28/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To assess the impact of a short-term nutrition intervention using education on a comprehensive array of nutrition and health topics in low-income women. DESIGN Pre- and postintervention surveys; 1 study condition (intervention group); experiential learning; pilot testing of education sessions. SETTING Community centers, homeless shelters, or University of Minnesota, in Minneapolis-St Paul metropolitan area. PARTICIPANTS Ethnically diverse, low-income women (n = 118), 23-45 years of age. INTERVENTION Three educational sessions providing a comprehensive curriculum of nutrition and health education via experiential and interactive lectures, activities, and demonstrations. One week to implement knowledge and behavioral changes, and pre- and postsurvey sessions to collect anthropometric data and evaluate changes in knowledge and behavior. MAIN OUTCOME MEASURES Health benefits of all food groups; identification of healthful foods; shopping, cooking, and gardening; and energy balance. ANALYSIS Paired t tests, Pearson correlations. RESULTS Postintervention increases in nutrition knowledge and favorable nutrition behavioral changes (P < .05). CONCLUSIONS AND IMPLICATIONS A short-term nutrition intervention using comprehensive nutrition and health education through experiential and interactive lessons, activities, and demonstrations has the capacity to increase nutrition knowledge and favorably change nutrition behaviors in a sample of low-income women.
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Affiliation(s)
- Claire Rustad
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St Paul, MN
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Hirokawa K, Tsutsumi A, Kayaba K. Mortality risks in relation to occupational category and position among the Japanese working population: the Jichi Medical School (JMS) cohort study. BMJ Open 2013; 3:bmjopen-2013-002690. [PMID: 23906947 PMCID: PMC3733305 DOI: 10.1136/bmjopen-2013-002690] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES A well-known demographic finding in modern society is the inverse association between socioeconomic status and mortality. The purpose of the study was to examine socioeconomic indicators, such as occupational category (white-collar vs blue -collar) and occupational position (managerial vs non-managerial) as determinants of all -cause, cardiovascular disease (CVD) and cancer mortality in a Japanese working population. DESIGN This is a prospective study. PARTICIPANTS Data of a baseline survey were collected between 1992 and 1995, and ultimately 6929 Japanese workers aged 65 years and younger (3333 men and 3596 women) from 12 rural communities across Japan were followed until the end of 2005. MAIN OUTCOME MEASURES The HRs of death and 95% CIs from all causes were calculated using the Cox proportional hazard model. RESULTS Men in blue-collar jobs showed an increased all-cause mortality risk compared with those in white-collar jobs (HR 1.64, 95% CI 1.10 to 2.45). Stratified by occupational category, non-managerial women in blue-collar jobs showed a decreased CVD mortality risk compared with managerial women (HR 0.15, 95% CI 0.03 to 0.81), after adjusting for confounding factors. However, non-managerial women in white-collar jobs showed an increased mortality risk compared with managerial women, although this was not significant (HR 2.34, 95% CI 0.25 to 21.87). CONCLUSIONS Socioeconomic disparity according to occupational category was related to the risk of all-cause mortality among Japanese men. There is a potential interaction of occupational category and position in CVD mortality among Japanese women.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, Ibaraki, Osaka, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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Medeiros CRG, Meneghel SN, Gerhardt TE. Desigualdades na mortalidade por doenças cardiovasculares em pequenos municípios. CIENCIA & SAUDE COLETIVA 2012; 17:2953-62. [DOI: 10.1590/s1413-81232012001100012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 08/30/2012] [Indexed: 11/22/2022] Open
Abstract
Estudo ecológico que teve por objetivo identificar a mortalidade por doenças cardiovasculares nos municípios da 16ª Regional de Saúde (RS), no período de 2003 a 2007, verificando diferenças entre eles, a distribuição por sexo e idade e relacionando o coeficiente médio de mortalidade do período com variáveis socioeconômicas, de investimento, de cobertura e de acesso em saúde, buscando identificar alguns fatores que poderiam ser significativos para explicar estas diferenças. Foi realizada análise de correlação e regressão múltipla. Os resultados indicaram que em municípios com até 5000 habitantes a cobertura da Estratégia Saúde da Família pode representar um fator protetor melhor do que nos municípios maiores e a renda per capita tem menor influência na mortalidade. Encontrou-se relação direta entre as internações por doenças cardiovasculares e a mortalidade, principalmente nos municípios maiores. A regressão múltipla mostrou a despesa em saúde por habitante/ano como o fator mais relacionado com o aumento da mortalidade. Concluiu-se que as variáveis selecionadasno estudoexplicam apenas parcialmente as diferenças na mortalidade por doenças cardiovasculares em um grupo de municípios similares de uma regional de saúde no sul do Brasil.
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