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Li H, Zhao Y, Wang L, Liu H, Shi Y, Liu J, Chen H, Yang B, Shan H, Yuan S, Gao W, Wang G, Han C. Association between PM 2.5 and hypertension among the floating population in China: a cross-sectional study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:943-955. [PMID: 36919640 DOI: 10.1080/09603123.2023.2190959] [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: 12/01/2022] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Few studies have investigated the association between PM2.5 and hypertension among floating populations. We therefore examined the relationship using binary logistic regression. Each grade of increment in the annual average PM2.5 (grade one: ≤15 µg/m3; grade two: 15-25 µg/m3; grade three: 25-35 µg/m3 [Excluding 25]; grade four: ≥35 µg/m3) was associated with an increased risk of hypertension (odds ratio [OR] = 1.081, 95% confidence interval (CI): 1.034-1.129). Among the female floating population (OR = 1.114, 95% CI: 1.030-1.204), those with education level of primary school and below (OR = 1.140, 95% CI: 1.058-1.229), construction workers (OR = 1.228, 95% CI: 1.058-1.426), and those living in the eastern region of China (OR = 1.241, 95% CI: 1.145-1.346) were more vulnerable to PM2.5. These results indicate that PM2.5 is positively associated with hypertension in floating populations. Floating populations who are female, less educated, construction workers, and living in the eastern region of China are more vulnerable to the adverse impacts of PM2.5.
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Affiliation(s)
- Hongyu Li
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Digital Health and Stroke Program, The George Institute for Global Health, Beijing, China
| | - Luyang Wang
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Haiyun Liu
- Department of Medicine, Shandong College of Traditional Chinese Medicine, Yantai, Shandong, China
| | - Yukun Shi
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Junyan Liu
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Haotian Chen
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Baoshun Yang
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Haifeng Shan
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
- Science and Education Department, Zibo Mental Health Center, Zibo, Shandong, China
| | - Shijia Yuan
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Wenhui Gao
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Guangcheng Wang
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Chunlei Han
- School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
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Liao F, Hu W, Zhang C. Does basic medical insurance promote public health? Evidence from China family panel study. Front Public Health 2023; 11:1269277. [PMID: 38162604 PMCID: PMC10755903 DOI: 10.3389/fpubh.2023.1269277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/10/2023] [Indexed: 01/03/2024] Open
Abstract
Background To promote common prosperity, China government has devoted much financial resources to the basic medical insurance system, it is of great significance to improve the health level of the insured groups to prevent them from returning to poverty due to illness. Whether or not the basic medical insurance can improve health status is an important policy issue after China has win the absolute poverty alleviation movement. Methods Based on the data of China Family Panel Studies this paper constructs a strong balanced panel data with two levels information, which including variables from family level and personal level. This paper uses the panel data fixed effect model and propensity score matching model to analysis. Results This paper finds that after controlling the family and personal confounding variables, the basic medical insurance has positive effect toward health status. With propensity score matching model, this paper finds that there is causality between basic medical insurance and public health. Conclusion Basic medical insurance has a significant health effect, that is, basic medical insurance has a significant positive impact on individual self-rated health. Participating in basic medical insurance can significantly improve the ability of families to face risk shocks, promote the accumulation of health capital in families, promote the diversification of livelihood strategies, and effectively prevent the occurrence of returning to poverty due to illness.
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Affiliation(s)
- Fuchong Liao
- Department of Public Administration, Central South University, Changsha, China
| | - Wenxiu Hu
- Centre of Population and Development Policy Studies, Fudan University, Shanghai, Shanghai, China
| | - Chun Zhang
- School of Business, Central South University, Changsha, China
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Barriers to Breast Cancer-Screening Adherence in Vulnerable Populations. Cancers (Basel) 2023; 15:cancers15030604. [PMID: 36765561 PMCID: PMC9913751 DOI: 10.3390/cancers15030604] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
Breast cancer screening through periodic mammography has been effective in decreasing mortality and reducing the impact of this disease. However, adherence to screening does not meet the desired expectations from all populations. The main objective of this review is to explore the barriers that affect adherence to breast cancer-screening programs in vulnerable populations according to race and/or ethnicity in order to propose measures to reduce the lack of adherence. We conducted a search of publications in the PubMed Central and Scopus databases. The eligible criteria for the articles were as follows: original quantitative studies appearing in SJR- and/or JCR-indexed journals from 2016 to 2021 in English or Spanish. Most of them present common barriers, such as race/ethnicity (47%), low socioeconomic (35.3%) and educational levels (29.4%), no family history of cancer and being single (29.4%), medical mistrust and a health information gap (23.5%), lack of private health insurance (17.6%) and not having annual health checks (17.6%). The target populations with the lowest adherence were Black, Asian, Hispanic and foreign women. Implementing awareness campaigns focused on these populations should be promoted, as well as working on diversity, cultural acceptance and respect with healthcare workers, in order to improve breast cancer-screening adherence worldwide.
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Yao Q, Li H, Liu C. Use of social health insurance for hospital care by internal migrants in China-Evidence from the 2018 China migrants dynamic survey. Front Public Health 2022; 10:1008720. [PMID: 36504980 PMCID: PMC9729771 DOI: 10.3389/fpubh.2022.1008720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background China's welfare system including social health insurance has been closely linked to its unique household registration system, despite high population mobility over the past few decades. This study aimed to determine the pattern of health insurance usage from internal migrants in mainland China for hospital care. Methods Data were extracted from the 2018 China Migrants Dynamic Survey. The respondents who enrolled in a social health insurance program and reported illness or injury over the past year were eligible for this study (n = 15,302). Two groups of outcome indicators were calculated assessing the use (incidence and settlement location) of insurance funds for hospital care and the burden of hospital expenditure (total hospital expenditure, out-of-pocket payments, and share of insurance reimbursement), respectively. Logit regression and Heckman's sample selection models were established to determine the predictors of insurance fund usage and the burden of hospital expenditure, respectively. Results Most respondents enrolled in a social health insurance program outside of their residential location (70.72%). About 28.90% were admitted to a hospital over the past year. Of those hospitalized, 72.98% were admitted to a hospital at their migration destination, and 69.96% obtained reimbursement from health insurance, covering on average 47% of total hospital expenditure. Those who had a local insurance fund aligned with residency (AOR = 2.642, 95% CI = 2.108-3.310, p < 0.001) and enrolled in employment-based insurance (AOR = 1.761, 95% CI = 1.348-2.301, p < 0.001) were more likely to use insurance funds for hospital care, and paid less out-of-pocket (β = -0.183 for local funds, p = 0.017; β = -0.171 for employment-based insurance, p = 0.005) than others. A higher share of insurance reimbursement as a proportion of hospital expenditure was found in the employment-based insurance enrollees (β = 0.147, p < 0.001). Insurance claim settlement at the residential location was associated with lower total hospital expenditure (β = -0.126, p = 0.012) and out-of-pocket payments (β = -0.262, p < 0.001), and higher share of insurance reimbursement (β = 0.066, p < 0.001) for hospital expenditure. Conclusion Low levels of health insurance benefits for hospital care are evident for internal migrants in mainland China, which are associated with the funding arrangements linked to household registration and inequality across different funds.
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Affiliation(s)
- Qiang Yao
- School of Political Science and Public Administration, Wuhan University, Wuhan, China,Centre for Social Security Studies, Wuhan University, Wuhan, China,*Correspondence: Qiang Yao
| | - Hanxuan Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia,Chaojie Liu
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Shao Q, Tao R, Luca MM. The Effect of Urbanization on Health Care Expenditure: Evidence From China. Front Public Health 2022; 10:850872. [PMID: 35242736 PMCID: PMC8885621 DOI: 10.3389/fpubh.2022.850872] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
This paper investigates the impact and non-linear effects of urbanization on health care expenditure in China. The results indicate that urbanization in both Eastern and Central regions can significantly increase health care expenditure. But the impact of urbanization is not significant, which is related to the backward economic development level and low urbanization rate in the Western region. Taking population aging into consideration, the results of the panel threshold regression model imply that the positive relationship between urbanization and health care expenditure becomes greater when the level of population aging exceeds 10.72% in the Eastern region and 7.00% in the Western region. Therefore, in the urbanization process, the government should pay attention to the positive effect of urbanization on health care expenditure, provide more financial support for the construction of medical facilities, and expand the coverage of medical services and security for residents, especially for elderly people.
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Affiliation(s)
- Qi Shao
- China Center for Human Capital and Labor Market Research, Central University of Finance and Economics, Beijing, China
| | - Ran Tao
- Qingdao Municipal Center for Disease Control & Prevention, Qingdao, China
| | - Magda Mihaela Luca
- Department of Dentistry, Victor Babeş University of Medicine and Pharmacy, Timisoara, Romania
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Liu X, Sun Q, Yao S, Zhang J, Li H. Disparities in the Outcomes Following Ischemic Stroke Between the Floating Population and Indigenous Population of Shanghai. Front Neurol 2021; 12:774337. [PMID: 34975731 PMCID: PMC8715939 DOI: 10.3389/fneur.2021.774337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Purposes: Through this study, we hope to gain more insights into the differences in outcome following an ischemic stroke between the floating population and the indigenous population of Shanghai.Method: In this retrospective cohort study, we analyzed patients with first-ever acute ischemic stroke who were admitted to a comprehensive stroke center in the Minhang district, Shanghai, from January 1, 2019, to December 31, 2020. All patient's demographic data and medical histories were prospectively collected and they were followed up for at least 3 months. The Indigenous population of Shanghai was defined as patients with an identification number starting with 310. All others were treated as floating population. The primary outcome was defined as an unfavorable prognosis at 3 months, with a modified Rankin Scale (mRS) score above 1. Secondary outcomes included the use of emergency medical service (EMS), 3 h arrival rate, and endovascular therapy in eligible patients. Logistic regression analysis was applied to investigate the differences.Results: Finally, 698 patients with first-ever acute ischemic stroke were included (with mean age of 65.32 years, 74.6% men). Of these, 302 patients belonged to the floating population group. Indigenous populations with ischemic stroke were older than the floating population (68.26 years vs. 61.47 years, P < 0.001). The floating population was more likely to achieve favorable outcomes at 3 months compared with the indigenous population in multivariable logistic regression analysis [Odds ratio (OR): 0.49, 95% CI: 0.32–0.75, P = 0.001]. The use of EMS, 3 h arrival rate, and the application of endovascular therapy were comparable between the floating population and indigenous population (OR: 0.89, 95% CI: 0.62–1.27, P = 0.519; OR: 0.78, 95% CI: 0.56–1.09, P = 0.14; and OR: 0.82, 95% CI: 0.54–1.26, P = 0.365, respectively).Conclusion: Compared with the indigenous population, the floating population with the first-ever ischemic stroke was more likely to have a favorable outcome at 3 months.
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Affiliation(s)
- Xiaochuan Liu
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Qian Sun
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Sichen Yao
- Wujing Community Health Service Center, Shanghai, China
| | - Junhui Zhang
- Nanqiao Community Health Service Center, Shanghai, China
| | - Huanyin Li
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
- *Correspondence: Huanyin Li
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Zhang W, Chen X, Wang C, Gao L, Chen W, Yang W. Perceptions and Attitudes Toward Obesity and its Management in Migrants and Rural Residents in China: a Cross-sectional Pilot Study. Obes Surg 2021; 32:152-159. [PMID: 34643851 DOI: 10.1007/s11695-021-05755-6] [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: 06/26/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The incidence of overweight and obesity in rural-to-urban migrants and rural residents is increasing rapidly. This study aims to explore the perceptions and attitudes toward obesity and its management among rural-urban migrants and rural residents who are left in rural regions, China. METHODS We performed a cross-sectional survey investigating migrants and rural residents aged 18-45 in China from October to November 2020. We created a questionnaire. Two hundred five questionnaires were completed. RESULTS Finally, 184 were included, of which 102 were migrants and 82 were non-migrants. More respondents were male (62%). There was no significant difference in BMI between the two groups. The migrants had good knowledge about obesity as a disease (75.5%) and agreed that obesity seriously threatens health (93.1%). It is worth noting that more non-migrant group believed that obesity was due to a lack of willpower (87.3% vs. 54.9%, p = 0.000) than the migrant group. More than half in both groups believed that obesity was caused by a bad lifestyle (69.6%) or addiction to food (58.7%). Half of the participants believed that biological factors caused obesity. Most participants in both groups still believed weight loss modalities were limited to exercise and diet while having extremely poor acceptance of pharmacotherapy and bariatric surgery. CONCLUSIONS This study found that the migrants and rural residents had a good understanding of obesity as a disease, and better among migrants than rural residents. However, they showed significant uncertainty and misconceptions about the efficacy and safety of pharmacotherapy and bariatric surgery.
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Affiliation(s)
- Wen Zhang
- School of Nursing, Jinan University, No. 601, Huangpu Avenue West, Guangzhou, Guangdong, China.,Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong, China
| | - Xi Chen
- School of Nursing, Jinan University, No. 601, Huangpu Avenue West, Guangzhou, Guangdong, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong, China.,Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China
| | - Lilian Gao
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong, China
| | - Weiju Chen
- School of Nursing, Jinan University, No. 601, Huangpu Avenue West, Guangzhou, Guangdong, China.
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue West, Guangzhou, Guangdong, China. .,Joint Institute of Metabolic Medicine between State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong and Jinan University, Guangzhou, China. .,State Key Laboratory of Pharmaceutical Biotechnology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China. .,Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Zhang P. Study on the Experience of Public Health System Construction in China's COVID-19 Prevention. Front Public Health 2021; 9:610824. [PMID: 33981659 PMCID: PMC8107211 DOI: 10.3389/fpubh.2021.610824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: China's experience in the process of COVID-19 prevention provides a reference for other countries in the world. This article studied the experience of public health system construction in China's COVID-19 prevention. Methods: Based on literature review and theoretical analysis, this paper constructs a theoretical framework of national public health system construction in health crisis. Based on this theoretical framework, combined with the policies and measures formulated by the Chinese government in the process of COVID-19 prevention, this article evaluate the advantages and deficiencies of China's public health system construction in response to COVID-19. Results: The Chinese government ensured the adequate supply of health resources, improved people's ability to pay medical expenses, and adopted advanced public health propaganda methods based on the Internet to help people grasp the basic information and development trend of COVID-19 in the process of COVID-19 prevention. At the same time, the utilization efficiency of health resources was low in China, people's ability to pay for medical expenses was unequal, and the disclosure of virus information in the early stage of the outbreak of COVID-19 is not timely. Conclusions: Other countries can learn from the advantages of China's public health system construction and avoid China's deficiencies in the process of public health system construction, which will help them improve the efficiency of COVID-19 prevention.
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Affiliation(s)
- Pengfei Zhang
- School of Labor and Human Resources, Renmin University of China, Beijing, China
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