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Anwer F, Malik AA. Hypertension Research in Pakistan: A Scientometric Analysis of Two Decades (2003-2022). Cureus 2024; 16:e59769. [PMID: 38846232 PMCID: PMC11153878 DOI: 10.7759/cureus.59769] [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] [Accepted: 05/06/2024] [Indexed: 06/09/2024] Open
Abstract
Hypertension is a highly prevalent chronic disease that leads to a significant number of deaths and disabilities as a consequence of cardiovascular complications. However, there is insufficient information regarding research trends and performance assessments from South Asian countries, including Pakistan. In this review, we analyzed research data related to hypertension from Pakistan over the last 20 years (2003-2022). We used the Web of Science (WoS) database to retrieve research data related to hypertension from Pakistan, and then applied scientometric analysis using the "R-Bibliometrix" package. An extensive range of indicators was studied to determine the quality and quantity of these hypertension-related publications. A total of 4,008 research articles from 891 sources were extracted through WoS over the last 20 years (2003-2022). There was a continuous growth in the number of research articles, with relatively more increase observed from 2012, and maximum output in 2021. Among 16,855 authors contributing from 67 countries, three authors had >50 publications and five had >1,500 citations. The country's leading affiliation was the Aga Khan University which showed networking trends with international institutes while the other national universities restricted their institutional partnerships to the provincial or city level. The Higher Education Commission was the only local sponsoring institute among the top funding sources. Pakistan Journal of Medical Sciences was the leading and most consistent source, whereas hypertension, diabetes mellitus, and obesity were the most frequently used keywords. This review provides a comprehensive account of hypertension-related research productivity from Pakistan. Some characteristic trends were detected for top authors' contributions, impact, productivity, international collaborations, funding sources, and institutional affiliations. Particularly, the funding sources and collaboration patterns of corresponding authors along with their affiliated institutes showed striking results. These findings can be very helpful for the relevant stakeholders in the accurate interpretation of trends and performance of hypertension-related research work from the region.
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Affiliation(s)
- Fahad Anwer
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, SAU
| | - Ahmad Azam Malik
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, SAU
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Xue L, Cai M, Liu Q, Ying X, Wu S. Trends and regional variations in chronic diseases and their risk factors in China: an observational study based on National Health Service Surveys. Int J Equity Health 2023; 22:120. [PMID: 37381035 DOI: 10.1186/s12939-023-01910-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/06/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Over the past 25 years, the spectrum of diseases in China has rapidly changed from infectious to non-communicable diseases (NCDs). This study aimed to identify the prevalence of chronic diseases over the past 25 years in China and estimate the trends and changes in risk factors related to NCDs. METHODS We conducted a descriptive analysis based on the National Health Service Survey (NHSS) from 1993 to 2018. The survey year (in parentheses) and its respective number of respondents were (1993) 215,163; (1998) 216,101; (2003) 193,689; (2008) 177,501; (2013) 273,688; and (2018) 256,304. In each survey, approximately half the participants were male. In addition, we estimated the trends in the prevalence and risk factors of NCDs from 1993 to 2018 and described their coefficient of variation in the provisions. RESULTS The prevalence of NCDs has risen rapidly, from 17.0% in 1993 to 34.3% 2018. Hypertension and diabetes were the two main NCDs accounting for 53.3% in 2018. Similarly, the prevalence of hypertension and diabetes have also increased rapidly, increasing 15.1 and 27.0 times respectively from 1993 to 2018. Moreover, from 1993 to 2018, the proportion of smoking decreased from 32.0% to 24.7%, and the proportion of drinking and physical activity increased from 18.4% and 8.0% to 27.6% and 49.9%, respectively. The proportion of obesity increased from 5.4% in 2013 to 9.5% in 2018. The prevalence of NCDs in rural areas (35.2%) in 2018 was slightly higher than that in urban areas (33.5%). Changes in the prevalence of NCDs in rural were larger than those in urban. However, from 2013 to 2018, the provincial gaps for these metrics narrowed, except for that of smoking (Coefficient of Variation from 0.14 to 0.16). CONCLUSIONS The prevalence of NCDs increased rapidly in China and was similar in urban and rural areas in 2018. Two key risk factors (drinking and obesity) increased in prevalence, while the other two (smoking and physical inactivity) decreased. These results indicate that China is facing considerable challenges in curbing chronic diseases to achieve the United Nations Sustainable Development Goals or the Healthy China 2030 goals. The government should take more active measures to change unhealthy lifestyles, improve efficiency in risk factor management, and pay more attention and allocate more health resources to rural areas.
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Affiliation(s)
- Long Xue
- Huashan Hospital, Fudan University, Shanghai, China
| | - Min Cai
- Center of Health Statistics and Information, National Health Commission, 1 Xizhimen Wai Nan Lu, Xicheng District, Beijing, China
| | - Qinqin Liu
- Center of Health Statistics and Information, National Health Commission, 1 Xizhimen Wai Nan Lu, Xicheng District, Beijing, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, 138 Medical College Road, Shanghai, China.
| | - Shiyong Wu
- Center of Health Statistics and Information, National Health Commission, 1 Xizhimen Wai Nan Lu, Xicheng District, Beijing, China.
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Elahi A, Ali AA, Khan AH, Samad Z, Shahab H, Aziz N, Almas A. Challenges of managing hypertension in Pakistan - a review. Clin Hypertens 2023; 29:17. [PMID: 37316940 DOI: 10.1186/s40885-023-00245-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension. METHODS A comprehensive literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included. RESULTS We found from this extensive review that several small studies report high prevalence of hypertension but there is a lack of population based prevalence of hypertension in Pakistan. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, low socioeconomic status, and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population. CONCLUSION There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level are needed for both prevention and control of hypertension.
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Affiliation(s)
| | | | - Aamir Hameed Khan
- Section of Cardiology, Department of Medicine, Ziauddin University, Karachi, Pakistan
| | - Zainab Samad
- Section of Cardiology, Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Hunaina Shahab
- Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Namra Aziz
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Aysha Almas
- Section of Internal Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan.
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Jiang D, Yan Y, Zhou H, Wang Q. The association between personal social capital and health-related quality of life among Chinese older people: A cross-sectional study. Front Nutr 2022; 9:995729. [PMID: 36570148 PMCID: PMC9773083 DOI: 10.3389/fnut.2022.995729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background Lower health-related quality of life (HRQoL) can result in adverse effects on the health of older people. This study aims to explore the relationship between personal social capital (PSC) and HRQoL among Chinese elderly people from rural-and-urban perspective. Materials and methods 4,802 samples were included from China's health-related quality of life Survey for Older Adults 2018 (CHRQLS-OA 2018). The PSC, including bonding and bridging social capital (BOC and BRC), was measured by the Chinese version of the Personal Social Capital Scale (PSCS-16). The HRQoL was evaluated by the European Five Dimensions Questionnaire (EQ-5D-3L). Linear and Tobit regression models were conducted to examine the relationship between PSC and HRQoL. Results The BOC and BRC of rural older people were significantly lower than those of urban older people. Pain/discomfort and anxiety/depression were the most significant health problems affecting the older samples. In the five dimensions, the proportion of rural older people with problems was higher than that of urban older people. Among rural older people, BOC was significantly related to self-rated health and EQ-5D utility index (p < 0.05); while BRC was insignificantly associated with self-rated health (p > 0.05) but related to EQ-5D utility index (p < 0.05). Both BOC and BRC were significantly correlated with self-rated health and EQ-5D utility index (p < 0.05) among urban older people. Conclusion Our study reveals older people's worrying PSC and HRQoL status. The relationship between PSC and HRQoL suggested that more social support and care of intimates should be encouraged to increase the PSC of older people, especially rural older people.
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Affiliation(s)
- Dongdong Jiang
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China,School of Public Health, Zhejiang University, Hangzhou, China
| | - Yajie Yan
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China
| | - Han Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Quan Wang
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Quan Wang,
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Bhatia M, Dixit P, Kumar M, Dwivedi LK. Validity of self-reported hypertension in India: Evidence from nationally representative survey of adult population over 45 years. J Clin Hypertens (Greenwich) 2022; 24:1506-1515. [PMID: 35809220 PMCID: PMC9659862 DOI: 10.1111/jch.14542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 12/03/2022]
Abstract
Self‐reported measures of health, in the context of developed countries, are well‐researched and commonly regarded as reliable predictors of the underlying health of the population. However, the validity of these measures is under‐researched and questionable in the context of low‐ and middle‐income countries. The authors used Longitudinal Ageing Study in India (LASI) survey data from India to compare self‐reported hypertension with biometrically‐measured hypertension. The results are reported in terms of sensitivity, specificity, and kappa as a measure of agreement. Logistic regression was undertaken to examine the characteristics of those who were unaware of their hypertensive status. Our analysis showed a low sensitivity of 56% and a high specificity of 90.5%. Agreement between self‐reported data and biometric measurement of hypertension was observed to be moderate (κ = 0.48). Large variations were observed among states and sub‐groups. The odds of false negative reporting of hypertension were lower in the individuals with higher age, high education, and greater wealth status. The authors conclude that self‐reported hypertension has important limitations and may be a source of systematic bias. It is recommended that planning and policy‐making in India be based more on an objective assessment of hypertension.
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Affiliation(s)
- Mrigesh Bhatia
- Dept. of Health Policy, London School of Economics, London, UK
| | - Priyanka Dixit
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| | - Manish Kumar
- International Institute for Population Sciences, Mumbai, India
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Gan W, Zhang Q, Yang D, Yin J, Wang Y, Song L, Chen T, Qi H. A behavior change wheel-based interactive pictorial health education program for hypertensive patients with low blood pressure health literacy: study protocol for a randomized controlled trial. Trials 2022; 23:369. [PMID: 35505379 PMCID: PMC9066838 DOI: 10.1186/s13063-022-06300-1] [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: 09/09/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background The prevalence of hypertension is increasing worldwide. Hypertension self-management usually involves the application and consideration of oral, written, or quantitative information. Hypertensive patients in China have limited high blood pressure health literacy (HBP-HL), which may lead to poorer clinical outcomes. This study aims to determine the feasibility and effectiveness of an interactive pictorial health education program based on behavior change wheel (BCW) theory and its effect on HBP-HL, self-efficacy, self-management ability, and health-related quality of life (HRQOL) in hypertensive patients with low HBP-HL. Methods This study is a randomized controlled trial (RCT). One of the municipal districts in Huzhou, China, will be randomly selected, and two communities with similar conditions within this district will be screened and selected. A total of 120 hypertensive patients aged 18 years and older will be recruited from these two community settings. One of the communities will be randomly allocated to an interactive pictorial health education program conducted by a comprehensive health literacy strategy that includes (i) training participants in effective health communication skills that address issues encountered in seeking medical care and (ii) the use of self-developed interactive pictorial hypertension education to improve patient understanding and behaviors versus a control group (routine community lecture health education only). The primary outcome measure is HBP-HL. Secondary outcomes are self-efficacy, self-management ability, HRQOL, social support, and improvement in blood pressure. Outcomes will be collected at 6, 9, and 12 months from trial entry. Discussion The strengths of this study are the establishment of a new health management program for hypertensive patients that closely combines BCW theory and health literacy. This trial has the potential to improve HBP-HL in hypertensive Chinese patients with low health literacy to improve the self-management of hypertension and help control blood pressure. Trial registration Clinical Trials.gov Protocol Registration and Results System ID NCT04327102. Prospectively registered on February 29, 2020
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Affiliation(s)
- Wei Gan
- School of Medicine & Nursing Sciences, HuZhou University, Huzhou, Zhejiang, China
| | - Qinghua Zhang
- School of Medicine & Nursing Sciences, HuZhou University, Huzhou, Zhejiang, China.
| | - Dan Yang
- School of Medicine & Nursing Sciences, HuZhou University, Huzhou, Zhejiang, China
| | - Jinyu Yin
- School of Medicine & Nursing Sciences, HuZhou University, Huzhou, Zhejiang, China
| | - Yujie Wang
- School of Medicine & Nursing Sciences, HuZhou University, Huzhou, Zhejiang, China
| | - Li Song
- School of Medicine & Nursing Sciences, HuZhou University, Huzhou, Zhejiang, China
| | - Ting Chen
- Present address: Department of Nursing, Jiangxi Medical College, Shangrao, Jiangxi, China
| | - Huan Qi
- Present address: School of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
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Zhang Q, Huang F, Zhang L, Li S, Zhang J. The effect of high blood pressure-health literacy, self-management behavior, self-efficacy and social support on the health-related quality of life of Kazakh hypertension patients in a low-income rural area of China: a structural equation model. BMC Public Health 2021; 21:1114. [PMID: 34112122 PMCID: PMC8194055 DOI: 10.1186/s12889-021-11129-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Health-Related Quality of Life (HRQoL) of hypertensive patients is not only affected by the disease itself but also by some subjective factors. Low health literacy is prevalent among ethnic minorities. Considering the Kazakh-Chinese people have the highest prevalence of hypertension in Xinjiang, and the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of HRQoL. The synergistic effects and the potential mechanism HBP-HL, self-management behavior, therapeutic adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the HBP-HL, and develop a structural equation model (SEM) to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods The data was obtained by questionnaire survey and physical examination in 2015. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Xinjiang. Firstly, the blood pressure was measured. Then the one-for-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, therapeutic adherence, self-efficacy, and social support were used to collect data. Finally, SEM was constructed, and p ≤ 0.05 was taken as significant. Results The data was analysed by SPSS18.0 and AMOS18.0 software. 516 Kazakh hypertension patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, therapeutic adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The SEM of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies.
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Affiliation(s)
- Qinghua Zhang
- School of Medicine, Hu Zhou University, 759-Second Ring East Road, Huzhou, 313000, Zhejiang, China.
| | - Feifei Huang
- School of Nursing, Fu Jian Medical University, Fu Zhou, Fujian, China
| | - Lei Zhang
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shasha Li
- School of Medicine, Hu Zhou University, 759-Second Ring East Road, Huzhou, 313000, Zhejiang, China
| | - Jingping Zhang
- Nursing Psychology Research Center of Xiangya Nursing School, Central South University, 172 Tong Zi Po Road, Changsha, 410000, Hunan, China.
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Zheng E, Xu J, Xu J, Zeng X, Tan WJ, Li J, Zhao M, Liu B, Liu R, Sui M, Zhang Z, Li Y, Yang H, Yu H, Wang Y, Wu Q, Huang W. Health-Related Quality of Life and Its Influencing Factors for Elderly Patients With Hypertension: Evidence From Heilongjiang Province, China. Front Public Health 2021; 9:654822. [PMID: 33796501 PMCID: PMC8007785 DOI: 10.3389/fpubh.2021.654822] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Hypertension is one of the most common public health issues worldwide. However, few existing studies examining health-related quality of life (HRQoL) were conducted on elderly patients with hypertension in China. Hence, this study aimed to assess the HRQoL of elderly patients with hypertension and its influencing factors using EuroQol five-dimensional-three-level (EQ-5D-3L) in China. Methods: Data were obtained from the 6th National Health Service Survey in Heilongjiang province from June to July 2018, with a stratified multistage random cluster sampling method. All eligible participants were interviewed using a standardized questionnaire, which included the EQ-5D-3L, socio-demographics characteristics, clinical and lifestyle characteristics. The mean EQ-5D index scores for the different subgroups were evaluated using ANOVA. A Tobit regression model was also employed to analyze the potential factors influencing HRQoL. Results: A total of 705 elderly patients with hypertension were included in this study. The mean EQ-5D utility score was 0.79 [standard deviation (SD) = 0.23]. The proportion of participants reporting pain/discomfort problems was the highest (57.0%), while problems in self-care was the lowest (17.2%). Influencing factors of HRQoL for elderly patients with hypertension included gender, age, income, education level, physical activity, health examination and coexisting diseases. Specifically, the female gender, being above 80 years old, having a lower education and/or higher income, and the presence of coexisting diseases were associated with lower utility index. In contrast, regular physical activity and medical examination had a positive impact on the HRQoL of elderly hypertension patients. Conclusion: Overall, elderly patients with hypertension in China have a lower HRQoL than the general population. To improve the HRQoL of elderly patients with hypertension, it is imperative that better public health education is provided to enhance the knowledge of hypertension, encourage the adoption of healthy habits such as regular physical activity and medical examination, and improve the management of coexisting diseases. More care should also be directed to males with hypertension who are above 80 years old.
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Affiliation(s)
- Erwei Zheng
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jiao Xu
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Juan Xu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xueyun Zeng
- School of Health Management, Harbin Medical University, Harbin, China
| | - Wan Jie Tan
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Jinmei Li
- Heilongjiang Provincial Health Publicity Education and Information Center, Harbin, China
| | - Miaomiao Zhao
- School of Public Health, Nantong University, Nantong, China
| | - Bo Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Rui Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Mingjie Sui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zhong Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yang Li
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongbin Yang
- The Third Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongjuan Yu
- The First Affiliated Hospital of Harbin Medical University, Harbin, China.,Southern University of Science and Technology Hospital, Shenzhen, China
| | - Yongqing Wang
- School of Health Management, Harbin Medical University, Harbin, China.,Heilongjiang University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, China
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Chai H, Fu R, Coyte PC. Unpaid Caregiving and Labor Force Participation among Chinese Middle-Aged Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E641. [PMID: 33451127 PMCID: PMC7828581 DOI: 10.3390/ijerph18020641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/23/2020] [Accepted: 01/10/2021] [Indexed: 11/16/2022]
Abstract
Unpaid family caregivers must consider the economic trade-off between caregiving and paid employment. Prior literature has suggested that labor force participation (LFP) declines with caregiving intensity, but no study has evaluated this relationship by accounting for the presence of both kinks and discontinuities. Here we used respondents of the China Health and Retirement Longitudinal Study baseline survey who were nonfarming, of working age (aged 45-60) and had a young grandchild and/or a parent/parent-in-law. For women and men separately, a caregiving threshold-adjusted probit model was used to assess the association between LFP and weekly unpaid caregiving hours. Instrumental variables were used to rule out the endogeneity of caregiving hours. Of the 3718 respondents in the analysis, LFP for men was significantly and inversely associated with caregiving that involved neither discontinuities nor kinks. For women, a kink was identified at the caregiving threshold of eight hrs/w such that before eight hours, each caregiving hour was associated with an increase of 0.0257 in the marginal probability of LFP, but each hour thereafter was associated with a reduction of 0.0014 in the marginal probability of LFP. These results have implications for interventions that simultaneously advance policies of health, social care and labor force.
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Affiliation(s)
- Huamin Chai
- School of Public Administration, East China Normal University, Shanghai 200241, China;
- Center for Public Policy Research, East China Normal University, Shanghai 200241, China
| | - Rui Fu
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada;
| | - Peter C. Coyte
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada;
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10
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Dance Fitness Classes Improve the Health-Related Quality of Life in Sedentary Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113771. [PMID: 32466496 PMCID: PMC7312518 DOI: 10.3390/ijerph17113771] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 01/04/2023]
Abstract
Introduction: This study aims to analyze the effect of two dance-focused and choreographic fitness classes on Health-Related Quality of Life (HRQoL) in sedentary worker women. Methods: 65 sedentary middle-aged worker women (38 ± 7.3 years old) completed a 16-week intervention randomly assigned to: (1) dance fitness group based on Zumba Fitness classes (DF group, n = 25)], (2) dance fitness + functional strength training group (DFFT group, n = 20), and (3) control group (n = 20). HRQoL was assessed by the 36-Item Short-Form Health-Survey (SF-36), which evaluates 8 dimensions of health [General Health (GH), Physical Functioning (PF), Social Functioning (SF), Physical Role (PR), Emotional Role (ER), Bodily Pain (BP), Vitality (V), and Mental Health (MH)] scored from 0 (worst) to 100 (best health status). Results: The control group statistically differed from both exercise groups in PF and PR, and from the DF group in SF and MH showing a lower score. No statistical differences were observed between exercise groups post-intervention, except in V. DF group showed increases in GH, PF, SF, V, PR, and MH post-intervention. Conclusions: A 16-week dance fitness intervention based on Zumba Fitness classes generates notable improvements in a wide range of HRQoL dimensions in sedentary middle-aged worker women, especially in V, PR and MH dimensions.
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Sun J, Lyu S, Zhao R. Socioeconomic Inequality in Health Outcomes Among the Elderly: Evidence from a Cross-Sectional Study in China. Risk Manag Healthc Policy 2020; 13:397-407. [PMID: 32523387 PMCID: PMC7234974 DOI: 10.2147/rmhp.s248019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/24/2020] [Indexed: 01/19/2023] Open
Abstract
Background and Aim Health is viewed as a form of human capital and a necessary basis for people to realize capabilities. Moreover, socioeconomic inequality in health outcome widens income inequality and exacerbates social inequality. The aim of this study is to measure socioeconomic inequality in health outcomes among the elderly in China. Methods The data used in this study were sourced from China Health and Retirement Longitudinal Study in 2015, including 5643 participants aged 60 and above. Concentration curve and concentration index were applied to measure the extent of socioeconomic inequality in health outcomes among older adults. Furthermore, the decomposition method of concentration index proposed by Wagstaff was employed to quantify each determinant's contribution to the measured socioeconomic inequality in health outcomes. Results The concentration index of Activity of Daily Living Scale and Center of Epidemiological Survey-Depression Scale score were -0.0064 and -0.0158, respectively, indicating pro-rich inequality in physical and mental health among the elderly. The decomposition analysis revealed that household income (41.15%), aged 70-79 (17.37%), being male (8.38%), and living in urban area (5.78%) were key factors to explain the pro-rich inequality in physical health. Furthermore, the results also suggested that household income (68.41%), being male (17.55%), having junior high school education (10.67%), and living in urban area (6.49%) were key factors to explain the pro-rich inequality in mental health. Conclusion This study revealed that there are pro-rich inequalities in physical and mental health among the elderly in China, and the degree of pro-rich inequality in mental health is higher than that in physical health. Moreover, the results also suggested that household income is the biggest contributor to socioeconomic inequality in physical and mental health. Furthermore, this study found that educational attainment makes a substantial contribution to socioeconomic inequality in health outcomes, while the contribution of health insurance to health inequality is limited.
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Affiliation(s)
- Jian Sun
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China
| | - Shoujun Lyu
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, People's Republic of China
| | - Rui Zhao
- Affiliated Hospital of Hebei University, Hebei 071000, People's Republic of China
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Analysis of Association of Occupational Physical Activity, Leisure-Time Physical Activity, and Sedentary Lifestyle with Hypertension according to the Adherence with Aerobic Activity in Women Using Korea National Health and Nutrition Examination Survey 2016-2017 Data. Int J Hypertens 2020; 2020:8943492. [PMID: 32110448 PMCID: PMC7042501 DOI: 10.1155/2020/8943492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/07/2019] [Accepted: 01/10/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose We investigated the association between occupational physical activity, leisure-time physical activity, and sedentary lifestyle with hypertension by adherence with aerobic exercise in middle-aged and elderly women. Methods A cross-sectional analysis was performed using Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative data between 2016 and 2017. A total of 4,241 women aged 40 years or older were included. Hypertension diagnosed by physician and exercise status was asked by questionnaires. Results Mean age of the participants was 58.4 (±11.4, range: 40∼80 years). There were 1,681 (39.6%) women in the aerobic activity adherence group. In the logistic regression analysis with adjustment for confounding factors, frequency of occupational physical activity (OPA) level (OR 1.931; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; Conclusions In the aerobic activity adherence group, further research is needed to identify the influence of occupational physical activity. In the aerobic activity nonadherence group, decreasing sitting hours and increasing endurance exercise may be helpful.
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Zou Q, He X, Li Z, Xu W, Zhang L. The effects of poverty reduction policy on health services utilization among the rural poor: a quasi-experimental study in central and western rural China. Int J Equity Health 2019; 18:186. [PMID: 31783857 PMCID: PMC6884802 DOI: 10.1186/s12939-019-1099-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 11/18/2019] [Indexed: 12/02/2022] Open
Abstract
Background China poverty reduction policy (PRP) addresses two important elements: the targeted poverty reduction (TPA) project since 2015 in line with social assistance policy as national policy; and reducing inequality in health services utilization by making provision of medical financial assistance (MFA). Therefore, this study aims to assess the effects of the PRP in health services utilization (both inpatient and outpatient services) among the central and western rural poor of China. Methods The study conducted household survey and applied propensity score matching (PSM) method to assess the effects of the PRP on health services utilization among the rural poor of Central and Western China. A sensitivity test was also performed on the PSM results to test their robustness. Results Key findings showed 17.6% of respondents were the beneficial of PRP. The average treatment effects on the treated (ATT) of the PRP on the inpatient visits within one year was found significantly positive (P = 0.026). Conclusion There has been relationship between PRP with medical financial assistance and reduction of inequality in health services utilization by the poorer, in particular to accessing the inpatient services from the county or township hospitals of China. Policy makers should pay attention for making provision of improving responsiveness of supply, when subsidizing on the demand side.
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Affiliation(s)
- Qi Zou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Xiaoqun He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Zhong Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Wanchun Xu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China.
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