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Keramat SA, Nguyen N, Kenny D, Hashmi R, Comans T. Trajectories of health-related quality of life and their association with disability in older Australians. Arch Gerontol Geriatr 2025; 135:105864. [PMID: 40294579 DOI: 10.1016/j.archger.2025.105864] [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: 09/17/2024] [Revised: 04/14/2025] [Accepted: 04/16/2025] [Indexed: 04/30/2025]
Abstract
BACKGROUND The relationship between various disabilities and the trajectories of HRQoL in older populations remains largely unexplored. Therefore, we aim to investigate the connections between HRQoL trajectories and different types of disabilities in older Australians. METHODS The study participants' HRQoL was measured using the SF-6D utility index. We applied the group-based trajectory model to identify distinct HRQoL trajectories and employed multinomial logistic regression to examine the relationship between HRQoL trajectories and various types of disabilities. RESULTS We identified three distinct trajectories of HRQoL among older Australians: low-declining, moderate-declining, and high-stable HRQoL groups. We found evidence indicating that the relative risks of being in the low-declining HRQoL group are greater for all types of disabilities. Older Australians living with physical disabilities (Relative Risk Ratio [RRR]: 6.62, 95 % CI: 4.76-9.22), psychosocial disabilities (RRR: 14.06, 95 % CI: 2.85-69.46), and other disabilities (RRR: 4.64, 95 % CI: 3.51-6.12) face a higher relative risk of being in the low-declining HRQoL group compared to their counterparts. Similarly, older Australians with work-limiting disabilities (RRR: 15.96, 95 % CI: 11.99- 21.24), disability onset (RRR: 10.61, 95 % CI: 8.19- 13.75), and multiple disabilities (RRR: 19.12, 95 % CI: 13.96- 26.18) also have a higher relative risk of being in a low-declining HRQoL group compared to their counterparts. CONCLUSIONS Our findings emphasise the urgent need for targeted interventions and support services for older Australians with physical, psychosocial, and work-limiting disabilities to address their elevated risk of declining HRQoL and enhance their overall well-being.
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Affiliation(s)
- Syed Afroz Keramat
- Centre for Health Services Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Australia.
| | - Nhi Nguyen
- School of public health, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Australia
| | - Danelle Kenny
- Centre for Health Services Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Australia
| | - Rubayyat Hashmi
- The Australian Centre for Housing Research, The University of Adelaide, Adelaide, South Australia 5000 Australia
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Australia
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Zhang BX, Luo JP, Sun JY, Geng MH, Mou YF, Cheng NN, Wang ZX, Yin WQ, Chen ZM, Ma DP. Study on the factors influencing the impaired abilities of daily living in middle-aged and older adult arthritis patients based on binary logistic regression and categorical decision tree model. Front Public Health 2025; 13:1531872. [PMID: 40529707 PMCID: PMC12170662 DOI: 10.3389/fpubh.2025.1531872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2024] [Accepted: 05/20/2025] [Indexed: 06/20/2025] Open
Abstract
Background Arthritis is the most disabling disease worldwide, and the presence of the disease usually greatly threatens the patient's activities of daily living (ADL). Currently, there are a few studies that are related to exploring factors associated with impaired ADL in middle-aged and older adult arthritis patients. This study aimed to explore the factors associated with impaired ADL in Chinese middle-aged and older adult patients through logistic regression and decision tree models. Methods The method of univariate analysis was the chi-square test. Variables with significant differences in univariate analysis were included in binary logistic regression model and decision tree model based on the E-CHAID algorithm to explore the factors associated with impaired ADL in middle-aged and older adult arthritis patients in China. Results The results of the logistic regression model indicated that sex, place of residence, age, education level, falls, Internet usage, depressive symptoms, pain, self-rated health, and number of comorbid chronic diseases were the influencing factors for impaired ADL. The decision tree results showed that pain was the most important variable predicting impaired ADL in middle-aged and older adult arthritis patients. The area under the curve of the logistic regression model and the decision tree model were 0.792 (95%CI: 0.780-0.804) and 0.767 (95%CI: 0.754-0.780), respectively. Conclusion The results of the study suggest that pain, self-rated health, Internet usage, age, and depressive symptoms are significant correlates of impaired ADL. Primary care providers need to provide intervention strategies that are individualized to the middle-aged and older adults with arthritis themselves.
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Affiliation(s)
- Bao-xuan Zhang
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Jin-ping Luo
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Jia-ying Sun
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Ming-hui Geng
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Yi-fan Mou
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Nan-nan Cheng
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Zhao-xuan Wang
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Wen-qiang Yin
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Zhong-ming Chen
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Dong-ping Ma
- School of Management, Shandong Second Medical University, Shandong, China
- "Health Shandong"Severe Social Risk Prevention and Management Synergy Innovation Center, Shandong, China
- Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
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Yin J, Bi S, Dong S, Hao J, Zhang S, Li J. Impact of health shocks on social capital: How long will it persist? SSM Popul Health 2025; 30:101800. [PMID: 40292241 PMCID: PMC12032922 DOI: 10.1016/j.ssmph.2025.101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Revised: 04/03/2025] [Accepted: 04/04/2025] [Indexed: 04/30/2025] Open
Abstract
Adverse health shocks impoverish over 150 million individuals worldwide annually. These shocks harm the health, wealth accumulation, and well-being of patients and their families. However, the effect of health shocks on social capital and their persistence remains uncertain. This cross-sectional study conducted in 2023 in socioeconomically deprived rural areas of Shandong, China, employed Ordinary Least Squares regression to examine the impact and persistence of health shocks on social capital. The results indicated that 29.24 % of households experienced health shocks. Households affected by health shocks within the past year showed a significant decrease in social capital (β = -2.82, P < 0.001).This impact diminished over time (between one and three years ago: β = -1.49, P = 0.21; more than three years ago: β = -1.10, P = 0.36). The findings also reveal a stronger impact on cognitive social capital compared to structural social capital (cognitive social capital: β = -1.78, P = 0.001; structural social capital: β = -1.038, P = 0.006). Policymakers should not only offer financial aid to families suffering from health shocks but also focus on restoring their social capital.
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Affiliation(s)
- Jinghan Yin
- Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Shuwen Bi
- Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Shiju Dong
- Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jin Hao
- Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Siqian Zhang
- Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jiajia Li
- Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
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Feng F, Huang Y. Latent profile analysis of depression in older adults spouse caregivers. Front Public Health 2025; 13:1450720. [PMID: 40135159 PMCID: PMC11932916 DOI: 10.3389/fpubh.2025.1450720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 02/26/2025] [Indexed: 03/27/2025] Open
Abstract
Objective With advancing age, older adults are more likely to experience health problems and a decline in functioning, necessitating long-term care. Spouses play a crucial role in providing care for the older adults. Depression is a significant mental health issue faced by older adult's spouses. Categorizing depression into homogeneous subgroups can unveil hidden insights. Methods This study utilized the Harmonized CHARLS dataset to investigate. Latent Profile Analysis (LPA) was employed to identify subgroups of older adult's spouses who experience depression, and chi-square tests were conducted for univariate analysis. Furthermore, multiple logistic regression was utilized to analyze the associated factors. Results Spouse caregivers were identified and classified as Low Level Depression (50.6%), High Level Depression (20.0%), and Unstable Affective Depression (29.4%). Gender, education level, self-assessment of health, communication with children, social participation, life satisfaction, and place of residence were found to be influential factors for depression among older adults spouse caregivers. Multiple logistic regression analysis indicated that, compared to individuals with low levels of depression, those with high levels were significantly associated with gender, education level, self-assessed health status, social engagement, life satisfaction, and place of residence. Similarly, compared to individuals with low levels of depression, those classified as having an unstable affective type were significantly associated with gender, education level, self-assessed health status, and life satisfaction. Furthermore, compared to individuals with high levels of depression, those with unstable affective depression were significantly associated with gender, self-assessed health status, weekly interactions with children, and participation in social activities. Conclusion This study revealed distinct subtypes of depression among older adults spousal caregivers, emphasizing the importance of targeted interventions in primary care. Tailored intervention strategies addressing the specific characteristics of each subtype may improve caregivers' mental health and enhance their quality of life.
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Affiliation(s)
- Fuzhe Feng
- School of Medicine, Sias University, Henan, China
| | - Yalong Huang
- The Third People’s Hospital of Henan Province, Zhengzhou, China
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Antonelli MA, Marini G. Do institutions matter for citizens' health status? Empirical evidence from Italy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2025; 26:95-115. [PMID: 38722437 PMCID: PMC11743420 DOI: 10.1007/s10198-024-01689-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/13/2024] [Indexed: 01/21/2025]
Abstract
This paper investigates the role of institutional quality in explaining cross-regional variation in population health status in Italy. We first introduce a composite Regional Health Status Indicator summarizing life expectancy, mortality and morbidity data. Then, we study the empirical relationship between this indicator and a set of socioeconomic, health system and institutional controls at the Italian regional level over the period of 2011-2019. We find that institutional quality is a driver of population health. Furthermore, well-functioning local institutions and regions compliant with national standards in terms of public healthcare services (Essential Levels of Care) make socioeconomic context no longer relevant for population health, potentially reducing inequalities.
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Affiliation(s)
| | - Giorgia Marini
- Department of Legal and Economic Studies, Sapienza University of Rome, Rome, Italy
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Liu S, Hu J. Impact of family doctor contracted services on the health of migrants: a cross-sectional study in China. Sci Rep 2024; 14:29510. [PMID: 39604578 PMCID: PMC11603316 DOI: 10.1038/s41598-024-81068-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 11/25/2024] [Indexed: 11/29/2024] Open
Abstract
This study investigates the impact of the family doctor contracted service system on the health of migrants in China, utilizing data from the 2018 China Migrants Dynamic Survey (CMDS). The study employs a double machine learning model to estimate the effect of family doctor contracted services (FDCS) on migrants' self-rated health (MSRH). The sample consists of 137,851 migrants, with family doctor service contract status, health education, and health records as key variables. To address potential endogeneity issues, an instrumental variable approach using the regional family doctor contracting rate was implemented. Mediation analysis was conducted to examine the roles of health education and health records in this relationship. The findings indicate that FDCS significantly improve MSRH. This positive effect is robust across various machine learning models, including Lassocv, Random Forest, and Gradient Boost. The instrumental variable approach confirms the validity of these results, mitigating concerns about endogeneity. Mediation analysis reveals that the positive impact of FDCS on MSRH is fully mediated by health education and health records, highlighting their critical roles in enhancing health outcomes. The FDCS play a crucial role in improving the health of migrants by providing continuous and comprehensive care. Enhanced health education and effective health records management are significant pathways through which these services exert their positive effects. Policy recommendations include expanding access to family doctor services, enhancing health education programs, and improving health records management to optimize healthcare delivery for migrants. Future research should consider longitudinal studies to further validate these findings and explore their applicability to specific subgroups or regions.
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Affiliation(s)
- Sijia Liu
- School of Health Management, Inner Mongolia Medical University, Hohhot, 010100, China
| | - Jiajing Hu
- School of Health Management, Inner Mongolia Medical University, Hohhot, 010100, China.
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Rahman A, Tohan MM, Islam A, Saha BR, Kundu S. Prevalence and social determinants of self-reported health status among reproductive age women in Nepal. Arch Womens Ment Health 2024:10.1007/s00737-024-01528-z. [PMID: 39560776 DOI: 10.1007/s00737-024-01528-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 10/29/2024] [Indexed: 11/20/2024]
Abstract
PURPOSE The self-reported health status (SRHS) is a subjective evaluation of an individual's health and has been connected to mortality and future health outcomes in numerous studies. However, the determinants of SRHS among women in Nepal remain largely unclear. In Nepal, traditional gender norms often result in women bearing greater responsibilities in terms of household chores, child-rearing, and taking care of elderly family members, all of which may potentially contribute to lower self-perceived health. Therefore, this study aims to identify the factors influencing SRHS among women in Nepal. METHODS The study utilized data from 7,442 women aged between 15 and 49 who participated in the Nepal Demographic and Health Survey (NDHS) 2022. Both univariate and multiple linear regression analyses were employed to ascertain the factors influencing self-rated health status (SRHS) among women in Nepal. RESULT Women in the age groups 15-24 years (AOR: 5.14, 95% CI: 3.07-8.62) and 25-34 years (AOR: 2.71, 95% CI: 1.99-3.68) were more likely to report good health status compared to older age groups. Additionally, women who were never married (AOR: 4.89, 95% CI: 3.62-5.32) or currently married (AOR: 1.46, 95% CI: 1.11-2.20) and those from wealthy families (AOR: 1.54, 95% CI: 1.07-2.21), also had a higher likelihood of reporting good health status. Other factors associated with a higher probability of reporting good health included not having a history of terminated pregnancy (AOR: 1.48, 95% CI: 1.11-1.97), having no history of genital discharge (AOR: 1.75, 95% CI: 1.29-2.38), not visiting a health facility in the last 12 months (AOR: 2.03, 95% CI: 1.43-2.88), and having no genital ulcers in the previous 12 months (AOR: 2.02, 95% CI: 1.24-3.28). Conversely, women with mild to severe depression and anxiety were less likely to report good health status compared to those with no depression or anxiety. CONCLUSION This study identified several social determinants of SRHS among Nepalese women. These socioeconomic determinants of health should be included in future research and health policy activities in Nepal and other comparable contexts.
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Affiliation(s)
- Ashfikur Rahman
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Mortuja Mahamud Tohan
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh.
- School of General Education (GenEd), Brac University, Dhaka, Bangladesh.
| | - Amirul Islam
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Bristi Rani Saha
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Satyajit Kundu
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, 4222, Australia
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Cai J, Li Y, Li R, Coyte PC. Has socioeconomic inequality in perceived access to health services narrowed among older adults in China? BMC Health Serv Res 2024; 24:1077. [PMID: 39285453 PMCID: PMC11406797 DOI: 10.1186/s12913-024-11510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/29/2024] [Indexed: 09/19/2024] Open
Abstract
OBJECTIVE To analyze the degree, evolution and causes of socioeconomic inequality in perceived access to health services among the older adults in China. METHODS The data used in this study were drawn from the 4 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2008, 2011, 2014, 2018. Erreygers index (EI) was used to measure socioeconomic inequality in perceived access to health services in each survey wave. A panel logit regression model was used to examine the impact of socioeconomic status on perceived access to health services. The recentered influence function (RIF) regression decomposition method was used to explore the causes of socioeconomic inequality in perceived access to health services. Inverse probability weighting (IPW) was employed to adjust estimates for missing responses and loss to follow-up. RESULTS "Pro-rich" socioeconomic inequality in perceived access to health services in China was found with inequality falling through time. The older adults with higher incomes, who had adequate financial support, and those who were wealthier compared with other residents reported lower socioeconomic inequality in perceived access to health services. Having basic health insurance and access to care resources when ill can help alleviate such inequalities. CONCLUSIONS Socioeconomic inequality in perceived access to health services was shown to be responsive to policies that enhance health insurance coverage and support the provision of (paid and unpaid) caregiving for the older adults.
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Affiliation(s)
- Jiaoli Cai
- School of Economics and Management, Beijing Jiaotong University, No.3 Shangyuancun, Haidian District, Beijing, 100044, China
- Research Center for Central and Eastern Europe, Beijing Jiaotong University, Beijing, 100044, China
| | - Yue Li
- School of Economics and Management, Beijing Jiaotong University, No.3 Shangyuancun, Haidian District, Beijing, 100044, China
| | - Ruoxi Li
- School of Economics and Management, Fuzhou University, No.2 Wulongjiang North Avenue, Daxue New District, Fuzhou, Fujian, 350108, China.
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building,155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada
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Hua Y, Fan X, Yang M, Su J, Guo J, Jin J, Sun D, Pei P, Yu C, Lyu J, Tao R, Zhou J, Lu Y. Association between socioeconomic status and risk of chronic obstructive pulmonary disease in China: a prospective cohort study. BMC Public Health 2024; 24:2077. [PMID: 39085848 PMCID: PMC11292937 DOI: 10.1186/s12889-024-19490-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE Socioeconomic status (SES) has been proven to be associated with chronic obstructive pulmonary disease (COPD) in Western populations, but the evidence is very limited in China. This study aimed to investigate the association between SES and the risk of COPD incident. METHODS This study was based on the China Kadoorie Biobank (CKB) project in Wuzhong District, Suzhou. A total of 45,484 adults aged 30-79 were included in the analysis during 2004-2008. We used Cox proportional hazard models to investigate the association between SES and the risk of COPD. Household income, education, private property and consumption potential was used to measure SES. Incident COPD cases were ascertained using hospitalization records, death certificates, and active follow-up. RESULTS A total of 524 COPD cases were identified during a median follow-up of 11.2 years. Household income was inversely associated with the risk of COPD (Ptrend<0.005). The adjusted hazard ratios (95% confidence intervals) for incident COPD were 0.88 (0.69-1.14), 0.77 (0.60-0.99), and 0.42 (0.31-0.57) for participants with annual household income of 10,000 ~ 19,999 yuan, 20,000 ~ 34,999 yuan and ≥ 35,000 yuan respectively, in comparison to participants with an annual household income < 10,000 yuan. Furthermore, we found that education level, refrigerator use, private toilet, private phone, and motor vehicle were adversely associated with COPD risk, while ownership of newly renovated flats was positively correlated with COPD incident. CONCLUSIONS This prospective study suggests that SES is associated with the risk of COPD in Chinese adults. Population-based COPD prevention strategies tailored for people with different SES could help reduce the burden of COPD in Chinese.
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Affiliation(s)
- Yujie Hua
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, 215004, China
| | - Xikang Fan
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Mengshi Yang
- Department of Epidemiology and Health Statistics, Southeast University, Nanjing, 210009, China
| | - Jian Su
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Jia Guo
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, 215004, China
| | - Jianrong Jin
- Wuzhong District Disease Control and Prevention Centre, Suzhou, 215000, China
| | - Dianjianyi Sun
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
| | - Canqing Yu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Jun Lyu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Xueyuan Road, Haidian District, Beijing, 100191, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, 100191, China
| | - Ran Tao
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China
| | - Jinyi Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Nanjing, 210009, Jiangsu, China.
| | - Yan Lu
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, 215004, China.
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Jiang H, Hu R, Wang YJ, Xie X. Predicting depression in patients with heart failure based on a stacking model. World J Clin Cases 2024; 12:4661-4672. [PMID: 39070824 PMCID: PMC11235518 DOI: 10.12998/wjcc.v12.i21.4661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/27/2024] [Accepted: 06/17/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND There is a lack of literature discussing the utilization of the stacking ensemble algorithm for predicting depression in patients with heart failure (HF). AIM To create a stacking model for predicting depression in patients with HF. METHODS This study analyzed data on 1084 HF patients from the National Health and Nutrition Examination Survey database spanning from 2005 to 2018. Through univariate analysis and the use of an artificial neural network algorithm, predictors significantly linked to depression were identified. These predictors were utilized to create a stacking model employing tree-based learners. The performances of both the individual models and the stacking model were assessed by using the test dataset. Furthermore, the SHapley additive exPlanations (SHAP) model was applied to interpret the stacking model. RESULTS The models included five predictors. Among these models, the stacking model demonstrated the highest performance, achieving an area under the curve of 0.77 (95%CI: 0.71-0.84), a sensitivity of 0.71, and a specificity of 0.68. The calibration curve supported the reliability of the models, and decision curve analysis confirmed their clinical value. The SHAP plot demonstrated that age had the most significant impact on the stacking model's output. CONCLUSION The stacking model demonstrated strong predictive performance. Clinicians can utilize this model to identify high-risk depression patients with HF, thus enabling early provision of psychological interventions.
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Affiliation(s)
- Hui Jiang
- Department of Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Rui Hu
- Department of Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Yu-Jie Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Xiang Xie
- Department of Ultrasound Diagnosis, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
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11
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Baek SK, Aye WT, Htet AS, Stigum H, Gopinathan U, Bjertness E. Educational inequalities and self-reported health among men and women aged 18-49 years in Yangon Region, Myanmar: analysis of a population-based, cross-sectional study. BMJ Open 2024; 14:e074468. [PMID: 38890138 PMCID: PMC11191797 DOI: 10.1136/bmjopen-2023-074468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/18/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES To estimate the prevalence of good self-reported health (SRH) in subpopulations based on the social determinants of health and to investigate the association between education (measured in years of schooling) and good SRH among men and women aged 18-49 years in Yangon Region, Myanmar. DESIGN Analysis of data from a population-based, cross-sectional study conducted in Yangon, Myanmar, from October to November 2016. A multistage sampling procedure was employed, and structured face-to-face interviews were conducted with standardised questions adapted from the Myanmar Demographic and Health Survey. Prevalence ratios (PRs) with 95% CIs were estimated using Poisson regression analyses by sex. SETTING Urban and rural areas of Yangon Region, Myanmar. PARTICIPANTS The sample included 2,506 participants (91.8% response rate) aged 18-49 years and excluded nuns, monks, soldiers, institutionalised people and individuals deemed too ill physically and/or mentally to participate. RESULTS The prevalence of good SRH was 61.2% (95% CI 59.3 to 63.1), with higher rates among men (72.0%, 95% CI 69.3 to 74.5), younger individuals (69.2%, 95% CI 66.2 to 72.1), urban residents (63.6%, 95% CI 60.8 to 66.3), extended family dwellers (66.6%, 95% CI 63.7 to 69.4) and those with a higher level of education (66.0%, 95% CI 61.3 to 70.5). After adjusting for confounders (age and area of residence), the association between years of schooling and SRH (PR) was 1.01 (95% CI 1.01 to 1.02, p=0.002) in men and 1.01 (95% CI 0.99 to 1.02, p=0.415) in women. CONCLUSIONS Good SRH was more prevalent among men than among women. Additionally, a 1-year increase in education was associated with a 1% increase in the prevalence of good SRH among men, whereas the association was not statistically significant among women. In order to enhance the educational benefits of health in Myanmar, we recommend a higher focus on the length of education and addressing gender inequalities in wage return from education.
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Affiliation(s)
- Sel Ki Baek
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Win Thuzar Aye
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Aung Soe Htet
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Hein Stigum
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Gopinathan
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Espen Bjertness
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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12
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Mendoza Y, González RE. Objective and subjective measures of air pollution and self-rated health: the evidence from Chile. Int Arch Occup Environ Health 2024; 97:413-433. [PMID: 38493267 DOI: 10.1007/s00420-024-02056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/06/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE The literature exploring individual differences in self-rated health has grown fast in recent years. Self-rated health (SRH) is a good indicator of general health status. This empirical study explores the association between outdoor air pollution and SRH in Chile. This type of analysis is infrequent in Latin America. METHODS We used objective and subjective air pollution measures. The first corresponds to PM2.5, and the latter to the perception of a high level of air pollution. Drawing on data from two independent and repeated nationwide surveys over the period 2006-2017 at the individual level in Chile, we performed repeated cross-sectional analyses for each year of survey application. Ordered Logit (OL) and Logit (L) multivariate models were used to investigate the association between SRH and air pollution measures, considering other socioeconomic and demographic covariates. RESULTS We found that the higher is the level of air pollution, the lower the SRH in Chile, regardless of whether air pollution is physically measured or perceived by respondents. The results were consistent over the years in the sign and significance of regression coefficients using two surveys and two forms of the outcome variable. CONCLUSIONS Our findings add evidence that air pollution is a relevant determinant of SRH. In addition, they show that subjective measures of air pollution can be as reliable as physical measures in the analysis of the association between air pollution and human health.
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Affiliation(s)
- Yenniel Mendoza
- Department of Administration and Economics, Faculty of Law and Business, Universidad de la Frontera, Temuco, Chile.
| | - Ricardo E González
- Department of Forest Sciences and Environment, Faculty of Agricultural Sciences and Environment, Universidad de la Frontera, Temuco, Chile
- Centro Nacional de Excelencia para la Industria de la Madera (CENAMAD), Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
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13
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Mansouri A, Khosravi Farsani A, Mohammadifard N, Nouri F, Jozan M, Tabatabaei GA, Salehidoost R, Rafiee H. Self-rated health and its determinants in patients with hypertension in Isfahan in 2019. BMC Public Health 2024; 24:480. [PMID: 38360624 PMCID: PMC10870428 DOI: 10.1186/s12889-024-17887-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Self-rated health (SRH) serves as an assessment of contentment regarding one's social, mental, and physical well-being and has been linked to both cardiovascular mortality and morbidity. Nonetheless, the relationship between SRH and medical outcomes in individuals with hypertension unsettled. This research endeavors to pinpoint the determinants that affect SRH in Iranian patients with hypertension. MATERIALS AND METHODS This cross-sectional study took place in Isfahan, Iran, from November 2018 to August 2019 and involved 886 patients with essential HTN. The data collection methods included a checklist for demographic information and risk factors, blood pressure measurements (systolic and diastolic), the Persian version of the 8-Item Morisky Medication Adherence scale, and a self-rated health questionnaire recommended by the World Health Organization. Independent sample T-test and chi squared test were used for comparison of variables between two groups of SRH. Additionally, multivariable logistic regression was used to analyze the factors influencing self-rated health status. RESULTS Among 886 participants (mean age 57.8 ± 8.8 years, 71.9% women), 89.62% reported good SRH. Comorbid conditions were significantly associated with poorer SRH (p < 0.05). Notably, higher education (odd ratio (OR) = 1.88, 95% confidence interval (CI) = 1.13-3.11, p = 0.015) and increased income (OR = 4.34, 95% CI = 1.43-13.18, p = 0.010) were identified as positive determinants of good SRH. CONCLUSION We concluded that socioeconomic factors (education and income) and comorbid conditions (diabetes, hyperlipidemia, and pulmonary diseases) are risk factors for poor SRH among hypertensive patients. These findings could help planning of health enhancement initiative.
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Affiliation(s)
- Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi Farsani
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Nouri
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Jozan
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghazaal Alavi Tabatabaei
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Rezvan Salehidoost
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Hamed Rafiee
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Mu F, He T, Wang K, Wang F. Knowledge, attitudes, and practices of patients with recurrent pregnancy loss toward pregnancy loss. Front Public Health 2024; 11:1308842. [PMID: 38274527 PMCID: PMC10808478 DOI: 10.3389/fpubh.2023.1308842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Objective Self-management is crucial in managing recurrent pregnancy loss (RPL). This study explored the knowledge, attitudes, and practices (KAP) of patients with RPL toward RPL. Methods This cross-sectional study was conducted among patients with RPL between January 2023 and June 2023 at the Second Hospital of Lanzhou University. Participants' demographic characteristics and KAP were determined using a self-designed questionnaire (Cronbach's α = 0.818). Structural equation modeling (SEM) was used to observe the correlations among KAP and different factors. Results This study analyzed 497 valid questionnaires. The mean knowledge, attitude, and practice scores were 11.59 ± 4.30 (possible range: 0-20, 57.95%), 44.17 ± 3.18 (possible range: 13-65, 67.95%), and 32.39 ± 5.22 (possible range: 8-40, 80.98%), indicating poor knowledge, moderate attitude, and proactive practice. Age was non-linearly associated with the KAP dimensions, with a positive impact of age on KAP among those aged <32 years old. Knowledge was directly influenced by education (β = 1.49, p < 0.001) and income (β = 1.08, p < 0.001). The attitude was directly influenced by knowledge (β = 0.25, p < 0.001) and indirectly influenced by education (β = 0.37, p = 0.001) and income (β = 0.27, p < 0.001). Practice was directly influenced by knowledge (β = 0.26, p < 0.001), attitude (β = 0.28, p < 0.001), and income (β = 0.68, p = 0.012), and indirectly influenced by knowledge (β = 0.07, p = 0.001), education (β = 0.59, p = 0.001), and income (β = 0.42, p < 0.001). Conclusion Women with RPL in Lanzhou show poor knowledge, moderate attitude, and proactive practice toward RPL. This study identified specific KAP items that would require improvements. The study also identified categories of patients who would need more attention.
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Affiliation(s)
| | | | | | - Fang Wang
- Department of Reproductive Medicine, Lanzhou University Second Hospital, Lanzhou, China
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15
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Yu Q, Wu J. Impact of income inequalities on subjective perception of older adult health: An analysis of healthy life expectancy in China from 1997 to 2006. Geriatr Gerontol Int 2024; 24:109-115. [PMID: 38086009 DOI: 10.1111/ggi.14768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/12/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024]
Abstract
AIM Driven by rapid socioeconomic development over recent decades, there are widening income inequalities and subjective health disparities among older adults in China. This study explored the relationship between income inequalities and self-rated healthy life expectancy (HLE) considering potential sex-specific differences. METHODS From a cohort of 1760 individuals aged ≥60 years from the China Health and Nutrition Survey (1997-2006), we calculated age-specific life expectancy (LE), HLE and the proportion of HLE to LE (HLE/LE) by sex using the IMaCh software, incorporated time-varying income levels of older adults. RESULTS Although longevity has significantly improved, the well-being of Chinese older adults could be further enhanced by assessing HLE, as the results showed that at age 60 years, ~20% of their LE was characterized by unhealthiness. Discriminated by economic status, lower-income individuals experienced worse self-rated health compared with the general population and affluent counterparts. For instance, at age 60 years, the LE, HLE and HLE/LE of low-income men were 19.8 (95% CI 18.4-21.1), 16.2 years (95% CI 15.0-17.5) and 81.8%, respectively, lower than their general (21.7, 95% CI: 20.4-23.0; 18.0, 95% CI 16.8-19.2; and 82.9%) and high-income counterparts (25.1, 95% CI 23.1-27.2; 21.4, 95% CI 19.5-23.3; and 85.3%). Sex disparities were noticeable among low-income individuals in HLE/LE, with low-income women showing the most significant disadvantage. CONCLUSIONS Income inequalities exacerbated subjective health disparities among older adults, particularly among lower-income individuals and women. Our findings carry significant implications for formulating public health and social welfare strategies, especially in nations grappling with an aging population and undergoing parallel socioeconomic development. Geriatr Gerontol Int 2024; 24: 109-115.
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Affiliation(s)
- Qi Yu
- Institute of Population Research, Peking University, Beijing, China
| | - Jilei Wu
- Institute of Population Research, Peking University, Beijing, China
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16
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Mohanty RK, Behera DK. Heterogeneity in health funding and disparities in health outcome: a comparison between high focus and non-high focus states in India. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:44. [PMID: 37461113 PMCID: PMC10351161 DOI: 10.1186/s12962-023-00451-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/01/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The Central Government of India introduced the National Health Mission (NHM) in 2005 to improve health outcomes by enhancing publicly financed (government) health expenditure and health infrastructure at the state level. This study aims to examine the effects of the state-level heterogeneity in publicly financed spending on health services on major health outcomes such as life expectancy, infant mortality rate, child mortality rate, the incidence of malaria, and immunization coverage (i.e., BCG, Polio, Measles, and Tetanus). METHODS This study investigates the relationships between publicly financed health expenditure and health outcomes by controlling income and infrastructure levels across 28 Indian States from 2005 to 2016. Along with all states, the empirical analysis has also been carried out for high-focus and non-high-focus states as per the NHM fund flow criteria. It has applied panel fixed-effects and random effects model wherever required based on the Hausman test. RESULTS The empirical results show that publicly financed health expenditure reduces infant mortality, child mortality, and malaria cases. At the same time, it improves life expectancy and immunization coverage in India. It also finds that the relationship between publicly financed health expenditure and health outcomes is weak, especially in the high-focus states. CONCLUSIONS Given the healthcare need for achieving desirable health outcomes, Indian States should enhance publicly financed expenditure on health services. This study augments essential guidance for implementing public health policies in developing countries.
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Affiliation(s)
- Ranjan Kumar Mohanty
- Xavier Institute of Management, XIM University, Bhubaneswar, Odisha 751013 India
| | - Deepak Kumar Behera
- Department of Economics and Finance, The Business School, RMIT University, 700000 Ho Chi Minh City, Vietnam
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17
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Hou B, Zhang H. Latent profile analysis of depression among older adults living alone in China. J Affect Disord 2023; 325:378-385. [PMID: 36640808 DOI: 10.1016/j.jad.2022.12.154] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND The number of older adults living alone has increased significantly. Depression is one of the significant mental health problems they face; classifying depressive conditions into homogeneous subgroups can help discover hidden information. METHODS The data comes from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent profile analysis (LPA) was used to identify depression subgroups among elderly living alone, Chi-square tests and Kruskal-Wallis tests were used to univariate analysis, multinomial logistic regression was used to analyze the related factors. RESULTS 1831 older adults living alone were identified and classified as low-level (30.4 %), moderate-level (55.3 %) and high-level (14.4 %). All variables, except age, were significant in the univariate analysis. Multinomial logistic regression showed that not participating in exercise, sometimes interacting with friends, anxiety symptoms, and impaired IADL were associated with the moderate- and high-level of depression in older adults living alone; good or fair self-rated health and life satisfaction were associated with the low-level of depression in older adults living alone. Anxiety symptoms were associated with high-level of depression in older adults living alone compared to moderate-level; good or fair self-rated health and life satisfaction were associated with moderate-level of depression in older adults living alone. LIMITATIONS The CES-D-10 cannot fully determine the presence of depression in elderly people living alone at high-level. CONCLUSIONS In future primary health care, it would be more meaningful to provide targeted interventions for different subgroups of depression in older adults living alone.
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Affiliation(s)
- Bailing Hou
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China.
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18
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Zheng W, Liang Y, Lee WS, Ko Y. The Mediation Effect of Perceived Attitudes toward Medical Service on the Association between Public Satisfaction with the Overall Medical Service and Self-Rated Health among the General Population in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3369. [PMID: 36834064 PMCID: PMC9959117 DOI: 10.3390/ijerph20043369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to examine the association between public satisfaction with the overall medical service and individuals' self-rated health among 18,852 Chinese adults aged 16-60 years by using data from the 2018 China Family Panel Studies. We further test whether such an association is mediated by perceived attitudes toward the medical service. The logistic regression model is used to explore the association between public satisfaction with the overall medical service and individuals' self-rated health (SRH) outcomes. Mediation analysis was conducted by using the Karlson-Holm-Breen (KHB) method. We found that public satisfaction with the overall medical service was associated with good SRH. Additional results indicated that the association between public satisfaction with the overall medical service and SRH was significantly mediated by perceived attitudes toward the medical service. The degree of mediation is much larger for individuals' satisfaction with the level of medical expertise than for trusting in doctors, attitudes toward medical service problems, and the attitude toward the level of the hospital. Targeted medical policy interventions are designed to promote individuals' perceived attitudes toward the medical service, which might help to improve individuals' health benefits.
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Affiliation(s)
- Wanwan Zheng
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
| | - Yuqing Liang
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
| | - Woon Seek Lee
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
| | - Youngwook Ko
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
- Institute for Basic Science, Daejeon 34126, Republic of Korea
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19
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Jackson A, Weaver RH, Weybright E, Lanigan J, Parker L, Iniguez A, Decker A. Changes in Social, Economic, and Health Risk Factors Across the Lifespan during the COVID-19 Pandemic: A Latent Transition Analysis. JOURNAL OF PREVENTION AND HEALTH PROMOTION 2022; 3:539-562. [PMID: 38603389 PMCID: PMC9510955 DOI: 10.1177/26320770221096839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The COVID-19 pandemic led to unique, pervasive, and changing global impacts. It is imperative to characterize groups of individuals based on modifiable factors, and to describe how groups have been impacted by the continuing pandemic in the United States to promote health and well-being and to inform preventive interventions. We used latent transition analysis to identify subgroups of modifiable psychosocial, economic, and health risk factors; to explore subgroup shifts across time; and to assess the prevalence of non-modifiable factors associated with subgroup membership. We recruited 450 participants 18 years and older living in the United States to complete a longitudinal survey exploring health during the pandemic. Participants completed three waves of data collection from April to November 2020. We used latent transition analysis to identify statuses, shifts in prevalence over three waves, and the relationships of non-modifiable covariates with each status. Five statuses were identified: high risk together, low risk together, high risk alone, low risk alone, and financial risk together. Statuses were relatively stable over time; the majority (60%-66%) of participants were in statuses categorized by multiple indicators of high modifiable risk, and the largest transitions were to lower risk subgroups. Increasing age, being male, and living in an urban area were the only non-modifiable covariates associated with status membership. It is imperative to continue to scale up targeted interventions aimed at promoting resilience, well-being, financial well-being, delays in healthcare use, food insecurity, and depression among individuals in higher-risk subgroups to promote health and well-being.
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Affiliation(s)
| | | | | | | | - Louise Parker
- Extension Youth and Families Unit,
Human Development, Washington State
University, Seattle, WA, USA
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20
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Chen L, Zheng Y, Wen W, Chu L. Long-term Care Expenditures and the Red Herring Hypothesis: Evidence from the Oldest-old in China. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09394-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
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Nie P, Clark AE, D'Ambrosio C, Ding L. Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions. Health Place 2022; 73:102743. [PMID: 35045352 DOI: 10.1016/j.healthplace.2022.102743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/27/2021] [Accepted: 01/10/2022] [Indexed: 01/07/2023]
Abstract
Unprecedented economic growth has been experienced over the several decades worldwide, but such rapid economic growth wasn't accompanied by equally-substantial improvement in health, especially health inequalities between the rich and poor. This study examines the role of housing in income-related health inequalities (income-health gradient) in urban China. We here analyze 1991-2015 China Health and Nutrition Survey data to ask how housing affects income-related health inequalities in urban China. We find pro-poor inequalities in self-reported bad health but pro-rich inequalities in objective bad health (general overweight/obesity, central obesity and high blood pressure). Housing conditions serve to reduce the health gradient, especially for objective health. On the contrary, homeownership exacerbates the health gradient. Improving housing conditions thus appears to be an effective way of reducing the income-health gradient in urban China.
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Affiliation(s)
- Peng Nie
- School of Economics and Finance, Xi'an Jiaotong University, 710061, Xi'an, China; Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany; IZA, Bonn, Germany
| | | | | | - Lanlin Ding
- School of Economics and Finance, Xi'an Jiaotong University, 710061, Xi'an, China.
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22
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Krawczyk-Suszek M, Kleinrok A. Health-Related Quality of Life (HRQoL) of People over 65 Years of Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020625. [PMID: 35055448 PMCID: PMC8776108 DOI: 10.3390/ijerph19020625] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 02/05/2023]
Abstract
Quality of life is an important indicator of the treatment process, lifestyle, and influence of many other factors, both exogenous and endogenous, on the body. Determining the quality of life of healthy people (health-related quality of life (HRQoL), considering the influence of various factors, is important due to the possibility of making subsequent comparative analyses regarding the quality of life of people diagnosed with diseases. In addition, it allows us to identify the most crucial factors influencing the HRQoL in the process of “good aging”. The purpose of the study was to present the HRQoL level of healthy people over 65 years of age. HRQoL was measured in five-year age groups (66–70, 71–75, 76–80, >80 years), considering the analyzed factors. Finally, 1038 healthy people were included in the study. The inclusion criteria were as follows: no diagnosed chronic diseases, no permanent treatment in specialist clinics, and no constant administration of medicaments. A comparative analysis was carried out, assuming a 5% conclusion error. The SF-36 questionnaire assessing the main dimensions of the quality of life was the tool used in the study to assess the HRQoL: the physical component summary (PCS), mental component summary (MCS) and index of life quality (ILQ). The factors significantly differentiating the average level of HRQoL were as follows: gender, place of residence, education, employment status, smoking and physical activity. Relationship status (p > 0.05) was one of the analyzed factors that did not influence the differences in the average level of the perceived HRQoL. More than a twofold greater chance of a higher HRQoL was reported in the group of men under 75 years of age (66–70: OR = 2.01; 71–75: OR = 2.52) compared to the group of women. The same relationship was noted in the case of higher education in respondents up to the age of 80 (66–70: OR = 1.56; 71–75: OR = 2.16; 76–80: OR = 2.74). Smoking by people over 80 years of age significantly increased the chances of a higher HRQoL in each of the dimensions (PCS: OR = 4.09; MCS: OR = 12.64; ILQ: OR = 5.79). Age as a non-modifiable factor significantly differentiates the level of the HRQoL of healthy people over 65 years of age. The results of the conducted study on HRQoL can be helpful when comparing the HRQoL of healthy people with a group of people with chronic diseases.
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Guan M. Associations of fruit & vegetable intake and physical activity with poor self-rated health among Chinese older adults. BMC Geriatr 2022; 22:10. [PMID: 34979973 PMCID: PMC8722069 DOI: 10.1186/s12877-021-02709-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the existing literature highlights the central roles of sociodemographic factors, fruit & vegetable (F&V) intake, and physical activities for maintaining good health, less is known about the associations in the Chinese context. This study attempted to explore the associations of servings of F&V intake and levels of physical activities with poor self-rated health (SRH) among Chinese older adults. METHODS Data were drawn from the Study on Global Ageing and Adult Health-China (SAGE-China) issued by the World Health Organization and included 7560 respondents aged ≥60 years in China. After screening out the potential confounding factors, multiple logistic regression models were adopted to explore the associations of sociodemographic factors, servings of F&V intake, and levels of physical activities with poor SRH. RESULTS Among the sample, nearly a quarter reported poor health status. There were significant gender differences in the case of servings of F&V intake and levels of physical activities. Logistic regressions indicated that higher fruit intake was associated with lower likelihood of vigorous level of physical activity as compared to zero intake. Likewise, higher vegetable intake (≥10 servings) was associated with a higher likelihood of vigorous & moderate level of physical activity when compared to lower intake (≤ 4 servings). Higher fruit intake was associated with a lower likelihood of poor SRH. Similarly, vegetable intake (5 servings: AOR = 0.69, 95%CI: 0.58-0.83; 6-9 servings: AOR = 0.72, 95%CI: 0.59-0.87) was significantly associated with poor SRH. Additionally, vigorous level of physical activity (AOR = 0.79, 95%CI: 0.65-0.97) and vigorous fitness/leisure (AOR = 0.57, 95%CI: 0.39-0.84) were significantly associated with poor SRH. CONCLUSION This study suggested that older adults with high fruit intake had lower probability of performing vigorous & moderate level of physical activity, while those with high vegetable intake had higher probability of performing vigorous & moderate level of physical activity. Likewise, the older adults with high F&V intake and higher probability of performing vigorous level of physical activity, walk/bike activity, and vigorous/moderate fitness/leisure had less likelihood to face the risk for poor SRH outcomes. The appropriate servings of F&V intake and levels of physical activity should be highlighted.
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Affiliation(s)
- Ming Guan
- Family Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,International Issues Center, Xuchang University, Road Bayi 88, Xuchang, Henan, China. .,School of Business, Xuchang University, Road Bayi 88, Xuchang, Henan, China.
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Self-Rated Health and Pain Problems in Mothers of Healthy Children or Children Requiring Outpatient Observation or Hospitalisation: A Pilot Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189543. [PMID: 34574464 PMCID: PMC8466010 DOI: 10.3390/ijerph18189543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022]
Abstract
A child's illness or disability is a considerable stressor for the mother and a risk factor for many psychological problems and somatic diseases. The purpose of the study was to (1) assess the prevalence of poor SRH and pain, (2) compare self-rated health and pain, (3) and identify the determinants of SRH and pain in mothers of healthy children and children requiring ambulatory observation or hospitalization. The study covered 234 mothers of both healthy and unhealthy children who required outpatient observation or treatment at an intensive care unit, neonatal intensive care unit, or oncology department. To analyse the variables obtained, the following tools were used: Self-Rated Health, Numerical Rating, Interpersonal Support Evaluation List, Peritraumatic Distress Inventory, Modified Hospital Anxiety and Depression Scale, and Impact of Effects Scale-Revised. The self-assessment of health in mothers of healthy children and those in need of outpatient observation or hospitalization at units with various specialities differed in a statistically significant way. The severity of the average and maximum pain among mothers of healthy children and those with a history of disease differed statistically significantly. Poor SRH co-occurred with severe maximum pain in all of the examined groups. Both in the control group and the group of mothers of children requiring outpatient observation, poor SRH co-occurred with a high level of anxiety. Only in the control group was a correlation found between the severity of the average and maximum pain and the severity of anxiety and depression symptoms.
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Lee E, Song J. The Effect of Physical and Mental Health and Health Behavior on the Self-Rated Health of Pregnant Women. Healthcare (Basel) 2021; 9:1117. [PMID: 34574890 PMCID: PMC8470925 DOI: 10.3390/healthcare9091117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/04/2021] [Accepted: 08/25/2021] [Indexed: 11/20/2022] Open
Abstract
Self-rated health (SRH) is an evaluation tool to assess an individual's level of health, including both general health and personal experience. There have been existing studies on women's SRH; however, few studies have been on pregnant women's SRH and its associated factors. This study investigated the SRH of pregnant women and their factors using the Korea Community Health Survey. The chi-squared test and multivariable logistic regression were used to investigate the effects of demographic, physical, and mental health and health behaviors on the SRH of pregnant women. As a result of the study, 54.0% out of 1032 pregnant women had good SRH. Their SRH score was good when they were young, economically active, and living in cities. Poor SRH was observed with depression, hypertension, and after experiencing a fall. Good SRH was found when they exercised and slept for more than 8 h a day. This study is the first to observe the SRH of pregnant women and its related factors in South Korea.
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Affiliation(s)
- Eunwon Lee
- Department of Nursing, Gwangju University, Jinwol-dong, Gwangju-si 61743, Korea;
| | - Jiyoung Song
- College of Nursing, Korea University, Anam-dong, Seongbuk-Gu, Seoul 02841, Korea
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Qin W, Xu L, Wu S, Shao H. Income, Relative Deprivation and the Self-Rated Health of Older People in Urban and Rural China. Front Public Health 2021; 9:658649. [PMID: 34295864 PMCID: PMC8291363 DOI: 10.3389/fpubh.2021.658649] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Substantial evidence indicated that absolute income is directly associated with health. Few studies have, however, examined if relative income may be equally associated with health. This study aimed to investigate the association between absolute income/relative deprivation (RD) and self-rated health (SRH). We also investigated whether the urban-rural difference was existing in these associations. Methods: Using cross-sectional data of 7,070 participants in the Shandong Family Health Service Survey of older people, this study applied binary logistic model and semi-parametric model to estimate the effect of absolute income and relative deprivation on SRH of older people. The Kakwani Index was used as a measure of relative deprivation at the individual level. Results: Absolute income has a significant positive effect on the SRH among both urban and rural older people. When considered RD as a variable, both absolute income and RD have negative significant effects on SRH among all older people. In addition, the negative effect of RD on rural elderly is more pronounced than that of urban older populations. Semi-parametric regression results show that there was a complex non-linear relationship between income and SRH. Psychological distress substantially attenuated the association between relative deprivation and SRH. Conclusions: Relative deprivation is negatively associated with self-rated health in both urban and rural older people after controlling the absolute income. RD may partly explain the association between income inequality and worse health status. Compared with the urban elderly, the effect of income-based relative deprivation on SRH was more pronounced among the rural elderly, and more care should be given to the lower income and rural older populations.
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Affiliation(s)
- Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission (NHC) Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Health Commission (NHC) Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Shoucai Wu
- Department of Geriatrics, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, China
| | - Hui Shao
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, United States
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Educational Disparities in COVID-19 Prevention in China: The Role of Contextual Danger, Perceived Risk, and Interventional Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073383. [PMID: 33805222 PMCID: PMC8036684 DOI: 10.3390/ijerph18073383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/22/2021] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
Despite the social disparities in COVID-19 infection, little is known about factors influencing social disparities in preventive behaviors during the pandemic. This study examined how educational disparities in mask-wearing, handwashing, and limiting public outings might be contingent upon three factors: contextual cue of danger, perceived risk of local outbreak, and interventional context with different levels of intensity (i.e, Wuhan vs. other areas). Data were obtained from a telephone survey of 3327 adults, who were recruited through a random-digit-dial method to be representative of all cell phone users in China. Interviews were conducted from 28 April to 26 May 2020. Stratified multiple regression models showed that educational disparities in all three behaviors were only consistently observed among people exposed to context cues of danger, with an enhanced sense of risk of a local outbreak, or in areas other than Wuhan. College education seems to make a difference in handwashing regardless of contextual cues of danger or perception of risk. The findings suggested that, in the process of an epidemic, emerging threats in one's immediate environment or raised awareness of risks are important conditions triggering educational disparities in prevention. However, effective public health interventions could potentially reduce such disparities.
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Jang SH. Relationship between Employment Type and Self-Rated Health among Korean Immigrants in the US: Focusing on Gender and Number of Years in the US. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1654. [PMID: 33572336 PMCID: PMC7916112 DOI: 10.3390/ijerph18041654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
Although Korean immigrants report worse self-rated health and a higher self-employment rate than other Asian immigrant groups, the relationship between their employment type and self-rated health is understudied. This study examines the relationship between employment type and self-rated health among Korean immigrants in the US. Survey data of 421 first-generation working-age (18-64 years old) Korean immigrants in the New York-New Jersey area were analyzed. The self-administrated survey questionnaire included 39 items (e.g., sociodemographic characteristics, self-rated health, and health insurance status). A logistic regression analysis was conducted to examine the relationship between the dependent variable-self-rated health (e.g., bad/not bad vs. good/very good)-and independent variable-employment type (e.g., work at non-ethnic firms, work at co-ethnic firms, self-employed, and unemployed)-by focusing on differences regarding gender and number of years living in the US. Self-employed and unemployed Korean immigrants were less likely to report good health compared to those working in non-ethnic firms. After controlling for sociodemographic characteristics (age, gender, marital status, education, health insurance status, membership in any Koran association, religion, and English proficiency), the relationship between employment type and self-rated health remained significant among female and recent Korean immigrants. More worksite interventions by occupational health nurses that target self-employed Korean immigrants, especially women and recent immigrants, are necessary.
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Affiliation(s)
- Sou Hyun Jang
- Department of Sociology & Convergence Program for Social Innovation, Sungkyunkwan University, Seoul 03063, Korea
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Housing and Adult Health: Evidence from Chinese General Social Survey (CGSS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030916. [PMID: 33494444 PMCID: PMC7908347 DOI: 10.3390/ijerph18030916] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 12/02/2022]
Abstract
Housing is one of the social determinants of health and the most basic survival needs of human beings. Many studies have preliminarily confirmed that housing factors can influence residents’ health. The aims of this study were: to evaluate the housing factors associated with self-rated health and mental health among Chinese residents; to explore the regional heterogeneity of the impact of housing on health; and to assess the effects of housing on health among different age groups. Data was derived from the Chinese General Social Survey (CGSS). Housing factors were analyzed along six dimensions: housing property, living space, number of living people, number of houses, living region and housing price. Self-rated health and mental health were used to measure health outcomes. Multivariate ordered logistic regression was performed to assess the relationship between housing and health. The living space, living region and housing price was significantly associated with self-rated health. The number of living people living region and housing price were related to mental health. The influence of housing factors on health were more pronounced among residents living in eastern and central area and among the middle-aged group (41–65). Present findings support the notion that housing factors were related to health outcomes. Future studies may focus on the impact of interventions that target on these factors, and the impact of housing on health among special groups such as migrant population and low-and-middle income families.
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Shafiee M, Hazrati M, Motalebi SA, Gholamzade S, Ghaem H, Ashari A. Can healthy life style predict successful aging among Iranian older adults? Med J Islam Repub Iran 2021; 34:139. [PMID: 33437735 PMCID: PMC7787035 DOI: 10.34171/mjiri.34.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Indexed: 11/11/2022] Open
Abstract
Background: Successful aging is a prominent and worldwide theme in gerontology. However, until recently, only few studies were conducted about successful aging in Iran. This study examined whether a healthy lifestyle could predict successful aging among older Iranians.
Methods: This cross sectional and descriptive study included 975 older Iranians who were selected through a multistage cluster-quota method from the health centers of Shiraz, Iran. A 5-part questionnaire, including demographic characteristics, the Seniors’ Healthy Lifestyle, Barthel Index, the Diner Life Satisfaction and Quality of Life, was used to collect the data. A logistic regression analysis was used in data analysis; data were analyzed using SPSS 21; and significance level was set at α = 0.05.
Results: The prevalence of successful aging among older Iranians was calculated at 24.0%. Results of multiple logistic regression analysis revealed that age (95% CI = 1.129- 1.702 and OR = 1.352), gender (95% CI = 0.412-0.764 and OR = 0.687), education level (95% CI = 1.443 – 1.699 and OR = 1.454), job (95% CI = 1.063-1.413 and OR = 1.185), monthly income (95% CI = 1.355-4.055 and OR = 2.272), insurance (95% CI = 0.344-0.842 and OR = 0.540), source of income (95% CI = 1.014-1.298 and OR = 1.145), and healthy lifestyle (95% CI = 0.772 - 0.858 and OR = 0.814) were predictors for successful aging.
Conclusion: Findings indicated that successful agers were mostly younger men, with higher education level and monthly income, who had insurance and a job and a healthy lifestyle. Thus, to age successfully, one must maintain and improve healthy lifestyle to prolong one’s health.
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Affiliation(s)
- Mohsen Shafiee
- Department of Nursing Geriatric, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Maryam Hazrati
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Deputy Ministry of Nursing Affaires, Ministry of Health and Medical Education, Tehran, Iran
| | - Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center, Research Institute for Prevention of Noncommunicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sakineh Gholamzade
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Department of Epidemiology School of Health, Shiraz University of Medical Sciences. Shiraz, Iran
| | - Asmidawati Ashari
- Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Selangor
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Working cancer survivors' physical and mental characteristics compared to cancer-free workers in Japan: a nationwide general population-based study. J Cancer Surviv 2021; 15:912-921. [PMID: 33433855 PMCID: PMC8519890 DOI: 10.1007/s11764-020-00984-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE This study compared working cancer survivors' self-rated health status (SRHS), physical functional capacity, depressive symptoms, and happiness to those of cancer-free workers. METHODS A nationwide general population-based cross-sectional study on a sample of Japanese was conducted. Prevalence of deteriorated SRHS, restricted physical functional capacity, depressive symptoms, and perceived happiness were compared between working cancer survivors and cancer-free workers with multivariable logistic regression analysis adjusted for age and sociodemographic and health-related backgrounds. RESULTS Of the 28,311 male and 26,068 female workers, 977 (3.5%) and 1267 (4.9%) were cancer survivors, respectively. Working cancer survivors reported deteriorated SRHS more frequently than cancer-free workers: 21.3% vs. 13.8%, multivariable-adjusted odds ratio (95% confidence interval), 1.64 (1.39-1.95) for men, 23.8% vs. 17.5%, 1.34 (1.16-1.54) for women. Restricted physical functional capacity was reported more frequently in working cancer survivors than cancer-free workers: 6.8% vs. 2.6%, 1.76 (1.34-2.32) for men, 4.9% vs. 2.0%, 2.06 (1.56-2.71) for women. No significant difference was found for depressive symptoms: 21.6% vs. 22.9% in men, 30.0% vs. 28.5% in women. Working cancer survivors felt happiness more frequently than cancer-free survivors in men (77.3% vs. 71.7%, 1.21 (1.01-1.45)) but not in women (76.1% vs. 74.9%). CONCLUSIONS Working cancer survivors had worse SRHS and more restricted physical functional capacity than cancer-free workers. In men, working cancer survivors felt happiness more frequently than cancer-free workers. IMPLICATIONS FOR CANCER SURVIVORS Continuous support to improve cancer survivors' SRHS and physical functional capacity would be necessary even while they are working.
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Hajizadeh M, Hu M, Asada Y, Bombay A. Explaining the gaps in psychological distress and suicidal behaviours between non-Indigenous and Indigenous adults living off-reserve in Canada: a cross-sectional study. CMAJ Open 2021; 9:E215-E223. [PMID: 33688030 PMCID: PMC8034301 DOI: 10.9778/cmajo.20200177] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Indigenous people are disproportionately affected by mental health issues in Canada. We investigated factors underlying the difference in psychological distress and suicidal behaviours between non-Indigenous and Indigenous populations living off-reserve in Canada. METHODS We conducted a cross-sectional study using data from the 2012 Canadian Community Health Survey - Mental Health. Respondents were aged 18 years and older. We measured the variation in psychological distress (10-item Kessler Psychological Distress Scale scores, ranging from 10 [no distress] to 50 [severe distress]) and the prevalence of lifetime suicidal ideation and suicide plan between the Indigenous and non-Indigenous populations and explained these differences using the Blinder-Oaxaca approach. RESULTS The overall response rate for the survey was 68.9%, comprising 18 300 respondents (933 Indigenous and 17 367 non-Indigenous adults). We found lower mean psychological distress scores among non-Indigenous people than among Indigenous people (15.1 v. 16.1, p < 0.001) and a lower prevalence of lifetime suicidal ideation (9.2% v. 16.8%, p < 0.001) and plan (2.3% v. 6.8%, p < 0.001). We found that if socioeconomic status among Indigenous people were made to be similar to that of the non-Indigenous population, the differences in mean psychological distress scores and prevalence of lifetime suicidal ideation and suicide plan would have been reduced by 25.7% (women 20.8%, men 36.9%), 10.2% (women 11.2%, men 11.9%) and 5.8% (women 7.8%, men 8.1%), respectively. INTERPRETATION Socioeconomic factors account for a considerable proportion of the variation in mental health outcomes between non-Indigenous and Indigenous populations in Canada. Improving socioeconomic status among Indigenous people through plans like income equalization may reduce the gap in mental health outcomes between the 2 populations in Canada.
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Affiliation(s)
- Mohammad Hajizadeh
- School of Health Administration (Hajizadeh, Hu), and Department of Community Health and Epidemiology (Asada), and Department of Psychiatry and School of Nursing (Bombay), Dalhousie University, Halifax, NS
| | - Min Hu
- School of Health Administration (Hajizadeh, Hu), and Department of Community Health and Epidemiology (Asada), and Department of Psychiatry and School of Nursing (Bombay), Dalhousie University, Halifax, NS
| | - Yukiko Asada
- School of Health Administration (Hajizadeh, Hu), and Department of Community Health and Epidemiology (Asada), and Department of Psychiatry and School of Nursing (Bombay), Dalhousie University, Halifax, NS
| | - Amy Bombay
- School of Health Administration (Hajizadeh, Hu), and Department of Community Health and Epidemiology (Asada), and Department of Psychiatry and School of Nursing (Bombay), Dalhousie University, Halifax, NS
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Xu L, Ma Y, Wang S, Feng J, Liu L, Wang J, Liu G, Xiu D, Fu W, Zhan S, Sun T, Gao P. Incidence of gastrointestinal stromal tumor in Chinese urban population: A national population-based study. Cancer Med 2021; 10:737-744. [PMID: 33320439 PMCID: PMC7877389 DOI: 10.1002/cam4.3644] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/07/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Information on incidence of gastrointestinal stromal tumor (GIST), the most common type of mesenchymal tumor in gastrointestinal tract, was limited in China. This study aimed to estimate the incidence of GIST in urban population from mainland China in 2016. METHODS Urban Employee Basic Medical Insurance (UEBMI) and Urban Residence Basic Medical Insurance (URBMI) in China were used. The denominator of incidence was the total person-years of insured individuals in 2016 in the database, covering approximately 0.43 billion individuals. The numerator was the number of incident GIST cases in 2016. RESULTS The crude incidence in 2016 was 0.40 per 100,000 person-years (95% CI, 0.06-1.03). Male incidence was higher than female incidence (0.44 vs. 0.36, rate ratio: 1.22, p < 0.001). The mean age at diagnosis was 55.20 years (SD = 14.26) and the incidence among those aged 50 years or older was 2.63 times (0.84 vs. 0.32, p < 0.001) higher than those aged under 50. The highest incidence was observed in East China (2.29, 95% CI: 0.46-5.54). CONCLUSIONS The incidence of GIST in mainland China was lower than Europe, North America and Korea. The mean age at diagnosis of GIST in China was younger than that of Europe and Canada. This study provides useful information to further research, policy formulating and management of GIST.
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Affiliation(s)
- Lu Xu
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina
| | - Yanpeng Ma
- Department of General SurgeryPeking University Third HospitalBeijingChina
| | - Shengfeng Wang
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina
| | - Jingnan Feng
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina
| | - Lili Liu
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina
| | - Jinxi Wang
- Shanghai Songsheng Business Consulting Co. LtdBeijingChina
| | - Guozhen Liu
- Peking University Health Information Technology Co. LtdBeijingChina
| | - Dianrong Xiu
- Department of General SurgeryPeking University Third HospitalBeijingChina
| | - Wei Fu
- Department of General SurgeryPeking University Third HospitalBeijingChina
| | - Siyan Zhan
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina
- Research Center of Clinical EpidemiologyPeking University Third HospitalBeijingChina
- Center for Intelligent Public HealthInstitute for Artificial IntelligencePeking UniversityBeijingChina
| | - Tao Sun
- Department of General SurgeryPeking University Third HospitalBeijingChina
| | - Pei Gao
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina
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Sousa JLD, Alencar GP, Antunes JLF, Silva ZPD. [Markers of inequality in self-rated health in Brazilian adults according to sex]. CAD SAUDE PUBLICA 2020; 36:e00230318. [PMID: 32490914 DOI: 10.1590/0102-311x00230318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 10/21/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to analyze self-rated health in Brazil's adult population according to markers of health inequality (color or race, region of residence, schooling, per capita household income, and social class), stratified by sex. We studied 59,758 individuals 18 years or older who participated in the 2013 National Health Survey, a population-based household survey. Data collection used face-to-face interviews and key physical measurements. Self-rated health was classified as positive, fair, or negative. Multinomial logistic regression was used to estimate crude and adjusted odds ratios (OR) and respective 95% confidence intervals (95%CI). Percentage agreement and kappa values were calculated to compare the results obtained by regression models and the expected values. Prevalence of positive self-rated health in the overall population was 66.2% (70% in men and 62.6% in women). In the adjusted analysis, the odds of worse self-rated health were significantly higher in individuals with lower per capita household income, less schooling, from the lowest social classes, residents of the North and Northeast regions, and those with brown and black color/race. Public policies for health promotion and recovery in these more vulnerable social groups can help reduce the persistent health inequalities in Brazil.
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Cai J, Laporte A, Zhang L, Zhao Y, Tang D, Fan H, Deng L, Coyte PC. Impacts of Absolute and Relative Income on Self-Rated Health in Urban and Rural China. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2020; 52:129-140. [PMID: 32363997 DOI: 10.1177/0020731420922689] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to assess the impacts of absolute and relative income on self-rated health (SRH) of residents in rural and urban China. Data were derived from the China Health and Nutrition Survey. Three distinct measures of relative income were considered (Gini coefficient, Yitzhaki index, and Deaton index) and computed for 3 geographic units (nation, province, and community). Nonlinear dynamic models for panel data were employed to test the absolute and relative income hypotheses. Absolute income was significantly associated with SRH among urban and rural populations. Relative income, as measured by the Gini coefficient, the Yitzhaki index, and the Deaton index, had statistically significant and negative impacts on SRH among the rural population, regardless of the reference group. For the urban population, the Gini coefficient was associated with SRH regardless of the reference group. In contrast, only the Yitzhaki index and the Deaton index at the provincial level were associated with SRH among the urban population. Our findings may provide a reference for policymakers to implement health policies designed to improve population health.
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Affiliation(s)
- Jiaoli Cai
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Audrey Laporte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Canadian Centre for Health Economics, Toronto, Ontario, Canada
| | - Li Zhang
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Yulin Zhao
- School of Economics, Wuhan University of Technology, Wuhan, China
| | - Di Tang
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.,School of Public Administration, East China Normal University, Shanghai, China
| | - Hongli Fan
- School of Insurance, Shandong University of Finance and Economics, Jinan, China
| | - Liqian Deng
- School of Economics and Management, Beijing Jiaotong University, Beijing, China
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Canadian Centre for Health Economics, Toronto, Ontario, Canada
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36
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Xu DD, Rao WW, Cao XL, Wen SY, An FR, Che WI, Bressington DT, Cheung T, Ungvari GS, Xiang YT. Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis. J Affect Disord 2020; 268:20-27. [PMID: 32158003 DOI: 10.1016/j.jad.2020.02.034] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/07/2020] [Accepted: 02/18/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUNDS Depression in children and adolescents is usually under-recognized. The findings of epidemiological studies on depressive symptoms in primary school students are inconsistent across studies. This study reports a systematic review and meta-analysis on the prevalence of depressive symptoms in primary school students in China. METHODS Literature search was performed in both international (PubMed, PsycINFO, EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and Chinese Biological Medical Literature) databases. The random-effects model was used to analyze data. RESULTS Twenty-seven studies involving 42,374 subjects were included. The pooled prevalence of depressive symptoms in Chinese primary school students was 17.2% (95% CI: 14.3%-20.5%). Subgroup analyses found that the prevalence significantly varied between geographic regions, with western China reporting the highest prevalence. Meta-regression analyses found that year of survey and study quality were significantly associated with the prevalence of depressive symptoms. CONCLUSIONS Given the high prevalence of depressive symptoms and its negative health outcomes, preventive measures, regular screening and effective treatments need to be implemented for this population.
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Affiliation(s)
- Dan-Dan Xu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China; Department of Biology, Faculty of Sciences, Harbin University, Harbin, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Si-Ying Wen
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weng-Ian Che
- Unit of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden
| | | | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia; University of Notre Dame Australia, Fremantle, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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37
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de-Mateo-Silleras B, Camina-Martín MA, Cartujo-Redondo A, Carreño-Enciso L, de-la-Cruz-Marcos S, Redondo-Del-Río P. Health Perception According to the Lifestyle of University Students. J Community Health 2020; 44:74-80. [PMID: 30014181 DOI: 10.1007/s10900-018-0555-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
University students are characterized by having inadequate eating habits, along with an unhealthy lifestyle, which, among other factors, can affect the perception they have of their state of health. The aim of the study was to evaluate the health perception of a group of university students according to lifestyle. A cross-sectional observational study was carried out on 214 university students from different universities and branches of knowledge. Anthropometric data were collected. Three questionnaires were administered: PREDIMED (Mediterranean Diet (MD) adherence), SF-36 (perception of health state) and GPAQ (physical activity (PA)). The differences between variables were analyzed using Student-t or Mann-Whitney U, Kruskal-Wallis and Pearson Chi-Square tests. Statistical significance was reached at p < 0.05. Most students were found to be normal weighted. The subjects presented an moderate MD adherence, this being better in Health Sciences students. 75.7% practiced light PA. The health perception is worse for most of the subscales analyzed than that of the reference population (except physical-function, physical-role, and emotional-role). There is an association between PA and health perception: students with intense PA have less body pain and better physical function; the less active, the less vitality. The more physically active subjects the greater MD adherence. Lifestyle and eating habits of health sciences students are healthier than that of students from other branches of knowledge. The physically active subjects have a better perception of quality of life-related to health and greater MD adherence.
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Affiliation(s)
- Beatriz de-Mateo-Silleras
- Department of Nutrition and Food Science, Faculty of Medicine, Valladolid University, C/Ramón y Cajal 7, 47005, Valladolid, Spain.
| | - Mª Alicia Camina-Martín
- Department of Nutrition and Food Science, Faculty of Medicine, Valladolid University, C/Ramón y Cajal 7, 47005, Valladolid, Spain
| | - Alicia Cartujo-Redondo
- Department of Nutrition and Food Science, Faculty of Medicine, Valladolid University, C/Ramón y Cajal 7, 47005, Valladolid, Spain
| | - Laura Carreño-Enciso
- Department of Nutrition and Food Science, Faculty of Medicine, Valladolid University, C/Ramón y Cajal 7, 47005, Valladolid, Spain
| | - Sandra de-la-Cruz-Marcos
- Department of Nutrition and Food Science, Faculty of Medicine, Valladolid University, C/Ramón y Cajal 7, 47005, Valladolid, Spain
| | - Paz Redondo-Del-Río
- Department of Nutrition and Food Science, Faculty of Medicine, Valladolid University, C/Ramón y Cajal 7, 47005, Valladolid, Spain
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38
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Yu X, Zhang W. All-cause mortality rate in China: do residents in economically developed regions have better health? Int J Equity Health 2020; 19:12. [PMID: 31964379 PMCID: PMC6975071 DOI: 10.1186/s12939-020-1128-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Urban-rural disparities have been extensively investigated, while most investigators overlooked urban-suburban-rural variations in population health. Although regional disparities in East-West China have been largely discussed, limited attention has been directed to the interaction between regional differences and urban-suburban-rural disparities. This study aims to analyze urban-suburban-rural variations in all-cause mortality rates across four geographic regions in China. Methods Data came from China’s National Census Survey and public statistical yearbooks in 2000 and 2010. Urban districts, county-level cities, and counties were respectively defined as urban, suburban, and rural areas. We obtained 2322 areas, including 2148 areas with two observations and 174 areas with only one observation. Data visualization was performed to depict geographic variations and changes in all-cause mortality rates. Five hierarchical linear regression analyses with generalized estimating equations (GEE) were employed to analyze variations in all-cause mortality rates over time. Demographic and socioeconomic attributes were introduced as covariates. Results Despite an overall decline in all-cause mortality rate, rural residents generally achieved worse health than urban and suburban counterparts. In contrast, urban-suburban disparities could be fully explained by demographic and socioeconomic differences. In addition, Northeastern and Central residents achieved better health than Eastern and Western residents. Last, there existed urban/suburban-rural disparities in all regions, except Northeastern, where urban/suburban-rural disparities were eliminated after controlling for socioeconomic and demographic attributes. Conclusion Even though suburban and rural areas were often merged, there exist urban/suburban-rural disparities in population health. Furthermore, urban/suburban-rural disparities vary across regions.
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Affiliation(s)
- Xuexin Yu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040, Sichuan, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, 37 Guo Xue Alley, Chengdu, 610040, Sichuan, China.
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39
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Hajizadeh M, Bombay A, Asada Y. Socioeconomic inequalities in psychological distress and suicidal behaviours among Indigenous peoples living off-reserve in Canada. CMAJ 2019; 191:E325-E336. [PMID: 30910880 DOI: 10.1503/cmaj.181374] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Indigenous peoples in Canada have high rates of psychological distress and suicide. We sought to assess the socioeconomic inequalities in psychological distress and suicidal behaviours, and the factors that explain them within Indigenous peoples living off-reserve. METHODS Using the nationally representative 2012 Aboriginal Peoples Survey collected from Indigenous adults living off-reserve in Canada, we measured income-related inequalities in psychological distress (measured on the 10-item Kessler Psychological Distress Scale) and suicidal behaviours (suicidal ideation and suicide attempt) and identified factors contributing to these inequalities using the concentration index (C) approach. RESULTS Among 14 410 individuals representing 600 750 Indigenous adults (aged ≥ 18 yr) living off-reserve in Canada, the mean score of psychological distress was 16.1; 19.4% reported lifetime suicidal ideation and 2.2% reported a lifetime suicide attempt. Women had higher psychological distress scores (mean score 16.7 v. 15.2, p < 0.001), and prevalence of suicidal ideation (21.9% v. 16.1%, p < 0.001) and suicide attempts (2.3% v. 2.0%, p = 0.002) than men. Poorer individuals disproportionately experienced higher psychological distress (C = -0.054, 95% confidence interval [CI] -0.057 to -0.050), suicidal ideation (C n = -0.218, 95% CI -0.242 to -0.194) and suicide attempts (C n = -0.327, 95% CI -0.391 to -0.263). Food insecurity and income, respectively, accounted for 40.2% and 13.7% of the psychological distress, 26.7% and 18.2% of the suicidal ideation and 13.4% and 7.8% of the suicide attempts concentrated among low-income Indigenous peoples. INTERPRETATION Substantial income-related inequalities in psychological distress and suicidal behaviours exist among Indigenous peoples living off-reserve in Canada. Policies designed to address major contributing factors such as food insecurity and income may help reduce these inequalities.
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Affiliation(s)
- Mohammad Hajizadeh
- School of Health Administration (Hajizadeh); Department of Psychiatry and School of Nursing (Bombay); Department of Community Health and Epidemiology (Asada), Dalhousie University, Halifax, NS
| | - Amy Bombay
- School of Health Administration (Hajizadeh); Department of Psychiatry and School of Nursing (Bombay); Department of Community Health and Epidemiology (Asada), Dalhousie University, Halifax, NS
| | - Yukiko Asada
- School of Health Administration (Hajizadeh); Department of Psychiatry and School of Nursing (Bombay); Department of Community Health and Epidemiology (Asada), Dalhousie University, Halifax, NS
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40
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Aftyka A, Rosa W, Taczała J. Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study. Scand J Caring Sci 2019; 34:698-709. [PMID: 31657048 DOI: 10.1111/scs.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Wojciech Rosa
- Department of Applied Mathematics, Faculty of Technology Fundamentals, Lublin University of Technology, Lublin, Poland
| | - Jolanta Taczała
- Department of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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41
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Zhang J, Hu H, Hennessy D, Zhao S, Zhang Y. Digital media and depressive symptoms among Chinese adolescents: A cross-sectional study. Heliyon 2019; 5:e01554. [PMID: 31193045 PMCID: PMC6514493 DOI: 10.1016/j.heliyon.2019.e01554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/23/2019] [Accepted: 04/17/2019] [Indexed: 11/15/2022] Open
Abstract
This study was designed to investigate the association between new digital media and depressive symptoms in a representative Chinese adolescent sample. An existing national data source was used, that surveyed 16,205 Chinese adolescents in 2013-2014. Adolescents who spent more time on screen activities or less time on non-screen activities were significantly more likely to have depressive symptoms. New digital media had a greater association on girls than boys regarding depression. The association of new digital media on depression also showed a decreased trend across economic regions with the lower economically developed western area showing the greatest link between digital media and depression, although this association was still significant in all economic regions.
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Affiliation(s)
- Jie Zhang
- Central University of Finance and Economics, Beijing, China
- State University of New York Buffalo State, 1300 Elmwood Avenue, Buffalo, New York, 14222, USA
| | - Hang Hu
- Central University of Finance and Economics School of Social and Psychology, 39 Xueyuan Road, Beijing, China
| | - Dwight Hennessy
- State University of New York Buffalo State, 1300 Elmwood Avenue, Buffalo, New York, 14222, USA
| | - Sibo Zhao
- Central University of Finance and Economics School of Social and Psychology, 39 Xueyuan Road, Beijing, China
| | - Yiwen Zhang
- Central University of Finance and Economics School of Social and Psychology, 39 Xueyuan Road, Beijing, China
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42
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Kim R, Chung W. Associations of socioeconomic and religious factors with health: a population-based, comparison study between China and Korea using the 2010 East Asian social survey. BMC Public Health 2019; 19:35. [PMID: 30621650 PMCID: PMC6323813 DOI: 10.1186/s12889-018-6380-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/28/2018] [Indexed: 11/21/2022] Open
Abstract
Background Cross-national comparisons of the associations of socioeconomic and religious factors with health can facilitate our understanding of differences in health determinants between countries and the development of policies to reduce health differentials appropriate to each country. However, very few such studies have been conducted in East Asia. Methods This study set out to compare the associations of socioeconomic and religious factors with health in China and Korea using the 2010 East Asian Social Survey, which was based on nationally representative samples. The study participants included 4980 individuals, 3629 in China and 1351 in Korea, aged ≥20 years. The dependent variable, individuals’ self-rated health, was categorized into poor, good, and excellent. Socioeconomic (education, employment, household income, and self-assessed social class) and religious factors (affiliation) were used as independent variables of interest. A multinomial logistic regression was performed with and without adjustments for factors such as demographics, health-related risks, the health system, and social capital. Results According to the results, China had a higher proportion of individuals who reported excellent health than did Korea (57.4% vs. 52.0%). After adjusting for all studied confounders, we found that the employment, household income, and social class gradient in health were significant in China, whereas the education and religion gradients in health were significant in Korea. For example, the odds ratio for poor health versus excellent health among those in the highest social class was 0.47 (95% CI, 0.27–0.84), compared to that of people in the lowest social class in China; and this odds ratio in people with college education or higher was 0.28 (95% CI, 0.14–0.59) compared to that of people with elementary school education or lower in Korea. Conclusions These findings demonstrate the important role of socioeconomic and religious factors in health in China and Korea as well as clear differences in this regard. Further cross-national studies are needed to provide a better understanding of the relationship between socioeconomic and religious factors and health and to draft appropriate health improvement policies in both countries. Electronic supplementary material The online version of this article (10.1186/s12889-018-6380-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roeul Kim
- Labor Welfare Research Institute, Korea Workers' Compensation and Welfare Service, Seoul, South Korea
| | - Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro, Seoul, Seodaemun-gu, 120-752, South Korea. .,Institute of Health Services Research, Yonsei University, Seoul, South Korea.
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Cai J, Zhang L, Zhao Y, Coyte PC. Psychological Mechanisms Linking County-Level Income Inequality to Happiness in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122667. [PMID: 30486410 PMCID: PMC6313330 DOI: 10.3390/ijerph15122667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/17/2018] [Accepted: 11/22/2018] [Indexed: 11/16/2022]
Abstract
Background In China, income levels and living standards have improved significantly, but many Chinese citizens still do not feel any happier. This phenomenon may be attributed to increased income inequality. Methods Using data from the 2013 Chinese General Social Survey (CGSS), we employed multilevel structural equation modeling (MSEM) to investigate the impact of county-level income inequality on individual-level happiness in China and multilevel mediation analysis with structural equation modeling (MMSEM) to explore the mechanisms through which income inequality impacted happiness. Results A negative relationship between income inequality and happiness was found. The negative association between them was explained by two psychological mechanisms, i.e., fairness and trust. The findings explained a “Chinese puzzle,” i.e., why people do not feel happier despite improved income and living standards. Conclusions Our findings may provide a reference for policy makers to implement policies designed to improve individual happiness. What is important now is to reduce income inequality, and to potentially improve perceptions of fairness and trust in China.
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Affiliation(s)
- Jiaoli Cai
- School of Economics and Management, Beijing Jiaotong University, No.3 Shangyuancun, Haidian District, Beijing 100044, China.
| | - Li Zhang
- School of Economics and Management, Beijing Jiaotong University, No.3 Shangyuancun, Haidian District, Beijing 100044, China.
| | - Yulin Zhao
- School of Economics, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, China.
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada.
- Canadian Centre for Health Economics, 155 College Street, Toronto, ON M5T 3M6, Canada.
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Wu J, Yang Y. Inequality trends in the demographic and geographic distribution of health care professionals in China: Data from 2002 to 2016. Int J Health Plann Manage 2018; 34:e487-e508. [PMID: 30238482 DOI: 10.1002/hpm.2664] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/10/2022] Open
Abstract
China has long been negatively affected by a shortage and maldistribution of health workers. This study aimed to examine the national and regional trends in the demographic and geographic distribution inequality of health care professionals in China from 2002 to 2016. Based on data from the China Health and Family Planning Statistical and China Statistical Yearbooks, we calculated the Gini coefficient and the Theil T and Theil L indices based on the number of health care professionals per capita and per geographic area to measure the inequalities in their demographic and geographic distribution, respectively. The contributions by intra-regional and inter-regional differences on total inequality were explored within and among East, Central, and West China via Theil index decomposition. We found that the national demographic distribution of health care professionals maintained in an absolute equality level, and the inequality indices decreased gradually, whereas the corresponding geographic inequalities were severe and presented a worsening trend. Compared with nurses, physicians not only maintained higher densities but also maintained a more equal distribution. Intra-regional disparities within the east, central, and western regions were the main cause for overall demographic inequality, whereas both intra-regional and inter-regional disparities significantly contributed to overall geographic inequality. To conclude, the distribution equality of health care professionals by population was satisfactory, whereas the corresponding distribution inequality by area was severe. Different types of distribution inequality of health care professionals existed regionally and nationally despite their increasing quantities and densities. Factors beyond population size should be considered when the government introduces health workforce allocation policies.
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Affiliation(s)
- Jingxian Wu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.,Department of Public Policy, City University of Hong Kong, Hong Kong SAR, PR China
| | - Yongmei Yang
- School of Public Health and Administration, Wenzhou Medical University, Wenzhou, Zhejiang, PR China.,School of Management, Xi'an University of Architecture and Technology, Xi'an, Shaanxi, PR China
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45
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Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants. Health Policy 2018; 122:854-865. [DOI: 10.1016/j.healthpol.2018.06.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 06/15/2018] [Accepted: 06/26/2018] [Indexed: 12/16/2022]
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Zhou Y, Yao X, Jian W. Improving health equity: changes in self-assessed health across income groups in China. Int J Equity Health 2018; 17:94. [PMID: 29970088 PMCID: PMC6029271 DOI: 10.1186/s12939-018-0808-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Beginning in 2010, China has endeavoured to expand health coverage and provide residents with fair access to primary health care with the intention of improving health equity. This study aims to measure changes in income-related health inequity in China between 2010 and 2014. METHODS Data were extracted from the nationally representative annual survey of the China Family Panel Studies in 2010 and 2014 with a first wave of 31,743 respondents and a second wave of 32,006 respondents over age 15. In both years, subjects were stratified into the following five categories of income: poorest 20%, lower 20%, medium 20%, higher 20% and richest 20%. The concentration curve and index was used to compare the distribution of health status in income quintiles, and a logistic model was used to examine the relationship between health and socioeconomic indicators with self-assessed health as the primary outcome of interest. RESULTS Income was significantly associated with self-assessed health in China. The concentration curve was above the line of equality in both years, while the self-assessed health line in 2014 was closer to the equality line. The concentration index (CIN) displayed the similar result of decreasing inequality, with the CIN in 2014 (- 0.157) closer to zero (the line of equality) than that of 2010 (- 0.167). In 2010, there was a decreasing trend of people reporting poor health from the poorest to the richest, while in 2014, there was no significant difference between the poorest and lower 20% or between the higher 20% and the medium 20%. The odds ratio of the prevalence of self-reporting poor health between the poorest and richest increased from 0.555 (95% CI: 0.484-0.636) in 2010 to 0.598 (95% CI: 0.513-0.696) in 2014. CONCLUSIONS From 2010 to 2014, the self-assessed health gap between income groups in China decreased, and health equity improved. However, health differences remain. In order to achieve better health for all, China should further strengthen the role of primary care in reducing health inequity.
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Affiliation(s)
- Yuqi Zhou
- Department of Health Policy and Management, Peking University School of Public Health, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Xi Yao
- Department of Health Policy and Management, Peking University School of Public Health, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Weiyan Jian
- Department of Health Policy and Management, Peking University School of Public Health, Xueyuan Road 38, Haidian District, Beijing, 100191, China.
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KIM EG, CHUNG S, CHUNG MG. Effects of Food Consumption on Self-rated Health: Evidence from Korean Adolescents. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:1044-1046. [PMID: 30182007 PMCID: PMC6119560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Ee-Gyeong KIM
- Dept. of Education, Chung-Ang University, Seoul, Korea
| | - Sarah CHUNG
- Harris School of Public Policy, University of Chicago, Chicago, IL, USA
| | - Min Gyo CHUNG
- Dept. of Computer Science, Seoul Women’s University, Seoul, Korea,Corresponding Author:
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Song X, Wu J, Yu C, Dong W, Lv J, Guo Y, Bian Z, Yang L, Chen Y, Chen Z, Pan A, Li L. Association between multiple comorbidities and self-rated health status in middle-aged and elderly Chinese: the China Kadoorie Biobank study. BMC Public Health 2018; 18:744. [PMID: 29907132 PMCID: PMC6003165 DOI: 10.1186/s12889-018-5632-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/29/2018] [Indexed: 11/25/2022] Open
Abstract
Background Understanding the correlates of self-rated health (SRH) can help public health professionals prioritize health-promotion and disease-prevention interventions. This study aimed to investigate the association between multiple comorbidities and global SRH and age-comparative SRH. Methods A total of 512,891 participants aged 30–79 years old were recruited into the China Kadoorie Biobank study from ten regions between 2004 and 2008. Multivariate logistic regression models were used to estimate the odds ratios (ORs) for the associations between comorbidities (including diabetes, hypertension, coronary heart disease, rheumatic heart disease, stroke, tuberculosis, emphysema/bronchitis, asthma, cirrhosis/chronic hepatitis, peptic ulcer, gallbladder disease, kidney disease, fracture, rheumatic arthritis, psychiatric disorders, depressive symptoms, neurasthenia, head injury and cancer) and SRH. Population attributable risks (PARs) were used to estimate the contribution of multiple comorbidities to poor global SRH and worse age-comparative SRH. Results After adjusting for covariates, suffering from various diseases increased the chance of reporting a poor global SRH [OR (95% CI) ranged from 1.10 (1.07, 1.13) for fracture to 3.21 (2.68, 3.83) for rheumatic heart disease] and a worse age-comparative SRH [OR (95% CI) ranged from 1.18 (1.13, 1.23) for fracture to 7.56 (6.93, 8.25) for stroke]. From the population perspective, 20.23% of poor global SRH and 45.12% of worse age-comparative SRH could attributed to the cardiometabolic diseases, with hypertension (7.84% for poor global SRH and 13.79% for worse age-comparative SRH), diabetes (4.35% for poor global SRH and 10.71% for worse age-comparative SRH), coronary heart disease (4.44% for poor global SRH and 9.51% for worse age-comparative SRH) and stroke (3.20% for poor global SRH and 10.19% for worse age-comparative SRH) making the largest contribution. Conclusions Various diseases were major determinants of global and age-comparative SRH, and cardiometabolic diseases had the strongest impact on both global SRH and age-comparative SRH at the population level. Prevention measures concentrated on these conditions would greatly reduce the total burden of poor SRH and its consequences such as poor quality of life and use of health care services.
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Affiliation(s)
- Xingyue Song
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China
| | - Wenhong Dong
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China.
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Beijing, 100191, China. .,Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China.
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Zhao C, Wong L, Zhu Q, Yang H. Prevalence and correlates of chronic diseases in an elderly population: A community-based survey in Haikou. PLoS One 2018; 13:e0199006. [PMID: 29902222 PMCID: PMC6002039 DOI: 10.1371/journal.pone.0199006] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 05/30/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The escalating problem of multiple chronic conditions among older adults in China draws public health attention due to increasing proportion of the elderly population. This study sought to assess the prevalence of and factors associated with four chronic diseases in older adults in Haikou, the capital city of Hainan Province, China. METHOD In this cross-sectional study, 9432 community-dwelling elderly people aged 60 years and older living in rural or urban areas in Haikou were investigated. The interviews collected self-reported information on the presence of four major chronic diseases, as well as socio-demographic characteristics, lifestyle factors and self-reported height and weight. FINDINGS Overall, 31.7% (2961/9344) reported at least one of the four chronic diseases. The prevalence of hypertension, diabetes mellitus, COPD, and stroke was 26.0% (2449/9407), 8.0% (749/9371), 1.0% (95/9360), and 1.9% (175/9382), respectively. Common correlates of the four major chronic diseases were older age, being engaged in intellectual work, currently being a smoker and obesity. Gender, locality of residence, and alcohol consumptions were also found to be associated to some of the chronic conditions. CONCLUSION This finding indicates that multiple chronic conditions among elderly people in Haikou are prevalent and warrant special attention to reduce diseases burden and align health care services to cater the holistic elderly patients' need.
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Affiliation(s)
- Chanjuan Zhao
- College of Public Health, Hainan Medical University, Haikou, Hainan Province, China
- * E-mail:
| | - Liping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Qing Zhu
- Department of Non-communicable Disease Control and Prevention, Haikou Center for Disease Control and Prevention, Haikou, Hainan Province, China
| | - Hao Yang
- Department of Non-communicable Disease Control and Prevention, Haikou Center for Disease Control and Prevention, Haikou, Hainan Province, China
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50
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Kendig H, Gong CH, Yiengprugsawan V, Silverstein M, Nazroo J. Life course influences on later life health in China: Childhood health exposure and socioeconomic mediators during adulthood. SSM Popul Health 2017; 3:795-802. [PMID: 29349264 PMCID: PMC5769110 DOI: 10.1016/j.ssmph.2017.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 11/19/2022] Open
Abstract
China's unprecedented population aging and social and economic change raise important issues concerning life course determinants of advantage or disadvantage into later life. Data from the China Health and Retirement Longitudinal Study (CHARLS) 2013 were analysed to identify the influence of childhood health on later life health as indicated by self-rated health and how this influence could be mediated by social and economic positions (SEP) and resources later in the life span. CHARLS provides nationally representative data on 18, 000 individuals aged 45 years and above in approximately 150 districts and 450 villages. Both multivariate logit regression model and KHB method (Karlson/Holm/Breen method) were applied to examine and decompose the life span influences on later life health. The results show that the childhood health, accounts for approximately half of the effect directly and another half of the effect indirectly through social and economic variations during adulthood. Relative living standard, marital status and urban residence are the most significant and important social and economic mediators for men; For women, living standard and secondary schooling are most influential while marital status is not significant. Implications for social and economic policies to improve later life health are discussed.
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Affiliation(s)
- Hal Kendig
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Australia
- ARC Centre of Excellence in Population Ageing Research, Australia
| | - Cathy Honge Gong
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Australia
- ARC Centre of Excellence in Population Ageing Research, Australia
| | - Vasoontara Yiengprugsawan
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Australia
- ARC Centre of Excellence in Population Ageing Research, Australia
| | | | - James Nazroo
- The ESRC Centre on Dynamics of Ethnicity (CoDE), the University of Manchester, UK
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