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BACKGROUND: Unmet healthcare need is a critical indicator, showing a plausible picture of how the healthcare system works in the unprecedented pandemic situation. It is important to understand what factors affect healthcare services of older adults in the midst of the outbreak, as this could help identify service- and performance-related challenges and barriers to the healthcare system. This study aimed to identify factors associated with unmet healthcare needs among the older Korean population amid the COVID-19 pandemic. METHODS: Cross-sectional data were used from the Experience Survey on Healthcare Use of Older Adults during the COVID-19 (COVID-19 Survey) in Korea (n = 1,917). Our main outcome, unmet healthcare need, was measured based on self-reported experience of overall, regular, and irregular outpatient care services-related unmet healthcare needs. Independent variables were selected based on previous studies on determinants of unmet healthcare need during the COVID-19 pandemic and Andersen's expanded behavioural model, which theorizes that healthcare-seeking behaviours are driven by psychosocial, enabling, and need factors. RESULTS: Using multiple logistic regression models, we identified a good understanding of the nation's health system was associated with lower likelihood of all types of unmet healthcare needs among older Korean adults (OR: 0.39, 95%CI: 0.25-0.61; OR: 0.36, 95%CI: 0.20-0.63; OR: 0.41, 95%CI: 0.23-0.75). Decreased social activities (i.e., shopping and visiting family members) and worsened psychological health issues (i.e., increased anxiety & nervousness and greater difficulty sleeping) were also factors affecting overall and irregular outpatient services-related unmet needs. CONCLUSIONS: To ensure timely access to necessary healthcare services for older adults in the era of the COVID-19 outbreak, improving older adult's understanding on how the healthcare system works is necessary. Moreover, changes in psychological condition and daily activities due to COVID-19 should be considered as possible barriers to healthcare services among older adults during the global pandemic.
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COVID-19 , Humanos , Anciano , COVID-19/epidemiología , Pandemias , Estudios Transversales , Atención a la Salud , República de Corea/epidemiologíaRESUMEN
BACKGROUND: Existing evidence highlights that the COVID-19 pandemic is associated with a large reduction in healthcare utilization for routine and less-urgent services around the world including Korea. During the COVID-19 pandemic, delayed and foregone healthcare are driven by various factors, and risk perception, a complex psychological construct, is one of them. The aim of this study was to examine how COVID-19 risk perceptions influence delayed and foregone care during the pandemic in Korea. METHODS: The Koreans' Happiness Survey (KHS) 2020 was used to analyze responses from 13,491 individuals over 19 years of age residing in Korea. To assess delayed and foregone care, self-reported delayed or foregone care after the COVID-19 outbreak was used. COVID-19 risk perceptions were analyzed in terms of fear and severity of the pandemic based on responses from the participants. Logistic regression models, stratified by gender, were used to examine the relationship between COVID-19 risk perception and delayed/foregone healthcare. RESULTS: Among the total 13,491 individuals included in the study, 4.0% (n = 541) reported delayed and foregone care in 2020. The results showed that higher level of fear of COVID-19 was associated with an increased likelihood of reporting delayed and foregone care in Korean adults (OR = 1.36, 95% CI = 1.08-1.73). The gender-stratified model revealed that greater fear of COVID-19 was associated with higher odds of delayed and foregone healthcare (OR = 1.71, 95%CI = 1.23-2.39) among women while the perceived severity did not have any association. However, the perceived severity was associated with a higher likelihood of delayed and foregone care in men (OR = 1.17, 95%CI = 1.04-1.32), but no association was found between fear of COVID-19 and delayed and foregone healthcare in men. CONCLUSIONS: To ensure the timely use of any needed healthcare services, it is worth considering establishing policy interventions to mitigate unnecessary fear and worries about COVID-19. This can be achieved by providing accurate information on the virus, protective measures, and treatment.
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COVID-19 , Adulto , Masculino , Humanos , Femenino , COVID-19/epidemiología , Pandemias , Servicios de Salud , Atención a la Salud , República de Corea/epidemiologíaRESUMEN
BACKGROUND: Prioritizing global health is important for positive health outcomes. Doctors play a pivotal role in addressing health issues that they need to recognize the importance of global health practice. However, medical education in global health is still in its early stages in many countries, including South Korea. METHODS: This study is a quantitative cross-sectional study. Medical students were recruited from all 40 Korean medical schools and data collection was conducted in 2021. Stratified proportional quota sampling was employed as the sampling method. The study examined medical students' interest in global health as the dependent variable. Independent variables included whether individuals had taken global health courses as part of their medical curriculum, while covariates included student background and institutional factors. Logistic regression was used to determine if taking a global health class was associated with global health interests. RESULTS: The study included 2450 participants and almost 32% of medical students (n = 781) were interested in global health. Taking global health classes in school was associated with a higher likelihood of developing an interest in global health (OR: 1.29, 95% CI: 1.00-1.67). The likelihood of being interested in global health decreased across the academic year (OR: 0.70, 95% CI: 0.53-0.94). Individuals in graduate entry programs were associated with an interest in global health (OR: 1.32, 95% CI: 1.01-1.72). CONCLUSION: This study provides the first comprehensive nationwide assessment of medical students' perspectives on global health education in South Korea. The findings underscore the importance of early and sustained exposure to global health topics in medical education in fostering interest in global health. These results can serve as valuable evidence for medical educators seeking to integrate global health education into their curricula.
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Estudiantes de Medicina , Humanos , Salud Global , Estudios Transversales , Curriculum , República de CoreaRESUMEN
Background: With intensifying air pollutant levels and the COVID-19 pandemic, physical inactivity of South Korean children and adolescents may be threatened. Therefore, monitoring and surveillance of physical activity (PA) and relevant indicators are important for policy making pertaining to health promotion. Report Card is a third comprehensive evaluation of PA-related behaviors among and the sources of influence for South Korean children and adolescents. Purpose: To provide the outcome of the South Korea's 2022 Report Card on PA for children and adolescents. Methods: Based on a variety of sources including national surveys collected pre- and during-COVID-19 and information collected from government webpages, 11 indicators were graded by a committee of experts informed by the best available evidence. Data from during-COVID-19 were available for Overall PA, Sedentary Behavior, and Sleep and considered together in generating the overall grades. Results: Grades were assigned to behavioral indicators (Overall PA: D-; Active Transportation: B+; Sedentary Behavior: D; Sleep: F) and sources of Influence (Family and Peers: C-; School: A; Community and Environment: B-; Government: A). Organized Sport and PA, Active Play, and Physical Fitness could not be graded due to the lack of data. The results largely indicated that children and adolescents show unfavorable behavioral grades even with favorable grades observed for the sources of influence indicators. Trivial differences were observed pre- and during-pandemic for Overall PA (≥60 min of MVPA for ≥4 d/wk: 20.8% vs 19.9%) and Sleep (met age-specific recommendation: 14.1% vs 15.0%); however, a marked increase in Sedentary Behavior was observed (≤2 h/d screen time: 28.8% vs 20.1%). A stark weekday vs weekend difference was observed in sleep duration. In terms of PA related sources of influence, high accessibility to PA facilities (81.1%) and high satisfaction of neighborhood public transit (74.6%) and safety (80.7%) were well reflected in our Active Transportation grade (B+). Nonetheless, perception of green environments including outdoor air quality (44.0%), noise (39.6%) and green space (56.5%) showed lower scores, suggesting that new barriers to active lifestyles are emerging for South Korean children and adolescents. Gender differences were also observed for overall PA (≥60 min of MVPA for ≥4 d/wk: 29.1% for boys vs 11.3% for girls) and sleep (met age-specific recommendations: 17.3% for boys vs 11.4% for girls), but not for sedentary behavior (≤2 h/d screen time: 26.4% for boys and 24.9% for girls). Conclusions: Government and school policies/programs and the built environment are, in general, conducive to physically active lifestyles for South Korean children and adolescents; however, behavioural indicators received poor grades except for Active Transportation. A thorough evaluation of policies/programs at government, local, and school levels is needed to ensure that the efforts to have PA-enhancing infrastructure and systems are actually being translated into the behavior of children and adolescents in South Korea. Furthermore, improving PA surveillance, monitoring, and advocacy to ultimately establish healthy lifestyle patterns among children and adolescents is a top priority.
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[This corrects the article DOI: 10.1016/j.jesf.2022.10.014.].
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BACKGROUND: To ensure equal access to necessary care regardless of an individual's socioeconomic status, it is crucial to understand the factors that act as barriers. Unmet health care needs can arise for a variety of complex reasons, including personal choice, financial barriers, or lack of services, and each of these reasons requires a different policy approach. Researchers have advocated for a more granular measure of unmet health care need for better policy implication. This study aimed to assess various factors associated with different types of unmet health care needs in Korea. METHODS: The Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012 was used to analyze responses from 17,610 individuals over age 19. To measure the unmet needs of this population, self-reported experience in the past 1 year was used, and individual's reasons for unmet need were sorted into three distinct categories - availability, acceptability, accessibility. Four different logistic regression models stratified by gender were used to examine the relationship between socioeconomic factors and unmet needs. RESULTS: While income was not a significant factor for men, women with lower incomes showed a higher likelihood of experiencing unmet need. In addition, women with lower incomes showed higher odds of having acceptability-related unmet needs during the past 1 year compared to men. Education and income levels were associated with accessibility-related unmet needs for both women and men. CONCLUSION: As unmet health care needs are considered to be a critical indicator of a country's health care system, it is crucial to identify and eliminate any obstacles that prevent access to health care services. Under the current universal health care system in Korea, women, particularly those of lower income and lower educational levels, have limited access to necessary health care services. A gender-specific health care plan is recommended to reduce the higher rate of unmet needs experienced by this group. To reduce accessibility-related unmet needs, increasing available services for younger age groups, reflecting their needs of health services, needs to be considered.
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Política de Salud , Necesidades y Demandas de Servicios de Salud/normas , Disparidades en Atención de Salud/estadística & datos numéricos , Adulto , Anciano , Femenino , Servicios de Salud , Accesibilidad a los Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Renta , Modelos Logísticos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Pobreza , República de Corea , Autoinforme , Clase Social , Factores Socioeconómicos , Adulto JovenRESUMEN
Overweight and obesity are major global public health concerns. Obesity is multifactorial in origin and influenced by genetics, psychosocial factors, eating and physical activity behaviors, as well as the environment. The objective of this study is to examine the impact of social cohesion on gender differences in body mass index (BMI) for urban-dwelling Canadians. Cross-sectional data were used from the Neighborhood Effects on Health and Well-being Study (NEHW) in Toronto, Canada (n=2300). Our main outcome, BMI, was calculated from self-reported height and weight (weight (kg)/height (m)2). Using multi-level logistic regression models, we identified a significant interaction between social cohesion and gender on being overweight/obese. Women with higher social cohesion had slightly lower odds of being overweight/obese (OR: 0.96, 95%CI: 0.94 to 0.99) compared to men, after adjusting for other sociodemographic factors (e.g., age, income, education), and neighborhood characteristics (e.g., walkability, neighborhood safety and material deprivation). Future public health research and interventions should consider the differential mechanisms involved in overweight/obesity by gender. The exact mechanisms behind how the social environment influences these pathways are still unclear and require future research.
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Índice de Masa Corporal , Características de la Residencia/estadística & datos numéricos , Medio Social , Población Urbana , Canadá , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Obesidad/prevención & control , Factores SexualesRESUMEN
BACKGROUND: This study aimed to examine how income-related inequalities in screening services for gastric and colorectal cancer in Korea have changed over the past decades, along with the implementation of the national cancer screening program, and also to quantify each contribution from various socio-demographic factors income-related inequalities with respect to these cancer screening services. METHODS: Three cycles (1998, 2005, and 2010-2012) of Korea National Health and Nutrition Examination Survey (KNHANES) were utilized. To measure income-related inequalities in the use of gastric and colorectal cancer, individuals over the age of 40 and the age of 50 were included respectively, and the Concentration Index (CI) was calculated for each cycle. To identify and quantify contribution from each socio-demographic factor, decomposition of the CIs was conducted. RESULTS: Throughout this study, CIs and horizontal inequity indices (HIs) steadily but consistently decreased, suggesting that inequalities and inequities in participation in gastric and colorectal cancer screening were weakened after the implementation of the national public cancer screening program. Decomposition analyses revealed that whereas decreases in inequalities mostly stemmed from income and educational levels; higher income and better education levels are still major contributors to the observed inequalities that influence participation in cancer screening services in Korea. CONCLUSION: Our empirical findings suggest that, although the policy of reducing out-of-pocket payment for cancer screening may contribute to the observed decreases in inequality, it alone is not likely to completely eliminate inequality. Further research is required to identify barriers that prevent people with lower socioeconomic status from participation in cancer screening, which allows equal access for equal need.
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Gastos en Salud/normas , Disparidades en Atención de Salud/tendencias , Tamizaje Masivo/estadística & datos numéricos , Neoplasias/prevención & control , Clase Social , Adulto , Detección Precoz del Cáncer/estadística & datos numéricos , Detección Precoz del Cáncer/tendencias , Femenino , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , República de CoreaRESUMEN
Reducing socioeconomic inequalities in health has become an important health policy agenda. This study aimed to measure socioeconomic inequalities in health in Korea over the past two decades and identify the contributing factors to the observed inequalities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 1998 to 2016/2018 were utilized. The concentration index (CI) was calculated to measure health inequalities, and decomposition analysis was applied to identify and quantify the contributing factors to the observed inequalities in health. The results indicated that health inequalities exist, suggesting that poor health was consistently more concentrated among Korean adults with lower income (1998: -0.154; 2016/2018: -0.152). Gender-stratified analyses also showed that poor health was more concentrated in lower income women and men, with the degree of inequalities slightly more pronounced among women. The decomposition approach revealed that income and educational attainment were the largest contributors to the observed health inequalities as higher income and education associated with better self-rated health. These findings suggest the importance of considering socioeconomic determinants, such as income and education, in efforts to tackling health inequalities, particularly considering that self-rated health is a predictor of future mortality and morbidity. Furthermore, it is essential to implement more egalitarian social, labour market, and health policies in order to eliminate the existing socioeconomic inequalities in health in Korea.
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OBJECTIVE: To assess the out-of-pocket (OOP) payments for health-care services of HIV/AIDS patients, and identify associated factors in Vietnam. METHODS: Cross-sectional multisite survey of 1016 HIV/AIDS patients attending 7 hospitals and health centres in Ha Noi, Hai Phong and Ho Chi Minh City in 2012. RESULTS: HIV/AIDS patients used inpatient and outpatient care on average 5.1 times (95% CI = 4.7-5.4) besides ART services. Inpatient care cost US$ 461 on average and outpatient care US$ 50. Mean annual health-care expenditure for HIV/AIDS patients was US$ 188 (95% CI = 148-229). 35.1% of households (95% CI = 32.2-38.1) experienced catastrophic health expenditure; 73.3% (95% CI = 70.6-76.1) of households would be affected if ART were not subsidised. Being a patient at a provincial clinic, male sex, unstable employment, being in the poorest income quintile, a CD4 count of <200 cells/mL and not yet receiving ART increased the likelihood of catastrophic medical expense. CONCLUSIONS: HIV/AIDS patients in Vietnam frequently use medical services and incur OOP payments for health care. Scaling up free-of-charge ART services, earlier access to and initiation of ART, and decentralisation and integration of HIV/AIDS-related services could reduce their financial burden.
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Síndrome de Inmunodeficiencia Adquirida/economía , Antirretrovirales/economía , Terapia Antirretroviral Altamente Activa/economía , Infecciones por VIH/economía , Costos de la Atención en Salud , Gastos en Salud/estadística & datos numéricos , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Adulto , Antirretrovirales/uso terapéutico , Terapia Antirretroviral Altamente Activa/métodos , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Aceptación de la Atención de Salud/psicología , Factores Socioeconómicos , Vietnam/epidemiologíaRESUMEN
Objectives: Mental health is the cornerstone of public health, particularly for older adults. There is a clear need to examine the impact of COVID-19 on mental health among older adults in South Korea, where the incidence of COVID-19 was relatively low and widespread transmission was controlled without a national lockdown. Methods: This analysis included a total of 1917 participants from the Experience Survey on Healthcare Use of Older Adults, which was conducted for adults aged 65 years or older by face-to-face interview. Results: The results showed that older adults with a good understanding of COVID-19 public health measures were less likely to experience mental health problems. In contrast, those with a greater risk perception of contracting COVID-19 had higher odds of experiencing tension and anxiety in addition to sadness and depression. Older adults who had a greater fear of COVID-19 and perceived higher-risk of contracting COVID-19 experienced more sleep problems. Conclusion: The findings provide new evidence on the factors that influence the mental health of older adults in South Korea during the pandemic and suggest the development of policy interventions.
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COVID-19 , Anciano , Ansiedad/epidemiología , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Depresión/epidemiología , Humanos , Salud Mental , Pandemias , República de Corea/epidemiología , Factores de Riesgo , SARS-CoV-2RESUMEN
Increasing difficulties in the use of healthcare services after the COVID-19 outbreak is a major concern as ensuring access to healthcare services is a primary health policy goal. The aim of this study was to examine the impacts of public perceptions regarding COVID-19 related public health measures on older adults' experience of unmet healthcare needs in Korea. A total of 1961 participants from the Korea Health Care System Performance, over the age of 65, were included in the analyses. Three different logistic regression models were used to assess the impact of public perceptions - understanding, trust and satisfaction- regarding COVID-19 public health measures on unmet healthcare needs. Our results show that a poor understanding of public health measures was associated with higher odds of unmet healthcare needs among Korean older adults (OR:2.65, 95%CI: 1.79-3.94). However, trust and satisfaction of public health measures were not related to unmet healthcare needs. Our findings suggest that the importance of effective risk communication to facilitate better understand quarantine polices rather than emphasizing trust or satisfaction over public health measure.
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This study aimed to investigate whether (1) depression is associated with cognitive decline in Korean older adults and (2) the relationship between depression and cognitive function varies by gender. Using Korean Longitudinal Study of Aging data of 2006 to 2014, we studied 1787 adults aged 65 years or older who had normal cognitive function at baseline. This study examined the effects of depression on cognitive decline by using an interaction term of baseline depression and time, and compared relationships by gender. Among male participants, K-MMSE (Korean-Mini-Mental Status Examination) scores decreased with age, at an annual rate of approximately 0.465 points. Baseline depression was found to accelerate the decline in cognitive function, by approximately 0.184 points per year. Among female participants, K-MMSE scores decreased with age, at an annual rate of approximately 0.585 points. Baseline depression was not related to the decline in cognitive function. These results suggest the need for community-based programs to increase awareness of mental health problems need to be developed to encourage the use of health services to prevent or delay cognitive decline in older Korean males.
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Disfunción Cognitiva/psicología , Depresión/psicología , Anciano , Disfunción Cognitiva/epidemiología , Depresión/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , República de Corea/epidemiología , Distribución por SexoRESUMEN
Given the potential negative effects of parental incarceration on millions of people, it is critical to examine the possible short- and long-term effects of parental incarceration on individuals. This study examines the effect of parental incarceration on the sports participation trajectories of children ranging from adolescence to young adulthood. Group-based trajectory models were set up using SAS analytics software to examine how parental incarceration affects the sports participation trajectories of children from adolescence to young adulthood. Data were drawn from the first four waves of the National Longitudinal Study of Adolescent Health in the United States (N = 6504). Neither paternal nor maternal incarceration had any significant effect on the trajectories of male participants. On the other hand, females who experienced father incarceration were more likely to be in the low-stable versus high-decreasing group (coefficient = -0.721, p < 0.05). Based on the results of this study, we conclude that programs promoting sports participation are needed for females who have experienced paternal incarceration. The results of this study also suggest that group-based trajectory modeling is a useful technique to examine the trajectories of sports participation from adolescence through to young adulthood.
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Conducta del Adolescente , Hijo de Padres Discapacitados/estadística & datos numéricos , Relaciones Padres-Hijo , Padres/psicología , Prisioneros/estadística & datos numéricos , Deportes/psicología , Adolescente , Adulto , Niño , Femenino , Conductas Relacionadas con la Salud , Humanos , Estudios Longitudinales , Masculino , Prisiones , Estados Unidos , Adulto JovenRESUMEN
Patient satisfaction is a useful predictor of adherence and outcomes of cardiovascular diseases (CVDs) treatment. This study explored the satisfaction of Vietnamese CVDs inpatients and outpatients using a scale specifically designed for CVDs patients and examined the factors associated with satisfaction towards CVDs treatment services. Interviews of 600 patients at the Hanoi Heart Hospital were conducted. We developed a measurement scale for both inpatient and outpatient services. Multivariate Tobit regression was used to determine the associated factors with patient satisfaction. For inpatients, Cronbach's alpha reported for the domains were in the range of 0.72-0.97, while for outpatients, Cronbach's alpha was within 0.61-0.97. Overall, patients were more satisfied with inpatient services (Mean = 81.8, SD = 5.8) than outpatient services (Mean = 79.7, SD = 5.2, p<0.05). In inpatients, the highest complete satisfaction was in "Attitude of Nurse" item (42.0%), the highest satisfaction score was in "Care and treatment" domain (Mean = 85.6, SD = 9.7) and the lowest in "Hospital facilities" domain (Mean = 78.3; SD = 9.2). Among outpatients, the highest complete satisfaction was in "Attitude of physicians when examining, guiding and explaining to the patient" item (19.7%), the highest satisfaction score was in "Attitude of medical staff" domain (Mean = 82.8; SD = 7.9) and the lowest in "Waiting time" domain (Mean = 76.6; SD = 8.2). People not having health insurances had significantly higher scores in "Waiting time", "Hospital facilities" and "Attitude of staff" domains (for outpatients) and in "Health service accessibility", "Hospital facilities" domains (for inpatients) as well as higher total satisfaction score than those having health insurance. Findings discovered through the application of the newly developed instrument showed low satisfaction regarding hospital facilities for inpatients and waiting time for outpatients, suggesting renovation efforts, while inferiority regarding patient satisfaction of health insurance covered patients compared to those without implied policy reform possibility. Further enhancement and validation of the developed instrument was required.
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Enfermedades Cardiovasculares/terapia , Atención a la Salud , Satisfacción del Paciente , Adulto , Anciano , Actitud del Personal de Salud , Enfermedades Cardiovasculares/patología , Estudios Transversales , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , VietnamRESUMEN
Obesity is a prominent global public health challenge as its prevalence has grown. Even though the increase in prevalence of obesity in Korea has been relatively low, it is expected to continually increase in the next several years, leading to social and economic burdens. This study aimed to assess socioeconomic inequalities in obesity among Korean adults. Using nationally representative survey datasets, the concentration index (CI) and decomposition of the CI were used to capture and quantify obesity-related inequalities from 1998 to 2015. The results suggested that pro-poor inequalities in obesity existed in Korea, indicating that obesity was more concentrated among individuals with lower income. In a gender-stratified model, obesity was more concentrated among women with lower income and men with higher income, showing that the trend and magnitude of inequalities in obesity each vary by gender. The decomposition approach revealed that, over the past 17 years, the main contributors to the existing inequalities were higher education and higher income levels. These findings suggest that comprehensive and multifaceted interventions at the local and national levels should be considered to address the identified income- and education-related barriers with respect to obesity among Korean adults.
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Obesidad/epidemiología , Factores Socioeconómicos , Adulto , Femenino , Humanos , Renta , Masculino , Pobreza , Prevalencia , República de Corea/epidemiología , Clase SocialRESUMEN
Problems of poor health status and low health service use among farmers in mountainous areas have not been fully investigated. A cross-sectional study was conducted in Son La, a mountainous province in Vietnam, to assess the self-rated health and health care service utilization among farmers. Visual analogue scale (VAS) was used to measure the self-rated health. Multivariate Tobit, Poisson, and logistic regression were employed to identify related factors. Among 197 farmers, the mean VAS score was 67.8 (SD = 15.5). Approximately 40% of participants reported health problems, and the most popular morbidity was hypertension-56.4%. There were 28.9% and 50.3% of farmers using inpatient and outpatient treatments in the last 12 months, respectively. Age, educational level, family income, marital status, alcohol use, and source of information have been identified as associated factors with self-rated health status and morbidities, while age, gender, education, and morbidities were related to health service utilization. Data indicated a high proportion of health issues and a high rate of health care service use among farmers in a mountainous area of Vietnam. Adaptable health policies and prevention programs or preventive health services should be implemented regularly in mountainous regions to protect farmers from the onset of morbidities and to enhance their health.
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Agricultores/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Estado de Salud , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vietnam/epidemiologíaRESUMEN
Cognitive function is a critical health issue in later life, the decline of which disrupts well-being and daily life function. Cognitive decline in older ages can also be understood in the context of the social environment such as social connectedness and engagement in personal life. This study aimed to examine: (1) whether participation in social activities contributes to preventing cognitive decline, and (2) what type of social activities are beneficial to maintaining cognitive function. Data from the Korean Longitudinal Study of Aging (KLOSA) 2006â»2014, a longitudinal survey of the household-dwelling population aged 45 and older in Korea were used. The results revealed that Mini-Mental State Examination (MMSE) scores decreased with increasing age, at a rate of approximately 0.18 units across all age-gender groups, and the decrease was steeper for adults aged 65 and over. Participation in social gatherings was likely to delay the decline in cognitive function after the age of 65. In a gender-stratified model, social activity may not have an impact on the decline of cognitive function for men, whereas participation in social gatherings was negatively related to the decline of MMSE scores in women. This study suggests the need for a gender-stratified policy for preventing the decline of cognitive function while promoting engagement in social activities in Korean older adults.
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Cognición , Disfunción Cognitiva/prevención & control , Participación Social/psicología , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/etiología , Femenino , Encuestas Epidemiológicas , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Factores de Riesgo , Factores Sexuales , Medio SocialRESUMEN
AIMS: Diabetic retinopathy (DR) is a leading cause of blindness in Canada. Despite established comprehensive guidelines for routine DR screening, the rate of provision of diabetic eye care services by ophthalmologists in Alberta decreased in past years. The aim of this study was to examine socioeconomic status (SES)-related inequalities in the use of eye care services for patients with diabetes in Alberta, Canada. METHODS: We used data from the Alberta Diabetes Surveillance System (ADSS), including visits to ophthalmologists over a 15-year period (1995-2009). Socioeconomic inequalities in the use of eye care services were assessed using the Relative Concentration Index (RCI). We used three different SES indicators: median household income and the Canadian material and social deprivation indices (MDI and SDI). RESULTS: Socioeconomic inequalities in use of eye care services exist in patients with diabetes, although the magnitudes of the inequalities were small and steadily decreased over time; income- and MDI-related RCI indicated that individuals with greater income or less material deprivation were more likely to use eye care services. However, for SDI-related RCI, socially deprived individuals were more likely to use eye care services (RCI: 1995: -0.066; 2002: -0.036; 2009: -0.028). CONCLUSIONS: Our findings suggest a need for attention to the potential impact of provincial policy on inequalities in eye care services among patients with diabetes, particularly as it relates to geographical differences across regional health zones.