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This study comprehensively assesses spatial distribution, pollution levels, and potential sources of heavy metal(loid)s in surface sediments across multiple river systems along the coastal area of the East China Sea. Copper in Qiantang River and Xiangshan Bay showed higher concentations and exceeded the threshold effect value, while the higher content of Lead was mainly found in the Saijiang River, Oujiang River, and Minjiang River. Heavy metal(loid)s in the alluvium of Qiantang River, Jiaojiang River, and Yangtze River showed low to moderate pollution levels, with Cd posing the highest ecological risk, followed by Hg. Meanwhile, Qiantang River, Jiaojiang River, Yangtze River, and Oujiang River exhibited considerable to moderate ecological risks and low toxic risk. PMF model analysis results reveal that concentrations of Cr, Ni, and As were closely related with natural geogenic input (36.56 %), while industrial and traffic activities (48.77 %) were primary source of Cu, Pb, Zn, and Hg, and main source of Cd was agricultural emissions (14.67 %).
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Monitoramento Ambiental , Sedimentos Geológicos , Metais Pesados , Rios , Poluentes Químicos da Água , Metais Pesados/análise , Sedimentos Geológicos/química , China , Medição de Risco , Poluentes Químicos da Água/análise , Rios/químicaRESUMO
Traditional assessments of anxiety and depression face challenges and difficulties when it comes to understanding trends in-group psychological characteristics. As people become more accustomed to expressing their opinions online, location-based online media and cutting-edge algorithms offer new opportunities to identify associations between group sentiment and economic- or healthcare-related variables. Our research provides a novel approach to analyzing emotional well-being trends in a population by focusing on retrieving online information. We used emotionally enriched texts on social media to build the Public Opinion Dictionary (POD). Then, combining POD with the word vector model and search trend, we developed the Composite Anxiety and Depression Index (CADI), which can reflect the mental health level of a region during a specific time period. We utilized the representative external data by CHARLS to validate the effectiveness of CADI, indicating that CADI can serve as a representative indicator of the prevalence of mental disorders. Regression and subgroup analysis are employed to further elucidate the association between public mental health (measured by CADI) with economic development and medical burden. The results of comprehensive regression analysis show that the Import-Export index (-16.272, p < 0.001) and average cost of patients (4.412, p < 0.001) were significantly negatively associated with the CADI, and the sub-models stratificated by GDP showed the same situation. Disposable income (-28.389, p < 0.001) became significant in the subgroup with lower GDP, while the rate of unemployment (2.399, p < 0.001) became significant in the higher subgroup. Our findings suggest that an unfavorable economic development or unbearable medical burden will increase the negative mental health of the public, which was consistent across both the full and subgroup models.
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Depressão , Mídias Sociais , Humanos , Depressão/epidemiologia , Ferramenta de Busca , Emoções , Ansiedade/epidemiologia , InternetRESUMO
Disease mapping models have been popularly used to model disease incidence with spatial correlation. In disease mapping models, zero inflation is an important issue, which often occurs in disease incidence datasets with high proportions of zero disease count. It is originated from limited survey coverage or unadvanced testing equipment, which makes some regions have no observed patients. Then excessive zeros recorded in the disease incidence dataset would mess up the true distributions of disease incidence and lead to inaccurate estimates. To address this issue, a zero-inflated disease mapping model is developed in this work. In this model, a zero-inflated process using Bernoulli indicators is assumed to characterize whether the zero inflation occurs for each region. For regions without zero inflation, a coherent and generative disease mapping model is applied for mapping the spatially correlated disease incidence. Independent spatial random effects are incorporated in both processes to account for the spatial patterns of zero inflation and disease incidence. External covariates are also considered in both processes to better explain the disease count data. To estimate the model, a Markov chain Monte Carlo algorithm is proposed. We evaluate model performance via a variety of simulation experiments. Finally, a Lyme disease dataset of Virginia is analyzed to illustrate the application of the proposed model.
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Algoritmos , Modelos Estatísticos , Humanos , Incidência , Distribuição de Poisson , Simulação por Computador , Método de Monte CarloRESUMO
For stage III colorectal cancer (CRC) patients with a high risk of recurrence, intensified adjuvant chemotherapy can improve overall survival. We aimed to develop a circulating tumor DNA (ctDNA) methylation marker model for predicting the relapse risk of stage III CRC patients. Differentially methylated markers identified between 53 normal mucosa samples and 165 CRC tissue samples, as well as between plasma samples from 75 stage I/II (early-stage) CRC patients and 55 stage IV (late-stage) CRC patients, were analyzed using Student's t-tests. The overlapping methylation markers shared by plasma and tissue samples were used to establish a methylation marker model to evaluate the tumor burden in the peripheral blood of CRC patients using the random forest method. This model was verified in the validation cohort (n = 44) and then applied to predict recurrence risk in 50 stage III CRC patients and monitor the clinical disease course in serial samples from four CRC patients. We built a five-marker-based ctDNA methylation model that had high sensitivity (84.21%) and specificity (84%) in identifying late-stage CRC in a validation cohort containing 24 stage I/II CRC patients and 20 stage IV CRC patients. The model achieved high sensitivity (87.5%) and specificity (94.12%) in predicting tumor relapse in an independent cohort of 50 stage III CRC patients and could be an independent recurrence risk factor for stage III patients [Hazard ratio (HR), 60.4; 95% confidence interval (CI): 7.68-397; p = 9.73e-5]. Analysis of serial blood samples of CRC showed that the model could monitor disease relapse earlier than imaging examination and serum carcinoembryonic antigen (CEA) and so may provide an opportunity for the early adjustment of therapeutic strategies. Moreover, the model could potentially monitor the clinical course and treatment response dynamically. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Ácidos Nucleicos Livres , Neoplasias Colorretais , Humanos , Biomarcadores Tumorais/genética , Metilação de DNA , Recidiva Local de Neoplasia/genética , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Medição de Risco , Ácidos Nucleicos Livres/genéticaRESUMO
Nonlinear optical properties have been extensively studied due to their promising nonlinear effects and various applications. With ultrashort duration and ultrahigh intensity, a femtosecond laser can fabricate various superior-quality micro-/nanostructures to improve the nonlinearity of materials, which are promising for stable and high-performance nonlinear devices. In this contribution, yttria-stabilized zirconia (YSZ) with fs laser-induced micro-/nanostructures is demonstrated to exhibit unique anisotropic light-material interaction and nonlinear optical response on [100], [110], and [111] planes. Time-resolved reflectivity of YSZ after fs laser excitation is investigated by a pump-probe experiment, which is consistent with simulations through the plasma model combined with a two-temperature model. These results indicate two early ablation mechanisms: Coulomb explosion and melting. Anisotropic crack structures are formed due to thermal stress, which is always ignored in fs laser fabrication and is verified by Raman mapping and analysis of slip systems on different crystal planes. Through the z-scan measurement, the nonlinear absorption (NLA) of crack structures is effectively improved, and a nearly 18 times enhancement of the NLA coefficient is acquired in [100] samples, while a 2 times enhancement in [110] and [111] samples. Such great enhancement of NLA is mainly due to the abundant presence of crack structures and the increase of fs laser-induced oxygen vacancies in [100] YSZ. These results provide a potential way of utilizing fs laser to improve the nonlinearity for the technological development in nonlinear devices.
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This paper empirically studies the relationship among inclusive finance, industrial structure upgrading and farmers' income, using the panel data of 28 provinces in China from 2006 to 2016.The research finds that inclusive finance can significantly promote the increase of farmers' income. Moreover, the Upgrading of Industry Structure (UIS) is the intermediary mechanism of inclusive finance to promote the increase of farmers' income, and this intermediary mechanism is heterogeneous among farmers with different income levels. Finally, the promotion effect of the UIS on farmers' income is affected by the threshold effect of inclusive finance. Compared with the development level of low inclusive finance, the promotion effect of the UIS on farmers' income is stronger under the development level of high inclusive finance. According to the results of empirical analysis, we suggest that the development strategy of inclusive finance should aim at the industrial development in rural areas, promote the organic connection between farmers and modern agricultural industry, and drive farmers to increase their income through the transformation and upgrading of rural industries.
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Agricultura/economia , Fazendeiros , Organização do Financiamento/economia , Renda , China , HumanosRESUMO
In this study, the Songgang River (SR) was selected as a typical tributary that is heavily polluted by rapid urbanization and industrialization. The polycyclic aromatic hydrocarbon (PAH) distribution at five representative sampling sites from different urban functional areas was studied. The chemical and physical properties and spatial and vertical distribution of PAHs in sediments were investigated. PAH source identification and the ecological risks of the sediments were evaluated. The results suggested that the industrial zone and dense residential and commercial areas were the most contaminated areas of the SR, as the chemical and physical properties of total organic carbon content in sediments was the highest at the dense residential and commercial areas (0.1-4.5%); however, the acid volatile sulfide, total nitrogen, and total phosphorus contents were the highest in the industrial zone, with ranges of 700.0-1618.4 mg/kg dw, 22.4-3543.9 mg/kg dw, and 82.3-4550.7 mg/kg dw, respectively. The spatial distribution of residual PAHs in the sediment cores showed a wide variation among different urban functional areas, and the vertical characterization (0-300 cm) depicted a significant decreasing trend with depth and with an abrupt increase at 180 cm. The concentration of ∑16 PAHs ranged from 208.7 to 7709.8 ng/g dw, with the highest concentrations obtained in the industrial zone. The low molecular weight-PAHs (153-6720 ng/g dw) were predominant in the sediments. Furthermore, there were combined sources (biomass burning: 40.3%; fossil fuel combustion: 25.5%; mixed source: 21.5%; oil pollution: 12.7%) and a long term accumulation effect, with anthropogenic activities and industrial pollution as the major contributing sources. The concentrations of Nap, Acy, Ace, Flu, and Ant exceeded the lower limit of the sediment quality criteria, and higher toxic equivalent concentration values of the total carcinogenic PAHs were observed nearby the midstream of the SR, which may cause adverse biological effects and implies a need for regular monitoring.
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Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes Químicos da Água/análise , China , Monitoramento Ambiental , Sedimentos Geológicos , Medição de RiscoRESUMO
Heavy metals in agricultural soil receive much attention because they are easily absorbed by crop into the ecosystem. Managing the discharge of heavy metals from the source is an effective way to prevent and control heavy metals pollution. Grouped principal component analysis (GPCA) and Positive Matrix Factorization (PMF) receptor models were utilized in this study to conduct source apportionment, and the former was optimal because of the accuracy of predicting. Based on the source contribution by GPCA/APCS, heavy metals were evaluated by fuzzy synthetic evaluation model and health risk assessment model. The results of source apportionment showed that heavy metals in Zhangye agricultural soil were mainly affected by steel industry, traffic, agrochemicals, manures, mining activities, leather industry and metal processing industry source. Fuzzy synthetic evaluation showed that the pollution levels of Chromium (Cr) derived by leather industry and metal processing industry and Nickel (Ni) derived by steel industry and traffic source were higher. Health risk assessment revealed that the non-carcinogenic and carcinogenic risks of Cr derived by leather industry and metal processing industry and Lead (Pb) derived by steel industry and traffic source were higher.
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Monitoramento Ambiental , Poluição Ambiental/estatística & dados numéricos , Metais Pesados/análise , Poluentes do Solo/análise , China , Lógica Fuzzy , Análise Multivariada , Medição de RiscoRESUMO
Rapid and extensive social and economic development has caused severe soil contamination by heavy metals in China. The spatial distribution, pollution levels, and health risks of metals were identified in an oasis-desert zone of northwest China. The mean concentrations of six heavy metals exceeded their corresponding background contents, and each metal concentration in farmland samples was higher than that in Gobi samples. Moreover, these heavy metals followed a similar spatial pattern and showed significant positive correlations with each other, indicating that they have the same sources. The contamination features of heavy metals and ecological risks were calculated using several quality indicators, and their health risks for population groups were quantified. The results showed that the Gobi and farmland soils were uncontaminated to moderately contaminated by heavy metals, and that farmland pollution was more serious than that of Gobi. The Gobi and farmland soils posed low ecological risks. As a whole, the non-carcinogenic risk which was caused by heavy metals was low for local residents, and the carcinogenic risk was within an acceptable level. Comparatively speaking, children were the more vulnerable population to health risks. The Zn and Cu pollution was relatively serious, and Cr and V were major contributors to health risks. Graphical abstract á .
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Monitoramento Ambiental , Metais Pesados/análise , Poluentes do Solo/análise , Criança , China , Clima Desértico , Exposição Ambiental , Humanos , Medição de RiscoRESUMO
The emergence of drug-resistant tuberculosis (TB) and HIV-TB co-infection fuels an urgent need to develop novel therapeutic approaches, including therapeutic vaccines. Therapeutic vaccines have been proven to be a good strategy by inducing antigen specific immune responses against TB infection. In the present study, a recombinant plasmid based on lentiviral vector expressing fusion antigen Ag85B-Rv3425 (A3), and was constructed the immunogenicity and treatment effects in TB mice were assessed. The results showed that A3 delivered by the plasmid could be expressed appropriately in vivo and induced higher production of tumor necrosis factor-α and interleukin-2 compared with A3 recombinant protein in mice. Moreover, the recombinant plasmid expressing A3 confered resistance to acute TB infection in mice, characterized by a reduction in the bacterial load in the lungs and spleen, as well as attenuated TB lesions in lung tissues. These results implicated that the recombinant plasmid based on lentiviral vector expressing A3 is a potent and promising therapeutic agent to treat acute TB infection.
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Surface sediments and clam Meretrix meretrix were collected from a northern estuarine region in Dongying City, China. Sediments were analysed for heavy metals (Hg, As, Cd, Cr, Cu, Pb, and Zn) and the clams were tested for metallothioneins (MTs) and lysosomal membrane stability (LMS). The heavy metal total concentrations decreased in the order of Cr>Zn>Cu>Pb>As>Cd>Hg. The results of Bureau Communautaire de Référence (BCR) sequential extraction of heavy metals showed that the geochemical speciation of all heavy metals was dominated by residual fraction. According to the responses of biomarkers in M. meretrix, the modified potential ecological risk index (PERI-B) can more accurately reflect heavy metals pollution. PERI-B showed all sediment samples have low or moderate risk, except at site S10 (considerable risk), and the main contribution of ecological risk heavy metals were Cd and Hg.
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Bivalves/química , Sedimentos Geológicos/análise , Metalotioneína/análise , Metais Pesados/análise , Poluentes Químicos da Água/análise , Animais , Arsênio/análise , Bivalves/efeitos dos fármacos , China , Ecologia/métodos , Monitoramento Ambiental , Poluição Ambiental/análise , Sedimentos Geológicos/química , Lisossomos/efeitos dos fármacos , Mercúrio/análise , Metais Pesados/toxicidade , Medição de Risco/métodos , Poluentes Químicos da Água/toxicidadeRESUMO
In health exposure modeling, in particular, disease mapping, the ecological fallacy arises because the relationship between aggregated disease incidence on areal units and average exposure on those units differs from the relationship between the event of individual incidence and the associated individual exposure. This article presents a novel modeling approach to address the ecological fallacy in the least informative data setting. We assume the known population at risk with an observed incidence for a collection of areal units and, separately, environmental exposure recorded during the period of incidence at a collection of monitoring stations. We do not assume any partial individual level information or random allocation of individuals to observed exposures. We specify a conceptual incidence surface over the study region as a function of an exposure surface resulting in a stochastic integral of the block average disease incidence. The true block level incidence is an unavailable Monte Carlo integration for this stochastic integral. We propose an alternative manageable Monte Carlo integration for the integral. Modeling in this setting is immediately hierarchical, and we fit our model within a Bayesian framework. To alleviate the resulting computational burden, we offer 2 strategies for efficient model fitting: one is through modularization, the other is through sparse or dimension-reduced Gaussian processes. We illustrate the performance of our model with simulations based on a heat-related mortality dataset in Ohio and then analyze associated real data.
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Viés , Exposição Ambiental/estatística & dados numéricos , Modelos Estatísticos , Teorema de Bayes , Bioestatística/métodos , Simulação por Computador , Transtornos de Estresse por Calor/mortalidade , Humanos , Incidência , Método de Monte Carlo , Distribuição Normal , OhioRESUMO
Concentrations of seven heavy metals in the coastal sediments of the northern Dongying City were measured. The spatial distribution and sources of heavy metals were discussed and the ecological risk was assessed using sediment quality guidelines (SQGs) and the potential ecological risk index (PERI). The concentration ranges of Hg, As, Pb, Cd, Cr, Cu, and Zn were calculated as 0.005-0.092, 3.44-10.41, 6.59-19.00, 0.50-1.10, 32.42-60.25, 1.72-23.78, and 31.13-69.96 mg·kg-1, respectively. Higher metal concentrations were observed at site S10, which was close to the mouth of Tiaohe River and contained plenty of organic matter, silt, and clay. Principal component analysis (PCA) indicated that As and Pb in the sediments were derived from natural weathering processes, while other metals were mainly attributed to anthropogenic sources, i.e., land-sourced pollutants transported by runoff. Concentrations of As, Cd, Cr, and Cu at some sampling sites exceeded the threshold effect level (TEL) stated in the SQGs implying occasional harmful effects on biological life. PERI showed that the sediments in this area generally had a medium risk, except sites S10, S3, and S9 posing a considerable risk, and that Cd and Hg were the major contributors to the ecological risk. It is necessary to take effective measures to control heavy metal fluxes from rivers around this area and to reduce the risk.
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Monitoramento Ambiental , Sedimentos Geológicos/análise , Metais Pesados/análise , Poluentes Químicos da Água/análise , China , Ecologia , Metais Pesados/efeitos adversos , Medição de Risco , Rios , Poluentes Químicos da Água/efeitos adversosRESUMO
OBJECTIVE: To examine the relationship between health risks and absenteeism and drug costs vis-a-vis comprehensive workplace wellness. METHODS: Eleven health risks, and change in drug claims, short-term and general illness calculated across four risk change groups. Wellness score examined using Wilcoxon test and regression model for cost change. RESULTS: The results showed 31% at risk; 9 of 11 risks associated with higher drug costs. Employees moving from low to high risk showed highest relative increase (81%) in drug costs; moving from high to low had lowest (24%). Low-high had highest increase in absenteeism costs (160%). With each risk increase, absenteeism costs increased by $CDN248 per year (P < 0.05) with average decrease of 0.07 risk factors and savings $CDN6979 per year. CONCLUSIONS: Both high-risk reduction and low-risk maintenance are important to contain drug costs. Only low-risk maintenance also avoids absenteeism costs associated with high risks.
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Órgãos Governamentais/economia , Promoção da Saúde/economia , Absenteísmo , Adulto , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Canadá , Colesterol/sangue , Colesterol/economia , Custos de Medicamentos , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Circunferência da Cintura/efeitos dos fármacos , Local de Trabalho/economiaRESUMO
A full-scale combined biological system is used for the treatment of treated wastewater discharged from a pharmaceutical industrial park. This treated water is rich in NH(4)(+)-N (average in 86.4 mg/L), low in COD/NH(4)(+)-N (average in 3.4) and low in BOD(5)/COD ratio (average in 0.24) with pH varying from 7.16 to 7.78. The final effluent of the combined treatment process was stably below 100mg/L COD and 20mg/L NH(4)(+)-N, separately, with organic loading rate of 4954 kg COD/d and 92.5 kg NH(4)(+)-N/d. It is found that the BOD(5)/COD ratio could be raised from 0.24 to 0.35, and the production of total VFAs account for 9.57% of the total COD via the treatment of hydrolysis/acidification. MBBR and oxidation ditch represent 35.4% and 60.7% of NH(4)(+)-N removal, 30.2% and 61.5% of COD removal, separately, of the total treatment process. PCR-DGGE is used for microbial community analysis of MBBR and oxidation ditch.
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Fenômenos Fisiológicos Bacterianos , Reatores Biológicos/microbiologia , Indústria Farmacêutica/instrumentação , Resíduos Industriais/prevenção & controle , Nitratos/metabolismo , Nitrogênio/metabolismo , Poluentes Químicos da Água/metabolismo , Purificação da Água/instrumentação , Desenho de Equipamento , Análise de Falha de Equipamento , Nitratos/isolamento & purificação , Nitrogênio/isolamento & purificação , Poluentes Químicos da Água/isolamento & purificaçãoRESUMO
A real-time observation of neurotransmitter release from a nerve cell is a useful method for not only neuroscience research, but also assessing of the influence of chemicals, including drugs, on the human nervous system. In this study, a more simple and sensitive method for real-time monitoring of dopamine release from a nerve model cell was developed. Highly sensitive detection of dopamine was performed by using tyramine oxidase for dopamine oxidation, which was followed by a luminol luminescence reaction. This enzyme-catalyzed luminescence method was applied to observe dopamine release from the PC12 cell as a nerve model cell upon stimulation with acetylcholine and an acetylcholine receptor agonist. The results demonstrated that the real-time monitoring of the activation of the PC12 cell was easily performed by this method. This method possessed many advantages, such as high sensitivity, rapid measurement and no pretreatment for cells. It might be applied to drug screening and the assessment of harmful influences of food additives and pesticides on the nerves.
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Dopamina/análise , Dopamina/metabolismo , Neurônios/metabolismo , Acetilcolina/farmacologia , Animais , Catálise , Cromatografia Líquida de Alta Pressão , Iodeto de Dimetilfenilpiperazina/farmacologia , Eletroquímica , Peróxido de Hidrogênio/análise , Indicadores e Reagentes , Luminescência , Luminol/química , Monoaminoxidase/química , Agonistas Nicotínicos/farmacologia , Oxirredução , Células PC12 , Ratos , Estimulação QuímicaRESUMO
OBJECTIVE: The objective of this study was to estimate savings to Medicare associated with participation in one or more health promotion programs offered to 59,324 retirees from a large employer and their aged dependents. METHODS: Propensity score and multiple regression techniques were used to estimate savings adjusted for demographic and health status differences between elderly retirees and dependents who used one or more health promotion services and nonparticipants. RESULTS: Participants who completed a health risk assessment saved from $101 to $648 per person per year. Savings were generally higher as more programs were used, but differences were not always statistically significant. CONCLUSION: Using the health risk assessment as a guide for health promotion programs can yield substantial savings for the elderly and the Medicare program. The federal government should test health promotion programs in randomized trials and pay for such programs if the results suggest cost savings and better health for Medicare beneficiaries.
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Redução de Custos , Promoção da Saúde/economia , Serviços de Saúde para Idosos/economia , Medicare/economia , Serviços Preventivos de Saúde/economia , Idoso , Idoso de 80 Anos ou mais , Promoção da Saúde/métodos , Inquéritos Epidemiológicos , Humanos , Masculino , Serviços Preventivos de Saúde/métodos , Aposentadoria , Estudos Retrospectivos , Medição de RiscoRESUMO
OBJECTIVE: The objective of this study was to quantify the healthcare costs per unit increase in body mass index (BMI). METHODS: This cross-sectional study included 35,932 employees and spouses in a manufacturing company who participated in an indemnity/PPO plan and one health risk appraisal during 2001 and 2002. RESULTS: Within the BMI range of 25 to 45 kg/m, medical costs and pharmaceutical costs increased dollar 119.7 (4%) and dollar 82.6 (7%) per BMI unit, respectively, adjusted for age and gender. The adjusted medical costs related to diabetes and heart disease increased by dollar 6.2 and dollar 20.3 per BMI unit. The likelihood of having any medical claim increased 11.6% per BMI unit for diabetes and 5.2% for heart disease. CONCLUSIONS: Each unit increase in BMI is associated with higher healthcare costs and increased likelihood of having claims for most major diagnostic codes and for diabetes and heart diseases.
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Índice de Massa Corporal , Gastos em Saúde , Estudos Transversais , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To examine the influence of physical activity (PA) and BMI on health care utilization and costs among Medicare retirees. RESEARCH METHODS AND PROCEDURES: This cross-sectional study was based on 42,520 Medicare retirees in a U.S.-wide manufacturing corporation who participated in indemnity/preferred provider and one health risk appraisal during the years 2001 and 2002. Participants were assigned into one of the three weight groups: normal weight, overweight, and obese. PA behavior was classified into three levels: sedentary (0 time/wk), moderately active (1 to 3 times/wk), and very active (4+ times/wk). RESULTS: Generalized linear models revealed that the moderately active retirees had US 1456 dollars, US 1731 dollars, and US 1177 dollars lower total health care charges than their sedentary counterparts in the normal-weight, overweight, and obese groups, respectively (p < 0.01). The very active retirees had US 1823 dollars, US 581 dollars, and US 1379 dollars lower costs than the moderately active retirees. Health care utilization and specific costs showed similar trends with PA levels for all BMI groups. The total health care charges were lower with higher PA level for all age groups (p < 0.01). DISCUSSION: Regular PA has strong dose-response effects on both health care utilization and costs for overweight/obese as well as normal-weight people. Promoting active lifestyle in this Medicare population, especially overweight and obese groups, could potentially improve their well-being and save a substantial amount of health care expenditures. Because those Medicare retirees are hard to reach in general, more creative approaches should be launched to address their needs and interests as well as help reduce the usage of health care system.
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Índice de Massa Corporal , Exercício Físico , Serviços de Saúde/estatística & dados numéricos , Aposentadoria , Fatores Etários , Idoso , Estudos Transversais , Feminino , Custos de Cuidados de Saúde , Humanos , Masculino , Medicare , Obesidade , Sobrepeso , Inquéritos e Questionários , Estados UnidosRESUMO
This study examined the relationship between physical activity and health care costs by different weight groups. The study sample consisted of 23,490 active employees grouped into normal weight, overweight, and obese categories. After adjustment for covariates, physically moderately active (1 to 2 times/week) and very active (3 + times/week) employees had approximately $250 less paid health care costs annually than sedentary employees (0 time/week) across all weight categories. The difference was approximately $450 in the obese subpopulation. The maximum possible savings was estimated to be 1.5% of the total health care costs if all obese sedentary employees would adapt a physically active lifestyle. As a strategy to control escalating health care costs, wellness programs should facilitate engagement in moderate physical activity of at least 1 to 2 times a week among sedentary obese people and help them to maintain this more active lifestyle.)