Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 184.082
Filtrar
1.
Braz. j. oral sci ; 20: e219638, jan.-dez. 2021. tab
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254752

RESUMEN

Diagnosis of oral and oropharyngeal cancer in advanced stages may be associated with social nature factors, access to health care, education, occupation, and behavioral/ cultural factors. Aim: To determine the factors related to high clinical-staging in patients diagnosed with squamous cell carcinoma in the oral and oropharyngeal region in a Cancer Center in Brazil between 2009 and 2015. Methods: It is an epidemiological, retrospective, and exploratory study. Patients diagnosed with squamous cell carcinoma had their medical records analyzed. The variables considered were sociodemographic, lifestyle, and disease characteristics. Descriptive and exploratory tests (Pearson's, chi-square test and, Student's t-test) were realized. Results: We analyzed 365 patient records, among which 289 (79.17%) were male, and 73 (20.0%) were female. Age ranged from 16 to 101 years, with a mean of 61.13. Regarding education, 157 (43.01%) studied < 8 years, 103 (28.21%) were illiterate and 102 (27.94%) studied > 8 years. 305 (83.56%) patients live in urban areas. There was an association between high clinical-staging and low educational level. For high clinical-staging, symptomatology, tobacco, and alcohol intake as well. Conclusion: Patients with low educational levels tend to report the disease later, and their diagnostics occurred in advanced stages. Thus, specific public health policies for this population, including access to dental care to recognize the clinical signs and early diagnosis, are necessary


Asunto(s)
Factores Socioeconómicos , Neoplasias de la Boca/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Registros Médicos
2.
An. psicol ; 37(2): 233-242, mayo-sept. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-202547

RESUMEN

The study of happiness and well-being is receiving increased attention in different fields. Recent research into well-being has focused on delving deeper into the individual's conception about the experience of well-being. McMahan and Estes (2011a) created a scale that assesses lay conceptions of well-being based on four dimensions: the experience of pleasure, avoidance of negative experience, self-development and contribution to others. The goal of this study was to adapt this scale, the Beliefs about Well-Being Scale (BWBS), to the Spanish population. The sample consisted of 1,024 participants from the general population ranging in age interval from 17 to 87 years old. The confirmatory factorial analysis results in a structure of four dimensions, similar to the original scale, although in the adaptation of the scale the items decrease from 16 to 12. The results of the reliability analysis reveal indexes similar to those of the original scale. These results confirm the validity of Beliefs about Well-Being Scale with general population in a cultural context different from the original study. This will allow cross-cultural studies to analyze the influence of culture in the perception of well-being


El estudio de la felicidad y el bienestar está recibiendo cada vez más atención en diferentes campos. Las investigaciones recientes sobre el bienestar se han centrado en profundizar en la concepción del individuo sobre la experiencia del bienestar. McMahan y Estes (2011a) crearon una escala que evalúa las concepciones legas del bienestar en base a cuatro dimensiones: la experiencia de placer, la evitación de la experiencia negativa, el autodesarrollo y la contribución a los demás. El objetivo de este estudio fue adaptar esta escala, Beliefs about Well-Being Scale (BWBS), a la población española. La muestra estuvo formada por 1.024 participantes de la población general con un intervalo de edad entre 17 y 87 años. El análisis factorial confirmatorio da como resultado una estructura de cuatro dimensiones, similar a la escala original, aunque en la adaptación de la escala los ítems disminuyen de 16 a 12. Los resultados del análisis de fiabilidad revelan índices similares a los de la escala original. Estos resultados confirman la validez de la Escala de Creencias sobre el Bienestar con población general en un contexto cultural diferente al del estudio original. Esto permitirá realizar estudios transculturales para analizar la influencia de la cultura en la percepción del bienestar


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Satisfacción Personal , Cultura , Adaptación Psicológica , Encuestas y Cuestionarios/normas , Felicidad , Comparación Transcultural , Filosofía , Pruebas Psicológicas/normas , Factores Socioeconómicos , Análisis Factorial , Placer , España
3.
An. psicol ; 37(2): 265-275, mayo-sept. 2021. graf
Artículo en Inglés | IBECS | ID: ibc-202550

RESUMEN

The main aim of this study was to find out more about the role of great-grandparenthood. A group of participants with greatgrandchildren (n = 78) was interviewed using a questionnaire containing questions that had been put through a previous pilot study, covering participants' sociodemographics, the activities that participants shared with their great-grandchildren, and their view of the role of great-grandparent and their related degree of satisfaction. The data were recorded and analyzed both with frequency tables and descriptive statistics and with the Kruskal-Wallis non-parametric test. The results showed several significant relationships between the shared activities and the sociodemographic variables, such as great-grandparents' age (p ≤ .05), education (p ≤ .01), health status (p ≤ .05), the distance at which they live from their great-grandchildren (p ≤ .05). Also, it was found that participants generally con-sider the role of great-grandparent to be a continuation of their prior role as grandparent, albeit from the perspective of a formal intergenerational typology, distinct from the informal typology and, above all, opposed to the role of substitute/surrogate. Greater perceived satisfaction was associated with this typical interaction of the formal role (p ≤ .01). Great-grandparents may already be fulfilling a notable function in today's four-generation families


El objetivo general de este trabajo es conocer mejor el rol de bisabuelidad. Se entrevistó a un grupo de voluntarios con bisnietos (n = 78) mediante un cuestionario, cuyo contenido fue pilotado previamente, con preguntas sobre sus características sociodemográficas, las actividades que solían compartir con sus bisnietos y su opinión del rol de bisabuelidad, con la satisfacción asociada. Los datos fueron registrados y analizados tanto con tablas de frecuencia y estadísticos descriptivos, como con la prueba no-paramétrica de Kruskal-Wallis. Los resultados obtenidos mostraron numerosas relaciones significativas entre las actividades compartidas y aspectos socio-demográficos de los bisabuelos como la edad (p ≤ .05), el nivel educativo (p ≤ .01), la salud (p ≤ .05), la distancia a la que viven de sus bisnietos (p ≤ .05). Además, de mostrar que perciben su rol de bisabuelidad en general como una continuidad del rol anterior de abuelidad, aunque desde una tipología intergeneracional formal, distinta a la tipología informal y, sobre todo, opuesta a la del rol sustituto/subrogado. La mayor satisfacción percibida estaba asociada a esa interacción típica del rol formal (p ≤ .01). Los bisabuelos podrían estar cumpliendo ya alguna función destacable en las familias actuales de cuatro generaciones


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Anciano , Anciano de 80 o más Años , Abuelos/psicología , Relaciones Intergeneracionales , Actividades Cotidianas/psicología , Proyectos Piloto , Factores Socioeconómicos , Encuestas y Cuestionarios , Satisfacción Personal
4.
Artículo en Chino | MEDLINE | ID: mdl-34218560

RESUMEN

Objective: To assess the health-related quality of life in the agricultural workers with schistosomiasis liver fibrosis using Europe Health-Related Quality of Life Questionnaire 5 Dimensions (EQ-5D) . Methods: From January to December 2019, a cross sectional study was applied to 3507 agricultural workers at a township, Kaihua County, Zhejiang Province, of which 424 agricultural workers with schistosomiasis liver fibrosis as objective group and of which 3083 agricultural workers without schistosomiasis liver fibrosis as the control group whom were respectively evaluated by the EQ-5D scale. At the same time, aspartate aminotransferase (AST) and platelet (PLT) ratio index (APRI) was calculated, and B-type ultrasound was used to test the degree of liver fibrosis among two groups. Results: There were 424 patients in the objective group, aged (66.29±7.21) years, and 3083 person in the control group, aged (65.98±14.81) years. The APRI scores between the control group and the objective group were (0.74±0.51) points and (1.04±0.53) points, respectively (P<0.01) . The total score of 5 items of EQ-5D was (6.86±2.21) points and (7.88±2.71) points, respectively, in the objective group had 375 cases of liver fibrosis grade I and 49 cases of liver fibrosis grade Ⅱ, which were significantly higher than that of the control group[ (5.50±1.17) points] (P<0.01) . Among the respondents, EQ-VAS score was negative correlated with EQ-5D scores (r=-0.616, P<0.01) . Conclusion: The health-related quality of life of agricultural workers with schistosomiasis liver fibrosis at a township, Quzhou City Kaihua County decreased compared with the control group.


Asunto(s)
Calidad de Vida , Esquistosomiasis , Estudios Transversales , Europa (Continente) , Agricultores , Humanos , Cirrosis Hepática , Factores Socioeconómicos , Encuestas y Cuestionarios
5.
BMC Health Serv Res ; 21(1): 653, 2021 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-34225719

RESUMEN

BACKGROUND: Patients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits. METHODS: We studied 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge. RESULTS: Patients with SMI from the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients from the most disadvantaged communities had 7.3 % greater 30-day observation stay revisits. CONCLUSIONS: These results suggest that additional investments are needed to ensure that patients with SMI from the most disadvantaged communities are receiving appropriate post-discharge care.


Asunto(s)
Cuidados Posteriores , Trastornos Mentales , Servicio de Urgencia en Hospital , Florida/epidemiología , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , New York/epidemiología , Alta del Paciente , Readmisión del Paciente , Estudios Retrospectivos , Factores Socioeconómicos
6.
Cien Saude Colet ; 26(7): 2601-2612, 2021 Jul.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34231673

RESUMEN

This study aimed to verify the association between work and sociodemographic factors, health behaviors, and cardiovascular risk in Brazilian adolescents. Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were analyzed, with a sample of 37,815 adolescents aged 12-17 years and morning shift students. Considering complex sampling, crude and adjusted Prevalence Ratios (PR) were calculated with interval estimates for variables by Poisson multiple regression model with robust variance estimate. The sociodemographic factors associated with work among Brazilian adolescents were male gender (PR 1.34), aged 15-17 years, with maternal schooling up to elementary school (PR 1.26), public school students (PR 1.63), and from the rural area (PR 1.90). Regarding lifestyle habits and social behavior, the association was significant in physically active (PR 1.19) and alcohol-consuming students (PR 1.35). In conclusion, work among Brazilian adolescent morning shift students is still strongly linked to social issues. Work was associated with alcohol consumption, and there was no association with metabolic markers.


Asunto(s)
Enfermedades Cardiovasculares , Factores de Riesgo de Enfermedad Cardiaca , Adolescente , Brasil/epidemiología , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Humanos , Masculino , Prevalencia , Factores de Riesgo , Factores Socioeconómicos
7.
Cien Saude Colet ; 26(7): 2625-2634, 2021 Jul.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34231675

RESUMEN

This study aimed to analyze the association of socioeconomic factors with the prevalence of dental caries in adolescents from São Luís, Maranhão, Brazil, to answer whether social inequalities persist in distributing this disease. This is a cross-sectional study nested in a prospective cohort. We included 2,413 adolescents aged 18-19 years evaluated in the 2016 second follow-up. The outcome was teeth with untreated dental caries (yes or no) assessed by the DMFT index. Socioeconomic and demographic characteristics were the independent variables. Descriptive statistical and Poisson regression analyses were performed, calculating crude and adjusted prevalence ratios (PRs) (alpha=5%). Belonging to economic classes C (PR=1.23; 95% CI: 1.11-1.37) or D-E (PR=1.48; 95% CI: 1.32-1.65), being married/living with a partner (PR=1.22; 95% CI: 1.07-1.39), having separated parents (PR=1.11; 95% CI 1.03-1.19) and a greater number of people in the household (PR=1.05; 95% CI: 1.03-1.07) were associated with a higher prevalence of dental caries. Social inequalities in adolescent oral health persist despite the implementation of the National Oral Health Policy. The current health care model should seek to reorient health education strategies, targeting them at vulnerable populations.


Asunto(s)
Caries Dental , Adolescente , Brasil/epidemiología , Estudios Transversales , Índice CPO , Caries Dental/epidemiología , Humanos , Prevalencia , Estudios Prospectivos , Factores Socioeconómicos
8.
Cien Saude Colet ; 26(7): 2819-2827, 2021 Jul.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34231694

RESUMEN

This study aimed to analyze the demand for health services or professionals by adolescents with individual determinants and contextual variables (school teaching modality and Social Vulnerability Index). Data were collected from March to June 2018, in state public schools in Olinda, Pernambuco, Brazil, through a structured questionnaire with questions from the Youth Risk Behavior Survey (YRBS) and the National School Health Survey (PeNSE). Among the 2,454 adolescents, the proportion of those looking for a health service was higher among women; in adolescents whose mothers had a minimum of nine schooling years; in the physically active; and whose parents did not receive a family aid (Bolsa Família). We observed that the contextual variables did not influence the demand for health services among adolescents. In the third model of the multilevel analysis, which analyzed the individual variables, we observed that only females (OR=1,80), having a mother with schooling greater than or equal to 9 years of study (OR=1,30), not receiving Bolsa Família (OR=1,23), and physically active (OR=1,32) were associated with an increased demand for health services or professionals.


Asunto(s)
Servicios de Salud , Instituciones Académicas , Adolescente , Brasil , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Factores Socioeconómicos
9.
Afr J Prim Health Care Fam Med ; 13(1): e1-e7, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-34212744

RESUMEN

BACKGROUND: Hypertension is a public health threat of global concern with increasing prevalence in many countries, including Nigeria. AIM: The aim of the study was to determine the prevalence and determinants of hypertension in a rural agrarian community in Edo North, Nigeria. SETTING: The study was carried out in Ayua, a community in Edo North, southern Nigeria. METHODS: This cross-sectional descriptive study involved the use of a structured interviewer-administered questionnaire to obtain relevant data. Body mass index (BMI), blood pressure and glucose were recorded. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0. RESULTS: Two hundred and nineteen participants aged 15 years completed the study with a mean age of 54.03 ± 16.61 years and females comprising 159 (72.6%) of the total. The prevalence of hypertension was 27.9% (in 61 participants). Twenty-one (9.8%) respondents gave a family history of hypertension. The mean BMI amongst respondents was 27.10 ± 6.61 kg/m2. Obesity and pre-obesity were found in 58 (26.5%) and 71(32.4%) respondents, respectively. The determinants of hypertension were age and BMI. Compared with those who were less than 40 years old, those aged 40-65 years and 65 years had 1.9 and 4.2 times increased odds of developing hypertension, respectively. Similarly, compared with the non-obese, obese participants had 2.3 times increased odd of having hypertension. CONCLUSION: Hypertension was highly prevalent in this rural community. Health sensitisation and intervention programmes are recommended in rural communities for early detection and management of hypertension, especially amongst older and obese adults.


Asunto(s)
Hipertensión/epidemiología , Obesidad/epidemiología , Determinantes Sociales de la Salud , Adulto , Anciano , Presión Sanguínea/fisiología , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Hipertensión/etnología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Obesidad/complicaciones , Obesidad/etnología , Obesidad/psicología , Prevalencia , Factores de Riesgo , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Población Urbana/estadística & datos numéricos
10.
Rev Esp Salud Publica ; 952021 Jul 02.
Artículo en Español | MEDLINE | ID: mdl-34212940

RESUMEN

OBJECTIVE: The preventive measures to be taken in the face of a new epidemic require knowledge of the number of infected and which groups are most vulnerable. To know the cumulative incidence of COVID-19 in the city of Madrid and its 21 districts in the first 4 months of the epidemic and its relationship with some socioeconomic and demographic variables. METHODS: Cross-sectional ecological study (39,270 cases). The 39,270 cases diagnosed from the beginning of the pandemic until June 26, 2020, published by the Comunidad de Madrid in were studied. In the districts, the distribution of gross and fair incidence is related to the ones of the independent variables (Municipal Statistics and Estudio de Salud 2018, Madrid Salud). The Incidence and the r and r2 coefficients, obtained with the factors and the Multiple Linear Regression (MLR) model, are studied. RESULTS: The city of Madrid presents a cumulative incidence of COVID-19, which is double the national one (100), with a Standardized Cumulative Incidence Ratio (RIAE) of 204.59 per 100. The districts with the most RIAE were those in the southeast, all>240 per 100. In the districts, the per capita household rate, the per capita income, and the mortality rate from infectious diseases in men reached high and inverse correlations with RIAE (all r>-0.3). The RLM model with these 3 indicators predicts 30% of the RIAES. CONCLUSIONS: The relationship between material wealth and the risk of COVID-19 infection is inverse. The knowledge in the districts of per capita income, household rate and mortality rate due to infectious diseases in men reduces the uncertainty about the accumulated incidence by 30%.


Asunto(s)
COVID-19/epidemiología , Disparidades en el Estado de Salud , Pandemias , Anciano , Anciano de 80 o más Años , Ciudades/epidemiología , Estudios Transversales , Demografía , Femenino , Humanos , Incidencia , Masculino , Factores Socioeconómicos , España/epidemiología
11.
BMC Health Serv Res ; 21(1): 643, 2021 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-34217287

RESUMEN

BACKGROUND: Worldwide, socioeconomic differences in health and use of healthcare resources have been reported, even in countries providing universal healthcare coverage. However, it is unclear how large these socioeconomic differences are for different types of care and to what extent health status plays a role. Therefore, our aim was to examine to what extent healthcare expenditure and utilization differ according to educational level and income, and whether these differences can be explained by health inequalities. METHODS: Data from 18,936 participants aged 25-79 years of the Dutch Health Interview Survey were linked at the individual level to nationwide claims data that included healthcare expenditure covered in 2017. For healthcare utilization, participants reported use of different types of healthcare in the past 12 months. The association of education/income with healthcare expenditure/utilization was studied separately for different types of healthcare such as GP and hospital care. Subsequently, analyses were adjusted for general health, physical limitations, and mental health. RESULTS: For most types of healthcare, participants with lower educational and income levels had higher healthcare expenditure and used more healthcare compared to participants with the highest educational and income levels. Total healthcare expenditure was approximately between 50 and 150 % higher (depending on age group) among people in the lowest educational and income levels. These differences generally disappeared or decreased after including health covariates in the analyses. After adjustment for health, socioeconomic differences in total healthcare expenditure were reduced by 74-91 %. CONCLUSIONS: In this study among Dutch adults, lower socioeconomic status was associated with increased healthcare expenditure and utilization. These socioeconomic differences largely disappeared after taking into account health status, which implies that, within the universal Dutch healthcare system, resources are being spent where they are most needed. Improving health among lower socioeconomic groups may contribute to decreasing health inequalities and healthcare spending.


Asunto(s)
Gastos en Salud , Renta , Adulto , Atención a la Salud , Disparidades en Atención de Salud , Humanos , Países Bajos , Clase Social , Factores Socioeconómicos
12.
Nutrients ; 13(6)2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-34199924

RESUMEN

The nutrition status of children is gaining more attention with a rapid nutrition transition. This study aimed to investigate trends and urban-rural differences in dietary energy and macronutrient composition among Chinese children. A total of 7565 participants aged 6 to 17 years were obtained from three rounds (1991, 2004 and 2015) of the Chinese Health and Nutrition Survey (CHNS). The individual diet was evaluated via three consecutive 24-hour dietary recalls and compared with the Chinese Dietary Reference Intakes (DRIs). From 1991 to 2015, there was a significant increase in children's fat intake, the proportion of energy intake from fat, and the proportion of children with more than 30% of energy from fat and less than 50% of energy from carbohydrates (p < 0.001). Compared with the DRI, the proportion with higher fat and lower carbohydrate intakes were, respectively, 64.7% and 46.8% in 2015. The urban-rural disparities in fat and carbohydrate intake gradually narrowed, while the gap in protein intake increased notably over time (p < 0.001). Chinese children experienced a rapid transformation to a low-carbohydrate and high-fat diet. Urban-rural disparities persistently existed; further nutritional interventions and education were of great significance, so as to ensure a more balanced diet for Chinese children.


Asunto(s)
Ingestión de Alimentos , Ingestión de Energía , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Niño , China/epidemiología , Femenino , Disparidades en el Estado de Salud , Humanos , Masculino , Encuestas Nutricionales , Factores Socioeconómicos
13.
Nutrients ; 13(6)2021 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-34205144

RESUMEN

The excessive consumption of nitrogen (N) and phosphorus (P), two vital nutrients for living organisms, is associated with negative environmental and health impacts. While food production contributes to a large amount of N and P loss to the environment, very little N and P is consumed as food. Food habits are affected by multiple regulations, including the dietary restrictions and dictates of various religions. In this study, religion-sensitive N-Calculator and P-Calculator approaches were used to determine the impact of religious dietary culture on the food N and P footprints of India in the major religious communities. Using 2013 data, the food N footprint of Hindus, Muslims, Christians, and Buddhists was 10.70, 11.45, 11.47, and 7.39 kg-N capita-1 year-1 (10.82 kg-N capita-1 year-1 was the national average), and the food P footprint was 1.46, 1.58, 1.04. and 1.58 kg-P capita-1 year-1 (1.48 kg-P capita-1 year-1 was the national average). The findings highlight the impact of individual choice on the N and P food footprints, and the importance of encouraging the followers of religion to follow a diet consistent with the food culture of that religion. The results of this study are a clear indication of the requirement for religion-sensitive analyses in the collecting of data pertinent to a particular country for use in making government policies designed to improve the recycling of food waste and the treatment of wastewater.


Asunto(s)
Cultura , Dieta/etnología , Ambiente , Nitrógeno/administración & dosificación , Fósforo/administración & dosificación , Religión , Budismo , Cristianismo , Alimentos/estadística & datos numéricos , Hinduismo , Humanos , India , Islamismo , Modelos Estadísticos , Factores Socioeconómicos
14.
Artículo en Inglés | MEDLINE | ID: mdl-34200437

RESUMEN

Nudging has received ample attention in scientific literature as an environmental strategy to promote healthy diets, and may be effective for reaching populations with low socioeconomic position (SEP). Therefore, the objective of this study was to investigate how the determinants of food choice shape the perceptions regarding supermarket-based nudging strategies among adults with low SEP. We conducted semi-structured interviews among fifteen adults with low SEP using a pre-defined topic list and visual examples of nudges. Interviews were recorded and transcribed verbatim and content analysis was used to analyse the data. The results show that food costs, convenience, healthiness, taste, and habits were frequently mentioned as determinants of food choice. However, the relative importance of these determinants seemed to be context-dependent. Interviewees generally had a positive attitude towards nudges, especially when they were aligned with product preferences, information needs, and beliefs about the food environment. Still, some interviewees also expressed distrust towards nudging strategies, suspecting ulterior motives. We conclude that nudging strategies should target foods which align with product preferences and information needs. However, the suspicion of ulterior motives highlights an important concern which should be considered when implementing supermarket-based nudging strategies.


Asunto(s)
Preferencias Alimentarias , Supermercados , Conducta de Elección , Dieta Saludable , Percepción , Factores Socioeconómicos
15.
Artículo en Inglés | MEDLINE | ID: mdl-34204018

RESUMEN

Despite near universal health insurance coverage in China, populations with low incomes may still face barriers in access and utilization of affordable health care. We aimed to identify the likelihood of forgone medical care due to cost by surveying individuals from the community to assess: (1) The percent with forgone medical care due to cost; and (2) Factors associated with forgone medical care due to cost. Surveys conducted (2016-2017) in Mandarin included demographic and medical care utilization-related items. Theoretically-informed, fully-adjusted analyses were employed. Approximately 94% of respondents had health insurance, which is somewhat similar to national estimates. Overall, 24% of respondents resided in rural areas, with 18% having less than a high school education, and 49% being male. More than 36% reported forgone medical care due to cost in the past 12 months. In fully-adjusted analyses, having lower education, generally not being satisfied with the commute to the hospital, and being a resident of a province with a lower density of physicians were associated with forgone medical care. Cost-related disparities in the access and utilization of needed medical care persist, even with near universal health insurance, which may be due to one's satisfaction with travel time to healthcare and other community assets.


Asunto(s)
Accesibilidad a los Servicios de Salud , Determinantes Sociales de la Salud , China , Femenino , Hospitales , Humanos , Seguro de Salud , Masculino , Pobreza , Factores Socioeconómicos
16.
Artículo en Inglés | MEDLINE | ID: mdl-34205125

RESUMEN

There are large socioeconomic inequalities in alcohol-related harm. The alcohol harm paradox (AHP) is the consistent finding that lower socioeconomic groups consume the same or less as higher socioeconomic groups yet experience greater rates of harm. To date, alcohol researchers have predominantly taken an individualised behavioural approach to understand the AHP. This paper calls for a new approach which draws on theories of health inequality, specifically the social determinants of health, fundamental cause theory, political economy of health and eco-social models. These theories consist of several interwoven causal mechanisms, including genetic inheritance, the role of social networks, the unequal availability of wealth and other resources, the psychosocial experience of lower socioeconomic position, and the accumulation of these experiences over time. To date, research exploring the causes of the AHP has often lacked clear theoretical underpinning. Drawing on these theoretical approaches in alcohol research would not only address this gap but would also result in a structured effort to identify the causes of the AHP. Given the present lack of clear evidence in favour of any specific theory, it is difficult to conclude whether one theory should take primacy in future research efforts. However, drawing on any of these theories would shift how we think about the causes of the paradox, from health behaviour in isolation to the wider context of complex interacting mechanisms between individuals and their environment. Meanwhile, computer simulations have the potential to test the competing theoretical perspectives, both in the abstract and empirically via synthesis of the disparate existing evidence base. Overall, making greater use of existing theoretical frameworks in alcohol epidemiology would offer novel insights into the AHP and generate knowledge of how to intervene to mitigate inequalities in alcohol-related harm.


Asunto(s)
Conductas Relacionadas con la Salud , Disparidades en el Estado de Salud , Humanos , Factores Socioeconómicos
17.
J Anal Psychol ; 66(3): 750-762, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34231899

RESUMEN

George Floyd's death, the COVID-19 pandemic and climate change are on a continuum from the immediate shock of viewing a video-recorded murder, to millions dying worldwide from disease, to deaths related to climate change accumulating over a millennium. They participate in the powerful archetypes of death and inequality. 'Increase', Hexagram 42 in the I Ching, archetypically addresses inequalities at all levels - racial, economic, political and the profound imbalance between humans and the environment. Floyd's death highlights the consequences of systemic racism and income inequalities. The pandemic as 'nature's revenge' hits minority populations harder due to underlying health conditions resulting from poverty and greater exposure to the virus in the workplace. President Trump as Trickster showed Americans their shadow and his response to the pandemic amplified its severity. The pandemic has shocked our social, political and economic systems and paused our species rush into environmental disasters at many levels. The disruptions present opportunities for reflection, experimentation and developing new systems as old forms are challenged. The ecological dimensions of Jung's concepts emphasize interconnectedness at all levels and the paradigm shift he called a 'new age' provides a framework for altering the course of the Anthropocene Era.


Asunto(s)
COVID-19 , Homicidio , Policia , Teoría Psicoanalítica , Racismo , Factores Socioeconómicos , Humanos , Estados Unidos
18.
Bone Joint J ; 103-B(7 Supple B): 98-102, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34192903

RESUMEN

AIMS: The purpose of this study was to determine the access to and ability to use telemedicine technology in adult patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA), and to determine associations with the socioeconomic characteristics of the patients, including age, sex, race, and education. We also sought to understand the patients' perceived benefits, risks, and preferences when dealing with telemedicine. METHODS: We performed a cross-sectional survey involving patients awaiting primary THA and TKA by one of six surgeons at a single academic institution. Patients were included and called for a telephone-administered survey if their surgery was scheduled to be between 23 March and 2 June 2020, and were aged > 18 years. RESULTS: The response rate was 52% (189 of 363 patients). A total of 170 patients (90.4%) reported using the internet, 177 (94.1%) reported owning a device capable of videoconferencing, and 143 (76.1%) had participated in a video call in the past year. When asked for their preferred method for a consultation, 155 (82.8%) and 26 (13.9%) ranked in-person and a videoconference as their first choice, respectively. The perceived benefits of telemedicine consultations included reduced travel to appointments (165 (88.2%) agreed) and reduced cost of attending appointments (123 (65.8%) agreed). However, patients were concerned that they would not establish the same patient-physician connection (100 (53.8%) agreed), and would not receive the same level of care (52 (33.2%) agreed) using telemedicine consultations compared with in-person consultations. CONCLUSION: Most patients undergoing arthroplasty have access to and are capable of using the technology required for telemedicine consultations. However, they still prefer in-person consultations due to concerns that they will not establish the same patient-physician connection and will not receive the same level of care, despite the benefits of reducing the time spent in travelling and the cost of attending appointments, and the appointments being easier to attend. Cite this article: Bone Joint J 2021;103-B(7 Supple B):98-102.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Accesibilidad a los Servicios de Salud , Derivación y Consulta , Telemedicina , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios
19.
Acta Biomed ; 92(3): e2021186, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34212910

RESUMEN

OBJECTIVES: To review the demographics and socioeconomic determinants of preterm birth (PTB) compared to term births among the Qatari population. METHODS: This was a retrospective data analysis of 59,308 births. Data were retrieved from a Population-based Cohort Study. Data were gathered from the PEARL-Peristat maternal newborn registry for 2011, 2012, 2017, and 2018. We compared the preterm births group (delivery < 37 weeks) with the term group (delivery ≥ 37 weeks) regarding socioeconomic factors, including maternal nationality, religion, level of education, mother's occupation, family income, housing, consanguinity, early childbearing, high-risk pregnancy, smoking, assisted conception, antenatal care, and place of delivery. RESULTS: The prevalence of preterm birth was 9%. There were more Saudi nations in the preterm group compared to term (33% vs. 28%, p-value < 0.001). There were more preterm births than term births among working mothers (40% vs. 35%), high-risk pregnancies (24% vs. 18%), those that has used assisted conception (18% vs. 3%), those without antenatal care (11% vs. 5.6%), and those delivered in a tertiary women hospital (88.5% vs. 84.5%) (all p-values < 0.001). There were more women living in villas (41% vs. 38%, p = 0.01) and more smokers (0.8% vs. 0.5%, p = 0.030) in the preterm group than in the term group. There were no differences between the two groups regarding religion, level of maternal education, family income, and early childbearing. CONCLUSION: In our population, we identified several factors associated with preterm births, the most important is Lack of antenatal care , assisted conception and working mothers.


Asunto(s)
Nacimiento Prematuro , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Embarazo , Nacimiento Prematuro/epidemiología , Qatar/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Factores Socioeconómicos
20.
Artículo en Inglés | MEDLINE | ID: mdl-34199387

RESUMEN

Children have been identified as being particularly vulnerable to energy poverty (EP), but little empirical research has addressed the effect of EP on children's health and wellbeing, especially in southern Europe. In this work we aimed to provide an in-depth description of the distribution of EP by sociodemographic, socioeconomic and housing characteristics, as well as to analyse the association between EP and health and wellbeing in children in Barcelona. We performed a cross-sectional study using data from the Barcelona Health Survey for 2016 (n = 481 children under 15 years). We analysed the association between EP and health outcomes through prevalence differences and prevalence ratios (PR) and their 95% confidence interval (CI), using Poisson regression models with robust variance. In Barcelona, 10.6% of children were living in EP and large inequalities were found by sociodemographic, socioeconomic and housing characteristics. EP was strongly associated with poor health in children (PR (95% CI): 7.70 (2.86, 20.72)). Living in EP was also associated with poor mental health (PR (95% CI): 2.46 (1.21, 4.99)) and with more cases of asthma (PR (95% CI): 4.19 (1.47, 11.90)) and overweight (PR (95% CI): 1.50 (1.05, 2.15)) in children. It is urgent to develop specific measures to avoid such serious and unfair health effects on children.


Asunto(s)
Vivienda , Pobreza , Niño , Ciudades , Estudios Transversales , Europa (Continente) , Humanos , Factores Socioeconómicos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...