Direct and indirect pathways between low income status and becoming a high-cost health care user in Ontario, Canada: a mediation analysis of health risk behaviors

2020 ◽  
Vol 51 ◽  
pp. 28-34.e4
Author(s):  
Luke Mondor ◽  
Tristan Watson ◽  
Kathy Kornas ◽  
Catherine Bornbaum ◽  
Walter P. Wodchis ◽  
...  
Keyword(s):  
Health Care ◽  
Health Risk ◽  
Risk Behaviors ◽  
Low Income ◽  
Mediation Analysis ◽  
Health Risk Behaviors ◽  
Income Status

Is HEADS in our heads? Health risk behavior is not routinely discussed with young people with chronic conditions

2016 ◽  
Vol 28 (4) ◽  
pp. 429-435 ◽  
Author(s):  
Kirsten A. Boisen ◽  
Pernille Grarup Hertz ◽  
Charlotte Blix ◽  
Grete Teilmann
Keyword(s):  
Health Care ◽  
Young People ◽  
Health Risk ◽  
Risk Behaviors ◽  
Health Care Professionals ◽  
Young Patients ◽  
Health Risk Behaviors ◽  
Home Education ◽  
Illegal Drugs ◽  
Usual Practice

Abstract Background: Outpatient clinic visits are a window of opportunity to address health risk behaviors and promote a healthier lifestyle among young people. The HEADS (Home, Education, Eating, Activities, Drugs [i.e. substance use including tobacco, alcohol, and illegal drugs], Sexuality [including contraception], Safety, Self-harm) interview is a feasible way of exploring health risk behaviors and resilience. Objective: The purpose of this study was to evaluate how often HEADS topics were addressed according to young patients and staff in pediatric and adult outpatient clinics. Methods: We conducted a questionnaire survey among young patients and health care professionals at a tertiary university hospital. Young patients reported on their cumulative experience and staff reported on their usual practice. Results: A total of 290 young patients aged 12–22 years (78% having a chronic condition) and 97 health care professionals participated. We found only small reported differences between staff and young patients regarding whether home, education, and activity were addressed. However, staff reported twice the rate of addressing smoking, alcohol, illegal drugs, sexuality, and contraception compared to young patients. Young patients reported that smoking, alcohol, illegal drugs, sexuality, and contraception were addressed significantly more at adult clinics in comparison to pediatric clinics. After controlling for age, gender and duration of illness, according to young patients, adjusted odds ratios for addressing smoking at adult vs. pediatric clinics was 2.47 (95% confidence interval [CI]: 1.26–4.83), alcohol 2.84 (95% CI:1.45–5.57), illegal drugs 4.20 (95% CI:1.69–10.44), sexuality 3.54 (95% CI: 1.67–7.50), contraception 3.68 (95% CI:1.61–8.41), and any of the above 2.95 (95% CI: 1.47–5.91). Conclusion: According to young patients, smoking, alcohol, illegal drugs, sexuality, and contraception were not routinely addressed at a tertiary hospital, and especially at paediatric clinics, these issues were seldom addressed.

scholarly journals The Impact of Unemployment on Mental and Physical Health, Access to Health Care and Health Risk Behaviors

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Jennifer R. Pharr ◽  
Sheniz Moonie ◽  
Timothy J. Bungum
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Risk ◽  
Risk Behaviors ◽  
Access To Health Care ◽  
Health Risk Behaviors ◽  
Unemployment Duration ◽  
Health Access ◽  
Access To Health ◽  
The Impact

The purpose of this study was to examine the impact of employment status and unemployment duration on perceived health, access to health care, and health risk behaviors. Data from Nevada's 2009 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. We compared participants who were unemployed (greater than and less than one year) to those who were employed and those who were voluntarily out of the labor force (OLF). Unemployed participants had significantly worse perceived mental health profiles, were more likely to delay health care services due to cost, and were less likely to have access to health care than employed participants and OLF participants. OLF participants were not significantly different from employed participants. Contrary to previous findings, unemployed participants in this study were not more likely to binge drink, smoke, or be physically inactive. Findings from this study suggest that the impetus for unemployment, be it voluntary or involuntary, may significantly impact a person's mental health.

scholarly journals Sociodemographic Disadvantage, Living With a Smoker, and Health Risk Behaviors in Middle-Aged and Older Women

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 337-338
Author(s):  
Carole Holahan ◽  
Charles Holahan ◽  
Sangdon Lim ◽  
Yen Chen ◽  
Daniel Powers
Keyword(s):  
Health Risk ◽  
Risk Behaviors ◽  
Low Income ◽  
Indirect Effects ◽  
Fruits And Vegetables ◽  
Smoking Status ◽  
Health Risk Behaviors ◽  
Unhealthy Lifestyle ◽  
Cross Sectional

Abstract Sociodemographic disadvantage places individuals at risk for an unhealthy lifestyle (Kushi et al., 2012; Shanker et al., 2010), as well as for exposure to second-hand household smoke (Gan et al., 2015; Zhang et al., 2012). However, the role of living with a smoker in the association between sociodemographic status and health behavior is unstudied. This study investigated the role of living with a smoker in partially explaining the link between sociodemographic disadvantage and physical inactivity and poor dietary behaviors. The study used limited access data from the Women’s Health Initiative Observational Study obtained from NHLBI. Participants were 83,597 women ranging in age from 49 to 81; 6038 participants lived with a smoker. Cross-sectional logistic regression analyses examined paths in the models; bias-corrected bootstrapped confidence intervals tested indirect effects in probit analyses. Analyses controlled for age, ethnicity, marital status, and participants’ current smoking status. Results demonstrated a significant association (p < .001) between sociodemographic disadvantage (composite of low education and low income) and living with a smoker (OR = 1.74). The unstandardized indirect effects (CIs are in brackets) from sociodemographic disadvantage through living with a smoker to no exercise, no walking, high percent dietary fat, and low servings of fruits and vegetables through living with a smoker were statistically significant (.023 [.019, .028], .026 [.023, .033], .041 [.037, .047], and .032 [.027, .036], respectively). These findings illustrate the need to address multiple non-smoking health risk behaviors in household smoking interventions for disadvantaged families. This project was supported by the NIH/NCI (R03CA215947).

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