Low Income, African American Race and Lower Education Level are Risk Factors for Failure to Seek Medical Care for Gastrointestinal Problems after ER Visit

2017 ◽  
Vol 152 (5) ◽  
pp. S443-S444
Author(s):  
Mir Fahad Faisal ◽  
Mouhanna AbuGhanimeh ◽  
Muhammad Shafiq ◽  
Raj Shah ◽  
Sreeni Jonnalagadda
2018 ◽  
Vol 52 ◽  
pp. 4s ◽  
Author(s):  
Caroline Cardozo Bortolotto ◽  
Christian Loret de Mola ◽  
Luciana Tovo-Rodrigues

OBJECTIVE: To analyze the quality of life and its determinants in a population living in a rural area. METHODS: This is a population-based, cross-sectional study with individuals aged 18 years or over from the rural area of Pelotas, State of Rio Grande do Sul, Brazil. We evaluated quality of life using the WHOQOL-BREF, which has four domains (physical, psychological, social relations, and environment) and two questions: overall quality of life and satisfaction with health. We considered as independent variables the demographic, socioeconomic, and health variables. We evaluated the associations using linear regression in the four domains and ordinal logistic regression in the two general questions on quality of life and satisfaction with health. RESULTS: The sample consisted of 1,479 individuals. The prevalence of the perception of overall very poor quality of life and dissatisfaction with health were 22.5% and 26.3%, respectively. Individuals who were older (p < 0.001), non-white (p = 0.004), with lower education level (p < 0.001), poorer (p = 0.001), and who had always lived in the rural area (p = 0.049) were less likely to have a better perception of overall quality of life. As for satisfaction with health, women (p = 0.001), older individuals (p = 0.001), those unemployed (p = 0.023), and those with diseases were less likely to report higher satisfaction with health. For the four domains evaluated, the results were consistent with those observed for the general questions. CONCLUSIONS: The most relevant aspects that negatively defined the quality of life of the population were being a woman, older, non-white, having a low income, having a lower education level, having always lived in the rural area, being unemployed, and having a disease. Given that they are significant factors as determinants of health, these results suggest that quality of life is an issue that should be placed among health needs, especially regarding the most vulnerable groups in rural areas.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Chien-Wen Yang ◽  
Si Li ◽  
Yishan Dong

Background. There are no nationwide population studies conducted to analyze the prevalence and risk factors associated with hypokalemia during pregnancy in the U.S. Method. We retrieved data from the Nationwide Inpatient Sample (NIS) and the National Inpatient Sample of Healthcare Cost and Utilization Project (HCUP) for pregnant patients with hypokalemia from 2012 to 2014. We used a chi-squared test to analyze categorical variables and an adjusted Wald test to compare quantitative variables. We applied logistic regression models to calculate adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) to identify the risk factors for hypokalemia. We used a p value <0.05 as the cutoff for statistical significance. Result. Among 12,431,909 pregnancy-related discharges, females of younger age (mean age 27.0 ± 6.2 vs. 28.1 ± 6.0, p < 0.001 ), of African American race, using government-paid insurance, with an income level in the first quartile, and of a higher Charlson Comorbidity Index score (≥1) were found to have a higher likelihood of hypokalemia during pregnancy ( p < 0.001 ). Gestational hypertension (GH) (including pre-eclampsia and eclampsia, aOR 2.03, 95% CI 1.94–2.12, p < 0.001 ), hyperemesis gravidarum (aOR 33.18, 95% CI 31.61–34.83, p < 0.001 ), and post-partum hemorrhage (aOR 1.42, 95% CI 1.31–1.53, p < 0.001 ) were found to be independently associated with a higher rate of hypokalemia during pregnancy. Conclusion. The prevalence of hypokalemia during pregnancy was less than 1% in this large, nationwide population-based study. There were significant differences between those patients who developed hypokalemia during pregnancy. Notably, those who had hypokalemia were younger, of African American race, and of a low-income level. Congestive heart failure, coronary artery disease, Cushing’s syndrome, GH, and hyperemesis gravidarum were found to be associated with hypokalemia during pregnancy.


2020 ◽  
Author(s):  
Kazem Khalagi ◽  
Akram Ansarifar ◽  
Noushin Fahimfar ◽  
Mahnaz Sanjari ◽  
Safoora Gharibzdeh ◽  
...  

Abstract Background: Iran's population is aging. One of the most common problems in Iranian public health is the high prevalence of cardio-metabolic risk factors. The purpose of this study was to investigate the relationship between cardio-metabolic and demographic risk factors and disability in people 60 years and older in Iran.Methods: Data from the Bushehr Elderly Health (BEH) program was used in the analysis. Demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis.Results: Mean (Standard Deviation) of the participants’ age was 69.34 (6.4) years (range: 60 and 96 years), and 48.06% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.33 (1.89 - 2.86)), having a lower education level, a history of diabetes mellitus (OR: 1.43 (1.17 -1.74)) and past smoking (OR: 1.25 (1.00 - 1.55)), and no physical activity (OR: 1.54 (1.23 - 1.87)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.38 (1.85 - 3.03)), having a lower education level, no physical activity (OR: 2.17 (1.61 - 2.86)) and low daily intake of calories were associated with dependency in BADL.Conclusion: Age, gender, education level and physical activity are risk factors of the dependency in both of BADL and IADL in the elderly people. Diabetes mellitus and past smoking are risk factors of the dependency in IADL, and low HDL cholesterol and low daily intake of calories are risk factors of the dependency in BADL.


Author(s):  
Longmei Tang ◽  
Shangchun Wu ◽  
Dianwu Liu ◽  
Marleen Temmerman ◽  
Wei-Hong Zhang

Background: In China, there were about 9.76 million induced abortions in 2019, 50% of which were repeat abortions. Understanding the tendency of repeat induced abortion and identifying its related factors is needed to develop prevention strategies. Methods: Two hospital-based cross-sectional surveys were conducted from 2005–2007 and 2013–2016 in 24 and 90 hospitals, respectively. The survey included women who sought an induced abortion within 12 weeks of pregnancy. The proportion of repeat induced abortions by adjusting the covariates through propensity score matching was compared between the two surveys, and the zero-inflated negative binomial regression model was established to identify independent factors of repeat induced abortion. Results: Adjusting the age, occupation, education, marital status and number of children, the proportion of repeat induced abortions in the second survey was found to be low (60.28% vs. 11.11%), however the unadjusted proportion was high in the second survey (44.97% vs. 51.54%). The risk of repeat induced abortion was higher among married women and women with children [ORadj and 95% CI: 0.31 (0.20, 0.49) and 0.08 (0.05, 0.13)]; the risk among service industry staff was higher when compared with unemployed women [ORadj and 95% CI: 0.19 (0.07, 0.54)]; women with a lower education level were at a higher risk of a repeat induced abortion (ORadj < 1). Compared with women under the age of 20, women in other higher age groups had a higher frequency of repeat induced abortions (IRadj: 1.78, 2.55, 3.27, 4.01, and 3.93, separately); the frequency of women with lower education levels was higher than those with a university or higher education level (IRadj > 1); the repeat induced abortion frequency of married women was 0.93 (0.90, 0.98) when compared to the frequency of unmarried women, while the frequency of women with children was 1.17 (1.10, 1.25) of childless women; the induced abortion frequency of working women was about 60–95% with that of unemployed women. Conclusions: The repeat induced abortion proportion was lower than 10 years ago. Induced abortion seekers who were married, aged 20 to 30 years and with a lower education level were more likely to repeat induced abortions.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazem Khalagi ◽  
Akram Ansarifar ◽  
Noushin Fahimfar ◽  
Mahnaz Sanjari ◽  
Safoora Gharibzdeh ◽  
...  

Abstract Background Iran’s population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. Methods The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. Results Mean (Standard Deviation) of the participants’ age was 69.3 (6.4) years (range: 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.3 (1.9–2.9)), having a lower education level, a history of diabetes mellitus (OR: 1.4 (1.2–1.7)) and past smoking (OR: 1.3 (1.0–1.6)), and no physical activity (OR: 1.5 (1.2–1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.4 (1.9–3.0)), having a lower education level, no physical activity (OR: 2.2 (1.6–2.9)) and daily intake of calories (OR: 0.99 (0.99–0.99)) were associated with dependency in BADL. Conclusion Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
So Young Park ◽  
Jieun Kim ◽  
Jung Il Son ◽  
Sang Youl Rhee ◽  
Do-Yeon Kim ◽  
...  

AbstractThe screening rate of diabetic retinopathy (DR) is low despite the importance of early diagnosis. We investigated the predictive value of dietary glutamic acid and aspartic acid for diagnosis of DR using the Korea National Diabetes Program cohort study. The 2067 patients with type 2 diabetes without DR were included. The baseline intakes of energy, glutamic acid and aspartic acid were assessed using a 3-day food records. The risk of DR incidence based on intake of glutamic acid and aspartic acid was analyzed. The DR group was older, and had higher HbA1c, longer DM duration, lower education level and income than non-DR group (all p < 0.05). The intake of total energy, glutamic acid and aspartic acid were lower in DR group than non-DR group (p = 0.010, p = 0.025 and p = 0.042, respectively). There was no difference in the risk of developing DR according to the intake of glutamic acid and ascorbic acid. But, aspartic acid intake had a negative correlation with PDR. Hence, the intake of glutamic acid and aspartic acid did not affect in DR incidence. However, lower aspartic acid intake affected the PDR incidence.


Author(s):  
Deniz Yeter ◽  
Ellen C. Banks ◽  
Michael Aschner

There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1–5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rashid K. Sayyid ◽  
Diana Magee ◽  
Amanda E. Hird ◽  
Benjamin T. Harper ◽  
Eric Webb ◽  
...  

Introduction: Radical cystectomy (RC) is a highly morbid procedure, with 30-day complication rates approaching 31%. Our objective was to determine risk factors for re-operation within 30 days following a RC for non-metastatic bladder cancer. Methods: We included all patients who underwent a RC for non-metastatic bladder cancer using The American College of Surgeons National Surgical Quality Improvement Program database between January 1, 2007 and December 31, 2014. Logistic regression analyses were used to evaluate predictors of re-operation. Results: A total of 2608 patients were included; 5.8% of patients underwent re-operation within 30 days. On multivariable analysis, increasing body mass index (BMI) (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01–1.07), African-American race (vs. Caucasian OR 2.29; 95% CI 1.21–4.34), and history of chronic obstructive pulmonary disease (COPD) (OR 2.33; 95% CI 1.45–3.74) were significant predictors of re-operation within 30 days of RC. Urinary diversion type (ileal conduit vs. continent) and history of chemotherapy or radiotherapy within 30 days prior to RC were not. Patients who underwent re-operation within this timeframe had a significantly higher mortality rate (4.0% vs. 1.6%) and were more likely to experience cardiac (7.2% vs. 1.9%), pulmonary (23.0% vs. 3.0%), neurological (2.0% vs. 0.49%), and venous thromboembolic events (10.5% vs. 5.4%), as well as infectious complications (64.5% vs. 24.1%) with a significantly longer hospital length of stay (16.5 vs. 7.0 days). Conclusions: Recognizing increasing BMI, COPD, and African-American race as risk factors for re-operation within 30 days of RC will allow urologists to preoperatively identify such high-risk patients and prompt them to adopt more aggressive approaches to minimize postoperative surgical complications.


Author(s):  
Tatiane da Silva Dal Pizzol ◽  
Cassia Garcia Moraes ◽  
Paulo Sérgio Dourado Arrais ◽  
Andréa Dâmaso Bertoldi ◽  
Luiz Roberto Ramos ◽  
...  

ABSTRACT: Introduction: The written information on medicines has been acknowledged as an important tool for health education. Objective: To analyze the use and understanding of medicine package inserts by users and assess sociodemographic and medical factors associated with their comprehension. Method: Data in this analysis are part of the PNAUM National Survey - a cross-sectional population-based study conducted in Brazil. Descriptive statistics and the Pearson χ2 tests were performed to compare proportions between sociodemographic and medical characteristics, as well as use and understanding of medicine package inserts. Results: A total of 28.427 individuals responded to questions related to medicine package inserts. From these, 59.6% (95%CI 57.7 - 61.5) said they usually read the inserts, and 98.4% (95%CI 98.0 - 98.8) considered them necessary. Among people who read the medicine package inserts, more than half indicated difficulties with legibility (57.4%; 95%CI 55,2 - 59,6) and readability (54.1%; 95%CI 52.1 - 56.1). People from a lower education level reported greater difficulty in understanding them. Conclusion: The larger portion of the population usually read medicine package inserts. Nevertheless, people have difficulty in reading and understanding them.


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