The impact of cigarette smoking on healthcare utilization among rural residents in China

Abstract Purpose Adolescents’ perceptions of parental norms may influence their substance use. The relationship between parental norms toward cigarette and alcohol use, and the use of illicit substances among their adolescent children is not sufficiently investigated. The purpose of this study was to analyze this relationship, including gender differences, using longitudinal data from a large population-based study. Methods The present study analyzed longitudinal data from 3171 12- to 14-year-old students in 7 European countries allocated to the control arm of the European Drug Addiction Prevention trial. The impact of parental permissiveness toward cigarettes and alcohol use reported by the students at baseline on illicit drug use at 6-month follow-up was analyzed through multilevel logistic regression models, stratified by gender. Whether adolescents’ own use of cigarette and alcohol mediated the association between parental norms and illicit drug use was tested through mediation models. Results Parental permissive norms toward cigarette smoking and alcohol use at baseline predicted adolescents’ illicit drug use at follow-up. The association was stronger among boys than among girls and was mediated by adolescents’ own cigarette and alcohol use. Conclusion Perceived parental permissiveness toward the use of legal drugs predicted adolescents’ use of illicit drugs, especially among boys. Parents should be made aware of the importance of norm setting, and supported in conveying clear messages of disapproval of all substances.

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The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

Ageing and Society ◽

10.1017/s0144686x21000702 ◽

2021 ◽

pp. 1-26

Author(s):

Yazhen Yang ◽

Maria Evandrou ◽

Athina Vlachantoni

Keyword(s):

Life Satisfaction ◽

Older People ◽

Adult Children ◽

Rural Areas ◽

Living Arrangements ◽

Psychological Wellbeing ◽

Urban Residents ◽

Intergenerational Support ◽

Rural Residents ◽

The Impact

Abstract Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

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Social Networks, Trust, and Disaster-Risk Perceptions of Rural Residents in a Multi-Disaster Environment: Evidence from Sichuan, China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042106 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2106 ◽

Cited By ~ 2

Author(s):

Kaijing Xue ◽

Shili Guo ◽

Yi Liu ◽

Shaoquan Liu ◽

Dingde Xu

Keyword(s):

Social Networks ◽

Risk Perception ◽

Self Efficacy ◽

Risk Perceptions ◽

Ordinary Least Squares ◽

Disaster Risk ◽

Mountainous Areas ◽

Rural Residents ◽

Response Efficacy ◽

The Impact

Individual perception of disaster risk is not only the product of individual factors, but also the product of social interactions. However, few studies have empirically explored the correlations between rural residents’ flat social networks, trust in pyramidal channels, and disaster-risk perceptions. Taking Sichuan Province—a typical disaster-prone province in China—as an example and using data from 327 rural households in mountainous areas threatened by multiple disasters, this paper measured the level of participants’ disaster-risk perception in the four dimensions of possibility, threat, self-efficacy, and response efficacy. Then, the ordinary least squares method was applied to probe the correlations between social networks, trust, and residents’ disaster-risk perception. The results revealed four main findings. (1) Compared with scores relating to comprehensive disaster-risk perception, participants had lower perception scores relating to possibility and threat, and higher perception scores relating to self-efficacy and response efficacy. (2) The carrier characteristics of their social networks significantly affected rural residents’ perceived levels of disaster risk, while the background characteristics did not. (3) Different dimensions of trust had distinct effects on rural residents’ disaster-risk perceptions. (4) Compared with social network variables, trust was more closely related to the perceived level of disaster risks, which was especially reflected in the impact on self-efficacy, response efficacy, and comprehensive perception. The findings of this study deepen understanding of the relationship between social networks, trust, and disaster-risk perceptions of rural residents in mountainous areas threatened by multiple disasters, providing enlightenment for building resilient disaster-prevention systems in the community.

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Leveraging Existing Data from CMS-Linked Cohort Studies for the Advancement and Translation of Frailty Research

Innovation in Aging ◽

10.1093/geroni/igaa057.2810 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 777-777

Author(s):

Qian-Li Xue ◽

Kristine Ensrud ◽

Shari Lin

Keyword(s):

Cohort Studies ◽

Healthcare Utilization ◽

Risk Adjustment ◽

Healthcare Services ◽

Self Report ◽

Added Value ◽

Care Organization ◽

Frailty Phenotype ◽

Frailty Assessment ◽

The Impact

Abstract As population aging is accelerating rapidly, there is growing concern on how to best provide patient-centered care for the most vulnerable. Establishing a predictable and affordable cost structure for healthcare services is key to improving quality, accessibility, and affordability. One such effort is the “frailty” adjustment model implemented by the Centers for Medicare & Medicaid Services (CMS) that adjusts payments to a Medicare managed care organization based on functional impairment of its beneficiaries. Earlier studies demonstrated added value of this frailty adjuster for prediction of Medicare expenditures independent of the diagnosis-based risk adjustment. However, we hypothesize that further improvement is possible by implementing more rigorous frailty assessment rather than relying on self-report of ADL difficulties as used for the frailty adjuster. This is supported by the consensus and clinical observations that neither multimorbidity nor disability alone is sufficient for frailty identification. This symposium consists of four talks that leverage data from three CMS-linked cohort studies to investigate the utility of assessment of the frailty phenotype for predicting healthcare utilization and costs. Talk 1 and 2 use data from the NHATS cohort to assess healthcare utilization by frailty status in the general population and the homebound subset. Talk 3 and 4 use data from the MrOS study and the SOF study to investigate the impact of frailty phenotype on healthcare costs. Taken together, their findings highlight the potential of incorporating phenotypic frailty assessment into CMS risk adjustment to improve the planning and management of care for frail older adults.

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A78 THE IMPACT OFGASTROINTESTINAL FOLLOW UP CARE ON HEALTHCARE UTILIZATION IN PATIENTS WITH ESINOPHILICESOPHAGITID (EOE).

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.076 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 45-46

Author(s):

K Alazemi ◽

M Alkhattabi ◽

J C Gregor

Keyword(s):

Emergency Room ◽

Healthcare Utilization ◽

Attrition Rate ◽

Quality Improvement Initiative ◽

Food Impaction ◽

Emergency Room Visits ◽

True Rate ◽

Funding Agencies ◽

The Impact

Abstract Background EOE is an increasingly recognized gastrointestinal condition that causes significant morbidity ranging from dietary limitations to food impactions requiring emergency room visits. There are a variety of dietary, pharmacologic and endoscopic treatments available but most are more practically guided by a subspecialist familiar and experienced with the condition. There is a perception among some physicians that follow up is sporadic and may be related at least in part to patient compliance. Aims To assess the true rate of EOE patients follow up rate at Lodon Health Scince Center Methods We used a retrospective cohort of patients diagnosed with EoE between July 2011 and June 2014 who met the traditional diagnostic criteria. As part of a quality improvement initiative, local follow up over the ensuing 5–7 years was tracked. The impact of follow up on subsequent healthcare utilization was analyzed. Results 123 patients with biopsy confirmed EoE were analyzed. Follow up appointments were made for 114/123 (92%) patients. 55/123 (45%) had repeat elective endoscopy booked. Only 10/114 (8.7%) of initial appointments went unattended but 15/55 (27.2%) of the patients offered ongoing follow up failed to attend. There were no complications (ie. perforation or bleeding) attributable to any of the procedures. 5/123 (4%) patients required repeat emergency room endoscopy for food impaction. Two patients required this on multiple occasions. 4/5 patients requiring repeat emergency room endoscopy for food impaction had received some sort of follow up, although 4/5 of these had at least one missed appointment. 2/5 patients having emergency room endoscopy required overnight admission. There were no perforations in the cohort. Conclusions Patients with a confirmed diagnosis of EOE do have a risk of requiring subsequent emergency endoscopy for food impaction although it is not clear that scheduled follow up significantly reduces that risk. Contrary to the perception of some physicians, patients with EoE are very likely to attend their first follow up visit although the attrition rate for subsequent scheduled visits is not insignificant. Funding Agencies None

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