scholarly journals Is there an association between social determinants and care dependency risk?

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Schneider ◽  
S Blüher ◽  
U Grittner ◽  
V Anton ◽  
E Schaeffner ◽  
...  
Keyword(s):  
Older People ◽  
Social Determinants ◽  
Population Based ◽  
Multiple Model ◽  
Levels Of Care ◽  
Care Dependency ◽  
Partnership Status ◽  
Level 1 ◽  
And Gender ◽  
Prospective Longitudinal

Abstract Background Despite a growing body of knowledge about the morbidities and functional impairment which frequently lead to care dependency, the role of social determinants is not yet well understood. The purpose of this study was 1) to examine the effect of social determinants on care dependency onset and progression, and 2) to analyse the effect of social determinants on various levels of care dependency. Methods We used data from the Berlin Initiative Study (BIS), a prospective, longitudinal, population-based cohort study including 2069 older participants (≥70 years of age) with visits in 2009, 2011 and 2013. Care dependency was assessed if participants require substantial assistance in at least two activities of daily living for 90 minutes daily (level 1) or three hours+ daily (level 2). Social determinants were defined as partnership status, education, income, age and gender. Data were analysed with multi-state time to event regression modeling which simultaneously model several competing events, as well as not only first but also second or third event in one model. Results During the study period, 556 participants (27.5%) changed their status of care dependency. Persons who reported having no partner at baseline were care-dependent more often than participants with a partner (43.7% ’no partner’ / 27.1% ’with partner’). In the multiple model having no partner compared to having a partner was associated with a higher risk of transition from no care dependency to level 1 (HR: 1.25, 95%CI: 0.97-1.64), however failed significance. The significant association between care dependency and income and between care dependency and education ceased as well after adjustment for co-morbidities. Conclusions Results indicate that older people without a partner tend to be on a higher risk of care dependency onset but not on a higher risk of care dependency progression. Inequality between education and income groups can be explained in terms of morbidity. Key messages The significant association between care dependency and income and between care dependency and education can be explained in terms of morbidity. Results indicate that older people without a partner tend to be on a higher risk of care dependency onset but not on a higher risk of care dependency progression.

Mental health in Ecuadorian migrants from a population-based survey: the importance of social determinants and gender roles

2010 ◽  
Vol 46 (11) ◽  
pp. 1143-1152 ◽  
Author(s):  
Julia Del Amo ◽  
Inma Jarrín ◽  
Ana García-Fulgueiras ◽  
Vicente Ibáñez-Rojo ◽  
Débora Alvarez ◽  
...  
Keyword(s):  
Mental Health ◽  
Gender Roles ◽  
Social Determinants ◽  
Population Based ◽  
And Gender ◽  
Population Based Survey

scholarly journals Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America, India, and China: A Population-Based Cohort Study

PLoS Medicine ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. e1001179 ◽  
Author(s):  
Cleusa P. Ferri ◽  
Daisy Acosta ◽  
Mariella Guerra ◽  
Yueqin Huang ◽  
Juan J. Llibre-Rodriguez ◽  
...  
Keyword(s):  
Latin America ◽  
Cohort Study ◽  
Older People ◽  
Socioeconomic Factors ◽  
Population Based ◽  
Specific Mortality ◽  
India And China

Anorectal Malformations and the Risk of Colorectal Cancer—Is Early Routine Endoscopic Screening Indicated?

2020 ◽  
Author(s):  
Anna Svenningsson ◽  
Anna Gunnarsdottir ◽  
Tomas Wester
Keyword(s):  
Colorectal Cancer ◽  
Early Adulthood ◽  
Anorectal Malformations ◽  
Population Based ◽  
Observational Period ◽  
Endoscopic Screening ◽  
Medical Birth Register ◽  
National Patient ◽  
And Gender

Abstract Introduction Colorectal cancer (CRC) has been reported in early adulthood in patients with anorectal malformation (ARM), and therefore, the need of endoscopic controls has been discussed. The aim of this study was to assess the risk of CRC in patients with ARM. Materials and Methods This was a nationwide population-based study with data from Swedish national health care registers. All patients diagnosed with ARM born in Sweden between 1964 and 1999 were identified in the National Patient Register. The same group was followed up in the Swedish Cancer Register from birth to December 31, 2014, for occurrences of CRC. Five age- and gender-matched individuals randomly selected from the Medical Birth Register served as controls for each ARM patient born between 1973 and 1999. Results A total of 817 patients (474 males) with ARM were included and followed up from birth to the end of observational period. Time of follow-up ranged from 15 to 50 years (mean: 28 years). None of the patients was diagnosed with CRC during the observational period. One case of rectal cancer and one case of sigmoid cancer were detected among the 3,760 controls. Conclusion In our study, the risk of CRC in early adulthood in patients with ARM is low. Our result does not support routine endoscopic follow-up for patients with ARM during the first decade of life.

scholarly journals The Impact of Intersectional Identities on Older People With HIV

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 723-723
Author(s):  
Mark Brennan-Ing ◽  
Charles Emlet
Keyword(s):  
Older People ◽  
African American Women ◽  
Well Being ◽  
Hiv Stigma ◽  
Neurocognitive Functioning ◽  
Bisexual Men ◽  
And Bisexual ◽  
And Gender ◽  
The Impact ◽  
Racial Ethnic

Abstract Kimberlé Crenshaw introduced the term “intersectionality” in the late 1980s to highlight the experience discrimination and marginalization of Black and African-American women originating from the confluence of their racial/ethnic and gender identities. Since that time the focus on intersectionality has broadened to consider other communities and individuals who may have multiple stigmatized and discredited identities, including older people with HIV (PWH). For example, Porter and Brennan-Ing described the “Five Corners” model as the intersection of ageism, racism, classism, sexism, and HIV stigma for older transgender and gender non-conforming PWH. HIV disproportionately affects marginalized communities (e.g., racial/ethnic and sexual minorities). Thus, for older PWH it is important to consider how HIV stigma may intersect with other marginalized identities and impact physical and psychological well-being. The first paper in this session examines how the intersection of HIV serostatus, gay identity, and age complicates identity disclosure, leading to social isolation and interference with care planning. The second paper describes how intersectional identities among older PWH interfere with access to mental health services in a population that is disproportionately affected by depression and PTSD. Our third paper examines the role of race, education, and behavioral health in neurocognitive functioning among a diverse sample of older HIV+ gay and bisexual men. Our last paper examines neurocognitive functioning among older Latinx PWH, finding that sexual and gender minorities were at greater risk for impairment. Implications of these findings for research and programming that accounts for the effects of intersectionality among older PWH will be discussed.

scholarly journals Social determinants of depression: association with age, gender and primary health care model

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J China
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Social Determinants ◽  
Care Physician ◽  
Health Policies ◽  
Age And Gender ◽  
Primary Health ◽  
And Gender ◽  
Primary Health Care Physician

Abstract Background Depression is one of the most common mental disorders worldwide and is a major contributor to the overall global burden of disease. The social determinants of age, gender and access to a primary health care physician have been identified as significant determinants of variability in the prevalence of depression. This research evaluates the association between depression and these social determinants in the city of Almada, in Portugal. Methods This cross-sectional study reports the one-month prevalence (December, 2015) of depression and its association with age, gender and access to a primary health care doctor in Almada's primary health care population. Data was collected from the 'Information System of the Regional Health Administration' (SIARS) database. The diagnostic tools used for the identification of cases were the ICPC-2 codes 'P76: Depressive Disorder' and 'P03: Feeling Depressed'. An odds ratio was applied as an association measure. Results Regarding gender and age: women are more likely to develop depression than men (OR 3.21) and the age group of 40-64 years is more likely to develop depression compared with other age groups (OR 2.21). The odds of being affected by depression for patients with a permanent primary health care physician, compared with users without a permanent primary health care physician, are higher (OR 2.24). Conclusions The patterns of association of age and gender, uncovered in this dataset, are consistent with previously reported findings for other Western countries. The association between depression and the assignment of a permanent primary health care doctor is highly significant. This finding suggests the existence of a higher detection rate of depression in patients with a permanent doctor and adds weight to the need to implement health policies that guarantee a primary health care physician for each patient. Key messages The age and gender gap in depression calls for stronger public health and intersectoral strategies to promote and protect mental health, in community-based settings. Reducing barriers and enhancing access to high-quality primary medical care must be a cornerstone of mental health policies.

ATRIAL FIBRILLATION, COGNITIVE DECLINE, AND DEMENTIA AMONG OLDER PEOPLE: A LONGITUDINAL POPULATION-BASED STUDY

2017 ◽  
Vol 13 (7) ◽  
pp. P238
Author(s):  
Mozhu Ding ◽  
Laura Fratiglioni ◽  
Kristina Johnell ◽  
Alessandra Marengoni ◽  
Petter Ljungman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Older People ◽  
Cognitive Decline ◽  
Population Based ◽  
Population Based Study

scholarly journals Five regions, five retinopathy screening programmes: a systematic review of how Portugal addresses the challenge

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andreia Marisa Penso Pereira ◽  
Raul Manuel da Silva Laureano ◽  
Fernando Buarque de Lima Neto
Keyword(s):  
Diabetic Retinopathy ◽  
Web Sites ◽  
National Health System ◽  
Health Department ◽  
Population Based ◽  
Care Providers ◽  
Levels Of Care ◽  
Diabetic Retinopathy Screening ◽  
Relevant Role ◽  
Retinopathy Screening

Abstract Background The implementation of a population-based screening programme for diabetic retinopathy involves several challenges, often leading to postponements and setbacks at high human and material costs. Thus, it is of the utmost importance to promote the sharing of experiences, successes, and difficulties. However, factors such as the existence of regional programmes, specificities of each country’s health systems, organisational and even linguistic barriers, make it difficult to create a solid framework that can be used as a basis for future projects. Methods Web of Science and PubMed platforms were searched using appropriate key words. The review process resulted in 423 articles adherent to the search criteria, 28 of which were accepted and analysed. Web sites of all Portuguese governmental and non-governmental organisations, with a relevant role on the research topic, were inspected and 75 official documents were retrieved and analysed. Results Since 2001, five regional screening programmes were gradually implemented under the guidelines of Portuguese General Health Department. However, complete population coverage was still not achieved. Among the main difficulties reported are the complex articulation between different levels of care providers, the low number of orthoptic technician in the national health system, the high burden that images grading, and treatment of positive cases represents for hospitals ophthalmology services, and low adherence rates. Yet, the comparison between strategies adopted in the different regions allowed the identification of potential solutions: hire orthoptic technician for primary health care units, eliminating the dependence of hospital professionals; use artificial intelligence algorithms for automatic retinographies grading, avoiding ophthalmologists overload; adoption of proximity strategies, as the use of portable retinographers, to promote adherence to screening. Conclusion Access to diabetic retinopathy screening remains remarkably variable in Portugal and needs urgent attention. However, several characteristics of effective screening programmes were found in Portuguese screening programmes, what seems to point toward promising outcomes, especially if each other highlights are considered. The findings of this research could be very useful for the other countries with similar socio-political characteristics. Trial registration PROSPERO registration ID CRD42020200115.

scholarly journals A prospective longitudinal model predicting early adult alcohol problems: evidence for a robust externalizing pathway

2015 ◽  
Vol 46 (5) ◽  
pp. 957-968 ◽  
Author(s):  
A. C. Edwards ◽  
C. O. Gardner ◽  
M. Hickman ◽  
K. S. Kendler
Keyword(s):  
Risk Factors ◽  
Peer Relationships ◽  
Parental Monitoring ◽  
Sensation Seeking ◽  
Structural Equation ◽  
Population Based ◽  
Equation Model ◽  
Alcohol Problems ◽  
Developmental Model ◽  
Prospective Longitudinal

BackgroundRisk factors for alcohol problems (AP) include biological and environmental factors that are relevant across development. The pathways through which these factors are related, and how they lead to AP, are optimally considered in the context of a comprehensive developmental model.MethodUsing data from a prospectively assessed, population-based UK cohort, we constructed a structural equation model that integrated risk factors reflecting individual, family and peer/community-level constructs across childhood, adolescence and young adulthood. These variables were used to predict AP at the age of 20 years.ResultsThe final model explained over 30% of the variance in liability to age 20 years AP. Most prominent in the model was an externalizing pathway to AP, with conduct problems, sensation seeking, AP at age 17.5 years and illicit substance use acting as robust predictors. In conjunction with these individual-level risk factors, familial AP, peer relationships and low parental monitoring also predicted AP. Internalizing problems were less consistently associated with AP. Some risk factors previously identified were not associated with AP in the context of this comprehensive model.ConclusionsThe etiology of young adult AP is complex, influenced by risk factors that manifest across development. The most prominent pathway to AP is via externalizing and related behaviors. These findings underscore the importance of jointly assessing both biologically influenced and environmental risk factors for AP in a developmental context.

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