scholarly journals POS0951 ASSOCIATION BETWEEN INDIVIDUAL AND COUNTRY-LEVEL SOCIOECONOMIC FACTORS AND HEALTH OUTCOMES IN AXIAL AND PERIPHERAL SPONDYLOARTHRITIS: ANALYSIS OF THE ASAS PERSPA STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 739-740
Author(s):  
D. Capelusnik ◽  
S. S. Zhao ◽  
A. Boonen ◽  
N. Ziade ◽  
C. López-Medina ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Marital Status ◽  
Educational Level ◽  
Functional Disability ◽  
Female Gender ◽  
Research Support ◽  
Global Functioning ◽  
Country Level ◽  
Lower Education ◽  
The Impact

Background:Health outcomes in spondyloarthritis (SpA) are largely determined by socioeconomic (SE) factors, leading to the great inequity observed between countries across the world. However, the impact of these SE factors on health outcomes across the different SpA phenotypes (axSpA, pSpA and PsA), is less well known.Objectives:To investigate (1) the association between individual and country-level SE factors and health outcomes in different SpA phenotypes, and (2) to explore whether any effect of these SE factors is mediated by the use of b/tsDMARD therapy.Methods:Patients with axSpA, pSpA or PsA from the multinational cohort ASAS-perSpA were included in the analysis. The effect of individual (age, gender, education and marital status) and country-level SE factors (Gross Domestic Product [GDP], Healthcare Expenditure [HCE], Human Development Index [HDI], Gini Index) over health outcomes (ASDAS≥2.1, continuous ASDAS, BASFI, fatigue and ASAS-HI) were assessed in multivariable mixed-effects logistic and linear regression models (as appropriate), adjusting for confounders. Interactions between each individual and country-level SE factors and disease phenotype and between both levels of SE factors, were tested. Finally, a mediation analysis was conducted to explore whether the impact of country-level SE factors on ASDAS is mediated through b/tsDMARD uptake.Results:A total of 4185 patients from 23 countries were included: 61% males, mean age 45 (SD 14), 65% axSpA, 10% pSpA and 25% PsA. Female gender, lower educational level and marital status (single vs married) were associated with higher ASDAS, without significant differences across disease phenotype. Living in lower-(vs higher) GDP countries was also associated with higher ASDAS (β=0.39 [95%CI 0.16; 0.63], with similar results for other economic indicators (Figure 1). 7% of the association between GDP and ASDAS was mediated by b/tsDMARD uptake. The above-mentioned individual and country-level SE factors remained significant to discriminate active disease (ASDAS≥2.1), with greater impact of gender (OR=1.32 [1.13; 1.54]), educational level (primary vs university OR=1.76 [1.40;2.20]) and lower GDP (OR= 1.74 [1.22;2.46]). Higher BASFI was also associated with gender (female vs male: β=0.12 [0.01; 0.24]), lower education (primary vs university: β=0.29 [0.11; 0.46], and marital status (single vs married: β=0.23 [0.09; 0.38]), without effect of country-level SE factors, and no differences across SpA phenotype. Gender and lower educational level were similarly associated with worse ASAS-HI scores (female vs male β=0.88 [0.68;1.09], and primary vs university β=0.61 [0.31;0.91]), while more fatigue was only associated with female gender and, in an opposite direction, with higher country-level SE factors (Figure 1). No interactions were found between individual and country-level SE factors for any of the outcomes.Conclusion:Individual (female gender and lower education) and country-level SE factors are independently associated with higher disease activity in SpA. Uptake of b/tsDMARD had a small mediating effect on the association between GDP and ASDAS. Lower education and female gender are also associated with worse outcomes of functional disability, global functioning and fatigue. Country-level SE factors are not associated with functional disability or global functioning; in contrast, there is a paradoxical effect with fatigue: living in a country with a higher SE status is independently associated with higher levels of fatigue. Management of disease outcome in SpA requires also awareness of the role of individual and country level SE-factors.Figure 1.Effect of individual and country-level socioeconomic factors on ASDAS and fatigue, derived from multivariable mixed-effects models adjusted by clinical confounders.Disclosure of Interests:Dafne Capelusnik Speakers bureau: BMS, Grant/research support from: Pfizer, Sizheng Steven Zhao: None declared, Annelies Boonen: None declared, Nelly Ziade Speakers bureau: Roche, Abbvie, Eli Lilly, Pfizer, Janssen, Novartis, Pierre Fabre, Apotex, Pharmaline, Paid instructor for: Abbvie, Eli Lilly, Sanofi-Aventis, Pfizer, Janssen, Consultant of: Roche, Abbvie, Eli Lilly, Pfizer, Janssen, Novartis, Gilead, NewBridge, Grant/research support from: Abbvie, NewBridge, Algorithm/Celgene, Clementina López-Medina: None declared, Maxime Dougados: None declared, Elena Nikiphorou Speakers bureau: Pfizer, Lilly, AbbVie, Sofia Ramiro Speakers bureau: Lilly, MSD, Novartis, UCB, Consultant of: AbbVie, Lilly, MSD, Novartis, UCB, Sanofi, Grant/research support from: MSD

scholarly journals Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: analysis of the ASAS-perSpA study

2021 ◽  
Author(s):  
Sizheng Steven Zhao ◽  
Elena Nikiphorou ◽  
Annelies Boonen ◽  
Clementina Lopez-Medina ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Marital Status ◽  
Socioeconomic Factors ◽  
Socioeconomic Development ◽  
Health Care Expenditure ◽  
Female Gender ◽  
Work Outcomes ◽  
Individual Level ◽  
Country Level ◽  
Lower Socioeconomic

Objective. To examine whether associations between socioeconomic factors and work outcomes in spondyloarthritis (SpA) differ across axial (axSpA), peripheral SpA (pSpA) and psoriatic arthritis (PsA), and whether associations for individual-level socioeconomic factors are modified by country-level factors. Methods. Patients with a physician diagnosis of SpA within working age (18-65 years) were included. Associations between individual- (age, gender, education, marital status) and country-level factors (Human Development Index, Health Care Expenditure (HCE), Gross Domestic Product, percentage unemployed) with work outcomes (employment status, absenteeism, presenteeism) were assessed using multivariable mixed-effects models. Associations between individual factors and outcomes were compared according to SpA phenotypes and country-level factors using interaction terms. Results. A total of 3835 patients (mean age 42 years, 61% males) from 23 countries worldwide were included (66% axSpA, 10% pSpA, 23% PsA). Being employed was associated with gender (male vs. female OR 2.5; 95%CI 1.9-3.2), education (university vs. primary OR 3.7; 2.9-4.7), marital status (married vs. single OR 1.3; 1.04-1.6), and age in a non-linear manner. University (vs primary) education was associated with lower odds of absenteeism (OR 0.7; 0.5-0.7) and presenteeism (OR 0.5; 0.3-0.7). Associations were similar across SpA phenotypes. Higher HCE was associated with more favourable work outcomes, e.g., higher odds of employment (OR 2.5; 1.5-4.1). Gender discrepancy in odds of employment was greater in countries with lower socioeconomic development. Conclusion. Higher educational attainment and higher HCE were associated with more favourable work outcomes, independently of SpA phenotype. The disadvantageous effect of female gender on employment is particularly strong in countries with lower socioeconomic development.

scholarly journals Instrumental Activities of Daily Living (iADL) Limitations in Europe: An Assessment of SHARE Data

2020 ◽  
Vol 17 (20) ◽  
pp. 7387
Author(s):  
Diana Portela ◽  
Marta Almada ◽  
Luís Midão ◽  
Elísio Costa
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Health Indicators ◽  
Female Gender ◽  
Physical And Mental Health ◽  
Instrumental Activities ◽  
Share Data ◽  
Lower Education ◽  
Perception Of Health ◽  
The Impact

This study aims to evaluate the instrumental activities of daily living (iADLs) limitations in Europe and its association with socio-demographic characteristics, economic parameters and physical and mental health status. We used data from the wave 6 of SHARE database. Individuals were classified as having either none or one or more limitations on iADLs. Participants aged 65 or more years who answered all questions for the variables included in this work were selected. A total of 54.8% of participants were female and had a mean age of 74.37 (SD = 7.08) years. A global prevalence of 1 or more iADLs in Europe was shown to be 23.8% and more prevalent in women than in men (27.1% vs. 17.6%) and in people aged 85 years or more (51.5%). Older age, female gender, lower education, physical inactivity, frailty, having two or more chronic diseases, presence of depression, polypharmacy, poor self-perception of health and lower network satisfaction were found to be factors associated with the presence of 1 or more iADLs limitation. This study highlights the burden of iADLs limitations at the European level. These are based on a multidimensional biopsychosocial model and are associated with both health conditions and environmental factors. This intersection between the physical and social world underscores its potential as a health indicator and can, to some extent, explain some of the pronounced differences seen among European countries. Different inter-tasks can also stress different dimensions of health indicators in distinct and specific groups of individuals. Minimizing the impact of iADL limitations can improve the quality and sustainability of public health systems.

scholarly journals Future Anxiety Among Private Sector Employees in Riyadh

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Reem Sefer Al Otaibi Fahd Bin Abdullah Al Rabeeh
Keyword(s):  
Private Sector ◽  
Marital Status ◽  
Educational Level ◽  
Education Level ◽  
Anxiety Level ◽  
Statistical Tool ◽  
Lower Education Level ◽  
Lower Education ◽  
Survey Approach ◽  
Monthly Salary

The study aimed to measure and identify Future Anxiety level among the employees of private sector in Riyadh in the light of the following variables: (age, monthly salary, marital status, and educational level). The study used the descriptive analytical method in its survey approach. Future anxiety scale designed by Salah Karamian was applied to a random sample of (212) male employees in the private sector in Riyadh. Using the Statistical tool SPSS, the results of the study showed the following: 1- The general mean of the future anxiety among the employees of the private sector in Riyadh valued (3.74) with high rating. 2- There are no statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of age. 3-  There are statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of monthly salary, especially for the employees who make (less than SAR2000) whose future anxiety level showed to be the highest. 4-  There are statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of marital status (Married- Single), as single employees are more anxious. 5-  There are statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of education level, as employees with lower education level are more anxious. In the light of the study findings, the researcher suggested several recommendations to reduce anxiety among employees and to support, motivate, train, and solve their problems.  

scholarly journals The disease burden of multimorbidity and its interaction with educational level

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243275
Author(s):  
Yi Hsuan Chen ◽  
Milad Karimi ◽  
Maureen P. M. H. Rutten-van Mölken
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Educational Level ◽  
Linear Models ◽  
Economic Status ◽  
National Health Survey ◽  
Mental Health Outcomes ◽  
Physical And Mental Health ◽  
Indicator Variable ◽  
The Impact

Introduction Policies to adequately respond to the rise in multimorbidity have top-priority. To understand the actual burden of multimorbidity, this study aimed to: 1) estimate the trend in prevalence of multimorbidity in the Netherlands, 2) study the association between multimorbidity and physical and mental health outcomes and healthcare cost, and 3) investigate how the association between multimorbidity and health outcomes interacts with socio-economic status (SES). Methods Prevalence estimates were obtained from a nationally representative pharmacy database over 2007–2016. Impact on costs was estimated in a fixed effect regression model on claims data over 2009–2015. Data on physical and mental health and SES were obtained from the National Health Survey in 2017, in which the Katz-10 was used to measure limitations in activities of daily living (ADL) and the Mental Health Inventory (MHI) to measure mental health. SES was approximated by the level of education. Generalized linear models (2-part models for ADL) were used to analyze the health data. In all models an indicator variable for the presence or absence of multimorbidity was included or a categorical variable for the number of chronic conditions. Interactions terms of multimorbidity and educational level were added into the previously mentioned models. Results Over the past ten years, there was an increase of 1.6%-point in the percentage of people with multimorbidity. The percentage of people with three or more conditions increased with +2.1%-point. People with multimorbidity had considerably worse physical and mental health outcomes than people without multimorbidity. For the ADL, the impact of multimorbidity was three times greater in the lowest educational level than in the highest educational level. For the MHI, the impact of multimorbidity was two times greater in the lowest than in the highest educational level. Each additional chronic condition was associated with a greater worsening in health outcomes. Similarly, for costs, where there was no evidence of a diminishing impact of additional conditions either. In patients with multimorbidity total healthcare costs were on average €874 higher than in patients with a single morbidity. Conclusion The impact of multimorbidity on health and costs seems to be greater in the sicker and lower educated population.

scholarly journals The Impact of Marital Status on Work Hours: A Quantitative Study of European Labor Market from Gender Perspective

2021 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Ashim Kumar Nandi
Keyword(s):  
Labor Market ◽  
Marital Status ◽  
Gender Gap ◽  
Linear Regression Analysis ◽  
European Social Survey ◽  
Work Hours ◽  
Family Policies ◽  
Division Of Household Labor ◽  
Country Level ◽  
The Impact

This article examines the effects of marital status to the gender gap in employment hours. This article uses linear regression analysis with data from the European Social Survey Round 8. Stata/SE 16 is used to analyze the data collected from 18 European countries to explore the research questions. Previous literatures identify some determinants of work hours such as demographic characteristics, the division of household labor, job characteristics, and country-level determinants (e.g., welfare state, work-hour regulations, family policies, part-time labor force participation etc.), but there are few studies on marital status as determinant of work hours. This article finds that there is an interaction among marital status and work hours to the different levels of gender. This article shows that there is a gender inequality in the European labor market, where men’s work hours are more than women’s work hours. Unmarried women work less hours than any other studied categories of marital status (e.g., married, divorced).

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

The Impact of Social Mobilization on Health Service Delivery and Health Outcomes

2018 ◽  
Author(s):  
Xavier Giné ◽  
Salma Khalid ◽  
Mansuri Ghazala
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Health Outcomes ◽  
Health Workers ◽  
Health Service Delivery ◽  
Health Providers ◽  
Child Health Outcomes ◽  
Rural Pakistan ◽  
Post Natal Care ◽  
The Impact

This chapter uses a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong emphasis on organizing women, who also identified health services as a development priority at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by female health workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.

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