Poor person and areal socioeconomic status is associated with increased diabetic retinopathy and visual impairment incidence and progression

2020 ◽  
pp. bjophthalmol-2020-316430
Author(s):  
Jin Rong Low ◽  
Alfred Tau Liang Gan ◽  
Eva K Fenwick ◽  
Preeti Gupta ◽  
Tien Y Wong ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Vision Loss ◽  
Population Based ◽  
Housing Type ◽  
Incidence Risk

BackgroundTo investigate the longitudinal associations between person-level and area-level socioeconomic status (PLSES and ALSES, respectively) with diabetic retinopathy (DR) and visual impairment (VI) in Asians with diabetes mellitus (DM).MethodsIn this population-based cohort study, we included 468 (39.4%) Malays and 721 (60.6%) Indians with DM, with a mean age (SD) of 58.9 (9.1) years; 50.6% were female and the mean follow-up duration was 6.2 (0.9) years. Individual PLSES parameters (education, monthly income and housing type) were quantified using questionnaires. ALSES was assessed using the Socioeconomic Disadvantage Index derived from Singapore’s 2010 areal census (higher scores indicate greater disadvantage). Incident DR and VI were defined as absent at baseline but present at follow-up, while DR and VI progression were defined as a ≥1 step increase in severity category at follow-up. Modified Poisson regression analysis was used to determine the associations of PLSES and ALSES with incidence and progression of DR and VI, adjusting for relevant confounders.ResultsIn multivariable models, per SD increase in ALSES score was associated with greater DR incidence (risk ratio (95% CI) 1.27 (1.13 to 1.44)), DR progression (1.10 (1.00 to 1.20)) and VI incidence (1.10 (1.04 to 1.16)), while lower PLSES variables were associated with increased DR (low income: 1.68 (1.21 to 2.34)) and VI (low income: 1.44 (1.13 to 1.83); ≤4 room housing: 2.00 (1.57 to 2.54)) incidence.ConclusionsWe found that both PLSES and ALSES variables were independently associated with DR incidence, progression and associated vision loss in Asians. Novel intervention strategies targeted at low socioeconomic status communities to decrease rates of DR and VI are warranted.

Associations of Socioeconomic Status and Rurality With New-Onset Cardiovascular Disease in Cancer Survivors: A Population-Based Analysis

2021 ◽  
pp. OP.20.01053
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Winson Y. Cheung
Keyword(s):  
Cardiovascular Disease ◽  
Socioeconomic Status ◽  
Cancer Survivors ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Population Based ◽  
Rural Residence ◽  
Low Socioeconomic ◽  
New Onset

PURPOSE: Patients with cancer are predisposed to develop new-onset cardiovascular disease (CVD). We aimed to assess if rural residence and low socioeconomic status modify such a risk. METHODS: Patients diagnosed with solid organ cancers without any baseline CVD and on a follow-up of at least 1 year in a large Canadian province from 2004 to 2017 were identified using the population-based registry. We performed logistic regression analyses to examine the associations of rural residence and low socioeconomic status with the development of CVD. RESULTS: We identified 81,418 patients eligible for the analysis. The median age was 62 years, and 54.3% were women. At a median follow-up of 68 months, 29.4% were diagnosed with new CVD. The median time from cancer diagnosis to CVD diagnosis was 29 months. Rural patients (32.3% v 28.5%; P < .001) and those with low income (30.4% v 25.9%; P < .001) or low educational attainment (30.7% v 27.6%; P < .001) experienced higher rates of CVD. After adjusting for baseline factors and treatment, rural residence (odds ratio [OR], 1.07; 95% CI, 1.04 to 1.11; P < .001), low income (OR, 1.17; 95% CI, 1.12 to 1.21; P < .001), and low education (OR, 1.08; 95% CI, 1.04 to 1.11; P < .001) continued to be associated with higher odds of CVD. A multivariate Cox regression model showed that patients with low socioeconomic status were more likely to die, but patients residing rurally were not. CONCLUSION: Despite universal health care, marginalized populations experience different CVD risk profiles that should be considered when operationalizing lifestyle modification strategies and cardiac surveillance programs for the growing number of cancer survivors.

A population-based study of visual impairment in the Lower Tugela health district in KZN, SA

2013 ◽  
Vol 72 (3) ◽  
Author(s):  
K.S. Naidoo ◽  
D Sweeney ◽  
J Jaggernath ◽  
B. Holden
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Refractive Error ◽  
Vision Loss ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Health District ◽  
Hypertensive Retinopathy ◽  
Age Related ◽  
Kwazulu Natal

A cross-sectional, population-based, epidemiological study of blindness and visual impairment was conducted to evaluate the prevalence of vision loss and various sight-threatening conditions in the Lower Tugela health district of the KwaZulu-Natal province, South Africa. This study was conducted on a randomly selected sample of 3444 individuals from the district. This number represented 84% of those who were visited and 80.1% of the total sample selected. The participants ranged in age from 5 to 93 years (mean of 29.2 years and a median of 20.0 years). The proportion of men to women differed between participants aged <30 years and those aged >30 years. In both age groups, women represented the majority of participants (66.5%), but the number of women to men in the older age group was approximately twice that found in the group aged less than 30 years. The difference in age between the men and women in the study was not statistically significant (p >0.5). The study revealed that 6.4% of the population studied were visually impaired. The distribution of uncorrected visual acuity was better for women than for men for both OD and OS (p = 0.000 for OD and OS). The main causes of visual impairment were refractive error (44.5%), cataract (31.2%), glaucoma (6.0%), hypertensive retinopathy (4.1%) and diabetic retinopathy (4.1%). Unilateral blindness (OD) was present in 0.78% (95% Confidence interval (CI): 0.42%-1.14%) of participants and unilateral blindness (OS) was present in 1.1% (95% CI: 0.70%-1.50%). Thirty-one participants (0.9%) were bilaterally blind with the main causes being cataracts (54.8%) and refractive error (12.9%). Glaucoma and hypertensive retinopathy were responsible for 6.4% of ..bilateral blindness. Diabetic retinopathy, other retinal conditions (coloboma) and corneal scarring were each responsible for 3.2% of bilateral blindness. Albinism, coloboma and age-related macular degeneration accounted for 9.7% of bilateral blindness. The data provides much needed information to support the planning of eye care programs in KwaZulu-Natal.  (S Afr Optom 2013 72(3) 110-118)

Associations of rural residence and low socioeconomic status on the risk of new onset cardiovascular disease (CVD) in cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 90-90
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Rodrigo Rigo ◽  
Winson Y. Cheung
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
Cancer Patients ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Low Ses ◽  
Rural Residence ◽  
Low Socioeconomic ◽  
Low Education

90 Background: Cancer patients are predisposed to CVD due to cancer treatments and shared risk factors (smoking/physical inactivity). We aimed to assess if rural residence and low socioeconomic status (SES) modify the risk of developing CVD. Methods: Patients diagnosed with non-metastatic solid organ cancers without baseline CVD in a large Canadian province from 2004 to 2017 were identified using the population-based registry. Postal codes were linked with Census data to determine rural residence as well as neighborhood-level income and educational attainment. Low income was defined as <46000 CAD/annum; low education was defined as a neighborhood in which <80% attended high school. Myocardial infarction, congestive heart failure, arrythmias and cerebrovascular accident constituted as CVD.We performed logistic regression analyses to examine the associations of rural residence and low SES with the development of CVD, adjusting for measured confounding variables. Results: We identified 81,275 patients diagnosed with cancer without pre-existing CVD. The median age was 62 years and 54.2% were women. The most prevalent cancer types included breast (28.6%), prostate (23.1%), and colorectal (14.9%). At a median follow-up of 68 months, 29.4% were diagnosed with new CVD. The median time from cancer diagnosis to CVD was 29 months. Rural patients (32.3 vs 28.4%,P < .001) and those with low income (30.4% vs 25.9%,P < .001) or low educational attainment (30.7% vs 27.6%,P < .001) experienced higher rates of CVD. After adjusting for baseline factors and treatment, rural residence (odds ratio[OR], 1.07; 95% confidence interval[CI], 1.04-1.11;P < .001), low income (OR,1.17;95%CI,1.12-1.21;P < .001) and low education (OR,1.08;95%CI,1.04-1.11;P < .001) continued to associate with higher odds of CVD. Further, patients with colorectal cancer were more likely to develop CVD compared with other tumors (OR,1.12;95% CI,1.04-1.16;P = .001). A multivariate Cox regression model showed that patients with low SES were more likely to die, but patients residing rurally were not. Conclusions: Approximately one-third of cancer survivors develop CVD on follow-up. Despite universal healthcare, marginalized populations experience different CVD risk profiles that should be considered when operationalizing lifestyle modification strategies and cardiac surveillance programs. [Table: see text]

scholarly journals The Effectiveness of the Good Affordable Food Intervention for Adults with Low Socioeconomic Status and Small Incomes

2020 ◽  
Vol 17 (7) ◽  
pp. 2535 ◽  
Author(s):  
Kathelijne M.H.H. Bessems ◽  
Evelyne Linssen ◽  
Marion Lomme ◽  
Patricia Van Assema
Keyword(s):  
Socioeconomic Status ◽  
Nutrition Education ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Portion Size ◽  
Control Group ◽  
Short Term ◽  
Low Socioeconomic ◽  
Post Test

Good Affordable Food (GAF) is a small-group nutrition education intervention for adults with low socioeconomic status and small incomes. It aims to empower participants to save money on groceries and consume healthier diets. This paper reports the short-term and longer-term effects on behavioural determinants and self-reported behavioural changes. A quasi-experimental control group design was applied with a baseline measurement, a post-test immediately after the intervention, and a follow-up measurement after six months. The study included 237 participants (intervention group: n = 131; control group: n = 106) at baseline, 197 at post-test, and 152 at follow-up. Data were collected by telephone, mostly using closed interview questions. Positive short-term and longer-term effects were found for attitude towards the costs of healthy foods, food label use, and the use of liquid butter or oil to prepare hot meals. Short-term intervention effects related to knowledge towards saving money on groceries, self-efficacy towards healthy eating, portion size awareness, and mindful eating. GAF was effective in changing some determinants and behaviours related to cost and food consumption, however, mostly in the short term. Thereby, it is an example of combining pricing and health information in nutrition education that developers of effective nutrition education for low-income groups can build on.

scholarly journals Association between socioeconomic status and self-reported, tested and diagnosed COVID-19 status during the first wave in the Northern Netherlands: a general population-based cohort from 49 474 adults

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e048020
Author(s):  
Yinjie Zhu ◽  
Ming-Jie Duan ◽  
Hermien H. Dijk ◽  
Roel D. Freriks ◽  
Louise H. Dekker ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
General Population ◽  
Low Income ◽  
Smoking Status ◽  
Sleep Time ◽  
Population Based ◽  
Lifestyle Factors ◽  
Self Report ◽  
Low Education ◽  
Tv Watching

ObjectivesStudies in clinical settings showed a potential relationship between socioeconomic status (SES) and lifestyle factors with COVID-19, but it is still unknown whether this holds in the general population. In this study, we investigated the associations of SES with self-reported, tested and diagnosed COVID-19 status in the general population.Design, setting, participants and outcome measuresParticipants were 49 474 men and women (46±12 years) residing in the Northern Netherlands from the Lifelines cohort study. SES indicators and lifestyle factors (i.e., smoking status, physical activity, alcohol intake, diet quality, sleep time and TV watching time) were assessed by questionnaire from the Lifelines Biobank. Self-reported, tested and diagnosed COVID-19 status was obtained from the Lifelines COVID-19 questionnaire.ResultsThere were 4711 participants who self-reported having had a COVID-19 infection, 2883 participants tested for COVID-19, and 123 positive cases were diagnosed in this study population. After adjustment for age, sex, lifestyle factors, body mass index and ethnicity, we found that participants with low education or low income were less likely to self-report a COVID-19 infection (OR [95% CI]: low education 0.78 [0.71 to 0.86]; low income 0.86 [0.79 to 0.93]) and be tested for COVID-19 (OR [95% CI]: low education 0.58 [0.52 to 0.66]; low income 0.86 [0.78 to 0.95]) compared with high education or high income groups, respectively.ConclusionOur findings suggest that the low SES group was the most vulnerable population to self-reported and tested COVID-19 status in the general population.

scholarly journals Low socioeconomic status is associated with self-reported HIV positive status among young MSM in Brazil and Peru

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thiago S. Torres ◽  
Lara E. Coelho ◽  
Kelika A. Konda ◽  
E. Hamid Vega-Ramirez ◽  
Oliver A. Elorreaga ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Latin American ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Sexual Attraction ◽  
Hiv Positive ◽  
Sociodemographic Characteristics ◽  
Hiv Status ◽  
Hiv Test ◽  
Young Msm

Abstract Background Despite efforts to stop HIV epidemic in Latin America, new HIV cases continue to increase in the region especially among young MSM (YMSM). This study aims to assess if sociodemographic characteristics are associated with self-reported HIV positive status among YMSM from three Latin American countries. Methods Cross-sectional web-based survey advertised on dating apps (Grindr and Hornet) and Facebook in Brazil, Mexico and Peru. For this analysis, we included YMSM aged 18–24 years who self-reported their HIV status. We used multivariable logistic regression models for each country separately to verify if sociodemographic characteristics (race, education and income) were associated with HIV self-reported status after adjusting for behavior characteristics (sexual attraction and steady partner). Results Among 43,687 MSM who initiated the questionnaire, 27,318 (62.5%) reported their HIV status; 7001 (25.6%) of whom were YMSM. Most YMSM (83.4%) reported an HIV test in the past year, and 15.7% reported an HIV positive status in Peru, 8.4% in Mexico and 7.7% in Brazil. In adjusted models, low-income was associated with higher odds of self-reported HIV positive status in Brazil (aOR = 1.33, 95%CI: 1.01–1.75) and Peru (aOR = 1.56, 95%CI: 1.02–2.40), but not in Mexico. Lower education was associated with higher odds of self-reported HIV positive status only in Brazil (aOR = 1.35, 95%CI: 1.05–1.75). Conclusions In this large, cross-country study, self-reported HIV positive status among YMSM was high. Lower socioeconomic status was associated with higher odds of self-reported HIV positive status in Brazil and Peru. There is an urgent need for HIV prevention interventions targeting YMSM, and efforts to address low-income YMSM are especially needed in Peru and Brazil.

Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

2021 ◽  
pp. 238008442110356
Author(s):  
D.J. Gaskin ◽  
H. Zare ◽  
R. McCleary ◽  
O. Kanwar ◽  
A.L. Davis
Keyword(s):  
Socioeconomic Status ◽  
Oral Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
The United States ◽  
Permanent Teeth ◽  
Dental Visit ◽  
Low Socioeconomic ◽  
The Past ◽  
Dental Needs

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents. Results: Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y. Conclusion: Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health. Knowledge Transfer Statement: Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

scholarly journals Cohort profile: The Chikwawa lung health cohort; a population-based observational non-communicable respiratory disease study in Malawi

2020 ◽  
Author(s):  
Martin Njoroge ◽  
Sarah Rylance ◽  
Rebecca Nightingale ◽  
Stephen Gordon ◽  
Kevin Mortimer ◽  
...  
Keyword(s):  
Health Economic ◽  
Lung Function ◽  
Low Income ◽  
Respiratory Symptoms ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
Sub Saharan ◽  
Lung Health

AbstractPurposeThe Chikwawa lung health cohort was established in rural Malawi in 2014 to prospectively determine the prevalence and causes of lung disease amongst the general population of adults living in a low-income rural setting in Sub-Saharan Africa.ParticipantsA total of 1481 participants were randomly identified and recruited in 2014 for the baseline study. We collected data on demographic, socio-economic status, respiratory symptoms and potentially relevant exposures such as smoking, household fuels, environmental exposures, occupational history/exposures, dietary intake, healthcare utilization, cost (medication, outpatient visits and inpatient admissions) and productivity losses. Spirometry was performed to assess lung function. At baseline, 56.9% of the participants were female, a mean age of 43.8 (SD:17.8) and mean body mass index (BMI) of 21.6 Kg/m2 (SD: 3.46)Findings to dateCurrently, two studies have been published. The first reported the prevalence of chronic respiratory symptoms (13.6%, 95% confidence interval [CI], 11.9 – 15.4), spirometric obstruction (8.7%, 95% CI, 7.0 – 10.7), and spirometric restriction (34.8%, 95% CI, 31.7 – 38.0). The second reported annual decline in forced expiratory volume in one second [FEV1] of 30.9mL/year (95% CI: 21.6 to 40.1) and forced vital capacity [FVC] by 38.3 mL/year (95% CI: 28.5 to 48.1).Future plansThe ongoing current phase of follow-up will determine the annual rate of decline in lung function as measured through spirometry, and relate this to morbidity, mortality and economic cost of airflow obstruction and restriction. Population-based mathematical models will be developed driven by the empirical data from the cohort and national population data for Malawi to assess the effects of interventions and programmes to address the lung burden in Malawi. The present follow-up study started in 2019.Strengths and limitations of this studyThis is an original cohort study comprising adults randomly identified in a low-income Sub-Saharan African Setting.The repeated follow up of the cohort has included objective measures of lung function.The cohort has had high rates of case ascertainment that include verbal autopsies.The study will include an analysis of the health economic consequences of rate of change of lung function and health economic modelling of impact of lung diseases and potential interventions that could be adopted.A main limitation of our study is the systematic bias may be introduced through the self-selection of the participants who agreed to take part in the study to date and the migration of individuals from Chikwawa.

Common age-related eye diseases and visual impairment

2017 ◽  
pp. 1165-1170
Author(s):  
Jacqueline Chua ◽  
Ching-Yu Cheng ◽  
Tien Yin Wong
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Macular Degeneration ◽  
Refractive Error ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Eye Disorders ◽  
Appropriate Treatment ◽  
Uncorrected Refractive Error

General physicians have an essential role in preventing vision loss in older people. However, most vision-threatening eye disorders are initially asymptomatic and often go underdiagnosed. Therefore screening, early detection, and timely intervention are important in their management. The most common cause of visual impairment is uncorrected or undercorrected refractive error, followed by cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. Spectacles and cataract surgery can successfully restore sight for uncorrected refractive error and cataract, respectively. Visual impairment as a result of age-related macular degeneration, glaucoma, and diabetic retinopathy can be prevented with appropriate treatment if they are identified early enough. This chapter provides an overview of common age-related eye disease and visual impairment.

Cardiovascular health and near visual impairment among older adults in the Republic of Congo: a population-based study

2020 ◽  
Author(s):  
Antoine Gbessemehlan ◽  
Catherine Helmer ◽  
Cécile Delcourt ◽  
Farid Boumediene ◽  
Bébène Ndamba-Bandzouzi ◽  
...  
Keyword(s):  
Older Adults ◽  
Visual Acuity ◽  
Visual Impairment ◽  
Cardiovascular Health ◽  
Central Africa ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Logistic Regression Models ◽  
Sub Saharan

Abstract Background Visual impairment (VI) and determinants of poor cardiovascular health are very common in sub-Saharan Africa. However, we do not know whether these determinants are associated to VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo. Methods Participants were Congolese older adults aged ≥ 65 years included in EPIDEMCA-FU (Epidemiology of Dementia in Central Africa - Follow-up) population-based cohort. Near VI was defined as visual acuity &lt; 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at 1 st follow-up were investigated using multivariable logistic regression models. Results Among the 549 participants included, 378 (68.8% [95% Confidence Interval: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high BMI ≥ 25 kg/m 2 (Odds Ratio= 2.15 [95% CI: 1.25–3.68]), diabetes (OR=2.12 [95% CI: 1.06–4.25]) and hypertension (OR=1.65 [95% CI: 1.02–2.64]) were independently associated with near VI. Conclusions Several determinants of poor cardiovascular health were associated to near VI in this population. This study suggests that promoting a good cardiovascular health could represent a target for VI prevention among older adults.

Sign in / Sign up

Export Citation Format

Share Document