scholarly journals Neighborhood-level and individual-level socioeconomic status and self-reported management of ischaemic heart disease: cross-sectional results from the Korea Health Examinees Study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e021577
Author(s):  
Jongho Heo ◽  
Juhwan Oh ◽  
Hwa-Young Lee ◽  
Ji-Yeob Choi ◽  
Sujin Kim ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Low Income ◽  
The Self ◽  
Cross Sectional ◽  
Individual Level ◽  
Income Status ◽  
School Graduation ◽  
Neighborhood Level

ObjectiveSeveral studies identified neighbourhood context as a predictor of prognosis in ischaemic heart disease (IHD). The present study investigates the relationships of neighborhood-level and individual-level socioeconomic status with the odds of ongoing management of IHD, using baseline survey data from the Korea Health Examinees-Gem study.DesignIn this cross-sectional study, we estimated the association of the odds of self-reported ongoing management with the neighborhood-level income status and percentage of college graduates after controlling for individual-level covariates using two-level multilevel logistic regression models based on the Markov Chain Monte Carlo function.SettingA survey conducted at 17 large general hospitals in major Korean cities and metropolitan areas during 2005–2013.Participants2932 adult men and women.Outcome measureThe self-reported status of management after incident angina or myocardial infarction.ResultsAt the neighbourhood level, residence in a higher-income neighbourhood was associated with the self-reported ongoing management of IHD, after controlling for individual-level covariates [OR: 1.22, 95% credible interval (CI): 1.01 to 1.61). At the individual level, higher education was associated with the ongoing IHD management (high school graduation, OR: 1.33, 95% CI: 1.08 to 1.65); college or higher, OR: 1.63, 95% CI: 1.22 to 2.12; reference, middle school graduation or below).ConclusionsOur study suggests that policies or interventions aimed at improving the quality and availability of medical resources in low-income areas may associate with ongoing IHD management. Moreover, patient-centred education is essential for ongoing IHD management, especially when targeted to patients with IHD with a low education level.

scholarly journals Analysis of Sociodemographic and Clinical Factors Associated with Hospitalized Stroke Patients of Bangladesh

1970 ◽  
Vol 6 (1) ◽  
pp. 19-23 ◽  
Author(s):  
AM Hossain ◽  
NU Ahmed ◽  
M Rahman ◽  
MR Islam ◽  
G Sadhya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Low Income ◽  
Heart Diseases ◽  
Previous History ◽  
Stroke Patients ◽  
College Hospital ◽  
Cross Sectional ◽  
History Of

A hospital based cross sectional study was carried out to analyze prevalence of risk factors for stroke in hospitalized patient in a medical college hospital. 100 patients were chosen using purposive sampling technique. Highest incidence of stroke was between the 6th and 7th decade. Patients came from both urban (54%) and rural (46%) areas and most of them belong to the low-income group (47%). In occupational category; service holder (28%) and retired person (21%) were the highest groups. Most of the study subjects were literate (63%). CT scan study revealed that the incidence of ischaemic stroke was 61% and haemorrhagic stroke 39%. Analysis indicated hypertension as major risk factor for stroke (63%) and major portion of the patients (42.85%) were on irregular or no treatment. Twenty four percent of the patients had heart diseases and out of 24 patients 45.83% were suffering from ischaemic heart disease. The present study detected diabetes in 21% patients. Fifty three percent of the study subjects were smoker, 39% patients had habit of betelnut chewing. Out of 26 female patients, only 23% had history of using oral contraceptives. Majority of the patients were sedentary workers (46%). Thirty seven percent of the stroke patients were obese. Among the stroke patients 9% had previous history of stroke and 3% had TIA respectively. Most of the patients (21%) were awake while they suffered from stroke and the time of occurrence was mostly in the afternoon (46%). This study found that hypertension, cigarette smoking, ischaemic heart disease and diabetes mellitus are the major risk factors prevalent in our community while other risk factors demand further study. Key words: stroke; risk factors; hospitalized patients; Bangladesh. DOI: 10.3329/fmcj.v6i1.7405 Faridpur Med. Coll. J. 2011;6(1): 19-23

Self-employment and Civic Inclination

2020 ◽  
Vol 63 (5) ◽  
pp. 719-737
Author(s):  
F. Carson Mencken ◽  
Bethany Smith ◽  
Charles M. Tolbert
Keyword(s):  
Regression Models ◽  
Political Activism ◽  
The Self ◽  
Data Sets ◽  
County Level ◽  
Cross Sectional ◽  
Individual Level ◽  
Self Employment ◽  
Level Data ◽  
Building Community

We test whether the self-employed have higher levels of civic inclination (trust, political activism, community closeness, community participation) compared to workers from the private sector. We examine the civic inclinations of the self-employed with two national cross-sectional data sets. We use a variety of discrete and continuous regression models. We find that the self-employed have higher levels of political activism, feel closer to neighbors and family, and have greater odds of engaging to solve community problems. We fail to detect differences in donating money, attending community events, and closeness to friends. Previous research has concluded with county-level data that the self-employed are important actors in building community and creating social capital. Our results add to this literature by showing that the self-employed have higher levels of civic inclination with individual-level data. Implications for theory and research are discussed.

scholarly journals Improvements in Neighborhood Socioeconomic Conditions May Improve Resident Diet

2020 ◽  
Author(s):  
Andrea S Richardson ◽  
Rebecca L Collins ◽  
Madhumita Ghosh-Dastidar ◽  
Feifei Ye ◽  
Gerald P Hunter ◽  
...  
Keyword(s):  
Low Income ◽  
Structural Equation ◽  
Natural Experiment ◽  
Group Testing ◽  
Positive Association ◽  
Dietary Quality ◽  
Equation Modeling ◽  
Socioeconomic Conditions ◽  
Cross Sectional ◽  
Individual Level

Abstract Neighborhood socioeconomic conditions (NSEC) are associated with resident diet, but most research has been cross-sectional. We capitalize on a natural experiment where one neighborhood experienced substantial investments, compared to a sociodemographically similar neighborhood that did not, in order to examine pathways from neighborhood investments to changed NSEC and changed dietary behavior. We examine differences between renters and homeowners. Data are from a random sample of households (n=831) in each of these low-income Pittsburgh neighborhoods who were surveyed in 2011 and 2014. Structural equation modeling tested direct and indirect pathways from neighborhood to resident dietary quality, adjusting for individual-level sociodemographics, with multi-group testing by homeowners versus renters. Neighborhood investments were directly associated with improved dietary quality for both renters (β, 95% confidence interval [CI]) =0.27, CI: 0.05, 0.50) and homeowners (β=0.51, CI: 0.10, 0.92). Among renters, investments were also associated with dietary quality through a positive association with commercial prices (β= 0.34, CI: 0.15, 0.54) and a negative association with residential prices (β=-0.30, CI: -0.59, -0.004). Among homeowners, we did not observe any indirect pathways from investments to dietary quality through tested mediators. Investing in neighborhoods may support resident diet, doing so through improvements in neighborhood commercial environments for renters, but mechanisms appear to differ for homeowners.

Association between socioeconomic status and comorbidities among patients with rheumatoid arthritis: results of a nationwide cross-sectional survey

Rheumatology ◽  
2019 ◽  
Vol 58 (9) ◽  
pp. 1617-1622 ◽  
Author(s):  
Anna Shin ◽  
Seunghwan Shin ◽  
Ji Hyoun Kim ◽  
You-Jung Ha ◽  
Yun Jong Lee ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Income ◽  
Suicide Ideation ◽  
Healthcare Services ◽  
Depressive Mood ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Comprehensive Health ◽  
Musculoskeletal Systems

Abstract Objectives We examined the association between socioeconomic status (SES) and comorbidity distribution among patients with RA. Methods Information on comprehensive health status of 1088 RA patients (weighted n = 612 303) was obtained from the 2007–2015 Korea National Health and Nutrition Examination Survey database. SES components were household equivalence income, education and area of residence. To minimize confounding by age, patients were stratified by median age (63 years). Age-adjusted odds ratio (OR) with 95% confidence interval (95% CI) was estimated, comparing weighted prevalence of individual comorbidities between low and high SES groups in each age stratum. Results Among RA patients aged <63 years (mean 49 years, 70% female), we observed age-adjusted associations of depression (OR 2.13, 95% CI 1.01, 4.53), depressive mood (OR 2.68, 95% CI 1.54, 4.65), suicide ideation (OR 3.01, 95% CI 1.79, 5.07), diabetes (OR 3.09, 95%CI 1.31, 7.29), obesity (OR 2.04, 95% CI 1.30, 3.20), hypertriglyceridemia (OR 2.36, 95% CI 1.28, 4.34) and osteoarthritis (OR 2.12, 95% CI 1.13, 3.99) with low income, of suicide ideation with low education (OR 2.25, 95% CI 1.14, 4.44), but no association of any comorbidities with area of residence. Unhealthy behavior patterns were comparable between low- and high-income groups but patients with low income reported a numerically higher rate of failed access to necessary healthcare services. We did not find any association between SES and comorbidities among those aged ⩾63 years (mean 72 years, 83% female). Conclusion Among Korean RA patients aged <63 years, socioeconomic inequalities of multiple comorbidities in mental, cardiometabolic and musculoskeletal systems were found.

scholarly journals Prevalence and associated factors of self-reported ischaemic heart disease and/or stroke: a cross-sectional nationally representative community-based study of adults in Malawi in 2017

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e048167
Author(s):  
Supa Pengpid ◽  
Karl Peltzer
Keyword(s):  
Logistic Regression ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Associated Factors ◽  
Disease Risk ◽  
Communicable Disease ◽  
Adult Population ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Nationally Representative

ObjectiveThis study aimed to assess the prevalence and associated factors of self-reported ischaemic heart disease (IHD) and/or stroke among adults in Malawi.DesignPopulation-based cross-sectional study.SettingNationally representative sample of general adult population in Malawi.ParticipantsThe sample included 4187 persons aged 18–69 years (32 years of median age) that participated in the ‘2017 Malawi STEPwise Approach to Non-Communicable Disease Risk-Factor Surveillance survey.’Primary and secondary outcome measuresSelf-reported history of IHD and/or stroke, along with biological, behavioural, psychosocial stress and sociodemographic covariates. Multivariable logistic regression calculated OR with 95% CI for IHD and/or stroke.ResultsThe prevalence of IHD and/or stroke was 6.5%, 4.4% among men and 8.4% among women. In adjusted logistic regression analysis, older age (50–69 years) (adjusted OR (AOR) 3.49, 95% CI 1.75 to 6.94), female sex (AOR 2.09, 95% CI 1.45 to 3.01), Chewa speaking (AOR 4.62, 95% CI 1.32 to 16.22), English speaking (AOR 5.63, 95% CI 1.43 to 22.19), suicidal ideation, plan and/or attempt (AOR 1.87, 95% CI 1.11 to 3.13) and sedentary behaviour (AOR 2.00, 95% CI 1.12 to 3.59) were associated with IHD and/or stroke. In addition, in unadjusted analysis, non-paid or unemployed, urban residence, overweight, obesity and having hypertension were associated with IHD and/or stroke.ConclusionsAlmost 1 in 10 women and 1 in 20 men aged 18–69 years had IHD and/or stroke in Malawi. Several risk and protective factors were found that can be targeted in population health interventions.

scholarly journals Association of Clinical Trial Participation After Myocardial Infarction with Socioeconomic Status, Clinical Characteristics, and Outcomes

2021 ◽  
Author(s):  
Joel Ohm ◽  
Tomas Jernberg ◽  
David Johansson ◽  
Anna Warnqvist ◽  
Margrét Leosdottir ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Trial ◽  
Socioeconomic Status ◽  
Heart Disease ◽  
Clinical Characteristics ◽  
Left Ventricular ◽  
Trial Participation ◽  
Real World Data ◽  
Individual Level ◽  
Trial Participants

Abstract Aims To investigate whether participants in clinical trials after myocardial infarction (MI) are representable for the post-MI population concerning characteristics, secondary prevention, and prognosis. Methods and Results Cohort study on 31,792 attendants to 1-year revisits after MI throughout Sweden (n = 2941 clinical trial participants) between 2008 and 2013 identified in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). Individual-level data on socioeconomic status (SES) (disposable income, educational level, and marital status) and outcomes (first recurrent nonfatal MI, coronary heart disease death, fatal or nonfatal stroke until study end 2018) were linked from other national registries. Trial participants were more likely to be men (risk ratio 1.09; 95% confidence interval 1.07-1.11), to be married (1.07; 1.04-1.10), have a highest-quintile income (1.42; 1.36-1.48), and post-secondary education (1.25; 1.18-1.33) while less likely to have a history of MI (0.88; 0.80-0.97), be persistent smokers (0.83; 0.75-0.92) and have left ventricular dysfunction (0.59; 0.44-0.79) compared to non-participants. During a mean 6.7-year follow-up, 5,206 outcome events occurred. Risk was lower in trial participants (hazard ratio 0.80; 95% CI 0.72-0.89), also after adjusting for clinical characteristics and post-MI therapies (0.85; 0.77-0.94) and additionally for SES (0.88; 0.79-0.97). Conclusions Clinical trial participants post-MI are more often male, have higher SES, a more advantageous risk profile, and better prognosis. Additional unmeasured participation bias was implied. Questionable external validity of post-MI trials highlights the importance of complementary studies using real-world data.

scholarly journals Assessing variation among the national essential medicines lists of 21 high-income countries: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045262
Author(s):  
Michael Sergio Taglione ◽  
Nav Persaud
Keyword(s):  
Low Income ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
High Income ◽  
Essential Medicines ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Essential Medicine List ◽  
Income Status ◽  
Essential Medicines Lists

ObjectiveEssential medicines lists have been created and used globally in countries that range from low-income to high-income status. The aim of this paper is to compare the essential medicines list of high-income countries with each other, the WHO’s Model List of Essential Medicines and the lists of countries of other income statuses.DesignHigh-income countries were defined by World Bank classification. High-income essential medicines lists were assessed for medicine inclusion and were compared with the subset of high-income countries, the WHO’s Model List and 137 national essential medicines lists. Medicine lists were obtained from the Global Essential Medicines database. Countries were subdivided by income status, and the groups’ most common medicines were compared. Select medicines and medicine classes were assessed for inclusion among high-income country lists.ResultsThe 21 high-income countries identified were most like each other when compared with other lists. They were more like upper middle-income countries and least like low-income countries. There was significant variability in the number of medicines on each list. Less than half (48%) of high-income countries included a newer diabetes medicines in their list. Most countries (71%) included naloxone while every country including at least one opioid medicine. More than half of the lists (52%) included a medicine that has been globally withdrawn or banned.ConclusionEssential medicines lists of high-income countries are similar to each other, but significant variations in essential medicine list composition and specifically the number of medications included were noted. Effective medicines were left off several countries’ lists, and globally recalled medicines were included on over half the lists. Comparing the essential medicines lists of countries within the same income status category can provide a useful subset of lists for policymakers and essential medicine list creators to use when creating or maintaining their lists.

scholarly journals Socioeconomic Inequalities in the Retail Food Environment around Schools in a Southern European Context

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1511 ◽  
Author(s):  
Julia Díez ◽  
Alba Cebrecos ◽  
Alba Rapela ◽  
Luisa N. Borrell ◽  
Usama Bilal ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Population Density ◽  
Food Environment ◽  
Self Regulation ◽  
Distance Measures ◽  
Food Sources ◽  
Excess Body Weight ◽  
Unhealthy Food ◽  
Cross Sectional ◽  
Neighborhood Level

Across Europe, excess body weight rates are particularly high among children and adolescents living in Southern European contexts. In Spain, current food policies appeal to voluntary self-regulation of the food industry and parents’ responsibility. However, there is no research (within Spain) assessing the food environment surrounding schools. We examined the association between neighborhood-level socioeconomic status (NSES) and the spatial access to an unhealthy food environment around schools using both counts and distance measures, across the city of Madrid. We conducted a cross-sectional study citywide (n = 2443 census tracts). In 2017, we identified all schools (n = 1321) and all food retailers offering unhealthy food and beverages surrounding them (n = 6530) using publicly available data. We examined both the counts of retailers (within 400 m) and the distance (in meters) from the schools to the closest retailer. We used multilevel regressions to model the association of neighborhood-level socioeconomic status (NSES) with both measures, adjusting both models for population density. Almost all schools (95%) were surrounded by unhealthy retailers within 400 m (median = 17 retailers; interquartile range = 8–34). After adjusting for population density, NSES remained inversely associated with unhealthy food availability. Schools located in low-NSES areas (two lowest quintiles) showed, on average, 29% (IRR (Incidence Rate Ratio) = 1.29; 95% CI (Confidence Interval) = 1.12, 1.50) and 62% (IRR = 1.62; 95% CI = 1.35, 1.95) more counts of unhealthy retailers compared with schools in middle-NSES areas (ref.). Schools in high-NSES areas were farther from unhealthy food sources than those schools located in middle-NSES areas (β = 0.35; 95% CI = 0.14, 0.47). Regulating the school food environment (within and beyond school boundaries) may be a promising direction to prevent and reduce childhood obesity.

Abstract P279: Neighborhood Socioeconomic Status and Physical Function in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Priya Palta ◽  
Mehul Patel ◽  
Michael Griswold ◽  
Anna Kucharska-Newton ◽  
Beverly G Windham ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Physical Function ◽  
Grip Strength ◽  
Walking Speed ◽  
Negative Binomial ◽  
Low Ses ◽  
Functional Impairments ◽  
Individual Level ◽  
Neighborhood Level ◽  
Neighborhood Ses

Introduction: Functional impairments influence the performance of activities of daily living and may result in dependence on others for basic self-care needs. Lower individual-level socioeconomic status (SES) is associated with more self-reported disability and lower measured walking speeds which convey a higher risk of cardiovascular and all-cause mortality. The role of neighborhood-level SES on these functional outcomes has not been widely examined. Hypothesis: We hypothesized that residing in a socioeconomically disadvantaged neighborhood is inversely associated with physical function, after accounting for individual-level SES. Methods: We included 5,388 participants (42% male, 19% black, mean age: 76 years) from the 2011-2013 examination of the ARIC cohort. Neighborhood SES was constructed from census-tract data and an index score was derived based on aggregate z-score estimates from the following 6 dimensions: median household income; median value of owner-occupied units; % adults with a high school degree; % adults with a college degree; % households receiving interest, dividend or rental income; and % adults employed in executive, managerial or professional occupations. Race-specific tertiles were generated to indicate low, middle and high neighborhood SES. The Short Physical Performance Battery (SPPB) was used to derive a summary score (0-12) of physical function based on the individual’s performance on gait speed, chair stands and balance exercises. Negative binomial regression was used to quantify the difference in the log of expected counts in the SPPB score between race-stratified low, middle and high neighborhood SES, adjusting for age, sex, body mass index (BMI), smoking, hypertension, diabetes, study center, and education as a measure of individual-level SES. The multivariable-adjusted effect of neighborhood SES on a 4-meter walking speed test and on grip strength was estimated by least-squares regression. Results: Blacks had a slower walking speed, higher grip strength and lower SPPB score compared to whites. Hypertension, higher BMI, and lower education were more prevalent among white and black individuals from low SES neighborhoods, compared to those from high SES neighborhoods. White participants residing in a low SES neighborhood had a 1.1 kilogram (95% CI: 0.3, 1.9) greater grip strength compared to those residing in high SES neighborhoods. Neighborhood SES was not associated with walking speed and SPPB in either whites or blacks. Associations were robust to adjustment for education. Conclusions: Individual but not neighborhood-level SES was associated with poorer physical function. The prevalence of adverse clinical comorbidities was higher among both black and white participants living in disadvantaged neighborhoods. Poorer individual, modifiable health and SES measures may be targets for interventions to reduce functional disparities.

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