Social inequalities in mortality in older women cannot be explained by biological and health behavioural factors — results from a Norwegian health survey (the HUNT Study)

2009 ◽  
Vol 37 (4) ◽  
pp. 401-408 ◽  
Author(s):  
Berit Rostad ◽  
Berit Schei ◽  
Tom Ivar Lund Nilsen
2011 ◽  
Vol 27 (suppl 2) ◽  
pp. s298-s308 ◽  
Author(s):  
Luiz Antonio Chaves Viana ◽  
Maria da Conceição Nascimento Costa ◽  
Jairnilson Silva Paim ◽  
Ligia Maria Vieira-da-Silva

An ecological study was carried out using information zones as units of analysis in order to assess the evolution of socio-spatial inequalities in mortality due to external causes and homicides in Salvador, Bahia State, Brazil, in 2000 and 2006. The Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) and the City Health Department (Secretaria Municipal de Saúde) provided the data sources, and causes of death were reviewed and reclassified based on reports from the Institute of Legal Medicine (Instituto Médico Legal). The information zones were classified into four social strata according to income and schooling. The ratio between mortality rates (inequality ratio) was calculated and confirmed a rise of 98.5% in the homicide rate. In 2000, the risk of death due to external causes and murders in the stratum with the worst living conditions was respectively 1.40 and 1.94 times greater than in the reference stratum. In 2006 these figures were 2.02 and 2.24. The authors discuss the implications for inter-sectoral public policies, based on evidence from the study's findings.


2021 ◽  
Author(s):  
Deleon Fergus ◽  
Yi-Hua Chen ◽  
Ying-Chih Chuang ◽  
Ai-Hsuan Ma ◽  
Kun-Yang Chuang

Abstract Objectives The aim of this study was to determine whether gender impacts potential associations between social relationships, sociodemographic, health and behavioural factors with resilience among older Taiwanese adults. Methods High and low resilience of older adults was determined based on the median value of the Friborg’s Resilience Scale. An independent sample t-test, χ2, and multivariate logistic regression were used to examine predictors for resilience which were then stratified by gender. Results Older women were less likely to be resilient than older men. Marital status, age, financial stress, and satisfaction with one's living environment were only significant in women. Traditional gender roles in the wider Taiwanese context can be attributed to these differences. Conclusions The relationships between gender, sociodemographics, health, and social and behavioural factors with resilience provide unique insights into how culture shapes trends in data.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035070 ◽  
Author(s):  
Kristin Hestmann Vinjerui ◽  
Pauline Boeckxstaens ◽  
Kirsty A Douglas ◽  
Erik R Sund

ObjectivesTo explore prevalences and occupational group inequalities of two measures of multimorbidity with frailty.DesignCross-sectional study.SettingThe Nord-Trøndelag Health Study (HUNT), Norway, a total county population health survey, 2006–2008.ParticipantsParticipants older than 25 years, with complete questionnaires, measurements and occupation data were included.Outcomes≥2 of 51 multimorbid conditions with ≥1 of 4 frailty measures (poor health, mental illness, physical impairment or social impairment) and ≥3 of 51 multimorbid conditions with ≥2 of 4 frailty measures.AnalysisLogistic regression models with age and occupational group were specified for each sex separately.ResultsOf 41 193 adults, 38 027 (55% female; 25–100 years old) were included. Of them, 39% had ≥2 multimorbid conditions with ≥1 frailty measure, and 17% had ≥3 multimorbid conditions with ≥2 frailty measures. Prevalence differences in percentage points (pp) with 95% confidence intervals of those in high versus low occupational group with ≥2 multimorbid conditions and ≥1 frailty measure were largest in women age 30 years, 17 (14 to 20) pp and 55 years, 15 (13 to 17) pp and in men age 55 years, 15 (13 to 17) pp and 80 years, 14 (9 to 18) pp. In those with ≥3 multimorbid conditions and ≥2 frailty measures, prevalence differences were largest in women age 30 years, 8 (6 to 10) pp and 55 years, 10 (8 to 11) ppand in men age 55 years, 9 (8 to 11) pp and 80 years, 6 (95% CI 1 to 10) pp.ConclusionMultimorbidity with frailty is common, and social inequalities persist until age 80 years in women and throughout the lifespan in men. To manage complex multimorbidity, strategies for proportionate universalism in medical education, healthcare, public health prevention and promotion seem necessary.


Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Maria de Fatima Marinho de Souza ◽  
Celia Landman Szwarcwald ◽  
Margareth Guimarães Lima ◽  
...  

2020 ◽  
Author(s):  
Melkamu Molla Ferede

Abstract Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.


2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )


2020 ◽  
Vol 8 (2) ◽  
pp. 7-59 ◽  
Author(s):  
Thierry Eggerickx ◽  
Jean-Paul Sanderson ◽  
Christophe Vandeschrick

Résumé Cet article dresse une synthèse de l’évolution de la mortalité en Belgique du 19ème siècle à nos jours en mettant l’accent sur les inégalités socio-démographiques et spatiales. Il se base sur une revue de la littérature et exploite les données de la Human Mortality Database (HMD) pour les analyses consacrées à l’évolution de la mortalité selon l’âge et le sexe depuis le début du 19ème siècle. L’appariement des données du Registre national, des recensements de la population et des bulletins de décès de l’état-civil est mobilisé pour les analyses plus récentes (1991-2015). En Belgique, la durée moyenne de vie dépasse aujourd’hui 80 ans, soit deux fois plus qu’il y a 170 ans. Mais, comme dans d’autres pays occidentaux, des inégalités subsistent et parfois même se renforcent. Ainsi, les inégalités entre groupes sociaux face à la mort sont importantes et elles se sont accentuées depuis le début des années 1990, au moins. Ces différences sociales s’observent pour toutes les causes de décès et à tous les âges, chez les femmes comme chez les hommes. Les disparités spatiales de mortalité, à l’échelle des régions, des arrondissements et des milieux de résidence se sont également accrues depuis au moins un quart de siècle. De plus, à même groupe social, les disparités spatiales de mortalité persistent. Cela signifie que des facteurs environnementaux, culturels, comportementaux agissent de la même manière sur la mortalité pour chacun des groupes sociaux. Abstract This article offers an overview of shifts in mortality in Belgium from the nineteenth century to the present, particularly in terms of sociodemographic and spatial disparities. It analyzes these shifts in mortality according to age and sex since the early nineteenth century, drawing from a review of the literature and using data from the Human Mortality Database (HMD). For the more recent analyses (1991-2015), data from the National Register, population censuses and official death records were matched up. In Belgium, the average life expectancy is now 80 years, twice as long as 170 years ago. As in other Western countries, however, disparities persist and sometimes even widen. There are thus major inequalities between social groups in regards to death, and these have been worsening since at least the early 1990s. These inequalities are apparent for each cause of death and ages at death, for women and for men. Spatial inequalities in mortality by region, district and residential area have also widened over at least the past quarter century. Even within similar social groups there are spatial disparities in mortality, indicating that environmental, cultural and behavioural factors affect mortality in the same way for each social group.


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