Trajectories of middle-aged and elderly people’s chronic diseases Disability Adjusted Life Years (DALYs): cohort, socio-economic status and gender disparities

Abstract Background The accelerated aging trend brought great chronic diseases burdens. Disabled Adjusted Life Years (DALYs) is a novel way to measure the chronic diseases burden. This study aimed to explore the cohort, socioeconomic status (SES), and gender disparities of the DALYs trajectories. Methods A total of 15,062 participants (55,740 observations) comes from China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Mixed growth curve model was adopted to predict the DALYS trajectories in 45–90 years old people influenced by different birth cohorts and SES. Results We find significant cohort, SES (resident place, education level and income) disparities differences in the chronic diseases DALYs. For individuals of earlier cohort, DALYs are developed in a late age but grow fast with age but reversed for most recent cohorts. Living in urban, having higher SES level will decrease the growth rate with age, but converges for most recent cohorts. Meanwhile, DALYs disparities of resident place and education level show gender differentials that those for female are narrowed across cohort but for male are not. Conclusions The cohort effects on chronic diseases DALYs are accumulated with China’s unique social, and political settings. There are large inequalities in early experiences, SES and DALYs. Efforts of reducing these inequalities must focus on the lower SES individuals and those living in rural areas, which greatly benefit individuals from recent cohorts.

Download Full-text

Factors associated with active aging in Chinese elderly in rural areas of Xiangtan County, China†

Frontiers of Nursing ◽

10.2478/fon-2021-0041 ◽

2021 ◽

Vol 8 (4) ◽

pp. 407-417

Author(s):

Xue-Lian Fu ◽

Jian-Guang Li ◽

Yin-Li Su ◽

Hong-Hong Wang ◽

Yang Guo ◽

...

Keyword(s):

Chronic Diseases ◽

Rural Areas ◽

Economic Status ◽

Rural Elderly ◽

Average Score ◽

Active Aging ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Chinese Elderly ◽

Number Of Children

Abstract Objectives To explore the level of active aging and correlates among rural elderly in Xiangtan County, China. Methods A cross-sectional survey was conducted from July to November 2019. A total of 945 rural elderly from 3 towns in Xiangtan County, China, were investigated by using the positive aging evaluation questionnaire (PAEQ), the activity of daily living scale (ADL), and the depression in old-age scale (DIA-S). Results The average score in the PAEQ among the rural elderly of Xiangtan County was 72.81 (range = 21–105). A moderate negative correlation was found between the score in the PAEQ and those in the ADL (r = −0.361) and DIA-S (r = −0.495). Symptoms of depression (β: −0.321, P = 0.001), number of chronic diseases (β: −0.281, P = 0.001), subjective economic status (β: 0.239, P = 0.001), ADL (β: −0.196, P = 0.001), education (β: 0.126, P = 0.001), number of children (β: 0.097, P = 0.001), and marital status (β: −0.060, P = 0.001) were significantly associated with levels of active aging in rural elderly, whereas gender and age were not independently related to active aging. Conclusions The level of active aging is at a moderately high level in the Chinese elderly in rural areas in Xiangtan County. The focus group of active aging in rural areas should be elderly people suffering from chronic diseases, physical decline, poor education and economic conditions, childlessness, and those without partners.

Download Full-text

The Socio-economic Status of Horse Owners in Rural Areas of Bangladesh

The Agriculturists ◽

10.3329/agric.v13i1.26547 ◽

2016 ◽

Vol 13 (1) ◽

pp. 46-52

Author(s):

M P Alam ◽

M S A Bhuiyan ◽

A K F H Bhuiyan

Keyword(s):

Genetic Resources ◽

Traditional Knowledge ◽

Rural Areas ◽

Economic Status ◽

Education Level ◽

Agriculture Sector ◽

Socio Economic Status ◽

One To One ◽

Horse Owners

A study was conducted for a period of 60 days to understand the socio-economic status of the horse keepers and explore the opportunity of Indigenous horse rearing in 22 villages of Mymensingh, Tangail, Sherpur and Jamalpur districts in Bangladesh. A total of 200 horse keeping households were surveyed through one-to-one interview. A pre-tested questionnaire was used to collect information. Farmer exercised traditional knowledge on horse rearing that was used mainly for pulling cart, transportation, land tillage and sports purposes for their livelihood. Most of the horse keepers were experienced in horse rearing for 0.2 to 40 years. Among the horse keepers 54% were landless followed by marginal (22.5%), small (12.5%), medium (8%) and large (3%).Their main occupation was horse pulling cart (88%) and the income from horse pulling cart was different from season to season which ranged from TK 3,000 to TK 20,000 per month. In case of secondary occupation, 81.5% farmers were involved in agriculture sector and 9% farmers involved in horse pulling cart. The horse keepers were mostly illiterate (84.7%), where the highest education level was S.S.C (1%). This study revealed valuable information which would help in designing proper policy and plan for the improvement of horse genetic resources and their keepers in Bangladesh.The Agriculturists 2015; 13(1) 46-52

Download Full-text

Examining gender differentials and determinants of private health insurance coverage in Zambia

BMC Health Services Research ◽

10.1186/s12913-021-07253-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

James Mulenga ◽

Mulenga C. Mulenga ◽

Katongo M. C. Musonda ◽

Chilizani Phiri

Keyword(s):

Health Insurance ◽

Rural Areas ◽

Agricultural Sector ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Healthcare Services ◽

Probit Regression ◽

Gender Differentials ◽

And Gender ◽

Professional Occupation

Abstract Background Health insurance is an essential aspect of healthcare. This is because it enables the insured to acquire timely and essential healthcare services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and determinants of health insurance coverage in Zambia. Methods The data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data were analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses. Results The study reveals that for women and men, age, wealth category, education, and professional occupation are positively associated with health insurance while being self-employed in the agricultural sector negatively influences health insurance coverage for both sexes. Other variables have gender-specific effects. For instance, being in marital union and having a clerical occupation increases the probability of having health insurance for women while being in the services, skilled, and unskilled manual occupations increases the probability of having health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men. Conclusion The study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include enhancing education, job creation, diversifying insurance schemes, and gender consideration in the design of National Health Insurance Scheme.

Download Full-text

The role of sugar products and non-alcoholic beverages in the food budget: change across birth cohorts and between socio-economic groups

British Food Journal ◽

10.1108/bfj-12-2020-1109 ◽

2021 ◽

Vol 123 (13) ◽

pp. 142-161

Author(s):

Antti Kähäri

Keyword(s):

Economic Status ◽

Education Level ◽

Alcoholic Beverages ◽

Birth Cohorts ◽

Content Type ◽

Beverage Consumption ◽

Socio Economic Status ◽

Cohort Differences ◽

Expenditure Share ◽

Food Expenditure

PurposeThis study investigates how the consumption of sugar products and non-alcoholic beverages has changed across birth cohorts. In addition, this study examines how the socio-economic gaps in the consumption of said products have evolved across birth cohorts.Design/methodology/approachThe research data are drawn from the Finnish household expenditure surveys covering the period 1985–2016 (n = 44,286). An age-period-cohort methodology is utilised through the age-period-cohort-trended lag model. The model assumes that the linear long-term component of change is caused by generations replacing one-another, and that the age effect is similar across cohorts.FindingsSugar products and non-alcoholic beverages occupied a larger portion of more recent birth cohorts' food baskets. Cohort differences were larger in beverage consumption. Lower income was associated with a higher food expenditure share of sugar products in several cohorts. A higher education level was linked to a higher food expenditure share of sugar products in more cohorts than a lower education level. In cohorts born before the 1950s, non-alcoholic beverages occupied a larger portion of the food baskets of the high socio-economic status groups. This gap reversed over time, leading to larger food expenditure shares of non-alcoholic beverages in low socio-economic status groups.Originality/valueThis study assessed how the consumption of sugar products and non-alcoholic beverages has changed across birth cohorts. In addition, this study assessed how socio-economic differences in the consumption of said products have changed. The results highlight that sugar products and non-alcoholic beverages occupy larger portions of more recent birth cohorts’ food baskets. The results also highlight a reversal of socioeconomic differences in non-alcoholic beverage consumption.

Download Full-text

Analysis of the Influencing Factors on the Preferences of the Elderly for the Combination of Medical Care and Pension in Long-Term Care Facilities Based on the Andersen Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155436 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5436

Author(s):

Yong Wei ◽

Liangwen Zhang

Keyword(s):

Medical Care ◽

Rural Areas ◽

Long Term Care ◽

Economic Status ◽

The Elderly ◽

Education Level ◽

Enabling Factors ◽

Term Care ◽

Andersen Model

Background: The purpose of this study is to evaluate the status quo and factors that influence the preferences of the elderly for the combination of medical care and pension (CMCP) in long-term care (LTC) facilities and to provide an evidence-based basis for building a multi-tiered, continuous LTC system with CMCP. Methods: Using a multi-stage sampling method, face-to-face questionnaire surveys were conducted on 3260 elderly people aged 60 years or over in 44 communities in 16 sub-districts in six districts in Xiamen. Based on the Andersen model, the chi-square test was used to analyze differences in population distribution, and binary logistic regression analysis was used to analyze the factors affecting the elderly’s preference for CMCP in LTC institutions in terms of the factors of predisposition, enablement, and personal needs. Results: Most elderly people choose traditional home care (82.01%), and only 12.89% choose LTC facilities with CMCP. This choice is influenced by a number of predisposing factors. The elderly who are at the upper end of the age range, have a higher education level, and live in rural areas are more likely to choose CMCP (odds ratio (OR) value greater than 1, p < 0.05). With regard to enabling factors, the elderly who were married, mainly taken care of by spouses, and had better economic status also tended to choose CMCP (OR > 1, p < 0.01). In terms of personal needs, the elderly with worse self-care status tended to choose CMCP (OR > 1, p < 0.01). Enabling factors have the largest contribution to the model, and they have the greatest impact on elder preference for CMCP services. In addition, the elderly with higher age and education level, non-remarried, with better economic status, and with poorer health status have a demand for a wider variety of CMCP services. Compared to those in urban areas, the elderly in rural areas have greater needs, mainly related to personal care, medical care, and psychological counseling. Conclusion: The preference of the elderly for CMCP are lower compared to their preference for home care in Xiamen, China. Preference for CMCP is affected by a range of factors such as age, education level, residence, income, and self-care ability, among which the enabling factors have the greatest impact.

Download Full-text

Socioeconomic inequalities in the prevalence of chronic diseases and preventive care among adults aged 45 and older in Shaanxi Province, China

BMC Public Health ◽

10.1186/s12889-019-7835-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Sha Lai ◽

Chi Shen ◽

Xiaowei Yang ◽

Xiaolong Zhang ◽

Yongjian Xu ◽

...

Keyword(s):

Chronic Diseases ◽

Preventive Care ◽

Rural Areas ◽

Concentration Index ◽

Economic Status ◽

Socioeconomic Inequalities ◽

Shaanxi Province ◽

Blood Glucose Monitoring ◽

Socioeconomic Indicators ◽

The Rich

Abstract Background Monitoring inequalities in chronic disease prevalence and their preventive care can help build effective strategies to improve health equality. Using hypertension and diabetes as a model, this study measures and decomposes socioeconomic inequalities in their prevalence and preventive care among Chinese adults aged 45 years and older in Shaanxi Province, an underdeveloped western region of China. Methods Data of 27,728 respondents aged 45 years and older who participated in the fifth National Health Services Survey conducted in 2013 in Shaanxi Province were analyzed. The relative indexes of inequalities based on Poisson regressions were used to assess disparities in the prevalence of hypertension and diabetes and their preventive care between those with the lowest and the highest socioeconomic status, and the concentration index was used to measure the magnitude of the socioeconomic-related inequality across the entire socioeconomic spectrum. The contribution of each factor to the inequality was further estimated via the concentration index decomposition. Results Our results indicate a higher prevalence of hypertension and diabetes among the rich than the poor individuals aged 45 years and older in Shaanxi Province, China. Among individuals with hypertension or diabetes, significant inequalities favoring the rich were observed in the use of preventive care, i.e. in adequate use of medication and of blood pressure/blood glucose monitoring. Furthermore, economic status, educational level, employment status, and urban-rural areas were identified as the key socioeconomic indicators for monitoring the inequalities in the patient preventive care. Conclusions Our study suggests that the existence of clear inequities in the prevalence of chronic diseases and preventive care among adults aged 45 and older in Shaanxi Province, China. These inequalities in chronic diseases could be as much a cause as a consequence of socioeconomic inequalities.

Download Full-text

Investigating gender disparities in the profile and treatment outcomes of tuberculosis in Ebonyi state, Nigeria

Epidemiology and Infection ◽

10.1017/s095026881400291x ◽

2014 ◽

Vol 143 (5) ◽

pp. 932-942 ◽

Cited By ~ 9

Author(s):

S. N. OSHI ◽

I. ALOBU ◽

K. N. UKWAJA ◽

D. C. OSHI

Keyword(s):

Treatment Outcomes ◽

Cohort Analysis ◽

Treatment Success ◽

Routine Data ◽

Gender Disparities ◽

Success Rates ◽

Infected Female ◽

Healthcare Facilities ◽

Gender Differentials ◽

And Gender

SUMMARYGlobally, twice as many men as women are being diagnosed with tuberculosis (TB) annually. Little is known about gender differentials in TB in Africa. A retrospective cohort analysis of routine data was conducted on adult TB patients treated between 2011 and 2012 in two large healthcare facilities in Nigeria. Gender differences in their demographic characteristics and treatment outcomes were analysed accordingly. Of 1668 TB patients enrolled, the male:female ratio was 1·4:1. The mean ages of males and females were 40·2 ± 14·7 and 36·1 ± 14·6 years, respectively (t test 6·62, P < 0·001). Male gender was associated with a higher failure to smear convert after 2 months (21·8% vs. 17·5%, P = 0·06) and 5 months (4·3% vs. 1·5%, P = 0·02) of treatment for smear-positive TB patients. Moreover, men were more likely than women to fail treatment (2·2% vs. 0·7%, P = 0·01). No significant differences exist in the treatment success rates between women and men (78·2% vs. 74·5%, P = 0·08). Adjusted analyses showed significant association between being an urban male and a HIV-infected female with unsuccessful outcome adjusted by socio-demographic and clinical factors. We found that gender disparities exist in TB profile and treatment outcomes in Nigeria and gender-specific strategies are needed to optimize TB management.

Download Full-text

Studies of child neglect (Psychological abuse) and gender disparities in different socio- economic status groups

ADVANCE RESEARCH JOURNAL OF SOCIAL SCIENCE ◽

10.15740/has/arjss/9.1/41-43 ◽

2018 ◽

Vol 9 (1) ◽

pp. 41-43

Author(s):

Shashi Singh ◽

Anjali Mathur ◽

Anamika Singh

Keyword(s):

Child Neglect ◽

Psychological Abuse ◽

Economic Status ◽

Gender Disparities ◽

Socio Economic Status ◽

And Gender

Download Full-text

Individual and community experience of rising burden of non-communicable diseases in two case districts of Nepal: a qualitative exploration

Global Health Promotion ◽

10.1177/17579759211001718 ◽

2021 ◽

pp. 175797592110017

Author(s):

Sudesh R. Sharma ◽

Anna Matheson ◽

Danielle Lambrick ◽

James Faulkner ◽

David W. Lounsbury ◽

...

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Rural Areas ◽

Economic Status ◽

Geographical Location ◽

Communicable Diseases ◽

Determinants Of Health ◽

Non Communicable Diseases ◽

Policy Level ◽

And Gender

Introduction: Non-communicable diseases (NCDs) are a rapidly emerging global health challenge with multi-level determinants popularly known as social determinants. The objective of this paper is to describe the individual and community experiences of NCDs in the two case districts of Nepal from a social determinants of health perspective. Method: This study adopted qualitative study design to identify the experiences of NCDs. Sixty-three interviews were conducted with key informants from different sectors pertinent to NCD prevention at two case districts and at the policy level in Nepal. Twelve focus group discussions were conducted in the selected communities within those case districts. Data collection and analysis were informed by the adapted Social Determinants of Health Framework. The research team utilised the framework approach to carry out the thematic analysis. The study also involved three sense-making workshops with policy level and local stakeholders. Results: Three key themes emerged during the analysis. The first theme highlighted that individuals and communities were experiencing the rising burden of NCDs and metabolic risks in both urban and rural areas. The other two themes elaborated on the participant’s experiences based on their socio-economic background and gender. Disadvantaged populations were more vulnerable to the risk of NCDs. Further, being female put one into an even more disadvantaged position in experiencing NCD risks and accessing health services. Conclusion: The findings indicated that key social determinants such as age, geographical location, socio-economic status and gender were driving the NCD epidemic. There is an urgent need to take action on social determinants of health through multi-sectoral action, thus also translating the spirit of the recommendations made a decade ago by the Commission on Social Determinants of Health in addressing a complex challenge like NCDs in Nepal.

Download Full-text