scholarly journals Gender-specific trends of educational inequality in diagnosed diabetes from 1999 to 2014 in Hong Kong: a serial cross-sectional study of 97,481 community-dwelling Chinese adults

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Gary Ka-Ki Chung ◽  
Francisco Tsz Tsun Lai ◽  
Eng-Kiong Yeoh ◽  
Roger Yat-Nork Chung
Keyword(s):  
Hong Kong ◽  
Educational Inequality ◽  
Social Determinant ◽  
Community Dwelling ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Relative Index ◽  
Index Of Inequality ◽  
Diagnosed Diabetes ◽  
Gender Specific

Abstract Background Gender differences in the trend of educational inequality in diabetes have been widely observed in the Western populations, indicating the increasing importance of educational attainment as a social determinant of diabetes among women. Nonetheless, relevant evidence is scarce in developed Asian settings for comparisons. This study examined the gender-specific trends of educational inequality in diagnosed diabetes in Hong Kong between 1999 and 2014. Methods A series of eight territory-wide population-representative samples of 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were surveyed between 1999 and 2014. Regression-based Relative Index of Inequality (RII) and age-standardized Slope Index of Inequality (SII) were adopted to examine the extent and trend of gender-specific educational inequality in self-reported physician-diagnosed diabetes. Results Age-standardized prevalence of diabetes increased in both genders over time, with a steeper surge among men. In addition, educational inequalities in diabetes, in both relative and absolute terms, significantly widened among women over the study period (annual RII change = 1.04; 95% CI = 1.02–1.07, annual SII change = 0.36%; 95% CI = 0.16–0.56%), with the peak in 2011 (RII = 2.44; 95% CI = 1.83–3.24, SII = 9.21%; 95% CI = 6.47–11.96%). However, no significant widening inequality was found among men. Further adjustment for household income level did not attenuate the observed educational inequality. Conclusions Despite a greater increase in diabetes prevalence among men, disparity in diabetes substantially widened across education levels among women in the past decade in Hong Kong. The gender perspective should be taken into considerations for policy making to alleviate the prevalence surge and rising educational inequality in diabetes.

scholarly journals Educational inequality in physician-diagnosed hypertension widened and persisted among women from 1999 to 2014 in Hong Kong

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Gary K. K. Chung ◽  
Francisco T. T. Lai ◽  
Eng-Kiong Yeoh ◽  
Roger Y. Chung
Keyword(s):  
Hong Kong ◽  
Educational Inequality ◽  
Social Determinant ◽  
Community Dwelling ◽  
Relative Index ◽  
Asian Populations ◽  
Hypertension Prevention ◽  
Education Levels ◽  
Index Of Inequality ◽  
Gender Specific

Abstract Gender differences in the trend of educational inequality in hypertension have been observed especially in the Asian populations, indicating the increasing importance of education as a social determinant of hypertension among women. This study examined the gender-specific trends of educational inequality in physician-diagnosed hypertension in Hong Kong between 1999 and 2014. Based on a series of eight government-led territory-wide household surveys conducted between 1999 and 2014, 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were analysed. The extent and trend of gender-specific educational inequality in self-reported physician-diagnosed hypertension were estimated by regression-based Relative Index of Inequality and age-standardised Slope Index of Inequality. Over the study period, age-standardised prevalence of self-reported hypertension increased in both genders, with the greatest prevalence among the least educated women. Educational inequalities in hypertension significantly widened in female from 1999 to 2009 and persisted thereafter; nonetheless, the respective inequality was negligible in male. Further adjustment for household income did not attenuate the observed inequality. To conclude, a widened and then persistent discrepancy in hypertension across education levels was observed among women, but not among men, in Hong Kong. The gender perspective should be carefully considered when designing hypertension prevention strategies and related health policies.

scholarly journals Trends in socioeconomic inequalities in the prevalence of functional dentition among older people in Brazil

2018 ◽  
Vol 34 (10) ◽  
Author(s):  
Fabiola Bof de Andrade ◽  
Jose Leopoldo Ferreira Antunes
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Socioeconomic Inequalities ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Relative Index ◽  
Functional Dentition ◽  
Natural Teeth ◽  
Index Of Inequality ◽  
Position Measure

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.

scholarly journals Educational inequality in the occurrence of abdominal obesity:Pró-Saúde Study

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Ronaldo Fernandes Santos Alves ◽  
Eduardo Faerstein
Keyword(s):  
Abdominal Obesity ◽  
Educational Inequality ◽  
Linear Trend ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Cross Sectional ◽  
Female Population ◽  
Relative Index ◽  
Education Levels ◽  
Index Of Inequality

OBJECTIVE To estimate the degree of educational inequality in the occurrence of abdominal obesity in a population of non-faculty civil servants at university campi.METHODS In this cross-sectional study, we used data from 3,117 subjects of both genders aged 24 to 65-years old, regarding the baseline ofPró-Saúde Study, 1999-2001. Abdominal obesity was defined according to abdominal circumference thresholds of 88 cm for women and 102 cm for men. A multi-dimensional, self-administered questionnaire was used to evaluate education levels and demographic variables. Slope and relative indices of inequality, and Chi-squared test for linear trend were used in the data analysis. All analyses were stratified by genders, and the indices of inequality were standardized by age.RESULTS Abdominal obesity was the most prevalent among women (43.5%; 95%CI 41.2;45.9), as compared to men (24.3%; 95%CI 22.1;26.7), in all educational strata and age ranges. The association between education levels and abdominal obesity was an inverse one among women (p < 0.001); it was not statistically significant among men (p = 0.436). The educational inequality regarding abdominal obesity in the female population, in absolute terms (slope index of inequality), was 24.0% (95%CI 15.5;32.6). In relative terms (relative index of inequality), it was 2.8 (95%CI 1.9;4.1), after the age adjustment.CONCLUSIONS Gender inequality in the prevalence of abdominal obesity increases with older age and lower education. The slope and relative indices of inequality summarize the strictly monotonous trend between education levels and abdominal obesity, and it described educational inequality regarding abdominal obesity among women. Such indices provide relevant quantitative estimates for monitoring abdominal obesity and dealing with health inequalities.

scholarly journals Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries

2020 ◽  
Vol 99 (12) ◽  
pp. 1341-1347
Author(s):  
F. Bof de Andrade ◽  
J.L.F. Antunes ◽  
F.C.D. Andrade ◽  
M.F.F. Lima-Costa ◽  
J. Macinko
Keyword(s):  
United States ◽  
Older Adults ◽  
South Korea ◽  
The United States ◽  
Self Report ◽  
Absolute Difference ◽  
Dental Services ◽  
Cross Sectional ◽  
Relative Index ◽  
Index Of Inequality

This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.

scholarly journals Hong Kong Chinese adults’ knowledge of exercise recommendations and attitudes towards exercise

BJGP Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. bjgpopen17X100929 ◽  
Author(s):  
Man Kin Wong ◽  
Sai Yip Ronald Cheng ◽  
Tsun Kit Chu ◽  
Cheuk Nang Lee ◽  
Jun Liang
Keyword(s):  
Hong Kong ◽  
Chronic Diseases ◽  
Sex Education ◽  
Psychosocial Support ◽  
Age Groups ◽  
Health Benefit ◽  
Hong Kong Chinese ◽  
Weak Correlation ◽  
Chinese Adults ◽  
Cross Sectional

BackgroundPhysical inactivity is known to be one of the major risk factors for many chronic conditions.AimTo determine Hong Kong Chinese adults’ physical activity (PA) knowledge, its relationship with certain variables including sex, education, age, and its correlation with different types of chronic diseases, such as heart disease, cerebrovascular disease, diabetes mellitus, obesity, and others. The Hong Kong Chinese adults' general attitudes towards PA will also be examined.Design & settingCross-sectional study in one primary care centre.MethodA randomized sample of Chinese adults aged >18 years with anonymous self-administered questionnaires.ResultsThe mean percentage of correct responses for exercise guidelines was 62.3%, 84.5% for traditional PA, and 48.4% for lifestyle PA, respectively. Traditional PA refers to exercises which use large muscle groups. Lifestyle PAs include activities which can be done throughout the day. The total mean percentage of correct responses was 67% (knowledge score 13.4 +/– 3.34). There were no significant differences between PA knowledge and sex, education levels, age groups, and presence of chronic diseases (P>0.05), but the knowledge level for lifestyle PA was less than that of traditional PA (P<0.001). A weak correlation was found between responders’ activeness for a health benefit and the PA knowledge levels (P>0.05). Two hundred and sixy-six (93.3%) responders reported a willingness to maintain or start exercise.ConclusionThe results suggest a need for more education about the latest PA recommendations, especially lifestyle PA. The weak correlation between PA knowledge and actual behaviour showed that PA knowledge itself might not affect PA behaviour. The enhancement of the general public’s knowledge, motivation, and psychosocial support along with stage-of-change interventions and the provision of counselling skills may result in PA behaviour change, which in turn can lead to the achievement of health benefits.

scholarly journals Relationship between serum triglyceride to high-density lipoprotein cholesterol ratio and sarcopenia occurrence rate in community-dwelling Chinese adults

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Na Wang ◽  
Mengjun Chen ◽  
Danhong Fang
Keyword(s):  
High Density Lipoprotein ◽  
High Density Lipoprotein Cholesterol ◽  
Density Lipoprotein ◽  
Serum Triglyceride ◽  
Community Dwelling ◽  
High Density ◽  
Lipoprotein Cholesterol ◽  
Occurrence Rate ◽  
Chinese Adults ◽  
Cross Sectional

Abstract Background A study conducted on elderly Korean men showed that a high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio was associated with a high risk of developing sarcopenia. We aimed to determine such an association in community-dwelling Chinese adults. Methods From May 2016 to August 2017, we conducted a cross-sectional study on Chinese adults at the First Affiliated Hospital of Wenzhou Medical University. Univariate and multivariate logistic regression analyses were applied to evaluate a possible relationship between TG/HDL-C ratio and sarcopenia occurrence. Results We included 2613 adults in this study, with 13.85% presenting with sarcopenia. The odds ratios (ORs) for TG and HDL-C were 0.67 (95% confidence interval [CI]: 0.51–0.87), and 1.97 (95% CI: 1.49–2.61), respectively. Moreover, TG/HDL-C ratio was independently associated with sarcopenia status (OR: 0.63; 95% CI: 0.49–0.81). Conclusions We found that TG and HDL-C were, respectively, negatively and positively associated with sarcopenia occurrence rate in community-dwelling Chinese adults. However, a negative association was found between sarcopenia occurrence rate and TG/HDL-C ratio.

scholarly journals Attitudes towards Advance Care Planning and Healthcare Autonomy among Community-Dwelling Older Adults in Beijing, China

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Ning Zhang ◽  
Xiao-hong Ning ◽  
Ming-lei Zhu ◽  
Xiao-hong Liu ◽  
Jing-bing Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Influential Factors ◽  
Community Dwelling ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Advance Care ◽  
Older Chinese ◽  
Older Chinese Adults ◽  
Beijing China

Objectives. To investigate the preferences of ACP and healthcare autonomy in community-dwelling older Chinese adults.Methods. A community-based cross-sectional study was conducted with older adults living in the residential estate of Chaoyang District, Beijing.Results. 900 residents were enrolled. 80.9% of them wanted to hear the truth regarding their own condition from the physician; 52.4% preferred to make their own healthcare decisions. Only 8.9% of them preferred to endure life-prolonging interventions when faced with irreversible conditions. 78.3% of the respondents had not heard of an ACP; only 39.4% preferred to document in an ACP. Respondents with higher education had significantly higher proportion of having heard of an ACP, as well as preferring to document in an ACP, compared to those with lower education. Those aged <70 years had higher proportion of having heard of an ACP, as well as refusing life-prolonging interventions when faced with irreversible conditions, compared to those aged ≥70 years.Conclusions. Although the majority of community-dwelling older Chinese adults appeared to have healthcare autonomy and refuse life-prolonging interventions in terms of end-of-life care, a low level of “Planning ahead” awareness and preference was apparent. Age and education level may be the influential factors.

scholarly journals Gender-specific temporal trends in overweight prevalence among Chinese adults: a hierarchical age-period-cohort analysis from 2008 to 2015

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Yinmei Yang ◽  
Mohammedhamid Osman Kelifa ◽  
Bin Yu ◽  
Carly Herbert ◽  
Yongbo Wang ◽  
...  
Keyword(s):  
Cohort Analysis ◽  
Temporal Trends ◽  
General Social Survey ◽  
Cohort Effects ◽  
Chinese Adults ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Gender Specific ◽  
Overweight Prevalence ◽  
Age And Cohort Effects

Abstract Background As a key health risk, the prevalence of overweight has been strikingly increasing worldwide. This study aimed to disentangle the net age, period, and cohort effects on overweight among Chinese adults by gender. Methods Data came from the Chinese General Social Survey from 2008 to 2015, which was a repeated cross-sectional survey (n = 55,726, aged 18 and older). χ2 or t tests were used to estimate the gender disparities in overweight and socioeconomic status (SES). A series of hierarchical age-period-cohort cross-classified random-effects models were performed using SAS version 9.4 to estimate the overall and gender-specific temporal trends of overweight, as well as the association between SES and overweight. Further, a series of line charts were used to present the age and cohort variations in overweight. Results After controlling for covariates, significant age and cohort effects were observed among adults in China (b = 0.0205, p < 0.001; b = 0.0122, p < 0.05; respectively). Specifically, inverted U-shaped age effects were identified for both genders, with a high probability of overweight occurring in middle age (b = –0.0012, p < 0.001). Overweight was more prevalent among men than women before 60 years old, and this trend reversed thereafter (b = –0.0253, p < 0.001). Moreover, men born during the war (before 1950) and reform cohorts (after the 1975s) demonstrated a substantial decline in overweight, while men born in 1950–1975 showed an increasing trend in overweight prevalence (b = 0.0378, p < 0.05). However, the cohort effect on women was not statistically significant. Additionally, a higher SES was related to an elevated probability of overweight. Conclusion Gender-specific age and cohort effects on the prevalence of overweight were observed among Chinese adults. Both China and other developing countries need to pay attention to the coming obesity challenge and related health inequality. Full life-cycle overweight prevention interventions should focus on middle-aged adults, men born in the war and reform eras, and adults with a higher SES.

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