scholarly journals Widening or narrowing income inequalities in myocardial infarction? Time trends in life years free of myocardial infarction and after incidence

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Juliane Tetzlaff ◽  
Fabian Tetzlaff ◽  
Siegfried Geyer ◽  
Stefanie Sperlich ◽  
Jelena Epping
Keyword(s):  
Myocardial Infarction ◽  
Low Income ◽  
Income Group ◽  
Federal State ◽  
Men And Women ◽  
Mortality Risks ◽  
Income Inequalities ◽  
Life Years ◽  
Incidence And Mortality ◽  
Over Time

Abstract Background Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan free of MI and after MI in different social subgroups. This study investigates income inequalities in MI-free life years and life years after MI and whether these inequalities widened or narrowed over time. Methods The analyses are based on claims data of a large German health insurance provider insuring approximately 2.8 million individuals in the federal state Lower Saxony. Trends in income inequalities in incidence and mortality were assessed for all subjects aged 60 years and older by comparing the time periods 2006–2008 and 2015–2017 using multistate survival models. Trends in the number of life years free of MI and after MI were calculated separately for income groups by applying multistate life table analyses. Results MI incidence and mortality risks decreased over time, but declines were strongest among men and women in the higher-income group. While life years free of MI increased in men and women with higher incomes, no MI-free life years were gained in the low-income group. Among men, life years after MI increased irrespective of income group. Conclusions Income inequalities in the lifespan spent free of MI and after MI widened over time. In particular, men with low incomes are disadvantaged, as life years spent after MI increased, but no life years free of MI were gained.

scholarly journals Social inequalities in mild and severe myocardial infarction: how large is the gap in health expectancies?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliane Tetzlaff ◽  
Siegfried Geyer ◽  
Mechthild Westhoff-Bleck ◽  
Stefanie Sperlich ◽  
Jelena Epping ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Social Inequalities ◽  
Mortality Risks ◽  
Socially Disadvantaged ◽  
Life Years ◽  
Incidence And Mortality ◽  
Low Incomes ◽  
Health Insurance Provider ◽  
Length Of Life ◽  
German Statutory Health Insurance

Abstract Background Acute myocardial infarction (MI) remains a frequent health event and a major contributor to long-term impairments globally. So far, research on social inequalities in MI incidence and mortality with respect to MI severity is limited. Furthermore, evidence is lacking on disparities in the length of life affected by MI. This study investigates social inequalities in MI incidence and mortality as well as in life years free of MI and affected by the consequences of mild or severe MI. Methods The study is based on data of a large German statutory health insurance provider covering the years 2008 to 2017 (N = 1,253,083). Income inequalities in MI incidence and mortality risks and in life years with mild or severe MI and without MI were analysed using multistate analyses. The assessment of MI severity is based on diagnosed heart failure causing physical limitations. Results During the study period a total of 39,832 mild MI, 22,844 severe MI, 276,582 deaths without MI, 15,120 deaths after mild MI and 16,495 deaths after severe MI occurred. Clear inequalities were found in MI incidence and mortality, which were strongest among men and in severe MI incidence. Moreover, substantial inequalities were found in life years free of MI in both genders to the disadvantage of those with low incomes and increased life years after mild MI in men with higher incomes. Life years after severe MI were similar across income groups. Conclusions Social inequalities in MI incidence and mortality risks led to clear disparities in the length of life free of MI with men with low incomes being most disadvantaged. Our findings stress the importance of primary and secondary prevention focusing especially on socially disadvantaged groups.

Differential Aging in Place and Depressive Symptoms: Interplay Among Time, Income, and Senior Housing

2017 ◽  
Vol 40 (3) ◽  
pp. 207-231 ◽  
Author(s):  
Sojung Park ◽  
BoRin Kim ◽  
Yoonsun Han
Keyword(s):  
Depressive Symptoms ◽  
Low Income ◽  
Aging In Place ◽  
Later Life ◽  
Income Group ◽  
Senior Housing ◽  
Housing Environment ◽  
Age In Place ◽  
Retirement Study ◽  
Over Time

Objective: We examined cumulative and differential experiences of aging in place. Method: Data came from the 2002 and 2010 wave of the Health Retirement Study. We modeled the trajectory of later-life depressive symptoms, and how senior-housing environments moderate the negative association between economic disadvantages and depressive symptoms. Results: At baseline, economically disadvantaged older adults were more likely to exhibit depressive symptoms. However, detrimental effects of income group (non-low income vs. moderate income; non-low income vs. low income) on depressive symptoms did not significantly change over time. The age-leveler hypothesis may account for nonsignificant effects of disadvantaged income groups over time. Discussion: Findings suggest that moderate-income seniors may experience positive differentials if they age in place in a supportive senior-housing environment. Moderate-income seniors may have broader opportunities in senior housing compared to private-home peers. Senior housing might partially counter risks such as low mental health, emerging from life-course disadvantage.

scholarly journals Why women empowerment is needed post COVID-19?

2020 ◽  
Author(s):  
Prerna Karulkar
Keyword(s):  
Low Income ◽  
Social Transformation ◽  
Income Group ◽  
Women Empowerment ◽  
Financial Independence ◽  
Men And Women ◽  
Individual Level ◽  
The Social ◽  
Grass Root ◽  
Grass Root Level

The dreadful COVID-19 pandemic has brought forth many harsh realities. This has affected men and women differently. As it is, women already suffer the fate of the lesser gender due to the prevalent patriarchal society. The ongoing outbreak has increased this divide. Women face many challenges be it in urban or rural area, middle or low-income group; the issues differ to an extent, but they exist. The roles as defined by the social norms have become more prominent. This paper attempts to study the various consequences of the COVID-19 pandemic on women and men. It provides an assessment as to why women empowerment is the need of the hour and tries to find probable solutions to the pertaining problems. Education and financial independence are two primary ways of empowerment at individual level. As a society, we need to rethink and revamp the values, beliefs, attitudes towards gender norms and predefined roles. We need to make changes at the grass root level to bring in equality. Global social transformation is required in order to weaken the deep-rooted patriarchy.

scholarly journals The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis

2020 ◽  
Author(s):  
Young-Eun Kim ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-beom Kim ◽  
Dun-Sol Go ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Outcome ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability

Abstract Background: This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods: The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country.Results: The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase.Conclusions: Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals Changes in life expectancy and lifespan variability by income quartiles in four Nordic countries: a study based on nationwide register data

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048192
Author(s):  
Henrik Brønnum-Hansen ◽  
Olof Östergren ◽  
Lasse Tarkiainen ◽  
Åsmund Hermansen ◽  
Pekka Martikainen ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Low Income ◽  
Social Disparities ◽  
Premature Deaths ◽  
Income Groups ◽  
Income Inequalities ◽  
Lifespan Variation ◽  
Lifespan Variability ◽  
Income Quartile ◽  
Over Time

ObjectivesLevels, trends or changes in socioeconomic mortality differentials are typically described in terms of means, for example, life expectancies, but studies have suggested that there also are systematic social disparities in the dispersion around those means, in other words there are inequalities in lifespan variation. This study investigates changes in income inequalities in mean and distributional measures of mortality in Denmark, Finland, Norway, and Sweden over two decades.DesignNationwide register-based study.SettingThe Danish, Finnish, Norwegian and Swedish populations aged 30 years or over in 1997 and 2017.Main outcome measuresIncome-specific changes in life expectancy, lifespan variation and the contribution of ‘early’ and ‘late’ deaths to increasing life expectancy.ResultsIncreases in life expectancy has taken place in all four countries, but there are systematic differences across income groups. In general, the largest gains in life expectancy were observed in Denmark, and the smallest increase among low-income women in Sweden and Norway. Overall, life expectancy increased and lifespan variation decreased with increasing income level. These differences grew larger over time. In all countries, a marked postponement of early deaths led to a compression of mortality in the top three income quartiles for both genders. This did not occur for the lowest income quartile.ConclusionIncreasing life expectancy is typically accompanied by postponement of early deaths and reduction of lifespan inequality in the higher-income groups. However, Nordic welfare societies are challenged by the fact that postponing premature deaths among people in the lowest-income groups is not taking place.

scholarly journals The gaps in health-adjusted life years (HALE) by income and region in Korea: a national representative bigdata analysis

2020 ◽  
Author(s):  
Seok-Jun Yoon ◽  
Young-Eun Kim ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-beom Kim ◽  
...  
Keyword(s):  
Low Income ◽  
Primary Outcome ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability

Abstract Background: This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability from the national claims data and aims to identify the differences and inequalities in income level and region. Methods: The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based years lived with disability (YLD) for 260 disease groups, and this was used as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 administrative districts to cover the whole country.Results: The primary outcome was HALE in the Korean population. The second outcome was the HALE’s gap in terms of income and region. HALE increased from 2008 to 2016. Results by gender suggest that HALE in males increases faster than in females. Results by income level show that HALE is higher in higher income level. In 2016, the gap in HALE between Q1 and Q2, the lower income group, was about 5.10 years. The gap in females by income level was smaller than that in males, which can be because males have greater inequality in terms of HALE by income level. Moreover, the gap in HALE by region was found to increase.Conclusions: Results suggest that there is an inequality in years of living with disability in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals Population Incidence and Mortality of Sepsis in an Urban African Setting, 2013–2016

2019 ◽  
Vol 71 (10) ◽  
pp. 2547-2552 ◽  
Author(s):  
Joseph M Lewis ◽  
Michael Abouyannis ◽  
Grace Katha ◽  
Mulinda Nyirenda ◽  
Grace Chatsika ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Low Income ◽  
Negative Binomial ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Public Health Response ◽  
Discharge Data ◽  
Population Incidence ◽  
Incidence And Mortality ◽  
Over Time

Abstract Background Sepsis is an important cause of mortality globally, although population incidence estimates from low-income settings, including sub-Saharan Africa, are absent. We aimed to estimate sepsis incidence burden using routinely available data from a large urban hospital in Malawi. Methods We linked routine-care databases at Queen Elizabeth Central Hospital, Blantyre, Malawi, to provide admission and discharge data for 217 149 adults from 2013–2016. Using a definition of sepsis based on systemic inflammatory response syndrome criteria and Blantyre census population data, we calculated population incidence estimates of sepsis and severe sepsis and used negative binomial regression to assess for trends over time. Missing data were multiply imputed with chained equations. Results We estimate that the incidence rate of emergency department–attending sepsis and severe sepsis in adults was 1772 per 100 000 person-years (95% confidence interval [CI], 1754–1789) and 303 per 100 000 person-years (95% CI, 295–310), respectively, between 2013 and 2016, with a year-on-year decrease in incidence. In-hospital mortality for patients admitted to the hospital with sepsis and severe sepsis was 23.7% (95% CI, 22.7–24.7%) and 28.1% (95% CI, 26.1 – 30.0%), respectively, with no clear change over time. Conclusions Sepsis incidence is higher in Blantyre, Malawi, than in high-income settings, from where the majority of sepsis incidence data are derived. Worldwide sepsis burden is likely to be underestimated, and data from low-income countries are needed to inform the public health response.

scholarly journals The Gaps in Health-Adjusted Life Years (HALE) by Income and Region in Korea: A National Representative Bigdata Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3473
Author(s):  
Young-Eun Kim ◽  
Yoon-Sun Jung ◽  
Minsu Ock ◽  
Hyesook Park ◽  
Ki-Beom Kim ◽  
...  
Keyword(s):  
Low Income ◽  
National Level ◽  
Income Group ◽  
Income Level ◽  
Insurance Premium ◽  
Lower Income Group ◽  
Life Years ◽  
Medical Benefits ◽  
Years Lived With Disability ◽  
Municipal Level

This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability (YLD) from the national claims data, as well as to identify the differences and inequalities in income level and region. The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based YLD for 260 disease groups, and used it as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 Korean municipal-level administrative districts. Our results revealed that HALE increased from 2008 to 2018. HALE in males increased faster than that in females. HALE was higher in higher income levels. In 2018, the gap in HALE between Q1 and Q2, the lower income group, was about 5.57 years. The gap in females by income level was smaller than that in males. Moreover, the gap in HALE by region was found to increase. Results suggest that there is an inequality in YLD in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.

scholarly journals Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis

Heart ◽  
2018 ◽  
Vol 104 (23) ◽  
pp. 1937-1948 ◽  
Author(s):  
Chun Wai Wong ◽  
Chun Shing Kwok ◽  
Aditya Narain ◽  
Martha Gulati ◽  
Anastasia S Mihalidou ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Marital Status ◽  
Meta Analysis ◽  
Stroke Incidence ◽  
Men And Women ◽  
Never Married ◽  
Search Terms ◽  
Incidence And Mortality ◽  
Language Restriction ◽  
Stroke Death

BackgroundThe influence of marital status on the incidence of cardiovascular disease (CVD) and prognosis after CVD is inconclusive. We systematically reviewed the literature to determine how marital status influences CVD and prognosis after CVD.MethodsA search of MEDLINE and Embase in January 2018 without language restriction was performed to identify studies that evaluated the association between marital status and risk of CVD. Search terms related to both marital status and CVD were used and included studies had to be prospective in design. The outcomes of interest were CVD, coronary heart disease (CHD) or stroke incidence and mortality. We performed random effects meta-analysis stratified by the types of population by calculating odds ratios (OR) and 95% confidence intervals (95% CI).ResultsOur analysis included 34 studies with more than two million participants. Compared with married participants, being unmarried (never married, divorced or widowed) was associated with increased odds of CVD (OR 1.42; 95% CI 1.00 to 2.01), CHD (OR 1.16,95% CI 1.04 to 1.28), CHD death (OR 1.43,95% CI 1.28 to 1.60) and stroke death (OR 1.55,95% 1.16 to 2.08). Being divorced was associated with increased odds of CHD (P<0.001) for both men and women while widowers were more likely to develop a stroke (P<0.001). Single men and women with myocardial infarction had increased mortality (OR 1.42, 95% CI 1.14 to 1.76) compared with married participants.ConclusionsMarital status appears to influence CVD and prognosis after CVD. These findings may suggest that marital status should be considered in the risk assessment for CVD and outcomes of CVD based on marital status merits further investigation.

Sign in / Sign up

Export Citation Format

Share Document