scholarly journals Awareness, treatment, and control of hypertension in adults aged 45 years and over and their spouses in India: A nationally representative cross-sectional study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. e1003740
Author(s):  
Sanjay K. Mohanty ◽  
Sarang P. Pedgaonkar ◽  
Ashish Kumar Upadhyay ◽  
Fabrice Kämpfen ◽  
Prashant Shekhar ◽  
...  
Keyword(s):  
Older Adults ◽  
Living Arrangement ◽  
Diet Restriction ◽  
Indian States ◽  
Salt Diet ◽  
Hypertension Prevalence ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Nationally Representative ◽  
And Control

Background Lack of nationwide evidence on awareness, treatment, and control (ATC) of hypertension among older adults in India impeded targeted management of this condition. We aimed to estimate rates of hypertension ATC in the older population and to assess differences in these rates across sociodemographic groups and states in India. Methods and findings We used a nationally representative survey of individuals aged 45 years and over and their spouses in all Indian states (except one) in 2017 to 2018. We identified hypertension by blood pressure (BP) measurement ≥140/90 mm Hg or self-reported diagnosis if also taking medication or observing salt/diet restriction to control BP. We distinguished those who (i) reported diagnosis (“aware”); (ii) reported taking medication or being under salt/diet restriction to control BP (“treated”); and (iii) had measured systolic BP <140 and diastolic BP <90 (“controlled”). We estimated age–sex adjusted hypertension prevalence and rates of ATC by consumption quintile, education, age, sex, urban–rural, caste, religion, marital status, living arrangement, employment status, health insurance, and state. We used concentration indices to measure socioeconomic inequalities and multivariable logistic regression to estimate fully adjusted differences in these outcomes. Study limitations included reliance on BP measurement on a single occasion, missing measurements of BP for some participants, and lack of data on nonadherence to medication. The 64,427 participants in the analysis sample had a median age of 57 years: 58% were female, and 70% were rural dwellers. We estimated hypertension prevalence to be 41.9% (95% CI 41.0 to 42.9). Among those with hypertension, we estimated that 54.4% (95% CI 53.1 to 55.7), 50.8% (95% CI 49.5 to 52.0), and 28.8% (95% CI 27.4 to 30.1) were aware, treated, and controlled, respectively. Across states, adjusted rates of ATC ranged from 27.5% (95% CI 22.2 to 32.8) to 75.9% (95% CI 70.8 to 81.1), from 23.8% (95% CI 17.6 to 30.1) to 74.9% (95% CI 69.8 to 79.9), and from 4.6% (95% CI 1.1 to 8.1) to 41.9% (95% CI 36.8 to 46.9), respectively. Age–sex adjusted rates were lower (p < 0.001) in poorer, less educated, and socially disadvantaged groups, as well as for males, rural residents, and the employed. Among individuals with hypertension, the richest fifth were 8.5 percentage points (pp) (95% CI 5.3 to 11.7; p < 0.001), 8.9 pp (95% CI 5.7 to 12.0; p < 0.001), and 7.1 pp (95% CI 4.2 to 10.1; p < 0.001) more likely to be aware, treated, and controlled, respectively, than the poorest fifth. Conclusions Hypertension prevalence was high, and ATC of the condition were low among older adults in India. Inequalities in these indicators pointed to opportunities to target hypertension management more effectively and equitably on socially disadvantaged groups.

scholarly journals The prevalence, awareness, treatment, and control of hypertension in older adults with an intellectual disability in Ireland: a cross sectional study

2021 ◽  
Author(s):  
Frances O’Brien ◽  
Philip McCallion ◽  
Rachael Carroll ◽  
Máire O’Dwyer ◽  
Eilish Burke ◽  
...  
Keyword(s):  
Older Adults ◽  
Intellectual Disability ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertension Prevalence ◽  
Disease Mortality ◽  
Nationally Representative ◽  
And Control

Abstract Aims Hypertension is a leading risk factor for cardiovascular disease, accounting for almost 50% of ischaemic heart disease mortality. This study aims to identify the prevalence, awareness, treatment, and control of hypertension and their predictors in older adults with an intellectual disability (ID). Methods and results This cross-sectional study utilized data from the ID Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). Participants were drawn from the nationally representative sample and included those who completed the self/informant report measures, in addition to objective blood pressure (BP) measurement. From the 551 individuals with ID, aged ≥40 years, hypertension prevalence was 35.2% [95% confidence interval (CI) 31.2–39.2%]. Of those with hypertension, 44.3% (95% CI 37.1–51.5%) were aware of their hypertensive status, and 64.2% (95% CI 57.3–71.1) were taking antihypertensive medication. Among those on treatment, 70.8% (95% CI 61.8–78.2%) had their BP controlled to below 140/90 mmHg. Significant predictors of awareness were age (P = 0.036) and level of ID (P = 0.004), predictors of treatment were age (P = 0.002), level of ID (P = 0.019), and diabetes (P = 0.001). Both diabetes and female gender were predictors of control of hypertension (P = 0.013 and P = 0.037, respectively). Conclusion The prevalence of hypertension in older adults with ID was lower than reports for the general Irish population, with overall levels of treatment and control, when identified, higher in the ID population. There was under-treatment and lower levels of awareness among those with more severe ID, which requires addressing. The finding, that when diagnosed, people with ID respond well to treatment should encourage addressing the under-treatment found here.

scholarly journals The association of widowhood and living alone with depression among older adults in India

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shobhit Srivastava ◽  
Paramita Debnath ◽  
Neha Shri ◽  
T. Muhammad
Keyword(s):  
Older Adults ◽  
Marital Status ◽  
Living Arrangement ◽  
Binary Logistic Regression ◽  
Well Being ◽  
Living Alone ◽  
Bivariate Analysis ◽  
Binary Logistic Regression Analysis ◽  
Effective Sample Size ◽  
Nationally Representative

AbstractWidowhood is a catastrophic event at any stage of life for the surviving partner particularly in old age, with serious repercussions on their physical, economic, and emotional well-being. This study investigates the association of marital status and living arrangement with depression among older adults. Additionally, the study aims to evaluate the effects of factors such as socio-economic conditions and other health problems contributing to the risk of depression among older adults in India. This study utilizes data from the nationally representative Longitudinal Ageing Study in India (LASI-2017–18). The effective sample size was 30,639 older adults aged 60 years and above. Descriptive statistics and bivariate analysis have been performed to determine the prevalence of depression. Further, binary logistic regression analysis was conducted to study the association between marital status and living arrangement on depression among older adults in India. Overall, around nine percent of the older adults suffered from depression. 10.3% of the widowed (currently married: 7.8%) and 13.6% of the older adults who were living alone suffered from depression. Further, 8.4% of the respondents who were co-residing with someone were suffering from depression. Widowed older adults were 34% more likely to be depressed than currently married counterparts [AOR: 1.34, CI 1.2–1.49]. Similarly, respondents who lived alone were 16% more likely to be depressed compared to their counterparts [AOR: 1.16; CI 1.02, 1.40]. Older adults who were widowed and living alone were 56% more likely to suffer from depression [AOR: 1.56; CI 1.28, 1.91] in reference to older adults who were currently married and co-residing. The study shows vulnerability of widowed older adults who are living alone and among those who had lack of socio-economic resources and face poor health status. The study can be used to target outreach programs and service delivery for the older adults who are living alone or widowed and suffering from depression.

scholarly journals Applying the Electronic Health Literacy Lens: Systematic Review of Electronic Health Interventions Targeted at Socially Disadvantaged Groups

10.2196/18476 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e18476 ◽  
Author(s):  
Christina Cheng ◽  
Alison Beauchamp ◽  
Gerald R Elsworth ◽  
Richard H Osborne
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Low Income ◽  
User Involvement ◽  
Low Literacy ◽  
Ehealth Literacy ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Electronic Health ◽  
Improve Health

Background Electronic health (eHealth) has the potential to improve health outcomes. However, eHealth systems need to match the eHealth literacy needs of users to be equitably adopted. Socially disadvantaged groups have lower access and skills to use technologies and are at risk of being digitally marginalized, leading to the potential widening of health disparities. Objective This systematic review aims to explore the role of eHealth literacy and user involvement in developing eHealth interventions targeted at socially disadvantaged groups. Methods A systematic search was conducted across 10 databases for eHealth interventions targeted at older adults, ethnic minority groups, low-income groups, low-literacy groups, and rural communities. The eHealth Literacy Framework was used to examine the eHealth literacy components of reviewed interventions. The results were analyzed using narrative synthesis. Results A total of 51 studies reporting on the results of 48 interventions were evaluated. Most studies were targeted at older adults and ethnic minorities, with only 2 studies focusing on low-literacy groups. eHealth literacy was not considered in the development of any of the studies, and no eHealth literacy assessment was conducted. User involvement in designing interventions was limited, and eHealth intervention developmental frameworks were rarely used. Strategies to assist users in engaging with technical systems were seldom included in the interventions, and accessibility features were limited. The results of the included studies also provided inconclusive evidence on the effectiveness of eHealth interventions. Conclusions The findings highlight that eHealth literacy is generally overlooked in developing eHealth interventions targeted at socially disadvantaged groups, whereas evidence about the effectiveness of such interventions is limited. To ensure equal access and inclusiveness in the age of eHealth, eHealth literacy of disadvantaged groups needs to be addressed to help avoid a digital divide. This will assist the realization of recent technological advancements and, importantly, improve health equity.

scholarly journals Black–White Disparities in Moves to Assisted Living and Nursing Homes Among Older Medicare Beneficiaries

2019 ◽  
Vol 75 (9) ◽  
pp. 1972-1982 ◽  
Author(s):  
Meghan Jenkins Morales ◽  
Stephanie A Robert
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Assisted Living ◽  
Multinomial Logistic Regression ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Housing Tenure ◽  
Medicare Beneficiaries ◽  
Nationally Representative

Abstract Objectives Investigate black-white disparities in older adults’ moves to assisted living and nursing homes and draw from the Andersen Healthcare Utilization Model to test explanations for any disparities. Methods Data are from a nationally representative sample of older community-dwelling Medicare beneficiaries from the 2015 (N = 5,212) National Health and Aging Trends Study (NHATS). We use stepwise multinomial logistic regression to examine black-white disparities in moves out of community housing to assisted living or a nursing home over 2 years, before and after adjusting for predisposing (age, gender), enabling (income, housing tenure, Medicaid, living arrangement) and need (activities of daily living [ADL] limitation, physical capacity, self-rated health, and dementia) factors. Results Black older adults are less likely to move to assisted living and are more likely to move to a nursing home compared to white older adults. Black-white disparities in moves to nursing homes are explained by black-white differences in enabling and need factors, whereas black-white disparities in moves to assisted living remain even after adjusting for enabling and need factors. Discussion Unmeasured factors related to systemic racism (e.g., residential racial segregation, racial discrimination) and/or black-white differences in care preferences might further explain black-white disparities in moves to assisted living and warrant further investigation.

Prevalence of Hypertension in Older and Middle-aged Adults in China: Estimates from Two National Longitudinal Surveys

2020 ◽  
pp. 78-84
Author(s):  
Cuicui Xia
Keyword(s):  
Older Adults ◽  
Eastern China ◽  
Clinical Intervention ◽  
Middle Aged ◽  
Longitudinal Surveys ◽  
Hypertension Prevalence ◽  
Aged People ◽  
Healthy Longevity ◽  
Nationally Representative ◽  
Middle Aged Adults

Hypertension is a leading chronic risk for population health in China, especially for older and middle-aged adults. However, a representative estimate of hypertension prevalence lacks for general older populations. With datasets from the Chinese Longitudinal Healthy Longevity Study (CLHLS) and China Health and Retirement Longitudinal Study (CHARLS), two nationally representative longitudinal surveys, this report aims to provide some estimates of hypertension prevalence in older and middle-aged adults overall and by social and demographic variables. There had been a marked increase in hypertension prevalence from 41% to 52% among older adults over the past two decades. Older adults, who were females, with urban residence, high income, from eastern China, and engaged in non-agricultural work, were more likely to be hypertensive. About 30% of middle-aged people in China were suffering from hypertension. These findings are significant in identifying potentially vulnerable populations with hypertension, which may have implications for clinical intervention.

The role of nontraditional lending for socially disadvantaged and financially stressed farmers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tia M. McDonald ◽  
Jonathan Law ◽  
Anil K. Giri ◽  
Dipak Subedi
Keyword(s):  
Design Methodology ◽  
Multinomial Logit ◽  
Causal Analysis ◽  
Content Type ◽  
Representative Data ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Lower Likelihood ◽  
Nationally Representative

PurposeIn recent years, socially disadvantaged farmers and ranchers have increased their usage of nontraditional lending nearly converging to levels of usage observed for nonsocially disadvantaged groups. The purpose of this research is to explore explanations for this trend in lending utilization by socially disadvantaged farmers and ranchers by examining factors that influence credit usage and credit choice.Design/methodology/approachA multinomial logit is used to estimate the probability of loan choice given characteristics of the producer and farm.FindingsWhile not a causal analysis, the results suggest that farm characteristics, which differ between socially disadvantaged and nonsocially disadvantaged producers, are associated with a lower likelihood of credit usage by an average socially disadvantaged farmer. For those that have loans, socially disadvantaged producers exhibit higher debt-to-asset ratios and lower current ratios, characteristics that are typically associated with higher than observed probability of usage of loans other than nontraditional. Socially disadvantaged producers also have lower value of assets which is associated with a higher probability of nontraditional loan usage.Originality/valueThis research is among the first to examine loan usage of socially disadvantaged producers using nationally representative data.

scholarly journals Hypertension prevalence and control among community‐dwelling lebanese older adults

2020 ◽  
Vol 22 (9) ◽  
pp. 1727-1731
Author(s):  
Ghina Fakhri ◽  
Sarah Assaad ◽  
Monique Chaaya
Keyword(s):  
Older Adults ◽  
Community Dwelling ◽  
Hypertension Prevalence ◽  
And Control

scholarly journals Coresidence Increases Risk of Testing Positive for COVID-19 Among Older Brazilians

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 972-972
Author(s):  
Flavia Andrade ◽  
Nekehia Quashie ◽  
Luisa Schwartzman
Keyword(s):  
Older Adults ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Family Members ◽  
Physical Contact ◽  
Living Alone ◽  
Sample Survey ◽  
Vulnerable Groups ◽  
Intergenerational Coresidence ◽  
Nationally Representative

Abstract Brazil is among the countries hit hardest by COVID-19, and older adults are among the vulnerable groups. Intergenerational coresidence and interdependence among family members, both prevalent in Brazil, likely increase social and physical contact. Using nationally representative data from the COVID-19 module of the Brazilian National Household Sample Survey, collected from July to November of 2020, we examined the association between living arrangements and exposure to and testing for COVID-19 among 63,816 Brazilians 60+. Our multivariate analyses utilize multilevel mixed-effects Poisson regression to examine the association between living arrangements and the COVID-19 outcome measures. Results show that those living alone were more likely to report having symptoms and having had a test for COVID-19. However, older adults in multigenerational (PR=1.532, 95% CI 1.15, 2.04, p&lt;0.001) and skipped generation households (PR=1.607, 95% CI 1.04, 2.48, p&lt;0.001) were more likely than solo-dwellers to test positive for COVID-19. Those with symptoms were more likely to test, regardless of their living arrangement. Among older adults without symptoms, those living alone had a higher probability of testing than those living in multigenerational or skipped-generation households. Overall, our findings suggest that coresidence with younger family members is a risk factor for older adults’ health due to the higher COVID-19 positivity. As younger Brazilians are increasingly vulnerable to COVID-19 and experiencing severe outcomes, policy makers need to be more attentive to the health needs of households that comprise older and younger cohorts, which are also more prevalent in poor and marginalized segments of the population.

scholarly journals Applying the eHealth literacy lens: A systematic review of eHealth interventions targeted at socially disadvantaged groups (Preprint)

2020 ◽  
Author(s):  
Christina Cheng ◽  
Alison Beauchamp ◽  
Gerald R Elsworth ◽  
Richard H Osborne
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Rural Communities ◽  
Low Income ◽  
User Involvement ◽  
Low Literacy ◽  
Ehealth Literacy ◽  
Disadvantaged Groups ◽  
Socially Disadvantaged ◽  
Improve Health

BACKGROUND eHealth holds the potential to improve health outcomes. However, eHealth systems need to match the eHealth literacy needs of users in order to be equitably adopted. Socially disadvantaged groups have lower access and skills to use technologies and are at risk of being digitally marginalised, leading to potential widening of health disparities. OBJECTIVE This systematic review aimed to explore the role of eHealth literacy and user involvement in developing eHealth interventions targeted at socially disadvantaged groups. METHODS A systematic search was conducted across ten databases for eHealth interventions targeted at older adults, ethnic minority groups, low-income groups, low-literacy groups, and rural communities. The eHealth Literacy Framework was used to examine eHealth literacy components of reviewed interventions. Results were analysed using narrative synthesis. RESULTS Fifty-one studies reporting on the results of 48 interventions were evaluated. Most studies were targeted at older adults and ethnic minorities with only two studies focused on low-literacy groups. eHealth literacy was not considered in the development of any of the studies and no eHealth literacy assessment was conducted. User involvement in designing interventions was limited and eHealth intervention developmental frameworks were rarely used. Strategies to assist users to engage with technical systems were seldom included in the interventions, and accessibility features were limited. The results of the included studies also provided inconclusive evidence on the effectiveness of eHealth interventions. CONCLUSIONS The findings highlight that eHealth literacy is generally overlooked in developing eHealth interventions targeted at socially disadvantaged groups while evidence about the effectiveness of such interventions is limited. To ensure equal access and inclusiveness in the age of eHealth, eHealth literacy of disadvantaged groups needs to be addressed to help avoid a digital divide. This will assist the realization of recent technological advancements and, importantly, improve health equity. CLINICALTRIAL

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