scholarly journals Distribution of the compression and expansion of morbidity in 194 countries and territories, 1990–2016: The role of income inequality

2021 ◽  
Author(s):  
He Chen ◽  
Jing Ning ◽  
Hongwei Hu ◽  
Haochen Jiang
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Binary Logistic Regression ◽  
Negative Influence ◽  
Health Changes ◽  
Health And Social Care ◽  
Compression And Expansion ◽  
Disease Study ◽  
Type 3 ◽  
Expansion Of Morbidity

Abstract Background Compression and expansion of morbidity are two critical hypotheses to analyze the relationship among morbidity, disability, and mortality. This study aims to analyze the global distribution of the compression and expansion of morbidity and to investigate its relationship with income inequality. Methods Data was from the Global Burden of Disease Study 2016 and Standardized World Income Inequality Database, version 8.2. Seven types of health changes were defined. Income inequality was measured with Gini coefficient index. Binary logistic regression was used to analyze the association of income inequality with the compression and expansion of morbidity. Results All the seven types of the compression and expansion of morbidity exist in the world, despite their uneven distribution. The relative expansion of morbidity with increased or constant life expectancy (Type 6) was the most popular type occurring to more than half of populations in the last quarter of century, which was followed by the relative compression of morbidity with increased or constant LE (Type 3, 30.71%). The income inequality was significantly associated with the health changes, which still held after controlling a variety of confounders and in robustness tests. Those societies with lower income inequality were more likely to incur Type 3. Conclusions It is necessary to distinguish the positive and negative changes in life expectancy when examing the compression and expansion of morbidity. The increasing popularity of Type 6 implies higher needs for health and social care. Measures to reduce income inequality or mitigate its negative influence on health changes might promote the occurrence of Type 3.

scholarly journals SAT0084 SERUM ADIPOKINES PROFILE IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH TNF-INHIBITORS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 976.2-976
Author(s):  
M. Novella-Navarro ◽  
B. Hernández-Breijo ◽  
F. Genre ◽  
L. Lera-Gómez ◽  
V. Pulito-Cueto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Remission Rate ◽  
Binary Logistic Regression ◽  
Negative Influence ◽  
Normal Weight ◽  
The Body ◽  
Response To Treatment ◽  
Bivariate Analysis ◽  
Tnf Inhibitor ◽  
Serum Leptin

Background:In recent years, the relationship between obesity and autoimmune diseases has taken interest, since adipose tissue has been identified as an endocrine organ that secretes cytokines (adipokines), among which leptin stands out as a soluble pro-inflammatory mediator associated with the body mass index (BMI).Objectives:The main objectives of this study are: i) to analyse the influence of BMI on clinical response in Rheumatoid Arthritis (RA) patients who initiate TNF-inhibitor (TNFi) therapy; ii) to analyse the differences in the serum profile of adipokines (leptin and adiponectin) according to BMI and their association with response to treatment.Methods:Observational study of a prospective cohort of 73 RA patients who initiated biological treatment with TNFi from the Complex Therapy Unit (CTU) of our Hospital. Patients were classified according to their BMI in normal-weight (BMI<25) and overweight/obesity (O/O) (IMC≥25). Demographic, clinical and laboratory variables were collected at baseline and at 6 months. Our outcome measures were DAS28-VSG remission (DAS28<2.6) at 6 months after TNFi initiation. Serum leptin and adiponectin levels were measured by Enzyme-Linked Immuno Sorbent Assay (ELISA) at baseline and 6 months. A descriptive sample analysis comparing the characteristics of both patient subgroups was performed using Chi-square, T-test for independent samples and U-Mann Whitney. Likewise, a bivariate analysis was carried out by means of binary logistic regression to assess the probable association of the parameters studied with remission.Results:Of the 73 patients studied, 51% were classified in O/O group. The O/O patients presented higher levels of baseline CRP (16.69±6.16 vs 8.74±3.81, p=0.01). No statistically significant differences were observed in the remaining variables (sex, age at the beginning of the TNFi, disease duration, baseline DAS-28), as well as therapeutic variables (use of previous DMARDs and doses of methotrexate and/or steroids). Patients with overweight/obesity presented higher DAS28-ESR values at 6 months of treatment (3.59±1.14 vs 2.93±1.27, p=0.02) and achieved remission less frequently (18.9% vs 48.6%, p=0.007). Serum leptin levels were significantly higher in O/O patients, both baseline (29.39±21.50 vs 13.49±8.78, p<0.001) and 6 months (33.06±22.03 vs 14.77±9.50, p<0.001) after TNFi initiation. In addition, O/O patients were less likely to reach remission at 6 months than normal-weight patients. [OR= 4.04 IC95% (1.40-11.64); p=0.009]. Lower frequency of remission was associated to greater leptin levels at 6 months [OR=0.94 CI95% (0.90-098); p=0.012]. No differences in serum adiponectin were found between both subgroups of patients.Conclusion:In this RA patient cohort, overweight/obesity is associated with i) a reduced response to TNFi therapy and ii) a lower short-term remission rate. Within the adipokine profile, leptin seems to play a relevant role in the maintenance of pro-inflammatory activity with a negative influence on the response to TNFi therapy in O/O patients.References:[1] Versini M. et al. Autoimmun Rev. 2014; 13, 981-1000[2] Toussirot E et al. Life Sci. 2015;140: 29-36.Disclosure of Interests:Marta Novella-Navarro: None declared, Borja Hernández-Breijo: None declared, Fernanda Genre: None declared, Leticia Lera-Gómez: None declared, Verónica Pulito-Cueto: None declared, Laura Nuño: None declared, Alejandro Villalba: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Chamaida Plasencia: None declared

KUALITAS AUDIT DAN AUDIT TENURE

2014 ◽  
Vol 10 (1) ◽  
pp. 61
Author(s):  
Reygen Pramana Jati
Keyword(s):  
Logistic Regression ◽  
Literature Review ◽  
Empirical Model ◽  
Audit Quality ◽  
Empirical Test ◽  
Binary Logistic Regression ◽  
Negative Influence ◽  
Test Results ◽  
Financial Report ◽  
Earnings Benchmarks

Audit quality is determined by auditor’s competence to find misstatements in financial report and report the findings in the audit report that makes auditor’s independency strongly affect audit quality, in addition to auditor’s competency in performing their duties. Auditor’s independency is related to lengthy audit engagement with client. This study aims to obtain empirical evidence about the influence of lengthy audit engagement to audit quality. Based on the literature review, the hypothesis proposed in this study is the length of the audit engagement negatively affects audit quality. This study uses earnings benchmarks as proxy of audit quality developed from Carey and Simnett (2006). To test the hypothesis, an empirical model was developed and tested with binary logistic regression technique. Empirical test results indicate a significant negative influence of lengthy audit engagements to audit quality. It means that lengthy audit engagement deteriorates audit quality, indicated by the failure to meet earnings benchmark. Keywords: Audit Tenure, Audit Quality, Earnings Benchmark

scholarly journals Growing Income-Based Inequalities in Old-Age Life Expectancy in Sweden, 2006–2015

Demography ◽  
2021 ◽  
Author(s):  
Stefan Fors ◽  
Jonas W. Wastesson ◽  
Lucas Morin
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Life Span ◽  
Old Age ◽  
Remaining Life ◽  
Neighborhood Deprivation ◽  
Income Gap ◽  
Remaining Life Expectancy ◽  
Mortality Improvement ◽  
Income Quartile

Abstract Sweden is known for high life expectancy and economic egalitarianism, yet in recent decades it has lost ground in both respects. This study tracked income inequality in old-age life expectancy and life span variation in Sweden between 2006 and 2015, and examined whether patterns varied across levels of neighborhood deprivation. Income inequality in remaining life expectancy at ages 65, 75, and 85 increased. The gap in life expectancy at age 65 grew by more than a year between the lowest and the highest income quartiles, for both men (from 3.4 years in 2006 to 4.5 years in 2015) and women (from 2.3 to 3.4 years). This widening income gap in old-age life expectancy was driven by different rates of mortality improvement: individuals with higher incomes increased their life expectancy at a faster rate than did those with lower incomes. Women with the lowest incomes experienced no improvement in old-age life expectancy. Furthermore, life span variation increased in the lowest income quartile, while it decreased slightly among those in the highest quartile. Income was found to be a stronger determinant of old-age life expectancy than neighborhood deprivation.

Fighting Income Inequality in Nigeria and Social Exclusion

2020 ◽  
pp. 170-181
Keyword(s):  
Social Policy ◽  
Income Inequality ◽  
Life Expectancy ◽  
Human Development ◽  
Social Exclusion ◽  
Human Development Index ◽  
Policy Reforms ◽  
African Countries ◽  
Methodical Approach ◽  
Sub Saharan

The chapter examines the income inequality and social exclusion in Nigeria. The gap between the haves and have-nots has become an issue of concern in Nigeria. This chapter, therefore, seeks to examine a methodical approach for measuring inequality in Nigeria; Nigeria's ranking in human development index (between 1990 and 2017); trends in inequality, poverty, unemployment, and life expectancy from 1980 to 2017; and the income inequality in Nigeria relative to other Sub-Saharan African countries along with sex disaggregated HDI relative to other Sub-Saharan African countries and the implications to social policy reforms.

scholarly journals Global, Regional, National, and Subnational Big Data to Inform Health Equity Research: Perspectives from the Global Burden of Disease Study 2017

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 159-172 ◽  
Author(s):  
Ali H. Mokdad ◽  
George A. Mensah ◽  
Varsha Krish ◽  
Scott D. Glenn ◽  
Molly K. Miller-Petrie ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Burden Of Disease ◽  
High Body Mass Index ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Years Of Life Lost ◽  
Healthy Life ◽  
Research Perspectives ◽  
Life Years ◽  
Disease Study

Objectives: Everyone deserves a long and healthy life, but in reality, health outcomes differ across populations. We use results from the Global Burden of Disease Study 2017 (GBD 2017) to report patterns in the burden of diseases, injuries, and risks at the global, regional, national, and subnational level, and by sociodemographic index (SDI), from 1990 to 2017.Design: GBD 2017 undertook a systematic analysis of published studies and available data providing information on prevalence, incidence, remission, and excess mortal­ity. We computed prevalence, incidence, mortality, life expectancy, healthy life expectancy, years of life lost due to prema­ture mortality, years lived with disability, and disability-adjusted life years with 95% uncertainty intervals for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries from 1990 to 2017. We also computed SDI, a summary indicator combining measures of income, education, and fertility.Results: There were wide disparities in the burden of disease by SDI, with smaller burdens in affluent countries and in specific regions within countries. Select diseases and risks, such as drug use disorders, high blood pressure, high body mass index, diet, high fasting plasma glucose, smoking, and alco­hol use disorders warrant increased global attention and indicate a need for greater investment in prevention and treatment across the life course.Conclusions: Policymakers need a com­prehensive picture of what risks and causes result in disability and death. The GBD provides the means to quantify health loss: these findings can be used to examine root causes of disparities and develop pro­grams to improve health and health equity.Ethn Dis. 2019;29(Suppl 1): 159-172; doi:10.18865/ed.29.S1.159.

scholarly journals Income inequality in disability-free life expectancy in Denmark

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Brønnum-Hansen ◽  
E Foverskov ◽  
I Andersen
Keyword(s):  
Income Inequality ◽  
Life Expectancy ◽  
Social Inequality ◽  
Socioeconomic Position ◽  
Life Tables ◽  
Register Data ◽  
Disposable Income ◽  
Inequality In Health ◽  
Disability Free Life Expectancy ◽  
The Difference

Abstract Background The state old-age pension in Denmark is adjusted in line with the projected increasing life expectancy without taking social inequality in health and life expectancy into account. The purpose of the study was to estimate income disparities in life expectancy and disability-free life expectancy (DFLE) at age 50. Methods By linking nationwide register data on income and mortality each individual at any age was divided into equivalised disposable income quartiles and life tables were constructed for each quartile. Data from the Danish Survey of Health, Ageing and Retirement in Europe (SHARE) was linked to register data providing access to information on respondents equivalised disposable income. Finally, data from the life tables were combined with prevalence on activity limitations by income quartiles from SHARE to estimate DFLE by Sullivan’s method. Differences in DFLE were investigated and decomposed into contributions from mortality and disability effects. Results A clear social gradient was seen for life expectancy as well as DFLE. Thus, life expectancy at age 50 differed between the highest and lowest income quartile by 8.0 years for men and 5.0 years for women. The difference in DFLE was 11.8 and 10.3 years for men and women, respectively. For men the mortality effect from the decomposition contributed by 4.1 years to the difference of 11.8 years in DFLE and 3.9 years to the difference in expected years with disability of 3.8 years while the disability effect contributed by 7.7 years. Conclusions The study quantifies social inequality in health in Denmark. Although income inequality in life expectancy and DFLE can partly be explained by loss of income due to chronic diseases, one would expect a welfare state to provide better financial security for citizens with health problems. Furthermore, the marked social disparity when approaching retirement age is questioning the fairness of implementing a pension scheme independently of socioeconomic position. Key messages Disability-free life expectancy differs between income quartiles by more than 10 years. Pension age follows the projected increasing life expectancy independently of socioeconomic position. This seems unfair.

scholarly journals Why has mortality in England and Wales been increasing? An iterative demographic analysis

2017 ◽  
Vol 110 (4) ◽  
pp. 153-162 ◽  
Author(s):  
Lucinda Hiam ◽  
Danny Dorling ◽  
Dominic Harrison ◽  
Martin McKee
Keyword(s):  
Life Expectancy ◽  
Social Care ◽  
Demographic Analysis ◽  
England And Wales ◽  
Life Expectancy At Birth ◽  
Health And Social Care ◽  
Diagnosis Of Dementia ◽  
Small Decline ◽  
Post War

Objectives To understand why mortality increased in England and Wales in 2015. Design Iterative demographic analysis. Setting England and Wales Participants Population of England and Wales. Main outcome measures Causes and ages at death contributing to life expectancy changes between 2013 and 2015. Results The long-term decline in age-standardised mortality in England and Wales was reversed in 2011. Although there was a small fall in mortality rates between 2013 and 2014, in 2015 we then saw one of the largest increases in deaths in the post-war period. Nonetheless, mortality in 2015 was higher than in any year since 2008. A small decline in life expectancy at birth between 2013 and 2015 was not significant but declines in life expectancy at ages over 60 were. The largest contributors to the observed changes in life expectancy were in those aged over 85 years, with dementias making the greatest contributions in both sexes. However, changes in coding practices and diagnosis of dementia demands caution in interpreting this finding. Conclusions The long-term decline in mortality in England and Wales has reversed, with approximately 30,000 extra deaths compared to what would be expected if the average age-specific death rates in 2006–2014 had continued. These excess deaths are largely in the older population, who are most dependent on health and social care. The major contributor, based on reported causes of death, was dementia but caution was advised in this interpretation. The role of the health and social care system is explored in an accompanying paper.

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