scholarly journals Educational Level, but Not Income or Area Deprivation, is Related to Macrovascular Disease: Results From Two Population-Based Cohorts in Germany

2021 ◽  
Vol 66 ◽  
Author(s):  
Violetta Ptushkina ◽  
Esther Seidel-Jacobs ◽  
Werner Maier ◽  
Sabine Schipf ◽  
Henry Völzke ◽  
...  

Objectives: An inverse relationship between education and cardiovascular risk has been described, however, the combined association of education, income, and neighborhood socioeconomic status with macrovascular disease is less clear. The aim of this study was to evaluate the association of educational level, equivalent household income and area deprivation with macrovascular disease in Germany.Methods: Cross-sectional data from two representative German population-based studies, SHIP-TREND (n = 3,731) and KORA-F4 (n = 2,870), were analyzed. Multivariable logistic regression models were applied to estimate odds ratios and 95% confidence intervals for the association between socioeconomic determinants and macrovascular disease (defined as self-reported myocardial infarction or stroke).Results: The study showed a higher odds of prevalent macrovascular disease in men with low and middle educational level compared to men with high education. Area deprivation and equivalent income were not related to myocardial infarction or stroke in any of the models.Conclusion: Educational level, but not income or area deprivation, is significantly related to the macrovascular disease in men. Effective prevention of macrovascular disease should therefore start with investing in individual education.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Chen ◽  
Hongfu Ren ◽  
Na Wang ◽  
Yaqing Xiong ◽  
Fei Xu

Abstract Background To examine associations of socioeconomic position (SEP), separately indicated by education, monthly family average income (FAI) and occupation, with health literacy (HL) among adults in regional China. Methods A cross-sectional survey was conducted among urban and rural adults (aged 25–69 years) who were randomly selected, using the probability proportionate to size sampling approach, from Nanjing municipality of China during October and December of 2016. HL, the outcome variable, was assessed using the Chinese Resident Health Literacy Scale. SEP, our independent variable, was separately measured with educational attainment, monthly family average income and occupation. Logistic regression models were introduced to examine SEP-HL association with odds ratio (OR) and 95% confidence interval (CI). Results Totally, 8698 participants completed the survey. The proportion of participants with unweighted and weighted adequate HL was 18.0% (95%CI = 17.2, 18.8%) and 19.9% (95%CI = 16.6, 23.6%), respectively, in this study. After adjustment for possible confounding factors, each SEP indicator was in significantly positive relation to both unweighted and weight HL level. Participants who obtained 13+ and 10–12 years educational attainment, respectively, had 2.41 (95%CI = 1.60, 3.64) and 1.68 (95%CI = 1.23, 2.29) times odds to record weighted adequate HL compared to their counterparts who were with 0–9 years education. Subjects within upper (OR = 1.92, 95%CI = 1.24, 2.98) and middle FAI tertile (OR = 1.59, 95%CI = 1.19, 2.13), respectively, were more likely to report weighted adequate HL relative to those who were within lower FAI tertile. White collars were more likely to have weighted adequate HL (OR = 1.33, 95%CI = 1.09, 1.61) than blue collars. Conclusions Each of education, FAI and occupation was positively associated with health literacy among urban and rural adults in China. The findings have important implications that different SEP indicators can be used to identify vulnerable residents in population-based health literacy promotion campaigns.


2021 ◽  
pp. tobaccocontrol-2020-056451
Author(s):  
Minal Patel ◽  
Alison F Cuccia ◽  
Shanell Folger ◽  
Adam F Benson ◽  
Donna Vallone ◽  
...  

IntroductionLittle is known on whether cigarette filter-related knowledge or beliefs are associated with support for policies to reduce their environmental impact.MethodsA cross-sectional, population-based sample of US adults aged 18–64 years (n=2979) was used to evaluate filter-related knowledge and beliefs by smoking status using data collected between 24 October 2018 and 17 December 2018. Multivariate logistic regression models explored whether these knowledge and belief items were associated with support for two policies, a US$0.75 litter fee and a ban on sales of filtered cigarettes, controlling for demographic characteristics and smoking status.ResultsRegardless of smoking status, 71% did not know plastic was a cigarette filter component and 20% believed filters were biodegradable. Overall, 23% believed filters reduce health harms and 60% believed filters make it easier to smoke; 90% believed cigarette butts are harmful to the environment. Individuals believing cigarette butts harmed the environment were more likely to support a litter fee (adjusted OR (aOR)=2.33, 95% CI: 1.71 to 3.17). Individuals believing that filters are not biodegradable had higher odds of supporting a litter fee (OR=1.47, 95% CI: 1.15 to 1.88). Respondents believing that filters do not make cigarettes less harmful were more likely to support a litter fee (aOR=1.50, 95% CI: 1.20 to 1.88) and filter ban (aOR=2.03, 95% CI: 1.64 to 2.50). Belief that filters make it easier to smoke was associated with decreased support for a filter ban (aOR=0.69, 95% CI: 0.58 to 0.83).ConclusionsComprehensive efforts are needed to educate the public about the impact of cigarette filters in order to build support for effective tobacco product waste policy.


2010 ◽  
Vol 25 (3) ◽  
pp. 409-419 ◽  
Author(s):  
Natalia Linos ◽  
Marwan Khawaja ◽  
Mohannad Al-Nsour

The aim of this study is to examine attitudes among married women toward wife beating and to investigate the hypothesis that female individual empowerment is associated with such attitudes within a broader context of societal patriarchy in Jordan. The study uses data from a cross-sectional survey of a representative sample of married women (n = 5,390) conducted in 2002. Associations between acceptance of wife beating and several women’s empowerment variables, including decision-making power, as well as other risk factors were assessed, using odds ratios from binary logistic regression models. The key finding is that the vast majority (87.5%) of Jordanian women believe that wife beating is justified in at least one hypothetical scenario, and justification is negatively associated with empowerment variables and some demographic, geographic, and socioeconomic factors.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Zifeng Liu ◽  
Xiaoting Su ◽  
Mianli Xiao ◽  
Peien Zhou ◽  
Jianwei Guo ◽  
...  

Hyperuricemia (HU) is a risk factor for different kinds of chronic noncommunicable diseases, and eating away from home (EAFH) may play an important role in their development, which has been ignored greatly so far. This study aimed to investigate the association between EAFH and HU in different models. A cross-sectional study involving 8,322 participants of the China Health and Nutrition Survey (CHNS) was conducted. Logistic regression models were used to analyze the data. We found that participants who consumed more away-from-home food had a higher risk for HU, and the adjusted odds ratio (aOR) and 95% confidence interval (CI) (for each increment in grades of EAFH) were 1.11 (1.02, 1.20) in a multiadjusted model (adjusted for age, gender, province, net individual income, body mass index, smoking, leisure-time physical activities, energy intake, and sleep duration). As for stratified analyses, the aOR (95% CI) of EAFH was 1.12 (1.01, 1.24) for men and 1.06 (0.92, 1.21) for women. Similar results can be found in the middle-aged and obese population, with aOR (95% CI) of EAFH as 1.17 (1.05, 1.30) and 1.15 (1.03, 1.29), respectively. In conclusion, EAFH is positively associated with the prevalence of HU.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029809 ◽  
Author(s):  
Farzaneh Saeedzadeh Sardahaee ◽  
Turid Lingaas Holmen ◽  
Nadia Micali ◽  
Erik R Sund ◽  
Ottar Bjerkeset ◽  
...  

ObjectiveWe conducted a population-based study on a sample of more than 7000 adolescents where we examined the associations between suicidal ideation (SI) and disordered eating (DE) and its related traits.DesignCross-sectional.SettingsData were derived from two Norwegian population-based cohorts, the Young-HUNT1 (1995–1997) and Young-HUNT3 (2006–2008) from the county of Nord-Trøndelag, Norway.ParticipantsA total of 7268 adolescents (15–19 years) who had completed self-reported questionnaires including items on SI, DE, body size and weight perception were included.Primary outcome measuresORs for SI given DE, body size or weight perception. Analyses were performed in multivariate logistic regression models.ResultsThe prevalence of SI was 23.1% in total population. Both girls and boys who reported DE, evaluated their body size asnot‘about the same as others’ or were ‘unhappy about their weight’ had between twofold to fivefold increase in odds for SI; these incremental risks were observed independent of sex, age, body mass index and socioeconomic status. We observed higher odds for SI among boys.ConclusionsOur findings suggest a clear association between SI and DE and its associated traits, in both genders but especially in males. Special attention should be paid on early detection of DE traits among adolescents.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Johannes Beller ◽  
Johann Bauersachs ◽  
Andreas Schäfer ◽  
Lars Schwettmann ◽  
Margit Heier ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S902-S902
Author(s):  
Holly Q Bennett ◽  
Fiona E Matthews ◽  
Louise Robinson ◽  
Lynne Corner ◽  
A Kingston ◽  
...  

Abstract Background: Previous research using cross-sectional data shows widening inequalities in disability-free life expectancy (DFLE) by socioeconomic status (SES) in the UK. We aimed to understand the underlying transitions of DFLE and years dependency free (DepFLE) using longitudinal data from the Cognitive Function and Ageing Studies (CFAS I and CFAS II). Methods: Two large population based studies of those aged 65+ in three centres (Newcastle, Nottingham, Cambridgeshire) interviewed at baseline in 1991 (CFAS I) and 2011 (CFAS II) with follow up two years later. Disability was measured using difficulty in activities of daily living (ADL), and dependency by time between help required for ADLs. SES was based on area deprivation categorised into study specific tertiles. Transitions between disability or dependency states and death were modelled using Interpolated Markov Chain software. Results: Between 1991 and 2011, DFLE and disabled life expectancy (DLE) at age 65 increased for men in every SES group, with men being less likely to become disabled or die, and more likely to recover, in 2011 than 1991 across SES groups. For the most disadvantaged women, DFLE was similar, and DLE increased, whilst for the remaining women DFLE increased and DLE was similar. For women probability of recovery increased and probability of death from disability decreased but probability of becoming disabled decreased only for the most advantaged. DepFLE patterns across time were similar but more pronounced. Conclusion: Preventive measures should focus on reducing the disability and dependency onset in the most disadvantaged to ensure inequalities do not widen further.


2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Kathleen M Fairfield ◽  
Adam W Black ◽  
Erika C Ziller ◽  
Kimberly Murray ◽  
F Lee Lucas ◽  
...  

Abstract Background We sought to describe lung cancer prevalence and mortality in relation to socioeconomic deprivation and rurality. Methods We conducted a population-based cross-sectional analysis of prevalent lung cancers from a statewide all-payer claims dataset from 2012 to 2016, lung cancer deaths in Maine from the state death registry from 2012 to 2016, rurality, and area deprivation index (ADI), a geographic area-based measure of socioeconomic deprivation. Analyses examined rate ratios for lung cancer prevalence and mortality according to rurality (small and isolated rural, large rural, or urban) and ADI (quintiles, with highest reflecting the most deprivation) and after adjusting for age, sex, and area-level smoking rates as determined by the Behavioral Risk Factor Surveillance System. Results Among 1 223 006 adults aged 20 years and older during the 5-year observation period, 8297 received lung cancer care, and 4616 died. Lung cancer prevalence and mortality were positively associated with increasing rurality, but these associations did not persist after adjusting for age, sex, and smoking rates. Lung cancer prevalence and mortality were positively associated with increasing ADI in models adjusted for age, sex, and smoking rates (prevalence rate ratio for ADI quintile 5 compared with quintile 1 = 1.41, 95% confidence interval [CI] =1.30 to 1.54) and mortality rate ratio = 1.59, 95% CI = 1.41 to 1.79). Conclusion Socioeconomic deprivation, but not rurality, was associated with higher lung cancer prevalence and mortality. Interventions should target populations with socioeconomic deprivation, rather than rurality per se, and aim to reduce lung cancer risk via tobacco treatment and control interventions and to improve patient access to lung cancer prevention, screening, and treatment services.


2020 ◽  
Vol 24 (11) ◽  
pp. 3997-4003 ◽  
Author(s):  
Falk Schwendicke ◽  
Ina Nitschke ◽  
Helmut Stark ◽  
Wolfgang Micheelis ◽  
Rainer A. Jordan

Abstract Objective This is the second part of a report on tooth loss in Germany 1997–2030. Here, we describe trends in the prevalence of edentulism in seniors 1997–2014, assess predictive factors for edentulism, and projected it into 2030. Material and methods We used data from three waves of the cross-sectional, multi-center, nationwide representative German Oral Health Studies. Overall, 3449 seniors (65–74 years) were included (1997: 1367; 2005: 1040; 2016: 1042). Age, sex, educational level, smoking status, and the cohort were entered into age-cohort binary-logistic regression models to assess the association of predictors with edentulism and to project edentulism in 2030 via Monte Carlo simulations. Results Between 1997 and 2014, the prevalence of edentulism decreased from 24.8 to 12.4%. With each year of age, the risk of being edentate increased (by 11%, p < 0.001); it was also significantly increased in female versus male (by 40%, p = 0.001), low versus medium and high educational level (up to 257%, p < 0.001), and in former and current smokers (up to 258%, p < 0.001). We predict the prevalence of edentulism to be reduced to 4.2% in 2030. The reduction will be higher in males, never and former smokers, and those with low socio-educational level. On an absolute level and despite a growing elderly population (aged 60–80 years), the number of edentate individuals will have decreased by 3.6 million in 2030 compared with 1997. Conclusions Edentulism in seniors has declined equitably in Germany. The decline is expected to continue until 2030. Further efforts are needed to tackle the underlying risk factors. Clinical relevance This study presents trends of edentulism in Germany for a period of three decades. It provides clinically relevant data for health care planning by 2030.


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