scholarly journals Impact of Socioeconomic Status on Cancer Incidence Risk, Cancer Staging, and Survival of Patients with Colorectal Cancer under Universal Health Insurance Coverage in Taiwan

Author(s):  
Wei-Yin Kuo ◽  
Han-Sheng Hsu ◽  
Pei-Tseng Kung ◽  
Wen-Chen Tsai

This study examined the impact of socioeconomic status on colorectal cancer risk, staging, and survival under the National Health Insurance (NHI) system in Taiwan. Monthly salary and education level were used as measures of socioeconomic status to observe the risk of colorectal cancer among individuals aged 40 years or above in 2006–2015 and survival outcomes of patients with colorectal cancer until the end of 2016. Data from 286,792 individuals were used in this study. Individuals with a monthly salary ≤Q1 were at a significantly lower incidence risk of colorectal cancer than those with a monthly salary >Q3 (HR = 0.80, 95%CI = 0.74–0.85), while those with elementary or lower education were at a significantly higher risk than those with junior college, university, or higher education (HR = 1.18, 95%CI = 1.06–1.31). The results show that socioeconomic status had no significant impact on colorectal cancer stage at diagnosis. Although salary was not associated with their risk of mortality, patients with colorectal cancer who had elementary or lower education incurred a significantly higher risk of mortality than those who had junior college, university, or higher education (HR = 1.39, 95%CI = 1.07–1.77). Education level is a significant determinant of the incidence risk and survival in patients with colorectal cancer, but only income significantly impacts incidence risk.

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Margareth Guimarães Lima ◽  
Silvânia Suely Caribé de Araújo ◽  
Marta Maria Alves da Silva ◽  
...  

ABSTRACT OBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.


2017 ◽  
Vol 62 (8) ◽  
pp. 41-52
Author(s):  
Agnieszka Nocko

The research on mortality and life expectancy by sex and education level was described in the article. To assess this phenomenon partial life expectancy rate of persons aged from 30 to 69 was used (e30—69). The research was conducted for the years 2002 and 2011. At the first stage life expectancy tables for people at the age of 30 and more, by sex and four groups of education, were estimated by Chiang’s method. Then on this basis the parameter e30—69 was computed. The obtained results confirmed that life expectancy is differentiated by sex and education. Longer life expectancy was noticed for people with higher education than for those with lower education. In the analysed period life expectancy of persons aged 30—69 was extended, except for women with at most lower secondary education. For women, the value of the assessed partial life expectancy parameter was less differentiated between the highest and the lowest level of education than for men.


2016 ◽  
Vol 23 (6) ◽  
pp. 546 ◽  
Author(s):  
H. Naik ◽  
X. Qiu ◽  
M. C. Brown ◽  
L. Eng ◽  
D. Pringle ◽  
...  

Purpose Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis.Methods As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors.Results Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001).Conclusions In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Eri Eguchi ◽  
Hiroyasu Iso ◽  
Kaori Honjo ◽  
Akiko Tamakoshi

Introduction: Magnitude of impact of healthy lifestyle behaviors and education level on cardiovascular mortality is uncertain. Hypothesis: Impact of education on cardiovascular mortality is explained mostly by lifestyle behaviors Methods: The survey cohort was a total of 42,647 subjects (18,442 men and 24,205 women) aged 40-79 years with satisfactory information from 1988 to 1990, and followed up until the end of 2009. Education levels were sub-grouped into higher education (last school age of ≥16 years old) and lower education (<16). We defined the healthy lifestyle score (fruits ≥1/day, fish ≥1/day, milk almost every day, exercise ≥5h/week and/or walking ≥0.5h/day, BMI 21-25kg/m2, ethanol intake <46.0g/day, non-smoker, and sleep 5.5-7.5h/day, ranging 0 to 8), and calculated multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) to determine the magnitude of impacts of healthy lifestyle behaviors and education level on cardiovascular mortality with persons who have lower education and 0-3 lifestyle score category as reference. Population attributable fraction (PAF) of lifestyle behaviors on cardiovascular mortality stratified by education level were also calculated. Results: During the 19.3 median years of follow-up, there were 8,314 total deaths and 2,377 CVD deaths. Compared with persons with lower education and 0-3 healthy lifestyle score category, those with lower education and 7-8 healthy lifestyles score category and those with higher education and 7-8 healthy lifestyle score category showed lower risk of mortality from total CVD. The respective multivariable-adjusted HRs (95% CI) were 0.37 (0.28-0.48) for those with lower education and 7-8 lifestyle score category, and 0.37 (0.30-0.46) for those with higher education and 7-8 lifestyle score category in total men and women, 0.25 (0.14-0.44) and 0.43 (0.31-0.59), respectively, for men, and 0.43 (0.31-0.60) and 0.36 (0.27-0.49), respectively, for women. PAF of CVD mortality for those who were not in the category of 7-8 lifestyle behavior were 40.1% in higher education group and 68.5% in lower education. Conclusions: More than 50% of risk reduction of cardiovascular mortality for those who have 7-8 healthy lifestyle score category compared to those who have 0-3 healthy lifestyles were found irrespective of education level which suggests large part of impact of education on cardiovascular mortality is explained by lifestyle behaviors.


Author(s):  
Reem Sefer Al Otaibi Fahd Bin Abdullah Al Rabeeh

The study aimed to measure and identify Future Anxiety level among the employees of private sector in Riyadh in the light of the following variables: (age, monthly salary, marital status, and educational level). The study used the descriptive analytical method in its survey approach. Future anxiety scale designed by Salah Karamian was applied to a random sample of (212) male employees in the private sector in Riyadh. Using the Statistical tool SPSS, the results of the study showed the following: 1- The general mean of the future anxiety among the employees of the private sector in Riyadh valued (3.74) with high rating. 2- There are no statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of age. 3-  There are statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of monthly salary, especially for the employees who make (less than SAR2000) whose future anxiety level showed to be the highest. 4-  There are statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of marital status (Married- Single), as single employees are more anxious. 5-  There are statistically significant differences in the degree of future anxiety among private sector employees in Riyadh according to the variable of education level, as employees with lower education level are more anxious. In the light of the study findings, the researcher suggested several recommendations to reduce anxiety among employees and to support, motivate, train, and solve their problems.  


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kenta Matsumura ◽  
◽  
Kei Hamazaki ◽  
Akiko Tsuchida ◽  
Haruka Kasamatsu ◽  
...  

Abstract Background Lower socioeconomic status is often thought to be associated with an elevated risk of postpartum depression; however, this relationship exhibits noticeable heterogeneity between studies. The present study examined this relationship in Japan. Methods Data were obtained from 90,194 mothers in an ongoing birth cohort of the Japan Environment and Children’s Study. Socioeconomic status was assessed based on the mothers’ highest education level during pregnancy. Postpartum depression was identified at 1 and 6 months postpartum based on an Edinburgh Postnatal Depression Scale score of ≥9, and analyses were also performed based on the sub-scores for anxiety, depression, and anhedonia symptoms. Logistic and generalized linear regression model analyses were used to calculate odds ratios for postpartum depression according to education level with the highest education group (≥16 years of education) defined as the reference group, while controlling for covariates in a stepwise fashion. Results Univariate analysis revealed that a lower education level was associated with a higher prevalence of postpartum depression and related symptoms. Although these relationships weakened in the fully adjusted models, odds ratios for cases and related symptoms remained significant at 1 and 6 months postpartum. Among three symptom dimensions, the relationship was strongest and weakest in the depressive and anxiety symptoms, respectively. Conclusions A lower education level was an independent risk factor for postpartum depression. In view of the low mobility of the education level, this finding suggests the potential importance of collecting information regarding education levels at the earliest opportunity.


2020 ◽  
Author(s):  
Agung Dwi Laksono ◽  
Sahrir Sillehu ◽  
Abu Khoiri ◽  
Ratna Dwi Wulandari

Abstract Health insurance is an effort to transfer risks to increase public access to the use of health services. The study was aimed at analyzing factors related to health insurance ownership among Mollucans in Indonesia. The sample size was 788 respondents. The variables analyzed included health insurance ownership, age group, gender, education level, employment status. The final stage was employed multinomial logistic regression. The results show Mollucans in the ≤19 age group were 0.182 times more likely than Mollucans in the ≥ 50 age group to have government-run type health insurance. Mollucans in the 20-29 age group were 0.219 times more likely than Mollucans in the ≥ 50 age group to have government-run health insurance. On the other hand, Mollucans with primary education was 0.196 times more likely than Mollucans with higher education to have a government-run type of health insurance. Mollucans with secondary education was 0.415 times more likely than Mollucans with higher education to have government-run health insurance. Meanwhile, unemployed Mollucans have a probability of 0.358 times compared to employed Mollucans to have the government-run type of health insurance. Finally, unemployed Mollucans are 0.056 times more likely than employed Mollucans to have private-run health insurance. It was concluded that 3 proven variables associated with health insurance ownership among Moluccans in Indonesia, namely age group, education level, and employment status.


2015 ◽  
Vol 61 (4) ◽  
pp. 267-270
Author(s):  
Aneta Munteanu ◽  
◽  
Rodica Luca ◽  
Cătălina Farcaşiu ◽  
Ioana-Andreea Stanciu ◽  
...  

Aim. To assess the knowledge of the preschool children’ parents about their toothbrushing. Material and method. During the first visit to the clinic, a questionnaire about the mother’ education level and children’ dental hygiene was given to the parents of 276 children aged 1 to 5 years, with caries in primary dentition. Results. a) 194 parents (70.29%) filled the questionnaire; b) in 15.46% of children (aged between 1 year 3 months and 3 years 3 months) the toothbrushing has not been yet introduced; most of the mothers with ≤10 classes started the toothbrushing after the age of 2 and mothers with middle and higher education level – in most cases after the age of 1; c) in 41.50% of children the toothbrushing was performed 1 time/day or less; d) 29.37% of children brushed their teeth without a parental surveillance and 48.75% with supervision. Conclusions. 1) Only in 5% of children toothbrushing was started before the age of 1; 2) About 30% of children had no parental supervision during their toothbrushing; 3) In a large percentage of mothers, especially those with lower education level, the knowledge about oral health care of preschool children are scarce.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 483.1-483
Author(s):  
M. Nejman ◽  
M. Hiller ◽  
J. Napora ◽  
A. Wojteczek ◽  
M. Ziętkiewicz ◽  
...  

Background:According to data collected by the Statistics Poland in 2014, lower back pain is the second most common complaint reported by people over the age of 60 and occurs in about 40% of them. Another 29% of respondents suffer from pain in other spine sections. Treatment of such a common condition can be a challenge due to the multitude of causes of pain, accompanying diseases and the patient’s approach to his own health.Objectives:The aim of the study was to investigate whether factors such as gender, age, level of education and pain severity affect self-chosen methods of treating back pain.Methods:A survey was conducted on students of Pomeranian Universities Of The Third Age. There were collected socio-demographic characteristics of the participants, features of back pain and detailed information on analgesic methods, including drugs, ointments, exercises and physiotherapy treatments (laser, cryotherapy, hydromassage, ultrasound, heat treatments and other). The responses of participants over the age of 50 were included in the analysis. The answers were divided into groups by age (younger - 50–69 years and older - over 70 years), sex, level of education (lower, medium and higher) and intensity of pain assessed on the VAS scale (<6 and ≥6). The collected data were compared in these groups.Results:546 answers were received. 291 respondents were 50-69 years old, 255 aged 70-90 and more, 86% (471) of participants were women. 43% of respondents had secondary education and the same number had higher education. Over 90% (494) declared that they have suffered from back pain. Most of them described pain as chronic (56%), the median pain intensity assessed on the VAS scale was 6 [1-10], and the mean pain intensity was 5.89 ± 1.79. 82.6% of respondents declared doing physical exercises to relieve back pain, 75.9% were using physiotherapy, 60.7% were taking analgesic drugs and 54.3% were using ointments, gels, patches and other local analgesic methods. The higher pain severity was observed in group of females (5.74 vs. 5.61, p=0.002) and people with lower education level (6.52) than in other groups (5.89 and 5.68, p=0.005). Analgesic drugs were taken more often by younger people (66.9% vs. 53.7%, p=0.003), women (62.5% vs. 49.2%, p=0.042), people of lower education level group (80.6% vs. 62.2% secondary education group vs. 52.5% higher education group, p<0.001) and by people with pain severity ≥6 (81.5% vs. 68.9%, p<0.001). Analgesic gels, ointments, patches and other pharmaceuticals were used more often only in group with higher pain severity (62.9% vs. 43.4%, p<0.001). Performing exercises to relieve pain was more often declared by women (84.4% vs. 70.8%, p=0.003) and people with higher education (85.1% vs. 81.3% secondary education group vs. 79.1% lower education group, p<0.001). The study showed that only in groups with varying intensity of pain there was a significant difference in the frequency of using physiotherapy treatments - 68.9% in group with pain severity <6 vs. 81.5% with pain severity ≥6 (p<0.001).Conclusion:1. The severity of pain has the greatest impact on the choice of back pain relief method, but this is not the only important factor.2. People with lower levels of education and men less often perform physical exercises for treatment regardless of the severity of back pain.3. In the treatment of back pain, attention should be given to recommending the patient an appropriate analgesic method, which will be easily used and more effective.References:Population aged 60+. Demographic structure and health. 2016. Statistics Poland.Disclosure of Interests: :None declared


Sign in / Sign up

Export Citation Format

Share Document