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Socioeconomic Gradient (socioeconomic + gradient)
Selected AbstractsCancer risk perceptions in an urban Mediterranean populationINTERNATIONAL JOURNAL OF CANCER, Issue 1 2005Montse García Abstract The objective of our study was to analyze the perceived (belief) or adopted (behavior) measures to reduce cancer risk in a Spanish population. We used cross-sectional data from the Cornella Health Interview Survey Follow-up Study (CHIS.FU). We analyzed 1,438 subjects who in 2002 answered questions about risk perceptions on cancer and related behavior (668 males and 770 females). The benefits of avoiding cigarette smoking (95.8%), sunlight exposure (94.9%) and alcohol (81.0%) were widely recognized. On the other hand, electromagnetic fields (92.1%), food coloring and other food additives (78.4%) or pesticides (69.4%), whose role in cancer occurrence, if any, remain unproven, were clearly considered as cancer risk factors in this population. Compared to men, women more frequently reported healthy behaviors, and the role of exogenous factors (i.e., environmental risk factors) were widely popular. There was a socioeconomic gradient on cancer risk perception with respect to several lifestyle or dietary factors. Individuals with higher educational level scored lower in several risk factors than those with primary or less than primary school education. Smokers reported adopting fewer healthy behaviors than former or never smokers. How people perceive health issues and risk or make choices about their own behavior does not always follow a predictable or rational pattern. © 2005 Wiley-Liss, Inc. [source] Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stayJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2010Jennifer Hollowell PhD Abstract Background, Patient deprivation is associated with greater need for total hip and knee replacement surgery (THR/TKR) and a higher prevalence of risk factors for surgical complications. Our aim was to examine associations between deprivation and aspects of the inpatient episode for patients undergoing these procedures. Methods, We analysed socioeconomic variations in preoperative surgical risk, postoperative morbidity and length of stay for 655 patients undergoing elective THR/TKR at a large metropolitan hospital. Surgical risk was assessed using the orthopaedic version of the POSSUM scoring system, postoperative morbidity was assessed using the postoperative morbidity survey, and socioeconomic status was measured using the Index of Multiple Deprivation. We adjusted for age, sex, surgical site and primary vs. revision surgery. Results, We found only a modest, clinically insignificant socioeconomic gradient in preoperative surgical risk and no socioeconomic gradient in postoperative morbidity. There was a strong socioeconomic gradient in length of stay, but only for patients undergoing TKR. This was due to deprived patients being more likely to remain in hospital without morbidity following TKR. Conclusions, Our findings suggest differential selection of healthier patients for surgery. Hospitals serving deprived communities may have excess, unfunded costs because of the increased length of stay of socioeconomically disadvantaged patients. [source] Childhood conditions and education as determinants of adult height and obesity among Greenland InuitAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010P. Bjerregaard Height and obesity are risk factors for cardiovascular disease and other physical and mental health conditions. Their association with childhood socioeconomic position has been demonstrated in studies among European and a few third world populations. In a random sample of adult Greenland Inuit (N = 2302) we studied the association between childhood socioeconomic conditions and height as well as prevalence of obesity (BMI , 30) in a cross sectional design. In block recursive graphical independence models, height was associated with mother's place of birth, birth cohort, childhood residence, alcohol problems in childhood home, and education among both men and women. Obesity was associated with mother's place of birth (for men) and with alcohol problems (for women). In General Linear Models, men with an all rural background and no education beyond primary school measured on average 165.1 cm compared with 172.1 cm for men with an all urban background (P < 0.001); women measured 153.9 and 161.1 cm (P < 0.001). Rural-urban differences in prevalence of obesity were not statistically significant. The height differences were considerably larger than between educational groups in European countries and of the same order of magnitude as those reported between men from the 17th century and men from 400 BC in the European and Mediterranean region. The rural-urban gradient in height follows the socioeconomic gradient and may negatively affect cardiovascular risk among the rural Greenlanders, while their physically active lifestyle and high consumption of n-3 fatty acids may counteract this. Am. J. Hum. Biol., 2010. © 2009 Wiley-Liss, Inc. [source] Universal versus Economically Polarized Change in Age at First Birth: A French,British ComparisonPOPULATION AND DEVELOPMENT REVIEW, Issue 1 2009Michael S. Rendall France and Britain in the 1980s and 1990s represented two contrasting institutional models for the integration of employment and motherhood: the "universalistic" regime in France offered subsidized childcare and maternity-leave benefits at all income levels; the "means-tested" regime in Britain mainly offered income-tested benefits for single mothers. Comparing the two countries, we test the hypothesis that the socioeconomic gradient of fertility timing has become increasingly mediated by family policy. We find increasing polarization in women's age at first birth by pre-childbearing occupation in Britain but not in France. Early first births persisted in Britain only among women in low-skill occupations, while shifts toward increasingly late first births occurred in clerical/secretarial occupations and higher occupational groups. Age at first birth increased across all occupations in France, but age at first birth in France was still much earlier on average than for all but low-skill British mothers. [source] Social inequality in tooth extraction in a Brazilian insured working populationCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2007Joaquim Murilo Silveira Neto Abstract,,, Objectives:, Given the scant evidence of the socioeconomic gradient in tooth loss incidence, the purpose of this study was to compare the odds of individuals of distinct social strata being subjected to tooth extraction. Methods:, We undertook a case,control study at the head office of a large Brazilian company whose employees had access to dental care through the company's dental insurance. Results:, During 2 years of observation, 264 teeth were extracted and the distribution of such extractions was rather unequal. A strong suggestion of a social gradient was noted and the odds of tooth extraction occurring per social strata, adjusted by age and gender, were five times higher in employees pertaining to the lowest social stratum, when compared with those at the highest. Conclusions:, We concluded that lower social strata were strongly associated with increased risk of having teeth extracted. Dental insurance was not able to equalize the chances of tooth extraction among different social strata, in a population of employed adults. [source] Assessing horizontal equity in medication treatment among elderly Mexicans: which socioeconomic determinants matter most?HEALTH ECONOMICS, Issue 10 2008Jürgen Maurer Abstract Many low- and middle-income countries are currently undergoing a dramatic epidemiological transition, with an increasing disease burden due to degenerative noncommunicable diseases. Inexpensive medication treatment often represents a cost-effective means to prevent, control or cure many of these health conditions. Using micro-data from the 2001 Mexican Health and Aging Study, we assess horizontal inequity in medication treatment among older Mexicans before the introduction of Popular Health Insurance in Mexico. In doing so, we investigate the role of various dimensions of socioeconomic status for obtaining indicated medication treatment within a comparatively fragmented health-care system that features relatively high out-of-pocket expenditures. Our empirical analysis suggests health insurance coverage as a key socioeconomic determinant of indicated medication use with large and statistically significant positive effects on take-up. The effects of insurance status thereby clearly dominate any other possible effects of socioeconomic status on medication treatment. Our results thus highlight the importance of access to reliable health care and comprehensive coverage for rational medication use in the management of degenerative diseases. In light of this evidence, we expect that recent Mexican health-care reforms, which expand health insurance coverage to the previously uninsured population, will alleviate socioeconomic gradients in medication treatment among older people in need. Copyright © 2007 John Wiley & Sons, Ltd. [source] | ||||||||||