Dataset Information

Urban and suburban differences in hypertension trends and self-care: three population-based cross-sectional studies from 2005-2011.

ABSTRACT:

Objectives

This study aimed to compare hypertension trends in the urban and suburban population, and to examine the use of several self-care behaviors among patients who were aware of their hypertension.

Methods

We examined the data from three cross-sectional adult populations obtained in 2005, 2008, and 2011, in Beijing.

Results

Our analyses indicated that from 2005 to 2011 the standardized rate of hypertension increased from 31.9% to 36.0% (P <0.001) among urban adults, and was relatively stable (40.8% -40.2%) among suburban adults (P = 0.02). About 10% of the patients reported having taken measures to control their weight for hypertension management. As compared to the other patients, the female patients in the urban areas reported the highest rate of regular BP measurement (52.6%). In addition, the patients who reported taking medication regularly increased among the males and females. Most of the women reported nonsmoking (?95%) and alcohol abstinence (?90%). The trend of nonsmoking decreased among the urban males. In contrast, the prevalence of nonsmoking increased among the suburban males, though the trend was not statistically significant (P = 0.055). Further, the patient-reported alcohol abstinence was found to exhibit a decreasing trend among the males.

Conclusions

We observed an increase in the hypertension prevalence from 2005 to 2011. The rates remained higher for suburban adults than for urban adults. Females generally had better self-care ability as compared to male patients. Further research is needed to promote self-care behaviors in hypertensive patients, especially for male patients.

SUBMITTER: Li G

PROVIDER: S-EPMC4322055 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Urban and suburban differences in hypertension trends and self-care: three population-based cross-sectional studies from 2005-2011.

Li Gang G Hu Huanhuan H Dong Zhong Z Xie Jin J Zhou Ying Y

PloS one 20150209 2

<h4>Objectives</h4>This study aimed to compare hypertension trends in the urban and suburban population, and to examine the use of several self-care behaviors among patients who were aware of their hypertension.<h4>Methods</h4>We examined the data from three cross-sectional adult populations obtained in 2005, 2008, and 2011, in Beijing.<h4>Results</h4>Our analyses indicated that from 2005 to 2011 the standardized rate of hypertension increased from 31.9% to 36.0% (P <0.001) among urban adults, a ...[more]

PMID: 25665069

Similar Datasets

Project description:BackgroundCare in a trauma centre is associated with significant reductions in mortality after severe injury. However, emerging evidence suggests that outcomes across similarly accredited trauma centres are not equivalent, even after adjusting for case-mix. The primary objective of this analysis was to evaluate secular trends in overall mortality at trauma centres. Secondarily, we explored trauma centre-specific mortality to determine the extent of variation between centres.MethodsData on 26 421 adults (??18 yr) admitted to a trauma centre between 2005 and 2011 were derived from the Ontario Trauma Registry. We used generalized estimating equations to calculate in-hospital mortality over time and hierarchical models to estimate trauma-centre-specific mortality. To quantify variability between centres, we calculated median odds ratios. Adjusted odds of death were calculated for each trauma centre to identify those with higher than expected, average and lower than expected mortality.ResultsOverall mortality at trauma centres decreased from 13.2% in 2005 to 11.2% in 2009. After adjusting for case mix, the odds of death decreased by approximately 3% a year (95% confidence interval 0%-5%). Trauma centre-specific mortality ranged from 11.4% to 13.1%. After adjusting for case mix, differences in trauma centre-specific mortality were observed (median odds ratio = 1.25), suggesting that the odds of dying could be 1.25-fold greater if the same patient was admitted to 1 randomly selected trauma centre as opposed to another. Differences were most pronounced for patients with isolated head injuries and among older patients as evidenced by higher median odds ratios and the number of outliers.InterpretationWe observed a significant improvement over time in the mortality of severely injured patients cared for at Ontario's trauma centres. However, considerable differences in trauma centre-specific mortality were observed. Differences were most pronounced among older injured patients and those with isolated traumatic brain injury. System-wide performance improvement initiatives should target these subgroups.

Project description:Changes in adverse-event rates among Medicare patients with common medical conditions and conditions requiring surgery remain largely unknown.We used Medicare Patient Safety Monitoring System data abstracted from medical records on 21 adverse events in patients hospitalized in the United States between 2005 and 2011 for acute myocardial infarction, congestive heart failure, pneumonia, or conditions requiring surgery. We estimated trends in the rate of occurrence of adverse events for which patients were at risk, the proportion of patients with one or more adverse events, and the number of adverse events per 1000 hospitalizations.The study included 61,523 patients hospitalized for acute myocardial infarction (19%), congestive heart failure (25%), pneumonia (30%), and conditions requiring surgery (27%). From 2005 through 2011, among patients with acute myocardial infarction, the rate of occurrence of adverse events declined from 5.0% to 3.7% (difference, 1.3 percentage points; 95% confidence interval [CI], 0.7 to 1.9), the proportion of patients with one or more adverse events declined from 26.0% to 19.4% (difference, 6.6 percentage points; 95% CI, 3.3 to 10.2), and the number of adverse events per 1000 hospitalizations declined from 401.9 to 262.2 (difference, 139.7; 95% CI, 90.6 to 189.0). Among patients with congestive heart failure, the rate of occurrence of adverse events declined from 3.7% to 2.7% (difference, 1.0 percentage points; 95% CI, 0.5 to 1.4), the proportion of patients with one or more adverse events declined from 17.5% to 14.2% (difference, 3.3 percentage points; 95% CI, 1.0 to 5.5), and the number of adverse events per 1000 hospitalizations declined from 235.2 to 166.9 (difference, 68.3; 95% CI, 39.9 to 96.7). Patients with pneumonia and those with conditions requiring surgery had no significant declines in adverse-event rates.From 2005 through 2011, adverse-event rates declined substantially among patients hospitalized for acute myocardial infarction or congestive heart failure but not among those hospitalized for pneumonia or conditions requiring surgery. (Funded by the Agency for Healthcare Research and Quality and others.).

Project description:ObjectivesThis study examines whether there is a difference between urban versus suburban and rural adolescents in their use of health services following two types of self-harm distinguished as self-harm with or without suicide intent.SettingA nationwide cross-sectional school survey of 11 406 Norwegian adolescents aged 13-19 years in 73 Norwegian junior and senior high schools.ParticipantsAdolescents who reported self-harm and provided valid responses to a follow-up question about having received subsequent help or treatment (n=959) were included in the study. Adolescents were divided into urban versus suburban and rural depending on: (1) the location of municipalities where they attended school and (2) the place of residence. Associations between urban versus suburban and rural areas and the use of health services following self-harm were assessed in those who self-harmed with and without suicide intent.Primary outcome measureUse of health services following self-harm.Results1 in 4 adolescents reported using health services following self-harm. Adolescents reporting self-harm with suicide intent were more likely to use health services than those who self-harmed without suicide intent. Following self-harm without suicide intent, adolescents in urban areas were four times more likely to use health services than adolescents in suburban and rural areas. There was no statistically significant area difference in the use of health services following self-harm with suicide intent.ConclusionsThis study found a geographical variation in the use of health services following self-harm without suicide intent, but not following self-harm with suicide intent. Differences in perception of self-harm and help-seeking behaviour between areas and different accessibility to services are suggested as possible explanations. There is a need to better understand how the interplay between individual characteristics and accessibility to services influences adolescents' use of health services following self-harm. We suggest that multilevel models are a valuable approach to achieve this goal.

Project description:IntroductionParents/guardians can effectively reduce tobacco smoking and secondhand smoke exposure among youth by adopting and enforcing rules against indoor tobacco smoking (ie, home smoke-free policies). We investigate home smoke-free policies from childhood to adolescence in the United States and across rural, suburban, and urban households.Aims and methodsWe analyzed 2019-2020 National Survey of Children's Health data from n = 5,955 parents of youth aged 0-17, living at home with a tobacco smoker in the United States (U.S). Geographical categories were: rural, suburban, and urban. Home smoke-free policy reflected prohibiting tobacco smoking inside the home. Weighted logistic regressions examined the (1) association between youth age and home smoke-free policies, (2) interaction between geographic category and youth age, and (3) differing associations between youth age and home smoke-free policies by geography. Models controlled for youth race, ethnicity, sex, parental education, household annual income, and home structure.ResultsApproximately 13.2% of U.S. households with a smoker did not have a home smoke-free policy. Stratified analyses found one-year increase in youth age was associated with lower odds of having a home smoke-free policy in rural (aOR:0.91; 95%CI: 0.87-0.95) and urban (aOR: 0.96; 95%CI: 0.92-1.00; p = .039), but not suburban (aOR:1.00; 95%CI: 0.95-1.05) households, controlling for covariates.ConclusionOdds of having a smoke-free home in the U.S. declined significantly in rural (9% per year) and urban (4%) but not suburban (0%) households. We quantify declines in home smoke-free policies as children age and identify geographic disparities for this environmental determinant of health.ImplicationsHealth promotion efforts targeting secondhand smoke prevention is needed, particularly for parents of older youth. Furthermore, there is a clear geographic bias in secondhand smoke exposure among all youth particularly older youth. Tailored interventions are needed to address geographic disparities in secondhand smoke exposure among rural and urban youth.

Project description:BackgroundAdults in rural counties in the United States (US) experience higher rates broadly of cardiovascular disease (CVD) compared with adults in urban counties. Mortality rates specifically due to heart failure (HF) have increased since 2011, but estimates of heterogeneity at the county-level in HF-related mortality have not been produced. The objectives of this study were 1) to quantify nationwide trends by rural-urban designation and 2) examine county-level factors associated with rural-urban differences in HF-related mortality rates.Methods and findingsWe queried CDC WONDER to identify HF deaths between 2011-2018 defined as CVD (I00-78) as the underlying cause of death and HF (I50) as a contributing cause of death. First, we calculated national age-adjusted mortality rates (AAMR) and examined trends stratified by rural-urban status (defined using 2013 NCHS Urban-Rural Classification Scheme), age (35-64 and 65-84 years), and race-sex subgroups per year. Second, we combined all deaths from 2011-2018 and estimated incidence rate ratios (IRR) in HF-related mortality for rural versus urban counties using multivariable negative binomial regression models with adjustment for demographic and socioeconomic characteristics, risk factor prevalence, and physician density. Between 2011-2018, 162,314 and 580,305 HF-related deaths occurred in rural and urban counties, respectively. AAMRs were consistently higher for residents in rural compared with urban counties (73.2 [95% CI: 72.2-74.2] vs. 57.2 [56.8-57.6] in 2018, respectively). The highest AAMR was observed in rural Black men (131.1 [123.3-138.9] in 2018) with greatest increases in HF-related mortality in those 35-64 years (+6.1%/year). The rural-urban IRR persisted among both younger (1.10 [1.04-1.16]) and older adults (1.04 [1.02-1.07]) after adjustment for county-level factors. Main limitations included lack of individual-level data and county dropout due to low event rates (<20).ConclusionsDifferences in county-level factors may account for a significant amount of the observed variation in HF-related mortality between rural and urban counties. Efforts to reduce the rural-urban disparity in HF-related mortality rates will likely require diverse public health and clinical interventions targeting the underlying causes of this disparity.

Project description:Highlights • Rurality was not significantly associated with BMI percentiles.• Suburban adolescents had significantly different dietary behaviors.• Being non-Hispanic black was a predictor of BMI and obesity-related risk factors.• Low household income was a predictor of BMI and obesity-related risk factors.• Additional obesity research using a three-category rurality classification is needed. Data from the nationally representative 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study was examined to identify differences in adolescent Body Mass Index (BMI) and obesity-related behaviors by rurality status (i.e., urban, suburban, rural) while accounting for relevant demographics (i.e., sex, race/ethnicity, household income). This secondary, cross-sectional analysis included 1,353 adolescents. Analyses included descriptive statistics, one-way analysis of variance, Chi-squared tests, and multiple linear regression models (reported significance level p < 0.05). Rurality was not associated with BMI when controlling for demographics. However, relative to rural adolescents, suburban adolescents had significantly higher junk food, sugar-sweetened beverages (SSB), sugary food (all β=+0.2, p ≤ 0.001), and fruit/vegetable intake (β=+0.1, p ≤ 0.05). Compared to Non-Hispanic White adolescents, Non-Hispanic Black adolescents had significantly higher BMI (β=+4.4, p ≤ 0.05), total sedentary time (β=+4.1, p ≤ 0.001), junk food, SSB, and sugary food intake (all β=+0.2, p ≤ 0.05). Relative to their lower-income household counterparts, adolescents from higher-income households had significantly lower BMI (β = -9.7, p ≤ 0.001), junk food (β = -0.2, p ≤ 0.05), and SSB intake (β = -0.5, p ≤ 0.001). Contrary to literature, rurality was not a significant predictor of adolescent BMI. While suburban status was significantly associated with several diet-related risk factors, it was not in the direction anticipated. Being non-Hispanic Black and from a low-income household had the greatest influence on adolescent BMI. Findings highlight the importance of using a three-category classification for rurality.

Dataset Information

Urban and suburban differences in hypertension trends and self-care: three population-based cross-sectional studies from 2005-2011.

Objectives

Methods

Results

Conclusions

Publications

Urban and suburban differences in hypertension trends and self-care: three population-based cross-sectional studies from 2005-2011.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets