Socioeconomic status and health communication inequalities in Japan: a nationwide cross-sectional survey.
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ABSTRACT:
SUBMITTER: Ishikawa Y
PROVIDER: S-EPMC3395686 | biostudies-other | 2012
REPOSITORIES: biostudies-other
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Project description:The objective of this study was to explore the socioeconomic inequalities in undernutrition among ever-married women of reproductive age. We used nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey, 2017−2018. Undernutrition was defined as a body mass index (BMI) of <18.5 kg/m2. The concentration index (C) was used to measure the socioeconomic inequality in the prevalence of women’s undernutrition. A multiple binary logistic regression model was carried out to find out the factors associated with women’s undernutrition. The prevalence of undernutrition among women of 15−49 years was 12%. Among them, 8.5% of women were from urban and 12.7% of women were from rural areas. The prevalence of undernutrition was highest (21.9%) among women who belonged to the adolescent age group (15−19 years). The C showed that undernutrition was more prevalent among the socioeconomically worst-off (poorest) group in Bangladesh (C = −0.26). An adjusted multiple logistic regression model indicated that women less than 19 years of age had higher odds (adjusted odds ratio, AOR: 2.81; 95% confidence interval, CI: 2.23, 3.55) of being undernourished. Women from the poorest wealth quintile (AOR: 3.93, 95% CI: 3.21, 4.81) had higher odds of being undernourished. On the other hand, women who had completed secondary or higher education (AOR: 0.55; 95% CI: 0.49, 0.61), married women who were living with their husbands (AOR: 0.72, 95% CI: 0.61, 0.86), and women exposed to mass media (AOR: 0.87, 95% CI: 0.79, 0.97) were less likely to be undernourished. Intervention strategies should be developed targeting the poorest to combat undernutrition in women of reproductive age in Bangladesh.
| S-EPMC9031436 | biostudies-literature
Project description:BACKGROUND:Many studies have reported that housing tenure (HT) is associated with health, but little is known about its association in Japan. We investigated the cross-sectional association between HT and self-rated health (SRH) among Japanese adults, taking demographic characteristics and socioeconomic status (SES) into consideration. METHODS:We used data from a nationally representative survey conducted by the Japanese Ministry of Health, Labour and Welfare (28,641 men and 31,143 women aged ?20 years). HT was divided into five categories: owner-occupied, privately rented, provided housing, publically subsidized, and rented rooms. SRH was evaluated using a single-item inventory and dichotomized into poor (very poor/poor) and good (very good/good/fair). We calculated adjusted odds ratios (OR) and their 95% confidence intervals (CI) for poor SRH with logistic regression models. Covariates included demographic factors (i.e., age, gender, marital status, family size, smoking status, and chronic medical conditions) and SES factors (i.e., education, equivalent household expenditures, and occupation). RESULTS:Among analyzed participants, 75.9% were owner-occupiers and 14.6% reported poor SRH. After adjustment for all covariates, compared with owner-occupiers, private renters (OR = 1.36, 95% CI = 1.26-1.47), publically subsidized renters (OR = 1.33, 95% CI = 1.19-1.48), and residents in rented rooms (OR = 1.41, 95% CI = 1.22-1.62) were more likely to report poor SRH. Stratified analyses by SES factors showed that the association between HT and poor SRH was stronger in the socially disadvantaged than in the higher socioeconomic group. CONCLUSIONS:Our results show a significant association between HT and SRH, independent of socio-demographic factors. HT may deserve greater attention as an indicator of socioeconomic position in Japan.
| S-EPMC6855483 | biostudies-literature
Project description:BackgroundDigital technologies are shaping medicine and public health.ObjectiveThe aim of this study was to investigate the attitudes toward and the use of digital technologies for health-related purposes using a nationwide survey.MethodsWe performed a cross-sectional study using a panel sample of internet users selected from the general population living in Germany. Responses to a survey with 28 items were collected using computer-assisted telephone interviews conducted in October 2020. The items were divided into four topics: (1) general attitudes toward digitization, (2) COVID-19 pandemic, (3) physical activity, and (4) perceived digital health (eHealth) literacy measured with the eHealth Literacy Scale (eHEALS; sum score of 8=lowest to 40=highest perceived eHealth literacy). The data were analyzed in IBM-SPSS24 using relative frequencies. Three univariate multiple regression analyses (linear or binary logistic) were performed to investigate the associations among the sociodemographic factors (age, gender, education, and household income) and digital technology use.ResultsThe participants included 1014 internet users (n=528, 52.07% women) aged 14 to 93 years (mean 54, SD 17). Among all participants, 66.47% (674/1014) completed up to tertiary (primary and secondary) education and 45.07% (457/1017) reported a household income of up to 3500 Euro/month (1 Euro=US $1.18). Over half (579/1014, 57.10%) reported having used digital technologies for health-related purposes. The majority (898/1014, 88.56%) noted that digitization will be important for therapy and health care, in the future. Only 25.64% (260/1014) reported interest in smartphone apps for health promotion/prevention and 42.70% (433/1014) downloaded the COVID-19 contact-tracing app. Although 52.47% (532/1014) reported that they come across inaccurate digital information on the COVID-19 pandemic, 78.01% (791/1014) were confident in their ability to recognize such inaccurate information. Among those who use digital technologies for moderate physical activity (n=220), 187 (85.0%) found such technologies easy to use and 140 (63.6%) reported using them regularly (at least once a week). Although the perceived eHealth literacy was high (eHEALS mean score 31 points, SD 6), less than half (43.10%, 400/928) were confident in using digital information for health decisions. The use of digital technologies for health was associated with higher household income (odds ratio [OR] 1.28, 95% CI 1.11-1.47). The use of digital technologies for physical activity was associated with younger age (OR 0.95, 95% CI 0.94-0.96) and more education (OR 1.22, 95% CI 1.01-1.46). A higher perceived eHealth literacy score was associated with younger age (β=-.22, P<.001), higher household income (β=.21, P<.001), and more education (β=.14, P<.001).ConclusionsInternet users in Germany expect that digitization will affect preventive and therapeutic health care in the future. The facilitators and barriers associated with the use of digital technologies for health warrant further research. A gap exists between high confidence in the perceived ability to evaluate digital information and low trust in internet-based information on the COVID-19 pandemic and health decisions.
| S-EPMC8612128 | biostudies-literature
Project description:BACKGROUND:Congenital nephrotic syndrome (CNS) and infantile nephrotic syndrome (INS) cause substantial morbidity and mortality. In Japan, there is a lack of knowledge regarding the characteristics of CNS and INS. This study aimed to clarify the characteristics of CNS and INS in Japan. METHODS:This cross-sectional nationwide survey obtained data from 44 institutions in Japan managing 92 patients with CNS or INS, by means of two survey questionnaires sent by postal mail. Patients aged <?16?years by 1 April 2015, with a diagnosis of CNS or INS, were included in this study. The primary outcome was end-stage kidney disease. RESULTS:A total of 83 patients with CNS or INS were analyzed. The most frequent disease type was non-Finnish (60.2%); 33 patients (39.8%) had Finnish type. Among those with non-Finnish-type disease, 26 had no syndrome and 24 had a syndrome, of which the most frequent was Denys-Drash syndrome (70.8%). Patients with non-Finnish-type disease with syndrome showed the earliest progression to end-stage kidney disease compared with the other two groups, whereas patients with non-Finnish-type disease without syndrome progressed more slowly compared with the other two groups. In the Finnish-type group, the disease was diagnosed the earliest; a large placenta was reported more frequently; genetic testing was more frequently performed (93.8%); mental retardation was the most frequent extra-renal symptom (21.2%); and thrombosis and infection were more frequent compared with the other groups. Patients with non-Finnish-type disease with syndrome had a higher frequency of positive extra-renal symptoms (79.2%), the most common being urogenital symptoms (54.2%). Treatment with steroids and immunosuppressants was more frequent among patients with non-Finnish-type disease without syndrome. Two patients with non-Finnish-type disease without syndrome achieved complete remission. In all groups, unilateral nephrectomy was performed more often than bilateral nephrectomy and peritoneal dialysis was the most common renal replacement therapy. CONCLUSIONS:The present epidemiological survey sheds light on the characteristics of children with CNS and INS in Japan. A high proportion of patients underwent genetic examination, and patient management was in accord with current treatment recommendations and practices. TRIAL REGISTRATION:Not applicable.
| S-EPMC7446144 | biostudies-literature
Project description:BackgroundCongenital limb deficiency is a rare and intractable disease, which impairs both function and appearance of the limbs. To establish adequate medical care, it is necessary to reveal the actual conditions and problems associated with this disease. However, there have been no extensive epidemiological surveys in Japan addressing this disease. This is the first nationwide epidemiological survey of congenital limb deficiency in this country.MethodsWith the cooperation of epidemiology experts, we performed a two-stage nationwide survey to estimate the number of patients with congenital limb deficiency and reveal basic patient features. We targeted orthopaedic surgery, paediatric, and plastic surgery departments. Hospitals were categorized according to the institution type and the number of hospital beds; hospitals were randomly selected from these categories. We selected 2283 departments from a total 7825 departments throughout Japan. In this study, we defined congenital limb deficiency as partial or total absence of the limbs, proximal to the proximal interphalangeal joint of the fingers/lesser toes or interphalangeal joint of the thumb/great toe. We distributed the first survey querying the number of initial patient visits from January 2014 to December 2015. Targets of the second survey were departments that reported one or more initial patient visits in the first survey.ResultsIn the first survey, 1767 departments responded (response rate: 77.4%). Among them, 161 departments reported one or more initial patient visits. We conducted the second survey among these 161 departments, of which 96 departments responded (response rate: 59.6%). The estimated number of initial visits by patients with congenital limb deficiency was 417 (95% confidence interval: 339-495) per year in 2014 and 2015. The estimated prevalence of congenital limb deficiency in Japan was 4.15 (95% confidence interval: 3.37-4.93) per 10,000 live births. The sex ratio was 1.40. Upper limbs were more affected than lower limbs.ConclusionsWe revealed the estimated number of initial patient visits per year and birth prevalence of congenital limb deficiency in Japan. Our results will contribute to establishing the disease concept and grades of severity of congenital limb deficiency.
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Project description:BackgroundPsoriasis is a disease that extends beyond the skin, with profound medical, social, and mental health implications. To our knowledge, no previous studies have specifically investigated the medical and socioeconomic characteristics of women with versus without psoriasis.ObjectiveWe investigated whether women with psoriasis differed from women without psoriasis with respect to comorbidities, socioeconomic status, healthcare consumption, and drug use, as well as how these characteristics differed according to psoriasis severity.MethodsIn this nationwide, register-based, cross-sectional study, data were collected from Danish registries from 1977 to 2017, linked at the individual level, and identified by International Classification of Diseases codes, prescription data, income and educational information, and contact with public health care services. Psoriasis was defined by either a hospital International Classification of Diseases code for psoriasis or calcipotriol prescription data. Psoriasis severity was stratified based on psoriasis treatment. Age-adjusted logistic regression models were used to estimate the odds ratios (ORs) of outcomes compared with those of women without psoriasis.ResultsA total of 77,143 women (3%) met the criteria for psoriasis. Psoriasis was significantly associated with all investigated outcomes. Women with psoriasis were less likely to have a high income (OR: 0.89; 95% confidence interval [CI], 0.87-0.91), more likely to visit their general practitioner more often (OR: 3.82; 95% CI, 3.70-3.95), and received pain medication more often (OR: 1.57; 95% CI, 1.52-1.62) compared with women without psoriasis.ConclusionPsoriasis was significantly associated with all investigated adverse medical and socioeconomic outcomes. Risk of outcomes increased with psoriasis severity. Our study highlights the need for a multidisciplinary collaboration to optimize medical care for women with (especially moderate and severe) psoriasis.
| S-EPMC8243156 | biostudies-literature
Project description:Magnitudes of health inequalities present consequences of socioeconomic impact on each health problem. To provide knowledge on the size of health problems in terms of socioeconomic burden, we examined the magnitudes and patterns of health inequalities across 12 health problems. A total of 17,292 participants older than 30 years were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010⁻2012). The age-adjusted prevalence ratios were compared across socioeconomic positions (SEPs) based on income, education, and occupation. The magnitudes of socioeconomic inequalities varied across 12 health problems and, in general, the patterns of socioeconomic inequalities were similar among groups of health problems (i.e., non-communicable diseases (NCDs), mental health, and subjective health states). Significant health inequalities across NCDs, such as diabetes, hypertension, ischemic heart disease, and arthritis, were observed mainly in women. Socioeconomic inequalities in mental health problems, such as depression, suicidal ideation, and suicide attempts, were profound for both genders and across SEP measures. Significant socioeconomic inequalities were also observed for subjective health. No or weak associations were observed for injury and HBV infection. The patterns of socioeconomic inequalities were similar among groups of health problems. Mental illnesses appeared to require prioritization of socioeconomic approaches for improvement in terms of absolute prevalence and relative socioeconomic distribution.
| S-EPMC6313447 | biostudies-literature
Project description:BackgroundIn Japan, heated tobacco products (HTPs) are promoted by the tobacco industry as reduced-risk tobacco products despite the lack of evidence for this claim. This study determined the distribution of HTP-harmfulness perception and identified the explanatory factors associated with the perception of HTP as less harmful than conventional cigarettes.MethodsA nationwide cross-sectional survey was conducted with Japanese people aged 20 years or older (INFORM Study 2020) using a self-administered questionnaire. We performed descriptive analysis and weighted logistic regression analysis to examine the relationship between explanatory factors (eg, individual characteristics, socioeconomic status, and trusted sources of cancer information) and the perception of HTPs as less harmful.ResultsAmong 3,420 participants, the proportions of those who perceived HTPs as less harmful were 40.3% and 18.3% for users and non-users of tobacco, respectively. For participants aged 20-39 years, the proportions were 49.9% and 30.4%, respectively. Among 1,160 tobacco non-users who were familiar with HTPs, male, aged under 39 years, and having lower education were associated with the perception of HTPs as less harmful. Trusted sources of cancer information were not associated with the perception of HTPs as less harmful.ConclusionThis study showed that, among tobacco non-users, being male, aged under 39 years, and having lower education were associated with a perception of HTPs as less harmful. Public health stakeholders should provide the latest evidence about HTP harmfulness in their daily practice and strengthen the regulations on HTP marketing directed at both tobacco- and tobacco non-users.
| S-EPMC11330704 | biostudies-literature
Project description:ObjectivesThe detrimental impacts of abuse on victims' well-being are well documented globally, including Japan. The ongoing COVID-19 pandemic may increase the incidence of abuse in the community, creating an additional burden amid the crisis. However, the incidence of abuse in Japan during COVID-19 remains to be evaluated. Accordingly, our study aimed to assess the incidence of physical and verbal abuse among the general population in Japan and to identify the associated factors of abuse during COVID-19.Design and settingWe used the data obtained from a nationwide, cross-sectional internet survey conducted in Japan between August and September 2020. Sampling weights were used to calculate national estimates, and multivariable logistic regression was performed to identify the associated factors for physical and verbal abuse.ResultsOut of the total 25 482 participants, 965 (3.8 %) reported experiencing physical abuse and 1941 (7.6%) verbal abuse from April 2020 to September 2020. The incidence of physical and verbal abuse was higher among female participants. Participants who lived in areas where the 'state of emergency' was enforced were more likely to suffer from physical abuse. Similarly, vulnerable participants such as those below age 18, with low income, bad family relationships, and disabled people were more likely to experience both physical and verbal abuse. Participants suffering from COVID-19-related symptoms, who had poor health status and widows/divorcees were more likely to be verbally abused. Furthermore, those who did not follow preventive behaviours such as wearing masks in public places, abusing drugs and drinking alcohol in high amounts were also more likely to experience abuse.ConclusionThe impact of abuse was found disproportionately greater in more vulnerable groups of the population. Pandemic has reinforced the existing social inequalities, which need to be addressed timely to prevent precarious repercussions.
| S-EPMC8889444 | biostudies-literature
Project description:BackgroundWhile mass media communications can be an important source of health information, there are substantial social disparities in health knowledge that may be related to media use. The purpose of this study is to investigate how the use of cancer-related health communications is patterned by race, ethnicity, language, and social class.Methodology/principal findingsIn a nationally-representative cross-sectional telephone survey, 5,187 U.S. adults provided information about demographic characteristics, cancer information seeking, and attention to and trust in health information from television, radio, newspaper, magazines, and the Internet. Cancer information seeking was lowest among Spanish-speaking Hispanics (odds ratio: 0.42; 95% confidence interval: 0.28-0.63) compared to non-Hispanic whites. Spanish-speaking Hispanics were more likely than non-Hispanic whites to pay attention to (odds ratio: 3.10; 95% confidence interval: 2.07-4.66) and trust (odds ratio: 2.61; 95% confidence interval: 1.53-4.47) health messages from the radio. Non-Hispanic blacks were more likely than non-Hispanic whites to pay attention to (odds ratio: 2.39; 95% confidence interval: 1.88-3.04) and trust (odds ratio: 2.16; 95% confidence interval: 1.61-2.90) health messages on television. Those who were college graduates tended to pay more attention to health information from newspapers (odds ratio: 1.98; 95% confidence interval: 1.42-2.75), magazines (odds ratio: 1.86; 95% confidence interval: 1.32-2.60), and the Internet (odds ratio: 4.74; 95% confidence interval: 2.70-8.31) and had less trust in cancer-related health information from television (odds ratio: 0.44; 95% confidence interval: 0.32-0.62) and radio (odds ratio: 0.54; 95% confidence interval: 0.34-0.86) compared to those who were not high school graduates.Conclusions/significanceHealth media use is patterned by race, ethnicity, language and social class. Providing greater access to and enhancing the quality of health media by taking into account factors associated with social determinants may contribute to addressing social disparities in health.
| S-EPMC3022647 | biostudies-literature