Health situation and health care of women aged 50 years and older in rural regions in Germany

Abstract Background In many countries demographic changes and regional differences lead to inequalities in healthcare provision. In Germany, this applies especially to rural regions and could affect the healthcare situation of middle-aged and older women in particular. Our study, which is part of the project “Frauen 5.0”, explores the health and healthcare situation of women 50 years and older in Northeastern Germany, with focus on outpatient gynaecological and general medical care and reasons for healthcare utilisation. Methods Our analyses comprise the health situation of women aged 50 years and older, their utilisation of outpatient gynaecologists and general practitioners (GPs), reasons for utilisation, access barriers to outpatient care, the demographic situation and the spatial distribution of gynaecological and GP practices in Northeastern Germany. We use a variety of data sources; main data source is the German Health Interview and Examination Survey for Adults (DEGS1, 2008-2011), which was carried out by the Robert Koch Institute and is representative of the German adult population. Results There is an unequal distribution of gynaecologic and GP practices in Northeastern Germany, with the highest density in and around Berlin. About 30% of gynaecologists and GPs in the study region are aged 60 years and older. Whereas in all age groups at least 80% of women used GP services in the last 12 months, the use of gynaecologic services declines from 80% in 18- to 29 year-old to 45% in 70- to 79 year-old women. Most important reasons for seeking gynaecological treatment are menopause and early detection of cancer. Conclusions The analyses show that there is need to ensure adequate health care for women aged 50 and over in rural regions in Germany. Based on the results, within the project “Frauen 5.0” innovative solutions for this task, e.g. interprofessional cooperation, will be identified. Key messages Analyses of outpatient healthcare services show an unequal distribution of gynaecologic and GP practices in Northeastern Germany; about 30% of the gynaecologists and GPs are aged 60 years and older. Whereas in all age groups at least 80% of women used GP services in the last 12 months, the use of gynaecologic services declines from 80% in 18- to 29 year-old to 45% in 70- to 79 year-old women.

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The requirements in medical rehabilitation of adult population of different age groups in hospital conditions

Health Care of the Russian Federation ◽

10.18821/0044-197x-2016-60-1-23-27 ◽

2019 ◽

Vol 60 (1) ◽

pp. 23-27

Author(s):

Nina S. Prilipko

Keyword(s):

Health Care ◽

Age Structure ◽

Adult Population ◽

Age Groups ◽

Medical Rehabilitation ◽

Age Group ◽

Structure Of Population ◽

Age Structure Of Population ◽

The Russian Federation ◽

Calculated Number

The study was carried out to determine requirements of adult population of Russia in medical rehabilitation in hospital conditions depending on age groups. To determine requirements of country population in medical rehabilitation in hospital conditions the age-specific indicators derived from data massive from three territories were standardized on population and morbidity in Russia in 2010. The number of hospitalized patients being in need of medical rehabilitation in hospital conditions was determined as indicator characterizing requirements of population in medical rehabilitation in hospital conditions. The age-specific requirements of adult population in medical rehabilitation in hospital conditions was determined and analyzed on the basis of number of cases of annual hospitalization for medical rehabilitation in hospital conditions according main classes and particular diseases. The largest number ofpatients being in need of medical rehabilitation in hospital conditions goes to elder age groups 60-69 years (874.7 cases per 10 000 of population) and 70 years and older (1346.3 cases per 10 000 of population). The least number of this kind of patients goes to age group of 18-29 years (106.2 cases per 10 000 of population). The proposed calculated number of cases of hospitalization of adult population for medical rehabilitation in hospital conditions can be implemented by executive authorities of subjects of the Russian Federation in health care sector of any territory for determining requirements ofparticular region in medical rehabilitation with consideration for age structure of population.

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Oral health and use of dental services in different stages of adulthood in Norway: a cross sectional study

BMC Oral Health ◽

10.1186/s12903-021-01626-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elin Hadler-Olsen ◽

Birgitta Jönsson

Keyword(s):

Health Care ◽

Young Adults ◽

Oral Health ◽

Dental Health ◽

Adult Population ◽

Age Groups ◽

Oral Health Care ◽

Cross Sectional Study ◽

Dental Services ◽

Cross Sectional

Abstract Background Socioeconomic status and oral health care habits may change throughout adult life. This calls for age-stratified analyses of oral health in the adult population to uncover differences that could be of importance for organizing adequate oral health care services. The aim of the present study was to describe self-reported oral health in different age groups in a general adult population in Norway, and to explore associations between self-reported oral health and age groups, sociodemographic factors, use of dental services, number of teeth and dental caries. Methods We used data from a cross-sectional study of almost 2000 Norwegian adults, 20–79 years old. The study included both a structured questionnaire and a clinical examination to assess sociodemographic variables, use of dental services, self-reported oral and general health as well as dental caries and number of teeth. For analysis, the participants were divided into three age groups: young adults (20–29 years), middle-aged adults (30–59 years), and senior adults (60 years and older). Differences among groups were analyzed by cross-tabulation, and logistic regression analyses were used to assess associations between variables. Results Forty-eight percent of the participants rated their oral health as good. Almost half of the participants had at least one carious tooth, with the highest caries prevalence among the young adults. To be caries free was strongly associated with reporting good oral health among the young and middle-aged adults. One third of the senior adults had fewer than 20 teeth, which was associated with reporting moderate or poor oral health. Less than half of the young adults reported regular use of dental services, and 40% of them had postponed dental visits for financial reasons during the past 2 years. Regardless of age group, having to postpone dental visits for financial reasons or having poor-to-moderate general health were associated with high odds for reporting moderate or poor oral health. Conclusions That there were important age-group differences in self-reported and clinical measures of oral health and in the use of dental health services demonstrates the importance of age-stratified analyses in oral health research. Many adults, especially among the young, faced financial barriers for receiving dental health services, which was associated with poorer self-reported oral health. This argues for a need to revisit the financing of oral health care for adults in Norway.

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Inequalities in all-cause and cause-specific mortality across the life course by wealth and income in Sweden: a register-based cohort study

International Journal of Epidemiology ◽

10.1093/ije/dyaa053 ◽

2020 ◽

Vol 49 (3) ◽

pp. 917-925

Author(s):

S Vittal Katikireddi ◽

Claire L Niedzwiedz ◽

Ruth Dundas ◽

Naoki Kondo ◽

Alastair H Leyland ◽

...

Keyword(s):

Life Course ◽

Health Inequalities ◽

Adult Population ◽

Early Adulthood ◽

Age Groups ◽

Adult Life ◽

Unequal Distribution ◽

Specific Mortality ◽

Economic Position ◽

Wealth Inequalities

Abstract Background Wealth inequalities are increasing in many countries, but their relationship to health is little studied. We investigated the association between individual wealth and mortality across the adult life course in Sweden. Methods We studied the Swedish adult population using national registers. The amount of wealth tax paid in 1990 was the main exposure of interest and the cohort was followed up for 18 years. Relative indices of inequality (RII) summarize health inequalities across a population and were calculated for all-cause and cause-specific mortality for six different age groups, stratified by sex, using Poisson regression. Mortality inequalities by wealth were contrasted with those assessed by individual and household income. Attenuation by four other measures of socio-economic position and other covariates was investigated. Results Large inequalities in mortality by wealth were observed and their association with mortality remained more stable across the adult life course than inequalities by income-based measures. Men experienced greater inequalities across all ages (e.g. the RII for wealth was 2.58 [95% confidence interval (CI) 2.54–2.63) in men aged 55–64 years compared with 2.29 (95% CI 2.24–2.34) for women aged 55–64 years), except among the over 85s. Adjustment for covariates, including four other measures of socio-economic position, led to only modest reductions in the association between wealth and mortality. Conclusions Wealth is strongly associated with mortality throughout the adult life course, including early adulthood. Income redistribution may be insufficient to narrow health inequalities—addressing the increasingly unequal distribution of wealth in high-income countries should be considered.

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Clinical and epidemiological characteristics of chickenpox in the adult population at the present stage

Sanitarnyj vrač (Sanitary Inspector) ◽

10.33920/med-08-2004-02 ◽

2020 ◽

pp. 17-24

Author(s):

Ekaterina Peredelskaya ◽

Tatyana Safyanova ◽

Mikhail Druchanov

Keyword(s):

Health Care ◽

Adult Population ◽

Final Diagnosis ◽

Health Care Institution ◽

Federal State ◽

Economic Damage ◽

Clinical Hospital ◽

Care Institution ◽

High Level ◽

Epidemiological Characteristics

Chickenpox is an urgent problem, as it is widely spread with a high level of morbidity and an increasing share in the structure of the General infectious pathology with significant economic damage. The aim of the study is to study the epidemiological and clinical features of chickenpox in adults hospitalized in Krai government-owned publicy funded health care institution «City clinical hospital No. 5, Barnaul» for the period 2008‑2018. Content analysis included statistical reporting forms No. 2 of Federal state statistical supervision «Data on infectious and parasitic diseases» in the city of Barnaul during the period 2008‑2018 of medical archival documents adult infectious Department Krai government-owned publicy funded health care institution «City clinical hospital №5, Barnaul» for the same period. Data processing was performed using calculation of intensive and extensive indicators, calculation of the arithmetic mean (X) and standard error of the average (m). Calculations were made using the STATISTICA-10 program. Consistently high rates were recorded, with an average of 64.32 ± 3.46 per 100,000 population. The percentage of hospitalized adults averaged 18.5% during the study period. Adults aged 18‑30 were more likely to be admitted to the hospital (90.3%); 41.6% were students. Adults with moderate severity were hospitalized more often (70.6%); 7 patients (1.3%) had complications: aphthous stomatitis (3 cases), pustulosis (2 cases), and pneumonia (2 cases). Patients with severe severity of the disease accounted for 2.4%, the premorbid background was burdened in 48% (HIV infection, tuberculosis). In 35% of patients with severe severity, the final diagnosis of Herpes zoster was made, all patients older than 40 years, stayed in the hospital for 20‑25 days.

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Corona Virus (COVID-19) Awareness Assessment - A Survey Study Amongst the Indian Population

Journal of Clinical and Medical Research ◽

10.37191/mapsci-2582-4333-2(3)-041 ◽

2020 ◽

Author(s):

Gabriela Fernandes

Keyword(s):

Health Care ◽

Social Media ◽

Health Care Workers ◽

Indian Population ◽

Age Groups ◽

Survey Study ◽

Social Distancing ◽

Corona Virus ◽

Care Workers ◽

Amount Of Knowledge

Aim: The aim of this survey study was to assess the level of awareness amongst Indian population regarding the COVID-19. Method: A survey was conducted amongst 745 individuals to assess their level of awareness regarding COVID-19 and steps to be taken for its prevention. Result: The results revealed that a considerable percentage of individuals learned about the pandemic through social media and news and were aware of the mode of spread of the virus and also steps to be taken to prevent it from spreading. But considerable percentage of people was also not fully aware regarding the age groups this virus will be affecting. Conclusion: Upon understanding the percentage of people not aware about the age groups this virus will be affecting, keeping in mind good amount of knowledge amongst individuals about maintaining hygiene and social distancing, this survey would help the health care workers to create awareness regarding the effect of this virus on different age groups to help prevent carelessness amongst youth in following the regime.

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Children’s Understanding of Informed Assents in Research Studies

Healthcare ◽

10.3390/healthcare9070871 ◽

2021 ◽

Vol 9 (7) ◽

pp. 871

Author(s):

Hortense Cotrim ◽

Cristina Granja ◽

Ana Sofia Carvalho ◽

Carlos Cotrim ◽

Rui Martins

Keyword(s):

Health Care ◽

Positive Relationship ◽

Age Groups ◽

High Capacity ◽

Decision Making Process ◽

Objective Understanding ◽

Level Of Understanding ◽

Age And Sex ◽

Acceptance Of Health Care

The assent procedure reflects an effort to enable the minor to understand, to the degree they are capable of, what their participation in the decision making process would involve. Aims: To evaluate the minors’ ability to understand the information provided to them when obtaining assent and to evaluate the opinion of the parents regarding the importance of asking the child’s assent. Methods: The sample included a total of 52 minors aged between 10 and 17 years who underwent exercise echocardiogram. The Quality of Informed Consent is divided into two parts: Part A was used to measure objective understanding and part B to measure subjective understanding. Results: The results show that the minors have a high capacity to understand the information given to them when asking for assent. A positive relationship was found between the two parts of the questionnaire. No statistically significant relationship was found between age and sex and part A and part B or between both age groups (<14 years old and ≥14 years old) and the measure. In the case of the parents, 96.6% of parents consider assent as an advantage for the child’s acceptance of health care. The opinion of the parents is not related to the age, sex or level of schooling. Conclusion: Minors showed a substantial level of understanding regarding the information provided to them. The parents considered the implementation of assent fundamental to the child’s acceptance of health care.

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The economic burden of vertigo and dizziness in the United States

Journal of Vestibular Research ◽

10.3233/ves-201531 ◽

2020 ◽

pp. 1-10

Author(s):

Jeremy S. Ruthberg ◽

Chandruganesh Rasendran ◽

Armine Kocharyan ◽

Sarah E. Mowry ◽

Todd D. Otteson

Keyword(s):

United States ◽

Health Care ◽

Economic Burden ◽

Clinical Characteristics ◽

Care Service ◽

Adult Population ◽

Health Care Service ◽

The United States ◽

Medical Expenditures ◽

Limited Information

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p < 0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.

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Evolution of the prevalence of obesity in the adult population in France, 2013–2016: the Constances study

Scientific Reports ◽

10.1038/s41598-021-93432-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sébastien Czernichow ◽

Adeline Renuy ◽

Claire Rives-Lange ◽

Claire Carette ◽

Guillaume Airagnes ◽

...

Keyword(s):

Linear Trend ◽

Adult Population ◽

Age Groups ◽

French Population ◽

Obesity Prevalence ◽

Point Change ◽

Men And Women ◽

Class 1 ◽

Prevalence Of Obesity ◽

Age And Sex

AbstractThis study provides trends in obesity prevalence in adults from 2013 to 2016 in France. 63,582 men and women from independent samples upon inclusion from the Constances cohort were included. Anthropometrics were measured at Health Screening Centers and obesity defined as a Body mass index (BMI) ≥ 30 kg/m2; obesity classes according to BMI are as follows: class 1 [30–34.9]; class 2 [35–39.9]; class 3 [≥ 40 kg/m2]. Linear trends across obesity classes by sex and age groups were examined in regression models and percentage point change from 2013 to 2016 for each age category calculated. All analyses accounted for sample weights for non-response, age and sex-calibrated to the French population. Prevalence of obesity ranged from 14.2 to 15.2% and from 14 to 15.3% in women and men respectively from 2013 to 2016. Class 1 obesity category prevalence was the only one to increase significantly across survey years in both men and women (p for linear trend = 0.04 and 0.01 in women and men respectively). The only significant increase for obesity was observed in the age group 18–29 y in both women and men (+ 2.71% and + 3.26% point increase respectively, equivalent to an approximate rise of 50% in women and 93% in men, p = 0.03 and 0.02 respectively). After adjustment for survey non-response and for age and sex distribution, the results show that class 1 obesity prevalence has significantly increased in both women and men from 2013 to 2016, and only in young adults in a representative sample of the French population aged 18–69 years old.

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Analysing the impact of the COVID-19 outbreak on everyday travel behaviour in Germany and potential implications for future travel patterns

European Transport Research Review ◽

10.1186/s12544-021-00486-2 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Viktoriya Kolarova ◽

Christine Eisenmann ◽

Claudia Nobis ◽

Christian Winkler ◽

Barbara Lenz

Keyword(s):

Public Transport ◽

Online Survey ◽

Adult Population ◽

Activity Patterns ◽

Age Groups ◽

Travel Behaviour ◽

German Population ◽

Travel Patterns ◽

Home Office ◽

The Impact

Abstract Introduction The global Coronavirus (COVID-19) pandemic is having a great impact on all areas of the everyday life, including travel behaviour. Various measures that focus on restricting social contacts have been implemented in order to reduce the spread of the virus. Understanding how daily activities and travel behaviour change during such global crisis and the reasons behind is crucial for developing suitable strategies for similar future events and analysing potential mid- and long-term impacts. Methods In order to provide empirical insights into changes in travel behaviour during the first Coronavirus-related lockdown in 2020 for Germany, an online survey with a relative representative sample for the German population was conducted a week after the start of the nationwide contact ban. The data was analysed performing descriptive and inferential statistical analyses. Results and Discussion The results suggest in general an increase in car use and decrease in public transport use as well as more negative perception of public transport as a transport alternative during the pandemic. Regarding activity-related travel patterns, the findings show firstly, that the majority of people go less frequent shopping; simultaneously, an increase in online shopping can be seen and characteristics of this group were analysed. Secondly, half of the adult population still left their home for leisure or to run errands; young adults were more active than all other age groups. Thirdly, the majority of the working population still went to work; one out of four people worked in home-office. Lastly, potential implications for travel behaviour and activity patterns as well as policy measures are discussed.

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Sickness absence and disability pension after carpal tunnel syndrome diagnosis: A register-based study of patients and matched references in Sweden

Scandinavian Journal of Public Health ◽

10.1177/14034948211002729 ◽

2021 ◽

pp. 140349482110027

Author(s):

Tea Lallukka ◽

Rahman Shiri ◽

Kristina Alexanderson ◽

Jenni Ervasti ◽

Ellenor Mittendorfer-Rutz ◽

...

Keyword(s):

Health Care ◽

Carpal Tunnel Syndrome ◽

Sickness Absence ◽

Carpal Tunnel ◽

Disability Pension ◽

Negative Binomial ◽

Age Groups ◽

Negative Binomial Regression ◽

Sociodemographic Factors ◽

Tunnel Syndrome

Aims: The aim of this study was to examine sickness absence and disability pension (SA/DP) during working lifespan among individuals diagnosed with carpal tunnel syndrome (CTS) and their matched references, accounting for sociodemographic factors. Methods: We used a register cohort of 78,040 individuals aged 19–60 years when diagnosed with CTS in secondary health care (hospitals and outpatient specialist health care) and their 390,199 matched references from the general population in 2001–2010. Sociodemographic factors and SA/DP net days during a three-year follow-up were included. Negative binomial regression was used. Results: For those not on DP at inclusion, the average number of SA/DP days per person-year was 58 days (95% confidence interval (CI) 56–60 days) among individuals with CTS and 20 days (95% CI 19–21 days) among the matched references. Among both groups, these numbers increased with age and were higher among women than among men. The rate ratio (RR) of SA/DP days was threefold higher among people with CTS than among the matched references (adjusted RR=3.00, 95% CI 2.91–3.10) Moreover, compared to the matched references, the RR for SA/DP was higher among men with CTS (RR=3.86, 95% CI 3.61–4.13) than among women with CTS (RR=2.69, 95% CI 2.59–2.78). The association between CTS and the number of SA/DP days was smaller among older age groups. Sociodemographic factors were similarly associated with SA/DP among people with and without CTS. Conclusions: Numbers of SA/DP days were higher among people with CTS than their matched references in all age groups, particularly among individuals in their early work careers, highlighting public-health relevance of the findings.

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