Social Class and Chronic Illness

1973 ◽  
Vol 3 (3) ◽  
pp. 357-368 ◽  
Author(s):  
Patrick W. Conover
Keyword(s):  
Socioeconomic Status ◽  
Chronic Disease ◽  
Chronic Illness ◽  
Social Class ◽  
Chronic Diseases ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Central Research ◽  
Income Category

This paper traces a three-stage history of theorization on the causal relationship between social class and chronic illness, focusing in particular on the contributions of Kadushin and Mechanic. Five areas of agreement between Kadushin and Mechanic are presented as a basis for further analysis: (1) the importance of data from the National Health Survey; (2) the necessity for controlling for age as an important variable; (3) the more severe measures of chronic diseases, as shown by criteria of activity limitation or work loss, are clearly class related, with the greatest magnitude of change between the lowest income category and the next highest category; (4) there are no data from other studies that can be counted as opposing the above evidence; (5) there is agreement that it is more likely that persons will accurately report more severe episodes of chronic illness than less severe episodes. Two central research questions are then addressed: What is the true shape of the relationship between socioeconomic status and chronic disease? What are the most reasonable of the possible causes of this relationship? Analysis of new material from the National Health Survey is presented in answer to these questions. The utility of these data for this purpose is defended. Certain relationships are noted: For whites and non-whites, with age adjusted or not adjusted, there is a strong relationship between income and measures of chronic disease. With a threefold division of the income category, the magnitude of the differences between income levels is large. These relationships hold over a wide range of specific chronic diseases. The conclusion is drawn that Kadushin's hypothesis of overreaction to illness by the lower classes is of little significance. More study is needed of the downwardly mobile effects of chronic illness. The effects of poor health and low socioeconomic status are presumed to be circular.

scholarly journals Association between number of medications used and nutritional markers among elderly persons with chronic diseases: National Health Survey (2013)

2019 ◽  
Vol 22 (1) ◽  
Author(s):  
Isabel Cristina Bento ◽  
Mary Anne Nascimento Souza ◽  
Sérgio Viana Peixoto
Keyword(s):  
Chronic Diseases ◽  
National Health ◽  
Health Survey ◽  
Fruits And Vegetables ◽  
Multinomial Logistic Regression ◽  
National Health Survey ◽  
Elderly Persons ◽  
Central Adiposity ◽  
Indicator Values ◽  
Sweet Foods

Abstract Objective: to evaluate the association between the number of medications taken and nutritional markers in Brazilian elderly persons diagnosed with chronic diseases. Method: study based on data from the National Health Survey (PNS) 2013, for the population aged 60 years or older who reported at least one chronic disease (hypertension, diabetes mellitus, heart disease, stroke, arthritis, depression, lung disease and chronic renal failure) (7,770 elderly persons). The outcome was the number of medications used for the selected diseases (0, 1 to 2 and 3 or more), and the exploratory variables were food consumption markers and anthropometric indicators (body mass index, waist circumference and waist-to-height ratio). The associations were evaluated by multinomial logistic regression, estimating the odds ratio and confidence intervals (95%) and considering potential confounding factors. Results: the use of a greater number of medications was positively associated with the consumption of fruits and vegetables, fish and milk, and negatively associated with the consumption of sweet foods, soft drinks and meat with excess fat; a greater consumption of medications was also associated with higher anthropometric indicator values. Conclusion: although a greater consumption of medications was associated with better dietary indicators, these elderly persons also had higher anthropometric indicator values, including a higher concentration of central adiposity.

scholarly journals Contribution of chronic diseases to the prevalence of disability in basic and instrumental activities of daily living in elderly Brazilians: the National Health Survey (2013)

2018 ◽  
Vol 34 (1) ◽  
Author(s):  
Antônio Macêdo Costa Filho ◽  
Juliana Vaz de Melo Mambrini ◽  
Deborah Carvalho Malta ◽  
Maria Fernanda Lima-Costa ◽  
Sérgio Viana Peixoto
Keyword(s):  
Chronic Diseases ◽  
National Health ◽  
Health Survey ◽  
Daily Living ◽  
The Elderly ◽  
National Health Survey ◽  
Activity Of Daily Living ◽  
Hazards Model ◽  
Basic Activity ◽  
Study Participants

Abstract: This study’s objective was to assess the contribution of selected chronic diseases to the prevalence of disability in elderly Brazilians, based on data from the National Health Survey (PNS 2013). Disability was defined as some degree of difficulty in performing ten activities, considering three levels: (i) without disability; (ii) disabled only in some instrumental activity of daily living (IADL); and (iii) disabled in some basic activity of daily living (BADL). The multinomial additive hazards model was the attribution method used to assess the contribution of each self-reported chronic condition (hypertension, diabetes, arthritis, stroke, depression, heart disease, and lung disease) to the prevalence of disability in this population, stratified by sex and age bracket (60 to 74 years and 75 or older). Study participants included 10,537 elderly Brazilians with a mean age of 70.0 years (SD = 7.9 years) and predominance of women (57.4%). Prevalence rates for disability in at least one IADL and at least one BADL were 14% (95%CI: 12.9; 15.1) and 14.9% (95%CI: 13.8; 16.1), respectively. In general, the contribution of chronic diseases to prevalence of disability was greater in younger elderly (60 to 74 years) and in the group with greatest severity (disabled in BADL), highlighting the relevance of stroke and arthritis in men, and arthritis, hypertension, and diabetes in women. This knowledge can help orient health services to target specific groups, considering age, sex, and current illnesses, aimed at preventing disability in the elderly.

Self-perceived health and psychological well-being among Serbian schoolchildren and adolescents: data from National Health Survey

Open Medicine ◽  
2011 ◽  
Vol 6 (4) ◽  
pp. 400-406 ◽  
Author(s):  
Aleksandra Jovic-Vranes ◽  
Janko Jankovic ◽  
Vladimir Vasic ◽  
Slavenka Jankovic
Keyword(s):  
Socioeconomic Status ◽  
National Health ◽  
Health Survey ◽  
Perceived Health ◽  
Well Being ◽  
Psychosocial Health ◽  
National Health Survey ◽  
Age Group ◽  
Psychological Well Being ◽  
Subjective Socioeconomic Status

AbstractThe purpose was to determinate possible factors associated with psychosocial health through self-perceived health and psychological well-being among Serbian schoolchildren and adolescents. A cross-sectional study. The study is based on the 2006 National Health Survey of the population of Serbia. A total of 2,721 schoolchildren and adolescents were included. Face-to-face questionnaire and self-administered questionnaire were used for collection of data. For the assessment of psychosocial health we created two indicators (varibles): Self perceived health (using the categorical principal components), and Psychological well-being (using reliability analisys). Data were analyzed using descriptive statistics, Pearson’s correlation coeficient and categorical regression. Self-perceived health was found to have a positive association with gender, age, objective and subjective socioeconomic status. Psychological well-being was associated with gender, age, social support, objective and subjective socioeconomic status. Age group was strongly associated with self-perceived health and psychological well-being. Older respondents and female perceived their health to be better than others. Male and respondents in age group 7–11 had higher levels of psychological well-being. Results show that both demographic and socioeconomic variables have an important influence on schoolchildren and adolescent self-perceived health and psychological well-being.

Anthropometric Cutoff Points for Predicting Chronic Diseases in the Mexican National Health Survey 2000

2003 ◽  
Vol 11 (3) ◽  
pp. 442-451 ◽  
Author(s):  
Claudia P. Sánchez-Castillo ◽  
Oscar Velázquez-Monroy ◽  
Arturo Berber ◽  
Agustín Lara-Esqueda ◽  
Roberto Tapia-Conyer ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Cutoff Points

Mental disorders and distress: Associations with demographics, remoteness and socioeconomic deprivation of area of residence across Australia

2015 ◽  
Vol 50 (12) ◽  
pp. 1169-1179 ◽  
Author(s):  
Joanne C Enticott ◽  
Graham N Meadows ◽  
Frances Shawyer ◽  
Brett Inder ◽  
Scott Patten
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Psychological Distress ◽  
Mental Disorders ◽  
National Health ◽  
Health Survey ◽  
National Survey ◽  
National Health Survey ◽  
Socioeconomic Disadvantage ◽  
Health And Wellbeing

Objectives: Australian policy-making needs better information on socio-geographical associations with needs for mental health care. We explored two national surveys for information on disparities in rates of mental disorders and psychological distress. Methods: Secondary data analysis using the 2011/2012 National Health Survey and 2007 National Survey of Mental Health and Wellbeing. Key data were the Kessler 10 scores in adults in the National Health Survey ( n = 12,332) and the National Survey of Mental Health and Wellbeing ( n = 6558) and interview-assessed disorder rates in the National Survey of Mental Health and Wellbeing. Estimation of prevalence of distress and disorders for sub-populations defined by geographic and socioeconomic status of area was followed by investigation of area effects adjusting for age and gender. Results: Overall, approximately one person in 10 reported recent psychological distress at high/very-high level, this finding varying more than twofold depending on socioeconomic status of area with 16.1%, 13.3%, 12.0%, 8.4% and 6.9% affected in the most to least disadvantaged quintiles, respectively, across Australia in 2011/2012. In the most disadvantaged quintile, the percentage (24.4%) with mental disorders was 50% higher than that in the least disadvantaged quintile (16.9%) in 2007, so this trend was less strong than for Kessler10 distress. Conclusion: These results suggest that disparities in mental health status in Australia based on socioeconomic characteristics of area are substantial and persisting. Whether considering 1-year mental disorders or 30-day psychological distress, these occur more commonly in areas with socioeconomic disadvantage. The association is stronger for Kessler10 scores suggesting that Kessler10 scores behaved more like a complex composite indicator of the presence of mental and subthreshold disorders, inadequate treatment and other responses to stressors linked to socioeconomic disadvantage. To reduce the observed disparities, what might be characterised as a ‘Whole of Government’ approach is needed, addressing elements of socioeconomic disadvantage and the demonstrable and significant inequities in treatment provision.

scholarly journals Mujeres cuidadoras familiares de personas con enfermedad crónica en Colombia

2016 ◽  
Vol 13 (1) ◽  
pp. 72 ◽  
Author(s):  
Lorena Chaparro-Díaz ◽  
Lucy Barrera-Ortiz ◽  
Elizabeth Vargas-Rosero ◽  
Sonia Patricia Carreño-Moreno
Keyword(s):  
Socioeconomic Status ◽  
Chronic Disease ◽  
Chronic Illness ◽  
Family Caregivers ◽  
Chronic Diseases ◽  
Cost Of Illness ◽  
Educational Level ◽  
Sociodemographic Characteristics ◽  
Socioeconomic Stratum ◽  
Age Range

Objetivo: describir las características socio demográficas y la sobrecarga en cuidadoras colombianas, y explorar la asociación existente entre la sobrecarga, con las variables de edad, escolaridad, estrato, tiempo como cuidadora y número de horas que cuida al día. Materiales y Métodos: estudio descriptivo y de asociación con 1.183 cuidadoras de las cinco regiones de Colombia. Se midieron las variables sociodemográficas y la  sobrecarga con el cuidado a partir de la aplicación de la Encuesta para la Caracterización del Cuidador Familiar de una Persona con Enfermedad Crónica y la Escala de Sobrecarga del Cuidador de Zarit. Resultados: el rango de edad de las cuidadoras que predomina está entre los 36 a 59 años, el nivel educativo es heterogéneo, la mitad de las cuidadoras se dedica al hogar como ocupación principal, religión predominante es católica. El 80 % cuida a la persona con enfermedad crónica desde el momento de su diagnóstico. Más de la mitad del grupo de participantes presentó ausencia de sobrecarga con el cuidado. La edad, el tiempo como cuidadora y el estrato socioeconómico, tienen una asociación estadísticamente significativa pero de magnitud débil con la sobrecarga de cuidado. No se encontró una asociación significativa entre la escolaridad de las cuidadoras. Conclusiones: se encontraron asociaciones de magnitud leve entre la edad, el estrato socioeconómico, el tiempo como cuidadora y la sobrecarga del cuidado; es vital consolidar un modelo que explique las variables que inciden en la sobrecarga de cuidadoras de personas con enfermedad crónica en el país.PALABRAS CLAVE: costo de enfermedad, cuidadores, enfermedad crónica, mujeres. Women, family caregivers of persons with chronic diseases in ColombiaABSTRACTObjective: to describe the sociodemographic characteristics and overload on Colombian female caregivers, and to explore the association between overload, with the variables of age, education, stratus, time as a caregiver and number of hours care per day. Materials and Methods: adescriptive study and association with 1183 caregivers from five regions of Colombia. Sociodemographic and care overload variables were measured  through the administration of the Encuesta para la Caracterización del Cuidador Familiar de una Persona con Enfermedad Crónica and  Escala de Sobrecarga del Cuidador de Zarit. Results: the age range of predominant caregivers is between 36 to 59 years, the educational level is heterogeneous, half of the caregivers is dedicated to the home as their main occupation, the predominant religion is Catholic. 80% care for the person with chronic illness from the time of diagnosis. More than half the group of participants presented absence of overload with care. Age, time as a caregiver and socioeconomic status, have a statistically significant but weak magnitude care overload association. No significant association between schooling of caregivers found. Conclusions: mild magnitude associations between age, socioeconomic stratum, time as a caregiver and care overload found, It is vital to consolidate a model that explains the variables that affect the overload of caregivers of persons with chronic diseases in the country.KEY WORDS: cost of illness, caregivers, chronic disease, women. Cuidadores familiares mulheres de pessoas com doenças crônicas na Colômbia RESUMOObjetivo: descrever as características sociodemográficas e sobrecarregar cuidadores colombianos, e explorar a associação entre a sobrecarga, com as variáveis idade, escolaridade, estrato, o tempo como um cuidador e do número de horas de cuidados por dia. Materiais e Métodos: estudo descritivo e de associação com os cuidadores 1183 uma das cinco regiões da Colômbia. variáveis sociodemográficas foram medidos e sobrecarga com cuidado a partir da aplicação do Encuesta para la Caracterización del Cuidador Familiar de una Persona con Enfermedad Crónica e do  Escala de Sobrecarga del Cuidador de Zarit. Resultados: a faixa etária dos cuidadores predomina é entre 36 a 59 anos, o nível educacional é heterogêneo, metade dos cuidadores é dedicado à casa como sua principal ocupação, religião predominante é a católica. 80% de cuidados para a pessoa com doença crónica a partir do momento do diagnóstico. Mais da metade do grupo de participantes apresentaram ausência de sobrecarga com cuidado. Idade, tempo como um cuidador e nível socioeconômico, têm uma associação estatisticamente significativa, porém fraca sobrecarga de cuidados de magnitude. Nenhuma associação significativa entre a escolaridade dos cuidadores encontrados. Conclusões: associações leves magnitude entre idade, nível socioeconômico, o tempo como uma sobrecarga do cuidador e cuidados encontrado; É vital para consolidar um modelo que explica as variáveis que afetam cuidadores sobrecarregar as pessoas com doença crônica no país. PALAVRAS-CHAVE: efeitos psicossociais da doença, cuidadores, doença crônica, as mulheres.  

scholarly journals Food diversity and consumption of ultra-processed food in the complementary feeding: National Health Survey, Brazil, 2013

2021 ◽  
Vol 10 (11) ◽  
pp. e10101119242
Author(s):  
Alessandra Silva Dias de Oliveira ◽  
Thais Santos Silva ◽  
Carolline Souza Tavares ◽  
Milena Miranda de Moraes ◽  
Flávia dos Santos Barbosa Brito ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
National Health ◽  
Health Survey ◽  
Complementary Feeding ◽  
National Health Survey ◽  
Demographic Variables ◽  
Processed Foods ◽  
Nutritional Adequacy ◽  
Food Diversity ◽  
Brazilian Children

Objective: To assess food diversity and absence of consumption of ultra-processed foods in complementary feeding of Brazilian children aged between six and 24 months according to socio-demographic variables. Methods: It is a cross-sectional study that analyzed data from the National Health Survey, 2013. The food diversity and ultra-processed foods consumption were evaluated separately and together. The joint analysis was measured by score, considering the consumption of each food group that constituting food diversity, as well as the absence by each of ultra-processed foods.  It was estimated prevalence, means score and confidence intervals (95%). Socio-demographic variables analyzed: gender, race, household situation, macro-regions and household conditions. Results: Of the 3701 eligible children, only 3.8% had nutritional adequacy (food diversity and absence of ultra-processed foods), 48.8 % had food diversity, and 15.7 % did not consume ultra-processed foods. Children with low socioeconomic status had a lower score on the nutritional adequacy and a lower prevalence of food diversity and a higher prevalence of ultra-processed foods consumption. Conclusions: A large portion of Brazilian children have low feeding diversity and consume ultra-processed foods, with inequalities related to the socioeconomic status and macro-region.  Public policies and health care actions must consider these differences to reduce the disparities.

scholarly journals Control of Glucose, Blood Pressure, and Cholesterol among Adults with Diabetes: The Brazilian National Health Survey

2021 ◽  
Vol 10 (15) ◽  
pp. 3428
Author(s):  
Rodrigo Citton P. dos Reis ◽  
Bruce B. Duncan ◽  
Célia Landmann Szwarcwald ◽  
Deborah Carvalho Malta ◽  
Maria Inês Schmidt
Keyword(s):  
Blood Pressure ◽  
National Health ◽  
Health Survey ◽  
Ldl Cholesterol ◽  
National Health Survey ◽  
Adherence To Treatment ◽  
Cvd Risk ◽  
Related Factors ◽  
Duration Of Diabetes ◽  
Basic Standards

ABC (glucose, blood pressure and LDL-cholesterol) goals are basic standards of diabetes care. We aimed to assess ABC control and related factors in a representative sample of Brazilian adults with diabetes. We analyzed 465 adults with known diabetes in the Brazilian National Health Survey. The targets used were <7% for glycated hemoglobin (A1C); <140/90 mmHg for blood pressure; and <100 mg/dL for LDL-C, with stricter targets for the latter two for those with high cardiovascular (CVD) risk. Individual goals were attained by 46% (95% CI, 40.3–51.6%) for A1C, 51.4% (95% CI, 45.7–57.1%) for blood pressure, and 40% (95% CI, 34.5–45.6%) for LDL-C. The achievement of all three goals was attained by 12.5% (95% CI, 8.9–16.2%). Those with high CVD risk attained blood pressure and LDL-C goals less frequently. A1C control improved with increasing age and worsened with greater duration of diabetes. Achievement of at least two ABC goals decreased with increasing BMI and greater duration of diabetes. In sum, about half of those with known diabetes achieved each ABC goal and only a small fraction achieved all three goals. Better access and adherence to treatment and strategies to personalize goals according to specific priorities are of the essence.

scholarly journals Physical Activity, Ability to Walk, Weight Status, and Multimorbidity Levels in Older Spanish People: The National Health Survey (2009–2017)

2020 ◽  
Vol 17 (12) ◽  
pp. 4333
Author(s):  
Pedro Ángel Latorre-Román ◽  
Juan Manuel Carmona-Torres ◽  
Ana Isabel Cobo-Cuenca ◽  
José Alberto Laredo-Aguilera
Keyword(s):  
Physical Activity ◽  
Health Status ◽  
Older People ◽  
National Health ◽  
Health Survey ◽  
Weight Status ◽  
Perceived Health ◽  
National Health Survey ◽  
Severe Difficulty ◽  
Chronic Health Problems

Background. Many studies have shown a relationship between physical functioning and health status in older people. Aim. The purpose of this study was to analyze the temporal trends of physical activity (PA), ability to walk, weight status, self-perceived health, and disease or chronic health problems in people over 65 years from 2009 to 2017, using the European Health Survey in Spain and the National Health Survey in Spain. Methods. This study included 13,049 older people: 6026 (2330 men and 3696 women; age (mean, SD (Standard Deviation)) = 75.61 ± 7.11 years old) in 2009 and 7023 (2850 men and 4173 women; age (mean, SD) = 76.01 ± 7.57 years old) in 2017. Results. In 2017, older people exhibited lower values of moderate PA (p < 0.001), a lower number of hours of walking per week (p < 0.001), and worse self-perceived health status (p < 0.001) compared to 2009. These differences are maintained when comparing the sexes. Compliance with PA recommendations was 27.9% and 6.1% (chi-squared = 352.991, p < 0.001) in 2009 and 2017, respectively. There were no significant differences in weight status between older people in 2009 and 2017. In 2017, older people had significantly high percentages of disease or chronic health problems (p < 0.05), number of diseases (p < 0.001), severe difficulty walking 500 m without assistance (p < 0.05), and severe difficulty going up or down 12 stairs. Conclusions. From 2009 to 2017, Spanish older people worsened their PA levels and perception of their health status, and they increased their disease levels, which could be associated with the worsening of ability to walk in 2017.

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