• 제목/요약/키워드: Health Disparity

검색결과 139건 처리시간 0.028초

Epidemiological Pattern of Breast Cancer in Iranian Women: Is there an Ethnic Disparity?

  • Taheri, Neger Sadat;Nosrat, Sepideh Bakhshandeh;Aarabi, Mohsen;Tabiei, Mohammad Naeimi;Kashani, Elham;Rajaei, Siamak;Besharat, Sima;Semnani, Shahryar;Roshandel, Gholamreza
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4517-4520
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    • 2012
  • Introduction: Northeastern Iran is known as a high risk area of upper gastrointestinal cancers. Recent reports have suggested a declining trend for these cancers as well as an increase in the incidence of other malignancies including breast cancer. Our present aim was to describe the epidemiological pattern of breast cancer in this region during 2004-2009. Methods: All new cancer cases from public and private diagnostic and therapeutic centers of Golestan province were registered. A structured questionnaire was prepared and used based on the standerds of the International Association of Cancer Registries. The international classification of diseases for oncology was considered for coding. Age standardized incidence rates (ASR) of breast cancer were calculated. Results: A total of 11,038 new cancer cases were registered during 2004-2009, of which, 1,101 (10%) were females with breast cancer. The median age of the breast cancer patients was 46 years. The ASR for breast cancer was 28 per 100,000 person-years. We found an unusual rapid increase in breast cancer rate at the age of 25 years. The ASR of breast cancer was significantly lower in females from Turkmen ethnicity and those from rural areas(P value <0.01). Conclusion: Our study showed high rate of breast cancer in Golestan province of Iran. We found an unusual peak of breast cancer in young women. So, the age of starting screening programs may need to be revised in this area. The rate of breast cancer was significantly lower in women from Turkmen ethnicity. Further studies are warranted to clarify the role of important determinants, especially regarding the ethnic disparity, on breast cancer in this region.

Low Coverage and Disparities of Breast and Cervical Cancer Screening in Thai Women: Analysis of National Representative Household Surveys

  • Mukem, Suwanna;Meng, Qingyue;Sriplung, Hutcha;Tangcharoensathien, Viroj
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8541-8551
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    • 2016
  • Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

학령전기 아동의 건강/질병 개념에 관한 연구 (A Study on Health / Illness Concepts of Preschoolers)

  • 이은주
    • 대한간호학회지
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    • 제22권2호
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    • pp.143-156
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    • 1992
  • This descriptive study explored the health and illness concepts of preschoolers to provide understanding on which to build research. The subjects were convenience sample three to six year of age attending one art institute in Cheju city. Data were collected through semistructured interviews by author, Children were asked to draw two figures, one healthy and one ill persons. The drawings were not analysed to grasp the meaning as in a projective technique, but only to relate to their response. Data were coded and categorized by content analysis. The results of this study are summarized as follows : 1) Three year olds responded with some unrelated answers but well to questions related to their experiences of illness ; older participants answered questions related health and illness concepts more easily. Generally the levels of subjects' responses did not differ according to age and sex. 2) Preschoolers' answers about the cause, treatment and prevention of illness, and the meaning and promotion of health were coded and then classificated to 9 categories, (food, obedience to authoritys physical function, presence or absence of illness or symptoms, hygiene. treatment, traumatic injury, rest and germs). Food and obeidence to authority categories were most frequent responses the food category was associated with obeidence to authority because it seemed that the children follow the orders of their parents or other authority figures to eat or not to eat something This result was compatible with that of previous studies that preschoolers perceived illness as possible punishment for misbehavior. Participants except for one four year old boy did not suggest that germs cause illness. The children perceived themselves and their families as healthy even though they had symptoms of illness. 3) Preschoolers' health and illness concepts were. influenced by their experiences and related to their development that rules derived from authority and if not complied with, will bring punishment. These oonceptualizations may be the disparity that they perceived themselves and their families as healthy even though they were ill. A previous study by Perrin and Gerrity suggested that the level of children's illness concepts correlated with that of their physical causality and was lower than it. But the levels of health and illness concepts in this sample higher than those of the physical causality.

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How to Improve Influenza Vaccination Rates in the U.S.

  • Yoo, Byung-Kwang
    • Journal of Preventive Medicine and Public Health
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    • 제44권4호
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    • pp.141-148
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    • 2011
  • Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities. This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

정부의 코로나19 대응능력에 대한 신뢰도가 지역별 발생과 사망률에 미치는 영향 (Effect of Trust in Government's Ability to Respond to COVID-19 on Regional Incidence and Mortality in Korea)

  • 최하영;김진현
    • 보건행정학회지
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    • 제33권1호
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    • pp.65-74
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    • 2023
  • Background: The government should find ways to improve the effectiveness of the policies to control the incidence and mortality of the infectious disease. The purpose of this study is to find out whether the trust in the government's ability to respond to coronavirus disease 2019 (COVID-19) affects the quarantine and hospitalization rate, incidence and mortality rates of COVID-19 and quarantine rules compliance in each region of Korea. Methods: The subject of this study is 250 regions (si·gun·gu) in Korea, and the 2020 Community Health Survey data from the Korea Disease Control and Prevention Agency (KDCA) was used for the trust in the government's ability to respond to COVID-19, quarantine and hospitalization rate and quarantine rules compliance. For the incidence and mortality of COVID-19 and community factors, data was obtained from KDCA and Korean Statistical Information Service. Path analysis was used to find out the degree of inter-variable influence, and community factors (socio-demographic factors, community health factors, and health behavior factors) were used as control variables. Results: The regional disparity in key variables showed that the late pandemic period cumulative incidence and mortality of COVID-19 were large, while the early pandemic period quarantine and hospitalization rate and quarantine rules compliance were small. Path analysis showed that when community factors were controlled, the trust in government was statistically significant in all of the late pandemic period cumulative incidence (p=0.024) and mortality (p=0.017), and quarantine rules compliance (p=0.011). Conclusion: This study revealed that the higher the trust in the government's ability to respond to COVID-19, the lower the COVID-19 mortality and the higher the quarantine rules compliance at the regional level in Korea. This suggests that when the government implements healthcare policies to control infectious diseases, it is necessary to consider trust to improve policy compliance and control the mortality of the disease and maintain high trust through several effective methods.

코로나 전후 보험유형에 따른 서울 지역 병원밖 급성심정지 환자의 결과 비교 (Comparing the outcomes of out-of-hospital cardiac arrest between national health insurance and medical aid in Seoul before and during COVID-19 pandemic)

  • 이경열
    • 한국응급구조학회지
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    • 제27권3호
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    • pp.7-16
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    • 2023
  • Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

작업장 특성에 따른 톨루엔 노출 근로자의 마뇨산 배출 특성 (A Specific Character on the Urinary Hippuric Acid Excretions of Workers Exposed to Toluene in Specific Character of Manufacturing Industry)

  • 박흥재;김형준;정성욱;이병호
    • 한국환경과학회지
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    • 제14권2호
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    • pp.201-207
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    • 2005
  • This study was carried out to investigate the correlation between toluene in air and hippuric acid in human urine, which is based in the results of the health check-in and measure of working environment, was investigated for five years. Toluene in air and hippuric acid in urine were checked 116 workers who exposed to toluene in five type of industry. The Mean concentration of toluene in air by type of industry and every year and sex distinction, had positive correlation.(p<0.01) The Mean concentration of hippuric acid in urine by type of industry, every year, sex distinction, disparity of age and term of duty had positive correlation.(p<0.01).

Modeling of an embedded carbon nanotube based composite strain sensor

  • Boehle, M.;Pianca, P.;Lafdi, K.;Chinesta, F.
    • Advances in aircraft and spacecraft science
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    • 제2권3호
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    • pp.263-273
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    • 2015
  • Carbon nanotube strain sensors, or so called "fuzzy fiber" sensors have not yet been studied sufficiently. These sensors are composed of a bundle of fiberglass fibers coated with CNT through a thermal chemical vapor deposition process. The characteristics of these fuzzy fiber sensors differ from a conventional nanocomposite in that the CNTs are anchored to a substrate fiber and the CNTs have a preferential orientation due to this bonding to the substrate fiber. A numerical model was constructed to predict the strain response of a composite with embedded fuzzy fiber sensors in order to compare result with the experimental results obtained in an earlier study. A comparison of the numerical and experimental responses was conducted based on this work. The longitudinal sensor output from the model matches nearly perfectly with the experimental results. The transverse and off-axis tests follow the correct trends; however the magnitude of the output does not match well with the experimental data. An explanation of the disparity is proposed based on microstructural interactions between individual nanotubes within the sensor.

Regional Differences in Access to Clinical Trials for Cancer in Korea

  • Kim, Woorim;Jang, Seongkyeong;Chang, Yoon Jung
    • 한국의료질향상학회지
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    • 제27권1호
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    • pp.20-25
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    • 2021
  • Purpose: The ability to access clinical trials for cancer treatment is important. This study investigated whether regional differences exist in oncologic clinical trial protocols conducted in South Korea. Methods: Records of all approved oncologic clinical trials conducted in 2019 were downloaded from the Republic of Korea Ministry of Food and Drug Safety. The study covered Seoul, the capital area, other metropolitan cities, and provincial areas. Descriptive statistics summarized the distribution patterns of clinical trials by region. Results: A total of 202 oncologic clinical trials were conducted in 63 institutions in 2019. Of these protocols, 186 (92%) were available in Seoul, 120 (59%) in the capital area, 64 (32%) in metropolitan cities, and 66 (33%) in provincial areas. More regional differences in protocol availability were observed in domestic trials, investigator-initiated trials, phase 1 and 2 trials, and smaller-scale trials. Conclusion: Most oncologic clinical trials were conducted in medical institutions located in Seoul, with the rest conducted in the capital area, metropolitan cities, and provincial areas. The findings reveal clear differences in protocol availability between Seoul and the other regions. Measures designed to improve geographical access to oncologic clinical trials may be needed given their growing importance in cancer treatment.

Analysis of Differences in Preterm Birth Rates According to Household Occupation in Japan From 2007 to 2019

  • Okui, Tasuku;Nakashima, Naoki
    • Journal of Preventive Medicine and Public Health
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    • 제55권4호
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    • pp.371-378
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    • 2022
  • Objectives: No studies have examined the association between preterm birth rates and socioeconomic factors in Japan using nationwide statistical data. We analyzed the association between preterm birth rates and household occupation using Vital Statistics data. Methods: Aggregated Vital Statistics data from Japan from 2007 to 2019 were obtained from the Ministry of Health, Labour and Welfare. From the data, the number of births according to year, age group, gestational period, number of pregnancies, and household occupation were used in this study. Crude preterm birth rates and preterm birth rates adjusted by maternal age according to household occupation were calculated for each year. Poisson regression analysis was conducted to evaluate the association between household occupation and preterm births. Results: Unemployed households had the highest preterm birth rate, and households with an occupation classification of "full-time worker 2" (an employee at a large company, civil servant, or board member) had the lowest preterm birth rate throughout each period. Poisson regression analysis revealed that unemployed households were statistically significantly associated with a high preterm birth risk. In contrast, the preterm birth rate adjusted by maternal age remained stable throughout each period regardless of household occupation, and preterm birth rates were found not to have increased in recent years in Japan. Conclusions: Unemployed households had higher preterm birth rates than other household occupations. Further studies investigating the characteristics of unemployed households are needed to identify the reasons for this disparity.