• Journal of Preventive Medicine and Public Health
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• 제54권3호
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• pp.190-198
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• 2021

Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

• Membrane and Water Treatment
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• 제9권4호
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• pp.273-278
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• 2018

Due to the lack of water in arid and semi-arid areas, reuse of wastewater can be a suitable way to compensate for water scarcity. Therefore, in this research, evaluation of the quality of wastewater of Kashan Treatment Plant to use for irrigation was studied. This descriptive cross-sectional study was conducted in 2016. pH, TSS, TDS, turbidity, COD, BOD5, Total Kjeldahl Nitrogen, Total Phosphorus, Total Coliform, fecal coliform, nematode eggs of inlet and outlet of wastewater treatment plant in Kashan were studied. Mean and standard deviation and wastewater quality parameters before and after treatment were tested with SPSS 22 (2014) software. The mean wastewater output of COD, BOD5, TSS, TDS and turbidity were respectively 86.6, 41.2, 11.11, 1095 mgL-1 and 17.5 NTU and the pH was equal to 7.22. Also, the average of Total Kjeldahl Nitrogen and phosphorus were 22.4 and 2.2 mgL-1 respectively. The mean of Total Coliform and fecal coliform were 225, 161 MPN / 100 ml respectively. In addition, no nematode eggs were found in final effluent. The results indicated that the treatment plants had a significant role in the control of microbial and organic pollution load of wastewater. Also, it is concluded that all parameters were in accordance with the standards of Iran's Department of Environment, so, it can be used for unrestricted irrigation.

• Child Health Nursing Research
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• 제13권1호
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• pp.13-20
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• 2007

Purpose: This investigation examined a model to predict body mass index in order to prevent later development of obesity among adolescents. The hypothesized model was developed based on the principle of Social Cognitive Theory that social influences predict perceptions of cognition as well as behavior. Method: The 5,770 adolescents, aged 14-18 who participated in this study came from 11 separate school districts in Busan and Kyungnam province of South Korea. The adolescent surveys were administered in a group setting at the participating school. Of the 5770 surveys, adolescents with more than 10 percent missing data in the entire survey were excluded. The final sample contained 4,527 cases. The adolescents were included 2,250 (49.7%) males and 2,277 (50.3%) females. Data was analyzed Pearson correlation coefficients using SPSS 12 program and structural equation model (SEM) using Maximum Likelihood estimation was employed using Amos 5.0. Results: Social support directly affects cognitive determinants. Cognitive determinants directly affect behavior determinants which directly affect BMI. Cognitive and behavioral factors mediated the relationship between social support and BMI (GFI= 0.984, CFI= 0.974, RMSEA=0.031). Conclusion: Social levels should be supportive to help adolescents have healthier behaviors. This support can be accomplished by providing frequent support to establish positive cognitive factors as the foundation of the solution to prevent overweight and obesity.

• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.303-310
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• 2017

Objectives: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. Methods: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. Results: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). Conclusions: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.

• 보건행정학회지
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• 제20권1호
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• pp.1-18
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• 2010

This article examines social determinants of population health in OECD countries, where life years, infant mortality, and PYLL are used as proxy variables of health. The unit of analysis is a country which is the OECD affiliate. A panel regression estimation is chosen as a method, using OECD Health Data. The results are: the increasing national health expenditure affected positively to improve population health. Education was rather a significant determinant of health than income level. The government direct investment for public health did not contribute positively to enhance population health. The expansion of health care coverage was working positively for improving health, but with a time lag. The supply of doctors was a most influential determinant of health. In case of Korea, the coverage expansion of health care was the most important determinant of health. The supply of doctors was, however, not a positive factor for better health, which is different result with the case of OECD countries.

• Journal of Preventive Medicine and Public Health
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• 제53권4호
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• pp.220-227
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• 2020

Objectives: The aim of this study was to assess how different social determinants of health (SDoH) may be related to variability in coronavirus disease 2019 (COVID-19) rates in cities and towns in Massachusetts (MA). Methods: Data about the total number of cases, tests, and rates of COVID-19 as of June 10, 2020 were obtained for cities and towns in MA. The data on COVID-19 were matched with data on various SDoH variables at the city and town level from the American Community Survey. These variables included information about income, poverty, employment, renting, and insurance coverage. We compared COVID-19 rates according to these SDoH variables. Results: There were clear gradients in the rates of COVID-19 according to SDoH variables. Communities with more poverty, lower income, lower insurance coverage, more unemployment, and a higher percentage of the workforce employed in essential services, including healthcare, had higher rates of COVID-19. Most of these differences were not accounted for by different rates of testing in these cities and towns. Conclusions: SDoH variables may explain some of the variability in the risk of COVID-19 across cities and towns in MA. Data about SDoH should be part of the standard surveillance for COVID-19. Efforts should be made to address social factors that may be putting communities at an elevated risk.

• Journal of Preventive Medicine and Public Health
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• 제54권1호
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• pp.1-7
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• 2021

The Korean government's strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.

• 보건교육건강증진학회지
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• 제26권1호
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• pp.63-80
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• 2009

Objectives: This study identified how personal characteristics, healthy behavior and social capital might influence on physical activity of adults. Methods: This study used data from the health survey of a city of Korea. We surveyed 1,000 adults sampled by stratified sampling methods from 67,889 households. Outcome variable was the stage of physical activity which was broken into 5 categories. Sociodemographic factors, healthy behavior, self-rated health status and social capital were used as control variables. Sociodemographic factors included age, sex, educational status, economic status measured by deprivation score, residential period within survey city. Social capital was measured by Integrated Questionnaire for the Measurement of Social Capital (SC-IQ). This study used chi-square test and ordered logistic regression models to examine the associations between independent variables and physical activity. Variables were added to the regression model in three groups using a hierarchical approach. Results: Physical activity was significantly more likely to become active if they have higher educational status, healthier behavior. Among the six dimensions of SC-IQ, only "groups and networks" that is structural dimensions of social capital and "trust and solidarity" that is cognitive dimensions of social capital were significantly related to physical activity of adults. We found that a person having higher density of membership and having larger size of networks showed the high possibility of active physical activity. A person having high solidarity was significantly associated with physical activity, but general trust was inversely related to physical activity. Output dimensions of social capital did not show significant relationship to physical activity. Conclusion: We found that social capital is useful concept to explain health behaviors like physical activity. However we must consider social, cultural and political context of the study to evaluate the effect of social capital to health status and health determinants and to capture the exact meaning of relationship between them. We suggest further researches to refine the concept of social capital and to explain the relationship of social capital to diverse health determinants.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5111-5116
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• 2013

Background: Early in the 21st century, cancers are the second cause of death worldwide. Colon cancer is third most common cancer and one of the few amenable to early diagnosis and treatment. Evaluation of factors affecting this cancer is important to increase survival time. Some of these factors affecting all diseases including cancer are social determinants of health. According to the importance of this disease and relation with these factors, this study was conducted to assess the relationship between social determinants of health and colon cancer survival. Materials and Methods: This was a cross-sectional, descriptive study for patients with colon cancer registered in the Cancer Research Center of Shahid Beheshti University of Medical Science, from April 2005 to November 2006, performed using questionnaires filled by telephone interview with patients (if patients had died, with family members). Data was analyzed with SPSS software (version 19) for descriptive analysis and STATA software for survival analysis including log rank test and three step Cox Proportional Hazard regression. Results: Five hundred fifty nine patients with ages ranging from 23 to 88 years with mean${\pm}$standard deviation of $63{\pm}11.8$ years were included in the study. The five year survival was 68.3%( 387 patients were alive and 172 patients were dead by the end of the study). The Cox proportional hazard regression showed 5-year survival was related to age (HR=0.53, p=0.042 for>50 years versus<50 years old) in first step, gender (HR=0.60, p=0.006 for female versus male) in second step, job (HR=1.7, p=0.001 for manual versus non manual jobs), region of residency (HR=3.49, p=0.018 for west versus south regions), parents in childhood (HR=2.87, p=0.012 for having both parents versus not having), anatomical cancer location (HR=2.16, p<0.033 for colon versus rectal cancer) and complete treatment (HR=5.96, p<0.001 for incomplete versus complete treatment). Conclusions: Social determinants of health such as job, city region residency and having parents during childhood have significant effects in 5-year survival of colon cancer and it may be better to consider these factors in addition to developing cancer treatment and to focus on these determinants of health in long-time planning.

• 지역사회간호학회지
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• 제32권4호
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• pp.430-444
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• 2021

Purpose: This study is an integrated literature review to analyze health problems and social determinants of multicultural adolescents in South Korea. Methods: An integrative review was conducted according to Whittemore & Knafl's guideline. An electronic search that included publications from 2018 to 2020 in the PubMed, EMBASE, Cochrane Library, CINAHL, RISS, and KISS databases was conducted. Of a total of 67 records that were identified, 13 finally met full inclusion criteria. Text network analysis was also conducted to identify keywords network trends using NetMiner program. Results: The health problems of multicultural adolescents were classified into mental health (depression, anxiety, suicide and acculturative stress) and health risk behaviors (smoking, risky drinking, smartphone dependence and sexual behavior). As social determinants affecting the health of multicultural adolescents, the biological factors such as gender, age, and visible minority, and the psychological factors such as acculturative stress, self-esteem, family support, and ego-resiliency were identified. The sociocultural factors were identified as family economic status, residential area, parental education level, and parents' country of birth. As a result of text network analysis, a total of 41 words were identified. Conclusion: Based on these results, mental health and health risk behaviors should be considered as interventions for health promotion of multicultural adolescents. Our findings suggest that further research should be conducted to broaden the scope of health determinants to account for the effects of the physical environment and health care system.