• Title/Summary/Keyword: Social determinants of health

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What Explains Socioeconomic Inequality in Health-related Quality of Life in Iran? A Blinder-Oaxaca Decomposition

  • Rezaei, Satar;Hajizadeh, Mohammad;Salimi, Yahya;Moradi, Ghobad;Nouri, Bijan
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.219-226
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    • 2018
  • Objectives: This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran. Methods: This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups. Results: The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect. Conclusions: We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.

Relationship Between Perceived Risk and Physician Recommendation and Repeat Mammography in the Female Population in Tehran, Iran

  • Moshki, Mahdi;Taymoori, Parvaneh;Khodamoradi, Sahmireh;Roshani, Daem
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.161-166
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    • 2016
  • Iranian women are at high risk of low compliance with repeat mammography due to a lack of awareness about breast cancer, negative previous experiences, cultural beliefs, and no regular visits to a physician. Thus research is needed to explore factors associated with repeated mammography participation. Applying the concept of perceived risk as the guiding model, this study aimed to test the fit and strength of the relationship between perceived risk and physician recommendation in explaining repeat mammography. A total of 601 women, aged 50 years and older referred to mammography centers in region 6, were recruited via a convenience sampling method. Using path analysis, family history of breast cancer and other types of cancer were modeled as antecedent perceived risk, and physician recommendation and knowledge were modeled as an antecedent of the number of mammography visits. The model explained 49% of the variance in repeat mammography. The two factors of physician recommendation and breast self-examination had significant direct effects (P < 0.05) on repeat mammography. Perceived risk, knowledge, and family history of breast cancer had significant indirect effects on repeat mammography through physician recommendation. The results of this study provide a background for further research and interventions not only on Iranian women but also on similar cultural groups and immigrants who have been neglected to date in the mammography literature.

Development of a Smoking and Drinking Prevention Program for Adolescents using Intervention Mapping (Intervention Mapping 설계를 통한 중학생 대상 흡연음주예방 교육프로그램 개발)

  • Kye, Su-Yeon;Choi, Seul-Ki;Park, Kee-Ho
    • The Journal of Korean Society for School & Community Health Education
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    • v.12 no.3
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    • pp.1-15
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    • 2011
  • Objectives: We describe the development of a smoking and drinking prevention program for adolescents, using intervention mapping. Methods: The study sample consisted of 1,000 high school second-grade students from 6 high schools in Seoul. The PRECEDE model was applied for the needs assessment. We carried out a social diagnosis by assessing the factors such as the quality of life, happiness level, and satisfaction with school life; an epidemiological diagnosis on the perceived health status, stress levels, and priority of health issues; a behavioral diagnosis on the smoking and drinking rate and the intention to smoke and drink; and an educational diagnosis on knowledge, beliefs, attitudes, self-efficacy, outcome expectations, social norms and life skills. Results: The development process included a needs assessment, identifying factors that influence smoking and drinking among adolescents. Intention, knowledge, perceived norms, perceived benefit, perceived cost, perceived susceptibility, self-efficacy, and life skills were identified as determinants. Three performance objectives were formulated to describe what an individual needs to do in order to avoid smoking and drinking. Subsequently, we constructed an intervention matrix by crossing the performance objectives with the selected determinants. Each cell describes the learning objectives of the smoking and drinking prevention program. The program used methods from the transtheoretical model, such as consciousness raising, outcome expectations, self-reevaluation, self-liberation, counterconditioning, environmental reevaluation, and stimulus control. The program deals with the effects of smoking and drinking, self-improvement, decision making, understanding advertisements, communication skills, social relationships, and assertiveness. Conclusions: By using the process of intervention mapping, the program developer was able to ensure a systematical incorporation of empirical and new data and theories to guide the intervention design. Programs targeting other health-related behavior and other methods or strategies can also be developed using this intervention mapping process.

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Effects of social support on toothbrushing in children and adolescents (아동·청소년의 사회적 지지와 칫솔질 실천의 연관성)

  • Kwak, Seon-Hui;Jeong, A-Yeon;Bae, Soo-Myoung;Shin, Sun-Jung;Shin, Bo-Mi
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.1
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    • pp.105-116
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    • 2019
  • Objectives: This study aimed to confirm the relationship between toothbrushing practice after lunch and typical oral health behaviors in children and adolescents according to the subject and type of social support. Methods: The study used data from the 2010 Korean Survey on the Health of Youth and Children and selected 8,704 elementary, middle, and high school students as final targets. Multiple logistic regression was conducted to confirm the link between social support and toothbrushing after lunch. Results: The results showed that in elementary and vocational high school students, statistical significance of all social support variables disappeared after controlling for both demographic and social factors and oral symptom experience. However, in the middle school students, the emotional support of the neighbors and the emotional support of the teachers showed statistically significant effect on brushing daily after lunch (p<0.05). In general high school students, there was a significant association between family emotional support and toothbrushing after lunch (p<0.01). Conclusions: The oral health promotion program for children and adolescents needs to be integrated and coordinated with the overall health promotion program. In particular, it is believed that the school-based program can strengthen the practice of health behaviors by inducing behavioral changes based on the formation of healthy relationships and trust of colleagues and teachers. Therefore, it is necessary to develop social network-based programs including social support such as emotional health and healthy relationships that can be applied among children for oral health promotion.

Predicting Exercise Behavior in Female Workers: An Application of the Theory of Planned Behavior (계획된 행동이론을 적용한 사업장 여성근로자의 운동실천 차이 분석)

  • Bae, Sang-Soo;Lee, Hoon-Jae;Lee, Chang-Ok;Joe, Hee-Suk
    • Korean Journal of Health Education and Promotion
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    • v.20 no.1
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    • pp.173-186
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    • 2003
  • The objectives of this study were to verify the determinants of regular exercise behavior in female workers by applying a modified Theory of Planned Behavior. The variables investigated for this study were health status, health concern, health habit, attitude (7 items), subjective norm (3 items), and perceived behavioral control(5 items). Data was collected from 204 female workers using a self-administered questionnaire. The results of this study were as follows. 1) Regular exercise behavior was significantly influenced by perceived behavior control for time, pleasurable attitude, and the subjective norm of their colleagues. 2) A modified Theory of Planned Behavior is particularly useful in explaining exercise behavior of female workers. We suggest that health care providers should focus on not only attitude and social norms but also perceived behavioral control in order to improve the exercise behavior of female workers.

The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)

  • Foscolou, Alexandra;Tyrovolas, Stefanos;Soulis, George;Mariolis, Anargiros;Piscopo, Suzanne;Valacchi, Giuseppe;Anastasiou, Foteini;Lionis, Christos;Zeimbekis, Akis;Tur, Josep-Antoni;Bountziouka, Vassiliki;Tyrovola, Dimitra;Gotsis, Efthimios;Metallinos, George;Matalas, Antonia-Leda;Polychronopoulos, Evangelos;Sidossis, Labros;Panagiotakos, Demosthenes B.
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.1
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    • pp.1-9
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    • 2017
  • Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

Study on the Determinants of Life Satisfaction among the Elderly: An Integrative Approach (노인 생활만족도 결정요인에 대한 통합적 접근)

  • Kim, Myeong-Suk;Ko, Jong-Wook
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.246-259
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    • 2013
  • The purpose of this study was to investigate the differential effects of the determinants of life satisfaction among the elderly and a variety of health, economic, leasure activity, social support and psychological variables were comprehensively examined as determinants of life satisfaction among the elderly. The sample of this study was composed of 347 old people participating in the leasure activity programs operated by 10 facilities for the aged in Seoul. Data were collected using structured questionnaires and analyzed employing structural equation modelling technique as a main data analysis method. It was found that subjective health condition, subjective economic level, productive and consumptive leasure activities, spouse and children support, self-esteem and extraversion had positive effects on life satifaction among the elderly. The theoretical and practical implications of this study were discussed and the directions for future research were suggested.

Factors affecting the mental health status of children from multicultural families in South Korea: a cross-sectional descriptive analysis of data from the multicultural adolescents panel study

  • Choi, Sunyeob
    • Child Health Nursing Research
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    • v.29 no.1
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    • pp.60-71
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    • 2023
  • Purpose: This study aimed to identify factors affecting the mental health status of children from multicultural families in South Korea. Methods: This study was based on Dahlgren and Whitehead's (1991) rainbow model as a conceptual framework and used data from the second phase of the multicultural adolescents panel study conducted by the National Youth Policy Institute. Multiple logistic regression analysis was performed using SPSS version 26.0, with p<.05 considered to indicate statistical significance. Results: In the final model, stress (odds ratio [OR]=0.53, p<.001), life satisfaction (OR=2.09, p=.004), self-esteem (OR=1.73, p=.032), and peer support (OR=1.46, p=.019) affected the mental health status of children from multicultural families. The living and working conditions and general socioeconomic, cultural, and environmental conditions did not significantly influence the mental health status of children from multicultural families in the final model. Conclusion: As components of Dahlgren and Whitehead's model, individual hereditary and lifestyle factors, as well as social and community networks, affected the mental health status of children from multicultural families. Therefore, in order to improve the mental health of children from multicultural families, efforts are needed to alleviate their stress, increase life satisfaction and self-esteem, and strengthen their social support.

A Structural Model Development on the Cardiovascular Disease Risk Factors among Male Manufacturing Workers (제조업 남자 근로자의 심혈관질환 위험요인에 대한 모형 구축)

  • Choi, Eun-Sook
    • Research in Community and Public Health Nursing
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    • v.17 no.2
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    • pp.153-165
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    • 2006
  • Purpose: The purpose of this study was to develop and test a structural model on cardiovascular disease risk factors among male manufacturing workers. Methods: Data were collected through questionnaires and health exams from 201 workers in a local electronic company during September 2004. Data analysis was done with SAS 9.1 for descriptive statistics and PC-LISREL 8.54 for covariance structural analysis Results: The overall fit of the hypothetical model to the data was moderate, it was modified by deleting five paths. The modified model had a better fit to the data($x^2=504.23$(p<001, df: 180), $x^2/df=2.80$, GFI=.95, RMR=.07, NFI=.90, PGFI=.64). Health behaviors and psychosocial distress were found to have significant direct effects on the cardiovascular disease risk factors. Self-concept had direct effect on psychosocial distress or health behaviors. Self-concept, work environment, and work condition had direct effect on social support. Work environment had indirect effect on psychosocial distress. Social support had indirect effect on health behaviors. But work environment and work condition were found to have little direct effect on health behaviors, psychosocial distress or cardiovascular disease risk factors. Conclusion: A cardiovascular health promotion program should therefore include psycho-social factors as well as health behavioral determinants in worksites.

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