• Title/Summary/Keyword: health Inequalities

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Knowledge and Beliefs of Malaysian Adolescents Regarding Cancer

  • Al-Naggar, Redhwan Ahmed;Jillson, Irene Anne;Abu-Hamad, Samir;Mumford, William;Bobryshev, Yuri V.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1097-1103
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    • 2015
  • Background: Few studies have explored the knowledge and attitudes of adolescents toward cancer prevention and treatment. This lack of research and its potential utility in the development of new educational initiatives and screening methods, or the reconstruction of existing ones, provided the impetus for this study. The primary research aim was to assess secondary school student knowledge of cancer and determine whether or not they possessed basic knowledge of cancer symptoms, risk factors, and treatments and to determine the relationship between cancer knowledge and key demographic factors. Materials and Methods: The Management and Science University conducted a cross-sectional study analyzing responses through cross-tabulation with the socio-demographic data collected. Results: The findings of our quantitative analysis suggest that Malaysian youth generally possess a moderate knowledge about cancer. Quantitative analyses found that socioeconomic inequalities and bias in education present as important factors contributing to cancer awareness, prevention, and treatment among Malaysian adolescents. Conclusions: The findings indicate that Malaysian youth generally possess a moderate knowledge about cancer but the current deficiencies in initiatives directed to cancer awareness continue to hinder the improvement in prevention of cancer among Malaysian adolescents.

Differences in Breast and Cervical Cancer Screening Rates in Jordan among Women from Different Socioeconomic Strata: Analysis of the 2012 Population-Based Household Survey

  • Al Rifai, Rami;Nakamura, Keiko
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6697-6704
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    • 2015
  • Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

Priority Setting for the Healthy City Program in Busan Using the Analytic Hierarchy Process (계층 분석법을 적용한 부산시 건강도시 사업의 우선순위 설정)

  • Yoon, Tae-Ho;Choi, Min-Hyeok;Cheong, Kyu-Seok;Kim, Yun-Hee;Kim, Keon-Yeop;Jung, Baek-Geun
    • Korean Journal of Health Education and Promotion
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    • v.28 no.3
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    • pp.31-42
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    • 2011
  • Objectives: Busan had the highest mortality and the shortest life expectancy at birth among 16 provinces in Korea in 2008 and there were considerable health inequalities within the region. This study was performed to build up a priority setting framework in Healthy City Busan project. Methods: Analytic hierarchy process was used to determine the relative priority weight for different strategic and program dimensions along with the consistency of response. An on-site workshop-based meeting (calculating importance) and online survey (calculating risk) were conducted to obtain data from 8 experts. Results: The results showed that in strategic criteria "active health promotion & diseases prevention" and "building infrastructure for the Health City project" were two most important factors. In program criteria, considering both importance and risk scores, "making a healthy community" and "building community health centers" in disadvantaged areas were a top priority group. In addition, "enacting an ordinance for the Healthy City", "building the infrastructure for health impact assessment" and "making health care safety net for vulnerable population" were also higher priorities group. Conclusions: Our findings suggest that the Healthy City project in Busan should be focused on strengthening health equity and building infrastructure for sustainability of the project.

The Effects of Medical Expenditure on Income Inequality in Elderly and Non-Elderly Households by Income Class (소득계층별 노인과 비 노인가구의 의료비 지출이 소득불평등에 미치는 영향)

  • Lee, Yong-Jae
    • Journal of Digital Convergence
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    • v.16 no.10
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    • pp.49-57
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    • 2018
  • This study aims to identify the inequalities and characteristics of health care expenditure of the elderly and non-elderly households by income level. As a result, health care expenditure of elderly households was statistically significantly higher than that of non-elderly households. As a result of calculating the concentration index of health care expenditure by income level, inequality was higher in order of non-elderly households, elderly households, and total households. In order to confirm the effect of health expenditure on household income inequality, we calculated the concentration index of income excluding total health care expenditure from total income. As a result, inequality was higher in order of elderly households, whole households, and non-elderly households. There was not much difference in inequality of health care expenditure among elderly households and non-elderly households. And, the health care expenditure of elderly households was much higher than that of non-elderly households. Also, inequality of health care expenditure by income group was serious. There should be no cases where the medical care support policy for elderly households can not use necessary medical services.

Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010

  • Kia, Abdollah Almasian;Rezapour, Aziz;Khosravi, Ardeshir;Abarghouei, Vajiheh Afzali
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.3
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    • pp.201-209
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    • 2017
  • Objectives: The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality. Methods: Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children. Results: Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children's sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant. Conclusions: This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

Factors influencing unmet dental needs of preschool children: A study based on data of the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHNES) (제6기(2013-2015년) 국민건강영양조사를 활용한 미취학 아동의 미충족 치과의료에 영향을 미치는 요인)

  • Yeo, An-Na;Kang, Yu-Min;Lee, Su-Young
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.1
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    • pp.117-129
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    • 2019
  • Objectives: The purpose of this study was to investigate the influence of demographic characteristics and oral health status on unmet dental needs among preschool children and to provide a basis for improvement of the dental care equality and accessibility using data from the $6^{th}$ National Health and Nutrition Survey. Methods: This study was performed using data collected from the $6^{th}$ National Health and Nutrition Survey. The subjects were 1,472 out of 22,940 people, who participated in the survey and under went oral examination. IBM SPSS Statistics (Version 20.0) was used for statistical analyses based on the complex sampling design. Frequency analysis was performed to determine the distribution of unmet dental needs according to the characteristics of the subjects. The Rao-Scott ${\chi}^2$ test was performed to examine the relationship of unmet dental needs with general characteristics and health- and oral health-related variables. Relevant factors were determined using binary logistic regression analysis. Results: The factors that had statistically significant relations with unmet dental needs included age, medical insurance, household income, limited physical activity, history of dental caries in deciduous teeth, and subjective health status. Logistic regression analysis of complex samples was conducted to determine factors related to unmet dental needs. The results of analysis showed that limited physical activity and history of dental caries in deciduous teeth were related to unmet dental needs. Conclusions: The results show the factors affecting, and the reasons for, the unmet dental needs of preschool children. Future studies are needed to develop national projects and oral health education reforms to address inequalities in preschool children's dental care.

Inequality in Private Health Care Expenditures: A 36-Year Trend Study of Iranian Households

  • Aghapour, Ehsan;Basakha, Mehdi;Kamal, Seyed Hossein Mohaqeqi;Pourreza, Abolghasem
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.4
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    • pp.379-388
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    • 2022
  • Objectives: Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households. Methods: This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP. Results: Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively. Conclusions: In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

Moderating Effects of Media Exposure on Associations between Socioeconomic Position and Cancer Worry

  • Jung, Minsoo;Chan, Carina Ka Yee;Viswanath, Kasisomayajula
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5845-5851
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    • 2014
  • Reducing fear of cancer is significant in developing cancer screening interventions, but the levels of fear may vary depending on the degrees of media exposure as well as individuals' socioeconomic positions (SEP). However, few studies have examined how the SEP influences the fear of cancer under the moderating process of general and specific forms of media exposure. We investigated the moderating effect of media exposure on the relationship between SEP and the level of fear of cancer by assuming that cancer knowledge is a covariate between those two. In particular, this study examined how exposure to both general and specific media changes the series of processes from SEP to fear of cancer. We conducted path analyses with three types of media - television, radio and the Internet- using data from a health communication survey of 613 adults in Massachusetts in the United States. We found that SEP influences cancer knowledge directly and fear of cancer indirectly, as moderated by the level of media exposure. Health-specific exposure, however, had a more consistent effect than general media exposure in lowering the fear of cancer by increasing knowledge about cancer. A higher level of health-specific exposure and greater amount of cancer knowledge lessened the fear of cancer. In addition, the more people were exposed to health information on television and the Internet, the lower the level of fear of cancer as a result. These findings indicate a relationship between SEP and fear of cancer, as moderated by the level and type of media exposure. Furthermore, the findings suggest that for early detection or cancer prevention strategies, health communication approaches through mass media need to be considered.

Is Educational Level Linked to Unable to Work Due to Ill-health?

  • Jung, Jiyoun;Choi, Jaesung;Myong, Jun-Pyo;Kim, Hyoung-Ryoul;Kang, Mo-Yeol
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.159-164
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    • 2020
  • Background: This study aimed to examine the association between educational level and unable to work due to ill-health (UWdIH) among 30- to 79-year-old South Koreans. Methods: A cross-sectional nationwide survey of the 2010-2016 Korea National Health and Nutritional Evaluation Survey was used for analyses. A total of 29,930 participants aged ≥30 and < 80 years, who do not have any disability in their daily life because of health problems, were included. Educational level and reason for nonworking are self-reported with multiple choices. Multivariate logistic regression was used to examine an association between education level and UWdIH by setting those who graduated college as their final education (n = 6,997) as a baseline while controlling for potential confounding factors. Results: In the age-stratified result, the ratio of UWdIH was increased as age increases in 3 educational groups (p < .0001). There was a tendency that low-level educated [International Standard Classification of Education (0-2)] participants showed higher ratio of UWdIH than high-level educated [International Standard Classification of Education (5≤)] participants in both sexes (odds ratio: 2.54, 95% confidence interval: 2.12-3.05). Conclusion: There is a clear link between educational level and UWdIH; the less the educated, the more likely to be UWdIH. Policy priority should be given to plans that can help this vulnerable social group to work and enjoy healthy lives.

Factors Influencing Healthy Living Practice by Socio-ecological Model (사회생태학적 모형에 의한 건강 생활 실천 관련 요인)

  • Kim, Yoonjung;Park, Jung-Ha
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.4
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    • pp.351-361
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    • 2021
  • The purpose of this study is to provide basic data for resolving individual and regional health inequalities by identifying factors that affect healthy living practices, and to protect the access to health equity and the access to health equity and the people's right to health. Raw data from the 2019 Community Health Survey were used, and descriptive statistical analysis and multivariate logistic regression analysis were performed using SAS 9.4 and IBM SPSS ver. 21. The healthy living practice rate was 33.8% overall, and there was a difference of 11~20% by region. In terms of individual factors, healthy living practices were significantly different in gender, age, occupation, sleep time, subjective health status, and subjective stress level. In the interpersonal factor, there was a difference in social activity for healthy living practice, and in the community factor, positive attitude toward the local physical environment, annual unsatisfied medical care, and use of health institutions were significant. In order to increase the practice of healthy living by region based on the research results, comprehensive policies and cooperative measures that can be approached at the individual, social and national level should be implemented along with specific strategies.