Trends In Health Status Research Articles

Evolving trends, regional differences, determinants, and disease sources of provincial-level health inequalities in china 1990–2019: a temporal convergence and novel triple decomposition analysis

BackgroundPromoting health equity has been a worldwide goal, but serious challenges remain globally and within China. Multiple decomposition of the sources and determinants of health inequalities has significant implications for narrowing health inequalities and improve health equity.MethodsLife expectancy (LE), healthy life expectancy (HALE), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year (DALY) rates in 31 provinces of mainland China were selected as health status indicators, obtained from the Global Burden of Disease (GBD) database. Temporal convergence analysis was used to test the evolving trends of health status. Dagum’s Gini coefficient decomposition was used to decompose the overall Gini coefficient based on intraregional and interregional differences. Oaxaca-Blinder decomposition was used to calculate contributions of determinants to interregional differences. The factor-decomposed Gini coefficient was used to analyze the absolute and marginal contribution of each component to overall Gini coefficients.ResultsFrom 1990-2019, China witnessed notable improvements in health status measured by LE, HALE, ASMR and age-standardized DALY rates.Nevertheless, the three regions (East, Central and West) exhibited significant inter-regional differences in health status, with the differences between the East and West being the largest. The adjusted short-term conditional β-convergence model indicated that the inter-provincial differences in LE, HALE, ASMR, and age-standardized DALY rates significantly converged at annual rates of 0.31%, 0.35%, 0.19%, and 0.28% over 30 years. The overall Gini coefficients of LE, HALE, and age-standardized DALY rates decreased, while the ASMR exhibited an opposite trend. Inter-regional and intra-regional differences accounted for >70% and<30% of overall Gini coefficients, respectively. Attribution analysis showed that socioeconomic determinants explained 85.77% to 91.93% of the eastern-western differences between 2010-2019, followed by health system determinants explaining 7.79% to 11.61%. The source-analysis of Gini coefficients of ASMR and age-standardized DALY rates revealed that noncommunicable diseases (NCDs) made the largest and increasing absolute contribution, while communicable, maternal, neonatal, and nutritional diseases (CMNNDs) had a diminishing and lower impact. However, NCDs exerted a negative marginal effect on the Gini coefficient, whereas CMNNDs exhibited a positive marginal effect, indicating that controlling CMNNDs may be more effective in reducing health inequities.ConclusionsRegional differences are a major source of health inequities in China. Prioritizing prevention and control of CMNNDs, rather than NCDs, may yield more pronounced impacts on reducing health inequalities from the perspective of marginal effect, although NCDs remain the largest absolute contributor to health inequalities.

Health risk factors, status and service utilisation of adults in primary health care settings in Qatar: The HEALTHSIGHT study protocol.

The emergence of non-communicable diseases (NCDs) has been well documented in recent literature which constitute a significant global burden of disease. Qatar which has a significantly high prevalence of NCDs with early on set. Epidemiological and health service utilization information plays a central role in facilitating informed decision making and application of the fundamental principles of PHC in planning and delivery of healthcare with aim to prevent and control NCDs. To enable this, the Department of Clinical Research at Primary Health Care Corporation (PHCC), Qatar's publicly funded and largest primary care provider designed the Health Assessment Linking Trends in Health Status, Risks, and Healthcare Utilization (HEALTHSIGHT) study. This paper describes the HEALTHSIGHT study protocol. The proposed study will use a cross sectional study design involving a random sample of participants enrolled across all 31 PHCC health centers. Individuals aged 18 and above years old registered with PHCC and hold a valid health card and contact information on PHCC's electronic medical records (EMR) will be eligible for inclusion. A stratified random sample not proportional to size sampling technique will be employed to obtain a representative sample size of the PHCC population (N = 6000). Participants will be scheduled for an appointment at a PHCC health centre where a data collector will obtain informed consent, collect vital sign information and administer a questionnaire. A phlebotomist will collect a blood sample. Health service utilization data will be extracted from PHCC's EMR. Epidemiological and health service utilization information is essential to plan and monitor primary care and public health services. The HEALTHSIGHT study, with the help of a randomly selected representative sample from Qatar's primary healthcare settings, provides a unique opportunity to capture this information. This study design will closely represent a real-world understanding of the health risk, status and utilisation and is likely to provide important data to guide primary care planning and delivery in Qatar. The proposed protocol provides an example of a robust nationwide study that be undertaken in short duration using limited resource which can be undertaken in other similar settings.

The benefits of leisure activities on healthy life expectancy for older people with diabetes

PurposeThe purpose of this study is to examine whether leisure activities can help reduce years lived with disability and increase healthy life expectancy of diabetics aged 50 years and above.MethodsAnalysis was based on five waves of follow-up survey data (Taiwan Longitudinal Study of Aging, TLSA) from 1996 to 2011. A total of 5131 participants aged 50 years and above in 1996 were included in the analysis, and gender, leisure activity participation, and diabetes mellitus were used as primary variables to examine the variation trend in health status in the participants. The health status in the various waves of surveys was measured using the activities of daily living scale, and nondisabled was defined as healthy. A multivariate logistic regression model was used to calculate the life expectancy (LE) and healthy life expectancy (HLE) of the people aged 50 years and above.ResultsThe diabetes older people with a high frequency of leisure activities have longer HLE than those with lower activity frequency. Using 50-year-old diabetic women as an example, the LE (HLE) of those with six or more leisure activities and those with three or fewer leisure activities was 30.40 (25.34) and 24.90 (20.87), respectively. The LE (HLE) of men with the same conditions was 24.79 (22.68) and 20.30 (18.45), respectively.ConclusionsThis study used life expectancy and healthy life expectancy as markers to evaluate health benefits and provided evidence that leisure activities can help extend the life span and maintain the health status of middle-aged and older diabetics.

Unit health state prediction based on VMD-TCN

To address the problem that it is difficult to accurately predict the health status of hydropower units using real-time monitoring data, this paper proposes a method for predicting the health status trend of hydropower units based on variational modal decomposition (VMD) and time convolution network (TCN); considering the nonlinear factors of the trend series of hydropower unit vibration index, a time series prediction model based on VMD-TCN is established to achieve accurate prediction of unit health status. And multiple sets of comparison experiments are designed to verify the higher accuracy and faster time of the proposed model.

Evaluation of the Health Status of Indonesian Watersheds Using Impervious Surface Area as an Indicator.

Impervious surfaces affect the ecosystem function of watersheds. Therefore, the impervious surface area percentage (ISA%) in watersheds has been regarded as an important indicator for assessing the health status of watersheds. However, accurate and frequent estimation of ISA% from satellite data remains a challenge, especially at large scales (national, regional, or global). In this study, we first developed a method to estimate ISA% by combining daytime and nighttime satellite data. We then used the developed method to generate an annual ISA% distribution map from 2003 to 2021 for Indonesia. Third, we used these ISA% distribution maps to assess the health status of Indonesian watersheds according to Schueler's criteria. Accuracy assessment results show that the developed method performed well from low ISA% (rural) to high ISA% (urban) values, with a root mean square difference value of 0.52 km2, a mean absolute percentage difference value of 16.2%, and a bias of -0.08 km2. In addition, since the developed method uses only satellite data as input, it can be easily implemented in other regions with some modifications according to differences in light use efficiency and economic development in each region. We also found that 88% of Indonesian watersheds remain without impact in 2021, indicating that the health status of Indonesian watersheds is not a serious problem. Nevertheless, Indonesia's total ISA increased significantly from 3687.4 km2 in 2003 to 10,505.5 km2 in 2021, and most of the increased ISA was in rural areas. These results indicate that negative trends in health status in Indonesian watersheds may emerge in the future without proper watershed management.

Ten years' trend analysis for Taiwanese youth high school students’ health behaviors

To delineate the 10 years' trend regarding Taiwanese adolescents' health perspectives and compare the differences of six adolescent health aspects between Taiwan and the U.S. The anonymous structured questionnaire was done every other year with representative sampling methods as Youth Risk Behavior Surveillance System in the United States. Twenty-one questions from six health aspects were extracted for further analysis. Multivariate regression analysis was performed to delineate the relationship among protective factors and risk-taking behaviors, respectively. Overall, 22,419 adolescents were recruited. There were decreasing trend in terms of risk-taking behaviors, such as early contact to pornography (< age 16) (70.6%-60.9%), early cigarette use (< age 13) (20.7%-14.0%), and seriously considering suicide (36.0%-17.8%). There was an increasing trend in behaviors harmful to health: current alcohol drinkers (18.9%-23.4%), and staying up late every day (15.2%-18.5%). Multivariate regression analysis after adjusting gender and grade; it disclosed an increasing trend in protective assets, such as having multiple intimate friends (75.8%-79.3%), satisfaction to body weight and body shape (31.5%-36.1% and 34.5%-40.7%), as well as always wearing a helmet while riding a bike (1.8%-3.0%). We should continuously monitor the health status trend of the adolescents to provide them with a healthier environment and well-being.

A general pattern of health erosion in the United States? An examination of self-reported health status from 1997 – 2018

PurposeRecent research has found a general pattern of health erosion in self-assessed pain and allostatic load among adults in the United States (US). It remains to be determined if self-reported health status, hereafter SRH, also follows this pattern. The aim of this study was to examine whether a general pattern of health erosion is found in SRH among adults in the United States (US). MethodsData from the National Health Interview Survey 1997–2018 were used to study sex, educational attainment, and racial/ethnic patterns in SRH by age, period and cohort among adults in the US. The analytic sample consisted of respondents aged 18 years or older at the moment of interview with valid information in the age, sex, education, race/ethnicity and health status question (n = 669,501). Estimates for the percent population reporting poor/fair health were produced by age, period and cohort to study trends in health status by sex, educational attainment and race/ethnicity. All estimates were weighted to account for complex survey design. ResultsNo discernible pattern of health erosion, or improvement, is observed in the age, period or cohort analyses of the percent of the population reporting poor/fair SRH by sex, educational attainment or race/ethnicity. ConclusionsThe analysis indicates that self-reported health does not follows the general pattern of health erosion found in self-assessed pain and allostatic load in the US. The percent of the population reporting poor/fair health status has remained relatively stable between 1997 and 2018. Further research is required to determine whether self-reported health is an appropriate metric to track population health in the US.

Bring Your Own Device: A Practical Framework to Leverage in the Electronic Patient-reported Outcomes Data Collection in Clinical Trials

Patient-reported outcomes (PROs) are used in pharmaceutical trials to obtain trends in health status. Companies commonly provision tablet and smartphone devices to collect PRO information. Alternatively, the Bring Your Own Device (BYOD) model allows patients to leverage personal devices and is actively being explored as a solution.&amp;nbsp; This article investigates the potential benefits of BYOD and outlines a framework of considerations. The framework addresses current challenges and proposes potential solutions to Measurement Equivalence, Technical, and Operational concerns. BYOD has not yet been implemented on any studies for regulatory submission. Nonetheless, there is reason to believe the model will gain traction in the coming years. With the provided framework, sponsors can assess whether the BYOD model is right for the considered study.

Dutch Public health Foresight Study, in the light of COVID-19

BackgroundThe future consequences of the corona pandemic for health are significant but uncertain. The Dutch Public health Foresight Study-2020 (PHFS-2020) analyses future trends in health status, determinants, prevention and care, in the light of COVID-19. The pandemic impacts health directly through COVID-19 and indirectly through changes in lifestyle, reduced regular care and socio-economic developments.MethodsThe Dutch PHFS-2020 applies a scenario approach which explores short- and long-term trends and their possible effect on health and health care. A Trendscenario is used, in combination with three scenarios for the future course of the pandemic and socio-economic developments. Based on these scenarios, societal challenges for the future are identified.ResultsIn 2020, COVID-19 was the most important causes of death in 2020, life expectancy was almost a year lower and the disease burden of the first wave was almost five times higher than an average flu season. The increase in overweight and smoking will lead to more health loss in the future, including increased mortality. The negative impacts of reduced health care and mental health are already visible and might worsen in the future. The socio-economic and intergenerational divides might become more prominent.ConclusionsThe PHFS-2020 shows that indirect effects of the crisis might be taken into account when considering future policy interventions targeting COVID-19. Negative impacts on mental health, possible increase of health inequalities and the long term effects of changes in life style are important indirect effects to be considered by policy makers. Next, a further ageing population might increase the vulnerability for possible future outbreaks.Key messages The results of this study supports broader consideration of measures and to be better prepared in the future.Public Health foresight help to be better prepared for future possible developments.

Long‐term trends in health status and determinants of health among the off‐reserve Indigenous population in Canada, 1991–2012

The Indigenous population in Canada totals approximately 1.6 million individuals, representing about 5% of the total population. The off‐reserve Indigenous population represents the fastest growing segment of the Indigenous population, with over 50% living in urban settings. Despite the size of the off‐reserve population, research on the health of Indigenous peoples tends to remain focused on reserve‐based populations. The purpose of this paper is to contribute to a better understanding of health and social determinants of health among off‐reserve Indigenous peoples in Canada. Using data from the 1991 and 2012 Aboriginal Peoples Surveys this paper examines changes in health status and the social determinants of health over a 20‐year time span. Results show a decline in health care use and self‐reported health status in the period between 1991 and 2012. The results may be related to urbanization, aging, and increased prevalence of some chronic conditions. The findings may also be tied to barriers to achieving adequate off‐reserve health care—jurisdictional disputes, disjointed program coverage, systemic racism, and a lack of equity‐oriented health services. There remains a pressing need for Indigenous and non‐Indigenous governments, researchers, and policymakers to build new relationships that bridge these gaps in health and access to timely care.

Are younger cohorts in the USA and England ageing better?

Whether worldwide increases in life expectancy are accompanied by a better health status is still a debate. People age differently, and there is a need to disentangle whether healthy-ageing pathways can be shaped by cohort effects. This study aims to analyse trends in health status in two large nationally representative samples of older adults from England and the USA. The sample comprised 55684 participants from the first seven waves of the English Longitudinal Study of Ageing (ELSA), and the first 11 waves of the Health and Retirement Study (HRS). A common latent health score based on Bayesian multilevel item response theory was used. Two Bayesian mixed-effects multilevel models were used to assess cohort effects on health in ELSA and HRS separately, controlling for the effect of household wealth and educational attainment. Similar ageing trends were found in ELSA (β = -0.311; p < 0.001) and HRS (β = -0.393; p < 0.001). The level of education moderated the life-course effect on health in both ELSA (β = -0.082; p < 0.05) and HRS (β = -0.084; p < 0.05). A birth-year effect was found for those belonging to the highest quintiles of household wealth in both ELSA (β = 0.125; p < 0.001) and HRS (β = 0.170; p < 0.001). Health inequalities have increased in recent cohorts, with the wealthiest participants presenting a better health status in both the USA and English populations. Actions to promote health in the ageing population should consider the increasing inequality scenario, not only by applying highly effective interventions, but also by making them accessible to all members of society.

The unrealized potential: cohort effects and age-period-cohort analysis.

This study aims to provide a systematical introduction of age-period-cohort (APC) analysis to South Korean readers who are unfamiliar with this method (we provide an extended version of this study in Korean). As health data in South Korea has substantially accumulated, population-level studies that explore long-term trends of health status and health inequalities and identify macrosocial determinants of the trends are needed. Analyzing long-term trends requires to discern independent effects of age, period, and cohort using APC analysis. Most existing health and aging literature have used cross-sectional or short-term available panel data to identify age or period effects ignoring cohort effects. This under-use of APC analysis may be attributed to the identification (ID) problem caused by the perfect linear dependency across age, period, and cohort. This study explores recently developed three APC models to address the ID problem and adequately estimate the effects of A-P-C: intrinsic estimator-APC models for tabular age by period data; hierarchical cross-classified random effects models for repeated cross-sectional data; and hierarchical APC-growth curve models for accelerated longitudinal panel data. An analytic exemplar for each model was provided. APC analysis may contribute to identifying biological, historical, and socioeconomic determinants in long-term trends of health status and health inequalities as well as examining Korean’s aging trajectories and temporal trends of period and cohort effects. For designing effective health policies that improve Korean population’s health and reduce health inequalities, it is essential to understand independent effects of the three temporal factors by using the innovative APC models.

Perceptions on use of home telemonitoring in patients with long term conditions \u2013 concordance with the Health Information Technology Acceptance Model: a qualitative collective case study

BackgroundHealth information technology (HIT) may be used to improve care for increasing numbers of older people with long term conditions (LTCs) who make high demands on health and social care services. Despite its potential benefits for reducing disease exacerbations and hospitalisations, HIT home monitoring is not always accepted by patients. Using the Health Information Technology Acceptance Model (HITAM) this qualitative study examined the usefulness of the model for understanding acceptance of HIT in older people (≥60 years) participating in a RCT for older people with Chronic Obstructive Pulmonary Disease (COPD) and associated heart diseases (CHROMED).MethodsAn instrumental, collective case study design was used with qualitative interviews of patients in the intervention arm of CHROMED. These were conducted at two time points, one shortly after installation of equipment and again at the end of (or withdrawal from) the study. We used Framework Analysis to examine how well the HITAM accounted for the data.ResultsParticipants included 21 patients aged between 60–99 years and their partners or relatives where applicable. Additional concepts for the HITAM for older people included: concerns regarding health professional access and attachment; heightened illness anxiety and desire to avoid continuation of the ‘sick-role’. In the technology zone, HIT self-efficacy was associated with good organisational processes and informal support; while ease of use was connected to equipment design being suitable for older people. HIT perceived usefulness was related to establishing trends in health status, detecting early signs of infection and potential to self-manage. Due to limited feedback to users opportunities to self-manage were reduced.ConclusionsHITAM helped understand the likelihood that older people with LTCs would use HIT, but did not explain how this might result in improved self-management. In order to increase HIT acceptance among older people, equipment design and organisational factors need to be considered.Trial registrationClinicalTrials.gov Identifier: NCT01960907 October 9 2013 (retrospectively registered) Clinical tRials fOr elderly patients with MultiplE Disease (CHROMED). Start date October 2012, end date March 2016. Date of enrolment of the first participant was February 2013.

Exercise interventions for patients with pediatric cancer during inpatient acute care: A systematic review of literature

Physical inactivity has been shown to exacerbate negative side effects experienced by pediatric patients undergoing cancer therapy. Exercise interventions are being created in response. This review summarizes current exercise intervention data in the inpatient pediatric oncology setting. Two independent reviewers collected literature from three databases, and analyzed data following the PRISMA statement for systematic reviews and meta-analyses. Ten studies were included, representing 204 patients. Good adherence, positive trends in health status, and no adverse events were noted. Common strategies included individual, supervised, combination training with adaptability to meet fluctuating patient abilities. We recommend that general physical activity programming be offered to pediatric oncology inpatients.

The American Telemedicine Association ATA 2017 Telehealth 2.0 Conference Abstracts.

The American Telemedicine Association ATA 2017 Telehealth 2.0 Conference Abstracts.

Trends of Health Status and Medical Utilization Among Korean Baby Boomers: Analysis From Korean Health Panel Survey 2008-2014

Trends of Health Status and Medical Utilization Among Korean Baby Boomers: Analysis From Korean Health Panel Survey 2008-2014

Analysis of 10-Year Physical Health Trends amongMedical College Freshmen

Purpose: This study was aimed at exploring the trends of health status of medical college freshmen in 10 years (2005-2014), as a guide for improving the physical health conditions of University students.&#x0D; Methods: Freshman physical test data from 2005 to 2014 were collected, and their height, body mass index (BMI), lung capacity and long distance running times were analyzed.&#x0D; Results: Mean height of male students increased significantly from 172.08±5.56 cm in 2005 to 159.36±5.27 cm in 2014 (t=26.028,P&lt;0.001), while that of female students increased significantly from 175.11±5.50 cm in 2005 to 162.66±5.03 cm in 2014 (t=28.291,P&lt;0.001). BMI of male students increased significantly (t=6.224,P&lt;0.001) within the same period, in contrast to that of the female students (t=7.458,P&lt;0.001). In addition, mean BMI of male students were higher than that of female students (Z=29.760,P&lt;0.001). Lung capacity showed a decline for both groups (male: t=12.944,P&lt;0.001; female: t=29.489,P&lt;0.001). Long–distance running times increased (male: t=21.833,P&lt;0.001; female: t=18.717,P&lt;0.001). The percentage of overweight and obese male students was significantly higher than that in female students (male: 12.73%; female: 4.84%), and both showed increasing trends (male: Z=9.056,P&lt;0.001; female: Z=3.643,P&lt;0.001). Non-compliance of lung capacity with long-distance running time increased over the years (male: Z=12.892,P&lt;0.001; female: Z=19.148,P&lt;0.001; male: Z=14.596,P&lt;0.001; female: Z=8.209,P&lt;0.001).&#x0D; Conclusion: Height of college freshmen showed an upward trend, but their physical health condition showed a downtrend within the period of study.

Adjusting prospective old-age thresholds by health status: empirical findings and implications. A case study of Italy

While traditional measures of population ageing are bound to the concept of chronological age, new indicators have been proposed that take into account the dramatic changes that have occurred in later life due to increasing longevity. In this paper, we re-evaluate demographic ageing in Italy using prospective oldage thresholds based on both total remaining life expectancy and remaining life expectancy in good health. We show that the proportion of individuals above the prospective thresholds has been increasing much more slowly than the proportion of people aged 65 years and older, and that the increase in the proportion of individuals above the prospective thresholds adjusted for health status has been more or less large depending on trends in health status at older ages. Given these results and the ongoing improvements in health conditions among older people, we think the consequences of population ageing for Italian society could be less severe than expected.

Effects of air pollution and climatic factors on Norway spruce forests in the Orlické hory Mts. (Czech Republic), 1979–2014

The area of the Orlicke hory Mts. has been characterised by decline and disturbances of Norway spruce (Picea abies/L./Karst.) stands since the 1980s. Currently, only three permanent research plots have been preserved from the original sixteen established plots in this region. In the present study, the health status, as indicated by defoliation, mortality, and stem radial growth, was studied in the peaty and climax spruce ecosystems in the upper elevations of the mountains from 1979 to 2014. This health status was correlated with ambient air pollution (SO2) as well as climate factors (temperature and precipitation). The health status of individual trees on the plots was determined by evaluation of the foliage status, and tree vitality was evaluated by measuring stem radial growth increment. Stress factor analysis showed that high air pollutant concentrations predisposed Norway spruce to stress from climatic events (drought, temperature changes), leading to forest decline. The most serious damage can be attributed to the combination of chemical and climatic stress. Stands with lowered vitality were attacked by secondary biotic pests (particularly bark beetle), resulting in rapid tree mortality. The damage process is marked not only by higher mortality, but also by chlorosis and necrosis of the needles. The stabilised trend in health status of the spruce stands was registered since approximately 1990s. In terms of climatic factors, the weather in June had the most visible influence on radial increment. Low temperatures and high precipitation were the limiting factors for radial growth in studied mountain area.

Temporal trends in health status among adults in the Childhood Cancer Survivor Study (CCSS).

10020 Background: The impact of temporal changes in childhood cancer therapy on long-term health status has not been evaluated. With expansion of CCSS, information about health status is available ...