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Biomedical and Environmental Sciences 2023年第11期36卷 1059-1067页

作者： HAO Shuai ZHANG Xue Yan GAO Jiao WANG Yan YAN Ai Hui Department of Otolaryngology First Affiliated Hospital of China Medical UniversityShenyang I10001LiaoningChina

Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS.Discharged patients were followed up to 72 weeks for all-cause recurrence events.Baseline SES was established based on occupation,education level,and family income of the patients 1 year before the operation.Kaplan–Meier method was used to calculate the recovery rate after ESS,and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.Results Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES;24-week overall recovery rate was 90.4%[95%confidence interval(CI):89.6%–91.2%]in patients of middle SES,13.5%(95%CI:12.8%–14.2%)in patients of low SES,and 31.7%(95%CI:30.7%–32.7%)in patients of high SES(both log-rank P<0.001).After adjustment for covariates,hazard ratios(HRs)were7.69(95%CI:6.17–9.71,Ptrend<0.001)for all-cause recurrence for low SES versus middle SES,and 6.19(95%CI:4.78–7.93,Ptrend<0.001)for middle SES versus high SES.Conclusion Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.

关键词： Chronic rhinosinusitis Endoscopic sinus surgery socioeconomic status

Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank

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Infectious Diseases of Poverty 2023年第1期12卷 1-23页

作者： Xiangyu Ye Yidi Wang Yixin Zou Junlan Tu Weiming Tang Rongbin Yu Sheng Yang Peng Huang Department of Epidemiology Center for Global HealthSchool of Public HealthNanjing Medical UniversityNanjingChina Institute of Global Health and Infectious Diseases University of North CarolinaChapel HillCAUSA Department of Biostatistics Center for Global HealthSchool of Public HealthNanjing Medical UniversityNanjingChina

Background socioeconomic status(SES)inequity was recognized as a driver of some certain infectious diseases.However,few studies evaluated the association between SES and the burden of overall infections,and even fewer identified preventable mediators.This study aimed to assess the association between SES and overall infectious diseases burden,and the potential roles of factors including lifestyle,environmental pollution,chronic disease history.Methods We included 401,009 participants from the UK Biobank(UKB)and defined the infection status for each participant according to their diagnosis records.Latent class analysis(LCA)was used to define SES for each participant.We further defined healthy lifestyle score,environment pollution score(EPS)and four types of chronic comorbidities.We used multivariate logistic regression to test the associations between the four above covariates and infectious diseases.Then,we performed the mediation and interaction analysis to explain the relationships between SES and other variables on infectious diseases.Finally,we employed seven types of sensitivity analyses,including considering the Townsend deprivation index as an area level SES variable,repeating our main analysis for some individual or composite factors and in some subgroups,as well as in an external data from the US National Health and Nutrition Examination Survey,to verify the main results.Results In UKB,60,771(15.2%)participants were diagnosed with infectious diseases during follow-up.Lower SES[odds ratio(OR)=1.5570]were associated with higher risk of overall infections.Lifestyle score mediated 2.9%of effects from SES,which ranged from 2.9 to 4.0%in different infection subtypes,while cardiovascular disease(CVD)mediated a proportion of 6.2%with a range from 2.1 to 6.8%.In addition,SES showed significant negative interaction with lifestyle score(OR=0.8650)and a history of cancer(OR=0.9096),while a significant synergy interaction was observed between SES and EPS(OR=1.0024).In subgroup analysis,we found that males and African

关键词： socioeconomic status Infectious diseases Healthy lifestyle Environmental pollution Chronic comorbidities

Impact of socioeconomic status and Demographic Composition on Disaster Mortality: Community‑Level Analysis for the 2011 Tohoku Tsunami

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International Journal of Disaster Risk Science 2022年第6期13卷 913-924页

作者： Takeshi Miyazaki School of Economics Kyushu UniversityFukuoka 819-0395Japan

On 11 March 2011, the Tohoku tsunami hit the northeastern region of Japan, causing massive damage to people and property. The tsunami was bigger than any other in Japan’s recorded history, but the damage varied by community. This research addressed the effects of socioeconomic status and demographic composition on mortality in the 2011 Tohoku tsunami using community-level data.These effects were estimated using regression analysis, taking into account a variety of potential contributing aspects at the community level, including strength of the tsunami,population characteristics, gender, age, education, household composition, evacuation methods, and occupation. It was found that the height of the tsunami and the shares of threegeneration households and employees in the manufacturing industry are all positively correlated with tsunami mortality.The impacts of these factors on mortality are particularly large for the older adults.

关键词： 2011 Tohoku tsunami Community-level analysis Demographic composition Disaster risk reduction Mortality socioeconomic status

socioeconomic traits and the risk of Barrett’s esophagus and gastroesophageal reflux disease: A Mendelian randomization study

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2631-2645页

作者： Yu-Xin Liu Cheng-Li Bin Lu Zhang Wen-Tao Yang Bai-Ping An Department of Oncology Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina Department of Gynecology and Obstetrics Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina Department of Endocrine Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610072Sichuan ProvinceChina Department of Cardiovascular Chengdu Integrated TCM&Western Medicine HospitalChengdu 610041Sichuan ProvinceChina

BACKGROUND Previous observational studies have shown that the prevalence of gastroesophageal reflux disease(GERD)and Barrett’s esophagus(BE)is associated with socioeconomic status.However,due to the methodological limitations of traditional observational studies,it is challenging to definitively establish causality.AIM To explore the causal relationship between the prevalence of these conditions and socioeconomic status using Mendelian randomization(MR).METHODS We initially screened single nucleotide polymorphisms(SNPs)to serve as proxies for eight socioeconomic status phenotypes for univariate MR analysis.The inverse variance weighted(IVW)method was used as the primary analytical method to estimate the causal relationship between the eight socioeconomic status phenotypes and the risk of GERD and BE.We then collected combinations of SNPs as composite proxies for the eight socioeconomic phenotypes to perform multivariate MR(MVMR)analyses based on the IVW MVMR model.Furthermore,a two-step MR mediation analysis was used to examine the potential mediation of the associations by body mass index,major depressive disorder(MDD),smoking,alcohol consumption,and sleep duration.RESULTS The study identified three socioeconomic statuses that had a significant impact on GERD.These included household income[odds ratio(OR):0.46;95% confidence interval(95%CI):0.31-0.70],education attainment(OR:0.23;95%CI:0.18-0.29),and the Townsend Deprivation Index at recruitment(OR:1.57;95%CI:1.04-2.37).These factors were found to independently and predominantly influence the genetic causal effect of GERD.Furthermore,the mediating effect of educational attainment on GERD was found to be mediated by MDD(proportion mediated:10.83%).Similarly,the effect of educational attainment on BE was mediated by MDD(proportion mediated:10.58%)and the number of cigarettes smoked per day(proportion mediated:3.50%).Additionally,the mediating effect of household income on GERD was observed to be mediated by sleep duration(proportion mediated:9.75%)CONCLUSION This

关键词： socioeconomic status Gastroesophageal reflux disease Barrett’s esophagus Two-step Mendelian randomization Multivariate Mendelian randomization

Association and potential mediators between socioeconomic status and childhood obesity in China:findings from a national cohort study

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Global Health Journal 2023年第3期7卷 157-166页

作者： Haixia Zhou Liwang Gao Yang Wu Xiaozhong Wen Wen Peng Na Yan Alice Fang Yan Youfa Wang Global Health Institute School of Public HealthXi'an Jiaotong University Health Science CenterXi'anShaanxi 710061China Department of Non-Communicable Disease Management Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijing 100045China Department of Sociology Center for Asian&Pacific Economic&SocialDevelopmentResearch Institute for Female CultureJiangxi University of Finance and EconomicsNanchangJiangxi 330032China Division of Behavioral Medicine Department of PediatricsJacobs Schoolof Medicine and Biomedical SciencesState University of New York at BuffaloBuffaloNY 14214USA Nutrition and Health Promotion Center and Department of Public HealthMedical SchoolQinghai UniversityXiningQinghai 810061China Division of Research Patient Care Services Stanford Health CarePalo AltoCA 94305USA

Objective:socioeconomic status(SES)is associated with childhood obesity,but the underlying factors remain unknown.This study aimed to identify mediators that may explain SES disparities in childhood obesity in China.Methods:Nationally representative longitudinal data from the China Education Panel Survey of 11 o019 children(13.03±0.79)collected from 2013-2014 to 2016-2017 academic years.Overweight/obesity was defined using Chinese national body mass index cut-points.Principal component analysis was used to convert the four SES indicators(maternal and paternal education,and occupation)into one comprehensive variable.Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models.Results:The prevalence of overweight/obesity was 12.8%,and was higher in boys than in girls(17.8%vs.7.6%,Pstatus mediated 70.0%of the effects of SES on obesity.No mediation effect was detected in girls.Conclusions:Chinese boys are more likely to be overweight or obese than girls.SES may impact childhood obesity through birth weight,being the only child in the family and children's self-perceived body weight status in boys,but not in girls.More attention should be made to address childhood obesity in high SES families among boys.Interventions targeting at these mediators are needed.

关键词： Childhood obesity socioeconomic status Mediators Health disparities

Influence of socioeconomic status on acute myocardial infarction in the Chinese population： the INTERHEART China study

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Chinese Medical Journal 2012年第23期125卷 4214-4220页

作者： GUO Jin LI Wei WANG Yang CHEN Tao Koon Teo LIU Li-sheng Salim Yusuf Medical Research & Biometrics Center National Center for Cardiovascular Disease Fu Wai Hospital Peking Union Medical College & Chinese Academy of Medical Sciences Beijing 100037 China Population Health Research Institute McMaster University Hamilton Canada Beijing Hypertension League Institute Beijing 100039 China

Background Many researches report that low socioeconomic status （SES） is associated with a higher risk of coronary heart disease （CHD）. This study aimed to determine whether levels of education, family income, and other SES were associated with acute myocardial infarction （AMI） in the Chinese population, and to compare the difference in this association between northern and southern regions in China. Methods We conducted a case-control study. Cases were first AMI （n=2909）. Controls （n=2947） were randomly selected and frequency matched to cases on age and sex. SES was measured using education, family income, possessions in the household, and occupation. Results Low levels of education （8 years） were more common in cases compared to controls （53.4% and 44.1%; P=0,0001）. After adjusting all risk factors, the level of education was associated with AMI risk in the Chinese population （P=-0.0005）. The odds ratio （OR） associated with education of 8 years or less, compared with more than 12 years （trade school/college/university） was 1.33 （95% CI 1.12-1.59）, and for education of 9-12 years 1.04 （95% CI 0.88-1.33）. The proportion of higher income population was more in controls than cases （39.4% and 35.3%）. Number of possessions and non-professional occupation were only weakly or not at all independently related to AMI. The adjusted OR associated with the lower education was 2.38 （95% CI 1.67-3.39） in women, and 1.18 （95% CI 0.99-1.42） in men （P=0.0001, for heterogeneity）. The interaction between levels of education and different regions was significant （P=0.0206, for interaction）. Conclusion Several socioeconomic factors including levels of education and income were closely associated with increase of AMI risk in China, most markedly in northeast and southern area. The effect of education was stronger towards AMI in women than men.

关键词： socioeconomic status acute myocardial infarction education China population

How socioeconomic status affected the access to health facilities and malaria diagnosis in children under five years:findings from 19 sub-Saharan African countries

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Infectious Diseases of Poverty 2023年第2期12卷 127-127页

作者： Yue Ge Di Liang Jun Cao Roland Gosling Vivian Mushi Jiayan Huang School of Public Health Global Health Institute Fudan University Shanghai China Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology Jiangsu Institute of Parasitic Diseases Wuxi China Department of Disease Control London School of Hygiene and Tropical Medicine London UK Department of Parasitology and Medical Entomology Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

Background Prompt and appropriate clinical management of malaria is critical for reducing the continued high burden of malaria among children under five years in sub-Saharan countries.However,more remains to be known about how a patient’s socioeconomic status(SES)would affect the access to diagnosis of malaria.Methods In this cross-sectional study using the Demographic and Health Survey and Malaria Indicators Survey,we pooled the data of 38,567 febrile under-five children in 2016–2018 from 19 sub-Saharan countries.Multivariable logistic regression was used to assess the associations between SES and two binary outcomes:the visit to a health facility and a blood test for fever.Stratified analyses were further conducted by the type of health facilities(public hospitals/public primary healthcare facilities/private hospitals/private primary healthcare facilities)for the latter outcome.Results Fifty-eight percent of the febrile children were taken to health facilities,among whom only 55%took blood tests.Compared to children from households in the highest wealth quintile,children in the lowest quintile were less likely to be taken to medical facilities[adjusted odds ratio(aOR)=0.775,95%confidence interval(CI):0.675–0.889].Parents with more than secondary education were more likely to seek care(aOR=1.830,95%CI:1.561–2.145)and to have blood tests(aOR=1.729,95%CI:1.436–2.082)for their febrile children than parents without formal education.The probabilities of receiving blood tests at public hospitals and public primary healthcare facilities stayed relatively high across parental education levels and wealth quintiles,while these probabilities remained the lowest at private primary healthcare facilities,ranging from 0.100(95%CI:0.074–0.127)to 0.139(95%CI:0.083–0.194)across parental education levels and from 0.104(95%CI:0.078–0.130)to 0.125(95%CI:0.090–0.160)across wealth quintiles.Conclusions Significant socioeconomic disparities existed both in the access to health facilities and laboratory diagnosis of malaria in children

关键词： Malaria diagnosis Children under five years of age socioeconomic status Healthcare facility Sub-Saharan Africa

The Association of socioeconomic status with the Burden of Cataract-related Blindness and the Effect of Ultraviolet Radiation Exposure: An Ecological Study

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Biomedical and Environmental Sciences 2021年第2期34卷 101-109页

作者： DENG Yan YANG Dan YU Jia Ming XU Jing Xian HUA Hui CHEN Ren Tong WANG Nan OU Feng Rong LIU Ru Xi WU Bo LIU Yang Department of Environmental Health School of Public HealthChina Medical UniversityShenyang 110122LiaoningChina Department of Ophthalmology the Fourth Affiliated HospitalChina Medical UniversityShenyang 110032LiaoningChina Academic Affairs Office China Medical UniversityShenyang 110122LiaoningChina Department of Immunology and Rheumatology First HospitalChina Medical UniversityShenyang 110001LiaoningChina Department of Anal and Rectal Diseases First HospitalChina Medical UniversityShenyang 110001LiaoningChina

Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.

关键词： Cataract Blindness socioeconomic status Ultraviolet rays Global burden of disease

Association between socioeconomic status and chronic obstructive pulmonary disease in Jiangsu province, China: a population-based study

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Chinese Medical Journal 2021年第13期134卷 1552-1560页

作者： Dan-Dan Zhang Jian-Nan Liu Qing Ye Zi Chen Ling Wu Xue-Qing Peng Gan Lu Jin-Yi Zhou Ran Tao Zhen Ding Fei Xu Linfu Zhou Department of Respiratory and Critical Care Medicine The First Affiliated HospitalNanjing Medical UniversityNanjingJiangsu 210029China Chronic Airway Disease Research Office Department of Respiratory MedicineGeriatric Hospital of Nanjing Medical UniversityNanjingJiangsu 210024China Department of Respiratory Medicine Jiangsu Province Geriatric HospitalNanjingJiangsu 210024China Nanjing Municipal Center for Disease Control and Prevention NanjingJiangsu 210037China Department of Pharmacy Geriatric Hospital of Nanjing Medical UniversityNanjingJiangsu 210024China School of Public Health Nanjing Medical UniversityNanjingJiangsu 211166China Jiangsu Provincial Center for Disease Control and Prevention NanjingJiangsu 210009China

Background:Chronic obstructive pulmonary disease(COPD)is a common public health problem worldwide.Recent studies have reported that socioeconomic status(SES)is related to the incidence of COPD.This study aimed to investigate the association between SES and COPD among adults in Jiangsu province,China,and to determine the possible direct and indirect effects of SES on the morbidity of COPD.Methods:A cross-sectional study was conducted among adults aged 40 years and above between May and December of 2015 in Jiangsu province,China.Participants were selected using a multistage sampling approach.COPD,the outcome variable,was diagnosed by physicians based on spirometry,respiratory symptoms,and risk factors.Education,occupation,and monthly family average income(FAI)were used to separately indicate SES as the explanatory variable.Mixed-effects logistic regression models were introduced to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for examining the SES-COPD relationship.A pathway analysis was conducted to further explore the pulmonary function impairment of patients with different SES.Results:The mean age of the 2421 participants was 56.63±9.62 years.The prevalence of COPD was 11.8%(95%CI:10.5%–13.1%)among the overall sample population.After adjustment for age,gender,residence,outdoor and indoor air pollution,body weight status,cigarette smoking,and potential study area-level clustering effects,educational attainment was negatively associated with COPD prevalence in men;white collars were at lower risk(OR:0.60,95%CI:0.43–0.83)of experiencing COPD than blue collars;compared with those within the lower FAI subgroup,participants in the upper(OR:0.68,95%CI:0.49–0.97)tertiles were less likely to experience COPD.Such negative associations between all these three SES indicators and COPD were significant among men only.Education,FAI,and occupation had direct or indirect effects on pulmonary function including post-bronchodilator forced expiratory volume in 1 s/forced vital capacity(FEV1/FVC),FEV1,FVC,and FEV1 perce

关键词： socioeconomic status Family average income Smoking Air pollution Body mass index Chronic obstructive pulmonary disease

The correlation between socioeconomic status and health self-management in the elderly

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International Journal of Nursing Sciences 2014年第4期1卷 410-415页

作者： Chang-Xiang Chen Li-Na Feng Shu-Xing Li School of Nursing and Rehabilitation Hebei United UniversityTangshanHebeiChina

Purpose:To determine the correlation between socioeconomic status and health selfmanagement in the elderly and to provide a scientific basis for the promotion of healthy ageing.Methods:We recruited 6173 people aged60 years from three regions in Hebei Province using the multi-stage stratified cluster sampling method.The participants were surveyed using questionnaires.Results:The health self-management behaviours of elderly people differed with the area of residence,education level,and personal monthly income.An ordered probit model showed that behaviours were better in elderly people who lived in urban areas,who were educated to college level or higher,and with higher monthly incomes(psocioeconomic status plays a decisive role in health self-management in the elderly.We suggest appropriate measures for promoting health self-management among the elderly.

关键词： Elderly people Health self-management socioeconomic status