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社会决定因素与慢性病存在之间的关联:来自骨关节炎倡议的数据。

Associations between social determinants and the presence of chronic diseases: data from the osteoarthritis Initiative.

机构信息

Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 10219, Saudi Arabia.

Department of Rehabilitation Sciences and Physical Therapy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.

出版信息

BMC Public Health. 2020 Aug 31;20(1):1323. doi: 10.1186/s12889-020-09451-5.

Abstract

BACKGROUND

Some studies investigated the relationship between musculoskeletal conditions and chronic diseases. However, no study examined the association between social determinants and chronic diseases among people at high risk for knee osteoarthritis. Thus, the current study was aimed to address this gap.

METHODS

A secondary data analysis was conducted on a total of 3280 men and women aged 45 to 79 who were recruited in the Osteoarthritis Initiative.

RESULTS

Multivariable logistic regression analyses show that age ≥ 65 years was associated with 1.98, 1.96, and 1.46 times odds of the presence of diabetes, heart attack, and multi-morbidity, respectively than age ≤ 64 years. Men were associated with 1.39, 1.41, 1.76, and 2.24 times odds of the presence of arthritis, cancer, diabetes, and heart attack, respectively than women. African American/Asian/ non-Caucasian was associated with 2.71, 2.56, and 1.93 times odds of the presence of arthritis, diabetes, and heart attack, respectively than Caucasian. Primary school/less education was associated with twice or more times the odds of arthritis and chronic obstructive pulmonary disease (COPD) than ≥high school education. Unemployment was associated with 1.41-, 1.73-, 1.58-, and 1.70-time odds of the presence of arthritis, cancer, COPD, and heart attack, respectively, then employed. Unmarried/widowed/separated was associated with 1.41, 1.75, 2.77, 2.76, 1.86, and 3.34 times odds of the presence of arthritis, asthma, cancer, COPD, diabetes, and heart attack, respectively than married. Annual income < 50,000 was associated with 1.33-, 1.44-, and 1.38-time odds of the presence of arthritis, diabetes, and multi-morbidity, respectively, then annual income ≥50,000. Overweight/obese was associated with 2.28 times the odds of the presence of diabetes than healthy weight. Current/former smoker was associated with 1.57, 2.47, 2.53, 1.63, and 1.24 times odds of the presence of arthritis, cancer, COPD, heart attack, and multi-morbidity, respectively than a nonsmoker. Consuming alcohol was associated with 1.32-, 1.65-, 1.50-, and 1.24-time odds of the presence of arthritis, COPD, diabetes, and multi-morbidity, respectively, then nonalcoholic.

CONCLUSIONS

Social determinants are associated with the presence of chronic diseases. Some of the social determinants are modifiable or treatable. Thus, these findings can inform public health strategies in the United States.

摘要

背景

一些研究调查了肌肉骨骼疾病与慢性疾病之间的关系。然而,尚无研究探讨社会决定因素与处于膝关节骨关节炎高危状态的人群中的慢性疾病之间的关联。因此,本研究旨在解决这一空白。

方法

对总共 3280 名年龄在 45 至 79 岁的男性和女性进行了二次数据分析,他们是在骨关节炎倡议中招募的。

结果

多变量逻辑回归分析表明,年龄≥65 岁与糖尿病、心脏病发作和多种疾病的存在分别相关,其优势比为 1.98、1.96 和 1.46 倍,而年龄≤64 岁。男性患关节炎、癌症、糖尿病和心脏病发作的优势比分别为女性的 1.39、1.41、1.76 和 2.24 倍。非裔美国人/亚洲人/非高加索人患关节炎、糖尿病和心脏病发作的优势比分别为高加索人的 2.71、2.56 和 1.93 倍。小学/低教育程度与关节炎和慢性阻塞性肺疾病(COPD)的发生几率是高中及以上教育程度的两倍或更高。失业与关节炎、癌症、COPD 和心脏病发作的发生几率分别为 1.41、1.73、1.58 和 1.70 倍,而就业则与之相反。未婚/丧偶/离异与关节炎、哮喘、癌症、COPD、糖尿病和心脏病发作的发生几率分别为 1.41、1.75、2.77、2.76、1.86 和 3.34 倍,而已婚则与之相反。年收入<50,000 与关节炎、糖尿病和多种疾病的发生几率分别为 1.33、1.44 和 1.38 倍相关,而年收入≥50,000。超重/肥胖与糖尿病的发生几率为 2.28 倍,而健康体重的发生几率为 2.28 倍。当前/前吸烟者患关节炎、癌症、COPD、心脏病发作和多种疾病的几率分别为 1.57、2.47、2.53、1.63 和 1.24 倍,而非吸烟者则与之相反。饮酒与关节炎、COPD、糖尿病和多种疾病的发生几率分别为 1.32、1.65、1.50 和 1.24 倍,而非饮酒者则与之相反。

结论

社会决定因素与慢性疾病的发生有关。其中一些社会决定因素是可以改变或治疗的。因此,这些发现可以为美国的公共卫生策略提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d15/7461338/005c3aca66cb/12889_2020_9451_Fig1_HTML.jpg

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