Zissimopoulou Orestia, Leontidou Eleni, Tsiptsios Dimitrios, Manolis Apostolos, Ioannides Dimitrios, Trypsiani Ioanna, Steiropoulos Paschalis, Constantinidis Theodoros C, Tripsianis Gregory, Nena Evangelia
Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Neurophysiology Department, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, United Kingdom.
Maedica (Bucur). 2020 Dec;15(4):490-502. doi: 10.26574/maedica.2020.15.4.490.
To describe the impact of subjects' family income, which was used as a proxy for socioeconomic status, with health characteristics and healthcare utilization of a large representative sample of population in Northern Greece, taking into account several socio-demographic characteristics and health behaviors of the participants. Eight hundred and twelve participants (43.7% males) with a mean age of 49.±14.8 years (range 19-83 years), from the area of Thrace, Greece, were enrolled in this cross-sectional populational study. A two-stage stratified sampling scheme was used and subjects were classified, according to the net mean monthly household income, into three financial levels: low .1000 Euro; medium 1001-2000 Euro; and high >2000 Euro. Self-reported questionnaires for socio-demographic, lifestyle and health related characteristics were collected. Sleep characteristics, utilizing Epworth Sleepiness Scale, Athens Insomnia Scale, Pittsburgh Sleep Quality Index and Berlin Questionnaire, and mental health, using Zung Self-rating Anxiety Scale and Beck Depression Inventory have been also assessed. The majority of participants belonged to the lower income level (476 subjects, 58.6%). Lower income level was associated with a higher prevalence of high alcohol consumption (p=0.030), low adherence to Mediterranean diet (p=0.016), low physical activity (p<0.001) and either short or long nocturnal sleep duration (p<0.001). After adjusting for all socio-demographic and lifestyle characteristics, subjects with low income had a higher risk for anxiety (aOR=1.97, p=0.017), depression (aOR=4.88, p<0.001), dyslipidemia (aOR=2.50, p=0.007), diabetes (aOR=3.58, p<0.001), obesity (aOR=1.97, p=0.038), cardiovascular disease (aOR=3.04, p=0.015) and sleep disorders, as well as for primary (aOR=3.56, p=0.017) and secondary (aOR=2.49, p=0.010) healthcare utilization compared to subjects with high income. Low income is an important factor, which adversely affects the health of individuals via different pathways such as adaptation of harmful everyday habits. Large-scale prospective cohort studies are necessary to verify these associations in a methodologically more robust way.
为描述作为社会经济地位替代指标的研究对象家庭收入，对希腊北部具有广泛代表性的大规模人群样本的健康特征和医疗保健利用情况的影响，同时考虑参与者的若干社会人口学特征和健康行为。来自希腊色雷斯地区的812名参与者（43.7%为男性）纳入了这项横断面人群研究，其平均年龄为49.±14.8岁（范围19 - 83岁）。采用两阶段分层抽样方案，根据家庭月平均净收入将研究对象分为三个经济水平：低（<1000欧元）；中（1001 - 2000欧元）；高（>2000欧元）。收集了关于社会人口学、生活方式和健康相关特征的自填式问卷。还使用爱泼沃斯嗜睡量表、雅典失眠量表、匹兹堡睡眠质量指数和柏林问卷评估了睡眠特征，使用zung自评焦虑量表和贝克抑郁量表评估了心理健康状况。大多数参与者属于低收入水平（476名，58.6%）。低收入水平与高酒精消费量较高（p = 0.030）、对地中海饮食依从性低（p = 0.016）、身体活动量低（p < 0.001）以及夜间睡眠时间短或长（p < 0.001）的患病率较高相关。在对所有社会人口学和生活方式特征进行调整后，与高收入参与者相比，低收入参与者患焦虑症（调整优势比[aOR]=1.97，p = 0.017）、抑郁症（aOR = 4.88，p < 0.001）、血脂异常（aOR = 2.50，p = 0.007）、糖尿病（aOR = 3.58，p < 0.001）、肥胖症（aOR = 1.97，p = 0.038）、心血管疾病（aOR = 3.04，p = 0.015）和睡眠障碍的风险更高，以及初级（aOR = 3.56，p = 0.017）和二级（aOR = 2.49，p = 0.010）医疗保健利用率更高。低收入是一个重要因素，它通过适应有害的日常习惯等不同途径对个体健康产生不利影响。有必要开展大规模前瞻性队列研究，以更稳健的方法验证这些关联。
