Healthy Ageing: Raising Awareness of Inequalities, Determinants, and What Could Be Done to Improve Health Equity

Sadana, Ritu; Blas, Erik; Budhwani, Suman; Koller, Theadora Swift; Paraje, Guillermo

doi:10.1093/geront/gnw034

Cited by 132 publications

(99 citation statements)

References 60 publications

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“…The patterns of association observed in our research between household income deciles/deprivation and access to regular primary care fall somewhere between “marginal exclusion” and “queuing” (Figure ). One possible policy focus in response to a “marginal exclusion” pattern is expanding provision of services to particular groups that are marginalized or excluded, whereas the “queuing” pattern requires an approach that combines population‐wide and targeted interventions (Sadana, Blas, Budhwani, Koller, & Paraje, ). Therefore, for Hong Kong, considering the findings from the current study and other local research, we see two main directions for policy intervention efforts to address the health inequality issues regarding access to primary care services: they are (a) to promote access by strengthening the concept and practice of primary care in the wider population while increasing community resources to residents at affordable rates and (b) to narrow the social gaps in access to regular primary care.…”

Section: Discussionmentioning

confidence: 99%

“…The patterns of association observed in our research between household income deciles/deprivation and access to regular primary care fall somewhere between "marginal exclusion" and "queuing" (Figure 1). One possible policy focus in response to a "marginal exclusion" pattern is expanding provision of services to particular groups that are marginalized or excluded, whereas the "queuing" pattern requires an approach that combines population-wide and targeted interventions (Sadana, Blas, Budhwani, Koller, & Paraje, 2016). Therefore, for…”

Section: Public Health and Policy Implications-the Way Forwardmentioning

confidence: 99%

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Poverty affects access to regular source of primary care among the general population in Hong Kong

et al. 2019

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A territory‐wide two‐stage stratified random sample of 2,282 community‐dwelling Hong Kong adults were surveyed between 2014 and 2015 to investigate the association between poverty and regular source of primary care utilization. Poverty was operationalized by income‐poverty and deprivation. About 94% of our sample reported having regular source of primary care (Western and/or Chinese medical practitioner) and about 69% among them were in private sector. Multivariable logistic regression showed that people who were income‐poor and deprived were less likely to have regular source of primary care (income‐poor: OR = 0.523, p = .027; deprived: OR = 0.488, p = .007) and visit private primary care doctors (income‐poor: OR = 0.445, deprived: OR = 0.222, both p < .0001). Those who had chronic diseases were more likely to have regular source of primary care (multimorbid: OR = 10.709, p < .0001), but less likely to access care in the private sector (one chronic disease: OR = 0.690, p = .019; multimorbid: OR = 0.374, p < .0001) than those without. Further, being older and less skilled were significantly associated with less likelihood of visiting a private doctor. Path analysis showed that the number of chronic diseases had significant indirect effect on having regular source of primary care with being income‐poor and deprived as the mediators (β = −.0183, p = .0016). Therefore, despite a public health‐care system that aims to deny no one from adequate health care for lack of means, regular source of primary care in Hong Kong is found to be pro‐rich. Future policies should tackle the problem of health‐care inequalities to meet the needs of the underprivileged.

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Section: Discussionmentioning

confidence: 99%

Section: Public Health and Policy Implications-the Way Forwardmentioning

confidence: 99%

Poverty affects access to regular source of primary care among the general population in Hong Kong

et al. 2019

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“…Intentional collaboration between healthcare organisations and community agencies that provide long‐term services and supports (LTSS) could facilitate implementation of approaches such as the HST, to assist families dealing with dementia. National policies demonstrate growing support for innovative community solutions in dementia care (Sadana, Blas, Budhwani, Koller, & Paraje, ; US Department of Health & Human Services, ). Recognising the importance of public policy in health and quality of life outcomes, Alzheimer's Disease International (Pot & Petrea, Bupa, & ADI, ) recommends expansion of LTSS to enhance support for family caregivers and for individuals with dementia to remain at home.…”

Section: Discussionmentioning

confidence: 99%

Directed content analysis of Veterans Affairs policy documents: A strategy to guide implementation of a dementia home safety toolkit for Veterans to promote ageing in place

Hebert

Trudeau

Sprinkle

et al. 2019

Health Soc Care Community

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Older adults’ preference to age in place, coupled with an increasing prevalence of dementia, creates an imperative to address home safety risks that occur due to cognitive impairment. Providing caregivers with home safety items and education can facilitate ageing in place for older adults living with dementia. In 2015–2017, we examined barriers and facilitators within 17 policy documents and dementia guidelines of the United States (US) Veterans Health Administration pertinent to implementation of a home safety toolkit (HST) for Veterans living with dementia. The documents were issued from 2000 to 2015. Directed qualitative content analysis of these documents guided by themes from stakeholder interviews revealed two key implementation barriers: a focus on physical rather than cognitive risks when determining medical necessity for home equipment, and a focus on rehabilitation and treatment rather than prevention. Mandates for person‐centred care planning, including comprehensive assessment, interdisciplinary collaboration, staff education and a focus on population health in primary care facilitate HST implementation. Content analysis can identify policy‐level barriers that slow innovation and facilitators that can increase access to care that support ageing in place.

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“…The senescent cells can affect their microenvironment and lead to intracellular alterations. An accumulation of dysfunctional cells disrupts tissue homeostasis and thus rises functional decline in organ system [9,[11][12][13][14]. Strehler stated that "my simple view is that aging is those things that go wrong when cells lose their ability to divide, if we could replace our cells as rapidly as they deteriorate, we could probably live very long, if not indefinitely" [10].…”

Section: What Is Aging?mentioning

confidence: 99%

Introductory Chapter: Aging is a Preventable Disorder

Çakmur¹

2018

Geriatrics Health

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Healthy Ageing: Raising Awareness of Inequalities, Determinants, and What Could Be Done to Improve Health Equity

Abstract: Each of these areas warrant in depth analysis and synthesis, whereas this article presents an overview for further consideration and action.

Cited by 132 publications

References 60 publications

Poverty affects access to regular source of primary care among the general population in Hong Kong

Poverty affects access to regular source of primary care among the general population in Hong Kong

Directed content analysis of Veterans Affairs policy documents: A strategy to guide implementation of a dementia home safety toolkit for Veterans to promote ageing in place

Introductory Chapter: Aging is a Preventable Disorder

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