Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income

Gagné, Thierry; Veenstra, Gerry

doi:10.18865/ed.27.4.371

Cited by 33 publications

(28 citation statements)

References 29 publications

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“…That means sex and gender differential effects of a wide range of SEP indicators on many outcomes have been documented for children, adults, and older adults. Among adults, many studies have shown stronger health effects of income and other related SEP indicators for males than females [86][87][88][89][90].…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in the Association between Household Income and Children’s Executive Function

Assari

Boyce

Bazargan

et al. 2020

Sexes

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The study aimed to investigate sex differences in the boosting effects of household income on children’s executive function in the US. This is a cross-sectional study using data from Wave 1 of the Adolescent Brain Cognitive Development (ABCD) study. Wave 1 ABCD included 8608 American children between ages 9 and 10 years old. The independent variable was household income. The primary outcome was executive function measured by the stop-signal task. Overall, high household income was associated with higher levels of executive function in the children. Sex showed a statistically significant interaction with household income on children’s executive function, indicating a stronger effect of high household income for female compared to male children. Household income is a more salient determinant of executive function for female compared to male American children. Low-income female children remain at the highest risk regarding poor executive function.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in the Association between Household Income and Children’s Executive Function

Assari

Boyce

Bazargan

et al. 2020

Sexes

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“…The use of an intersectional framework represents a new way of understanding the complex nature of health inequities,22 and it may provide an improved awareness of the heterogeneous distribution of type 2 diabetes risk in the population 17. To the best of our knowledge, however, only one previous study from Canada has used an intersectional approach in the study of diabetes risk 23. Here, it should be emphasized that we are not referring to heterogeneity in terms of different diabetes phenotypes, but in terms of differences in the propensity for suffering from type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

Understanding the complexity of socioeconomic disparities in type 2 diabetes risk: a study of 4.3 million people in Sweden

Wemrell

Bennet

Merlo

2019

BMJ Open Diab Res Care

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ObjectiveInvestigating demographic and socioeconomic factors as intersecting rather than as separate dimensions may improve our understanding of the heterogeneous distribution of type 2 diabetes in the population. However, this complexity has scarcely been investigated and we still do not know the accuracy of these factors for predicting type 2 diabetes. Improved understanding of the demographic and socioeconomic disparities predicting type 2 diabetes risk in the population would contribute to more precise and effective public health interventions.Research design and methodsWe analyzed the risk of type 2 diabetes among 4 334 030 individuals aged 40–84 years who by 2010 had resided in Sweden for at least 5 years. We stratified the study population into 120 strata defined by categories of age, gender, income, education, and immigration status. We calculated measures of absolute risk (prevalence) and relative risk (prevalence ratio), and quantified the discriminatory accuracy of the information for predicting type 2 diabetes in the population.ResultsThe distribution of type 2 diabetes risk in the population was highly heterogeneous. For instance, immigrated men aged 70–79 years with low educational achievement and low income had a risk around 32 times higher than native women aged 40–49 years with high income and high educational achievement (ie, 17.6% vs 0.5%). The discriminatory accuracy of the information was acceptable.ConclusionA more detailed, intersectional mapping of socioeconomic and demographic distribution of type 2 diabetes can assist in public health management aiming to reduce the prevalence of the disease.

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“…Previous research also suggests that prevalence rates in hypertension and diabetes are higher among south Asian and Black Canadians than White Canadians [15,16]. Another study highlights the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada [17].…”

Section: Discussionmentioning

confidence: 91%

Outcomes of Emergency Medical Patients Admitted to a Medical Surveillance Unit: a Retrospective Cross-Sectional Study

Vantomme

Siddiqui

Cossette

et al. 2020

SN Compr. Clin. Med.

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High-acuity patients occasionally require advanced resources and monitoring, but do not qualify for intensive care admission in large intensive care unit (ICU). For these patients, intermediate care units (IMCUs) can provide adequate care. IMCUs lessen the patient burden for both the general ward and the ICU, allowing for more free beds in the ICU and ward. The main purpose of this study was to explore typical patient characteristics/demographics of patients admitted to an IMCU from the emergency room (ER) and mortality rate. This study is a retrospective cross-sectional study of a medical surveillance unit (MSU), which is an IMCU located in Pasqua Hospital, Regina. All patients admitted to the MSU from the ER in 2017 and 2018 were included in the study. This study retrospectively reviewed 715 patients in total. Patients' age, sex, discharge disposition, comorbidities, primary and secondary diagnoses, admission and discharge date to/from the MSU, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, early assessment and response system (EARS) score, and acuity score were recorded. A total of 715 patient charts were reviewed for this study, with 323 patients in 2017 and 392 patients in 2018. Approximately a third of the study participants were diabetic, and half were hypertensive. Male sex had higher comorbidities including asthma or cerebrovascular accidents, and women had been diagnosed with coronary heart disease or liver disease. Both male and female were equally affected by substance use. 25.6% of the study population were smokers, 15.5% were intravenous drugs, and 16.8% were suffering with alcohol use disorder. Respiratory diseases account for a quarter of all primary diagnoses made in the MSU. Overall mortality rate was 5.9%. The APACHE II, EARS, and acuity scores were significantly different between deceased and alive patients (p < 0.001, p < 0.007, and p < 0.001, respectively). Half of the patients were discharged to home and a quarter were transferred to the ward. Nearly two-third of the study population was not readmitted to hospital within 30 days. This is one of the first studies to describe IMCU patients characteristics transferred from the ER in Canada. The APACHE II, EARS, and acuity scores were found significantly different between deceased and alive patients. These scores could therefore be used to develop tools that can identify high-risk patients for equitable allocation of healthcare resources to reduce mortality. Keywords Medical surveillance unit. Quality of care. Intermediate care unit. Modified early warning score This article is part of the Topical Collection on Medicine

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Inequalities in Hypertension and Diabetes in Canada: Intersections between Racial Identity, Gender, and Income

Cited by 33 publications

References 29 publications

Sex Differences in the Association between Household Income and Children’s Executive Function

Sex Differences in the Association between Household Income and Children’s Executive Function

Understanding the complexity of socioeconomic disparities in type 2 diabetes risk: a study of 4.3 million people in Sweden

Outcomes of Emergency Medical Patients Admitted to a Medical Surveillance Unit: a Retrospective Cross-Sectional Study

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