Social Determinants of Polypharmacy in First Generation Mexican Immigrants in the United States

Assari, Shervin; Saqib, Mohammed; Wisseh, Cheryl; Bazargan, Mohsen

doi:10.15171/ijtmgh.2019.19

Cited by 5 publications

(12 citation statements)

References 23 publications

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“…Fifty studies focussed on education [16, 18, Fig. 1 Study selection and exclusion according to the PRISMA flow diagram 20-67], 18 studies on income [16, 23, 30, 32-34, 37, 41, 46-48, 50, 53, 61, 63, 64, 66, 68], 6 on wealth [22,27,45,57,67,69], 4 studies on occupation [23,44,48,57], 7 studies on employment [16,17,49,58,60,63,66], 5 studies on social class [17,25,36,38,60], 2 used SES categories [31,70] and 1 used area-level deprivation [20]. Studies were conducted across a range of countries as follow: India [60,66], Jordan [21], Netherlands [70], Sweden [18,23,39,52], Spain [25], Belgium [26,30], Pakistan [29,68], UK [17,20,36,38,69], China …”

Section: Study Characteristicsmentioning

confidence: 99%

“…Studies were conducted across a range of countries as follow: India [60,66], Jordan [21], Netherlands [70], Sweden [18,23,39,52], Spain [25], Belgium [26,30], Pakistan [29,68], UK [17,20,36,38,69], China [33,44,59,65], Japan [46,67], Singapore [40], Kuwait [42], Malaysia [43,58], Poland [45], Togo [47], Saudi Arabia [55,61], Taiwan [56], Vietnman [57]. Most studies were conducted within Brazil [28,31,32,37,41,48,50,51,53,62,63] and the US [16,24,27,34,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Fifty studies [16,18, investigated the association between education and polypharmacy, 38 studies [18, 21-31, 33, 35, 37, 40-42, 44, 46-48, 50-55, 57-61, 63-67] were eligible for meta-analysis giving a pooled OR of 1.21 (95% CI 1.15-1.28; I 2 = 94%) for receipt of polypharmacy in those of lower education when compared to higher education (Fig. 2).…”

Section: Association Between Education and Polypharmacymentioning

confidence: 99%

“…Four studies [23,44,48,57] reported the association between occupation and polypharmacy, and 7 [16,17,49,58,60,63,66] reported the association between employment and polypharmacy. Three studies [23,44,57] assessing occupation and 5 studies [17,58,60,63,66] Fig.…”

Section: Association Between Occupation Employment and Polypharmacymentioning

confidence: 99%

“…While previous studies have shown that certain patientbased factors, such as age, are associated with increased levels of polypharmacy, the role of socioeconomic factors such as education, income and occupation, is less clear. The literature suggests that such socioeconomic factors could play an important role in polypharmacy, with studies highlighting factors such as income [10][11][12][13][14] and employment [15][16][17] as possible contributors to the prevalence of polypharmacy. For example, a Swedish study [18] investigated the relationship between polypharmacy, socioeconomic status (SES) and inappropriate medication usage.…”

Section: Introductionmentioning

confidence: 99%

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Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis

et al. 2023

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Background Socioeconomic status (SES) may influence prescribing, concordance and adherence to medication regimens. This review set out to investigate the association between polypharmacy and an individual’s socioeconomic status. Methods A systematic review and meta-analyses of observational studies was conducted across four databases. Older people (≥ 55 years) from any healthcare setting and residing location were included. The search was conducted across four databases: Medline (OVID), Web of Science, Embase (OVID) and CINAHL. Observational studies from 1990 that reported polypharmacy according to SES were included. A random-effects model was undertaken comparing those with polypharmacy (≥ 5 medication usage) with no polypharmacy. Unadjusted odds ratios (ORs), 95% confidence intervals (CIs) and standard errors (SE) were calculated for each study. Results Fifty-four articles from 13,412 hits screened met the inclusion criteria. The measure of SES used were education (50 studies), income (18 studies), wealth (6 studies), occupation (4 studies), employment (7 studies), social class (5 studies), SES categories (2 studies) and deprivation (1 study). Thirteen studies were excluded from the meta-analysis. Lower SES was associated with higher polypharmacy usage: individuals of lower educational backgrounds displayed 21% higher odds to be in receipt of polypharmacy when compared to those of higher education backgrounds. Similar findings were shown for occupation, income, social class, and socioeconomic categories. Conclusions There are socioeconomic inequalities in polypharmacy among older people, with people of lower SES significantly having higher odds of polypharmacy. Future work could examine the reasons for these inequalities and explore the interplay between polypharmacy and multimorbidity.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Association Between Education and Polypharmacymentioning

confidence: 99%

Section: Association Between Occupation Employment and Polypharmacymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis

et al. 2023

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Polypharmacy among older adults in Brazil: Association with sociodemographic factors and access to health services

Ramos

Boing

Andrade

et al. 2022

Dialogues in Health

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Racism May Interrupt Age-related Brain Growth of African American Children in the United States

Assari

Mincy

2021

jpediatrchildhealthcare

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Background: Considerable research has documented age-related growth in brain size as a marker of normal brain development. This is particularly important because brain volume has a significant role in overall cognitive performance. However, less research is done on whether age-related changes in the global brain volume differ across diverse racial and ethnic groups. We hypothesized that age-related growth in brain size would be disrupted in African American children who are historically affected by racism. Purpose: Considering race as a proxy of racism rather than genetics, this study tested racial and ethnic differences in the effects of age on global brain volume using structural brain imaging data. Built on a sociological, rather than a biological theory, we built our study on Marginalization-related Diminished Returns (MDRs) framework, which argues that under racism, resources and assets are less effective for social groups that are historically racialized, discriminated against, marginalized, and segregated. Considering age as an asset/resource that increases the global brain volume, we expected weaker effects of age on overall brain size of African American and Hispanic children, than White and non-Hispanic children, again as a result of racism. Methods: We borrowed the structural Magnetic Resonance Imaging (sMRI) data from the Children Brain Cognitive Development (ABCD) study, which included 9,311 9-10 year old children. The independent variable was the child’s age treated as a continuous measure (in months). The primary outcome was global brain volume. Sex, parental employment, parental education, household income, and parental marital status were the covariates. Race and ethnicity, as proxies of racism, were the moderators. To analyze the data, we used linear regression models. Results: Age was positively associated with the global brain size in children. In line with the MDRs, the positive association between age and global brain volume was weaker for African American than White children, while family structure, sex, and family socioeconomic status was controlled. Conclusions: Under racism, age has unequal effects on global brain size of diverse racial groups. In line with the MDRs, we observe diminished agerelated growth of the brain for African American children, which documents detrimental effects of racism. For White children who are not affected by racism, age makes a large difference regarding global brain volume. Age-related growth of global brain size is diminished in African American children, whose daily lives are shaped by racism. School and residential segregation may have a role in reducing the effect of age on children’s brain growth in African American families. The results should not be interpreted as inferiority of one group but social processes that hinder normal development of a historically oppressed group.

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Social Determinants of Polypharmacy in First Generation Mexican Immigrants in the United States

Cited by 5 publications

References 23 publications

Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis

Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis

Polypharmacy among older adults in Brazil: Association with sociodemographic factors and access to health services

Racism May Interrupt Age-related Brain Growth of African American Children in the United States

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