Socioeconomic inequalities in hospitalizations for chronic ambulatory care sensitive conditions: a systematic review of peer-reviewed literature, 1990–2018

Wallar, Lauren E.; Prophetis, Eric De; Rosella, Laura

doi:10.1186/s12939-020-01160-0

Cited by 29 publications

(22 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous cross-sectional studies found out that income and education contributed a large proportion to health sector variables, such as chronic disease incidence and health service use [35][36][37][38][39][40]. Our study found income did not contribute as pro-rich inequality in food preference in a longitudinal view as much as cross-section data obtained.…”

Section: Discussionsupporting

confidence: 53%

The Mobility of Income-related Inequality in Food Preferences Among Chinese Adults: a Population-based Longitudinal Study

Xu¹,

Zhou²,

Zhu³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background:This study aimed to investigate the income-related inequality of food preference and its mobility in the long run, and to quantify the determinants’ contributions of socioeconomic inequality mobility in food preference in China.Methods:The data were sourced from the China Health and Nutrition Survey (CHNS) conducted in 2006, 2009, 2011 and 2015, respectively. A study sample of 3940 adults were included for analysis. Five preselected questions were used to construct a summary food preference index. Cross-sectional and longitudinal concentration indices were used to measure the income-related inequality in food preference at a certain time and for a period, respectively. Health-related income mobility index was used to measure the gap between cross-sectional and longitudinal income-related health inequality concentration indices. Decomposition analysis was used to decompose income mobility index into its determinants.Results:The mean scores of food preference increased from 17.641 in 2006 to 18.881 in 2015. The richest people had the highest mean scores of food preference compared to other income groups in each year. Age, gender, income, education, and dietary knowledge score were positively associated with healthy food preference. The concentration indices of food preference score on income in each year were all positive, indicating that there was pro-rich inequality in food preference score with the rich having higher preference scores in each period. The income mobility index of food preference was -0.1426 after 4 periods, indicating that the degree of pro-rich inequality in food preference was larger than that at the baseline in the long run. Decomposition analysis showed that being married and living in Western China made healthy food preference more concentrated among the rich in the long run. Whereas increasing age and dietary knowledge contributed to making healthy food preference behavior less concentrated among the rich in the long run.Conclusions:The cross-sectional measure of food preference score inequality was underestimated in the long run. Our study suggests that people with decreased income could be taken as targeted population in future public intervention measures, and narrowing the regional gap between Eastern and Western China could be strengthened in future Chinese policies.

show abstract

Section: Discussionsupporting

confidence: 53%

The Mobility of Income-related Inequality in Food Preferences Among Chinese Adults: a Population-based Longitudinal Study

Xu¹,

Zhou²,

Zhu³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Such disparities exist in every aspect of care, from diagnosis to management ( 3 ), particularly with regard to Black and Hispanic patients compared with White patients ( 4 ). The underpinnings of these differences are complex, relating to factors such as access to care, implicit or explicit biases from healthcare workers and systems, and social determinants of health ( 5 ).…”

mentioning

confidence: 99%

Association of Race and Ethnicity with COVID-19 Test Positivity and Hospitalization Is Mediated by Socioeconomic Factors

et al. 2021

View full text Add to dashboard Cite

Rationale: Black race and Hispanic ethnicity are associated with increased risks for coronavirus disease (COVID-19) infection and severity. It is purported that socioeconomic factors may drive this association, but data supporting this assertion are sparse. Objectives: To evaluate whether socioeconomic factors mediate the association of race/ethnicity with COVID-19 incidence and outcomes. Methods: We conducted a retrospective cohort study of adults tested for (cohort 1) or hospitalized with (cohort 2) COVID-19 between March 1, 2020, and July 23, 2020, at the University of Miami Hospital and Clinics. Our primary exposure was race/ethnicity. We considered socioeconomic factors as potential mediators of our exposure’s association with outcomes. We used standard statistics to describe our cohorts and multivariable regression modeling to identify associations of race/ethnicity with our primary outcomes, one for each cohort, of test positivity (cohort 1) and hospital mortality (cohort 2). We performed a mediation analysis to see whether household income, population density, and household size mediated the association of race/ethnicity with outcomes. Results: Our cohorts included 15,473 patients tested (29.0% non-Hispanic White, 48.1% Hispanic White, 15.0% non-Hispanic Black, 1.7% Hispanic Black, and 1.6% other) and 295 patients hospitalized (9.2% non-Hispanic White, 56.9% Hispanic White, 21.4% non-Hispanic Black, 2.4% Hispanic Black, and 10.2% other). Among those tested, 1,256 patients (8.1%) tested positive, and, of the hospitalized patients, 47 (15.9%) died. After adjustment for demographics, race/ethnicity was associated with test positivity—odds-ratio (95% confidence interval [CI]) versus non-Hispanic White for Non-Hispanic Black: 3.21 (2.60–3.96), Hispanic White: 2.72 (2.28–3.26), and Hispanic Black: 3.55 (2.33–5.28). Population density mediated this association (percentage mediated, 17%; 95% CI, 11–31%), as did median income (27%; 95% CI, 18–52%) and household size (20%; 95% CI, 12–45%). There was no association between race/ethnicity and mortality, although this analysis was underpowered. Conclusions: Black race and Hispanic ethnicity are associated with an increased odds of COVID-19 positivity. This association is substantially mediated by socioeconomic factors.

show abstract

“…These therapeutic areas involving medications with clinically relevant pharmacogenomic information may denote clinical areas where targeted genotyping could occur in resource-constrained clinical environments to best optimize prescribing practices for minority patients. Ambulatory care-sensitive conditions (ACSCs), where proper treatment and management is believed to prevent avoidable hospital admissions, include chronic conditions such as asthma, hypertension, and diabetes-conditions prevalent both in our study's patient cohort and generally within the African American population [14][15][16]. Multiple studies have examined patterns of hospitalization due to ACSCs by race/ethnicity, and these have reported higher rates of hospitalizations for African American compared to Whites [17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients

Saulsberry

Danahey

Middlestadt

et al. 2021

JPM

View full text Add to dashboard Cite

Known disparities exist in the availability of pharmacogenomic information for minority populations, amplifying uncertainty around clinical utility for these groups. We conducted a multi-site inpatient pharmacogenomic implementation program among self-identified African-Americans (AA; n = 135) with numerous rehospitalizations (n = 341) from 2017 to 2020 (NIH-funded ACCOuNT project/clinicaltrials.gov#NCT03225820). We evaluated the point-of-care availability of patient pharmacogenomic results to healthcare providers via an electronic clinical decision support tool. Among newly added medications during hospitalizations and at discharge, we examined the most frequently utilized medications with associated pharmacogenomic results. The population was predominantly female (61%) with a mean age of 53 years (range 19–86). On average, six medications were newly prescribed during each individual hospital admission. For 48% of all hospitalizations, clinical pharmacogenomic information was applicable to at least one newly prescribed medication. Most results indicated genomic favorability, although nearly 29% of newly prescribed medications indicated increased genomic caution (increase in toxicity risk/suboptimal response). More than one of every five medications prescribed to AA patients at hospital discharge were associated with cautionary pharmacogenomic results (most commonly pantoprazole/suboptimal antacid effect). Notably, high-risk pharmacogenomic results (genomic contraindication) were exceedingly rare. We conclude that the applicability of pharmacogenomic information during hospitalizations for vulnerable populations at-risk for experiencing health disparities is substantial and warrants continued prospective investigation.

show abstract

Socioeconomic inequalities in hospitalizations for chronic ambulatory care sensitive conditions: a systematic review of peer-reviewed literature, 1990–2018

Cited by 29 publications

References 71 publications

The Mobility of Income-related Inequality in Food Preferences Among Chinese Adults: a Population-based Longitudinal Study

The Mobility of Income-related Inequality in Food Preferences Among Chinese Adults: a Population-based Longitudinal Study

Association of Race and Ethnicity with COVID-19 Test Positivity and Hospitalization Is Mediated by Socioeconomic Factors

Applicability of Pharmacogenomically Guided Medication Treatment during Hospitalization of At-Risk Minority Patients

Contact Info

Product

Resources

About