Income-Related Health Inequalities in Korea

Data from the 2001 Korean National Health and Nutrition Examination Survey and the ill health concentration index (CI) were used to examine income-related health inequalities among Koreans. Participants (>19 years old) were requested to provide information regarding monthly household income, expenditures, subjective living conditions, and health status. Ill health was determined both subjectively through self-rated health (SRH) scores and objectively through the number of diseases (ND). At the individual level, the CIs for SRH and ND were -0.147 and -0.093, respectively; age–gender adjusted CIs were -0.065 and -0.071, respectively. These values remained unchanged when estimating CI for grouped data. These results indicate that ill health was more pronounced among lower income groups in Korea. However, avoidable health inequality in Korea was smaller than in the United Kingdom and the United States, larger than in Sweden, Eastern Germany, Finland, and Western Germany, and roughly equal to the Netherlands, Spain, and Switzerland

Racial differences in neurocognitive outcomes post-stroke: The impact of healthcare variables

AbstractObjectives:The present study examined differences in neurocognitive outcomes among non-Hispanic Black and White stroke survivors using the NIH Toolbox-Cognition Battery (NIHTB-CB), and investigated the roles of healthcare variables in explaining racial differences in neurocognitive outcomes post-stroke.Methods:One-hundred seventy adults (91 Black; 79 White), who participated in a multisite study were included (age:M=56.4;SD=12.6; education:M=13.7;SD=2.5; 50% male; years post-stroke: 1–18; stroke type: 72% ischemic, 28% hemorrhagic). Neurocognitive function was assessed with the NIHTB-CB, using demographically corrected norms. Participants completed measures of socio-demographic characteristics, health literacy, and healthcare use and access. Stroke severity was assessed with the Modified Rankin Scale.Results:An independent samplesttest indicated Blacks showed more neurocognitive impairment (NIHTB-CB Fluid Composite T-score:M=37.63;SD=11.67) than Whites (Fluid T-score:M=42.59,SD=11.54;p=.006). This difference remained significant after adjusting for reading level (NIHTB-CB Oral Reading), and when stratified by stroke severity. Blacks also scored lower on health literacy, reported differences in insurance type, and reported decreased confidence in the doctors treating them. Multivariable models adjusting for reading level and injury severity showed that health literacy and insurance type were statistically significant predictors of the Fluid cognitive composite (p&lt;.001 andp=.02, respectively) and significantly mediated racial differences on neurocognitive impairment.Conclusions:We replicated prior work showing that Blacks are at increased risk for poorer neurocognitive outcomes post-stroke than Whites. Health literacy and insurance type might be important modifiable factors influencing these differences. (JINS, 2017,23, 640–652)</jats:p

The Relation Between Discrimination, Sense of Coherence and Health Varies According to Ethnicity; A Study Among Three Distinct Population Groups Living in Israel

Self-reported experiences of discrimination and sense of coherence (SOC) have been found to be associated with health. A face-to-face survey of Long Term Jewish Residents (LTJR), Arabs and former Soviet Union (fSU) immigrants in Israel was performed. Respondents reported their physical and mental health, self-reported experiences of discrimination, SOC and socioeconomic status. Multivariable logistic regressions and bootstrapping path analyses were performed. Discrimination was associated with health after adjusting for all other variables. SOC was also associated with health. SOC did not mediate the strong association between discrimination and health among Israeli LTJR, but was a significant mediator among Arabs and fSU immigrants. Discrimination seems to have a direct effect on health only among the majority and not among minority populations. High levels of SOC may reduce the negative effects of discrimination on health by serving as a coping resource, however only among minorities

Statistical Inference on Changes in Income Inequality in Australia

This paper studies the changes in income inequality of individuals in Australia between 1986 and 1999. Individuals are divided into various subgroups along several dimensions, such as region of residence, age, employment status etc. The changes in inequality over time, between and within the various subgroups is studied, and the bootstrap method is used to establish whether these changes are statistically significant.Income inequality; Gini coefficient; Theil inequality measure; bootstrap.

Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UK

AIMS/HYPOTHESIS: This study aimed to determine the extent to which increased insulin resistance and fasting glycaemia in South Asian men, compared with white European men, living in the UK, was due to lower cardiorespiratory fitness (maximal oxygen uptake [[Formula: see text]]) and physical activity. METHODS: One hundred South Asian and 100 age- and BMI-matched European men without diagnosed diabetes, aged 40–70 years, had fasted blood taken for measurement of glucose concentration, HOMA-estimated insulin resistance (HOMA(IR)), plus other risk factors, and underwent assessment of physical activity (using accelerometry), [Formula: see text], body size and composition, and demographic and other lifestyle factors. For 13 South Asian and one European man, HbA(1c) levels were >6.5% (>48 mmol/mol), indicating potential undiagnosed diabetes; these men were excluded from the analyses. Linear regression models were used to determine the extent to which body size and composition, fitness and physical activity variables explained differences in HOMA(IR) and fasting glucose between South Asian and European men. RESULTS: HOMA(IR) and fasting glucose were 67% (p < 0.001) and 3% (p < 0.018) higher, respectively, in South Asians than Europeans. Lower [Formula: see text], lower physical activity and greater total adiposity in South Asians individually explained 68% (95% CI 45%, 91%), 29% (11%, 46%) and 52% (30%, 80%), respectively, and together explained 83% (50%, 119%) (all p < 0.001) of the ethnic difference in HOMA(IR). Lower [Formula: see text] and greater total adiposity, respectively, explained 61% (9%, 111%) and 39% (9%, 76%) (combined effect 63% [8%, 115%]; all p < 0.05) of the ethnic difference in fasting glucose. CONCLUSIONS/INTERPRETATION: Lower cardiorespiratory fitness is a key factor associated with the excess insulin resistance and fasting glycaemia in middle-aged South Asian, compared with European, men living in the UK. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-013-2969-y) contains peer-reviewed but unedited supplementary material, which is available to authorised users

Technical and Scale Efficiencies for Chinese Rural Credit Cooperatives: A Bootstrapping Approach in Data Envelopment Analysis

Chinese rural credit cooperatives (RCCs) are a major supplier of credit to the rural sector in the country. However, Chinese RCCs are currently encountering operating problems, and an experimental reform is being carried out to restructure and reform the RCCs. In order to have some idea about the efficacy of reform, it is important to have an understanding of the institutional economics underlying the delivery of rural credit in China. This paper evaluates pure technical efficiency, overall technical efficiency, and scale efficiencies for RCCs in China using nonparametric techniques. The use of a bootstrap algorithm is proposed to perform inference for efficiency measures. Keywords: bootstrapping, Chinese rural credit cooperatives, data envelopment analysis, scale efficiency, technical efficiency.

Leveraging Mindfulness to Build Resilience and Professional Quality of Life in Human Service Professionals

Objective: Mindfulness-based interventions (MBIs) have shown promise in cultivating resilience and are widely accepted as efficacious in the treatment of a range of psychological disorders. This paper explores the feasibility of a Mindful-Awareness and Resilience Skills Training (MARST) program to enhance mindfulness and resilience, as a means of increasing psychological well-being and alleviating burnout and compassion fatigue in human service professionals. Method: In this randomised control trial, 46 human service professionals were randomly allocated to either a MARST group or to a no intervention, control group. Results: Multivariate analysis of covariance (MANCOVA), with pre-test scores as the covariates, revealed that the MARST intervention resulted in significant improvements in mindfulness, resilience, compassion satisfaction, and psychological well-being, and significant reductions in burnout and compassion fatigue; at post-intervention. These results were maintained at one month follow-up, with the exception of compassion satisfaction which was non-significant. Mediation analysis using a bootstrap resampling method indicated that mindfulness fully mediated changes in resilience and psychological well-being, as a result of the MARST intervention. Self-reported reductions in burnout following the intervention were mediated by mindfulness and resilience, and decreased compassion fatigue was mediated by resilience. Conclusions: The results of this study suggest that the MARST program may assist in developing resilience and ameliorating burnout and compassion fatigue in human service professionals. The study also provides evidence for the potential of mindfulness-based approaches to enhance resilience.</jats:p