Underuse of medication for circulatory disorders among unmarried women and men in Norway?

BACKGROUND: It is well established that unmarried people have higher mortality from circulatory diseases and higher all-cause mortality than the married, and these marital status differences seem to be increasing. However, much remains to be known about the underlying mechanisms. Our objective was to examine marital status differences in the purchase of medication for circulatory diseases, and risk factors for them, which may indicate underuse of such medication by some marital status groups. METHODS: Using data from registers covering the entire Norwegian population, we analysed marital status differences in the purchase of medicine for eight circulatory disorders by people aged 50-79 in 2004-2008. These differences were compared with those in circulatory disease mortality during 2004-2007, considered as indicating probable differences in disease burden. RESULTS: The unmarried had 1.4-2.8 times higher mortality from the four types of circulatory diseases considered. However, the never-married in particular purchased less medicine for these diseases, or precursor risk factors of these diseases, primarily because of a low chance of making a first purchase. The picture was more mixed for the divorced and widowed. Both groups purchased less of some of these medicines than the married, but, especially in the case of the widowed, relatively more of other types of medicine. In contrast to the never-married, divorced and widowed people were as least as likely as the married to make a first purchase, but adherence rates thereafter, indicated by continuing purchases, were lower. CONCLUSION: The most plausible interpretation of the findings is that compared with married people, especially the never-married more often have circulatory disorders that are undiagnosed or for which they for other reasons underuse medication. Inadequate use of these potentially very efficient medicines in such a large population group is a serious public health challenge which needs further investigation. It is possible that marital status differences in use of medicines for circulatory disorders combined with an increasing importance of these medicines have contributed to the widening marital status gap in mortality observed in several countries. This also requires further investigation

Detrimental effects of early rural life on blood pressure among urban male migrants in Wroclaw, Poland

The purpose of the study was to compare the blood pressure of rural-to-urban migrants and the sedentary population (non-migratory) of the city of Wrocław, Poland. Additionally, the effect of time spent in the rural area on blood pressure was also assessed. The study sample consisted of 2753 males aged 25-75 years, following a medical examination, underwent an interview and anthropometric measurements between 1989-90. Based on the place of origin all males were divided into rural-to-urban migrant inhabitants of Wrocław (N=1222) and sedentary inhabitants of Wrocław (N=921). The percentage of time spent in the rural area [(time spent in rural area/age)*100] was then calculated and was used in analysis. In each age category, the rural-urban migrants were found to be shorter in height. Age, BMI, level of education and time of migration had a significant effect on both the systolic and diastolic blood pressure irrespective of the level of education. It was demonstrated that the time of migration, allowing for age, body size and education level, significantly correlated with blood pressure. The later in time, the males migrated from rural to urban areas, the higher their blood pressure. It was hypothesized that unhealthy behavior could still have continued in a new urban environment, resulting in migrant - sedentary differences in health parameter

Detrimental effects of early rural life on blood pressure among urban male migrants in Wroclaw, Poland

The purpose of the study was to compare the blood pressure of rural-to-urban migrants and the sedentary population (non-migratory) of the city of Wrocław, Poland. Additionally, the effect of time spent in the rural area on blood pressure was also assessed. The study sample consisted of 2753 males aged 25-75 years, following a medical examination, underwent an interview and anthropometric measurements between 1989-90. Based on the place of origin all males were divided into rural-to-urban migrant inhabitants of Wrocław (N=1222) and sedentary inhabitants of Wrocław (N=921). The percentage of time spent in the rural area [(time spent in rural area/age)*100] was then calculated and was used in analysis. In each age category, the rural-urban migrants were found to be shorter in height. Age, BMI, level of education and time of migration had a significant effect on both the systolic and diastolic blood pressure irrespective of the level of education. It was demonstrated that the time of migration, allowing for age, body size and education level, significantly correlated with blood pressure. The later in time, the males migrated from rural to urban areas, the higher their blood pressure. It was hypothesized that unhealthy behavior could still have continued in a new urban environment, resulting in migrant - sedentary differences in health parameter