OBJECTIVETo date, there has been little information published on the death of rural road accident deaths. This study uses burden of injury method to explore a more accurate estimate of years of life lost due to road traffic crashes occurring over a four-year period in Guilan province, northern Iran.

METHODSRural road accident deaths from 2009 to 2013 were extracted from Iran's Forensic Medicine System, Death Registry System and Road Trauma Research center database.

RESULTSDuring the study period, the average years of life lost due to motor vehicle crashes was 13.8 per 1 000 persons, ranging from 11.9 during March 2011-2012 to 15.8 per 1 000 persons during March 2012-2013.

CONCLUSIONRoad accident deaths in 2013 remained at the same high level as in 2009. The information obtained from this study provides a new perspective on fatal road traffic crash victims in rural settings and show us that more attention is needed in this area.

Accidents, Traffic ; mortality ; statistics & numerical data ; Humans ; Income ; Iran ; Rural Population

OBJECTIVEIn order to figure out how and to what degree the social and economic development and control strategy influencing the epidemics of tuberculosis and to provide reference for tuberculosis prevention and control in China.

METHODSBased on the data from the nationwide random surveys on tuberculosis in 1979, 1984/1985, 1990 and 2000 and the indexes on social and economic development of China, correlation coefficient was used to analyze the relationship of three factors including (1) the change of epidemic situation of tuberculosis from 1979 to 2000; (2) the level of social and economic development; (3) the implementation of Health V Project.

RESULTSThe prevalence rate of smear positive tuberculosis was significantly correlated to per capita net income of rural population, consumption level of city population, per capita GDP, density of population, and proportion of rural population. Among which the correlation with per capita net in come of rural population, consumption level of city population, per capita GDP, or density of population showed negative, correlation but the proportion of rural population showed positive. The range of GDP increase was similar in both areas with or without the implementation of Health V Project from 1990 to 2000 (77.2% and 77.8%). However, the ranges of the decline of prevalence rate were quite different (44.4% and 12.3%) in the two areas. In the western part of China, the range of GDP increase was similar in the areas with or without the implementation of Health V Project. However, the prevalence rate declined in the area that implementing the project but increased in other areas without the project.

CONCLUSIONThe level of social and economic development had influenced the prevalence rate of tuberculosis, but the implementation of tuberculosis control project played an important role in the reduction of tuberculosis prevalence rate from 1979 to 2000 in China.

China ; epidemiology ; Female ; Humans ; Income ; statistics & numerical data ; Male ; Prevalence ; Rural Population ; Socioeconomic Factors ; Tuberculosis ; epidemiology

OBJECTIVETo investigate the factors related to maternal mortality rate in 1000 counties of projects on reducing maternal mortality rate (MMR) and eliminating tetanus neonates in China, 2003.

METHODSStudy on the association was performed using data on average income per capita, hospital delivery rate and MMR.

RESULTSData showed that income per capita and hospital delivery rate had strong association with MMR. MMR for women with income less than 1000 Chinese Yuan per capita was 100.9 per 100 000 live births, and with income over 2000 Yuan per capita was 61.8 per 100 000 live births. MMR was 107.2 per 100 000 live births for women with hospital delivery rate less than 50%, and 54.1 per 100 000 live births with hospital delivery rate over 75%. The hospital delivery rate was less than 50% in the counties with income less than 1000 Yuan per capita, and over 75% with income over 2000 Yuan per capita. Only 19.1% of the counties with income less than 1000 Yuan per capita and 66.7% over 2000 Yuan per capita reached 75% hospital delivery rate.

CONCLUSIONMMR and hospital delivery rate were affected by economic level of individuals. MMR seemed inversely proportional to income per capita and hospital delivery rate. The hospital delivery rate in 1000 counties was closely associated with income per capita. MMR could be reduced by enhancing hospital delivery rate.

China ; epidemiology ; Delivery, Obstetric ; statistics & numerical data ; Female ; Humans ; Income ; statistics & numerical data ; Maternal Health Services ; Maternal Mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Socioeconomic Factors

OBJECTIVETo explore the influencing factors of smoking behavior transition at different stage of smoking among undergraduate students.

METHODS8138 undergraduate students from grade 1 to 3 were selected using cluster sampling method from an university in Guangzhou with their smoking behaviors and relevant factors studied through a self-administered questionnaire. Beginners, un-regular smokers and regular smokers were defined as "case group", while non-smokers, beginners and un-regular smokers were defined as "control group" accordingly. Three multivariable logistic regressions were separately conducted to explore the influencing factors of behavioral transition at different stage of smoking.

RESULTSOf the 8138 students investigated, the prevalence rates of beginners, un-regular smokers and regular smokers were 19.6%, 2.0% and 1.1%, respectively; while all of the above said three rates increased with grades of the students. Some students might still try to smoke or become regular smoker in the university. In male undergraduate students, determinants for the transition from non-smokers to s mokers were: source of students, father' s educational level, smoking-related knowledge and belief, and smoking habit of the roommates. Risks that influencing the transition from beginners to un-regular smokers were: being non-medical students,smoking-related belief, roommates and classmates who were smokers and transition from un-regular smokers to regular smokers would include father' s educational level and average income of family. In female undergraduate students,influencing factors from non-smokers to beginners were mother's educational level, smoking-related belief, and roommates smokers, while father's educational level, roommates and classmates' smoking habits were significant associated with beginners' change to un-regular smokers.

CONCLUSIONThe influencing factors related to the transition of different stage on smoking would be different in undergraduate students,and some specific measures should be taken based on the different stage of smoking.

Age Distribution ; China ; epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Income ; statistics & numerical data ; Male ; Smoking ; epidemiology ; Universities ; statistics & numerical data

OBJECTIVETo analyze the direct economic burden of stroke in rural areas of Hanzhong.

METHODSPlan on primary interview was made after the purpose of the study had been informed to the managers of the 'surveillance field base', heads and members of the monitor assistants and detailed information was collected in the fields. Every single patient of stroke was then interviewed by the above said interviewers,using a self-designed questionnaire. 164 patients with stroke were interviewed in 53 villages with 75,000 persons lived there. The main items involved in the questionnaire would include: costs for inpatient or outpatient, reaching-out fees, fee for accommodation during treatment as outpatient, costs for treatment at home, long term medicine, caregivers and funerals as well as average income.

RESULTSThe median of annual direct economic burden was 3100 Yuan for each patient in Hanzhong rural area. There were no significant differences seen between males and females or among age groups (P > 0.05). The proportion of patients with medians of annual direct economic burden of: 1000 Yuan and below, 1001-5000 Yuan, 5001-10,000 Yuan, 10,001-20,000 Yuan and over 20,001 Yuan, were 29.2%, 36.0%, 18.3%, 9.8% and 6.0% respectively. The median of annual direct economic burden of first episode stroke was 5500 Yuan for each patient, and that of stroke was 1700 Yuan for each chronic patient. The direct economic burden of first episode was significantly higher than that of stroke (P < 0.01). The costs of hospitalization, accommodation of hospitalization and treatment at home of middle-aged patients were significant higher than that of old age patients (P < 0.05).

CONCLUSIONIn this study, the direct economic burden of stroke was 2.9 times of the annual personal average income, which was contrary to the reports from other countries. However, the State Health Bureau bore 87.1% of the direct economic burden for urban patients, but patients in the rural areas had to pay from their own pockets. The direct economic burden of stroke was heavy in Hanzhong rural region, which called for measures to be made to decrease the direct economic burden of stroke in the region.

Age Distribution ; Aged ; China ; Cost of Illness ; Female ; Humans ; Income ; statistics & numerical data ; Male ; Middle Aged ; Rural Population ; statistics & numerical data ; Sex Distribution ; Stroke ; economics

PURPOSE: By studying the economic data related to road traffic accidents in recent 10 years, this paper explores the impact of various economic factors on the number of casualties in traffic accidents in China, and puts forward related prevention and management measures. METHODS: Based on five economic factors including the number of new health institutions, health investment, transportation investment and disposable income per capita, this paper collects the data of traffic accidents in 31 provinces and municipalities of China from 2004 to 2016 and estimates the parameters using fixed effect model. RESULTS: The number of health institutions, health investment, transportation investment and disposable income per capita are negatively correlated with the number of traffic accident casualties; the number of new health institutions is positively correlated with the number of traffic accident casualties; health investment and transportation investment have a great impact on the number of road traffic accident casualties. CONCLUSION Economic development has a positive impact on improving traffic conditions, but the increase in the number of new health institutions does not reduce the number of casualties in accidents. The irrational layout of health institutions and imperfect road traffic management mechanism should be taken into account.
Accidents, Traffic ; mortality ; prevention & control ; statistics & numerical data ; China ; epidemiology ; Economics ; Health ; economics ; Health Facilities ; statistics & numerical data ; Humans ; Income ; Time Factors ; Transportation ; economics ; Wounds and Injuries ; epidemiology

Against the backdrop of population aging, this paper presents the analysis of need-standardised health care utilization among elderly in India. Based on nationally representative morbidity and health care survey 2004, we demonstrate that the need for health care utilization is indeed pro-poor in nature. However, the actual health care utilization is concentrated among richer sections of the population. Further, the decomposition analysis reveals that income has a very strong role in shifting the distribution of health care away from the poor elderly. The impact of income on utilization is well-demonstrated even at the ecological-level as states with higher per capita incomes have higher elderly health care utilization even as the levels of need-predicted distribution across these states are similar. We also find that the distribution of elderly across social groups and their educational achievements favours the rich and significantly contributes to overall inequality. Nevertheless, contribution of need-related self-assessed health clearly favours pro-poor inequality. In concluding, we argue that to reduce such inequities in health care utilization it is necessary to increase public investments in health care infrastructure including geriatric care particularly in rural areas and underdeveloped regions to enhance access and quality of health care for the elderly.
Aged ; Aged, 80 and over ; *Cultural Characteristics ; Evidence-Based Medicine ; Female ; Health Care Rationing/*statistics & numerical data ; Health Equity/*statistics & numerical data ; Health Services for the Aged/*utilization ; Humans ; Income/*statistics & numerical data ; India/epidemiology ; Male ; Middle Aged ; Socioeconomic Factors ; *Utilization Review

OBJECTIVES: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. METHODS: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. RESULTS: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). CONCLUSIONS: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.
Adolescent ; Ambulatory Care/*utilization ; Child ; Child, Preschool ; Female ; Health Surveys ; Humans ; Income ; Infant ; Infant, Newborn ; Insurance, Health/economics/*statistics & numerical data ; Male ; Medically Uninsured ; Odds Ratio ; Republic of Korea

OBJECTIVES: This study was conducted in order to determine how the association between socioeconomic position(SEP) and health status changes with age among Seoul residents aged 25 and over. METHODS: We utilized the 2001 and 2005 Seoul Citizens Health Indicators Surveys. We used self-rated 'poor' health status as an outcome variable, and family income as an indicator of SEP. In order to characterize the differential effects of socioeconomic position on health by age, we conducted separate multivariate analyses by 10-year age groups, controlling for sociodemographic covariates. In order to assess the relative health inequality across socioeconomic groups, we estimated the Relative Index of Inequality (RII). RESULTS: The risk of 'poor health' is significantly high in low family income groups, and this increased risk is seen at all ages. However, the magnitude of relative socioeconomic inequality in health, as measured by the odds ratio and RII, is not identical across age groups. The difference in health across income groups is small in early adulthood (ages 25-34), but increases with age until relatively late in life (ages 35-64). It then decreases among the elderly population (ages more than 65). When the RII reported in 2005 is compared to that reported in 2001, RII can be seen to have increased across all ages, with the exception of individuals aged 25-34. CONCLUSIONS: The magnitude of health inequality is the greatest during mid- to late adulthood (ages 45-64). In addition, health inequalities have worsened between 2001 and 2005 across all age groups after economic crisis.
Adult ; Age Factors ; *Family ; Female ; *Health Status ; *Health Status Indicators ; Humans ; Income/*statistics & numerical data ; Korea/epidemiology ; Male ; Middle Aged ; Socioeconomic Factors

OBJECTIVES: This study aimed to verify the association between wealth or income level and health status after adjusting for other socio-economic position (SEP) indicators among Korean adults aged 45 and over. METHODS: Data were obtained from the 1st wave of Korean Longitudinal Study of Ageing (households: 6,171, persons: 10,254). We used self-rated health status and activities of daily living (ADLs) as dependent variables. Explanatory variables included both net wealth measured by savings, immovables, the other valuated assets and total income including pay, transfer, property and so on. Binary logistic regression was conducted to examine the relationships. Also, in order to determine the relative health inequality across economic groups, we estimated the relative index of inequality (RII). RESULTS: The inequality of health status was evident among various wealth and income groups. The wealthiest group (5th quintile) was much healthier than the poorest group, and this differential increased with age. Likewise, higher income was associated with better health status among the elderly. However, these effects, as measured by the odds ratio and RII, showed that wealth was more important in determining health status of elderly people. CONCLUSIONS: This study suggests that economic capability plays a significant role in determining the health status and other health-related problems among the elderly. Particularly, our results show that health status of the aged is related more closely to the individual's wealth than income.
Activities of Daily Living ; Aged ; Aging ; Female ; *Health Status ; Health Status Disparities ; Humans ; Income/*statistics & numerical data ; Korea/epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Socioeconomic Factors