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Aim: Chronic diseases are influential components of stroke, one of the dominant reasons for dementia and premature mortality. Environmental risks are risk factors for transitioning from stroke to dementia. This study addresses the transition behaviors in stroke and dementia development associated with chronic diseases and environmental risks. Methods: This study is an integrated survey of medical and environmental informatics concerning stroke patients' quality of life. A total of 10 627 stroke patients diagnosed in Taiwan were surveyed in this study. A covariate model and subgroup analysis were used to evaluate the influence of chronic diseases and environmental risk factors (i.e., divorce rate, unemployment rate, solitariness rate, temperature, and air pollution rate) on stroke and the corresponding dementia transition behaviors. Results: This study constructed a total of 98 covariate analysis models, consisting of 14 transition types [10 transitions from chronic diseases to stroke (5 metabolic risk states × 2 stroke states) and 4 transitions from stroke to dementia (2 stroke states × 2 dementia states)] by 7 covariates (i.e., sex, age, divorce rate, unemployment rate, temperature, air pollution, and solitariness rate). Among the 98 transitions, 26 were statistically significant. Conclusions: Sex, age, divorce rate, unemployment rate, temperature, and air pollution rate exerted a partially significant influence on the transition from chronic diseases to stroke. Sex, age, unemployment rate, and temperature partially influenced the transition from stroke to dementia. This study also considered high‐risk sub‐populations of stroke patients, particularly males aged 65 years and below. Geriatr Gerontol Int 2024; 24: 766–772. [ABSTRACT FROM AUTHOR]

Purpose: Despite a rapid increase in older men living alone, relatively little is known about their life satisfaction and related factors. Based on Levine's conservation model, this study aimed to explore predictors of life satisfaction among older men living alone in South Korea. Methods: Using logistic regression, a cross-sectional secondary data analysis was conducted among aged men living alone (N=548) from the 2020 National Survey of Older Koreans. Results: The factors associated with a risk of lower life satisfaction in older men living alone were income lower than the standard median income, unemployment, living in rural areas, moderate-high nutritional risk, declined sensory function, depression, and social isolation. Conclusion: To enhance the life satisfaction of older men living alone, customized interventions are required, including comprehensive health assessment with a holistic perspective. Addressing economic stability alongside prevention and multidimensional interventions is needed to mitigate nutritional risks, sensory function decline, depression, and social isolation. Healthcare providers and policymakers in local communities should understand the sociocultural characteristics of older Korean men living alone and provide well-suited formal and informal support programs to address these needs. [ABSTRACT FROM AUTHOR]

Patients with bipolar disorder have higher rates of type 2 diabetes (T2D) compared to the general population. Neighbourhood deprivation is associated with T2D and bipolar disorder. The aim of this study was to explore the potential effect of neighbourhood deprivation on incident T2D in patients with bipolar disorder. This nationwide open cohort study (1997–2018) included adults in Sweden ≥20 years with bipolar disorder (90,780 patients) to examine the subsequent risk of T2D. The association between neighbourhood deprivation and T2D was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for individual‐level sociodemographic factors and comorbidities. Neighbourhood deprivation was significantly associated with T2D in patients with bipolar disorder. The HRs were 1.61 (95% CI 1.40–1.86) for men and 1.83 (1.60–2.10) for women living in high deprivation neighbourhoods compared to those from low deprivation neighbourhoods. After adjustment, these results remained significant: 1.35 (1.17–1.56) in men and 1.39 (1.20–1.60) in women living in high deprivation neighbourhoods. The suggested graded association of higher incident T2D among patients with bipolar disorder, observed when levels of neighbourhood deprivation increased, raises important clinical and public health concerns. The results may help develop a contextual approach to prevention of T2D in patients with bipolar disorder that includes the neighbourhood environment. [ABSTRACT FROM AUTHOR]

Background: With increasing urbanization, number of urban slums is also rising. The health facilities and indicators in urban slums are poor as compared to other urban population. The present study presents an analysis of the health problems, utilization of health services and vulnerability of urban slums. Aims & Objectives: To map the slums in urban areas and assess the vulnerability of households. Methodology: The study was conducted in all urban slums of five cities of Nainital and Udham Singh Nagar districts namely Haldwani, Ramnagar, Rudrapur, Jaspur and Kashipur. Group discussions involving community members, ward surveys by ASHA workers and household level vulnerability assessment were done using standard format according to "Guidelines and Tools for Vulnerability Mapping and Assessment of Urban Health, 2017". Results: Most urban slum dwellers are daily wage laborers with major population suffering mainly from diabetes, hypertension, respiratory infection. Lack of drugs and diagnostic facilities are the major concerns. Infrastructure needs strengthening in most of the slums. Around three fourth of population belonged to vulnerable group with remaining in highly vulnerable group. Conclusion: There are social problems in urban slums like illiteracy, lack of awareness, unemployment which worsen the health problems. So, a holistic approach is needed for the solution. [ABSTRACT FROM AUTHOR]

Background and aims: Sepsis is a serious and life-threatening condition caused by a dysregulated immune response to an infection. Recent guidance issued in the UK gave recommendations around recognition and antibiotic treatment of sepsis, but did not consider factors relating to health inequalities. The aim of this study was to summarise the literature investigating associations between health inequalities and sepsis. Methods: Searches were conducted in Embase for peer-reviewed articles published since 2010 that included sepsis in combination with one of the following five areas: socioeconomic status, race/ethnicity, community factors, medical needs and pregnancy/maternity. Results: Five searches identified 1,402 studies, with 50 unique studies included in the review after screening (13 sociodemographic, 14 race/ethnicity, 3 community, 3 care/medical needs and 20 pregnancy/maternity; 3 papers examined multiple health inequalities). Most of the studies were conducted in the USA (31/50), with only four studies using UK data (all pregnancy related). Socioeconomic factors associated with increased sepsis incidence included lower socioeconomic status, unemployment and lower education level, although findings were not consistent across studies. For ethnicity, mixed results were reported. Living in a medically underserved area or being resident in a nursing home increased risk of sepsis. Mortality rates after sepsis were found to be higher in people living in rural areas or in those discharged to skilled nursing facilities while associations with ethnicity were mixed. Complications during delivery, caesarean-section delivery, increased deprivation and black and other ethnic minority race were associated with post-partum sepsis. Conclusion: There are clear correlations between sepsis morbidity and mortality and the presence of factors associated with health inequalities. To inform local guidance and drive public health measures, there is a need for studies conducted across more diverse setting and countries. [ABSTRACT FROM AUTHOR]

Objectives: Structural racism (SR) is viewed as a root cause of racial and ethnic disparities in maternal health outcomes. However, evidence linking SR to increased odds of severe adverse maternal outcomes (SAMO) is scant. This study assessed the association between state-level indicators of SR and SAMO during childbirth. Methods: Data for non-Hispanic Black and non-Hispanic white women came from the US Natality file, 2017–2018. The exposures were state-level Black-to-white inequity ratios for lower education level, unemployment, and prison incarceration. The outcome was patient-level SAMO, including eclampsia, blood transfusion, hysterectomy, or intensive care unit admission. Adjusted odds ratios (aORs) of SAMO associated with each ratio were estimated using multilevel models adjusting for patient, hospital, and state characteristics. Results: A total of 4,804,488 birth certificates were analyzed, with 22.5% for Black women. SAMO incidence was 106.4 per 10,000 (95% CI 104.5, 108.4) for Black women, and 72.7 per 10,000 (95% CI 71.8, 73.6) for white women. Odds of SAMO increased 35% per 1-unit increase in the unemployment ratio for Black women (aOR 1.35; 95% CI 1.04, 1.73), and 16% for white women (aOR 1.16; 95% CI 1.01, 1.33). Odds of SAMO increased 6% per 1-unit increase in the incarceration ratio for Black women (aOR 1.06; 95% CI 1.03, 1.10), and 4% for white women (aOR 1.04; 95% CI 1.02, 1.06). No significant association was observed between SAMO and the lower education level ratio. Conclusions for Practice: State-level Black-to-white inequity ratios for unemployment and incarceration are associated with significantly increased odds of SAMO. Significance: What is already known on this subject? Structural racism is viewed as a root cause of racial and ethnic disparities in maternal health outcomes, independent of socioeconomic determinants of health. However, supporting evidence is scant. What this study adds? In this population-based study in 2017–2018, state-level Black-to-white inequities in unemployment and incarceration are associated with significantly increased odds of severe adverse maternal outcomes (i.e., blood transfusion, hysterectomy, and ICU admission) during childbirth for non-Hispanic Black women, and to a lesser extent, for non-Hispanic white women. Addressing structural racism in maternal care may contribute to improving maternal health equity. [ABSTRACT FROM AUTHOR]