Promoting Social Participation in the Primary Care Field: An Ecological Study on the Potential Reduction of Multimorbidity Prevalence.

IF 3 Q1 PRIMARY HEALTH CARE
Ryota Takahashi, Tadao Okada, Kazushige Ide, Taishi Tsuji, Katsunori Kondo
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Abstract

Background: No municipal-level study has elucidated the social determinants associated with multimorbidity prevalence (MP).

Objective: This article aimed to determine the differences in MP among municipalities and investigate factors associated with such differences through an ecological study of data obtained from a nationwide survey. This article focused on social participation and household income, which are associated with single chronic diseases, such as hypertension.

Methods: Study design was a cross sectional study, which used the data from the Japan Gerontological Evaluation Study, a population-based gerontological study among functionally independent older adults aged ≥65 years in Japan. Overall, 152 212 participants from 2016 to 2017 across 91 municipalities were included in the final analysis. Multiple regression analysis was performed with MP as objective variable; social participation or household income were explanatory variables, and education, population density, and health check-ups were adjustment variables.

Results: Intermunicipal differences in MP were 28.4% to 43.1% and 23.2% to 38.8% among men and women, respectively. Significant negative correlation was observed between MP and proportion of social participation (non-standardized coefficient [B] = -.18 for men and women). A significant positive correlation was noted between MP and equivalent household income of ≤2 million yen in women (B = .21).

Conclusion: Considerable differences in MP existed among municipalities. Areas with high proportion of social participation showed significantly lower MP. Considering the difficulty in managing multimorbidity within the primary care field and limited evidence on effective interventions, community-level interventions encouraging social participation among older individuals might reduce MP. Primary care physicians should consider a community health approach for multimorbidity.

促进初级保健领域的社会参与:关于降低多病流行可能性的生态学研究》。
背景:没有一项市级研究阐明了与多病症患病率(MP)相关的社会决定因素:还没有一项市级研究阐明了与多病症患病率(MP)相关的社会决定因素:本文旨在通过对全国范围内的调查数据进行生态学研究,确定各市多病患病率的差异,并调查与这些差异相关的因素。本文重点关注与高血压等单一慢性病相关的社会参与和家庭收入:研究设计为横断面研究,使用了日本老年学评估研究的数据,该研究是一项基于人口的老年学研究,对象是日本年龄≥65 岁、功能独立的老年人。最终分析共纳入了 2016 年至 2017 年 91 个市镇的 152 212 名参与者。以MP为客观变量,社会参与或家庭收入为解释变量,教育、人口密度和健康检查为调整变量,进行多元回归分析:结果:男性和女性的 MP 在城市间的差异分别为 28.4% 至 43.1%,23.2% 至 38.8%。MP 与社会参与比例之间存在显著的负相关(男性和女性的非标准化系数 [B] = -.18)。女性的 MP 与等值家庭收入低于 200 万日元之间存在明显的正相关(B = .21):结论:不同城市的 MP 存在很大差异。社会参与比例高的地区的 MP 明显较低。考虑到在初级保健领域管理多病症的困难以及有效干预措施的证据有限,鼓励老年人参与社会活动的社区干预措施可能会降低 MP。初级保健医生应考虑采用社区保健方法来治疗多病症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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