Subjective social status, health and well-being among older adults in China and South Korea: a cross-sectional analysis.

INTRODUCTION: Social status, which encompasses various psychosocial dimensions, such as income, education and social relationships, can have a significant impact on physical and mental health outcomes. The study aims to explore the association among subjective social status, health and well-being among individuals aged 55 years and older in China and South Korea. PARTICIPANTS: Sample population included individuals aged 55 years and older: China (n=1779) and South Korea (n=421). OUTCOME MEASURES: Outcome measures included self-reported health status and well-being which were assessed by life satisfaction and general happiness. RESULTS: The percentage of participants who reported a 'very good' health condition was higher in South Korea (14.5%) than in China (11.0%). The percentage of participants who reported feeling very satisfied (14.7%) with their life was lower in South Korea (11.8%). In China, 6.7% of the respondents reported their health as 'very bad' (rating 5), while in South Korea, this percentage was higher at 18.1%. Regression analysis revealed an inverse association among higher social status and poorer health, lower life satisfaction and lower happiness levels. For example, individuals who placed themselves in the highest social status category had 0.26 times lower odds (95% CI=0.13 to 0.55) of reporting poorer self-rated health status than those in the lowest category. Similarly, compared with individuals who place themselves in the lowest social status category, those who place themselves in the highest social status category have 0.03 times lower odds of reporting lower life satisfaction (95% CI=0.02 to 0.07). CONCLUSION: Overall, the results highlight a significant association among social status, subjective health, life satisfaction and general happiness in both the countries. Health policymakers should identify effective strategies to promote healthy ageing and reduce disparities in health and well-being outcomes among older adults from different social backgrounds.

Patient attitude and determinants toward chronic diseases control: A cross-sectional survey in rural China.

Objectives: The patients' attitude is critical in disease control. This study aims to explore the determinants of patients' attitude and satisfaction. Methods: A total of 844 patients in the rural areas of Shandong, Henan, and Sichuan provinces with hypertension or diabetes were randomly selected for investigation. The outcome variables were the patients' attitude and satisfaction toward chronic disease control, which were measured through patient self-reported. Binary logistic regression models were used to explore the determinants of patients' attitude and satisfaction. Results: Teachers were more likely to regard that chronic disease management was helpful in their chronic disease control than that in farmers (OR = 3.994, 95% confidence interval (CI) = 1.309-12.188). Moreover, the probability of health institutions recording chronic diseases changes and guiding rehabilitation for patients regularly is considered helpful 2.688 times more than those that are not. In addition, receiving chronic disease management services can make patients repute that chronic disease management services are helpful in controlling chronic diseases more capably (OR = 1.582, 95% CI = 2.198-10.771). In terms of satisfaction, patients who do not know regular follow-up tend to be dissatisfied with chronic diseases control result (OR = 0.376, 95% CI = 0.192-0.737; OR = 0.592, 95%CI = 0.417-0.841). Conclusion: The government increases the promotion of chronic disease management in rural areas to improve patients' awareness. Health institutions also can provide diversified services to meet the needs of more people. At last, paying more attention to the timeliness of health services need to be considered to develop a health plan.

The use of annual physical examinations among the elderly in rural China: a cross-sectional study.

BACKGROUND: Periodic physical examination is considered helpful in preventing illness and promoting health among the elderly. Limited information is available about the use of annual physical examinations among the elderly in rural areas, however. This research explores the distribution characteristics of annual physical examination use and its determinants among people aged 60 or over in rural China. METHODS: A cross-sectional study was undertaken to estimate distribution characteristics of annual physical examination use and to collect data of sociodemographic characteristics, health knowledge level, and health communication channels. Participants were 1128 people aged 60 or over, randomly selected from four different provinces in the East, Mid-East, Mid-West, and West China. Logistic regression determined the predictors of annual physical examination use. RESULTS: Participants were predominantly aged 60-79 (44.1%) and 70-79 (42.0%). A total of 716 (63.5%) participants underwent annual physical examinations. Those who reported acquiring health knowledge via bulletin boards and village doctors had a higher probability of using annual physical examinations (OR = 3.15 and 1.53). The probability for civil servants/retired having annual physical examinations was 2.16 times higher than for farmers. Those who had an average level of health knowledge had a higher probability of using annual physical examinations than those at the below-average level (odds ratio: 2.07). CONCLUSION: The government and public health institutions should assist farmers to acquire the habit of having annual physical examinations. Traditional channels, such as bulletin boards, should be used to deliver health information. Village doctors should be supported in delivering health information to the elderly in rural areas.

Equity of the essential public health service in rural china: evidence from a nationwide survey of hypertensive patients.

OBJECTIVES: To explore healthcare disparities in rural China two years after the implementation of the Essential Public Health Service (EPHS) reform in 2009. METHODS: A cross-sectional study was conducted by surveying 930 hypertension patients (HPs) from different regions in rural China in 2011. The percentages of patients using recommended four or more follow-up visits in a year were calculated by patient socio-demographic characteristics and statistically examined using chi-square and logistic regression to uncover disparities and correlated factors in EPHS use. RESULTS: The rates were not significantly different by age, gender, education, insurance status or income, but significantly different by region and hypertension history (p<0.01). Higher rates were also observed on patients who sought actively follow-up service at clinics, making appointment for the next follow-up with doctors, awareness of the need of follow-up, more satisfied with the follow-up services, and better medication adherence (p<0.01). CONCLUSIONS: There were no disparities observed among HPs in the use of follow-up services, suggesting that the reform has to some extent achieved its goal in ensuring equal access to EPHS. In this regard, regional implementation of the national policies and improvement of EPHS management at local level should be further improved.

Impact evaluation of HIV/AIDS education in rural Henan province of China.

Nowadays, there is a trend of HIV prevalence transmitting from high-risk group to average-risk group in China. Rural China is the weak link of HIV prevention, and rural areas of Henan province which is one of the most high-risk regions in China have more than 60% of the AIDS patients in the province. Thus, improving the HIV awareness and implementing health education become the top-priority of HIV/AIDS control and prevention. A multistage sampling was designed to draw 1129 people living with HIV/AIDS (PLWHAs) and 1168 non-PLWHAs in 4 prevalence counties of Henan province. A health promoting and social-psychological support model was constructed to improve the health knowledge of participants. Chi-square tests and unconditional logistic regression were performed to determine the intervention effect and influencing factors. All groups had misunderstandings towards the basic medical knowledge and the AIDS transmission mode. Before the intervention, 59.3% of the HIV/AIDS patients and 74.6% of the healthy people had negative attitudes towards the disease. There was statistically significant difference in the improvement of knowledge, attitude and action with regards to HIV prevention before and after intervention (P<0.05). PLWHAs who were males (OR=1.731) and had higher education level (OR=1.910) were found to have better HIV/AIDS health knowledge, whereas older PLWHAs (OR=0.961) were less likely to have better HIV/AIDS health knowledge. However, the intervention effect was associated with the expertise of doctors and supervisors, the content and methods of education, and participants' education level. It was concluded that health education of HIV/AIDS which positively influences the awareness and attitude of HIV prevention is popular in rural areas, therefore, a systematic and long-term program of HIV control and prevention is urgently needed in rural areas.