ABSTRACT
BACKGROUND: Life expectancy (LE) has usually been used as a metric to monitor population health. In the last few years, metrics such as Quality-Adjusted-Life-Expectancy (QALE) and Health-Adjusted-Life- Expectancy (HALE) have gained popularity in health research, given their capacity to capture health related quality of life, providing a more comprehensive approach to the health concept. We aimed to estimate the distribution of the LE, QALEs and HALEs across Socioeconomic Status in the Chilean population. METHODS: Based on life tables constructed using Chiang II´s method, we estimated the LE of the population in Chile by age strata. Probabilities of dying were estimated from mortality data obtained from national registries. Then, life tables were stratified into five socioeconomic quintiles, based on age-adjusted years of education (pre-school, early years to year 1, primary level, secondary level, technical or university). Quality weights (utilities) were estimated for age strata and SES, using the National Health Survey (ENS 2017). Utilities were calculated using the EQ-5D data of the ENS 2017 and the validated value set for Chile. We applied Sullivan´s method to adjust years lived and convert them into QALEs and HALEs. RESULTS: LE at birth for Chile was estimated in 80.4 years, which is consistent with demographic national data. QALE and HALE at birth were 69.8 and 62.4 respectively. Men are expected to live 6.1% less than women. However, this trend is reversed when looking at QALEs and HALEs, indicating the concentration of higher morbidity in women compared to men. The distribution of all these metrics across SES showed a clear gradient in favour of a better-off population-based on education quintiles. The absolute and relative gaps between the lowest and highest quintile were 15.24 years and 1.21 for LE; 18.57 HALYs and 1.38 for HALEs; and 21.92 QALYs and 1.41 for QALEs. More pronounced gradients and higher gaps were observed at younger age intervals. CONCLUSION: The distribution of LE, QALE and HALEs in Chile shows a clear gradient favouring better-off populations that decreases over people´s lives. Differences in LE favouring women contrast with differences in HALEs and QALEs which favour men, suggesting the need of implementing gender-focused policies to address the case-mix complexity. The magnitude of inequalities is greater than in other high-income countries and can be explained by structural social inequalities and inequalities in access to healthcare.
Subject(s)
Healthy Life Expectancy , Quality of Life , Infant, Newborn , Male , Female , Humans , Child, Preschool , Chile , Life Expectancy , Quality-Adjusted Life YearsABSTRACT
BACKGROUND: Health inequities have a profound impact on all dimensions of people's lives, with invariably worse results among the most disadvantaged, transforming them into a more fragile and vulnerable population. These unfair inequalities also affect dimensions focused on subjectivity, such as health-related quality of life (HRQoL), which has been positioned, in recent decades, as an important outcome in health decision-making. The main objective of this study is to estimate socioeconomic inequality in HRQoL of Chilean by household income. METHODS: Secondary analysis of the National Health Survey (ENS 2016-2017, Chile). This survey includes a nationally representative, stratified, and multistage household sample of people aged 15 and above. Socioeconomic inequality in HRQoL (EQ5D) is estimated by the concentration index (CI) ranked by household income. Decomposition analysis is conducted to examine potential explanatory sociodemographic factors. RESULTS: The CI for household income inequality in HRQoL was -0.063. The lower the household income, the worse the HRQoL reported by in Chile. The decomposition analysis revealed that socioeconomic position contributes 75,7% to inequality in the quality of life, followed by educational level (21.8%), female gender (17.3%), and type of Health Insurance (15%), age (-19.7%) and residence (-10.8%). Less than 1% corresponds to the unexplained residual component. CONCLUSIONS: Our findings suggest the existence of a disproportionate concentration of worse HRQoL in the most disadvantaged socioeconomic groups in Chile. This inequality is largely, yet not completely, associated with household income. Other significant factors associated with this inequality are education, gender, and healthcare insurance. These results suggest the need of strengthening efforts to reducing socioeconomic gaps in health outcomes in Chile, as a means to achieve social justice and equity in health and healthcare.
Subject(s)
Income , Quality of Life , Humans , Female , Socioeconomic Factors , Chile/epidemiology , Health SurveysABSTRACT
OBJECTIVE: The aim of this study was to analyze the blood serum levels of CTX-II in professional indoor soccer players, at three different times during one season: at the start of the pre-season, four months later (a time that marks the middle of the season) and at the end of the season. METHODS: Fourteen male soccer players of mean age 19 years were included. Blood samples of 3 mL were collected from each individual. The samples were analyzed by means of Elisa tests. RESULTS: There was a significant increase in the serum level of CTX-II in the indoor soccer players, from the beginning to the end of the season (p < 0.01). CONCLUSION: These data suggest that joint degradation had occurred in these soccer players, by the end of this period. It is evident that further studies are needed, with methodological rigor, so as to make an effective contribution toward precise elucidation of the etiology of this osteoarthritis and its relationship with the biomarkers, as a tool for early diagnosis.
OBJETIVO: Analisar os níveis séricos sanguíneos de CTX-II em atletas profissionais de futebol de salão, em três momentos distintos durante uma temporada: no início da pré-temporada, quatro meses após (período que marca o meio da temporada) e no fim da temporada. MÉTODOS: Foram incluídos 14 atletas do gênero masculino e média de idade de 19 anos. Foram coletados 3 mL de sangue de cada indivíduo. As amostras foram analisadas pelo teste do tipo Elisa. RESULTADOS: Houve aumento significativo dos níveis séricos de CTX-II nos atletas de futebol de salão, comparando-se o início e o fim de uma temporada (p < 0.01). CONCLUSÃO: Esses dados sugerem a ocorrência de degradação articular nos atletas, ao término desse período. Fica evidente a necessidade de futuros estudos, com rigor metodológico, que possam contribuir efetivamente para a elucidação precisa da etiologia da OA e sua relação com os biomarcadores como instrumento de diagnóstico precoce.
ABSTRACT
OBJETIVO: Analisar os níveis séricos sanguíneos de CTX-II em atletas profissionais de futebol de salão, em três momentos distintos durante uma temporada: no início da pré-temporada, quatro meses após (período que marca o meio da temporada) e no fim da temporada. MÉTODOS: Foram incluídos 14 atletas do gênero masculino e média de idade de 19 anos. Foram coletados 3 mL de sangue de cada indivíduo. As amostras foram analisadas pelo teste do tipo Elisa. RESULTADOS: Houve aumento significativo dos níveis séricos de CTX-II nos atletas de futebol de salão, comparando-se o início e o fim de uma temporada (p < 0,01). CONCLUSÃO: Esses dados sugerem a ocorrência de degradação articular nos atletas, ao término desse período. Fica evidente a necessidade de futuros estudos, com rigor metodológico, que possam contribuir efetivamente para a elucidação precisa da etiologia da OA e sua relação com os biomarcadores como instrumento de diagnóstico precoce.
OBJECTIVE:The aim of this study was to analyze the blood serum levels of CTX-II in professional indoor soccer players, at three different times during one season: at the start of the pre-season, four months later (a time that marks the middle of the season) and at the end of the season.METHODS:Fourteen male soccer players of mean age 19 years were included. Blood samples of 3 mL were collected from each individual. The samples were analyzed by means of Elisa tests.RESULTS:There was a significant increase in the serum level of CTX-II in the indoor soccer players, from the beginning to the end of the season (p< 0.01).CONCLUSION:These data suggest that joint degradation had occurred in these soccer players, by the end of this period. It is evident that further studies are needed, with methodological rigor, so as to make an effective contribution toward precise elucidation of the etiology of this osteoarthritis and its relationship with the biomarkers, as a tool fr early diagnosis.
