HAL Id: hal-02510412
https://hal-amu.archives-ouvertes.fr/hal-02510412
Submitted on 23 Apr 2020
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Prospective study on chronic diseases and healthcare
costs for the south of France region, 2016-2028
Bérengère Davin, S. Cortaredona, Valérie Guagliardo, Steve Nauleau, Bruno
Ventelou, P. Verger
To cite this version:
Bérengère Davin, S. Cortaredona, Valérie Guagliardo, Steve Nauleau, Bruno Ventelou, et al..
Prospec-tive study on chronic diseases and healthcare costs for the south of France region, 2016-2028. European
Journal of Public Health, Oxford University Press (OUP): Policy B - Oxford Open Option D, 2019,
29 (Supplement_4), �10.1093/eurpub/ckz185.029�. �hal-02510412�
cardiovascular disease than individuals without ID. Professional service providers and parents are often those being asked, it is more seldom that the knowledge comes from the target group (ID) themselves.
Aim:
To identify experiences and feelings among adolescents with ID regarding activity and sports participation, and to identify how they express and perceive the opportunities they have for being active in the community and surroundings where they live, including body and health awareness.
Methods:
12 adolescents with ID, boys and girls, from Mid-Sweden participated in the study. The participants took part in a semi-structured interview that focused on experiences and aspects regarding activity and sports in their surroundings. Interviews identified three aspects: Activity, Surroundings, and Body- and health awareness. Adolescents with ID seems motivated to participate in activities and sports. The role of significant others, family and friends, support and the feeling of joy all seem crucial when reporting being outdoors, participating in ball games and in music activities. They are aware of limitations, sometimes feel bullied and are afraid of being excluded. Participation in activities and sports may be positively associated with health, but limitations such as awareness and support from society challenge the perception of ‘fitting in’ experienced by adolescents with ID. There is a need for deeper understanding to implement and follow up on the UN convention on rights for individuals with ID, as well as the 2030 sustainable development goals.
Key messages:
The project aims to identify how individuals with ID can
increase their participation in societal activities and hence feel more active and included as citizens.
Special attention is given to include stakeholders in order to
promote implementation and long-term success.
Psychosocial difficulties, obesity and disadvantage in a cohort of Irish children
Mckenzie Dow
M Dow1,2, A Brinkley2, G O’Malley2,3, C Murrin1
1School of Public Health, Physiotherapy and Sports Science, University
College Dublin, Dublin, Ireland
2W82GO Programme, Temple Street Children’s University Hospital, Dublin,
Ireland
3School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin,
Ireland
Contact: mckenzie.dow@ucdconnect.ie
Background:
Childhood obesity is stabilising in Ireland, but less so in children from disadvantaged backgrounds. There is also evidence for a relationship between psychosocial difficulties and obesity in youth, but findings are often mixed. This study aimed to describe the relationships between psychosocial difficulties, obesity, and disadvantage in a national cohort of children in Ireland.
Methods:
Participants (n = 7275) were surveyed and measured at age nine and thirteen as part of the Growing Up in Ireland study (GUI). Psychosocial difficulties were measured using the
Strengths and Difficulties Questionnaire (SDQ).
Disadvantage was represented by the education status of the primary caregiver. BMI was calculated using measured height and weight. Weight status categories were created using the UK 1990 Growth Data. Correlation analyses were used to examine the relationship between child BMI and SDQ scores. Associations between weight categories, psychosocial difficul-ties and education status were examined using Chi-square analysis.
Results:
In children whose parents had secondary education, the obesity rate was 27.9%, compared to 24.7% in those with a college degree (p < 0.01). This relationship was also significant at age thirteen (<0.01). Furthermore, BMI was positively correlated with SDQ total score, (r = .107, p = 0.01) at age nine and at age thirteen (r = .089, p = 0.01). A significant associa-tion was also found between weight status categories and psychosocial difficulties at ages nine (p < 0.1), and thirteen (p < 0.1). Further findings will be reported following a preliminary longitudinal analysis.
Conclusions:
Obesity is associated with psychosocial difficulties, as well as the education status of the primary caregiver, in a large sample of Irish children. These findings are important for under-standing the relationship between childhood obesity and psychological health and have implications for the treatment of obesity in young people.
Key messages:
There are higher rates of obesity in children whose parents
do not have a college degree.
Childhood obesity remains a serious public health issue, and
is associated with psychosocial difficulties in an Irish cohort of children.
1.G. The burden of multiple chronic conditions
Prospective study on chronic diseases and healthcarecosts for the south of France region, 2016-2028
Berengere Davin
B Davin1, S Cortaredona2,3, V Guagliardo1, S Nauleau4, B Ventelou5,
P Verger1,2,3
1ORS PACA, Southeastern Health Regional Observatory, Marseille, France 2Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France 3IHU-Me´diterrane´e Infection, Marseille, France
4ARS PACA, Southeastern Health Regional Agency, Marseille, France 5Aix-Marseille Univ, CNRS, EHESS, Centrale Marseille, Aix-Marseille School
of Economics, Marseille, France Contact: berengere.davin@inserm.fr
Background:
In France, Health Regional Agencies (HRA) have to elaborate a Public Health Plan for the 5 coming years. For estimating future population health needs and associated costs to adapt the health services on the regional territory, the HRA in southeastern France requested a prospective analysis, based on demographic and epidemiologic scenarios about major chronic diseases, to evaluate future trends.
Methods:
Six chronic diseases were selected: diabetes (1 or 2), cardiovascular diseases, respiratory diseases, cancers, neurolo-gical diseases and dementia. We used medico-administrative data from the National health insurance fund, and adapted algorithms to identify people with these diseases. We calculated prevalence rates according to gender and age and used two alternative scenarios (a constant one, and a trend-based one) to estimate the number of people with chronic diseases in 2023 and 2028, starting in 2016. We also estimated future healthcare costs according a constant and a trend-based scenario.
Results:
The algorithms detect reasonable rates of disease compared to official rates available for 2016. Due to demographic (ageing) and/or epidemiologic trends, the number of people with chronic diseases will highly increase during the next ten years in the South of France region. For instance, between 2016 and 2028, there will be from 15% to 20% more people with diabetes. Associated costs will also be higher (+33% between
16 European Journal of Public Health, Vol. 29, Supplement 4, 2019
2016 and 2028), especially those granted to nursing care (+40%).
Conclusions:
Burden of diseases and health expenditures are going to increase in the future. Projections are needed to help policymakers anticipating the required health services adapta-tion. Medico-administrative database are an invaluable source of data to do so. The next step of this project will consist in estimating those trends for smaller geographical areas. Key messages:
Data of the French Health Insurance fund can be used to predict future prevalence of chronic diseases and healthcare costs.
South of France will face a main increase of people with chronic diseases.
Patients with more comorbidities have better detection but poorer management of chronic diseases Grace Sum
G Sum1, GCH Koh1, SW Mercer2, YW Lim3, A Majeed4, B Oldenburg5,
JT Lee6
1Saw Swee Hock School of Public Health, National University of Singapore,
Singapore, Singapore
2Usher Institute of Population Health Sciences, University of Edinburgh, UK 3Yong Loo Lin School of Medicine, National University of Singapore,
Singapore, Singapore
4Department of Primary Care and Public Health, Imperial College London,
UK
5Nossal Institute for Global Health, University of Melbourne, Melbourne,
Australia
Contact: gracesum@u.nus.edu Background:
The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comor-bidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have significant clinical implications as highlighted in the recent National Institute for Care Excellence (NICE) guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, intreated, and uncon-trolled for NCDs, in six large MICs.
Methods:
Cross-sectional analysis of WHO SAGE Wave 1 (2007-10), which consisted of adults aged 18 years from six populous MICs including, China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557).
Results:
Higher number of comorbidities was associated with better detection of hypertension, angina and arthritis, and better odds of having treatment for hypertension and angina. However, increasing comorbidity had the opposite effect on being uncontrolled, and was associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Comorbidity with concordant conditions was not associated with decreased nor increased odds of being uncontrolled for all NCDs.
Conclusions:
Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Improving continuity of care and monitoring treatment are priorities for health systems with ageing populations.
Key messages:
Patients with more comorbidities have better diagnosis of
chronic conditions.
but this does not translate into better management and
control of these conditions.
The concurrence of chronic diseases among
unemployed and employed persons: a register-based study
Merel Schuring
B Yildiz1, M Schuring1, MG Knoef2, L van Zoonen3, A Burdorf1 1Department of Public Health, Erasmus MC, Rotterdam, Netherlands 2Department of Economics, Leiden University, Leiden, Netherlands 3Erasmus Graduate School of Social Sciences and Humanities, Erasmus
University Rotterdam, Rotterdam, Netherlands Contact: m.schuring@erasmusmc.nl Background:
The first aim of this study was to describe the prevalence of chronic diseases and multimorbidity among employed and unemployed persons. The second aim was to investigate associations of sociodemographic characteristics with the prevalence of chronic diseases and multimorbidity.
Methods:
Data linkage of large-scale registries on employment status, medication use and sociodemographic characteristics for all Dutch residents in 2016 was applied. In total, 5,074,227 subjects aged 18-65 years were included in the study. The prevalence of six common chronic diseases and multimorbid-ity was investigated among unemployed and employed persons. Multivariate logistic regression analyses were per-formed to examine associations of sociodemographic char-acteristics with the prevalence of chronic diseases and multimorbidity.
Results:
Unemployed persons had a higher prevalence of psychological disorders (18.3% vs 5.4%), cardiovascular disease (20.1% vs 8.9%), inflammatory diseases (24.5% vs 15.8%), and respira-tory illness (11.7% vs 6.5%) compared to employed persons. Unemployed persons were more likely to have one (OR 1.30, 95% CI 1.29-1.31), two (OR 1.74, 95% CI 1.73-1.76) and at least three chronic diseases (OR 2.59, 95% CI 2.56-2.61) than employed persons. Older persons, women, lower educated persons and migrants were more likely to have one, two, and at least three chronic diseases. Especially at younger ages, psychological disorders and inflammatory conditions were more prevalent but declined from middle age onwards among unemployed persons, whereas as slight increase from middle age onwards was observed among employed persons. Conclusions:
Using objective data, this study provided evidence for inequalities in the prevalence of chronic diseases and multi-morbidity, indicating employment status to be an important determinant of health. Policy measures and health interven-tions should target chronic diseases and multimorbidity, especially among unemployed persons.
Key messages:
Using objective data, this study showed that unemployed
persons had a higher prevalence of chronic diseases and multimorbidity compared to employed persons.
In particular older persons, women, lower educated persons
and migrants were more likely to have chronic diseases and multimorbidity.
Depressive symptoms, neuroticism and participation in breast and cervical cancer screening in the UK Claire Niedzwiedz
CL Niedzwiedz1, KA Robb1, SV Katikireddi2,1, JP Pell1, DJ Smith1 1Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK 2MRC/CSO Social and Public Health Sciences Unit, University of Glasgow,
Glasgow, UK
Contact: claire.niedzwiedz@glasgow.ac.uk Background:
Globally, more than 2 million women are diagnosed with breast or cervical cancer every year. Depressive symptoms and personality traits have been implicated in cancer-related mortality, but the potential mechanisms through which these associations may operate are not well understood. We aimed to assess how depressive symptoms and neuroticism are
12th European Public Health Conference 2019–01: Parallel Programme 17
