János Sándor1,2, Attila Nagy3,2, Anett Földvári3, Edit Szabó3, Orsolya Csenteri3, Ferenc Vincze3, Valéria Sipos3, Nóra Kovács3, Anita Pálinkás3, Magor Papp4, Gergely Fürjes3, Róza Ádány3,2,5. 1. Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary, sandor.janos@sph.unideb.hu. 2. WHO Collaborating Centre on Vulnerability and Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary. 3. Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary. 4. National Institute of Primary Care, Budapest, Hungary and. 5. MTA-DE-Public Health Research Group, University of Debrecen, Debrecen, Hungary.
Abstract
BACKGROUND: Because the cardiovascular mortality in Hungary is high, particularly among the socio-economically deprived and the Roma, it is implied that primary health care (PHC) has a limited ability to exploit the opportunities of evidence-based preventions, and it may contribute to social health inequalities. OBJECTIVES: Our study investigated the underuse of PHC preventive services. METHODS: Random samples of adults aged 21-64 years free of hypertension and diabetes mellitus were surveyed with participation rate of 97.7% in a cross-sectional study. Data from 2199 adults were collected on socio-demographic status, ethnicity, lifestyle and history of cardio-metabolic preventive service use. Delivery rates were calculated for those aged 21-44 years and those aged 45-64 years, and the influence of socio-demographic variables was determined using multivariate logistic regression. RESULTS: Delivery rates varied between 12.79% and 99.06%, and the majority was far from 100%. Although most preventive service use was independent of education, younger participants with vocational educations underutilized problematic drinking (P = 0.011) and smoking (P = 0.027) assessments, and primary or less educated underutilized blood glucose (P = 0.001) and serum cholesterol (P = 0.005) checks. Health care measures of each lifestyle assessment (P nutrition = 0.032; P smoking = 0.021; P alcohol = 0.029) and waist circumference measurement (P = 0.047) were much less frequently used among older Roma. The blood glucose check (P = 0.001) and family history assessment (P = 0.043) were less utilized among Roma. CONCLUSIONS: The Hungarian PHC underutilizes the cardio-metabolic prevention contributing to the avoidable mortality, not generating considerably health inequalities by level of education, but contributing to the bad health status among the Roma.
BACKGROUND: Because the cardiovascular mortality in Hungary is high, particularly among the socio-economically deprived and the Roma, it is implied that primary health care (PHC) has a limited ability to exploit the opportunities of evidence-based preventions, and it may contribute to social health inequalities. OBJECTIVES: Our study investigated the underuse of PHC preventive services. METHODS: Random samples of adults aged 21-64 years free of hypertension and diabetes mellitus were surveyed with participation rate of 97.7% in a cross-sectional study. Data from 2199 adults were collected on socio-demographic status, ethnicity, lifestyle and history of cardio-metabolic preventive service use. Delivery rates were calculated for those aged 21-44 years and those aged 45-64 years, and the influence of socio-demographic variables was determined using multivariate logistic regression. RESULTS: Delivery rates varied between 12.79% and 99.06%, and the majority was far from 100%. Although most preventive service use was independent of education, younger participants with vocational educations underutilized problematic drinking (P = 0.011) and smoking (P = 0.027) assessments, and primary or less educated underutilized blood glucose (P = 0.001) and serum cholesterol (P = 0.005) checks. Health care measures of each lifestyle assessment (P nutrition = 0.032; P smoking = 0.021; P alcohol = 0.029) and waist circumference measurement (P = 0.047) were much less frequently used among older Roma. The blood glucose check (P = 0.001) and family history assessment (P = 0.043) were less utilized among Roma. CONCLUSIONS: The Hungarian PHC underutilizes the cardio-metabolic prevention contributing to the avoidable mortality, not generating considerably health inequalities by level of education, but contributing to the bad health status among the Roma.
Authors: Valéria Sipos; Anita Pálinkás; Nóra Kovács; Karola Orsolya Csenteri; Ferenc Vincze; József Gergő Szőllősi; Tibor Jenei; Magor Papp; Róza Ádány; János Sándor Journal: BMJ Open Date: 2018-02-03 Impact factor: 2.692
Authors: Ferenc Vincze; Anett Földvári; Anita Pálinkás; Valéria Sipos; Eszter Anna Janka; Róza Ádány; János Sándor Journal: Int J Environ Res Public Health Date: 2019-09-26 Impact factor: 3.390
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Authors: Anita Lukács; Edina Horváth; Zsuzsanna Máté; Andrea Szabó; Katalin Virág; Magor Papp; János Sándor; Róza Ádány; Edit Paulik Journal: BMC Public Health Date: 2019-11-15 Impact factor: 3.295
Authors: János Sándor; Anita Pálinkás; Ferenc Vincze; Nóra Kovács; Valéria Sipos; László Kőrösi; Zsófia Falusi; László Pál; Gergely Fürjes; Magor Papp; Róza Ádány Journal: Int J Environ Res Public Health Date: 2018-08-24 Impact factor: 3.390
Authors: Riikka Lämsä; Anu E Castaneda; Anneli Weiste; Marianne Laalo; Päivikki Koponen; Hannamaria Kuusio Journal: Int J Environ Res Public Health Date: 2020-08-12 Impact factor: 3.390
Authors: Attila Juhász; Csilla Nagy; Orsolya Varga; Klára Boruzs; Mária Csernoch; Zoltán Szabó; Róza Ádány Journal: Int J Environ Res Public Health Date: 2020-09-19 Impact factor: 3.390