Shervin Assari; Babak Najand; Ali Ayoubian
Abstract
Background: Age is a major determinant of chronic respiratory disease (CRD). This is important because CRD have a main role in shaping morbidity and mortality of individuals and populations. However, less research is done on whether age-related changes in development of CRD differ across diverse racial ...
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Background: Age is a major determinant of chronic respiratory disease (CRD). This is important because CRD have a main role in shaping morbidity and mortality of individuals and populations. However, less research is done on whether age-related changes in development of CRD differ across diverse racial groups.Objectives: Using a conceptual model that considers race as a proxy of racism rather than genetics and attributing racial differences to sociological rather than biological differences, this study was conducted to explore racial differences in the effects of age on CRD. Based on Marginalization-related Diminished Returns (MDRs) framework, we expect diminished relevance of risk and resources for marginalized people due to racism, segregation, and social stratification.Methods: Using data from baseline PATH-Adults data, we included 23761 adults. The independent variable was age treated as a categorical variable. The primary outcome was presence of any CRD including asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Sex and education were the covariates. Race, as a proxy of racism, was the moderator. To analyze the data, we used logistic regression mode with and without interaction term between age and race.Results: Higher age was associated with higher odds of CRD, while sex, and socioeconomic status (SES) was controlled. In line with the MDRs framework, the positive association between age and CRD was weaker for Black than White adults.Conclusion: Under racism, age loses some of its effect as a major determinant of CRD across racialized groups.
Mohammadkarim Bahadori; Ehsan Teymourzadeh; Seyed Mojtaba Hosseini; Gholam Hossein Alishiri; Ali Ayoubian
Abstract
Background: It is important to set up hospitals, since they play a key role in providing health care services based on the budget allocated to the health sector. Objective: This study evaluated factors militating against the establishment of hospitals in Iran. It also emphasized the importance ...
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Background: It is important to set up hospitals, since they play a key role in providing health care services based on the budget allocated to the health sector. Objective: This study evaluated factors militating against the establishment of hospitals in Iran. It also emphasized the importance of health care services. Methods: This cross-sectional study was conducted in 2012 using a qualitative approach. The study sample consisted of 22 people, officials, administrators and health experts who were recruited by purposeful selection. In order to collect data, a semi-structured interview was conducted. Data was analyzed using an Atlas-Ti software. Results: Analysis of the interviews suggest that the issue of providing services in terms of ease of access and equity in the allocation of health services is also the focus of particular attention. The socio-economic status of regions were examined in terms of the need for poverty alleviation, equity in health and well-being of interest to industry participants. The survey interviews revealed that the issue of financing and human resources for provincial hospitals, were the key challenges raised by participants in the study. Conclusion: According to the findings of this study, feasibility studies and evidence-based management optimal decisions were adopted in order to build and operate hospitals in the provinces.