Hatice Simsek

Relationship of socioeconomic status with health behaviors and self-perceived health in the elderly: A community-based study, Turkey.

The purpose of the present study was to determine the effects of socioeconomic status on health behaviors and perceived health.

Decomposing socioeconomic inequalities in self assessed health in Turkey

IntroductionThis study aimed to measure socioeconomic inequalities in Self Assessed Health (SAH) and evaluate the determinants of such inequalities in terms of their contributions amongst the Turkish population.MethodsWe used data from the Turkish part of World Health Survey 2003 with 10,287 respondents over 18 years old. Concentration index (CI) of SAH was calculated as a measure of socioeconomic inequalities in health, and contributions of each determinant to inequality were evaluated using a decomposition method.ResultsIn total 952 participants (9.3%) rated their health status as either bad or very bad. The CI for SAH was −0.15, suggesting that suboptimal SAH was reported more by those categorised as poor. The multiple logistic regression results indicated that having secondary, primary or less than primary school education, not being married and being in the lowest wealth quintile, significantly increased the risk of having poor SAH. The largest contributions to inequality were attributed to education level (70.7%), household economic status (9.7%) and geographical area lived in (8.4%).ConclusionThe findings indicate that socioeconomic inequalities measured by SAH are apparent amongst the Turkish population. Education and household wealth were the greatest contributing factors to SAH inequality. These inequalities need to be explicitly addressed and vulnerable subgroups should be targeted to reduce the socioeconomic disparities.

Management of health-care waste in Izmir, Turkey

The aim of this study was to evaluate health-care waste in the 18 districts of metropolitan municipality of the third biggest city in Turkey. This cross-sectional study was carried out with 825 health institutions established in the 18 districts of Izmir metropolitan municipality, in 2007. The total amount of health-care waste collected was 4841 tons and 621 kilograms per patients bed in 2007. Most of the medical wastes were collected from Konak, Karsiyaka and Bornova districts and were 2308, 272 and 1020 tons, respectively. Regarding to overpopulation, the number of health institutions in these districts are more than the number of health institutions in the other administrative districts. There was a statistically significant, positive correlation between the amount of health-care waste collected and population of the 18 districts (r = 0.79, p < 0.001), and number of beds/patients (r = 0.83, p < 0.001). To provide a safe health-care waste management metropolitan municipality must provide hazardous waste separation in health institutions, establish sterilization units for infectious waste, and provide the last storage of medical waste in completely different, safe and special areas apart from the municipal waste storage areas.

Prevalence of Metabolic Syndrome and Affecting Factors among Individuals Aged 30 and over in Balçova District of İzmir

BACKGROUND The studies have shown that metabolic syndrome (MetS) leads to an increase twice as much in cardiovascular diseases (CVD) and four times as much in diabetes mellitus (DM) prevalence since the second half of the 20(th) century. AIMS This study aims to determine and discuss the prevalence of the MetS and co- factors among individuals at the age of 30 and over in Balcova district of İzmir province according to the American National Cholesterol Education Program - Adult Treatment Panel III (NCEP ATP III) and InternationalDiabetes Federation (IDF) criteria. STUDY DESIGN Cross-sectional study. METHODS Data obtained from the Balcova Heart Project in İzmir were used in the study. The dependent variable of the study is MetS existence. The independent variables were socio-demographic characteristics (age, gender, education level, and marital status), self-perceived economic status, physical activity, smoking status, healthy nutrition and body mass index (BMI). RESULTS The prevalence of MetS was 36.9% according to the diagnostic criteria of IDF, while it was 27.4% according to ATP III criteria. According to the both criteria, increasing age, low education, poor economic status perception, physical inactivity, and obesity increase the risk of MetS. Apart from the IDF criteria, being female and a current smoker increase the risk of the MetS in the NCEP-ATP III. CONCLUSION Compared to educational studies of MetS as of today, which are community and health-oriented studies, it is challenging that the prevalence of MetS was found to be high for both criteria in our study. Therefore, in particular, primary health care doctors must be prompted to protect the public against DM and CVD in particular.

Medical students’ risk perceptions on decreased attention, physical and social risks in using mobile phones and the factors related with their risk perceptions

ABSTRACT The aim of this cross-sectional study is to determine the mobile phone use, risk perception and related factors among the medical students. The study population was 1465 medical students. The dependent variable was the risk perception on mobile phones. The risk perception was assessed in three dimensions: decreased attention, physical risks and social risks. The exploratory factor analysis was used for the success of the scale, and the factor loadings were calculated using the varimax rotation method. Logistic Regression Analysis was applied to determine the factors associated with risk perception. The presented results are based on 1079 students (Access rate = 73.7%). In all dimensions of risk perception, more than half of the medical students had high risk perceptions. Female students and lower social classes had high risk perceptions. An understanding of the determinants and mobile phone utilization characteristics might help in developing effective risk communication to these subgroups.

Socioeconomic factors associated with tobacco smoking in Turkey: a cross-sectional, population-based study

Background Gender and lower socioeconomic status are associated with smoking. Aims This study aimed to determine the association between socioeconomic factors and cigarette tobacco smoking in Balcova, Izmir, Turkey, with a focus on gender differences. Methods The study population was all men and women (36 187) aged over 30 years living in Balcova from October 2007 to May 2009. Data were collected in interviews and included smoking status (current, former, never), age, gender, marital status, educational level, occupational class/working status, health insurance and having a chronic disease. Logistic regression analysis was used to evaluate the association between socioeconomic characteristics and smoking status. Results Of the 36 187 study subjects, 16 080 (44%) agreed to participate and 15 174 (42%) with complete data were evaluated. The majority were women (66.2%); mean ages of men and women were 53.1 (SD 13.1) and 51.3 (SD 13.2) respectively. Current smoking was higher in men (41.7% versus 31.2% of women), and more men were ex-smokers (33.1% versus 13.5% of women) but more women had never smoked (55.3% versus 25.2% of men). For women, being married and having low educational level were associated with current smoking and previous smoking (P < 0.05). Current smoking was also more frequent among working women (P < 0.05). For men, low educational level and occupational class were associated with being a current smoker and an ex-smoker (P < 0.05). Conclusions Socially disadvantaged groups, especially those with low education or unemployed men, were more likely to be current smokers and smoking cessation was lower in these groups. Smoking habits were different in men and women. Socioeconomic factors should always be considered when developing smoking cessation policies.

Association of sarcopenia with depressive symptoms and functional status among ambulatory community-dwelling elderly

OBJECTIVE Sarcopenia, functional disability, and depression are common problems in the elderly. Sarcopenia is associated with physical disability, functional impairment, depression, cardiometabolic diseases, and even mortality. This study aims to determine the association of sarcopenia with depression and functional status among ambulatory community-dwelling elderly aged 65 years and older. MATERIALS AND METHOD The sample of this cross-sectional study consisted of 28,323 people, aged 65 years and older, living in Bornova, Izmir. Multi-stage sample selection was performed to reach 1007 individuals. However, 966 elderly people could be reached, and 861 elderly people who can walk were included in the study. The data were collected by the interviewers at home through face-to-face interview. RESULTS The mean age was 72.2 ± 5.8 (65-100) years. The prevalence of functional disability, depressive symptoms, and sarcopenia were 21.7%, 25.2%, and 4.6%, respectively. In multivariate analysis depression was associated with sarcopenia, being illiterate and divorced, perception of the economic situation as poor/moderate, increased number of chronic diseases, and having at least one physical disability. IADL associated functional disability with sarcopenia, being illiterate/literate and female, increased age and number of medications, and the BMI. CONCLUSION Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability. Elderly people at high risk of sarcopenia should be screened for functional disability and depression. Appropriate interventions should also be implemented.

The metabolic syndrome prevalence and associated social and economic factors in a population of age between 30 and 69years: from the ongoing trial of Balcova Heart Study.

The term ‘socioeconomic status’ covers a wide range of measures, including education, income, occupation, living conditions, income inequality, and many other aspects of life [1]. Little is known on the association between social and economic factors and the metabolic syndrome, considered as a distinct clinical entity, specially addressing gender effects in the social patterning of the disease [2]. In this community-based cross-sectional study, prevalence of the metabolic syndrome and associated socioeconomic status was assessed among the 30–69 year old residents of an administrative quarter in Izmir, in 2008. At the time of the study, the population of the quarter in this age group was 3754. Data were collected in two stages. Firstly, detailed information was provided to the individuals who agreed to participate in the study during household visits, and every participant completed a questionnaire by face-to-face interview with trained surveyors at home. The questionnaire was defined by Boratavs [3] classification of social inequalities for the urban areas and included questions on the demographic and socioeconomic status of the participants. Education, household income and social class were considered to be the major inequalities in the study. Secondly, anthropometric measures and blood samples of the participants were collected at the community center. The study period included 30 days. After excluding participants who did not attend the first or the second visit and with missing or incorrect data in the main variables, a total of 1883 subject were included in the study with a 50.2% of response rate. Participation among women was higher than men, because, most of the men were working during office hours and failed to attend to the second visits at the community center. The mean age of the excluded subjects was 48.1±8.3 years with a male to female ratio of 2.4. To define the metabolic syndrome according to the NCEP ATP III guidelines [4], three out of five risk factor components are required, and the definition does not specify that any particular component be present. Based on the International Standard Classification of Education, illiterate, primary and secondary schools were pooled as the low educated class (LEC) [5]. Household income was assessed by self report according to the minimum wage in Turkey. Participants with missing substantial data (55 women and 11 men) were excluded from income analysis. Social classes and income were defined according to Boratav as presented in Table 1 [3]. Univariate analyses were performed to evaluate the statistical significance of the prevalence rates of the social inequalities in women and men with the metabolic syndrome. Binary logistic regression analysiswas used formen andwomen to assess the association between social inequalities and the metabolic syndrome. Covariates in the final model included level of education, household income and occupation with the presence of the metabolic syndrome as a dependent variable.