The Global Burden of Diabetes
Published 9 July 2010
Mohammed K. Ali, Mary Beth Weber, K.M. Venkat Narayan
Citations317
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Abstract
This chapter contains sections titled: Introduction Distribution and trends Major burdens Economic and social implications Changing trends in costs Gaps and future directions References
Keywords
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The quality of communication both in the history-taking segment of the visit and during discussion of the management plan was found to influence patient health outcomes.
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3,983 Citations1979William B. Kannel
For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men and for CVD death and CHF, it was greater for women.
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In at-risk patients with type 2 diabetes, intensive intervention with multiple drug combinations and behavior modification had sustained beneficial effects with respect to vascular complications and on rates of death from any cause and from cardiovascular causes.
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The LancetThe global burden of diabetic foot disease
2,483 Citations2005Andrew J.M. Boulton, Loretta Vileikytė +2 more
When assessing the economic effects of diabetic foot disease, it is important to remember that rates of recurrence of foot ulcers are very high, being greater than 50% after 3 years.
Medical CareEvidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization
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An intervention designed specifically to meet the needs of a heterogeneous group of chronic disease patients, including those with comorbid conditions, was feasible and beneficial beyond usual care in terms of improved health behaviors and health status.
JAMADiabetes in Asia
1,979 Citations2009Juliana C.N. Chan, Vasanti Malik +5 more
Type 2 diabetes is an increasing epidemic in Asia, characterized by rapid rates of increase over short periods and onset at a relatively young age and low body mass index; prevention and control of diabetes should be a top public health priority in Asian populations.
Diabetes CareGlobalization of Diabetes
1,952 Citations2011Frank B. Hu
Interactions between Westernized diet and lifestyle and genetic background may accelerate the growth of diabetes in the context of rapid nutrition transition, and primary prevention through promotion of a healthy diet and lifestyle should be a global public policy priority.
Obstetrical & Gynecological SurveyA Potential Decline in Life Expectancy in the United States in the 21st Century
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Diabetes CareEffectiveness of Self-Management Training in Type 2 Diabetes
1,860 Citations2001Susan L. Norris, Michael M. Engelgau +1 more
Evidence supports the effectiveness of self-management training in type 2 diabetes, particularly in the short term, and further research is needed to assess the effectiveness on sustained glycemic control, cardiovascular disease risk factors, and ultimately, microvascular and cardiovascular disease and quality of life.
JAMAEffects of Exercise on Glycemic Control and Body Mass in Type 2 Diabetes Mellitus
1,857 Citations2001Normand G. Boulé, Elizabeth Haddad +3 more
Exercise training reduces HbA1c by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.
The LancetSustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study
1,789 Citations2006Jaana Lindström, Pirjo Ilanne‐Parikka +15 more
Lifestyle intervention in people at high risk for type 2 diabetes resulted in sustained lifestyle changes and a reduction in diabetes incidence, which remained after the individual lifestyle counselling was stopped.
The LancetThe burden and costs of chronic diseases in low-income and middle-income countries
1,599 Citations2007Dele Abegunde, Colin Mathers +3 more
This paper estimates the disease burden and loss of economic output associated with chronic diseases-mainly cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes-in 23 selected countries which account for around 80% of the total burden of chronic disease mortality in developing countries.
The LancetThe long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study
1,598 Citations2008Guangwei Li, Ping Zhang +16 more
Group-based lifestyle interventions over 6 years can prevent or delay diabetes for up to 14 years after the active intervention, however, whether lifestyle intervention also leads to reduced CVD and mortality remains unclear.
The LancetEpidemic obesity and type 2 diabetes in Asia
1,560 Citations2006Kun‐Ho Yoon, Jin Hee Lee +6 more
Urgent action is needed, and advocacy for lifestyle changes is the first step, and countries should review and implement interventions, and take a comprehensive and integrated public-health approach.
JAMAPhysician Gender Effects in Medical Communication
1,356 Citations2002Debra Roter, Judith A. Hall +1 more
Female primary care physicians engage in more communication that can be considered patient centered and have longer visits than their male colleagues, and gender-related practice patterns in some subspecialties may differ from those evident in primary care.
Diabetes CareEconomic Costs of Diabetes in the U.S. in 2007
1,326 Citations2008American Diabetes Association
Archives of NeurologyDiabetes Mellitus and Risk of Alzheimer Disease and Decline in Cognitive Function
1,262 Citations2004Zoe Arvanitakis, R. J. Wilson +3 more
Diabetes mellitus may be associated with an increased risk of developing AD and may affect cognitive systems differentially, and this study evaluated the association of diabetes mellitus with risk of AD and change in different cognitive systems.
Diabetes CareFull Accounting of Diabetes and Pre-Diabetes in the U.S. Population in 1988–1994 and 2005–2006
1,163 Citations2008Catherine C. Cowie, Keith Rust +9 more
Over 40% of people aged ≥20 years have hyperglycemic conditions, and prevalence is higher in minorities, particularly in non-Hispanic blacks.
Diabetes Research and Clinical PracticeGlobal healthcare expenditure on diabetes for 2010 and 2030
1,145 Citations2010Ping Zhang, Xinzhi Zhang +5 more
The very low expenditures per capita in poor countries indicate that more resources are required to provide basic diabetes care in such settings as well as indicating that more prevention efforts are needed to reduce this burden.
Diabetic MedicineIncidence and trends of childhood Type 1 diabetes worldwide 1990–1999
1,078 Citations2006The DIAMOND Project Group
To examine incidence and trends of Type 1 diabetes worldwide for the period 1990–1999, the World Health Organization’s Agency for Healthcare Research and Quality (AHRQ) declared that “Type 1 diabetes needs to be considered as a global epidemic”.
Diabetes CareInterventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings
1,067 Citations2001Carry M. Renders, Gerlof D. Valk +4 more
Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care.
New England Journal of MedicineInfections in Patients with Diabetes Mellitus
1,038 Citations1999Nirmal Joshi, Gregory M. Caputo +2 more
Several aspects of immunity are altered in patients with diabetes, andPolymorphonuclear leukocyte function is depressed, particularly when acidosis is also present, and antioxidant systems involved in bactericidal activity may be impaired.
Clinical Infectious DiseasesIncreased Risk of Common Infections in Patients with Type 1 and Type 2 Diabetes Mellitus
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Patients with DM1 and DM2 are at increased risk for lower respiratory tract infection, urinary tract infections, and skin and mucous membrane infection, and risks increased with recurrences of common infections.
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Comprehensive interventions combining cognitive, behavioral, and affective components were more effective than single-focus interventions and improved health outcomes and utilization.
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885 Citations1993Kate Lorig, Peter Mazonson +1 more
It is found that health education in chronic arthritis may add significant and sustained benefits to conventional therapy while reducing costs.
PubMedEpidemiology of type 2 diabetes: Indian scenario.
844 Citations2007Viswanathan Mohan, Sandeep Sreedharan +3 more
Early identification of at-risk individuals using simple screening tools like the Indian Diabetes Risk Score (IDRS) and appropriate lifestyle intervention would greatly help in preventing or postponing the onset of diabetes and thus reducing the burden on the community and the nation as a whole.
Diabetes CareThe Burden of Mortality Attributable to Diabetes
820 Citations2005Gojka Roglić, Nigel Unwin +6 more
These are the first global estimates of mortality attributable to diabetes, and diabetes is likely to be the fifth leading cause of death globally.
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815 Citations1995Robert M. Anderson, Martha M. Funnell +4 more
This study indicated that patient empowerment is an effective approach to developing educational interventions for addressing the psychosocial aspects of living with diabetes and is conducive to improving blood glucose control.
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771 Citations2009Ambady Ramachandran, Ronald C.W. +1 more
National strategies to raise public awareness about the disease and to improve standard of care and implementation of programmes for primary prevention are urgently needed to reduce the economic burden due to diabetes at personal, societal, and national levels.
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770 Citations2010Jean Claude Mbanya, Ayesha A. Motala +3 more
A multisectoral approach to diabetes control and care is vital for expansion of socioculturally appropriate diabetes programmes in sub-Saharan African countries and the rate of diabetes-related morbidity and mortality in this region could grow substantially.
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743 Citations1994Robert F. DeBusk, Nancy Houston Miller +15 more
This randomized, controlled trial compared the effectiveness of a physician-directed, nurse-managed, home-based case-management system for coronary risk factor modification with that of usual medical care.
Journal of General Internal MedicineThe relative importance of physician communication, participatory decision making, and patient understanding in diabetes self-management
722 Citations2002Michele Heisler, Reynard R. Bouknight +3 more
For patients receiving diabetes care across 25 Veterans’ Affairs facilities, ratings of providers’ communication effectiveness were more important than a participatory decision-making style in predicting diabetes self-management, raising the possibility that both provider styles enhance self- management through increased patient understanding or self-confidence.
JAMADiabetes and Mortality Following Acute Coronary Syndromes
706 Citations2007Sean M. Donahoe, Garrick C. Stewart +5 more
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607 Citations2004Arleen F. Brown
Although some compelling evidence exists for an association between low SEP and adverse health outcomes for persons with diabetes and other chronic conditions, the pathways through whichSEP and health are related in persons with chronic illness are poorly understood.
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590 Citations2002Jinan Saaddine, Michael M. Engelgau +4 more
There is a substantial gap between the recommended and actual care of diabetes in the United States between 1988 and 1995, and U.S. national data is used to provide a reference and benchmark of the quality of diabetes care as measured by the DQIP indicators.
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564 Citations2007Hertzel C. Gerstein, Pasqualina Santaguida +6 more
IFG and IGT are associated with similar, high relative risk for incident diabetes, and the combined abnormality of IFG plus IGT is associated with the highest relative risk.
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563 Citations2007Anita Kurian, Kathryn Cardarelli
Better understanding and awareness of the disparities of CVD risk factors by race and ethnicity may help clinicians and public health professionals develop culturally sensitive interventions, prevention programs, and services specifically targeted toward risk burdens in each of these populations.
Annals of Internal MedicineNurse Case Management To Improve Glycemic Control in Diabetic Patients in a Health Maintenance Organization
557 Citations1998Ronald E. Aubert, William H. Herman +6 more
A 12-month randomized, controlled trial compared a nurse case management model of diabetes care with usual diabetes management in a primary care setting and showed a strong association between algorithm-directed nurse interventions and improved glycemic control.
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531 Citations1992Cathy D. Sherbourne, Ron D. Hays +3 more
Patients who were distressed about their health, used avoidant coping strategies, or who reported worse physical and role functioning were less likely to adhere in general, but patient satisfaction with two features of care was positively related to adherence in some models, but satisfaction with the technical quality of carewas negatively associated with adherence to specific recommendations among heart disease patients.
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516 Citations2000Edward W. Gregg
Diabetes is associated with lower levels of cognitive function and greater cognitive decline among older women and women who had diabetes for more than 15 years had a 57% to 114% greater risk of major cognitive decline.
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513 Citations1996Robert H. Friedman
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482 Citations2004Abdul Ghaffar, K Srinath Reddy +1 more
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421 Citations2001Anoop Misra, RM Pandey +4 more
Appreciable prevalence of obesity, dyslipidaemia, diabetes mellitus, substantial increase in body fat, generalised and regional obesity in middle age, particularly in females, need immediate attention in terms of prevention and health education in such economically deprived populations.
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417 Citations1998Marcia A. Testa, Donald C. Simonson
Improved glycemic control of type 2 DM is associated with substantial short-term symptomatic, QOL, and health economic benefits.
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417 Citations1992Per Hjortdahl, E Lærum
The LancetGlobal and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment
413 Citations2006Goodarz Danaei, Carlene M.M. Lawes +3 more
This work quantifies population-level effects of all higher-than-optimum concentrations of blood glucose on mortality from ischaemic heart disease and stroke worldwide and concludes that programmes for cardiovascular risk and diabetes management and control at the population level need to be more closely integrated.
Diabetes CareChronic Care Clinics for Diabetes in Primary Care
411 Citations2001Edward H. Wagner, Louis C. Grothaus +5 more
periodic primary care sessions organized to meet the complex needs of diabetic patients imrproved the process of diabetes care and were associated with better outcomes, including patient satisfaction and HbA1c levels.
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404 Citations2009Gojka Roglić, Nigel Unwin
Diabetes is a considerable cause of premature mortality, a situation that is likely to worsen, particularly in low and middle income countries as diabetes prevalence increases, and investments in primary and secondary prevention are urgently required.
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395 Citations2002Bengt Jönsson
Current comprehensive economic data on the costs of diabetes are required for policy decisions to optimise resource allocation and to evaluate different approaches for disease management, especially in developing countries.
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392 Citations2007Oscar H. Franco, Ewout W. Steyerberg +3 more
The increase in the risk of CVD and mortality from diabetes represents an important decrease in life expectancy and life expectancy free of CVC.
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386 Citations2003Alberto Barceló, Cristián Aedo +2 more
Despite limitations of the data, diabetes imposes a high economic burden to individuals and society in all countries and to Latin American and the Caribbean as whole.
The Journal of Clinical Endocrinology & MetabolismHealth care expenditures for people with diabetes mellitus, 1992.
379 Citations1994Robert J. Rubin, W. Altman +1 more
It is found that health care expenditures for people with diabetes constituted about one in seven health care dollars spent in 1992, and health care reform and insurers should take note of these findings and structure benefit packages to promote care likely to reduce the costs of caring for diabetics.
The Lancet NeurologySocioeconomic status and stroke
375 Citations2006A Cox, Christopher McKevitt +2 more
The evidence is strongest for mortality and incidence of stroke, with high rates of stroke in low socioeconomic groups being a consistent finding and the implications of these findings are discussed and recommendations for future research are made.
Diabetes CareThe Diabetes Network Internet-Based Physical Activity Intervention
369 Citations2001H Garth McKay, Diane K. King +3 more
It is concluded that greater attention should be focused on methods to sustain involvement with Internet-based intervention health promotion programs over time to enhance the care of diabetes and other chronic conditions.
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352 Citations1999J. G. R. Howie, David Heaney +4 more
It may be time to reward doctors who have longer consultations, provide greater continuity of care, and both enable more patients and enable patients more.
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352 Citations1995Luigi Uccioli, Ezio Faglia +7 more
The use of specially designed shoes is effective in preventing relapses in diabetic patients with previous ulceration, and the use of therapeutic shoes was negatively associated with foot ulcer relapses.
Diabetes CareDiabetes management in a health maintenance organization. Efficacy of care management using cluster visits.
350 Citations1999C N Sadur, N. Moline +8 more
A 6-month cluster visit group model of care for adults with diabetes improved glycemic control, self-efficacy, and patient satisfaction and resulted in a reduction in health care utilization after the program.
Diabetes CareExcess Costs of Medical Care for Patients With Diabetes in a Managed Care Population
345 Citations1997Joe V. Selby, G. Thomas Ray +2 more
Diabetes is a costly condition by virtue of its high prevalence and high per person costs and effective disease management programs that aim to prevent complications could potentially lead to cost savings in managed care settings.
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342 Citations2001Samson O Oyibo, Edward B. Jude +5 more
Journal of Clinical EpidemiologyMeta-analysis of the effects of educational and psychosocial interventions on management of diabetes mellitus
323 Citations1988Deborah K. Padgett, Emily Mumford +2 more
A meta-analysis of the literature of controlled studies of educational and psychosocial interventions in the treatment of diabetes mellitus yielded 93 studies of 7451 patients testing the effects of eight intervention types, finding diet instruction and social learning interventions showed the strongest and weakest effects.
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319 Citations1991Scot E. Moss, Ronald Klein +1 more
Diabetic persons experience very high mortality, especially from vascular diseases, compared to the general population, and age-sex standardized mortality ratios in a geographically defined population of younger onset and older onset diabetic persons are examined.
Health AffairsThe Economic Burden Of Diabetes
314 Citations2010Timothy M. Dall, Yiduo Zhang +4 more
New research provides revised comprehensive estimates that suggest that the U.S. national economic burden of pre-diabetes and diabetes reached $218 billion in 2007, and underscores the urgency of better understanding how prevention and treatment strategies may or may not help reduce costs.
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311 Citations2000K.M. Venkat Narayan, Edward W. Gregg +3 more
Diabetes is a major public health problem and is emerging as a pandemic, and there is considerable potential now to better utilize existing treatments to reduce diabetes complications.
Diabetes CareHealth care and health status and outcomes for patients with type 2 diabetes.
310 Citations2000Maureen I Harris
Rates of health care access and utilization, screening for diabetes complications, and treatment of hyperglycemia, hypertension, and dyslipidemia in type 2 diabetes are high; however, health status and outcomes are unsatisfactory.
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306 Citations1997Todd Gilmer, Patrick J. O’Connor +2 more
HbA1c provides useful information to providers and patients regarding both health status and future medical care charges and suggests that investment in clinical systems to improve diabetes care may benefit both payers and patients.
Journal of the American Geriatrics SocietyA Randomized Trial of Group Outpatient Visits for Chronically Ill Older HMO Members: The Cooperative Health Care Clinic
303 Citations1997Arne Beck, John C. Scott +5 more
The impact of group outpatient visits to traditional “physician‐patient dyad” care among older chronically ill HMO members on health services utilization and cost, self‐reported health status, and patient and physician satisfaction is compared.
Diabetes CareProblems Paying Out-of-Pocket Medication Costs Among Older Adults With Diabetes
303 Citations2004John D. Piette, Michele Heisler +1 more
Clinicians should actively identify patients with diabetes who are facing medication cost pressures and assist them by modifying their medication regimens, helping them understand the importance of each prescribed medication, providing information on sources of low-cost drugs, and linking patients with coverage programs.
BMJRandomised controlled trial of structured personal care of type 2 diabetes mellitus
302 Citations2001Niels de Fine Olivarius, Henning Beck‐Nielsen +3 more
Diabetes CareGroup Visits Improve Metabolic Control in Type 2 Diabetes
300 Citations2001Marina Trento, P. Passera +7 more
Group consultations may improve metabolic control in the medium term by inducing more appropriate health behaviors and are feasible in everyday clinical practice without increasing working hours.
Medical CareHealth Insurance Status, Cost-Related Medication Underuse, and Outcomes Among Diabetes Patients in Three Systems of Care
295 Citations2004John D. Piette, Todd H. Wagner +2 more
Many patients with diabetes use less of their medication than prescribed because of the cost, and those reporting cost-related adherence problems have poorer health, although the VA’s drug coverage may protect patients from this increased risk.
The American Journal of MedicineEffect of a multidisciplinary intervention on medication compliance in elderly patients with congestive heart failure
295 Citations1996Michael W. Rich, D. B. GRAY +3 more
A multidisciplinary treatment strategy is associated with improved medication compliance during the first 30 days following hospital discharge in elderly patients with congestive heart failure, and improved compliance may contribute to improved outcomes in these patients.
HeartDiabetes in Africa: epidemiology, management and healthcare challenges
294 Citations2008Naomi Levitt
The total number of people with diabetes in the region is expected to grow because of changing demography, and a concerted multisectoral effort will be critical to ensuring improvement in healthcare delivery.
Journal of the American Geriatrics SocietyPreventing Disability and Managing Chronic Illness in Frail Older Adults: A Randomized Trial of a Community‐Based Partnership with Primary Care
289 Citations1998Suzanne G. Leveille, Edward H. Wagner +5 more
Effective new strategies that complement primary care are needed to reduce disability risks and improve self‐management of chronic illness in frail older people living in the community.
Journal of General Internal MedicineA nurse-coordinated intervention for primary care patients with non-insulin-dependent diabetes mellitus
284 Citations1995Morris Weinberger, M. Sue Kirkman +6 more
The intervention, designed to be a pragmatic, low-intensity adjunct to care delivered by physicians, modestly improved glycemic control but not HRQOL or diabetes-related symptoms.
British Journal of OphthalmologyVisual impairment and blindness in Europe and their prevention
278 Citations2002Ivo Kocur, Serge Resnikoff
In highly industrialised countries of Europe, the leading causes of childhood serious visual loss are lesions of the central nervous system, congenital anomalies and retinal disorders, while in the middle income countries of European, congenitals cataract, glaucoma and retinopathy of prematurity are highly expressed.
The LancetDiabetes care in sub-Saharan Africa
269 Citations2006David Beran, John Yudkin
The current evidence on diabetes care in sub-Saharan Africa is reviewed and an 11-point action plan to address this problem in the region is proposed.
Diabetes CareThe Direct Medical Cost of Type 2 Diabetes
268 Citations2003Michael Brändle, Honghong Zhou +6 more
Insulin treatment and diabetes complications have a substantial impact on the direct medical costs of type 2 diabetes, as well as its treatments, complications, and comorbidities.
CirculationImpact of Traditional and Novel Risk Factors on the Relationship Between Socioeconomic Status and Incident Cardiovascular Events
262 Citations2006Michelle A. Albert, Robert J. Glynn +2 more
A decrease in incident CVD events with increasing levels of education and income is observed, in contrast to the relationship between income and CVD Events, which was explained only partially by traditional and novel risk factors for CVD.
PLoS ONEA Cross-Sectional Study of the Microeconomic Impact of Cardiovascular Disease Hospitalization in Four Low- and Middle-Income Countries
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Individual in selected LMIC bear significant financial burdens following CVD hospitalization, yet with substantial variation across and within countries, Lack of insurance may drive much of the financial stress of CVD in LMIC patients and their families.
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257 Citations2006Lawrence O. Gostin, Madison Powers
This Commentary explores how social justice sheds light on major ongoing controversies in the field, and it provides examples of the kinds of policies that public health agencies, guided by a robust conception of justice, would adopt.
Diabetes CareA Randomized Trial of an Intervention to Improve Self-Care Behaviors of African-American Women With Type 2 Diabetes
257 Citations2002Thomas C. Keyserling, Carmen D. Samuel‐Hodge +7 more
The intervention was associated with a modest enhancement of PA and was acceptable to participants, and 86% indicated that the peer counselor's role in the program was important.
ThoraxA simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis
247 Citations2010Anna P. Ralph, M Ardian +12 more
This simple, validated method for grading CXR severity in adults with smear-positive pulmonary TB correlates with baseline clinical and microbiological severity and response to treatment, and is suitable for use in clinical trials.
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