Advertisement

Journal of Public Health

, Volume 23, Issue 5, pp 257–265 | Cite as

Relationship of behavioral risk factors for chronic diseases and preventive health services utilization among adults, aged 50+, from eleven European countries

  • Manolis Linardakis
  • Angeliki Papadaki
  • Emmanouil Smpokos
  • Katerina Micheli
  • Maria Vozikaki
  • Anastas Philalithis
Original Article

Abstract

Aim

The current study aims to assess the relationship between behavioral risk factors (BRFs) for chronic diseases and preventive health services utilization among European adults.

Subjects and Methods

We used data from 16,125 adults, aged 50+ years, from 11 countries participating in the Survey of Health, Ageing and Retirement in Europe (2004/05). Prevalence of BRFs (high body weight, smoking, physical inactivity and risky alcohol consumption) was examined in relation to preventive health services utilization, which was assessed via a 12-component score (PHSUs) (scale: 0–100). Estimations were based on the complex study design.

Results

Of the participants, 90.7% were seeing a general practitioner (GP) and 52.7% had 2+ BRFs. Adults with high body weight had lower odds of seeing a dentist (0.75, p < 0.05) or having sigmoidoscopy/colonoscopy (0.70, p < 0.05) and higher odds of receiving GP advice to exercise regularly (1.56, p < 0.05). Smokers had lower odds of having mammograms (0.76, p < 0.05), sigmoidoscopy/colonoscopy (0.72, p < 0.05) and being tested for hidden blood in stool (0.63, p < 0.05). Risky drinkers had lower odds of having mammograms (0.23, p < 0.05). Lower mean PHSUs were found for adults with high body weight (p = 0.001), smokers (p = 0.001) and risky drinkers (p = 0.008), while PHSUs did not differ by BRF clusters (p = 0.218). In adults with 2+ BRFs, Greece was the country with the lowest mean PHSUs (28.0, p < 0.05).

Conclusion

Adults with high body weight, those who smoked and were risky drinkers used fewer preventive health services. Primary prevention programs should be developed to reduce BRF prevalence and promote preventive health services use in this population.

Keywords

Preventive health services Behavioral risk factors Chronic disease SHARE study 

Abbreviations

SHARE

Study of Health, Ageing and Retirement in Europe

BRFs

Behavioral Risk Factors

PHSUs

Preventive Health Services Utilization score

Notes

Funding

The European Union (EU) provided funding to the present study through the co-funded program of “Thalis-Panteion-Investigating Crucial Interdisciplinary Linkages in Ageing Societies,” which is part of the Operational Program of “Education and Lifelong Learning” (MIS380266).

Conflict of interest

The authors declare that they have no conflicts of interests.

References

  1. Anderson LH, Martinson BC, Crain AL, Pronk NP, Whitebird RR, O'Connor PJ, Fine LJ (2005) Health care charges associated with physical inactivity, overweight, and obesity. Prev Chronic Dis 2(4):A09PubMedCentralPubMedGoogle Scholar
  2. BenDebba M, Heller J, Ducker T, Eisinger J (2002) Cervical spine outcomes questionnaire: its development and psychometric properties. Spine (Phila Pa 1976) 27(19):2116–2123CrossRefGoogle Scholar
  3. Bertakis KD, Azari R (2006) The influence of obesity, alcohol abuse, and smoking on utilization of health care services. Fam Med 38(6):427–434PubMedGoogle Scholar
  4. Borsch-Supan A, Brugiavini A (eds) (2005) The Survey of Health, Ageing and Retirement in Europe—methodology. Mannheim Research Institute for the Economics of Ageing, MannheimGoogle Scholar
  5. Borsch-Supan A, Brandt M, Hunkler C, Kneip T, Korbmacher J, Malter F, Schaan B, Stuck S, Zuber S (2013) Data Resource Profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). Int J Epidemiol 42(4):992–1001PubMedCentralCrossRefPubMedGoogle Scholar
  6. Caldwell J, Kirby J (2012) Preventive Health Care Utilization by Adult Residents of MSAs and non-MSAs: Differences by Race/Ethnicity, 2009. Statistical Brief #383. August 2012. Agency for Healthcare Research and Quality, Rockville, MD.:http://meps.ahrq.gov/data_files/publications/st383/stat383.shtml
  7. Crimmins EM, Kim JK, Sole-Auro A (2011) Gender differences in health: results from SHARE, ELSA and HRS. Eur J Public Health 21(1):81–91PubMedCentralCrossRefPubMedGoogle Scholar
  8. Ferrante J, Fyffe D, Vega M, Piasecki A, Ohman-Strickland P, Crabtree B (2010) Family physicians’ barriers to cancer screening in extremely obese patients. Obesity (Silver Spring) 18(6):1153–1159CrossRefGoogle Scholar
  9. Fine LJ, Philogene GS, Gramling R, Coups EJ, Sinha S (2004) Prevalence of multiple chronic disease risk factors. 2001 National Health Interview Survey. Am J Prev Med 27(2 Suppl):18–24CrossRefPubMedGoogle Scholar
  10. Hallberg D (2006) Cross-national differences in income poverty among Europe’s 50+. Working Paper 2006:14, ISSN 1653–6975, Uppsala-SwedenGoogle Scholar
  11. Hill RK, Thompson JW, Shaw JL, Pinidiya SD, Card-Higginson P (2009) Self-reported health risks linked to health plan cost and age group. Am J Prev Med 36(6):468–474CrossRefPubMedGoogle Scholar
  12. Jurges H, Avendano M, Mackenbach JP (2008) Are different measures of self-rated health comparable? An assessment in five European countries. Eur J Epidemiol 23(12):773–781CrossRefPubMedGoogle Scholar
  13. Kim DH, Sagar UN, Adams S, Whellan DJ (2009) Lifestyle risk factors and utilization of preventive services in disabled elderly adults in the community. J Community Health 34(5):440–448CrossRefPubMedGoogle Scholar
  14. Klein-Geltink JE, Choi BC, Fry RN (2006) Multiple exposures to smoking, alcohol, physical inactivity and overweight: Prevalences according to the Canadian Community Health Survey Cycle 1.1. Chronic Dis Can 27(1):25–33PubMedGoogle Scholar
  15. Linardakis M, Smpokos E, Papadaki A, Komninos ID, Tzanakis N, Philalithis A (2013) Prevalence of multiple behavioral risk factors for chronic diseases in adults aged 50+, from eleven European countries-the SHARE study (2004). Prev Med 57(3):168–172CrossRefPubMedGoogle Scholar
  16. Linardakis M, Papadaki A, Smpokos E, Komninos I, Philalithis A (2014) Multiple behavioral risk factors for chronic diseases in adults aged 50+: regional differences across eleven European countries. J Public Health (Germany) 22:101–109. doi: 10.1007/s10389-013-0597-0 CrossRefGoogle Scholar
  17. Lionis C, Symvoulakis EK, Markaki A, Vardavas C, Papadakaki M, Daniilidou N, Souliotis K, Kyriopoulos I (2009) Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review. Int J Integr Care 9, e88PubMedCentralPubMedGoogle Scholar
  18. Littman AJ, Koepsell TD, Forsberg CW, Boyko EJ, Yancy WS Jr (2011) Preventive care in relation to obesity: an analysis of a large, national survey. Am J Prev Med 41(5):465–472CrossRefPubMedGoogle Scholar
  19. Maciosek M, Coffield A, Flottemesch T, Edwards N, Solberg L (2010) Greater use of preventive services in US health care could save lives at little or no cost. Health Aff (Millwood) 29(9):1656–1660CrossRefGoogle Scholar
  20. Ostbye T, Taylor DJ, Yancy WJ, Krause K (2005) Associations between obesity and receipt of screening mammography, Papanicolaou tests, and influenza vaccination: results from the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study. Am J Public Health 95(9):1623–1630PubMedCentralCrossRefPubMedGoogle Scholar
  21. Pavi E, Karampli E, Zavras D, Dardavesis T, Kyriopoulos J (2010) Social determinants of dental health services utilisation of Greek adults. Community Dent Health 27(3):145–150PubMedGoogle Scholar
  22. Permpongkosol S (2011) Iatrogenic disease in the elderly: risk factors, consequences, and prevention. Clin Interv Aging 6:77–82PubMedCentralCrossRefPubMedGoogle Scholar
  23. Peytremann-Bridevaux I, Santos-Eggimann B (2007) Use of preventive services of overweight and obese Europeans aged 50–79 years. J Gen Intern Med 22(7):923–929PubMedCentralCrossRefPubMedGoogle Scholar
  24. Sari N (2009) Physical inactivity and its impact on healthcare utilization. Health Econ 18(8):885–901CrossRefPubMedGoogle Scholar
  25. Silva DA, Peres KG, Boing AF, Gonzalez-Chica DA, Peres MA (2013) Clustering of risk behaviors for chronic noncommunicable diseases: a population-based study in southern Brazil. Prev Med 56(1):20–24CrossRefPubMedGoogle Scholar
  26. Sturm R (2002) The effects of obesity, smoking, and drinking on medical problems and costs. Health Aff (Millwood) 21(2):245–253CrossRefGoogle Scholar
  27. Tountas Y, Karnaki P, Pavi E (2002) Reforming the reform: the Greek National Health System in transition. Health Policy 62(1):15–29CrossRefPubMedGoogle Scholar
  28. Vals K, Kiivet RA, Leinsalu M (2013) Alcohol consumption, smoking and overweight as a burden for health care services utilization: a cross-sectional study in Estonia. BMC Public Health 13:772PubMedCentralCrossRefPubMedGoogle Scholar
  29. Vander Weg MW, Howren MB, Cai X (2012) Use of routine clinical preventive services among daily smokers, non-daily smokers, former smokers, and never-smokers. Nicotine Tob Res 14(2):123–130CrossRefPubMedGoogle Scholar
  30. World Health Organization (2010) Global status report on noncommunicable diseases. World Health Organization, GenevaGoogle Scholar
  31. World Health Organization (2011) Noncommunicable diseases country profiles 2011. World Health Organization, GenevaGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Manolis Linardakis
    • 1
  • Angeliki Papadaki
    • 2
  • Emmanouil Smpokos
    • 1
  • Katerina Micheli
    • 1
  • Maria Vozikaki
    • 1
  • Anastas Philalithis
    • 1
  1. 1.Department of Social Medicine, Faculty of MedicineUniversity of CreteHeraklionGreece
  2. 2.Centre for Exercise, Nutrition & Health Sciences, School for Policy StudiesUniversity of BristolBristolUK

Personalised recommendations