Could gastrointestinal disorders differ in two close but divergent social environments?

Grodzinsky Ewa, Hallert Claes, Faresjö Tomas, Bergfors Elisabet, Faresjö, Faresjö Åshild

Description

Many public health problems in modern society affect the gastrointestinal area. Knowledge of the disease occurrence in populations is better understood if viewed in a psychosocial context including indicators of the social environment where people spend their lives. The general aim of this study was to estimate the occurrence in the population and between sexes of common gastrointestinal conditions in two neighborhood cities representing two different social environments defined as a "white-collar" and a "blue-collar" city. Methods We conducted a retrospective register study using data of diagnosed gastrointestinal disorders (cumulative incidence rates) derived from an administrative health care register based on medical records assigned by the physicians at hospitals and primary care. Results Functional gastrointestinal diseases and peptic ulcers were more frequent in the white-collar city, while diagnoses in the gallbladder area were significantly more frequent in the blue-collar city. Functional dyspepsia, irritable bowel syndrome, and unspecified functional bowel diseases, and celiac disease, were more frequent among women while esophageal reflux, peptic ulcers, gastric and rectal cancers were more frequent among men regardless of social environment. Conclusions Knowledge of the occurrence of gastrointestinal problems in populations is better understood if viewed in a context were the social environment is included. Indicators of the social environment should therefore also be considered in future studies of the occurrence of gastrointestinal problems.

Sujets

• Social environment
• General Population
• Digestive disease
• Sex
• Public health

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 4
• Langue: English

Extrait

Grodzinskyet al.International Journal of Health Geographics2012,11:5 http://www.ijhealthgeographics.com/content/11/1/5

R E S E A R C H

INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS

Open Access

Could gastrointestinal disorders differ in two close but divergent social environments? 1 2 3 1 3* Ewa Grodzinsky , Claes Hallert , Tomas Faresjö , Elisabet Bergfors and Åshild Olsen Faresjö

Abstract Background:Many public health problems in modern society affect the gastrointestinal area. Knowledge of the disease occurrence in populations is better understood if viewed in a psychosocial context including indicators of the social environment where people spend their lives. The general aim of this study was to estimate the occurrence in the population and between sexes of common gastrointestinal conditions in two neighborhood cities representing two different social environments defined as a“whitecollar”and a“bluecollar”city. Methods:We conducted a retrospective register study using data of diagnosed gastrointestinal disorders (cumulative incidence rates) derived from an administrative health care register based on medical records assigned by the physicians at hospitals and primary care. Results:Functional gastrointestinal diseases and peptic ulcers were more frequent in the whitecollar city, while diagnoses in the gallbladder area were significantly more frequent in the bluecollar city. Functional dyspepsia, irritable bowel syndrome, and unspecified functional bowel diseases, and celiac disease, were more frequent among women while esophageal reflux, peptic ulcers, gastric and rectal cancers were more frequent among men regardless of social environment. Conclusions:Knowledge of the occurrence of gastrointestinal problems in populations is better understood if viewed in a context were the social environment is included. Indicators of the social environment should therefore also be considered in future studies of the occurrence of gastrointestinal problems. Keywords:Social environment, General population, Gastrointestinal disorders, Sex, Public health

Background Many public health problems in modern society affect the gastrointestinal area. Knowledge of the disease occurrence in populations is better understood if viewed in a psycho social context including indicators of the social environ ment where people spend their lives. The etiology of functional gastrointestinal diseases (FGD) such as irritable bowel syndrome (IBS), functional dyspepsia (FD) and gas troesophageal reflux (GERD) is complex and in many ways still unclear and there is still a lack of understanding of the pathology [1,2]. The dysfunctions that lead to or aggravate FGD are a combination of biological, psychological and psychosocial factors [3]. These multiple sets of factors are likely to interact in the pathogenesis and clinical

* Correspondence: [e-mail] 3 Dept of Medicine and Health Sciences, Linköping University, SE581 83 Linköping, Sweden Full list of author information is available at the end of the article

manifestations of the disorders. This multifactorial pattern is often evident in other gastrointestinal disorders and in many other public health diseases in a complex contem porary society. Several attempts have been made to create biopsychosocial models to help bring some order to factors and to explain the interaction of environmental, cultural, social, psychological and biological factors [46]. Knowledge of the disease prevalence rates is crucial for describing the population burden of diseases and asses sing the associated health care utilization and health care cost [7]. Available sources for this purpose include health surveys, screening investigations, and register studies [8]. Previous studies of functional gastrointestinal disorders such as IBS have shown the value of using administrative health care registers [9,10]. The General Practice Research Database (GPRD) in United Kingdom (UK) had also been used in different studies of several diseases such as GERD and chronic obstructive pulmonary

© 2012 Grodzinsky et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.