Ageism in cardiology

Bowling, Ann

doi:10.1136/bmj.319.7221.1353

Cited by 183 publications

(122 citation statements)

References 23 publications

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“…7 Therefore, much of the literature has centred around utilisation of services for CHD, where there is evidence for inequitable care by age (as well as other sociodemographic characteristics, including, sex, socioeconomic position, and ethnicity) 8,9 at primary, secondary, and tertiary care levels. 10,11 This is despite invasive treatments being shown to be effective among older age groups. 12 More recent studies would also seem to suggest that there is an interaction between age and sex, for example, older women experiencing the 'double jeopardy' of inequity.…”

Section: Introductionmentioning

confidence: 85%

Age and sex interaction in reported help seeking in response to chest pain

Adamson

Donovan²,

Ben-Shlomo³

et al. 2008

Br J Gen Pract

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There is a growing literature suggesting that access to cardiology services is affected by age. However, there is a dearth of studies that have considered age and sex in conjunction. AimThis study aims to examine the impact of age, and its interaction with sex, on reported healthcare seeking, based on responses to symptom vignettes, in an attempt to standardise symptomatology across all responders. Design of studyA cross-sectional survey design was utilised. SettingPrimary care. MethodA random sample of 911 individuals, stratified by sex, was selected from one practice in the UK. Participants were invited to state how they would react in response to the chest pain symptoms presented. Patterns of response were examined, by age and sex, using χ 2 and logistic regression models. ResultsThis study identified differences by age and sex in a general practice population in the propensity to seek health care. In particular, men aged 60-69 years and women aged 70 years and over were more likely to report healthcare seeking than younger responders. For example, women aged 70 years and over had over three times greater odds of reporting contact with the GP compared to the reference category. Evidence for an interaction effect between age and sex was observed. ConclusionThe results suggest that the inequity that has been demonstrated in access to cardiology services by age is not likely to be due to the patient's illness behaviour as, overall, older people are more likely than younger people to be willing to consult their doctors. Keywordsaged; gender identity; heart; patient acceptance of health care.

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Section: Introductionmentioning

confidence: 85%

Age and sex interaction in reported help seeking in response to chest pain

Adamson

Donovan²,

Ben-Shlomo³

et al. 2008

Br J Gen Pract

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“…Unfortunately, significant evidence has been found that there is de-facto age-based rationing by health care providers. The older that patients are, the less likely they are to receive specialty care or intensive medical care even when other explanatory variables have been taken into account (Bowling 1999, Kapp 1998. Jones et al (1996) found that elderly patients with isolated long-bone fractures were less likely than younger patients to receive pain medication, and when they did receive pain medication they waited for longer times and received lower doses.…”

Section: Agementioning

confidence: 99%

“…As a society we tend to assume that death in old age is 'natural' or 'timely' (Howarth 1998) and therefore less worthy of concern than deaths of those who are younger. Combining this assumption with the lack of research on the experience of the dying elderly, many older people do not receive the care and support that is provided to younger dying patients (Bowling 1999, Kapp 2002, Pedersen et al 2008). …”

Section: Agementioning

confidence: 99%

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The Effects of Race, Socioeconomic Status, and Religion on Formal End-of-Life Planning

Burdsall

2000

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Individuals who are facing death today are doing so in an environment that is significantly different than it was in the past. Medical technology is increasingly able to keep people alive even with multiple complex chronic conditions. While these advances in medicine are beneficial to many, it can also unnecessarily prolong inevitable deaths.Concerns over the ability to have a death that is in alignment with personal values has increased the interest in the use of formal end-of-life planning including writing an advance instructional directive and assigning a durable power of attorney for health care. Although research has indicated that the use of these formal planning strategies is beneficial, not everyone completes them. Using a current nationally representative sample, the three specific aims of this study were to examine whether there are racial and ethnic differences in formal end-of-life planning done by older African American, Hispanic, and White adults; to examine socioeconomic factors including education and income in formal end-of-life planning as well as assess the contribution of these factors in explaining racial and ethnic differences in formal end-of-life planning; and to examine the role of religiosity in formal end-of-life planning and to assess its influence on racial and ethnic differences in explaining formal end-of-life planning.Logistic regression was run on data from the Health and Retirement Study Both Blacks and Hispanics were less likely to complete a written advance directive, assign a proxy, or complete both forms of formal planning than were Whites.Group differences remained after controlling for region of death and cause of death.Both Blacks and Hispanics were less likely to complete any form of formal planning than Whites. Group differences remained after additionally controlling for gender, age, marital status, whether the decedent had children, income, education, religious preference, importance of religion, and frequency of attending religious services.Higher levels of income and education both increased the odds that formal advance planning would take place. Religious preference was not significant, but decedents who had stated that religion was very important were less likely to plan while those that attended services frequently were more likely to plan.

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“…However, older people are often denied access to cardiac investigation and coronary revascularisation. 16 …”

Section: Opinionmentioning

confidence: 99%