People with multiple unhealthy lifestyles are less likely to consult primary healthcare

Abstract

BackgroundBehavioural interventions are often implemented within primary healthcare settings to prevent type 2 diabetes and other lifestyle-related diseases. Although smoking, alcohol consumption, physical inactivity and poor diet are associated with poorer health that may lead a person to consult a general practitioner (GP), previous work has shown that unhealthy lifestyles cluster among low socioeconomic groups who are less likely to seek primary healthcare. Therefore, it is uncertain whether behavioural interventions in primary healthcare are reaching those in most need. This study investigated patterns of GP consultations in relation to the clustering of unhealthy lifestyles among a large sample of adults aged 45 years and older in New South Wales, Australia.MethodsA total of 267,153 adults participated in the 45 and Up Study between 2006 and 2009, comprising 10% of the equivalent demographic in the state of New South Wales, Australia (response rate: 18%). All consultations with GPs within 6 months prior and post survey completion were identified (with many respondents attending multiple GPs) via linkage to Medicare Australia data. An index of unhealthy lifestyles was constructed from self-report data on adherence to published guidelines on smoking, alcohol consumption, diet and physical activity. Logistic and zero-truncated negative binomial regression models were used to analyse: (i) whether or not a person had at least one GP consultation within the study period; (ii) the count of GP consultations attended by each participant who visited a GP at least once. Analyses were adjusted for measures of health status, socioeconomic circumstances and other confounders.ResultsAfter adjustment, participants scoring 7 unhealthy lifestyles were 24% more likely than persons scoring 0 unhealthy lifestyles not to have attended any GP consultation in the 12-month time period. Among those who attended at least one consultation, those with 7 unhealthy lifestyles reported 7% fewer consultations than persons with 0 unhealthy lifestyles. No effect modification was observed.ConclusionTo optimise the prevention of lifestyle-related diseases, interventions for positive behavioural change need to incorporate non-primary healthcare settings in order to reach people with multiple unhealthy lifestyles.

Geographic inequity in healthy food environment and type 2 diabetes: can we please turn off the tap?

“…One problem is that the complexity of sustaining the prevention effort has not been captured well by randomised trials, 6 , 7 which veer towards individual‐level (sometimes referred to as “high‐risk”) strategies rather than evaluations of structural interventions at the population level 8 . General practitioners have a very valuable role to play, but placing the burden of prevention squarely on them will not work 9 . The determinants of T2DM risk are intergenerational, relational, multifaceted and inequitably distributed 10 .…”

Characteristics of customary non‐attenders in general practice who are diagnosed with cancer: A cross‐sectional study in Denmark

“…However, such strategies would also raise some questions. First, patients who very rarely consult their GP, at least before the disease affects their healthcare seeking, may have more unhealthy lifestyle than regular attenders (Feng, Girosi, & McRae, ; Vos et al, ). Thus, if the customary non‐attenders were to consult the GP, the GP may engage in health promotion discussions with these rare attenders although the effectiveness on population level of such an approach is debatable (Krogsboll, Jorgensen, Gronhoj Larsen, & Gotzsche, ).…”

Tipologías de estilos de vida en jóvenes universitarios

“…Los pocos estudios disponibles que han perseguido este objetivo, se han centrado en poblaciones generales de adultos, niños o trabajadores [16][17][18][19][20][21] . No obstante, recientemente se han llevado a cabo estudios en universitarios, los cuales han identificado la clara existencia de tipos de estudiantes en relación con sus hábitos de salud, siendo más frecuentes las agrupaciones de hábitos no saludables que conforman perfiles de alto riesgo para estos jóvenes.…”