Browsing by Author "Sözmen, K"

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    Decomposing socioeconomic inequalities in self assessed health in Turkey
    Sözmen, K; Baydur, H; Simsek, H; Ünal, B
    Introduction: This study aimed to measure socioeconomic inequalities in Self Assessed Health (SAH) and evaluate the determinants of such inequalities in terms of their contributions amongst the Turkish population. Methods: We used data from the Turkish part of World Health Survey 2003 with 10,287 respondents over 18 years old. Concentration index (CI) of SAH was calculated as a measure of socioeconomic inequalities in health, and contributions of each determinant to inequality were evaluated using a decomposition method. Results: In total 952 participants (9.3%) rated their health status as either bad or very bad. The CI for SAH was -0.15, suggesting that suboptimal SAH was reported more by those categorised as poor. The multiple logistic regression results indicated that having secondary, primary or less than primary school education, not being married and being in the lowest wealth quintile, significantly increased the risk of having poor SAH. The largest contributions to inequality were attributed to education level (70.7%), household economic status (9.7%) and geographical area lived in (8.4%). Conclusion: The findings indicate that socioeconomic inequalities measured by SAH are apparent amongst the Turkish population. Education and household wealth were the greatest contributing factors to SAH inequality. These inequalities need to be explicitly addressed and vulnerable subgroups should be targeted to reduce the socioeconomic disparities.
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    Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008
    Dinç, G; Sözmen, K; Gerçeklioglu, G; Arik, H; Critchley, J; Ünal, B
    Background: Cardiovascular disease (CVD) mortality increased in developed countries until the 1970s then started to decline. Turkey is about to complete its demographic transition, which may also influence mortality trends. This study evaluated trends in coronary heart disease (CHD) and stroke mortality between 1988 and 2008. Methods: The number of deaths by cause (ICD-8), age and sex were obtained from the Turkish Statistical Institute (TurkStat) annually between 1988 and 2008. Population statistics were based on census data (1990 and 2000) and Turkstat projections. European population standardised mortality rates for CHD and stroke were calculated for men and women over 35 years old. Joinpoint Regression was used to identify the points at which a statistically significant (p < 0.05) change of the trend occurred. Results: The CHD mortality rate increased by 2.9% in men and 2.0% in women annually from 1988 to 1994, then started to decline. The annual rate of decline for men was 1.7% between 1994-2008, whilst in women it was 2.8% between 1994-2000 and 6.7% between 2005-2008 (p < 0.05 for all periods). Stroke mortality declined between 1990-1994 (annual fall of 3.8% in both sexes), followed by a slight increase between 1994-2004 (0.6% in men, 1.1% in women), then a further decline until 2008 (annual reduction of 4.4% in men, 7.9% in women) (p < 0.05 for all periods). Conclusions: A decrease in CVD mortality was observed from 1995 onwards in Turkey. The causes need to be explored in detail to inform future policy priorities in noncommunicable disease control.
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    Determinants of prevalence, awareness, treatment and control of high LDL-C in Turkey
    Sözmen, K; Ünal, B; Sakarya, S; Dinç, G; Yardim, N; Keskinkiliç, B; Ergör, G
    Objective: High blood cholesterol is one of the main modifiable risk factors for cardiovascular diseases (CVDs). The aim of the study is to determine the factors associated with the prevalence, awareness, treatment, and control of high low-density lipoprotein-cholesterol (LDL-C) among adults aged >= 20 years in Turkey. Methods: We used data from Chronic Diseases and Risk Factors Survey conducted in 2011-2012. The presence of high LDL-C, lipid-lowering treatment eligibility, and achievement of target LDL-C were defined according to the third Adult Treatment Panel guidelines on treatment of high cholesterol. Multivariate logistic regression analyses were performed to determine the associations between participant characteristics and high LDL-C prevalence, awareness, treatment, and control. Results: Framingham risk score categorization was performed for 13121 individuals aged >= 20 years. Approximately, 28% of the participants presented with high LDL-C. Among those with high LDL-C, 55.8% were aware of their situation; among those aware of high LDL-C, 46.9% were receiving lipid-lowering medication, and 50.6% of individuals who were receiving treatment achieved target LDL-C levels on the basis of their coronary heart disease (CHD) risk. Control of high LDL-C was negatively associated with the presence of diabetes mellitus (odds ratio: 0.36, 95% CI: 0.27-0.49, p<0.001). Conclusion: Despite the high awareness rates, there was a high proportion of adults who did not receive treatment or achieve recommended levels of LDL-C during treatment. The low treatment and control levels among individuals based on their CHD risk levels call for a better application of recommendations regarding personal preventive measures and treatments in Turkey.
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    Determinants of Breast and Cervical Cancer Screening Uptake Among Women in Turkey
    Sözmen, K; Unal, B; Sakarya, S; Dinc, G; Yardim, N; Keskinkilic, B; Ergör, G
    The aim of the study was to assess the influence of sociodemographic characteristics on breast and cervical cancer screening among women 30 years and older in Turkey. We used data from the National Chronic Diseases and Risk Factors Survey conducted by the Ministry of Health in 2011. Multivariate logistic regression analysis was used to assess the association of sociodemographic factors, lifestyle variables, and cancer screening. Overall, 22.0% of women ever had a Pap smear test for cervical cancer screening and 19.0% ever had a mammography for breast cancer screening(n = 6846). Individuals with a university degree, social security, doing moderate physical activity, and consuming 5 portions of fruit or vegetable/day were more likely to receive Pap smear test and mammography. Residing in the eastern region and living in rural area was associated with lower likelihood of receiving both types of screening.