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Uptake of health checks by residents from the Danish social housing sector – a register-based cross-sectional study of patient characteristics in the ‘Your Life – Your Health’ program

Authors: Larsen, Lars Bruun; Sandbaek, Annelli; Thomsen, Janus Laust; Bjerregaard, Anne-Louise;

Uptake of health checks by residents from the Danish social housing sector – a register-based cross-sectional study of patient characteristics in the ‘Your Life – Your Health’ program

Abstract

Poor uptake among socio-economically disadvantaged and susceptible populations is a well-known challenge of general health check interventions, and is widely cited as one of the reasons for the lack of population level effects seen in many studies. We report on patient characteristics among attendees and non-attendees of health checks made available to residents in the social housing sector of the municipality of Aarhus. We focus on this general population, as well as a particular sub-group living in an exceptionally deprived social housing area, and discuss the properties of intervention uptake that we need to be aware of to qualify and compare the effects of general versus targeted health checks in socially deprived areas.Cross-sectionally in a sample of 6650 residents of the Aarhus social housing sector who were invited for a health check in the first year of the 'Your Life - Your Health' program. The analyses consisted of 1) descriptive analysis of the characteristics of attenders/non-attenders, 2) unadjusted and adjusted Poisson regression to examine associations of patient characteristics and uptake of health checks, and 3) decision tree analyses (CHAID) to examine interaction and homogeneity in patient characteristics among attenders.Of the overall population 30% attended. In a nested cohort of people residing in a particularly deprived social housing settlement, 25% attended. Further, in the overall population, we found an association between the likelihood of taking up a health check and age, sex, country of origin, educational attainment, cohabitation, occupational status, and past medical treatment. In the nested cohort the association between uptake and medical treatment was non-significant, while the association between uptake and occupation was limited to people who were employed. These results resonate with past evidence on health check attendance.Attendance in the 'Your Life - Your Health' program is higher among people of a higher socio-economic status. This should be taken into consideration when analysing and interpreting the overall study effects. Moreover, the results suggest that a targeted approach in the social housing sector could be more effective than a mass screening approach. However, more information is required to make such assertion definitive.

Keywords

Male, Patient Acceptance of Health Care/statistics & numerical data, Denmark, Helbredstjek, Uptake, Social deprivation, Socially deprived areas, community health services, health examination, Humans, Registries, Almen nyttige boligområder, Physical Examination, Aged, attendance, socially deprived areas, Social housing sector, Public Housing, Physical Examination/statistics & numerical data, Health examination, Health check, Community health services, Public Housing/statistics & numerical data, Middle Aged, Patient Acceptance of Health Care, social deprivation, Cross-Sectional Studies, Socioeconomic Factors, uptake, health check, Attendance, Female, Public aspects of medicine, RA1-1270, social housing sector, Research Article, Program Evaluation

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    12
    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Top 10%
Green
gold