Browsing by Author "Liu, Xiaoxiao"

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    Geospatial patterns of comorbidity prevalence among people with osteoarthritis in Alberta Canada
    (2020-10-15) Liu, Xiaoxiao; Shahid, Rizwan; Patel, Alka B; McDonald, Terrence; Bertazzon, Stefania; Waters, Nigel; Seidel, Judy E; Marshall, Deborah A
    Abstract Background Knowledge of geospatial pattern in comorbidities prevalence is critical to an understanding of the local health needs among people with osteoarthritis (OA). It provides valuable information for targeting optimal OA treatment and management at the local level. However, there is, at present, limited evidence about the geospatial pattern of comorbidity prevalence in Alberta, Canada. Methods Five administrative health datasets were linked to identify OA cases and comorbidities using validated case definitions. We explored the geospatial pattern in comorbidity prevalence at two standard geographic areas levels defined by the Alberta Health Services: descriptive analysis at rural-urban continuum level; spatial analysis (global Moran’s I, hot spot analysis, cluster and outlier analysis) at the local geographic area (LGA) level. We compared area-level indicators in comorbidities hotspots to those in the rest of Alberta (non-hotspots). Results Among 359,638 OA cases in 2013, approximately 60% of people resided in Metro and Urban areas, compared to 2% in Rural Remote areas. All comorbidity groups exhibited statistically significant spatial autocorrelation (hypertension: Moran’s I index 0.24, z score 4.61). Comorbidity hotspots, except depression, were located primarily in Rural and Rural Remote areas. Depression was more prevalent in Metro (Edmonton-Abbottsfield: 194 cases per 1000 population, 95%CI 192–195) and Urban LGAs (Lethbridge-North: 169, 95%CI 168–171) compared to Rural areas (Fox Creek: 65, 95%CI 63–68). Comorbidities hotspots included a higher percentage of First Nations or Inuit people. People with OA living in hotspots had lower socioeconomic status and less access to care compared to non-hotspots. Conclusions The findings highlight notable rural-urban disparities in comorbidities prevalence among people with OA in Alberta, Canada. Our study provides valuable evidence for policy and decision makers to design programs that ensure patients with OA receive optimal health management tailored to their local needs and a reduction in current OA health disparities.
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    NO2 Exposure and Myocardial Infarction Hospitalizations in Calgary, Canada
    (2018-01-02) Liu, Xiaoxiao; Bertazzon, Stefania; Draper, Dianne Louise; Kaplan, Gilaad; TownShend, Ivan J.
    Air pollution is a leading public health concern. This research investigated the health effects of nitrogen dioxide (NO2) on myocardial infarction (MI) in Calgary, Canada. Seasonal trend decomposition and hot spot analysis were applied exploring the spatial and seasonal pattern of MI. Both males and females followed a seasonal pattern with MI peaks in winter and summer. MI exhibited spatial clustering over communities with a larger proportion of older people, lower socioeconomic status, and proximity to industrial areas. A space-time model integrating harmonic regression and land use regression model was applied to estimate air pollution at fine spatial and temporal resolutions. providing accurate air pollution exposure for health risk studies. The varying association between MI and NO2 was examined with spatial autoregressive model (SAR) and geographically weighted regression (GWR), which accounts for spatial autocorrelation and spatial non-stationarity in MI. Result indicated that NO2 had a positive significant association with MI hospitalizations. However, the size and significance declined when age and gender were accounted for. By identifying potential factors in the hot spots, new evidence may be found to aid understanding of MI etiology. The advantage of this research is the space-time air pollution estimates at DA level, which enables reliable risk assessment at fine spatial scale. Further research shall be done with approach of multilevel model or hierarchic model to account for both individual and contextual factors. The research provides important information for health promotion. By raising the awareness regarding the spatial variation of air pollution, people may be able to further protect themselves from areas with relatively higher air pollution concentrations, especially for those vulnerable population such as elderly and people with asthma. It is helpful for policy makers and health researchers in targeting efforts and resources to areas in most needs. Overall, the air quality in Calgary is good, under the World Health Organization air pollution guidelines. Air pollution research in a cleaner area such as Calgary shows further indications about health impacts of air pollution at an acceptable level, which may shed new light regarding threshold research and further improvement of the existed air pollution guidelines.
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    Spatial-temporal variation and risk factor analysis of hand, foot, and mouth disease in children under 5 years old in Guangxi, China
    (2019-11-08) Liu, Huan; Song, Genxin; He, Nan; Zhai, Shiyan; Song, Hongquan; Kong, Yunfeng; Liang, Lizhong; Liu, Xiaoxiao
    Abstract Background Hand, foot and mouth disease (HFMD) incidence is a critical challenge to disease control and prevention in parts of China, particularly Guangxi. However, the association between socioeconomic factors and meteorological factors on HFMD is still unclear. Methods This study applied global and local Moran’s I to examine the spatial pattern of HFMD and series analysis to explore the temporal pattern. The effects of meteorological factors and socioeconomic factors on HFMD incidence in Guangxi, China were analyzed using GeoDetector Model. Results This study collected 45,522 cases from 87 counties in Guangxi during 2015, among which 43,711 cases were children aged 0–4 years. Temporally, there were two HFMD risk peaks in 2015. One peak was in September with 7890 cases. The other appeared in May with 4687 cases of HFMD. A high-risk cluster was located in the valley areas. The tertiary industry, precipitation and second industry had more influence than other risk factors on HFMD incidence with explanatory powers of 0.24, 0.23 and 0.21, respectively. The interactive effect of any two risk factors would enhance the risk of HFMD. Conclusions This study suggests that precipitation and tertiary industry factors might have stronger effects on the HFMD incidence in Guangxi, China, compared with other factors. High-risk of HFMD was identified in the valley areas characterized by high temperature and humidity. Local government should pay more attention and strengthen public health services level in this area.