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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 3  |  Page : 261-269

Sociopsychological and biochemical determinants of health and disease in executive health check-up


1 Department of Hospital Administration, Jawaharlal Nehru Medical College, KAHER, Belagavi, Karnataka, India
2 Department of Microbiology, Jawaharlal Nehru Medical College, KAHER, Belagavi, Karnataka, India
3 Department of Public Health, Jawaharlal Nehru Medical College, KAHER, Belagavi, Karnataka, India
4 BLDE University, Vijayapur, Karnataka, India

Date of Submission25-Nov-2021
Date of Acceptance04-Apr-2022
Date of Web Publication17-Sep-2022

Correspondence Address:
Assit. Prof. A B Kudachi
Department of Hospital Administration, Jawaharlal Nehru Medical College, KAHER, Belgavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_259_21

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  Abstract 


BACKGROUND: Preventive health check-ups are known to be associated with significant reductions in morbidity, mortality, and economic costs related to various diseases, especially chronic lifestyle diseases that progress silently.
OBJECTIVE: The objective is to evaluate the sociopsychological and biochemical issues of health and disease in executive health check-up as well as to employ them for encouraging people to utilize the available preventive health services.
MATERIALS AND METHODS: This cross-sectional study enrolled 768 individuals aged >20 years, irrespective of their gender, reporting for an executive health check-up and evaluated their demographic profile, morbidity, type of family, diet and socioeconomic status, biochemical profiling, and sociopsychological features. The data were statistically analyzed using correlations among different variables by Karl Pearson's correlation coefficient method. P < 0.05 and 0.001 indicated statistical significance.
RESULTS: The participants had a mean age of 48.24 ± 12.84 years and a Male and Female ratio of nearly 2:1. The demographic parameters showed a significant association with the different levels of biochemical parameters (P < 0.05/0.001).
CONCLUSION: There exist significant correlations between sociopsychological, and biochemical determinants of health and disease in executive health check-up. These incite the need for utilizing preventive/precautionary health services and early detection of disease status is speculative. There is uncertainty among the public and health-care professionals in utilizing these preventive health-care services in a beneficial, judicious, as well as in cost-effective manner.

Keywords: Demography, disease, health promotion, health, preventive health services, psychology


How to cite this article:
Kudachi A B, Nagmoti M B, Rajshree S K, Mudhol R S. Sociopsychological and biochemical determinants of health and disease in executive health check-up. Indian J Health Sci Biomed Res 2022;15:261-9

How to cite this URL:
Kudachi A B, Nagmoti M B, Rajshree S K, Mudhol R S. Sociopsychological and biochemical determinants of health and disease in executive health check-up. Indian J Health Sci Biomed Res [serial online] 2022 [cited 2022 Sep 25];15:261-9. Available from: https://www.ijournalhs.org/text.asp?2022/15/3/261/356275




  Introduction Top


The World Health Organization defines health as a state of complete, mental and social well-being and not merely the absence of disease or infirmity.[1],[2] Any deviation from this state of health is referred to as disease/illness/sickness.[3] Every human has the fundamental right to enjoy the highest attainable standard of health.[4] However, owing to the current lifestyle, food habits, lack of exercise, stress and neglect, vulnerability to many diseases like diabetes, hypertension, dyslipidemia, coronary artery disease, and malignancy have increased tremendously.[5],[6],[7],[8]

Early detection of the disease in its latent phase facilitates timely therapeutic interventions, thereby significantly reducing the associated morbidity, mortality, and economic burden.[5],[6],[7],[8] Preventive health check-ups (PHC) have widely been adopted by many health-care centers toward this goal.[6],[7] Periodic health examinations also provide opportunities to review patients' ongoing medical issues, counsel them on preventive health and improve the physician–patient relationship.[9] Moreover, modeling analyses have shown a significant decline in mortality associated with coronary heart disease (CHD) due to a reduction in cardiovascular risk factors and timely CHD management.[10],[11],[12],[13]

However, there is uncertainty among the public as well as the health-care professionals regarding the effectiveness and the feasibility of utilizing these services in a beneficial, judicious, and cost-effective manner.[14],[15] This concern has been countered by other researchers who reported higher mortality rates in the absence of regular PHC and increased survival in cases of routine PHC.[16],[17] They also assert that preventive health services reduce eventual demand for medical care, thus, enhancing the economic efficiency.[17]

Therefore, PHCs are integral to health promotion, especially in the current scenario of silent killer diseases.[18] Previous studies have evaluated various PHC parameters independently; correlating them to risk of various diseases and conditions. The need for a holistic PHC protocol motivated the designing of the present research that aimed to evaluate the socio-psychological, biochemical profiling of health and disease in executive health check-up, as well as to employ them for encouraging people to utilize preventive health services.


  Materials and Methods Top


This hospital-based, cross-sectional study was conducted at a tertiary care hospital in Belagavi, Karnataka, India, from July 2019 to January 2020, after obtaining ethical clearance from the Institutional Review Board Ethical committee (Humans) KAHER, Belagavi. Ref.No.KAHER/ Ehtics/2018-19/ D-128 dated 29.5.2018. The minimum sample size required was calculated to be 664, based on a study by Ramesh et al., who found the prevalence of hypertension to be 52%, using the following formula n = (Z2 × PQ)/d2 [where, Z = standard normal variables (99% confidence) =2.25; P = prevalence = 52%; Q = 100-P = 100-52 = 48%; and d = acceptable errors = 0 5%].[19]

Accordingly, the study enrolled 768 individuals aged >20 years, irrespective of their gender, reporting for an executive health check-up to the afore-mentioned hospital, after obtaining written informed consent from them. Individuals with age <20 years, pre-existing disease or condition and with lack of will to participate in the study were excluded. The following parameters were recorded from all the participants. Executive health check-up was conducted on demand of the patient.

Demographic determinants

A detailed history was recorded from all participants including demographic parameters such as age, gender, social history (alcoholism and/or smoking habit), type of family, diet, and socioeconomic status (SES).[20]

Biochemical determinants

Venipuncture was performed on the participants under complete aseptic conditions and the collected blood samples were sent to the laboratory for biochemical investigations including assessment of hemoglobin (Hb), fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1c), cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), and thyroid-stimulating hormone (TSH) levels. Renal function test and urine analysis were also performed.

Sociopsychological determinants

All participants underwent an assessment of their psychological wellbeing along with its components including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Higher scores implied higher levels of psychological wellbeing.[21],[22]

Statistical analysis

Data were compiled and analyzed using statistical software R version 3.6.3 (R foundation for statistical computing Vienna, Austria) and Microsoft Excel. Categorical variables were presented in the form of frequency table. Continuous variables were presented in mean ± SD form. The data were statistically analyzed using correlations among different variables by Karl Pearson's correlation coefficient method. P < 0.05 indicated statistical significance. P < 0.05 was considered statistically significant.


  Results Top


The study included 768 participants with a mean age of 67.06 ± 32.94 years and a M:F ratio of nearly 2:1. [Table 1] presents the descriptive statistics/frequency distribution of the various study parameters. Majority of the participants were aged between 40 and 59 years (31.12%), with the minimum and maximum ages observed to be 20 years and 60 years, respectively. [Table 2] summarizes the mean values of the various study parameters.
Table 1: Demographic profile of patients

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Table 2: Morbidity profile of patients

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Further tables present the comparative analysis between the demographic profile and the biochemical parameters which included gender (M:F), age (>20), social history (smoking, alcohol, both), type of family (nuclear, joint), SES (Class I, II, and III), and diet (vegetarian, mixed). [Table 3] depicts the comparison of demographic profiles with Hb%. Using one-way ANOVA and Chi-square test, no significant difference was noted in the mean of Hb% and their components over demographic parameters such as gender, age, and social history, type of family, SES, and diet. The demographic profile and the status of HBA1C (normal: Prediabetic: Diabetic) showed significant association (P < 0.05) [Table 4].
Table 3: Association between demographic profile and status of hemoglobin percentage

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Table 4: Association between demographic profile and status of glycated hemoglobin

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The demographic profile and the status of cholesterol, HDL, LDL, and TG as shown in [Table 5], [Table 6], [Table 7], [Table 8], respectively, showed no significant association when Chi-square test and P value test were employed.
Table 5: Association between demographic profile and status of cholesterol

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Table 6: Association between demographic profile and status of high-density lipoprotein

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Table 7: Association between demographic profile and status of low-density lipoprotein

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Table 8: Association between demographic profile and status of triglyceride

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[Table 9] shows the association of demographic profile and status of renal FT. Participants with vegetarian diet showed a significant positive association (P < 0.05) and [Table 10] shows the association of demographic profile and status of TSH with no significant association between different profiles.
Table 9: Association between demographic profile and status of renal function test

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Table 10: Association between demographic profile and status of thyroid-stimulating hormone

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[Table 11] summarizes the correlations among different variables (Karl Pearson's correlation coefficient method). A significant positive correlation was observed between FBS and PPBS (P < 0. 01), HBA1C and FBS and also PPBS (P < 0. 01), SGOT and SGPT (P < 0. 01), Renal FT and SGOT (P < 0. 005).
Table 11: Correlations among different variables by Karl Pearson's correlation coefficient method

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  Discussion Top


Preventive health check-ups are known to be associated with significant reductions in morbidity, mortality, and economic costs related to various diseases, especially chronic lifestyle diseases that progress silently.[16],[17],[18] Despite this, they are under-utilized due to the speculation regarding their efficacy and efficiency.[14],[15] Hence, this study was conducted to evaluate the sociopsychological and biochemical determinants of health and disease in executive health check-up, as well as to employ them for encouraging people to utilize preventive health services the observation made in the present research are in concordance with Velupillai et al., who also determined that health is influenced by psychological, social, and biological determinants (P < 0.05).[23] They found that socio-economic gradients in health were influenced by environmental conditions, personal and professional relationships, knowledge, lifestyle choices and altered mental functions, that predisposed the participants toward the practice of health-promoting or health damaging behaviors.[23]

However, the present study demonstrated no significant association between the levels of psychological wellbeing and the demographic parameters (P > 0.05). This is in contrast to the works of Dorji et al., and Lincoln et al., who reported that psychological wellbeing was influenced by many factors including gender, age, marital status, education, SES, and spirituality.[24],[25] This could perhaps be accounted for by regional differences between the study populations, marital status, education, occupation and income, religion and spirituality, and health marital status, education, occupation and income, religion and spirituality, and health.

The significant association seen between HbA1c and demographic parameters was also reflected in the study done by Bijlsma-Rutte et al., who showed that there was an association between SES and HbA1c levels.[26]

Hence, the present study establishes the correlations between sociopsychological, and biochemical determinants of health and disease in executive health check-up, besides creating awareness regarding the need for utilizing preventive health services. This also provides an evidence based foundation for deep rethinking of distributive justice so as to improve the health status of those least advantaged on the social health gradient. Moreover, this study serves as an education platform for encouraging early detection and timely intervention, especially for lifestyle-associated diseases.

However, this research has its limitations in being a single-center study with a limited sample size. These can be overcome by multi-centric, long-term, prospective clinical studies with a larger sample size.

Conclusion

There exist significant correlations between sociopsychological, and biochemical profiling determinants of health and disease in executive health check-up. These incite the need for utilizing preventive health services. Preventive measures can also be taken by early diagnosis of diseases. It also includes advice on diet and physical activity. Periodical health checkups help the ongoing medical issues to counsel on preventive measures and to improve the physician and patient relationship.

Acknowledgment

Authors would like to acknowledge all study participants.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Constitution of the World Health Organization. In: World Health Organization: Basic Documents. 45th ed. Geneva: World Health Organization; 2005. Available from: https://apps.who.int/iris/handle/10665/43134. [Last accessed on 2017 Sep 27].  Back to cited text no. 1
    
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Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med 2007;356:2388-98.  Back to cited text no. 12
    
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Maciosek MV, Coffield AB, Flottemesch TJ, Edwards NM, Solberg LI. Greater use of preventive services in U.S. health care could save lives at little or no cost. Health Aff (Millwood) 2010;29:1656-60.  Back to cited text no. 14
    
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Cohen JT, Neumann PJ, Weinstein MC. Does preventive care save money? Health economics and the presidential candidates. N Engl J Med 2008;358:661-3.  Back to cited text no. 15
    
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Ramesh R, Yuri Gagarin P, Senthil Murugan R, Rizwan SA, Virgin Joena M, Aravind A. A study on the utility of preventive health check-up in early detection of disease states. Int J Res Med Sci 2016;4:4022-5.  Back to cited text no. 19
    
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Ryff CD, Keyes CL. The structure of psychological well-being revisited. J Pers Soc Psychol 1995;69:719-27.  Back to cited text no. 22
    
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Velupillai YN, Packard CJ, Batty GD, Bezlyak V, Burns H, Cavanagh J, et al. Psychological, social and biological determinants of ill health (pSoBid): Study protocol of a population-based study. BMC Public Health 2008;8:126.  Back to cited text no. 23
    
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Dorji N, Dunne M, Gurung M. Socio-demographic correlates of psychological wellbeing among older adults in Bhutan. Envir Soc Psychol 2019;4:1-8.  Back to cited text no. 24
    
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Lincoln KD, Taylor RJ, Chae DH, Chatters LM. Demographic correlates of psychological well-being and distress among older African Americans and Caribbean black adults. Best Pract Ment Health 2010;6:103-26.  Back to cited text no. 25
    
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Bijlsma-Rutte A, Rutters F, Elders PJM, Bot SD, Nijpels G. Socio-economic status and HbA1c in type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev 2018;34:e3008.  Back to cited text no. 26
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11]



 

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