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There is growing evidence to suggest that childhood deprivation is linked to social inequalities and has important consequences for health in later life. Past studies tend to focus on the influence of cumulative deprivation on the risk of developing a particular disease. This study adds to the literature by exploring how deprivation in childhood may be linked to how people (who already have a disease) self-manage their condition in later life. Questionnaires and focus groups were analysed to explore this relationship (n=91) among coronary heart disease patients living in a deprived urban area of Northern England. The results suggest that childhood deprivation may influence health behaviours and lifestyle in later life especially with regard to diet, health locus of control and doctor visits.

Although much is known about inequalities in the prevalence of CHD, less is known about the barriers experienced in self-managing it. Questionnaires, focus groups, and Internet forums were analyzed to explore obstacles in self-managing CHD. Most people found it difficult and costly to maintain a healthy lifestyle. Gender inequalities included women being more likely to live on their own and with a lower income. Marital status was an issue as several were either caring for an ill spouse or were coping with their recent death. Socio-demographic factors played a key role in influencing people's ability to manage their CHD.

A dynamic model of the evolution of health for those over the age of 50 is embedded in a structural, econometric model of retirement and saving. Effects of smoking, obesity, alcohol consumption, depression, and other proclivities on medical conditions are analyzed, including hypertension, diabetes, cancer, lung disease, heart problems, stroke, psychiatric problems, and arthritis. Compared to a population in good health, the current health of the population reduces retirement age by about one year. Including detailed health dynamics in a retirement model does not influence estimates of the marginal effects of economic incentives on retirement.

Purpose – To examine potential sex differences among American Indian and Alaska Native peoples (AIANs) in diabetes prevalence, comorbidities, healthcare utilization, and treatment costs within the Indian Health Services (IHS).

Methodology/Approach – Data were drawn from the IHS Improving Healthcare Delivery Data Project with 437,608 persons in our analytical sample. We described sex and age differences in diabetes, comorbidities, healthcare utilization, and treatment costs among the adults with diabetes. We evaluated the statistical differences between men and women using confidence intervals calculated at the 95% level, with nonoverlapping confidence intervals indicating statistical significance.

Findings – The prevalence of diabetes among females was somewhat higher than that of males (10.82 vs 9.16%, respectively, p < 0.05). Among adults with diabetes, males had statistically higher prevalence of hypertension, cardiovascular disease, and substance use disorders and fewer mental health disorders compared to females. Although males had overall lower average cost of services than females, males had higher utilization for hospital inpatient services than females, and females used more outpatient services.

Research limitations/implications – We are limited to one fiscal year of data and thus cannot predict the influence of healthcare utilization patterns on the overall health of this population. Although a large sample, the findings are only generalizable to the active users of the participating IHS Service Units.

Originality/Value of Paper – This study fills a major gap in our knowledge of sex differences in diabetes prevalence, comorbidities, healthcare utilization, and treatment costs among AIANs. Differences in the comorbidities that characterized the AIAN adult males and females with diabetes in this sample have important implications for mortality and cost of care. Diabetes management that addresses such gender-specific comorbidities, particularly substance use disorders among men and mental health disorders among women, promises to reduce these comorbidities and related complications.

Nutrition, as a science, is poorly understood, both professionally and publicly. The confusion that surrounds this science makes it very difficult, if not impossible, to formulate public health policy, which creates opportunities for political manipulation and control. Nutrition, for a century or more, has been variously described as a summation of the physiological and biochemical properties of individual nutrients in food rather than the whole food itself. This infers that isolated nutrients in supplements will function in the same way as nutrients in food. It also infers that removing or minimizing “undesirable” nutrients from food will make the food more healthful. This arises from the highly reductionist way that we focus on individual nutrients minus their natural context, both the context within the foods of which they are a part and the context within biological systems where they function. The shortcomings of this belief system may be illustrated by hugely costly mistakes made in the past, even more than a century ago, that corrupt current practices. Such mistakes have become so embedded in the contemporary narrative on nutritional science, both fundamentally and practically, that we fail to recognize the damage they continue to cause.

Alternatively, when nutritional effects are considered more within their natural contexts, that is, more wholistically, then it helps to explain, for example, the remarkable ability of nutrition, as provided by a whole food plant-based diet, to prevent even to cure varied types of cardiovascular disease. Furthermore, the breadth of this nutritional effect for a wide variety of illnesses and diseases suggests that nutrition, properly provided by a whole food plant-based diet, is more efficacious than a combination of all the contemporary pills and procedures combined. It also suggests that genetic determinism is not the explanation for disease that is widely advanced. And finally, among still more consequences, there are many societal outcomes that can be substantially mitigated, including the escalating cost of health care and the dangerously increasing array of destructive practices that damage the environment. Many of the momentous health, economic, environmental and sociopolitical problems currently faced may be traced to a misunderstanding of the effects of food and nutrition. The task therefore is how to bring this message to the attention of a public who for too long have gradually adopted flawed food production and healthcare systems that are on the verge of collapse, threatening the collapse of entire societies as we know them. More specifically, a public and professional dialog on the meaning of nutrition, especially its wholistic properties, is desperately needed, especially in medical schools where nutrition as a science is almost totally ignored.

Diabetes is a chronic disease and the major types of diabetes are type 1 and type 2. On aging, people with diabetes tend to have long-term problems in hypertension, coronary artery disease, obesity, and nerves. Given the increasing number of complications in recent years, by 2040, 624 million people will have diabetes worldwide and l in 8 adults will have diabetes in the future. Machine learning (ML) is evolving rapidly, many aspects of medical learning use ML. In this study, tension-type headaches (TTH) were associated with diabetes using SPSS, Pearson correlation, and ANOVA tests. Data were collected from Delhi NCR Hospital. It contains 30 diabetic subjects. The purpose of this study was to correlate diabetes analysis from TTH and other diseases using the latest technologies to analyze the Internet of Things and Big Data and Stress Correlation (TTH) on human health. The authors used Pearson correlation to correlate study variables and see if there was any effect between them. There was an important relationship between the percent variable, the total number of individuals, the number of individuals, and the minimum variable. The age (field) of the number of individuals to one of the total number of individuals showed a strong correlation (1.000) with a significant value of p (1.000). Overall, cases of TTH increased with age in men and do not follow the pattern of change in diabetes with age, but in cases of TTH, patterns of headaches such as diabetes increase to age 60 and then tend to decrease.

In our society, there are some trends that are not exciting. We are living increasingly in an aging society and we are becoming fatter (globesity). Moreover, we are facing an alarming decline in physical activity (PA) worldwide. In this context, chronic diseases are booming and health expenditures are skyrocketing. Stimulating PA is likely the best way to reduce the burden of disease and increase the social, psychological, and economic well-being of a community. In this chapter, two projects aimed at increasing PA among individuals are presented. The key point of the two projects is that they medicalize PA. The first project was carried out in Italy. A series of doctors started to “prescribe” PA as if it were a medicine. Therefore, PA is presented as a real cure to treat diseases and pathologies. The other project was supported by a private enterprise. The “concept” of the project is summarized as follows: “The quantity and quality of the physical activity carried out by the patient should be considered by the general practitioner as a clinical parameter as well as other parameters, such as blood pressure, weight, and glucose level.” It is possible that the success of these two initiatives stems from the fact that the biomedical complex has a strong influence on the part of the population. It is very effective to use a reliable source to spread a health promotion message. It becomes a medicalization without pathologization and a form of medicalization without pharmacologicalization. In Conrad’s (2007) words, it becomes a conceptual medicalization.

The purpose of this chapter is to use sociological theory and research to develop an explanation for how chronic illnesses are managed at home and to thereby suggest some ways in which a sociological perspective can be applied to improve health care for persons with chronic illnesses. Self-care illness management is crucial to the prevention of and reduction of morbidity and mortality from chronic illness.

Review and synthesis of research literature.

Sociological research and theory suggest two important insights that should inform health care services aimed at improving self-care; chronic illness care occurs in the context of the household, neighborhood, and community and, therefore, the “patient” (i.e., the object of health services) is really the caregiving social network around the patient, and because the risk of chronic illness and the resources available to deal with it are socially (and unequally) distributed, “health care” interventions need to take account of disparities in risks and resources that will affect the patient’s ability to successfully comply with self-care regimens.

The review does not include an examination of the clinical research literature. It does, however, suggest that sociologists need to explicitly study chronic illness and health care related to it.

The chapter links the long history of research on family caregiving to the concern with the success of self-management of chronic illness. It also links concerns about that success to social disparities in the distribution of social resources and hence to morbidity and mortality disparities.