The Household Water Insecurity Experiences Scale: answer patterns and cutoffs in Mexico.

OBJECTIVE: To investigate the degree in which answer patterns in the Household Water Insecurity Experiences Scale (HWISE) relate to scores aiming at identifying latent groups with different water insecurity levels in a nationwide representative sample of the Mexican population. MATERIALS AND METHODS: Based on data from the 2021 National Survey on Health and Nutrition (Estudio Nacional de Salud y Nutrición 2021, Ensanut 2021), sequence data representations, and a latent class analysis (LCA), in this article we estimate the likely misclassification errors of different cutoffs proposed for the HWISE scoring system. RESULTS: The main results suggest that a 5-item subset of the HWISE may exhibit a more reliable and cost-effective behavior than the complete 12-item set for a 2-level partition of the sample. CONCLUSIONS: Our methodological approach provides new insights regarding the efficiency and likely errors in distinguishing between levels of water insecurity based on the Mexican chapter of the HWISE.

An Entropy-Based Approach to Measuring Diet Adherence.

The aim of this study is to put forward an approach designed to calculate and sum up discrepancies between the actual food acquisition or intake and any standard or norm. Based on secondary analysis of cross-sectional data from the Mexican National Survey of Household Income and Expenditure, our proposed method to produce classes of entropy-based Diet Adherence Indices generates a Food Basket Adherence Index (FBAI) for Mexico City (2129 households). Findings suggest that it is possible to measure and decompose diet adherence using a cross entropy measure. Using food expenditure data and a normative food basket for Mexico City results, we show households' deviations from the suggested norm for different food groups. The average FBAI was 0.44, far above the minimum score of 0 which would indicate full adherence to the normative food basket. Our measure has a distribution wide enough to detect meaningful changes and distinguish between groups with known differences, providing important new insights on the linkages between home food environments and income distribution, and food insecurity and household distribution.

Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries.

The feasibility of non-pharmacological public health interventions (NPIs) such as physical distancing or isolation at home to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in low-resource countries is unknown. Household survey data from 54 African countries were used to investigate the feasibility of SARS-CoV-2 NPIs in low-resource settings. Across the 54 countries, approximately 718 million people lived in households with ⩾6 individuals at home (median percentage of at-risk households 56% (95% confidence interval (CI), 51% to 60%)). Approximately 283 million people lived in households where ⩾3 people slept in a single room (median percentage of at-risk households 15% (95% CI, 13% to 19%)). An estimated 890 million Africans lack on-site water (71% (95% CI, 62% to 80%)), while 700 million people lacked in-home soap/washing facilities (56% (95% CI, 42% to 73%)). The median percentage of people without a refrigerator in the home was 79% (95% CI, 67% to 88%), while 45% (95% CI, 39% to 52%) shared toilet facilities with other households. Individuals in low-resource settings have substantial obstacles to implementing NPIs for mitigating SARS-CoV-2 transmission. These populations urgently need to be prioritised for coronavirus disease 2019 vaccination to prevent disease and to contain the global pandemic.

Within-country migration and obesity dynamics: analysis of 94,783 women from the Peruvian demographic and health surveys.

BACKGROUND: Rural-to-urban migration is associated with increased obesity, yet it remains unknown whether this association exist, and to what extent, with other types of internal migration. METHODS: We conducted a secondary analysis of the Peruvian Demographic and Health Surveys (2005 to 2012) on data collected from women aged 15-49 years. Participants were classified as rural stayers, urban stayers, rural-to-urban migrants, intra-rural migrants, intra-urban migrants, and urban-to-rural migrants. Marginal effects from a logit regression model were used to assess the probabilities of being and becoming obese given both the length of time in current place of residence and women's migration status. RESULTS: Analysis of cross-sectional survey data generated between 2005 and 2012. Data from 94,783 participants was analyzed. Intra-urban migrants and rural-to-urban migrants had the highest rates of obesity (21% in 2012). A steady increase in obesity is observed across all migration statuses. Relative to rural non-migrants, participants exposed to urban environments had greater odds, two- to three-fold higher, of obesity. The intra-rural migrant group also shows higher odds relative to rural stayers (42% higher obesity odds). The length of exposure to urban settings shows a steady effect over time. CONCLUSION: Both exposure to urban environments and migration are associated with higher odds of obesity. Expanding the characterization of within-country migration dynamics provides a better insight into the relationship between duration of exposure to urban settings and obesity.

On the comparability of frailty scores under the accumulation of deficits approach.

BACKGROUND: While the cumulative deficit model is arguably the most popular instrument for population-level frailty screening, several questions remain unanswered regarding the comparability of the resulting scores across subpopulations. METHODS: Based on data from the five waves of the Mexican Health and Aging Study (MHAS) we draw upon the alignment method to test for measurement invariance of frailty scores as per the accumulation of deficits approach. RESULTS: Our results show that adjusting for measurement non-invariance not only improves predictive validity of our frailty measures, but resulting scores are more consistent with what is theoretically expected from them in longitudinal research. CONCLUSIONS: There are clear potential benefits of measurement invariance testing as a general analytical framework from which to tackle with issues of comparability in frailty research.

Patterns of Women's exposure to psychological violence: A global examination of low- and middle-income countries.

Introduction: Under Sustainable Development Goal 5, prevalence of intimate partner violence (IPV) is a globally reportable indicator. There is a lack of consensus on how to measure and report psychological IPV, affecting prevalence estimates and cross-country comparability. We examine similarities and differences in the patterning of women's experiences of psychological abuse in low- and middle-income countries (LMICs) to inform common cut points. Methods: Data include 13,452 ever-partnered women from six LMICs participating in the WHO multi-country study on women's health and domestic violence against women and 306,101 from 47 LMICs participating in the Demographic and Health Surveys. A confirmatory latent class analysis (LCA) approach was applied to identify the optimal class structure using the 3 DHS and 4 WHO psychological IPV items, assessed the impact of physical and sexual IPV on class structure, and tested class generalizability across countries. We validated the three-class solution by regressing the classes on physical IPV, sexual IPV, controlling behaviors, and injury due to domestic violence. We used item response theory (IRT) methods to assess item-level characteristics of the items. Results: Analysis confirmed the three-class structure in most countries. Addition of physical and sexual IPV did not change overall class structure or improve discrimination or homogeneity of the items. The three-class structure was invariant within most WHO-classified regions. Operationalized classes informed by the LCA resulted in prevalences of roughly 90% low-to-no class, 7% moderate-intensity class, and 3% high-intensity class. Classes showed convergent validity with all outcomes tested. IRT analysis revealed good discriminations but substantial information overlaps over a narrow range of the latent psychological violence construct. Conclusions: This study confirms the three-class pattern but suggests some differences across countries. and regions. We suggest cut points distinguishing violent from non-violent acts and demarcating levels of severity for future study. Findings offer evidence-based guidance to rectify challenges.

Health and Institutional Risk Factors of COVID-19 Mortality in Mexico, 2020.

INTRODUCTION: Several studies in developed and developing countries have analyzed the health risk factors associated with COVID-19 mortality. Comorbid diseases are a key explanatory factor behind COVID-19 mortality, but current studies treat comorbidities in isolation, at average-population values, and rarely assess how death risk varies for different health profiles across institutions. Estimating death risk variations for different interactions between comorbid diseases and across healthcare institutions is crucial to gaining a significant depth of understanding in relation to mortality during the pandemic. METHODS: This study relies on data from approximately half a million people in Mexico (of all recorded cases through August 15, 2020) and on Bayesian estimation to provide a more robust estimate of the combined effect of several comorbidities and institutional inequalities on COVID-19 mortality. RESULTS: The findings of the study illustrate the additive effects of several comorbid diseases, with the presence of obesity, diabetes, hypertension, and chronic kidney disease increasing the mortality risk of COVID-19. There are also variations in the risk of death across the heterogeneous Mexican health system. CONCLUSIONS: This study shows that COVID-19 mortality risk sharply increases in patients with 2 or more comorbid diseases (obesity, diabetes, hypertension, and cardiovascular diseases) in Mexico. However, death risk varied significantly across institutions for patients with the same comorbidity profile.

Finding advanced third-stage larvae of Gnathostoma turgidum Stossich, 1902 in Mexico from natural and experimental host and contributions to the life cycle description.

In order to clarify the role of Gnathostoma turgidum as an etiological agent involved in human gnathostomiasis in Mexico, establish the taxonomic identity of the advanced third-stage larvae (AdvL(3)), and contribute to the knowledge of its life cycle, experimental host infections, examination of potential natural hosts, and morphological comparisons were carried out. Examination of ten species of potential hosts at San Pedro las Playas and Tres Palos Lagoon in Guerrero state, Mexico revealed that two (Kinosternon integrum and Rana zweifeli) were infected by 15 AdvL(3) of G. turgidum. A specific identity was obtained comparing these larvae with those recovered from hosts experimentally infected. The AdvL(3) measured 1.6 mm in length, with two cervical papillae (both in 12th row) and an excretory pore on the 19th row. The average of cephalic hooklets, from first to fourth row, was 30.8, 34.0, 36.7, and 39.6, respectively. This is the first record of AdvL(3) of G. turgidum in America, and it represents a significant contribution for the understanding of the life cycle of this species.

Small-area estimates of stunting. Mexico 2010: Based on a hierarchical Bayesian estimator.

The Sustainable Development Goal (SDG) 2.2 proposes ending stunting and wasting in children under five years of age by 2025. In Mexico, progress in the reduction of stunting has slowed in the 21st century. One of the challenges in tackling stunting is that it has become more concentrated in certain areas, but there are no data detailing its precise location. This paper produces the first small-area estimates of stunting for the Mexican municipalities by applying a hierarchical Bayesian estimator using data from a nationally representative survey (ENSANUT 2012, in Spanish) and the sample of the National Housing and Population Census 2010. The findings suggest the existence of large within-state differences in the prevalence of stunting and that this phenomenon is highly spatially clustered. The paper also illustrates the value of the small-area stunting estimates by performing a spatial analysis on the relationship between stunting and food insecurity at the municipal level.

Towards an EU measure of child deprivation.

This paper proposes a new measure of child material and social deprivation (MSD) in the European Union (EU) which includes age appropriate child-specific information available from the thematic deprivation modules included in the 2009 and 2014 waves of the "EU Statistics on Income and Living Conditions" (EU-SILC). It summarises the main results of the in-depth analysis of these two datasets, identifies an optimal set of robust children MSD items and recommends a child-specific MSD indicator for use by EU countries and the European Commission in their regular social monitoring. In doing this, the paper replicates and expands on the methodological framework outlined in Guio et al. (2012, 2016), particularly by including additional advanced reliability tests.

Does measurement invariance hold for the official Mexican multidimensional poverty measure? A state-level analysis 2012.

One of the main goals in poverty measurement is making comparisons of prevalence and severity across geographical units. This is attained by merely disaggregating the index in question. The underlying assumption is that comparisons across units are tenable, inasmuch as the same indicators are utilised for constructing the index. Nonetheless, in practice, this assumption is very rarely tested. From the statistical perspective, measurement invariance (MI) must hold for comparisons to be valid, and violations thereof indicate that a given poverty index measures different things across different countries, states, counties, etc. Consequently, differentials in severity and prevalence cannot be attributed exclusively to the underlying construct (i.e. poverty) but to factors not considered in the measure. This article tests whether MI holds for two indexes: the Mexican official multidimensional measure (MPM) and an adjusted multidimensional measure (MPM-A) that uses less severe thresholds. The analysis is conducted using a novel method called the 'alignment method'. It uses these two measures and the method as an illustration of why it is vital to introduce MI tests into poverty measurement. The results suggest that partial strong MI holds for the official measure and MI is violated when the thresholds are adjusted. Partial strong MI guarantees making valid comparisons across the 32 states. Should the official measure requires to be updated with other thresholds, it would be necessary to adjust the threshold or drop the indicator for water deprivation.