A cross-country comparison of tobacco consumption among youths from selected South-Asian countries.

BACKGROUND: Tobacco consumption (TC) among youths poses significant public health problem in developing countries. This study utilized the data of Global Youth Tobacco Survey (GYTS), 2007 to examine and compare youth TC behavior in Bangladesh, Nepal and Sri Lanka. METHODS: The GYTS covered a total of 2,242 Bangladeshi, 1,444 Nepalese and 1,377 Sri-Lankan youths aged 13-15 years. They represented response rates of 88.9%, 94.6%, and 85.0% for the three countries, respectively. Socioeconomic, environmental, motivating, and programmatic predictors of TC were examined using cross tabulations and logistic regressions. RESULTS: Prevalence of TC was 6.9% (9.1% in males, 5.1% in females) in Bangladesh, 9.4% (13.2% in males, 5.3% in females) in Nepal and 9.1% (12.4% in males, 5.8% in females) in Sri Lanka. The average tobacco initiation age was 9.6, 10.24 and 8.61 years, respectively. Cross tabulations showed that gender, smoking among parents and friends, exposure to smoking at home and public places, availability of free tobacco were significantly (P < 0.001) associated with TC in all three countries. The multivariable analysis [odds ratio (95% confidence interval)] indicated that the common significant predictors for TC in the three countries were TC among friends [1.9 (1.30-2.89) for Bangladesh, 4.10 (2.64-6.38) for Nepal, 2.34 (1.36-4.02) for Sri Lanka], exposure to smoking at home [1.7 (1.02-2.81) for Bangladesh, 1.81 (1.08-2.79) for Nepal, 3.96 (1.82-8.62) for Sri Lanka], exposure to smoking at other places [2.67 (1.59-4.47) for Bangladesh, 5.22 (2.76-9.85) for Nepal, 1.76 (1.05-2.88) for Sri Lanka], and the teaching of smoking hazards in schools [0.56 (0.38-0.84) for Bangladesh, 0.60 (0.41-0.89) for Nepal, 0.58 (0.35-0.94) for Sri Lanka]. CONCLUSIONS: An understanding of the influencing factors of youth TC provides helpful insights for the formulation of tobacco control policies in the South-Asian region.

Productive engagement of older adults in China: A multilevel analysis.

AIM: This study investigates how the personal characteristics and behavior, and health status of older adults in China influenced their productive engagement in paid and unpaid jobs. METHODS: Data for this analysis came from 2002, 2005, 2008 and 2011 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used a random intercept multilevel multinomial logit model to analyze data from 3208 older adults aged 65 from the 2002 wave, which decreased to 1385 in 2011. The main study variable is older adults' engagement in paid jobs and unpaid work (including housework, care-taking, poultry farming, and planting vegetables that have an economic value). RESULTS: There was a strong association between older adults' productive engagement and their functional limitations to daily living activities, health and healthy behavior. Older adults with inadequate finance were more likely to be working to support themselves. Those who exercised less and living in the provinces with higher GDP were less likely to work post-retirement. Chronic diseases, advances in age, no education and rural residence did not deter older adults from doing unpaid work. CONCLUSION: Older adults in China were actively engaged in paid and unpaid activities. Efforts to support the active engagement of older adults require all stakeholders to promote healthy living, facilitate social engagements and provide an age-friendly work environment. Geriatr Gerontol Int 2021; 21: 1138-1146.

Population indices measuring health outcomes: A scoping review.

BACKGROUND: Population health indices such as disability adjusted life years (DALY) and quality adjusted life years (QALY) are often used in an effort to measure health of populations and identify areas of concern that require interventions. There has been an increase of number of population health indices since the last review published more than a decade ago. Therefore, this study aims to provide an overview of existing population health indices and examine the methods used to develop them. METHODS: The search was conducted across three databases: PubMed, CINAHL and Emerald using four key concepts: 'health', 'index', 'context', 'develop', which was supplemented with Google searching and reference scanning. A researcher screened the titles, abstracts and subsequently full texts and confirmed the findings with the research team at each stage. Data charting was performed according to the included publications and identified indices. The collation was performed by describing the indices and made observation on its development method using a priori framework consist of four processes: underpinning theory, model or framework; data selection and processing; formation of index; testing of index. RESULTS: Twenty-six publications describing population health indices were included, and 27 indices were identified. These indices covered the following health topics: overall health outcomes (n = 15), outcomes for specific health topics (n = 4), diseases outcome (n = 6), assist health resource allocation for priority minority subgroup or geographic area (n = 4), quality of health or health care (n = 2). Twenty-one indices measure health for general populations while six measure defined subpopulations. Fourteen of the indices reported at least one of the development processes according to the a priori framework: underpinning theory, model or framework (n = 7); data selection and processing (n = 8); formation of index (n = 12); testing of index (n = 9). CONCLUSIONS: Few population health indices measure specific health topics or health of specific sub-population. There is also a lack of usage of theories, models or framework in developing these indices. Efforts to develop a guideline is proposed on how population health indices can be developed systematically and rigorously to ensure validity and comprehensive assessment of the indices.

Linear and nonlinear causal relationship between energy consumption and economic growth in China: New evidence based on wavelet analysis.

The energy-growth nexus has important policy implications for economic development. The results from many past studies that investigated the causality direction of this nexus can lead to misleading policy guidance. Using data on China from 1953 to 2013, this study shows that an application of causality test on the time series of energy consumption and national output has masked a lot of information. The Toda-Yamamoto test with bootstrapped critical values and the newly proposed non-linear causality test reveal no causal relationship. However, a further application of these tests using series in different time-frequency domain obtained from wavelet decomposition indicates that while energy consumption Granger causes economic growth in the short run, the reverse is true in the medium term. A bidirectional causal relationship is found for the long run. This approach has proven to be superior in unveiling information on the energy-growth nexus that are useful for policy planning over different time horizons.

Blood glucose screening among elderly Malaysians: Who to target?

BACKGROUND: Early detection of raised blood glucose can reduce the risk of developing diabetes. Despite being a high-risk group, a significant proportion of the elderly population does not undergo blood glucose screening. The aim of the present study was to examine the factors affecting blood glucose screening among the elderly. METHODS: Data from a sample of 2463 respondents in the National Health and Morbidity Survey 2011 were used. Pearson Chi-squared tests were conducted to find factors associated with screening behavior. A logit model was used to analyze the likelihood of screening. RESULTS: Income, age, education, ethnicity, employment status, availability of medical coverage, and smoking behavior were significantly associated with blood glucose screening. The likelihood of blood glucose screening was positively correlated with available monthly income and was higher in those aged 60-69 years, those attaining higher education, Malays, and elderly who are medically covered. CONCLUSIONS: The findings of the present study provide insights for health policy formulation for the elderly. As part of their efforts to reduce national health costs, governments should pay particular attention to the elderly, who are likely to be unscreened for blood glucose levels, because they face even larger risk exposure.

Adolescent tobacco use and its determinants: evidence from Global Youth Tobacco Survey, Bangladesh 2007.

Adolescent tobacco use (ATU) is on the rise worldwide and the problem is particularly severe in developing countries. Based on nationally representative data, this study aims to investigate the association between ATU and its possible correlates for Bangladesh, where the prevalence rate of ATU is high. The data set is extracted from the Global Youth Tobacco Survey for Bangladesh conducted in 2007. The survey collected information from a total of 3113 students from 52 schools, with a response rate of 100% at the school level, while a response rate of 88.9% was achieved from the students. Students covered in the survey were in grades 7, 8, 9, and 10, with age ranging from 11 to 17 years. The prevalence rate of ATU at the time of the survey was 8.4%, while 35.6% of the students had used at least a type of tobacco products before. Logistic regressions were used to obtain the odds ratios (ORs) in favor of ATU for each of the possible determinants and the confidence intervals (CIs) of these ratios. Use of tobacco among friends (OR = 3.46; CI = 2.37-5.05), the experience of seeing others smoking at home (OR = 2.10; CI = 1.36-3.22) or other places (OR = 1.6; CI = 1.02-2.57), receiving pocket money (OR = 7.6; CI = 4.59-13.28), receiving free tobacco from vendors (OR = 2.3; CI = 1.44-3.78), and exposure to advertisements and promotions of tobacco products (OR = 1.83; CI = 1.23-2.79) were associated with a higher likelihood of ATU. Increased awareness of health hazards of tobacco use through education in schools helped mitigate the problem of ATU. The findings of this study have ramifications for tobacco control prevention strategies in Bangladesh.

Safe delivery practices: experience from cross-sectional data of Bangladeshi women.

This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy.

Tobacco consumption and illegal drug use among Bangladeshi males: association and determinants.

This article aimed to identify the determinants of tobacco consumption and illegal drug use (IDU) as well as to examine the association between these two variables using a representative sample of 3,771 Bangladeshi males aged 15 to 54 years. Data were collected through Bangladesh Demographic and Health Survey 2007. To identify the determinants, the patterns of tobacco consumption and IDU were analyzed by age, education and occupation, residence, mass media, premarital sex, wealth, and sexually transmitted infections (STIs). Prevalence of smoking cigarette and bidi was roughly 60%. However, the prevalence of IDU was 3.4%, and this proportion is statistically significant (Z = 11.32, p = .000). After bivariate analysis, almost all variables except STIs were significantly associated with tobacco consumption. Similarly, all variables except residence and mass media were associated with IDU. Based on multivariable adjusted logistic regression analysis, the likelihood of using IDU was approximately twofold (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.23-2.53) among bidi smokers and fourfold (OR = 3.8, 95% CI = 2.62-5.56) among cigarette smokers as compared with nonsmokers.

Tobacco smoking and its association with illicit drug use among young men aged 15-24 years living in urban slums of Bangladesh.

BACKGROUND: Tobacco smoking (TS) and illicit drug use (IDU) are of public health concerns especially in developing countries, including Bangladesh. This paper aims to (i) identify the determinants of TS and IDU, and (ii) examine the association of TS with IDU among young slum dwellers in Bangladesh. METHODOLOGY/PRINCIPAL FINDINGS: Data on a total of 1,576 young slum dwellers aged 15-24 years were extracted for analysis from the 2006 Urban Health Survey (UHS), which covered a nationally representative sample of 13,819 adult men aged 15-59 years from slums, non-slums and district municipalities of six administrative regions in Bangladesh. Methods used include frequency run, Chi-square test of association and multivariable logistic regression. The overall prevalence of TS in the target group was 42.3%, of which 41.4% smoked cigarettes and 3.1% smoked bidis. The regression model for TS showed that age, marital status, education, duration of living in slums, and those with sexually transmitted infections were significantly (p<0.001 to p<0.05) associated with TS. The overall prevalence of IDU was 9.1%, dominated by those who had drug injections (3.2%), and smoked ganja (2.8%) and tari (1.6%). In the regression model for IDU, the significant (p<0.01 to p<0.10) predictors were education, duration of living in slums, and whether infected by sexually transmitted diseases. The multivariable logistic regression (controlling for other variables) revealed significantly (p<0.001) higher likelihood of IDU (OR = 9.59, 95% CI = 5.81-15.82) among users of any form of TS. The likelihood of IDU increased significantly (p<0.001) with increased use of cigarettes. CONCLUSIONS/SIGNIFICANCE: Certain groups of youth are more vulnerable to TS and IDU. Therefore, tobacco and drug control efforts should target these groups to reduce the consequences of risky lifestyles through information, education and communication (IEC) programs.