Bone development in children living on house-boats on a river in Vietnam.

BACKGROUND: With the rapid urbanization of Vietnam, living on boats has come to be associated with underprivileged socioeconomic status, and there are major concerns regarding the health of children living under such conditions. Bone development is a critical concern in children because the foundation for skeletal health is established early in life. We evaluated the bone properties of children living under underprivileged conditions on boats in Hue City, Vietnam, with respect to a number of household factors. METHODS: One hundred and twenty children aged 7-11 years selected randomly from households living on boats in Hue were included in this study. Tibial and radial speed of sound (SOS) were measured by non-invasive quantitative ultrasonometry. Socioeconomic profiles, health promotion proficiency, and nutritional intake of households were assessed by structured interview. The bone properties of 60 children aged 7-11 living on land were also assessed as controls. RESULTS: The Z-scores of tibial and radial SOS of boat children were -0.16 +/- 0.89 and -0.24 +/- 0.75 (mean +/- SD), respectively. Tibial SOS exhibited a significant correlation with radial SOS (r = 0.39, P < 0.01). Among the household factors examined, the educational level of fathers (P < 0.05) and the health promotion proficiency (P < 0.05) of households exhibited positive associations with the tibial bone properties of the children. The tibial and radial SOS of boat children were lower than those of children living on land (P = 0.001 and P = 0.086, respectively). CONCLUSION: The results of the present study revealed the underdevelopment of bone properties in children living on houseboats, which was correlated with their living conditions.

Variation of health status among people living on boats in Hue, Vietnam.

OBJECTIVES: To examine patterns of disease and injury in people living on boats in Hue City, Vietnam, and their relations to socioeconomic conditions, sanitary practices, disease prevention proficiency, and people's preference to continued living on boats. METHODS: The subjects were 3737 people aged 5 years and over living on boats in Hue City, Vietnam. Diseases and injuries were diagnosed according to ICD-10. The associations between disease/injury and socioeconomic conditions, sanitary practices, disease prevention proficiency, and preference to continued living on boats were analysed by logistic regression. MAIN RESULTS: The prevalence rates of certain infectious and parasitic diseases, diseases of the respiratory system, diseases of the skin and subcutaneous tissue, diseases of the digestive system, and injuries were 85.3%, 78.0%, 51.2%, 15.4%, and 13.2%, respectively. Various associations were seen between diseases/injuries and socioeconomic conditions. Patterns of disease were strongly influenced by sanitary practices. Better disease prevention proficiency was significantly related to lower prevalence of the first three categories of diseases/injuries regardless of sex, age, or socioeconomic status (p < 0.05, p < 0.001, p < 0.001, respectively). Diseases were more prevalent among people who preferred not to continue living on boats. CONCLUSIONS: This large scale comprehensive field study illustrated major diseases and injuries among people living on boats. Variations in health status showed a web-like relation of socioeconomic conditions, sanitary practices, disease prevention proficiency, and preference to continued living on boats. Measures to develop disease prevention proficiency reduce the risk of disease and injury.

Critical contribution of sanitation infrastructure and primary medical care to child health status in Japan from 1955 to 2000.

We examined the associations between prefectural health status of children and sanitation infrastructure, medical care services and socioeconomic status in Japan during 1955-2000. Four indicators of child health status: infant mortality rate (IMR), Ascaris lumbricoides prevalence and height and weight of elementary school children, and five prefectural social indicators: water supply, sewerage, number of physicians, income and women's education, were calculated over five-year intervals and examined by correlation and panel data analyses. Associations between paediatric health and five social indicators were significant (p<0.001) until 1970. After adjustment for income or education, water supply diffusion rate showed a significantly negative association with IMR until the 1980s. A significantly positive correlation was observed between the number of physician and paediatric health from 1955-70 after adjustment for income. Water supply development showed a positive association with paediatric health after adjustment for economic or educational impact during the phases of rapid and steady economic growth, while medical care showed a positive correlation with paediatric health after adjustment for income during only the phase of rapid economic growth. Relationships between child health status and social indicators have changed over time with stage of economic development.