RESUMO
Due to some of the limitations of monetary measures, various non-monetary approaches for assessing household wealth have been developed as alternative tools for classifying household socio-economic status. Among them, wealth indices based on household durable assets are being used. The literature revealed that two basic methods of constructing wealth indices are employed: an unweighted method, where assets are weighted equally; and a weighted method, where specific weights are assigned to assets. In the case of using the weighted method, weighting can be assigned using various techniques. The overall objective of the study is to compare the wealth indices constructed by using weighted and unweighted methods for assessing the socio-economic status of households in rural Bangladesh. Firstly, the study attempts to construct wealth indices based on durable assets using the unweighted method and two techniques of the weighted method: weighted index using the inverse of proportion, and weighted index using principal component analysis (PCA). Following this, the study compares some distributional characteristics of these indices as well as monetary indicators. At the same time, the study evaluates and examines some attractive properties of these indices such as the extent of clumping and truncation, consistency with traditional monetary measures. Comparative analysis revealed that the unweighted asset index, as well as weighted asset index using PCA, can be treated as an efficient alternative to the monetary measures to evaluate the living standard of the households in the present study. However, due to some advantage's asset index using PCA can be considered to be somewhat better than the unweighted index. But, as the unweighted asset index is not very different from the weighted asset index using PCA, it can also be used as an alternative to the monetary measures without the need to use weighting.
RESUMO
BACKGROUND: In recent years, developing countries like Bangladesh are facing a higher burden of non-communicable diseases such as hypertension as a result of demographic transition. Prevalence of hypertension is often studied in this setting. However, evidence on undiagnosed hypertension is not widely available in the existing literature. Therefore, the current study focuses on inequalities in the prevalence of undiagnosed hypertension in Bangladesh. METHODS: A total of 8835 participants aged 35+ years were included in this study using nationally representative Bangladesh Demographic and Health Survey 2011 (BDHS). In the survey, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of these participants were measured three times with approximately 10 minutes of an interval between each measurement. Any respondent with either SBP ≥ 140 mmHg or DBP ≥ 90 mmHg was considered as patient with hypertension as per the guidelines from American Heart Association. Among the participants, undiagnosed hypertension was defined as having SBP > =140 mmHg or DBP > =90 mmHg and never taking prescribed medicine or being told by health professionals to lower/control blood pressure. Multiple logistic regression analysis was applied for identifying factors associated with undiagnosed hypertension. Further, socioeconomic inequalities in the prevalence of undiagnosed hypertension were estimated using Concentration Index (C). RESULTS: We found 978 (59.9% of the total) were undiagnosed among 1685 hypertensive patients studied. Regression analysis showed individuals with being underweight, having poor socioeconomic conditions, and lower educational qualifications were more likely to have undiagnosed hypertension. A similar association between undiagnosed hypertension and socioeconomic quintiles was observed using concentration index (C = - 0.07). On the other hand, individuals from higher age group (50-64 or above), female sex, and Sylhet region were at lower risk of undiagnosed hypertension. CONCLUSIONS: This study showed that a large proportion of the cases with hypertension are remained undiagnosed in Bangladesh, especially among the poor and low educated population. Screening and awareness building initiatives on hypertension should be taken for this group of population to reduce the burden of undiagnosed hypertension.