Influence of culture, residential segregation and socioeconomic development on rural elderly health-related quality of life in Guangxi, China.

BACKGROUND: This study aimed to assess ethnic differences in health-related quality of life (HRQoL) among the rural elderly, and to examine the influence of ethnic culture, residential segregation and socioeconomic development on HRQoL. METHODS: A total of 6,511 rural elderly aged 60 years and older from 5,541 households in 116 villages across eight ethnic groups in Guangxi Zhuang Autonomous region were selected and assessed for HRQoL. The EQ-5D index values were calculated based on the Chinese Time Trade-Off values set. The EQ-5D descriptive system scores, visual analogue scale scores, and index values were described by ethnic group. The EQ-5D index was modeled against ethnic culture, residential segregation and socioeconomic development using villages as random effects. RESULTS: The median (IQR) of HRQoL among all the ethnic groups was 0.88 (0.80, 0.96). Pain/discomfort was the most prevalent problem, followed by anxiety/depression. After controlling for sociodemographic characteristics, a significant difference in HRQoL among ethnic groups persisted, but this was not true for residential segregation. CONCLUSION: Social welfare and health policies designed to improve the health of the rural elderly should focus more on older, female, less-educated, Yao minority individuals as well as lower-income households.

Hygienic Risk Exposures Across Ethnic Groups in Rural Areas of Guangxi, China: Prevalence, Associated Factors, and Perceptions of Policy.

BACKGROUND: Controlling hygienic risk exposures (HREs) is important for reducing acute respiratory infection or parasitic infection; however, studies across vulnerable ethnicities are limited. This study aimed to identify the prevalence and associated factors of HREs and perception on HRE policies among ethnic groups in Guangxi, China. METHODS: A community-based cross-sectional study was conducted in rural areas of Guangxi, China, among Han majority and Zhuang, Yao, Miao, Dong, Mulao, and Maonan minorities. The prevalence of HREs and perceptions concerning the HRE policies were presented using descriptive statistics. Associated factors were analyzed using a logistic regression model, and adjusted prevalence ratios and 95% confidence interval were calculated. RESULTS: High prevalence of HREs on hand and soil hygiene were found in all ethnicities. Miao minority had the highest prevalence of HREs, particularly in poor hand washing (74.1%), infrequent nail clipping (90.4%), and outdoor soil contact (92.7%), compared with the others. Prevalence of HREs in some ethnic minority groups were significantly different from those in Han majority after adjusted with other significant factors. Village leaders were more aware of existing national and community regulations related to HREs than household heads. Village leaders and household heads of almost all ethnic groups perceived high policy's compliance in their village or household on avoiding fertilizing with farmyard manure. CONCLUSIONS: HREs were prevalent in all ethnic groups, especially in Miao minority. Ethnicity, one of social determinants, was significantly associated with HREs. Raising awareness at both the village and household levels on HREs is needed for all ethnic groups.

Factors Associated With Smoking Intentions Among Chinese College Students.

Smoking intention is a strong predictor of future smoking behavior. The aim of this study is to identify the significant factors associated with smoking intention among Chinese college students. A total of 2,827 students in Eastern, Middle, and Western regions of China, randomly selected using a multistage sampling method, completed the self-administered questionnaires. The association of independent variables with smoking intention was evaluated using the logistic regression model. Overall, the proportion of college students with a strong smoking intention was 6.9%. Male students (odds ratio [OR] 2.205, 95% confidence interval [CI] [1.374, 3.538]), those students whose mothers smoked (OR 3.328, 95% CI [1.527, 7.252]), those whose mothers had a higher educational level (OR 0.583, 95% CI [0.346, 0.984]), current smokers (OR 14.081, 95% CI [9.306, 21.307]), former smokers (OR 3.824, 95% CI [1.728, 8.463]), and those for whom most (OR 2.663, 95% CI [1.348, 5.261]) or a few (OR 1.826, 95% CI [1.045, 3.191]) of their closest friends were smokers had statistically significant associations with the smoking intentions of Chinese college students. Further studies are needed to elucidate mechanisms and pathways across various factors, and these factors should be incorporated into future multilevel interventions designed to decrease smoking intention among college students.

Gender and ethnic health disparities among the elderly in rural Guangxi, China: estimating quality-adjusted life expectancy.

BACKGROUND: Ethnic health inequalities for males and females among the elderly have not yet been verified in multicultural societies in developing countries. The aim of this study was to assess the extent of disparities in health expectancy among the elderly from different ethnic groups using quality-adjusted life expectancy. DESIGN: A cross-sectional community-based survey was conducted. A total of 6,511 rural elderly individuals aged ≥60 years were selected from eight different ethnic groups in the Guangxi Zhuang Autonomous Region of China and assessed for health-related quality of life (HRQoL). The HRQoL utility value was combined with life expectancy at age 60 years (LE60) data by using Sullivan's method to estimate quality-adjusted life expectancy at age 60 years (QALE60) and loss in quality-adjusted life years (QALYs) for each group. RESULTS: Overall, LE60 and QALE60 for all ethnic groups were 20.9 and 18.0 years in men, respectively, and 24.2 and 20.3 years in women. The maximum gap in QALE60 between ethnic groups was 3.3 years in males and 4.6 years in females. The average loss in QALY was 2.9 years for men and 3.8 years for women. The correlation coefficient between LE60 and QALY lost was -0.53 in males and 0.12 in females. CONCLUSION: Women live longer than men, but they suffer more; men have a shorter life expectancy, but those who live longer are healthier. Attempts should be made to reduce suffering in the female elderly and improve longevity for men. Certain ethnic groups had low levels of QALE, needing special attention to improve their lifestyle and access to health care.