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1.
Yale J Biol Med ; 94(1): 159-164, 2021 03.
Article in English | MEDLINE | ID: mdl-33795993

ABSTRACT

Black, Latinx, and Indigenous people have contracted the SARS-CoV-2 virus and died of COVID-19 at higher rates than White people. Individuals rated public transit, taxis, and ride-hailing as the modes of transportation putting them at greatest risk of COVID-19 infection. Cycling may thus be an attractive alternative for commuting. Amid the increase in bikeshare usage during the early months of the pandemic, bikeshare companies made changes to membership requirements to increase accessibility, targeting especially essential workers. Essential workers in the United States are disproportionately Black and Latinx, underpaid, and reliant on public transit to commute to work. We document changes made by bikeshare companies, including benefits to various groups of essential workers, and we discuss such changes in the context of longstanding racial disparities in bikeshare access. While well intended, the arbitrary delineation in eligibility for such benefits by class of essential workers unwittingly curtailed access for many who may have benefited most. Given that equity in bikeshare is an important tool to improve access to safe transportation, critical changes in the distribution, accessibility, and usability of bikeshare networks is essential. Bikeshare companies, city planners, and policy makers should collaborate with community-based bike advocates to implement changes, as vocalized by those most in need of alternative forms of transportation.


Subject(s)
Bicycling/trends , Commerce/trends , Ethnic Groups , Health Status Disparities , Social Justice , Transportation/methods , Bicycling/economics , Commerce/organization & administration , Health Policy , Humans , Pandemics , Safety , Socioeconomic Factors , Transportation/economics , Transportation/statistics & numerical data , United States/epidemiology , Urban Health
2.
Front Immunol ; 12: 663074, 2021.
Article in English | MEDLINE | ID: mdl-33815424

ABSTRACT

Routine childhood immunizations are proven to be one of the most effective public health interventions at controlling numerous deadly diseases. Therefore, the CDC recommends routine immunizations for children and adolescent populations against vaccine-preventable diseases e.g., tetanus, pertussis, diphtheria, etc. This current review sought to examine barriers to pediatric vaccine uptake behaviors during the COVID-19 pandemic. We also explored the implications for parental vaccine hesitancy/delay during an ongoing health crisis and proposed recommendations for increasing vaccine confidence and compliance. Our review determined that the receipt for vaccinations steadily improved in the last decade for both the United States and Tennessee. However, this incremental progress has been forestalled by the COVID-19 pandemic and other barriers i.e. parental vaccine hesitancy, social determinants of health (SDoH) inequalities, etc. which further exacerbate vaccination disparities. Moreover, non-compliance to routine vaccinations could cause an outbreak of diseases, thereby, worsening the ongoing health crisis and already strained health care system. Healthcare providers are uniquely positioned to offer effective recommendations with presumptive languaging to increase vaccination rates, as well as, address parental vaccine hesitancy. Best practices that incorporate healthcare providers' quality improvement coaching, vaccination reminder recall systems, adherence to standardized safety protocols (physical distancing, hand hygiene practices, etc.), as well as, offer telehealth and outdoor/drive-through/curbside vaccination services, etc. are warranted. Additionally, a concerted effort should be made to utilize public health surveillance systems to collect, analyze, and interpret data, thereby, ensuring the dissemination of timely, accurate health information for effective health policy decision-making e.g., vaccine distribution, etc.


Subject(s)
/prevention & control , Health Knowledge, Attitudes, Practice , Healthcare Disparities/statistics & numerical data , Vaccination/statistics & numerical data , Adolescent , Child, Preschool , Humans , Infant , Pandemics , Parents , Public Health/statistics & numerical data , Socioeconomic Factors , Tennessee , United States , Vaccine-Preventable Diseases/immunology , Vaccines/immunology
3.
Med Sci Monit ; 27: e929280, 2021 Apr 07.
Article in English | MEDLINE | ID: mdl-33824264

ABSTRACT

BACKGROUND In addition to sociodemographic and COVID-19- related factors, the needs of school support, including material, psychological and information support, have seldom been discussed as factors influencing anxiety and depression among college students during the COVID-19 pandemic. MATERIAL AND METHODS In this cross-sectional study, 3351 college students from China were surveyed through questionnaires about their sociodemographic and COVID-19 characteristics, the needs of school support, and their experiences with anxiety and depression. RESULTS Anxiety and depression were reported by 6.88% and 10.50% of students, respectively. Married, higher education, non-medical, and urban students had significantly higher risks of anxiety or depression. Additionally, symptoms such as cough and fever, especially when following a possible contact with suspected individuals, quarantine history of a personal contact, going out 1-3 times a week, not wearing a mask, and spending 2-3 hours browsing COVID-19-related information were significantly associated with the occurrence of anxiety or depression. Those who used methods to regulate their emotional state, used a psychological hotline, and who had visited a psychiatrist showed higher anxiety or depression. Those who used online curricula and books, used preventive methods for COVID-19, and who had real-time information about the epidemic situation of the school showed lower anxiety and depression. CONCLUSIONS In addition to sociodemographic and COVID-19-related aspects, students' needs for psychological assistance and information from schools were also associated with anxiety and depression among college students.


Subject(s)
Anxiety/epidemiology , Depression/epidemiology , Schools/organization & administration , Students/psychology , Adolescent , Adult , Anxiety/prevention & control , Anxiety/psychology , /prevention & control , China/epidemiology , Communicable Disease Control/standards , Cross-Sectional Studies , Depression/prevention & control , Depression/psychology , Female , Financial Support , Health Education/organization & administration , Health Education/statistics & numerical data , Hotlines/organization & administration , Hotlines/statistics & numerical data , Humans , Information Dissemination , Male , Mental Health , Pandemics/prevention & control , Prevalence , Psychosocial Support Systems , Schools/economics , Schools/standards , Socioeconomic Factors , Students/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Young Adult
5.
BMC Fam Pract ; 22(1): 66, 2021 04 08.
Article in English | MEDLINE | ID: mdl-33832436

ABSTRACT

BACKGROUND: To estimate the prevalence of symptoms and signs related to a COVID-19 case series confirmed by polymerase chain reaction (PCR) for SARS-CoV-2. Risk factors and the associated use of health services will also be analysed. METHODS: Observational, descriptive, retrospective case series study. The study was performed at two Primary Care Health Centres located in Madrid, Spain. The subjects studied were all PCR SARS-CoV-2 confirmed cases older than 18 years, diagnosed from the beginning of the community transmission (March 13) until April 15, 2020. We collected sociodemographic, clinical, health service utilization and clinical course variables during the following months. All data was gathered by their own attending physician, and electronic medical records were reviewed individually. STATISTICAL ANALYSIS: A descriptive analysis was carried out and a Poisson regression model was adjusted to study associated factors to Health Services use. RESULTS: Out of the 499 patients studied from two health centres, 55.1% were women and mean age was 58.2 (17.3). 25.1% were healthcare professionals. The most frequent symptoms recorded related to COVID-19 were cough (77.9%; CI 95% 46.5-93.4), fever (77.7%; CI95% 46.5-93.4) and dyspnoea (54.1%, CI95% 46.6-61.4). 60.7% were admitted to hospital. 64.5% first established contact with their primary care provider before going to the hospital, with a mean number of 11.4 Healthcare Providers Encounters with primary care during all the follow-up period. The number of visit-encounters with primary care was associated with being male [IRR 1.072 (1.013, 1.134)], disease severity {from mild respiratory infection [IRR 1.404 (1.095, 1.801)], up to bilateral pneumonia [IRR 1.852 (1.437,2.386)]}, and the need of a work leave [IRR 1.326 (1.244, 1.413]. CONCLUSION: Symptoms and risk factors in our case series are similar to those in other studies. There was a high number of patients with atypical unilateral or bilateral pneumonia. Care for COVID has required a high use of healthcare resources such as clinical encounters and work leaves.


Subject(s)
Patient Acceptance of Health Care/statistics & numerical data , Pneumonia, Viral , Primary Health Care , Symptom Assessment , /diagnosis , /physiopathology , Demography , Disease Transmission, Infectious/statistics & numerical data , Female , Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/etiology , Primary Health Care/methods , Primary Health Care/statistics & numerical data , Risk Factors , Severity of Illness Index , Socioeconomic Factors , Spain/epidemiology , Symptom Assessment/methods , Symptom Assessment/statistics & numerical data
6.
Libyan J Med ; 16(1): 1901438, 2021 Dec.
Article in English | MEDLINE | ID: mdl-33820499

ABSTRACT

Coronavirus Disease (COVID-19) has caused global mental health impacts, and healthcare workers (HCWs) face an increased risk of exposure to the disease when compared to the general population. This study aimed to assess factors associated with mental health among Lebanese HCWs six months after the start of the COVID-19 pandemic. A cross-sectional study was conducted among HCWs at a tertiary hospital, in Lebanon between June and July 2020. The survey included data on demographics, exposure to COVID-19, preparedness to COVID-19 outbreak, risk perceptions of COVID-19, and mental health dimensions. Chi-squared and Fisher's exact tests were used to understand the association among these variables. One hundred and ninety-three of 1,600 Lebanese HCWs participated. More than 80% reported high preparedness levels towards the COVID-19 outbreak, 69% believed that their job was putting them at risk, and 70% altruistically accepted these risks. Anxiety and depression symptomatology were present in 24% and 23% of HCWs; who were more likely to feel more stress at work (83% vs 60%; p = 0.004; 82% vs 61%; p = 0.01, respectively), feel afraid of falling ill (72% vs 55%; p = 0.03; 77% vs 54%; p = 0.01, respectively), fear death (21% vs 7%; p = 0.01; 25% vs 6%; p ≤ 0.001, respectively), and believed that people avoided their families (39% vs 21%; p = 0.01; 35% vs 65%; p = 0.02, respectively). HCWs who reported signs of depression were less likely to altruistically accept the risks of caring for COVID-19 patients, compared to those who did not (57% vs 74%; p = 0.03). This study aimed to detect factors associated with mental health among Lebanese HCWs during the COVID-19 pandemic. Findings suggested that altruistic acceptance of COVID-19 risks is higher among HCWs with positive exposure history to COVID-19 and those with less depressive symptomatology.


Subject(s)
Health Personnel , Mental Disorders/epidemiology , Occupational Diseases/epidemiology , Pandemics , Adult , Aged , Cross-Sectional Studies , Female , Humans , Lebanon/epidemiology , Male , Mental Disorders/etiology , Middle Aged , Occupational Diseases/etiology , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , Tertiary Care Centers , Young Adult
7.
Urol Clin North Am ; 48(2): 215-222, 2021 May.
Article in English | MEDLINE | ID: mdl-33795055

ABSTRACT

The emergence of the COVID-19 pandemic and subsequent public health emergency (PHE) have propelled telemedicine several years into the future. With the rapid adoption of this technology came socioeconomic inequities as minority communities disproportionately have yet to adopt telemedicine. Telemedicine offers solutions to patient access issues that have plagued urology, helping address physician shortages in rural areas and expanding the reach of urologists. The Centers for Medicare & Medicaid Services have adopted changes to expand coverage for telemedicine services. The expectation is that telemedicine will continue to be a mainstay in the health care system with gradual expansion in utilization.


Subject(s)
/epidemiology , Telemedicine , Urology , Centers for Medicare and Medicaid Services, U.S. , Diffusion of Innovation , Humans , Socioeconomic Factors , United States
8.
Article in English | MEDLINE | ID: mdl-33804550

ABSTRACT

In this study, we aimed to analyze the demographic factors, socioeconomic factors, health behavior factors, and health education of urban and rural adolescents and their impact on obesity in rural and urban youths. We analyzed data from 60,040 students from 800 schools using the 14th Youth Health Behavior Web-based Survey data for 2018. The mean age of the participants was 15.01 ± 1.77; 30,463 (50.7%) males and 29,577 (49.3%) females. The data were analyzed using a chi-square test and multinominal logistic regression analysis. Rural adolescents had significantly lower parental income, parental education, and academic performance levels. Urban adolescents tended to have a higher rate of breakfast fasting, ate more fast-food, exercised less, had a higher rate of sleep dissatisfaction, and had significantly higher current alcohol intake. Rural adolescents reported more stress and obesity levels than their urban counterparts. Factors influencing the obesity of urban adolescents were grade level, father's education, mother's education, academic performance level, fast-food, exercise, current alcohol intake, and sleep satisfaction. Factors influencing the obesity of rural adolescents were parents' income level, academic performance level, exercise, and sleep satisfaction. To effectively prevent and manage adolescent obesity, which is an indicator of health equity among adolescents, an effort must be made to improve health education and the local environment in both urban and rural areas.


Subject(s)
Health Behavior , Rural Population , Adolescent , Demography , Female , Health Education , Humans , Male , Socioeconomic Factors , Urban Population
9.
Article in English | MEDLINE | ID: mdl-33806546

ABSTRACT

Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.


Subject(s)
Health Equity , Parks, Recreational , Europe , Humans , North America , Socioeconomic Factors
10.
Article in English | MEDLINE | ID: mdl-33808724

ABSTRACT

BACKGROUND: The study aimed to analyze the burden and territorial diversification of adolescent suicide and the link between suicide attempts and selected socioeconomic variables in Poland. METHODS: Rates of suicide by voivodeships for years 1999-2019 were obtained from the General Police Headquarters of Poland database. The burden of premature death was expressed in years of life lost (YLL) and costs of lost productivity, which were estimated using the human capital approach. The link between suicide rates and socioeconomic determinants has been analyzed with Pearson's correlation coefficient. RESULTS: Over the analyzed period, an increase in suicide attempt rates and a decrease in suicide death rates have been observed. Mean YLL and costs of lost productivity per year amounted to 11,982 and 153,172,415 PLN, respectively. Territorial diversification in suicide attempt rates corresponds to the living condition, poverty, association-based capital, and satisfaction with family situation in individual voivodeships. The number of deaths due to suicide is negatively correlated with an indicator of good living conditions. CONCLUSIONS: Our findings provide quantitative evidence of the national impact of suicide and suggest that addressing social capital and poverty may have a role in preventing adolescent mortality due to suicide.


Subject(s)
Efficiency , Mortality, Premature , Adolescent , Costs and Cost Analysis , Humans , Poland/epidemiology , Socioeconomic Factors
11.
J Infect Dev Ctries ; 15(3): 342-349, 2021 Mar 31.
Article in English | MEDLINE | ID: mdl-33839707

ABSTRACT

INTRODUCTION: Our study aims to assess the prevalence of COVID-19 in the Middle East and North Africa (MENA) region. It aims also to examine the various factors that have led to the unequal distribution of the confirmed cases among the different MENA countries. METHODOLOGY: Data was retrieved from the World Health Organization situation reports issued between January 29 and June 5, 2020. It included the numbers of cumulative cases, new cases, and cumulative deaths reported by MENA countries. Similarly, we searched for relevant articles in PubMed and Medline. RESULTS: A total of 481,347 cases and 11,851 deaths occurred in the MENA region, accounting for 7.37% and 3.06% of the global cases and deaths respectively. Iran had the highest number of cases and deaths accounting for 34.1% and 68.1% of the MENA cases and deaths respectively. Together the Gulf Cooperation Council (GCC) countries accounted for 52.2% and 10.6% of MENA cases and deaths respectively. Egypt had the highest number of confirmed cases and deaths among the African countries of the region. Syria, Libya and Yemen (countries at war) had the lowest numbers of reported cases. The MENA region overall case fatality rate (CFR) was estimated at 2.46%. The highest CFR (22.75%) occurred in Yemen, and the lowest (0.07%) in Qatar. CONCLUSIONS: The unequal distribution of wealth among the MENA countries, the lack of sociopolitical stability, and the high number of undetected and underreported cases in some of them have resulted in varied incidences of COVID-19 related morbidity and mortality.


Subject(s)
/epidemiology , World Health Organization , Africa, Northern/epidemiology , Humans , Incidence , Middle East/epidemiology , Politics , Prevalence , Socioeconomic Factors
12.
Sci Rep ; 11(1): 7890, 2021 04 12.
Article in English | MEDLINE | ID: mdl-33846443

ABSTRACT

COVID-19 is a global crisis where India is going to be one of the most heavily affected countries. The variability in the distribution of COVID-19-related health outcomes might be related to many underlying variables, including demographic, socioeconomic, or environmental pollution related factors. The global and local models can be utilized to explore such relations. In this study, ordinary least square (global) and geographically weighted regression (local) methods are employed to explore the geographical relationships between COVID-19 deaths and different driving factors. It is also investigated whether geographical heterogeneity exists in the relationships. More specifically, in this paper, the geographical pattern of COVID-19 deaths and its relationships with different potential driving factors in India are investigated and analysed. Here, better knowledge and insights into geographical targeting of intervention against the COVID-19 pandemic can be generated by investigating the heterogeneity of spatial relationships. The results show that the local method (geographically weighted regression) generates better performance ([Formula: see text]) with smaller Akaike Information Criterion (AICc [Formula: see text]) as compared to the global method (ordinary least square). The GWR method also comes up with lower spatial autocorrelation (Moran's [Formula: see text] and [Formula: see text]) in the residuals. It is found that more than 86% of local [Formula: see text] values are larger than 0.60 and almost 68% of [Formula: see text] values are within the range 0.80-0.97. Moreover, some interesting local variations in the relationships are also found.


Subject(s)
/mortality , Spatial Regression , Algorithms , Female , Geography , Humans , India/epidemiology , Least-Squares Analysis , Male , Regression Analysis , Risk Factors , Socioeconomic Factors , Time Factors
13.
Ann Acad Med Singap ; 50(3): 222-231, 2021 03.
Article in English | MEDLINE | ID: mdl-33855318

ABSTRACT

INTRODUCTION: As part of infection control measures for COVID-19, individuals have been encouraged to adopt both preventive (such as handwashing) and avoidant behavioural changes (e.g. avoiding crowds). In this study, we examined whether demographics predicted the likelihood that a person would adopt these behaviours in Singapore. METHODS: A total of 1,145 participants responded to an online survey conducted between 7 March and 21 April 2020. We collected demographic information and asked participants to report which of 17 behaviour changes they had undertaken because of the COVID-19 outbreak. Regression analyses were performed to predict the number of behavioural changes (preventive, avoidant, and total) as a function of demographics. Finally, we sought to identify predictors of persons who declared that they had not undertaken any of these measures following the outbreak. RESULTS: Most participants (97%) reported at least one behavioural change on account of the pandemic, with changes increasing with the number of local COVID-19 cases (P<0.001). Additionally, women and those who were younger adopted more preventive behaviours (gender: P<0.001; age: P=0.001). Women were more likely to increase handwashing frequency, and younger individuals were more likely to wear face masks prior to legislation. Finally, women and those who were married adopted more avoidant behaviours (gender: P<0.001; marital status: P<0.001), with both groups avoiding crowded areas and staying home more than usual. Women also voluntarily reduced physical contact, whereas those who were married preferentially chose outdoor venues and relied on online shopping. CONCLUSION: Our characterisation of behavioural changes provides a baseline for public health advisories. Moving forward, health authorities can focus their efforts on encouraging segments of the population who do not readily adopt infection control measures against COVID-19.


Subject(s)
/prevention & control , Hand Disinfection/trends , Health Behavior , Risk-Taking , Adult , Age Factors , Aged , Aged, 80 and over , Female , Follow-Up Studies , Health Policy , Health Surveys , Humans , Male , Middle Aged , Pandemics , Self Report , Sex Factors , Singapore/epidemiology , Socioeconomic Factors
15.
Codas ; 33(2): e20190243, 2021.
Article in Portuguese, English | MEDLINE | ID: mdl-33909758

ABSTRACT

PURPOSE: Investigate the correlation between the provision of speech therapists in the Brazilian public healthcare system and social indicators between 2007 and 2016. METHODS: An ecological study was conducted. The units of analysis were the 27 federative units of Brazil. Indicators of the provision of speech therapists in public healthcare and the relative evolution of this provision in the period as well as the Human Development Index and Gini Index related to the year 2010 were analyzed. Correlations were investigated using Spearman's test (α = 5%). RESULTS: In 2007, the provision of speech therapists in the public healthcare system was 3.55/105 residents, with the lowest indicator in the state of Amazonas and the highest in the state of Mato Grosso do Sul. In 2016, this indicator nearly doubled in the country; the lowest indicator was again in the state of Amazonas and the highest was in the state of Piauí. An important relative evolution occurred in the provision of speech therapists in Brazil in the period analyzed, with significant variation among the federative units. A negative correlation was found between the relative evolution in the last decade and the Human Development Index and a positive correlation was found with the Gini Index. CONCLUSION: The increase in the provision of speech therapists in the Brazilian public healthcare system was greater in federative units with lower human development and a greater concentration of income. Despite this, the results from 2016 showed the maintenance of the status quo, with a greater provision in federative units with greater human development.


Subject(s)
Allied Health Personnel , Speech , Brazil , Delivery of Health Care , Humans , Socioeconomic Factors
16.
Braz Oral Res ; 35: e040, 2021.
Article in English | MEDLINE | ID: mdl-33909862

ABSTRACT

This study aimed to evaluate the influence of choosing different socioeconomic status indicators in research regarding older adults' oral health. This is a cross-sectional study that analyzed baseline data from the Brazilian Longitudinal Study on Aging (ELSI-Brazil). The outcomes were edentulism (n = 9,073) and self-reported oral health (n = 9,365). The following socioeconomic indicators were assessed: individual income, per capita household income, and wealth index. Poisson regression analysis with robust variance was performed to estimate prevalence ratios (PR), with their respective 95% confidence intervals (CI), after adjusting for socioeconomic and oral health behavior variables. Absolute inequality measures were also estimated. The individual income indicator was not statistically associated with the results after adjustments. When using per capita household income indicator, individuals in the richest quintile showed a 12% lower prevalence of poor self-reported oral health [PR: 0.88 (CI: 0.78-0.98)], relative to the poorest, and there was no association with edentulism. When the wealth index was chosen, there was a 22% lower prevalence of edentulism [PR: 0.78 (CI: 0.64-0.94)] and 15% lower prevalence of self-reported poor oral health [PR: 0.85 (CI: 0.78-0.93)] in individuals of the richest quintile, both relative to the poorest quintile. Regarding absolute inequality measures, for edentulism, the wealth index showed the highest absolute inequality. When considering self-reported oral health, per capita household income showed the greatest absolute inequality. Despite scientific challenges and the difficulty of socioeconomic indicator metrics, further investments in its development are critical to measure, promote, and improve population oral health.


Subject(s)
Income , Oral Health , Aged , Brazil/epidemiology , Cross-Sectional Studies , Humans , Longitudinal Studies , Socioeconomic Factors
17.
Braz Oral Res ; 35: e042, 2021.
Article in English | MEDLINE | ID: mdl-33909864

ABSTRACT

This study aimed to analyze the influence of socioeconomic factors on the frequency of diagnoses of oral mucosal changes and the number of hospitalized patients with oral and oropharyngeal cancer in Brazil. This cross-sectional study analyzed data from all Brazilian cities in the period 2011-2017. The frequency of diagnoses of oral mucosal changes and the number of hospitalized patients of oral and oropharyngeal cancer in Brazil were extracted from the Primary Care Information System (SIAB) and Brazilian National Cancer Institute (INCA) databases. The socioeconomic factors evaluated were the Gini coefficient of inequality, municipal Human Development Index (MHDI), inadequate basic sanitation rate, employment rate, illiteracy rate and expected years of schooling. Associated factors were examined using bivariate Spearman's correlations and multivariate Poisson regressions, and statistically significant (p < 0.05) correlations between study variables and regression coefficients were obtained. A higher frequency of diagnoses of mucosal changes was observed in cities with a higher Gini coefficient (B = 11.614; p < 0.001), higher MHDI (B = 11.298; p < 0.001), and higher number of hospitalized patients with oral and oropharyngeal cancer (B = 0.001, p < 0.002). Cities with higher Gini coefficients (B = 8.159, p < 0.001), higher inadequate basic sanitation rates (B = 0.09, p = 0.001), lower expected years of schooling (B = -0.718, p < 0.001), and higher illiteracy rates (B = 0.191, p < 0.001) had a higher frequency of hospitalized patients with oral and oropharyngeal cancer. In conclusion, more developed cities showed a higher frequency of diagnoses of mucosal changes. Greater inequality and worse socioeconomic conditions are associated with a higher frequency of hospitalized patients with oral and oropharyngeal cancer in Brazil.


Subject(s)
Mouth Neoplasms , Brazil/epidemiology , Cities , Cross-Sectional Studies , Humans , Mouth Neoplasms/epidemiology , Socioeconomic Factors
18.
Cad Saude Publica ; 37(3): e00013120, 2021.
Article in Portuguese | MEDLINE | ID: mdl-33852658

ABSTRACT

The study aimed to estimate the prevalence of cooccurrence of obesogenic risk factors in Brazilian adolescents and associated sociodemographic and family characteristics. This is a cross-sectional study of data from the Brazilian National School Health Survey, 2009 (n = 53,274). The outcome variable (cooccurrence of obesogenic risk factors) varied from zero to five and was obtained as the sum of the risk behaviors: daily consumption of soft drinks; daily consumption of candy; insufficient consumption of fruits; insufficient consumption of vegetables; and insufficient physical activity. The explanatory variables were sex, age, skin color, region of Brazil, household goods and services score, maternal schooling, type of school, family composition, parental monitoring, and main meals shared with parents or guardians. A Venn diagram was used for exploratory analysis, plus ordinal logistic regression with partial proportional odds model for multivariate analysis. The results showed higher odds of simultaneous occurrence of the factors in adolescent girls, in teens with less parental supervision, and teens who shared fewer meals with their parents or guardians. Meanwhile, adolescents living in more developed regions of the country and those whose mothers had more schooling showed lower odds of cooccurrence of obesogenic risk factors. Actions that encourage greater family involvement and supervision in dietary behavior can have a positive impact on the prevention of obesity in Brazilian adolescents, especially in less developed regions and in homes where the mothers have less schooling.


Subject(s)
Adolescent Behavior , Obesity/epidemiology , Adolescent , Brazil/epidemiology , Cross-Sectional Studies , Feeding Behavior , Female , Humans , Parents , Risk Factors , Socioeconomic Factors
19.
Front Public Health ; 9: 643640, 2021.
Article in English | MEDLINE | ID: mdl-33898378

ABSTRACT

Background: The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e., lockdown, stay-at-home) on the life-space mobility of older people. Objective: To investigate the immediate impact of COVID-19 pandemic on life-space mobility of community-dwelling Brazilian older adults and examine the social determinants of health associated with change in life-space mobility. Design: Baseline data from a prospective cohort study (REMOBILIZE Study). Setting: Community. Subject: A convenience snowball sample of participants aged 60 and older (n = 1,482) living in 22 states in Brazil. Methods: We conducted an online and phone survey using an adapted version of the Life-Space Assessment (LSA). Linear regression models were used to investigate social determinants of health on the change in LSA score. Results: Regardless of their gender and social determinants of health, participants showed a significant reduction in life-space mobility since COVID-19 pandemic outbreak. Life-space mobility reduction was higher among black individuals, those living alone and aged between 70 and 79. Other variables associated with change in life-space mobility, to a lesser extent, were sex, education and income. Conclusion: Social restriction measures due to pandemic caused substantial reduction in older adults' life-space mobility in Brazil. Social inequalities strongly affected vulnerable groups. Concerted actions should be put in place to overcome the deterioration in life-pace mobility amongst these groups. Failure in minimizing health inequalities amplified by the pandemic may jeopardize the desired achievements of the Decade of Healthy Aging.


Subject(s)
Pandemics , Social Determinants of Health , Aged , Aged, 80 and over , Brazil/epidemiology , Communicable Disease Control , Female , Health Status Disparities , Humans , Linear Models , Male , Middle Aged , Prospective Studies , Socioeconomic Factors , Surveys and Questionnaires
20.
BMJ Open ; 11(3): e047310, 2021 03 31.
Article in English | MEDLINE | ID: mdl-33789857

ABSTRACT

OBJECTIVE: We assessed the impact of key population variables (age, gender, income and education) on perceptions of governmental effectiveness in communicating about COVID-19, helping meet needs for food and shelter, providing physical and mental healthcare services, and allocating dedicated resources to vulnerable populations. DESIGN: Cross-sectional study carried out in June 2020. PARTICIPANTS AND SETTING: 13 426 individuals from 19 countries. RESULTS: More than 60% of all respondents felt their government had communicated adequately during the pandemic. National variances ranged from 83.4% in China down to 37.2% in Brazil, but overall, males and those with a higher income were more likely to rate government communications highly. Almost half (48.8%) of the respondents felt their government had ensured adequate access to physical health services (ranging from 89.3% for Singapore to 27.2% for Poland), with higher ratings reported by younger and higher-income respondents. Ratings of mental health support were lower overall (32.9%, ranging from 74.8% in China to around 15% in Brazil and Sweden), but highest among younger respondents. Providing support for basic necessities of food and housing was rated highest overall in China (79%) and lowest in Ecuador (14.6%), with higher ratings reported by younger, higher-income and better-educated respondents across all countries. The same three demographic groups tended to rate their country's support to vulnerable groups more highly than other respondents, with national scores ranging from around 75% (Singapore and China) to 19.5% (Sweden). Subgroup findings are mostly independent of intercountry variations with 15% of variation being due to intercountry differences. CONCLUSIONS: The tendency of younger, better-paid and better-educated respondents to rate their country's response to the pandemic more highly, suggests that government responses must be nuanced and pay greater attention to the needs of less-advantaged citizens as they continue to address this pandemic.


Subject(s)
/prevention & control , Government Programs , Pandemics/legislation & jurisprudence , Age Factors , Cross-Sectional Studies , Economic Status , Government , Humans , Male , Sex Factors , Socioeconomic Factors
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