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1.
Int J Behav Nutr Phys Act ; 21(1): 13, 2024 Feb 05.
Article in English | MEDLINE | ID: mdl-38317165

ABSTRACT

BACKGROUND: Interest in applying a complex systems approach to understanding socioeconomic inequalities in health is growing, but an overview of existing research on this topic is lacking. In this systematic scoping review, we summarize the current state of the literature, identify shared drivers of multiple health and health behavior outcomes, and highlight areas ripe for future research. METHODS: SCOPUS, Web of Science, and PubMed databases were searched in April 2023 for peer-reviewed, English-language studies in high-income OECD countries containing a conceptual systems model or simulation model of socioeconomic inequalities in health or health behavior in the adult general population. Two independent reviewers screened abstracts and full texts. Data on study aim, type of model, all model elements, and all relationships were extracted. Model elements were categorized based on the Commission on Social Determinants of Health framework, and relationships between grouped elements were visualized in a summary conceptual systems map. RESULTS: A total of 42 publications were included; 18 only contained a simulation model, 20 only contained a conceptual model, and 4 contained both types of models. General health outcomes (e.g., health status, well-being) were modeled more often than specific outcomes like obesity. Dietary behavior and physical activity were by far the most commonly modeled health behaviors. Intermediary determinants of health (e.g., material circumstances, social cohesion) were included in nearly all models, whereas structural determinants (e.g., policies, societal values) were included in about a third of models. Using the summary conceptual systems map, we identified 15 shared drivers of socioeconomic inequalities in multiple health and health behavior outcomes. CONCLUSIONS: The interconnectedness of socioeconomic position, multiple health and health behavior outcomes, and determinants of socioeconomic inequalities in health is clear from this review. Factors central to the complex system as it is currently understood in the literature (e.g., financial strain) may be both efficient and effective policy levers, and factors less well represented in the literature (e.g., sleep, structural determinants) may warrant more research. Our systematic, comprehensive synthesis of the literature may serve as a basis for, among other things, a complex systems framework for socioeconomic inequalities in health.


Subject(s)
Health Status , Income , Adult , Humans , Socioeconomic Factors , Health Behavior , Obesity
2.
BMC Geriatr ; 24(1): 138, 2024 Feb 07.
Article in English | MEDLINE | ID: mdl-38321378

ABSTRACT

BACKGROUND: There is a causal link between childhood socioeconomic status and health status in adulthood and beyond. It's vital to comprehend the relationship between childhood socioeconomic status and mental health among older Chinese individuals from the current generation who have undergone significant social changes in China. This understanding is critical to foster healthy demographic and social development in China. METHODS: Using data from the 2020 China Family Panel Studies, we investigate the relationship between childhood socioeconomic status and depression in older adults. Additionally, we examine the mediating role of adult socioeconomic status and subjective well-being. RESULTS: 1) Childhood socioeconomic status of Chinese older adults differences by region of residence, while depression levels differences by gender, region of residence, and marital status. 2) Adult socioeconomic status mediated the relationship between childhood socioeconomic status and depression in older adults. 3) Adult socioeconomic status and subjective well-being had a chain-mediated role in the relationship between childhood socioeconomic status and depression in older adults. CONCLUSIONS: In terms of childhood socioeconomic status, older adults in urban regions were significantly higher than those in rural regions. As for depression level, female older adults were more depressed than males; married older people have the lowest depression levels, while unmarried and widowed older people have higher depression levels; older adults in rural regions had higher depression levels than those in urban regions. Evidence from our study further suggests that childhood socioeconomic status can suppress the depression level in older adults through adult socioeconomic status; it can also further reduce the depression level in older adults through the chain mediation of adult economic status affecting subjective well-being. As depression is more prevalent among older individuals with a lower childhood socioeconomic status, it is vital to prioritize the extensive impact of childhood socioeconomic status as a distal factor and investigate "upstream" solutions to enhance childhood socioeconomic status and reduce the gap during the early years of life.


Subject(s)
Depression , Social Class , Male , Humans , Female , Aged , Depression/psychology , Socioeconomic Factors , Health Status , Mental Health , China
3.
BMC Health Serv Res ; 24(1): 169, 2024 Feb 06.
Article in English | MEDLINE | ID: mdl-38321433

ABSTRACT

BACKGROUND: The presence of chronic conditions such as type 2 diabetes mellitus (T2DM) requires behavioral lifestyle changes mediated by individuals' motivation for change and adherence to treatment. This study aims to explore activation levels in individuals with T2DM treated in primary care facilities and to identify the association between demographic, clinical, psychosocial factors, and patient activation amongst populations in the Brazilian state of Amazonas. METHODS: SAPPA is a cross-sectional study conducted in Amazonas, approved by the Universidade Federal do Amazona's IRB in Brazil. Individuals with T2DM were evaluated in their homes (n = 4,318,325). The variables were sex, age, skin color, education level; health-related variables such as body mass index, nutritional behavior, and frequency of physical activity. Measures related to patient self-management behaviors over the past 6 months (Patient Activation Measure - PAM-13) were included in the survey. Descriptive and frequency data are presented as mean (standard deviation (SD)) or numeric percentage). Statistical testing was performed using IBM SPSS V.26, and a p-value of < 0.050 showed significance. Activation levels were dichotomized into low activation (Levels 1 and 2) and high activation (Levels 3 and 4). A multivariate linear model assessed the association between the PAM-13 score and the following variables: age, sex, BMI, skin color, number of comorbidities, burden of symptoms, and number of medications. RESULTS: Logistic regression analyses indicated a statistically significant association between sex, age, education, self-rated health, and general satisfaction with life. men were 43% more likely to score lower levels (p < 0.001). The results also indicated that advanced age had lower PAM levels (p < 0.001). Participants with fewer years of education were 44% more likely to have lower levels of PAM (p = 0.03). Worse self-rated health (p < 0.001) and lower general life satisfaction (p = 0.014) were associated with lower PAM levels. CONCLUSIONS: Low patient activation was associated with worse sociodemographic, health, and psychological conditions in the Amazon population. The low level of patient activation observed in this sample highlights an important impediment to diabetes disease management/self-management in disadvantaged populations.


Subject(s)
Diabetes Mellitus, Type 2 , Male , Humans , Diabetes Mellitus, Type 2/therapy , Cross-Sectional Studies , Brazil , Patient Participation , Socioeconomic Factors
4.
Popul Health Metr ; 22(1): 3, 2024 Feb 07.
Article in English | MEDLINE | ID: mdl-38321440

ABSTRACT

BACKGROUND: Denmark was one of the few countries that experienced an increase in life expectancy in 2020, and one of the few to see a decrease in 2021. Because COVID-19 mortality is associated with socioeconomic status (SES), we hypothesize that certain subgroups of the Danish population experienced changes in life expectancy in 2020 and 2021 that differed from the country overall. We aim to quantify life expectancy in Denmark in 2020 and 2021 by SES and compare this to recent trends in life expectancy (2014-2019). METHODS: We used Danish registry data from 2014 to 2021 for all individuals aged 30+. We classified the study population into SES groups using income quartiles and calculated life expectancy at age 30 by year, sex, and SES, and the differences in life expectancy from 2019 to 2020 and 2020 to 2021. We compared these changes to the average 1-year changes from 2014 to 2019 with 95% confidence intervals. Lastly, we decomposed these changes by age and cause of death distinguishing seven causes, including COVID-19, and a residual category. RESULTS: We observed a mortality gradient in life expectancy changes across SES groups in both pandemic years. Among women, those of higher SES experienced a larger increase in life expectancy in 2020 and a smaller decrease in 2021 compared to those of lower SES. Among men, those of higher SES experienced an increase in life expectancy in both 2020 and 2021, while those of lower SES experienced a decrease in 2021. The impact of COVID-19 mortality on changes in life expectancy in 2020 was counterbalanced by improvements in non-COVID-19 mortality, especially driven by cancer and cardiovascular mortality. However, in 2021, non-COVID-19 mortality contributed negatively even for causes as cardiovascular mortality that has generally a positive impact on life expectancy changes, resulting in declines for most SES groups. CONCLUSIONS: COVID-19 mortality disproportionally affected those of lower SES and exacerbated existing social inequalities in Denmark. We conclude that in health emergencies, particular attention should be paid to those who are least socially advantaged to avoid widening the already existing mortality gap with those of higher SES. This research contributes to the discussion on social inequalities in mortality in high-income countries.


Subject(s)
COVID-19 , Cardiovascular Diseases , Male , Humans , Female , Adult , Life Expectancy , Socioeconomic Factors , Denmark/epidemiology
5.
Front Public Health ; 12: 1298308, 2024.
Article in English | MEDLINE | ID: mdl-38327581

ABSTRACT

Introduction: Human T Lymphotropic Virus type 1 (HTLV-1) is a neglected retrovirus associated with many clinical disorders, most notably Adult T-cell Leukemia/Lymphoma and HTLV-1-Associated Myelopathy (HAM). Found in endemic clusters across the world, high prevalence has been reported in minoritized groups who suffer from health inequities. This study investigates the association between HTLV-1 prevalence and the following socioeconomic determinants of health: education, income, and employment, which are markers of health inequity. Methods: A systematic review was conducted by searching the following databases: Ovid/Medline, Embase, Global Health Database, Web of Science, LILACS and SciELO. Primary studies in English, Spanish and Portuguese mentioning HTLV-1 and one of education, income and/or employment were included. A random-effects meta-analysis was performed, and odds ratios (OR) were calculated to determine the association between these socioeconomic determinants of health and HTLV-1 prevalence. Results: 42 studies were included. The likelihood of having HTLV-1 was higher in individuals with less than completed primary education compared to those who completed primary education (OR 1.86 [95% CI 1.34-2.57]; p < 0.01). This may be because individuals with low education have reduced access to and understanding of health information, thus increasing the prevalence of risk factors associated with HTLV-1 infection. No other determinants were found to be statistically significant. Conclusion: Fewer years of schooling are associated with increased likelihood of contracting HTLV-1. Therefore, health promotion materials and public health policies regarding HTLV-1 must consider those with lower educational levels to effectively reduce disease transmission. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335004, identifier (CRD42022335004).


Subject(s)
HTLV-I Infections , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic , Humans , Adult , HTLV-I Infections/epidemiology , Paraparesis, Tropical Spastic/epidemiology , Risk Factors , Socioeconomic Factors
6.
Sci Rep ; 14(1): 2639, 2024 02 01.
Article in English | MEDLINE | ID: mdl-38302519

ABSTRACT

Pakistan is facing a high prevalence of malnutrition and Minimum Dietary Diversity (MDD) is one of the core indicators that remain below the recommended level. This study assesses MDD and its associated factors among children aged 6 to 23 months in Pakistan. The study uses a cross-sectional study using the dataset of the latest available Multiple Indicators Cluster Survey (MICS) for all provinces of Pakistan. Multistage sampling is used to select 18,699 children aged 6 to 23 months. The empirical method is the Logistic Regression Analysis and Chi-Square Test. The dataset is freely and publicly available with all identifier information removed, and no ethics approvals are required. About one-fifth (20%) of infants and young children aged 6 to 23 months had met MDD, this number varies from 17 to 29%, highest in Baluchistan and lowest in Punjab province of Pakistan. The age group (18-23) indicates a 2.45 times greater chance of having MDD. Age (< 0.001), diarrhea (0.01), prenatal care (0.06), mother's education (< 0.001), computer access (< 0.001), wealth quantile (< 0.001), and residence (< 0.001) were significantly associated with meeting MDD. However, gender (0.6) and mother's age (0.4) both were statistically insignificant in meeting MDD. Regarding mothers' education, compared to no education, the chance of MDD is 1.45 times greater for highly educated mothers in the Punjab province. Dietary diversity among children aged 6 to 23 months in Pakistan is low. It is recommended that mothers should be aware and encouraged to use dietary diverse food for infants and younger children.


Subject(s)
Diet , Malnutrition , Infant , Female , Pregnancy , Child , Humans , Child, Preschool , Pakistan/epidemiology , Cross-Sectional Studies , Socioeconomic Factors
7.
Anticancer Res ; 44(2): 631-637, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38307585

ABSTRACT

BACKGROUND/AIM: This study aimed to investigate the demographic and socioeconomic factors associated with disparities in the time-to-treatment for melanoma. PATIENTS AND METHODS: We conducted an analysis of patients with melanoma from 2004 to 2019 using the National Cancer Database. Time intervals from diagnosis to surgery, radiation, and chemotherapy were compared based on age, sex, race, and socioeconomic status. RESULTS: A total of 647,273 patients with melanoma were included. Overall, Hispanic patients had the longest times to surgery, radiation, and chemotherapy compared to non-Hispanic patients (surgery 38.52 vs. 31.90 days, radiation 130.12 vs. 99.67 days, chemotherapy 93.66 vs. 83.72 days, all p<0.01). Similarly, black patients and those who were uninsured had the longest times-to-treatment. CONCLUSION: We identified significant disparities in time-to-treatment, related to both race and socioeconomic factors. It is increasingly imperative to conduct further investigations into the root causes of these disparities to effectively address and rectify the inequities present in breast cancer care.


Subject(s)
Healthcare Disparities , Melanoma , Time-to-Treatment , Humans , Hispanic or Latino , Melanoma/therapy , Social Class , Socioeconomic Factors
8.
BMC Geriatr ; 24(1): 128, 2024 Feb 02.
Article in English | MEDLINE | ID: mdl-38308219

ABSTRACT

BACKGROUND: Food security is a function of food access and dietary diversity. Older age is a period when adequate and diverse dietary intake is a challenge. This study aimed to investigate the association between food security on the one hand and dietary diversity and socioeconomic factors on the other hand among the free-living older people in the city of Tehran. METHODS: In this cross-sectional study, 583 older people, aged 60-80 years living in Tehran city, were selected through the systematic cluster sampling method. Food security was determined by the United States Household Food Security Survey Module (US-HFSSM (.Socioeconomic status (SES) and two 24-h recalls were obtained. Dietary Diversity Score (DDS) was calculated using the FAO 2010 guideline. Multinomial logistic regression was applied. RESULTS: The average age of participants was 67.87 ± 5.86 years. Based on US-HFSSM, 56.9% of older people were food secure; while 25.7%, 14.2% and 3.2% suffered from food insecurity (FI) without hunger, with moderate hunger, and with severe hunger, respectively. There was no association between FI and DDS, even after controlling for confounders. FI with mild hunger was associated with household income (OR = 2.744, 95% CI = 1.100-6.846), while FI with severe hunger was associated with Fars ethnicity (OR = 0.146, 95% CI = 0.051-0.424). CONCLUSIONS: Overall, socio-economic status and demographic characteristics were the predictors of FI among older people. The findings can have implication in design and targeting of interventions directed at older people.


Subject(s)
Food Supply , Social Class , Humans , Aged , Iran/epidemiology , Cross-Sectional Studies , Socioeconomic Factors , Food Security
10.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 50(1): [e102090], ene.- feb. 2024. tab, graf
Article in Spanish | IBECS | ID: ibc-229436

ABSTRACT

Objetivos Analizar el riesgo de COVID-19 con relación a la morbilidad previa, así como el riesgo de nuevos eventos cardiovasculares (ECV) en pacientes COVID-19 y la supervivencia a un año. Metodología Estudio casos-control y estudio de cohortes prospectivo. Se incluyeron 275 pacientes aleatorizados >18 años diagnosticados de COVID-19 y se aparearon con 825 COVID-19 negativos por edad y sexo (proporción 1:3). Las variables principales fueron diagnóstico de COVID-19 y eventos post-COVID-19. Se estudiaron variables sociodemográficas, comorbilidad y ECV previo. Se realizaron sendos modelos predictivos de factores asociados al desarrollo de COVID-19 y de ECV post-COVID-19, así como un análisis de supervivencia a un año. Resultados Los varones con ECV previo duplican el riesgo de padecer COVID-19 (odds ratio [OR] 2,11; intervalo de confianza [IC] 95% 1,32–3,36). En las mujeres el riesgo aumenta con la edad (OR 1,01; IC 95% 1,00–1,02), la diabetes mellitus (DM) (OR 1,90; IC 95% 1,14–3,17) y el deterioro cognitivo (OR 4,88; IC 95% 2,50–9,53). La inmunosupresión actúa como factor protector en ambos sexos. La edad (OR 1,02; IC 95% 1,00–1,04), hipertensión arterial (HTA) (OR 2,21; IC 95% 1,17–4,17), la infección COVID-19 (OR 4,81; IC 95% 2,89–7,98) y el ECV previo (OR 4,46; IC 95% 2,56–7,75) predicen el desarrollo de un nuevo ECV post-COVID-19. Los pacientes COVID-19 positivos tienen menor supervivencia (mediana de siete vs. 184 días). Conclusiones El ECV previo en varones y la DM junto al deterioro cognitivo en mujeres aumentan el riesgo de presentar COVID-19. La edad, HTA, ECV previo y la infección COVID-19 predicen la aparición de un ECV (AU)


Aim To analyze the risk of COVID-19 in relation to previous morbidity; to analyze the risk of new cardiovascular events (CVE) in COVID-19 patients and one-year survival. Methodology Case–control study and prospective cohort study. Two hundred and seventy-five randomized patients >18 years old with COVID-19 were included and matched with 825 without COVID-19 by age and sex (ratio 1:3). The main variables were diagnosis of COVID-19 and post-COVID-19 events. Sociodemographic variables, comorbidity, and previous CVD were studied. Two predictive models of factors associated with the development of COVID-19 and post-COVID-19 CVE were performed, as well as a one-year survival analysis. Results Men with a previous CVE double the risk of suffering from COVID-19 (OR 2.11; 95% CI: 1.32–3.36). In women, the risk increases with age (OR 1.01; 95% CI: 1.00–1.02), diabetes (DM) (OR 1.90; 95% CI: 1.14–3.17) and cognitive impairment (OR 4.88; 95% CI: 2.50–9.53). Immunosuppression acts as a protective factor in both sexes. Age (OR 1.02; 95% CI: 1.00–1.04), arterial hypertension (OR 2.21; 95% CI: 1.17–4.17), COVID-19 infection (OR 4.81; 95% CI: 2.89–7.98) and previous CVE (OR 4.46; 95% CI: 2.56–7.75) predict the development of a new post-COVID-19 CVE. Positive COVID-19 has lower survival (median 7 days vs. 184 days). Conclusions Previous CVE in men and DM along with cognitive impairment in women increase the risk of presenting COVID-19. Age, arterial hypertension, previous CVE, and COVID-19 infection predict the appearance of new CVE (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , /epidemiology , Case-Control Studies , Prospective Studies , Cohort Studies , Survival Analysis , Socioeconomic Factors , Incidence , Comorbidity , Spain/epidemiology
11.
Rev. clín. med. fam ; 17(1): 13-23, Feb. 2024. tab, ilus
Article in Spanish | IBECS | ID: ibc-230605

ABSTRACT

Objetivo: el objetivo de esta revisión es estudiar el efecto que los determinantes sociales de la salud tienen sobre la prevalencia y pronóstico de la enfermedad pulmonar obstructiva crónica (EPOC). Métodos: se ha hecho una revisión exploratoria (scoping review) de los artículos publicados entre 2013 y 2023, y una búsqueda bibliográfica en Pubmed. Se encontraron 31 artículos que cumplieran los criterios de inclusión. Resultados: niveles educativos precarios, así como bajos ingresos económicos se relacionan con un aumento en el riesgo de EPOC, con incrementos del 44,9% y el 22,9% de los casos respectivamente. La dedicación a ciertos oficios, como la agricultura o los servicios de restauración, también aumenta la prevalencia de esta enfermedad y su impacto sobre la mortalidad. La soltería o viudez, el desempleo y vivir en áreas rurales con alta contaminación atmosférica son factores que se asocian a más hospitalizaciones, síntomas graves, menor productividad y mayor mortalidad. Las desigualdades sociales afectan el acceso a la atención médica y la adherencia al tratamiento. La EPOC es más común en hombres y en personas mayores, aunque algunos estudios muestran mayor riesgo en mujeres debido a su dedicación a las tareas domésticas y su exposición a sustancias contaminantes. Conclusiones: determinantes sociales de la salud como el bajo nivel socioeconómico, la ocupación laboral, la contaminación doméstica o ambiental, el estado civil, lugar de residencia o dificultad de acceso al sistema sanitario actúan como factores de riesgo de la EPOC e influyen desfavorablemente sobre ella.(AU)


Aim: the objective of this review is to study the impact of social determinants of health on the prevalence and prognosis of COPD.Methods: an exploratory scoping review of papers published between 2013 and 2023 was performed. A bibliographic search was conducted on pubmed, yielding 31 papers that met the inclusion criteria.Results: low educational levels and low incomes are linked to an increased risk of COPD with increments of 44.9% and 22.9% of cases respectively. Involvement in certain occupations such as agriculture or food services also increases the prevalence of the disease and its impact on mortality. Being single or widowhood, unemployment, and living in rural areas with high air pollution are associated with more hospitalizations, severe symptoms, reduced productivity and higher mortality. Social inequalities impact access to medical care and treatment adherence. COPD is more common in men and the elderly, although some studies reveal a higher risk in women due to household chores and exposure to pollutants.Conclusions: social determinants of health such as low socio-economic status, occupational status, household or environmental pollution, marital status, place of residence or difficulty accessing the healthcare system act as risk factors for COPD and have an unfavourable impact on this.(AU)


Subject(s)
Humans , Male , Female , Social Determinants of Health , Pulmonary Disease, Chronic Obstructive/epidemiology , Socioeconomic Factors , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/mortality
15.
BMC Public Health ; 24(1): 340, 2024 02 01.
Article in English | MEDLINE | ID: mdl-38302948

ABSTRACT

BACKGROUND: Ethiopia has committed to ending undernutrition by implementing nutrition intervention strategies, including promoting optimal feeding and care practices. To monitor and evaluate optimal infant feeding practices, it is crucial to have reliable and quality data on infant feeding indicators. Therefore, this study aimed to evaluate the extent to which breastfeeding mothers in Ethiopia have completed the continuum of age-appropriate infant feeding practices and the barriers they face. METHODS: In this study, a sequential explanatory mixed method design was used. First, using datasets from performance monitoring for action (PMA) in Ethiopia, we estimated the level of the outcome and associated factors. In the quantitative (QUAN) analysis, 1755 mothers of infants were included to generate estimates. A generalized estimating equations logistic regression model was used to identify factors associated with the outcome by accounting for the clustering nature of the data by enumeration area. Then, a qualitative (QUAL) study was conducted with 14 mothers to explore their infant feeding practices using an in-depth interview guide and analyzed using a thematic approach. Results from both quantitative and qualitative data were integrated, described under the identified thematic areas, and interpreted concurrently. RESULTS: This study showed that 13.96% (95% CI: 12.4 to 15.6%) of mothers practiced a complete continuum of age-appropriate infant feeding. Over 8% of mothers did not practice any optimal feeding. Nearly 47% of mothers practiced optimal breastfeeding, and one-fifth of mothers practiced optimal complementary feeding. Results from both quantitative and qualitative data showed that mothers' complete continuum of age-appropriate infant feeding practice was affected by their level of income, knowledge, and attitude towards optimal infant feeding, as well as by important others, including husbands, grandmothers, and health workers. CONCLUSION: The level of a complete continuum of age-appropriate infant feeding practice is low among breastfeeding mothers in Ethiopia. Mothers' optimal feeding practices in Ethiopia are affected by their level of knowledge and attitude towards infant feeding, income or access to food, and health workers or family members. Therefore, collaborative efforts are needed to strengthen mothers' education on the health benefits of optimal infant feeding and design and promote strategies to improve household income or access to diverse food.


Subject(s)
Breast Feeding , Mothers , Infant , Female , Humans , Ethiopia , Socioeconomic Factors , Feeding Behavior , Health Knowledge, Attitudes, Practice
16.
Glob Public Health ; 19(1): 2311682, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38325424

ABSTRACT

Tuberculosis is recognised as a disease of the economically disadvantaged people due to its association with financial vulnerability. Mozambique still faces the challenge of the high burden of TB and associated costs. We aimed to understand the social and economic impacts of TB and the need for social support among people with TB in Mozambique. We conducted a qualitative study using a phenomenological approach focusing on the lived experiences and perceptions of people with TB. A total of 52 semi-structured one-to-one in-depth interviews were conducted and data were analysed using a reflexive thematic analysis. Three themes were drawn from the analysis: (i) TB has a social and economic impact that requires adaptation and resourcefulness amongst those affected; (ii) People with TB have different preferences and needs for social support, and (iii) People with TB have different knowledge of, and experiences with, formal social support. TB affects family and community relationships mainly due to impacts on the household's finances. People with TB in Mozambique are not entitled to any form of social support, and they need to rely on help from family and the community which is often insufficient. Further investigation is needed on how social support schemes can be developed in Mozambique.


Subject(s)
Tuberculosis , Humans , Adult , Mozambique , Qualitative Research , Social Support , Socioeconomic Factors
17.
BMC Public Health ; 24(1): 470, 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38355531

ABSTRACT

BACKGROUND: Higher levels of socioeconomic deprivation have been consistently associated with increased risk of premature mortality, but a detailed analysis by causes of death is lacking in Belgium. We aim to investigate the association between area deprivation and all-cause and cause-specific premature mortality in Belgium over the period 1998-2019. METHODS: We used the 2001 and 2011 Belgian Indices of Multiple Deprivation to assign statistical sectors, the smallest geographical units in the country, into deprivation deciles. All-cause and cause-specific premature mortality rates, population attributable fraction, and potential years of life lost due to inequality were estimated by period, sex, and deprivation deciles. RESULTS: Men and women living in the most deprived areas were 1.96 and 1.78 times more likely to die prematurely compared to those living in the least deprived areas over the period under study (1998-2019). About 28% of all premature deaths could be attributed to socioeconomic inequality and about 30% of potential years of life lost would be averted if the whole population of Belgium faced the premature mortality rates of the least deprived areas. CONCLUSION: Premature mortality rates have declined over time, but inequality has increased due to a faster pace of decrease in the least deprived areas compared to the most deprived areas. As the causes of death related to poor lifestyle choices contribute the most to the inequality gap, more effective, country-level interventions should be put in place to target segments of the population living in the most deprived areas as they are facing disproportionately high risks of dying.


Subject(s)
Health Status Disparities , Mortality, Premature , Male , Humans , Female , Belgium/epidemiology , Socioeconomic Factors , Cause of Death , Mortality
19.
BMJ Open ; 14(2): e073447, 2024 Feb 10.
Article in English | MEDLINE | ID: mdl-38341217

ABSTRACT

BACKGROUND: Globally, malnutrition among women of reproductive age is on the rise and significantly contributing to non-communicable disease, deaths and disability. Even though the double burden of malnutrition (DBM) is a common problem among women in sub-Saharan Africa (SSA), there are limited studies examining the factors contributing to underweight, overweight, and obesity at the SSA level. OBJECTIVE: To determine the factors associated with the DBM, and their relative magnitude, among women of reproductive age in SSA. DESIGN: Cross-sectional study design. SETTING: 33 SSA countries. PARTICIPANTS: 240 414 women of reproductive age. PRIMARY AND SECONDARY OUTCOME MEASURES: A multilevel multinomial logistic regression model was applied to identify factors associated with malnutrition. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association. RESULTS: The pooled prevalence of underweight, overweight and obesity among women in SSA were 8.87%, 16.47% and 6.10%, respectively. Women who are from rural residence and smoke cigarettes were more likely to be underweight. Conversely, women between the age of 24-34 and 35-49, who have higher education, belong to a middle and rich household, are ever married, have high parity, use contraceptives, have media exposure and smoke cigarettes were more likely to be overweight and/or obese. CONCLUSION: The findings of our study suggest that certain factors such as residence, education status, wealth, marital status, occupation, cigarette smoking, and contraceptive use have a significant assocation with malnutrition among women. Therefore, it is important for public health programs aimed at preventing the double burden of malnutrition to focus on these factors through comprehensive public awareness and cost-effective operational health interventions.


Subject(s)
Malnutrition , Overweight , Female , Humans , Overweight/epidemiology , Socioeconomic Factors , Logistic Models , Thinness/epidemiology , Cross-Sectional Studies , Obesity/epidemiology , Malnutrition/epidemiology , Contraceptive Agents , Prevalence , Multilevel Analysis
20.
PLoS One ; 19(2): e0296910, 2024.
Article in English | MEDLINE | ID: mdl-38381720

ABSTRACT

BACKGROUND: With the evolution of China's social structure and values, there has been a shift in attitudes towards marriage and fertility, with an increasing number of women holding diverse perspectives on these matters. In order to better comprehend the fundamental reasons behind these attitude changes and to provide a basis for targeted policymaking, this study employs natural language processing techniques to analyze the discourse of Chinese women. METHODS: The study focused on analyzing 3,200 comments from Weibo, concentrating on six prominent topics linked to women's marriage and fertility. These topics were treated as research cases. The research employed natural language processing techniques, such as sentiment orientation analysis, Word2Vec, and TextRank. RESULTS: Firstly, the overall sentiment orientation of Chinese women toward marriage and fertility was largely pessimistic. Secondly, the factors contributing to this negative sentiment were categorized into four dimensions: social policies and rights protection, concerns related to parenting, values and beliefs associated with marriage and fertility, and family and societal culture. CONCLUSION: Based on these outcomes, the study proposed a range of mechanisms and pathways to enhance women's sentiment orientation towards marriage and fertility. These mechanisms encompass safeguarding women and children's rights, promoting parenting education, providing positive guidance on social media, and cultivating a diverse and inclusive social and cultural environment. The objective is to offer precise and comprehensive reference points for the formulation of policies that align more effectively with practical needs.


Subject(s)
Marriage , Natural Language Processing , Child , Female , Humans , Socioeconomic Factors , Population Dynamics , Women's Rights , Fertility , Attitude , China
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