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2.
Health Aff (Millwood) ; 41(2): 265-272, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35130061

ABSTRACT

The objective of this study was to describe how structural racism and sexism shape the employment trajectories of Black women in the US health care system. Using data from the American Community Survey, we found that Black women are more overrepresented than any other demographic group in health care and are heavily concentrated in some of its lowest-wage and most hazardous jobs. More than one in five Black women in the labor force (23 percent) are employed in the health care sector, and among this group, Black women have the highest probability of working in the long-term-care sector (37 percent) and in licensed practical nurse or aide occupations (42 percent). Our findings link Black women's position in the labor force to the historical legacies of sexism and racism, dating back to the division of care work in slavery and domestic service. Our policy recommendations include raising wages across the low-wage end of the sector, providing accessible career ladders to allow workers in low-wage health care to advance, and addressing racism in the pipeline of health care professions.


Subject(s)
Health Care Sector , Racism , Developing Countries , Employment , Female , Health Workforce , Humans , Social Class , Socioeconomic Factors
3.
Health Aff (Millwood) ; 41(2): 247-255, 2022 02.
Article in English | MEDLINE | ID: mdl-35130066

ABSTRACT

Patients receiving home health services from high-quality home health agencies often experience fewer adverse outcomes (for example, hospitalizations) than patients receiving services from low-quality agencies. Using administrative data from 2016 and regression analysis, we examined individual- and neighborhood-level racial, ethnic, and socioeconomic factors associated with the use of high-quality home health agencies. We found that Black and Hispanic home health patients had a 2.2-percentage-point and a 2.5-percentage-point lower adjusted probability of high-quality agency use, respectively, compared with their White counterparts within the same neighborhoods. Low-income patients had a 1.2-percentage-point lower adjusted probability of high-quality agency use compared with their higher-income counterparts, whereas home health patients residing in neighborhoods with higher proportions of marginalized residents had a lower adjusted probability of high-quality agency use. Some 40-77 percent of the disparities in high-quality agency use were attributable to neighborhood-level factors. Ameliorating these inequities will require policies that dismantle structural and institutional barriers related to residential segregation.


Subject(s)
Home Care Agencies , Social Segregation , Humans , Residence Characteristics , Socioeconomic Factors
4.
Braz. j. oral sci ; 21: e226288, jan.-dez. 2022. ilus
Article in English | LILACS, BBO - Dentistry | ID: biblio-1366204

ABSTRACT

Aim: To describe the pattern of toothache experience in a cohort of children aged 2-5 over 21 years and to find the relationship between previous toothache experience and later reports of toothache to get finding on the most critical period of toothache as a problem in life. Methods: This is a secondary data analysis from Indonesia Family Life Survey (IFLS). A total of 1,927 children from IFLS-1 with complete data were included as baseline participants. They were followed up four times within 21 years (age 6-9y, age 9-12y, age 16-19y, age 23- 26y). Toothache was based on the question of self-reported toothache experience during the last four weeks. After 21 years, a total of 1,098 individuals could be traced and completed every cohort of the survey. Toothache experiences were reported for frequencies in every cohort and accumulative experiences over 21 years. Logistic regression tests were performed to analyze the association of previous toothache experience and later toothache experience. Results: Almost 40% of the respondents reported toothache at least once in their life. The age of 6-9 years is the period when a high percentage of children had teeth-related pain. The experience of toothache at this period was significantly related to every period of age in life. Conclusions: The period of early mixed dentition is important. Oral health status in this period is associated with future oral health. A comprehensive dental health prevention program targeting this population is essential to increase the quality of life


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Toothache/epidemiology , Oral Health , Socioeconomic Factors , Dental Health Surveys , Prevalence , Longitudinal Studies , Indonesia/epidemiology
5.
Front Endocrinol (Lausanne) ; 13: 849718, 2022.
Article in English | MEDLINE | ID: mdl-35498399

ABSTRACT

Objectives: French Guiana is a multicultural overseas territory where obesity is a major public health problem. This study aimed to highlight the nutritional and socioeconomic determinants of overweight and obesity in different populations in French Guiana. Methods: A two-stage random sample of 1390 individuals aged 15 to 75 years was surveyed by telephone, and the participants were initially screened for diabetes. Logistic regression was fitted on the sample to adjust for potential confounding factors. Results: Overweight and obesity were found in 54.7% of the respondents, a higher proportion than in mainland France. There was a significant body image discrepancy in our population, with a higher risk of obesity among single women, often immigrants from the non-French Caribbean and South America, unemployed or low education. Conclusions: The main factors associated with obesity were being a precariousness immigrant; there was often a mismatch between body image and overweight/obesity, which is a major obstacle to the improvement of dietary behaviors and lifestyle. This information provides operational clues as to where to act and the necessary adaptations to attempt to modify behaviors in a culturally-adapted manner.


Subject(s)
Obesity , Overweight , Female , Humans , Life Style , Obesity/epidemiology , Overweight/epidemiology , Prevalence , Socioeconomic Factors
6.
Front Public Health ; 10: 850157, 2022.
Article in English | MEDLINE | ID: mdl-35493377

ABSTRACT

Background: The Chinese health system has long been committed to eliminating inequalities in health services utilization. However, few studies have analyzed or measured these inequalities in economically underdeveloped regions in China. Methods: A total of 6,627 respondents from 3,000 households in Heilongjiang Province were extracted from the Sixth National Health Services Survey. We measured horizontal inequity in both 2-week outpatient rate and annual inpatient rate, and then identified the factors contributing to inequality. Results: The horizontal inequity indices of the 2-week outpatient and annual impatient rates in Heilongjiang Province were 0.0586 and 0.1276, respectively. Household income, health status, place of residence, basic medical insurance, and commercial health insurance were found to be the main factors affecting inequality in health services utilization. The contributions of household income to these two indices were 184.03 and 253.47%, respectively. Health status factors, including suffering from chronic disease, limitations in daily activities, and poor self-rated health, played positive roles in reducing inequality in these two indices. The contributions of place of residence to these two indices were 27.21 and -28.45%, respectively. Urban Employee Basic Medical Insurance made a pro-rich contribution to these two indices: 56.25 and 81.48%, respectively. Urban and Rural Resident Basic Medical Insurance, Urban Resident Basic Medical Insurance, New Rural Cooperative Medical Scheme, and other basic medical insurance made a pro-poor contribution to these two indices: -73.51 and -54.87%, respectively. Commercial health insurance made a pro-rich contribution to these two indices: 20.79 and 7.40%, respectively. Meanwhile, critical illness insurance made a slightly pro-poor contribution to these two indices: -4.60 and -0.90%, respectively. Conclusions: The findings showed that the "equal treatment in equal need" principle was not met in the health services utilization context in Heilongjiang Province. To address this issue, the government could make policy changes to protect low-income populations from underused health services, and work to improve basic medical insurance, critical illness insurance, and social security systems.


Subject(s)
Facilities and Services Utilization , Healthcare Disparities , China , Critical Illness , Humans , Socioeconomic Factors
7.
Front Public Health ; 10: 797272, 2022.
Article in English | MEDLINE | ID: mdl-35493387

ABSTRACT

This study aims to compare determinants of health facility delivery for women under a health insurance scheme and those not under a health insurance scheme. Secondary data drawn from the National Demographic and Health Survey was used for the analysis. The characteristics of the women were presented with simple proportions. Binary multilevel logistic regression was used to examine the determinants of health facilities for women who enrolled in health insurance and those who did not. All statistical analyses were set at 5% level of significant level (p = 0.24). The result showed that 2.1% of the women were under a health insurance scheme. Disparity exists in health insurance ownership as a higher proportion of those enrolled in health insurance were those with higher education attainment, in urban parts of the country, and those situated on higher wealth quintiles. There is a significant difference between those with and those without health insurance. It implies that a higher proportion of women who enrolled in health insurance delivered in health facility delivery compared to those who do not. The unique determinants of health facility delivery for women under health insurance were parity and birth order, while unique determinants of health facility delivery for women not enrolled in health schemes were employment status, marriage type, and geopolitical zones. Uniform predictors of health facility delivery for both groups of women were maternal education, household wealth quintiles, autonomy on healthcare, number of antenatal contacts, residential status, community-level poverty, community-level media use, and community-level literacy. Intervention programs designed to improve health facility delivery should expand educational opportunities for women, improve household socioeconomic conditions, target rural women, and encourage women to undertake a minimum of four antenatal contacts.


Subject(s)
Delivery, Obstetric , Health Facilities , Female , Humans , Insurance, Health , Nigeria , Pregnancy , Socioeconomic Factors
8.
Front Cell Infect Microbiol ; 12: 861053, 2022.
Article in English | MEDLINE | ID: mdl-35493737

ABSTRACT

Background: Dermatitis is an important global health problem that not only affects social interaction and physical and mental health but also causes economic burden. Health problems or distress caused by dermatitis may be easily overlooked, and relevant epidemiological data are limited. Therefore, a better understanding of the burden of dermatitis is necessary for developing global intervention strategies. Methods: All data on dermatitis, including atopic dermatitis (AD), contact dermatitis (CD) and seborrhoeic dermatitis (SD), were obtained from the Global Burden of Disease 2019 (GBD2019) database. The extracted age-standardized incidence rates (ASIR) and disability-adjusted life-years (DALYs) rates (ASDR) data were analysed by stratification, including by sex, country or region, and sociodemographic index (SDI) indicators. Finally, we analysed the correlation between the global burden of dermatitis and socioeconomic development status. Results: According to the GBD 2019 estimate, the ASIR and ASDR for the three major types of dermatitis in 2019 were 5244.3988 (95% CI 4551.7244-5979.3176) per 100,000 person-years and 131.6711 (95% CI 77.5876-206.8796) per 100,000 person-years. The ASIR and ASDR of atopic dermatitis, contact dermatitis and seborrhoeic dermatitis are: Incidence (95%CI,per 100,000 person-years), 327.91 (312.76-343.67), 3066.04 (2405.38-3755.38), 1850.44 (1706.25- 1993.74); DALYs (95%CI, per 100,000 person-years), 99.69 (53.09-167.43), 28.06 (17.62-41.78), 3.93 (2.24-6.25). In addition, among the three dermatitis types, the greatest burden was associated with AD. According to the ASDR from 1990 to 2019, the burden of dermatitis has exhibited a slow downward trend in recent years. In 2019, the ASIR showed that the USA had the greatest burden, while the ASDR showed that Asian countries (such as Japan, Mongolia, Kazakhstan, and Uzbekistan) and some European countries (France, Estonia) had the greatest burden. According to SDI stratification and the three major dermatitis types, high ASIR and ASDR corresponded to high SDI areas (especially for AD). Conclusion: The burden of dermatitis is related to socioeconomic development status, especially for AD, which is positively correlated with the SDI. The results based on GBD2019 data are valuable for formulating policy, preventing and treating dermatitis and reducing the global burden of dermatitis.


Subject(s)
Dermatitis, Seborrheic , Disability-Adjusted Life Years , Humans , Incidence , Quality-Adjusted Life Years , Socioeconomic Factors
10.
PLoS One ; 17(5): e0267821, 2022.
Article in English | MEDLINE | ID: mdl-35511859

ABSTRACT

BACKGROUND: Determining the nutritional status of lactating women is important because underweight lactating mothers will have low energy levels and reduced cognitive abilities, which will affect the inadequate care of their young children. Thus, malnutrition is passed down from generation to generation, perpetuating the vicious cycle. There is scarce national data on determinants of underweight among lactating mothers in Ethiopia. Hence, this study aimed to identify individual and community-level determinants of underweight among lactating mothers in Ethiopia. METHODS: Data from the Ethiopian Demographic and Health Survey (EDHS) from 2016 were used. A total of 3848 lactating mothers were included in this study, and a multilevel, multivariable logistic regression model was fitted to identify determinants of underweight among lactating mothers. RESULTS: The odds of being underweight among rural lactating mothers were 65% higher (AOR = 1.65, 95% CI = 1.13, 2.41) than lactating mothers in the urban area. The odds of being underweight among lactating mothers who have toilet facilities were 33% lower (AOR = 0.67, 95%CI = 0.54, 0.83) compared with those do not have toilet facilities. Those mothers in the age group of 25-34 years and greater than 35 years had (AOR = 0.61,95%CI = 0.48, 0.79), and (AOR = 0.66, 95%CI = 0.47, 0.95) times lower chance of being underweight compared with those who had 15-24 years of age, respectively. The likelihood of being underweight among lactating mothers in high community poverty (AOR = 1.40, 95%CI = 1.08, 1.82) was higher than the lower community poverty level. CONCLUSION: Underweight among lactating mothers was significantly associated with individual-level (age and toilet facilities) variables and community-level (residence and community poverty). Therefore, focusing on these identified factors could improve underweight among lactating mothers in Ethiopia.


Subject(s)
Mothers , Thinness , Adult , Child , Child, Preschool , Ethiopia/epidemiology , Female , Humans , Lactation , Multilevel Analysis , Socioeconomic Factors , Thinness/epidemiology
11.
PLoS One ; 17(5): e0267700, 2022.
Article in English | MEDLINE | ID: mdl-35511875

ABSTRACT

BACKGROUND: The death of children under-five years is one of the critical issues in public health and improving child survival continues to be a matter of urgent concern. In this paper, we assessed the proximate and socio-economics determinants of child mortality in Guinea. METHODS: Using the 2018 Guinea Demographic and Health Survey (GDHS), we extracted demographic and mortality data of 4,400 children under-five years. Both descriptive and multivariable logistic regression analyses were conducted. RESULTS: Under-five mortality was 111 deaths per 1,000 live births in Guinea. The likelihood of death was higher among children born to mothers who belong to other religions compared to Christians (aOR = 2.86, 95% CI: 1.10-7.41), smaller than average children compared to larger than average children (aOR = 1.97, 95% CI: 1.28-3.04) and those whose mothers had no postnatal check-up visits after delivery (aOR = 1.72, 95% CI: 1.13-2.63). Conversely, the odds of death in children with 2-3 birth rank & >2 years of birth interval compared to ≥4 birth rank and ≤2 years of birth interval were low (aOR = 0.53, 95% CI: 0.34-0.83). CONCLUSION: We found that household/individual-level socioeconomic and proximate factors predict under-five mortality in Guinea. With just about a decade left to the 2030 deadline of the Sustainable Development Goals (SDGs), concerted efforts across all key stakeholders, including government and development partners, need to be geared towards implementing interventions that target these predictors.


Subject(s)
Child Mortality , Infant Mortality , Birth Intervals , Child , Family Characteristics , Female , Guinea/epidemiology , Humans , Infant , Pregnancy , Socioeconomic Factors
12.
BMC Health Serv Res ; 22(1): 602, 2022 May 05.
Article in English | MEDLINE | ID: mdl-35513830

ABSTRACT

BACKGROUND: Utilisation of continuum of maternal health care services is crucial for a healthy pregnancy and childbirth and plays an important role in attaining Universal Health Coverage (UHC) and Sustainable Development Goals (SDGs) related to maternal and child health. This paper aims to assess the percentage of dropouts across various stages of utilization of continuum of maternal health services (CMHS) in India and also investigates the factors hindering the utilization of these services. METHODS: We used recent data from National Family Health Survey(NFHS) encompassing a total sample of 1,70,937 pregnant women for the period 2015-16. The percentage of women dropping out while seeking maternal health care is measured using descriptive statistics. While, the factors impeding the utilization of maternal health services is estimated using a Multinomial Logistic Regression Model, where dependent variable (CMHS) is defined as complete care, incomplete care and no care. RESULTS: Only17% of pregnant women availed the utilisation of complete care and 83% either did not seek any care or dropped after seeking one or two services. For instance, it is found that 79% of women who registered for antenatal care services (ANC) did not avail the same adequately. An empirical investigation of determinants of inadequate utilization of CMHS revealed that factors like individual characteristics, for instance- access to media (RRR: 2.06) and mother's education play (RRR: 3.61) a vital role in the uptake of CMHS. It is also found that the interaction between wealth index and place of residence plays a pivotal role in seeking complete care. Lastly, the results revealed that male participation (RRR: 2.69) and contacting multi-purpose worker (MPW) (RRR: 2.33) are also at play. CONCLUSION: The study suggests that the major determinants of utilisation of CMHS are access to media, mother's education, affordability barriers and male participation. Hence, policy recommendations should be oriented towards strengthening these dimensions and the utilisation of adequate ANC has to be considered as the need of the hour.


Subject(s)
Maternal Health Services , Child , Female , Humans , India , Male , Maternal Health , Patient Acceptance of Health Care , Pregnancy , Prenatal Care , Socioeconomic Factors
13.
PLoS One ; 17(5): e0268006, 2022.
Article in English | MEDLINE | ID: mdl-35507569

ABSTRACT

The objective of this study was to quantify the magnitude of absolute and relative oral health inequality in countries with similar socio-political environments, but differing oral health care systems such as Canada, the United States (US), and the United Kingdom (UK), in the first decade of the new millennium. Clinical oral health data were obtained from the Canadian Health Measures Survey 2007-2009, the National Health and Nutrition Examination Survey 2007-2008, and the Adult Dental Health Survey 2009, for Canada, the US and UK, respectively. The slope index of inequality (SII) and relative index of inequality (RII) were used to quantify absolute and relative inequality, respectively. There was significant oral health inequality in all three countries. Among dentate individuals, inequality in untreated decay was highest among Americans (SII:28.2; RII:4.7), followed by Canada (SII:21.0; RII:3.09) and lowest in the UK (SII:15.8; RII:1.75). Inequality for filled teeth was negligible in all three countries. For edentulism, inequality was highest in Canada (SII: 30.3; RII: 13.2), followed by the UK (SII: 10.2; RII: 11.5) and lowest in the US (SII: 10.3; and RII: 9.26). Lower oral health inequality in the UK speaks to the more equitable nature of its oral health care system, while a highly privatized dental care environment in Canada and the US may explain the higher inequality in these countries. However, despite an almost equal utilization of restorative dental care, there remained a higher concentration of unmet needs among the poor in all three countries.


Subject(s)
Health Status Disparities , Oral Health , Adult , Canada , Humans , Nutrition Surveys , Socioeconomic Factors , United Kingdom , United States
14.
Sci Rep ; 12(1): 7280, 2022 May 04.
Article in English | MEDLINE | ID: mdl-35508678

ABSTRACT

Evidence suggests that there are social inequalities in multimorbidity, with a recent review indicating that area levels of deprivation are consistently associated with greater levels of multimorbidity. Definitions of multimorbidity, the most common of which is the co-occurrence of more than one long term condition, can include long term physical conditions, mental health conditions or both. The most commonly used measure of deprivation in England and Wales is the Index of Multiple Deprivation (IMD), an index of seven different deprivation domains. It is unclear which features of IMD may be mediating associations with multimorbidity. Thus, there may be associations because of the individual characteristics of those living in deprived areas, characteristics of the areas themselves or overlap in definitions. Data from over 25,000 participants (aged 16+) of Understanding Society (Wave 10, 1/2018-3/2020) were used to understand the most salient features of multimorbidity associated with IMD and whether physical or mental conditions are differentially associated with the seven domains of IMD. 24% of participants report multimorbidity. There is an increased prevalence of multimorbidity composed of only long-term physical conditions in the most deprived decile of deprivation (22%, 95% CI[19,25]) compared to the least deprived decile (16%, 95% CI[14,18]). Mental health symptoms but not reporting of conditions vary by decile of IMD. Associations with multimorbidity are limited to the health, income, education and employment domains of IMD. We conclude that multimorbidity represents a substantial population burden, particularly in the most deprived areas in England and Wales.


Subject(s)
Income , Multimorbidity , Adult , Employment , Humans , Socioeconomic Factors , United Kingdom/epidemiology
15.
BMC Public Health ; 22(1): 881, 2022 May 04.
Article in English | MEDLINE | ID: mdl-35509072

ABSTRACT

BACKGROUND: Despite the importance of having trust in the health system, there is a paucity of research in this field in Sweden. The aim of this study was to estimate the level of trust in the health system and to assess the factors associated with it in northern Sweden. METHODS: A cross-sectional survey was conducted in 2014 in the four northern regions of Sweden. A total of 24 795 participants (48% response rate) aged 18 to 84 years were involved in the study. A log-binomial regression was used to measure the association between sociodemographic factors and trust in the health system. RESULTS: Two thirds of the participants (68.5%) reported high trust in the health system i.e. had very much or quite a lot confidence in the health system. Women had lower prevalence of trust compared to men (PR = 0.96; 95% CI = 0.94-0.98) while older participants had a higher trust compared to youth (PR = 1.11; 95% CI = 1.06-1.16). Participants with lower level of education, those who experienced economic stress, those who were born outside Sweden and those living in small municipalities also had lower prevalence of trust in the health system. Conversely, lower income was associated with higher trust (PR = 1.08; 95% CI = 1.04-1.12). Finally, a strong relationship between higher social capital (having emotional and instrumental support, horizontal trust, and higher social participation) and trust in the health system was also found. CONCLUSIONS: Trust in the health system was moderately high in northern Sweden and strongly associated with sociodemographic and social capital factors. Trust is a complex phenomenon and a deeper exploration of the relation between trust in the health system and sociodemographic factors is needed.


Subject(s)
Social Factors , Trust , Adolescent , Cross-Sectional Studies , Female , Humans , Male , Social Support , Socioeconomic Factors , Surveys and Questionnaires , Sweden , Trust/psychology
17.
Cad Saude Publica ; 38(4): e00196821, 2022.
Article in Portuguese | MEDLINE | ID: mdl-35508029

ABSTRACT

The study aimed to analyze the prevalence of self-reported limitation of functional mobility and associated factors from 2000 to 2015 in elderly residing in the city of São Paulo, Brazil. The analyses used data from the four waves (2000, 2006, 2010, and 2015) in the Health, Well-Being, and Aging Study (SABE). Regression models were conducted to analyze the demographic, socioeconomic, behavioral, and health-related characteristics of individuals associated with limitations of mobility in each wave of the study, and multilevel analysis was performed for comparison between the four waves. The results showed an increase in the prevalence of self-reported limitations in mobility, most evident in the year 2006. There was also an association between chronic health conditions such as history of stroke (PR = 1.43; 95%CI: 1.29; 1.58, in 2000), presence of osteoarticular diseases (PR = 1.35; 95%CI: 1.23; 1.49, in 2015), and complaint of "backache" (PR = 1.33; 95%CI: 1.22; 1.45, in 2006), as well as with socioeconomic aspects such as insufficient income (PR = 1.17; 95%CI: 1.07; 1.28, in 2010). In a context of rapid population aging, these results provide relevant information for promoting public policies to prevent the decline in mobility in the elderly.


Este estudo teve como objetivo analisar a prevalência de limitação na mobilidade funcional autorreferida e os fatores associados no período entre os anos 2000 e 2015, em idosos residentes no Município de São Paulo, Brasil. Para as presentes análises foram utilizados os dados das quatro ondas (2000, 2006, 2010 e 2015) do Estudo Saúde, Bem Estar e Envelhecimento (SABE). Foram conduzidos modelos de regressão para analisar as características demográficas, socioeconômicas, comportamentais e relativas à saúde dos indivíduos associadas à limitação da mobilidade em cada onda do estudo, e análise multinível para a comparação entre as quatro ondas. Os resultados indicaram aumento nas prevalências de limitações na mobilidade autorreferida, mais evidente no ano de 2006. Foi observado, ainda, associação com condições crônicas de saúde, como a história de AVC (RP = 1,43; IC95%: 1,29; 1,58, em 2000), a presença de doenças osteoarticulares (RP = 1,35; IC95%: 1,23; 1,49, em 2015), e a queixa de "dor nas costas" (RP = 1,33; IC95%: 1,22; 1,45, em 2006), bem como com aspectos socioeconômicos, como a renda insuficiente (RP = 1,17; IC95%: 1,07; 1,28, em 2010). Em um contexto de envelhecimento populacional acelerado, esses resultados trazem informações relevantes para a promoção de políticas públicas voltadas à prevenção de declínio da mobilidade em pessoas idosas.


Este estudio tuvo como objetivo analizar la prevalencia de limitación en la movilidad funcional autoinformada y sus factores asociados durante el período entre los años 2000 y 2015, en ancianos residentes en el Municipio de São Paulo, Brasil. Para los análisis actuales se utilizaron los datos de cuatro oleadas (2000, 2006, 2010 y 2015) del Estudio Salud, Bienestar y Envejecimiento (SABE). Se aplicaron modelos de regresión para analizar las características demográficas, socioeconómicas, comportamentales y relativas a la salud de los individuos, asociadas a la limitación de la movilidad en cada oleada del estudio, y un análisis multinivel para la comparación entre las 4 oleadas. Los resultados indicaron un aumento en las prevalencias de limitaciones respecto a la movilidad autoinformada, pero fue evidente en el año 2006. Se observó, incluso, una asociación con las condiciones crónicas de salud, como un historial de ACV (RP = 1,43; IC95%: 1,29; 1,58, en 2000), la presencia de enfermedades osteoarticulares (RP = 1,35; IC95%: 1,23; 1,49, en 2015), y la queja de "dolor de espalda" (RP = 1,33; IC95%: 1,22; 1,45, en 2006), así como con aspectos socioeconómicos, como la renta insuficiente (RP = 1,17; IC95%: 1,07; 1,28, en 2010). En un contexto de envejecimiento poblacional acelerado, esos resultados presentan información relevante para la promoción de políticas públicas dirigidas a la prevención del declive de la movilidad en personas ancianas.


Subject(s)
Aging , Aged , Brazil/epidemiology , Humans , Multilevel Analysis , Prevalence , Self Report , Socioeconomic Factors
18.
BMJ Open ; 12(5): e054134, 2022 May 09.
Article in English | MEDLINE | ID: mdl-35534073

ABSTRACT

OBJECTIVES: Childcare practices determine the child nutritional outcomes, but resources for good practices are unequally distributed across socioeconomic status (SES). This study first examined the associations between social capital and childcare practices separately across SES groups. It then investigated the mediation effect of social capital between SES and childcare practices. DESIGN: This cross-sectional study used the Short Version of the Adapted Social Capital Assessment Tool to measure structural social capital (group membership, social support and citizenship activities) and cognitive social capital of mothers. Data were analysed using multilevel logistic regressions with random intercepts and mediation modellings. SETTING: Rural Lilongwe, Malawi. PARTICIPANTS: A total of 320 mothers with a child aged between 12 months and 23 months. PRIMARY OUTCOME MEASURES: Childcare practice outcomes included were minimum dietary diversity, handwashing and complete vaccination. RESULTS: Among structural social capital dimensions, social support was found to be positively associated with minimum dietary diversity (adjusted OR (AOR)=1.44, 95% CI 1.22 to 1.71; p<0.001) and handwashing for all mothers (AOR=1.42, 95% CI 1.23 to 1.64; p<0.001). In the subgroup analysis, the higher SES group had higher odds of meeting the minimum dietary diversity (AOR=1.63, 95% CI 1.18 to 2.26; p=0.01) and handwashing with increased social support (AOR=1.53, 95% CI 1.13 to 2.08; p=0.01) than the lower SES. The mediation effect of social support accounted for 27.3% of the total effect between SES and minimum dietary diversity. Cognitive social capital was negatively associated with vaccination for the lower SES group (AOR=0.07, 95% CI 0.01 to 0.68; p=0.03). CONCLUSIONS: To improve feeding and handwashing practices and to reduce health inequalities in rural Malawi, governments and organisations should consider promoting the value of social support and health. Future research is needed to explain the negative association between cognitive social capital and vaccination among the lower SES group.


Subject(s)
Social Capital , Child , Child Care , Cross-Sectional Studies , Female , Humans , Infant , Malawi , Social Class , Socioeconomic Factors
19.
BMC Infect Dis ; 22(1): 421, 2022 May 02.
Article in English | MEDLINE | ID: mdl-35501702

ABSTRACT

BACKGROUND: Immunization plays a vital role in child health and survival. Zero-dose children are coming increasingly into focus as part of the global Immunization Agenda 2030. Although the percentage of zero-dose children has decreased in Turkey over time, regional/socioeconomic inequalities persist. This study aims to analyze the trend in zero-dose children and the factors associated with this problem in Turkey in light of regional inequalities. METHODS: Six data sets (1993, 1998, 2003, 2008, 2013, and 2018) were pooled from the last six Turkey Demographic and Health Surveys (TDHSs). The vaccination module for children aged 12-35 months and variables related to household characteristics, socio-economic, cultural characteristics of parents, bio-demographic/health-related factors were taken from the DHS data. Binary logistic regression analyses were carried out by taking into account the complex sample design of surveys for Turkey in general, the East region, and other regions. RESULTS: Significant progress has been made in reducing the number of zero-dose children in Turkey over the last three decades, as it has dropped from 3.2 to 0.9%. The results of multivariate analyses revealed that survey year, household wealth, the mother's level of education, payment of bride price, mother's native language, place of delivery, and the number of antenatal care visits are associated with zero-dose children. Factors associated with zero-dose children also differ between the East region, and other regions. CONCLUSION: Public health programs targeting uneducated parents, poor households, lack of social security, Kurdish-speaking mothers, older mothers and those without antenatal care should be implemented to promote childhood immunization.


Subject(s)
Immunization , Mothers , Child , Educational Status , Female , Humans , Pregnancy , Socioeconomic Factors , Turkey/epidemiology
20.
BMC Public Health ; 22(1): 878, 2022 May 03.
Article in English | MEDLINE | ID: mdl-35501795

ABSTRACT

BACKGROUND: Researchers and policymakers are increasingly concerned that personalisation schemes in social and health care might be worsening social and health inequities. This has been found internationally, where better outcomes from such schemes have been found amongst those who have higher education and more household income. METHOD: This study looks at one of the world's largest personalisation schemes, the Australian National Disability Insurance Scheme. Using publicly available data we examine the allocation and utilisation of NDIS funds according to social gradient. RESULTS: We find that the rate at which people with disability 'spend' or effectively use their disability care funds follows a social gradient. That is, those in areas of higher socioeconomic disadvantage are not spending as much of their allocated budgets on care services across the year compared to people in areas of higher socioeconomic advantage. This represents a clear issue of equity in the use of public money to people with disability in Australia. CONCLUSION: We argue that this points to the need to provide targeted supports for the use of disability care funds in areas of higher socioeconomic disadvantage. Without effective supports for fund use, the NDIS and other personalisation schemes may be positioned to worsen existing social inequalities.


Subject(s)
Insurance, Disability , Australia , Budgets , Humans , Socioeconomic Factors
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