Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 43.434
Filtrar
2.
Ann Med ; 53(1): 581-586, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33825598

RESUMEN

Although coronavirus disease 2019 (COVID-19) is a pandemic, it has several specificities influencing its outcomes due to the entwinement of several factors, which anthropologists have called "syndemics". Drawing upon Singer and Clair's syndemics model, I focus on synergistic interaction among chronic kidney disease (CKD), diabetes, and COVID-19 in Pakistan. I argue that over 36 million people in Pakistan are standing at a higher risk of contracting COVID-19, developing severe complications, and losing their lives. These two diseases, but several other socio-cultural, economic, and political factors contributing to structured vulnerabilities, would function as confounders. To deal with the critical effects of these syndemics the government needs appropriate policies and their implementation during the pandemic and post-pandemic. To eliminate or at least minimize various vulnerabilities, Pakistan needs drastic changes, especially to overcome (formal) illiteracy, unemployment, poverty, gender difference, and rural and urban difference.


Asunto(s)
/epidemiología , Diabetes Mellitus/epidemiología , Pandemias/prevención & control , Insuficiencia Renal Crónica/epidemiología , Sindémico , /prevención & control , Cambio Climático/economía , Cambio Climático/estadística & datos numéricos , Factores de Confusión Epidemiológicos , Países en Desarrollo/economía , Países en Desarrollo/estadística & datos numéricos , Diabetes Mellitus/economía , Diabetes Mellitus/prevención & control , Abastecimiento de Alimentos/economía , Abastecimiento de Alimentos/estadística & datos numéricos , Alfabetización en Salud/economía , Alfabetización en Salud/estadística & datos numéricos , Humanos , Pakistán/epidemiología , Pandemias/economía , Política , Pobreza/economía , Pobreza/estadística & datos numéricos , Insuficiencia Renal Crónica/economía , Insuficiencia Renal Crónica/prevención & control , Desempleo/estadística & datos numéricos
3.
Artículo en Inglés | MEDLINE | ID: mdl-33800525

RESUMEN

This research investigates the relationships between airborne and depositional industrial lead emission concentrations modeled using Environmental Protection Agency's (EPA's) American Meteorological Society/Environmental Protection Agency Regulatory Model (AERMOD) and childhood blood lead levels (BLL) in the Detroit Metropolitan Area (DMA) 2006-2013. Linear and mediation interaction regression models estimated the effects of older housing and airborne and depositional lead emission concentrations on black and white childhood BLLs, controlling for neighborhood levels of racial isolation and poverty-important social structures in the DMA. The results showed a direct relationship between airborne and depositional lead emissions and higher childhood BLL, after controlling for median housing age. Lead emissions also exacerbated the effect of older housing on black and white children's BLLs (indirect relationship), after controlling for social structures. Findings from this research indicate that black and white children exposed to lead-based paint/pipes in older housing are further impacted by industrial lead pollution that may lead to permanent neurological damage.


Asunto(s)
Intoxicación por Plomo , Plomo , Anciano , Niño , Exposición a Riesgos Ambientales , Vivienda , Humanos , Intoxicación por Plomo/epidemiología , Pobreza , Características de la Residencia
4.
Artículo en Inglés | MEDLINE | ID: mdl-33806590

RESUMEN

Menstrual hygiene management and health is increasingly gaining policy importance in a bid to promote dignity, gender equality and reproductive health. Effective and adequate menstrual hygiene management requires women and girls to have access to their menstrual health materials and products of choice, but also extends into having private, clean and safe spaces for using these materials. The paper provides empirical evidence of the inequality in menstrual hygiene management in Kinshasa (DRC), Ethiopia, Ghana, Kenya, Rajasthan (India), Indonesia, Nigeria and Uganda using concentration indices and decomposition methods. There is consistent evidence of wealth-related inequality in the conditions of menstrual hygiene management spaces as well as access to sanitary pads across all countries. Wealth, education, the rural-urban divide and infrastructural limitations of the household are major contributors to these inequalities. While wealth is identified as one of the key drivers of unequal access to menstrual hygiene management, other socio-economic, environmental and household factors require urgent policy attention. This specifically includes the lack of safe MHM spaces which threaten the health and dignity of women and girls.


Asunto(s)
Higiene , Pobreza , República Democrática del Congo , Países en Desarrollo , Etiopía , Femenino , Ghana , Conocimientos, Actitudes y Práctica en Salud , Humanos , India , Indonesia , Kenia , Menstruación , Nigeria , Uganda
5.
Artículo en Inglés | MEDLINE | ID: mdl-33807727

RESUMEN

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.


Asunto(s)
Exposición Profesional , Salud Laboral , Países en Desarrollo , Personal de Salud , Humanos , Renta , Pobreza
6.
Artículo en Inglés | MEDLINE | ID: mdl-33808628

RESUMEN

The Supplemental Nutrition Assistance Program (SNAP) is designed to improve household diet and food security-a pressing problem confronting low-income families in the United States. Previous studies on the issue often ignored the methodological issue of endogenous program participation. We revisit this important issue by estimating a simultaneous equation system with ordinal household food insecurity. Data are drawn from the 2009-2011 Current Population Survey Food Security Supplement (CPS-FSS), restricted to SNAP-eligible households with children. Our results add to the stocks of empirical findings that SNAP participation ameliorates food insecurity among adults only, but increases the probabilities of low and very low food security among children. These contradictory results indicate that our selection approach with a single cross section is only partially successful, and that additional efforts are needed in further analyses of this complicated issue, perhaps with longitudinal data. Socio-demographic variables are found to affect food-secure households and food-insecure households differently, but affect SNAP nonparticipants and participants in the same direction. The state policy tools, such as broad-based categorical eligibility (BBCE) and simplified reporting, can encourage SNAP participation and thus ameliorate food insecurity. Our findings can inform policy deliberations.


Asunto(s)
Asistencia Alimentaria , Adulto , Niño , Composición Familiar , Abastecimiento de Alimentos , Humanos , Pobreza , Estados Unidos
7.
Wien Klin Wochenschr ; 133(Suppl 1): 1-21, 2021 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-33881635

RESUMEN

Pellagra is characterized by "dermatitis - diarrhea - dementia - death". Various causes were discussed over the course of two centuries. The initial presumption was that the sun caused changes in exposed areas of the body. The "Zeïsts" blamed the maize (corn), which forms the main constituent in the diet of poor peoples, for being an insufficient nutrient and thus causing the pellagra in such indigent populations. The "Toxikozeïsts", however, regarded toxins produced by innocuous bacteria and fungi in unripe or in ripe but badly stored maize or in maize flour or in poorly baked maize bread as the cause of pellagra. Pellagra as an allergic disease was also discussed. Self-experiments of Goldberger's group in 1916 and finally Elvehjem's detection of niacin deficiency in maize in 1937 solved the problem.In the Austrian empire and (from 1867 on) in the Austro-Hungarian monarchy, pellagra was diagnosed and combated in the provinces of Küstenland, Tirolia and Bukovina and in Hungary. Originally believing in the noxiousness of maize in the poor population, extensive measures were planned and partially executed. Primarily measures for providing salubrious maize products were planned for the population, such as public bakeries and eating houses, kilns and storage houses for maize. For the treatment of pellagra patients, so-called pellagrosaria and auxiliary hospitals were established and the number of general practitioners was increased. It was also important to educate the population about preventing pellagra by consuming proper food. Pellagra funds to sustain the measures were established. In the provinces, pellagra commissions, chaired by the governor and consisting of twelve experts of the relevant medical branches, were appointed as an advisory and expert body.


Asunto(s)
Pelagra , Austria , Diarrea , Humanos , Hungría , Pelagra/epidemiología , Pobreza
9.
Artículo en Inglés | MEDLINE | ID: mdl-33804888

RESUMEN

A poor start in life shapes children's development over the life-course. Children from low- and middle-income countries (LMICs) are exposed to low levels of early stimulation, greater socioeconomic deprivation and persistent environmental and health challenges. Nevertheless, little is known about country-specific factors affecting early childhood development (ECD) in LMICs. Using data from 68 LMICs collected as part of the Multiple Indicator Cluster Surveys between 2010 and 2018, along with other publicly available data sources, we employed a multivariate linear regression analysis at a national level to assess the association between the average Early Childhood Development Index (ECDI) in children aged 3-5 and country-level ecological characteristics: early learning and nurturing care and socioeconomic and health indicators. Our results show that upper-middle-income country status, attendance at early childhood education (ECE) programs and the availability of books at home are positively associated with a higher ECDI. Conversely, the prevalence of low birthweight and high under-5 and maternal mortality are negatively associated with ECDI nationally. On average, LMICs with inadequate stimulation at home, higher mortality rates and without mandatory ECE programs are at greater risks of poorer ECDI. Investment in early-year interventions to improve nurturing care and ECD outcomes is essential for achieving Sustainable Development Goals.


Asunto(s)
Países en Desarrollo , Renta , Niño , Desarrollo Infantil , Preescolar , Humanos , Mortalidad Materna , Pobreza
10.
Artículo en Inglés | MEDLINE | ID: mdl-33805614

RESUMEN

This study examined the life-motivating values of residents in underserved minority communities to inform the development of community engagement strategies. Semi-structured interviews were conducted to explore the main research questions: (1) what were the values of research participants, and (2) what did they consider important in their lives? The participants included twenty-seven ethnically diverse individuals living in low-income neighborhoods in New York City (NYC). Thematic analysis was performed to identify common themes and patterns related to the values that participants considered important in their lives. Three broad themes were identified: (1) benevolence; (2) universalism, and (3) self-direction. Benevolence implies a sense of belonging as the central meaning in life; community engagement strategies focused on this value emphasize concern for the welfare of loved ones. Community engagement strategies focused on universalism emphasize social justice and concern for the environment and the world. Finally, community engagement strategies focused on self-direction seek to satisfy participants' needs for control, autonomy, and mastery. This study introduces the Value-Based Framework for Community-Centered Research. It illustrates how value exploration is central to a community-centered approach to public health research and can be an important first step for designing studies that are better aligned with community needs and contexts. Such an approach can also help to co-create a "research identity" with community members and integrate their values into a project's purpose, thereby increasing community ownership and engagement in the study.


Asunto(s)
Comunicación , Salud Pública , Humanos , Ciudad de Nueva York , Pobreza , Características de la Residencia
11.
J Youth Adolesc ; 50(5): 872-892, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33829400

RESUMEN

Because the demographic composition of neighborhoods and schools overlaps, their effects on educational attainment are not independent of each other. Throughout the early teenage years, the timing and duration of exposure to neighborhood and school contexts can vary, advocating for a longitudinal approach when studying schooling outcomes. This study uses Avon Longitudinal Study of Parents and Children data (N = 4502; 49% female) to examine how exposure to poverty between ages 10-16 predicts educational attainment. The results indicate that enduring exposure to neighborhood poverty relates to educational attainment, while timing does not. For school poverty, longer exposure is related to lower attainment, but earlier exposure has a stronger impact than later exposure. Adolescents who were exposed to poverty in both contexts for the full observation period had the lowest educational attainment. The findings highlight the importance of understanding when and how long adolescents are exposed to contextual poverty.


Asunto(s)
Pobreza , Instituciones Académicas , Adolescente , Niño , Escolaridad , Femenino , Humanos , Estudios Longitudinales , Masculino , Características de la Residencia
12.
Medicine (Baltimore) ; 100(15): e25399, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847636

RESUMEN

ABSTRACT: Obesity is associated with detrimental changes in cardiovascular and metabolic parameters, including blood pressure, dyslipidemia, markers of systemic inflammation, and insulin resistance. In the elderly living with the human immunodeficiency virus (EPLHIV), and being treated with antiretroviral medications, the obesity complications escalate and expose the elderly to the risk of noncommunicable diseases. Given that over 3 million EPLHIV in sub-Sahara Africa, we assessed the prevalence of obesity and its associated factors among EPLHIV in a low-resource setting.This was a cross sectional study of EPLHIV aged 50 years and older, being treated with antiretroviral medications from 2004 to 2018. HIV treatment data collected from multiple treatment sites were analyzed. Baseline characteristics of the participants were described, and multivariable relative risk model was applied to assess the associations between obesity (body mass index [BMI] ≥30 kg/m2) and the prespecified potential risk factors.Of the 134,652 in HIV cohort, 19,566 (14.5%) were EPLHIV: 12,967 (66.3%) were normal weight (18.5 ≤ BMI < 25), 4548 (23.2%) were overweight (25 ≤ BMI < 30), while 2,051 (10.5%) were obese (BMI ≥30). The average age the normal weight (57.1; standard deviation 6.6) and the obese (56.5; standard deviation 5.5) was similar. We observed that being an employed (relative risk [RR] 1.71; 95% confidence interval [CI] 1.48-2.00; P < .001), educated (RR 1.93; 95% CI 1.54-2.41; P < .001), and presence of hypertension (RR 1.78; 95% CI 1.44-2.20; P < .001), increased the risk of obesity. Also, being male (RR 0.38; 95% CI 0.33-0.44; P < .001), stages III/IV of the World Health Organization clinical stages of HIV (RR 0.58; 95% CI 0.50-0.68; P < .001), tenofovir-based regimen (RR 0.84; 95% CI 0.73-0.96, P < .001), and low CD4 count (RR 0.56; 95% CI 0.44-0.71; P < .001) were inversely associated with obesity.This study demonstrates that multiple factors are driving obesity prevalence in EPLHIV. The study provides vital information for policy-makers and HIV program implementers in implementing targeted-interventions to address obesity in EPLHIV. Its findings would assist in the implementation of a one-stop-shop model for the management of HIV and other comorbid medical conditions in EPLHIV.


Asunto(s)
Infecciones por VIH/epidemiología , Sobrepeso/epidemiología , Pobreza , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/epidemiología , África del Sur del Sahara/epidemiología , Anciano , Antirretrovirales/uso terapéutico , Índice de Masa Corporal , Recuento de Linfocito CD4 , Estudios Transversales , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Factores Socioeconómicos
13.
Gac Sanit ; 35 Suppl 1: S30-S32, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33832620

RESUMEN

OBJECTIVE: The large-scale social distancing policy conducted twice was unable to reduce the rate of development of COVID-19 widespread in Makassar, yet it increased. One of the causes was that social awareness is still lacking especially for people in the poverty line. This study attempts to describe the social behavior of people in poverty line toward COVID-19 case in Makassar. METHOD: This research is a qualitative descriptive study based on the case. The data analysis was undertaken qualitatively. RESULTS: The results revealed that the limited understanding of people in poverty line about COVID-19 and health protocols makes their behavior indifferent and disobedient to health protocols. In addition, the government's top-down approach to deal with COVID-19 pandemic was ineffective. However, bottom-up collaborative interventions need to be carried out through a group approach to gain an understanding of the COVID-19 health protocol, especially for people in poverty line and other vulnerable groups.


Asunto(s)
/prevención & control , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Colaboración Intersectorial , Pandemias , Pobreza , Participación de los Interesados , /epidemiología , /transmisión , Participación de la Comunidad , Agencias Gubernamentales , Política de Salud , Humanos , Indonesia/epidemiología , Administración en Salud Pública , Investigación Cualitativa , Responsabilidad Social , Participación de los Interesados/psicología , Población Urbana
16.
Wiad Lek ; 74(3 cz 2): 678-683, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33843634

RESUMEN

OBJECTIVE: The aim: To study the difference in health care expenditures in groups of countries with different GNI per capita. PATIENTS AND METHODS: Materials and methods: In 4 groups of countries with different GNI per capita were analyzed indicators of Current health expenditure per capita ($) (СHE), Domestic general government health expenditure per capita, PPP ($) (GGHE $) and GGHE%, Domestic private health expenditure per capita, PPP ($) (PHE) and PHE%, Out-of-pocket expenditure (%) (OOP), Current health expenditure (% of GDP) (CHE% GDP). RESULTS: Results: The group of high-income countries differs by CHE, GGHE $, GGHE%, PHE $, PHE%, OOP, CHE% GDP (p <0.001), the group with incomes above the average - by CHE, GGHE $, PHE $, PHE%, CHE%GDP (p <0.001). Groups with lower average income and low income do not differ in CHE, GGHE$, PHE$, PHE%, OOP (p> 0.05). GNI per capita has a positive effect on GDP%GDP, CHE, GGHE, PHE in the high-income group and negatively affects the OOP (p <0.05), GNI per capita has a positive effect on CHE, GGHE in the above-average income group, GNI per capita has a positive effect on CHE, GGHE, GGHE%, PHE and negatively affects OOP (p <0.05) in the income group below average. GNI per capita has a positive effect on the OOP and negatively affects the CHE%GDP (p <0.05) in the low-income group. CONCLUSION: Conclusions: Each group of countries, depending on per capita income, has its own health care costs.


Asunto(s)
Costos de la Atención en Salud , Gastos en Salud , Humanos , Pobreza
17.
Artículo en Inglés | MEDLINE | ID: mdl-33672237

RESUMEN

Neglected Tropical Diseases (NTDs) trap individuals in a cycle of poverty through their devastating effects on health, wellbeing and social-economic capabilities that extend to other axes of inequity such as gender and/or ethnicity. Despite NTDs being regarded as equity tracers, little attention has been paid toward gender dynamics and relationships for gender-equitable access to NTD programs in sub-Saharan Africa (SSA). This paper examines the impact of NTDs on women's health and wellbeing in SSA using Kenya as a case study. This research is part of a larger research program designed to examine the impact of NTDs on the health and wellbeing of populations in Kenya. Thematic analysis of key informants' interviews (n = 21) and focus groups (n = 5) reveals first that NTDs disproportionately affect women and girls due to their assigned gender roles and responsibilities. Second, women face financial and time constraints when accessing health care due to diminished economic power and autonomy. Third, women suffer more from the related social consequences of NTDs (that is, stigma, discrimination and/or abandonment), which affects their health-seeking behavior. As such, we strongly suggest a gender lens when addressing NTD specific exposure, socio-economic inequities, and other gender dynamics that may hinder the successful delivery of NTD programs at the local and national levels.


Asunto(s)
Enfermedades Desatendidas , Salud de la Mujer , Prestación de Atención de Salud , Femenino , Humanos , Kenia/epidemiología , Enfermedades Desatendidas/epidemiología , Pobreza
18.
Lancet ; 397(10282): 1388-1399, 2021 04 10.
Artículo en Inglés | MEDLINE | ID: mdl-33691094

RESUMEN

13 years after the first Lancet Series on maternal and child undernutrition, we reviewed the progress achieved on the basis of global estimates and new analyses of 50 low-income and middle-income countries with national surveys from around 2000 and 2015. The prevalence of childhood stunting has fallen, and linear growth faltering in early life has become less pronounced over time, markedly in middle-income countries but less so in low-income countries. Stunting and wasting remain public health problems in low-income countries, where 4·7% of children are simultaneously affected by both, a condition associated with a 4·8-times increase in mortality. New evidence shows that stunting and wasting might already be present at birth, and that the incidence of both conditions peaks in the first 6 months of life. Global low birthweight prevalence declined slowly at about 1·0% a year. Knowledge has accumulated on the short-term and long-term consequences of child undernutrition and on its adverse effect on adult human capital. Existing data on vitamin A deficiency among children suggest persisting high prevalence in Africa and south Asia. Zinc deficiency affects close to half of all children in the few countries with data. New evidence on the causes of poor growth points towards subclinical inflammation and environmental enteric dysfunction. Among women of reproductive age, the prevalence of low body-mass index has been reduced by half in middle-income countries, but trends in short stature prevalence are less evident. Both conditions are associated with poor outcomes for mothers and their children, whereas data on gestational weight gain are scarce. Data on the micronutrient status of women are conspicuously scarce, which constitutes an unacceptable data gap. Prevalence of anaemia in women remains high and unabated in many countries. Social inequalities are evident for many forms of undernutrition in women and children, suggesting a key role for poverty and low education, and reinforcing the need for multisectoral actions to accelerate progress. Despite little progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as improvements since 2000 might be offset by the COVID-19 pandemic.


Asunto(s)
Trastornos de la Nutrición del Niño/epidemiología , Trastornos de la Nutrición del Niño/prevención & control , Países en Desarrollo , Desnutrición/epidemiología , Desnutrición/prevención & control , Adulto , Índice de Masa Corporal , Lactancia Materna , Niño , Escolaridad , Femenino , Humanos , Madres , Pobreza , Determinantes Sociales de la Salud
19.
Ugeskr Laeger ; 183(11)2021 03 15.
Artículo en Danés | MEDLINE | ID: mdl-33734073

RESUMEN

The COVID-19 pandemic may not only increase mortality due to the virus but also due to the indirect effects. The disease continues to ravage health and economic metrics globally, which is likely to increase maternal and under five-year child mortality in low- and middle-income countries. This review highlights key areas of concern for maternal and under five-year child mortality due to the indirect effects of the COVID-19 pandemic in low- and middle-income countries.


Asunto(s)
/epidemiología , Países en Desarrollo/estadística & datos numéricos , Mortalidad Materna , Madres/estadística & datos numéricos , Pandemias , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Desnutrición/epidemiología , Servicios de Salud Materna , Salud Mental , Pobreza , Embarazo , Complicaciones Infecciosas del Embarazo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...