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1.
Int J Equity Health ; 20(1): 106, 2021 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-33902603

RESUMEN

BACKGROUND: Partial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic. METHODS: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities. RESULTS: Most participants reported their health status as "very good" (39.0%) or "excellent" (42.3%). CCI of SRH and mental health were - 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%), p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health). CONCLUSIONS: Per capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups.


Asunto(s)
Disparidades en el Estado de Salud , Renta/estadística & datos numéricos , Adulto , China/epidemiología , Femenino , Humanos , Masculino , Factores Socioeconómicos , Encuestas y Cuestionarios
2.
Rev Lat Am Enfermagem ; 29: e3409, 2021.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-33852681

RESUMEN

OBJECTIVE: to identify indicators that can be used in the management of Mental Health Services. METHOD: an integrative review in which we adopted the Population, Concept, and Context strategy to formulate the following Guiding Question: "Which indicators can be used for the management of mental health services?". RESULTS: a total of 22 articles were included and divided into two main groups: countries with initial high income (54%) as well as low- and middle-income countries (46%). We identified 5 studies that had experienced the use of indicators, 5 studies that had reported partial implementation, 9 studies that did not report use or implementation, 1 study on the indicator selection process, 1 as an implementation pilot, and a final study with a discussion for implementation. High-income countries also find it difficult to implement mental health indicators. The main difficulties in adopting the use of indicators are lack of basic mental health services, financial resources, legislation, political interest, and guidelines for its management. CONCLUSION: it is unusual to find a descriptive comparison of quality monitoring programs at the system level in the technical-scientific literature related to mental health indicators.


Asunto(s)
Servicios de Salud Mental , Humanos , Renta
3.
Rev Bras Epidemiol ; 24(suppl 1): e210016, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33886889

RESUMEN

AIM: This research analyzed a joint spatial distribution and explored the possible associations between epidemiological aspects and feminicide rates, in towns of the Sergipe State in Northeastern Brazil. METHODOLOGY: An exploratory ecological study investigated the global spatial autocorrelation of epidemiological aspects with femicide rates from towns in Sergipe State, Brazil, (n = 75), in the 2013-2017 period, using the "global" and "local" Moran statistic method and a multiple spatial regression. The exposure variables included socioeconomic and demographic conditions, services and health condition, and femicide rates. We used the software Stata 11.0, SPSS 18.0 and GeoDa 0.95-i. RESULTS: The spatial distribution of femicide rates was not random and showed high spatial autocorrelation and predominance of significant spatial groupings of towns with the highest mortality rates due to femicide in the central region of Sergipe State. In the multiple regression analysis, the percentage of women in charge of families and the Municipal Human Development Index were positively associated with the femicide rates in towns in Sergipe's municipalities in the studied period (p < 0.05). The opposite situation occurred between the Income Concentration Index (GINI) and the femicide rates. CONCLUSION: This is the first study that has analyzed the factors associated with the spatial clusters of femicide rates in a geographical space where there is a predominance of patriarchal culture. There was a femicide increase in locations with the lowest social inequality, the highest human development and authority exercised by women in the family environment.


Asunto(s)
Composición Familiar , Renta , Brasil/epidemiología , Ciudades , Femenino , Geografía , Humanos , Factores Socioeconómicos
4.
JAMA Netw Open ; 4(4): e217373, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33825836

RESUMEN

Importance: An accurate understanding of the distributional implications of public health policies is critical for ensuring equitable responses to the COVID-19 pandemic and future public health threats. Objective: To identify and quantify the association of race/ethnicity-based, sex-based, and income-based inequities of state-specific lockdowns with 6 well-being dimensions in the United States. Design, Setting, and Participants: This pooled, repeated cross-sectional study used data from 14 187 762 households who participated in phase 1 of the population-representative US 2020 Household Pulse Survey (HPS). Households were invited to participate by email, text message, and/or telephone as many as 3 times. Data were collected via an online questionnaire from April 23 to July 21, 2020, and participants lived in all 50 US states and the District of Columbia. Exposures: Indicators of race/ethnicity, sex, and income and their intersections. Main Outcomes and Measures: Unemployment; food insufficiency; mental health problems; no medical care received for health problems; default on last month's rent or mortgage; and class cancellations with no distance learning. Race/ethnicity, sex, income, and their intersections were used to measure distributional implications across historically marginalized populations; state-specific, time-varying population mobility was used to measure lockdown intensity. Logistic regression models with pooled repeated cross-sections were used to estimate risk of dichotomous outcomes by social group, adjusted for confounding variables. Results: The 1 088 314 respondents (561 570 [51.6%; 95% CI, 51.4%-51.9%] women) were aged 18 to 88 years (mean [SD], 51.55 [15.74] years), and 826 039 (62.8%; 95% CI, 62.5%-63.1%) were non-Hispanic White individuals; 86 958 (12.5%; 95% CI, 12.4%-12.7%), African American individuals; 86 062 (15.2%; 95% CI, 15.0%-15.4%), Hispanic individuals; and 50 227 (5.6%; 95% CI, 5.5%-5.7%), Asian individuals. On average, every 10% reduction in mobility was associated with higher odds of unemployment (odds ratio [OR], 1.3; 95% CI, 1.2-1.4), food insufficiency (OR, 1.1; 95% CI, 1.1-1.2), mental health problems (OR, 1.04; 95% CI, 1.0-1.1), and class cancellations (OR, 1.1; 95% CI, 1.1-1.2). Across most dimensions compared with White men with high income, African American individuals with low income experienced the highest risks (eg, food insufficiency, men: OR, 3.3; 95% CI, 2.8-3.7; mental health problems, women: OR, 1.9; 95% CI, 1.8-2.1; medical care inaccessibility, women: OR, 1.7; 95% CI, 1.6-1.9; unemployment, men: OR, 2.8; 95% CI, 2.5-3.2; rent/mortgage defaults, men: OR, 5.7; 95% CI, 4.7-7.1). Other high-risk groups were Hispanic individuals (eg, unemployment, Hispanic men with low income: OR, 2.9; 95% CI, 2.5-3.4) and women with low income across all races/ethnicities (eg, medical care inaccessibility, non-Hispanic White women: OR, 1.8; 95% CI, 1.7-2.0). Conclusions and Relevance: In this cross-sectional study, African American and Hispanic individuals, women, and households with low income had higher odds of experiencing adverse outcomes associated with the COVID-19 pandemic and stay-at-home orders. Blanket public health policies ignoring existing distributions of risk to well-being may be associated with increased race/ethnicity-based, sex-based, and income-based inequities.


Asunto(s)
Control de Enfermedades Transmisibles/estadística & datos numéricos , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Renta/estadística & datos numéricos , Factores Sexuales , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Composición Familiar , Femenino , Disparidades en el Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Desempleo/estadística & datos numéricos , Estados Unidos , Adulto Joven
5.
Pediatr Dent ; 43(2): 123-128, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33892837

RESUMEN

Purpose: To investigate the association of diabetes and dental caries in U.S. adolescents in the National Health and Nutrition Examination Survey (NHANES). Methods: NHANES 2005 to 2010 data represented 24.38 million U.S. adolescents. Outcome variables were dental-caries-experience and untreated dental decay. Analyses included descriptive statistics and logistic regressions. Multivariable models controlling for known common confounding variables using weighted estimates for odds ratios (ORs) and 95% confidence intervals (CI). Results: Diabetes and prediabetes prevalence were 0.35 percent and 12.8 percent, respectively. Subjects with increased blood glucose and HbA1C had significantly greater dental caries (78.9 percent versus 56.3 percent) and (83.2 percent versus 56.2 percent, P<0.001) when compared to those with normal values. Fully adjusted models revealed that diabetic adolescents were more than twice as likely to experience dental caries compared to nondiabetic adolescents (OR=2.43, CI=2.39 to 2.47). Similarly, diabetic individuals were more likely to have untreated dental decay than non-diabetics (OR=3.37, CI=3.32 to 3.42). Conclusion: Diabetic adolescents, compared to nondiabetics, had higher odds of dental caries experience and untreated dental decay after controlling for age, race/ethnicity, gender, body mass index, family income-to-poverty ratio, and country of birth. This study highlights the need for continued interprofessional collaboration to address oral health in prediabetic and diabetic adolescents.


Asunto(s)
Caries Dental , Diabetes Mellitus , Adolescente , Caries Dental/epidemiología , Humanos , Renta , Encuestas Nutricionales , Salud Bucal , Prevalencia
6.
Artículo en Inglés | MEDLINE | ID: mdl-33801588

RESUMEN

This study aims to calculate the health-adjusted life years (HALE) by using years lived with disability (YLD) from the national claims data, as well as to identify the differences and inequalities in income level and region. The study was carried out on total population receiving health insurance and medical benefits. We calculated incidence-based YLD for 260 disease groups, and used it as the number of healthy years lost to calculate HALE. We adopted the insurance premium to calculate the income as a proxy indicator. For the region classification, we chose 250 Korean municipal-level administrative districts. Our results revealed that HALE increased from 2008 to 2018. HALE in males increased faster than that in females. HALE was higher in higher income levels. In 2018, the gap in HALE between Q1 and Q2, the lower income group, was about 5.57 years. The gap in females by income level was smaller than that in males. Moreover, the gap in HALE by region was found to increase. Results suggest that there is an inequality in YLD in terms of income level in Korea. Therefore, we need intensive management for the low-income group to promote HALE at the national level.


Asunto(s)
Renta , Esperanza de Vida , Femenino , Estado de Salud , Masculino , Años de Vida Ajustados por Calidad de Vida , República de Corea/epidemiología
7.
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
8.
Artículo en Inglés | MEDLINE | ID: mdl-33805068

RESUMEN

Off-farm diversification offers an important pathway out of poverty while health-impaired rural farmers can hardly seize the opportunity in developing countries. This paper investigates how chronic illness shapes livelihood structure and income generation in rural China. Our sample consists of 3850 rural households in Southern China and we rely on instrumental variable regressions to identify causal effects. We find that farmers with chronic illness tend to diversify towards local off-farm employments, rather than migrants, since local off-farm employments are more likely to act in a strategically complementary way to farming. Further analysis shows that income returns of diversification tend to be substantially higher for the health-impaired. While the relationship between diversification and income presents a conventional inverted U shape for the healthy, it is best categorized as upward sloping with diminishing marginal effects for farmers with chronic illness.


Asunto(s)
Composición Familiar , Renta , Agricultura , China/epidemiología , Enfermedad Crónica , Humanos , Población Rural
9.
J Am Dent Assoc ; 152(5): 369-376, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33810832

RESUMEN

BACKGROUND: The degree to which children experience unmet need for dental care during the COVID-19 pandemic and its association with pandemic-related household job or income loss are unknown. METHODS: The authors performed a cross-sectional household survey of 348 families in Pittsburgh, Pennsylvania, from June 25 through July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report. RESULTS: Caregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%), followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. The authors found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P = .022). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (relative risk, 1.77; 95% confidence interval, 1.08 to 2.88). CONCLUSIONS: In this sample, 3 times as many households reported unmet dental care for a child compared with unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred. PRACTICAL IMPLICATIONS: If unmet dental care continues as a result of the COVID-19 pandemic, nontraditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.


Asunto(s)
Pandemias , Niño , Estudios Transversales , Atención Odontológica , Accesibilidad a los Servicios de Salud , Humanos , Renta
10.
J Environ Manage ; 289: 112524, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-33838464

RESUMEN

Exploring the effectiveness of climate aid is crucial to distribute funds scientifically and maximize its impact. A body of related literature has estimated the impact of international climate aid on carbon emissions. However, these studies did not adequately consider the multi-dimensional heterogeneity of climate aid's carbon reduction effect. Based on national panel data of 77 recipients from 1980 to 2016, this study is the first to analyze the heterogeneous characteristics of climate aid's carbon reduction effect from three dimensions of emission level, aid level, and income level. Results show that, totally speaking, climate aid has a significant negative effect on carbon emissions in recipient countries. From the perspective of heterogeneity, climate aid has significant reduction effects for the recipient countries with middle-emission level. Meanwhile, climate aid also has significant negative effects on carbon emissions in recipient countries with high-aid level, i.e., only when the amount of aid reaches relatively high levels can climate aid play its role in reducing emissions. Furthermore, climate aid only conducts a significant reduction effect for middle-income recipients. This study recommends proposing a new collective quantified financial target, pursuing low-carbon economic development, optimizing the aid distribution, and enhancing capacity building to maximize the effectiveness of climate aid.


Asunto(s)
Dióxido de Carbono , Carbono , Cambio Climático , Desarrollo Económico , Renta
11.
Braz Oral Res ; 35: e040, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909862

RESUMEN

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


Asunto(s)
Renta , Salud Bucal , Anciano , Brasil/epidemiología , Estudios Transversales , Humanos , Estudios Longitudinales , Factores Socioeconómicos
12.
Artículo en Inglés | MEDLINE | ID: mdl-33802277

RESUMEN

Migrant health has been identified as one of the most pressing issues of the 21st century. Migration experiences are influenced by gender and gender norms and have important implications for the sexual health of migrant women. This systematic review explored socioecological factors influencing sexual health experiences and health outcomes of migrant Asian women living in "Western" high-income countries. PRISMA guidelines were followed and this study was registered with PROSPERO. Five academic databases were searched for peer-reviewed articles published between 2000 and 2019. Of 2415 studies retrieved, 17 met the selection criteria: 12 qualitative, 4 quantitative, and 1 mixed-methods study. The four levels of Bronfenbrenner's socioecological model were applied to examine the individual, interpersonal, institutional, and societal factors of influence. Most studies (n = 13) reported individual level factors, focusing on knowledge and use of contraceptives. At a societal level, host country sociocultural factors, including gender and cultural norms, influenced knowledge, ability to access and utilise contraceptives, and access to health services. Findings suggest that the public health policy, practice, and research to improve the sexual health of migrant women requires greater consideration of the intersecting factors of gender, culture, and the migration process.


Asunto(s)
Salud Sexual , Migrantes , Países Desarrollados , Femenino , Humanos , Renta , Evaluación de Resultado en la Atención de Salud
13.
Artículo en Inglés | MEDLINE | ID: mdl-33802430

RESUMEN

BACKGROUND: A systematic review synthesizing studies examining the determinants of dental service use drawing on the (extended) Andersen model is lacking. Hence, our purpose was to fill this knowledge gap; Methods: Three established electronic databases (PubMed, PsycInfo, as well as CINAHL) were searched. Observational studies focusing on the determinants of dental service use drawing on the Andersen model were included; Results: In sum, 41 studies have been included (ten studies investigating children/adolescents and 31 studies investigating adults). Among children, particularly higher age (predisposing characteristic), higher income (enabling resource) and more oral health problems (need factor) were associated with increased dental service use. Among adults, findings are, in general, less consistent. However, it should be noted that one half of the studies found an association between increased education (predisposing characteristic) and increased dental service. In general, study quality was rather high. However, it should be noted that most studies did not report how they dealt with missing data; Conclusions: Our systematic review revealed that all components (i.e., predisposing characteristics, enabling resources and need factors) of the Andersen model tend to be associated with dental service use among children, whereas the findings are more mixed among adults. In conclusion, beyond need factors, dental service use also tend to be driven by other factors. This may indicate over-or, more likely-underuse of dental services and could enrich the inequality discussion in dental services research.


Asunto(s)
Renta , Salud Bucal , Adolescente , Adulto , Niño , Escolaridad , Humanos
14.
Artículo en Inglés | MEDLINE | ID: mdl-33803141

RESUMEN

Background: The prevalence of dependency personality disorder is high among elderly individuals with a low level of social support. The objective of this study was to explore the dependency associated with important community resources among elderly individuals with a low level of social support from the perspective of resource demand. Methods: The population-based cross-sectional study was conducted in 22 locations in China. A total of 950 participants aged ≥60 years were selected using a complex multistage sampling design. All the data were collected using questionnaires via face-to-face interviews. The dependency was assessed using the standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II. Community resources were assessed using 43 items. Logistic regression analysis was used to evaluate the association between dependency and important community resources. Results: Bivariate analysis showed that the level of social support was negatively associated with levels of income (p < 0.001) and education (p = 0.008) and was positively associated with social communication and interactions (p < 0.001). The logistic regression analysis showed that the emergency call or survival monitoring system (ECSMS) was the most important community resource that was significantly associated with the levels of dependency; the odds ratio was 2.64 (95% CI, 1.07-3.91; p = 0.031) among elderly individuals with a low level of social support. Conclusions: The levels of dependency were most significantly associated with the ECSMS among elderly individuals with a low level of social support. Our results suggest that improving the ECSMS can be the main problem in the development of community resources.


Asunto(s)
Renta , Apoyo Social , Anciano , China , Estudios Transversales , Humanos , Oportunidad Relativa
15.
Artículo en Inglés | MEDLINE | ID: mdl-33804508

RESUMEN

The causal effect of public pensions on the mental wellbeing of the elderly in lower and middle-income countries deserves further investigation. This paper first constructed a theoretical framework for the impact of New Rural Society Pension Insurance pensions in China on the mental wellbeing of the rural elderly, and described potential channels through which pension income may affect mental wellbeing. We then used the fixed effect model and the instrument variable approach to estimate the casual effects of pension income on the mental wellbeing of the rural elderly. The results reveal that pension income improves mental wellbeing by relieving depression of the rural elderly; however, the beneficial effects of pension income are very limited. Pension income has no beneficial effects on the mental health of the rural elderly in the east region, whereas it slightly relieves depression of those in the middle and west regions. We also found that pension income produces small improvements in the mental health of older females, elderly persons living independently, and those with relatively poor economic conditions.


Asunto(s)
Seguro , Pensiones , Anciano , China , Femenino , Humanos , Renta , Población Rural
16.
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
17.
Artículo en Inglés | MEDLINE | ID: mdl-33807919

RESUMEN

BACKGROUND: Climate change influences patterns of human mobility and health outcomes. While much of the climate change and migration discourse is invested in quantitative predictions and debates about whether migration is adaptive or maladaptive, less attention has been paid to the voices of the people moving in the context of climate change with a focus on their health and wellbeing. This qualitative research aims to amplify the voices of migrants themselves to add nuance to dominant migration narratives and to shed light on the real-life challenges migrants face in meeting their health needs in the context of climate change. METHODS: We conducted 58 semi-structured in-depth interviews with migrants purposefully selected for having moved from rural Bhola, southern Bangladesh to an urban slum in Dhaka, Bangladesh. Transcripts were analysed using thematic analysis under the philosophical underpinnings of phenomenology. Coding was conducted using NVivo Pro 12. FINDINGS: We identified two overarching themes in the thematic analysis: Firstly, we identified the theme "A risk exchange: Exchanging climate change and health risks at origin and destination". Rather than describing a "net positive" or "net negative" outcome in terms of migration in the context of climate change, migrants described an exchange of hazards, exposures, and vulnerabilities at origin with those at destination, which challenged their capacity to adapt. This theme included several sub-themes-income and employment factors, changing food environment, shelter and water sanitation and hygiene (WaSH) conditions, and social capital. The second overarching theme was "A changing health and healthcare environment". This theme also included several sub-themes-changing physical and mental health status and a changing healthcare environment encompassing quality of care and barriers to accessing healthcare. Migrants described physical and mental health concerns and connected these experiences with their new environment. These two overarching themes were prevalent across the dataset, although each participant experienced and expressed them uniquely. CONCLUSION: Migrants who move in the context of climate change face a range of diverse health risks at the origin, en route, and at the destination. Migrating individuals, households, and communities undertake a risk exchange when they decide to move, which has diverse positive and negative consequences for their health and wellbeing. Along with changing health determinants is a changing healthcare environment where migrants face different choices, barriers, and quality of care. A more migrant-centric perspective as described in this paper could strengthen migration, climate, and health governance. Policymakers, urban planners, city corporations, and health practitioners should integrate the risk exchange into practice and policies.


Asunto(s)
Emigración e Inmigración , Migrantes , Bangladesh , Humanos , Renta , Áreas de Pobreza , Investigación Cualitativa
18.
Artículo en Inglés | MEDLINE | ID: mdl-33800177

RESUMEN

To compare African American (AA) and non-Hispanic White men living in same residential areas for the associations between educational attainment and household income with perceived discrimination (PD). The National Survey of American Life (NSAL), a nationally representative study, included 1643 men who were either African American (n = 1271) or non-Hispanic White (n = 372). We compared the associations between the two race groups using linear regression. In the total sample, high household income was significantly associated with lower levels of PD. There were interactions between race and household income, suggesting that the association between household income and PD significantly differs for African American and non-Hispanic White men. For non-Hispanic White men, household income was inversely associated with PD. For African American men, however, household income was not related to PD. While higher income offers greater protection for non-Hispanic White men against PD, African American men perceive higher levels of discrimination compared to White males, regardless of income levels. Understanding the role this similar but unequal experience plays in the physical and mental health of African American men is worth exploring. Additionally, developing an enhanced understanding of the drivers for high-income African American men's cognitive appraisal of discrimination may be useful in anticipating and addressing the health impacts of that discrimination. Equally important to discerning how social determinants work in high-income African American men's physical and mental health may be investigating the impact of the mental health and wellbeing of deferment based on perceived discrimination of dreams and aspirations associated with achieving high levels of education and income attainment of Black men.


Asunto(s)
Afroamericanos , Renta , Hombres , Racismo , Grupo de Ascendencia Continental Europea , Humanos , Masculino , Salud Mental , Estados Unidos
19.
Artículo en Inglés | MEDLINE | ID: mdl-33808312

RESUMEN

The International Health Regulations (2005) promote national capacity in core institutions so that countries can better detect, respond to and recover from public health emergencies. In accordance with the 'all hazards' approach to public health risk, this systematic review examines poisoning and toxic exposures in Myanmar. A systematic literature search was undertaken to find articles pertaining to poisoning in Myanmar published between 1998 and 2020. A number of poisoning risks are identified in this review, including snakebites, heavy metals, drugs of abuse, agrochemicals and traditional medicine. Patterns of poisoning presented in the literature diverge from poisoning priorities reported in other lower-middle income countries in the region. The experience of professionals working in a Yangon-based poison treatment unit also indicate that frequently observed poisoning as a result of pharmaceuticals, methanol, and petroleum products was absent from the literature. Other notable gaps in the available research include assessments of the public health burden of poisoning through self-harm, household exposures to chemicals, paediatric risk and women's occupational risk of poisoning. There is a limited amount of research available on poisoning outcomes and routes of exposure in Myanmar. Further investigation and research are warranted to provide a more complete assessment of poisoning risk and incidence.


Asunto(s)
Envenenamiento , Salud Pública , Niño , Femenino , Humanos , Renta , Metanol , Mianmar/epidemiología , Envenenamiento/epidemiología
20.
J Affect Disord ; 286: 99-107, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33714177

RESUMEN

BACKGROUND: Long working hours can be a risk factor for poor mental health; however, little is known about the potential factors moderating their relation. This study investigates the association between working hours and depressive symptoms, and explores the potential moderating effect of gender, income level, and job status on this association using a nationally representative sample of working population in South Korea. METHODS: Data of 7,082 workers aged 19 years or above were obtained from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted in 2014, 2016, and 2018 in South Korea. Working hours were categorized into 35-39, 40, 41-52, 53-68, and ≥69 hours/week. Depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). RESULTS: Individuals working ≥69 hours/week were more likely to have moderate to severe depressive symptoms compared to those working 40 hours/week. The association between longer working hours and depressive symptoms was especially prominent in female workers, standard wage workers, and workers with low income levels. We observed significant partial mediation pathways between working hours and PHQ-9 scores through both perceived usual stress level and self-rated health in the total sample. LIMITATIONS: The cross-sectional design of the study limits causal interpretation of the findings. CONCLUSION: Working longer than the legal upper limit of 52 hours/week puts workers at a greater risk for depression. Females, low-income workers, and wage workers are more vulnerable to the negative consequences of long working hours on mental health.


Asunto(s)
Depresión , Empleo , Adulto , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Renta , República de Corea/epidemiología , Adulto Joven
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