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1.
JAMA Netw Open ; 6(1): e2251524, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36656577

RESUMO

Importance: Although access to pediatric cancer care has implications for use of such care and patient outcomes, little is known about the geographic accessibility of pediatric cancer care and how it may vary by population characteristics across the continental US. Objective: To estimate the travel time to pediatric cancer care settings in the continental US, identify potential disparities among subgroups of children and adolescents and young adults (AYAs), and identify areas needing improved access to pediatric cancer care. Design, Setting, and Participants: This cross-sectional study collected data from August 1 to December 1, 2021. Pediatric oncologists' service locations in 2021 served as the pediatric cancer care settings, data for which were scraped from 2 websites containing information about health professionals. Demographic characteristics for younger children and AYAs aged 0 to 21 years were obtained from the 2015 to 2019 American Community Survey 5-year estimates. Data were analyzed from January 1 to April 31, 2022. Main Outcomes and Measures: The main outcome was the travel time from geographic centroids of zip code tabulation areas to the nearest pediatric oncologist. The median (IQR) travel times for each demographic subgroup were estimated. Per capita pediatric oncologist supply was calculated by dividing the total number of pediatric oncologists for each state or US Census division by its population. Results: Of the 90 498 890 children and AYAs included in the study, 63.6% were estimated to travel less than 30 minutes and 19.7% to travel between 30 and 60 minutes (for a total of 83.3%) to the nearest pediatric oncologist. Median (IQR) travel times were longest for the American Indian or Alaska Native pediatric population (46 [16-104] minutes) and residents of rural areas (95 [68-135] minutes), areas with high deprivation levels (36 [13-72] minutes), and the South (24 [13-47] minutes) and Midwest (22 [11-51] minutes) compared with the general population of children and AYAs. The pediatric oncologist supply was lowest in Wyoming (0 oncologists per 100 000 pediatric population) and highest in Washington, DC (53.3 oncologists per 100 000 pediatric population). Pediatric oncologist supply across Census divisions was lowest in the Mountain division (3.3 oncologists per 100 000 pediatric population) and highest in the New England division (8.1 oncologists per 100 000 pediatric population). Conclusions and Relevance: Results of this study showed that most children and AYAs in the continental US had adequate access to pediatric cancer care, although disparities existed among racial and ethnic groups and residents in rural areas, areas with high deprivation levels, and some Southern and Midwestern states. Reducing these disparities may require innovative approaches, such as expanding the capabilities of local facilities and creating partnerships with adult oncology centers and primary care physicians.


Assuntos
Acesso aos Serviços de Saúde , Neoplasias , Adolescente , Adulto Jovem , Humanos , Criança , Estudos Transversais , Neoplasias/epidemiologia , Neoplasias/terapia , Etnicidade , Censos
2.
J Epidemiol Community Health ; 77(2): 81-88, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36600558

RESUMO

BACKGROUND: Emergency employment programmes during the 1930s and 1940s invested income, infrastructure and social services into communities affected by the Great Depression. We estimate the long-term associations of growing up in an area exposed to New Deal emergency employment in 1940 with cognitive functioning in later life. METHODS: Members of the Health and Retirement Study cohort (N=5095; mean age 66.3 at baseline) who were age 0-17 in 1940 were linked to their census record from that year, providing prospective information about childhood contextual and family circumstances. We estimated the association between subcounty-level emergency employment participation in 1940 and baseline cognition and rate of cognitive decline between 1998 and 2016. RESULTS: Compared with those living in the lowest emergency employment quintile in 1940, those who were exposed to moderate levels of emergency employment (third quintile) had better cognitive functioning in 1998 (b=0.092 SD, 95% CI 0.011 to 0.173), conditional on sociodemographic factors. This effect was modestly attenuated after adjusting for respondents' adult education, finances and health factors. There were no significant effects of area-level emergency employment on rate of cognitive decline. CONCLUSIONS: Exposure to New Deal employment policies during childhood is associated with long-term cognitive health benefits. This is partially explained by increases in educational attainment among those with greater levels of emergency employment activity in the place where they were raised. Future research should investigate which types of New Deal investments may most be related to long-term cognitive health, or if the associations we observe are due to co-occurring programmes.


Assuntos
Censos , Aposentadoria , Adulto , Humanos , Idoso , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Aposentadoria/psicologia , Estudos Prospectivos , Emprego/psicologia , Cognição
3.
PLoS One ; 18(1): e0278573, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36630356

RESUMO

This paper describes the development of an RStudio (now known as Posit) dashboard derived from the Integrated Postsecondary Educational Data System, the United States Census Bureau, and the Bureau of Labor Statistics and provides the user with institutional, community, and career information of IPEDS reporting higher education institutions in the United States and its territories. With this dashboard, users can select and learn about institutions, explore enrollment trends and demographics, compare outcomes, and correlate community and institutional variables. Users can also link degrees to career projections and wages. This paper explains how the dashboard was developed with examples of R programming language.


Assuntos
Censos , Ocupações , Estados Unidos , Previsões
4.
Health Rep ; 34(1): 16-31, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36716076

RESUMO

Background: This study described the differences in the hospitalization rates of First Nations children and youth living on and off reserve, Inuit children and youth living in Inuit Nunangat (excluding Nunavik), and Métis children and youth, relative to non-Indigenous children and youth and examined rate changes across 2006 and 2011. Data and methods: The 2006 and the 2011 Canadian Census Health and Environment Cohorts provided five years of hospital records that Statistics Canada linked to peoples' self-reported Indigenous identity as recorded on the census. Causes of hospitalizations were based on the most responsible diagnosis coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada, aggregated by chapter code. Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population. Rate ratios (RRs) were reported for each Indigenous group relative to non-Indigenous children and youth. Results: For the 2006 and the 2011 cohorts, ASHRs were generally higher among Indigenous children and youth than among non-Indigenous children and youth. For some health conditions, hospitalization patterns also varied across the two time periods within the given Indigenous groups. Among children, leading elevated RRs occurred for diseases of the respiratory system, the digestive system and injuries. Elevated mental health-related RRs were observed among all Indigenous groups for both cohort years of youth. Significant increases in mental health-related ASHRs were observed in 2011 compared with 2006 among all youth groups, except for Inuit youth living in Inuit Nunangat, possibly due in part to data limitations. Among Indigenous youth, elevated RRs were observed for pregnancy, childbirth and the puerperium, and for injuries. For all youth (except Inuit), childbirth-related ASHRs decreased in 2011 compared with 2006. Interpretation: Findings align with previously observed hospitalization disparities between Indigenous and non-Indigenous children and youth. These data enabled the tracking of changes over time to partly address national information gaps about population health outcomes for children and youth, namely hospitalization.


Assuntos
Censos , Índios Norte-Americanos , Gravidez , Feminino , Humanos , Criança , Adolescente , Canadá/epidemiologia , Hospitalização
5.
Sci Total Environ ; 858(Pt 3): 160216, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36402316

RESUMO

Monitoring carbon dioxide (CO2) emissions of urban areas is increasingly important to assess the progress towards the Paris Agreement goals for climate neutrality. Cities are currently voluntarily developing their local inventories, however, the approaches used across different cities are not systematically assessed, present consistency issues, neglect the biogenic fluxes and have restricted spatial and temporal resolution. In order to assess the accuracy of the urban emission inventories and provide information which is useful for planning local climate change mitigation actions, high resolution modelling approaches combined or evaluated with atmospheric observations are needed. This study presents a new high-resolution bottom-up (BU) model which provides hourly maps of all major components contributing to the local urban surface CO2 flux (i.e. building emissions, traffic emissions, human respiration, soil respiration, plant respiration, plant photosynthetic uptake) and can therefore be used for direct comparison with in-situ atmospheric observations and development of local scale atmospheric inversion methodologies. The model design aims to be simple and flexible using inputs that are available in most cities, facilitating transferability to different locations. The inputs are primarily based on open geospatial datasets, census information, road traffic monitoring and basic meteorological parameters. The model is applied on the city centre of Basel, Switzerland, for the year 2018 and the results are compared to a local inventory. It is demonstrated that the model captures the highly dynamic spatiotemporal variability of the urban CO2 fluxes according to main environmental drivers, population activity dynamics and geospatial information proxies. The annual modelled emissions from buildings and traffic are estimated 14.8 % and 9 % lower than the respective information derived by the local inventory. The differences are mainly attributed to the emissions from the industrial areas and the highways which are beyond the geographical coverage of the model.


Assuntos
Dióxido de Carbono , Censos , Humanos , Cidades , Geografia , Meteorologia
6.
Environ Res ; 219: 115180, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36584842

RESUMO

BACKGROUND: There is ample evidence that air pollution increases mortality risk, but most studies are based on modelled estimates of air pollution, while the subjective perception of air quality is scarcely assessed. We aimed to compare the effects of objective and subjective exposure to air pollution on cardiorespiratory mortality in Brussels, Belgium. METHODS: Data consisted of the 2001 Belgian census linked to registry-based mortality data for the follow-up period 2001-2014. We included individuals aged >30 years of age residing in Brussels at baseline (2001). Air pollution exposure was assessed with objective (modelled annual mean concentrations of PM2.5 in micrograms per cubic metre, µg/m3) and subjective indicators (poor self-reported air quality perception in the census). We used Cox Proportional Hazard models with age as the underlying time scale to evaluate associations with cardiovascular disease (CVD) and respiratory disease mortality, and separately, ischaemic heart disease (IHD), cerebrovascular disease, and COPD excluding asthma mortality. We specified single- and two-exposure models and evaluated effect modification by neighbourhood unemployment rate. RESULTS: 437,340 individuals were included at baseline. During follow-up (2001-2014), 22,821 (5%) individuals had died from CVDs and 8572 (2%) from respiratory diseases. In single-exposure models, PM2.5 was significantly associated with an increased risk in CVD and IHD mortality (e.g. for IHD, per 5 µg/m3 increase: Hazard Ratio, HR:1.22, 95%CI:1.08-1.37), and poor air quality perception with COPD excluding asthma mortality (HR:1.23, 95%CI:1.15-1.33). Associations remained significant in the two-exposure models, and additionally, perception was associated with respiratory disease mortality. Associations became gradually stronger with increasing neighbourhood unemployment rate [e.g. in the highest, Q3: PM2.5 and cerebrovascular disease mortality (HR:1.53, 95%CI:1.04-2.24)]. CONCLUSION: Our findings suggest that objective and subjective exposure to air pollution increased the risk of dying from cardiovascular and respiratory diseases respectively in Brussels. These results encourage policies reducing pollution load in Brussels whilst considering socio-economic inequalities.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Doenças Cardiovasculares , Transtornos Cerebrovasculares , Doença da Artéria Coronariana , Isquemia Miocárdica , Doença Pulmonar Obstrutiva Crônica , Transtornos Respiratórios , Doenças Respiratórias , Humanos , Adulto , Poluentes Atmosféricos/toxicidade , Poluentes Atmosféricos/análise , Material Particulado/toxicidade , Material Particulado/análise , Censos , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Doença da Artéria Coronariana/induzido quimicamente , Doenças Respiratórias/induzido quimicamente , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/induzido quimicamente , Percepção , Asma/induzido quimicamente
7.
Environ Res ; 216(Pt 1): 114517, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36220445

RESUMO

BACKGROUND: Exposure to green spaces is associated with improved mental health and may reduce risk of suicide. Here, we investigate the association between long-term exposure to residential surrounding greenness and suicide mortality. METHODS: We used data from the 2001 Belgian census linked to mortality register data (2001-2011). We included all registered individuals aged 18 years or older at baseline (2001) residing in the five largest urban areas in Belgium (n = 3,549,514). Suicide mortality was defined using the tenth revision of the World Health Organisation International Classification of Diseases (ICD-10) codes X60-X84, Y10-Y34, and Y870. Surrounding greenness was measured using the Normalized Difference Vegetation Index (NDVI) within a 300 m and 1,000 m buffer around the residential address at baseline. To assess the association between residential surrounding greenness and suicide mortality, we applied Cox proportional hazards models with age as the underlying time scale. Models were adjusted for age, sex, living arrangement, migrant background, educational attainment, neighbourhood socio-economic position. We additionally explored potential mediation by residential outdoor nitrogen dioxide (NO2) concentrations. Finally, we assessed potential effect modification by various socio-demographic characteristics of the population (sex, age, educational attainment, migrant background, and neighbourhood socio-economic position). Associations are expressed as hazard ratios and their 95% confidence intervals (CI) for an interquartile range (IQR) increase in residential surrounding greenness. RESULTS: We observed a 7% (95%CI 0.89-0.97) and 6% (95%CI 0.90-0.98) risk reduction of suicide mortality for an IQR increase in residential surrounding greenness for buffers of 300 m and 1,000 m, respectively. Furthermore, this association was independent of exposure to NO2. After stratification, the inverse association was only apparent among women, and residents of Belgian origin, and that it was stronger among residents aged 36 or older, those with high level of education, and residents of most deprived neighbourhoods. CONCLUSION: Our results suggest that urban green spaces may protect against suicide mortality, but this beneficial effect may not be equally distributed across all strata of the population.


Assuntos
Parques Recreativos , Suicídio , Humanos , Feminino , Estudos Longitudinais , Bélgica/epidemiologia , Dióxido de Nitrogênio , Censos
8.
BMC Public Health ; 22(1): 2262, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463132

RESUMO

BACKGROUND: Despite the civil registration and vital statistics (CRVS) system in Nepal operating for several decades, it has not been used to produce routine mortality statistics. Instead, mortality statistics rely on irregular surveys and censuses that primarily focus on child mortality. To fill this knowledge gap, this study estimates levels and subnational differentials in mortality across all ages in Nepal, primarily using CRVS data adjusted for incompleteness. METHODS: We analyzed death registration data (offline or paper-based) and CRVS survey reported death data, estimating the true crude death rate (CDR) and number of deaths by sex and year for each province and ecological belt. The estimated true number of deaths for 2017 was used with an extension of the empirical completeness method to estimate the adult mortality (45q15) and life expectancy at birth by sex and subnational level. Plausibility of subnational mortality estimates was assessed against poverty head count rates. RESULTS: Adult mortality in Nepal for 2017 is estimated to be 159 per 1000 for males and 116 for females, while life expectancy was estimated as 69.7 years for males and 73.9 years for females. Subnationally, male adult mortality ranges from 129 per 1000 in Madhesh to 224 in Karnali and female adult mortality from 89 per 1000 in Province 1 to 159 in Sudurpashchim. Similarly, male life expectancy is between 64.9 years in Karnali and 71.8 years in Madhesh and female male life expectancy between 69.6 years in Sudurpashchim and 77.0 years in Province 1. Mountain ecological belt and Sudurpashchim and Karnali provinces have high mortality and high poverty levels, whereas Terai and Hill ecological belts and Province 1, Madhesh, and Bagmati and Gandaki provinces have low mortality and poverty levels. CONCLUSIONS: This is the first use of CRVS system data in Nepal to estimate national and subnational mortality levels and differentials. The national results are plausible when compared with Global Burden of Disease and United Nations World Population Prospects estimates. Understanding of the reasons for inequalities in mortality in Nepal should focus on improving cause of death data and further strengthening CRVS data.


Assuntos
Doenças Desmielinizantes Hereditárias do Sistema Nervoso Central , Expectativa de Vida , Adulto , Recém-Nascido , Criança , Feminino , Masculino , Humanos , Nepal/epidemiologia , Censos
9.
Zhongguo Zhong Yao Za Zhi ; 47(21): 5817-5823, 2022 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-36471999

RESUMO

Imported medicinal materials are an important part of Chinese medicinal resources. To be specific, about 10% of the around 600 commonly used Chinese medicinal materials are from abroad, and the introduction of foreign medicinal materials has promoted the development of Chinese medicine. Amid the advancement of reform and opening up and the "Belt and Road" Initiative, major headway has been made in the cross-border trade in China, bringing opportunities for the import of medicinal materials from border ports. However, for a long time, there is a lack of systematic investigation on the types of exotic medicinal materials at border ports. In the fourth national census of traditional Chinese medicine resources, National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, together with several organizations, investigated the nearly 40 border ports, Chinese medicinal material markets, and border trade markets in 6 provinces/autonomous regions in China for the first time and recorded the types, sources, circulation, and the transaction characteristics of imported medicinal materials. Moreover, they invited experts to identify the origins of the collected 237 medicinal materials. In addition, the status quo and the problems of the medicinal materials were summarized. This study is expected to lay a basis for clarifying the market and origins of imported medicinal materials as well as the scientific research on and supervision of them.


Assuntos
Medicamentos de Ervas Chinesas , Materia Medica , Medicina Tradicional Chinesa , Registros , Censos , China
10.
N Z Med J ; 135(1567): 54-78, 2022 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-36521086

RESUMO

AIM: To examine ethnicity data quality; in particular, the representation and potential under-counting of Maori in health and disability sector data, as well as implications for inequities. METHODS: Maori and non-Maori ethnicity data are analysed at: 1) a population aggregate level across multiple 2018 datasets (Estimated Resident Population, Census Usually Resident Population, Health Service User (HSU) population and Primary Health Organisation (PHO) enrolments); and 2) an individual level for those linked in PHO and 2018 Census datasets. Ethnicity is drawn from the National Health Index (NHI) in health datasets and variations by age and gender are explored. RESULTS: Aggregate analyses show that Maori are considerably under-represented in HSU and PHO data. In linked analysis Maori were under-counted on the NHI by 16%. Under-representation in data and under-counting occur across both genders but are more pronounced for Maori men with variations by age. CONCLUSION: High quality ethnicity data are fundamental for understanding and monitoring Maori health and health inequities as well as in the provision of targeted services and interventions that are responsive to Maori aspirations and needs. The continued under-counting of Maori in health and disability sector data is a breach of Te Tiriti o Waitangi and must be addressed with urgency.


Assuntos
Censos , Havaiano Nativo ou Outro Ilhéu do Pacífico , Feminino , Humanos , Masculino , Nova Zelândia/epidemiologia
11.
BMC Pregnancy Childbirth ; 22(1): 952, 2022 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-36539750

RESUMO

BACKGROUND: The provision of quality obstetric care in health facilities is central to reducing maternal mortality, but simply increasing childbirth in facilities not enough, with evidence that many facilities in sub-Saharan Africa do not fulfil even basic requirements for safe childbirth care. There is ongoing debate on whether to recommend a policy of birth in hospitals, where staffing and capacity may be better, over lower level facilities, which are closer to women's homes and more accessible. Little is known about the quality of childbirth care in Liberia, where facility births have increased in recent decades, but maternal mortality remains among the highest in the world. We will analyse quality in terms of readiness for emergency care and referral, staffing, and volume of births. METHODS: We assessed the readiness of the Liberian health system to provide safe care during childbirth use using three data sources: Demographic and Health Surveys (DHS), Service Availability and Readiness Assessments (SARA), and the Health Management Information System (HMIS). We estimated trends in the percentage of births by location and population caesarean-section coverage from 3 DHS surveys (2007, 2013 and 2019-20). We examined readiness for safe childbirth care among all Liberian health facilities by analysing reported emergency obstetric and neonatal care signal functions (EmONC) and staffing from SARA 2018, and linking with volume of births reported in HMIS 2019. RESULTS: The percentage of births in facilities increased from 37 to 80% between 2004 and 2017, while the caesarean section rate increased from 3.3 to 5.0%. 18% of facilities could carry out basic EmONC signal functions, and 8% could provide blood transfusion and caesarean section. Overall, 63% of facility births were in places without full basic emergency readiness. 60% of facilities could not make emergency referrals, and 54% had fewer than one birth every two days. CONCLUSIONS: The increase in proportions of facility births over time occurred because women gave birth in lower-level facilities. However, most facilities are very low volume, and cannot provide safe EmONC, even at the basic level. This presents the health system with a serious challenge for assuring safe, good-quality childbirth services.


Assuntos
Cesárea , Serviços de Saúde Materna , Recém-Nascido , Gravidez , Feminino , Humanos , Estudos Transversais , Libéria , Declaração de Nascimento , Censos , Parto Obstétrico , Parto , Instalações de Saúde , Acesso aos Serviços de Saúde
12.
BMC Pregnancy Childbirth ; 22(1): 925, 2022 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-36482353

RESUMO

BACKGROUND: Birth weight is considered a crucial indicator of individual and population health, as it determines a newborn's growth and development. An extensive body of research has explored various determinants of perinatal health, including the impact of living arrangements. This population-based study analyzes the relationship between mothers' partnership status and household structure and children's low birth weights. It addresses two basic research objectives: on one hand, how living/not living in a couple affects birth weight; on the other, how partnership status impact on birthweight when mothers live in extended households with other non-nuclear members. METHODS: A novel database provided by the Spanish Office for National Statistics (INE), which links the 2011 census with births registered from 2011 to 2015 (sample size 22,433) is used. Llogistic regression models are estimated tto obtain adjusted odds ratios (OR) for the relative effects of living arrangements and other covariates such as characteristics of births and mothers' socioeconomic profiles, on birth weight. RESULTS: Differences in low-birth-weight rates may be attributed to the dissimilar socio-demographic characteristics of the groups of mothers in the different coresidential situations. Although our models revealed that the impact of the covariates on birth weight was similar to that shown by previous studies, this was not the case for the effect of the main explanatory variable. Contrary to expectations, the presence/absence of a male partner in nuclear or in extended households does not reveal significant protection against low birth weight. Children born in households in which the male partner was absent were not more likely to have a low birth weight. On the other hand, analyzing the possible protective effect of extended households, we did not detect significant differences in the likelihood of low birth weight between single mothers without and with non-nuclear coresidents in their households. CONCLUSIONS: Our analysis provides novel evidence regarding the effect of partnership status and household type on perinatal health in Spain. First, contrary to what has been observed in previous studies in Spain and elsewhere, our study shows that living without a partner has no effect on low birth weight. Second, we reveal that households including non-nuclear coresidents are associated with low birth weight suggesting that even in a basically familist societal context such as the Spanish one, the extended family does not fully protect against poor perinatal outcomes.


Assuntos
Mães , Pesquisa , Criança , Recém-Nascido , Feminino , Masculino , Humanos , Peso ao Nascer , Censos , Recém-Nascido de Baixo Peso
13.
Front Public Health ; 10: 1024491, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36504946

RESUMO

Background: Against a backdrop of aging and declining birthrates, the demand for long-term care insurance (LTCI) systems in various countries throughout the world continues to rise. Most traditional LTCI systems only cover a limited group of people, which cannot solve the problem of nursing needs among other groups, and, further, it makes financial sustainability very difficult to achieve. Purpose: This article aims to explore how Nantong successfully achieves both "full coverage" and "financial sustainability" through institutional innovation. Objects: Institutional innovation logic and financial sustainability of LTCI system in Nantong, one prefecture-level city with the highest degree of aging in China. Methods: Through field interviews and research, this article examines the LTCI system in Nantong, exploring its logic and its successful realization of institutional innovation, which combines international and local experience. The study further uses quantitative methods to measure the system's financial sustainability. Data: From the seventh national population census bulletin, the 13th Five-Year population development plan, the Nantong Municipal Bureau of Statistics and Nantong Statistical Yearbook 2020 from Nantong government. And from the authors' field survey data in the Medical Insurance Bureau of Nantong. Results: The findings reveal that the Nantong model effectively disperses institutional risks by means of horizontal and vertical transfer payments, diversified financing, and service outsourcing, achieving its dual goals of full coverage and financial sustainability in the long run. Conclusion: Nantong Model has interrupted the path dependence of traditional dual systems and the philosophy of fragmented institutional construction. Nantong's path-breaking institutional construction paradigm has important theoretical and practical value. Contributions: The experience of Nantong may prove valuable and instructive, for not only other cities in China but also developing countries across the globe.


Assuntos
Envelhecimento , Seguro de Assistência de Longo Prazo , Humanos , Censos , China , Cidades
14.
Int J Prison Health ; ahead-of-print(ahead-of-print)2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36573688

RESUMO

PURPOSE: Depression has become a major health concern, particularly in developing countries. This disorder is highly prevalent among certain vulnerable populations, such as prisoners. In Peru, prisons are overcrowded, and the health of prisoners is neglected. Thus, this study aims to estimate the prevalence of depression diagnosed during incarceration in male inmates from all Peruvian prisons and assess its associated factors. DESIGN/METHODOLOGY/APPROACH: A cross-sectional study was conducted based on the secondary data analysis of the National Census of Prison Population 2016 in Peru. This study included records of prisoners who reported whether they were diagnosed with depression by a health-care professional after admission into the prisons. Descriptive, bivariate and multivariable analyses were performed. FINDINGS: Of the 63,312 prisoners included in this study, 1,007 reported an in-prison diagnosis of depression by a health-care professional, which represents a prevalence of 1.59%. Substance use disorder (adjusted prevalence ratio [aPR] 3.10; 95% confidence interval [CI]: 1.91-5.03), hypertension (aPR 7.20; 95% CI: 6.28-8.24) and previous discrimination (aPR 1.97; 95% CI: 1.62-2.40) were strongly associated with depression, even when adjusting for multiple confounders. Other directly associated variables were, for example, violence during childhood, infrequent visits in prison and diabetes. ORIGINALITY/VALUE: The right of prisoners to adequate health care is being neglected in Peru. Mental health is a cornerstone of health quality. Acknowledging which factors are associated with depression in prison is important to implement strategies to improve the mental health of prisoners.


Assuntos
Depressão , Prisioneiros , Humanos , Masculino , Depressão/epidemiologia , Peru/epidemiologia , Prisões , Estudos Transversais , Censos , Prisioneiros/psicologia
15.
Ann Epidemiol ; 76: 98-107, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36332754

RESUMO

PURPOSE: Quantify the misclassification of abortion accessibility resulting from calculations based on block groups, census tracts, ZCTAs, or counties versus census blocks. METHODS: We included 850 facilities from the 2018 ANSIRH Facility Database and Planned Parenthood website. Accessibility was the proportions of 18-44 year-old women living within a 30-, 60-, and 90-minute drive from an abortion-providing facility. We calculated accessibility using five different geographic units: census blocks, block groups, census tracts, ZCTAs, and counties. We estimated the potential magnitude of abortion accessibility misclassification resulting by calculating the difference between accessibility calculated using each geographic unit, respectively, for each drive time as compared to census blocks. RESULTS: In this analysis, counties, the largest geographic unit considered, underestimated national abortion accessibility compared with census blocks by up to 24.21 percentage points; while block group-, census tract, or ZCTA-based national estimates of abortion accessibility in the US resulted in small underestimates relative to estimates constructed using census blocks. CONCLUSIONS: Studies of population accessibility should use the smallest feasible geographic unit of analysis. While this study focused on abortion accessibility, our findings likely apply to other health services, particularly those with distributions like abortion care.


Assuntos
Censos , Acesso aos Serviços de Saúde , Gravidez , Estados Unidos , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Bases de Dados Factuais
16.
Sci Rep ; 12(1): 20085, 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36418443

RESUMO

Fine-grained population maps are needed in several domains, like urban planning, environmental monitoring, public health, and humanitarian operations. Unfortunately, in many countries only aggregate census counts over large spatial units are collected, moreover, these are not always up-to-date. We present POMELO, a deep learning model that employs coarse census counts and open geodata to estimate fine-grained population maps with [Formula: see text]m ground sampling distance. Moreover, the model can also estimate population numbers when no census counts at all are available, by generalizing across countries. In a series of experiments for several countries in sub-Saharan Africa, the maps produced with POMELO are in good agreement with the most detailed available reference counts: disaggregation of coarse census counts reaches [Formula: see text] values of 85-89%; unconstrained prediction in the absence of any counts reaches 48-69%.


Assuntos
Censos , Monitoramento Ambiental
17.
PLoS One ; 17(11): e0277549, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36395259

RESUMO

Population-level national networks on social media are precious and essential for network science and behavioural science. This study collected a population-level Twitter network, based on both language and geolocation tags. We proposed a set of validation approaches to evaluate the validity of our datasets. Finally, we re-examined classical network and communication propositions (e.g., 80/20 rule, six degrees of separation) on the national network. Our dataset and strategy would flourish the data collection pool of population-level social networks and further develop the research of network analysis in digital media environment.


Assuntos
Censos , Mídias Sociais , Humanos , Internet , Rede Social , Comunicação
18.
Soc Sci Med ; 315: 115557, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36413855

RESUMO

Epistemic tensions have long been evident within naturopathy, a heterodox healthcare occupation licensed across much of North America. Naturopaths less inclined toward bioscientific explanatory and evidentiary norms have long used the trope of the 'green allopath' to critique the practices of their more biomedically- (i.e., 'allopathically') inclined colleagues. Using the 'green allopathy' narrative as a conceptual starting point, this work uses a qualitatively-driven, mixed methods design involving interviews (n = 17) and a census-style survey (n = 366) to characterize the paradigmatic and practice patterns of licensed naturopaths in Ontario, Canada between 2017 and 2019. At odds with many interviewees' accounts, survey results suggest that the occupation's overall epistemic character, aligned with the concept of holism, has not changed much over the last two decades. Nevertheless, findings suggest notable changes in Ontario naturopaths' clinical practice patterns over the same period, including: more frequent use of botanical medicines, nutritional supplements and acupuncture; less frequent use of physical medicine (e.g., massage, hydrotherapy); and, an overall reduction in homeopathic usage. Controlling for other factors, older naturopaths are more likely to rely often on non-biomedical diagnostic modes (p = 0.042), suggesting an emerging shift, in practice, toward a 'green allopathy'. Naturopaths' widespread ongoing engagement with therapeutic modalities whose epistemic premises diverge strongly from conventional biomedicine (e.g., homeopathy, East Asian medicine), appears mediated by the increasing body of related bioscientific evidence, and by gender and age (p-values <0.05). Gender and age also significantly predict naturopaths' alignment with more pharmaceutically-oriented care (p values < 0.05). Though naturopathy's 'green allopathization' appears underway, the demographic predominance of women within the profession may temper this trend in the years ahead.


Assuntos
Terapia por Acupuntura , Naturologia , Feminino , Humanos , Masculino , Ontário , América do Norte , Censos
19.
Soc Sci Med ; 315: 115524, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36413859

RESUMO

INTRODUCTION: Little research has conducted to examine the association between social deprivation and social fragmentation, overall and method-specific suicide risk, and how these associations may change over time. This study investigated the association between social deprivation and social fragmentation with overall and method-specific suicide in Hong Kong from 1999 to 2018. METHODS: Suicide death data of each small tertiary planning unit (STPU) was obtained from the Census and Statistics Department of Hong Kong. Socio-economic characteristics in STPU level were obtained from Census and Bi-census. Exploratory principal component analysis was used to construct the social deprivation (SDI) and social fragmentation indices (SFI) based on the socio-economic characteristics. Bayesian hierarchical modelling was conducted to explore the association between SDI and SFI with overall and method-specific suicide over time, controlling for population density and male-to-female ratio. RESULTS: Higher risk of suicide was generally observed around Kowloon Peninsula and some parts in the Northern, Northwestern and Southwestern areas depending on methods. The effect of SDI and SFI on suicide risk varied by years and methods. In 2014-2018, for every 10% increase in SDI, the suicide risk for overall, jumping, hanging, and charcoal burning elevated by 22% (95%Crl = 10%-37%), 26% (95%Crl = 12%-41%), 31% (95%Crl = 14%-51%), and 21% (95%Crl = 4%-42%) respectively. CONCLUSION: Spatial variations and effects of SDI and SFI on overall and method-specific suicide risks varied by different periods. SDI was observed to be a stronger factor in the recent years. Situations should be monitored, and interventions should be implemented and adjusted accordingly to the changes.


Assuntos
Suicídio , Humanos , Feminino , Masculino , Hong Kong/epidemiologia , Privação Social , Teorema de Bayes , Censos
20.
N Z Med J ; 135(1565): 31-40, 2022 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-36356267

RESUMO

AIMS: To compare the distribution of Maori and New Zealand (NZ) European populations in Aotearoa New Zealand by neighbourhood deprivation, for the five censuses between 1991 and 2013, and to identify changes in the distribution pattern over time. METHODS: Geographical meshblock data from the 1991-2013 New Zealand censuses, by NZDep Index deprivation score, and by prioritised ethnic group population, were combined to analyse ethnic population counts by deprivation decile and deprivation score. Trends over time were analysed. RESULTS: Maori were over-represented in the more deprived NZDep deciles and under-represented in the least deprived deciles for all census periods. The NZ European population were over-represented in the least deprived deciles, and under-represented in the more deprived deciles. In each census, over 40% of the Maori population have been living in the two most deprived deciles, compared to less than 15% for NZ European. CONCLUSION: The patterns of inequity in socio-economic deprivation between Maori and NZ Europeans have remained virtually unchanged since 1991, despite various Government commitments to reduce inequity. Socio-economic deprivation for Maori is a key determinant of health inequity, and bolder Government measures prioritised for Maori are needed to change this socio-economic gradient if health equity goals are to be met.


Assuntos
Etnicidade , Havaiano Nativo ou Outro Ilhéu do Pacífico , Humanos , Nova Zelândia/epidemiologia , Censos , Pobreza
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