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1.
BMC Public Health ; 20(1): 1559, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066763

RESUMO

BACKGROUND: Undernutrition among under five children in India is a major public health problem. Despite India's growth in the economy, the child mortality rate due to undernutrition is still high in both urban and rural areas. Studies that focus on urban slums are scarce. Hence the present study was carried out to assess the prevalence and determinants of undernutrition in children under five in Maharashtra, India. METHODS: A community-based cross-sectional study was conducted in 16 randomly selected clusters in two districts of Maharashtra state, India. Data were collected through house to house survey by interviewing mothers of under five children. Total 2929 mothers and their 3671 under five children were covered. Multivariate logistic regression analysis was carried out to identify the determinants of child nutritional status seperately in urban and rural areas. RESULTS: The mean age of the children was 2.38 years (±SD 1.36) and mean age of mothers was 24.25 years (± SD 6.37). Overall prevalence of stunting among children under five was 45.9%, wasting was 17.1 and 35.4% children were underweight. Prevalence of wasting, stunting and underweight were more seen in an urban slum than a rural area. In the rural areas exclusive breast feeding (p < 0.001) and acute diarrhea (p = 0.001) were associated with wasting, children with birth order 2 or less than 2 were associated with stunting and exclusive breast feeding (p < 0.05) and low maternal education were associated with underweight. Whereas in the urban slums exclusive breast feeding (p < 0.05) was associated with wasting, sex of the child (p < 0.05) and type of family (p < 0.05) were associated with stunting,and low income of the family (p < 0.05) was associated with underweight. CONCLUSIONS: Factors like sex of the child, birth order,exclusive breast feeding,economic status of the family, type of family,acute diarrhea and maternal education have influence on nutritional status of the child. Improvement of maternal education will improve the nutritional status of the child. Strategies are needed to improve the economic status of the community. TRIAL REGISTRATION: Trial registration number: CTRI/2017/12/010881 ; Registration date:14/12/2017. Retrospectively registered.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Áreas de Pobreza , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Mães/estatística & dados numéricos , Prevalência , Fatores de Risco , Fatores Socioeconômicos
2.
Rev Saude Publica ; 54: 90, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33027343

RESUMO

OBJECTIVE: To analyze factors associated with diarrheal disease in the rural Caribbean region of Colombia. METHOD: A cross-sectional study conducted in the rural area of the Cesar Department, Colombia, between November 2017 and June 2018. Self-reported cases of diarrheal disease were surveyed, and water samples from 42 households were collected and analyzed. Descriptive statistics were employed in the analysis of socioeconomic status, environmental and sanitary conditions, and we evaluated their association with the diarrheal disease using the Poisson regression models. Each model was adjusted with variables suggested by specific directed acyclic graphs. RESULTS: Poor water supply conditions, hygiene and basic sanitation were reported in the study area. All water samples were classified either as high risk for health problems or unfit for human consumption. The diarrheal disease had a prevalence of 7.5% across all ages and of 23.5% in children under five years old. The variables rainy season (PR = 0.24; 95%CI 0.07-0.85), children under five years old (PR = 4.05; 95%CI 1.70-9.68), water from deep wells (PR = 16.90; 95%CI 2.45-116.67), water from artificial ponds (PR = 11.47; 95%CI 1.27-103.29), toilets availability (PRA = 0.23; 95%CI 0.06-0.96), and swine presence (PR = 0.20; 95%CI 0.05-0.74) were significantly associated with the occurrence of diarrheal disease. CONCLUSION: Water supply, hygiene and basic sanitation conditions have been associated with the diarrheal disease, affecting almost a quarter of the population under five years old. There is an urge for the design of effective policies that improve environmental and sanitation conditions in rural areas.


Assuntos
Diarreia/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Lactente , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
5.
Surg Clin North Am ; 100(5): 823-833, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32882165

RESUMO

This article reviews key population trends affecting rural American health. The article explains the role of demography in defining and studying rural health using example data from the 2014 to 2018 American Community Survey. Specific trends, including depopulation, aging, racial/ethnic diversification, socioeconomic status, and health characteristics found in rural areas, are highlighted. Insights are offered into how population trends, changing age and sex structures, and socioeconomic distributions have implications for rural health care practitioners and surgeons. Several areas and opportunities to address current and future rural health needs are identified.


Assuntos
Demografia/estatística & dados numéricos , Saúde da População Rural/estatística & dados numéricos , População Rural/estatística & dados numéricos , Humanos , Estados Unidos
6.
BMC Public Health ; 20(1): 1468, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993550

RESUMO

BACKGROUND: In Ethiopia, malaria is one of the public health problems, and it is still among the ten top leading causes of morbidity and mortality among under-five children. However, the studies conducted in the country have been inconclusive and inconsistent. Thus, this study aimed to assess factors associated with malaria among under-five children in Ethiopia. METHODS: We retrieved secondary data from the malaria indicator survey data collected from September 30 to December 10, 2015, in Ethiopia. A total of 8301 under-five-year-old children who had microscopy test results were included in the study. Bayesian multilevel logistic regression models were fitted and Markov chain Monte Carlo simulation was used to estimate the model parameters using Gibbs sampling. Adjusted Odd Ratio with 95% credible interval in the multivariable model was used to select variables that have a significant association with malaria. RESULTS: In this study, sleeping under the insecticide-treated bed nets during bed time (ITN) [AOR 0.58,95% CI, 0.31-0.97)], having 2 and more ITN for the household [AOR 0.43, (95% CI, 0.17-0.88)], have radio [AOR 0.41, (95% CI, 0.19-0.78)], have television [AOR 0.19, (95% CI, 0.01-0.89)] and altitude [AOR 0.05, (95% CI, 0.01-0.13)] were the predictors of malaria among under-five children. CONCLUSIONS: The study revealed that sleeping under ITN, having two and more ITN for the household, altitude, availability of radio, and television were the predictors of malaria among under-five children in Ethiopia. Thus, the government should strengthen the availability and utilization of ITN to halt under-five mortality due to malaria.


Assuntos
Saúde da Criança/estatística & dados numéricos , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária/prevenção & controle , População Rural/estatística & dados numéricos , Teorema de Bayes , Criança , Pré-Escolar , Etiópia , Características da Família , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Análise Multinível , Estatísticas não Paramétricas , Inquéritos e Questionários
7.
BMC Public Health ; 20(1): 1472, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993592

RESUMO

BACKGROUND: Urban-rural disparity in mortality at older ages is well documented in China. However, surprisingly few studies have systemically investigated factors that contribute to such disparity. This study examined the extent to which individual-level socioeconomic conditions, family/social support, health behaviors, and baseline health status contributed to the urban-rural difference in mortality among older adults in China. METHODS: This research used the five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, a nationally representative sample of older adults aged 65 years or older in China (n = 28,235). A series of hazard regression models by gender and age group examined the association between urban-rural residence and mortality and how this association was modified by a wide range of individual-level factors. RESULTS: Older adults in urban areas had 11% (relative hazard ratio (HR) = 0.89, p < 0.01) lower risks of mortality than their rural counterparts when only demographic factors were taken into account. Further adjustments for family/social support, health behaviors, and health-related factors individually or jointly had a limited influence on the mortality differential between urban and rural older adults (HRs = 0.89-0.92, p < 0.05 to p < 0.01). However, we found no urban-rural difference in mortality (HR = 0.97, p > 0.10) after adjusting for individual socioeconomic factors. Similar results were found in women and men, and among the young-old and the oldest-old populations. CONCLUSIONS: The urban-rural disparity in mortality among older adults in China was largely attributable to differences in individual socioeconomic resources (i.e., education, income, and access to healthcare) regardless of gender and age group.


Assuntos
Comportamentos Relacionados com a Saúde , Nível de Saúde , Renda/estatística & dados numéricos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Longevidade , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Risco , Percepção Social , Apoio Social , Fatores Socioeconômicos , Adulto Jovem
8.
J Environ Public Health ; 2020: 2123652, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879630

RESUMO

Background: Open defecation was largely a rural phenomenon most widely attributed to poor latrine ownership at community level. We aimed at examining latrine ownership and its determinants in rural villages of the Tigray region, Northern Ethiopia. Methods: Community-based cross-sectional study was conducted from June to July 2018. A total of 756 randomly selected households were involved in the study. The multistage cluster sampling technique was used to select study households. Data were checked, coded, and entered into Epi-Info version 7. Besides, it was exported to SPSS version 20 for data analysis. Multivariable logistic regression analysis was involved to estimate the net effect size of factors associated with latrine ownership. Results: The proportion of households owning latrine was 35.7%. The majority (84.4%) of constructed latrines were utilized by household families. Households advocated latrine IEC by Health Extension Workers (HEWs) (AOR = 1.902, 95% CI: 1.269-2.852), living in their private house (AOR = 3.13, 95% CI: 1.528-6.401), and the occupation status of government employees (AOR = 3.54, 95% CI: 0.586-21.397) are more likely to lead to the construction of latrines. The availability of latrine made on slab floor (AOR = 1.790, 95% CI: 0.297-3.102), having a latrine constructed inside the household compound (AOR = 4.463, 95% CI: 1.021-19.516), and delivery of latrine IEC by Women Development Armies (WDAs) (AOR = 2.425, 95% CI: 0.728-8.083) may lead to better latrine utilization at the household level. Conclusion: Households owning latrine at the community level were low. The desired level of latrine ownership will be realized if all sanitation and hygiene components are kept on eye side by side in line with identified predictor factors.


Assuntos
Propriedade/estatística & dados numéricos , População Rural/estatística & dados numéricos , Toaletes/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Emprego , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
9.
BMC Public Health ; 20(1): 1442, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967642

RESUMO

BACKGROUND: There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group. METHODS: Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie's decomposition was used to parse out differences into observed and unobserved components. RESULTS: After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie's decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents. CONCLUSIONS: Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers' depressive symptoms.


Assuntos
Depressão/epidemiologia , Disparidades nos Níveis de Saúde , População Rural/estatística & dados numéricos , Migrantes/psicologia , População Urbana/estatística & dados numéricos , Idoso , China/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Migrantes/estatística & dados numéricos
10.
Environ Health Prev Med ; 25(1): 51, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912134

RESUMO

BACKGROUND: China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project. METHODS: In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas. RESULTS: The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing. CONCLUSIONS: The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.


Assuntos
Saúde Mental/estatística & dados numéricos , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Idoso , Idoso de 80 Anos ou mais , China , Estudos Transversais , Feminino , Política de Saúde , Humanos , Modelos Logísticos , Masculino , Análise Multivariada
12.
J Rural Health ; 36(4): 602-608, 2020 09.
Artigo em Inglês | MEDLINE | ID: covidwho-745694

RESUMO

PURPOSE: This study compared the average daily increase in COVID-19 mortality rates by county racial/ethnic composition (percent non-Hispanic Black and percent Hispanic) among US rural counties. METHODS: COVID-19 daily death counts for 1,976 US nonmetropolitan counties for the period March 2-July 26, 2020, were extracted from USAFacts and merged with county-level American Community Survey and Area Health Resource File data. Covariates included county percent poverty, age composition, adjacency to a metropolitan county, health care supply, and state fixed effects. Mixed-effects negative binomial regression with random intercepts to account for repeated observations within counties were used to predict differences in the average daily increase in the COVID-19 mortality rate across quartiles of percent Black and percent Hispanic. FINDINGS: Since early March, the average daily increase in the COVID-19 mortality rate has been significantly higher in rural counties with the highest percent Black and percent Hispanic populations. Compared to counties in the bottom quartile, counties in the top quartile of percent Black have an average daily increase that is 70% higher (IRR = 1.70, CI: 1.48-1.95, P < .001), and counties in the top quartile of percent Hispanic have an average daily increase that is 50% higher (IRR = 1.50, CI: 1.33-1.69, P < .001), net of covariates. CONCLUSION: COVID-19 mortality risk is not distributed equally across the rural United States, and the COVID-19 race penalty is not restricted to cities. Among rural counties, the average daily increase in COVID-19 mortality rates has been significantly higher in counties with the largest shares of Black and Hispanic residents.


Assuntos
Afro-Americanos/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/mortalidade , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Pneumonia Viral/mortalidade , Infecções por Coronavirus/terapia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Pandemias , Pneumonia Viral/terapia , Pobreza/estatística & dados numéricos , Fatores de Risco , População Rural/estatística & dados numéricos , Estados Unidos
13.
Ann Agric Environ Med ; 27(3): 448-455, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955229

RESUMO

INTRODUCTION: Cerebrovascular diseases in Poland constitute a bigger threat to life in men than in women, especially after the age of 60. Death rates indicate higher stroke over-mortality in the rural population rather than the urban. At the same time, stroke is the main cause of long-term disability, since half of the patients are unable to independently perform daily activities, which makes them dependent on other people. MATERIAL AND METHODS: The study was conducted in the Independent Public Healthcare Institution in Krasnik, eastern Poland. It covered the medical records of 1,500 patients, 780 women (52%) and 720 men (48%), aged 20-100, diagnosed with cerebral infarction. The patients were hospitalised between 2011-2016 in the Neurology Ward with a Stroke Unit, the Internal Medicine Ward, and the Anaesthetics and Intensive Care Ward. RESULTS: The stroke patients hospitalised in the Independent Public Healthcare Institution in Krasnik were residents of urban communes (59.1% of subjects) and rural communes (40.9%). The most often diagnosed type of stroke was due to embolism of the cerebral arteries (I63.4) in women (63.48%). In men, the most most often diagnosed type was cerebral infarction due to thrombosis of the cerebral arteries (I63.3; 51.33%). Stroke in 36.15% of the female subjects resulted in death. In male subjects, death occurred in 26.11% of the cases. CONCLUSIONS: Women aged around 78-years-old were the most likely to suffer a stroke. In men, it occurred eight years earlier. Despite residents of urban areas being hospitalised due to stroke more often, deaths caused by this disease were recorded the most frequently among rural residents. It can be concluded that primary stroke prevention is the only effective measure for reducing morbidity and premature mortality in the population.


Assuntos
População Rural/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , População Urbana/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Prevalência , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/etiologia , Adulto Jovem
14.
Ann Agric Environ Med ; 27(3): 469-475, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32955231

RESUMO

INTRODUCTION: Currently, malignancies are the most severe medical problems worldwide. Numerous, already known risk factors in carcinogenesis could be potentially avoided. Some cancer risk factors have been recognized and have become the targets of primary prophylaxis. OBJECTIVE: The aim of the study was to ascertain the state of knowledge about risk factors, primary prevention and early detection of malignancies of gastrointestinal tract (GIT) in the urban and rural population of the Lublin province in Eastern Poland. MATERIAL AND METHODS: The study was cross-sectional. The originally designed questionnaire was applied to the group of 1,352 patients, representatives of both the rural and urban environments of the Lublin province during random appointments with their general practitioner (GP). RESULTS: The study showed low awareness of the issues connected with GIT malignancies within the studied group. The problem was particulary apparent in the rural population. CONCLUSIONS: In order to raise general awareness of cancer, different means should be applied in urban and rural populations. GPs and the media were found to have the leading rols in the promotion of primary prevention.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Neoplasias Gastrointestinais/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Prevenção Primária/estatística & dados numéricos , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/prevenção & controle , Polônia , Fatores de Risco , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
15.
J Rural Health ; 36(4): 602-608, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32894612

RESUMO

PURPOSE: This study compared the average daily increase in COVID-19 mortality rates by county racial/ethnic composition (percent non-Hispanic Black and percent Hispanic) among US rural counties. METHODS: COVID-19 daily death counts for 1,976 US nonmetropolitan counties for the period March 2-July 26, 2020, were extracted from USAFacts and merged with county-level American Community Survey and Area Health Resource File data. Covariates included county percent poverty, age composition, adjacency to a metropolitan county, health care supply, and state fixed effects. Mixed-effects negative binomial regression with random intercepts to account for repeated observations within counties were used to predict differences in the average daily increase in the COVID-19 mortality rate across quartiles of percent Black and percent Hispanic. FINDINGS: Since early March, the average daily increase in the COVID-19 mortality rate has been significantly higher in rural counties with the highest percent Black and percent Hispanic populations. Compared to counties in the bottom quartile, counties in the top quartile of percent Black have an average daily increase that is 70% higher (IRR = 1.70, CI: 1.48-1.95, P < .001), and counties in the top quartile of percent Hispanic have an average daily increase that is 50% higher (IRR = 1.50, CI: 1.33-1.69, P < .001), net of covariates. CONCLUSION: COVID-19 mortality risk is not distributed equally across the rural United States, and the COVID-19 race penalty is not restricted to cities. Among rural counties, the average daily increase in COVID-19 mortality rates has been significantly higher in counties with the largest shares of Black and Hispanic residents.


Assuntos
Afro-Americanos/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/mortalidade , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Pneumonia Viral/mortalidade , Infecções por Coronavirus/terapia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Pandemias , Pneumonia Viral/terapia , Pobreza/estatística & dados numéricos , Fatores de Risco , População Rural/estatística & dados numéricos , Estados Unidos
17.
J Registry Manag ; 47(1): 4-12, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32833378

RESUMO

OBJECTIVES: Researchers often approximate individual-level socioeconomic status (SES) from census tract and county data. However, area-level variables do not serve as accurate proxies for individual-level SES, particularly among some demographic subgroups. The present study aimed to analyze the potential bias introduced by this practice. METHODS: Data included (1) individual-level SES from the Mortality Disparities in American Communities study (n ≈ 3,471,000 collected in 2008), and (2) census tract- and county-level SES from the 2006-2010 American Community Survey. Analyses included correlations among SES indicators (eg, median household income, having a high school degree, unemployment) across individual versus census tract and county levels, stratified by sex, age, race/ethnicity, and urbanicity. Finally, generalized estimating equations evaluated demographic differences in whether area-level SES matched or underestimated individual-level SES. RESULTS: Low correlations were observed between individual- and area-level SES (census tract: Spearman's r range = 0.048 for unemployment to 0.232 for median household income; county: r range = 0.028 for unemployment to 0.157 for median household income; all P < .0001). SES indicators were more likely to match for males, older participants, and urban groups. Area-level SES indicators were more likely to underestimate individual-level SES for older participants and rural groups, indicating that individuals who are part of these groups may live in systematically lower-SES communities than their own SES might connote. CONCLUSIONS: In this population-based study of 3.5 million participants, area-level indicators were poor proxies for individual-level SES, particularly for participants living in rural areas.


Assuntos
Censos , Sistema de Registros/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Feminino , Humanos , Masculino , População Rural/estatística & dados numéricos , Classe Social , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
18.
Proc Natl Acad Sci U S A ; 117(36): 22009-22014, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32820075

RESUMO

Can "urban-centric" local television news coverage of the COVID-19 pandemic affect the behavior of rural residents with lived experiences so different from their "local" news coverage? Leveraging quasi-random geographic variation in media markets for 771 matched rural counties, we show that rural residents are more likely to practice social distancing if they live in a media market that is more impacted by COVID-19. Individual-level survey responses from residents of these counties confirm county-level behavioral differences and help attribute the differences we identify to differences in local television news coverage-self-reported differences only exist among respondents who prefer watching local news, and there are no differences in media usage or consumption across media markets. Although important for showing the ability of local television news to affect behavior despite urban-rural differences, the media-related effects we identify are at most half the size of the differences related to partisan differences.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , População Rural/estatística & dados numéricos , Televisão/estatística & dados numéricos , Betacoronavirus , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Inquéritos e Questionários , Estados Unidos/epidemiologia
20.
Khirurgiia (Mosk) ; (7): 6-11, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32736457

RESUMO

OBJECTIVE: To analyze morbidity and factors affecting mortality in emergency abdominal surgery in the Russian Federation. MATERIAL AND METHODS: The study included patients with acute abdominal diseases aged 18 years and older. All patients were hospitalized in emergency surgical care departments of 3.194 state healthcare institutions in 84 regions of the Russian Federation in 2018. Morbidity, surgical activity and mortality were analyzed. RESULTS: There were 680.337 cases of hospitalization in emergency surgical department, morbidity rate was 582 cases per 100 000. The most common emergency surgical diseases were acute appendicitis (142.3 cases per 100 000), acute cholecystitis (139.0 cases per 100 000) and acute pancreatitis (131.2 cases per 100 000). Surgery was performed in 399.051 (58.7%) patients. In-hospital mortality rate was 2.4% (16 051 cases). CONCLUSION: There are certain factors affecting mortality rate in acute abdominal diseases. The leading problems in organizing emergency surgical care in Russia are insufficient equipment of rural and small municipal surgical hospitals, different staffing with surgeons in rural areas and large cities and late hospitalization of patients.


Assuntos
Assistência à Saúde/estatística & dados numéricos , Doenças do Sistema Digestório/epidemiologia , Doenças do Sistema Digestório/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Abdome/cirurgia , Doença Aguda/epidemiologia , Doença Aguda/mortalidade , Doença Aguda/terapia , Adolescente , Adulto , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Doenças do Sistema Digestório/mortalidade , Procedimentos Cirúrgicos do Sistema Digestório/mortalidade , Emergências/epidemiologia , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Morbidade , População Rural/estatística & dados numéricos , Federação Russa/epidemiologia , Adulto Jovem
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