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1.
Braz. j. oral sci ; 20: e219638, jan.-dez. 2021. tab
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254752

RESUMEN

Diagnosis of oral and oropharyngeal cancer in advanced stages may be associated with social nature factors, access to health care, education, occupation, and behavioral/ cultural factors. Aim: To determine the factors related to high clinical-staging in patients diagnosed with squamous cell carcinoma in the oral and oropharyngeal region in a Cancer Center in Brazil between 2009 and 2015. Methods: It is an epidemiological, retrospective, and exploratory study. Patients diagnosed with squamous cell carcinoma had their medical records analyzed. The variables considered were sociodemographic, lifestyle, and disease characteristics. Descriptive and exploratory tests (Pearson's, chi-square test and, Student's t-test) were realized. Results: We analyzed 365 patient records, among which 289 (79.17%) were male, and 73 (20.0%) were female. Age ranged from 16 to 101 years, with a mean of 61.13. Regarding education, 157 (43.01%) studied < 8 years, 103 (28.21%) were illiterate and 102 (27.94%) studied > 8 years. 305 (83.56%) patients live in urban areas. There was an association between high clinical-staging and low educational level. For high clinical-staging, symptomatology, tobacco, and alcohol intake as well. Conclusion: Patients with low educational levels tend to report the disease later, and their diagnostics occurred in advanced stages. Thus, specific public health policies for this population, including access to dental care to recognize the clinical signs and early diagnosis, are necessary


Asunto(s)
Factores Socioeconómicos , Neoplasias de la Boca/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Registros Médicos
2.
Front Public Health ; 9: 675927, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34604151

RESUMEN

Background: The incidence of chronic diseases has increased dramatically due to rapid aging and lifestyle changes of China in recent decades. The population aged more than 45 years is an important participant in the labor force market, and the health status directly affects their labor force participation decision. This study aims to explore the relationship between chronic diseases and the labor force participation among the elderly Chinese population aged more than 45 years. Method: We employ a multivariate probit (MVP) model to construct five structural equations for an analysis. The advantage of this model is that it can deal with the endogeneity of chronic diseases. Results: Firstly, compared with the elderly, younger people are more likely to participate in the labor force market; the influence of chronic diseases is the largest for presenile women in the decision-making of labor force participation; the impact of psychological problems on labor force participation cannot be ignored, especially for men aged more than 45 years. In addition, sociodemographic factors such as geographical location and marital status also have direct effects on the probability of labor force participation while the impact of both family wealth and family number is much smaller. Finally, unhealthy lifestyles through chronic diseases have negative and indirect marginal effects on labor force participation. Conclusions: This article proves that chronic diseases have a negative impact on the labor force participation for Chinese aged more than 45 years. The public should give more tolerance and opportunities to these groups. The population aged more than 45 years are more vulnerable and face more psychological problems, which will lead to a decline in labor force participation. Psychological health counseling and services are urgently needed. As the urban areas enjoy more social welfare, Chinese welfare policy needs to be tilted toward the rural elderly. For individuals, maintaining healthy lifestyles can help you stay away from chronic diseases and stay in the labor force market.


Asunto(s)
Envejecimiento , Empleo , Anciano , China/epidemiología , Enfermedad Crónica , Femenino , Humanos , Masculino , Factores Socioeconómicos
3.
Front Public Health ; 9: 717747, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34595148

RESUMEN

Background: The lockdowns associated with the COVID-19 pandemic has been called a crisis in mental health, and adolescents may have been among the most affected. Comparing the first period of societal lockdown in spring 2020 to periods going back to 2014 using a rich cross-sectional dataset based on repeated surveys, we explore the potential changes in self-reported mental well-being across sociodemographic groups among Norway's adolescents. Methods: Norway closed schools and implemented strict restrictions in March 2020; an electronic questionnaire survey was distributed to lower secondary school students in Trøndelag county (N = 2,443) in May 2020. Results were compared with similar surveys conducted annually in the same county dating back to 2014. Logistic regression models were applied to investigate potential changes in depressive symptoms, loneliness, and quality of life and life satisfaction, and to detect possible differences in the impact of lockdown between the genders and socioeconomic groups. Results: The prevalence of boys and girls reporting high quality of life (43-34%; 23-16%) and life satisfaction (91-80%; 82-69%) decreased significantly compared to the pre-pandemic. For girls only, lockdown was associated with higher odds for reporting high depressive symptoms. As expected, the least privileged socioeconomic groups showed the greatest psychological distress. However, our trend analyses provided no evidence that the socioeconomic inequalities in psychological distress (according to prevalence of high depressive symptoms or loneliness) changed substantial in any direction during the first wave of the pandemic [between the pre-pandemic and inter-pandemic periods]. Conclusion: Adolescents are vulnerable, and interventions should provide them with mental health support during crises such as societal lockdown. In particular, the social and health policy, public health, and further research should target these least privileged groups.


Asunto(s)
COVID-19 , Pandemias , Adolescente , Control de Enfermedades Transmisibles , Estudios Transversales , Femenino , Humanos , Masculino , Salud Mental , Noruega/epidemiología , Calidad de Vida , SARS-CoV-2 , Autoinforme , Factores Sexuales , Factores Socioeconómicos
4.
J Nepal Health Res Counc ; 19(2): 252-258, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34601512

RESUMEN

BACKGROUND: Information on trends in the prevalence of overweight and obesity and the high-risk groups helps plan health promotion programmes and health policy. This study examined trends in overweight and obesity from 2006 to 2016 and the associated socio-demographic factors in 2016 among 20 to 49-year-old women in Nepal. METHODS: Nationally representative cross-sectional data were used from three Demographic and Health Surveys conducted in 2006 (n=7809), 2011 (n=4561), and 2016 (n=4904) in Nepal. Bodyweight and height were measured by trained personnel. Overweight was defined as 23.0 to 27.5 kg/m2 and obesity as >27.5 kg/m2 based on Asian-specific criteria in the main analyses. Multinomial logistic regression models were adjusted for age, parity, education, and wealth index. RESULTS: The prevalence of overweight increased from 16.6% to 26.8% and obesity from 3.9% to 14.3% between 2006 and 2016. The adjusted odds ratios and 95% confidence intervals were 2.26 (2.06 to 2.49) for overweight and 5.26 (4.48 to 6.18) for obesity in 2016 compared with 2006. Age 30 to 49 years, higher wealth index, parity 1 to 3 and education were associated with a higher prevalence of overweight and obesity, whereas the association between the area of residence (urban/rural) and prevalence of overweight or obesity was not statistically significant. CONCLUSIONS: The prevalence of overweight and obesity increased among Nepalese women of reproductive age between 2006 and 2016. More research is needed on how to prevent overweight and obesity among women, especially women aged 30 to 49 years or with higher wealth, in Nepal.


Asunto(s)
Obesidad , Sobrepeso , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Nepal/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , Embarazo , Prevalencia , Factores Socioeconómicos , Adulto Joven
5.
Global Health ; 17(1): 117, 2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598720

RESUMEN

BACKGROUND: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. OBJECTIVES: We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. METHODS: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. RESULTS: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). CONCLUSIONS: The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.


Asunto(s)
Adaptación Psicológica , COVID-19/psicología , Miedo , Salud Global/estadística & datos numéricos , Distrés Psicológico , Adulto , COVID-19/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
6.
Medicine (Baltimore) ; 100(39): e27315, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596131

RESUMEN

ABSTRACT: Participation in volunteer activity has positive effects on health among elderly. Few studies have investigated the association between volunteer activity and depression among Chinese elderly. This study aimed to examine the association between volunteer activity and depression among the elderly in China regarding rural-urban differences.Totally 8255 subjects from the 2015 China Health and Retirement Longitudinal Study were selected in this study. Depression was assessed by 10-item Center for Epidemiologic Studies Depression Scale. Types and frequency of volunteer activity were measured in the questionnaire. Multiple linear regression analysis was used to explore the relationship between volunteer activity and depression of elderly.In our study, the urban elderly had lower depressive scores than rural elderly (6.7 ±â€Š5.8 vs. 9.1 ±â€Š6.7). After adjustment for all covariates, our results revealed that almost daily participation in formal volunteer activities was negatively associated with depression among urban elderly (B = -2.69, SE = 1.05, P = .010); almost daily caring for a sick or disabled adult was positively associated with depression among both urban and rural elderly (urban:B = 3.13, SE = 1.54, P = .043; rural:B = 2.56, SE = 1.18, P = .031).These findings suggested that there was a negative association between formal volunteer activity and depression among urban elderly, while there was a positive association between caring for a sick or disabled adult and depression among both urban and rural elderly. The government should take effective measures to encourage the elderly to participate in formal volunteer activities to prevent them from depression.


Asunto(s)
Depresión/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Voluntarios/psicología , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , Cuidadores/psicología , China/epidemiología , Femenino , Conductas Relacionadas con la Salud , Humanos , Estilo de Vida , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos
7.
Medicine (Baltimore) ; 100(39): e27339, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596139

RESUMEN

ABSTRACT: The effect of hypothermia as a mortality risk factor at 30 days in the elderly who had hip fracture (HF) surgery is still controversial because it may be due to a set of poorly identified factors. In this study, we aim to determine if exposure to intra and immediate postoperative hypothermia increases the incidence of mortality at 30 days in elderly patients who had HF surgery.Survival study in the elderly who had HF surgery with and without exposure to hypothermia. Sociodemographic, anesthetic and surgical factors were collected. The temperature of the rectum was measured at the end of the surgery and in the recovery room. The effect of hypothermia was analyzed by the incidence of mortality at 30 days. Other results were considered, such as, surgical site infection (SSI), blood transfusions, and influence of implants used in the 30-day mortality.Three hundred eighty five subjects were eligible, to include 300. Inadvertent hypothermia was 12%, the 30-day overall mortality was 9% and in subjects with hypothermia it was 25% (P = .002). Subjects with hypothermia had a higher risk of SSI (relative risk 4.2, 95% confidence interval 1.3-13.6, P = .03) and receive more transfusions (relative risk 3.6, 95% confidence interval 2.0-6.5, P < .001).Elderly subjects with HF exposed to hypothermia who undergo hip hemiarthroplasty and who receive 2 or more blood transfusions during their treatment, are at greater risk of dying after 30 days of the surgery. Hypothermia, as a possible causative factor of mortality, should continue to be studied.


Asunto(s)
Hemiartroplastia/mortalidad , Hemiartroplastia/métodos , Fracturas de Cadera/mortalidad , Fracturas de Cadera/cirugía , Hipotermia/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Transfusión Sanguínea/estadística & datos numéricos , Temperatura Corporal , Femenino , Humanos , Masculino , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Infección de la Herida Quirúrgica/epidemiología
8.
Medicine (Baltimore) ; 100(39): e27350, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34596141

RESUMEN

ABSTRACT: A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors.The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health.PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38-8.38]) and significant (P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44-5.4) and non-significant (P = .503) in the multivariate regression analysis.In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.


Asunto(s)
Enfermedad de la Arteria Coronaria/epidemiología , Enfermedades Periodontales/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Anciano , Presión Sanguínea , Índice de Masa Corporal , Comorbilidad , Estudios Transversales , Dislipidemias/epidemiología , Electrocardiografía , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
9.
Pan Afr Med J ; 39: 195, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603576

RESUMEN

Introduction: active ageing is the process of optimizing opportunities for health in order to enhance quality of life and wellbeing. It is influenced by physical activity, social participation and social network, cognitive and continuous learning and socio-economic factors. It involves disease prevention and promotion of healthy behaviours that can reduce the risk and occurrence of non-communicable diseases in middle age and also at old age. The study aimed to determine and compare the active ageing process and its determinants among middle-aged men in rural and urban areas in Nigeria. Methods: this was a comparative cross-sectional study among middle-aged men 40-60 years using mixed methods. A multi-stage sampling technique was used to select 720 respondents. A structured interviewer administered questionnaire and Key informant interviews were used to collect data. Results: respondents in the rural area were a little older compared to the respondents in the urban area with a mean age of 49.6 ± 6.3 years and 48.6 ± 6.2 years respectively. A higher proportion of the respondents in the rural area (83.2%) than the respondents in the urban area (73.8%) practice good active ageing processes in their lives. There was a significant association between education of respondent and the practice of active ageing among respondents in the urban and rural areas. Multivariate logistic regression showed that physical activity (aOR 7.62, 95% CI: 243-23.94, P = 0.001), life-long learning (aOR 51.73, 95% CI: 12.14-220.49, P = 0.000) and community participation (aOR 3.46, 95% CI: 2.51-4.77, P=0.000) are predictors of active ageing. Conclusion: the study showed that respondents in the rural area practice good active ageing compared to the respondents in the urban area and hence engaged more in sufficient active life in their daily activities, reducing the risk of non-communicable diseases.


Asunto(s)
Envejecimiento Saludable/fisiología , Calidad de Vida , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Envejecimiento/fisiología , Estudios Transversales , Conductas Relacionadas con la Salud , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Factores Socioeconómicos , Encuestas y Cuestionarios
10.
Int J Public Health ; 66: 584916, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34616240

RESUMEN

Objective: Much of the extensive quantitative research linking socio-economic position (SEP) and health utilizes three common indicators: income, occupation and education. Existing survey data may enable researchers to include indicators of additional forms of capital in their analyses, permitting more nuanced consideration of the relationship between SEP and health. Our objective was to identify the breadth of survey questions related to economic, cultural, and social capital available through Statistics Canada surveys, and the extent to which those surveys also include health measures. Methods: We compiled a list of all population-based Statistics Canada surveys, and developed a broad list of potential indicators of forms of capital. We systematically searched the surveys for those indicators and health measures, analyzing their co-occurrence. Results: Traditional SEP indicators were present in 73% of surveys containing health measures, while additional indicators of social and cultural capital were available in 57%. Conclusion: Existing national survey data represent an under-exploited opportunity for research examining the relationship between various forms of capital and health in Canada. Future empirical explorations of these data could enrich our theoretical understanding of health inequities.


Asunto(s)
Disparidades en el Estado de Salud , Canadá , Conjuntos de Datos como Asunto , Humanos , Capital Social , Factores Socioeconómicos , Encuestas y Cuestionarios
11.
Infect Dis Poverty ; 10(1): 122, 2021 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-34620243

RESUMEN

BACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.


Asunto(s)
Vacunas contra la COVID-19 , Intención , Vacunación , Adolescente , Adulto , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/administración & dosificación , Estudios Transversales , Femenino , Salud Global , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adulto Joven
12.
BMC Health Serv Res ; 21(1): 1070, 2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34627235

RESUMEN

BACKGROUND: Inadequate antenatal care (ANC) has been associated with adverse pregnancy outcomes. ANC quality is considered a key component of the right to health and a route to equity and dignity for women and their children. Although ANC coverage is relatively high in Brazil, there are revealed some health disparities when coverage is examined by socio-demographic determinants. In this study we evaluated ANC quality and its socio-demographic determinants using data from the 2015 Pelotas birth cohort, Rio Grande do Sul, Brazil. METHODS: This study is part of the 2015 Pelotas population-based birth cohort (n = 3923 pregnant women) conducted in southern Brazil. ANC quality was assessed through 19 content and service utilization indicators recommended by the Brazilian Ministry of Health. Descriptive analyses and associations of each of the ANC indicators and independent variables were performed using the chi-square and linear trend test. ANC indicators were analyzed individually and aggregated as a score. Associations between ANC score quality and socio-demographic variables were assessed with ordinal regressions. Mediation analysis with G-computation was performed to estimate direct and indirect effect of mother's level of education on ANC quality mediated by the number of consultations and timing of ANC initiation. Base and post confounders were included. RESULTS: The results showed that except for breast examination, height measurement, tetanus toxoid vaccination and ANC starting at the first trimester, all ANC indicators showed more than 80% coverage during ANC visits. In the adjusted analysis, inadequate quality ANC was associated with lower maternal education level, not having a partner, being multiparous, being attended by a private provider and by the same professional in all consultations. In the mediation analyses, 6.8% of the association between ANC quality and mother's education was mediated by the trimester in which ANC started, while 12.8% was mediated by the number of ANC visits. CONCLUSIONS: ANC quality is associated with pregnant women's socio-demographic characteristics. Significant efforts are needed to improve the quality of facility-based maternity care.


Asunto(s)
Servicios de Salud Materna , Atención Prenatal , Brasil , Niño , Femenino , Humanos , Embarazo , Calidad de la Atención de Salud , Factores Socioeconómicos
13.
Int J Public Health ; 66: 1604004, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34630005

RESUMEN

Objectives: To quantify the Black/Hispanic disparity in COVID-19 mortality in the United States (US). Methods: COVID-19 deaths in all US counties nationwide were analyzed to estimate COVID-19 mortality rate ratios by county-level proportions of Black/Hispanic residents, using mixed-effects Poisson regression. Excess COVID-19 mortality counts, relative to predicted under a counterfactual scenario of no racial/ethnic disparity gradient, were estimated. Results: County-level COVID-19 mortality rates increased monotonically with county-level proportions of Black and Hispanic residents, up to 5.4-fold (≥43% Black) and 11.6-fold (≥55% Hispanic) higher compared to counties with <5% Black and <15% Hispanic residents, respectively, controlling for county-level poverty, age, and urbanization level. Had this disparity gradient not existed, the US COVID-19 death count would have been 92.1% lower (177,672 fewer deaths), making the rate comparable to other high-income countries with substantially lower COVID-19 death counts. Conclusion: During the first 8 months of the SARS-CoV-2 pandemic, the US experienced the highest number of COVID-19 deaths. This COVID-19 mortality burden is strongly associated with county-level racial/ethnic diversity, explaining most US COVID-19 deaths.


Asunto(s)
Afroamericanos , COVID-19 , Disparidades en el Estado de Salud , Hispanoamericanos , Pandemias , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , COVID-19/etnología , COVID-19/mortalidad , Niño , Preescolar , Hispanoamericanos/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Factores Socioeconómicos , Estados Unidos/epidemiología , Adulto Joven
14.
Pan Afr Med J ; 39: 197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34603578

RESUMEN

The COVID-19 pandemic has changed the world in so many ways since 2019 when the first case was recorded. COVID-19 pandemic has impacted negatively on economy, health, education and infrastructure globally. COVID-19 vaccine was developed with the aim of stopping the pandemic and allowing the rebuilding of our societies and economies. The vaccine was rolled out in December 2020 and the distribution plan appears to be skewed in favour of high income countries. This paper highlights the need for consideration of the principles of equity and universal health coverage in the distribution plan of the vaccine. It emphasizes the need to ensure that the interests of citizens of developing and low income countries are well protected. The paper concludes that issues of disparity in economic status of countries entering agreement with the vaccine manufacturing companies, absence of logistic support among others should not be a barrier to ensuring equitable access to vaccine for all consistent with the sustainable development goal 3.7.


Asunto(s)
Vacunas contra la COVID-19/provisión & distribución , COVID-19/prevención & control , Disparidades en Atención de Salud/economía , Cobertura Universal del Seguro de Salud/economía , Vacunas contra la COVID-19/economía , Países en Desarrollo , Industria Farmacéutica/economía , Salud Global , Equidad en Salud , Accesibilidad a los Servicios de Salud/economía , Humanos , Factores Socioeconómicos
15.
PLoS One ; 16(9): e0257634, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34547041

RESUMEN

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has negatively impacted health systems worldwide, including in Bangladesh, limiting access to family planning information (FP) and services. Unfortunately, the evidence on the factors linked to such disruption is limited, and no study has addressed the link among Bangladeshis. This study aimed to examine the socioeconomic, demographic, and other critical factors linked to the use of FP in the studied areas during the COVID-19 pandemic. METHODS: The characteristics of the respondents were assessed using a cross-sectional questionnaire survey and descriptive statistics. The variables that were substantially linked with FP usage were identified using a Chi-square test. In addition, a multivariate logistic regression model was used to identify the parameters linked to FP in the study areas during the COVID-19 pandemic. RESULTS: The prevalence of FP use among currently married 15-49 years aged women was 36.03% suggesting a 23% (approximately) decrease compared to before pandemic data. Results also showed that 24.42% of the respondents were using oral contraceptive pills (OCP) which is lower than before pandemic data (61.7%). Multivariate regression analysis provided broader insight into the factors affecting FP use. Results showed that woman's age, education level of the respondents, working status of the household head, locality, reading a newspaper, FP workers' advice, currently using OCP, ever used OCP, husbands' supportive attitude towards OCP use, duration of the marriage, ever pregnant, the number of children and dead child were significantly associated with FP use in the study areas during COVID-19 pandemic. CONCLUSIONS: This study discusses unobserved factors that contributed to a reduction in FP use and identifies impediments to FP use in Bangladesh during the COVID-19 epidemic. This research further adds to our understanding of FP usage by revealing the scope of the COVID-19 pandemic's impact on FP use in Bangladesh's rural and urban areas.


Asunto(s)
COVID-19/epidemiología , Servicios de Planificación Familiar/estadística & datos numéricos , Pandemias , Adulto , Anciano , Bangladesh/epidemiología , Niño , Estudios Transversales , Escolaridad , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Embarazo , Prevalencia , Factores Socioeconómicos
16.
Artículo en Inglés | MEDLINE | ID: mdl-34574582

RESUMEN

The reduction of population concentration in some urban land uses is one way to prevent and reduce the spread of COVID-19 disease. Therefore, the objective of this study is to prepare the risk mapping of COVID-19 in Tehran, Iran, using machine learning algorithms according to socio-economic criteria of land use. Initially, a spatial database was created using 2282 locations of patients with COVID-19 from 2 February 2020 to 21 March 2020 and eight socio-economic land uses affecting the disease-public transport stations, supermarkets, banks, automated teller machines (ATMs), bakeries, pharmacies, fuel stations, and hospitals. The modeling was performed using three machine learning algorithms that included random forest (RF), adaptive neuro-fuzzy inference system (ANFIS), and logistic regression (LR). Feature selection was performed using the OneR method, and the correlation between land uses was obtained using the Pearson coefficient. We deployed 70% and 30% of COVID-19 patient locations for modeling and validation, respectively. The results of the receiver operating characteristic (ROC) curve and the area under the curve (AUC) showed that the RF algorithm, which had a value of 0.803, had the highest modeling accuracy, which was followed by the ANFIS algorithm with a value of 0.758 and the LR algorithm with a value of 0.747. The results showed that the central and the eastern regions of Tehran are more at risk. Public transportation stations and pharmacies were the most correlated with the location of COVID-19 patients in Tehran, according to the results of the OneR technique, RF, and LR algorithms. The results of the Pearson correlation showed that pharmacies and banks are the most incompatible in distribution, and the density of these land uses in Tehran has caused the prevalence of COVID-19.


Asunto(s)
COVID-19 , Algoritmos , Humanos , Irán , Aprendizaje Automático , SARS-CoV-2 , Factores Socioeconómicos
17.
Cien Saude Colet ; 26(9): 3955-3964, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34586251

RESUMEN

The objective of this study is to describe the profile of use of primary health care services, estimated by the PNS, of the population living in households registered and not registered with the Famly Health Strategy - FHS, in the years 2013 and 2019. Cross-sectional study carried out using microdata from national health surveys 2013 and 2019. The sample originated from a master sample, consisting of a set of units from selected areas in a register..The variables sex, age, skin color, income, education, self-perceived health, home registered with the FHS, medical care in the last year, type of service you seek when you are ill were selected. The dependent variables were use of health services and use of public health services. The dependent and independent variables were described with the respective confidence interval and adjusted logistic regression was performed for each outcome analyzed. In public health services, lower income, have chronic diseases (arterial hypertension or high cholesterol), be pregnant, and having a bad self-perception of health were associated with used more health services in both periods. Living in registered households was associated with more used health services (public or private). The family health strategy is an important strategy for expanding access equally.


Asunto(s)
Salud de la Familia , Servicios de Salud , Brasil , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Embarazo , Factores Socioeconómicos
18.
Cien Saude Colet ; 26(9): 4007-4019, 2021 Sep.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34586255

RESUMEN

The global burden and the prevalence of systemic arterial hypertension (SAH) have increased over the last two decades, especially in low- and middle-income countries, and are a concern to health authorities. This study analyzed the prevalence of SAH reported by Brazilian adults in 2008, 2013, and 2019, and individual disease control in 2013 and 2019. Data from the National Household Sample Survey (2008) and National Health Survey (2013-2019) were employed. We calculated the disease's prevalence ratios using Poisson regression, adjusted for sociodemographic characteristics. Regarding health care and PHC organization indicators, we calculated proportions by gender, age group, ethnicity, and region. The results reveal persistent regional inequalities, with lower prevalence in the North and Northeast and higher prevalence in the Southeast and South. While the health care access and use indicators are positive, reflecting PHC improvements in recent years, we highlight the importance of adopting multifaceted SAH prevention and control strategies in the country.


Asunto(s)
Hipertensión , Adulto , Brasil/epidemiología , Accesibilidad a los Servicios de Salud , Encuestas Epidemiológicas , Humanos , Hipertensión/epidemiología , Prevalencia , Factores Socioeconómicos
19.
Cien Saude Colet ; 26(9): 4021-4032, 2021 Sep.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34586256

RESUMEN

This paper aims to evaluate gender and racial inequalities in the access and use of health services in Brazil Based on the 2019 National Health Survey (PNS). Its main objective is to understand how white, black, or brown men and women seek medical care in Primary Health Care, the gateway to the Brazilian health system. Analyses from a gender perspective show that cultural and social patterns affect individual actions and choices and mainly access to and use of health services. The results also show that men and women reproduce the expected gender behavior, socially and culturally constructed, which impacts their self-assessment of health status, care, and their exposure to the risk of disease and death. The intersectional analysis reveals that racial inequalities are aligned with those observed between men and women, exponentiating vulnerabilities for self-identified black or brown people, reflecting the structural socioeconomic inequalities of Brazilian society. In this context, the universality and integrality recommended in the Unified Health System contribute as a public policy to the guarantee of rights, equalization of opportunities, and adequate access to equal care.


Asunto(s)
Grupos de Población Continentales , Identidad de Género , Brasil , Femenino , Servicios de Salud , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Factores Socioeconómicos
20.
Cien Saude Colet ; 26(9): 4309-4320, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34586281

RESUMEN

The purpose of this study is to determine the factors associated with negative self-rated health in Brazil. The sample consisted of 5,259 adults from five representative capitals of the five regions of Brazil. Data collection was achieved in the following municipalities: Palmas (North Region), João Pessoa (Northeast Region), Goiânia (Central-West Region), Vitória (Southeast Region) and Florianópolis (South Region). For the analysis of the data, Binary Logistic Regression for determine the factors associated with negative self-rated health was used. Negative self-rated health was identified in 31.43% of Brazilians. The factors that were significantly associated were bad air quality, does not have public spaces for leisure, older age group, insufficient salary to cover expenses, a rare practice of physical exercises, does not perform healthy eating, active commuting for study or employment and commuting time for above 30 minutes, dissatisfaction with health services and still, not working, not looking for a job and finally, reside in some Brazilian regions. The study presents the importance of socioenvironmental and behavioral factors for the self-rated health of Brazilian adults, as well as it shows high rates of negative self-rated health compared to other studies.


Asunto(s)
Ejercicio Físico , Actividades Recreativas , Adulto , Anciano , Brasil , Ciudades , Estudios Transversales , Humanos , Modelos Logísticos , Factores Socioeconómicos
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