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Hoveidaei AH, Nakhostin-Ansari A, Chalian M, Razavi SE, Khonji MS, Hosseini-Asl SH, Darijani SR, Pooyan A, LaPorte DM. Burden of Hand Osteoarthritis in the Middle East and North Africa (MENA): An Epidemiological Analysis From 1990 to 2019. J Hand Surg Am 2023; 48:245-256. [PMID: 36710229 DOI: 10.1016/j.jhsa.2022.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE Hand osteoarthritis (OA) is a common cause of disability in older people. Although often underemphasized, it may affect quality of life and imposes a considerable burden on the health system. This study evaluated the epidemiology of hand OA in the Middle East and North Africa (MENA) region. METHODS This epidemiological study was performed based on the Global Burden of Disease study from 1990 to 2019. The incidence, prevalence, and years lived with disability (YLD) in all 21 MENA countries during the study period were reported in rate, age-standardized, and percentage. RESULTS Hand osteoarthritis in MENA increased 2.7-fold, from 1.6 million cases to 4.3 million from 1990 to 2019 with an age-standardized incidence rate of 50.2 (95% CI, 38.2-66.4) per 100,000 people in 2019. Saudi Arabia had the highest age-standardized prevalence in both 1990 (2.3%) and 2019 (2.3%), whereas Turkey had the lowest (0.3%) in both years. Total YLDs due to hand osteoarthritis increased by more than 2.7-fold, from 50,335 to 135,336 during the study period. The highest rate of increase in YLD rate from 1990 to 2019 was in Iran (3.3) and the largest decrease was in Qatar (-11.5). CONCLUSIONS In contrast to the global trend, MENA hand OA prevalence and YLDs did not decrease between 1990 and 2019 and remained constant over time. Aging and increasing obesity rates, particularly among women, might be the contributing factors. Hand OA epidemiology varies by country, possibly due to genetic, ethnic, and environmental factors. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic II.
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Affiliation(s)
- Amir Human Hoveidaei
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Chalian
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA
| | - Seyed Erfan Razavi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saeid Khonji
- Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Hosseini-Asl
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Atefe Pooyan
- Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, Seattle, WA
| | - Dawn M LaPorte
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
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Child Marriage and Later-Life Risk of Obesity in Women: A Cohort Analysis Using Nationally Representative Repeated Cross-Sectional Data from Tajikistan. WOMEN 2023. [DOI: 10.3390/women3010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Child marriage, defined as union before age 18 years, has detrimental health and socioeconomic consequences. This study examines whether women married as children have a disproportionately higher risk of being obese at adulthood compared to their peers married as adults. Using data from the 2012 and 2017 waves of the Tajikistan Demographic and Health Survey, we matched women aged 25 to 49 years by birth year and month to create four birth cohorts. We fitted multivariable logistic regressions to assess the differential odds of being obese and estimated simultaneous quantile regression models to examine the differences in average body mass index (BMI) between women married as adults and as children within birth cohorts. We found that the adjusted odds of being obese for women married as children were 1.5 (CI: 1.3–1.7) times those of those who were married as adults, after controlling for sociodemographic correlates along with birth cohort and survey wave fixed effects. Results of the quantile regression analyses suggest higher expected BMI levels among women married as children compared to those of women married as adults across different quantiles of BMI. The differences though were more pronounced in the younger cohorts than in the older cohorts.
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Tumas N, Rodríguez López S, Mazariegos M, Ortigoza A, Anza Ramírez C, Pérez Ferrer C, Moore K, Yamada G, Menezes MC, Sarmiento OL, Pericàs JM, Belvis Costes F, Lazo M, Benach J. Are Women's Empowerment and Income Inequality Associated with Excess Weight in Latin American Cities? J Urban Health 2022; 99:1091-1103. [PMID: 36357625 PMCID: PMC7613896 DOI: 10.1007/s11524-022-00689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/12/2022]
Abstract
While income gradients and gender inequalities in excess weight have been noted elsewhere, data from Latin American cities is lacking. We analyzed gender-specific associations between city-level women's empowerment and income inequality with individual-level overweight/obesity, assessing how these associations vary by individual education or living conditions within cities in Latin America. Data came from national surveys and censuses, and was compiled by the SALURBAL project (Urban Health in Latin America). The sample included 79,422 individuals (58.0% women), living in 538 sub-cities, 187 cities, and 8 countries. We used gender-stratified Poisson multilevel models to estimate the Prevalence Rate Ratios (PRR) for overweight/obesity (body mass index ≥ 25 kg/m2) per a unit change in city-level women's empowerment (proxied by a score that measures gender inequalities in employment and education) and income inequality (proxied by income-based Gini coefficient). We also tested whether individual education or sub-city living conditions modified such associations. Higher city labor women's empowerment (in women) and higher city Gini coefficient (in men) were associated with a lower prevalence of overweight/obesity (PRR = 0.97 (95%CI 0.94, 0.99) and PRR = 0.94 (95%CI 0.90, 0.97), respectively). The associations varied by individual education and sub-city living conditions. For labor women's empowerment, we observed weakened associations towards the null effect in women with lower education and in residents of sub-cities with worse living conditions (men and women). For the Gini coefficient, the association was stronger among men with primary education, and a negative association was observed in women with primary education. Our findings highlight the need for promoting equity-based policies and interventions to tackle the high prevalence of excess weight in Latin American cities.
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Affiliation(s)
- Natalia Tumas
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain.
- Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain.
- Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Santiago Rodríguez López
- Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina
- Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Mónica Mazariegos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Cecilia Anza Ramírez
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú
| | | | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Goro Yamada
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | | | | | - Juan M Pericàs
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain
- Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain
- Liver Unit, Internal Medicine Department, Vall d'Hebron Institute for Research, Vall d'Hebron University Hospital, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Francesc Belvis Costes
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain
- Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain
| | - Mariana Lazo
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Joan Benach
- Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain
- Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain
- Ecological Humanities Research Group (GHECO), Universidad Autónoma, Madrid, Spain
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The sociocultural mechanism of obesity: The influence of gender role attitudes on obesity and the gender gap. Soc Sci Med 2021; 293:114655. [PMID: 34942576 DOI: 10.1016/j.socscimed.2021.114655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 11/22/2022]
Abstract
Worldwide, women are more likely to be obese than men, but research on the mechanism of the gender gap in obesity is relatively lacking. This article uses five rounds of Chinese General Social Survey (CGSS) data from 2010 to 2017 to empirically test the impact of gender role attitudes on obesity and the gender gap and to explore the mechanism. The main results show that the traditional gender role attitude will improve the probability of obesity in women, but it will not positively impact obesity in men. Using the proportion of "March 8th red flag bearer" at the provincial level as an instrumental variable to alleviate the possible estimation errors caused by omitted variables, the results show that the lower the proportion of red flag bearers, the higher the probability of obesity of women, and still will not improve the probability of obesity of men. The robustness test based on the generalized propensity score method (GPSM) supports the above results. The mechanism analysis shows that economic status and market participation are two essential mechanisms of gender role attitudes and female obesity. Traditional gender role attitudes increase the risk of women's obesity by reducing their economic status and labour market participation.
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Inocian EP, Nolfi DA, Felicilda-Reynaldo RFD, Bodrick MM, Aldohayan A, Kalarchian MA. Bariatric surgery in the Middle East and North Africa: narrative review with focus on culture-specific considerations. Surg Obes Relat Dis 2021; 17:1933-1941. [PMID: 34332910 DOI: 10.1016/j.soard.2021.06.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/19/2021] [Accepted: 06/18/2021] [Indexed: 12/26/2022]
Abstract
There is an increasing volume of bariatric surgeries in the Middle East and North Africa (MENA), but the context of bariatric surgery in the region is not fully understood. Incorporating culture-specific considerations in the provision of care to patients who undergo bariatric surgery may help to optimize outcomes after surgery. We conducted a narrative review of published research studies on bariatric surgery in the MENA region, highlighting cultural and contextual aspects relevant to the care of bariatric surgery patients who undergo surgery in this geographic area. The authors searched the following online databases: PubMed, CINAHL, Embase, and Academic Search Elite from 2010-2020 for studies conducted in 18 countries in the MENA region. This narrative review identifies cultural-specific considerations that may affect bariatric care and outcomes in 6 domains: knowledge of bariatric surgery; mental health, body image, and quality of life; influence of family; religion and lifestyle; preoperative practices; and healthcare access. Provision of culturally congruent care may help patients to achieve the best possible outcomes after bariatric surgery. Results may inform efforts to provide safe and culture-specific care in the MENA region, as well as those who migrate or seek care in other countries. More research is warranted on this heterogeneous population to optimize postsurgery weight trajectory and psychosocial adjustment.
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Affiliation(s)
- Ergie P Inocian
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania.
| | - David A Nolfi
- Gumberg Library, Duquesne University, Pittsburgh, Pennsylvania
| | | | - Mustafa M Bodrick
- Health Academy, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Abdullah Aldohayan
- Department of Surgery, King Saud University Medical City, Riyadh, Saudi Arabia
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Differences in Health Characteristics of Geographic Subgroups of Arab Americans in a Northern California Health Plan. J Racial Ethn Health Disparities 2021; 9:399-405. [PMID: 33502685 DOI: 10.1007/s40615-021-00970-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Arab Americans are a diverse ethnic group originating from a large geographic area in the Middle East and North Africa (MENA). We aim to characterize differences in health between Arab Americans from different geographic subgroups within MENA. METHODS We used cross-sectional electronic health record (EHR) data for a subset of 4913 Arab Americans aged 20-84 in a 2016 Northern California health plan study cohort who could be assigned to one of 4 geographic subgroups (Gulf, African, Levant, and Other) based on EHR ethnicity data. We calculated age-adjusted prevalence estimates for men and women and used generalized linear models to compare Gulf, African, and Other subgroups to Levant Arabs on risk factors (obesity and smoking), chronic conditions (diabetes, hypertension, hyperlipidemia, and asthma), and mental health (depression and anxiety). RESULTS Among women, prevalence of smoking was lower among Gulf, African, and Other Arabs than Levant Arabs. Among men, prevalence of obesity, diabetes, and hyperlipidemia was lower among Gulf, African, and Other Arabs than Levant Arabs, while prevalence of depression was higher for these subgroups than Levant Arabs. DISCUSSION We found substantial differences in health characteristics across Arab Americans from different geographic subgroups. Our results suggest that more detailed race and ethnicity information should be collected on Arab Americans to better understand their diverse health risks.
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