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Blake AL, Bennett NR, McKenzie JA, Tulloch-Reid MK, Govia I, McFarlane SR, Walters R, Francis DK, Wilks RJ, Williams DR, Younger-Coleman NO, Ferguson TS. Social support and ideal cardiovascular health in urban Jamaica: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003466. [PMID: 39078827 PMCID: PMC11288424 DOI: 10.1371/journal.pgph.0003466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/19/2024] [Indexed: 08/02/2024]
Abstract
Recent studies have suggested that high levels of social support can encourage better health behaviours and result in improved cardiovascular health. In this study we evaluated the association between social support and ideal cardiovascular health among urban Jamaicans. We conducted a cross-sectional study among urban residents in Jamaica's south-east health region. Socio-demographic data and information on cigarette smoking, physical activity, dietary practices, blood pressure, body size, cholesterol, and glucose, were collected by trained personnel. The outcome variable, ideal cardiovascular health, was defined as having optimal levels of ≥5 of these characteristics (ICH-5) according to the American Heart Association definitions. Social support exposure variables included number of friends (network size), number of friends willing to provide loans (instrumental support) and number of friends providing advice (informational support). Principal component analysis was used to create a social support score using these three variables. Survey-weighted logistic regression models were used to evaluate the association between ICH-5 and social support score. Analyses included 841 participants (279 males, 562 females) with mean age of 47.6 ± 18.42 years. ICH-5 prevalence was 26.6% (95%CI 22.3, 31.0) with no significant sex difference (male 27.5%, female 25.7%). In sex-specific, multivariable logistic regression models, social support score, was inversely associated with ICH-5 among males (OR 0.67 [95%CI 0.51, 0.89], p = 0.006) but directly associated among females (OR 1.26 [95%CI 1.04, 1.53], p = 0.020) after adjusting for age and community SES. Living in poorer communities was also significantly associated with higher odds of ICH-5 among males, while living communities with high property value was associated with higher odds of ICH among females. In this study, higher level of social support was associated with better cardiovascular health among women, but poorer cardiovascular health among men in urban Jamaica. Further research should explore these associations and identify appropriate interventions to promote cardiovascular health.
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Affiliation(s)
- Alphanso L. Blake
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
- School of Clinical Medicine and Research, The Faculty of Medical Sciences, The University of the West Indies, Nassau, The Bahamas
| | - Nadia R. Bennett
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Joette A. McKenzie
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Marshall K. Tulloch-Reid
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Shelly R. McFarlane
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Renee Walters
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Damian K. Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, Georgia, United States of America
| | - Rainford J. Wilks
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Novie O. Younger-Coleman
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Trevor S. Ferguson
- Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
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Gary-Webb TL, Dyer H, Mckenzie J, Younger-Coleman N, Tulloch-Reid M, Blake A, Govia I, Bennett N, McFarlane S, Wilks RJ, Williams DR, Ferguson TS. Community stressors (violence, victimization, and neighborhood disorder) with cardiometabolic outcomes in urban Jamaica. Front Public Health 2023; 11:1130830. [PMID: 37346100 PMCID: PMC10280444 DOI: 10.3389/fpubh.2023.1130830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Background Despite limited data on neighborhood factors and health risk in Caribbean populations, previous analyses from Jamaica have shown that neighborhood and home disorder were associated with lower physical activity and higher cumulative biological risk among women, while poorer neighborhood infrastructure was associated with higher overweight/obesity among men. Design Cross-sectional survey design. Objectives In this study, we explored whether community stressors, as measured by community violence, victimization and neighborhood disorder scores, were associated with cardiometabolic outcomes (obesity, diabetes, hypertension and high cholesterol) in urban Jamaican communities. Sex-specific Poisson regression models were used to estimate prevalence ratios (PR) for these associations, adjusting for age, education, diet, physical activity and smoking. Participants Of the 849 participants (M = 282; F = 567), mean age was 48 ± 18.5 years and most had at least a high school education. Men were more likely to be current smokers (29.4 vs. 10.6%) and adequately physically active (53.2 vs. 42.0%); more women were obese (46.0 vs. 19.0%), more likely to have hypertension (52.9 vs. 45.4%) and had high cholesterol (34.2 vs. 21.6%) (all p < 0.05). Results We observed significant associations only for those in the middle tertile of neighborhood disorder with prevalence of higher cholesterol [PR:1.72 (1.20 to 2.47)] in women and lower prevalence of obesity [PR:0.24 (0.10 to 0.53)] in men. Conclusion Results suggest that higher, but not the highest level of neighborhood disorder was associated with higher cholesterol levels in women and lower obesity in men. Future work will explore additional approaches to measuring neighborhood characteristics in Jamaica and the mechanisms that may underlie any relationships that are identified.
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Affiliation(s)
- Tiffany L. Gary-Webb
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Harika Dyer
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joette Mckenzie
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Novie Younger-Coleman
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Marshall Tulloch-Reid
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Alphanso Blake
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Ishtar Govia
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Nadia Bennett
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Shelly McFarlane
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - Rainford J. Wilks
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Trevor S. Ferguson
- Caribbean Institute for Health Research (CAIHR), The University of the West Indies, Mona, Kingston, Jamaica
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Gu J, Ming X. The Influence of Living Conditions on Self-Rated Health: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9200. [PMID: 34501800 PMCID: PMC8431523 DOI: 10.3390/ijerph18179200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 11/24/2022]
Abstract
Despite growing attention to living conditions as a social determinant of health, few studies have focused on its diverse impacts on self-rated health. Using data from the China Family Panel Study in 2018, this study used logistic regression analysis to examine how living conditions affect self-rated health in China, finding that people cooking with sanitary water and clean fuel were more likely to report good health, and that homeownership was associated with higher self-rated health. The self-rated health of people living in high-quality housing was lower than that of people living in ordinary housing, and people living in tidy homes were more likely to report good health. The findings suggest that the link between multiple living conditions and self-rated health is dynamic. Public health policies and housing subsidy programs should therefore be designed based on a comprehensive account of not only housing grade or income status, but also whole dwelling conditions.
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Affiliation(s)
- Jiafeng Gu
- Institute of Social Science Survey, Peking University, Beijing 100871, China
| | - Xing Ming
- School of Sociology and Political Science, Shanghai University, Shanghai 200444, China;
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Yeasmin S, Banik R, Hossain S, Hossain MN, Mahumud R, Salma N, Hossain MM. Impact of COVID-19 pandemic on the mental health of children in Bangladesh: A cross-sectional study. CHILDREN AND YOUTH SERVICES REVIEW 2020; 117:105277. [PMID: 32834275 PMCID: PMC7387938 DOI: 10.1016/j.childyouth.2020.105277] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 05/09/2023]
Abstract
COVID-19 pandemic poses a significant mental health threat among children in Bangladesh. This study aims to explore the impact of COVID-19 on the mental health of children during the lockdown in Bangladesh. An online cross-sectional study was conducted from 25th April to 9th May 2020 among 384 parents having at least one child aged between 5-15 years using non-probability sampling. K-means clustering used to group children according to mental health score and confirmatory factor analysis (CFA) performed to identify the relationship among the parental behavior and child mental health, and also these associations were assessed through chi-square test. Children were classified into four groups where 43% of child had subthreshold mental disturbances (mean Major Depressive Disorder (MDD)-10; 2.8), 30.5% had mild (mean MDD-10; 8.9), 19.3% suffered moderately (mean MDD-10; 15.9), and 7.2% of child suffered from severe disturbances (mean MDD-10; 25.2). The higher percentage of mental health disturbances of children with the higher education level of parents, relative infected by COVID-19 (yes), parents still need to go the workplace (yes), and parent's abnormal behavior but lower to their counterparts. This paper demonstrates large proportions of children are suffering from mental health disturbances in Bangladesh during the period of lockdown. Implementation of psychological intervention strategies and improvement in house-hold financial conditions, literacy of parents, taking care of children, and job security may help in improving the psychological/mental status of children and the authors believe that the findings will be beneficial to accelerate the rate of achieving the Sustainable Development Goal (SDG) linked to health status in Bangladesh.
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Affiliation(s)
- Sabina Yeasmin
- Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Rajon Banik
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68, Shahid Tajuddin Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Sorif Hossain
- Institute of Statistical Research and Training, University of Dhaka, Bangladesh
| | - Md Nazmul Hossain
- Department of Statistics, Islamic University, Kushtia, Khulna, Bangladesh
| | - Raju Mahumud
- Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Nahid Salma
- Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
| | - Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh
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Naheeda P, Sharifullah K, Ullah SS, Azeem AM, Shahzad Y, Kinza W. Development of a cost-effective CVD prediction model using lifestyle factors. A cohort study in Pakistan. Afr Health Sci 2020; 20:849-859. [PMID: 33163052 PMCID: PMC7609114 DOI: 10.4314/ahs.v20i2.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Cardiovascular diseases (CVD) such as hypertension and ischemic heart diseases cause 35 to 40% of deaths every year in Pakistan. Several lifestyle factors such as dietary habits, lack of exercise, mental stress, body habitus (i.e., body mass index, waist), personal habits (smoking, sleep, fitness) and clinical conditions (i.e., diabetes, dyslipidemia and hypertension) have been shown to be strongly associated with the etiology of CVD. Epidemiological studies in Pakistan have shown poor adherence of people to healthy lifestyle and lack of knowledge in adopting healthy alternatives. There are well validated cardiovascular risk estimation tools (QRISK model) that cn predict the probability of future cardiac events. The existing tools are based on laboratory investigations of biochemical test but there is no widely accepted tool available that predicts the CVD risk probability based on lifestyle factors. Aims: Aim of the current study was to develop alternative CVD risk estimation model based on lifestyle factors and physical attributes (without using laboratory investigation) using QRISK model as the gold standard. Study Design: Clinical and lifestyle data of one hundred and sixty subjects were collected to formulate a regression model for predicting CVD risk probability. Methods: Lifestyle factors as independent variables (IV) include BMI, waist circumference, physical activities (stamina, strength, flexibility, posture), smoking, general illnesses, dietary intake, stress and physical characteristics. CVD risk probability of QRISK Intervention computed through clinical variables was used as a dependent variable (DV) in present research. Chronological age was also included in analysis in addition to selected lifestyle factors. Regression analysis, principal component analysis and bivariate correlations were applied to assess the relationship among predictor variables and cardiovascular risk score. Results: Chronological age, waist circumference, BMI and strength showed significant effect on CVD risk probability. The proposed model can be used to calculate CVD risk probability with 72.9% accuracy for the targeted population. Conclusion: The model involves only those features which can be measured without any clinical test. The proposed model is rapid and less costly hence appropriate for use in developing countries like Pakistan.
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Affiliation(s)
- Parveen Naheeda
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Khan Sharifullah
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
- Corresponding author: Sharifullah Khan, School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
| | - Shah Saeed Ullah
- Department of Cardiology, Shifa International Hospital Islamabad, Pakistan
| | - Abbas Muhammad Azeem
- University Institute of Information Technology, PMAS, Arid Agriculture University, Rawalpindi, Pakistan
| | - Younis Shahzad
- School of Electrical Engineering and Computer Science, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Waqar Kinza
- Department of Cardiology, Shifa International Hospital Islamabad, Pakistan
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Ameye H, Swinnen J. Obesity, income and gender: The changing global relationship. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2019. [DOI: 10.1016/j.gfs.2019.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ferguson TS, Younger-Coleman NOM, Tulloch-Reid MK, Bennett NR, Rousseau AE, Knight-Madden JM, Samms-Vaughan ME, Ashley DE, Wilks RJ. Factors associated with elevated blood pressure or hypertension in Afro-Caribbean youth: a cross-sectional study. PeerJ 2018; 6:e4385. [PMID: 29456896 PMCID: PMC5815333 DOI: 10.7717/peerj.4385] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/29/2018] [Indexed: 12/20/2022] Open
Abstract
Background Although several studies have identified risk factors for high blood pressure (BP), data from Afro-Caribbean populations are limited. Additionally, less is known about how putative risk factors operate in young adults and how social factors influence the risk of high BP. In this study, we estimated the relative risk for elevated BP or hypertension (EBP/HTN), defined as BP ≥ 120/80 mmHg, among young adults with putative cardiovascular disease (CVD) risk factors in Jamaica and evaluated whether relative risks differed by sex. Methods Data from 898 young adults, 18–20 years old, were analysed. BP was measured with a mercury sphygmomanometer after participants had been seated for 5 min. Anthropometric measurements were obtained, and glucose, lipids and insulin measured from a fasting venous blood sample. Data on socioeconomic status (SES) were obtained via questionnaire. CVD risk factor status was defined using standard cut-points or the upper quintile of the distribution where the numbers meeting standard cut-points were small. Relative risks were estimated using odds ratios (OR) from logistic regression models. Results Prevalence of EBP/HTN was 30% among males and 13% among females (p < 0.001 for sex difference). There was evidence for sex interaction in the relationship between EBP/HTN and some of risk factors (obesity and household possessions), therefore we report sex-specific analyses. In multivariable logistic regression models, factors independently associated with EBP/HTN among men were obesity (OR 8.48, 95% CI [2.64–27.2], p < 0.001), and high glucose (OR 2.01, CI [1.20–3.37], p = 0.008), while high HOMA-IR did not achieve statistical significance (OR 2.08, CI [0.94–4.58], p = 0.069). In similar models for women, high triglycerides (OR 1.98, CI [1.03–3.81], p = 0.040) and high HOMA-IR (OR 2.07, CI [1.03–4.12], p = 0.039) were positively associated with EBP/HTN. Lower SES was also associated with higher odds for EBP/HTN (OR 4.63, CI [1.31–16.4], p = 0.017, for moderate vs. high household possessions; OR 2.61, CI [0.70–9.77], p = 0.154 for low vs. high household possessions). Alcohol consumption was associated with lower odds of EBP/HTN among females only; OR 0.41 (CI [0.18–0.90], p = 0.026) for drinking <1 time per week vs. never drinkers, and OR 0.28 (CI [0.11–0.76], p = 0.012) for drinking ≥3 times per week vs. never drinkers. Physical activity was inversely associated with EBP/HTN in both males and females. Conclusion Factors associated with EBP/HTN among Jamaican young adults include obesity, high glucose, high triglycerides and high HOMA-IR, with some significant differences by sex. Among women lower SES was positively associated with EBP/HTN, while moderate alcohol consumption was associated lower odds of EBP/HTN.
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Affiliation(s)
- Trevor S Ferguson
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | | | - Marshall K Tulloch-Reid
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Nadia R Bennett
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Amanda E Rousseau
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | | | | | - Deanna E Ashley
- School of Graduate Studies and Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Rainford J Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
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Ferguson TS, Younger-Coleman NOM, Tulloch-Reid MK, Hambleton IR, Francis DK, Bennett NR, McFarlane SR, Bidulescu A, MacLeish MY, Hennis AJM, Wilks RJ, Harris EN, Sullivan LW. Educational Health Disparities in Cardiovascular Disease Risk Factors: Findings from Jamaica Health and Lifestyle Survey 2007-2008. Front Cardiovasc Med 2017; 4:28. [PMID: 28555188 PMCID: PMC5430054 DOI: 10.3389/fcvm.2017.00028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 04/24/2017] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Socioeconomic disparities in health have emerged as an important area in public health, but studies from Afro-Caribbean populations are uncommon. In this study, we report on educational health disparities in cardiovascular disease (CVD) risk factors (hypertension, diabetes mellitus, hypercholesterolemia, and obesity), among Jamaican adults. METHODS We analyzed data from the Jamaica Health and Lifestyle Survey 2007-2008. Trained research staff administered questionnaires and obtained measurements of blood pressure, anthropometrics, glucose and cholesterol. CVD risk factors were defined by internationally accepted cut-points. Educational level was classified as primary or lower, junior secondary, full secondary, and post-secondary. Educational disparities were assessed using age-adjusted or age-specific prevalence ratios and prevalence differences obtained from Poisson regression models. Post-secondary education was used as the reference category for all comparisons. Analyses were weighted for complex survey design to yield nationally representative estimates. RESULTS The sample included 678 men and 1,553 women with mean age of 39.4 years. The effect of education on CVD risk factors differed between men and women and by age group among women. Age-adjusted prevalence of diabetes mellitus was higher among men with less education, with prevalence differences ranging from 6.9 to 7.4 percentage points (p < 0.05 for each group). Prevalence ratios for diabetes among men ranged from 3.3 to 3.5 but were not statistically significant. Age-specific prevalence of hypertension was generally higher among the less educated women, with statistically significant prevalence differences ranging from 6.0 to 45.6 percentage points and prevalence ratios ranging from 2.5 to 4.3. Similarly, estimates for obesity and hypercholesterolemia suggested that prevalence was higher among the less educated younger women (25-39 years) and among more educated older women (40-59 and 60-74 years). There were no statistically significant associations for diabetes among women, or for hypertension, high cholesterol, or obesity among men. CONCLUSION Educational health disparities were demonstrated for diabetes mellitus among men, and for obesity, hypertension, and hypercholesterolemia among women in Jamaica. Prevalence of diabetes was higher among less educated men, while among younger women the prevalence of hypertension, hypercholesterolemia, and obesity was higher among those with less education.
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Affiliation(s)
- Trevor S. Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Novie O. M. Younger-Coleman
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Marshall K. Tulloch-Reid
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Ian R. Hambleton
- Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Bridgetown, Barbados
| | - Damian K. Francis
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Nadia R. Bennett
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Shelly R. McFarlane
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Aurelian Bidulescu
- Indiana University School of Public Health – Bloomington, Bloomington, IN, USA
| | - Marlene Y. MacLeish
- Department of Medical Education, Morehouse School of Medicine, Atlanta, GA, USA
| | - Anselm J. M. Hennis
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Rainford J. Wilks
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
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Brown CR, Hambleton IR, Hercules SM, Alvarado M, Unwin N, Murphy MM, Harris EN, Wilks R, MacLeish M, Sullivan L, Sobers-Grannum N. Social determinants of breast cancer in the Caribbean: a systematic review. Int J Equity Health 2017; 16:60. [PMID: 28381227 PMCID: PMC5382386 DOI: 10.1186/s12939-017-0540-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/21/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Breast cancer is the leading cause of cancer deaths among women in the Caribbean and accounts for >1 million disability adjusted life years. Little is known about the social inequalities of this disease in the Caribbean. In support of the Rio Political Declaration on addressing health inequities, this article presents a systematic review of evidence on the distribution, by social determinants, of breast cancer risk factors, frequency, and adverse outcomes in Caribbean women. METHODS MEDLINE, EMBASE, SciELO, CINAHL, CUMED, LILACS, and IBECS were searched for observational studies reporting associations between social determinants and breast cancer risk factors, frequency, or outcomes. Based on the PROGRESS-plus checklist, we considered 8 social determinant groups for 14 breast cancer endpoints, which totalled to 189 possible ways ('relationship groups') to explore the role of social determinants on breast cancer. Studies with >50 participants conducted in Caribbean territories between 2004 and 2014 were eligible for inclusion. The review was conducted according to STROBE and PRISMA guidelines and results were planned as a narrative synthesis, with meta-analysis if possible. RESULTS Thirty-four articles were included from 5,190 screened citations. From these included studies, 75 inequality relationships were reported examining 30 distinct relationship groups, leaving 84% of relationship groups unexplored. Most inequality relationships were reported for risk factors, particularly alcohol and overweight/obesity which generally showed a positive relationship with indicators of lower socioeconomic position. Evidence for breast cancer frequency and outcomes was scarce. Unmarried women tended to have a higher likelihood of being diagnosed with breast cancer when compared to married women. While no association was observed between breast cancer frequency and ethnicity, mortality from breast cancer was shown to be slightly higher among Asian-Indian compared to African-descent populations in Trinidad (OR 1.2, 95% CI 1.1-1.4) and Guyana (OR 1.3, 95% CI 1.0-1.6). CONCLUSION Study quantity, quality, and variability in outcomes and reporting limited the synthesis of evidence on the role of social determinants on breast cancer in the Caribbean. This report represents important current evidence on the region, and can guide future research priorities for better describing and understanding of Caribbean breast cancer inequalities.
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Affiliation(s)
| | | | | | | | - Nigel Unwin
- Chronic Disease Research Centre, Bridgetown, Barbados
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Ju YJ, Han KT, Lee TH, Kim W, Park JH, Park EC. Association between weight control failure and suicidal ideation in overweight and obese adults: a cross-sectional study. BMC Public Health 2016; 16:259. [PMID: 26975568 PMCID: PMC4791804 DOI: 10.1186/s12889-016-2940-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/08/2016] [Indexed: 01/22/2023] Open
Abstract
Background Korea has the highest suicide rate in the OECD and is one of the few OECD countries whose suicide rates have not decreased in recent years. To address these issues, we investigated the effects of weight control failure on suicidal ideation in the overweight and obese populations. Methods We performed a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey (2008–2012) consisting of 6621 individuals 40 years of age or older. Logistic regression analysis was used to identify the relationship between weight control failure and suicidal ideation in the overweight and obese populations. Results A total of 6621 participants were analyzed in this study (overweight group: 2439; obese group: 4182). Among them, weight control failure (weight gain with weight loss efforts) was experienced in 962 obese (males 16.3 %, females 29.6 %) and 412 overweight individuals (males 9.1 %, females 23.4 %). Weight control failure was significantly associated with suicidal ideation in obese females (OR = 1.70, 95 % CI 1.21–2.39), but this association was not significant in obese males or in either sex of the overweight group. Conclusions Findings from this study suggest that weight control failure is associated with an increased risk of suicidal ideation among obese women. Furthermore, intervention programs that aim to address the prevalence of suicide, especially for obese women, are needed.
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Affiliation(s)
- Yeong Jun Ju
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Tae Han
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Hoon Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woorim Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong Hun Park
- Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. .,Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
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11
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Simon GA, Fletcher HM, Golden K, McFarlane-Anderson ND. Urinary isoflavone and lignan phytoestrogen levels and risk of uterine fibroid in Jamaican women. Maturitas 2015. [DOI: 10.1016/j.maturitas.2015.06.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Gordon-Strachan G, Cunningham-Myrie C, Fox K, Kirton C, Fraser R, McLeod G, Forrester T. Richer but fatter: the unintended consequences of microcredit financing on household health and expenditure in Jamaica. Trop Med Int Health 2014; 20:67-76. [PMID: 25329229 DOI: 10.1111/tmi.12403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Kristin Fox
- Sir Arthur Lewis Institute of Social and Economic Studies; University of the West Indies; Mona Jamaica
| | - Claremont Kirton
- Department of Economics; University of the West Indies; Mona Jamaica
| | - Raphael Fraser
- Department of Statistics; Florida State University; Tallahassee FL USA
| | - Georgia McLeod
- Department of Economics; University of the West Indies; Mona Jamaica
| | - Terrence Forrester
- UWI Solutions for Developing Countries; University of the West Indies; Mona Jamaica
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13
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Barrett SC, Huffman FG, Johnson P, Campa A, Magnus M, Ragoobirsingh D. A cross-sectional study of Jamaican adolescents' risk for type 2 diabetes and cardiovascular diseases. BMJ Open 2013; 3:e002817. [PMID: 23847264 PMCID: PMC3710979 DOI: 10.1136/bmjopen-2013-002817] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/24/2013] [Accepted: 04/25/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To compare obese versus non-obese Jamaican adolescents' risk for type 2 diabetes (T2D) and cardiovascular diseases (CVDs); and to explore a suitable and economical method of screening for these risk factors in the school settings. DESIGN A descriptive cross-sectional study of adolescents' risk for T2D and CVD. All the participants were examined at their respective schools. SETTING Jamaica, West Indies. POPULATION 276 Jamaican adolescents aged 14-19 years, randomly selected from grades 9 to 12 from 10 high schools on the island and included both boys and girls. All ethnicities on the island were represented. MAIN OUTCOME MEASURES High fasting blood glucose, total cholesterol, glycated haemoglobin (HbA1c), blood pressure, body mass index (BMI), waist circumference, waist-to-hip ratio, family history of obesity, T2D and CVDs, low physical activity, and presence of Acanthosis Nigricans. All blood measures were analysed using the finger prick procedure. RESULTS Waist circumference, waist-to-hip ratio, Acanthosis Nigricans, total cholesterol, family history of T2D and blood pressure were the strongest predictors of BMI (p=0.001). Over one-third of the participants were overweight. Jamaican adolescent females had a significantly higher number of risk factors and were less physically active than males (p<0.05). Over 80% of participants reported ≥3 risk factors for T2D and CVD. Participants with BMI ≥25 reported five or more risk factors. One-third of the overweight participants were classified with metabolic syndrome. CONCLUSIONS Jamaican adolescents are at risk of T2D and CVD. Family history of disease and anthropometric measures identified more participants at risk than did the blood measures. Jamaican adolescent females reported more risk factors for T2D and CVD as compared to males. Collection of this type of data was feasible within the school settings. All data were collected in 1 day per school. Intervention measures are needed to educate Jamaican adolescents to reduce overweight and subsequently the risk factors.
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Affiliation(s)
- Sheila C Barrett
- Department of Dietetics and Nutrition and Hospitality Administration, School of Family, Consumer, and Nutrition Sciences, Northern Illinois University, DeKalb, Illinois, USA
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14
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Abstract
We undertook a systematic review of studies assessing the association between socioeconomic status (SES) and measured obesity in low- and middle-income countries (defined by the World Bank as countries with per capita income up to US$12,275) among children, men and women. The evidence on the subject has grown significantly since an earlier influential review was published in 2004. We find that in low-income countries or in countries with low human development index (HDI), the association between SES and obesity appears to be positive for both men and women: the more affluent and/or those with higher educational attainment tend to be more likely to be obese. However, in middle-income countries or in countries with medium HDI, the association becomes largely mixed for men and mainly negative for women. This particular shift appears to occur at an even lower level of per capita income than suggested by an influential earlier review. By contrast, obesity in children appears to be predominantly a problem of the rich in low- and middle-income countries.
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Affiliation(s)
- G D Dinsa
- Norwich Medical School, University of East Anglia, Norwich, UK
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15
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Pavlica T, Bozic-Krstic V, Rakic R. Body mass index, waist-to-hip ratio and waist/height in adult population from Backa and Banat - the Republic of Serbia. Ann Hum Biol 2010; 37:562-73. [PMID: 20141483 DOI: 10.3109/03014460903512829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Nutritional status is vital in the assessment of physical fitness and health status of populations. AIM This study aimed to describe relationships between BMI, waist-to-hip ratio (WHR) and waist/height (W/Ht) and factors such as education, residence, origin and ethnic belonging among adults in Backa and Banat. SUBJECTS AND METHODS The study was conducted in 47 villages in the north of Serbia. The tested group consisted of 4247 individuals, aged 20+. RESULTS The problem of overweight and obesity was more common among men (66%) than women (49.71%). In the group with normal BMI, the majority of men and women were characterized by normal WHR and W/Ht values, but among them there were also groups with incorrect WHR (males >or= 0.95, females >or= 0.8) and W/Ht (>or= 0.5). Socio-demographic factors had a little impact on BMI, WHR and W/Ht in men in certain age groups while their impact was higher in women. These factors, especially education and origin, had a significant impact on nutritional status in young and middle-aged women, whereas they were not significant in older female participants (> 60). CONCLUSION Despite the fact that this part of the country has undergone intensive social changes since the last decade of 20th century, the nutritional status of the population has not significantly changed.
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Affiliation(s)
- Tatjana Pavlica
- Laboratory for Human Biology, Department for Biology and Ecology, University of Novi Sad, 21000 Novi Sad, Serbia.
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16
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Ntandou G, Delisle H, Agueh V, Fayomi B. Physical Activity and Socioeconomic Status Explain Rural-Urban Differences in Obesity: a Cross-Sectional Study in Benin (West Africa). Ecol Food Nutr 2008. [DOI: 10.1080/03670240802003835] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Tanumihardjo SA, Anderson C, Kaufer-Horwitz M, Bode L, Emenaker NJ, Haqq AM, Satia JA, Silver HJ, Stadler DD. Poverty, obesity, and malnutrition: an international perspective recognizing the paradox. ACTA ACUST UNITED AC 2007; 107:1966-72. [PMID: 17964317 DOI: 10.1016/j.jada.2007.08.007] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Indexed: 11/25/2022]
Abstract
In the year 2000, multiple global health agencies and stakeholders convened and established eight tenets that, if followed, would make our world a vastly better place. These tenets are called the Millennium Development Goals. Most of these goals are either directly or indirectly related to nutrition. The United Nations has led an evaluation team to monitor and assess the progress toward achieving these goals until 2015. We are midway between when the goals were set and the year 2015. The first goal is to "eradicate extreme poverty and hunger." Our greatest responsibility as nutrition professionals is to understand the ramifications of poverty, chronic hunger, and food insecurity. Food insecurity is complex, and the paradox is that not only can it lead to undernutrition and recurring hunger, but also to overnutrition, which can lead to overweight and obesity. It is estimated that by the year 2015 noncommunicable diseases associated with overnutrition will surpass undernutrition as the leading causes of death in low-income communities. Therefore, we need to take heed of the double burden of malnutrition caused by poverty, hunger, and food insecurity. Informing current practitioners, educators, and policymakers and passing this information on to future generations of nutrition students is of paramount importance.
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Affiliation(s)
- Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA.
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Walker SP, Thame MM, Chang SM, Bennett F, Forrester TE. Association of growth in utero with cognitive function at age 6-8 years. Early Hum Dev 2007; 83:355-60. [PMID: 16973311 DOI: 10.1016/j.earlhumdev.2006.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2005] [Revised: 06/18/2006] [Accepted: 07/20/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND Size at birth is associated with later cognitive development. The timing of growth faltering in utero may affect developmental consequences. AIM To determine whether growth in utero is related to cognitive outcomes in childhood. A secondary aim was to determine any associations between maternal nutritional status and cognition. STUDY DESIGN AND SUBJECTS Subjects were participants in a prospective cohort study of developmental origins of adult disease. Eligible subjects were aged 6-8 years at their next scheduled visit to the study clinic and their mothers had abdominal ultrasound measurements at 14, 25 and 35 weeks gestation. 186 of 264 eligible children attended the clinic and were tested. OUTCOME MEASURES Raven's Progressive Matrices (reasoning ability), Peabody Picture Vocabulary Test (receptive vocabulary) and Digit Span Forwards (auditory working memory). RESULTS In multiple regression analyses controlling for children's age and socioeconomic status, head circumference at 14 weeks gestation was significantly associated with reasoning ability. The difference between the lowest and highest quartiles was equivalent to 0.4 S.D. No other significant associations with fetal growth were found. Maternal weight gain was not associated with cognitive scores; however, change in triceps skinfold between 25 and 35 weeks gestation was positively associated with reasoning ability and remained a significant predictor when included in the regression model. CONCLUSIONS There were few associations between growth in utero and cognition. Growth in head circumference in early gestation and maternal nutrition in late gestation may affect later cognitive ability. Further research in this area is needed to confirm these results.
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Affiliation(s)
- Susan P Walker
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica.
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Wilks R, Younger N, Mullings J, Zohoori N, Figueroa P, Tulloch-Reid M, Ferguson T, Walters C, Bennett F, Forrester T, Ward E, Ashley D. Factors affecting study efficiency and item non-response in health surveys in developing countries: the Jamaica national healthy lifestyle survey. BMC Med Res Methodol 2007; 7:13. [PMID: 17328814 PMCID: PMC1821035 DOI: 10.1186/1471-2288-7-13] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2006] [Accepted: 02/28/2007] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Health surveys provide important information on the burden and secular trends of risk factors and disease. Several factors including survey and item non-response can affect data quality. There are few reports on efficiency, validity and the impact of item non-response, from developing countries. This report examines factors associated with item non-response and study efficiency in a national health survey in a developing Caribbean island. METHODS A national sample of participants aged 15-74 years was selected in a multi-stage sampling design accounting for 4 health regions and 14 parishes using enumeration districts as primary sampling units. Means and proportions of the variables of interest were compared between various categories. Non-response was defined as failure to provide an analyzable response. Linear and logistic regression models accounting for sample design and post-stratification weighting were used to identify independent correlates of recruitment efficiency and item non-response. RESULTS We recruited 2012 15-74 year-olds (66.2% females) at a response rate of 87.6% with significant variation between regions (80.9% to 97.6%; p < 0.0001). Females outnumbered males in all parishes. The majority of subjects were recruited in a single visit, 39.1% required multiple visits varying significantly by region (27.0% to 49.8% [p < 0.0001]). Average interview time was 44.3 minutes with no variation between health regions, urban-rural residence, educational level, gender and SES; but increased significantly with older age category from 42.9 minutes in the youngest to 46.0 minutes in the oldest age category. Between 15.8% and 26.8% of persons did not provide responses for the number of sexual partners in the last year. Women and urban residents provided less data than their counterparts. Highest item non-response related to income at 30% with no gender difference but independently related to educational level, employment status, age group and health region. Characteristics of non-responders vary with types of questions. CONCLUSION Informative health surveys are possible in developing countries. While survey response rates may be satisfactory, item non-response was high in respect of income and sexual practice. In contrast to developed countries, non-response to questions on income is higher and has different correlates. These findings can inform future surveys.
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Affiliation(s)
- Rainford Wilks
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Novie Younger
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Jasneth Mullings
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Namvar Zohoori
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Peter Figueroa
- The Ministry of Health, Kingston Mall, Kingston, Jamaica
| | - Marshall Tulloch-Reid
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Trevor Ferguson
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | | | - Franklyn Bennett
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Terrence Forrester
- Tropical Medicine Research Institute, the University of the West Indies, Mona, Kingston 7, Jamaica
| | - Elizabeth Ward
- The Ministry of Health, Kingston Mall, Kingston, Jamaica
| | - Deanna Ashley
- The Ministry of Health, Kingston Mall, Kingston, Jamaica
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20
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Walker SP, Chang SM, Powell CA. The association between early childhood stunting and weight status in late adolescence. Int J Obes (Lond) 2006; 31:347-52. [PMID: 16718285 DOI: 10.1038/sj.ijo.0803383] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cross-sectional studies have shown associations between stunting and overweight; however, there are few prospective studies of stunted children. OBJECTIVES To determine whether stunting before age 2 years is associated with overweight and central adiposity at 17-18 years and whether growth in height among stunted children predicts body mass index (BMI) in late adolescence. DESIGN Prospective cohort study. PARTICIPANTS One-hundred and three participants stunted by age 2 years and 64 non-stunted participants (78% of participants enrolled in childhood). Participants were measured in early childhood and at ages 7, 11 and 17 years. RESULTS Stunted subjects remained shorter and had lower BMIs, smaller skinfolds and circumferences than non-stunted subjects. Overweight (BMI >/=25 m(2)) was not significantly different among stunted and non-stunted male subjects (5.2 and 12.5%) but non-stunted female subjects were more likely to be overweight than those who experienced early childhood stunting (11.1 and 34.4%, P=0.013). Centralization of fat (waist to hip ratio (WHR), subscapular/triceps skinfold ratio (SSF/TSF)) did not differ between stunted and non-stunted groups (mean WHR 0.77 and mean SSF/TSF 1.18 in both groups). Stunted subjects with greater increases in height-for-age for the intervals 3-7 and 7-11 years had higher BMI at age 17 years (P=0.04 and P=0.001, respectively). CONCLUSION Participants stunted by age 2 years were less likely to be overweight than those who were never stunted. This suggests that cross-sectional studies of the association between stunting and overweight may be misleading. Among stunted children, greater linear growth during mid- to late childhood was associated with greater BMI at age 17 years.
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Affiliation(s)
- S P Walker
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Jamaica.
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