Urbanization and Non-communicable disease mortality in Thailand: an ecological correlation study

Geospatial analysis of spatial distribution, patterns, and relationships of health status in the belt and road initiative

The Health Silk Road plays a crucial role in the Belt and Road Initiative, and comprehending the health status within the participating countries is fundamental for fostering cooperation in public health. This paper collected five health indicators to represent the health status of the Belt and Road countries. Employing spatial statistics, the spatial patterns of health indicators and the associations with influencing factors were investigated. The utilized spatial statistics encompass spatial autocorrelation methods, geographical detector and spatial lag model. The results revealed obvious disparities and significant positive spatial autocorrelation of health indicators within the Belt and Road countries. Specifically, countries in Sub-Saharan Africa exhibited significant clustering of limited health indicators, while countries in Europe and Central Asia demonstrated significant clustering of robust health indicators. Furthermore, the health indicators exhibited significant spatial heterogeneity and association with the influencing factors. Universal health coverage, household air pollution, and the prevalence of undernourishment emerge as influential factors affecting health indicators. Overall, our findings highlighted complex influencing factors that contributed to the profound health inequalities across the Belt and Road countries. These factors should be duly considered in public health collaborations within the Belt and Road Initiative.

Poverty, noncommunicable diseases, and perceived health risks among older adults during the COVID-19 pandemic in urban Thailand

The COVID-19 pandemic has had negative impacts on vulnerable populations worldwide. This study aimed to examine the association between the health worries of urban older people in Thailand and covariates related to income and non-income poverty, noncommunicable diseases (NCDs), and metabolic risk factors (MRFs). The study utilized the 2021 Survey on Housing and Support Services for Poor Older Adults, which sampled lower-income urban adults aged at least 55 years from five national regions. Bivariate analyses were performed to determine the relationships of NCDs and MRFs with the covariates. Then, binary logistic regression was used to analyze outcomes of perceived health risks including becoming infected with COVID-19, declining health status, and being unable to access health care. Higher educational attainment and income levels were observed to be negatively correlated with worse health status and the inability to access health care. Subjective household crowding consistently had a positive association with the three health concerns. Having MRFs was related only to concerns about health status and access to health care during the pandemic. Welfare and health policies need to improve their responsiveness to the needs of the older population, especially for protection from socioeconomic shocks such as those seen with the current pandemic.

A Multi-Site Thailand Heart Failure Snapshot Study

BACKGROUND

The prevalence of heart failure (HF) is increasing in many low-income and middle-income countries, but the limited availability of data on patient profiles and clinical outcomes, particularly at a community level, challenges health service planning.

METHODS

The Thai HF Snapshot Study was a multi-site, observational study conducted in Thailand between June 2017 to June 2019. It aimed to document demographic, clinical and sociodemographic characteristics, and to compare clinical outcomes by the level of the hospital.

RESULTS

A total of 512 participants were recruited across Thailand: mean age was 64.9±15.3 years and 286 were female (55.9%). The most frequently identified admitting diagnosis was ischaemic heart disease (45.1%). Most patients (70.3%) were classified as New York Heart Association class II at discharge. Patients in university hospitals were frailer (3.2 vs 2.9; p=0.015), had more depressive symptoms (8.1 vs 5.7; p<0.001), and had lower functional status (66.2 vs 73.3; p<0.001) than those in tertiary care.

CONCLUSION

Although HF patients admitted to university hospitals had access to advanced technology and health care specialists, clinical outcomes likely affected patient acuity. Interventions are urgently needed to ensure improved HF management considering the social determinants of health in Thailand.

Exposure to Messages on Risk Factors for Noncommunicable Diseases in a Rural Province of Vietnam

Background

Providing messages on risk factors for noncommunicable diseases (NCDs) plays an important role in preventing disease.

Objectives

This study investigated how often adults living in a rural area in northern Vietnam heard about risks factor for NCD and where they obtained that information.

Methods

A cross-sectional survey was conducted using a multistage stratified cluster sampling to recruit 2970 participants. Data analyses were adjusted for all variables in a two-level multilevel Poisson regression model.

Results

Overall, 77% of respondents had heard about NCDs, while 38.3 to 50% had been exposed to messages on risk factors of NCDs in the last month. Television, radio, and friends/neighbors were the most common sources of information. Most people exposed information no more than one or two sources. Factors associated with exposure to messages about risk were occupation, age group, education, and economic status.

Conclusion

Intervention programs should focus on providing information primarily through television, considering influencing factors as well ensuring that messages reach target audiences.

Heart failure and social determinants of health in Thailand: An integrative review

Background

Heart failure is a highly burdensome syndrome and is rapidly increasing in prevalence in low and middle-income countries and outcomes are influenced at the level of the patient, provider and health system. Understanding heart failure beyond a biomedical perspective and the relationship between health outcomes and social determinants of health is critical for informing policy development and improving health outcomes.

Aim

To identify the social determinants of health for improving health outcomes for individuals with heart failure in Thailand.

Method

This integrative review included studies published between January 1, 2008, and March 31, 2016 in both the Thai and English language identified through searching Scopus, PubMed, and CINAHL.

Results

Six experimental, eight descriptive and two qualitative studies were identified met the inclusion and exclusion criteria. The majority of study participants were elderly, female, had low-education and income levels, were participating in a universal coverage scheme and living in a rural setting. All interventions were delivered at the level of the individual, focusing on education to improve knowledge, self-care, and functional status. Findings showed an improvement in health outcomes which were moderated by social determinants of health such as gender and income.

Conclusion

As the burden of heart failure increases in Thailand and other emerging economies, developing culturally appropriate, affordable and acceptable models of intervention considering social determinants of health is necessary.

Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi

Hypertension is a major public health problem and important area of research due to its high prevalence and being major risk factor for cardiovascular diseases and other complications. Objectives. (1) To assess the prevalence of hypertension and its associated factors and (2) to estimate awareness, treatment, and adequacy of control of hypertension among study subjects. Methods and Materials. A community based cross-sectional study with multistage sampling design was conducted among urban population of Varanasi. A modified WHO STEPS interview schedule on 640 study subjects aged 25-64 years was used. Results. The prevalence of hypertension was 32.9% (male: 40.9%, female: 26.0%). Mean systolic and diastolic BP were 124.25 ± 15.05 mmHg and 83.45 ± 9.49 mmHg, respectively. Higher odds of being hypertensive were found in male subjects, eldest age group, married subjects, subjects of upper socioeconomic status, illiterate subjects, and retired subjects. Tobacco and alcohol consumption, overweight, obesity, and abdominal obesity were also associated with hypertension. Out of the total hypertensive 211 subjects, only 81 (38.4%) were aware about their hypertension status; out of those, 57 (70.4%) were seeking treatment and 20 (35.08%) had their blood pressure adequately controlled. Conclusion. Around one-third of the subjects were hypertensive and half of the study subjects were prehypertensive in this area. The awareness, treatment, and control of high blood pressure were also very low.

Chiang Mai University Health Worker Study aiming toward a better understanding of noncommunicable disease development in Thailand: methods and description of study population

BACKGROUND

Urbanization is considered to be one of the key drivers of noncommunicable diseases (NCDs) in Thailand and other developing countries. These influences, in turn, may affect an individual's behavior and risk of developing NCDs. The Chiang Mai University (CMU) Health Worker Study aims to provide evidence for a better understanding of the development of NCDs and ultimately to apply the evidence toward better prevention, risk modification, and improvement of clinical care for patients with NCDs and NCD-related conditions.

METHODS

A cross-sectional survey of health care workers from CMU Hospital was conducted between January 2013 and June 2013. Questionnaires, interviews, and physical and laboratory examinations were used to assess urban exposure, occupational shift work, risk factors for NCDs, self-reported NCDs, and other NCD-related health conditions.

RESULTS

From 5,364 eligible workers, 3,204 participated (59.7%). About 11.1% of the participants had high blood pressure (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) and almost 30% were considered to be obese (body mass index ≥25 kg/m(2)). A total of 2.3% had a high fasting blood glucose level (≥126 mg/dL), and the most common abnormal lipid profile was high low-density lipoprotein (≥160 mg/dL), which was found in 19.2% of participants.

DISCUSSION

The study of health workers offers three potential advantages. The first is that the study of migrants was possible. Socioenvironmental influence on NCD risk factors can be explored, as changes in environmental exposures can be documented. Second, it allows the investigators to control for access to care. Access to care is potentially a key confounder toward understanding the development of NCDs. Lastly, a study of health personnel allows easy access to laboratory investigations and potential for long-term follow-up. This enables ascertainment of a number of clinical outcomes and provides potential for future studies focusing on therapeutic and prognostic issues related to NCDs.