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Pai M, Muhammad T. Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators. BMC Geriatr 2023; 23:685. [PMID: 37872470 PMCID: PMC10591391 DOI: 10.1186/s12877-023-04380-5] [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: 05/10/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND While functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one's social status is associated with FMIs. We fill this gap in the literature by examining (1) the association between subjective social status (SSS) and FMIs among older adults in India and (2) whether this association between SSS and FMIs is mediated and moderated by life satisfaction and depression. METHODS Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults aged 60 years and above. FMIs were assessed using established scales on impairments in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. SSS was assessed using the Macarthur scale. Life satisfaction was measured using responses to five statements gauging respondent's overall satisfaction with life. Depression was calculated using the shortened version of the Composite International Diagnostic Interview (CIDI-SF). Multivariable regression was employed to examine the association between variables, and the interaction terms and Karlson-Holm-Breen (KHB) method were used separately to test the mediation and moderation effects. RESULTS 39.11% of the sample had a low SSS, 8.26% were depressed, and 32.07% reported low life satisfaction. A total of 8.74%, 10.91%, and 8.45% of the study population reported at least one impairment in ADL, IADL, and mobility, respectively. Older adults in the higher SSS group were less likely to have ADL impairment (beta: -0.017, CI: -0.030, -0.0032) and mobility impairment (beta: -0.044, CI: -0.076, -0.013). Depression moderated the association between SSS and mobility impairment (p-value: 0.025), and life satisfaction moderated the association between SSS and ADL impairments (p-value: 0.041) and SSS and IADL impairments (p-value: 0.037). Depression mediated 20.28%, 31.88%, and 18.39% of the associations of SSS with ADL, IADL, and mobility impairments, respectively. Similarly, life satisfaction mediated 23.24%, 52.69%, and 27.22% of the associations of SSS with ADL, IADL, and mobility impairments. CONCLUSIONS That SSS is associated with FMIs among older Indians, even after considering their objective socioeconomic status (SES), suggests that the use of SSS is relevant to the study of health inequalities in India. The finding that life satisfaction and depression mediate and moderate this association is crucial in pinpointing those older Indians at risk of the functional and mobility-related repercussions of lower SSS.
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Affiliation(s)
- Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
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Kareem YO, Ameyaw EK, Amoah RM, Adegboye OA, Yaya S. An assessment of Individual, community and state-level factors associated with inadequate iodised salt consumption among pregnant and lactating women in Nigeria. BMC Pregnancy Childbirth 2023; 23:524. [PMID: 37464273 DOI: 10.1186/s12884-023-05833-w] [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: 06/15/2022] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Iodine deficiency is the most common cause of thyroid disease, and in its severe form can result in cretinism; the impairment of the brain development of a child. Pregnant and breastfeeding women's daily iodine requirement is elevated due to physiological changes in iodine metabolism, requiring up to double the iodine intake of other women. Although Nigeria was the first African country to be declared iodine sufficient in 2007, recent evidence has shown that only about seven in ten households consume salt with adequate iodine content (≥ 15 ppm), with variation across states. The study aimed to assess the Individual- and household-, community- and state-level factors associated with inadequate iodised salt consumption among pregnant women and breastfeeding mothers in Nigeria. METHODS This study utilised the Multiple Indicator Cluster Survey to assess factors associated with inadequate iodised salt consumption among 4911 pregnant women and breastfeeding mothers in Nigeria. The descriptive analysis was presented using frequencies and percentages. The prevalence of adequate and inadequate iodised salt consumption with their 95% confidence interval were computed. Several multi-level mixed effect log-binomial logistic regressions were used to explore the factors associated with inadequate iodised salt consumption. The Loglikelihood, Akaike Information Criterion and Bayesian Information Criterion were used to assess the goodness of fit of the models. All analyses were adjusted for the complex survey design and analysed using Stata 15.0 at p < 0.05. RESULTS The prevalence of inadequate iodised salt consumption among pregnant and breastfeeding mothers was 35.2% (95% CI: 33.1-37.5). Inadequate consumption of iodised salt was highest among pregnant and breastfeeding women aged 45-49 years (48.2%; 95%CI: 37.8-58.8), as well as those with non-formal education (52.7%; 95%CI: 47.7-57.6) and no education (34.6%; 95%CI: 31.3-38.1). Our findings revealed that pregnant and breastfeeding women living in the poorer, middle, richer and richest quintiles were 32%, 47%, 35% and 62% less likely to consume salt with inadequate iodine compared to those in the poorest households. Those with non-formal education were 1.8 times (95%CI: 1.36-2.42) more likely to consume salt with deficient iodine than those without education. Pregnant and breastfeeding mothers residing in moderately and most deprived communities were 3.5 (95%CI: 2.57-4.73) and 4.7 times (95%CI: 3.38-6.55) more likely to consume salt with inadequate iodine than those from least deprived communities. Women in the Northwestern region and those from the Southwestern region were 4.0 and 3.5 times, respectively, more likely to consume salt with inadequate iodine compared to pregnant and breastfeeding women residing in the North-Central region. CONCLUSIONS The study has shown that inadequate consumption of iodised salt dominates among older pregnant and breastfeeding women. Also, women with non-formal education have higher prospects of consuming salt with lesser iodine. There is a need to enhance women's economic opportunities and empowerment as well as sensitisation on their nutritional requirements during pregnancy and breastfeeding. Both formal and non-formal educational initiatives on nutrition are extremely important and should be prioritised by the Nigerian government in its efforts to encourage the consumption of iodised salt among pregnant and lactating mothers. Additionally, health promotion interventions that seek to advocate iodised salt intake must be prioritised by the actors in the health sector.
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Affiliation(s)
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Lingnan, Hong Kong
| | - Roberta Mensima Amoah
- Maternal and Child Health Unit, Directorate of University Health Services, University for Development Studies, Tamale, Ghana
| | - Oyelola A Adegboye
- Menzies School of Public Health, Charles Darwin University, Darwin, NT, 0811, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada.
- The George Institute for Global Health, Imperial College London, London, United Kingdom.
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Saha A, Rahaman M, Mandal B, Biswas S, Govil D. Rural urban differences in self-rated health among older adults: examining the role of marital status and living arrangements. BMC Public Health 2022; 22:2175. [PMID: 36434537 PMCID: PMC9700952 DOI: 10.1186/s12889-022-14569-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The rural-urban gap in socioeconomic and morbidity status among older adults is prevalent in India. These disparities may impact the levels and factors of self-rated health (SRH). The objective of the study is to compare the levels and determinants of SRH between rural and urban areas by considering the moderating effects of marital status and living arrangements. SUBJECTS AND METHODS The present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total sample of 30,633 older adults aged 60 years and above were selected for the study. Descriptive statistics, bivariate chi-square test, the interaction effect of living arrangements and marital status, and logistic estimation were applied to accomplish the study objectives. RESULTS The prevalence of poor SRH was found 7% higher in rural areas compared to urban counterparts. A substantial rural-urban disparity in the patterns of poor SRH was also observed. The interaction effect of marital status and living arrangement on self-rated health suggested that older adults who were currently unmarried and living alone were 38% more likely to report poor SRH than those who were currently married and co-residing in rural India. In addition to marital status and living situation, other factors that significantly influenced SRH include age, socio-cultural background (educational attainment and religion), economic background (employment status), health status (ADLs, IADLs, multi-morbidities), and geographic background (region). CONCLUSION The present study's findings demonstrated that, notwithstanding local variations, marital status and living circumstances significantly influenced SRH in India. In the present study, unmarried older people living alone were more susceptible to poor SRH in rural areas. The present study supports the importance of reinforcing the concepts of care and support for older individuals. There is a need for special policy attention to older individuals, particularly those unmarried and living alone. Although older individuals had difficulty performing ADLs and IADLs and had multi-morbidities, they reported poorer health. Therefore, offering them social support and top-notch medical assistance is crucial.
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Affiliation(s)
- Amiya Saha
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
| | - Margubur Rahaman
- grid.419349.20000 0001 0613 2600Department of Migration & Urban Studies, International Institute for Population Sciences, Mumbai, 400088 India
| | - Bittu Mandal
- grid.450280.b0000 0004 1769 7721School of Humanities and Social Sciences, Indian Institute of Technology, Indore, 453552 India
| | - Sourav Biswas
- grid.419349.20000 0001 0613 2600Department of Population & Development, International Institute for Population Sciences, Mumbai, 400088 India
| | - Dipti Govil
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
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Social Group Differences in Influencing Factors for Chinese Urban Residents’ Subjective Well-Being: From the Perspective of Social Stratification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159409. [PMID: 35954763 PMCID: PMC9368222 DOI: 10.3390/ijerph19159409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023]
Abstract
With the great pressure of modern social life, the problem of residents’ subjective well-being has attracted scholars’ attention. Against the background of institutional transformation, China has a special social stratification structure. The socio-economic resources and living needs of different social classes are different, resulting in differences in the level of subjective well-being and the influencing factors for this. Taking Guangzhou as an example, based on the data of a household survey conducted in 2016, this paper obtains the social hierarchical structure through two-step clustering, and explores the differences between influencing factors for subjective well-being using multiple linear regression models. The clustering results divided Guangzhou urban residents into four classes: retirees, white-collar workers outside the system, manual workers and white-collar workers inside the system. The subjective well-being of white-collar workers inside the system and manual workers is high. The subjective well-being of white-collar workers outside the system is below the average value, and retirees have poor subjective well-being. The results of the regression analysis show that the subjective well-being of all social classes could be improved by active participation in fitness exercises, harmonious neighborhood relationships and a central residential location. Health-related factors such as physical health, sleeping time and density of neighborhood medical facilities, have a significant impact on manual workers’ subjective well-being. An increase in the density of neighborhood leisure facilities could help to improve the subjective well-being of white-collar workers outside the system. However, this would inhibit the subjective well-being of white-collar workers within the system. By revealing the differences in influencing factors for different social groups’ subjective well-being, the research conclusions could provide a reference for the formulation of targeted policies and measures to improve residents’ subjective well-being in urban China.
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Owusu Ansah K, Dey NEY, Adade AE, Agbadi P. Determinants of life satisfaction among Ghanaians aged 15 to 49 years: A further analysis of the 2017/2018 Multiple Cluster Indicator Survey. PLoS One 2022; 17:e0261164. [PMID: 35061700 PMCID: PMC8782464 DOI: 10.1371/journal.pone.0261164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 11/26/2021] [Indexed: 11/19/2022] Open
Abstract
The inclusion of life satisfaction in government policies as a tracker of the social and economic progress of citizens has been recommended. This has encouraged the scientific investigation of life satisfaction levels of people in tandem with factors responsible for these levels. Only a few studies have attempted to do this in Ghana with mixed findings. This study, therefore, extends previous literature by examining the determinants of life satisfaction among Ghanaians in two ways: a full sample and a gender-stratified sample. We analysed cross-sectional data from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (MICS 6). A sample of 20,059 women and men of ages ranging from 15 to 49 years participated in this study. The Cantril's Self-Anchoring Ladder Life Satisfaction scale was used to capture the life satisfaction of participants alongside relevant sociodemographic questions. About 35% of participants reported they were satisfied in life with males reporting more suffering levels [39.59%; 95% CI:36.38, 42.88] and females more thriving levels [36.41%; 95% CI:35.01, 37.84]. In the full sample multivariable model, gender, age, parity, education, marital status, wealth index, and region of residence were significantly associated with life satisfaction. Gender variations were also found across these associations. These findings collectively provide useful information for policymakers and practitioners to optimize interventions for the Ghanaian population aimed at improving life satisfaction. Evidence from this study also calls on the government of Ghana to begin tracking the life satisfaction of her citizens.
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Affiliation(s)
| | | | | | - Pascal Agbadi
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, SAR, China
- Department of Nursing, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
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Owusu AY, Teye-Kau M, Tenkorang EY. The contexts of housing stability and change among HIV-positive persons in the Lower Manya Krobo Municipality, Ghana. Health Promot Int 2021; 36:384-396. [PMID: 32712651 DOI: 10.1093/heapro/daaa062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Due to stigma, discrimination and economic insecurity, persons living with HIV/AIDS (PLWHAs) are highly vulnerable to housing instability. For instance, PLWHAs are more likely to either remain stable in inadequate homes or change residence. Yet, few studies explore the contexts of housing stability and change among PLWHAs, especially in sub-Saharan Africa, where the majority reside. This study used qualitative in-depth interviews to explore the narratives of 38 PLWHAs on the contexts of housing stability and the circumstances leading to change in residence. On diagnosis with HIV, the majority of PLWHAs (58%) changed housing locations, mostly from bad to worse conditions. Reasons for change include: eviction due to stigma and discrimination, inability to afford rent, quest to hide HIV status and death of a cohabiting partner. Our findings suggest policy makers should pay attention to the deplorable and poor housing conditions of PLWHAs in Ghana.
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Affiliation(s)
- Adobea Y Owusu
- Institute of Statistical, Social & Economic Research (ISSER), University of Ghana, Legon, Ghana
| | - Mabel Teye-Kau
- Department of Sociology, University of Calgary, Calgary, AB, Canada
| | - Eric Y Tenkorang
- Department of Sociology, Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John's NL, A1C 5S7, Canada
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Abalo EM, Mensah CM, Agyemang-Duah W, Peprah P, Budu HI, Gyasi RM, Donkor P, Amoako J. Geographical Differences in Perceived Health Status Among Older Adults in Ghana: Do Gender and Educational Status Matter? Gerontol Geriatr Med 2018; 4:2333721418796663. [PMID: 30202775 PMCID: PMC6124182 DOI: 10.1177/2333721418796663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/08/2018] [Accepted: 08/01/2018] [Indexed: 11/15/2022] Open
Abstract
Studies have constantly reported mixed evidence on the associations between rural/urban differences and self-rated health (SRH) status among older populations. More importantly, the roles of other relevant sociodemographic characteristics such as gender and educational levels in these associations are mostly overlooked. The current study examines the geographical differences in SRH of older cohorts in Kumasi Metropolis and Bosomtwe District of Ghana. Data from a Spatial Health and Healthcare Study (SHHS) were analyzed using chi-square test and ordinal logistic regression models. Although the study discovered a statistically significant difference in SRH between the rural and urban samples, the multivariate analysis found insignificant effect in SRH between urban and rural samples after adjusting for theoretically relevant covariates. However, the interactions indicated that this association significantly strengthens for rural dwellers who were highly educated. Moreover, age, average monthly income, reporting sickness in the past 90 days, and not noticing any change in health status in retrospective to 12 months were independent predictors of SRH. Effective interventions through collaborative efforts by the Ghanaian sociopolitical structure and micro-level dynamics are needed to ensure holistic improvements in health outcomes among vulnerable older persons.
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Affiliation(s)
| | | | | | - Prince Peprah
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Razak M Gyasi
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Lingnan University, Tuen Mun, Hong Kong SAR
| | - Philomina Donkor
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jones Amoako
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Akinyemi JO, Morakinyo OM. Household environment and symptoms of childhood acute respiratory tract infections in Nigeria, 2003-2013: a decade of progress and stagnation. BMC Infect Dis 2018; 18:296. [PMID: 29970043 PMCID: PMC6029367 DOI: 10.1186/s12879-018-3207-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) remains a disease of public health importance in Nigeria. Though, previous studies have identified factors associated with childhood ARI symptoms, the progress made in reducing the burden of this major childhood morbidity in the past decade in Nigeria has not been quantified. Therefore, this study describes the trends in the prevalence and factors associated with ARI symptoms among under-five (U5) children in Nigeria between years 2003 and 2013. METHODS A retrospective cross-sectional analysis of nationally representative data from the Nigeria Demographic and Health Surveys (NDHS) for years 2003, 2008 and 2013 was done. The study sample included women of reproductive age who had U5 children presenting with a cough accompanied with short rapid breaths in the last 2 weeks prior data collection. Data were analysed using complementary log regression model. RESULTS Prevalence of ARI symptoms were 10.3, 4.6 and 3.8% for years 2003, 2008 and 2013 respectively. The use of unclean cooking fuel was not associated with ARI symptom in 2003 and 2008, but in 2013 (OR = 2.50, CI: 1.16-5.42). Living in houses built with poor quality materials was associated with higher risk of ARI symptoms in 2008 (OR = 1.34, CI: 1.11-1.61) and 2013 (OR = 1.59, CI: 1.32-1.93). Higher risk of ARI symptoms was also associated with younger child's age, Northern regions and household wealth quintile between 2003 and 2013. CONCLUSIONS Though there has been a significant progress in the reduction of the prevalence of ARI symptoms between 2003 and 2013, the same could not be said of household environmental risk factors. Interventions to reduce the contributory effects of these factors to the occurrence of ARI symptoms should be instituted by government and other relevant stakeholders.
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Affiliation(s)
- Joshua Odunayo Akinyemi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Oyewale Mayowa Morakinyo
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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Bisung E, Kangmennaang J, Luginaah I. Neighborhood structural differences and women's mental health: an empirical study in Accra, Ghana. Qual Life Res 2017; 27:661-671. [PMID: 29119453 DOI: 10.1007/s11136-017-1731-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE This study explores the relationships between neighborhood structural differences such as socioeconomic status (SES), income inequality, and ethnic diversity on women's mental health in Accra, Ghana. METHODS The study used secondary data from the 2009 Women Health Survey Accra II, linked with the 2010 sub-metro level census figures on income inequality. The analytical sample consists of 2814 women nested within 195 enumeration areas (clusters) in the Accra Metropolitan Area (AMA). Multilevel binary logit and complimentary log-log models were used to analyze the data. RESULTS Results suggest that social capital and neighborhood socioeconomic structural factors such SES, ethnic diversity, and housing ownership were associated with depressive symptoms, feeling downhearted, and self-reported health. CONCLUSIONS These findings suggest that policies and programs that improve the physical and economic conditions of deprived neighborhoods, as well as civic initiatives that improve social capital and cohesion, may be important for promoting collective actions and improving health outcomes in urban settings like Accra.
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Affiliation(s)
- Elijah Bisung
- School of Kinesiology and Health Studies, Queen's University, 28 Division St, Kingston, ON, K7L 3N6, Canada.
| | - Joseph Kangmennaang
- Department of Geography and Environmental Management, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Isaac Luginaah
- Department of Geography, Western University, London, ON, N6A 5C2, Canada
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Duboz P, Boëtsch G, Gueye L, Macia E. Self-rated health in Senegal: A comparison between urban and rural areas. PLoS One 2017; 12:e0184416. [PMID: 28886107 PMCID: PMC5590920 DOI: 10.1371/journal.pone.0184416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 08/23/2017] [Indexed: 11/26/2022] Open
Abstract
Introduction Although the relationship between mortality and self-rated health has been demonstrated in sub-Saharan Africa, information in this area is rudimentary. In Senegal, no study has been undertaken comparing self-rated health between urban and rural areas. The objective of this study is therefore to compare self-rated health and its main predictors in Dakar and in a rural isolated area, Tessekere municipality, taking into account socio-demographic and economic factors, social relations, as well as measures of physical and mental health. Material and methods This study was carried out in 2015 on a population sample of 1000 individuals living in Dakar and 500 individuals living in the municipality of Tessekere, constructed using the quota method. Self-rated health, health variables, psychosocial, sociodemographic and economic characteristics were collected during face-to-face interviews. Statistical analyses used were Chi-square tests and binary logistic regressions. Results Results show that self-rated health in Senegalese urban area (Dakar) is better than in rural area (Tessekere), but the determinants of self-rated health partly differ between these two environments. Age and gender play a fundamental role in self-rated health as much in Dakar as in Tessekere but diabetes and social support play a role in self-rated health only in urban environment, whereas economic well-being is associated to self-rated health only in rural area. Conclusion The analyses carried out in these two environments show that despite the existence of common determinants (age, gender, stress), the determinants for formulating an answer to the question of self-rated health differ. People’s social and cultural environments thus play a fundamental role in the process of rating one’s health and, in the short and long term, in the mortality rate.
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Affiliation(s)
- Priscilla Duboz
- UMI 3189 ESS (CNRS/UCAD/UGB/USTTB/CNRST), Faculté de Médecine, de Pharmacie et d'Odontostomatologie, Université Cheikh Anta Diop de Dakar (UCAD), Dakar-Fann, Senegal
- Tessekere International Human-Environment Observatory (Labex DRIIHM, INEE, CNRS), Faculté de Médecine, de Pharmacie et d'Odontostomatologie, Université Cheikh Anta Diop de Dakar (UCAD), Dakar-Fann, Senegal
- * E-mail:
| | - Gilles Boëtsch
- UMI 3189 ESS (CNRS/UCAD/UGB/USTTB/CNRST), Faculté de Médecine, de Pharmacie et d'Odontostomatologie, Université Cheikh Anta Diop de Dakar (UCAD), Dakar-Fann, Senegal
- Tessekere International Human-Environment Observatory (Labex DRIIHM, INEE, CNRS), Faculté de Médecine, de Pharmacie et d'Odontostomatologie, Université Cheikh Anta Diop de Dakar (UCAD), Dakar-Fann, Senegal
| | - Lamine Gueye
- UMI 3189 ESS (CNRS/UCAD/UGB/USTTB/CNRST), Faculté de Médecine, de Pharmacie et d'Odontostomatologie, Université Cheikh Anta Diop de Dakar (UCAD), Dakar-Fann, Senegal
| | - Enguerran Macia
- UMI 3189 ESS (CNRS/UCAD/UGB/USTTB/CNRST), Faculté de Médecine, de Pharmacie et d'Odontostomatologie, Université Cheikh Anta Diop de Dakar (UCAD), Dakar-Fann, Senegal
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Adebowale SA, Morakinyo OM, Ana GR. Housing materials as predictors of under-five mortality in Nigeria: evidence from 2013 demographic and health survey. BMC Pediatr 2017; 17:30. [PMID: 28103828 PMCID: PMC5248529 DOI: 10.1186/s12887-016-0742-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 11/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nigeria is among countries with high Under-Five Mortality (U5M) rates worldwide. Both maternal and childhood factors have been linked to U5M in the country. However, despite the growing global recognition of the association between housing and quality of life, the role of housing materials as predictors of U5M remain largely unexplored in Nigeria. This study, therefore, investigated the relationship between housing materials and U5M in Nigeria. METHODS The study utilised the 2013 Nigeria Demographic and Health Survey data. A representative sample of 40,680 households was selected for the survey. The sample included 18,516 women of reproductive age who had given birth in the past 5 years prior the survey; with attention on the survival status of the index child (the most recent delivery). Data were analysed using descriptive statistics, Chi-square, Cox-proportional hazard and Brass 2-parameter models (α = 0.05). RESULTS The hazard ratio of U5M was 1.46 (C.I = 1.02-1.47, p < 0.001) and 1.23 (C.I = 1.24-1.71, p < 0.001) higher among children who lived in houses built with inadequate and moderate housing materials respectively than those in good housing materials. Under-five deaths show a downward trend (slope = -0.4871) relative to the housing materials assessment score. The refined U5M rate was 143.5, 127.0 and 90.8 per 1000 live birth among women who live in houses built with inadequate, moderate and adequate housing materials respectively. Other predictors of U5M were; the size of the child at birth, preceding birth interval, prenatal care provider, residence and education. Under-five death reduces with increasing maternal level of; education, wealth quintile, media exposure and housing material type and mostly experienced by Muslim women (6.0%), rural women (6.5%) and women residence in the North-West geopolitical zones (6.9%). CONCLUSIONS Living in houses built with poor housing materials promoted U5M in Nigeria. Provision of sustainable housing by the government and the maintenance of existing housing stock to healthful conditions will play a significant role in reducing the burden of U5M in Nigeria.
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Affiliation(s)
- Stephen Ayo Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oyewale Mayowa Morakinyo
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Godson Rowland Ana
- Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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