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Dhlakama H, Lougue S, Mwambi HG, Ogunsakin RE. A Multilevel Analysis of the Associated and Determining Factors of TB among Adults in South Africa: Results from National Income Dynamics Surveys 2008 to 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10611. [PMID: 36078327 PMCID: PMC9518336 DOI: 10.3390/ijerph191710611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
TB is preventable and treatable but remains the leading cause of death in South Africa. The deaths due to TB have declined, but in 2017, around 322,000 new cases were reported in the country. The need to eradicate the disease through research is increasing. This study used population-based National Income Dynamics Survey data (Wave 1 to Wave 5) from 2008 to 2017. By determining the simultaneous multilevel and individual-level predictors of TB, this research examined the factors associated with TB-diagnosed individuals and to what extent the factors vary across such individuals belonging to the same province in South Africa for the five waves. Multilevel logistic regression models were fitted using frequentist and Bayesian techniques, and the results were presented as odds ratios with statistical significance set at p < 0.05. The results obtained from the two approaches were compared and discussed. Findings reveal that the TB factors that prevailed consistently from wave 1 to wave 5 were marital status, age, gender, education, smoking, suffering from other diseases, and consultation with a health practitioner. Also, over the years, the single males aged 30-44 years suffering from other diseases with no education were highly associated with TB between 2008 and 2017. The methodological findings were that the frequentist and Bayesian models resulted in the same TB factors. Both models showed that some form of variation in TB infections is due to the different provinces these individuals belonged. Variation in TB patients within the same province over the waves was minimal. We conclude that demographic and behavioural factors also drive TB infections in South Africa. This research supports the existing findings that controlling the social determinants of health will help eradicate TB.
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Affiliation(s)
- Hilda Dhlakama
- Department of Statistics, University of Johannesburg, Johannesburg 2028, South Africa
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Siaka Lougue
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Henry Godwell Mwambi
- School of Mathematics, Statistics and Computer Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Ropo Ebenezer Ogunsakin
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
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Ellison GT, Mattes RB, Rhoma H, de Wet T. Economic vulnerability and poor service delivery made it more difficult for shack-dwellers to comply with COVID-19 restrictions. S AFR J SCI 2022. [DOI: 10.17159/sajs.2022/13301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In South Africa, demand for housing close to viable/sustained sources of employment has far outstripped supply; and the size of the population living in temporary structures/shacks (and in poorly serviced informal settlements) has continued to increase. While such dwellings and settlements pose a number of established risks to the health of their residents, the present study aimed to explore whether they might also undermine the potential impact of regulations intended to safeguard public health, such as the stringent lockdown restrictions imposed to curb the spread of COVID-19 in 2020 and 2021. Using a representative sample of 1381 South African households surveyed in May–June 2021, the present study found that respondents in temporary structures/shacks were more likely to report non-compliance (or difficulty in complying) with lockdown restrictions when compared to those living in traditional/formal houses/ flats/rooms/hostels (OR: 1.61; 95% CI: 1.06, 2.45). However, this finding was substantially attenuated and lost precision following adjustment for preceding socio-demographic and economic determinants of housing quality (adjusted OR: 1.20; 95% CI: 0.78, 1.87). Instead, respondents were far more likely to report non-compliance (or difficulty in complying) with COVID-19 lockdown restrictions if their dwellings lacked private/indoor toilet facilities (adjusted OR: 1.56; 95% CI: 1.08, 2.22) or if they were ‘Black/ African’, young, poorly educated and under-employed (regardless of their socio-economic position, or whether they resided in temporary structures/shacks, respectively). Restrictions imposed to safeguard public health need to be more sensitively designed to accommodate the critical roles that poverty and inadequate service delivery play in limiting the ability of residents living in temporary structures/shacks and inadequately serviced dwellings/settlements to comply.
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Affiliation(s)
- George T.H. Ellison
- Faculty of Science and Technology, University of Central Lancashire, Preston, UK
- School of Medicine, University of Leeds, Leeds, UK
- Academic Development and Support, University of Johannesburg, Johannesburg, South Africa
| | - Robert B. Mattes
- Institute for Democracy, Citizenship and Public Policy in Africa, University of Cape Town, Cape Town, South Africa
- School of Government and Public Policy, University of Strathclyde, Glasgow, UK
| | - Hanan Rhoma
- School of Medicine, University of Leeds, Leeds, UK
| | - Thea de Wet
- Academic Development and Support, University of Johannesburg, Johannesburg, South Africa
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Watanabe K, Totsu Y, Duong TT, Van Truong P, Huong PTT. Sexual awareness and cognitive social capital among high school students: a cross-sectional study in rural Vietnam. J Rural Med 2020; 15:132-138. [PMID: 33033532 PMCID: PMC7530599 DOI: 10.2185/jrm.2020-010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/20/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: Since the late 1980s, Vietnam has seen numerous social changes,
likely leading to changes in adolescent sexual awareness. Adolescents are currently
exposed to a plethora of sexual information without adequate sex education and knowledge.
Globally, researchers have identified sexual knowledge and self-esteem as determinants of
adolescent sexual awareness and behavior, but little is known about the role of social
capital, especially in rural areas. This study aimed to clarify the relationship between
sexual awareness and cognitive social capital among high school students in rural
Vietnam. Materials and Methods: We conducted a questionnaire-based survey assessing
sexual knowledge, sexual awareness, perceptions of peers’ sexual experience, structural
and cognitive social capital, and self-esteem (Rosenberg Self-Esteem Scale) in March 2017
among 1,583 11th graders at four public high schools in Hai Duong Province, Vietnam. Results: The final sample comprised 1,517 students (95.8% of total
responses): 609 boys (40.1%) and 908 girls (59.9%). Multiple logistic regression analysis
was performed with intolerance toward premarital sex as the dependent variable. In the
first model, the independent variables were self-esteem, knowledge of proper timing for
condom use, and perception that many peers are sexually experienced. The second model
added an indicator of cognitive social capital. In the first model, self-esteem, knowledge
of proper timing for condom use, and perception that many peers are sexually experienced
were all significantly associated with intolerance toward premarital sex for both boys and
girls. In the second model, for both boys and girls, only cognitive social capital was
significantly associated with intolerance toward premarital sex. Conclusion: The results of this study regarding the effect of social capital
in rural Vietnam are consistent with previous findings in urban areas. Social capital
should be emphasized in efforts to improve sexual awareness and, in turn, sexual and
reproductive health among adolescents in rural areas.
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Affiliation(s)
| | | | | | | | - Phuong Thi Thu Huong
- Center for Population Research, Information and Database (CPRID), General Office for Population and Family Planning (GOPFP), Vietnam
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Rodgers J, Valuev AV, Hswen Y, Subramanian SV. Social capital and physical health: An updated review of the literature for 2007-2018. Soc Sci Med 2019; 236:112360. [PMID: 31352315 DOI: 10.1016/j.socscimed.2019.112360] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/08/2019] [Accepted: 06/10/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE Social capital is frequently indicated as a determinant of population health. Despite an increase in the frequency of public health studies including such measures, our understanding of social capital's effects on health remains unclear. In 2008, a systematic review of the "first decade" of research on social capital and health was published in the textbook Social Capital and Health. Our study intends to update and expand upon this original review to account for developments in the literature over the second decade of research on social capital and health. METHODS We employed a systematic review of empirical studies investigating the relationship between measures of social capital and physical health outcomes published between January 1, 2007 and December 31, 2018. To identify potential studies, we conducted searches of PubMed, Embase, and PsychINFO databases in January 2019 using combinations of "social capital" and "physical health" search terms. RESULTS We identified 1,608 unique articles and reviewed 145 studies meeting our inclusion criteria. The most frequently examined health condition was self-reported health (57%), followed by mortality (12%), cardiovascular diseases (10%), obesity (7%), diabetes (6%), infectious diseases (5%), and cancers (3%). Of these studies, 127 (88%) reported at least partial support for a protective association between social capital and health. However, only 41 (28%) reported exclusively positive findings. The majority (59%) of results were mixed, suggesting a nuanced relationship between social capital and health. This finding could also be indicative of differences in study design, which showed substantial variation. CONCLUSIONS Despite limitations in the literature, our review chronicles an evolution in the field of social capital and health in terms of size and sophistication. Overall, these studies suggest that social capital may be an important protective factor for some physical health outcomes, but further research is needed to confirm and clarify these findings.
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Affiliation(s)
- Justin Rodgers
- Department of Social and Behavioral Sciences, Harvard University, 310 Huntington Ave, Boston, MA, 02115, USA.
| | - Anna V Valuev
- Department of Global Health and Health Policy, Harvard University, 14 Story Street Cambridge, MA, 02138, USA
| | - Yulin Hswen
- Department of Social and Behavioral Sciences, Harvard University, 310 Huntington Ave, Boston, MA, 02115, USA
| | - S V Subramanian
- Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA
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Gehlen M, Nicola MRC, Costa ERD, Cabral VK, de Quadros ELL, Chaves CO, Lahm RA, Nicolella ADR, Rossetti MLR, Silva DR. Geospatial intelligence and health analitycs: Its application and utility in a city with high tuberculosis incidence in Brazil. J Infect Public Health 2019; 12:681-689. [PMID: 30956159 DOI: 10.1016/j.jiph.2019.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/26/2018] [Accepted: 03/17/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Geospatial Intelligence and Health Analysis have been used to identify tuberculosis (TB) hotspots and to better understand their relationship to social and economic factors. The purpose of this study was to use geospatial intelligence to assess the distribution of TB and its correlations with Human Development Index (HDI) in a city with high TB incidence in Brazil. METHODS We conducted an ecological study, using National System of Information on Noticeable Disease (SINAN) to identify TB cases. Geocoding was performed using QGIS 2.0 software and Google Maps API 3.0. We applied geospatial intelligence to detect where in the city clustering of TB cases occurred, and assessed the association of an area's HDI (each one of the components - longevity, education, and income) with TB spatial distribution. RESULTS During the study period (2011-2013), there were 737 TB cases. TB cases showed heterogeneity across the 29 neighborhoods. The neighborhoods with HDI-income lower than the mean had higher TB incidence (p = 0.036). CONCLUSIONS We found several hotspots of TB across the 29 neighborhoods, and an inverse association between HDI-income and TB incidence. These findings provide useful information and may help to guide TB control programs.
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Affiliation(s)
- Mirela Gehlen
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria R C Nicola
- Programa de Pós-Graduação em Biologia Molecular e Celular Aplicada a Saúde (Biosaude), Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Elis R D Costa
- Centro de Desenvolvimento Científico e Tecnológico, Secretaria Estadual da Saúde do Rio Grande do Sul (CDCT/SES), Porto Alegre, RS, Brazil
| | - Vagner K Cabral
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Caroline O Chaves
- Pontifícia Universidade Católica do Rio Grande do Sul, Faculdade de Física, Brazil
| | - Regis A Lahm
- Pontifícia Universidade Católica do Rio Grande do Sul, Faculdade de Física, Brazil
| | - Alberto D R Nicolella
- Centro de Informação Toxicológica do Rio Grande do Sul, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brazil
| | - Maria L R Rossetti
- Programa de Pós-Graduação em Biologia Molecular e Celular Aplicada a Saúde (Biosaude), Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil; Centro de Desenvolvimento Científico e Tecnológico, Secretaria Estadual da Saúde do Rio Grande do Sul (CDCT/SES), Porto Alegre, RS, Brazil
| | - Denise R Silva
- Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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Wang L, Dong W, Ou Y, Chen S, Chen J, Jiang Q. Regional differences and determinants of self-rated health in a lower middle income rural Society of China. Int J Equity Health 2018; 17:162. [PMID: 30409130 PMCID: PMC6225556 DOI: 10.1186/s12939-018-0875-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/18/2018] [Indexed: 12/02/2022] Open
Abstract
Objective Self-rated health represents a reliable and important health measure related to general health and quality of life. This study aimed to identify the differences of health states of rural residents in a lower middle income setting in China and its associated factors. Methods A descriptive study of a stratified random sample of 3870 individuals was conducted in rural Anhui during 2015. We investigated the influence of five independent variables: individual demographic characteristics, family factors, social capital traits, physical health conditions and healthy lifestyle habits of participants who self-related their health as good. A chi-square test and ordinal logistic regression analyses were used to identify the relationship of these variables and self-rated health. Results The study found that respondents who negatively rated their health often were female, elderly, poor, lived alone, had low levels of education, inadequate social support, poor physical health, used healthcare services and lived in the lower economic regions. We found no significant correlations between self-rated health and employment, marital status, medical insurance, or exercise frequency. Surprisingly, smoking and drinking also seemed to be unrelated to poor self-reported health. Conclusion Health differences based on region were apparent in rural China. We highlighted the possible impacts of income, age, physical health, education, advanced age, and social support on health. The results from this study could inform the delivery of appropriate health and social healthcare interventions to promote rural residents’ health and quality of life.
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Affiliation(s)
- Lidan Wang
- School of Health Management, Anhui Medical University, No.81, Mei Shan Road, Hefei, 230032, Anhui, China.
| | - Weizhen Dong
- Anhui No.2 Provincial People's Hospital, NO.1868, Dangshan Road, Hefei, 230041, Anhui, China
| | - Yunqing Ou
- Department of Sociology and Legal Studies, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Shuting Chen
- Anhui Provincial Cancer Hospital, No. 107, Lake Road, Hefei, 230031, Anhui, China
| | - Jingjing Chen
- Children's Hospital of Nanjing Medical University, No.72,Guang Zhou Road, Nanjing, 210008, Jiangsu, China
| | - Qicheng Jiang
- School of Public Health, Anhui Medical University, No.81, Mei Shan Road, Hefei, 230032, Anhui, China.
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Rao N, Esber A, Turner A, Mopiwa G, Banda J, Norris A. Infertility and self-rated health among Malawian women. Women Health 2018; 58:1081-1093. [PMID: 29240537 DOI: 10.1080/03630242.2017.1414098] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
Infertility is prevalent and stigmatized in sub-Saharan Africa. Self-rated health, a subjective indicator that has been consistently related to objectively measured health, may be useful in evaluating the relationship between women's infertility and health. Data were from surveys conducted from July 2014 to January 2015 with women aged 15-39 years (n = 915) as part of the initial assessment in a cohort study in Lilongwe district, Malawi. We first assessed correlates of self-reported infertility among women in rural Malawi. We then used multiple logistic regression to examine associations between infertility and self-rated health. Of women surveyed, 20 percent had a history of infertility. Compared to women who had not experienced infertility, women with a history of infertility were older (p = 0.05), less educated (p = 0.01), and more likely to report depressive symptoms (p = 0.02) and forced first intercourse (p = 0.02) and to have been previously diagnosed with a sexually transmitted infection (p = 0.05). However, women with a history of infertility were not significantly more likely to report poor self-rated health (adjusted odds ratio: 1.69; 95 percent confidence interval: 0.70-4.07). Infertility was prevalent in our sample of Malawian women but was not significantly related to self-rated health, an instrument widely used in public-health research.
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Affiliation(s)
- Nisha Rao
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- b Department of Medicine , Columbia University Medical Center , New York , New York , USA
| | - Allahna Esber
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
| | - Abigail Turner
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
| | | | - Joana Banda
- d Child Legacy International , Lilongwe , Malawi
| | - Alison Norris
- a The Ohio State University College of Medicine , Columbus , Ohio , USA
- c The Ohio State University College of Public Health , Columbus , Ohio, USA
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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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Cau BM, Falcão J, Arnaldo C. Determinants of poor self-rated health among adults in urban Mozambique. BMC Public Health 2016; 16:856. [PMID: 27553080 PMCID: PMC4995828 DOI: 10.1186/s12889-016-3552-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 08/18/2016] [Indexed: 11/17/2022] Open
Abstract
Background Self-rated health is a measure expressing the general condition of health of individuals. Self-rated health studies are common in developed countries and in some developing regions. Despite increasing proportion of adult and older population in sub-Saharan Africa and poor population health indicators, there is a dearth of studies on self-rated health in the region. This study examines factors associated with poor self-rated health among adult individuals in Maputo metropolitan area in Mozambique. Methods Data for this study come from a survey of 1768 individuals aged 18 years or more carried out in Maputo metropolitan area, Mozambique, in 2015. Employing multiple logistic regression, the study used a subsample of 677 female and male respondents aged 40 years or more to estimate the determinants of poor self-rated health. Results About 54 % of respondents aged 40 years or more believed that their health status was poor. Female respondents [Odds Ratios (OR) = 3.43, p <0.01], single (OR = 4.71, p < 0.05), widow (OR = 1.81, p < 0.05), separated or divorced (OR = 2.08, p < 0.05) and those believing that hypertension or heart problem was a major community health problem (OR = 1.56, p < 0.05) displayed higher odds of reporting poor health than their peers, net of other factors. Furthermore, individuals aged 40–49 years (OR = 0.45, p < 0.01), or 50–59 years (OR = 0.59, p < 0.05), those whose work involves intensive physical activity (OR = 0.60, p < 0.05) and those from households treating drinking water (OR = 0.49, p < 0.01) showed lower odds of reporting poor health, adjusting for other factors. Conclusion Overall, the results point to the importance of age, gender, marital status, socioeconomic circumstances, individuals’ health behaviors and perceived community health problems as key determinants of poor self-rated health among adults in Maputo metropolitan area. Given the growing number of adult and older people in sub-Saharan Africa, the rising importance of non-communicable diseases and the scarcity of studies on determinants of poor self-rated health among adults in the region, our findings may have implications for a better understanding of the drivers of poor health among adults in urban sub-Saharan Africa
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Affiliation(s)
- Boaventura M Cau
- Departamento de Geografia, Universidade Eduardo Mondlane (UEM), C.P. 257, Maputo, Mozambique. .,Centro de Pesquisa em População e Saúde (CEPSA), Maputo, Mozambique.
| | - Joana Falcão
- Centro de Pesquisa em População e Saúde (CEPSA), Maputo, Mozambique
| | - Carlos Arnaldo
- Departamento de Geografia, Universidade Eduardo Mondlane (UEM), C.P. 257, Maputo, Mozambique.,Centro de Pesquisa em População e Saúde (CEPSA), Maputo, Mozambique
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Patel S, Dowse R. Understanding the medicines information-seeking behaviour and information needs of South African long-term patients with limited literacy skills. Health Expect 2015; 18:1494-507. [PMID: 24112215 PMCID: PMC5060885 DOI: 10.1111/hex.12131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although much health information-seeking behaviour (HISB) research has been reported in patients with good literacy skills, little is known about HISB in patients with limited literacy skills served by under-resourced health-care systems. OBJECTIVE To investigate medicine information-seeking behaviour and information needs in patients with limited literacy. METHODS Using a question guide, four focus group discussions (FGDs) were conducted to explore themes related to information needs, information-seeking practices and awareness of and ability to utilize information sources. Twenty-two isiXhosa-speaking long-term patients with limited formal education were recruited from a primary health-care clinic in South Africa. Discussions were audio-recorded and transcribed verbatim. NVivo(®) was used for initial coding of transcripts. Codes were analysed, and potential themes and subthemes in the entire data set were identified and refined. FINDINGS The results of this study reflect a passive, disempowered patient. Poor awareness of information sources, lack of health-related knowledge and stigma contributed to a lack of information-seeking practice, thus potentially adversely influencing patient-provider interactions. Patients neither asked questions nor were encouraged to ask questions. All expressed an unmet need for information and a desire for receiving the illustrated written medicines-related information displayed in the FGDs. The main sources of information were health-care professionals, followed by family and friends. CONCLUSION The significant level of patient disempowerment and passivity reported amongst patients underpinned their inability to actively seek information. Neither sources of information nor types of appropriate medicines information could be identified. Unmet information needs and a desire for information were reported.
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Affiliation(s)
- Sonal Patel
- Faculty of PharmacyRhodes UniversityGrahamstownSouth Africa
| | - Ros Dowse
- Faculty of PharmacyRhodes UniversityGrahamstownSouth Africa
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Investigating the relationship between self-rated health and social capital in South Africa: a multilevel panel data analysis. BMC Public Health 2015; 15:266. [PMID: 25884690 PMCID: PMC4373512 DOI: 10.1186/s12889-015-1601-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/02/2015] [Indexed: 12/05/2022] Open
Abstract
Background The relationship between social capital and self-rated health has been documented in many developed compared to developing countries. Because social capital and health play important roles in development, it may be valuable to study their relationship in the context of a developing country with poorer health status. Further, the role of social capital research for health policy has not received much attention. This paper therefore examines the relationship between social capital and health in South Africa, a country with the history of colonialism and apartheid that has contributed to the social disintegration and destruction of social capital. Methods This study uses data from the National Income Dynamics Study (NIDS), the first nationally representative panel study in South Africa. Two waves of the NIDS were used in this paper – Wave 1 (2008) and Wave 2 (2010). Self-rated health, social capital (individual- and contextual-level), and other covariates related to the social determinants of health (SDH) were obtained from the NIDS. Individual-level social capital included group participation, personalised trust and generalised trust while contextual-level or neighbourhood-level social capital was obtained by aggregating from the individual-level and household-level social capital variables to the neighbourhood. Mixed effects models were fitted to predict self-rated health in Wave 2, using lagged covariates (from Wave 1). Results Individual personalised trust, individual community service group membership and neighbourhood personalised trust were beneficial to self-rated health. Reciprocity, associational activity and other types of group memberships were not found to be significantly associated with self-rated health in South Africa. Results indicate that both individual- and contextual-level social capital are associated with self-rated health. Conclusion Policy makers may want to consider policies that impact socioeconomic conditions as well as social capital. Some of these policies are linked to the SDH. We contend that the significant social capital including community service membership can be encouraged through policy in a way that is in line with the values of the people. This is likely to impact on health and quality of life generally and lead to a reduction in the burden of disease in South Africa considering the historic context of the country.
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Agampodi TC, Agampodi SB, Glozier N, Siribaddana S. Measurement of social capital in relation to health in low and middle income countries (LMIC): a systematic review. Soc Sci Med 2015; 128:95-104. [PMID: 25596373 DOI: 10.1016/j.socscimed.2015.01.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Social capital is a neglected determinant of health in low and middle income countries. To date, majority of evidence syntheses on social capital and health are based upon high income countries. We conducted this systematic review to identify the methods used to measure social capital in low and middle-income countries and to evaluate their relative strengths and weaknesses. An electronic search was conducted using Pubmed, Science citation index expanded, Social science citation index expanded, Web of knowledge, Cochrane, Trip, Google scholar and selected grey literature sources. We aimed to include all studies conducted in low and middle-income countries, published in English that have measured any aspect of social capital in relation to health in the study, from 1980 to January 2013. We extracted data using a data extraction form and performed narrative synthesis as the measures were heterogeneous. Of the 472 articles retrieved, 46 articles were selected for the review. The review included 32 studies from middle income countries and seven studies from low income countries. Seven were cross national studies. Most studies were descriptive cross sectional in design (n = 39). Only two randomized controlled trials were included. Among the studies conducted using primary data (n = 32), we identified18 purposely built tools that measured various dimensions of social capital. Validity (n = 11) and reliability (n = 8) of the tools were assessed only in very few studies. Cognitive constructs of social capital, namely trust, social cohesion and sense of belonging had a positive association towards measured health outcome in majority of the studies. While most studies measured social capital at individual/micro level (n = 32), group level measurements were obtained by aggregation of individual measures. As many tools originate in high income contexts, cultural adaptation, validation and reliability assessment is mandatory in adapting the tool to the study setting. Evidence on causality and assessing predictive validity is a problem due to the scarcity of prospective study designs. We recommend Harpham et al. s' Adapted Social Capital Assessment Tool (A-SCAT), Hurtado et al. s' six item tool and Elgar et al. s' World Value Survey Social Capital Scale for assessment of social capital in low and middle income countries.
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Affiliation(s)
- Thilini Chanchala Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
| | - Suneth Buddhika Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Nicholas Glozier
- Brain and Mind Research Institute/CCS Sydney Medical School, University of Sydney, Australia
| | - Sisira Siribaddana
- Department of Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
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Dageid W, Grønlie AA. The associations between resilience, social capital and self-rated health among HIV-positive South Africans. J Health Psychol 2013; 20:1463-73. [PMID: 24345683 DOI: 10.1177/1359105313513623] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the relationship between resilience, social capital and self-rated health among 263 HIV-positive South Africans living in poverty, using questionnaires. Self-rated good health was predicted by younger age, trust in community-based organizations and having contacts of different religions. The findings highlight the importance of community-based networks and resources for care and support for persons living with HIV/AIDS in poor, rural areas. Furthermore, resilience, which also related positively to education and income, contributed positively to self-rated health, drawing attention to the interplay between resources at individual and community levels.
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Affiliation(s)
| | - Anette A Grønlie
- University of Oslo, Norway The Norwegian Center for Child Behavioral Development, Norway
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Association of neighbourhood and individual social capital, neighbourhood economic deprivation and self-rated health in South Africa--a multi-level analysis. PLoS One 2013; 8:e71085. [PMID: 23976923 PMCID: PMC3743525 DOI: 10.1371/journal.pone.0071085] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 07/01/2013] [Indexed: 11/24/2022] Open
Abstract
Introduction Social capital is said to influence health, mostly in research undertaken in high income countries' settings. Because social capital may differ from one setting to another, it is suggested that its measurement be context specific. We examine the association of individual and neighbourhood level social capital, and neighbourhood deprivation to self-rated health using a multi-level analysis. Methods Data are taken from the 2008 South Africa National Income Dynamic Survey. Health was self-reported on a scale from 1 (excellent) to 5 (poor). Two measures of social capital were used: individual, measured by two variables denoting trust and civic participation; and neighbourhood social capital, denoting support, association, behaviour and safety in a community. Results Compared to males, females were less likely to report good health (Odds Ratio 0.82: Confidence Interval 0.73, 0.91). There were variations in association of individual social capital and self-rated health among the provinces. In Western Cape (1.37: 0.98, 1.91) and North West (1.39: 1.13, 1.71), trust was positively associated with reporting good health, while the reverse was true in Limpopo (0.56: 0.38, 0.84) and Free State (0.70: 0.48, 1.02). In Western Cape (0.60: 0.44, 0.82) and Mpumalanga (0.72: 0.55, 0.94), neighbourhood social capital was negatively associated with reporting good health. In North West (1.59: 1.27, 1.99) and Gauteng (1.90: 1.21, 2.97), increased neighbourhood social capital was positively associated with reporting good health. Conclusion Our study demonstrated the importance of considering contextual factors when analysing the relationship between social capital and health. Analysis by province showed variations in the way in which social capital affected health in different contexts. Further studies should be undertaken to understand the mechanisms through which social capital impacts on health in South Africa.
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Cramm JM, van Dijk HM, Nieboer AP. [The importance of neighborhood social cohesion and social capital for the well being of older adults in the community]. Tijdschr Gerontol Geriatr 2013; 44:50-8. [PMID: 23463407 DOI: 10.1007/s12439-013-0010-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF THE STUDY We aimed to investigate whether social capital (obtaining support through indirect ties such as from neighbors) and social cohesion (interdependencies among neighbors) within neighborhoods positively affect the well-being of older adults. DESIGN AND METHODS This cross-sectional study included 945/1440 (66 % response rate) independently living older adults (aged >70 years) in Rotterdam. We fitted a hierarchical random-effects model to account for the hierarchical structure of the study design: 945 older adults (level 1) nested in 72 neighborhoods (level 2). RESULTS Univariate analyses showed that being born in the Netherlands, house ownership, education, income, social capital of individuals, neighborhood security, neighborhood services, neighborhood social capital, and neighborhood social cohesion were significantly related to the well-being of older adults. Multilevel analyses showed that social capital of individuals, neighborhood services, neighborhood social capital, and neighborhood social cohesion predicted the well-being of older adults. Single and poor older adults reported lower well-being than did better-off and married older adults. However, the effects of marital status and income were mediated by neighborhood services, social capital, and social cohesion. Neighborhood services, social capital and social cohesion may act as buffer against the adverse effects of being single and poor on the well-being of older adults. IMPLICATIONS The results of this study support the importance of social capital of individuals, as well as social capital within the neighborhood and social cohesion within the neighborhood for well-being of older adults. The well-being of older adults may also be enhanced through the improvement of quality of neighborhood services.
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Affiliation(s)
- J M Cramm
- Erasmus Universiteit Rotterdam, Burgemeester Oudlaan 50, Rotterdam, The Netherlands
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Webel AR, Cuca Y, Okonsky JG, Asher AK, Kaihura A, Salata RA. The impact of social context on self-management in women living with HIV. Soc Sci Med 2013; 87:147-54. [PMID: 23631790 PMCID: PMC3656470 DOI: 10.1016/j.socscimed.2013.03.037] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 02/18/2013] [Accepted: 03/25/2013] [Indexed: 02/06/2023]
Abstract
HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicted all domains of HIV self-management including daily health practices (F = 5.40, adjusted R(2) = 0.27, p < 0.01), HIV social support (F = 4.50, adjusted R(2) = 0.22, p < 0.01), and accepting the chronic nature of HIV (F = 5.57, adjusted R(2) = 0.27, p < 0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women's social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population.
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Affiliation(s)
- Allison R. Webel
- Frances Payne Bolton School of Nursing Case Western Reserve University, 10900 Euclid Avenue Cleveland, OH 44106-4904, USA, Fax: 216-368-3542, Phone: 216-368-3939
| | - Yvette Cuca
- Department of Social and Behavioral Sciences, University of California, San Francisco 3333 California St., Suite 455, San Francisco, CA 94118, USA
| | - Jennifer G. Okonsky
- Department of Community Health Systems University of California, San Francisco School of Nursing 2 Koret Way Suite #N-505 San Francisco, CA 94143-0608, USA
| | - Alice K. Asher
- Department of Community Health Systems University of California, San Francisco School of Nursing 2 Koret Way Suite #N-505 San Francisco, CA 94143-0608, USA
- Institute for Global Health University of California, San Francisco 50 Beale Street, Suite 1200 San Francisco, CA 94105, USA
| | - Alphoncina Kaihura
- Department of Community Health Systems University of California, San Francisco School of Nursing 2 Koret Way Suite #N-505 San Francisco, CA 94143-0608, USA
| | - Robert A. Salata
- Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, 10900 Euclid Avenue Cleveland, OH 44106, USA
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Kim JR, Jeong BG, Park KS, Kang YS. The Associations of Empowerment and Social Capital with Self-Rated Health in Communities with Poor Health. ACTA ACUST UNITED AC 2012. [DOI: 10.5393/jamch.2012.37.3.131] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cramm JM, van Dijk HM, Nieboer AP. The importance of neighborhood social cohesion and social capital for the well being of older adults in the community. THE GERONTOLOGIST 2012; 53:142-52. [PMID: 22547088 DOI: 10.1093/geront/gns052] [Citation(s) in RCA: 204] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY We aimed to investigate whether social capital (obtaining support through indirect ties such as from neighbors) and social cohesion (interdependencies among neighbors) within neighborhoods positively affect the well being of older adults. DESIGN AND METHODS This cross-sectional study included 945 of 1,440 (66% response rate) independently living older adults (aged ≥70 years) in Rotterdam. We fitted a hierarchical random effects model to account for the hierarchical structure of the study design: 945 older adults (Level 1) nested in 72 neighborhoods (Level 2). RESULTS Univariate analyses showed that being born in the Netherlands, house ownership, education, income, social capital of individuals, neighborhood security, neighborhood services, neighborhood social capital, and neighborhood social cohesion were significantly related to the well being of older adults. Multilevel analyses showed that social capital of individuals, neighborhood services, neighborhood social capital, and neighborhood social cohesion predicted the well being of older adults. Single and poor older adults reported lower well being than did better off and married older adults. However, the effects of marital status and income were mediated by neighborhood services, social capital, and social cohesion. Neighborhood services, social capital, and social cohesion may act as buffer against the adverse effects of being single and poor on the well being of older adults. IMPLICATIONS The results of this study support the importance of social capital of individuals, as well as social capital within the neighborhood and social cohesion within the neighborhood for well being of older adults. The well being of older adults may also be enhanced through the improvement of quality of neighborhood services.
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Affiliation(s)
- Jane M Cramm
- Institute of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR Rotterdam, the Netherlands.
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