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Seidu AA, Malau-Aduli BS, McBain-Rigg K, Malau-Aduli AEO, Emeto TI. Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana. Reprod Health 2024; 21:69. [PMID: 38783342 PMCID: PMC11112844 DOI: 10.1186/s12978-024-01810-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana. METHODS A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis. RESULTS Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes. CONCLUSION The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.
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Affiliation(s)
- Abdul-Aziz Seidu
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
- Department of Population and Health, University of Cape Coast, P.O. Box UC 182, Cape Coast, Ghana.
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Kristin McBain-Rigg
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| | - Aduli E O Malau-Aduli
- School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Theophilus I Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD, 4811, Australia.
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Walker AN, Weeto MM, Priddy CB, Yakubu S, Zaitoun M, Chen Q, Li B, Feng Y, Zhong Y, Zhang Y, Wei T, Bafei SEC, Feng Q. Healthy eating habits and a prudent dietary pattern improve Nanjing international students' health-related quality of life. Front Public Health 2023; 11:1211218. [PMID: 38098838 PMCID: PMC10720919 DOI: 10.3389/fpubh.2023.1211218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/19/2023] [Indexed: 12/17/2023] Open
Abstract
Purpose Low-quality dietary practices, such as fast food consumption and skipping meals, deteriorate the quality of life. However, the available studies on diet and health-related quality of life (HRQoL) used matrices not specific to nutrition. Moreover, how diet affects the HRQoL of international students in China is unknown. Therefore, using a cross-sectional study, the effect of dietary patterns and habits on the HRQoL of international students in Nanjing, China, was examined. Methods The researchers collected dietary data using a food frequency questionnaire (FFQ) from February to March 2022. Then, the Food Benefit Assessment (FBA) was used to access HRQoL. Finally, the effect of eating habits and dietary patterns on HRQoL was explored using multilinear regression. Results Approximately 454 responses were obtained, with the responses mostly from male subjects (56.4%) and those aged 26 years and above (75.6%). The quality of life according to the food consumed was about average for all the constructs except for aesthetics and disease prevention, as 65.8% skipped meals, particularly breakfast (47.8%). Furthermore, three dietary patterns were identified: prudent, Western, and animal protein patterns. Consequently, by skipping breakfast, vitality (β = -2.362, p = 0.04), wellbeing (β = -3.592, p = 0.007), digestive comfort (β = -4.734, p = 0.008), and disease prevention (β = -5.071, p = 0.031) were all reduced. However, consuming at least three meals daily enhanced vitality (β = 2.254, p = 0.003) and disease prevention (β = 4.441, p = 0.019). Furthermore, aesthetics (β = 4.456, p = 0.05), physical appearance (β = 5.927, p = 0.003), and vitality (β = 3.323, p = 0.009) were also significantly increased by healthy dietary patterns. However, a more Westernized diet led to frequent snacking (β = -4.631, p = 0.032), a decline in wellbeing (β = -5.370, p < 0.001), and discomfort with digestion (β = -5.101, p = 0.01). Finally, increased frequency of snacking (β = -6.036, p = 0.012), a decrease in wellbeing (β = -4.494, p = 0.004), digestive comfort (β = -9.940, p < 0.001), physical appearance (β = -4.926, p = 0.027), and disease prevention (β = -5.835, p = 0.043) were all associated with an increase in animal protein patterns. Conclusion This research indicates that healthy eating habits and patterns positively impact international students' HRQoL. Therefore, the appropriate authorities should advise students to consume healthy foods regularly to improve their HRQoL.
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Affiliation(s)
- Anita Nyarkoa Walker
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Makhala Mary Weeto
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | | | - Salimata Yakubu
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Margaret Zaitoun
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qianfeng Chen
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bohan Li
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yucong Feng
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuxia Zhong
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuandie Zhang
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tao Wei
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
| | | | - Qing Feng
- Department of Nutrition and Food Hygiene, Nanjing Medical University, Nanjing, Jiangsu, China
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Patel R, Bansod DW. How do responses vary between mothers and their daughters on measuring daughter's self-rated health (SRH): a study among school-going adolescent girls in the primary setting of Varanasi, India. BMC Res Notes 2022; 15:289. [PMID: 36064590 PMCID: PMC9446715 DOI: 10.1186/s13104-022-06174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/25/2022] [Indexed: 11/26/2022] Open
Abstract
Objective How self-rated health (SRH) varies when the response on SRH is recorded from the respondent herself (adolescent girl) and her mother on her behalf. This study examines the prevalence of SRH among adolescent girls from her point of view as well as from her mother’s point of view. This insight could help us interpret the differences in opinion of girls and their mothers while measuring the girls’ self-rated health. Results Almost one-fifth (19.4%) of the girls reported poor SRH. In contrast, only one in eight mothers (12.3%) could report their daughters under the category of poor SRH. Nearly one-third (76.5%) of the mothers reported their daughter’s SRH as good when daughters themselves rated poorly on SRH and another one-tenth (9.6%) reported their daughter’s SRH as poor when daughters themselves categorized in the good SRH category [χ2 = 9.900; p < 0.002]. More than 90 percent of the Rich and Middle wealth index women, women in the household with only daughters and no son, women whose husbands had higher education, women with higher secondary education, and non-working women visualized their daughter’s SRH as good when daughters themselves reported poor SRH. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06174-1.
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Affiliation(s)
- Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
| | - Dhananjay W Bansod
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
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Ferrari Junior GJ, Teixeira CS, Felden ÉPG. Socioenvironmental factors and behaviors associated with negative self-rated health in Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:4309-4320. [PMID: 34586281 DOI: 10.1590/1413-81232021269.18172020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/02/2020] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study is to determine the factors associated with negative self-rated health in Brazil. The sample consisted of 5,259 adults from five representative capitals of the five regions of Brazil. Data collection was achieved in the following municipalities: Palmas (North Region), João Pessoa (Northeast Region), Goiânia (Central-West Region), Vitória (Southeast Region) and Florianópolis (South Region). For the analysis of the data, Binary Logistic Regression for determine the factors associated with negative self-rated health was used. Negative self-rated health was identified in 31.43% of Brazilians. The factors that were significantly associated were bad air quality, does not have public spaces for leisure, older age group, insufficient salary to cover expenses, a rare practice of physical exercises, does not perform healthy eating, active commuting for study or employment and commuting time for above 30 minutes, dissatisfaction with health services and still, not working, not looking for a job and finally, reside in some Brazilian regions. The study presents the importance of socioenvironmental and behavioral factors for the self-rated health of Brazilian adults, as well as it shows high rates of negative self-rated health compared to other studies.
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Affiliation(s)
- Geraldo Jose Ferrari Junior
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
| | | | - Érico Pereira Gomes Felden
- Centro de Ciências da Saúde e do Esporte, Universidade do Estado de Santa Catarina. R. Pascoal Simone 358, Coqueiros. 88080-350 Florianópolis SC Brasil.
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Duboz P, Boëtsch G, Guisse A, Macia E. Assessing health impacts of an environmental pan-African development project: A migration perspective. SSM Popul Health 2020; 11:100633. [PMID: 32728608 PMCID: PMC7381683 DOI: 10.1016/j.ssmph.2020.100633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/29/2020] [Accepted: 07/14/2020] [Indexed: 12/02/2022] Open
Abstract
The general objective of this article is to analyze to what extent the implementation of the Great Green Wall project is likely to disrupt migratory movements towards the rural environment and, consequently, the socio-economic structures and health status of local populations. This study was carried out in 2015 on a population sample of 500 individuals living in the municipality of Tessekere, constructed using the quota method. Socioeconomic and demographic characteristics, migratory status and self-rated health of individuals were collected during face-to-face interviews. Statistical analyses used were Chi-square tests, student and binary logistic regressions. Results show that internal migrants in the municipality of Tessekere represent 13.40% of the study population. Migrants more often work as civil servants, artisans, craft workers or traders than the region's native population, who are generally livestock breeders or jobless. While place of birth does not play a significant role, it appears that the length of residence of migrants in rural areas influences health status: migrants residing in the municipality of Tessekere for less than 10 years are less likely to report poor health, regardless of their sex, age, occupation, material well-being and perceived stress. In conclusion, an environmental requirement (combating desertification), addressed by an international political project - the Great Green Wall - and then applied at the national level, has transformed the demographic, economic and health structure of a local population. In conclusion, our study showed that (1) an examination of migration can offer a means of interpreting the impact of development projects and the local changes they entail, and (2) migration is a unique prism through which one can study how exposure to a new physical and social environment influences the health of populations.
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Affiliation(s)
- Priscilla Duboz
- UMI 3189 Environnement, Santé, Sociétés, CNRS/UCAD/UGB/ USTTB/CNRST, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, BP 5005, Dakar, Senegal
| | - Gilles Boëtsch
- UMI 3189 Environnement, Santé, Sociétés, CNRS/UCAD/UGB/ USTTB/CNRST, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, BP 5005, Dakar, Senegal
| | - Aliou Guisse
- UMI 3189 Environnement, Santé, Sociétés, CNRS/UCAD/UGB/ USTTB/CNRST, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, BP 5005, Dakar, Senegal
| | - Enguerran Macia
- UMI 3189 Environnement, Santé, Sociétés, CNRS/UCAD/UGB/ USTTB/CNRST, Faculté de Médecine de Dakar, Université Cheikh Anta Diop, BP 5005, Dakar, Senegal
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Tetteh J, Kogi R, Yawson AO, Mensah G, Biritwum R, Yawson AE. Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization's study on global AGEing and adult health, Wave 2. PLoS One 2019; 14:e0224327. [PMID: 31689325 PMCID: PMC6830754 DOI: 10.1371/journal.pone.0224327] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
Background Functional difficulty assessment has been proven as a key factor in the health evaluation of adults. Previous studies have shown a reduction in health and functional difficulties with increasing age. This analysis was conducted to quantify the effect of poor self-rated health on functional difficulty among older adults in Ghana. Method This analysis was based on the World Health Organization Study on Global AGEing and Adult Health in Ghana for older adults 50 years and above. Fifteen standard functioning difficulty tools were extracted and used for the analysis. Three predictive models with the Coarsened Exact Matching method involving Negative Binomial, Logistics and Ordered logistic regression were performed using Stata 14. Results Overall, the prevalence of poor Self-rated health was 34.9% and that of functional difficulties among older adults in Ghana was 69.4%. Female sex, increasing age, being separated, having no religious affiliation, not currently working and being underweight were associated with and significantly influence poor Self-rated health [AOR(95%CI)p-value = 1.41(1.08–1.83)0.011, 3.85(2.62–5.64)0.000, 1.45(1.08–1.94)0.013, 2.62(1.68–4.07)0.000, 2.4(1.85–3.12)0.000 and 1.39(1.06–1.81)0.017 respectively]. In addition, poor Self-rated health and geographical location (rural vs. urban)significantly influence functioning difficulties among older adults in Ghana as predicted by the three models [Negative Binomial: PR(95%CI) = 1.62(1.43–1.82), Binary logistic: AOR(95%CI) = 3.67(2.79–4.81) and ordered logistic: AOR(95%CI) = 2.53(1.14–2.03)]. Conclusion Poor SRH is more pronounced among older adult females in Ghana. Some determinants of poor SRH include; age, geographical location (urban vs. rural), marital status, religion, and employment status. This provides pointers to important socio-demographic determinants with implications on the social function of older adults in line with the theme of the national aging policy of 2010, ‘ageing with security and dignity’ and ultimately in the national quest to achieve the Sustainable Development Goals by 2030.
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Affiliation(s)
- John Tetteh
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kogi
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - George Mensah
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Richard Biritwum
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- * E-mail: ,
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Niamba L, Gagnon A, Adjiwanou V, Legrand TK. Arrangements résidentiels et santé des personnes âgées à Nouna (Burkina Faso) : approches transversale et longitudinale. CAHIERS QUÉBÉCOIS DE DÉMOGRAPHIE 2019. [DOI: 10.7202/1074180ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cullati S, Mukhopadhyay S, Sieber S, Chakraborty A, Burton-Jeangros C. Is the single self-rated health item reliable in India? A construct validity study. BMJ Glob Health 2018; 3:e000856. [PMID: 30483411 PMCID: PMC6231101 DOI: 10.1136/bmjgh-2018-000856] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/17/2018] [Accepted: 10/06/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction In high-income countries, the self-rated health (SRH) item is used in health surveys to capture the population’s general health because of its simplicity and satisfactory validity and reliability. Despite scepticism about its use in low-income and middle-income countries, India implemented the SRH item in many of its demographic and population health surveys, but evidence of its validity is lacking. The objective was to assess the construct validity of the SRH item in India. Methods Data for 4492 men and 4736 women from the Indian sample of the World Health Survey (2003) were used. Overall, 43 health status indicators were grouped into health dimensions (physical, mental and functional health, chronic diseases, health behaviours) and the SRH item was regressed on these indicators by using sex-stratified multivariable linear regressions, adjusted with demographic and socioeconomic variables. Results Respondents (participation rate 95.6%; mean age 38.9 years) rated their health as very good (21.8%), good (36.4%), moderate (26.6%), bad (13.2%) or very bad (2.0%). Among men, the adjusted explained SRH variance by health dimensions ranged between 18% and 41% (physical 33%, mental 32%, functional health 41%, chronic diseases 23%, health behaviours 18%). In multivariable models, the overall explained variance increased to 45%. The 43 health status indicators were associated with SRH and their effect sizes were in the expected direction. Among women, results were similar (overall explained variance 48%). Conclusion The SRH item has satisfactory construct validity and may be used to monitor health status in demographic and population health surveys of India.
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Affiliation(s)
- Stéphane Cullati
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland.,Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland.,Swiss NCCR 'LIVES-Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland
| | | | - Stefan Sieber
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland.,Swiss NCCR 'LIVES-Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland
| | | | - Claudine Burton-Jeangros
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland.,Swiss NCCR 'LIVES-Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland
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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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Dake FAA. Examining equity in health insurance coverage: an analysis of Ghana's National Health Insurance Scheme. Int J Equity Health 2018; 17:85. [PMID: 29914497 PMCID: PMC6006705 DOI: 10.1186/s12939-018-0793-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background Following years of out-of-pocket payment for healthcare, some countries in Africa including Ghana, Kenya and Rwanda have instituted social health protection programs through health insurance to provide access to quality and affordable healthcare especially for the poor. This paper examines equity in coverage under Ghana’s National Health Insurance Scheme (NHIS). Methods Secondary data from the 2008 Ghana Demographic and Health Survey based on an analytical sample of 4821 females (15–49 years) and 4568 males (15–59 years) were analysed using descriptive, bivariate and multivariate methods. Concentration curves and indices were used to examine equity in coverage on the NHIS. Results As at 2008, more than 60% of Ghanaians aged 15–59 years were not covered under the NHIS with slightly more females (38.9%) than males (29.7%) covered. Coverage was highest among the highly educated, professionals, those from households in the richest wealth quintile and urban residents. Lack of coverage was most concentrated among the poor. Conclusions Universal coverage under the NHIS is far from being achieved with marked exclusion of the poor. There is the need for deliberate action to enrol the poor under the NHIS.
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Affiliation(s)
- Fidelia A A Dake
- Regional Institute for Population Studies, University of Ghana, P.O. Box LG 96, Legon, Accra, Ghana.
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Ouédraogo S, Ridde V, Atchessi N, Souares A, Koulidiati JL, Stoeffler Q, Zunzunegui MV. Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa. BMJ Open 2017; 7:e013405. [PMID: 28993378 PMCID: PMC5640067 DOI: 10.1136/bmjopen-2016-013405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In Africa, health research on indigent people has focused on how to target them for services, but little research has been conducted to identify the social groups that compose indigence. Our aim was to identify what makes someone indigent beyond being recognised by the community as needing a card for free healthcare. METHODS We used data from a survey conducted to evaluate a state-led intervention for performance-based financing of health services in two districts of Burkina Faso. In 2015, we analysed data of 1783 non-indigents and 829 people defined as indigents by their community in 21 villages following community-based targeting processes. Using a classification tree, we built a model to select socioeconomic and health characteristics that were likely to distinguish between non-indigents and indigents. We described the screening performance of the tree using data from specific nodes. RESULTS Widow(er)s under 45 years of age, unmarried people aged 45 years and over, and married women aged 60 years and over were more likely to be identified as indigents by their community. Simple rules based on age, marital status and gender detected indigents with sensitivity of 75.6% and specificity of 55% among those 45 years and over; among those under 45, sensitivity was 85.5% and specificity 92.2%. For both tests combined, sensitivity was 78% and specificity 81%. CONCLUSION In moving towards universal health coverage, Burkina Faso should extend free access to priority healthcare services to widow(er)s under 45, unmarried people aged 45 years and over, and married women aged 60 years and over, and services should be adapted to their health needs. ETHICS CONSIDERATIONS The collection, storage and release of data for research purposes were authorised by a government ethics committee in Burkina Faso (Decision No. 2013-7-066). Respondent consent was obtained verbally.
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Affiliation(s)
- Samiratou Ouédraogo
- University of Montreal Public Health Research Institute, Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Canada
| | - Valéry Ridde
- University of Montreal Public Health Research Institute, Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Canada
| | - Nicole Atchessi
- University of Montreal Public Health Research Institute, Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, Canada
| | - Aurélia Souares
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | | | - Quentin Stoeffler
- Department of Economics, Istanbul Technical University, Istanbul, Turkey
| | - Maria-Victoria Zunzunegui
- University of Montreal Public Health Research Institute, Montreal, Canada
- Department of Social and Preventive Medicine, University of Montreal School of Public Health, Montreal, 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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Fonta CL, Nonvignon J, Aikins M, Nwosu E, Aryeetey GC. Predictors of self-reported health among the elderly in Ghana: a cross sectional study. BMC Geriatr 2017; 17:171. [PMID: 28760156 PMCID: PMC5537992 DOI: 10.1186/s12877-017-0560-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-reported health is a widely used measure of health status across individuals. As the ageing population increases, the health of the elderly also becomes of growing concern. The elderly go through life facing social, economic and financial hardships. These hardships are known to affect the health status of people as they age. The purpose of this study is to assess social and health related factors of self-reported health among the elderly in Ghana. METHODS A multivariate regression analysis in form of a binary and ordinal logistic regression were used to determine the association between socioeconomic, demographic and health related factors, on self-reported health. The data used for this study was drawn from the World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) Wave 1. RESULTS In total, out of 2613 respondent, 579 (20.1%) rated their health status as poor and 2034 (79.9%) as good. The results showed that the odds of reporting poor health was 2.5 times higher among the old-old compared to the young old. The elderly with one or more than one chronic condition had the odds of 1.6 times and 2 times respectively, of reporting poor health. Engaging in mild to moderate exercise increased the chances of reporting poor health by 1.8 times. The elderly who had never worked in a lifetime were 2 times more likely to report poor health. In the same way, residents of Eastern and Western parts of Ghana were 2 times more likely to report poor health compared to those in the Upper West region. Respondents with functional limitations and disabilities were 3.6 times and 2.4 times respectively, more likely to report poor health. On the other hand, the odds of reporting poor health was 29, 36 and 27% less among respondents in the highest income quintiles, former users of tobacco and those satisfied with certain aspects of life respectively. Also, current alcohol users were 41% less likely to report poor health. CONCLUSION The health status of the elderly is to an extent determined by the circumstances in which they are born, grow and live. The findings suggest that addressing social issues faced by individuals in youthful age will go a long way to achieving good health in the future. People with physical limitations and disabilities are most vulnerable to unmet healthcare needs and support system from government, policy makers and family.
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Affiliation(s)
- Cynthia Lum Fonta
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
- West African Science Service Center on Climate Change and Adapted Land Use, WASCAL Competent Center, Blvd Mouammar Kadhafi, 06, Ouagadougou, BP 9507 Burkina Faso
| | - Justice Nonvignon
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
| | - Moses Aikins
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
| | - Emmanuel Nwosu
- Department of Economics, University of Nigeria Nsukka, Enugu State, Nigeria
| | - Genevieve Cecilia Aryeetey
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
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Jebena MG, Lindstrom D, Lachat C, Belachew T, Kolsteren P. The effect of food insecurity on health status of adolescents in Ethiopia: longitudinal study. BMC Public Health 2017; 17:465. [PMID: 28521757 PMCID: PMC5437384 DOI: 10.1186/s12889-017-4406-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 05/07/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The effect of food insecurity on health and wellbeing of a population has been the subject of much research. Yet, limited research has investigated its effect on adolescents' health and wellbeing in Ethiopia. METHOD We used data from the Jimma Longitudinal Family Survey of Youth which began tracking a cohort of adolescents in 2005 to examine the social, behavioral and economic determinants of their health and well-being. A total of 1,919 sample were included in the main analyses. All youths provided data related to their food insecurity experiences and their health status. A mixed effect logistic regression using random intercept and trend model was used to examine the relationship between food insecurity and their health status. Fixed effects estimates were also computed to check the parsimoniousness of the random intercept and trend model. RESULTS The results indicated that the mean (±SD) age of adolescents was 18.6(±1.4). Nine hundred twenty three (48.1%) of them were female. The magnitude of self-rated health status was relatively unstable ranging from 18.9%, 34.7% to 37.3% in each round. Similarly, 20.4%, 48.4% and 20.6% of adolescents were food insecure during each consecutive round of the survey respectively. Exposure to food insecurity is strongly associated with self-rated health status (β = 0.28, P < 0.001) and poor self-rated health was also more pronounced for some time (β =2.11, P < 0.001) and decline after a turning point (β = -0.38, P < 0.001). CONCLUSIONS These findings imply that any social, nutrition and public health interventions designed to improve adolescent health should consider underlying social determinants of health such as food insecurity.
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Affiliation(s)
- Mulusew G. Jebena
- Department of Population and Family Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - David Lindstrom
- Department of Sociology, Brown University, Box 1916, Maxcy Hall, Providence, RI 02912 USA
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - Tefera Belachew
- Department of Population and Family Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
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Nayak S, Hubbard A, Sidney S, Syme SL. Characteristics associated with self-rated health in the CARDIA study: Contextualising health determinants by income group. Prev Med Rep 2016; 4:199-208. [PMID: 27413683 PMCID: PMC4929073 DOI: 10.1016/j.pmedr.2016.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/05/2016] [Indexed: 11/24/2022] Open
Abstract
An understanding of factors influencing health in socioeconomic groups is required to reduce health inequalities. This study investigated combinations of health determinants associated with self-rated health (SRH), and their relative importance, in income-based groups. Cross-sectional data from year 15 (2000 - 2001) of the CARDIA study (Coronary Artery Risk Development in Young Adults, USA) - 3648 men and women (mean 40 years) - were split into 5 income-based groups. SRH responses were categorized as 'higher'/'lower'. Health determinants (medical, lifestyle, and social factors, living conditions) associated with SRH in each group were analyzed using classification tree analysis (CTA). Income and SRH were positively associated (p < 0.05). Data suggested an income-based gradient for lifestyle/medical/social factors/living conditions. Profiles, and relative importance ranking, of multi-domain health determinants, in relation to SRH, differed by income group. The highest ranking variable for each income group was chronic burden-personal health problem (<$25,000); physical activity ($25-50,000; $50-75,000; $100,000 +); and cigarettes/day ($75-100,000). In lower income groups, more risk factors and chronic burden indicators were associated with SRH. Social support, control over life, optimism, and resources for paying for basics/medical care/health insurance were greater (%) with higher income. SRH is a multidimensional measure; CTA is useful for contextualizing risk factors in relation to health status. Findings suggest that for lower income groups, addressing contributors to chronic burden is important alongside lifestyle/medical factors. In a proportionate universalism context, in addition to differences in intensity of public health action across the socioeconomic gradient, differences in the type of interventions to improve SRH may also be important.
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Affiliation(s)
- Shilpa Nayak
- Department of Public Health and Policy, The Whelan Building, Quadrangle, The University of Liverpool, Liverpool L69 3GB, UK
| | - Alan Hubbard
- School of Public Health, The University of California, Berkeley, Berkeley, USA
| | - Stephen Sidney
- Kaiser Permanente Northern California Division of Research, Oakland, USA
| | - S. Leonard Syme
- School of Public Health, The University of California, Berkeley, Berkeley, USA
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Abstract
Purpose Perceived health (PH) is a subjective measure of global health of individuals. While many studies have evaluated outcomes in patients with primary immune deficiency (PID), published literature evaluating PH among patients with PID is sparse. We evaluated the results of the largest self-reported survey of patients with PID to determine the factors that may contribute to differences in PH. Methods Data from a National Survey of Patients with Primary Immune Deficiency Diseases conducted by the Immune Deficiency Foundation was studied. Multivariate logistic regression was employed for data analysis. Results Thirty percent of the patients perceived their health status as excellent or very good (EVG), 31 % as good (G), and 39 % as fair, poor or very poor (P). Older patients were less likely to have EVG-PH compared to G-PH. Ones with college degrees were more likely to have P-PH compared to G-PH, and less likely to have EVG-PH. Patients who were acutely ill and hospitalized in the past 12 months, ones with limited activity, and chronic diseases, were more likely to have P-PH compared to G-PH. Patients with “on demand” access to specialty care and ones on regular IVIG had higher OR of having EVG-PH as opposed to G-PH. Patients cared for mostly by an immunologist were less likely to have P-PH compared to G-PH. Conclusions Our results emphasize the importance of PH in clinical practice. We suggest that recognizing the factors that drive PH in patients with PID is important for the development of disease prevention and health promotion programs, and delivery of appropriate health and social services to individuals with PID.
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How can we improve healthcare access and general self-rated health among orphans and vulnerable children? Findings from a Kenyan cross-sectional study. Int J Public Health 2015; 60:589-97. [PMID: 25929578 DOI: 10.1007/s00038-015-0681-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES This study analyzes healthcare access and general self-rated health (GSRH) among orphan and vulnerable child (OVC) households enrolled in an empowerment program in Eastern Province, Kenya. Analyses investigate whether reported monthly income mediates the association between program participation and medical security. Predictors of GSRH are also investigated. METHODS Cross-sectional survey data on families (n = 707) participating in a multisectoral empowerment program were collected in June 2012. Regression methods were used to investigate study aims. RESULTS Monthly income mediated 14.3 % of the total effect of program participation on healthcare accessibility. Program participation was not significantly associated with higher GSRH. CONCLUSIONS Increased reported monthly income predicted improved healthcare access, but only explained a portion of improved healthcare access in the study population. Partnerships between community-based empowerment programs and clinical providers might successfully target multiple outcomes among OVC, including improved healthcare access, though further research on potential synergies is required. GSRH was associated with increased access to food, medical care, literacy, safe drinking water and household income. Further research on GSRH among OVC should target measurement validity, potential sources of disparity in GSRH between OVC and non-OVC, and targets for improving GSRH among OVC.
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The components of self-perceived health in the Kailali district of Nepal: a cross-sectional survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3215-31. [PMID: 25789457 PMCID: PMC4377960 DOI: 10.3390/ijerph120303215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 01/14/2023]
Abstract
Self-perceived health is a health measure with well-established links with mortality, healthcare services utilization, and future health. Various components of self-perceived health have been identified in different populations. In this study, we aimed to investigate the components of self-perceived health in a Nepali population. This was a cross-sectional survey conducted in the Kailali district of Nepal in 2014. The sample was initially consisted of 309 households, representative of the population of one municipality and one village; however, 304 participants were included in the analyses. Information on socio-demographic characteristics, health condition, satisfaction with healthcare services, psychological factors, and health behaviors was extracted. Logistic regression analyses were carried out to identify putative components of self-perceived health. Among the 304 respondents, 244 (80.3%) and 60 (19.7%) perceived their health as good and poor, respectively. Middle age and lower satisfaction with healthcare services were associated with worse self-perceived health, accounting for 10.3% of variance. No regular exercise, drinking, smoking, and being unhappy were also related with worse self-perceived health, after adjustment for age and satisfaction level. In the final model, however, drinking status did not significantly contribute. Our findings support previous findings that individuals with positive health behaviors and psychological wellbeing are more likely to perceive their health better. This study may direct public health policies toward more targeted interventions.
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Campos ACV, Ferreira e Ferreira E, Vargas AMD, Albala C. Aging, Gender and Quality of Life (AGEQOL) study: factors associated with good quality of life in older Brazilian community-dwelling adults. Health Qual Life Outcomes 2014; 12:166. [PMID: 25433521 PMCID: PMC4261579 DOI: 10.1186/s12955-014-0166-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In Brazil, a rapidly aging country suffering from large inequalities, the study of the quality of life (QOL) of aged people is important for the future health. The aim of this study was to examine the associations among QOL, gender, and physical and psychosocial health in older Brazilian community-dwelling adults to identify factors that are associated with better QOL. METHODS The "Aging, Gender and Quality of Life (AGEQOL)" study, which included 2,052 respondents aged 60 or older, was conducted in Sete Lagoas, Brazil between January and July 2012. The respondents answered questions regarding their socioeconomic and demographic information, health and social situations, cognitive impairment, depressive symptoms and family satisfaction. The authors also applied the Brazilian version the World Health Organization Quality of Life QOL Assessment-Brief Instrument (WHOQOL-BREF) and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old). Ordinal logistic regression with the Proportional-Odds and Logit function was used to test the association between QOL and physical and psychosocial health according to age and socioeconomic status. RESULTS Older adults of both genders with five or more years of education, good self-rated health, an absence of depressive symptoms, and no family dysfunction reported better QOL. Retired men had a better QOL compared to non-retired men (OR = 2.2; 95% CI = 1.4-3.2), but this association was not observed in females. Men living in mixed arrangements (OR = 0.5; p = 0.033) and women who did not practice physical activity (OR = 0.7; p = 0.022) tended to have poorer QOL. CONCLUSIONS We conclude that there are gender differences related to better QOL in this sample. Women with good physical and psychosocial health are more likely to have a better QOL. For men, the best QOL was associated with high socioeconomic conditions and good physical and psychosocial health.
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Affiliation(s)
- Ana Cristina Viana Campos
- School of Dentistry, Universidade Federal de Minas Gerais, Presidente Antônio Carlos 6627, Belo Horizonte, 31270-901, Minas Gerais, Brazil.
| | - Efigênia Ferreira e Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Presidente Antônio Carlos 6627, Belo Horizonte, 31270-901, Minas Gerais, Brazil.
| | - Andréa Maria Duarte Vargas
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Presidente Antônio Carlos 6627, Belo Horizonte, 31270-901, Minas Gerais, Brazil.
| | - Cecilia Albala
- Unidad Nutrición, Salud Pública y Envejecimiento Saludable, INTA, Universidad de Chile, El Líbano 5524 Macul, Santiago, 138-11, Chile.
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Lifestyle behaviors and self-rated health: the living for health program. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2014; 2014:315042. [PMID: 25530764 PMCID: PMC4228703 DOI: 10.1155/2014/315042] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 10/03/2014] [Accepted: 10/08/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Lack of adherence to dietary and physical activity guidelines has been linked to an increase in chronic diseases in the United States (US). The aim of this study was to assess the association of lifestyle behaviors with self-rated health (SRH). METHODS This cross-sectional study used self-reported data from Living for Health Program (N = 1,701) which was conducted from 2008 to 2012 in 190 health fair events in South Florida, US. RESULTS Significantly higher percent of females as compared to males were classified as obese (35.4% versus 27.0%), reported poor/fair SRH (23.4% versus 15.0%), and were less physically active (33.9% versus 25.4%). Adjusted logistic regression models indicated that both females and males were more likely to report poor/fair SRH if they consumed ≤2 servings of fruits and vegetables per day (OR = 2.14, 95% CI 1.30-3.54; OR = 2.86, 95% CI 1.12-7.35, resp.) and consumed mostly high fat foods (OR = 1.58, 95% CI 1.03-2.43; OR = 3.37, 95% CI 1.67-2.43, resp.). The association of SRH with less physical activity was only significant in females (OR = 1.66, 95% CI 1.17-2.35). CONCLUSION Gender differences in health behaviors should be considered in designing and monitoring lifestyle interventions to prevent cardiovascular diseases.
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Tao X, Chow SKY, Wong FKY. Determining the validity and reliability of the Chinese version of the Kidney Disease Quality of Life Questionnaire (KDQOL-36™). BMC Nephrol 2014; 15:115. [PMID: 25015224 PMCID: PMC4115482 DOI: 10.1186/1471-2369-15-115] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 07/08/2014] [Indexed: 01/18/2023] Open
Abstract
Background Health-related quality of life is a crucial outcome for the chronic kidney disease population, the Kidney Disease Quality of Life (KDQOL) questionnaire is commonly used as an integral part of clinical evaluations. The abbreviated version of the KDQOL-36™ has been translated into Mandarin Chinese, but has not been tested for use in the Chinese patients. The aim of the study was to evaluate the validity and reliability of the KDQOL-36™ with a sample of Chinese patients. Methods The Mandarin Chinese version of the KDQOL-36™ has been translated by Amgen, Inc. and the MAPI Institution following the instrument translation specifications provided by the RAND health. The translated instrument was further reviewed by a Chinese expert panel for content validity and translational equivalence. The KDQOL-36™ along with Beck depression Inventory-II were administrated to 103 chronic renal disease patients recruited through convenience sampling procedure from the renal wards and an outpatient dialysis clinic. The convergent validity was determined through investigating the correlational evidence of the KDQOL-36™ with the Beck depression Inventory-II and the overall health rating. Known-group validity was supported by the evidence that the instrument could differentiate subgroups of patients. The internal consistency was estimated using Cronbach’s α and test-retest reliability was examined using an intraclass correlation coefficient. Results For the convergent validity, there were positive correlations between the overall health rating and most of the KDQOL-36™ subscales, and the Beck depression inventory score was inversely correlated with the mental component summary score and disease-specific scores of the scale. Significant correlations were noted between disease-targeted and generic dimensions of the KDQOL-36™. The results of the known-group comparisons indicated females, the unemployed, and patients had a longer dialysis history reported a worse quality of life. With regard to the reliability, the Cronbach’s alpha ranged from 0.69 to 0.78, and the intraclass correlation test-retest was higher than 0.70. Conclusions The Mandarin Chinese version of the KDQOL-36™ is a brief, valid, and reliable instrument for use in examining the quality of life of chronic kidney disease patients in China.
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Affiliation(s)
| | - Susan Ka Yee Chow
- School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong.
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Onadja Y, Atchessi N, Soura BA, Rossier C, Zunzunegui MV. Gender differences in cognitive impairment and mobility disability in old age: a cross-sectional study in Ouagadougou, Burkina Faso. Arch Gerontol Geriatr 2013; 57:311-8. [PMID: 23827740 DOI: 10.1016/j.archger.2013.06.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 06/06/2013] [Accepted: 06/07/2013] [Indexed: 11/26/2022]
Abstract
This study aims to examine differences in cognitive impairment and mobility disability between older men and women in Ouagadougou, Burkina Faso, and to assess the extent to which these differences could be attributable to gender inequalities in life course social and health conditions. Data were collected on 981 men and women aged 50 and older in a 2010 cross-sectional health survey conducted in the Ouagadougou Health and Demographic Surveillance System. Cognitive impairment was assessed using the Leganés cognitive test. Mobility disability was self-reported as having any difficulty walking 400 m without assistance. We used logistic regression to assess gender differences in cognitive impairment and mobility disability. Prevalence of cognitive impairment was 27.6% in women and 7.7% in men, and mobility disability was present in 51.7% of women and 26.5% of men. The women to men odds ratio (95% confidence interval) for cognitive impairment and mobility disability was 3.52 (1.98-6.28) and 3.79 (2.47-5.85), respectively, after adjusting for the observed life course social and health conditions. The female excess was only partially explained by gender inequalities in nutritional status, marital status and, to a lesser extent, education. Among men and women, age, childhood hunger, lack of education, absence of a partner and being underweight were independent risk factors for cognitive impairment, while age, childhood poor health, food insecurity and being overweight were risk factors for mobility disability. Enhancing nutritional status and education opportunities throughout life span could prevent cognitive impairment and mobility disability and partly reduce the female excess in these disabilities.
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Affiliation(s)
- Yentéma Onadja
- Département de démographie, Université de Montréal, 3150 rue Jean-Brillant, Montréal, Québec H3T 1N8, Canada.
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