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Chen J, Wang S, Han Y, Zhang Y, Li Y, Zhang B, Li X, Zhang J. Geodetector analysis of individual and joint impacts of natural and human factors on maternal and child health at the provincial scale. Sci Rep 2024; 14:1643. [PMID: 38238587 PMCID: PMC10796915 DOI: 10.1038/s41598-024-52282-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024] Open
Abstract
This ecological study examined the individual and joint impacts of natural-human factors on the spatial patterns of maternal and child health status in China at the provincial scale in 2020. We considered natural factors (forest coverage, average temperature, and total sulfur dioxide and particulate matter emissions) and human factors (economic development, urbanization, healthcare access, and education level). We combined maternal, infant, and under-five mortality rates into a composite maternal and child health index using the entropy method. The spatial autocorrelation analysis of this index highlighted distinct health patterns across provinces, whereas the geodetector method assessed the effects of natural-human factors on the patterns. A notable east-central-west stepwise decline in health status was observed. Global Moran's I showed positive spatial clustering, with high-high clustering areas in the Yangtze River Delta and low-low clustering areas in western regions. Factor detection identified eight significant natural-human factors impacting maternal and child health, with total sulfur dioxide emission density having the greatest impact. The interaction between average schooling years and total sulfur dioxide emission notably affected maternal and child health patterns. The study concludes that natural-human factors critically affect the spatial distribution of maternal and child health.
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Affiliation(s)
- Jialu Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Shuyuan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Ying Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yongjin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yuansheng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Beibei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Xiang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China
| | - Junhui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, No.1, Section 1, Xianglin Road, Longmatan District, Luzhou, 646000, Sichuan, People's Republic of China.
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Cui S, Que W, Jiao Z, Deng Q, Zhang X, Cao Y, Liu N, Li A, Sowanou A, Li Z, Wang T, Li Y, Yu J, Pei J. Disease and Economic Burden of Kashin-Beck Disease - China, 2021. China CDC Wkly 2024; 6:40-44. [PMID: 38250701 PMCID: PMC10797301 DOI: 10.46234/ccdcw2024.009] [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: 08/23/2023] [Accepted: 11/22/2023] [Indexed: 01/23/2024] Open
Abstract
What is already known about this topic? Kashin-Beck disease (KBD) is a chronic and degenerative osteoarthropathy characterized by cartilage degeneration. It is an endemic disease that is highly prevalent among the Chinese population and poses a significant health risk. What is added by this report? This is the first national report on the economic burden of KBD in China. According to the data from 2021, KBD has caused significant disease and economic burdens. The most substantial reduction in healthy life expectancy was observed among patients with degree II severity and those aged 60 years and older, resulting in a total indirect economic burden of 112.74 million Chinese Yuan (CNY). What are the implications for public health practice? The results of this study will contribute to informing the development of tailored prevention and control strategies by the government. These strategies will include targeted policies and recommendations for appropriate healthcare and financial subsidies, which will be based on the demographic characteristics of the endemic areas.
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Affiliation(s)
- Silu Cui
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Wenjun Que
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Zhe Jiao
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Qing Deng
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Xufeng Zhang
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Yanhong Cao
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Ning Liu
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Ailin Li
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Alphonse Sowanou
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Zhe Li
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Tuo Wang
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Yang Li
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Jun Yu
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Kashin-Beck Disease Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Junrui Pei
- NHC Key Laboratory of Etiology and Epidemiology (Harbin Medical University); Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Key Laboratory of Etiology and Epidemiology, Education Bureau of Heilongjiang Province; Institute of Endemic Fluorosis Control, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention; Harbin Medical University, Harbin City, Heilongjiang Province, China
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Wu Y, Gong Y, Zhang Y, Li S, Wang C, Yuan Y, Lv X, Liu Y, Chen F, Chen S, Zhang F, Guo X, Wang X, Ning Y, Zhao H. Comparative Analysis of Gut Microbiota from Rats Induced by Se Deficiency and T-2 Toxin. Nutrients 2023; 15:5027. [PMID: 38140286 PMCID: PMC10745411 DOI: 10.3390/nu15245027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of this study was to analyze the differences in gut microbiota between selenium deficiency and T-2 toxin intervention rats. Knee joint and fecal samples of rats were collected. The pathological characteristics of knee cartilage were observed by safranin O/fast green staining. DNA was extracted from fecal samples for PCR amplification, and 16S rDNA sequencing was performed to compare the gut microbiota of rats. At the phylum level, Firmicutes (81.39% vs. 77.06%) and Bacteroidetes (11.11% vs. 14.85%) were dominant in the Se-deficient (SD) group and T-2 exposure (T-2) groups. At the genus level, the relative abundance of Ruminococcus_1 (12.62%) and Ruminococcaceae_UCG-005 (10.31%) in the SD group were higher. In the T-2 group, the relative abundance of Lactobacillus (11.71%) and Ruminococcaceae_UCG-005 (9.26%) were higher. At the species level, the high-quality bacteria in the SD group was Ruminococcus_1_unclassified, and Ruminococcaceae_UCG-005_unclassified in the T-2 group. Lactobacillus_sp__L_YJ and Lactobacillus_crispatus were the most significant biomarkers in the T-2 group. This study analyzed the different compositions of gut microbiota in rats induced by selenium deficiency and T-2 toxin, and revealed the changes in gut microbiota, so as to provide a certain basis for promoting the study of the pathogenesis of Kashin-Beck disease (KBD).
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Affiliation(s)
- Yifan Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.W.); (Y.Z.); (Y.L.); (F.C.)
| | - Yi Gong
- MED-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China;
| | - Yu Zhang
- Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.W.); (Y.Z.); (Y.L.); (F.C.)
| | - Shujin Li
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Chaowei Wang
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Yuequan Yuan
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Xi Lv
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Yanli Liu
- Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.W.); (Y.Z.); (Y.L.); (F.C.)
| | - Feihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.W.); (Y.Z.); (Y.L.); (F.C.)
| | - Sijie Chen
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Feiyu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
- Clinical Research Center for Endemic Disease of Shaanxi Province, The Second Affiliated Hospital of Xi’an Jiaotong University, No.157 Xi Wu Road, Xi’an 710004, China
| | - Xi Wang
- Department of Occupational and Environmental Health, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (Y.W.); (Y.Z.); (Y.L.); (F.C.)
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi’an 710061, China
| | - Yujie Ning
- Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, National Health and Family Planning Commission, Xi’an 710061, China; (S.L.); (C.W.); (Y.Y.); (X.L.); (S.C.); (F.Z.); (X.G.)
| | - Hongmou Zhao
- Foot and Ankle Surgery Department, Honghui Hospital of Xi’an Jiaotong University, Xi’an 710001, China
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Qi F, Cui SL, Zhang B, Li HN, Yu J. A study on atypical Kashin-Beck disease: an endemic ankle arthritis. J Orthop Surg Res 2023; 18:328. [PMID: 37127661 PMCID: PMC10152785 DOI: 10.1186/s13018-023-03633-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/22/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND To study the epidemiological characteristics of atypical Kashin-Beck disease cases without characteristic hand lesions such as interphalangeal joint enlargement and brachydactyly and the characteristics of ankle joint lesions. METHODS We investigated Kashin-Beck in the endemic villages in Heilongjiang Province. The patients were judged according to the "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010). The severity of foot lesions was judged based on the changes of X-ray images. Residents of non-Kashin-Beck disease area were selected as normal controls in Jilin Province. RESULTS A total of 119 residents over 40 years old were surveyed in a natural village in the non-endemic area. A total of 1190 residents over 40 years old were surveyed in 38 endemic areas of Kashin-Beck disease. A total of 710 patients with Kashin-Beck disease were detected, including 245 patients with grade I, 175 patients with grade II, 25 patients with grade III, and 265 atypical patients. Among all investigated patients, 92.0% (653/710) had ankle joint changes, and it was 80.0% (196/245) in grade I patients and 95.4% (167/175) in grade II. Varying degrees of ankle joint changes were found in both grade III and atypical patients. The grade of Kashin-Beck disease was correlated with the degree of ankle joint change (P < 0.001), and the correlation coefficient rs = 0.376. Atypical Kashin-Beck disease patients in mild and severe endemic area of Kashin-Beck disease were younger than those with typical Kashin-Beck disease. CONCLUSIONS We found a correlation between the degree of ankle joint change and the grade of Kashin-Beck disease. The higher the grade of Kashin-Beck disease, the more serious the change of the ankle joint.
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Affiliation(s)
- Fang Qi
- Institute for Kashin-Beck Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, China
| | - Si-Lu Cui
- Institute for Kashin-Beck Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, China
| | - Bing Zhang
- Institute for Kashin-Beck Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, China
| | - Hao-Nan Li
- Institute for Kashin-Beck Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, China
| | - Jun Yu
- Institute for Kashin-Beck Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China.
- National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University(23618504), Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, China.
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Qu B, Wu S, Zhao P, Ma ZF, Goodacre R, Yuan L, Chen Y. Geographical pattern of minerals and its association with health disparities in the USA. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023:10.1007/s10653-023-01510-1. [PMID: 36805365 DOI: 10.1007/s10653-023-01510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to determine the common latent patterns of geographical distribution of health-related minerals across the USA and to evaluate the real-world cumulative effects of these patterns on overall population health. It was an ecological study using county-level data (3080 contiguous counties) on the concentrations of 14 minerals (i.e., aluminum, arsenic, calcium, copper, iron, lead, magnesium, manganese, mercury, phosphorus, selenium, sodium, titanium, zinc) in stream sediments (or surface soils), and the measurements of overall health including life expectancy at birth, age-specific mortality risks and cause-specific (summarized by 21 mutually exclusive groups) mortality rates. Latent class analysis (LCA) was employed to identify the common clusters of life expectancy-related minerals based on their concentration characteristics. Multivariate linear regression analyses were then conducted to examine the relationship between the LCA-derived clusters and the health measurements, with adjustment for potential confounding factors. Five minerals (i.e., arsenic, calcium, selenium, sodium and zinc) were associated with life expectancy and were analyzed in LCA. Three clusters were determined across the USA, the 'common' (n = 2056, 66.8%), 'infertile' (n = 739, 24.0%) and 'plentiful' (n = 285, 9.3%) clusters. Residents in counties with the 'infertile' profile were associated with the shortest life expectancy, highest mortality risks at all ages, and highest mortality rates for many reasons including the top five leading causes of death: cardiovascular diseases, neoplasms, neurological disorders, chronic respiratory conditions, and diabetes, urogenital, blood and endocrine diseases. Results remained statistically significant after confounding adjustment. Our study brings novel perspectives regarding environmental geochemistry to explain health disparities in the USA.
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Affiliation(s)
- Bingjie Qu
- Xi'an Jiaotong-Liverpool University, Wisdom Lake Academy of Pharmacy, Suzhou, China
- Institute of Systems, Molecular & Integrative Biology, University of Liverpool, Liverpool, UK
| | - Shiqiang Wu
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Peng Zhao
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Royston Goodacre
- Department of Biochemistry and Systems Biology, Centre for Metabolomics Research, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Linxi Yuan
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Ying Chen
- Xi'an Jiaotong-Liverpool University, Wisdom Lake Academy of Pharmacy, Suzhou, China.
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Ning Y, Hu M, Chen S, Zhang F, Yang X, Zhang Q, Gong Y, Huang R, Liu Y, Chen F, Pei L, Guo X, Kang L, Wang X, Zhang Y, Wang X. Investigation of selenium nutritional status and dietary pattern among children in Kashin-Beck disease endemic areas in Shaanxi Province, China using duplicate portion sampling method. ENVIRONMENT INTERNATIONAL 2022; 164:107255. [PMID: 35561595 DOI: 10.1016/j.envint.2022.107255] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Selenium deficiency is a primary risk factor of Kashin-Beck disease (KBD). This study aimed to investigate whether children in endemic areas could maintain sufficient selenium intake after termination of selenium supplement administration, and evaluate their comprehensive nutritional status and dietary structure. METHODS Duplicate portion sampling combined with a questionnaire was adopted to collect data on categories and quantity of all food ingested in three consecutive days. Occipital hair was also collected to detect selenium content by hydride generation atomic fluorescence spectrometry (HGAFS). CDGSS3.0 software and factor analysis were integrated to assess the children's comprehensive nutritional status and dietary structure. RESULTS This study included 240 sex-matched (1:1) children aged 7-12 years from KBD endemic (n = 120) and non-endemic (n = 120) areas. Overall, 720 solid food, 720 liquid, and 240 hair samples were collected for selenium determination. The mean selenium level in hair of children in endemic areas (0.38 ± 0.16 mg/kg) was significantly lower than that in children in non-endemic areas (0.56 ± 0.28 mg/kg, Z = -5.249, p < 0.001). The dietary selenium intake of children in endemic areas was 40.0% lower than that in children in non-endemic areas (Z = -9.374, p < 0.001). Children in endemic areas consumed significantly less diverse dietary items leading to significantly less intake of multiple nutrients compared to children in non-endemic areas. CONCLUSIONS The dietary selenium intake of most children in endemic areas was less than the recommended amount. The dietary structure of children was undiversified, which limited the intake of multiple nutrients. Therefore, comprehensive nutrition rather than sole selenium intake should be the primary concern in the future.
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Affiliation(s)
- Yujie Ning
- School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, 710061, PR China
| | - Minhan Hu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, 710061, PR China
| | - Sijie Chen
- School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, 710061, PR China
| | - Feiyu Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, 710061, PR China
| | - Xiaodong Yang
- Shaanxi Provincial Institute for Endemic Disease Prevention and Control, Xi'an 710003, PR China.
| | - Qingping Zhang
- Shaanxi Provincial Institute for Endemic Disease Prevention and Control, Xi'an 710003, PR China
| | - Yi Gong
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Ruitian Huang
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Yanli Liu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Feihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Leilei Pei
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China
| | - Xiong Guo
- School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, 710061, PR China.
| | - Lianke Kang
- Center for Disease Control and Prevention of Qishan, Baoji 722400, PR China
| | - Xinyi Wang
- Center for Disease Control and Prevention of Hantai, Hanzhong 723000, PR China
| | - Yan Zhang
- Center for Disease Control and Prevention of Ningshan, Ankang 711699, PR China
| | - Xi Wang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, 710061, PR China; Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, PR China.
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Chen J, Lin Z, Li LA, Li J, Wang Y, Pan Y, Yang J, Xu C, Zeng X, Xie X, Xiao L. Ten years of China's new healthcare reform: a longitudinal study on changes in health resources. BMC Public Health 2021; 21:2272. [PMID: 34903184 PMCID: PMC8670033 DOI: 10.1186/s12889-021-12248-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China launched a new round of healthcare-system reform in 2009 and proposed the goal of equal and guaranteed essential medical and health services for all by 2020. We aimed to investigate the changes in China's health resources over the past ten years after the healthcare reform. METHODS Data were collected from the China Statistical Yearbook and China Health Statistics Yearbook from 2009 to 2018. Four categories and ten indicators of health resources were analyzed. A descriptive analysis was used to present the overall condition. The Health Resource Density Index was applied to showcase health-resource distribution in demographic and geographic dimensions. The global and local Moran's I were used to assess the spatial autocorrelation of health resources. Concentration Index (CI) was used to quantify the equity of health-resource distribution. A Geo-Detector model and Geographic Weighted Regression (GWR) were applied to assess the association between gross domestic product (GDP) per capita and health resources. RESULTS Health resources have increased over the past ten years. The global and local Moran's I suggested spatial aggregation in the distribution of health resources. Hospital beds were concentrated in wealthier areas, but this inequity decreased yearly (from CI=0.0587 in 2009 to CI=0.0021 in 2018). Primary medical and health institutions (PMHI) and their beds were concentrated in poorer areas (CI remained negative). Healthcare employees were concentrated in wealthier areas (CI remained positive). In 2017, the q-statistics indicated that the explanatory power of GDP per capita to beds, health personnel, and health expenditure was 40.7%, 50.3%, and 42.5%, respectively. The coefficients of GWR remained positive with statistical significance, indicating the positive association between GDP per capita and health resources. CONCLUSIONS From 2009 to 2018, the total amount of health resources in China has increased substantially. Spatial aggregation existed in the health-resources distribution. Health resources tended to be concentrated in wealthier areas. When allocating health resources, the governments should take economic factors into account.
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Affiliation(s)
- Jiang Chen
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuochen Lin
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li-An Li
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Li
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuyao Wang
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Pan
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jie Yang
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuncong Xu
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaojing Zeng
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoxu Xie
- School of Public Health, Fujian Medical University, Fuzhou, China.
| | - Liangcheng Xiao
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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