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Urban-Rural Differences in Respiratory Tract Infections in Medieval and Early Modern Polish Subadult Samples. BIOARCHAEOLOGY AND SOCIAL THEORY 2020. [DOI: 10.1007/978-3-030-53417-2_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
BACKGROUND Changes in health care access and birthing practices may pose barriers to optimal breastfeeding in modernizing rural populations. OBJECTIVES We evaluated temporal and maternal age-related trends in birth and breastfeeding in a modernizing Maya agriculturalist community. We tested 2 hypotheses: (1) home births would be associated with better breastfeeding outcomes than hospital births, and (2) vaginal births would be associated with better breastfeeding outcomes than cesarean births. METHODS We interviewed 58 Maya mothers (ages 21-85) regarding their births and breastfeeding practices. General linear models were used to evaluate trends in birthing practices and breastfeeding outcomes (timing of breastfeeding initiation, use of infant formula, age of introduction of complementary feeding, and breastfeeding duration). We then compared breastfeeding outcomes by location (home or hospital) and mode of birth (vaginal or cesarean). RESULTS Timing of breastfeeding initiation and the rate of formula feeding both increased significantly over time. Younger mothers introduced complementary foods earlier, breastfed for shorter durations, and formula fed more than older mothers. Vaginal hospital births were associated with earlier breastfeeding initiation and longer breastfeeding durations than home births. Cesarean births were associated with later breastfeeding initiation, shorter breastfeeding durations, and more formula feeding than vaginal hospital births. CONCLUSION We have observed temporal and maternal age-related trends toward suboptimal breastfeeding patterns in the Maya community. Contrary to our first hypothesis, hospital births per se were not associated with negative breastfeeding outcomes. In support of our second hypothesis, cesarean versus vaginal births were associated with negative breastfeeding outcomes.
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Veile A, Martin M, McAllister L, Gurven M. Modernization is associated with intensive breastfeeding patterns in the Bolivian Amazon. Soc Sci Med 2013; 100:148-58. [PMID: 24444850 DOI: 10.1016/j.socscimed.2013.10.034] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 10/22/2013] [Accepted: 10/24/2013] [Indexed: 11/16/2022]
Abstract
For many traditional, non-industrialized populations, intensive and prolonged breastfeeding buffers infant health against poverty, poor sanitation, and limited health care. Due to novel influences on local economies, values, and beliefs, the traditional and largely beneficial breastfeeding patterns of such populations may be changing to the detriment of infant health. To assess if and why such changes are occurring in a traditional breastfeeding population, we document breastfeeding patterns in the Bolivian Tsimane, a forager-horticulturalist population in the early stages of modernization. Three predictions are developed and tested to evaluate the general hypothesis that modernizing influences encourage less intensive breastfeeding in the Tsimane: 1) Tsimane mothers in regions of higher infant mortality will practice more intensive BF; 2) Tsimane mothers who are located closer to a local market town will practice more intensive BF; and 3) Older Tsimane mothers will practice more intensive BF. Predictions were tested using a series of maternal interviews (from 2003 to 2011, n = 215) and observations of mother-infant dyads (from 2002 to 2007, n = 133). Tsimane breastfeeding patterns were generally intensive: 72% of mothers reported initiating BF within a few hours of birth, mean (±SD) age of CF introduction was 4.1 ± 2.0 months, and mean (±SD) weaning age was 19.2 ± 7.3 months. There was, however, intra-population variation in several dimensions of breastfeeding (initiation, frequency, duration, and complementary feeding). Contrary to our predictions, breastfeeding was most intensive in the most modernized Tsimane villages, and maternal age was not a significant predictor of breastfeeding patterns. Regional differences accounted for variation in most dimensions of breastfeeding (initiation, frequency, and complementary feeding). Future research should therefore identify constraints on breastfeeding in the less modernized Tsimane regions, and examine the formation of maternal beliefs regarding infant feeding.
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Affiliation(s)
- Amanda Veile
- Department of Anthropology, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125-3393, USA.
| | - Melanie Martin
- Integrative Anthropological Sciences Program, Department of Anthropology, University of California-Santa Barbara, Santa Barbara, CA 93106, USA
| | - Lisa McAllister
- Integrative Anthropological Sciences Program, Department of Anthropology, University of California-Santa Barbara, Santa Barbara, CA 93106, USA
| | - Michael Gurven
- Integrative Anthropological Sciences Program, Department of Anthropology, University of California-Santa Barbara, Santa Barbara, CA 93106, USA
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Abbas RA, Alghobashy AA. Effect of an environmental health educational programme for paediatricians in an Egyptian University Hospital: before and after study. JRSM SHORT REPORTS 2012; 3:86. [PMID: 23476728 PMCID: PMC3545340 DOI: 10.1258/shorts.2012.012093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To study the effect of an educational intervention on paediatricians' knowledge, attitudes and practices regarding children's environmental health and to identify the sources of information and common environmental history taking constrains. DESIGN Before and after study. SETTING Zagazig University Paediatric Hospital. PARTICIPANTS Practising paediatricians from all specialty units. MAIN OUTCOME MEASURES The outcome of a specifically designed educational programme about paediatric environmental health was assessed using structured pre- and post-test questionnaires. RESULTS Nearly half the participants were aware about most of the paediatric environmental health-related topics. Textbooks/guidelines (85.7%) and the Internet (64.3%) were the main sources of information. The participants demonstrated relatively strong positive attitudes towards the importance of children's environmental health. However, less than half of them (44.6%) reported environmental history taking as a routine practice; where lack of time (94.6%), wide range of hazardous exposures (91.1%) and lack of expertise and training (91.1%) were the main constrains. Significant improvement in participants' knowledge, attitudes and practices was revealed after the educational programme. CONCLUSIONS There is a demand for continuous medical education about environmental health in paediatric practice, particularly environmental and occupational history taking.
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Affiliation(s)
- Reem A Abbas
- Department of Community, Occupational and Environmental Medicine, Faculty of Medicine, Zagazig University, Zagazig City, Sharqia Governorate 44519, Egypt
| | - Ashgan A Alghobashy
- Department of Paediatrics, Faculty of Medicine, Zagazig University, Zagazig City, Egypt
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Vavken P, Dorotka R. Burden of musculoskeletal disease and its determination by urbanicity, socioeconomic status, age, and sex: Results from 14,507 subjects. Arthritis Care Res (Hoboken) 2011; 63:1558-64. [DOI: 10.1002/acr.20558] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lucan SC, Karpyn A, Sherman S. Storing empty calories and chronic disease risk: snack-food products, nutritive content, and manufacturers in Philadelphia corner stores. J Urban Health 2010; 87:394-409. [PMID: 20405225 PMCID: PMC2871092 DOI: 10.1007/s11524-010-9453-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child's food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from. We evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, low-income school neighborhoods. We recorded the manufacturer, calories, fat, sugar, and sodium for all snack items, excluding candy and prepared foods. We then compared the nutritive content of assessed snack items to established dietary recommendations and a school nutrition standard. In total, stores stocked 452 kinds of snacks, with only 15% of items common between all three neighborhoods. Total and unique snacks and snack food manufacturers varied by neighborhood, but distributions in snack type varied negligibly: overall, there were no fruit snacks, no vegetable snacks, and only 3.6% of all snacks (by liberal definition) were whole grain. The remainder (96.4% of snacks) was highly processed foods. Five of 65 manufacturers supplied 73.4% of all kinds of snack foods. Depending on serving size definition, 80.0-91.5% of snack foods were "unhealthy" (by the school nutrition standard), including seven of 11 wholegrain products. A single snack item could supply 6-14% of a day's recommended calories, fat, sugar, and sodium on average (or 56-169% at the extreme) for a "typical" child. We conclude that corner store snack food inventories are almost entirely unhealthful, and we discuss possible implications and next steps for research and intervention.
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Affiliation(s)
- Sean C Lucan
- Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
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Priftis KN, Mantzouranis EC, Anthracopoulos MB. Asthma symptoms and airway narrowing in children growing up in an urban versus rural environment. J Asthma 2009; 46:244-51. [PMID: 19373631 DOI: 10.1080/02770900802647516] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The development of asthma and allergy appears to be the result of gene-environment interaction. Potential environmental risk factors such as outdoor and indoor air pollution, infections, allergen exposure, diet, and lifestyle patterns may trigger respiratory symptoms and compromise lung function in children. Specific features of urban and rural lifestyle may constitute distinct risk factors but may also coexist within certain socioeconomic levels. Children of rural environments are at lower risk for asthma and aeroallergen sensitization. The protective effect has been associated with close contact with large animals, but the genetic factor also plays a contributory role. Children with prolonged exposure to urban environment are at increased risk of reduced lung function and those that reside in polluted areas exhibit slower lung growth. It is possible that polluted urban environment per se facilitates subclinical small airway disease. Evidence to date supports a strong relation between residential area as a potential risk factor for childhood asthma symptoms and airway obstruction and a western type of socioeconomic development.
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Affiliation(s)
- Kostas N Priftis
- Department of Allergy-Pneumonology, Penteli Children's Hospital, P. Penteli, Athens, Greece.
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Caniato RN, Stich HL, Alvarenga M, Kraemer A, Baune BT. Changing rates of physical and psychosocial impairments over 9 years in cohorts of school beginners in Germany. J Public Health (Oxf) 2008. [DOI: 10.1007/s10389-008-0221-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Facchini F, Fiori G, Bedogni G, Galletti L, Belcastro MG, Ismagulov O, Ismagulova A, Sharmanov T, Tsoy I, Rizzoli S, Goldoni M. Prevalence of overweight and cardiovascular risk factors in rural and urban children from Central Asia: the Kazakhstan health and nutrition examination survey. Am J Hum Biol 2008; 19:809-20. [PMID: 17696140 DOI: 10.1002/ajhb.20646] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Kazakhstan is undergoing a rapid modernization process, which carries the risk of an epidemic of obesity and cardiovascular disease. We enrolled a sample of about 50 children for every combination of gender, environment (urban vs. rural), ethnic group (Kazakh vs. Russian), and age group from 7 to 18 years, for a total of 4,808 children. Anthropometry and blood pressure were measured on all children while fasting blood cholesterol and glucose were measured only in 2,616 children aged > or =12 years. The prevalence of overweight and risk of overweight ranged from 2.8 (rural male Kazakhs) to 9.1% (urban male Russians). The prevalence of prehypertension and hypertension ranged from 8.3 (urban females) to 15.9% (rural females); that of hypercholesterolemia from 11.5 (male rural Russians) to 26.5% (female rural Kazakhs); and the overall prevalence of impaired fasting glucose was 0.1%. We conclude that overweight and cardiovascular risk factors are less prevalent in children living in Kazakhstan than in those living in Western countries. However, these figures are not negligible and suggest that preventive measures are needed to contain the epidemic of overweight and cardiovascular disease that will most likely accompany the modernization of Kazakhstan in the next years.
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Affiliation(s)
- Fiorenzo Facchini
- Department of Experimental Evolutionary Biology, Anthropology Unit, Bologna University, Bologna, Italy.
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Stansbury JP. Recovering from Hurricane Mitch: Household and Place in Predicting Honduran Child Nutritional Status. Ecol Food Nutr 2007. [DOI: 10.1080/03670240701486685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
The rural environment is not as wholesome as some might think. In fact, smoking, drinking, illicit drug use, and obesity are more prevalent in rural than in urban youngsters. Childhood mortality is higher in rural areas, with drowning, motor vehicle accidents, firearm injuries, and farm machinery accidents as the leading causes. Air and water quality are monitored less and actually may be worse in the country than in urban areas. This article describes children's health problems associated with the rural environment and provides a list of resources for addressing these problems.
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Affiliation(s)
- Debra C Cherry
- Occupational Health Sciences, University of Texas Health Center at Tyler, 11937 US Highway 271, Tyler, TX 75708, USA.
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Chevarley FM, Owens PL, Zodet MW, Simpson LA, McCormick MC, Dougherty D. Health Care for Children and Youth in the United States: Annual Report on Patterns of Coverage, Utilization, Quality, and Expenditures by a County Level of Urban Influence. ACTA ACUST UNITED AC 2006; 6:241-64. [PMID: 17000414 DOI: 10.1016/j.ambp.2006.06.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Revised: 06/24/2006] [Accepted: 06/30/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine child and hospital demographics and children's health care coverage, use, expenditures, and quality by a county-level measure of urban influence. METHODS Two national health care databases serve as the sources of data for this report: the 2002 Medical Expenditure Panel Survey (MEPS) and the 2002 Nationwide Inpatient Sample (NIS) and State Inpatient Databases (SID) from the Healthcare Cost and Utilization Project (HCUP). In both data sets, county urbanicity is defined by use of a collapsed version of the 2003 Urban Influence Codes, to distinguish among children residing in and hospitals located in large metropolitan (metro) counties, small metro counties, micropolitan counties, and noncore counties. RESULTS Demographics. In large metro counties, greater percentages of the child population are Hispanic or black non-Hispanic than in small metro, micropolitan, and noncore counties; in micropolitan and noncore counties, higher proportions of children are below 200% of the federal poverty level than in large metro and small metro counties. Noncore areas have a greater percentage of children in fair or poor health compared with those in small metro and micropolitan counties. Most hospitals are located in large and small metro areas, and large metro areas have a higher proportion of teaching hospitals compared with other areas. Health care. In general, there were no overall differences by place of residence in the proportion of children with and without insurance, although differences emerged in subpopulations within Urban Influence Code types. Hispanic children residing in large metro counties were more likely to be uninsured than those in small metro counties. Overall, the proportion of children with at least one dental visit was larger in small metro areas compared with both large metro and noncore areas. The proportion of children with medicines prescribed was generally lower in large metro areas compared with all other areas both overall and among subpopulations of children. Children in noncore areas were more likely to have a hospital inpatient stay and any emergency department use compared with children in large metro areas. Children in large metro counties had longer average inpatient stays and a higher hospital inpatient charge per day compared with children in all other counties. Although most hospitalizations for children from large metro areas occurred in large metro areas, over half of hospitalizations for noncore children occurred outside of noncore counties. Further, children from noncore counties appear to be hospitalized for ambulatory sensitive conditions more than children from all other areas. CONCLUSIONS County-level data analyses performed using a collapsed version of the Urban Influence Codes with MEPS and HCUP data shed additional light on the health care patterns for children that were not previously evident when only the dichotomous metropolitan/nonmetropolitan geographic schema was used.
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Affiliation(s)
- Frances M Chevarley
- Agency for Healthcare Research and Quality, Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850, USA.
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Graham JP, Corella Barud V, Avitia Diaz R, Gurian P. The In-Home Environment and Household Health: A Cross-Sectional Study of Informal Urban Settlements in Northern México. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2005; 2:394-402. [PMID: 16819094 DOI: 10.3390/ijerph2005030003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People living in poverty make up nearly half of the global population and a large proportion of these individuals inhabit cities, living in informal settlements. However, only limited research on in-home environmental exposures and the associated health effects in these communities is available. This research investigates the home environment in unplanned settlements of a rapidly growing city on the U.S.-México border and its impact on the health of households with children under 12 years of age. A cross-sectional design was used to assess household exposures and health outcomes at the household level. A total of 202 households were selected from two informal settlements in the peri-urban region of Ciudad Juárez, México. The following variables were significantly associated with the report of at least one household member experiencing a health outcome in a two week period. Allergies were positively associated with insecticide use inside the home (adjusted Relative Odds (RO), 2.71; 95% confidence interval (CI), 1.2-6.3). Respiratory problems were associated with households using a wood burning stove vs. a gas stove (adjusted RO, 5.64; 95% CI, 1.1-27.9). Diarrhea was negatively associated with presence of a flush toilet in the home (adjusted RO, 0.22; 95% CI,0.1-0.6). Finally, eye irritations were positively associated with indoor tobacco smoke (adjusted RO, 2.23; 95% CI, 1.1-4.5). This research highlights exposures associated with poor living conditions in informal settlements and their associations with detrimental effects on health. More efforts should be made to understand the dynamics of poor urban environments including the health effects of exposures linked with poor housing conditions.
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Affiliation(s)
- Jay P Graham
- Division of Environmental Health Engineering, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E6642, Baltimore, MD 21205, USA.
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Fuller CM, Borrell LN, Latkin CA, Galea S, Ompad DC, Strathdee SA, Vlahov D. Effects of race, neighborhood, and social network on age at initiation of injection drug use. Am J Public Health 2005; 95:689-95. [PMID: 15798131 PMCID: PMC1449242 DOI: 10.2105/ajph.2003.02178] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated individual- and neighborhood-level factors associated with adolescent initiation of injection drug use. METHODS Injection drug users (IDUs) who had been injecting 2 to 5 years underwent HIV testing and completed a sociobehavioral risk survey. Modeling techniques accounting for intraneighborhood correlations were used in data analyses. RESULTS Adolescent-initiating IDUs were less likely than adult-initiating IDUs to report high-risk sex and injection behaviors and more likely to report high-risk networks. African American IDUs from neighborhoods with large percentages of minority residents and low adult educational levels were more likely to initiate injection during adolescence than White IDUs from neighborhoods with low percentages of minority residents and high adult education levels. CONCLUSIONS Racial segregation and neighborhood-level educational attainment must be considered when drawing inferences about age at initiation of injection drug use and related high-risk behaviors.
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Affiliation(s)
- Crystal M Fuller
- Center for Infectious Disease Epidemiologic Research, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 4th Floor, Room R422, New York, NY 10032, USA.
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