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1.
Diabetes Metab Res Rev ; 40(5): e3824, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38837532

ABSTRACT

AIMS: This study reports the prevalence and characteristics related to the development of thyroid autoimmunity among children newly diagnosed with type I diabetes (T1D) during the COVID-19 pandemic in Kuwait. MATERIALS AND METHODS: This is a prospective observational study of all children under age 14 years newly diagnosed with T1D in Kuwait. We define the duration of the COVID-19 pandemic from the official declaration of the first identified positive COVID-19 case on 24 February 2020 until 31 December 2022. For comparison, we use the time period directly before the COVID-19 pandemic, 1 January 2017 to 23 February 2020. RESULTS: One thousand twenty-four (1024) children newly diagnosed with T1D in Kuwait during the study period were included. Among newly diagnosed children, 20.3% tested positive for thyroid antibodies during the COVID-19 pandemic, compared with 14.5% during the pre-pandemic period (p = 0.015). Children with positive COVID-19 status were more likely to present with thyroid antibodies (p = 0.035). After adjusting for other characteristics, patients diagnosed with T1D during the COVID-19 pandemic had double the odds of testing positive for thyroid antibodies (Adjusted odds ratio = 2.173, 95%CI: 1.108, 4.261, p = 0.024). CONCLUSIONS: Incident cases of T1D during the COVID-19 pandemic may be different in aetiology or contextual factors leading to a higher risk of thyroid autoimmunity. Longitudinal studies are needed to understand the role of COVID-19 in the onset and progression of T1D and on thyroid autoimmunity and disease.


Subject(s)
Autoimmunity , COVID-19 , Diabetes Mellitus, Type 1 , SARS-CoV-2 , Humans , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/immunology , Kuwait/epidemiology , COVID-19/epidemiology , COVID-19/immunology , Child , Male , Female , Prevalence , Prospective Studies , Adolescent , Child, Preschool , SARS-CoV-2/immunology , Thyroid Gland/immunology , Infant , Autoantibodies/blood , Autoantibodies/immunology , Thyroiditis, Autoimmune/epidemiology , Thyroiditis, Autoimmune/immunology , Risk Factors
2.
Adv Nutr ; 15(5): 100203, 2024 May.
Article in English | MEDLINE | ID: mdl-38462217

ABSTRACT

Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 food choice behavior, and focused on LMIC. Studies were excluded if they focused on migration from LMIC to a high-income country. Of the 433 articles that were identified, 53 met the inclusion criteria. Five mechanisms of how livelihood change can affect food choice were identified: occupation, locality, time, income, and social relations. Changes in occupation altered the balance of the availability and affordability of foods in local food environments compared with individual food production. Changes in location, time use, and income influenced where food was purchased, what types of foods were acquired, and how or where foods were prepared. Additionally, changes in social relationships and norms led to expanded food preferences, particularly among urban populations. Time limitations and higher discretionary income were associated with consumption of ultraprocessed foods. Understanding the relationships between the changes in livelihood occuring in LMIC and food choices of households in these countries can inform the development of policies, programs, and other actions to promote sustainable healthy diets and planetary health.


Subject(s)
Choice Behavior , Developing Countries , Food Preferences , Income , Humans , Food Preferences/psychology , Food Supply , Socioeconomic Factors , Poverty , Family Characteristics , Feeding Behavior/psychology
3.
BMC Nutr ; 10(1): 7, 2024 Jan 09.
Article in English | MEDLINE | ID: mdl-38195646

ABSTRACT

BACKGROUND: The COVID-19 pandemic was associated with widespread social disruptions, as governments implemented lockdowns to quell disease spread. To advance knowledge of consequences for households in resource-limited countries, we examine food insecurity during the pandemic period. METHODS: We conducted a cross-sectional study and used logistic regression to examine factors associated with food insecurity. Data were collected between August and September of 2021 through a Health and Demographic Surveillance System (HDSS) using a survey instrument focused on knowledge regarding the spread of COVID-19; food availability; COVID-19 related shocks/coping; under-five child healthcare services; and healthcare services for pregnant women. The study is set in two communities in Eastern Ethiopia, one rural (Kersa) and one urban (Harar), and included a random sample of 880 households. RESULTS: Roughly 16% of households reported not having enough food to eat during the pandemic, an increase of 6% since before the pandemic. After adjusting for other variables, households were more likely to report food insecurity if they were living in an urban area, were a larger household, had a family member lose employment, reported an increase in food prices, or were food insecure before the pandemic. Households were less likely to report food insecurity if they were wealthier or had higher household income. CONCLUSIONS: After taking individual and household level sociodemographic characteristics into consideration, households in urban areas were at higher risk for food insecurity. These findings suggest a need for expanding food assistance programs to more urban areas to help mitigate the impact of lockdowns on more vulnerable households.

4.
PLOS Glob Public Health ; 3(11): e0002532, 2023.
Article in English | MEDLINE | ID: mdl-37910574

ABSTRACT

Understanding community members' knowledge of SARS-CoV-2 transmission and prevention is essential for directing public health interventions to reduce disease spread and improve vaccination coverage. Here, we describe knowledge of COVID-19 transmission, prevention, and symptoms among community residents in Mozambique. We conducted a cross-sectional survey among 33,087 households in a Health and Demographic Surveillance System in Manhiça, Mozambique. Participants were recruited in April 2021 before the Delta variant wave to the peak of Omicron cases in February 2022. Principal components analysis was used to create scores representing knowledge of COVID-19 symptoms, transmission, and prevention. Multiple imputation and quasi-Poisson regression were used to examine associations between demographic characteristics and sources of COVID-19 information, and knowledge of COVID-19 symptoms, transmission, and prevention. We examined whether sources of COVID-19 information mediated the relationship between educational attainment and knowledge of symptoms, transmission, and prevention. Across this rural community, 98.2%, 97.0%, and 85.1% of respondents reported knowing how COVID-19 could be prevented, that SARS-CoV-2 can cause disease, and how SARS-CoV-2 is transmitted, respectively. The most recognized COVID-19 symptoms were cough (51.2%), headaches (44.9%), and fever (44.5%); transmission mechanisms were saliva droplets (50.5%) or aerosol (46.9%) from an infected person; and prevention measures were handwashing (91.9%) and mask-wearing (91.8%). Characteristics associated with greater knowledge of symptoms, transmission, and prevention included having at least primary education, older age, employment, higher wealth, and Christian religion. Respondents who had experienced COVID-19 symptoms were also more likely to possess knowledge of symptoms, transmission, and prevention. Receiving information from television, WhatsApp, radio, and hospital, mediated the relationship between educational attainment and knowledge scores. These findings support the need for outreach and for community-engaged messaging to promote prevention measures, particularly among people with low education.

5.
BMC Public Health ; 23(1): 2086, 2023 10 25.
Article in English | MEDLINE | ID: mdl-37880613

ABSTRACT

BACKGROUND: COVID-19 resulted in enormous disruption to life around the world. To quell disease spread, governments implemented lockdowns that likely created hardships for households. To improve knowledge of consequences, we examine how the pandemic period was associated with household hardships and assess factors associated with these hardships. METHODS: We conducted a cross-sectional study using quasi-Poisson regression to examine factors associated with household hardships. Data were collected between August and September of 2021 from a random sample of 880 households living within a Health and Demographic Surveillance System (HDSS) located in the Harari Region and the District of Kersa, both in Eastern Ethiopia. RESULTS: Having a head of household with no education, residing in a rural area, larger household size, lower income and/or wealth, and community responses to COVID-19, including lockdowns and travel restrictions, were independently associated with experiencing household hardships. CONCLUSIONS: Our results identify characteristics of groups at-risk for household hardships during the pandemic; these findings may inform efforts to mitigate the consequences of COVID-19 and future disease outbreaks.


Subject(s)
COVID-19 , Shock , Humans , COVID-19/epidemiology , Pandemics , Ethiopia/epidemiology , Cross-Sectional Studies , Communicable Disease Control , Family Characteristics , Shock/epidemiology
6.
Article in English | MEDLINE | ID: mdl-37843778

ABSTRACT

International migration often results in major changes in living environments and lifestyles, and these changes may lead to the observed increases in obesity and diabetes among foreign-born people after resettling in higher-income countries. A possible mechanism linking changes in living environments to the onset of health conditions may be changes in the microbiome. Previous research has shown that unfavorable changes in the composition of the microbiome can increase disposition to diseases such as diabetes, obesity, kidney disease, and inflammatory bowel disease. We investigated the relationship between human migration and microbiome composition through a review using microbiome- and migration-related search terms in PubMed and Web of Science. We included articles examining the gut, oral, or oropharyngeal microbiome in people who migrated internationally. Nine articles met eligibility criteria. All but one examined migration from a non-Western to a Western country. Four of these found a difference in the microbiome of migrants compared with non-migrating residents of their country of birth, seven found differences in the microbiome of migrants compared with the native-born population in the country of resettlement, and five found microbiome differences associated with duration of stay in the country of resettlement. Microbiome composition varies with country of birth, age at migration, time since immigration, and country of resettlement. The results suggest that migration may lead to changes in the microbiome; thus, microbiome characteristics are a plausible pathway to examine changes in health after resettlement in a new country.

7.
Health Place ; 83: 103106, 2023 09.
Article in English | MEDLINE | ID: mdl-37659156

ABSTRACT

Place of origin and place of current residence may shape migrants' health-related behaviors. Using the nationally-representative US New Immigrant Survey (n = 7930), we examined associations between country of origin, state of residence, and dietary changes among foreign-born adults. 65% of migrants reported dietary change since immigration (mean score = 7.3; range = 1-10); 6% of the variance was explained by country of origin characteristics; 1.6% by US state of residence; 1.4% by their interaction. Country of origin factors, specifically availability of animal source foods and sweets, were associated with dietary change, availability of sweets also including greater abandonment of specific foods and adoption of others.


Subject(s)
Emigrants and Immigrants , Humans , Animals , Emigration and Immigration , Food , Health Behavior , Internationality
8.
Soc Sci Med ; 335: 116213, 2023 10.
Article in English | MEDLINE | ID: mdl-37717468

ABSTRACT

The American South has been characterized as a Stroke Belt due to high cardiovascular mortality. We examine whether mortality rates and race differences in rates reflect birthplace exposure to Jim Crow-era inequalities associated with the Plantation South. The plantation mode of agricultural production was widespread through the 1950s when older adults of today, if exposed, were children. We use proportional hazards models to estimate all-cause mortality in Non-Hispanic Black and White birth cohorts (1920-1954) in a sample (N = 21,941) drawn from REasons for Geographic and Racial Differences in Stroke (REGARDS), a national study designed to investigate Stroke Belt risk. We link REGARDS data to two U.S. Plantation Censuses (1916, 1948) to develop county-level measures that capture the geographic overlap between the Stroke Belt, two subregions of the Plantation South, and a non-Plantation South subregion. Additionally, we examine the life course timing of geographic exposure: at birth, adulthood (survey enrollment baseline), neither, or both portions of life. We find mortality hazard rates higher for Black compared to White participants, regardless of birthplace, and for the southern-born compared to those not southern-born, regardless of race. Race-specific models adjusting for adult Stroke Belt residence find birthplace-mortality associations fully attenuated among White-except in one of two Plantation South subregions-but not among Black participants. Mortality hazard rates are highest among Black and White participants born in this one Plantation South subregion. The Black-White mortality differential is largest in this birthplace subregion as well. In this subregion, the legacy of pre-Civil War plantation production under enslavement was followed by high-productivity plantation farming under the southern Sharecropping System.


Subject(s)
Black or African American , Mortality , Adult , Aged , Child , Humans , Infant, Newborn , Race Factors , Stroke/mortality , White , Southeastern United States , Agriculture , Birth Setting
9.
Data Brief ; 50: 109508, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37663768

ABSTRACT

Data were collected as part of the Child Health and Mortality Prevention Surveillance (CHAMPS) network to learn about the effects of COVID-19 lockdowns on child health and access to care. Data were collected between August and September 2021 through a Health and Demographic Surveillance System (HDSS) operating in Eastern Ethiopia using a survey instrument focused on knowledge about COVID-19 and changes in food availability and healthcare services during the COVID-19 related lockdown. The data are representative of two communities in Eastern Ethiopia, one rural (Kersa) and one urban (Harar), and consist of a random sample of 880 households.

10.
Indian J Psychiatry ; 65(7): 736-741, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37645353

ABSTRACT

Introduction: There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic. Materials and Methods: Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 (n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated. Result: Two disease clusters were identified: using the 1st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease. Conclusion: Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics.

12.
Public Health Nutr ; 26(11): 2383-2395, 2023 11.
Article in English | MEDLINE | ID: mdl-37606074

ABSTRACT

OBJECTIVE: To understand early-life growth in the Middle East and North Africa (MENA) region, and how it has changed over time, we estimated the prevalence of wasting and overweight at ages under 5 years. DESIGN: Cross-sectional data from twenty-nine Demographic and Health Surveys with direct anthropometric data and parent-reported demographic information were examined. The study utilised the WHO Child Growth Standards to classify overweight (weight-for-height z-score ≥ 2 sd above the median), wasting (weight-for-height z-score ≤ 2 sd below the median) and unhealthy weight defined as either wasting or overweight. SETTING: Nationally representative for nine of the MENA countries (Armenia, Azerbaijan, Egypt, Jordan, Mauritania, Morocco, Tunisia, Turkey and Yemen). PARTICIPANTS: Children under age 5 from nine MENA countries between 1987 and 2016 (n 155 961). RESULTS: Across the region, at the most recent time point, between 7·3 and 23·6 % of children experienced unhealthy weight (Jordan - 7·3 %, Egypt -23·6 %); 1·7 and 16·6 % had wasting (Turkey, Yemen) and 2·0 and 15·0 % had overweight (Yemen, Egypt). Overweight was more common than wasting in all countries except Yemen and Mauritania. Between 1987 and 2016, the prevalence of unhealthy weight in the region increased (10·0-18·4 %) due to increases in both wasting and overweight. Boys had a higher prevalence of unhealthy weight than girls. CONCLUSION: Undernutrition continues to be a problem in some countries in the MENA region, and overnutrition is emerging as a health concern in many countries in the region. Countries in the region must advance programmes that reduce undernutrition while not overlooking or inadvertently promoting overnutrition.


Subject(s)
Malnutrition , Overweight , Child , Child, Preschool , Female , Humans , Male , Cross-Sectional Studies , Malnutrition/epidemiology , Malnutrition/ethnology , North African People/statistics & numerical data , Overweight/epidemiology , Overweight/ethnology , Prevalence , Tunisia , Turkey , Middle Eastern People/statistics & numerical data
13.
PLoS One ; 18(7): e0288746, 2023.
Article in English | MEDLINE | ID: mdl-37467226

ABSTRACT

Adolescent pregnancies, a risk factor for obstetric complications and perinatal mortality, are driven by child marriage in many regions of South Asia. We used data collected between 2017-2019 from 56,155 married adolescents and women in a health and demographic surveillance system to present a population-level description of historical trends in child marriage from 1990-2019 as well as epidemiologic associations between maternal age and pregnancy outcomes in Baliakandi, a rural sub-district of Bangladesh. For pregnancies identified between 2017-2019, we used Kaplan-Meier estimates to examine timing of first pregnancies after first marriage and multinomial logistic regression to estimate associations between maternal age and perinatal death. We described the frequency of self-reported obstetric complications at labor and delivery by maternal age. In 1990, 71% of all marriages were to female residents under 18 years of age. This decreased to 57% in 2010, with the largest reduction among females aged 10-12 years (22% to 3%), and to 53% in 2019. Half of all newly married females were pregnant within a year of marriage, including adolescent brides. Although we observed a decline in child marriages since 1990, over half of all marriages in 2019 were to child brides in Baliakandi. In this same population, adolescent pregnancies were more likely to result in obstetric complications (13-15 years: 36%, 16-17 years: 32%, 18-34 years: 23%; χ2 test, p<0.001) and perinatal deaths (13-15 years: stillbirth OR 2.23, 95% CI 1.01-2.42; 16-17 years: early neonatal death OR 1.57, 95% CI: 1.01-2.42) compared to adult pregnancies. Preventing child marriage can improve the health of girls and contribute to Bangladesh's commitment to reducing child mortality.


Subject(s)
Perinatal Death , Pregnancy , Adult , Adolescent , Infant, Newborn , Humans , Female , Child , Bangladesh/epidemiology , Marriage , Pregnancy Outcome/epidemiology , Maternal Age
14.
Pediatr Blood Cancer ; 70(8): e30424, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37194456

ABSTRACT

In low- and middle-income countries (LMICs), malignancies remain underreported due to lack of quality data. This study outlines the histopathological pattern of pediatric solid malignancies in children aged 0-15 years at the largest referral hospital in Ethiopia. A total of 432 solid malignancies were evaluated. The most common malignancies were lymphoma (21.8%), retinoblastoma (19.4%), and Wilms tumor (13.9%). Burkitt lymphoma accounted for 2.1%, despite being the most reported pediatric malignancy in sub-Saharan Africa in published literature. Definitive diagnosis could not be made in 7% of cases, related to the lack of confirmatory testing. The study highlights the need for improvement in diagnostic capabilities in LMICs.


Subject(s)
Kidney Neoplasms , Retinal Neoplasms , Wilms Tumor , Child , Humans , Ethiopia/epidemiology , Retrospective Studies , Wilms Tumor/epidemiology
15.
J Epidemiol Community Health ; 77(5): 336-342, 2023 05.
Article in English | MEDLINE | ID: mdl-36918271

ABSTRACT

BACKGROUND: Concordance in chronic disease status has been observed within couples. In urban India and Pakistan, little is known about couple concordance in diabetes, hypertension, and dyslipidaemia and associated socioeconomic characteristics and modifiable risk factors. METHODS: We analysed cross-sectional data from 2548 couples from the Centre for cArdio-metabolic Risk Reduction in South Asia cohort in Chennai, Delhi and Karachi. We estimated couple concordance in presence of ≥1 of diabetes, hypertension and dyslipidaemia (positive concordance: both spouses (W+H+); negative concordance: neither spouse (W-H-); discordant wife: only wife (W+H-); or discordant husband: only husband (W-H+)). We assessed associations of five socioeconomic and household characteristics, and six modifiable risk factors with couple concordance using multinomial logistic regression models with couples as the unit of analysis (reference: W-H-). RESULTS: Of the couples, 59.4% (95% CI 57.4% to 61.3%) were concordant in chronic conditions (W+H+: 29.2% (95% CI 27.4% to 31.0%); W-H-: 30.2% (95% CI 28.4%- to 32.0%)); and 40.6% (95% CI 38.7% to 42.6%) discordant (W+H-: 13.1% (95% CI 11.8% to 14.4%); W-H+: 27.6% (95% CI 25.9% to 29.4%)). Compared with couples with no conditions (W-H-), couples had higher relative odds of both having at least one condition if they had higher versus lower levels of: income (OR 2.03 (95% CI 1.47 to 2.80)), wealth (OR 2.66 (95% CI 1.98 to 3.58)) and education (wives' education: OR 1.92 (95% CI 1.29 to 2.86); husbands' education: OR 2.98 (95% CI 1.92 to 4.66)) or weight status (overweight or obesity in both spouses ORs 7.17 (95% CI 4.99 to 10.30)). CONCLUSIONS: Positive couple concordance in major chronic conditions is high in urban India and Pakistan, especially among couples with relatively higher socioeconomic position. This suggests that prevention and management focusing on couples at high risk for concordant chronic conditions may be effective and more so in higher socioeconomic groups.


Subject(s)
Diabetes Mellitus , Dyslipidemias , Hypertension , Humans , Pakistan/epidemiology , India/epidemiology , Cross-Sectional Studies , Diabetes Mellitus/epidemiology , Risk Factors , Hypertension/epidemiology , Spouses , Socioeconomic Factors , Chronic Disease , Dyslipidemias/epidemiology
17.
Am J Clin Nutr ; 117(1): 141-148, 2023 01.
Article in English | MEDLINE | ID: mdl-36789933

ABSTRACT

BACKGROUND: In the United States, the prevalence of obesity among adults has increased 3-fold since the 1980s, but patterns of incidence of new cases of obesity are not known. OBJECTIVES: To examine the incidence of new cases of obesity: overall, by demographic and educational subgroups, by weight status, and changes during this century. METHODS: We analyzed adult (≥20 y) anthropometric records from the US nationally representative Panel Study of Income Dynamics from 2001 to 2017. Among those not having obesity (body mass index, BMI, ≥30 kg/m2) at first observation, we used Poisson models to estimate the incidence of obesity [cases/1000 person-years (PYs)] and incidence rate ratio (IRR). RESULTS: Among 13,888 adults followed for 115,797 PYs, the incidence of obesity in 2001-2017 was 28.1/1000 PYs (95% CI: 26.7, 29.7). Over the periods 2001-2005, 2005-2009, and 2009-2013, the incidence of obesity was stable, but in 2013-2017 the incidence increased by 18% compared to 2009-2013 [IRR: 1.18 (95% CI: 1.06, 1.30)]. Blacks had higher obesity incidence [47.9/1000 PYs (95% CI: 42.7, 53.1)] than Whites [26.2/1000 PYs (95% CI: 24.6, 27.9)]. Risk was particularly high among Black females [57.9/1000 PYs (95% CI: 49.1, 66.8)] and Black young adults (20-29 y) [65.5/1000 PYs (95% CI: 54.2, 76.7)]. Across race, obesity incidence was highest in young adults (20-29 y) [34.1/1000 PYs (95% CI: 31.5, 36.7)] and declined with age [age 70+ y: 18.9/1000 PYs (95% CI: 16.6, 21.8)]. Those with overweight had an obesity risk 7 times higher than those with normal weight [62.1/1000 PYs (95% CI: 58.8, 65.3) vs. 8.8/1000 PYs (95% CI: 8.1, 9.6)]. Those with less than high-school education had higher obesity incidence than those with education beyond high-school [39.4/1000 PYs (95% CI: 34.4, 44.4) vs. 24.7/1000 PYs (95% CI: 23.1, 26.3)]. CONCLUSIONS: Incidence of obesity was stable over the first 13 y of the last 2 decades but increased by 18% in 2013-2017. Blacks and younger adults were at highest risk, and those with overweight were also at high risk for developing obesity.


Subject(s)
Obesity , Overweight , Adult , Female , Humans , Body Mass Index , Incidence , Obesity/epidemiology , Obesity/ethnology , Overweight/epidemiology , Overweight/ethnology , Risk Factors , United States/epidemiology
18.
J Migr Health ; 7: 100146, 2023.
Article in English | MEDLINE | ID: mdl-36660182

ABSTRACT

Foreign-born people have different patterns of health, and several psychosocial and contextual factors may contribute to these differences. Type of visa with which one resettles is an important consideration because it is linked both with the reason for initially migrating and with experiences after arriving in the U.S. This study examines the association between visa type and health in terms of self-rated health and diagnosed chronic conditions. Using the New Immigrant Survey (NIS), a nationally representative study of foreign-born people at the time of receiving legal permanent residence in the U.S., we used logistic regression models to estimate the odds of having chronic conditions and the odds of reporting fair or poor health. People who had refugee, asylum, parole and post-arrival legalization visa types had the highest prevalence of any chronic condition; they were also most likely to report being in fair or poor self-rated health, even after controlling for other characteristics. Conversely, people who had diversity visas had the highest self-rated health and the fewest chronic conditions. Overall, the type of visa a person holds is associated with health and chronic disease even years after resettlement.

19.
Ann Epidemiol ; 77: 67-74, 2023 01.
Article in English | MEDLINE | ID: mdl-36519722

ABSTRACT

AIM: We aim to evaluate weight status in mother-child household pairs and patterns specific to over-nutrition households and double burden households. METHODS: We used nationally representative data from the most recent Demographic and Health Survey (2001-2014) in the Middle East & North African (MENA) Region (n = 45,104) to examine weight status of mother-child dyads. Under-nutrition households were defined as mothers with underweight and children with wasting; over-nutrition households as mothers with overweight/obesity and children with overweight; and double burden households as mothers with underweight and children with overweight or mothers with overweight/obesity mother and children with wasting. Survey-adjusted multinomial logistic regression were used to quantify predictors of weight patterns. RESULTS: Across the MENA region, 8.6% of households were experiencing double burden malnutrition, 11% were experiencing over-nutrition and 0.2% were experiencing under-nutrition. Wealthier households with older mothers, higher birth-order children, more educated parents and private water access were more likely to be over-nutrition or double burden households. Compared to over-nutrition households, double burden households were poorer and more likely to have a child with low birthweight. CONCLUSIONS: Over-nutrition is the most common unhealthy weight pattern, followed by double-burden; socioeconomic status and birth weight are consistent predictors of unhealthy mother-child pairs.


Subject(s)
Malnutrition , Overweight , Female , Humans , Cross-Sectional Studies , Malnutrition/epidemiology , Mother-Child Relations , Mothers , North African People , Obesity , Prevalence , Socioeconomic Factors , Surveys and Questionnaires , Thinness/epidemiology , Middle Eastern People
20.
Sci Rep ; 12(1): 20291, 2022 11 24.
Article in English | MEDLINE | ID: mdl-36434028

ABSTRACT

In developed countries, low disparity in lifespan contributed by the reduction in the burden of noncommunicable diseases (NCDs) is the key to advances in epidemiological transition. Contrarily, India passing through a phase of the dual burden of CDs and NCDs shows a heavy burden of NCDs responsible for the high disparity in lifespan. The Gini coefficient was decomposed for examining the contribution of 22 causes of death and their repercussions for inequality in age at death for 30 years between 1990-1994 and 2015-2019, using Global Burden of Disease data. The outcomes of the study reveal that India's epidemiological transition has been just modest on account of high inequality in mortality by NCDs emplaced in the middle through old age despite a consistent mortality decline at infant through old age for communicable diseases (CDs). The structural changes in causes of death structure is shaped by CDs rather than NCDs, but overall bolstered by the adult mortality decline, especially in women. However, the process is restrained by the small contribution of the middle age group and a benign contribution of old mortality decline owing to the low threshold age. India needs to target health interventions in seeking significant mortality decline in the middle age group of 50-69 years that is warranted for epidemiological transition apace as evident in the developed nations.


Subject(s)
Communicable Diseases , Noncommunicable Diseases , Adult , Middle Aged , Infant , Humans , Female , Aged , Cause of Death , India/epidemiology , Noncommunicable Diseases/epidemiology , Longevity
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