COVID-19 and threats to irregular migrants in Kuwait and the Gulf.

Prior to the COVID-19 Pandemic, the Gulf region was home to ~29 million foreign residents, an estimated 20-40% of whom were residing there in an irregular status. Most of them had skilfully devised strategies to survive in this irregular situation, with friends and relatives acting as essential support networks. The COVID-19 Pandemic suddenly disrupted this well-established social order. This article outlines the lived experiences of 26 irregular migrants residing in Kuwait when the Pandemic occurred. Twelve of our interviewees were planning to leave in response to the amnesty declared on 1 April, while 14 were planning to stay or were uncertain. Network support continued to provide an essential element in enabling their survival. Intermediaries such as kafeels (sponsors) were often unavailable or unwilling to provide assistance. The health and welfare of irregular migrants require special policy attention since they now face an enhanced risk of being apprehended and deported.

Obesity among Kuwaitis aged 50 years or older: prevalence, correlates, and comorbidities.

OBJECTIVES: Obesity is a serious global health problem. Our objectives are to assess the prevalence of overweight and obesity among elderly Kuwaitis aged 50 or older, examine their sociodemographic correlates, and analyze the association between obesity and its comorbidities. METHODS: A cross-sectional face-to-face interview survey using a structured questionnaire was conducted among 2,443 Kuwaiti men and women aged 50 or older. Height and weight were measured and body mass index (BMI) was calculated. RESULTS: About 81% respondents were overweight of whom 46% were obese. Mean BMI was 30.0 (31.2 for women and 28.1 for men). Multinomial logistic regression analysis revealed that relatively young elderly Kuwaitis (50-59) were 1.7 and 2.2 times more likely to be overweight and obese, respectively, compared with those aged 70 or older. Married individuals had 2.3 times higher risk to be overweight or obese than non-married individuals. Women were 3.6 times more likely to suffer from obesity than men. Overweight and obesity were found to be independent risk factors for hypertension (OR = 1.3 and 1.9, respectively), diabetes (OR = 1.4), and osteoarthritis (OR = 1.8 and 1.6, respectively). CONCLUSIONS: Prevalence of overweight and obesity is alarmingly high among elderly Kuwaitis. The associated disease burden is substantial. Stakeholders should address the problem and launch national extensive health-promoting campaigns targeting perceptible lifestyle changes.

Decline in co-residence of parents and children among older Kuwaiti men and women: what are the significant correlates?

A trend towards decline in co-residence with children is apparent in several countries while it is absent in others. The objectives of this paper are to address the patterns of co-residence with children among older Kuwaiti men and women aged 60+ and to assess the determinants of such patterns within the context of rapid socioeconomic changes occurring in the country (n = 1588). The data for this paper were collected as part of a household survey on the psychosocial health and disability among 2487 older Kuwaitis aged 50+. Forward step-wise logistic regression was run to assess the significant socio-demographic and health related correlates of living without any co-resident children. We found that the percentage living without any co-resident children increased from 5% in 1999 to 24% in 2005/6. About 13% women and 1% men were living alone in 2005/6. In the multivariate analysis, older age, female gender, non-Bedouin cultural background, a smaller number of children, higher educational level, and the presence of one or more domestic helpers were positively associated with the absence of co-resident children. On the other hand, those who were not married were less likely to reside without co-resident children, as were those with higher family incomes. Except for self-rated health none of the health related variables, such as chronic illnesses or depressive symptom experience, emerged as significant. Modernization forces seem to be at the core of the observed decline in co-residence with children.

Prevalence and correlates of major chronic illnesses among older Kuwaiti nationals in two governorates.

OBJECTIVE: To provide community-based information on the prevalence of diabetes, hypertension and heart disease and to highlight their significant correlates. MATERIALS AND METHODS: Data were collected in a cross-sectional household survey of 2,487 Kuwaiti nationals aged 50 and over in 2005/2006. A proportionately representative sample of 1,451 respondents from a relatively more urban area (Capital) and 1,036 respondents from a relatively less urban area (Ahmadi) were interviewed. A proxy respondent was used in 5.4% of cases. Among the 2,605 potentially eligible persons approached, 2,487 (95.5%) participated. RESULTS: Doctor-diagnosed prevalences of hypertension, diabetes and heart disease in the two governorates were reported to be 53.4, 50.6 and 17.5%, respectively. If the prevalence in the two governorates is reflective of the nation, a remarkable increase seems to have occurred since 1996. The prevalence of each of the three diseases increased linearly by age among both sexes. Comorbidity of the three diseases increased from 3.6 to 9.4 and to 20.9% among those aged 50-59, 60-69 and > or =70 years, respectively. Logistic regression showed the prevalence of chronic illnesses to be significantly higher among persons who were older, retired, non-Bedouin, less educated, had higher income, were less socially active, were obese and had poorer exercise behavior. The prevalence of diabetes and heart disease was significantly lower among women than men. CONCLUSION: Judging from data on two governorates, the prevalence of diabetes, hypertension and heart disease is likely to have increased to alarmingly high levels among older Kuwaitis, highlighting the need for focused intervention programs in order to reduce morbidity and increase healthy life years.

Parental perceptions of costs and benefits of children as correlates of fertility in Kuwait.

Kuwait is a high fertility country where the average number of desired children still exceeds 5. However, fertility behaviour is beginning to show a noticeable change and the current TFR is about 4.2 children. In order to understand the decline in fertility, the impact of perceived benefits and costs of children on Kuwaiti women's desired and achieved fertility is analysed. Data from a nationally representative survey of Kuwaiti households held in 1999 are used. Bivariate analyses show that the mean desired number of children is significantly higher among those who rank higher on the perceived value of children, and lower among those who are concerned about the cost of raising children. Achieved fertility (children ever born) shows a similar pattern. In the multivariate analysis, however, large family values emerge as the only significant predictor of (higher) desired as well as achieved fertility, net of the respondent's demographic and socioeconomic characteristics. The sociocultural, economic and political contexts that shape the mother's perceptions of the benefits and costs of children are analysed and it is concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behaviour.

Unmet need for contraception in Kuwait: issues for health care providers.

Based on a nationally representive household survey of Kuwaiti women held in 1999 (n = 1502) unmet need for contraception was analyzed in Kuwait, an oil-rich Muslim country. It was found that 9.7% currently married women had an unmet need for contraception. Of those, 6.1% wanted to stop child bearing, while 3.6% wanted to space their children. A bivariate comparison of the women with unmet need and current contraceptors showed that the unmet need group comprised of relatively older women with a significantly higher level of parity and ones where husband or wife disapproved of contraception. Also, larger percentages of the unmet need group belonged to relatively lower socio-economic status and were Bedouins. Among the reasons for current non-use, two-third believed that they had a low risk of pregnancy due to infrequent sexual activity or sub-fecundity, and 22% were not using a method because of health concerns. A significantly larger percentage of the unmet need group disapproved of contraception, and believed that Islam forbids family planning, compared to current users (30% and 15%, respectively). The logistic regression analysis showed that the wife's perception of the husband's disapproval of contraceptive use had the strongest negative association with unmet need. We conclude that the contraceptive needs of about 90% of all non-pregnant currently married women who wanted to delay or limit children were being met adequately despite the absence of a formal family planning program, while about 10% women had an unmet need. Issues for health care providers are discussed and family planning counseling is recommended for higher risk older women with unmet need.

Oral health in Kuwait before the Gulf War.

OBJECTIVE: The aim of this oral health survey was to determine the oral health status and oral health behavior in the whole population in Kuwait. This survey was part of the Kuwait Health Survey, which was conducted by the Ministry of Public Health. The original data were destroyed during the Gulf War (1990/1991), but the aim of this report is to publish the main findings concerning oral health and related factors. METHODOLOGY: The data were collected between April 1984 and April 1985. The sample consisted of 3,358 households and 26,530 individuals. The survey consisted of interviews and clinical examinations (> 12-year-olds). WHO (1977) criteria were used for examinations. RESULTS: Females were more often brushing their teeth at least once a day than males and non-Kuwaitis slightly more often than Kuwaitis. Over one third (39%) had visited a dentist during the previous 12 months. The proportion of subjects with soft deposit was 66%, calculus 45%, intensive gingivitis 46% and advanced periodontitis 18%. The caries experience was prevalent (52%) in primary dentition (< 8-year-olds) and in permanent dentition, highest (95%) among the 60- to 64-year-olds. CONCLUSION: Preventive programs for periodontal diseases and for dental caries are urgently needed. The coverage of curative care of both diseases also needs to be improved. Health behavior improvement should be targeted by oral health promotion activities.

Living arrangements of older women and men in Kuwait.

The main objectives of this article are to analyze the correlates of living arrangements of persons aged 60 or above in the oil-rich, Muslim country of Kuwait and to examine whether or not patterns of co-residence differ by gender. Data were obtained from a nationally representative survey of households of Kuwaiti nationals, and this paper is based on the 687 older Kuwaiti residents of these households. Living arrangements were generally similar for women and men. Eighty nine percent of women and 94 percent of men co-reside in households with at least one son or daughter. Only 0.3 percent of men and 1.9 percent of women live alone. Socio-demographic characteristics of women and men differed significantly; 58 percent of women were widowed compared with 5 percent of men. Logistic regression analysis showed that women had two times higher odds than men of living without their children. The odds of residing without children also increased with the respondent's age and education but decreased with increasing wealth. Continued rapid demographic, socioeconomic, and cultural change in Kuwait foretells continued decline in co-residence with children, and the implications of such change in a small city-state merits further research.