Changes In Socio-demographic Characteristics Research Articles

Methodology for assessing regional health care in the context of control over functional focus and social orientation

Subject. The article investigates regional health care as an integral part of national public health. Objectives. We focus on substantiation of methods to assess public health achievements against social indicators reflecting its usefulness to society. Methods. The study employs general scientific methods of cognition, statistical analysis, systems and integrated approaches. Synthesis and logical generalization enabled to develop concluding summaries and formulate proposals for systematizing the assessment of the work of regional health authorities. Results. The study found that the result of regional and national health care functioning is reflected in the degree of achievement of goals, which are defined as positive changes in socio-demographic characteristics of the region and the country. Positive trends in the social aspect are associated with improvement in life quality, which depends on many factors, one of which is high-quality modern healthcare that meets public demand as needed and when required Conclusions. Comparing the indicators characterizing functional tasks with social goals, it is possible to conclude on the degree of their achievement. The study showed that it is necessary to focus on comprehensive assessment of groups of indicators combined according to the characteristics of particular tasks of health care functioning, as well as on systems approach, in which it is advisable to describe health systems to assess balance and sustainability.

Implementation of integrated maternity care in the southwestern region of the Netherlands: evaluation of its effect on preterm birth, low birthweight infants and number of secondary care consultations

ObjectivesTo determine whether integrated maternity care is associated with reduced preterm births (PTB) and fewer small-for-gestational-age infants (SGA), and whether its implementation leads to a reduction of secondary care consultations.DesignRetrospective...

Sociodemographic characteristics and transmission risk factors in patients hospitalized for COVID-19 before and during the lockdown in France

BackgroundThe efficacy of lockdown in containing the COVID-19 pandemic has been reported in different studies. However, the impact on sociodemographic characteristics of individuals infected with SARS-CoV-2 has not been evaluated. The aim of this study was to describe the changes in sociodemographic characteristics of patients hospitalized for COVID-19 and to compare the transmission risk factors of COVID-19 before and during lockdown in France.MethodsAn observational retrospective study was conducted in a University Hospital in Paris, France. Data from patients hospitalized for COVID-19 in the Infectious Diseases Department between February 26 and May 11, 2020 were collected. The study population was divided into 2 groups: group A of patients infected before lockdown, and group B of patients infected during lockdown, considering a maximum incubation period of 14 days. Sociodemographic characteristics and transmission risk factors were compared between the 2 groups using Student’s t-test for continuous variables and Chi-2 test or Fisher exact test for categorical variables.ResultsThree hundred eighty-three patients were included in the study, 305 (79.6%) in group A and 78 (20.4%) in group B. Patients in group A were significantly younger (60.0 versus (vs) 66.5 years (p = 0.03)). The professionally active population was larger in group A (44.3% vs 24.4%). There were significantly more non-French-speaking people in group B (16.7% vs 6.6%, p < 0.01). Most patients from group A had individual accommodation (92.8% vs 74.4%, p < 0.01). Contact with a relative was the main transmission risk factor in both groups (24.6% vs 33.3%, p = 0.16). Recent travel and large gathering were found only in group A. The proportion of people living in disadvantaged conditions, such as homeless people or people living in social housing, was significantly higher in group B (11.5% vs 4.3%, p = 0.03) as was the proportion of institutionalized individuals (14.1% vs 3.0%, p < 0.01).ConclusionsIn this study conducted in patients hospitalized for COVID-19 in Paris, France, the likelihood of being infected despite the lockdown was higher for people who do not speak French, live in social housing, are homeless or institutionalized. Targeted measures have to be implemented to protect these populations.

Major differences in the characteristics of users of the copper intrauterine device or levonorgestrel intrauterine system at a clinic in Campinas, Brazil.

To compare the sociodemographic characteristics of users of the copper intrauterine device (Cu-IUD) and the levonorgestrel intrauterine system (LNG-IUS) at a family planning clinic in Campinas, SP, Brazil. A retrospective audit study was conducted to analyze the characteristics of new users of IUDs at the clinic of the Department of Obstetrics and Gynecology, University of Campinas. Data covered insertions performed between 1979 and 2006 when only the Cu-IUD was offered at the clinic, and between 2007 and 2019 when the LNG-IUS was also offered, both free of charge to women. Logistic regression analysis was performed. There were 31385 insertions. Cu-IUD: n=17156 (1979-2006) and n=2013 (2007-2019); LNG-IUS n=12216 (2007-2019). Up to 2006, Cu-IUD users were less likely to be nulligravidas, more likely to be younger than 40years of age, and with fewer years of schooling. Following introduction of LNG-IUS, the sociodemographic characteristics of users presented major changes over time. Comparing the period 1979-2006 with 2007-2019, new users of the LNG-IUS were more likely to be older than 40years of age, with fewer years of completed schooling, and to be nulligravidas. Major changes in sociodemographic characteristics of users were noted according to preference over time. Introduction of the LNG-IUS presents a major opportunity to increase IUD use.

Better Diet Quality in the Healthy Hunger-Free Kids Act and WIC Package Reduced Childhood Obesity.

* Abbreviations: HEI 2010 — : Healthy Eating Index 2010 HHFKA — : Healthy, Hunger-Free Kids Act WIC — : Special Supplemental Nutrition Program for Women, Infants, and Children The reductions in the prevalence of childhood obesity achieved by the Healthy, Hunger-Free Kids Act (HHFKA) and the changes in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package have not been widely recognized. Both the HHFKA and the regulatory updates to the WIC package substantially changed the quality of the foods provided. Both changes improved diets and led to reductions in the prevalence of obesity in the most vulnerable youth served by these programs. The HHFKA was passed by Congress in 2010, and its implementation was required in schools by 2012. In the Act, Congress set age-appropriate caloric ranges, required that at least 51% of grains be whole grains, required students to take at least one-half cup serving of fruits or vegetables with every school breakfast or lunch, and required that schools offer 1 cup of flavored or unflavored fat-free milk or 1% milk. Despite concerns, the changes were not associated with an increase in plate waste.1 In several studies, researchers have confirmed an increase in the quality of school meals and in improved consumption. For example, dietary quality was assessed before and after implementation of the new HHFKA standards by using the Healthy Eating Index 2010 (HEI 2010) and food consumption data from the nationally representative NHANES.2 The HEI 2010 score reflected the degree to which dietary intake was consistent with the 2010 Dietary Guidelines for Americans. The HEI 2010 scores among students aged 5 to 18 years were stratified by low-income, low-middle–income, and middle-high–income students and compared to those among non–school lunch participants in the same income categories. The HEI 2010 scores increased from 42.7 to 54.6 among school lunch participants compared to a decrease from 34.8 to 34.1 among nonparticipants. The differences in comparison with non–school lunch participants were 12.6, … Address correspondence to William H. Dietz, MD, PhD, Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, 214 11th St NE, Washington, DC 20002. E-mail: dietzwcd4{at}gmail.com

Increasing the Numbers of Homeless Veterans Served by the Veterans Health Administration from 2008 to 2015: maintaining focus on the intended target population and on sustaining service intensity

ABSTRACT In 2009, the Department of Veterans Affairs (VA) set a goal of ending veteran homelessness by expanding health care and housing services. The process of expanding programs on a large scale can lead to erosion of focus on program goals, especially if it involves serving a target population that is challenging to assist and that may require delivery of services at a high level of intensity. This study examined changes from 2008 to 2015 in the numbers of homeless veterans served; changes in in the target population served (socio-demographic and diagnoses treated); and changes in the intensity of services provided (number of mental health contacts per veteran annually). The number of homeless veterans served increased 125% (by over 134,000/year) as compared to only 15% for non-homeless veterans. Housing subsidies provided through HUD vouchers increased 75-fold from less than 1000 to almost 60,000. These large expansions were accomplished with little evidence of changes in sociodemographic characteristics or diagnoses among those treated, or reductions in the numbers of mental health services provided per veteran. These data demonstrate a large expansion of services for homeless veterans, especially supported housing, and successful maintenance of focus on the intended target population.

Multiscale spatial contexts and neighbourhood effects

This thesis has developed alternative methods of operationalising neighbourhoods at multiple spatial scales and used them to advance our understanding of spatial inequalities and neighbourhood effects. The underlying problem that motivated this thesis is that many empirical studies use predefined administrative units, and this does not often align with the underlying theory or geography. Despite the extensive literature on neighbourhood effects and, more generally, on sociospatial inequalities, spatial scale remains an under-analysed concept. As a response to this research gap, this thesis takes a multiscale approach to both theory and empirical analysis of neighbourhood effects, highlighting the multitude of spatial processes that may affect individual outcomes of people. To operationalise this, we created bespoke areas (centred around each location) at a range of one hundred scales representing people’s residential contexts, primarily in the Netherlands but also in multiple European capitals. Using microgeographic data and a large number of scales combined with small distance increments revealed subtle changes in sociodemographic characteristics across space. In doing so, we provided new insights into ethnic segregation, potential exposures to poverty, and neighbourhood effects on income, all in light of the fundamental issue of spatial scale: The analyses of sociospatial inequalities are substantially affected by the scale used to operationalise spatial context, and this varies within and between cities and urban regions. The aim of this thesis was therefore not to find a single, ‘true’ scale of neighbourhood, but to acknowledge, operationalise, and better understand the multiplicity of spatial scales.

The Change in Attitudes Towards Abortion in Former West and East Germany After Reunification: A Latent Class Analysis and Implications for Abortion Access.

Introduction The legal status of abortion has changed in the regions of former East Germany after reunification due to the adoption of restrictive West German abortion policies. The aim of this study was to evaluate the impact on attitudes towards abortion and the associated health care implications in Western and Eastern Germany. Materials and Methods Nationally representative data on public support for legally restricting abortion access were taken from the German General Social Survey and included the surveys 1992, 1996, 2000, 2006 and 2012 (N = 14 459). Two indicators of barriers to access to abortion care were calculated for each federal state, based on the number of abortion facilities and the proportion of women seeking abortion outside their state of residency. Data were analysed using latent class analysis. Results Results suggested that abortion attitudes could be classified into three distinct subgroups: 1) support for abortion access independent of womenʼs reason; 2) support on the basis of maternal or foetal health reasons but not for socio-economic reasons (e.g. financial restrictions); and 3) no support. The size of subgroups in favour of partial or complete restriction on abortion access increased in both regions over the study period and this trend could not be explained by changes in socio-demographic characteristics. Respondents living in a federal state with more barriers to access to abortion care were more likely to hold restrictive abortion attitudes. Conclusion Negative attitudes towards abortion have increased in Western and Eastern Germany during the two decades following reunification and may harm women by limiting acceptability and accessibility of abortion care. Abortion policies, public discourse and provision of abortion care should be informed by international guidelines protecting womenʼs health and rights.

Sociodemographic Characteristics of Women Able to Obtain Medication Abortion Before and After Ohio's Law Requiring Use of the Food and Drug Administration Protocol.

Purpose: In 2011, a law went into effect in Ohio that regulates how abortion care providers can offer medication abortion to their patients. We sought to evaluate changes in sociodemographic characteristics of Ohio medication abortion patients before and after the implementation of this law.Methods: We used a retrospective cohort design, comparing characteristics of women obtaining a medication abortion at four abortion facilities before and after the law. We used chart data from January 2010 to January 2011 and February 2011 to October 2014. For any significant changes in sociodemographics found before and after the law, we used stratified cross-tabulations to disentangle whether they were likely related to the restricted gestational limit imposed by the law (lowered from 9 to 7 weeks gestation), or whether they were likely related to other burdens brought on by the law, such as increased costs and visits.Results: Women obtaining a medication abortion after the law were more likely to be older (p=0.01), have higher levels of education (p<0.001), be of white race (p<0.001), have private insurance (p=0.001), have no children (p=0.002), and reside in a higher income zip code (p=0.03). Both the reduced gestational limit and the increased costs and visits likely contributed to declines among black women and women with lower levels of education. The reduced gestational limit for medication abortion likely contributed to a decline among younger women and Medicaid recipient groups. The increased costs and visits imposed by the law likely contributed to the decline in medication abortion among women with no insurance and women with children.Conclusion: The lower gestational limit, higher cost, and time and travel burdens exacted by Ohio's medication abortion law were associated with disproportionate reductions in medication abortion among the most disadvantaged groups. The law was associated with reduced access among women who were younger, of black race, less educated, and in lower socioeconomic groups.

Trends in Fetal Growth Between 2000 to 2014 in Singleton Live Births from Israel

Trends in birthweight and abnormal fetal growth, namely term low birthweight (LBW), macrosomia, small-for-gestational age (SGA) and large-for-gestational age (LGA), are important indicators of changes in the health of populations. We performed this epidemiological study to evaluate these trends among 2,039,415 singleton live births from Israel over a period of 15 years. Birth certificate data was obtained from the Ministry of Health. Multivariable linear and logistic regression models were used to evaluate crude and adjusted estimates compared to the baseline of 2000 and polynomial trends. During the study period we observed a significant decrease in the rates of infants born SGA and LGA (10.7% to 9.2%, 10.2% to 9.6% respectively). After adjustment, based on the imputed data set, term mean birthweight increased by 6.0 grams (95% CI: 2.9, 9.1), and term LBW odds decreased by 19% in 2014 compared to 2000 (adj ORs: 0.81; 95% CI: 0.77, 0.85). Significant decreases were also observed for adjusted SGA, LGA and macrosomia rates. The decrease in abnormal fetal growth rates were not entirely explained by changes in sociodemographic characteristics or gestational age and may imply real improvement in child intrauterine growth in Israel during the last 15 years, especially in the Jewish population.

Understanding and projecting the restaurantscape: The influence of neighborhood sociodemographic characteristics on restaurant location

To better understand the location patterns of different types of restaurants across the United States, we investigate the relationship between neighborhood sociodemographic characteristics and restaurant location using a unique data set from 2013 covering 30,772U.S. zip codes. The estimation results from negative binomial regression models confirm the significant impacts of various sociodemographic factors (e.g., population density, median age, median household income, average household size, educational attainment, gender distribution, housing tenure, neighborhood urbanization) on restaurant location. We also project future restaurant growth potential based on model estimates and projected changes in sociodemographic characteristics by 2020. The results are analyzed, and several metropolitan areas in Texas and Florida are identified as having high potential for growth. Lastly, implications are provided for restaurant real estate practitioners.

Do changes in socio-demographic characteristics impact up-to-date immunization status between 3 and 24 months of age? A prospective study among an inner-city birth cohort in the United States

ABSTRACTIntroduction: Low-income child populations remain under-vaccinated. Our objective was to determine differences in the relative importance of maternal health literacy and socio-demographic characteristics that often change during early childhood on up-to-date (UTD) immunization status among a low-income population. Methods: We performed secondary data analysis of a longitudinal prospective cohort study of 744 Medicaid-eligible mother-infant dyads recruited at the time of the infant's birth from an inner-city hospital in the United States and surveyed every 6 months for 24 months. Our primary outcome was infant UTD status at 24 months abstracted from a citywide registry. We assessed maternal health literacy with the Test of Functional Health Literacy in Adults (short version). We collected socio-demographic information via surveys at birth and every 6 months. We compared predictors of UTD status at 3, 7, and 24 months. Results: The cohort consisted of primarily African-American (81.5%) mothers with adequate health literacy (73.9%). Immunizations were UTD among 56.7% of infants at 24 months of age. Maternal health literacy was not a significant predictor of UTD immunization status. Instead, adjusted results showed that significant predictors of not-UTD status at 24 months were lack of a consistent health care location or “medical home” (OR 0.17, 95%CI 0.18–0.37), inadequate prenatal care (OR 0.48, 95%CI 0.25–0.95), and prior not-UTD status (OR 0.31, 95%CI 0.20–0.47). Notably, all upper confidence limits are less than 1.0 for these variables. Health care location type (e.g., hospital-affiliate, community-based, none) was a significant predictor of vaccine status at age 3 months, 7 months, and 24 months. Conclusions: Investing in efforts to support early establishment of a medical home to obtain comprehensive coordinated preventive care, including providing recommended vaccines on schedule, is a prudent strategy to improve vaccination status at the population level.

The Social Connectedness and Life Satisfaction Nexus: A Panel Data Analysis of Women in Australia

ABSTRACTThis study explores the interplay between time pressures at home and at work, social connectedness, and well-being as reported by Australian women. Specifically, taking advantage of longitudinal data (from the Household, Income, and Labour Dynamics in Australia survey for the years 2001 to 2013) and employing the newly developed “blow up and cluster” estimation technique, this study finds there has been a marginal decline in the life satisfaction of Australian women. After accounting for changes in sociodemographic characteristics, a more pervasive negative trend in life satisfaction appears to be reported by both men and women, and both genders report higher levels of life satisfaction for greater levels of almost all measures of social connectedness. This study adds to a growing body of evidence pointing toward the importance of frequent and meaningful social connections to societal well-being, as well as the need to refocus attention on well-being in public-policy spheres.

Recent changes in sociodemographic characteristics, dietary behaviors and clinical parameters of adults receiving food assistance in France.

BackgroundIn 2004–2005, a survey carried out on food recipients in France revealed an alarming nutritional situation. In 2011–2012, and using a protocol similar to that of 2004–2005, our objective was to update the description of sociodemographic characteristics, dietary behaviors and clinical parameters of food assistance recipients and to analyze changes since 2004–2005.MethodsBoth surveys included multistage random sampling of adults benefitting from structures that supply food pantries and charitable grocery stores. Data on sociodemographic characteristics and dietary behaviors were collected along with weight, height and blood pressure measurements. Comparisons between the 2004–2005 (n = 883) and 2011–2012 (n = 1,058) survey observations were made, adjusting for socio-demographic changes which had occurred in the meantime.ResultsSince 2004–2005, proportions of food recipients ≥55 years (13.1–19.1 %), born in France (29.2–36.8 %) and employed (5.5–11.7 %) have increased; food insufficiency has decreased (95–74 %). For over half of the recipients, canned (52.4 %) and non-perishable (50.9 %) foods were obtained only from food assistance. Frequency of consumption significantly increased even after adjustment for socio-demographic changes; this was the case for dairy products (for twice a day consumption, 30.2–36.4 %), fruits and vegetables (three times a day, 7.8–13.9 %), and meat, eggs and fish (twice a day, 9.4–19.2 %). In 2011–2012, 15.6 % of men and 36.0 % of women were obese, while 44.5 and 35.1 % had high blood pressure, respectively.ConclusionsBetween 2004–2005 and 2011–2012 in France, consumption of staple foods has been slightly improved in food assistance recipients. However, prevalence of cardiovascular risk factors remains high, which underlines the need for long-term efforts at better quality of foods delivered.

Revisiting the destination ranking procedure in development of an Intervening Opportunities Model for public transit trip distribution

An Enhanced Intervening Opportunities Model (EIOM) is developed for Public Transit (PT). This is a distribution supply dependent model, with single constraints on trip production for work trips during morning peak hours (6:00 a.m.–9:00 a.m.) within the Island of Montreal, Canada. Different data sets, including the 2008 Origin–Destination (OD) survey of the Greater Montreal Area, the 2006 Census of Canada, GTFS network data, along with the geographical data of the study area, are used. EIOM is a nonlinear model composed of socio-demographics, PT supply data and work location attributes. An enhanced destination ranking procedure is used to calculate the number of spatially cumulative opportunities, the basic variable of EIOM. For comparison, a Basic Intervening Opportunities Model (BIOM) is developed by using the basic destination ranking procedure. The main difference between EIOM and BIOM is in the destination ranking procedure: EIOM considers the maximization of a utility function composed of PT Level Of Service and number of opportunities at the destination, along with the OD trip duration, whereas BIOM is based on a destination ranking derived only from OD trip durations. Analysis confirmed that EIOM is more accurate than BIOM. This study presents a new tool for PT analysts, planners and policy makers to study the potential changes in PT trip patterns due to changes in socio-demographic characteristics, PT supply, and other factors. Also it opens new opportunities for the development of more accurate PT demand models with new emergent data such as smart card validations.

Changes in sociodemographic characteristics at baseline in two Swedish cohorts of patients with early rheumatoid arthritis diagnosed 1996–98 and 2006–09

Objectives: To compare baseline sociodemographic characteristics in two rheumatoid arthritis (RA) cohorts enrolled 10 years apart, and to examine differences with respect to the general population.Method: Clinical and sociodemographic data were collected in 320 early RA patients during 1996–98 (TIRA-1) and 467 patients in 2006–09 (TIRA-2). Multivariate logistic regression tests were performed and intercohort comparisons were related to general population data, obtained from official databases.Results: TIRA-2 patients were older than TIRA-1 (58 vs. 56 years). Women (both cohorts, 67%) were younger than men in TIRA-1 (55 vs. 59 years) and in TIRA-2 (57 vs. 61 years). Disease activity was similar but TIRA-2 women scored worse pain and worse on the HAQ. Approximately 73% were cohabiting, in both cohorts and in the general population. Education was higher in TIRA-2 than in TIRA-2 but still lower than in the general population. Women had consistently higher education than men. Education was associated with age, younger patients having higher education. In both cohorts, lower education was associated with increased disability pension and increased sick leave. Sick leave was lower in TIRA-2 than in TIRA-1 (37% vs. 50%) but disability pension was higher (16% vs. 10%). In TIRA-1, 9% of women had disability pension compared with 17% in TIRA-2. A similar decrease in sick leave and an increase in disability pension were also seen in the general population. Older age and a higher HAQ score were associated with increased sick leave and being in the TIRA-2 cohort was associated with decreased sick leave.Conclusions: TIRA-2 patients were slightly older, better educated, had lower sick leave and higher disability pension than those in TIRA-1. Similar changes were seen simultaneously in the general population. Belonging to the TIRA-2 cohort was associated with decreased sick leave, indicating that societal changes are of importance.

Child neglect in one-child families from Suzhou City of Mainland China

BackgroundThe one-child policy introduced in China in 1979 has led to far-reaching changes in socio-demographic characteristics. Under this policy regime, each household has few children. This study aims to describe the prevalence of child neglect in one-child families in China and to examine the correlates of child neglect.MethodsA cross-sectional study of 2044 children aged 6 to 9 years and recruited from four primary schools in Suzhou City, China was conducted. Neglect subtypes were determined using a validated indigenous measurement scale reported by parents. Child, parental and family characteristics were obtained by questionnaires and review of social security records. Linear regression analyses were performed to estimate the associations between these factors and the subtypes of child neglect.ResultsThe prevalence of child any neglect was 32.0% in one child families in Suzhou City, China. Supervisory (20.3%) neglect was the most prevalent type of child neglect, followed by emotional (15.2%), physical (11.1%), and educational (6.0%) neglect After simultaneous adjustment to child and family characteristics and the school factor, boys, children with physical health issues and cognitive impairment, younger and unemployed mother, were positively associated with neglect subtypes. We also found that parents with higher education and three-generation families were negatively associated with neglect.ConclusionThe rates of child neglect subtypes vary across different regions in China probably due to the different policy implementation and socio-economic levels, with a lower level of physical and educational neglect and a higher level of emotional neglect in this study. The three-generation family structure was correlates of neglect which may be unique in one child families. This indicates that future intervention programs in one-child families should target these factors.

Effects of the economic crisis on smoking prevalence and number of smokers in the USA

ObjectiveScanty and controversial information is available on the impact of macroeconomic fluctuations on smoking behaviour. No study has quantified the effects of fiscal crises on smoking prevalence. This study aimed...

Prevalence of HIV and Other Sexually Transmitted Infections among Female Sex Workers in Kisumu, Western Kenya, 1997 and 2008

BackgroundIn 1997, a survey in Kisumu found a prevalence of HIV infection among female sex workers (FSW) of 75%. Only 50% reported using a condom with the last client. In 2008, we conducted another survey to collect data to inform an intervention targeting FSW in Kisumu.MethodsIn 2008 FSW were recruited by respondent-driven sampling. Women completed a questionnaire and were tested for HIV and other sexually transmitted infections (STIs). Multiple logistic regression analysis was done to explore factors associated with HIV-infection, and with condom use. Prevalence of HIV infection was compared in the two surveys from 1997 and 2008. Multivariate analysis was used to assess whether a change in HIV prevalence between the two surveys could be explained by changes in socio-demographic characteristics and/or behavioral factors.Results481 FSW participated in the 2008 study. HIV prevalence was 56.5% (95% CI 52.0–61.6). Factors independently associated with HIV were age older than 29 years; being a widow; STI treatment in the past year; herpes simplex virus Type-2 infection; bacterial vaginosis; and trichomoniasis. Condom use with last client was reported by 75.0% (95% CI 70.9–78.9). Predictors of condom use with the last client were age older than 29 years; higher price paid by last client; ever having been tested for HIV. Predictors of unprotected sex were being drunk during last sex act; usually having sex during menses; and STI treatment in the past year. The odds ratio of HIV infection associated with year of survey was 0.49 (95% CI 0.33–0.75) after adjusting for socio-demographic and behavioral factors.ConclusionsThe prevalence of HIV among FSW in Kisumu was found to be lower in 2008 than in 1997, while reported condom use was higher. However, access to HIV/STI prevention and care services needs to improve to further decrease HIV transmission between FSW and their clients.

The Changing Relationship Between Obesity and Disability in Middle and Older Adults: 1997 and 2006 China Health and Nutrition Surveys

The Changing Relationship Between Obesity and Disability in Middle and Older Adults: 1997 and 2006 China Health and Nutrition Surveys