Chronic Non-communicable Conditions Research Articles

Sociodemographic and socioeconomic patterns of chronic non-communicable disease among the older adult population in Ghana

BackgroundIn Ghana, the older adult population is projected to increase from 5.3% of the total population in 2015 to 8.9% by 2050. National and local governments will need information about non-communicable diseases (NCDs) in this population in order to allocate health system resources and respond to the health needs of older adults.DesignThe 2007/08 Study on global AGEing and adult health (SAGE) Wave 1 in Ghana used face-to-face interviews in a nationally representative sample of persons aged 50-plus years. Individual respondents were asked about their overall health, diagnosis of 10 chronic non-communicable conditions, and common health risk factors. A number of anthropometric and health measurements were also taken in all respondents, including height, weight, waist and hip circumferences, and blood pressure (BP).ResultsThis paper includes 4,724 adults aged 50-plus years. The highest prevalence of self-reported chronic conditions was for hypertension [14.2% (95% CI 12.8–15.6)] and osteoarthritis [13.8%, (95% CI 11.7–15.9)]. The figure for hypertension reached 51.1% (95% CI 48.9–53.4) when based on BP measurement. The prevalence of current smokers was 8.1% (95% CI 7.0–9.2), while 2.0 (95% CI 1.5–2.5) were infrequent/frequent heavy drinkers, 67.9% (95% CI 65.2–70.5) consume insufficient fruits and vegetables, and 25.7% (95% CI 23.1–28.3) had a low level of physical activity. Almost 10% (95% CI 8.3–11.1) of adults were obese and 77.6% (95% CI 76.0–79.2) had a high-risk waist-to-hip ratio (WHR). Risks from tobacco and alcohol consumption continued into older age, while insufficient fruit and vegetable intake, low physical activity and obesity increased with increasing age. The patterns of risk factors varied by income quintile, with higher prevalence of obesity and low physical activity in wealthier respondents, and higher prevalence of insufficient fruit and vegetable intake and smoking in lower-income respondents. The multivariate analysis showed that only urban/rural residence and body mass index (BMI) were common determinates of both self-reported and measured hypertension, while all other determinants have differing patterns.ConclusionsThe findings show a high burden of chronic diseases in the older Ghanaian population, as well as high rates of modifiable health risk factors. The government could consider targeting these health behaviors in conjunction with work to improve enrolment rates in the National Health Insurance Scheme.

The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature

To document physical health problems that asylum seekers experience on settlement in the community and to assess their utilisation of healthcare services and barriers to care, in an international context. A systematic review of quantitative and qualitative studies was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, PsycINFO, Embase and CINAHL databases were searched from 2002 to October 2012, focusing on adult asylum seekers residing in the community in high-income countries. The search yielded 1499 articles, of which 32 studies met the inclusion criteria - 23 quantitative and nine qualitative. Asylum seekers had complex health profiles spanning a range of infectious diseases, chronic non-communicable conditions, and reproductive-health issues. They appeared to utilise health services at a higher rate than the host population, yet faced significant barriers to care. The findings of this study highlight the health inequities faced by asylum seekers residing in the communities of host countries, internationally. National data on asylum seekers' health profiles, service utilisation and barriers to care, as well as cross-country policy comparisons, are urgently required for the development of effective Australian health programs and evidence-based policy. What is known about the topic? The clinical and political focus of asylum seekers' health has largely been on the higher incidence of mental disorders and the impact of immigration detention. Since policy changes made in late 2011, an increasing number of asylum seekers have been permitted to live in the community while their claims are processed. There is a paucity of research exploring the physical health needs of asylum seekers residing in the community. What does this paper add? The international literature highlights the complexity of asylum seekers' health profiles. Although they appear to utilise health services at a higher rate than the host population, they continue to face many barriers to care. What are the implications for practitioners? Studies that explore policy options, including cross-country comparisons of health policy and guidelines that improve health outcomes, to foster equity of access and reduce health inequalities between asylum seekers and the host population are urgently required.

High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy

The global rise in non-communicable disease (NCD) suggests that US-based refugees are increasingly affected by chronic conditions. However, health services have focused on the detection of infectious disease, with relatively limited data on chronic NCDs. Using data from a retrospective medical record review of a refugee health program in the urban Northeast (n = 180), we examined the prevalence of chronic NCDs and NCD risk factors among adult refugees who had recently arrived in the US, with attention to region of origin and family composition. Family composition was included because low-income adults without dependent children are at high risk of becoming uninsured. We found that half of the adult refugees in this sample had at least one chronic NCD (51.1%), and 9.5% had three or more NCDs. Behavioral health diagnoses were most common (15.0%), followed by hypertension (13.3%). Half of adults were overweight or obese (54.6%). Chronic NCDs were somewhat more common among adults from Iraq, but this difference was not significant (56.8 vs. 44.6%). Chronic NCDs were common among adults with and without dependent children (61.4 vs. 44.6%, respectively), and these two groups did not significantly differ in their likelihood of having a chronic NCD after adjustment for age and gender (AOR = 0.78, 95% CI = 0.39, 1.55). This study suggests that chronic NCDs are common among adult refugees in the US, including refugees at high risk for uninsurance. We propose that refugee health services accommodate screening and treatment for chronic NCDs and NCD risk factors, and that insurance outreach and enrollment programs target recently arrived refugees.

The 2011 UN General Assembly on noncommunicable diseases: How neurologic disorders got left out

On September 19–20, the United Nations (UN) General Assembly held a meeting in New York to address the global burden of noncommunicable diseases (NCD). This meeting should have been relevant to neurologists, especially those interested in public health, international health, or both. Neurologic disorders, particularly in less developed regions of the world, are dominated by nonfatal, noncommunicable chronic conditions often affecting relatively young populations. Epilepsy, neuropathies, intellectual impairment, and developmental disabilities plague low-income countries, while higher income, older populations are devastated by Alzheimer dementia, Parkinson disease, and stroke.1 Headache disorders affect those at all income levels and engender substantial global economic loss.2 Unfortunately, among all the neurologic NCDs previously recognized by the World Health Organization (WHO) (table 1), only stroke was considered in the plan by the NCD Alliance in September.3 In fact, the NCDs addressed at this landmark meeting were limited to cancer, diabetes, chronic obstructive pulmonary disease (COPD), and cardiovascular disorders (CVD).4 View this table: Table 1 Noncommunicable diseases previously recognized by WHO6 Addressing all NCDs in a single program would have been daunting. The broad range of conditions, many with unrelated risk factors, makes it difficult to develop a cohesive approach. Some are preventable and others have cost-effective treatments. Consequently, developing a marketable “sound bite” is a challenge in this era of budget deficits and debt …

Health Promotion in the Workplace: Assessing Stress and Lifestyle With an Intranet Tool

BackgroundChronic noncommunicable conditions, particularly cardiovascular and metabolic diseases, are the major causes of death and morbidity in both industrialized and low- to middle-income countries. Recent epidemiological investigations suggest that management of lifestyle factors, such as stress and lack of physical activity, could have an important value in cardiometabolic conditions, while information technology tools could play a significant facilitatory role.ObjectivesThe objective of our study was to verify the feasibility of using a private website, directed to the workers of a major Italian company, to describe their health profile and lifestyle and work habits using an ad hoc self-administered questionnaire.MethodsWe administered anonymous multiple choice Web-based questionnaires to 945 participants (683 completed the task) as part of an ongoing health promotion program in a multinational company. Qualitative and quantitative data were synthesized with nonlinear principal component analysis to construct indicators (ie, variables) for stress, control, and lifestyle domains. Considering in addition absenteeism, the Calinski-Harabasz statistic and cluster analysis jointly differentiated seven clusters, which displayed different distributions of standardized classification variables. The final step consisted in assessing the relationship of the resulting seven subject typologies with personal data, illnesses, and metabolic syndrome status, carried out for the most part with descriptive methods.ResultsStatistical analyses singled out two not-overlapping domains of stress and control, as well as three not-overlapping domains of physical activity, smoking, and alcohol habits. The centroids of the seven clusters generated by the procedure were significantly (P < .001) different considering all possible 21 comparisons between couples of groups. Percentage distributions of variables describing personal information (gender, age group, work category, illness status, or metabolic syndrome) within participant typologies show some noteworthy findings: females, workers aged 35–44 years, junior white collar workers, and respondents reporting illness were more prevalent in the stress group than in the overall studied population; preclinical metabolic syndrome status was more prevalent in the group with higher alcohol consumption. Absentees reported more illness.ConclusionsThe present Intranet-based study shows the potential of applying diverse statistical techniques to deal jointly with qualitative and quantitative self-reported data. The resulting formal description of subject typologies and their relationship with personal characteristics might provide a convenient tool for supporting health promotion in the work environment.

Cognitive Functioning and the Probability of Falls among Seniors in Havana, Cuba

This article explores the connection between cognitive functioning and falls among seniors (> or = 60 years of age) in Havana, Cuba, after controlling for observable characteristics. Using the SABE (Salud, Bienestar, and Envejecimiento) cross-sectional database, we used an econometric strategy that takes advantage of available information to reduce the endogeneity problem of cognitive functioning and the individual probability of falling. Our findings suggest that memory scores and cognitive functioning impacts the probability of falling--even after controlling for demographics, socioeconomic status, existence of chronic non-communicable conditions, vision/ hearing capacity, and baseline health. Monitoring elderly with low cognitive functioning may be a cost-effective way to reduce the economic burden of falls.

Knowledge and prevalence of risk factors for hypertension among workers in the banking industry in Benin-City, Edo State, Nigeria

Hypertension is one of the chronic non-communicable conditions in the developing countries. The banking industry, which is very demanding of its workforce, as evidenced by its long banking hours, with little physical activity could predispose bank workers to developing hypertension. The focus of this study is therefore to determine the knowledge and prevalence of risk factors of hypertension among workers in the banking industry in Benin- City, Edo- State, Nigeria. This cross-sectional study was carried out among workers in the banking industry in Benin–City, Edo–State, Nigeria. A simple random sampling method was used for the selection of eight banks. All the workers in the eight banks were included in the study. A total of 192 questionnaires was retrieved and analysed. Results: The prevalence of hypertension among bank workers was 17.7%. Ninety- three (48.4%) of the respondents had a correct knowledge of hypertension while 138 (70.8%) of them had a good knowledge about the complications of hypertension. One hundred and twenty five (65.1%) respondents had good knowledge about risk factors of hypertension. Eighty- five (44.3%) of the respondents, and 30(15.6%) of the respondents took alcohol and smoked respectively. Fifteen (7.8%) of the respondents were obese. More males than females consumed alcohol, smoked and added extra salt to food. This difference was found to be statistically significant for only alcohol and smoking. Sixty–two (32.3%) of the respondents added extra salt to their food while, 173 (90.1%) of the respondents believed their work was stressful. About half of the respondents (50.9%) worked for more than 8hrs per day, while 75% of them worked 6 days per week. Conclusion: This study has shown that a significant number of bank workers had hypertension. There was also a high prevalence of the risk factors of hypertension among the study population despite their good knowledge about these risk factors and the complications of hypertension. Therefore, there is need for rigorous health education on risk factors avoidance and reduction among bank workers. Keywords: hypertension, knowledge, prevalence The Tropical Journal of Health Sciences Vol. 12(1) 2005: 26-30