Low Socioeconomic Development Research Articles

Regionalização da atenção psicossocial: uma visão panorâmica da Rede de Atenção Psicossocial de Minas Gerais, Brasil

Abstract The present study aims at analyzing the regionalization of the services carried out by the Psychosocial Care Network (RAPS in Portuguese) in the state of Minas Gerais (MG) in Brazil, yielding indicators that may enhance the SUS strategic management towards the strengthening of the psychosocial care provided by the state. It is a cross-sectional study, based on the data collected in May 2019 from government websites, considering the state’s Macro-Regions and Health Regions as units of analysis. Indicators of service coverage in relation to the population in accordance to normative parameters determined by the Ministry of Health for a better understanding of the effective coverage were produced, and a general indicator (iRAPS) of the supply of services in this network in Minas Gerais state was validated. The outcomes allow a detailed analysis of the structural aspect of the RAPS in MG and unveil the development of a robust network. However, important regional heterogeneities were noticed and also a lack of services aiming at specific populations providing assistance 24 hours a day, which weakens the proper access to RAPS in several parts of the state. Higher values of iRAPS were found in health regions with low socioeconomic development and low general offer of health services, a fact that differs from the national scenario, which may imply state policy investments aiming at offering RAPS within the state hinterland areas.

BEST PRACTICES TO ACHIEVING PEACE JUSTICE AND STRONG INSTITUTIONS (SDG 16)

Low socio-economic development can support the conditions for social violence and conflict, but it is also a consequence of violence and conflict. Through Goal 16, the SDGs recognize the long reaching consequences of conflict and violence for development outcomes. Not only is violence a severe hindrance for development, it can reverse many years of development gains. A whole of society approach is required to proactively address on and offline misinformation networks, ensuring that government, civil society, private sector and vulnerable populations work together to inform policies and programming that balances freedom of expression with the need to curb mis/disinformation. Recognizing the centrality of Goal 16 as an enabler and accelerator for the 2030 Agenda, further efforts are required to strengthen national capacities for data collection, analysis and data prioritization. As with many other Sustainable Development Goals it is also urgent to address the lack of data disaggregated by sex, race, colour, age, language, religion, national, ethnic or social origin, disability, migration or other status. KEYWORD: crime, peace, SDG16, conflict, sustainable development, COVID-19

Socioeconomic development role in hospitalization related to air pollution and meteorology: A study case in southern Brazil

Air pollution is one of the foremost environmental threats to human health. However, the meteorological and social factors that lead to respiratory and cardiovascular diseases have not been fully elucidated. In this study, we use Principal Component Analysis and Generalized Linear Model (PCA-GLM) to investigate the combined effect of socioeconomic development and air pollution on cardiorespiratory hospitalization in southern Brazil. This region has the highest rates of hospitalization by cardiorespiratory diseases in the country. We analyze three main sources of data: (i) air pollutants density from TROPOMI/Sentinel-5p satellite; (ii) temperature, humidity, and planetary boundary layer height (PBLH) modeled with the Weather Research Forecast model; and (iii) hospitalization by cardiorespiratory diseases obtained from the Brazilian National Health System. We estimate the Relative Risk (RR) using the PCA-GLM coefficients and interquartile variations of air pollutants density and meteorological parameters. Our results show that the population living in colder and drier municipalities is more prone to cardiorespiratory hospitalization. Regarding respiratory hospitalization, municipalities with lower socioeconomic development are more sensitive to meteorology and pollution variability than highly developed ones. In less developed municipalities, we observe the highest rates of cardiorespiratory hospitalization even if air pollution is low, which we interpret in terms of higher vulnerability. The RR analysis suggests that air pollution is an important environmental risk to cardiovascular diseases and respiratory diseases is more sensitive to air pollution and meteorology than cardiovascular ones. Our findings corroborate the mounting evidence that social vulnerability is a significant factor affecting the increase of cardiorespiratory hospitalization in the world.

Opportunities and risks of the climate policy in Russia

The climate agenda involves significant economic dimension and component. This is precipitated, on the one hand, by the climate change impact on the economy and its implications for economic development that necessitate costs for planning and implementing adaptation measures, and, on the other hand, by the imperatives of structural and technological modernization of the economy to strengthen its competitiveness and sustainability of socio-economic development including reduction of industrial greenhouse gases (GHG) emissions and increasing the ecosystems’ carbon sink capacity. The above implies harmonization of ecological, climatic, socio-economic, and technological characteristics to produce an effective national low GHG emissions socio-economic development strategy required by the Paris Climate Agreement. This in turn calls for comprehensive assessment of the impact produced by new low-carbon technologies on economic dynamics using the framework of macrostructural calculations and scenarios of economic development of Russia with different volumes of funding invested in decarbonization. It is argued that the most efficient is a group of so-called moderate scenarios that provide for both GHG reduction and economic growth rates above the global average. More ambitious scenarios involve risks of slowing GDP growth given weighty additional investment which constrains the dynamics of household consumption. The key role of the Russian ecosystems capacity to absorb and sequester carbon in implementation of the low GHG emissions socio-economic development strategy is substantiated and the imperative for the complex of measures to improve the efficiency of land use and forestry resources (LULUCF), primarily the quality of R&D and the national monitoring system development, is emphasized.

The Influence of the Covid-19 Pandemic on General Trends in the Functioning and Competitiveness of Private Clinics

This article aims to examine the impact of the pandemic on competition in the medical services market of the Sumy region, which is ranked among the Ukrainian regions with small medical personnel and low socio-economic development. This study involved marketing research methods (surveys and content analysis), statistical methods for information processing, factor analysis, and alternatives analysis. The results unveiled the intense competition for patients and medical staff in the healthcare market of the Sumy region. The organization’s competitiveness before the pandemic was assessed by factors such as «the doctors’ treatment of patients and their qualifications» and «the availability of necessary medical services». During the pandemic, the essential factor in choosing a medical institution was «patient safety, reducing the risk of coronavirus». Before the pandemic, the competition between medical organizations was most influenced by the population paying capacity and the shortage of qualified medical personnel. Private clinics ranked below public clinics in delivering a wide range of medical services because of the lack of medical specialists. However, the pandemic has strengthened the position of private clinics through two factors. First, private clinics have expanded their range of services through narrow specialists who have moved from public institutions to private clinics. Second, private clinics have provided a higher level of client safety through a tight filter for patients with symptoms of coronavirus infection. Besides, using remote technologies by medical organizations has become a competitive advantage. The authors noted that remote technologies in healthcare are not common in the Sumy region and Ukraine in general, as patients distrust this service. This study is of practical value because it allows assessing the impact of global challenges on healthcare development in the regions to assess private medicine competitiveness changes. In addition to its practical value, private market research, especially in times of pandemic threat, confirms or rejects some theoretical hypotheses aimed at analyzing the performance of the private sector in health care facilities. This work opens new avenues for a deeper study of the similarities between private and public health facilities, especially in the face of legal and pandemic constraints.

Prevalence, Deaths, and Disability-Adjusted Life-Years Due to Asthma and Its Attributable Risk Factors in 204 Countries and Territories, 1990-2019

Understanding global trends in the point prevalence, deaths, and disability-adjusted life-years (DALYs) for asthma will facilitate evidence-based decision-making. What are the global, regional, and national burdens of asthma in 204 countries and territories between 1990 and 2019 by age, sex, and sociodemographic index (SDI)? Publicly available data from the Global Burden of Disease study from 1990 through 2019 were used. All estimates were presented as counts and age-standardized rates per 100,000, along with their associated uncertainty intervals. In 2019, the global age-standardized point prevalence and death rates for asthma were 3,415.5 and 5.8 per 100,000, which represent a 24%and 51.3%decrease since 1990, respectively. Moreover, in 2019, the global age-standardized DALY rate was 273.6 and the global point prevalence of asthma was highest in the group 5 to 9 years of age. Also in 2019, the United States (10,399.3) showed the highest age-standardized point prevalence rate of asthma. Generally, the burden of asthma decreased with increasing SDI. Globally, high BMI (16.9%), smoking (9.9%), and occupational asthmagens (8.8%) contributed to the 2019 asthma DALYs. Asthma remains an important public health issue, particularly in regions with low socioeconomic development. Future research is needed to examine thoroughly the associations asthma has with its risk factors and the factors impeding optimal self-management. Further research also is needed to understand and implement better the interventions that have reduced the burden of asthma.

Factors affecting fertility in the multicultural environment of Thrace in Northern Greece

Greece is currently characterized by its low fertility levels and a postponement of childbearing toward older ages. Greek Thrace, being a part of Greek territory since the second decade of the 20th century and the study area of this analysis, follows the same national trends, without forgetting the effects of local factors that cause some unique features in its fertility characteristics. Christian and Muslim populations inhabit this area; thus, a multicultural regime prevails. Besides that, Thrace’s ecological and environmental diversity, cultural and social variability, low socioeconomic development, high unemployment, and significant social and economic disparities affect the fertility decisions of the couples solely. This study explores the influence of several factors such as education, occupation, and religion on the fertility outcomes of the population by applying bivariate and multiple regression methods. The results confirm the complex nature of the couples’ fertility decisions under the agency of the cultural and socioeconomic environment. Such findings can outline policy guidelines in addressing population issues in this area. Additionally, they may serve in the interpretation of demographic phenomena of the whole country.

Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: Analysis of the ASAS-perSpA study

ObjectiveTo examine whether associations between socioeconomic factors and work outcomes in spondyloarthritis (SpA) differ across axial (axSpA), peripheral SpA (pSpA) and psoriatic arthritis (PsA), and whether associations for individual-level socioeconomic factors are modified by country-level factors. MethodsPatients with a physician diagnosis of SpA within working age (18–65 years) were included. Associations between individual- (age, gender, education, marital status) and country-level factors (Human Development Index, Health Care Expenditure (HCE), Gross Domestic Product, percentage unemployed) with work outcomes (employment status, absenteeism, presenteeism) were assessed using multivariable mixed-effects models. Associations between individual factors and outcomes were compared according to SpA phenotypes and country-level factors using interaction terms. ResultsA total of 3835 patients (mean age 42 years, 61% males) from 23 countries worldwide were included (66% axSpA, 10% pSpA, 23% PsA). Being employed was associated with gender (male vs. female OR 2.5; 95%CI 1.9–3.2), education (university vs. primary OR 3.7; 2.9–4.7), marital status (married vs. single OR 1.3; 1.04–1.6), and age in a non-linear manner. University (vs primary) education was associated with lower odds of absenteeism (OR 0.7; 0.5–0.96) and presenteeism (OR 0.5; 0.3–0.7). Associations were similar across SpA phenotypes. Higher HCE was associated with more favourable work outcomes, e.g., higher odds of employment (OR 2.5; 1.5–4.1). Gender discrepancy in odds of employment was greater in countries with lower socioeconomic development. ConclusionHigher educational attainment and higher HCE were associated with more favourable work outcomes, independently of SpA phenotype. The disadvantageous effect of female gender on employment is particularly strong in countries with lower socioeconomic development.

Health impacts of fine particles under climate change mitigation, air quality control, and demographic change in India

Despite low per capita emissions, with over a billion population, India is pivotal for climate change mitigation globally, ranking as the third largest emitter of greenhouse gases. We linked a previously published multidimensional population projection with emission projections from an integrated assessment model to quantify the localised (i.e. state-level) health benefits from reduced ambient fine particulate matter in India under global climate change mitigation scenarios in line with the Paris Agreement targets and national scenarios for maximum feasible air quality control. We incorporated assumptions about future demographic, urbanisation and epidemiological trends and accounted for model feedbacks. Our results indicate that compared to a business-as-usual scenario, pursuit of aspirational climate change mitigation targets can avert up to 8.0 million premature deaths and add up to 0.7 years to life expectancy (LE) at birth due to cleaner air by 2050. Combining aggressive climate change mitigation efforts with maximum feasible air quality control can add 1.6 years to LE. Holding demographic change constant, we find that climate change mitigation and air quality control will contribute slightly more to increases in LE in urban areas than in rural areas and in states with lower socio-economic development.

Gender and Socioeconomic Disparities in Global Burden of Epilepsy: An Analysis of Time Trends From 1990 to 2017

Objective: The objective of the study is to investigate the gender and socioeconomic disparities in the global burden of epilepsy by prevalence and disability-adjusted life-years (DALYs).Methods: The global, regional, and national gender-specific prevalence and DALYs caused by epilepsy by year and age were extracted from the Global Burden of Disease (GBD) Study 2017. The Gini coefficient and concentration index (CI) were calculated to demonstrate the trends in between-country inequality in the epilepsy burden from 1990 to 2017. Paired Wilcoxon signed rank test, Pearson correlation, and linear regression analyses were performed to analyze the association of gender disparity in epilepsy and socio-demographic index (SDI).Results: The DALYs number of epilepsies increased from 1990 to 2017 by 13.8%, whereas age-standardized DALY rates showed a substantial reduction (16.1%). Men had a higher epilepsy burden than women of the same period. The epilepsy burden appeared to be higher in countries with lower socioeconomic development (CI < 0). The Gini coefficient decreased from 0.273 in 1995 to 0.259 in 2017, representing a decline in the between-country gap. Age-standardized prevalence and DALY rates of men were higher than those of women in each SDI-based country group (p < 0.0001). Male-minus-female difference (r = −0.5100, p < 0.0001) and male-to-female ratio (r = −0.3087, p < 0.0001) of age-standardized DALY rates were negatively correlated with SDI.Conclusion: Although global health care of epilepsy is in progress, the epilepsy burden was concentrated in males and developing countries. Our findings highlight the importance of formulating gender-sensitive health policies and providing more services in developing countries.

Analysis of national coverage of neonatal cystic fibrosis screening in Brazil from 2008 to 2017

Introduction The Brazilian neonatal screening program established in 2001 included the investigation of cystic fibrosis (CF) in the phase III of the program. For this purpose, the immunoreactive trypsin (IRT) measurement was added to the newborn screening test. The purpose of National Neonatal Screening Program is to reach 100% of live births in Brazil. The aim of this study was to analyze the coverage of neonatal Screening for Cystic Fibrosis (CF) in Brazil from 2008 to 2017. Materials and methods This is an ecological study design based on data collected from the Brazilian Outpatient Information System regarding the detection of IRT as a component of the heel stick test from 2008 to 2017. Moreover, we gathered data from the Brazilian Live Birth Information System referring to live births from 2008 to 2017. We calculated the coverage of IRT measurement for every 100 live births, using the number of IRT measurement procedures as the numerator and the number of live births stratified by federative units (states), as well as by the Brazilian regions as the denominator. These regions correspond to the divisions of the national territory based on criteria such as natural, social, cultural and economic aspects. Results From 2008 to 2017, the regions presented the following coverage medians: South (84.1%), Southeast (71.4%), Midwest (47.3%) Northeast (12.3%) and North (10.9%). In the analysis of federative units, in the years 2013 to 2017, Paraná and Distrito Federal presented the highest median of coverage (100%), while the states with the lowest median were Rio Grande do Norte (12.1%), Amazonas (16.8%) and Paraíba (27.5%). Highest coverage was found in the South region, where are located most of the states with high socioeconomic development and high supply of health services, while the lowest coverage was found in the North region, where are located manly the states with low socioeconomic development and low supply of health services. According to data from the Brazilian Ministry of Health, the universalization of neonatal screening for cystic fibrosis occurred in 2013, however, at the end of this year, most states in the North and Northeast regions had not registered IRT measurements in the Outpatient Information System. Conclusion Although the coverage of neonatal screening for CF has improved nationwide over the years of the study, the disparity in the coverage of IRT measurements at the interregional and interstate levels is notable. Systematic implementation of neonatal screening for cystic fibrosis with equity and access to the entire population is suggested, leading to a greater number of children benefiting from treatment and a better quality of life.

Fertility transition and socioeconomic development in districts of India, 2001-2016.

The fertility-development relationship is bi-directional, context-specific, multi-phased and inconsistent over time. Indian districts provide an ideal setting to study this association due to their size, diversity and disparity in socioeconomic development. The objective of this study was to understand the association of fertility and socioeconomic development among the 640 districts of India. Data were drawn from multiple sources: Censuses of India 2001 and 2011; DLHS-2; NFHS-4; and other published sources. A district-level data file for Total Fertility Rate (TFR) and a set of developmental indices were prepared for the 640 districts for 2001 and 2016. Computation of a composite index (District Development Index, DDI), Ordinary Least Squares, Two Stage Least Squares and panel regressions were employed. By 2016, almost half of all Indian districts had attained below-replacement fertility, and 15% had a TFR of above 3.0. The DDI of India increased from 0.399 in 2001 to 0.511 by 2016 and showed large variations across districts. The correlation coefficient between TFR and DDI was -0.658 in 2001 and -0.640 in 2016. Districts with a DDI of between 0.3 and 0.6 in 2001 had experienced a fertility decline of more than 20%. The fertility-development relationship was found to be strongly negative, convex and consistent over time, but the level of association varied regionally. For any given level of DDI, fertility in 2016 was lower than in 2001; and the association was stronger in districts with a DDI below 0.45. The negative convex association between the two was prominent in the northern, central and eastern regions and the curves were flatter in the west, south and north-east. The increasing number of districts with low fertility and low development draws much attention. Some outlying districts in the north-eastern states had high TFR and high DDI (>0.6). Based on the findings, a multi-layered strategy in districts with low socioeconomic development is recommended. Additional investment in education, child health, employment generation and provisioning of contraceptives would improve the human development to achieve India's demographic goals.

State of the evidence: a survey of global disparities in clinical trials

IntroductionIdeally, health conditions causing the greatest global disease burden should attract increased research attention. We conducted a comprehensive global study investigating the number of randomised controlled trials (RCTs) published on...

Ekalavya Model Residential School [EMRS] and Inclusive Education in Kerala

Tribal people who are the original inhabitants of India are the poorest and the most vulnerable in Kerala. Kerala, with its world-famous ‘Kerala Model of Development’ has achieved spectacular social development that is the best among the third world countries in the world and her social development indicators are justifiably comparable with many developed nations too. This bright and rosy picture of Kerala has been shadowed by the abysmally low socio-economic development of its tribal people. Social exclusion, cultural alienation, poverty, low economic development, lack of political will and administrative apathy bundled with low enrolment in schools and the shockingly high dropout rate among tribal children signify the need and importance of Ekalavya Model Residential School [EMRS] in realizing socio-economic integration and mainstreaming of tribal population in Kerala. In this article, the investigator explores various problems and prospects of EMRS in Kerala.

Powering Development in Climate Vulnerable Areas: The Role of Decentralized Solar Solutions in India

In India, poor and marginalized communities face the dual challenges of low socioeconomic development and extreme vulnerability to climate change. Although there have been significant improvements in India’s rural household electrification, electricity availability for health centers, schools, and rural enterprises is still limited. Decentralized solar energy solutions are increasingly considered for bringing reliable electricity to community facilities, especially in climate vulnerable areas.

Assessment of socioeconomic inequality based on virus-contaminated water usage in developing countries: A review

Water is an essential resource required for various human activities such as drinking, cooking, and other recreational activities. While developed nations have made significant improvement in providing adequate quality water and sanitation devoid of virus contaminations to a significant percentage of the residences, many of the developing countries are still lacking in these regards, leading to many death cases among the vulnerable due to ingestion of virus-contaminated water and other waterborne pathogens. However, the recent global pandemic of COVID-19 seems to have changed the paradigm by reawakening the importance of water quality and sanitation, and focusing more attention on the pervasive effect of the use of virus-contaminated water as it can be a potential driver for the spread of the virus and other waterborne diseases, especially in developing nations that are characterized by low socioeconomic development. Therefore, this review assessed the socioeconomic inequalities related to the usage of virus-contaminated water and other waterborne pathogens in developing countries. The socioeconomic factors attributed to the various waterborne diseases due to the use of virus-contaminated water in many developing countries are poverty, the standard of living, access to health care facilities, age, gender, and level of education. Some mitigation strategies to address the viral contamination of water sources are therefore proposed, while future scope and recommendations on tackling the essential issues related to socioeconomic inequality in developing nations are highlighted.

Genesis of Responsible Resource Consumption Tools in Regional Development Strategy of Socio-economic Systems

At present, the issue ecological balance restoring and rational resource con-sumption is especially acute, which determines large-scale transformations at the world level, as well as the need to modernize the tools for socio-economic develop-ment systems of countries (macro-level), individual territories and regions (meso-level), a set of interacting economic systems and economic units (microlevels). The article examines the problems of responsible resource consumption in regional socioeconomic systems, which led to change of effective growth paradigm to: 1) the sustainable development paradigm, society’s informatization; 2) selective regional policy of interregional differentiation. Obviously, at the macro-level, there is an intensive search for effective management of regional resource consumption; development of mechanisms and tools for environmental responsibility management. That is why a decrease in the level of negative impacts, as well as the consequences of low socio-economic development, determines the genesis of responsible resource consumption tools in regions’ strategizing as a key development task. However, the study of the ontology “responsible resource consumption tools” goes through the concept of sustainable development and is transformed into an integral, logically linked system of views, united by a common idea and aimed at achieving the goal of work.

Villages, Customary Laws and Community Management of Ethnic Minority Groups in the Central Highlands

Vietnam has been fundamentally an agricultural country and consequently, rural areas with farmers play a critical role in its socio-economic development. As villages and communes are foundational social structures of the agricultural society, they have been the focal points in the development process throughout the history, especially during the modernization and industrialization of the country. For ethnic minority groups in the Central Highlands, despite their relative low socio-economic development level, the social relations are community – based, which forms the potential strength of the nation. Socio-economic development and village management have become central tasks set forth by the Party and the national government of Vietnam. The goals are to foster the development of the Central Highland villages while protect them from adversary derivative conditions, creating prerequisite conditions for the region’s integration with the market economy that is being formed and developed. With the development trend, the tools for managing and regulating basic social relations are customary laws and State laws. In this paper, we discuss a traditional form of society which is the village and its customary laws as solutions to developing advanced social relations, enhancing the internal power of the region, creating a driving force for the country.

Current treatments for diseases caused by Helicobacter pylori

The prevalence of Helicobacter pylori in the world reaches 50 % of the population, with infection in some regions up to 80 %. In developing countries with low socio-economic development, (Ukraine also), gastrointestinal diseases associated with Helicobacter pylori occupy one of the leading positions in the incidence structure. These include gastric and duodenal ulcer, gastritis, lymphoma and gastric cancer. Helicobacter pylori eradication is performed in accordance with recognized medical world therapeutic regimens that include proton pump inhibitors, bismuth and antibiotics. Gold standard is triple therapy, which contains (omeprazole, amoxicillin and clarithromycin), the use of which allows you to timely prevent the serious effects of persistence of Helicobacter pylori in the gastrointestinal tract (perforated ulcers, gastric lymphoma, cancer of the stomach).

Climate as a risk factor for armed conflict.

Research findings on the relationship between climate and conflict are diverse and contested. Here we assess the current understanding of the relationship between climate and conflict, based on the structured judgments of experts from diverse disciplines. These experts agree that climate has affected organized armed conflict within countries. However, other drivers, such as low socioeconomic development and low capabilities of the state, are judged to be substantially more influential, and the mechanisms of climate-conflict linkages remain a key uncertainty. Intensifying climate change is estimated to increase future risks of conflict.