National Representative Survey Research Articles

Digitalization in China: who’s left behind?

ABSTRACT In an age of digitalization, who still refuses to use digital technology? Drawing on nationally-representative Chinese General Social Survey data, this article finds that about half of Chinese households do not actively use the Internet or e-payment systems, despite their ubiquity. This article estimates the effects of socioeconomic resources on these technologies’ (non-)use across urban, resident but previously urban, resident but previously rural, and rural hukou household registrations in China. Educational attainment is associated with higher odds of use among rural hukou, but the size of this effect is nearly double compared to urban hukou. Additionally, being female increases the odds of use among urban and resident but previously urban hukou, and lowers the odds of use in rural hukou, but which are attenuated by the mediating effects of education. The results give credence to education as a direct and indirect mechanism for digital skills development, especially for rural households. Individuals proximal to rural living conditions have fewer opportunities to learn about digital technology, resulting in greater dependency on education as a rare source of skills training. Simultaneously, education indirectly creates opportunities for women to learn digital skills by improving chances for higher-status job participation that require information management skills, especially in rural regions where traditional cultural norms constrain opportunities for upward mobility. Ultimately, digital technology non-use is traced not to lack of interest, but to lack of skills development opportunities among the socioeconomically disadvantaged.

Misperceptions of immigrant flows and their associations with anti-immigrant attitudes

ABSTRACT Research has documented that misperceptions about the size and characteristics of immigrant populations are associated with anti-immigration attitudes. In the United States, immigration from Asia began to outpace immigration from Latin America starting in 2010, but public discourse about immigration remains focused on the latter. This study seeks to understand to what extent the public misperceives not just the sizes of immigrant populations, but the relative flows of subgroups. I further ask whether misperceptions of immigration flows can be corrected, and whether these misperceptions – and corrected perceptions – affect beliefs about immigration’s impacts and policy attitudes. I address these questions using a nationally-representative survey experiment, in which participants read accurate information about current immigration patterns. Findings reveal that while this information raised the overall accuracy of respondents’ perceptions of the share of immigrants coming from Latin America versus from Asia, it did not change their perceptions of immigration’s impacts, nor did it alter policy attitudes. Changing attitudes by addressing common misperceptions likely requires more targeted approaches.

Association Between Changes in Depressive Symptoms and Sarcopenia: Findings From a Nationwide Cohort Study

ObjectivesThe aim of this study was to investigate the association between changes in depressive symptoms and sarcopenia by repeated measures of depressive symptoms at a follow-up visit every 2 years. DesignCross-sectional design and longitudinal design. Setting and ParticipantsWe conducted a cross-sectional and longitudinal study using data from the China Health and Retirement Longitudinal Study, which is a representative national survey. A total of 12,287 participants were included in Wave 1 (2011–2012) for the cross-sectional analysis, followed by a total of 5285 participants in Wave 2 (2013–2014) and Wave 3 (2015–2016) for the longitudinal analysis based on the cross-sectional analysis. MethodsDepressive symptoms were measured by the 10-item Center for the Epidemiological Studies of Depression Short Form. Sarcopenia was defined according to the Asian Sarcopenia Working Group criteria (AWGS 2019). Changes in depressive symptoms in Wave 1 and Wave 2 were used as exposure, and sarcopenia in Wave 3 was used as outcome. Cox proportional hazards regression model was used to test the relationship between changes in depressive symptoms and sarcopenia. ResultsIn cross-sectional analysis, depression was significantly associated with sarcopenia (odds ratio, 1.27; 95% CI, 1.10–1.48). In subsequent longitudinal analyses, a total of 174 sarcopenia events occurred, and those with increased depressive symptoms and persistent depressive symptoms were at higher risk for sarcopenia than those without depressive symptoms, with multivariable-adjusted hazard ratios of 1.65 (95% CI, 1.00–2.73) and 1.68 (95% CI, 1.06–2.68), respectively. Conclusions and ImplicationsPeople with increased depressive symptoms and persistent depressive symptoms may have a higher risk of developing sarcopenia over time. In the future, more research is needed to confirm the mechanism by which long-term changes in depression contribute to the risk of sarcopenia, and to propose preventive measures accordingly.

Ambition or comparison? Socioeconomic status and wellbeing differences between local and migrant workers.

Pursuing wellbeing is an essential part of human life and plays a determining role in public health and social sustainability. Prior research identified objective socioeconomic status (O-SES), such as real income and homeownership, as facilitators of human subjective wellbeing (SWB). However, not all humans with better SES reported high SWB. This paper expects that subjective socioeconomic status (S-SES) is the key path through which O-SES shapes SWB and that this indirect relationship varies by household registration status, length of residentship, and type of migrant status. Based on a national representative survey dataset-China General Social Survey 2010 (CGSS), the results of generalized structural equation modeling (GSEM) show that household income and homeownership as O-SES are positively related to SWB. Self-evaluated household SES as an important indicator of S-SES not only has a positive relationship with SWB but also significantly mediates the relationship between O-SES and SWB, especially for the new-local residents (NLRs), urban-to-urban migrants (UUMs) and rural-to-urban migrants (RUMs). This study has substantial implications for targeting the comparative psychology and sustainable productivity of Chinese migrants and the local labor force since it is currently facing a growing aging society.

Clergy-lay political (mis)alignment in 2019–2020

AbstractWe use data from the new and nationally representative National Survey of Religious Leaders, supplemented with the 2018 General Social Survey, to examine the extent to which clergy are politically aligned with people in their congregations. Two assessments of alignment—clergy reports of how their political views compare to the political views held by most people in their congregations, and comparisons between clergy and lay voting preferences in the 2016 election—yield the same findings. Clergy in Black Protestant and predominantly white evangelical churches are much more likely to be politically aligned with their people than are Catholic or, especially, white mainline Protestant clergy, who often are more liberal than their people. Contrary to media reports suggesting that evangelical clergy are now likely to be less conservative than their people, the vast majority are either politically aligned with, or more conservative than, their members.

Life Satisfaction Before and During COVID-19 Pandemic in Thailand.

Objective: To investigate prevalence of life satisfaction in the Thai population before and during the COVID-19 epidemic, and factors associated with life satisfaction during the epidemic. Methods: Multistage sampling was used to draw a sample from the Thai population. A total of 3,115 Thai participants age 15years or older from a nationally-representative longitudinal survey in 2019 and in 2021 were included in this study. The study applied the Scale with Life Satisfaction (SWLS) instrument to measure life satisfaction among the Thai population before and during the COVID-19 epidemic. Multiple regression analysis was used to investigate the association between life satisfaction and other variables. The follow-up survey response rate for individuals was 44.8%. Results: An average life satisfaction score during the COVID-19 epidemic (in 2021) was 22.4 which decreased from 25.5 before the COVID-19 epidemic (in 2019). More than one-third of the participants (36.5%) reported having less life satisfaction during the epidemic, which was nearly 20 percentage points higher than before the epidemic (17.7%). Controlling for life satisfaction in 2019, the analysis found statistical associations between demographic and economic characteristics and health-related behaviours, and life satisfaction during 2021. People in the older age cohorts (p ≤ 0.001), in a rural area (p ≤ 0.05), having higher education (p ≤ 0.001), still being employed (p ≤ 0.01) and becoming unemployed (p ≤ 0.01) had higher life satisfaction. The possibility of higher life satisfaction was also found in people who maintained good health (p ≤ 0.01), sufficient physical activity (p ≤ 0.001), and fruit and vegetable intake (p ≤ 0.01). People with income loss during the epidemic had lower life satisfaction (p ≤ 0.05). Conclusion: The findings suggest that policies and systems for resilience and social protection are needed for empowering individuals-especially the poor and vulnerable-to cope with crises, and improve health and wellbeing outcomes.

Assessment of determinants influencing the attitude of men towards justifying beating their wife in India: insights from two national representative surveys

Assessment of determinants influencing the attitude of men towards justifying beating their wife in India: insights from two national representative surveys

Anticipated fear and anxiety of Automated Driving Systems: Estimating the prevalence in a national representative survey.

Automated Driving Systems (ADS) may reshape mobility. Yet, related fear and anxiety are largely unknown. We estimated the prevalence and risk factors of anticipated anxiety towards ADS. In a nationally representative face-to-face household survey, we assessed anticipated levels of anxiety towards ADS based on DSM-5 specific phobia criteria, using structured diagnostic interviews. We estimated weighted prevalences and conducted adjusted logistic regression models. Of N=2076 respondents, 40.82% (95%-confidence interval (CI) 37.73-43.98) anticipated experiencing some symptoms of phobia of ADS, 15.22% (CI 13.19-17.51) anticipated subthreshold phobia, and 3.39% (CI 2.42-4.75) anticipated full-blown phobia of ADS. Of subjects anticipating subthreshold phobia, 74.02% showed no strong, enduring fears of driving non-automated cars and 65.07% presented no other specific phobias (full-blown anticipated phobia: 50.37% and 50.03%, respectively). Anticipated phobia highly overlapped with anticipating marked or strong fears of passively encountering ADS in traffic (odds ratio 312.4-1982.2). About 20% of subjects anticipated at least subthreshold and 4% of subjects anticipated full-blown phobia of ADS. It appears to be distinct from fears related to non-automated driving and other specific phobias. Our findings call for prevention and treatment of phobia of ADS as they become increasingly ubiquitous.

The (Un)Equal Effect of Binary Socialisation on Adolescents’ Exposure to Pornography: Girls’ Empowerment and Boys’ Sexism from a New Representative National Survey

Due to the increasing trend in the use of pornography recorded in recent years, along with the decreasing age of its consumers, many studies have investigated its potential negative effects on adolescents, who are developing their social and sexual identity, often producing inconsistent results. With the present study, which is based on a large representative sample of Italian students attending public upper secondary schools, predictors as well as negative and positive effects of pornography use on adolescents’ attitudes, beliefs and well-being have been identified through a psychosocial approach. To achieve these results, the study involved a two-step analysis: first, the decision tree method for classification was applied to identify the main predictors of different frequencies in pornography consumption; subsequently, multinomial logistic regressions were carried out to detect the effects of pornography use. The results show a large difference between boys and girls in terms of frequency of pornography use, but also in the effects on adherence to gender roles, which is related to a still strongly stereotyped socialisation. Instead, similar negative effects on both girls and boys were found on self-esteem, body satisfaction, negative primary emotions and distress, suggesting the need for adequate sex education provided by both parents and schools to counteract taboos and blind internalisation of models of beauty and sexual behaviours provided by pornography.

Going deeper with health equity measurement: how much more can surveys reveal about inequalities in health intervention coverage and mortality in Zambia?

BackgroundAlthough Zambia has achieved notable improvements in reproductive, maternal, newborn and child health (RMNCH), continued efforts to address gaps are essential to reach the Sustainable Development Goals by 2030. Research to better uncover who is being most left behind with poor health outcomes is crucial. This study aimed to understand how much more demographic health surveys can reveal about Zambia’s progress in reducing inequalities in under-five mortality rates and RMNCH intervention coverage.MethodsUsing four nationally-representative Zambia Demographic Health Surveys (2001/2, 2007, 2013/14, 2018), we estimated under-five mortality rates (U5MR) and RMNCH composite coverage indices (CCI) comparing wealth quintiles, urban‐rural residence and provinces. We further used multi-tier measures including wealth deciles and double disaggregation between wealth and region (urban residence, then provinces). These were summarised using slope indices of inequality, weighted mean differences from overall mean, Theil and concentration indices.ResultsInequalities in RMNCH coverage and under-five mortality narrowed between wealth groups, residence and provinces over time, but in different ways. Comparing measures of inequalities over time, disaggregation with multiple socio-economic and geographic stratifiers was often valuable and provided additional insights compared to conventional measures. Wealth quintiles were sufficient in revealing mortality inequalities compared to deciles, but comparing CCI by deciles provided more nuance by showing that the poorest 10% were left behind by 2018. Examining wealth in only urban areas helped reveal closing gaps in under-five mortality and CCI between the poorest and richest quintiles. Though challenged by lower precision, wealth gaps appeared to close in every province for both mortality and CCI. Still, inequalities remained higher in provinces with worse outcomes.ConclusionsMulti-tier equity measures provided similarly plausible and precise estimates as conventional measures for most comparisons, except mortality among some wealth deciles, and wealth tertiles by province. This suggests that related research could readily use these multi-tier measures to gain deeper insights on inequality patterns for both health coverage and impact indicators, given sufficient samples. Future household survey analyses using fit-for-purpose equity measures are needed to uncover intersecting inequalities and target efforts towards effective coverage that will leave no woman or child behind in Zambia and beyond.

Alarming low physical activity levels in Chilean adults with disabilities during COVID-19 pandemic: a representative national survey analysis.

People with disabilities usually face barriers to regularly engaging in physical activities. Estimating physical activity patterns are necessary to elaborate policies and strategies to facilitate active lifestyles, considering the particular access difficulties experienced by this population. This study aimed (i) to describe the prevalence of physical activity levels and (ii) to examine the associations of physical activity levels with socio-demographic variables and type of disability in the 2020 Chilean National Physical Activity and Sports Habits in Populations with Disabilities (CNPASHPwD) survey during the coronavirus disease 19 (COVID-19) pandemic. Cross-sectional data from 3,150 adults (18-99 years old), 59.8% female, were analyzed from November to December 2020. Self-reported age, gender, type of disability (i.e., physical, visual, hearing, intellectual, or mixed), socio-economic status, area and zone of residence, and physical activity levels (0 min/week, < 150 min/week, ≥ 150 min/week) were obtained. 11.9% of the participants were classified as active (≥ 150 min/week), and 62.6% declared no involvement in physical activity. A larger proportion of females (61.7%) did not meet the current guidelines (≥ 150 min/week of physical activity) in comparison with males (p < 0.001). Participants with visual and hearing disabilities were more likely to be active than those with other types of disabilities. Those living in the central and southern regions of Chile were more likely to be physically active than those from the northern region. Also, older participants, women, and those from lower socio-economic statuses were less likely to meet the physical activity guidelines. Alarmingly, nine out of ten participants were categorized as physically inactive, particularly women, older adults, and those with a low socioeconomic status. If the pandemic context moderated, the considerable prevalence of reduced physical activity levels deserves future exploration. Health promotion initiatives should consider these aspects, emphasizing inclusive environments and increasing opportunities to favor healthy behaviors, countering the COVID-19 effects.

BURDEN OF CARDIOVASCULAR DISEASES, KIDNEY DISEASES AND DEMENTIA ATTRIBUTABLE TO HYPERTENSION IN FRANCE

Objective: Cardiovascular and renal diseases and dementia constitute major hypertension-related conditions and have a high burden for public health. The aim of our study was to estimate the burden of these diseases attributable to hypertension in France by providing the number of hospital stays and deaths attributable to hypertension in 2017. Design and method: Age- and sex-specific attributable fractions were calculated by combining relative risks extracted from the literature with the prevalence of hypertension (defined as a systolic blood pressure higher than 140mmHg) estimated in the Esteban Study, a national representative survey. These fractions were applied to the nationwide statistics of death and hospitalization stays with a primary diagnosis for cardiovascular or renal diseases, or dementia whose risk is known to increase with hypertension. Data were extracted from the French National Health Insurance Information System (SNDS) which contains nationwide and exhaustive hospital stays and deaths occurring in France. Results: In France in 2017, 1 043 207 hospital stays and 185 459 deaths related to cardiovascular, renal or dementia condition occurred. Of these, 164 093 hospital stays (119 640 in men and 44 453 in women) and 35 017 deaths (17 436 in men and 16 142 in women) were estimated to be attributable to hypertension, representing 16% of all cardiovascular, renal and dementia-related hospital stays and 19% of all cardiovascular renal and dementia deaths. Regarding the attributable fraction, the largest impact was observed on hemorrhagic stroke (26.8% of cases attributable to hypertension in men and 15.8% in women) and on ischemic heart disease (25.0% in men and 15.4% in women). For all cardiovascular diseases the highest attributable fraction were reach in adults aged 55-74 years old. Conclusions: In France, the burden attributable to hypertension is high and is expected to increase in the coming years given the aging of the population. The reduction of the burden attributable to hypertension requires ambitious public health policies aimed at promoting healthy lifestyles but also an improvement in the awareness and management of hypertension, which has not improved over the last 20 years, unlike in several other European countries.

Common mental disorder and suicidality among doctors: differences by specialty.

Common mental disorders (CMDs) and suicidal ideation (SI) are prevalent among doctors, yet limited evidence exists investigating the relationship of specialty area to these outcomes. This study aimed to determine the prevalence of likely CMD and SI among doctors and to investigate whether likelihood of these outcomes varied by area of medical specialty. A secondary analysis of a representative national survey of 12,252 Australian doctors was conducted. Demographic and work-related variables, SI and CMD (GHQ-28), were assessed among doctors (n = 7037; 57%) working in a range of specialty areas. Logistic regression was used to examine the association between specialty and mental health outcomes in unadjusted and adjusted models. Almost one-quarter of doctors (n = 1560; 23%) reported symptom levels indicating likely CMD whilst 9% (n = 667) reported SI in the last year. Doctors in surgery (adjusted odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.54-0.97, P = 0.03) were at significantly lower risk of CMD than General Practitioners (GPs), whilst doctors in anaesthetics (adjusted OR = 1.45; 95% CI 1.09-1.93, P = 0.01) and paediatrics (adjusted OR = 1.88; 95% CI 1.02-3.47, P = 0.04) were at significantly higher risk of experiencing SI compared to GPs after accounting for confounders. Results demonstrated that doctors in Australia working in certain specialties, specifically anaesthetics and paediatrics, were at significantly greater risk of suicidal ideation compared to GPs after accounting for confounders. Interventions to address CMD and SI among doctors in all specialties remain urgently needed.

Impacts of the COVID-19 pandemic on subjective wellbeing in the Middle East and North Africa: A gender analysis.

The pathways through which the COVID-19 pandemic has impacted population mental health are potentially gendered. Little research has explored these pathways in low- and middle-income country contexts, such as in the Middle East and North Africa (MENA) region, where socioeconomic roles are highly gendered. To address this gap, we examine the relationships between pandemic-related socioeconomic changes and subjective wellbeing in the MENA region. Our core hypothesis is that the COVID-19 pandemic affected men and women's subjective wellbeing differently in part because these effects were mediated by gendered socioeconomic roles. We exploit multiple waves of longitudinal, nationally-representative phone survey data across Egypt, Jordan, Morocco, Sudan, and Tunisia. The data were collected between November 2020 and August 2021 and include 32,296 observations of 20,256 unique individuals. Mental health is measured through the WHO-5 subjective wellbeing scale. Our key independent variables capture pandemic-related employment loss, income loss, experience of limitations on food access, enrollment of children in alternative schooling modalities, and receipt of formal and informal transfers. We find significantly worse subjective wellbeing for women in Egypt and Morocco during the pandemic, but not the three other countries. There were negative associations between employment and income loss during the pandemic and subjective wellbeing, but not gender-differentiated ones. In contrast, high levels of limitations on food access were associated with worse mental health for men than women. Receipt of transfers generally did not have any association with subjective wellbeing. Further research is needed into how social assistance programs implemented in response to pandemics may be designed so as to address the negative mental health consequences of such events.

Optimising targeted dietary intervention strategies based on regional disparities of the related burden of cardiovascular disease in China

Optimising targeted dietary intervention strategies based on regional disparities of the related burden of cardiovascular disease in China

Association of endometriosis with genital human papillomavirus infection in US women: a national population-based study

The prevalence of genital human papillomavirus (HPV) in women with endometriosis has never been reported in a national representative survey. We aimed to investigate the association of endometriosis with the prevalence of HPV. We analyzed the data on 1768 women (representing 43,824,157 women) in the United States aged 20–54 years from the National Health and Nutrition Examination Survey in the prevaccination era (2003–2006). The diagnosis of endometriosis was based on a self-report. The prevalence of any HPV in women with endometriosis did not differ from that in women without endometriosis after controlling for potential confounders such as age, ethnicity, family income, marital status, and the number of deliveries (adjusted prevalence ratio (aPR) 0.84, 95% confidence interval (CI) 0.61–1.15). No significant association was found between the prevalence of high-risk HPV and the diagnosis of endometriosis (aPR 0.71, 95% CI 0.44–1.14). If the participants were not covered by health insurance, the prevalence of any HPV infection in women with endometriosis was higher than in those without endometriosis (aPR 1.44, 95% CI 0.94–2.20). In contrast, in a subgroup who had health insurance, a lower prevalence of any HPV infection was observed in women with endometriosis (aPR 0.71, 95% CI 0.50–1.03), and P for interaction was statistically significant (P = 0.01). There was no association between endometriosis and HPV infection in this study of HPV vaccine-naïve women of reproductive age. The association was not different by the type of HPV. However, access to healthcare may modify the association between endometriosis and HPV infection.

Sociodemographically Stratified Exploration of Pancreatic Cancer Incidence in Younger US Patients: Implication of Cannabis Exposure as a Risk Factor

Introduction. The aetiology for the recent increase in pancreatic cancer incidence (PCI) in the US is unknown. This paper provides an epidemiological investigation of the exponential increase in PCI in young people aged 15–34 years, particularly amongst females, with a focus on the exponential rise amongst African American females, and its relationship to substance use. Methods. National pancreatic cancer data from recent reports. Tobacco, alcohol and daily cannabis use data taken from the annual nationally representative National Survey of Drug Use and Health, response rate = 74%. Results. Amongst the 15–34-year-aged cohort, PCI was found to be significantly more common in females (females: β-est. = 0.1749 p = 0.0005). African American females are noted to have the highest rates of daily cannabis use amongst females in the 26–34 and 35–49-year groups. The relationship between PCI and daily cannabis use was strongly positive across all ethnicities and in both sexes. In African American females, the Pearson correlation between daily cannabis use and PCI was R = 0.8539, p = 0.0051. In an additive multivariable model for each sex and race, cannabis was the only significant term remaining in the final model in the 15–34-year-aged cohort and thus out-performed alcohol as a risk factor. The most significant term in multivariate models was the alcohol:cannabis interaction which was highly significant in all ethnicities from p = 2.50 × 10−7 for Caucasian American females and the highest E-value pair was for Hispanic American females (E-value estimate = 1.26 × 10102 and E-value lower bound 2.20 × 1074). Conclusion. These data show that cannabis fulfills quantitative criteria of causality in all age, sex and ethnicity cohorts, and thus explains both the recent surge in PCI and its ethnocentric predominance. Cannabis interacts powerfully genotoxically and cancerogenically with alcohol, with increases in cannabis use driving the current PCI surge. These results raise the important question as to how much cannabis might be responsible for the modern renaissance in cancer rates amongst younger people.

Geographic Variations in the Prevalence, Awareness, Treatment, and Control of Dyslipidemia among Chinese Adults in 2018–2019: A Cross-sectional Study

ObjectiveTo investigate the spatial patterns of the prevalence, awareness, treatment, and control rates of dyslipidemia at the provincial level in China. MethodsA national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in mainland China in 2018–2019, using a multi-stage, stratified, cluster-randomized sampling design. Subjects, as households, were selected, followed by a home visit to collect information. Both descriptive and linear regression procedures were applied in the analyses. ResultsThe overall prevalence of dyslipidemia was 35.6%, and wide geographic variations of prevalence, treatment, and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1 ± 13.8 years. The highest-lowest difference regarding the provincial level prevalence rates were 19.7% vs. 2.1% for high low-density lipoprotein cholesterol, 16.7% vs. 2.5% for high total cholesterol, 35.9% vs. 5.4% for high triglycerides, and 31.4% vs. 10.5% for low high-density lipoprotein cholesterol. The treatment rate of dyslipidemia was correlated with the socio-demographic index (P < 0.001), urbanization rate (P = 0.01), and affordable basic technologies and essential medicines (P < 0.001). ConclusionPrevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence, treatment, and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.

Ups and downs of conducting a national representative survey on hypertension during pandemic time: main results of SEPHAR IV.

This national representative survey sought to assess hypertension's prevalence, awareness, treatment and control in Romania. A representative sample (by age, sex and residence) of 1477 Romanian adults (51.19 ± 16.61 years, range 18-80 years, 59.9% women) was multimodally evaluated during two study visits. Hypertension was defined as SBP at least 140 mmHg and/or DBP at least 90 mmHg or previously diagnosed hypertension, regardless of BP. Awareness was defined by knowledge of previous hypertension diagnosis or of current use of antihypertensive treatment. Treatment was defined by antihypertensive medication taken at least 2 weeks prior to enrolment. Control was defined as SBP less than 140 mmHg and DBP less than 90 mmHg at both visits in treated hypertensive patients. Hypertension prevalence was 46% ( n = 680) consisting of 81.02% ( n = 551) known hypertensive patients and 18.98% ( n = 129) newly diagnosed hypertensive patients. Awareness, treatment and control of hypertension were: 81% ( n = 551), 83.8% ( n = 462) and 39.2% ( n = 181). Despite numerous pandemic-related obstacles in conducting a national survey, SEPHAR IV updates hypertension epidemiological data of a high-cardiovascular-risk Eastern-European population. This study confirms previous predictions of hypertension prevalence, treatment and control, which remain unfavourable because of unsatisfactory control of promoting factors.

Biodiversity is overlooked in the diets of different social groups in Brazil

Food biodiversity is essential for improving nutrition and reducing hunger in populations worldwide. However, in middle and low-income countries, the biodiversity of food production does not necessarily represent food consumption patterns by population. We used Brazil, one of the world's megabiodiverse countries, as a case study to investigate the following questions: what is the prevalence of consumption of biodiverse foods in Brazil, and what are the socioeconomic factors that influence their consumption throughout the country? We used data from a Brazilian representative national dietary survey to estimate the frequency of food consumption of unconventional food plants, edible mushrooms, and wild meat, in according to socioeconomic variables. Thus, we investigated the socioeconomic predictors of Unconventional Food Plants consumption using methods of Machine Learning (ML) and multiple zero-inflated Poisson (ZIP) regression. We showed that biodiverse food consumption in Brazil is low, just related by 1.3% of the population, varying in according to area, ethnicity, age, food insecurity, sex, and educational level. Our findings of low utilization of biodiversity suggest an important mismatch between the rich biodiversity of the country and its representation in the human diet.