Self-reported Chronic Diseases Research Articles

Self-Reported Sleep Duration Is a Useful Tool to Predict Sarcopenia in Chilean Older Adults: Evidence from the ALEXANDROS Longitudinal Study

Age-related sleep disorders share common pathways with sarcopenia. Prospective data from Latin American populations are scarce, and the association between sleep disorders and sarcopenia in Chileans remains unknown. Thus, we aimed to study the longitudinal association between sleep disorders and sarcopenia in a cohort study of 1116 community-dwelling Chilean older people ≥60 years old from the ALEXANDROS cohorts. After the exclusion criteria, 318 subjects were followed. Sociodemographic data, self-reported chronic diseases, sedentarism, sleep characteristics, anthropometric measurements, handgrip strength, and muscle performance were assessed. Results indicated that at baseline, the prevalence of sarcopenia was 24.10% without gender differences, and the prevalence of self-reported sleep problems was 23.3%, higher in women (26.46% versus 17.15% in men). The adjusted Cox regression models for sarcopenia showed an association between sarcopenia, sleep disorders (HR = 2.08, 95% IC 1.14–3.80), and long sleep duration (HR = 2.42, 95% IC 1.20–4.91). After 8.24 years of follow-up, there were 2.2 cases of sarcopenia per 100 person-years. This study demonstrates that sleep disorders are an independent risk factor for sarcopenia in Chilean older people. The identification of sleep disorders through self-reported data provides an opportunity for early identification of risk and cost-effective sarcopenia prevention.

The burden and treatment of non-communicable diseases among healthcare workers in sub-Saharan Africa: a multi-country cross-sectional study.

Non-communicable diseases (NCDs), the leading cause of death globally, are estimated to overtake communicable diseases in sub-Sahara Africa, where healthcare workers (HCWs) play a crucial role in prevention and treatment, but are in extreme shortage, thereby increasing the burden of NCDs among this specific population. To provide evidence for policy-making, we assessed the NCD burden, associated factors and treatment among HCWs in four sub-Saharan African countries. We conducted a cross-sectional study across four sub-Saharan African countries [Côte d'Ivoire (CIV), Democratic Republic of the Congo (DRC), Madagascar (MDG), and Nigeria (NIG)] between February and December 2022. In a standardized questionnaire, sociodemographic, chronic disease and treatment data were self-reported. We estimated the prevalence of (1) at least one chronic disease, (2) hypertension, and used backward elimination logistic regression model to identify risk factors. We recruited a total of 6,848 HCWs. The prevalence of at least one chronic disease ranged between 9.7% in NIG and 20.6% in MDG, the prevalence of hypertension between 5.4% in CIV and 11.3% in MDG. At most, reported treatment rates reached 36.5%. The odds of each of both outcomes increased with age (at least one chronic disease adjusted odds ratio: CIV: 1.04; DRC: 1.09; MDG: 1.06; NIG: 1.10; hypertension: CIV: 1.10; DRC: 1.31; MDG: 1.11; NIG: 1.11) and with BMI (at least one chronic disease: CIV: 1.10; DRC: 1.07; MDG: 1.06; NIG: 1.08; hypertension: CIV: 1.10; DRC: 1.66; MDG: 1.13; NIG: 1.07). Odds of both outcomes were lower among males, except in CIV. In NIG, the odds of both outcomes were higher among medical doctors and odds of hypertension were higher among those working in secondary care. In MDG, working in secondary care increased and working as auxiliary staff decreased the odds of at least one chronic disease. The prevalence of self-reported chronic disease varied across the four sub-Saharan countries with potentially very low treatment rates. We identified several individual (age, sex, and BMI) and occupational (profession, level of healthcare) factors that influence the odds of NCDs. These factors should be taken into account when developing interventions addressing the burden and management of NCDs among HCWs.

Determinants of self-reported chronic disease diagnoses among older persons in South Africa.

Chronic diseases tend to affect the quality of life for older persons worldwide, especially in resource-constrained developing countries. Chronic diseases contribute to a large number of deaths among the population of South Africa. This study examines the determinants of self-reported chronic disease diagnoses among older persons in South Africa. The study setting was South Africa. Cross-sectional data from the 2019 South Africa General Household Survey were analysed (n[weighted] = 4 887 334). We fitted a binary logistic regression model to determine the relationship between socio-demographic factors and being diagnosed with self-reported chronic diseases. We found that at least 5 in 10 older persons were diagnosed with self-reported chronic disease. The bivariate findings showed that age, population group, sex, marital status, level of education, disability status, household composition and province were significantly associated with self-reported chronic disease diagnoses. At the multivariate level, we found that age, sex, population group, marital status, educational level, disability status, household wealth status, household composition and province were key predictors of self-reported chronic disease diagnoses. We found that various factors were key determinants of being diagnosed with self-reported chronic diseases. This study offers important insights into the main correlations between older adults and self-reported chronic illness diagnoses. More study is required on the health of the elderly as it will help direct policy discussions and improve the development of health policies about the elderly.Contribution:This study highlights the need for a better understanding of, and continued research into, the determinants health among older populations to guide future healthcare strategies.

Chronic diseases and determinants of community health services utilization among adult residents in southern China: a community-based cross-sectional study

BackgroundThe burden of chronic diseases has become a major public health concern, and high-efficiency use of community health services is essential in combating chronic diseases. This study described the status of chronic diseases in southern China and explored the determinants of health service utilization among adult residents.MethodsData were obtained from one part of community survey data from four counties in Ganzhou City, southern China. A multistage, stratified random sampling method was used to conduct a cross-sectional survey between 2018 and 2020. Overall, 7430 valid questionnaires were collected. A lasso-linear regression analysis was performed to explore the determinants of community health service utilization.ResultsAccording to the study, most participants (44.6%) reported having relatively good health, while 42.1% reported having moderate health. Chronic diseases were reported by 66.9% of the respondents. The three most prevalent self-reported chronic diseases were hypertension (22.6%), hyperlipidemia (5.9%), and diabetes (5.9%). Among residents with chronic diseases, 72.1% had one chronic disease, while the rest had multiple. Only 13.9% of residents frequently utilized community health services, while 18.9% never used them. Additionally, among residents who reported having chronic diseases, 14.1% had never attended community health services. Four categories of factors were the key determinants of community health service utilization: (1) personal characteristics, age, and sex; (2) health-related factors, such as family history, self-reported health conditions, and the number of chronic diseases; (3) community health service characteristics, such as satisfaction with and accessibility to community health services; and (4) knowledge of chronic diseases. Specifically, women tend to utilize healthcare services more frequently than men. Additionally, residents who are advanced in age, have a family history of chronic diseases, suffer from multiple chronic conditions, rate their self-reported health condition as poor, have a better knowledge about chronic diseases, have better accessibility to community health services, and have higher the satisfaction with community health services, tend to utilize them more frequently.ConclusionsGiven the limited healthcare resources, the government should promote the effective utilization of community health facilities as a critical community-based strategy to combat the growing threat of chronic diseases in southern China. The priority measures involve enhancing residents’ access to and satisfaction with community health services and raising awareness of chronic illnesses among older individuals with poor health status.

The impact of health on labour market outcomes: A rapid systematic review

The relationship between an individual's health and their labour market outcomes has long been a subject of health economics research. This review aims to provide an up-to-date, global review of the substantive findings in the existing literature. We pay particular attention to causal effects, acknowledging the methodological complexities that have long challenged the research and emphasizing the importance of overcoming them to present robust, policy-relevant evidence. The recent literature shows a notable advancement in addressing these methodological issues compared to previous work.The evidence reviewed suggests that individuals with better health overwhelmingly exhibit higher earnings and often enhanced labour supply. These findings extend beyond geographical boundaries, as evidence from diverse regions underscores the global significance of this association. The review covers evidence from a wide range of health indicators and conditions – including e.g. self-reported health, chronic diseases, disability, nutritional health, infections, mental health, addictions and others. Within and across the different health domains, the health-related factors exert varying degrees of influence on labour market outcomes, highlighting the multifaceted nature of the health-labour relationship and its potentially profound implications for individuals, communities, and economies.

The association between BCG scars and self-reported chronic diseases: A cross-sectional observational study within an RCT of Danish health care workers

IntroductionThe live-attenuated vaccines Bacillus Calmette-Guérin (BCG) and Vaccinia have been associated with beneficial non-specific effects. We assessed the prevalence of BCG and Vaccinia vaccine scars in a cohort of Danish health care workers and investigated the association between the presence of vaccine scars and self-reported chronic diseases. MethodsCross-sectional study utilizing baseline data collected during 2020–2021 at enrollment in a BCG trial aiming to assess the effect of BCG vaccination on absenteeism and infectious disease morbidity during the SARS-COV-2 pandemic. In Denmark, Vaccinia was discontinued in 1977, and BCG was phased out in the early 1980s. We used logistic regression analysis (adjusted for sex, birth year, and smoking status) to estimate the association between scar status and chronic diseases, providing adjusted Odds Ratios (aORs) with 95 % Confidence Intervals, for participants born before 1977, and born from 1965 to 1976. ResultsThe cohort consisted of 1218 participants (206 males; 1012 females) with a median age of 47 years (Q1–Q3: 36–56). Among participants born 1965–1976 (n = 403), who experienced the phase-outs, having BCG and/or Vaccinia scar(s) vs. having no vaccine scars yielded an aOR of 0.51 (0.29–0.90) of self-reported chronic disease; an effect primarily driven by BCG. In the same birth cohort, having vaccine scar(s) was most strongly associated with a lower prevalence of chronic respiratory and allergic diseases; the aORs being 0.39 (0.16–0.97) and 0.39 (0.16–0.91), respectively. ConclusionHaving a BCG scar was associated with a lower prevalence of self-reported chronic disease.

Social determinants of chronic diseases reporting among slum dwellers in Egypt.

The high prevalence of chronic diseases in urban slums poses increasing challenges to future social and economic development for these disadvantaged areas. Assessing the health status of slum residents offers guidance for formulating appropriate policies and interventions to improve slum residents' health outcomes. This research aimed to identify the social determinants of chronic diseases reporting among slum dwellers in Egypt. A cross-sectional survey was conducted from March to December 2021 in three slum areas in Giza governorate, Egypt, including 3,500 individuals. We constructed an asset index and a welfare index to measure the economic status and living conditions of slum residents, respectively. We used these indices, along with demographic and socio-economic factors, as independent variables in the analysis. We modeled factors associated with health status using a two-level mixed logistic model to control the effects of slum areas and the potential correlation between household members. The study contributed significantly to a better understanding of the context in which slum dwellers live and the interlinkages among poor living conditions, low economic status, and health outcomes. The results showed a high rate of self-reported chronic diseases among adults aged 18 and older, reaching more than 22%, while it did not exceed 2.0% among children in the slum areas. Therefore, measuring the determinants of chronic diseases was limited to adults. The sample size was 2530 adults after excluding 970 children. The prevalence of chronic diseases among adults ranged between 16.3% in Zenin and 22.6% in Bein El Sarayat. Our findings indicated that low socio-economic status was significantly associated with reporting chronic diseases. Future policies should be dedicated to improving living conditions and providing necessary healthcare services for these vulnerable areas.

Sex Work and Health Problems in the Sexual and Gender Minority Population: Analysis of a Population Survey in Peru

Background. Sexual and gender minorities (SGM) who perform sex work are susceptible to sexually transmitted infections and substance abuse that can lead to chronic diseases, as well as discrimination and violence that deteriorate their mental health. Aim. To evaluate the association between a history of sex work and health problems in the sexual and gender minority population from Peru. Methods. A cross-sectional study was conducted based on the data of the first virtual survey for LGBTI people in Peru in 2017. The prevalence of self-reported chronic diseases, infectious diseases, and mental health problems in the last 12 months and their association with the history of sex work were evaluated. Adjusted prevalence ratios (APR) with 95% confidence intervals were calculated using Poisson regression with robust variance. Results. We analyzed data from 10629 people, of which 7.0% performed sex work. The prevalence of chronic diseases, infectious diseases, and mental health problems was 13.0%, 10.4%, and 23.7%, respectively. A significant association was found between a history of sex work with chronic diseases (APR: 1.25, 95% CI: 1.04–1.50), infectious diseases (APR: 2.11, 95% CI: 1.86–2.41), and mental health problems (APR: 1.27, 95% CI, 1.12–1.45). Conclusion. We found evidence that chronic diseases, infectious diseases, and mental health problems are associated with sex work history among the SGM population in Peru. There is a need to provide health interventions focused on disease prevention and control for this population.

Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study.

This study aims to identify multimorbidity patterns and examine whether health poverty vulnerability (HPV) varies among adults aged 45 years or more. Data from 4338 participants were extracted from a Chinese cross-sectional study. Latent class analysis was used to identify multimorbidity patterns based on 11 self-reported chronic diseases. A 3-stage feasible generalized least-squares method was used to measure the HPV. The associations and influencing factors were analyzed using the Tobit model. The mean HPV values were 0.105 ± 0.225 and 0.329 ± 0.357, based on extreme poverty and those of low- and middle-income countries' poverty line, respectively. Four latent multimorbidity patterns were identified, comprising hypertension (57.33%), cardiovascular diseases (19.94%), the musculoskeletal system (13.09%), and spine (9.64%). The HPV value from hypertension (coefficient [Coef] =0.03, 95% confidence interval (CI) = 0.00-0.05) was significantly higher than that of the musculoskeletal system based on extreme poverty. In addition, the HPV values for hypertension (Coef =0.08, 95% CI = 0.05-0.11), spine (Coef =0.06, 95% CI = 0.02-0.11), and cardiovascular diseases (Coef =0.07, 95% CI = 0.03-0.11) were significantly high based on low- and middle-income countries' poverty line. Age ≥75 years, registered poor households, catastrophic medical expenditure, and toilet style were major risk factors. Although the multimorbidity pattern-induced HPV has been significant improved on extreme poverty, it still poses a very serious challenge with regard to low- to middle-income countries' poverty line. The sensitivity analysis proved the robustness of the results. Policymakers should focus on adults with 3 multimorbidity patterns, namely, registered poor households, age ≥75 years, and catastrophic health expenditure, to adopt targeted interventions to prevent and eliminate HPV.

Changes on risky drinking after the COVID-19 outbreak in Brazil: results from three consecutive web surveys.

Risky drinking (RD) is associated with an increased risk of chronic and infectious diseases, injuries, and violence. This study aimed to assess changes in risky drinking (RD) in Brazil after COVID-19 outbreak, both overall and among individuals with self-reported chronic diseases and mental health disorders. We conducted three independent, anonymous web surveys in Brazil including adult participants: S1 (April/2020, n=19,257), S2 (August/2020, n=1,590), and S3 (January/2021, n=859). Participants were recruited through adapted snowball sampling and sponsored social network advertisements. RD was assessed using the Alcohol Use Disorder Identification Test-Concise, designed to identify individuals at risk of alcohol-related problems. Logistic regression analyses with bootstrapping (B=2,000) were performed, with stratification by sex, age, education, employment, household size, and the presence of chronic and mental health conditions, as well as lifestyle factors, to address sample imbalances. The estimated prevalence of RD was 45.8% [95%CI 45.5, 46.1] in S1, 35.3% [95%CI 34.9, 35.6] in S2, and 33.7% [95%CI 33.3, 34.0] in S3. Participants with chronic diseases consistently presented lower RD prevalence across all three surveys, compared to those without such conditions. Conversely, individuals with mental health disorders presented higher RD prevalence than those without such diagnoses in S1 and S2, but not in S3. Despite the decrease in RD prevalence, monitoring of alcohol consumption trends remains essential for shaping effective public health policies. Additionally, the observed variations among individuals reporting chronic and mental health disorders highlight the need for targeted interventions in future crises.

Factors Associated With Frailty Among Older Adults Attending a Rural Public Primary Care Clinic in Malaysia

Introduction: Frailty is a condition occurring in older age with a reduction in homeostatic reserve and inability to react against external stressors. This resulted in falls, disability, loss of independence and mortality. At present, there are limited studies on frailty in the rural settings in Malaysia. We aimed to determine the proportion of frailty and the factors associated with frailty among older adults attending a rural clinic in Selangor. Methods: A cross-sectional study involving older adults aged >60 years who attended a rural public healthcare clinic were recruited from February-April 2018 using a systematic random sampling method. Face-to-face interview using structured pretested questionnaires and physical assessment was conducted. Data collected included socio-demography, frailty status, functional status, cognitive function, self-reported chronic diseases and polypharmacy. All analyses were done using SPSS software version 22.0. Results: The response rate was 93% with 250 participants. A total of 29 (11.6%) participants were frail and 75 (30%) were pre-frail. The factors associated with pre-frail and frail among older adults were the presence of two chronic diseases or more (aOR=4.89; 95%CI=1.29, 18.51; p=0.019), presence of polypharmacy (aOR=1.97; 95%CI=1.05, 3.72; p=0.035), abnormal walking speed based on Time Up and Go test (aOR=12.80; 95%CI=4.57, 35.86; p<0.001), and dependent IADLs based on Lawton’s IADLs (aOR= 3.06; 95%CI=1.28, 7.33; p=0.012). Conclusion: Older adults attending the rural primary clinic with risk factors such as multiple chronic diseases and polypharmacy should be screened for frailty as the condition is potentially reversible if interventions are started early.

Prevalence and risk factors for falls among community-dwelling adults in Riyadh area

Objectives This study aimed to assess fall prevalence, identify related risk factors, and establish cut-off scores for fall risk measures among community-dwelling adults in Riyadh region of Saudi Arabia. Methods A cross-sectional study was conducted in community, Riyadh city, Saudi Arabia. A sample of 276 Saudi citizens aged ≥40 years who were able to read and write in Arabic. Fall history and number of falls in the past 12 months were determined via self-reports. Variables assessed included demographic information, self-reported chronic diseases, depressive symptoms, and back pain severity. Results Participants were classified as either fallers (n = 28, 10.14%) or non-fallers. Fallers were more likely to have arthritis (odds ratio [OR]: 7.60, p = 0.001), back pain (OR: 5.22, p = 0.002), and higher depressive symptom scores (OR: 1.09, p = 0.013) than non-fallers. The number of reported falls was significantly associated with an elevated body mass index (incidence rate ratio [IRR]: 1.09, p = 0.045), arthritis (IRR: 8.74, p < 0.001), back pain (IRR: 4.08, p = 0.005), neurological diseases (IRR: 13.75, p < 0.007), and depressive symptoms (IRR: 1.08, p = 0.005). Cut-off scores predictive of falls associated with back pain and depressive symptoms were 1.5 (sensitivity: 0.61; specificity: 0.79; area under the curve [AUC]: 0.70) and 11.5 score (sensitivity: 0.57; specificity: 0.76; AUC: 0.66), respectively. Conclusions The prevalence of falls was relatively low among the individuals considered in this study. Chronic conditions, back pain severity, and depressive symptoms were determined to be associated with falls among community-dwelling individuals in Saudi Arabia.

Functional limitation in the older Brazilian adults: Association with multimorbidity and socioeconomic conditions.

The aim of this study was to assess the association between multimorbidity and the presence of functional limitation in basic (BADL) and instrumental activities of daily living (IADL) among Brazilian older adults and to verify whether this association is moderated by socioeconomic conditions. Cross-sectional study with data from the Brazilian National Health Survey (PNS) (2019) for the Brazilian population aged 60 years and over. The dependent variables were functional limitation, based on self-reported difficulty in performing one or more activities of daily living, including six BADL (feeding, bathing, using the toilet, dressing, crossing a room on the same floor and getting out of bed) and four IADL (shopping, managing money, taking medication and using transportation). The independent variables were multimorbidity (presence of two or more self-reported chronic diseases) and socioeconomic measures (per capita household income, asset score, and education level). The association between multimorbidity and outcomes was assessed using adjusted logistic regression models. The moderating effect of socioeconomic conditions on the association between multimorbidity and functional limitations was assessed by including an interaction term. The final sample consisted of 22,725 individuals. The prevalence of functional limitation was 8.5% (95%CI: 7.9-9.2) and 18.6% (95%CI: 17.8-19.5) in BADL and IADL, respectively. Multimorbidity was associated with BADL [OR: 2.30 (95%CI: 1.93-2.74)] and IADL [OR: 2.26 (95%CI: 1.98-2.57)]. The odds of functional limitation were higher among individuals with lower levels of education and income, but there was no interaction between multimorbidity and socioeconomic position measures. Multimorbidity was associated with functional limitation (BADL and IADL) and socioeconomic conditions, and this association was constant across socioeconomic position levels.

Post-acute symptoms 4 months after SARS-CoV-2 infection during the Omicron period: a nationwide Danish questionnaire study.

Post-acute symptoms are not uncommon after SARS-CoV-2 infection with pre-Omicron variants. How Omicron and COVID-19 booster vaccination influence the risk of post-acute symptoms is less clear. We analyzed data from the nationwide Danish questionnaire study EFTER-COVID comprising 44,553 individuals ≥15 years old, tested between July 2021 and January 2022, in order to evaluate the association of the Omicron variant and COVID-19 booster vaccination with post-acute symptoms and new-onset general health problems, four months after infection with SARS-CoV-2. Risk differences (RDs) were estimated by comparing Omicron -cases to controls, Omicron to Delta -cases, and Omicron vaccinated cases with three to -two doses, adjusted for age, sex, BMI, self-reported chronic diseases, Charlson comorbidity index, healthcare occupation, and vaccination status. Four months after testing for SARS-CoV-2 during the Omicron period, cases experienced substantial post-acute symptoms and new-onset health problems compared to controls; the largest RD was observed for memory issues (RD=7.2%, 95%CI: 6.4 to 8.1). However, risks were generally lower than in the Delta period, particularly for dysosmia (RD=-15.0%, 95%CI: -17.0 to -13.2) and dysgeusia (RD=-11.2%, 95%CI: -13.2 to -9.5). Booster vaccination was associated with fewer post-acute symptoms and new-onset health problems, four months after Omicron infection, compared to two COVID-19 vaccine doses.

Associations of individual chronic diseases and multimorbidity with multidimensional frailty

ObjectiveTo examine the associations between individual chronic diseases and multidimensional frailty comprising physical, psychological, and social frailty. MethodsDutch individuals (N = 47,768) age ≥ 65 years completed a general health questionnaire sent by the Public Health Services (response rate of 58.5 %), including data concerning self-reported chronic diseases, multidimensional frailty, and sociodemographic characteristics. Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). Total frailty and each frailty domain were regressed onto background characteristics and the six most prevalent chronic diseases: diabetes mellitus, cancer, hypertension, arthrosis, urinary incontinence, and severe back disorder. Multimorbidity was defined as the presence of combinations of these six diseases. ResultsThe six chronic diseases had medium and strong associations with total ((f2 = 0.122) and physical frailty (f2 = 0.170), respectively, and weak associations with psychological (f2 = 0.023) and social frailty (f2 = 0.008). The effects of the six diseases on the frailty variables differed strongly across diseases, with urinary incontinence and severe back disorder impairing frailty most. No synergetic effects were found; the effects of a disease on frailty did not get noteworthy stronger in the presence of another disease. ConclusionsChronic diseases, in particular urinary incontinence and severe back disorder, were associated with frailty. We thus recommend assigning different weights to individual chronic diseases in a measure of multimorbidity that aims to examine effects of multimorbidity on multidimensional frailty. Because there were no synergetic effects of chronic diseases, the measure does not need to include interactions between diseases.

At-home thermal discomfort is associated with non-communicable chronic diseases

Abstract Background Air temperature is a relevant environmental determinant of hospitalization and mortality. Less known is the prevalence of at-home thermal discomfort and its associations with health indicators. This work aimed to characterize the association between thermal discomfort and self-reported non-communicable chronic diseases in adults living in the municipality of Lisbon. Methods Observational cross-sectional study with data collected through individual telephone interviews, with a non-probabilistic stratified (by gender, age, education, and area of residence) sample. Logistic regression models were used to estimate effect sizes, controlling for age, gender, educational level, and morbidity indicators. Results Overall, 855 adults (25+ years old) living in the municipality of Lisbon participated in the study. Only respondents who reported to be 10+ hours per day at home were included in the analysis. The sample was balanced for genders (55,2% female), with an average age of 53,4 years (SD = 17,0; maximum age=93 years old), and 40,2% (n = 356) not having a higher-level education. About three-quarters (74,2%; n = 552) reported feeling thermal discomfort at home and 56,9% (n = 414) reported having at least one non-communicable disease diagnosed. When considering the sample's most prevalent self-reported chronic diseases, a significant association with thermal discomfort was found for asthma and hypercholesterolemia (chi-square=4,08; p=.004; and chi-square=4,87; p=.027, respectively). After adjusting for sex, age, educational level, area of residence, and other self-reported morbidities, asthma was found as a significant predictor of thermal discomfort (OR = 3,03; 95% CI: 1,03-8,90). Conclusions These preliminary results suggest that some chronic diseases may have an unequal impact on thermal regulation and comfort. This is an important message also for those responsible for the development of policies against energy poverty. Key messages • At-home thermal discomfort is a relevant indicator to consider when monitoring chronic diseases and urban health. • Suffering from chronic diseases may have a relevant impact on thermal discomfort and this should be taken into account when defining policies against energy-poverty.

Culturally-Relevant Physical Activity over the Lifecourse and Association with Chronic Disease

Abstract Background Culturally-relevant physical activity (PA) such as traditional dance shows significant promise in health promotion. Besides the value of the PA itself, these practices can also include important connections to culture, history, community, family, and the outdoors, promoting health and wellbeing. The primary study goals were to: (1) illuminate trajectories in lifetime participation in four culturally-relevant PA (surfing, outrigger canoe paddling, spearfishing, and hula) and (2) explore factors associated with engagement in these activities over the lifecourse, including gender, race/ethnicity, and chronic disease. Methods English-speaking residents in Hawai'i, USA (n = 1066) were recruited from an existing research panel to complete a questionnaire delivered online or by phone. Weighted quasi-Poisson and logistic regression models predicted engagement and self-reported chronic disease, adjusting for race/ethnicity, age, gender, and education. Significance was p<.05. Results Respondents were 50% female and 50% male. Over their lifetime, 64% of respondents participated in at least one of the four culturally-relevant PAs. Variation in participation was seen by type of culturally-relevant PA and over the lifespan. Engagement was highest during earlier periods of life and tended to decrease over age, but trends varied notably by race/ethnicity, gender, generation, and by the four PA types. For chronic disease, there was a general pattern of lifetime engagement in the four activities being related to lower likelihood of hypertension (with models for paddling and surfing showing significance). Lifetime engagement in surfing was significantly related to lower likelihood of diabetes. Conclusions Engagement in culturally-relevant PA was associated with lower likelihood for chronic disease. Trends varied notably by factors relevant for health promotion, planning, and policy to achieve health equity. Key messages • Engagement in culturally-relevant PA over the lifespan was associated with lower likelihood of chronic disease. Culturally relevant PA, including traditional dance, is relevant in Europe and beyond. • Culturally-relevant PA can engage culture, history, community, family, and the outdoors supporting holistic health and wellbeing. This is an important area of future research and health promotion.

Association of cigarette smoking with increased use of heated tobacco products in middle-aged and older adults with self-reported chronic obstructive pulmonary disease, asthma, and asthma-COPD overlap in Japan, 2022: the JASTIS study

BackgroundSmoking cessation is the most important intervention in chronic obstructive pulmonary disease (COPD), asthma, and asthma-COPD overlap (ACO); however, high rates of current cigarette smoking are observed in adults with these respiratory diseases. Meanwhile, rapidly increasing use of heated tobacco products (HTPs) is observed in Japan; however, the status of HTPs use has not been fully understood in adults with COPD, asthma, and ACO. This study aimed to reveal the association between COPD, asthma, and ACO and HTPs use in adults.MethodsData on Japanese individuals ≥ 40 years old obtained from the Japan Society and New Tobacco Internet Survey were analyzed. The prevalence of HTPs use in adults with COPD, asthma, and ACO, among individuals categorized into three groups according to cigarette smoking (never, former, and current), was calculated and the relationship between each disease and HTPs use were evaluated. The clinical diagnosis of these diseases was based on the self-reported diagnosis, as obtained from questionnaires.ResultsA total of 19,308 individuals were included. The proportions of never, past, and current cigarettes smokers were 10,900 (56.5%), 4,903 (25.4%), and 3,505 (18.2%), respectively, and that of HTPs use was 1,813 (9.4%). In current cigarettes smokers, the adjusted odds ratios (ORs) of HTPs use was 2.88 (95% CI [confidence interval], 1.86–4.47), 1.23 (95% CI, 0.99–1.52), and 5.81 (95% CI, 3.12–10.82) in adults with COPD, asthma, and ACO compared to those without these respiratory diseases, respectively. Meanwhile, in past cigarettes smokers, the adjusted ORs of HTPs use was 0.51 (95% CI, 0.24–1.08), 0.69 (95% CI, 0.53–0.88), and 0.25 (95% CI, 0.06–1.07) in adults with COPD, asthma, and ACO, respectively.ConclusionsHTPs use is more prevalent among current cigarettes smokers with COPD, asthma, and ACO compared to those without these respiratory diseases. Complete cessation of smoking both cigarettes and HTPs is the only way to achieve complete smoking cessation, therefore, adults with COPD, asthma, and ACO need to make greater efforts to quit smoking.

Self-Reported Chronic Disease Co-morbidities among Patients on Antiretroviral Therapy: A facility based cross-sectional study in Jimma, Southwest Ethiopia

Background: People living with HIV who have access to antiretroviral therapy (ART) are living longer and healthier lives. The clinical management of such patients is evolving towards a new spectrum of comorbidities. People living with HIV are increasingly experiencing a range of multiple comorbidities conditions. Measurement of comorbidity has currently received more attention from medical researchers. Therefore, this study has assessed self-reported chronic disease comorbidities among patients on antiretroviral therapy in Jimma, Southwest Ethiopia. Methods: A facility based cross-sectional study design was employed among 351 ART clients visiting Jimma University Teaching Hospital in March 2014 that were identified by systematic random sampling. Data were collected by interviewer-administered questionnaires that mainly assessed socio-demographic data, disease-related care factors, community factors and treatment delivery-related factors. Descriptive analysis was performed. Bivariate and multivariate logistic regression analyses were used to identify associated factors by using SPSS version software. Association between the explanatory and dependent variables was assessed at the p-value of less than 0.05. The results were presented in a narrative form, tables and graphs. Results: Of the total respondents, 137 (39%) had comorbidities with different diseases. From this, the majority of them have tuberculosis 71 (51.82 %), followed by hypertensions 26 (19.0%), asthma 21 (15.3%), diabetes 11 (8.0 %) and heart diseases 8 (5.8%).Being current CD4 count < 250 cells/ml (AOR=2.715 [CI = 1.461, 5.1 poor level of general health conditions (AOR=5.894 [CI= 3.172, 10.951]), discontinuation opportunistic infection prophylaxes (AOR= 2.578 [CI = 1.371,4.845]), having any clinical symptoms for HIV/AIDS (AOR= 6.46 [CI= 3.428, 12.175]) and having substance use disorders (AOR= 4.925 [CI= 2.629, 9.225]) were factors that shown statistically significant associations with having comorbidities. Conclusions: The finding indicated that magnitudes of comorbidities were numerous. Different clinical and behavioral factors mentioned above lead the patients to the development of comorbidities. Therefore, we recommend the concerned organization to give greater emphasis on those identified factors as influential and due attention should be given to those factors curving the problems and burden of comorbidities among the HIV/AIDS patients.

Social indicators and other factors associated with chronic non-communicable diseases in rural quilombolas in the north of Minas Gerais

The aim of this article is to investigate factors associated with self-reported non-communicable chronic diseases (NCDs) in quilombolas from rural communities in the northern region of Minas Gerais, Brazil. It is a cross-sectional study, conducted in 2019 through semi-structured interviews and questionnaire application on 1110 individuals. A log-linear Poisson model was used. Twenty-seven percent of the sample had at least one of the listed NCDs. The highest prevalence was detected in females (PR: 1.31; 95%CI: 1.17-1.48), aged over 60 years (PR: 2.19; 95%CI: 1.77-2.70). There was an increased prevalence of NCDs in people who reported having suffered prejudice while seeking healthcare (PR: 1.17; 95%CI: 1.04-1.31) and who had their last healthcare service more than 12 months ago (PR: 1.22; 95%CI: 1.05-,1.42). This reality demonstrates that, despite advances in specific public policies aimed at these groups, prejudice, difficulty in accessing healthcare, and affirmative action policies still persist.